Paths to remission or control. Newcastle and Low Carb.

[AndBreathe]

Moderator Note: This side conversation about the merits of low calorie vs low carb approaches was split away from a newbie thread to prevent it being overwhelmed - https://forum.diabetes.org.uk/boards/threads/getting-myself-in-a-mess.106308/

You can reverse your diabetes. And if you do that soon, and keep it reversed, there will be minimal effect on your life expectancy; in fact you can make yourself healthier than you have ever been.

Get yourself onto the NHS Low Calorie Diet Programme: https://www.england.nhs.uk/diabetes/treatment-care/diabetes-remission/ . It is now being rolled out to the whole of England: https://www.england.nhs.uk/2023/04/nhs-to-expand-soups-and-shakes-for-people-with-type-2-diabetes/ .

The eligibility requirements are:
"be aged 18 – 65 years"-- tick;
"have a diagnosis of type 2 diabetes within the last 6 years"-- tick; and
"have a BMI over 27 kg/m2 (where individuals are from White ethnic groups) or over 25 kg/m2 (where individuals are from Black, Asian and other ethnic groups)"-- tick. Your BMI is over 35, which means you are officially obese; even if you hadn't developed Type 2, your health is being undermined and your life expectancy shortened by your obesity.

Just do it. Ask your GP about the NHS Low Calorie Diet Programme. Demand to be referred to it.

There are a number of Type 2s on this forum who have successfully reversed their diabetes. You can too.

You may wonder: Why do I, as a Type 1, care about this? ... Because there is no cure for Type 1. It is not possible to reverse Type 1. I wish I were in your position-- because then I could do something about it. You are actually lucky; take advantage of your good luck. All best wishes, and do let us know how you get on!

In my view, there is no need for any restrictive diet programme for a newly diagnosed individual to make a difference to their lives with diabetes.

If that person's way of eating is adversely influencing their blood sugar, then eating starvation levels for weeks on end will not help them understand what is causing their issues. It may aid losing weight, but it does not educate them in terms of their longer term personal wellbeing management.

In my view, it is more advantageous to educate and adjust the lifestyle (which is likely to involve adjusting eating routines, and may include exercise).

So, so often I have observed individuals counting down to the end of their 12-week programme and working out what their treat will be. More often than not, that treat is sometime likely to be unhelpful to their longer term cause.

I have also observed folks thinking they'd sorted things because they did the 12-week programme, only to revert to an active T2 status down the line.

Of course, anyone can undo good work, but embedding healthy patterns early on, at a time when the individual is most likely motivated seems to make sense to me. After all, there is much agreement amongst the members here that maintaining a good healthy position is trickier than achieving that goal. (That goal could be blood glucose numbers, weight loss, exercise, stopping smoking, reducing alcohol intake or any combination of the foregoing.)

 

[Spathiphyllum]

So, so often I have observed individuals counting down to the end of their 12-week programme and working out what their treat will be. More often than not, that treat is sometime likely to be unhelpful to their longer term cause.

I have also observed folks thinking they'd sorted things because they did the 12-week programme, only to revert to an active T2 status down the line.

Of course, anyone can undo good work, but embedding healthy patterns early on, at a time when the individual is most likely motivated seems to make sense to me. After all, there is much agreement amongst the members here that maintaining a good healthy position is trickier than achieving that goal.

The whole point of the NHS Low Calorie Diet Programme is that it is *NOT* a "12-week programme". It is a year-long programme. (And it is based on extensive research, primarily in this country but also around the world.)

There is an initial 3-month period of very low calorie restriction-- proven in research to maximise your chance of losing the excess fat in and around your liver and pancreas which has caused your Type 2; and during these 3 months you also get regular, personalised support. *And then* there is a further 9 months of regular, personalised support-- to help you change your habits in relation to food and exercise.

This is great! Of course people need support in undoing old unhealthy habits and developing new healthy habits. And that is exactly what this programme is designed to do.

Sorry to get so emphatic! ; ) But personally-- as I've expressed in other posts-- I feel very strongly that we as a society need to do far more in terms of supporting people to avoid or reverse disease, rather than spending huge amounts of money, and condoning huge amounts of human suffering, trying to 'mop up afterwards'.

