Newcastle Diet - Reversal Questions

Eurobuff

Well-Known Member
Messages
356
Type of diabetes
Type 2
Treatment type
Diet only
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.
 

AndBreathe

Master
Retired Moderator
Messages
11,323
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
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.
 
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mekalu2k4

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242
Type of diabetes
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I do not have diabetes
my hba1c is 5.4% but if I ate some bread it would shoot up
This is a standard pattern of human body reaction. So be glad that your body is reacting as majority humans do, then you know what/ how to adjust your diet. Limit your carbs intake to daily minimum requirements.

after 5 months dropped to 56kgs (bmi 22.4)
This is very good achievement. Try to maintain this bmi of 22.4. However, BMI is not a good parameter to work with; it is only target 1. Now move on to next targets.

1. Measure your body fat, that is a good parameter to work with to keep T2D in check. Digital bathroom scales will tell your body fat. I use this http://www.amazon.com/GoWISE-USA-Digital-Bathroom-Scale/dp/B00CZPF5L2/ - it is working fine. Look up on internet for charts for body fat ranges; Once you measure, then you know what to work on.

2. your waist measurement. An experienced athlete told me to keep my waist around 33 inches. But it is for me.

4. What is your blood pressure? It will go low due to lower bmi. Mine is 105/65. it used to be 140/95

5. Exercise: Weekly target of 200 min [internet says 150min]. BE Careful: Avoid exercise if you cannot for any reason; Do not injure yourself. Not everyone can run [I was obese in the past, could not walk at all; forget about running; but my BMI is now 23.5, I run now - at 5kmph for 10 min non-stop, with incline on treadmill], but if you can do cardio that is great. Now I do exercise for 90 min everyday; do sweat a lot - just to ensure my body fat, weight in check.

6. Diet: Limit your carbs. Again - if you have a digital bathroom scale and see your readings daily; then you know how your weight is changing for different foods. Naturally, you adjust your diet over few weeks. After that, it is only maintaining the pattern. I tried to take raw diet, but failed. But I am on restricted carb diet for long. I tried LCLF recently, my body fat went up, so I stopped and now back to LCLF diet, for me around 1200 cal per day works, but you need to find yourself for your body.

my hba1c is 5.4%
This test is enough as it averages for last 3 months. Just that we need to get this done now and then. I get this done every 6 months, May be you can do with lesser frequency, after a while you will adjust yourself.
I do complete blood work once in every year, as mandatory requirement of my job. This helps in understanding lipids etc which is equally important.

Be active on the forum, to update your status. Good luck.
 
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Eurobuff

Well-Known Member
Messages
356
Type of diabetes
Type 2
Treatment type
Diet only
Thanks everyone. I really appreciate it. With regards to the bread/carbs, I just used that as an example. I am eating about 50g carbs per day, which is probably why my hba1c is what it is. I lost the weight when I reduced my carbs (in my non-diabetic days I was eating about 200grams per day). I've worked out that I am using about 1600 calories per day. My blood pressure is generally 120's over 80's with my pulse rate being between 80-85. I'm guilty of not exercising like I should. I usually start off well and then get bored after a week, and then give up, and start again a few weeks later. I had a pretty active job (well lots of walking/ walking fast & up & downstairs), but I was made redundant and my new job, is a lot of sitting around, chained to a computer (not literally of course). I think I need to find some effective exercise that I can do from home, if that's possible, as there's no gyms near me, and if I went jogging I'd probably get mugged! My hba1C is getting checked every 6 months. I tend to use Boot's scales to get weighed when I'm out shopping. My waist is 32 inches. 2hrs after I've eaten my BG is somewhere between 5.6-6.6, but there is an odd rogue reading hear and there of 7.2, 7.3, although last week I did have a reading of 8.0 2 1/4hrs after eating, which I can't explain, as I hadn't ate anything different, although earlier on in the day I felt really ill (not diabetes related) and was in severe pain in my back and had taken high dose painkillers, so I don't know if that was a coincidence or not? In reference to Professor Taylor's statement about BG being under 8 - 1hour after eating, mine usually are (apart from last week), so I'm not sure if by his calculations he would class me as non diabetic? At the moment I'm still losing weight, but slowly and steadily, so if the rate at which you lose weight isn't important I might just see if my BG improves even further, keeping on the low carb diet.
 

trotskyite

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Messages
104
Thanks everyone. I really appreciate it. With regards to the bread/carbs, I just used that as an example. I am eating about 50g carbs per day, which is probably why my hba1c is what it is. I lost the weight when I reduced my carbs (in my non-diabetic days I was eating about 200grams per day). I've worked out that I am using about 1600 calories per day. My blood pressure is generally 120's over 80's with my pulse rate being between 80-85. I'm guilty of not exercising like I should. I usually start off well and then get bored after a week, and then give up, and start again a few weeks later. I had a pretty active job (well lots of walking/ walking fast & up & downstairs), but I was made redundant and my new job, is a lot of sitting around, chained to a computer (not literally of course). I think I need to find some effective exercise that I can do from home, if that's possible, as there's no gyms near me, and if I went jogging I'd probably get mugged! My hba1C is getting checked every 6 months. I tend to use Boot's scales to get weighed when I'm out shopping. My waist is 32 inches. 2hrs after I've eaten my BG is somewhere between 5.6-6.6, but there is an odd rogue reading hear and there of 7.2, 7.3, although last week I did have a reading of 8.0 2 1/4hrs after eating, which I can't explain, as I hadn't ate anything different, although earlier on in the day I felt really ill (not diabetes related) and was in severe pain in my back and had taken high dose painkillers, so I don't know if that was a coincidence or not? In reference to Professor Taylor's statement about BG being under 8 - 1hour after eating, mine usually are (apart from last week), so I'm not sure if by his calculations he would class me as non diabetic? At the moment I'm still losing weight, but slowly and steadily, so if the rate at which you lose weight isn't important I might just see if my BG improves even further, keeping on the low carb diet.
A measurement of over 31.5cm (female) indicates your health is at risk by your waist size. http://www.heartfoundation.org.au/healthy-eating/Pages/waist-measurement.aspx
So I would say you are safe to lose a bit more according to the stats, of course you should ok everything with gp/dietitian.
What I (personally) would do is wait till you have got at or under 80cm waist then start eating a normal amount of carbs for 3 days and perform your own (or at gp?) ogtt. I say this as I have read that a t2 can pass an ogtt even with diabetes because when low carbing the pancreas can store insulin on its surface and release it all at once.

The measurements are based on your being of European origin for Asians etc they are lower.
 
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Eurobuff

Well-Known Member
Messages
356
Type of diabetes
Type 2
Treatment type
Diet only
A measurement of over 31.5cm (female) indicates your health is at risk by your waist size. http://www.heartfoundation.org.au/healthy-eating/Pages/waist-measurement.aspx
So I would say you are safe to lose a bit more according to the stats, of course you should ok everything with gp/dietitian.
What I (personally) would do is wait till you have got at or under 80cm waist then start eating a normal amount of carbs for 3 days and perform your own (or at gp?) ogtt. I say this as I have read that a t2 can pass an ogtt even with diabetes because when low carbing the pancreas can store insulin on its surface and release it all at once.

The measurements are based on your being of European origin for Asians etc they are lower.

Thanks, I'll do that. About the OGTT though, my GP won't do that, they will only do a hba1C as they've said OGTT is an expensive test. I'd do my own though. What would I need? And how many carbs is "normal", and is it net carbs or total carbs?
 

trotskyite

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Messages
104
"For the OGTT to be accurate, you will need to eat foods that are rich in carbohydrates for 3 days before the test. Your carbohydrate intake should be at least 150 grams each day." (total???)
Personally what I would do is just glug back a 500ml of original lucozade and check after 1hr and 2 hrs as that's similar to what I had to do last time I was at gp surgery.
I'm sure people will point out this is not accurate/healthy but I am only saying what I would do to give me an idea if I can tolerate glucose. Last time I did one it was 5.5 after 2hrs so well within the normal range. That convinced me but, strangely, not the gp or nurse even though it was their idea lol
 
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Eurobuff

Well-Known Member
Messages
356
Type of diabetes
Type 2
Treatment type
Diet only
"For the OGTT to be accurate, you will need to eat foods that are rich in carbohydrates for 3 days before the test. Your carbohydrate intake should be at least 150 grams each day." (total???)
Personally what I would do is just glug back a 500ml of original lucozade and check after 1hr and 2 hrs as that's similar to what I had to do last time I was at gp surgery.
I'm sure people will point out this is not accurate/healthy but I am only saying what I would do to give me an idea if I can tolerate glucose. Last time I did one it was 5.5 after 2hrs so well within the normal range. That convinced me but, strangely, not the gp or nurse even though it was their idea lol

Net carbs is the total figure in the food (not what sugars) minus fibre.
ImageUploadedByDCUK Forum1430772976.072053.jpg


So in this example 1 slice would be 12.4 net carbs (15.1 total carbs)
 

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Eurobuff

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Messages
356
Type of diabetes
Type 2
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Diet only
Oh that's interesting. I got this far and didn't know that :) I just look at the total carbs then usualy avoid anything with more than 1g sugar

OK, so if I just go for 150grams total - for 3 days. I won't go for Cadburys Creme Eggs then, just "normal non-diabetic food" like bread and potatoes?
 

Eurobuff

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Messages
356
Type of diabetes
Type 2
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Diet only
Lol, maybe. I just want to get that little bit of weight off, and I can look forward to Creme Egg Day!
 
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Indy51

Expert
Messages
5,540
Type of diabetes
Type 2
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Diet only
Do an internet search for "DIY OGTT" and you should find details of how to do the test at home. Or you can do something like outlined in this video:

 
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Eurobuff

Well-Known Member
Messages
356
Type of diabetes
Type 2
Treatment type
Diet only
Do an internet search for "DIY OGTT" and you should find details of how to do the test at home. Or you can do something like outlined in this video:


Thanks I'll take a look at that
 

Syd

Well-Known Member
Messages
93
Type of diabetes
Type 2
Treatment type
Diet only
@AndBreathe When you were taken off the diabetic register in December 2014 were you coded as being 'Diabetes resolved' or 'Diabetes in remission'?

I ask because I had my annual review last January and the DN stated that if my next Hba1C result was of a similar order (32 mmol/mol) and my fasting glucose was under 7 mmol/l then she would record me as being 'diabetes resolved' My further reading on this is that 'diabetes resolved' is akin to stating that there has been a misdiagnosis of diabetes and going forward I would be treated as if I had never had the disease at all. This would mean no annual checks, for retinopathy etc. would be carried out.

On the other hand a coding of 'diabetes in remission' means that I would still need monitoring and get the annual checks. To that extent I would still be on the diabetic register and receiving treatment for diabetes in the form of annual checks.

I am confident that provided that I keep off the weight which I have lost then I will be diabetes free for a while to come, but I would still like the reassurance of the annual checks and so I will be pushing for a coding of 'diabetes in remission', to that extent I still have diabetes and will still be on the register.

Although the common parlance for a successful resolution of diabetes is 'diabetes reversal' this does not seem to form part of the NHS coding of its patients.
 

AndBreathe

Master
Retired Moderator
Messages
11,323
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
@AndBreathe When you were taken off the diabetic register in December 2014 were you coded as being 'Diabetes resolved' or 'Diabetes in remission'?

I ask because I had my annual review last January and the DN stated that if my next Hba1C result was of a similar order (32 mmol/mol) and my fasting glucose was under 7 mmol/l then she would record me as being 'diabetes resolved' My further reading on this is that 'diabetes resolved' is akin to stating that there has been a misdiagnosis of diabetes and going forward I would be treated as if I had never had the disease at all. This would mean no annual checks, for retinopathy etc. would be carried out.

On the other hand a coding of 'diabetes in remission' means that I would still need monitoring and get the annual checks. To that extent I would still be on the diabetic register and receiving treatment for diabetes in the form of annual checks.

I am confident that provided that I keep off the weight which I have lost then I will be diabetes free for a while to come, but I would still like the reassurance of the annual checks and so I will be pushing for a coding of 'diabetes in remission', to that extent I still have diabetes and will still be on the register.

Although the common parlance for a successful resolution of diabetes is 'diabetes reversal' this does not seem to form part of the NHS coding of its patients.

I asked at the time, but the GP I spoke to on that visit has never actually had cause to do this, so didn't know herself what she had to do. She did ask if I would be willing to continue to have an annual HbA1c, as a further safety net to my own testing, and I was very happy with that. As it transpires, we're still discussing my lipids, and a potential referral to a lipid specialist (who knew they existed?), so this year at least I won't be going the whole year anyway.

