Type 2 Diabetes: NHS to offer 800 cal diet

Mbaker

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4,339
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Diet only
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Available fast foods in Supermarkets
Better than nothing, so long as the persons on the trial are aware that they need to eat a third less, exercise a bit and that their metabolism decreases. It is great that the NHS recognises that Type 2 can be reversed.

With the options I have reviewed, if money were no object I would take myself off to Germany and do a 21 day fast under clinical supervision or the Russian equivalent, and maintain with Keto; failing that Keto and IF / multi-day fasting.
 
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eddie07

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131
Type of diabetes
Type 2
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Diet only
Better than nothing, so long as the persons on the trial are aware that they need to eat a third less, exercise a bit and that their metabolism decreases. It is great that the NHS recognises that Type 2 can be reversed.

With the options I have reviewed, if money were no object I would take myself off to Germany and do a 21 day fast under clinical supervision or the Russian equivalent, and maintain with Keto; failing that Keto and IF / multi-day fasting.
I concur. Probably the most appropriate solution for most of us.
 
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Spl@

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Diet only
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Humans that only take.
An attempt at least.

It still sites being overweight as a cause not a symptom.

The shakes still have an appreciable carb content with skimmed milk and porridge being some of the elements. So it still sounds like a NHS plate in a drink just smaller portions.

It's only for people over a bmi of 30.

Lastly. How will this help long term. Changing people to meat and salad/veg is sustainable for life and costs far less. These people will need hand holding through the experience and then when their 'treatment' ends what do they do. They will be told to eat the NHS plate and got straight back to where they started.

Bet weight help organisations are behind it. We know how wonky they can get the healthy ideas.
 

Yellredder

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90
Type of diabetes
Prediabetes
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Diet only
I've been having by HBA1C done annually since having my daughter 7 years ago - and it's always been ok until I was consuming about 600 calories a day for about 4 months. I'd had an op which meant I couldn't eat, and whilst I drank, it was bloomin hard work! I wasn't overweight, but I did lose a lot of weight - and that's when I became pre-Diabetic. I mostly drank soup and lattes!
 
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HSSS

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@Debandez bbc article is asking for contact from t2’s.

Do you have type 2 diabetes? Would you take part in this low-calorie diet if your GP offered it to you? Have you been on a similar diet in the past? Email [email protected] .
Please include a contact number if you are willing to speak to a BBC journalist. You can also contact us in the following ways:
WhatsApp: +44 7555 173285
Tweet: @BBC_HaveYourSay
Text an SMS or MMS to 61124 or +44 7624 800 100
Please read our terms & conditions and privacy policy

Could be your chance to get the low carb alternative and your article and message in there!
 

NicoleC1971

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3,451
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Pump
An attempt at least.

It still sites being overweight as a cause not a symptom.

The shakes still have an appreciable carb content with skimmed milk and porridge being some of the elements. So it still sounds like a NHS plate in a drink just smaller portions.

It's only for people over a bmi of 30.

Lastly. How will this help long term. Changing people to meat and salad/veg is sustainable for life and costs far less. These people will need hand holding through the experience and then when their 'treatment' ends what do they do. They will be told to eat the NHS plate and got straight back to where they started.

Bet weight help organisations are behind it. We know how wonky they can get the healthy ideas.
I agree that long term maintenance is tricky if you've done 800 calories of shakes for 8 weeks and people will need lots of dietary re education. There was follow up of the original trial and some people had kept some of the weight off....... Low carb seems the better option and the VIRTA health trial should have been considered although it isn't of the RCT gold standard which NICE demands...Then there is all politics of reversing out of the energy balance and fat is bad messaging.
The media message did not got into the details of why Professor Taylor's approach worked: namely that people lost visceral fat around their livers and pancreases and NOT just mass (15kg on average). This is why bariatric patients universally reverse their diabetes in the immediate weeks after surgery and long before they've lost lots of weight.
Lastly Prof Taylor is going to investigate the options for the sunbstantial minority of type 2s who are TOFIS! (THIN ON THE OUTSIDE FAT ON THE INSIDE).
Glad to hear of the principle of reversal being accepted and also wondering what the PREVENT for pre diabetes programmes will be like and if they will actually get 100,000 folks to attend.
 
