Why won't the NHS tell you the secret to treating diabetes?

Status
Not open for further replies.

pixie1

Well-Known Member
Messages
372
Type of diabetes
Type 2
Treatment type
Diet only
I wasn't aware that I had asked a question. The theory that we all have a fat threshold comes, I believe, from Roy Taylor, and is not a mainstream viewpoint. I happen to accept this as a possibility, but what we seem to have missed, and he has missed too, is that there are two ways IR operates. One seems to be due to hepatic fat excess, as demonstrated so well by Roy Taylor, but there is also mitochondrial IR in the muscle and skin tissue. He has not provided proof that both of these are dealt with adequately by his protocol.

One IR is governed by the Krebs Cycle, and the other by the TCA cycle. The Krebs cycle is controlled primarily by insulin and adrenaline, and the TCA cycle by other enzymes such as grehlin and its adjunct whose name I forget. These enzymes are from different organs in the body, so may well have different mechanisms in terms of IR, and so different solutions supposedly. So I do not consider Roy Taylor has a silver bullet for us. He introdus=ces us to a useful tool, thats all.

I agree that BMI is a poor indicator of poor health. I didn't say otherwise, but it is the current definition of obesity. My wife was 8 stone when I married her, but children and life ballooned her to 19 stone. I had hovered at 9 stone TOFI for most of my adult life. I got diabetes, my wife did not, I ballooned to 18 stone after DX, but am now back to 10 stone. I still have diabetes. My weight was caused by diabetes, not the other way round.

Interesting, I like Dr Aitken though, behind his thinking everyone has their own carbohydrate threshold, if stepped over, weight gain occurs.
To kick start weight loss carbs reduced for 2 weeks, to boost metabolism, once weight loss achieved to the desired goal. Then carbs are introduced, if weight gain began then carb threshold has been reached.
Makes the best sense.

Bmi was introduced for those who were malnourished under weight and height for their age group, observations were made by anthropologists, the differences between school age kids in areas of squalor was rife rather than those in privilege backgrounds.
Changes of height and weight gain occurred achieved through better nutrition.
It is now an outdated tool.
 

Tannith

BANNED
Messages
1,230
  • There is also the problem that various studies have shown that fasting plasma venous glucose measurements and OGTT do not identify the same patients as having diabetes.
  • One study showed the following distribution of patients in terms of their fit for the criteria used to diagnose diabetes for both tests[2]:
    • 40% meet criteria for diagnosis of diabetes based on fasting plasma venous glucose measurement.
    • 31% meet criteria for diagnosis of diabetes based on two-hour plasma venous glucose measurement, after OGTT.
    • 28% meet both sets of criteria for diagnosis of diabetes.
Studies of outcome based upon the mode of diagnosis of diabetes show worse outcomes in terms of cardiovascular morbidity and mortality in those diagnosed on the basis of the two-hour plasma glucose result, as part of the OGTT. For this reason, and the fact that OGTT is the only useful method for diagnosing patients with IGT, the WHO still recommends the retention of the OGTT as a diagnostic test for diabetes mellitus and/or IGT. https://patient.info/doctor/glucose-tolerance-tests
 
  • Like
Reactions: RachelK

Goonergal

Master
Retired Moderator
Messages
13,466
Type of diabetes
Type 2
Treatment type
Diet only
  • There is also the problem that various studies have shown that fasting plasma venous glucose measurements and OGTT do not identify the same patients as having diabetes.
  • One study showed the following distribution of patients in terms of their fit for the criteria used to diagnose diabetes for both tests[2]:
    • 40% meet criteria for diagnosis of diabetes based on fasting plasma venous glucose measurement.
    • 31% meet criteria for diagnosis of diabetes based on two-hour plasma venous glucose measurement, after OGTT.
    • 28% meet both sets of criteria for diagnosis of diabetes.
Studies of outcome based upon the mode of diagnosis of diabetes show worse outcomes in terms of cardiovascular morbidity and mortality in those diagnosed on the basis of the two-hour plasma glucose result, as part of the OGTT. For this reason, and the fact that OGTT is the only useful method for diagnosing patients with IGT, the WHO still recommends the retention of the OGTT as a diagnostic test for diabetes mellitus and/or IGT. https://patient.info/doctor/glucose-tolerance-tests

The linked report states:

  • The World Health Organization (WHO) now recommends that glycated haemoglobin (HbA1c) can be used as a diagnostic test for diabetes (see below)[3].
  • OGTT is not recommended as a screening test for diabetes mellitus.
 
