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

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

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  1. Tannith

    Tannith · Well-Known Member

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    Thank you for your thoughtful reply. I do have a plan B which is to input my final weight into an NHS calculator to see how many calories I need to maintain it. Then weigh weekly at least to catch myself if I exceed it. Plus starting daily walks after Covid.I have no access to any fancy tests nor the money to pay for them, but I am able to do home tests OGT with the help of my packet of glucose and a mini kitchen scale to weigh it. I have to infer my insulin secretion from periodic OGTs and FBGs, with the occasional HBA1C from my GP. I am hoping to identify my "Personal Fat Threshold" by tracking my weight loss and comparing it with the glucose tests. When the glucose tests are acceptable I shall record the weight at the time and religiously stick to it.
    That is IF my vlcal diet works. I am well aware (and pretty scared) that it may not because I know for certain I have had T2 for 4 years. For most people the diet still works at 4 years, but we are all individuals. It could work, but only partially, eg only some but not all of my beta cells might recover. I shall only be able to tell when I have lost sufficient weight and get to the point where losing more gives no further improvement in FBG/OGT. Fingers crossed.
    If the diet doesn't work for me I shall have to look at metformin or low carb to control my blood sugars. But I hope not as metformin gives some people horrid digestive side effects, and low carb provides too little fibre for bowel health and too much saturated fat for my liking.
     
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  2. Ronancastled

    Ronancastled Type 2 · Well-Known Member

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    See Section 3.3 of this paper which quotes a large number of scientific papers on Low Carb scientific studies.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/

    I haven't had a chance to review it yet but the author has pulled together 99 studies on reversal.
    Could be a handy index for future referral.
     
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  3. Oldvatr

    Oldvatr Type 2 · Expert

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    Thank you. At first glance, this is quite well written and informative. I am particularly impressed about where they talk about the NHS and NICE guidelines as only defining a Standard of Care i.e. treatment. and that the current standard of care will not achieve remission even with a following wind since that is not the purpose of the NICE guidelines. How true is that?

    I will read this in depth later, but I like their drift in this.

    The other thing I notice is that they say that most clinical trials do not measure insulin, but measure C-Peptide instead. Actually, most of the ones I have seen use Insulin Clamp techniques which is a titration technique in vivo rather than in vitro,
    Even the poor Lab Rats get this treatment.

    Their review of the ND VLCdiets reflects the experiences shared here in this forum, and I think their summary at the end is spot on.

    Their review of LC diets does admit, as I expected, that the studies so far are either small size (n<50) or short duration with no long term follow up, So my comment on there being few suitable studies is one I still stand by, It would be difficult to claim 'evidence-based' at a NICE tribunal. But they do report better results than for VLC diets, and I think the evidence does support, but not prove, that. I have not got to the end of the report, so there may be some aviso's in it regarding LC

    They have mentioned nutrient deficiencies in the other diet reviews, but not raised any in the LC review, and the nutritionists will jump on them for that, I suspect. This may be unconscious bias creeping in,

    I see S. Phinney got a mention at the end as an editor. Again not entirely unbiassed?
     
    • Informative Informative x 1
    #323 Oldvatr, Jan 8, 2021 at 10:17 PM
    Last edited: Jan 9, 2021
  4. Antje77

    Antje77 LADA · Moderator
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    You can have as much fibre as you like when eating low carb, and there is no need to eat saturated fat either.
    I'm not at all criticising your choices, we all choose the path which fits us best, but can it be you have been misinformed on this?
     
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  5. lucylocket61

    lucylocket61 Type 2 · Expert

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    To add to this, it's easy to be vegetarian low carbing too.
     
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  6. bulkbiker

    bulkbiker Type 2 · Oracle

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    Which is precisely what the ND does as well (if you believe what you say).. ketosis through starvation instead of the avoidance of carbohydrate.

    I know which I find easier and more pleasant and with longer term benefits.
     
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  7. Tannith

    Tannith · Well-Known Member

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    How do you explain those of us on here who are obese, sometimes severely so, have Not lost weight, and remain the weight we had when diagnosed, but maintain, year after year, normal blood glucose levels due to low carbing only?
    Treating the symptoms and not the disease. @Richard'63 There's your answer.
     