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KK123

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3,967
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Insulin
It sounds like a gimmick to me, no more than a fad diet. Of course an 800 calorie shake diet will work if it's only about losing weight, and scientifically that weight loss (which is basically from consuming fewer carbs) will 'result' in lower numbers at the end probably due to metabolic reasons.....oh look, reversed type 2. What about after that?, I am assuming nobody stays on this 800 cal diet for ever? I know it's a start as others have said but what advice follows it? What is that person told to do then?, if it's the eatwell nonsense, well just wait until they unfortunately start the type 2 issue all over again a week after. The focus is wrong as far as I am concerned, the 800 cals will enable a person to lose weight as if THAT is all this is about but it most certainly does not reverse type 2 other than very temporarily at the moment they take the end result tests. They should be selling this as 'the eat 800 cals diet which works because it is LOWER CARBS than you have been eating' followed by 'then eat lower carbs for life'...but they won't because they are still perpetuating the myth that if only fat people didn't eat so much'. No mention of the thin type 2s of course, do they start this 800 cal thing?
 

Spl@

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513
Type of diabetes
Prediabetes
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Diet only
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Humans that only take.
It sounds like a gimmick to me, no more than a fad diet. Of course an 800 calorie shake diet will work if it's only about losing weight, and scientifically that weight loss (which is basically from consuming fewer carbs) will 'result' in lower numbers at the end probably due to metabolic reasons.....oh look, reversed type 2. What about after that?, I am assuming nobody stays on this 800 cal diet for ever? I know it's a start as others have said but what advice follows it? What is that person told to do then?, if it's the eatwell nonsense, well just wait until they unfortunately start the type 2 issue all over again a week after. The focus is wrong as far as I am concerned, the 800 cals will enable a person to lose weight as if THAT is all this is about but it most certainly does not reverse type 2 other than very temporarily at the moment they take the end result tests. They should be selling this as 'the eat 800 cals diet which works because it is LOWER CARBS than you have been eating' followed by 'then eat lower carbs for life'...but they won't because they are still perpetuating the myth that if only fat people didn't eat so much'. No mention of the thin type 2s of course, do they start this 800 cal thing?

They say people will only be included if you have a bmi of at least 30. I think that is NHS speak for clinicly obese.
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
It sounds like a gimmick to me, no more than a fad diet. Of course an 800 calorie shake diet will work if it's only about losing weight, and scientifically that weight loss (which is basically from consuming fewer carbs) will 'result' in lower numbers at the end probably due to metabolic reasons.....oh look, reversed type 2. What about after that?, I am assuming nobody stays on this 800 cal diet for ever? I know it's a start as others have said but what advice follows it? What is that person told to do then?, if it's the eatwell nonsense, well just wait until they unfortunately start the type 2 issue all over again a week after. The focus is wrong as far as I am concerned, the 800 cals will enable a person to lose weight as if THAT is all this is about but it most certainly does not reverse type 2 other than very temporarily at the moment they take the end result tests. They should be selling this as 'the eat 800 cals diet which works because it is LOWER CARBS than you have been eating' followed by 'then eat lower carbs for life'...but they won't because they are still perpetuating the myth that if only fat people didn't eat so much'. No mention of the thin type 2s of course, do they start this 800 cal thing?
Your predjudice is showing, There are other valid diets apart from Low Carb. The Newcastle Diet study on which this NHS venture is based has indeed shown promise of reversal that is sustainable in the longer term. This diet (ND) is discussed at length in many threads in this forum and in the Success Stories section too.

As has indeed been pointed out, the question of onging maintenence after the diet period is not covered and this will be necessary as much as or more than the shakes, There are several respondents on this site who can attest to the efficacy of this diet, but also some who have shown that it too can be reversed, so is not a CURE in itself.

As regards TOFI, the report quite clearly states that a requirement for the NHS plan is a BMI of 30+ so will exclude most TOFI that i know of.

As regards Low Carb, then this is often the choice of maintenance diet used in the follow on period, and is a useful adjunct to the Plan But it is not essential, or mandated,
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
It sounds like a gimmick to me, no more than a fad diet. Of course an 800 calorie shake diet will work if it's only about losing weight, and scientifically that weight loss (which is basically from consuming fewer carbs) will 'result' in lower numbers at the end probably due to metabolic reasons.....oh look, reversed type 2. What about after that?, I am assuming nobody stays on this 800 cal diet for ever? I know it's a start as others have said but what advice follows it? What is that person told to do then?, if it's the eatwell nonsense, well just wait until they unfortunately start the type 2 issue all over again a week after. The focus is wrong as far as I am concerned, the 800 cals will enable a person to lose weight as if THAT is all this is about but it most certainly does not reverse type 2 other than very temporarily at the moment they take the end result tests. They should be selling this as 'the eat 800 cals diet which works because it is LOWER CARBS than you have been eating' followed by 'then eat lower carbs for life'...but they won't because they are still perpetuating the myth that if only fat people didn't eat so much'. No mention of the thin type 2s of course, do they start this 800 cal thing?