Many people would be far healthier-- and happier, and cost the NHS and economy much less in the long run-- if they had a sort of combination of psychologist and personal trainer to help them for a year. Unfortunately we don't do that for most of the people who could benefit from it. But Type 2s who meet the criteria stated in my previous post have finally got this chance. ... Anyway, all the best to all of you, and hope you have a happy and healthy weekend!

 

[bulkbiker]

There is an initial 3-month period of very low calorie restriction-- proven in research to maximise your chance of losing the excess fat in and around your liver and pancreas which has caused your Type 2;

The research has proven that this will work for about 11 % of the people involved in the longer term (5 years).
That in itself is a pretty poor success rate but we should not be surprised as we have know for decades that crash diets rarely lead to sustainable weight loss.

supporting people to avoid or reverse disease

I agree completely but when you are looking at a condition that can be summed up as carbohydrate intolerance then surely cutting back on the problem foods is a far better way of treating it than cutting out almost all foods.
When that minor restriction can lead to sustainable weight loss without the need for such severe restriction surely this would be a far better alternative and worthy of more investment by the NHS.

if they had a sort of combination of psychologist and personal trainer to help them for a year.

They would indeed benefit greatly but with the current state of the NHS I doubt that the Low Cal programme will have that level of support and instead that people will be given 3 months supply of food replacement pouches and left to go it alone.

 

[Spathiphyllum]

They would indeed benefit greatly but with the current state of the NHS I doubt that the Low Cal programme will have that level of support and instead that people will be given 3 months supply of food replacement pouches and left to go it alone.

People on the NHS Low Calorie Programme are absolutely not being "given 3 months supply of food replacement pouches and left to go it alone."

Could people please not spread misinformation about this programme??

Diabetes UK strongly supports this programme. Where is a DUK moderator when you need one?

 

[Burylancs]

The research has proven that this will work for about 11 % of the people involved in the longer term (5 years).
That in itself is a pretty poor success rate but we should not be surprised as we have know for decades that crash diets rarely lead to sustainable weight loss.

I agree completely but when you are looking at a condition that can be summed up as carbohydrate intolerance then surely cutting back on the problem foods is a far better way of treating it than cutting out almost all foods.
When that minor restriction can lead to sustainable weight loss without the need for such severe restriction surely this would be a far better alternative and worthy of more investment by the NHS.


They would indeed benefit greatly but with the current state of the NHS I doubt that the Low Cal programme will have that level of support and instead that people will be given 3 months supply of food replacement pouches and left to go it alone.

Yup it's astonishing that they are rolling out a programme that they know will fail 90% of participants in the medium term even though they have been carefully selected to take part. The money and time would better spent on something like providing meters and strips to ALL new T2s and education how to use testing.

 

[everydayupsanddowns]

Everyone please!

There are multiple methods of managing diabetes well.

Some people choose a short low calorie intervention aiming for significant weight loss, and then move to a maintenance menu to help the weight to stay off. For those who have the most success with this method, pancreatic function is measurably restored and carbohydrates can become less problematic.

Other people prefer low carbohydrate, or very low carbohydrate diet, and maintain this way of eating long-term. Some successfully manage this for years or even decades, and can even find that long held issues with hunger disappear, and weight loss can happen without feeling deprived.


Low calorie / weight loss / soup&shake doesn’t work (or appeal) to everyone.

Low carb or keto doesn’t work (or appeal) to everyone.

It really doesn’t help newcomers feel encouraged that there are multiple options towards a successful outcome if different sides try to undermine the effectiveness of a method they did not choose themselves.

Please accept that some people will want to try a different method to the one that worked for you.

 

[Burylancs]

Everyone please!

There are multiple methods of managing diabetes well.

Some people choose a short low calorie intervention aiming for significant weight loss, and then move to a maintenance menu to help the weight to stay off. For those who have the most success with this method, pancreatic function is measurably restored and carbohydrates can become less problematic.

