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Tannith's views on reversing T2

Discussion in 'Type 2 Diabetes' started by Tannith, Apr 17, 2021.

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  1. lucylocket61

    lucylocket61 Type 2 · Expert

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    @Tannith :

    What is your most recent Hba1c?
    When was this test done?
    What is your current position regarding weight - are you overweight, underweight or at the correct weight for your height and build?

    Without this information I don't see how this thread can go forward.

    Simply repeating information given in posts directly to you is not going to be productive.
     
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  2. Tannith

    Tannith · Well-Known Member

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    I haven't put you on the ignore list or anyone else ever. However I have found that several times when I have answered specific questions from yourself and others I have been told that that counts as "derailing the thread"
     
  3. lucylocket61

    lucylocket61 Type 2 · Expert

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    I suggest you contact a mod to help you understand what constitutes derailing and how to avoid it. Please answer specific questions on this thread.
     
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  4. Ronancastled

    Ronancastled Type 2 · Well-Known Member

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    Well this thread is all yours @Tannith to deal with your progress/queries & answer/ask questions, it cant be derailed.

    The one thing about the OGTT is that it's very severe, it's impossible to replicate with real food due to the addition of fats/protein/sucrose. Also if your only in the first few months post remission it's far too early to expect your beta cells to have repaired sufficiently, as you probably know this can take up to 12 month. Forcing your damaged pancreas to produce enough insulin to cover 75g of pure glucose could hinder it's healing at this stage.

    If you are looking for a baseline for gauging improvement you may as well enjoy it.
    Pick a carby meal that you can repeat easily at a similar time, since the OGTT is normal done first thing in the morning after a fast I'd recommend a breakfast cereal, Cornflakes, Frosties, one you enjoy.
    They are all about 70-80% carbs anyway so a full bowl will be close to 75g of carbs.
    Here's a thread on one of my early attempts doing the same.
    https://www.diabetes.co.uk/forum/th...cose-tolerance-test-ogtt.173115/#post-2240693

    That 75g Rapilose is like a nuclear bomb going off next to your pancreas, give yourself a chance to heal.
     
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  5. VashtiB

    VashtiB Type 2 · Well-Known Member

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    Hi @Tannith ,

    I know I've said this on a number of your threads but I think it is important. I have lost a lot of weight- approx 30 kgs within the first 12 months of being diagnosed. the first 2 years (at most) of having diabetes.

    My weight is now lower than when I did not have diabetes yet I still have it. I keep my blood sugar levels controlled through low carb so I am either well controlled or in remission or whatever you would like to call it. I could still do with losing more weight but my blood sugar levels are fine with what I eat.

    In view of your view on weight loss as the key I thin it is important for you to provide the flooring information:
    1- Your current weight or BMI
    2- Your weight or BMI upon diagnosis
    3- your most recent HbA1C and when that was
    4- Your HbA1C on diagnosis
    5- what medication is any you are on.

    These are objective factors which would allow people to understand your views. In my view not providing this information may derail the thread as it is about weight loss reversing T2 vs other methods- eg low carb. I can say I stick to less than 20 grams of carbs a day.

    If, for example, the only way to get to 'remission/reversal' whatever is to be underweight I would not be interested at all. If it could be achieved with the BMI in say 'overweight' I might be. I am never ever going to achieve underweight I may be able to achieve overweight (rather than obese for example). So if your proposed solution means I need to be underweight I will pass straight away as I cannot achieve that.

    Very low calorie diets and low calorie in general is what got me here. I have no interest in returning to low calorie unless there is something to gain.
     
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  6. Tannith

    Tannith · Well-Known Member

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    Questions

    Several of you seem to know my HBC already. So why do you keep on asking?

    “Was your Hba1c 39 and when was this taken? I seem to remember that as your figure.” Lucy

    Several of you obviously also know that I can’t get another one during covid, as you have said that your own areas do them so I should ask about tests my area. Or suggested I can get as many as I like privately (Brunneria). Have you seen the price of them?

    “HBA1C I can't know until the pandemic is over. Not that it would help at the moment while the OGT is nowhere near yet, and all 3 have to be right to reverse T2 to normoglycaemic” “………..not up to 3 months in the past, like the HBA1C. Current results are what I need at the moment, as once they are in about the middle of the normoglycaemic range (in all 3 tests) I shall feel safe enough to stop my weight loss diet. I have no problem with doing the HBA1C later as it is a useful long term measure of average BG, but it’s not urgent for me. Which is just as well as I can’t get one during Covid anyway.”

