Raised GGT levels, Diabetes and Non-alcoholic Fatty liver Disease (NAFLD):trail of low carb diet

[Lamont D]

As I've already posted my results on other threads.

As an example for @Southport GP.

My recent blood test results indicate that all my results are normal.
These were taken in response to my endocrinologist asking wether statins would help with my cholesterol. I wasn't happy, but took them for a month. Decided not to because of minor side effects and already feeling better after stopping them. My GP agreed!

My GP was full of praise for my weight loss and the reversal of my liver condition and my Hba1c.

It has been low carbing, that has done it!

If you ever, do have a patient with RH, you know now, what to recommend.

Many thanks for sharing your findings!

 

[Indy51]

@nosher8355 In his video lecture, Prof Taylor refers to the development of Type 2 as a "long silent scream from the liver", accompanied by elevated enzyme levels well before loss of BG control, so its seems that the liver dysfunction is a precursor to development of type 2. It also seems that a fatty pancreas will be involved:

http://www.fend-lectures.org/index.php?menu=view&id=94

 

[Lamont D]

Thanks @Indy51
I will have a good read of that, when time allows.

I have to take my ex fatty liver and the rest of me to work!

 

[Southport GP]

That is really wonderful post and it does give me a reason to look at things in a way that I have often thought.

Fatty Liver disease and non alcoholic FLD is what my wife suffers from, I myself have had scans and symptoms and was started but never kept on tablets for liver function tests.
I struggled to rid myself until low carbing. Now it's healthy and liver and kidney function are normal!
My wife has seen her improve since reducing her carbs.

Could the liver have more of a connection than is widely thought on diabetes especially T2, the reason I ask this is because, it is quite simplistic and of course every diabetic is unique, is that visceral fat causes quite a lot of symptoms concerning insulin production and insulin resistance. The liver causes dawn phenomenon and liver dumps when needed.
Could the liver be controlling insulin production, so that the pancreas just obeys the liver to how much it produces.

I ask because I'm interested to know and understand why I developed RH, since I have had a fatty liver for longer than I was diagnosed over fifteen years ago. And the message to my pancreas was to consistently over produce insulin to compensate.

If I'm wildly talking rubbish, let me down easily!

I honestly believe that education and learning will help in the future, things like home economics and cooking in school for our youngsters is imperative.
We have to get the powers that be, to understand, what can be done by a reduction of sugars that we consume and that the dependency on carbs to feed the world has to change.
A properly balanced lifestyle, where, good 'real' food is ate by those who just exist on convenient and take outs!

Yes I suspect there is an important link here !
Prof Roy Taylor has looked into this. I think its all in his 2012 Banting Lecture
At least for some patients in the liver, excess dietary glucose leads to hepatocyte triglyceride accumulation (fatty liver) which in its turn leads to insulin resistance and T2DM. The liver has the highest density of glycogen storage (for Glucose) in the body, but once these stores are full further excess dietary glucose leads to progressive hepatocyte triglyceride accumulation (fatty liver) via ‘de novo lipogenesis’ This in turn predisposes to insulin resistance and T2DM.

 

[Southport GP]

Well, experience in this field (Change) tells me it's significantly more likely to pique interest that a mere improvement in patient health.

Sadly in this day and age, altruism and philanthropy will almost always be over-ridden by hard commercial cash benefits, unless there's enough money around to make the financial difference completey immaterial.

I'm perhaps over-stepping the mark here, but does the savings you report having have made take into account the costs of running the trial/research? By that I mean the manpower allocated to seeing patients, any group support or any other activity that wouldn't otherwise have been occurring? I'm assuming any additional testing in order to gather data would have come from the practise BAU budgets.

Good question
We managed to get a one off grant from our CCG for £7500 but otherwise we funded the work all ourselves The savings are not given back to us so we really paid for the work ourselves I would estimate it costs about £10000 a year to run for our practice but that would still leave the tax payer in the black as the drug savings were far more I am trying to interest others now but change is so very hard to bring about in the NHS as so many of us are exhausted by decades of being a political football

 

[sanguine]

Brilliant, and I look forward to reading the full version

Thanks for letting us see a pre-publication summary!

 

[AndBreathe]

Good question
We managed to get a one off grant from our CCG for £7500 but otherwise we funded the work all ourselves The savings are not given back to us so we really paid for the work ourselves I would estimate it costs about £10000 a year to run for our practice but that would still leave the tax payer in the black as the drug savings were far more I am trying to interest others now but change is so very hard to bring about in the NHS as so many of us are exhausted by decades of being a political football

To be clear, I wasn't arguing or challenging anything you've said. How could I, as a complete outside? I'm just so pleased you guys are actually acting, rather than just thinking and moaning outside the box. It is an unfortunate reality that practises must balance the books, but on the other hand, over time, it surely must drive more creativity, as you guys are showing.

The thought process behind my question was trying to work out how I could perhaps engage with my own practise to generate enough interest for action to occur, resulting in a sustained change. I need to read the full article, then think through what you guys actually did and consider how, if I were running this as a Six Sigma or plain old commercial project, how I would plan and pitch it. But, in doing that, I need to understand the deliverable "What's in it for me?", and, vitally, convert that into a cash (even if it's wooden dollars, as in your own situation) benefit, as we know cash/finances are enormous stressors and motivators.

For my own practise, I could fold my time and expertise in as a "donation", because I would find it such a fascinating piece of work to plan and help deliver, and of course, the benefits and results could be extremely exciting for people like me.

Thanks again for both doing the work, and for getting my few grey cells twitching.

 

[Arab Horse]

Good question
We managed to get a one off grant from our CCG for £7500 but otherwise we funded the work all ourselves The savings are not given back to us so we really paid for the work ourselves I would estimate it costs about £10000 a year to run for our practice but that would still leave the tax payer in the black as the drug savings were far more I am trying to interest others now but change is so very hard to bring about in the NHS as so many of us are exhausted by decades of being a political football

I remember many, many years ago in the lab when budget controls came in. In those days the NHS was very overstaffed and waste was rampant. I worked in a small district general hospital (having returned to work when my children started school, no such thing as maternity leave or pay in those days) and, being appalled at the waste I made it my mission to save where we could and was quite successful. Then came "the savings"! There were 3 hospitals in the group and we had to save x% of our budget (can't remember the figure now, 20% springs to mind but may be wrong). The other 2 hospitals in the group managed to make considerable savings although not meeting the target but we were way out as I had already made a huge savings. Costs per test we were still by far the cheapest of the three labs but that counted for nothing as our % savings after "budget day" was considerably less than the % savings the other 2 labs had achieved so we were the "bad guys". Seems nothing has changed in all those years. I applaud you for your forward thinking and efforts.

I wish you luck in your efforts; the eventual savings for the NHS could be enormous if all GP practices were as forward looking as yours. my surgery has basically left me to sort myself out; never seen a Dr. I was put on metformin and sitagliptin and told to watch my diet (but too many carbs in the advice). To be fair the diabetic nurse knows that I know what it all means but when I was first diagnosed after my free NHS health check I was still working long hours and accepted the standard advice (far too many carbs) and it wasn't until I left work and had time to research on the internet and read forums like this one that I started to see a great improvement in my BG. I had in the meantime taken myself off Sitagliptin after reading a few papers and told my DN that I would not take it. She wanted to put me on a different drug so that I could eat more normally as I am very carb intolerant but at the moment I manage OK (with the odd lapse)!

 

[Southport GP]

To be clear, I wasn't arguing or challenging anything you've said. How could I, as a complete outside? I'm just so pleased you guys are actually acting, rather than just thinking and moaning outside the box. It is an unfortunate reality that practises must balance the books, but on the other hand, over time, it surely must drive more creativity, as you guys are showing.

The thought process behind my question was trying to work out how I could perhaps engage with my own practise to generate enough interest for action to occur, resulting in a sustained change. I need to read the full article, then think through what you guys actually did and consider how, if I were running this as a Six Sigma or plain old commercial project, how I would plan and pitch it. But, in doing that, I need to understand the deliverable "What's in it for me?", and, vitally, convert that into a cash (even if it's wooden dollars, as in your own situation) benefit, as we know cash/finances are enormous stressors and motivators.

For my own practise, I could fold my time and expertise in as a "donation", because I would find it such a fascinating piece of work to plan and help deliver, and of course, the benefits and results could be extremely exciting for people like me.

Thanks again for both doing the work, and for getting my few grey cells twitching.

Yes it's important to apply the 'what's in it for me test 'that you mention which is the reason sites like this work so well!
I must try and get open access for the article so it's free to view when published meanwhile I'm trying to get publicity for the summary of the work that appears at the start of his post so please feel free to send it on to any low carb blogs any of you have a hand in

 

[Arab Horse]

Yes it's important to apply the 'what's in it for me test 'that you mention which is the reason sites like this work so well!
I must try and get open access for the article so it's free to view when published meanwhile I'm trying to get publicity for the summary of the work that appears at the start of his post so please feel free to send it on to any low carb blogs any of you have a hand in

Has it been on Facebook? If not I have hundreds of friends (!) all over the world due to my Straight Egyptian Arabian
horses and I do also have others from my previous employment, real friends and family etc. so would be happy to put it on for you. I am sure others here would also be prepared to do the same; don't do twitter but I am sure others here do.

