youngmanfrank
Well-Known Member
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I haven't worked out my BMI (T am 5' 3" so I guessing I am a bit under weight for my height. My liver scan will tell me if all is well and if they don't find anything then I will start the diet; I don't think they can tell if you have a fatty liver from a normal scan but I will ask them when I go for the scan.
I only found I was diabetic when I went for a free NHS health check and was gobsmacked to find I was diabetic as was the DN when I went for my first visit. She was expecting someone larger! She couldn't believe that I had no symptoms as my glucose was 18.6mmol/L and my HbA1c was 10.4%
Although the newcastle diet was supposed to mimic the effects of gastric bypass surgery it appears that is not the case, except for the calorie restriction/weight loss part.
From http://www.healthline.com/health-news/aging-how-gastric-bypass-eliminates-type-2-diabetes-072913:
"Here's how it works: After gastric bypass, which is a common weight loss solution for the severely obese, the small intestine spontaneously begins to produce a molecule called GLUT-1 that helps the body use glucose.
“The quite amazing thing is that this is not present normally in the small intestine of adults, but only in the fetus,” said Dr. Erini Nestoridi, a research fellow in Stylopoulos' lab, in an interview with Healthline. “This happens most likely because the intestine has to work harder to do its job, for example to absorb the nutrients or move the food further down. Also, it may be that the mechanical stress of 'dumping' the food directly to the intestine, since the stomach is bypassed, contributes to these changes.”
Although weight loss and improved diabetes symptoms go hand in hand, previous research has shown that gastric bypass surgery helps resolve the disease even before weight loss occurs."
If you are female and 5'3" and 7 stone you are already seriously underweight on the BMI scale - have a look yourself at:
http://www.nhs.uk/Tools/Pages/Healthyweightcalculator.aspx
Have to comment on this even though it is from a while ago.
The quote "before weight loss occurs" is incorrectly reported. They do lose weight, just not much. The fasting bloods which are used to assess diabetes reversal are controlled by how much fat is in the liver. There is very little weight of this fat in the liver and it is used quickly when fasting, it will be used within a few days also the weight loss seen by loss of muscle glycogen (in water) will be controlled as they will be rehydrated. This coupled with the fact they will be mainly on a milk only diet for a week before the operation (for the very reason to reduce the size (fat) of the liver to access the stomach) Tells you exactly why bariatric surgery works to reverse diabetes.
I was saying the hypothesis that bariatric surgery,above the calorie restriction/fat loss, alters the body in some way to reverse type2 is unsupported. The main point that was pushed (by bariatric surgeons(i wonder why ££££?)) was that no weight loss had occurred before fasting bloods came down to normal. However we now know that fasting bloods are controlled, (in t2) by the insulin resistance of the liver and this is caused by the levels of intra-hepatic fat. This fat is burned for energy and disappears within days on a fasting diet which corresponds to normalising fasting blood glucose. This normalisation of fasting blood glucose which is the test they were using to establish reversal of diabetes.(even though it is not it is reversal of hepatic insulin resistance further weight loss is needed to truly reverse t2)Does this infer that the basis of the Newcastle Diet is flawed because the stomach is no bypassed and therefore the small intestine, I guess, is not forced tp function a modified manner?
Yes, I realise I am now under weight but I was about 8 stone 10lbs before I cut the carbs which put me bang in the middle of my range (so my ideal weight although I preferred to be a few pounds lighter but wasn't bothered enough to do anything about it)! I have since posting put on about 4lbs but the idea of doing the ND is to try and reverse my diabetes, not to lose weight. I struggle to get my glucose normal but don't want to go on the downward spiral of more drugs increasing amounts if I can help it.
I realise I am a very untypical T2 and there is a chance the diet will not work for me but I feel it is worth a try as I have nothing to lose: Well, a few more pounds but I can put those back on gradually.
I was saying the hypothesis that bariatric surgery,above the calorie restriction/fat loss, alters the body in some way to reverse type2 is unsupported. The main point that was pushed (by bariatric surgeons(i wonder why ££££?)) was that no weight loss had occurred before fasting bloods came down to normal. However we now know that fasting bloods are controlled, (in t2) by the insulin resistance of the liver and this is caused by the levels of intra-hepatic fat. This fat is burned for energy and disappears within days on a fasting diet which corresponds to normalising fasting blood glucose. This normalisation of fasting blood glucose which is the test they were using to establish reversal of diabetes.(even though it is not it is reversal of hepatic insulin resistance further weight loss is needed to truly reverse t2)
The Newcastle diet replicated this fasting and looked at what happened in the liver and pancreas and showed exactly what was seen in people who had undergone bariatric surgery but without the actual surgery.
Another point overlooked was the fact that before surgery ,for up to two weeks, you are put on a milk diet that is to "shrink the liver" ie de-fat it which would have gone most if not all the way to "reversal" before surgery.
See below:
http://www.dbh.nhs.uk/Library/Patient_Information_Leaflets/WPR32820 Milk Yoghurt Diet.pdf
MILK AND YOGHURT PRE-OPERATIVE DIET
"Before your weight loss surgery, it is essential that you follow a special diet for two weeks. This diet is to help shrink the liver so the surgeon can operate more easily."
Liver fat can go down substantially even in 2 days before you would notice any weight loss:
http://www.sciencedaily.com/releases/2009/08/090824151304.htm
"If you lose a small amount of weight, you can markedly reduce the fat content in your liver. In fact, even two days of calorie restriction can cause a large reduction in liver fat and improvement in liver insulin sensitivity."
Actually using a S E Asian bmi calculator you were obese at diagnosis as the cut-off is 25OK thanks for the explanation, though it sort of depresses me a little as I have lost a fair bit of weight (11kg) since diagnosis and I wasn't obese to start with and my fasting BGs are still not consistently low 5s or even 4s. Or am I just being impatient?
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