    Which charts show 39 as prediabetic? As far as I can find that is the first point for the USA but cannot find any others.” HSSS

    When @Jim Lahey pointed out that my HBA1C was poor ( I never said these were his exact words)I looked up the scales online There are an awful lot of them. You can google them yourself as I have not kept them all. This triggered me to restart the diet, and also to look into the OGT test which is IMO the most efficient one for measuring beta cell function and hence potential reversal of T2

    Out of interest since you have seen improvement, how many carbs a day are you eating on your restricted calorie diet? How many were you eating for the last few years prior to recent improvements? HSSS

    No idea, but Lucy asked at the time I posted about the diet that I was eating that I was eating an awful lot of carbs. (again, not her exact words). Most of my life I have eaten about 55% of my calories from carbs. That’s my normal.

    You specifically separate reversal and remission. You partially define remission as lower hb1ac. Could you clarify what, to you, the two terms mean please? Most definitions use the terms interchangeably to mean non diabetic blood glucose levels/hb1ac, usually on no medication sustained for a period of time. You seem to use them otherwise. HSSS

    I very emphatically differentiate between the two. I use “remission” as you describe ie to describe just blood glucose levels lowered to non diabetic. I use “reversal” to describe the complete (albeit possibly temporary) reversal of diabetes not just the symptom of blood glucose levels. To me it means that the previously sick beta cells have been restored to normal pre diabetic function, and that they can, by themselves, deal with the same levels of carbs as those of a never diabetic, ie without any help from glucose lowering therapies like low carb, or from drugs.

    I think this distinction between the 2 definitions of remission is the crux of this thread. Also that asking/answering personal questions about my BMI (which have in any case been answered several times on previous threads) will simply derail the thread and turn it into a discussion of various people’s views on what a weight loss diet should consist of. What Prof Taylor has said, and I have quoted many times, is that any weight loss diet you choose will do. The only important thing is that you lose the weight. He has also said it is the Personal Fat Threshhold, not BMI that matters.

    PS Vasthti B I am not on any medication (for T2) nor have I ever been.
     
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  7. Jaylee

    Jaylee Type 1 · Moderator
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    Hi @Tannith ,

    Did you know you can put your relevant stats & wot not in the signature section on your member profile.. :)

    Hope this helps.
     
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  8. Oldvatr

    Oldvatr Type 2 · Expert

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    Ah! The Personal Fat Threshold. No wonder this thread is going round in circles. The PFT is a concept that Taylor invented as a possible mechanism to explain his results. It is only a hypothesis and is unproven. He seems to be the only one pushing it, and no one else has stood up to agree with him as far as I can see in many pages of Google searching.. It is Fairy Dust. You believe it or you don't. You can not measure it, and you have no idea if the bacon butty you just ate has pushed you over it or not. It is invisible, and therefore a useless target to aim for. Probably impossible to prove.

    Hia ND diet did find a form of correlation between overall weight loss as having some relationship to diabetes recovery, thats true, but was it the loss itself, or the final weight value attained, or the sudden shock to the system bought about through starvation, or simply the speed of the loss.

    There is no way of measuring PFT, nor of knowing whether your bacon butty has just caused you to exceed it, so it is a pretty useless marker to aim at since we are otherwise ignorant of where or what it is. I suspect Taylor is equally ignorant since he has not managed to define it any better
    https://eprint.ncl.ac.uk/211388

    There are many parameters that he did not measure that may be important, but it is not actually the bodyweight or BMI that matters. If you look at the science he used to prove his diet, he used MRI scans to measure fatty liver and fat in the pancreas, and it is the reduction of this specific fat that is the key to getting the beta cells working again. Any diet that reduces this fat will lead to an equivalent result. It is not a weight loss diet that is needed. otherwise, you could use WW or Cambridge, or a multitude of other commercial diet plans instead. But we do not get many success stories from those diet users. So I think it is the shock tactic that ND or Keto introduces that has the magic touch.
     
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  9. lucylocket61

    lucylocket61 Type 2 · Expert

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    Ok. A whole series of non-answers and/or evasions on simple basic information.