The NHS plan is targeted at T2D specifically. It seems to reduce the Insulin Resistance that is a characteristic of that condition, and is something that a T1D is unlikely to suffer from. The diet is therfore probably not so suitable for T1D except as a pure weight loss program. T1D would need to continue insulin treatment during and after the diet period, so will not experience reversal. Some Insulin Dependant T2D et al may see improvement depending on the reason for their insulin need.
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
The
It sounds like a gimmick to me, no more than a fad diet. Of course an 800 calorie shake diet will work if it's only about losing weight, and scientifically that weight loss (which is basically from consuming fewer carbs) will 'result' in lower numbers at the end probably due to metabolic reasons.....oh look, reversed type 2. What about after that?, I am assuming nobody stays on this 800 cal diet for ever? I know it's a start as others have said but what advice follows it? What is that person told to do then?, if it's the eatwell nonsense, well just wait until they unfortunately start the type 2 issue all over again a week after. The focus is wrong as far as I am concerned, the 800 cals will enable a person to lose weight as if THAT is all this is about but it most certainly does not reverse type 2 other than very temporarily at the moment they take the end result tests. They should be selling this as 'the eat 800 cals diet which works because it is LOWER CARBS than you have been eating' followed by 'then eat lower carbs for life'...but they won't because they are still perpetuating the myth that if only fat people didn't eat so much'. No mention of the thin type 2s of course, do they start this 800 cal thing?
The diet was originally developed as the Cambridge Diet, so is in essence a weight loss program, It has been in use for many years now so is not a Fad diet by any means. It evolved into the Slimfast Diet, which is still in use today, and is considered viable and safe by nutritionists. WW is a variant of the plan.
 

Mr_Pot

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Messages
4,573
Type of diabetes
Type 2
Treatment type
Diet only
Providing support after the diet is ok for a trial but where would the resources come from if the treatment became mainstream?
 

DCUKMod

Master
Staff Member
Messages
14,298
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
It sounds like a gimmick to me, no more than a fad diet. Of course an 800 calorie shake diet will work if it's only about losing weight, and scientifically that weight loss (which is basically from consuming fewer carbs) will 'result' in lower numbers at the end probably due to metabolic reasons.....oh look, reversed type 2. What about after that?, I am assuming nobody stays on this 800 cal diet for ever? I know it's a start as others have said but what advice follows it? What is that person told to do then?, if it's the eatwell nonsense, well just wait until they unfortunately start the type 2 issue all over again a week after. The focus is wrong as far as I am concerned, the 800 cals will enable a person to lose weight as if THAT is all this is about but it most certainly does not reverse type 2 other than very temporarily at the moment they take the end result tests. They should be
It sounds like a gimmick to me, no more than a fad diet. Of course an 800 calorie shake diet will work if it's only about losing weight, and scientifically that weight loss (which is basically from consuming fewer carbs) will 'result' in lower numbers at the end probably due to metabolic reasons.....oh look, reversed type 2. What about after that?, I am assuming nobody stays on this 800 cal diet for ever? I know it's a start as others have said but what advice follows it? What is that person told to do then?, if it's the eatwell nonsense, well just wait until they unfortunately start the type 2 issue all over again a week after. The focus is wrong as far as I am concerned, the 800 cals will enable a person to lose weight as if THAT is all this is about but it most certainly does not reverse type 2 other than very temporarily at the moment they take the end result tests. They should be selling this as 'the eat 800 cals diet which works because it is LOWER CARBS than you have been eating' followed by 'then eat lower carbs for life'...but they won't because they are still perpetuating the myth that if only fat people didn't eat so much'. No mention of the thin type 2s of course, do they start this 800 cal thing?
@KK123 - if you google "Richard Doughty", you'll see what. Can happen to slim T2s adopting this approach, and the span of his personal years required efforts.

