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Phinney and Volek start new online health practise


Have you considered that support forums are not designed for people who are happy and have good outcomes and those who do generally dont write and complain about it.

When people are unhappy with a professional or trades person most will complain and moan to all their friends, work mates and everyone they know and meet but when people have a positive experience or outcome they generally dont tell many people at all.

When was the last time you wrote a letter of thanks for a job well done? Most never have in their lives even if they have thought about it.

There are almost certainly more people happy with their doctors than you give credit for, they just dont complain about it because they have nothing to complain about.

As I have said many times I was lucky that I was put straight on insulin because like T1's I was given access to a knowledgeable diabetic hospital unit with SDN's working under the control of a highly experienced Consultant Endocrinologist.

Like most, my doctor knew little about diabetic control but that doesnt mean I cant talk to him and explain what and why I am doing what I am does it? And like most reasonable people I found he was willing to listen to what I had to say and when he saw the results what did he have to say about that? I was getting slimmer and healthier and all my blood tests came back normal.

I am also lucky in that I have never had high cholesterol so didnt have to worry about that although my doctor did once recommended that as I was diabetic I should take a statin, I merely said that my cholesterol was not high and that I had read the Cochrane review library review on statins and at that time, 6 years ago, they reported that there was little point in prescribing for those who did not have high cholesterol.

What I didnt do was moan and complain that he didnt know what he was talking about and start quoting lchf diet gurus and on line bloggers who are no more knowledgeable than any other on line ranter.

As the name suggests our GP's are "General" Practitioners, they and cant know about everything, they have a broad general knowledge about human anatomy and medicine and the latest suggested treatments and as such they are not infallible gods but neither are they stupid and out to kill us and thats an opinion I often read on here.

Edit: for anyone interested in viewing the Cochran Reviews heres the link, its so much better to discuss facts with your doctor rather than quote on line bloggers http://www.cochranelibrary.com/topic/Endocrine & metabolic/ follow the links to other areas.
 
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As I said @Sid Bonkers you were lucky .. my experience and those of many others is wildly different.. Neither my "diabetes" GP nor my DN have shown any interest whatsoever in my results or how they were achieved.
 
@Sid Bonkers, here's the problem, for most people, type 2's diabetes is a progressive disease IF needed dietary changes are not made and physical activity is not increased, regardless of whether medication is used or not. Yesterday, I came across an interview that represents the best of standard of care for type 2 diabetes in the US...

https://wa-health.kaiserpermanente.org/podcast-living-with-diabetes/

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In it, we meet Harry who was diagnosed with type 2 diabetes in 2005. At that time is blood pressure, cholesterol, triglyceride, and glucose levels were increasing. He had arthritis. He led a sedentary lifestyle, was overweight, ate white rice at most meals, liked and ate "sweet foods", and didn't eat a lot of fruit and vegetables. He doesn't state what his top weight was, but does mention that he did weigh 235 pounds at some point after he began changing his diet and exercising in 2012.

In 2012, he was informed he had an A1c of 12.2% and that he would need to start insulin. By that time he was experiencing his first complication of diabetes: peripheral neuropathy which he described as affecting his lower legs and "numb toes". He asked for 6 months to make needed lifestyle changes. The doctor agreed but reminded him that he had indicated he would so previously but had not. Faced with the possibility worsening complications, he began to make slow changes.

At Christmas, he was given a Fitbit. This got him up an moving. When he realized he could easily walk 5,000 steps a day, he upped his goal to 10,000 steps (and continues to maintain that level of walking today).

He began reading books on how to lose weight. He was clear from the onset that he didn't want to restrict his eating to the point that he couldn't see himself maintaining for the rest of his life so he chose to eat smaller portions and to eat less than 200 g carbohydrates a day. By doing this, he began losing 1 to 2 pounds a week. His weight which previously had been 235 pound dropped to 180 pounds. At the time of the interview in 2016, he has maintained his weight of 180 pounds for 1 1/2 years.

At first his A1c was checked quarterly, then every 6 months, and now yearly. His eyes are checked yearly. His last 4 A1c's have ranged from 5.5% to 5.7%. He does this with diet and exercise only. He never has taken insulin or diabetes medications. He still has arthritis. He doesn't state if his other symptoms related to metabolic syndrome and/or diabetes improved or not. I assume they did but I don't know. [Edit]: His eye health remains healthy, no problems have been noted.

He continues to eat less than 200 g carbs a day. He now eats low carb tortillas, lean meats, particularly turkey, fruits and vegetables, and smaller portions of brown rice.

[Edited to add]: He also states that diabetics can eat whatever they want in moderation, just in smaller portions and only occasionally.

Sometime after his high A1c in 2012 he took a Living Well With Chronic Conditions workshop. Following that he took the one specifically for diabetes and later began facilitating these workshops himself. He finds his ongoing participation in these workshops helpful.

Initially he was intimidated by the fitness of people who worked out at the gym, so he and his wife signed up for the Silver Sneakers instead which is an exercise program specifically designed for seniors. They didn't go at first, but once they got started, they liked it. Today in addition to walking, he also works out at the gym, typically on the exercise bike and rowing machine. He also does resistant weight training but doesn't try to over exert himself.

What surprises me is that he's able to maintain a non-diabetic A1c eating 200 carbs a day. I'm going to speculate that this is due to his exercise regimens which include working out at the gym and walking a minimum of 30 minutes a day.

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He's fortunate. I also was diagnosed with type 2 diabetes in 2005 (or 2006) and maintain a similar A1c, but if I eat more than 50 - 60 carbs a day, even with walking, my glucose levels would exceed 140 mg/dl which is known to cause damage. That said, I can knock a high glucose level down by up to 90 points with a 2 to 3 mile walk.

Last night I had a muffin that was about this size of my fist with dinner. I have a Paleo muffin made with almond flour once a week, but they were out, so I got a gluten-free muffin instead. My 2-hour post meal glucose level was 232 mg/dl so I immediately went our for a brisk 2 mile walk which dropped my glucose level to 141 mg/dl. Admittedly, I would have liked it lower, but it was late so I went to bed. Glucose level was 108 mg/dl upon awakening this morning.

Here's what we know and don't know about Harry...

I know of no hospital or health insurance sponsored diabetes workshops or classes in the US that teach the low carb diet even though we have at least 25 studies now demonstrating that it works. I doubt Harry learned about low carb in the workshops he took because the class I took through our hospital's diabetes clinic in 2009 still promoted normal carbohydrate intake, though to their credit I do recall them discussing whole grains and making the suggestion to eat only half of a banana, not a whole banana. That diet is what I've eaten my entire life, up until 2015, and my diabetes got worse and worse until I started the LCKD two years ago.

200 carbs a day is not low carb.

While he does have a non-diabetic A1c, we don't know the upper range of his daily glucose levels. Again, any level above 140 mg/dl is damaging.

We don't know if his peripheral neuropathy is better, stable, or worse. He didn't say.

Standard of care in the US...

What we know about the standard of care in the US is that while many doctors know of the low carb diet today, too many continue to discount it as "unsustainable therefore not worthy of consideration".

Standard of care treatment for diabetes continues to be classes that teach [higher carbohydrate] diets that require medication to work, and slow but continued progression for most. And once you cross over into type 2 diabetes, you are pressured to take diabetes medications and a statin.

Sadly, whether you're willing to acknowledge it or not, medical care today is strongly influenced by the pharmaceutical industry and dietary guidelines are strongly influenced by the "big food" industry.

Change will only happen through forums like this and researchers like Volek and Phinney.
 
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And here's a page describing the Diabetes Self-Management Program. When I read this part I was so disappointed - (bolded words are mine)...

The original Diabetes Self-Management Program was developed in Spanish. After successful outcomes were found with that program, the Stanford Patient Education Research Center received a grant from the California HealthCare Foundation for the randomized, controlled study to test the workshop's effectiveness for English-speakers. The study was completed in 2008.

Six months after the workshop, participants had significant improvements in depression, symptoms of hypoglycemia, communication with physicians, healthy eating, and reading food labels. They also had significant improvements in patient activation and self-efficacy. At 12 months, DSMP participants continued to demonstrate improvements in depression, communication with physicians, healthy eating, patient activation, and self-efficacy. There were no significant changes in utilization or A1C (A1C values were already in the desirable range at the beginning of the study for most particpants).**

This appears to be a drug compliance program. They fail to mention actual results based on physical examinations and lab tests. Will try to find a copy of the book used in the workshop.
 
bulkbiker said:
As I said @Sid Bonkers you were lucky .. my experience and those of many others is wildly different.. Neither my "diabetes" GP nor my DN have shown any interest whatsoever in my results or how they were achieved.
Click to expand...

I went in prepared to listen to everything they said.
Then they happily listened to me, and we discussed an individual course of treatment we were both going to be able to support.
If you go in, with your own already preconceived course of treatment, and expect them to sit there while you tell them the internet guru is the only way forward, I doubt they'll be overly interested in rubber stamping it to be honest.
Most people, even HCP's tend to listen as much as the other person in the conversation, after a while.

(Telling your doctor someone on the internet says they know nothing, then if they pay an online fee, the guru on the internet can tell them directly doesn't seem to be a winning business plan either)
 


So, why is a normal BG range quoted as being up to 200mg/dl, and normal fasting below 108mg/dl, and it's not damaging to non diabetes?
 

