Is type 2 reversible with Prof Roy Taylor

[cold ethyl]

It's my impression that 'they' have said long time that weight loss is an effective way of reducing the progression of diabetes but it's been very vague. It's just that Prof Taylor has been able to quantify it , show the mechanisms by which it may work and demonstrate that in some people a very rapid weight loss can, at least for a time, set diabetes progression into reverse.
If someone was told emphatically that weight loss on this sort of scale /time frame could potentially reverse a very serious condition* and were given a means to achieve it then it might well have a different outcome to a doctor just suggesting that losing a few pounds may help.
(though we have to wait for the trials to really know how effective it is in a bigger population and how durable the changes are)
*though I suspect many don't realise the potential consequences of diabetes.

In a US diabetes prevention trial they found that those who lost 10% of their weight in the six months after a prediabetes diagnosis were far less likely to develop diabetes in the next three years than those that didn't http://www.futurity.org/speedy-weight-loss-may-put-brakes-on-diabetes/

I think that your comment about being given strict guidelines and support is where the trials are now heading. The vague lose some weight and nonchalance with which the diagnosis is often given do nothing to underline the seriousness of the disease if left unchecked and the importance of weight loss as a means to good control. If nothing else comes out of this work, you'd hope the NHS could get its act together on that.

 

[Bluetit1802]

I think what he might say here is that maybe you do have more weight to lose....he said that for some people diabetes can happen at what the BMI curve thinks of as acceptable levels - so your BMI may be gone on the chart but you could be over your personal fat threshold and hence still have fat in liver and pancreas. I have set myself a target weight that is at upper end of what I was in my early twenties. I may have to go even lower to get into non diabetic range. Will just have to see.

Thanks. My BMI is 21 and I have a big frame with broad shoulders. I am as light now as I was as a slim teenager, and my collar bone looks like a skeleton! I daren't lose any more, so if I am over my personal threshold with fat it may have to stay. unless there is another way of getting rid of it.

 

[cold ethyl]

Thanks. My BMI is 21 and I have a big frame with broad shoulders. I am as light now as I was as a slim teenager, and my collar bone looks like a skeleton! I daren't lose any more, so if I am over my personal threshold with fat it may have to stay. unless there is another way of getting rid of it.

He did say it doesn't work for about a third. You eat a reasonable amount of carbs and are in ore-diabetic range so I'd say that you should be rightfully proud of those achievements. It is also about balancing life and the disease - each of us will make that call in various ways and I think that good control can be reached by several paths. He didn't go into low carbing and it would be interesting to see the longevity of control with that and weight loss combined without a full reversal. He showed a graph which showed that over 15 yrs even those with good control slipped but nothing about why other than the usual spiel about progressive illness ( though he does think it doesn't have to be) and I'd have been interested to know how much of that was regaining weight, high carb diet or whatever.

 

[phoenix]

@Bluetiti1802
I think you raise an important point/question . T2 probably isn't one entity. ( about a year ago there was an article suggesting that it was a category error, a disease in search of a definition with all sorts of varied presentations http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)62207-7/fulltext )
Though It may well be that in many cases, reducing visceral fat will improve insulin tolerance, if the cause of the hyperglycemia lies elsewhere it isn't going to help.

 

[Brunneria]

And if our type 2 has reduced beta cell function, then presumably, our personal fat threshold may be significantly lower than it was when we had full beta cell function.

So returning to the size that worked as a slim youth may no longer work.

But reducing body fat has to be less of a strain on those surviving beta cells, so the slimmer the better, until it obviously isn't. If you see what I mean.

 

[Bluetit1802]

LOL yes, I see what you mean. At least I can look at myself in the mirror (fully dressed that is) and be proud of myself.

 

[cold ethyl]

I think that is the bit that they keep glossing over... Reversal doesn't mean that your beta cells are regenerated ( though I think we had a discussion on here that there is some evidence that new ones can be made?)so yes really what you are doing is using your remaining ones judiciously as a result of improving insulin resistance and defatting the necessary organs. He showed some graphs of how 1st phase response improves and how total insulin production returns to normal- this chap sent him a photo of his meter reading4.2 after a blueberry muffin! But still I'd say that you might be better low carbing after it to keep that remaining function tip top for as long as possible. Or maybe that's just me?

 

[AndBreathe]

It's all very interesting, but @Bluetit1802, if your HbA1c was mine, how would you be living differently? That's not a challenge, aside from asking literally that question.

Of course, I like my numbers as they are, but I'm not in any big rush to replicate @Andrew Colvin ' s activity where Bread & Butter Pudding or the like are concerned.