    I'm done.
     
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  10. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    I believe your premise is driving a narrowed view. Weight loss for me is the first area that needs examination. Weight loss should be a by product of the actions rather than a direct act. This is proven by the biggest loser results and the impacts of caloric restriction, bounce-back in general (unless exercise and a reduction of the original food intake (Professor Taylor)).

    Weight loss doesn't just target fat, it takes connective tissue, strength and muscle mass. Weight loss requires a form of eating that our recent and distant ancestors did not have to do, or even think about generally. Fat loss is what is desirable whilst maintaining as much lean mass as possible. Low carb has been demonstrated to be muscle sparing especially when ketones are in use.

    I cannot speak for drugs, but a well formulated low carb / ketogenic diet has been scientifically shown to improve 22 out of 26 cardiovascular measures (Virta Health: https://www.virtahealth.com/blog/psqi-trial-1-yr). Usually significant fat loss is achieved, many state cognitive benefits, some get insulin resistance improvements (I have maintained carrots and butternut squash, with an HOMA-IR below 1). There are positive results for PCOS, as a adjunct to cancer treatments, gut issues, migraines, etc - whilst many of these additional areas need studies to be accepted, people are not waiting for rubber stamps. So low carb does alot more than just reductions in HbA1c.

    I would suggest as a Type 2 it is important to regulate insulin production and use first, minimise post-prandial rises, whilst satisfying satiety. The "weight loss" methods can "work", but they extract a price. The low carb price is to miss the convenience products generally - this is another story. I don't know what else you are prepared to try. I took the decision to do everything, by everything I mean fasting, keto / carnivore, exercise and lifestyle.
     
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  11. Jaylee

    Jaylee Type 1 · Moderator
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    Hi Olvatr,

    Hope your well?

    The above puzzles me.. Are we talking about visceral fat "muffling" healthy insulin production, coupled with insulin resistance. Or is it a case of beta cells dying? Surely if they are deminshing, we are talking about moving towards... My "territory.?" :)
    Which can't really be reversed under any circumstances. Though it would help prolong by easing off the carbs.

    If I was to draw an analogy of a guitar cab placed in a soundproof recording booth & cranked up. It's still technically making a noise..
     
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  12. HSSS

    HSSS Type 2 · Expert

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    Thank you for the replies. Sorry this is long but a few questions have built up.

    I have searched. Extensively. And simply cannot find them. USA put 39 as the closest to normal figure, just into prediabetic by 1mmol. Absolutely none have it as diabetic as far as I can find. This is why I’d like to see these scales you mention. If it’s so easy to find why can’t I? Would you be willing to help me? Ever considered Jim was wrong if this is what he actually said?

    ok mathematically you are eating 1000 cals a day. 50% carbs so 500 cals carbs. A carb is 4 cals so 125 carbs a day. Technically low carb. And it might be less, maybe more we don’t know if you don’t count. Maybe you are low carb?? Maybe previously you were eating twice that many Maybe that’s helping? Maybe your normal level of carbs is why you ended up type 2 and returning to it will return you to diagnostic levels. Maybe you never could deal with that amount for a lifetime without consequence.

    As you agree, it’s not the method that matters according to prof Taylor. Just the loss. In which case why are you so against low carb which does in fact achieve that same 15kg weight loss goals for many? I’m personally at a loss why an arbitrary 15kg? Surely that depends on the body, the metabolism, the actual personal fat threshold of the individual and how much excess there is to start with ?

    And what is the explanation for those that do meet the criteria ie recently diagnosed and lose the weight but still don’t reach the goal? I am not the only one here in that category. My belief is that type 2 is a cluster of similar conditions with varying factors influencing the onset and continuation of the disease. One type responds well to the fat threshold hypothesis. Others do not and for them this was never the cause of their type 2 so not the solution either.


    sorry still confused. you identify a key factor - Beta cell function - that allows “normal”, non diabetic carb consumption. Presumably measure by blood glucose levels and response? How do you know the bgl you’ve improved are because of your beta cell function as opposed to improved insulin resistance? There’s no way to know directly about your beta cells is there?. Wouldn’t insulin levels drop if beta cell malfunction was the problem when in fact most of us have high insulin levels? We can however measure insulin and resistance.

    I never meant remission was limited to blood glucose levels. Just that that was a measure of it. Many report a lack of insulin resistance too and more normal insulin levels if they are able to test them. Some that choose to eat more carbs report that at least temporarily they cope with them better. Most prefer not to, as they like low carb eating or have no wish to tempt a repeat of a diabetic status. I accepted it appears rely on ongoing dietary measures even if a little more relaxed. I believe this is because it is not a cure. I believe the person is still (potentially) diabetic, just without symptoms or complications as a result of the measures taken. Whatever genetic circumstances that allowed “normal” non diabetic eating to become diabetic are highly likely still present and would cause it again should the “normal” non diabetic eating be reverted to. A personal carb threshold maybe? Or short lived beta cells?

    Your definition of reversal sounds either like “cure” to me if it’s permanent (woo hoo but I’ve not seen any evidence it is) or the fact that if it’s temporary (as the studies suggest for most it is and are ongoing to see what happens to the rest) means that that it’s much the same as my remission. A management tool that needs to be maintained.

    I also still am stuck on what “normal” carb consumption is. Over time and location this can be vastly different and is cultural not biological. 60yrs ago carbs were a much small % of diet and t2 diabetes much much less common. Correlation perhaps, perhaps not. Countries with the highest level of carbs, processed foods and processed seed oils as fats (lethal combination imo) also have the highest levels of type 2. Countries eating more unprocessed foods and natural animal fats and fewer refined carbs have less T2.


    If there are flaws in my understanding that can be demonstrated with science I’d very much like to be made aware of it. However there are so many unanswered issues that the personal fat threshold hypothesis doesn’t answer I’m not sure that is the entire answer either.
     
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  13. ziggy_w

    ziggy_w Type 2 · Well-Known Member

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    Hi all,

    @Oldvatr -- I agree with you -- the ideas of the PFT (pesonal fat threshold) seems to be a tautology (a circular argument) in my mind -- i.e. you will be no longer diabetic when you reach your your personal fat threshold, and the personal threshold is the weight, at which you are no longer diabetic. So you need to continue to lose weight. This is also very much, what @Tannith seems to be arguing.

    @Tannith -- You state that 4 years is the time limit, at which beta cell recovery is possible. However, if I remember correctly -- mean time after diagnosis at which reversal occured in Roy Taylor's study was somewhere around 6 or 8 years (though I may remember incorrectly, I am just too tired to look this up). So, in other words, of those who reversed T2 due to weight loss, half were diagnosed for less than 6 or 8 years and half were diagnosed for longer than this. So, possibly a timeline of only four years for beta cell recovery might be a bit pessimistic (even if I remember incorrectly and in fact four years is the correct number, half of the subjects who reversed were diagnosed more than four years ago). So chances are still very good -- even if you have been T2 longer than this.

    @HSSS -- In Germany, the level at which prediabetes is diagnosed is also 39mmol. We seem to have just simply adopted the U.S. standards for diagnosis.
     
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    #33 ziggy_w, Apr 19, 2021 at 1:03 AM
    Last edited: Apr 19, 2021
  14. Goonergal

    Goonergal Type 2 · Moderator
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    Post #10 above refers.
     
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  15. zand

    zand Type 2 · Expert

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  16. zand

    zand Type 2 · Expert

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    Yes, me too. Following low cal diets made me get ever fatter long term. I warned @Tannith of this back in 2017(?) when she first started trying to cure her T2 by the very method that caused mine. To be fair though, I wouldn't have listened to the warning either. Sometimes we can only find out these things for ourselves by learning the hard way.
     
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  17. zand

    zand Type 2 · Expert

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  18. bulkbiker

    bulkbiker Type 2 · Oracle

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    Especially as in the initial Counterpoint trial they tested for ketones...
    In this particular case the subjects were likely in ketosis due to starvation but the production of ketones is the same.
     
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  19. HSSS

    HSSS Type 2 · Expert

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    Jim’s comment that alarmed you was “That equates to an average glucose level of 6.5mmol/L. Borderline pre-diabetic and certainly indicates some insulin resistance. No judgement from me, but personally I'd not really call that reversal/remission without more data. A fasting insulin test would fill in the blanks. I would expect it to be elevated with a HbA1c of 39. If not then insulin production likely impaired.” (Thanks @Goonergal for that link)

    This was an average comparison/conversion mentioned. Diagnosis is made on fasting bgl (https://www.diabetes.co.uk/fasting-plasma-glucose-test.html) or hb1ac (https://www.diabetes.co.uk/Diabetes-diagnosis.html) or OGTT (https://www.diabetes.co.uk/oral-glucose-tolerance-test.html). An average bgl is either restating of hb1ac if it’s a conversion like this is or heavily dependant on how many tests are taken and when if measured directly (back to different tests showing different things with different meanings) and not diagnostic.