Wow.. you make a huge number of assumptions about me...
When first diagnosed I had only just found this site and was a meek and mild Type 2 who listened when the DN said -I had a progressive chronic condition and would end up injecting insulin.There was no talk about diet or that I could do anything else to help myself just follow what they said and take the pills.. It was only after finding the info contained here that I decided to do my own thing. No-one listened to me I was just told what to do. That is why I am now so strident about the LCHF way and want to let everyone know that you don't have to do what you are told.
As I said above you were amazingly lucky to have received the level of care that you did. You seem to think that everyone gets the same but unfortunately that is not the case. Your experience may have been good mine was decidedly the opposite.
I have never mentioned any internet "gurus" (your words) to my HCP's mainly because I no longer have any contact with them.
 
Winnie53 said:
My statement was based on research findings summarized in Jenny Ruhl's book, Diabetes 101, 2nd Edition. Some or all of it, not sure, can also be read here on her website... http://www.phlaunt.com/diabetes/14045678.php
Click to expand...

I can find nothing that gives her qualifications, and that is a very selective set of studies she seems to quote
http://www.phlaunt.com/diabetes/16422495.php has an interesting statistical analysis she seems to try to fit her belief as well.
Interesting she seems to be alone in her view, as she seems to be the only person ever quoted for this theory.

I've tested enough people personally to conclude either many people are diabetic without knowing, or she's wrong.
 

Are you familiar with Joseph Kraft, M.D.'s work? Here's the briefest overview I have found over the last year. I have and have read his book too. Based on his work, it's now believed by those who have studied his work that diabetes is underdiagnosed...

 

Maybe it takes more than 1 or 2 appoitments to form a good rapport, and build a working relationship, if you stops seeing them so quickly?
I've been working with mine for six years since diagnosis now.
 

Yes, he's a pathologist?

His book's a re-hash of a 70's paper.
https://www.linkedin.com/in/josephrkraft
he's been writing about this for 4 decades.
http://www.hippokrati.fi/wp-content/uploads/2017/01/Joseph-Kraft.pdf

So everyone's been diabetic since the 70's, without knowing, in which case they would all have diabetic complications by now, without ever being diagnosed diabetic.
 
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douglas99 said:
Maybe it takes more than 1 or 2 appoitments to form a good rapport, and build a working relationship, if you stops seeing them so quickly?
I've been working with mine for six years since diagnosis now.
Click to expand...
As I said you are very lucky to have open minded HCP's.
Does it ever occur to you that other people's experience could be different to yours yet still just as valid?
 
Douglas, honestly you are the most difficult person. What is your educational background?

I just heard an excellent quote the concisely summarizes the ground breaking significance of Dr. Kraft's life work. Need to type it up. Back soon.
 
“I want to go back to this concept of insulin because to me this is one of the biggest missing pieces of information in conventional management of diabetes. So many people are lead to believe that diabetes is all about blood sugar, type 2 diabetes in particular. But really underlying that really is insulin resistance and these elevated insulin levels. I spoke earlier on the summit with Dr. Joseph Kraft who is an 80+ year old pathologist who’s done decades of research studying insulin. And he really made a strong point that it’s the insulin levels that do more damage, even than the blood sugar. So people can have elevated insulin levels for years and years and years and never become diabetic but still have the same types of complications, right. They can still have cardiovascular inflammation and problems. They can still develop kidney problems. They can still even develop neuropathy and nerve and circulation issues without even ever becoming full blown diabetic. And I think one of the biggest concerns is what we’re talking about today which is this fire on the brain, Alzheimer’s Disease, dementia, cognitive impairment, much of it related to elevated insulin levels in the blood.”

Dr. Brian Mowll, Host of The Diabetes Summit interview with Mark Menolascino, MD on March 20, 2017.
 
Winnie53 said:
Douglas, honestly you are the most difficult person. What is your educational background?

I just heard an excellent quote the concisely summarizes the ground breaking significance of Dr. Kraft's life work. Need to type it up. Back soon.
Click to expand...

Do you need an educational background to question why, out of 73% of 3650 subjects that he declared 'demonstrated diabetic insulin patterns', it seems strange the after nearly half a century after his study, we haven't actually seem the same group show 73% exhibiting complications?
Will we see it happen in 2160 now he's re-published his study?
 
Douglas, it was a sincere question. I'm self taught, though I come from a family educated in science and mathematics. Dad was trained in chemistry, mother in biology. Grandparents, both sides, and uncles were all engineers.

I've spent the last 2 years, anywhere from 10 to 40 hours a week reading and learning about diabetes, cardiovascular disease, cognitive impairment, and autoimmune disease because I've been hit hard with ALL of these conditions. So for me this isn't "fun and games". It's hard to have a conversation with you because you reject everything presented to you.
 

Alzheimer's seemed to be more related to the insulin resistance, which causes the high insulin level, and treatment by GLP antagonists may be a viable option. So restoring the pathway, and letting the brain use the insulin, rather than simply turning it off.
However that still doesn't explain why we haven't seen a massive unexplained flood of all diabetes systems over the last 4 decades.
 
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