Reversing Type 2 Diabetes

[Grazer]

Good post Stephen. If we do what we can, we only hold ourselves to account.

 

[Paul1976]

Wow!! Well said Stephen!!

 

[Unbeliever]

I'm more robust than that. At this point in my diabetic journey I'm pretty disillusioned with a medical profession that fails to understand any of the things that I've done to address my condition. All I ever hear is "don't test", "eat more carbs", "ketones are bad for you", "your Total cholesterol is too high" (I haven't heard the last one yet, but I'm bracing myself for next week). I have next to zero confidence that my Doc could properly interpret a c-pep test, or if he did he'd do so with exactly the same resources as I do, but probably with less than half the enthusiasm.

Every step I've taken so far I've taken on my own, usually doing exactly the opposite of whatever the medical profession told me. That's just the kind of guy I am. If I hadn't taken responsibility for my diabetes, and blindly followed the advice I was given, I'd probably be washing down my low-fat diet with a glass of orange-juice and a hand full of statins and hoping that my next HbA1c would be "Good Enough!".

If I end up as a blind-amputee with kidney failure, at least I'll be able to console myself with the fact that I tried my best, did my own research and didn't blindly put my faith in a medical profession that frankly doesn't give a monkey's about me, or my diabetes.

It's kinda working out so far, don't you think?[/quote]

In a nutshell , that is the worst thing about diabetes and the thing which frightens me most. The doctor or even worse he Nurse.
When I am asked at my Annnual review if i am depressed i reply that I am - not by the diabetes but by the treatment of it.
You mange to control your dibetes IN SPITE of the Drs and Nurses and certainly not with their help.
The most we can seem to expec is that they will consent to allow us to continue with the progress we have made by ourselves.
I have often considered refusing further "treatment " for my diabetes. The checks etc actually interfere wih my overall conrol
but they have the power to make my life even more uncomfortable and ea into my time by covering their backs.
It is just a little difficult now that inappropriate medication has caused me to suffer complications.
There is no doubt in my mind that if undiagnosed longer i would have been beter off. I am told that I have probably had diabetes for most of my adult life but hardly suffered a day's illness and it did not show during pregnacy.
Accidental diagnosis and the automatic medication that followed led directly to my previously healthy low carb and low gi diet
being ditched [ and increased medication led to complications which may well blind me.
I consider my diabnosis to be he worst thing that ever happened to me. Not ebven the medical profession can deny it.

So good luck to you Borofergie - its your body and your life. had i not been befuddled by the medication which had a devastaing effect upon me beyond the usual stomach problems as well as the trauma surrounding my diagnosis - I almost died- - I may well have gone down a different route.

I have refused insulin and improved my control while reducing my medication. It is necessary to be strong - not to fight the disease as much as to fight those who are entrusted with the task of "helping " us.
They would like us all to be sheep. No offence Grazer-

I agreed wih Xyzzy's post in the general sense in that knowledge can be a double-edged sword. but we have to be true to ourselves. I tend to give up only when I have explored every avenue too. I would despise myself if I did otherwise,

 

[Paul_c]

I was told over three years ago that I had an impaired glucose tolerance and was considered to be pre-diabetic, yet was NOT given any warning just how dangerous being diabetic could be or that I could actually do anything to delay or prevent becoming diabetic.

Had they told me back then just how important it was to get my act together and lose weight and get on a healthier low GL diet with exercise then I'd have done it.

They should be doing pre-diabetes screening and education to help reduce the numbers of us that go on to be diagnosed as T2s in order to reduce the NHS bill. An ounce of prevention is worth a pound of cure...

Now they have a massive T2 time bomb ticking with large numbers of the population not aware that they are in danger and that they can do anything about it.

The food manufacturers aren't helping matters with the ridiculous amounts of sugar and fat hidden away in foods that don't need all that much... just walk around any supermarket and be horrified at just how much shelf space is taken up with food and drinks that are loaded with sugar... and stuff that is promoted as healthy low-fat alternatives are filled with sugar. A well known brandname night time drink has 50% sugar in the normal version, but the "lite" version has 75% sugar!!!

Our government being in bed with the food processors and supermarkets is just making things worse and they have the gall to complain about the bill the NHS is facing for the diabetes explosion that's happening right now...

 

[xyzzy]

I'm more robust than that...
...Its kinda working out so far, don't you think?

An excellent post Stephen regarding how you, I and many others on the site have regained control of our lives by taking control of our own destiny. However... (you knew that was coming)

...I would still suggest caution. Do not confuse the **** advice that the majority gets which forces us to find the psychological strength to go against decades of instinctively believing what our gp's and HCP's tell us and the psychological damage that could occur to that strength with something like knowing how much insulin you produce could do.

I am not for one moment suggesting that you personally could not deal with that knowledge just that it is very much an individual thing that each person should consider carefully prior to having that kind of test done.

Regarding the interpretation of a c-peptide result. The c-peptide test will measure how much insulin you are producing. It's the primary test for determining T1 diabetes and therefore has to be reliable. If you have a **** doctor who cannot or misinterprets the result that's a different matter. The amount of insulin your pancreas produces is not effected by how good or bad someone interprets the result of a test that measures it. There is no causal linkage. If you are better at interpreting the result then great but your own interpretation of the result will also not change the amount of insulin your pancreas produces so I would still urge careful consideration to any T2 thinking of taking a c-peptide test.

 

[Defren]

I'd happily pay for my own, and interpret my own results

£200 from here http://www.medichecks.com/index.cfm...me=C Peptide&gclid=CLvph7SwqrACFUYntAodMyyjVw

I think you should think VERY carefully about the psychological impact having the test done could do. If it came back and said you had little beta cell function remaining then unless someone finds a miracle cure you would need to accept your reversal hopes would be dashed. Further that even on your VLC regime that has in all likelihood stopped progression that if that progression is continuing however slowly then at some point your levels will rise assuming nothing else gets you first. I would suggest like most things of a similar nature such as an alzheimer test it is a thing you do after the most careful consideration.

I'm more robust than that. At this point in my diabetic journey I'm pretty disillusioned with a medical profession that fails to understand any of the things that I've done to address my condition. All I ever hear is "don't test", "eat more carbs", "ketones are bad for you", "your Total cholesterol is too high" (I haven't heard the last one yet, but I'm bracing myself for next week). I have next to zero confidence that my Doc could properly interpret a c-pep test, or if he did he'd do so with exactly the same resources as I do, but probably with less than half the enthusiasm.

Every step I've taken so far I've taken on my own, usually doing exactly the opposite of whatever the medical profession told me. That's just the kind of guy I am. If I hadn't taken responsibility for my diabetes, and blindly followed the advice I was given, I'd probably be washing down my low-fat diet with a glass of orange-juice and a hand full of statins and hoping that my next HbA1c would be "Good Enough!".

If I end up as a blind-amputee with kidney failure, at least I'll be able to console myself with the fact that I tried my best, did my own research and didn't blindly put my faith in a medical profession that frankly doesn't give a monkey's about me, or my diabetes.

It's kinda working out so far, don't you think?

Excellent post Stephen!

We are all blinded by the traditional low fat diet, but for most T2's it is just not an option. Even if it was, then it begs the question, if a low fat diet works, how is it that the USA and the UK are now dealing with an obesity epidemic? Low(er) carbs and taking control of our own diabetes is the only way forward, to ensure we do keep our feet and eyes, the NHS/DUK line would have us all blind wheelchair users, destined for an early grave!

 

[xyzzy]

if a low fat diet works, how is it that the USA and the UK are now dealing with an obesity epidemic?

Sorry to disagree Jo but there is ample evidence that a low fat diet works fine for non diabetics as a means of weight loss. In fact there is ample evidence that most sensible diets work. The issue to me from a T2 perspective is that a high carb low fat diet is anything but good for me.