  • Like
Reactions: zand

kokhongw

Well-Known Member
Messages
2,394
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
  • There is also the problem that various studies have shown that fasting plasma venous glucose measurements and OGTT do not identify the same patients as having diabetes.
  • One study showed the following distribution of patients in terms of their fit for the criteria used to diagnose diabetes for both tests[2]:
    • 40% meet criteria for diagnosis of diabetes based on fasting plasma venous glucose measurement.
    • 31% meet criteria for diagnosis of diabetes based on two-hour plasma venous glucose measurement, after OGTT.
    • 28% meet both sets of criteria for diagnosis of diabetes.
Studies of outcome based upon the mode of diagnosis of diabetes show worse outcomes in terms of cardiovascular morbidity and mortality in those diagnosed on the basis of the two-hour plasma glucose result, as part of the OGTT. For this reason, and the fact that OGTT is the only useful method for diagnosing patients with IGT, the WHO still recommends the retention of the OGTT as a diagnostic test for diabetes mellitus and/or IGT. https://patient.info/doctor/glucose-tolerance-tests

OGTT only shows half the problem... the glucose centric view../

Dr Joseph Kraft captures the real issue...the insulin centric view
https://denversdietdoctor.com/diabetes-vascular-disease-joseph-r-kraft-md/
Kraft-Curves-Cummins-1024x658.png
 

HoppyKangaroo

Newbie
Messages
1
Type of diabetes
Type 2
Treatment type
Diet only
Hi, I was diagnosed T2 30 April 2018. I immediately went low carb and never went on medication because I was able to control my glucose by diet alone. My A1c was 6.9. I have never wavered, and within a few weeks my bloods were back to normal range consistently, my A1c was 5.0 and has stayed there. All other deranged blood readings also went back to normal. In less than 5 months I lost 35 kilos, about 75lbs and kept it off, went from a size 22/24 to a size 12. It's not easy, but it can be done. My doctor who wasn't supportive to begin with and even threatened to stop treating me when I said no meds - I wanted to at least try diet first, he says he's never seen anyone do that. He lost weight recently, and when I asked how he did it, he looked pretty sheepish and said 'low carb'. That's how you do it. No expensive meds, no worsening health. It's been fantastic.
 
  • Like
Reactions: lucylocket61

Tannith

BANNED
Messages
1,230
This week's FBG results: Fri 4.8; Sat4.7; Sun 4.6;Mon 4.4; Tue 5.4; Wed 5.4 Thur 4.8. Average 4.87 - a drop on last week albeit a small one. I'm obviously moving in the right direction. Starting back on low cal diet today. I am also pleased that I have only put on half a pound over Christmas. I have a bit further to go yet.
 
  • Like
Reactions: Jillery

bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
Treatment type
Diet only
Hi, I was diagnosed T2 30 April 2018. I immediately went low carb and never went on medication because I was able to control my glucose by diet alone. My A1c was 6.9. I have never wavered, and within a few weeks my bloods were back to normal range consistently, my A1c was 5.0 and has stayed there. All other deranged blood readings also went back to normal. In less than 5 months I lost 35 kilos, about 75lbs and kept it off, went from a size 22/24 to a size 12. It's not easy, but it can be done. My doctor who wasn't supportive to begin with and even threatened to stop treating me when I said no meds - I wanted to at least try diet first, he says he's never seen anyone do that. He lost weight recently, and when I asked how he did it, he looked pretty sheepish and said 'low carb'. That's how you do it. No expensive meds, no worsening health. It's been fantastic.
Well done you! Taking control is so empowering.. and getting the GP to start low carb and benefitting is a wonderful side story. Lets hope they pass it on to other patients.
 
  • Like
Reactions: zand

Tannith

BANNED
Messages
1,230
OGTT only shows half the problem... the glucose centric view../

Dr Joseph Kraft captures the real issue...the insulin centric view
https://denversdietdoctor.com/diabetes-vascular-disease-joseph-r-kraft-md/
Kraft-Curves-Cummins-1024x658.png
Great article. But as far as I know there is no way ordinary people can do an insulin test at home? So we are still left with the FBG and OGT. I have also looked up the other guy you mention - Dr De Fronzo. Interesting stuff also. I wholeheartedly agree that the NHS does not take prediabetes seriously enough. Or early diabetes either. I stopped the v.l.cal diet I was doing in 2017/18 too early because the NHS told me I was no longer diabetic. I was not only still well into the prediabetic range but also into the fully diabetic range by many scoring systems. That could have cost me not only my health but potentially even my life. I am also shocked to see that, (according to Dr De Fronzo, prediabetics have lost 50% beta cell function and diabetics 80% beta cell function. I had not realised that it was nearly as bad as that. Thank you for your very useful post.
 

bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
Treatment type
Diet only
prediabetics have lost 50% beta cell function and diabetics 80% beta cell function. I had not realised that it was nearly as bad as that
It isn't true.. its speculative.
If you had lost that much beta cell function you would not be able to "normalise" your blood sugar response and you'd be well on the way to LADA.
 

Ronancastled

Well-Known Member
Messages
1,236
Type of diabetes
Type 2
Treatment type
Diet only
@Tannith Here is a study you may find interesting.
Previous T2's who achieved full remission through weight loss were followed up for 2 years.
https://diabetes.diabetesjournals.org/content/68/Supplement_1/66-OR

They recovered over 90% of their Beta Cell function in comparison to a non-diabetic control group.
0.94 nmol/min/m2 at 24 months vs 1.02 nmol/min/m2.
The current thinking is that Beta Cells are not permentantly destroyed at least in the aerly stages of T2.
They've either become exhausted, dormant or impaired.
The removal of the excess glucotoxity returns normal function within 12 months.