  8. zand

    zand Type 2 · Master

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    @Tannith low carb does treat the disease. It healed my NAFLD.
     
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  9. lucylocket61

    lucylocket61 Type 2 · Expert

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    You misunderstand. Obesity is one of the symptoms, carb intolerance is the disease.

    Would you mind sharing what you think a low carb diet looks like and entails please?

    I eat lots of veg and salad every day, little meat, no meat most days. My fats are mayonnaise (full fat) olive oil and a little butter over a weeks food, so very little saturated fat. My meat is tuna, salmon and chicken. All healthy stuff. I eat a slice of two of homemade organic wholemeal bread most days. I have eggs twice a week and full fat milk in my drinks. I have about 80-100g of carbs a day.

    And this is a low carb diet which I have been following for 9 years. My diabetes was in remission within 3 months, and has remained in remission since, until I got long covid-19. I haven't had to take any diabetes meds.

    Perhaps you aren't aware of the wide variety of low carbing possible?
     
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  10. Tannith

    Tannith · Well-Known Member

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    The comment about treating the symptoms not the disease was from @Richard'63 not mine, though I agree with him. Your diet sounds very pleasant, and is about what I would have thought a low carb diet would be.
     
  11. lucylocket61

    lucylocket61 Type 2 · Expert

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    If my diet is what you thought a low carb diet would be, why do you consider it low in fibre and too much saturated fat?
     
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  12. lucylocket61

    lucylocket61 Type 2 · Expert

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    Please can you clarify what you consider the symptom, and what you consider the disease?
     
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  13. Tannith

    Tannith · Well-Known Member

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    It is round about what I would eat if I were doing low carb, except that I would use semi skimmed or soy milk to avoid excess saturated fat. But I think a lot of keto carnivores are eating very large amounts of sat fat, both in the meat and as extras (butter/cream) and I get the impression that their diets would be pretty high in sat fat. And that for a low carber you are probably lower than most in sat fat. I don't know. I am not an expert in low carb diets, and it is also hard to find a definition online of how low low carb is supposed to be.
     
  14. lucylocket61

    lucylocket61 Type 2 · Expert

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    There is a huge difference between keto carnivore and low carbing, with hundreds of variations in-between.

    Low carb, as defined, is less than around 130g of carbs per day.

    Have a look round the low carb section of the forum for ideas. My sort of intake and choice of food is typical.

    Do you have any questions about saturated fats in your diet? Perhaps, like with understanding what a low carb can be, you may have some ideas about fats which based on outdated or mistaken thoughts?
     
  15. Tannith

    Tannith · Well-Known Member

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    You would have to address your question to @Richard'63 who posted the comment.
     
  16. lucylocket61

    lucylocket61 Type 2 · Expert

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    I have. By quote his post, he is alerted to my question.
     
  17. Tannith

    Tannith · Well-Known Member

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    I don't currently need to find out anything about how to do a low carb diet as I have already chosen a very low calorie diet and haven't finished doing it yet. If it doesn't work ( & I have about a 60% chance of its working having had T2 for 4 years), I shall look first at metformin which is apparently very good and consistent at lowering blood sugar, and doesn't give digestive problems to all users.
     
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  18. Mike d

    Mike d Type 2 · Expert

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    No doubt we'll get a report both in terms of expectations and results
     
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  19. zand

    zand Type 2 · Master

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    @Tannith Metformin didn't give me tummy problems as long as I ate a low carb diet. The few times I went over my own 80-100g carb limit were disastrous. My doctor won't prescribe it for me anymore as my HbA1c is normally 48 or less, so good luck with getting it. It does help with insulin resistance and stopping liver dump so helped my FBGs. It had minimal effect on my HbA1c though. If you do take it then bear in mind that you may need to supplement with vit B12 as Metformin depletes the level of B12.
     
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  20. Tannith

    Tannith · Well-Known Member

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    lucylocket61 said:
    You misunderstand. Obesity is one of the symptoms, carb intolerance is the disease.

    Treating the symptoms and not the disease.
    Please can you clarify what you consider the symptom, and what you consider the disease?



    Richard, would you mind enlightening Lucylocket and others on your definition of symptoms and disease. I agree with you but no doubt you could explain it better than I can.
     
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