If you analyse the carb fat protein ratios between the UK, USA and Australia the rise in obesity levels cannot simply be attributed to those countries adopting the same approaches. Although this only deals with sugars then for example:

http://www.mdpi.com/2072-6643/3/4/491

Abstract: Ecological research from the USA has demonstrated a positive relationship between sugars consumption and prevalence of obesity; however, the relationship in other nations is not well described. The aim of this study was to analyze the trends in obesity and sugar consumption in Australia over the past 30 years and to compare and contrast obesity trends and sugar consumption patterns in Australia with the UK and USA. Data on consumption of sugar in Australia, the UK and USA were obtained from the Food and Agriculture Organization for the years 1980–2003. The prevalence of obesity has increased 3 fold in Australians since 1980. In Australia, the UK and USA, per capita consumption of refined sucrose decreased by 23%, 10% and 20% respectively from 1980 to 2003. When all sources of nutritive sweeteners, including high fructose corn syrups, were considered, per capita consumption decreased in Australia (−16%) and the UK (−5%), but increased in the USA (+23%). In Australia, there was a reduction in sales of nutritively sweetened beverages by 64 million liters from 2002 to 2006 and a reduction in percentage of children consuming sugar-sweetened beverages between 1995 and 2007. The findings confirm an “Australian Paradox”—a substantial decline in refined sugars intake over the same timeframe that obesity has increased. The implication is that efforts to reduce sugar intake may reduce consumption but may not reduce the prevalence of obesity.

The following admittedly quite old study actually shows the UK has been increasing its fat consumption throughout the period that obesity rates are rising.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2550498/pdf/bmj00605-0041.pdf

What this implies to me is that obesity is far more complex than just what dietary regime someone adopts. My personal belief is despite the "Australian paradox" it is more likely linked to the pure energy density of modern foods (calorific intake) rather than one specific diet or another. More specifically it is not "good" low fat foods that are are to blame but more likely high sugar and highly processed high calorific foods that are far more likely to be to blame. So in essence obesity is something to do with the quality of foods people are eating. This is why I am so pro interventionist about things like fast food, taxation and stuff like that.

To me carbohydrates become THE issue AFTER you become diabetic and it is madness if not down right murderous to advocate a high carb diet to a diet only diabetic. As far as I'm aware advocating a low carb high fat diet was the same attitude that was stated by HCP's before the low fat craze started in the 1980's and seems eminently sensible. However if someone eats far too many calories on their low fat high carb diet they may get a good hBA1c but still end up obese and run a high risk of CVD etc.

 

[borofergie]

What this implies to me is that obesity is far more complex than just what dietary regime someone adopts. My personal belief is despite the "Australian paradox" it is more likely linked to the pure energy density of modern foods (calorific intake) rather than one specific diet or another.

Or maybe it's to do with the fact that the authors of the "Australian paradox" paper rigged the data:

 

[xyzzy]

:lol:

Yes take your line of best fit from the dates that will fit your feory!

I see that all the time in my work with financial data where one financial services company will try to persuade you its products are better than the oppo's by measuring the performance of its products between advantageous dates...

I suppose to really rule out a fix you should look at the UK and US sugar consumption data over the same date period.

Well at least it removes the anomaly from my own idea about obesity being down to the high energy density of low quality processed foods.

How do you account for the graph in the 1995 paper that shows the carb / fat ratio equalising over the 1940 to 1995 period? Again an interpretation of that is obesity has increased as fat intake has risen.

 

[Defren]

Sorry to disagree with you Steve. Before the low fat diet craze the obesity epidemic was no where near as bad as it is now. Look at your parents and grandparents, few were overweight or obese. People happily ate fat then, I remember my grandmothers favourite 'treat' bread and dripping. Low fat usually equates to high sugar, and since people tend to eat a lot of carbs, then the low fat diet was in my opinion always doomed to failure.


1. Obesity can be found in 'non-toxic environments.'

2. The poor are more obese than the rich, even though they exercise more.

3. Obesity is often found linked with malnutrition.

4. People who eat high fat low carb diets do not become obese.

5. Only some people get fat in our so-called 'toxic environment.'

6. The thrifty gene hypothesis has been thoroughly refuted.

7. Non-western cultures who adopt a western diet get fatter and sicker.

8. Epidemic of obesity, diabetes, and other 'diseases of civilization' in cats and dogs.

9. Obesity associates closely with other 'diseases of civilization.'

10. We eat less fat and more carbohydrates than we did before the obesity epidemic.

11. The most elegant and simple explanation for the cause of obesity in our population is that the epidemic was triggered by our collective switch to a low fat high carbohydrate diet.

http://www.why-low-carb-diets-work.com/ ... esity.html

 

[xyzzy]

Before the low fat diet craze the obesity epidemic was no where near as bad as it is now. Look at your parents and grandparents, few were overweight or obese. People happily ate fat then, I remember my grandmothers favourite 'treat' bread and dripping. Low fat usually equates to high sugar, and since people tend to eat a lot of carbs, then the low fat diet was in my opinion always doomed to failure.

So as I've asked Stephen then explain this graph.



The swap to low fat in the 80's was crazy for diabetics It does not mean it was crazy for the overall population. In my mind there is a difference between a "low fat" and a "high ****" diet. They are two different things.

Just comments on some of your points.

2. The poor are more obese than the rich, even though they exercise more.

No I don't buy that I don't see the rich are necessarily more or less active than the poor nowadays. What is different is the quality of food the rich eat. Do all those thin rich people eat high fat diets to keep thin? No they eat good quality food and avoid the high **** high energy density ones.

4. People who eat high fat low carb diets do not become obese.

Disagree strongly. So an average person who eats 3500 calories / day on a lchf diet is not going to get just a fat as someone who eats the same 3500 / day on another ratio such as hclf. No don't buy that. What I would say is it's a lot harder to eat 3500 / day on lchf because of the make up of the regime and you may have to eat more on lchf to become obese as it takes more energy to convert fat to the glucose that the body uses than carbs to glucose (I think)

7. Non-western cultures who adopt a western diet get fatter and sicker.

Show me evidence of that. I would guess the average Chinese agricultural worker eats a lot of rice. He goes gets a job in the big city and earns more. Does he change his whole cultural attitude and eating habits? My argument would be that his background diet will still largely be set by his culture but may get adjusted not by eating "low fat" but by eating "high ****" like Big Macs and full sugar Coke. So he moves from a high carb but probably low energy density diet to a high carb high energy **** diet. That does not mean "low fat" is the culprit in all of this.

8. Epidemic of obesity, diabetes, and other 'diseases of civilization' in cats and dogs.

Cats and dogs get obese because their owners massively overfeed them, do not exercise them, again all energy density related. Show me an overweight working sheepdog. I will agree that in recent years vets have got fixated on making dogs far too thin. A dog that is full and content will keep in "social mode" rather than enter "hunting mode" and is therefore a lot less likely to bite etc.

10. We eat less fat and more carbohydrates than we did before the obesity epidemic.

Not according to that chart.

11. The most elegant and simple explanation for the cause of obesity in our population is that the epidemic was triggered by our collective switch to a low fat high carbohydrate diet.

The most elegant and simple explanation for the cause of obesity in our population is the epidemic of fast food, sugary drinks and a modern lifestyle. Again show me that is not the reason rather than "low fat" being the reason.

Like I say I think its a far more complex thing than just blaming "low fat".

...and of course none of the above excuses the low fat brigade trying to kill me as a diet only T2.

 

[borofergie]

So as I've asked Stephen then explain this graph.

That'd be my very great pleasure BlindDog:

As you can see, I've taken the liberty of updating the data on the graph (using the results of the National Diet and Nutrition Survey 2008/09. This data shows that by the end of the decade total carbohydrate intake had increased to about 49% of energy, while total fat intake had declined to 35% (and by simple maths protein must be 16%)*
http://www.food.gov.uk/multimedia/pdfs/ ... rt0809.pdf

Pretty conclusive eh?

What's worse is that significantly the biggest part of that carbohydrate consumption is grain:

The major contributor to carbohydrate intake was cereals and cereal products, with the contribution ranging from 40% for toddlers, 42% for adults and 43-46 % for children aged four to 18 years. There was little change in contribution to carbohydrate intake from this group from past surveys.

Next biggest is vegetables + potatoes @15%, followed by milk @ 7% of carbs.

I'd bet if you compared the pre-1960s high-carb diet the modern high-carb diet , you'd find the bulk of carbs in the latter was coming from starches and not from grains. You know that as a diabetic, it's much easier to avoid sugars and starches than it is to avoid flour products.

I'm not going to even bother to mention how healthy animal fats have been replaced with unhealthy (and infalmmatory) polyunsaturated vegetable oils (from grains!).