Other people prefer low carbohydrate, or very low carbohydrate diet, and maintain this way of eating long-term. Some successfully manage this for years or even decades, and can even find that long held issues with hunger disappear, and weight loss can happen without feeling deprived.


Low calorie / weight loss / soup&shake doesn’t work (or appeal) to everyone.

Low carb or keto doesn’t work (or appeal) to everyone.

It really doesn’t help newcomers feel encouraged that there are multiple options towards a successful outcome if different sides try to undermine the effectiveness of a method they did not choose themselves.

Please accept that some people will want to try a different method to the one that worked for you.

Hmmm...no mention of medication in the two limited options you propose. One wonders what the last 100 years of research and development has been about if T2s are being encouraged to manage their condition the way the Ancient Greeks did. I notice you yourself avail yourself of all the modern advances available to you.

 

[everydayupsanddowns]

Hmmm...no mention of medication in the two limited options you propose. One wonders what the last 100 years of research and development has been about if T2s are being encouraged to manage their condition the way the Ancient Greeks did. I notice you yourself avail yourself of all the modern advances available to you.

Of course medication can be very effective! And provides a significant part of the picture for many here - but it‘s role in supporting people with diabetes as part of their diabetes management alongside lifestyle changes, was not the basis of the distracting argument that was emerging on the thread.

Without medication I would probably not have survived past my mid 20s, whereas thanks to insulin I have been living with diabetes for more than 30 years with no significant complications - so obviously I am a fan

 

[Dragonheart]

Hmmm...no mention of medication in the two limited options you propose. One wonders what the last 100 years of research and development has been about if T2s are being encouraged to manage their condition the way the Ancient Greeks did. I notice you yourself avail yourself of all the modern advances available to you.

Type 1 really have no options but to take medication. Different condition different treatment.

Type 2 has been managed medically for the last 50+yrs and as a result is seen as progressive. Sure it helps slow things down but by and large deals with symptoms not causes. It’s topping up the leaky bucket rather than fixing it. Obviously there’s a place for medication and advances but it should always be an adjunct to suitable lifestyle and diet changes not a replacement for it. Too many just want a magic pill and their donuts.

 

[Burylancs]

Type 1 really have no options but to take medication. Different condition different treatment.

Type 2 has been managed medically for the last 50+yrs and as a result is seen as progressive. Sure it helps slow things down but by and large deals with symptoms not causes. It’s topping up the leaky bucket rather than fixing it. Obviously there’s a place for medication and advances but it should always be an adjunct to suitable lifestyle and diet changes not a replacement for it. Too many just want a magic pill and their donuts.

All management of T2 deals with symptoms not causes and of course diet and lifestyle changes are essential anyway.

 

[everydayupsanddowns]

Type 2 has been managed medically for the last 50+yrs and as a result is seen as progressive.

One of the most significant aspects of the results of the Direct trial is that T2 diabetes does not necessarily have to be seen as inevitably progressive in all cases any longer.

Reversing Type 2 Diabetes

Discover how Newcastle University research by Professor Roy Taylor could reverse Type 2 diabetes and change lives. Read the full story.

from.ncl.ac.uk

“Most recently, the Newcastle research has shown that the small, shrunken pancreas found in Type 2 diabetes actually recovers to its normal size and shape over the two years.

Research trial​

One trial, DiRECT (Diabetes Remission Clinical Trial), found that almost nine out of 10 people taking part who lost 15kg or more put their Type 2 diabetes into remission. The study also found that almost half of those were still off all their Type 2 diabetes medication with normal blood glucose levels after one year [without medication].“

About Professor Taylor

Roy Taylor is professor of Medicine and Metabolism at Newcastle University. His work has shown that Type 2 diabetes is not inevitably progressive and life-long

 

[Dragonheart]

One of the most significant aspects of the results of the Direct trial is that T2 diabetes does not necessarily have to be seen as inevitably progressive in all cases any longer.

Reversing Type 2 Diabetes

Discover how Newcastle University research by Professor Roy Taylor could reverse Type 2 diabetes and change lives. Read the full story.

from.ncl.ac.uk

“Most recently, the Newcastle research has shown that the small, shrunken pancreas found in Type 2 diabetes actually recovers to its normal size and shape over the two years.

