Surgery versus medical and lifestyle treatment for type2.

[ickihun]

This seems hot news.

http://www.bariatricnews.net/?q=news/112760/armms-t2d-researchers-assess-long-term-outcomes-surgery

 

[DavidGrahamJones]

I suppose it's a good idea that somebody is looking at the long term outcomes of bariatric surgery for type IIs as far as their diabetes is concerned. I'm assuming that it's not a lot of good for type IIs who are not also overweight. I think I read somewhere that Bypass Surgery was better than the gastric band. Google digs up costs of Gastric Bands as being between £5k and £8k, Gastric Balloon between £2k and £5k and Gastric Bypass between £9.5K and £15K. Return to work after just 7 days.

I think Professor Roy Taylor's research at Newcastle University is also interesting, further info available at http://www.ncl.ac.uk/magres/research/diabetes/reversal/#overview. Looking at the cost and possible dangers (although slight) of Bariatric surgery maybe the Newcastle diet is a simpler method of achieving the same result. I believe that is what Professor Taylor was setting out to do anyway. If sticking to such a draconian regime is not possible, how about "hospitalizing" patients for the 2 months required for the Newcastle Diet. Not much good if you're working but cost wise comparable.

What I like about the draconian 600 - 800 calories a day is the ability to eat a meal rather than something the size of an egg.

 

[ickihun]

The only thing new about this particular study is that they are no longer requiring young age restrictions and a BMI over 35 to limit the people being chosen to go on this particular protocol.

Some of the previous protocols includiing kinds of bariatric surgery , especially some of the less invasive kinds of gastric band surgeries

I haven't looked lately at the NIH protocols lately to see whether this particular study also has women of childbearing age restrictions or not.

Nhs Sunderland allows child bearing age women to qualify. However they have to agree not to get pregnant for over 2yrs after surgery.
I'm ok I've been sterilized. Had to be due to last horrendeous weight bearing pregnancy.
I think they are offered a less restrictive operation.

 

[ickihun]

I suppose it's a good idea that somebody is looking at the long term outcomes of bariatric surgery for type IIs as far as their diabetes is concerned. I'm assuming that it's not a lot of good for type IIs who are not also overweight. I think I read somewhere that Bypass Surgery was better than the gastric band. Google digs up costs of Gastric Bands as being between £5k and £8k, Gastric Balloon between £2k and £5k and Gastric Bypass between £9.5K and £15K. Return to work after just 7 days.

I think Professor Roy Taylor's research at Newcastle University is also interesting, further info available at http://www.ncl.ac.uk/magres/research/diabetes/reversal/#overview. Looking at the cost and possible dangers (although slight) of Bariatric surgery maybe the Newcastle diet is a simpler method of achieving the same result. I believe that is what Professor Taylor was setting out to do anyway. If sticking to such a draconian regime is not possible, how about "hospitalizing" patients for the 2 months required for the Newcastle Diet. Not much good if you're working but cost wise comparable.

What I like about the draconian 600 - 800 calories a day is the ability to eat a meal rather than something the size of an egg.

I prefer op to Newcastle diet for the full reason of medical intervention. I changed to lchf diet and I was ill. Ended up on more medication. Betablockers were added for my racing heart beat then hospitalised as it started running off even more, so it was increased. Increased when I reduced my protein. And had to add another med for water retention, which I didn't have pre-lchf.
I've been told I will be monitored so I can reduce my meds.
I'd like reduced to very little meds and less insulin to none. If possible with weight loss which is supported to stay off permanently to help me live a much longer life.
I will do whatever to get that outcome and more!

I'm not fully sure how my body will react but I've got 2 specialists and a supportive team.

 

[DavidGrahamJones]

I will do whatever to get that outcome and more!

I don't blame you either. We are all so very different and our circumstances so individual that what's good for me isn't going to be good for everybody, not by a long shot. I have eaten substantially less than my BMR for a long time so surgery isn't going to help me that much. Having said that I know that it would have an immediate effect on my medication requirements.

A friend had a gastric bypass a few years ago and has done exceptionally well, stopped all meds and is a lot lighter. I also have a friend who had a band fitted and it was only partially effective due the the flexible nature of the band (it stretches, at least the one she had did).

The Newcastle approach is exceptionally draconian and I know how difficult it is in my attempts to emulate the research done at Newcastle, especially as there are others in the family to be considered and insist on having things like cheese in the fridge (I love cheese). It has certainly straightened out my BG which had gone bonkers after 3 years successful low carb low fat, and I lost all of 5 kgs in 6 weeks. Unfortunately like all drastic regime changes it seems as though the body gets used to it and then all weight loss stops.