*there is that 16% protein number again.

 

[phoenix]

XYzzy, Stephen,
You might like to google this. The link won't work (its a set of powerpoint slides with graphs)
40 years of BNF What has changed in Nutrition

 

[borofergie]

I got the full dataset for the "National Food Survey" (1940-2000).

The data stinks:

However, for consumption of food out of the home (which accounts for around 10%
of total intake) the estimates produced using the pilot data did show a shortfall which
was most likely mainly due to the under-recording of items accompanying main
dishes (e.g. chips) and on the incidence of certain 'free foods' (e.g. tea and coffee
consumed at work, food eaten by children at nursery).

I also don't understand how the average reported calorie intake declined from 2382kcal a day in 1944 to 1800kcal a day in 2000.

That's not what we'd expect is it? Has calorie consumption gone down by 25% since the 40s?

 

[lucylocket61]

My explanation for all this:

Trans fats and their new baby brother 'interesterated fats' have some malignant and undocumented effect on our body and the way it absorbs and uses them. I think some people cannot process these transfats and their ilk. And some people are actually malnourished, despite having a high fat diet, because their fat intake is predominantly these artificial fats which are not recognised as such by their bodies.

I do not think the effect of these transfats have been fully acknowledged and explored by the medical researchers.

 

[Defren]

The most elegant and simple explanation for the cause of obesity in our population is the epidemic of fast food, sugary drinks and a modern lifestyle. Again show me that is not the reason rather than "low fat" being the reason.

Like I say I think its a far more complex thing than just blaming "low fat".

...and of course none of the above excuses the low fat brigade trying to kill me as a diet only T2.

Of course sugary foods play a huge part, I don't think anyone would deny that. I will go back to what I said earlier. If we look at our parents and grandparents diets, most meals if not all meals were home cooked, made with fresh ingredients. Things like bread and dripping were a treat. I can clearly remember bread proving in a huge bowl beside the open fire. This was the norm, bought bread really quite rare. As a child, daily it was an evening meal of meat and vegetables followed by a desert of some sort usually made with fruit.

Carbohydrates and low fat were alien terms to people then, and in general the populace was of a healthy weight. Seeing an overweight person would make you stop and stare (very rude I agree) as it was something rarely seen. Children, myself included were never indoors. At the weekend and holidays I would have breakfast and be out playing, run in at lunch time, grab an apple or sandwich and be out again, then come home for a proper dinner, and be allowed to run that of until bath time. I might have a piece of fruit for supper. No carbs, and no low fat.

I am certain if you are honest, you will recognise a lot of what I have said, as it was the norm back then.

 

[xyzzy]

The table Stephen is referring to is this one.



Likewise I am highly suspicious that it shows calorie intakes declining since 1940. To me those figures make no sense at all. How can you have a decline in calorific intake yet an increase in obesity and T2?

Stephen on your original answer to me. I agree it is quite persuasive IF you can show pre 1960 carbs were starchy and not grains as you suggest. If you can't show that then your argument is less provable as you would have expected to see high obesity and T2 rates in the 40's and 50's when carb intakes were likewise higher.

I was going to say I could counter your argument by saying calorific intake must have increased over that time and could also account for the increase but now it appears that's not so black and white either!

 

[lucylocket61]

I'm sorry, but that table is rubbish!!!

No way would the average person be having 1750 cals. Particularly the men. They would be skeletons in no time.

And no way has there been a reduction in carbs. What about the huge rise in eating chocolate? And all the sugar added to everyday foods.

I stronly suspect this table of statistics is highly dubious.

 

[borofergie]

Here is the proper graph:

 

[borofergie]

Let's look at the macronutrient ratios of mammals:

All mammals (apart from humans):

• Carbs 0% to 16%
• Protein 15 to 25%
• SaFA and MUFA 56% to 77%
• PUFA 1% to 14%

Now UK humans

• Carbs 49%
• Protein 16%
• SaFA+MUFA+PUFA 35%

So, you eat three times more carbs than any other mammal
You eat a tiny quantity of fat, compared to any other mammal.
Then you wonder why you all get fat!

Keep on munching those healthy wholegrains kids!