Research trial​

One trial, DiRECT (Diabetes Remission Clinical Trial), found that almost nine out of 10 people taking part who lost 15kg or more put their Type 2 diabetes into remission. The study also found that almost half of those were still off all their Type 2 diabetes medication with normal blood glucose levels after one year. “

About Professor Taylor

Roy Taylor is professor of Medicine and Metabolism at Newcastle University. His work has shown that Type 2 diabetes is not inevitably progressive and life-long

And this is exactly the point I’m making. That and low carb which is the approach I favour. T2 is/was seen as progress because of the medication only approach. These lifestyle/diet approaches show it does not need to be that way.

 

[Dragonheart]

All management of T2 deals with symptoms not causes and of course diet and lifestyle changes are essential anyway.

Not true. Removing the cause of the symptoms be it visceral fat around the organs or carb ingestion in excess of the amount we can cope with due to hyperinsulimia and insulin resistance is addressing cause. Merely forcing bgl down with drugs doesn’t address this.

If only all T2 accepted lifestyle and diet change is essential. A horrific % won’t accept or follow this. Those on forums like this are in the minority

 

[childofthesea43]

Not true. Removing the cause of the symptoms be it visceral fat around the organs or carb ingestion in excess of the amount we can cope with due to hyperinsulimia and insulin resistance is addressing cause. Merely forcing bgl down with drugs doesn’t address this.

If only all T2 accepted lifestyle and diet change is essential. A horrific % won’t accept or follow this. Those on forums like this are in the minority

And to drive that point home, about 1 in 20 T2s are in remission a year after diagnosis but only about 1 in 14000 after five years, almost all owed to weight regain through losing the plot.

 

[Burylancs]

Not true. Removing the cause of the symptoms be it visceral fat around the organs or carb ingestion in excess of the amount we can cope with due to hyperinsulimia and insulin resistance is addressing cause. Merely forcing bgl down with drugs doesn’t address this.

If only all T2 accepted lifestyle and diet change is essential. A horrific % won’t accept or follow this. Those on forums like this are in the minority

It's not addressing cause at all. Hyperinsulinemia and insulin resistance are the cause, visceral fat is a visible symptom of them.

 

[Burylancs]

And to drive that point home, about 1 in 20 T2s are in remission a year after diagnosis but only about 1 in 14000 after five years, almost all owed to weight regain through losing the plot.

All of which suggests this is not a viable option for the management if T2 in the medium term.

 

[Burylancs]

One of the most significant aspects of the results of the Direct trial is that T2 diabetes does not necessarily have to be seen as inevitably progressive in all cases any longer.

Reversing Type 2 Diabetes

Discover how Newcastle University research by Professor Roy Taylor could reverse Type 2 diabetes and change lives. Read the full story.

from.ncl.ac.uk

“Most recently, the Newcastle research has shown that the small, shrunken pancreas found in Type 2 diabetes actually recovers to its normal size and shape over the two years.

Research trial​

One trial, DiRECT (Diabetes Remission Clinical Trial), found that almost nine out of 10 people taking part who lost 15kg or more put their Type 2 diabetes into remission. The study also found that almost half of those were still off all their Type 2 diabetes medication with normal blood glucose levels after one year [without medication].“

About Professor Taylor

Roy Taylor is professor of Medicine and Metabolism at Newcastle University. His work has shown that Type 2 diabetes is not inevitably progressive and life-long

 

[Burylancs]

Taylor could call a cat a dog but it wouldn't make it one. Neither will calling Good Control 'reversal' or 'remission '.

 

[childofthesea43]

It's not addressing cause at all. Hyperinsulinemia and insulin resistance are the cause, visceral fat is a visible symptom of them.

Have you done the research to demonstrate that? If so you must publish it urgently as it will change the game entirely.

 

[bulkbiker]

Have you done the research to demonstrate that? If so you must publish it urgently as it will change the game entirely.

There are plenty of people who have Prof Ben Bikman for one.