1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

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

Discussion in 'Diabetes Discussions' started by hyponilla, Nov 22, 2020.

Thread Status:
Not open for further replies.
  1. pixie1

    pixie1 Type 2 · Well-Known Member

    Messages:
    251
    Likes Received:
    178
    Trophy Points:
    103
    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    It is now an outdated tool.
     
    • Informative Informative x 1
  2. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

    Messages:
    2,395
    Likes Received:
    1,692
    Trophy Points:
    198
    That is why it works only for the select few...
     
    • Agree Agree x 3
  3. Tannith

    Tannith · Well-Known Member

    Messages:
    1,021
    Likes Received:
    378
    Trophy Points:
    103
    • 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 Like x 1
    • Informative Informative x 1
  4. Goonergal

    Goonergal Type 2 · Moderator
    Staff Member

    Messages:
    12,398
    Likes Received:
    18,802
    Trophy Points:
    298
    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.
     
    • Agree Agree x 3
    • Informative Informative x 2
    • Like Like x 1
  5. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

    Messages:
    2,395
    Likes Received:
    1,692
    Trophy Points:
    198
    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/
    [​IMG]
     
    • Informative Informative x 1
  6. HoppyKangaroo

    HoppyKangaroo Type 2 · Newbie

    Messages:
    1
    Likes Received:
    1
    Trophy Points:
    21
    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.
     
    • Winner Winner x 9
    • Like Like x 1
  7. Tannith

    Tannith · Well-Known Member

    Messages:
    1,021
    Likes Received:
    378
    Trophy Points:
    103
    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 Like x 1
  8. bulkbiker

    bulkbiker Type 2 · Oracle

    Messages:
    18,178
    Likes Received:
    12,140
    Trophy Points:
    298
    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 Like x 1
  9. Tannith

    Tannith · Well-Known Member

    Messages:
    1,021
    Likes Received:
    378
    Trophy Points:
    103
    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.
     
  10. bulkbiker

    bulkbiker Type 2 · Oracle

    Messages:
    18,178
    Likes Received:
    12,140
    Trophy Points:
    298
    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.
     
    • Agree Agree x 4
  11. Ronancastled

    Ronancastled Type 2 · Well-Known Member

    Messages:
    530
    Likes Received:
    320
    Trophy Points:
    123
    @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.
     
    • Informative Informative x 3
    • Agree Agree x 1
  12. lucylocket61

    lucylocket61 Type 2 · Expert

    Messages:
    5,454
    Likes Received:
    2,330
    Trophy Points:
    178
    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.
     
    • Agree Agree x 5
  13. zand

    zand Type 2 · Expert

    Messages:
    9,956
    Likes Received:
    16,013
    Trophy Points:
    198
    I sent for a fasting insulin test. The results were horrifying, showing that I do indeed have hyperinsulimia.
     
    • Informative Informative x 1
    • Useful Useful x 1
  14. lucylocket61

    lucylocket61 Type 2 · Expert

    Messages:
    5,454
    Likes Received:
    2,330
    Trophy Points:
    178
    can I ask where you got the test from please?
     
  15. zand

    zand Type 2 · Expert

    Messages:
    9,956
    Likes Received:
    16,013
    Trophy Points:
    198
    Medichecks.
     
    • Friendly Friendly x 1
  16. HSSS

    HSSS Type 2 · Expert

    Messages:
    5,396
    Likes Received:
    2,664
    Trophy Points:
    198
    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
     
  17. zand

    zand Type 2 · Expert

    Messages:
    9,956
    Likes Received:
    16,013
    Trophy Points:
    198
    They may have done. It was a while back that I had mine tested.
     
  18. Tannith

    Tannith · Well-Known Member

    Messages:
    1,021
    Likes Received:
    378
    Trophy Points:
    103
    "December 2020 Passed a Rapilose 75g OGTT 3.0 @ 2 Hours " Excellent! Well done you!
     
  19. Tannith

    Tannith · Well-Known Member

    Messages:
    1,021
    Likes Received:
    378
    Trophy Points:
    103
    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 Like x 1
  20. oldgreymare

    oldgreymare Type 1 · Well-Known Member

    Messages:
    378
    Likes Received:
    344
    Trophy Points:
    123
    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.
     
    • Informative Informative x 1
Thread Status:
Not open for further replies.
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook