Today programme, radio 4, covers diabetes...

And also on the website at http://www.bbc.co.uk/news/health-33932930

I emailed a response to the article as follows:

What's most shocking in my view as a Type 2 diabetic is the frequent lack of understanding of the condition by HCPs, especially when so much money is being spent on drugs and treatment of complications. Promotion of the Eatwell plate and eating carbohydrates is simply bonkers for a diabetic. You want to reduce money spent on T2 in the NHS? Get patients to eat a low-carb diet that doesn't impact blood sugar levels so much - we don't need carbs, the liver will produce enough glucose to feed the brain. I've got my HbA1c back to non-diabetic levels on low-carb diet and exercise alone, lost 20 kg in weight and I have no intention in burdening the NHS with drug and complication treatment costs thank you.

Low-carb is also good for T1 diabetics, reducing the amount of insulin they need.

Obesity doesn't cause T2 by the way - it's a metabolic condition, there are many obese people who will never get diabetes and plenty of thin, fit people who do. It's often the condition that causes the obesity not the other way round.

But watch out, the drugs companies hate people like me who treat themselves because they like the condition to be progressive - they can sell more metformin, gliclazide, insulin and the rest and then all the drugs to treat the complications. It doesn't have to be that way.

So NICE - drop the Eatwell plate, get the drugs companies off your back and train HCPs and patients alike on low carbohydrate diets.

My invoice is in the post ...

sanguine said:

And also on the website at http://www.bbc.co.uk/news/health-33932930

I emailed a response to the article as follows:

What's most shocking in my view as a Type 2 diabetic is the frequent lack of understanding of the condition by HCPs, especially when so much money is being spent on drugs and treatment of complications. Promotion of the Eatwell plate and eating carbohydrates is simply bonkers for a diabetic. You want to reduce money spent on T2 in the NHS? Get patients to eat a low-carb diet that doesn't impact blood sugar levels so much - we don't need carbs, the liver will produce enough glucose to feed the brain. I've got my HbA1c back to non-diabetic levels on low-carb diet and exercise alone, lost 20 kg in weight and I have no intention in burdening the NHS with drug and complication treatment costs thank you.

Low-carb is also good for T1 diabetics, reducing the amount of insulin they need.

Obesity doesn't cause T2 by the way - it's a metabolic condition, there are many obese people who will never get diabetes and plenty of thin, fit people who do. It's often the condition that causes the obesity not the other way round.

But watch out, the drugs companies hate people like me who treat themselves because they like the condition to be progressive - they can sell more metformin, gliclazide, insulin and the rest and then all the drugs to treat the complications. It doesn't have to be that way.

So NICE - drop the Eatwell plate, get the drugs companies off your back and train HCPs and patients alike on low carbohydrate diets.

My invoice is in the post ...

Click to expand...

The Newcastle Diet appears to show that once the patient reduces weight, the diabetes goes into remission.

So I think as even you have admitted losing 20kg, and seen an improvement in your diabetic condition, it would seem unlikely that there is no link between visceral fat and type 2.
However, obesity caused other problems, so it is probably wise to address that at this moment as well.

I know I would rather not become obese again, after losing the weight after diagnosis, for the many other benefits being fitter has provided.

SunnyExpat said:

The Newcastle Diet appears to show that once the patient reduces weight, the diabetes goes into remission.

So I think as even you have admitted losing 20kg, and seen an improvement in your diabetic condition, it would seem unlikely that there is no link between visceral fat and type 2.
However, obesity caused other problems, so it is probably wise to address that at this moment as well.

I know I would rather not become obese again, after losing the weight after diagnosis, for the many other benefits being fitter has provided.

Click to expand...

I don`t think I have seen anyone on these pages suggest that there is no link between visceral fat and t2. It is frequently pointed out however, that obesity is often a result of t2 rather than a cause. The disease is way too complex for a" one size fits all" solution, very often the very meds used to treat the condition actually cause weight gain.

chri5 said:

I don`t think I have seen anyone on these pages suggest that there is no link between visceral fat and t2. It is frequently pointed out however, that obesity is often a result of t2 rather than a cause. The disease is way too complex for a" one size fits all" solution, very often the very meds used to treat the condition actually cause weight gain.

Click to expand...

Metformin causes weight gain?
If not which ones?

SunnyExpat said:

Metformin causes weight gain?
If not which ones?

Click to expand...

Gliclazide in my experience, never mentioned metformin.

SunnyExpat said:

So I think as even you have admitted losing 20kg, and seen an improvement in your diabetic condition, it would seem unlikely that there is no link between visceral fat and type 2.
However, obesity caused other problems, so it is probably wise to address that at this moment as well.

I know I would rather not become obese again, after losing the weight after diagnosis, for the many other benefits being fitter has provided.

Click to expand...

What I said was that obesity per se doesn't cause T2. If your insulin resistance is increasing then continuing to eat a high carb diet will raise triglycerides and the elevated insulin facilitates the laying down of visceral fat. Most of us here are trying to get the media to stop talking rubbish such as obesity causes T2.

I have filled in the proforma on the website along similar lines to @sanguine 's email. We can only try.

.

No sign of any comments being published beneath the article yet.

and they seem to have removed the comment box, unless that's because I've used it.

.

I thought best to respond direct to DUK careline - 0345 123 2399

Explained that 8 years on their starchy carb diet resulted in crippling peripheral neuropathy, extreme tiredness, reduced kidney function, early stage retinopathy ...;

3 months of low carb, increased fat & veg cleared my muscle pain & restored my mobility, & now after 7 years of LCHF my health & mobility are excellent (at 76);

I have been on Trudi Deakin's X-PERT course a few years ago & was advised by the dietitian running it to write to X-PERT about my results & concerns with the course;
That Dr Deakin has subsequently produced a book "Eat Fat - a guide to low carb living;"
that I have emailed "Balance" regarding interviewing Dr Deakin, &the editor replied that he would consider an interview - NOT forthcoming - just the same old advice on unknown long term dangers;

that Dr Unwin has published papers in the BMJ about the benefits of LCHF;

that my requests to D UK for references to the dangers of LCHF have never had a response;
that 3 D uk folk came to a Hounslow diabetes support group meeting listened to my promotion of Dr Deakin's book, took my reference & promised that a dietitian would contact me ....

that as a subject of the long running heart/diabetes study SABRE, thorough tests & scans last September showed NO health concerns;

She promised to report, & someone would contact me - she checked she up-to-date contact details.

Sorry to anyone who couldn't get through while I was on the phone ....

I have given up listening to this type of programme.

Say for one minute, Diabetes UK et al agree to low carb diet, basically eliminating all grain to effectively control Type 2 Diabetes, you are opening avenues as to cause and effect... what knock on effect would that have? Grain would be demonized, agriculture is big business, now we enter damage control, contingency plans and Government intervention - I'm a very cynical person!
A good case study on manufacturing behaviour can be seen in Dispatches documentary on salt, guess who has control? http://www.channel4.com/info/press/...hes-investigates-salt-are-you-eating-too-much

If you want your voices to be heard, perhaps, as a collective you contact a reputable journalist and investigator to put a documentary together to present some facts - hba1c's are evidence that can't be fluffed over.

sanguine said:

What I said was that obesity per se doesn't cause T2. If your insulin resistance is increasing then continuing to eat a high carb diet will raise triglycerides and the elevated insulin facilitates the laying down of visceral fat. Most of us here are trying to get the media to stop talking rubbish such as obesity causes T2.

Click to expand...

Chicken and egg. Did my being overweight cause insulin resistance or did my insulin resistance cause me to be overweight?
In my experience I gained shed loads of weight after being prescribed Rosiglitazone, greatly helped by the Citilapram prescribed for the anxiety of gaining weight. I lost some of the shed when taken off it because of liver function problems. I gained when put on Gliclazide and lost when I went onto low carb diet which helped me ditch Gliclazide. I now have a fatty liver which doesn't make losing weight that easy, even with lowering calories and exercising till it hurts.
As has been mentioned, one size doesn't fit all, we are all different. Shame about the radio program, especially as the real story, the one about how so many people lose weight and bring their condition under more control is never publicised. The media are missing a scoop.

The topic is now being covered on BBC News as one of "today's headlines"... They basically say Type 1 occurs in children and people with type 2 are obese and it's their fault.

And how all those money go into treating. No one stopped to think that since they're spending all those money for years now and it's only getting worse - maybe they're spending the money wrong... Like telling people that eating fat is bad and starchy carbs are good.

sanguine said:

What I said was that obesity per se doesn't cause T2. If your insulin resistance is increasing then continuing to eat a high carb diet will raise triglycerides and the elevated insulin facilitates the laying down of visceral fat. Most of us here are trying to get the media to stop talking rubbish such as obesity causes T2.

Click to expand...

This makes an interesting discussion.
It's well suited for the 'Diabetes Discussion' forum, rather than the 'Low Carb' forum.

You call it rubbish, however, for many, or maybe just me, if I hadn't taken a route to obesity, I doubt I would have become diabetic.
Maybe it is chicken and egg, maybe both obesity and type 2 are both symptoms of poor diet, but I do know it's not rubbish that when I decided to change diet so as to not be obese, I found I wasn't suffering from the type 2 either. Or maybe it's the other way round.

But regardless of cause and effect, I found, as many have others, fix one, fix the other.

So get those patients out of the way, and then maybe the burden on the NHS will be reduced significantly enough to have made it a worthwhile case.
Reduce obesity, and you'll also benefit from reducing a lot of other complications of obesity, regardless of how it was caused.

It's very easy to get hung up on low carb as the only solution, but it's also a simple test if it is the ultimate solution, and obesity is caused by type 2, which is caused by carbs.
Let people lose weight. If obesity is a symptom of diabetes, everyone will still be diabetic.
If your insulin resistance is increasing then continuing to eat a high carb diet will raise triglycerides and the elevated insulin facilitates the laying down of visceral fat.
Eventually all the 'thin' diabetics will become obese.

The Newcastle Diet will be debunked, all diabetics will become obese, regardless of weight at point of diagnosis.

But it's more likely any 'diet' will be lower carb, as a classical diet removed refined carbs, potato, pasta, so defining the carb threshold becomes the target.

Obesity doesn't just "contribute(??)" to diabetes as a health problem... It affects breathing, legs, mobility.. Everything... Why can't someone just tackle the ready meals, the takeaways and direct the public back to proper size plates etc.
Obesity is causing the crisis in NHS not just diabetics.

SunnyExpat said:

Reduce obesity, and you'll also benefit from reducing a lot of other complications of obesity, regardless of how it was caused.

Click to expand...

Just one slight problem, as someone who has kept an eye on my calorie intake for at least 8 years and I have food diaries to show that I was eating 500, 1000 and even 1500 calories less than my Basic Metabolic Rate and at times exercised till it hurt, as much as swimming 1km, 5 times a week, 1 hr in the gym 3 times a week as well as playing golf, having swimming lessons and spending an hour with a PT, weight reduction doesn't always happen. I know that my weight loss has occurred when I stopped Rosiglitazone, stopped Gliclazide and later started low carb.

Reduce weight is a great plan, but if anyone thinks it's just about calories consumed and calories burned, then they have a bit more to learn.

graj0 said:

Just one slight problem, as someone who has kept an eye on my calorie intake for at least 8 years and I have food diaries to show that I was eating 500, 1000 and even 1500 calories less than my Basic Metabolic Rate and at times exercised till it hurt, as much as swimming 1km, 5 times a week, 1 hr in the gym 3 times a week as well as playing golf, having swimming lessons and spending an hour with a PT, weight reduction doesn't always happen. I know that my weight loss has occurred when I stopped Rosiglitazone, stopped Gliclazide and later started low carb.