 

[cold ethyl]

I think there's the rub.. By reversal I assume he means the ability to behave as a non- diabetic as much as possible( with the understanding that weight gain will return us to the diabetic state once we cross our PFT again) and while I see many on here with excellent control, done just through diet, we are by and large not eating a diet that the majority of non- diabetics would be following. Your numbers @AndBreathe are great but I'd be interested to know how many carbs you eat a day and what they are? Eating more and testing us only way to be sure, but to me it's a risk I'd not want to take too often.

 

[Brunneria]

And, since EVERYTHING deteriorates with age, I expect the surviving beta cells will do that too.
So personal fat thresholds may well reduce, and reduce, over time.

Sorry to spread such doom and gloom, but it is (sadly) just thinking practically.

 

[jack412]

I think he means by reversal a normal insulin response to a GTT, going by what he has previously said and the tests he does

 

[Bluetit1802]

It's all very interesting, but @Bluetit1802, if your HbA1c was mine, how would you be living differently? That's not a challenge, aside from asking literally that question.

Of course, I like my numbers as they are, but I'm not in any big rush to replicate @Andrew Colvin ' s activity where Bread & Butter Pudding or the like are concerned.

No matter what my HbA1c drops to, I will still regard myself as a diabetic with a disease that might progress. I may have an odd treat, I may eat hubby's meat and spud pie once a week without feeling guilty and testing myself a million times afterwards, but I will never go back to the mounds of bread and spuds I used to eat, and I will never go back to Cornflakes for breakfast, I just do not feel the need any more. I enjoy my current diet, I enjoy my new figure and size 10 clothes, I enjoy how I feel in myself. I'm not going back.

 

[Bluetit1802]

Go girl!
I couldn't get into a size 10 even when I weighed around 6 stone all those years ago.
I still remained a size12.

I rather think they have changed the sizing since then to make us think we are slimmer than we actually are. A size 10 now is what a size 12 used to be.

 

[Kat100]

No matter what my HbA1c drops to, I will still regard myself as a diabetic with a disease that might progress. I may have an odd treat, I may eat hubby's meat and spud pie once a week without feeling guilty and testing myself a million times afterwards, but I will never go back to the mounds of bread and spuds I used to eat, and I will never go back to Cornflakes for breakfast, I just do not feel the need any more. I enjoy my current diet, I enjoy my new figure and size 10 clothes, I enjoy how I feel in myself. I'm not going back.

The new figure is the best part ....I find ...
I to have a treat sometimes ...not often ..
I would eat that pie but without the meat x

 

[AndBreathe]

No matter what my HbA1c drops to, I will still regard myself as a diabetic with a disease that might progress. I may have an odd treat, I may eat hubby's meat and spud pie once a week without feeling guilty and testing myself a million times afterwards, but I will never go back to the mounds of bread and spuds I used to eat, and I will never go back to Cornflakes for breakfast, I just do not feel the need any more. I enjoy my current diet, I enjoy my new figure and size 10 clothes, I enjoy how I feel in myself. I'm not going back.

That was the purpose of my question.

You have returned yourself to levels so close to non-diabetic, it probably makes no material difference, with a more comfortable (including figure/fashion choices etc.) lifestyle, so diabetes/reversed diabetes or however we might choose to refer to it are just labels.

@cold ethyl , my carb levels vary these days as I no longer chase a lower target, nor do I have an upper limit. I am eating to my personal comfort zones, influenced by the numbers my meter shows me from time to time. But, for completeness, I am almost always below 100gr, and never have overtly sugary foods. I never really had desserts, and I was never bothered by chocolate. I know, 100%, that I haven't had a single sliver of chocolate, or cake, since before diagnosis, and it doesn't bother me one iota. I have been fortunate, always to have been able to tolerate modest quantities of rice and bread, and I now have the odd portion of cottage pie or baked potato; albeit not whoppers.

I have never asserted to be cured/reversed or anything else; nor am I suggesting you think I have. I don't like labels, so nor do I refer to myself as diabetic, except on here, and very occasionally when my OH would get a bit frustrated by my diet in the early days. If asked, by anyone, "Are you diabetic?", my answer would be, "Yes", but that has actually only happened to me once - several months ago.

 

[Kat100]

I rather think they have changed the sizing since then to make us think we are slimmer than we actually are. A size 10 now is what a size 12 used to be.

yes you really have to shop around ...that is why us girls need so much time in the shops .....No standard size in all shops ...perhaps we are lucky that we have so much to,choose from ....but these days ...I don't enjoy shopping as much ...has this changed with diet. I wonder ....

 

[douglas99]

It's all very interesting, but @Bluetit1802, if your HbA1c was mine, how would you be living differently? That's not a challenge, aside from asking literally that question.

Of course, I like my numbers as they are, but I'm not in any big rush to replicate @Andrew Colvin ' s activity where Bread & Butter Pudding or the like are concerned.