Coincidentally, I have also just received a letter requiring me to book my retinal screening, which I had assumed I'd lose. I've booked that this morning, but until I have a further chat over the next month or so, I won't know
 

Eurobuff

Well-Known Member
Messages
356
Type of diabetes
Type 2
Treatment type
Diet only
@AndBreathe When you were taken off the diabetic register in December 2014 were you coded as being 'Diabetes resolved' or 'Diabetes in remission'?

I ask because I had my annual review last January and the DN stated that if my next Hba1C result was of a similar order (32 mmol/mol) and my fasting glucose was under 7 mmol/l then she would record me as being 'diabetes resolved' My further reading on this is that 'diabetes resolved' is akin to stating that there has been a misdiagnosis of diabetes and going forward I would be treated as if I had never had the disease at all. This would mean no annual checks, for retinopathy etc. would be carried out.

On the other hand a coding of 'diabetes in remission' means that I would still need monitoring and get the annual checks. To that extent I would still be on the diabetic register and receiving treatment for diabetes in the form of annual checks.

I am confident that provided that I keep off the weight which I have lost then I will be diabetes free for a while to come, but I would still like the reassurance of the annual checks and so I will be pushing for a coding of 'diabetes in remission', to that extent I still have diabetes and will still be on the register.

Although the common parlance for a successful resolution of diabetes is 'diabetes reversal' this does not seem to form part of the NHS coding of its patients.

Hi @Syd When I attended the lecture at Newcastle University by Prof Taylor, he did say that in cases where the patients had successfully reversed the diabetes he had recommended to their GP's that they were still to have the annual retinal screening for a further 2 years and only IF there was absolutely no sign whatsoever of diabetic retinopathy that he would say it was OK to stop screening (providing that the diabetes was still in reversal of course)
 

mekalu2k4

Well-Known Member
Messages
242
Type of diabetes
Parent
Treatment type
I do not have diabetes
My opinion on ND diet: Tried over 6 days only - strictly followed.
1. it is extremely difficult to follow initially. One needs to be perfect in measuring everything that goes inside - not just weight; but by carbs, protein etc.
2. Great results (at least for me - a non-diabetic) - yes simply great results. lost 1.5lbs in 6days, not bad given that I am already at 23.5 bmi. At this BMI it is difficult to lose plenty weight. Not only it takes time, but also significant effort in terms of rigorous exercise and diet.
3. ND is initially difficult; where as raw diet is easy initially. As time passes they do opposite ways.
4. Feels and moods are great; more energy later [first few days I felt very weak though]

I think it is the direct, most important benefit/ result I experienced from joining this forum. I tried complete raw diet but could not withstand that; so cannot speak about that. I am planning to put myself at least 7 days per month on ND - like every 4th day.
 
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Syd

Well-Known Member
Messages
93
Type of diabetes
Type 2
Treatment type
Diet only
Thanks @Eurobuff and @AndBreathe for your replies.

I give the link for the NHS present regime with regard to diabetes reversal and eye screening.

http://diabeticeye.screening.nhs.uk/primarycare

You will see that at the present once there has been a positive diagnosis of diabetes the recommendation is that the eye screening be continued annually for life. The patient should be coded as diabetes in remission, if coded as diabetes resolved the position is different and eye screening will not continue.

The position may change as a result of Prof Taylor's research but for the moment there does not seem to be a halfway house of continuing screening for a couple of years and then stopping.
 

AndBreathe

Master
Retired Moderator
Messages
11,323
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Thanks @Eurobuff and @AndBreathe for your replies.

I give the link for the NHS present regime with regard to diabetes reversal and eye screening.

http://diabeticeye.screening.nhs.uk/primarycare

You will see that at the present once there has been a positive diagnosis of diabetes the recommendation is that the eye screening be continued annually for life. The patient should be coded as diabetes in remission, if coded as diabetes resolved the position is different and eye screening will not continue.

The position may change as a result of Prof Taylor's research but for the moment there does not seem to be a halfway house of continuing screening for a couple of years and then stopping.

Excellent, thanks. I did see (pardon the pun) the letter for retinal screening as a positive, and would have continued to accept invitations as long as they came. I'll clarify with my GP next I speak with her, exactly what I should be expecting, in her view. I was so surprised when she suggested removing me from the register last time, that I wasn't quite prepared with all the "next questions">

Thanks again.