Unless of course the route to T2 is through another pathway which such as genetic factors.
 

lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
@Tannith Here is a study you may find interesting.
Previous T2's who achieved full remission through weight loss were followed up for 2 years.
https://diabetes.diabetesjournals.org/content/68/Supplement_1/66-OR

They recovered over 90% of their Beta Cell function in comparison to a non-diabetic control group.
0.94 nmol/min/m2 at 24 months vs 1.02 nmol/min/m2.
The current thinking is that Beta Cells are not permentantly destroyed at least in the aerly stages of T2.
They've either become exhausted, dormant or impaired.
The removal of the excess glucotoxity returns normal function within 12 months.

Unless of course the route to T2 is through another pathway which such as genetic factors.
Which is another great reason for reducing carbs, it gives our pancreas a chance to recover. Something that reducing calories while eating a lot of carbs, can't do.
 

zand

Master
Messages
10,780
Type of diabetes
Type 2
Treatment type
Diet only
I sent for a fasting insulin test. The results were horrifying, showing that I do indeed have hyperinsulimia.
 

HSSS

Expert
Messages
7,461
Type of diabetes
Type 2
Treatment type
Diet only
I thought they stopped doing them by post still. I had a test ready to send back when they stopped doing it that way and am too far from their test centres
 

zand

Master
Messages
10,780
Type of diabetes
Type 2
Treatment type
Diet only
I thought they stopped doing them by post still. I had a test ready to send back when they stopped doing it that way and am too far from their test centres
They may have done. It was a while back that I had mine tested.
 

Tannith

BANNED
Messages
1,230
@Tannith Here is a study you may find interesting.
Previous T2's who achieved full remission through weight loss were followed up for 2 years.
https://diabetes.diabetesjournals.org/content/68/Supplement_1/66-OR

They recovered over 90% of their Beta Cell function in comparison to a non-diabetic control group.
0.94 nmol/min/m2 at 24 months vs 1.02 nmol/min/m2.
The current thinking is that Beta Cells are not permentantly destroyed at least in the aerly stages of T2.
They've either become exhausted, dormant or impaired.
The removal of the excess glucotoxity returns normal function within 12 months.

Unless of course the route to T2 is through another pathway which such as genetic factors.
"December 2020 Passed a Rapilose 75g OGTT 3.0 @ 2 Hours " Excellent! Well done you!
 

Tannith

BANNED
Messages
1,230
It isn't true.. its speculative.
If you had lost that much beta cell function you would not be able to "normalise" your blood sugar response and you'd be well on the way to LADA.
That's not what De Forenzo says at all. He says as below referring to his "FINDINGS" not speculation:
"As individuals progressed from NGT to impaired fasting glucose (IFG), there was a 50% decline in β-cell volume, suggesting a significant loss of β-cell mass long before the onset of type 2 diabetes. With the progression to overt diabetes, there was a further and significant loss of β-cell volume. Although β-cell volume should not be viewed to be synonymous with β-cell mass, these results suggest that significant loss of β-cell mass occurs long before the onset of type 2 diabetes, according to current diagnostic criteria (46).

In summary, our findings (4042) demonstrate that, at the stage of IGT, individuals have lost over 80% of their β-cell function, while the results of Butler et al. (47) suggest that subjects with “pre-diabetes” have lost approximately half of their β-cell volume. "
https://diabetes.diabetesjournals.org/content/58/4/773
 
  • Like
Reactions: kokhongw

oldgreymare

Well-Known Member
Messages
537
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
Commuting, overcrowded spaces, especially after the arrival of covid-19...
That's not what De Forenzo says at all. He says as below referring to his "FINDINGS" not speculation:
"As individuals progressed from NGT to impaired fasting glucose (IFG), there was a 50% decline in β-cell volume, suggesting a significant loss of β-cell mass long before the onset of type 2 diabetes. With the progression to overt diabetes, there was a further and significant loss of β-cell volume. Although β-cell volume should not be viewed to be synonymous with β-cell mass, these results suggest that significant loss of β-cell mass occurs long before the onset of type 2 diabetes, according to current diagnostic criteria (46).

In summary, our findings (4042) demonstrate that, at the stage of IGT, individuals have lost over 80% of their β-cell function, while the results of Butler et al. (47) suggest that subjects with “pre-diabetes” have lost approximately half of their β-cell volume. "
https://diabetes.diabetesjournals.org/content/58/4/773
His findings are only one study? Would need to be replicated in many additional studies under different researchers to be considered dogma. But I agree the idea that significant Beta cell destruction due to insulin resistance and subsequent cell exhaustion can happen before overt BG symptoms sounds sadly too plausible. What is much more interesting are possible mechanisms to reverse such destruction before it becomes irreversible as mentioned above by @Ronancastled. Certainly when I was first diagnosed, my endocrinologist wanted me on injected insulin for 3 months before assessing me for c-peptide (the standard insulin level proxy test), in the hope my beta cells recovered from fatigue - unfortunately I'm T1 so they did not.
 
Status
Not open for further replies.