I'll respond to that, as my HbA1c is the same, I already eat carbs, and I'm doing the Newcastle diet.
I don't think I particularly see great peaks, as my normal fasting low was a point or so above yours, so that would suggest I must have a lesser range overall and lower highs.
Now my low seems to have dropped down, I will be interested to see what my HbA1c is next week or thereabouts.
Even based on that if my diabetes is 'cured', or goes into remission, I probably wouldn't change a great deal.

I like being thin, and active.
I don't stress over what I eat now, I (probably) wouldn't go back to eating the box of donuts, it would just be nice to know I wouldn't react badly.
I would still use the scales every day, I find it's a great incentive.
Portion control, and healthy eating is a way of life, actually, I'd probably go for a different type of veg, include potato, and maybe back to some of my homemade bread. But not the half loaf doorstops I used to have to accompany a meal, they would be the meal now.

The only difference really is I wouldn't have to tighten up my eating habits for a longer time,, which I reluctant to do until I'm forced to, so even a breathing space is a bonus.

 

[andcol]

LOL yes, I see what you mean. At least I can look at myself in the mirror (fully dressed that is) and be proud of myself.

At least I can look at myself in a mirror and not need 2 of them like before

Now I have had my flippant comment I would like to add that I think I have reversed my condition and test the bounds constantly. However, it is hard to determine if this is true as I never tested myself prior to having issues so don't know how I responded to food before. Although I now eat between 250 and 300 grams of carbs per day and I have had to raise myself to this level to maintain my weight at 12st 8lbs along with my nut intake I have been pushing the quality of the carbs trying bags of cola bottles etc. and have seen pretty amazing results.

However, will I ever get complacent and go back to the amount of carbs I used to eat (my wife and I reckon I eat about 1/3 of what I used to in quantity but much of the calories are now as nuts so much less bulk) I doubt as I just do not feel the urge to eat the sweets/doughnuts/cakes that I used to. For example, someone bought krispy kreams and fruit pastilles in to work today for his birthday and they sat on the desk next to me all day and I really was not interested.

To answer @Brunneria - yes I expect I have a reduced capacity than that that I used to have but the profs trial only ever was for people that had been diagnosed in the last 4 years; may be that limits the damage. Alternatively there is some discussion about the body going into repair mode instead of replace mode when it is starved of calories and that is why the starvation diet actually works to reverse as your failing B-Cells get repaired. Who knows really they will need to do some analysis of the B-Cell density before and after to see if there is a difference.

Finally, I do expect as I get older I will slip back as parts of me start to fail. The question is how long can I remain in this state or am I not (and never have been) a T2 but my levels were caused by other things (such as an inflamed pancreas - wrote about this on another thread). The reason I say this is that I do not seem to "suffer" from any of the symptoms of insulin resistance that many post on the forum and never have done. It could all be being masked by the exercise I do but do not think this is the case due to the period where I damaged my leg and had the operation.

Sorry not well structured


Edit: Oh BTW I am at the moment on reduced calories again (since last monday) and now down to 12st 6lbs so no tests for the next few weeks

 

[cold ethyl]

That was the purpose of my question.

You have returned yourself to levels so close to non-diabetic, it probably makes no material difference, with a more comfortable (including figure/fashion choices etc.) lifestyle, so diabetes/reversed diabetes or however we might choose to refer to it are just labels.

@cold ethyl , my carb levels vary these days as I no longer chase a lower target, nor do I have an upper limit. I am eating to my personal comfort zones, influenced by the numbers my meter shows me from time to time. But, for completeness, I am almost always below 100gr, and never have overtly sugary foods. I never really had desserts, and I was never bothered by chocolate. I know, 100%, that I haven't had a single sliver of chocolate, or cake, since before diagnosis, and it doesn't bother me one iota. I have been fortunate, always to have been able to tolerate modest quantities of rice and bread, and I now have the odd portion of cottage pie or baked potato; albeit not whoppers.

I have never asserted to be cured/reversed or anything else; nor am I suggesting you think I have. I don't like labels, so nor do I refer to myself as diabetic, except on here, and very occasionally when my OH would get a bit frustrated by my diet in the early days. If asked, by anyone, "Are you diabetic?", my answer would be, "Yes", but that has actually only happened to me once - several months ago.

Thanks for that both of you ( I'm including @Bluetit1802 as she seems to be doing similar things)That is sort of where I assume you were operating but always nice to know for sure. That is the sort of scenario I hope to be working with when I shift last two stone- few carbs as and when but not a return to the masses I ate before- I like the less bloated me.

 

[andcol]

what I took home was that weight loss of around 20% is a good target and that the protocol works in part because people who try it believe in it so stick to it..

I have posted some of my graphs previously and I saw a step changed at about 15% reduction. That step change was not only tightening up my levels but also a step change in my blood pressure. Blood pressure hasn't really change from that point but as I have lost more I hve found a reduction in the peak level after eating but this may be caused by eating more carbs.