    So far it’s been identified the USA and Germany class hb1ac of 39 as the very first measure of prediabetes. Most of the rest of the world and WHO use 42. There still no link to any charts showing any of your measures at the start of this low calorie effort qualified as diabetic.

    Your in post #119 https://www.diabetes.co.uk/forum/th...the-secret-to-treating-diabetes.178134/page-6 mistakenly compares hb1ac (and the equivalent conversion to average bgl) to fasting blood glucose and then you use the charts for fbg diagnosis. This is a false comparison and cannot be made. Neither hb1ac nor average bgl can be converted to fbg and Jim pointed that out at the time more than once (as did I) and that he was not considering your levels poor, just you were. Also his comments are qualified in several places about needing more data which you still don’t have, particularly about insulin production levels. High insulin and resistance V dead beta cells not producing insulin V suppressed beta cells with low production. All 3 massively different issues needing different approaches.

    You stated back then you were aiming for fbg of the very bottom of normal, and that unlike the Newcastle experiments which were defined by time you planned to keep going until your weight loss caused the fbg (and now OGTT too) to become normal. Many faults in your logic and assumptions not based in science were put to you in the above linked thread - that this one seems to be rehashing. Including the reality you are trying to control your diabetes with weight which will need to be maintained. Exactly the same as a carb level needs maintenance. I fail to see how one is masking a potential problem/only putting the problem in remission and the other isn’t.

    I pray for you that weight/personal fat threshold or call it whatever else you like is indeed the ONLY issue causing your diabetes seeing as you are hell bent on your narrow view of the issues. If your beta cells are faulty for any other reason, if you have a lack of insulin for any other reason (age or LADA just being two possibilities) or any other cause such as insulin resistance unrelated to visceral fat then you could diet away into oblivion without resolving the diabetes and cause a whole raft of other issues along the way.
     
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  20. Tannith

    Tannith · Well-Known Member

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    I never claimed these were his exact words, but he said that 39 was not good enough. So obviously I immediately looked it up on google to check before taking action and returning to my diet. one example is:
    What are normal hemoglobin A1c levels, and are low or high levels dangerous?
    · Readers Comments 57

    · Share Your Story

    • In most labs, the normal range for hemoglobin A1c is 4% to 5.9%.
    • In well-controlled diabetic patients, hemoglobin A1c levels are less than 7.0%.
    • In poorly controlled diabetes, its level is 8.0% or above.

    https://www.medicinenet.com/hemoglobin_a1c_test/article.htm
    This is a typical one. Though it is the ONLY one giving a top of normal figure as high as 5.9 Almost all give 5.6 as the highest normal, so I go by the majority. All that give a lowest figure give 4 as bottom of normal. There is a page somewhere with literally dozens of coloured charts showing the range of HBA1C normal as going from 4 (lowest normal) to 5.6 (highest normal), but they are a struggle to copy & paste & I keep getting adverts. My practice is to work out the middle point of the normal ranges of the charts for all the tests and aim for those. At about the same time I found a way to do OGT at home Nd find the normal range. My OGT result was quite dreadful at that time - well up into the diabetic scale. I think aiming for the middle point of normal on the 3 scales that are available to me is a good way to decide when my diet could stop. By definition I should have reached the elusive Personal fat threshold by then. I am doing a really lenient diet, well within the usual advice on the net (ie "don't reduce calories by more than 500 below your daily calorie requirement.") So middle of normal would be 4.8. Equivalent in the other scale of 29 mmol /mol. https://www.diabetes.co.uk/hba1c-units-converter.html I imagine that 29 mmol/mol would be what all of us would be aiming for, except perhaps for some very keen people who would be aiming for the bottom of the normal scale ie 4%(20.2 mmol/l), but Im not that desperate myself!
    I realise you asked other things but it was a long post. I am too busy now.
     
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