It sounds like you're ready to go with the surgery and I'm you will have a successful outcome. All the very best.

 

[ickihun]

About 31yrs ago I had diabetes symptoms for 8 or so yrs (thrush, thirst and night wees) and had recovered from burst appendix open operation. I discovered weilder products which bodybuilders used. Argos was selling 3 containers of firmaloss for £9.99. I used them with semi-skimmed milk.
I replaced 2 meals additional with protein and veg for main meal. No carb with meal (previously having chips, potato and lots of margerined white bread from prestos.
I then became addicted to the weight loss so I stopped solid food. 2 or 3 milkshakes per day. (200cals per milkshake).
I lost 7stones. I went from size uk 24 at the age of 15yr old to size uk 14-16. Some would argue still overweight for a 15yr old!!!
Once I stopped milkshakes the weight started adding again. I had no parental guidance nor medical supervision.

I regained the full starting size this year. (30yrs later)

 

[ringi]

The Newcastle Diet can be undone by what someone eats when they come off it. I expect that intermittent fasting and low carb would work better in "real life", if the long term results are looked at. Even if they don't get a complete result, I expect a year of them before the Newcastle Diet would reduce the number of people who undo the Newcastle Diet.

 

[ickihun]

Do many stick to the newcastle diet long term? I thought it was for a set of weeks only.
I guess like IF . Done in sessions?

I'd like a stable new lifestyle I can rely on and continue with for life.
Not on and off when I'm well enough to stick to it.
A life change.

I'd confuse people around me and I'd constantly have to explain myself. Morally disruptive for people who aren't newcastle diet savvy. And my progress!

 

[ringi]

Do many stick to the newcastle diet long term? I thought it was for a set of weeks only.

The Newcastle diet is for a set number of weeks, but once it is finished people still need to avoid often eating lots of carbs. Its like getting a broken leg fixed, even when it is healed you can't jump of roofs.

 

[DavidGrahamJones]

but once it is finished people still need to avoid often eating lots of carbs.

Like any diet, the whole idea is that a change of habits is required, assuming overeating was the cause of overweight in the first place. The Harris Benedict formula or similar is used to calculate how much we should eat (in calories, not nutrition) and if I was ever to have eaten what I'm supposed to I'd be dead by now.

 

[ickihun]

The Newcastle diet is for a set number of weeks, but once it is finished people still need to avoid often eating lots of carbs. Its like getting a broken leg fixed, even when it is healed you can't jump of roofs.

So is bariatric surgery. Your chance to start again from scratch in full surgery. A chance to reset the body and metabolism. If you understand it. Many have been given basic instructions with their surgery.
I hope I'm not wrong but I feel my knowledge now will give me a whole new awareness of IR. My only disability is bulging discs and scatica needs resolution so I can exercise afterwards too.
I am going to press for mri or will go private for it. I need exercise too to help with body deformity which isn't corrected even with skin reduction in yrs later. Exercise helps with IR and muscle toning. The skin cannot shrink back much. Not as quick as weight loss. I might have a better chance than others as I lose weight slowly due to hormones interferring too. It will make a huge difference if metformin has to be stopped pre-op and stopped for too long. Tablets are huge for bariatric patients small stomach. Not sure if a liquid form?
It's a very fortunate chance to get me back to the best my body can be to carry along into old age.
Without exercise IR can threaten longevity. Getting and keeping IR sufferers active can make the difference to whether IR can be suppressed or not.
I'm currently unable to exercise but I walk in pain as much as I can. More for my heart and circulation/cholesterol health.
I'm content I'm doing the most my body can do the best with. This will continue til I'm no longer able to control my own mind. I dread if I'd need an old person's home. I wouldnt last long with their diabetes care regime!

 

[ringi]

Like any diet, the whole idea is that a change of habits is required, assuming overeating was the cause of overweight in the first place. The Harris Benedict formula or similar is used to calculate how much we should eat (in calories, not nutrition) and if I was ever to have eaten what I'm supposed to I'd be dead by now.

I think part of the problem is that Newcastle diet, not being "real food" does not provide "training wheels" for the test of someone's life.

 

[DavidGrahamJones]

Its like getting a broken leg fixed, even when it is healed you can't jump of roofs.

