Hi, although I went to the lecture I'm still have some unanswered questions, and I'm hoping someone can answer them.
1 - The people who have now been took ff the diabetic register, what results were you getting when the doctor decided you were no longer diabetic and if you were to eat something very sugary, what would your BG level be? My fasting levels are 5's, my hba1c is 5.4% but if I ate some bread it would shoot up.
2 - Personal Fat Threshold/Weight Loss. How do you know what weight to go down to? I weighed 62kgs at diagnosis (Bmi 24.8) after 5 months dropped to 56kgs (bmi 22.4). Does the weight need to come off quickly, or doesn't it matter as long as the weight has gone. Is there a point that you've got to stop losing weight because it's not working, and how do you know when that is?
Sorry I seem to have rambled on, I would like to give it a go, but I'm not sure what figures to be aiming for.
Firstly, I should state that I have never done the ND. I encountered it when I had already started making progress by reducing my carbs, and decided to stick with that. But, I have done lots of reading and research into the diet, and I have corresponded with Professor Taylor for clarification on a number of points concerning his definition of reversal, so I feel fairly well equipped to respond here.
To your questions:
1. I was taken off the Diabetic Register in December 2014, following the series of HbA1c results you can see in my signature. I only ever had one HbA1c in the diabetic range (also in my signature), so got onto this thing fairly promptly. My fasting range is 3.5-4.5, with overall averages in the mid 4s. Somehow, now, I seem to run quite low, with absolutely no ill-effects. It seems to me to be where my body likes to run.
With regard to sugary foods; I don't eat many sweet things (didn't before diabetes either, though), so as your example is bread, I'll redefine the question as higher carb. I actually pretty much still eat a reduced carb diet, although I don't seem to have had any mega disasters when I have pushed the envelope. Ive looked back in my food and bloods records, which I still maintain every day, to find a decent example.
On 13th April, at brunch, at friends', we were served, Chilli Beef Enchilladas, Garlic and Tomato Rice, with Black Beans. Without accounting for any thickener in the Chilli (there clearly was some, but life's too short to get that anal!), my reckons was the meal contained 102gr carb.
I was 4.3 shortly before eating (that wasn't fasting, but I'd only had several cups of tea, with milk beforehand). At 1 hour, I rose to 6.2, then back to 5.2 at 2 hours, and continued back to the 4s at 2.5 hours. Naturally, I was pretty happy with that little adventure. I reckon that's probably my carries the single meal since diagnosis.
As I say, I tend to run low, so please don't be despondent if my numbers seem a bit wild. Others, like
@Andrew Colvin , or
@Pipp , or,
@paulins may have experiences they can share. I think Andrew is still on the Register, but I do know he has returned to a very non-diabetic/normalised diet, so he may be your best bench-mark.
(Apologies for,the shout out chaps, and thanks, in advance for anything you can add.)
2. The thing about the Personal Fat Threshold (PFT) that Prof Taylor discusses is that it's just that, otherwise there would be a simple reversal for,ill for those with decent pancreatic function, but significant insulin resistance, but thus far, that doesn't seem to exist. Prof Taylor suggests that something like 15kg or it may have been 15% of diagnostic weight (sorry can't quite recall that detail, but it is in his apparel somewhere), to be a bit of a guide. I haven't lost masses of weight, but I now find myself at borderline healthy/underweight, as I found it difficult to stabilise my weight when I felt I had lost enough. (Who ever thought that would happen?). So, I think it's safe to say that if I had a PFT it's likely I have breached it.
Prof Taylor states clearly that the rate and method of weight loss is immaterial. It is the loss that is critical.
I think each person, alongside their advisors, needs to decide when enough is enough. Clearly, clinically, there would be a stage when malnutrition would become apparent, if an individual persevered too long with any weight loss regime. I would think that provided the individual feels well, and is in the "healthy" range, they have to decide for themselves. I decided to deliberately get well down into the healthy range, so that I might have a bit of leeway for slight gain, as I tried to stabilise. But, as I said before, that bit didn't work out quite so well for me!
But, for me, personally, my primary goal was always to get my bloods in order. At the outset I was so unconcerned about weight that I didn't weigh myself for the first 3 months. I wanted one goal, and one focus. At that point, any trimming up was a bonus, but I knew it was happening, as my clothes became ill-fitting, to put it mildly. By the time I stepped on some scales I was like a bag lady!
On a more general note, I asked Professor Taylor to describe his definition of reversal for me, as I could not find any guidelines for such a judgement anywhere. I also asked if a OGTT was a critical test for such a judgement (as I hate the thought of fluffing down all that glucose).
He replied stating that an OGTT was not necessary to conform reversal, and that an HbA1c would suffice, backed up by home, finger prick checking at the 1 hour point. When asked to clarify his reference point at 1 hour, he responded "No fixed level, but less than 8mM (144mg/dl) is OK." That is lifted directly from his email. He also confirmed that the standard diagnostic levels were used for assessing both OGTT and HbA1c tests, when considering reversal.
Other reading suggests that's quite a tight 1 hour score, but I haven't challenged it with Professor Taylor.
Sorry my response is so long, but I have tried to answer as fully as I could. I hope it makes sense.
Good luck with it all.