ND research - the view from ‘the other side’ ( as some see them)

Boo1979 said:

Speaking as one of those who’s diabetes is at a severe enough level to require meds in addition to dietary and other interventions in order to keep BMs at a reasonable level, Im really unsure what the **** you intend to mean by that comment

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What I mean by that comment is that the research is aimed at lowering costs for the NHS which means lowering the costs of medication. Prof Taylor talks about the cost to the NHS from type 2. Which bit of that don't you understand?

@Boo1979 please explain why you thought it was okay to swear at me on this forum.

Bluetit1802 said:

It's all crackers.

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What's also crackers is that this enormous diet effort yielded "remission" in only about 46 percent of cases after 12 months. The other crackers aspect is the overwhelming emphasis on losing weight, as if this were the be-all and end-all of reversing diabetes. If I were one of the 54 percent who either did not get "remission" or whose remission was only temporary and ended within 12 months, I would be fairly cheesed off. But perhaps I am saying that because I know that in many cases a low-carb diet will do the trick, without requiring extreme calorie restriction (although personally I did use fairly extreme calorie restriction during the first two months of my LC lifestyle).

This of course does not mean that the extreme low-calorie diet is not a very interesting avenue to pursue! (Edited to add: It is that stuff about liver/pancreas fat that is the most interesting.) In particular I would love to see what would happen with the ND diet (a short-term diet), followed immediately by transition to LC (a lifetime commitment) -- particularly for those who are obese and may need to lose weight initially, quite apart from the Type 2 diabetes factor.

Another thing that is interesting, but I assume that because it is a well-run study they controlled for it, is that presumably an extreme calorie-controlled diet such as ND is also a lower-carb diet compared to what people were eating prior to the diet. Drastic reduction in quantity of food = probably a significant reduction in carbs. (Once again I assume they controlled for it????)

Much food for thought, if you will excuse the pun.

I used to think of it as very much a continuous scale with arbitrary labels, e.g. when I was diagnosed it was firmly in the "diabetic" range but not by very far and I wondered what the big deal was vs "pre-" diabetic.

However, and I probably shouldn't say anything without first going back and checking, but I remember watching a presentation in which it seemed that some measure - insulin resistance, I think - did slowly rise up to a certain point and then suddenly start rising dramatically more rapidly.

I've no idea if this tipping point is used to form guidelines on terminology but I thought it was interesting.

Boo1979 said:

Thats not what you wrote which came across as quite offensive, as does your last sentance above
To assume that only people on meds cost tha nhs any money is simplistic twaddle, unless of course you believe noone not on meds
1) ever has an eye test 2) ever sees a GP or other HCP 3) ever suffers a diabetes related complication 4) ever has a diabetes connected co morbidity etc etc etc

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I was replying to the definition of remission that both yourself and ringi made. Both of you mentioned that it involved type 2's not taking medication.

>last 2 months of that period medication free. AND
>Therefore I think "remission" has been defined based on not needing any drugs diabetes.

YOU both pointed out the medication issue which is why I wrote what I did. I didn't pass ANY judgement on it from my own perspective just gave a perspective as to why the NOT being on meds was important to being considered in remission.

Re the heated exchange starting here, could I give my observations as an outsider who does feel strongly about diabetes and blame:

I don't think the comment about costing the NHS money was judgmental, it was matter of fact, but when I read it I could instantly see how it could upset because I am defensive about that subject myself.

And re the swearing, I didn't think anyone was sworn "at", just someone was very annoyed.

That's just my observations now I'm going to quietly step backward and walk away in case a fight breaks out

AdamJames said:

However, and I probably shouldn't say anything without first going back and checking, but I remember watching a presentation in which it seemed that some measure - insulin resistance, I think - did slowly rise up to a certain point and then suddenly start rising dramatically more rapidly.

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Insulin resistance worsens when too much insulin is circulating. It seems unclear which comes first, but it is certain that it is a vicious circle. Insulin resistance creates more insulin production. More insulin production creates more insulin resistance. The trick is to reduce the amount of circulating insulin and the vicious circle will stop. The best way to reduce the amount of insulin production is to reduce the amount of carbs consumed and also to be aware of high insolugenic foods that are low carb.

Bluetit1802 said:

... and also to be aware of high insolugenic foods that are low carb.

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That's a new one to me, thank you very much. After a recent and not entirely successful experiment with carbs, I'm planning to go low-carb again. Research required...

Boo1979 said:

46% is actually quite impressive given that the group receiving the best available “treatment as usual” only achieved a 4% remission rate

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Agreed. But anecdotally, likely to be rather lower than the success rate of an LC lifestyle (for those who are medically suited for it and who are medically followed to make sure they are sticking to it, i.e. under similar conditions to the ND studies). Of course we cannot say for sure because there are no strictly comparable data on LC, and this study was not designed for that.

Also that 46 percent ND success rate is at 12 months. What about 24 months, 48, 96....? "Living anecdotes" such as myself want to know. I am now coming up to 11 months on LC and have little doubt that my remission is long-term. I will be very surprised if it does not carry on for 24, 48, hopefully 96 months and beyond. I get my motivation from the dozens, nay hundreds of other "living anecdotes" on this forum. Because the disease is supposed to be progressive, I am ready for a possible deterioration in the future but until then I know what to do!!

BTW I have a T2D first cousin who did the ND diet when it was very new. It did not result in "remission" and he tells me that his T2 is "controlled, as long as I take my meds." He pays no special attention to his diet. He of course is "just an anecdote" in the same way as I am. Last time we met he was very puzzled that I was on a low-carb diet!

(Edited to fix nascent Spoonerism in first paragraph. Edited again a bit later to fix the conjugation, reflecting that "data" is a plural noun.)

AdamJames said:

That's a new one to me, thank you very much. After a recent and not entirely successful experiment with carbs, I'm planning to go low-carb again. Research required...

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Indeed. It's an interesting subject. Note how high fruit is.

http://www.mendosa.com/blog/?p=3624
https://public.tableau.com/profile/christoffer.green#!/vizhome/InsulinogenicFoodData/Dashboard1
http://ajcn.nutrition.org/content/93/5/984/T1.expansion.html (press the little arrow top right to expand)

Boo1979 said:

best available “treatment as usual” only achieved a 4% remission rate

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Be very interesting to know how they managed to reverse their chronic progressive disease though don't you think?
Maybe they joined this forum...

After reading the linked article at the start of the thread I noticed that the 45.6% was mentioned but once... and suddenly it was all "our" scientists.. Really? I though the scientists were employed by Newcastle and Glasgow universities not Diabetes.org.uk.

And I really loved this bit...
"Half of the participants are getting the best Type 2 diabetes care available." yeah right... and the ones that aren't are the one's that go into remission...go figure...

A paper is due to be published by VirtaHealth showing their 1-year results, from what they have posted on their blog, the results are closer to 75% then 40%. They use very low carb with a high level of daily support, but unlike the ND study do not exclude people based on low BMI or having had Type2 for a long time.

I

Boo1979 said:

No - that is the scientific method of all reaerch projects - half of participants recieve the research protocol (ND in this instance) the other 50% get teatment as usual and the results are compared in order to see if there are statistically significant differences in their effects. Something affecting 46% of subjects vs 4% is a highly significant difference. The next step is to explain and build on that difference

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I was more commenting on the statement that they are receiving the "best" care...I get how the study works.