Am I allowed to disagree? I'm not sure why anyone would want to jump off a roof, even though I've seen videos. LOL

I learned this from a kids program about what happens when you break a bone. I double checked just now to make sure my dim brain isn't just playing tricks. If you break a bone a second time after the first break has mended properly, the break is neither likely or unlikely to happen in the same place. The mended bone is good to go 100%, just don't jump off the roof. LOL

As far as the Newcastle Diet is concerned, of course you're right, one wouldn't go back to eating the eatwell plate for example. The importance of the very low calories in the Newcastle Diet is the effect it has on the pancreas and on insulin resistance. I've been attempting the Newcastle regime because after 4 years low carb low fat, my body was converting protein into glucose and my BG was all over the place. Luckily I'm able to discuss my health with my doctor in a sensible non confrontational way (she's the medic after all) and she didn't insist on medication straight away but allowed me to try a few things. Cutting out the dairy reduced total cholesterol so one good move. I mentioned Newcastle to her and she agreed that I should try. I managed 6 weeks when I started to re-introduce protein, chicken and lamb and I'm pleased to say that my BG is much more controlled. I'm still not eating meat more than 3 times a week, otherwise it's mainly veg with some egg and cheese, but not much.

I need to do the Newcastle again to get the weight shifted, I managed about 5 kgs in 6 weeks which if my dieting days with Tesco Diets is anything to go by, isn't bad at all.

 

[DavidGrahamJones]

I think part of the problem is that Newcastle diet, not being "real food" does not provide "training wheels" for the test of someone's life.

"real food", now that's very interesting. In my book that excludes anything that's been processed in any way form or manner. So technically even tinned tomatoes are out, but they're very good in so many recipes.

The whole point of the Newcastle diet is that it's temporary and if you can manage severe calorie restriction for ten weeks, then hopefully that discipline will help. Your mindset must change just to do the Newcastle. No guarantee of course.

I've modified the Newcastle Diet because I found that the shakes I was using were actually making my BG spike, it was better for me to go without food all together. Now that my BG is on the straight and narrow again, I might try the shakes again.

I've been dieting for the best part of 10 years (10 years because that's when I gave up alcohol) and I've got food diaries coming out of my ears to show that it isn't the amount of food that I eat that's the problem. I was always told that you should only reduce your BMR by 500 calories to lose about a pound a week. That didn't work, nor did all the exercise, or 1000 calories less than BMR or 1500 calories less than BMR.

I think what I'm trying to say is that we are all so very different, I don't personally like the idea of "meal replacements" but can see the necessity when really cutting right back on the calories.

 

[ringi]

As far as the Newcastle Diet is concerned, of course you're right, one wouldn't go back to eating the eatwell plate for example. The importance of the very low calories in the Newcastle Diet is the effect it has on the pancreas and on insulin resistance. I've been attempting the Newcastle regime because after 4 years low carb low fat

I think doing low carb first for a good time may be of great benefit for anyone that does the Newcastle Diet, as there is a lifestyle already setup for when the diet ends.

 

[DavidGrahamJones]

I think doing low carb first for a good time may be of great benefit for anyone that does the Newcastle Diet, as there is a lifestyle already setup for when the diet ends.

Absolutely right. Interestingly although my years with Tesco Diets were not very fruitful weight wise, I had learned a lot of good habits, self control being one of them. Of course there are little tricks like not filling your fridge with stuff you shouldn't eat, always tricky with a family, but maybe they shouldn't eat those things either. The great thing was that when I was taken off Rosiglitazone (I gained 8stone when first prescribed), the pounds and stones fell off until I was put on Gliclazide, then it was nothing again.

Obviously I've had my own input to be overweight, but there was a time when an eighteen stone left prop was a bit useful . . . . . so long as you were playing rugby. No good when you get older and have a mortgage to pay. Medication has been the bane of my life and why I'm trying to avoid anything involving drugs.

 

[ringi]

@DavidGrahamJones If you are still on Gliclazide see if your doctor will put you on Forxiga instead as Gliclazide has the side effect of weight gain unlike Forxiga.

 

[ickihun]

I cannot take forxiga either. Like victoza the side affects were horrific.
I hope my consultant doesn't try asking me to retry forxiga, well canagliflozin.
I'll lose my mind if I get horrific thrush again. I'm scarred mentally by thrush symptoms. How I coped at 6yr old with it untreated properly, amazes even myself!

 

[ringi]

I know very little about thrush, but would it be possible to start the antifungal treatment before getting it?

 

[JohnEGreen]

I think that would be like taking antibiotics as a prophylactic which is sometimes done with some success.