 

[Southport GP]

Has it been on Facebook? If not I have hundreds of friends (!) all over the world due to my Straight Egyptian Arabian
horses and I do also have others from my previous employment, real friends and family etc. so would be happy to put it on for you. I am sure others here would also be prepared to do the same; don't do twitter but I am sure others here do.

Yes please The message is low carb helps fatty liver as well as type two diabetes

 

[Arab Horse]

Yes please The message is low carb helps fatty liver as well as type two diabetes

I need to credit you with the article; can I have your name and qualifications or do you want it go under Southport GP?

 

[Indy51]

Yes it's important to apply the 'what's in it for me test 'that you mention which is the reason sites like this work so well!
I must try and get open access for the article so it's free to view when published meanwhile I'm trying to get publicity for the summary of the work that appears at the start of his post so please feel free to send it on to any low carb blogs any of you have a hand in

I noticed this popped up in the 'Tweet With Us' area of the forum today as a link from you, so posting it here for people who may not have noticed. Is this the study you meant?

http://www.diabesityinpractice.co.uk/media/content/_master/4311/files/pdf/dip4-3-102-8.pdf

 

[SunnyExpat]

@Southport GP

A good article, and a suggestion from the British Liver Trust to follow it up.

This was the original low carb diet, with an increased intake of green vegetables, whole-fruits, such as blueberries, strawberries, raspberries and the “healthy fats” found in olive oil, butter, eggs, nuts and full-fat plain yoghurt wasn't it?

Would a substantially increased amount of saturated fats and red meats included in the diet sheet be worthy of the next trial?

 

[Arab Horse]

I have had a few problems recently the latest being to badly fracture my wrist and, having osteoporosis pining or plating is not an option as the boned are too fragile so I have to pray everything stays in place and the plaster keeps it stable; what would we do without the NHS.
@Southport GP
I thought of posting something like this on FB, I will have a think again tomorrow as it has been a long day and my wrist is pretty painful so I am off to bed but please tell me of anything you would like changed/added/deleted. I would also like to credit you with the study and mention your practice. Let me know what you think. Many people have taken an interest in my T2 diabetes as everyone I know has been as gobsmacked as I am to hear that I am diabetic; the consensus is that I am the last person they would have thought would be a T2 diabetic.

"A GP in Southport has undertaken a study on patients with non alcoholic fatty liver disease. Makes interesting reading and could turn your life around if you suffer from this or, like me, type 2 diabetes.
AT LAST!! after so much work over three years our article is to be published this September in Diabesity in Practice. the Editor has agreed for you all to have a pre-publication summary. this is part of my efforts to get recognition that the low carb diet is a valid choice -not just for folk with diabetes but also for some of those with liver problems. Also that this is a diet that works on the longer term -not just a few weeks.
The message is low carb helps fatty liver as well as type two diabetes."

 

[Southport GP]

Yes our paper is out- hurrah!
After much work its been so delayed I wonder if it will look like old news if I tag it on the end here
I hope no one minds if I start a new poste with the actual thing which is I suspect showing off a bit but that aside I do think its important

 

[AndBreathe]

Yes our paper is out- hurrah!
After much work its been so delayed I wonder if it will look like old news if I tag it on the end here
I hope no one minds if I start a new poste with the actual thing which is I suspect showing off a bit but that aside I do think its important

Go for it. More often than not, if we don't blow our own trumpets, nobody's going to do it for us.

 

[Arab Horse]

Yes our paper is out- hurrah!
After much work its been so delayed I wonder if it will look like old news if I tag it on the end here
I hope no one minds if I start a new poste with the actual thing which is I suspect showing off a bit but that aside I do think its important

Unfortunately I haven't got time to read it tonight; absolutely nothing to do with Downton Abbey being on telly and I still have to feed the cat; horses tucked up in bed for the night so can have a lazy hour! I will look forward to reading it tomorrow.

 

[Suercc]

I remain a huge fan of lchf. Why didn't I find it years ago.
Feel really well. Lost 33lbs. Off most meds. Hba1c 5-6

Yet suddenly recalled for raised levels in LFT. Why now? Any thoughts ?