Reduce weight is a great plan, but if anyone thinks it's just about calories consumed and calories burned, then they have a bit more to learn.

Click to expand...

Just curious how you calculated your basal metabolic rate? Exercise helps a bit with weight loss, but not as much as we would like.

CatLadyNZ said:

Just curious how you calculated your basal metabolic rate? Exercise helps a bit with weight loss, but not as much as we would like.

Click to expand...

It's the good old Harris Benedict Formula, it's over 100 years old now but calculates the amount of calories you require based on gender, age, height and weight. When I started to look at losing weight all those years ago I looked at several different weight loss organisations like weight watchers, Tesco Diets (no longer in existence), Rosemary Connolly, etc etc and they all use a formula very similar to the Harris Benedict formula which I've included below. It was a useful exercise for me because since moving in with my wife in 1989 I had broadly speaking avoided processed foods, especially after gaining 3 stones in the first 3 months of living with my wife who told me that I wasn't going to have the same old muck that I ate as a bachelor. We typically ate WW frozen meals to begin with because we both worked long hours and added vegetables like broccoli, cauliflower, carrots etc. and when I visited my GP because of this sudden weight gain he maintained that it was the salt content of frozen meals, so all meals were prepared from scratch. I never felt that I ate that much although I enjoyed a few beers which is why I gave up when the Rosiglitazone started to affect my liver It wasn't the alcohol, I had a long discussion with my doctor about my alcohol consumption, even he couldn't see how it would have affected my liver, he knew it was the Rosiglitazone. No matter, I haven't touched a drop for 8 years or more. The formula assume you lie in bed all day:

English BMR Formula
Women: BMR = 655 + ( 4.35 x weight in pounds ) + ( 4.7 x height in inches ) - ( 4.7 x age in years )
Men: BMR = 66 + ( 6.23 x weight in pounds ) + ( 12.7 x height in inches ) - ( 6.8 x age in year )

Metric BMR Formula
Women: BMR = 655 + ( 9.6 x weight in kilos ) + ( 1.8 x height in cm ) - ( 4.7 x age in years )
Men: BMR = 66 + ( 13.7 x weight in kilos ) + ( 5 x height in cm ) - ( 6.8 x age in years )

There are multipliers which depend on how much exercise you do.

To determine your total daily calorie needs, multiply your BMR by the appropriate activity factor, as follows:

1. If you are sedentary (little or no exercise) : Calorie-Calculation = BMR x 1.2
2. If you are lightly active (light exercise/sports 1-3 days/week) : Calorie-Calculation = BMR x 1.375
3. If you are moderatetely active (moderate exercise/sports 3-5 days/week) : Calorie-Calculation = BMR x 1.55
4. If you are very active (hard exercise/sports 6-7 days a week) : Calorie-Calculation = BMR x 1.725
5. If you are extra active (very hard exercise/sports & physical job or 2x training) : Calorie-Calculation = BMR x 1.9

The interesting thing for me is that this is what medics use to calculate your BMR, god help me if I'm ever hospitalised and in a coma, because the formula says I should eat 2000 calories a day and I don't usually eat more than 1200. My GP did say that I didn't eat enough but if I eat more my weight goes up. so I'm not playing their game of try this and try that and see what happens. Sadly the medical profession don't have a clue and this is what worries me. So many overweight people are labelled as over eaters and some might be, eating too much will increase your weight but you have to continue eating too much to sustain that extra weight.

Dieting really isn't straight forward.

BTW, I agree, exercise helps, of course, but it's surprising how little fuel (calories) it burns. I've spent too long on the bike at the gym, set to difficulty 12 (out of 20) to know how little you burn. I believe the idea is that with more muscle you will burn more calories, not that the bike knows how many muscles I've got. LOL