Whatever the "solution", no one size fits all.

It wouldn't be my choice, but my colleague @Pipp sid very well on it several years ago now.
 

KK123

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3,967
Type of diabetes
Type 1
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Insulin
Wow, I didn't realise I would get so many replies to my post! Oldvatr, I really am not prejudiced in any way, my point was more to do with the way the diet is being portrayed, ie as a lose weight and you'll be fine way. Isn't that the same way as saying 'you're fat and that's why you got diabetes'? I am all for whatever works for people, I can see that such a diet will work to begin with but surely diabetes will come back unless it (or something similar) follows? My description of it as 'fad' was too much I accept but I meant in the way of diets that are only short term., @Oldvatr, @DCUKMod - I will read Doughty, thank you.
 
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KK123

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3,967
Type of diabetes
Type 1
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Insulin
The NHS plan is targeted at T2D specifically. It seems to reduce the Insulin Resistance that is a characteristic of that condition, and is something that a T1D is unlikely to suffer from. The diet is therfore probably not so suitable for T1D except as a pure weight loss program. T1D would need to continue insulin treatment during and after the diet period, so will not experience reversal. Some Insulin Dependant T2D et al may see improvement depending on the reason for their insulin need.

Hi there, is it that once any IR is sorted, a person can go back to eating 'normally' then or what happens after the trial period, what advice would be given?
 

Oldvatr

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8,470
Type of diabetes
Type 2
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Wow, I didn't realise I would get so many replies to my post! Oldvatr, I really am not prejudiced in any way, my point was more to do with the way the diet is being portrayed, ie as a lose weight and you'll be fine way. Isn't that the same way as saying 'you're fat and that's why you got diabetes'? I am all for whatever works for people, I can see that such a diet will work to begin with but surely diabetes will come back unless it (or something similar) follows? My description of it as 'fad' was too much I accept but I meant in the way of diets that are only short term., @Oldvatr, @DCUKMod - I will read Doughty, thank you.
I agree, When you explain it like this then it becomes clearer, and I was just concerned that Newbies may get the wrong ideas which is why I added the explanation since although I am a Low Carber myself, I do see the ND as viable especially for those not wanting the extra fuss of LC.

The point you make about the problems of follow through not being supported is valid, and of concern, since we do see reversals and needing to repeat the diet. It IS a diet in that it is time limited and not sustainable in long term, but I see it as a start to getting the NHS to consider using diet more robustly than it does at present. It is the first time I have seen the NHS admit to having a possible contender to bariatric surgery, which is their only cure mechanism to date. We should encourage this trial, since it may open the door to lifestyle changes such as LC being accepted at last. It is a stepping stone.
 

Oldvatr

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Hi there, is it that once any IR is sorted, a person can go back to eating 'normally' then or what happens after the trial period, what advice would be given?
IR is a moving target, and what goes can come around again if the original stimulus is continued. So some form of lifestyle change will be required to maintain 'normal' levels. Having done some IR reversal by another route I find that I am more carb tolerant, but it gradually fades, and I need to take repeat steps to bring me back down again. I need to continue testing my sugars else I would not realise I was falling by the wayside, The NHS does not support SMBG for T2D so they are at a severe disadvantage to start with.
 

bulkbiker

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NHS does not support SMBG for T2D so they are at a severe disadvantage to start with
According to a mild twitter spat with Partha Kar yesterday that's not true! Although he didn't come up with any evidence and I have struggled to find any concrete data.
My own views on ND are fairly well known but if anything can be considered a "fad diet" then surely replacing food with artificially concocted shakes must be a prime contender. Yes the results have been promising but I still haven't seen any 5 year follow up data even though the initial trials started in 2011? It does make me wonder why?
 

Oldvatr

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8,470
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Type 2
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According to a mild twitter spat with Partha Kar yesterday that's not true! Although he didn't come up with any evidence and I have struggled to find any concrete data.
My own views on ND are fairly well known but if anything can be considered a "fad diet" then surely replacing food with artificially concocted shakes must be a prime contender. Yes the results have been promising but I still haven't seen any 5 year follow up data even though the initial trials started in 2011? It does make me wonder why?
According to NICE Guidelines NG28 as last updated in 2017
"
Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:
  • the person is on insulin or
  • there is evidence of hypoglycaemic episodes or
  • the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
  • the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy.