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  #1   ^
Old Thu, Jan-14-21, 01:44
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Demi Demi is offline
Posts: 23,488
Plan: Low Carb
Stats: 217/203/160 Female 5'10"
Progress: 25%
Location: UK
Default Low carb diet may be short term alternative to meds for diabetics

Low-carb diet could help fight type 2 diabetes

A low-carbohydrate diet can help to put type 2 diabetes into temporary remission, a study has found.

The research, published in the British Medical Journal, is further evidence that changes to diet may be a short-term alternative to medication for the millions of Britons living with the most common form of the condition.

The charity Diabetes UK estimates that more than four million people in the UK have type 2 diabetes, many of them without realising it. While there is no cure, keeping blood sugar levels at a healthy level through diet has long been a recommended treatment.

But there has also been confusion, with some doctors recommending both low-carb and low-fat diets.

A team of international researchers analysed data from 23 trials involving 1,357 people to assess the effectiveness and safety of low-carb diets and very low-carb diets compared with mostly low-fat control diets.

Low-carb diets were defined as less than 26 per cent of daily calories from foods such as bread, rice and pasta, with diets containing less than 10 per cent of calories from the same foods considered very low-carb.

After 6 and 12 months, many of the 1,357 participants showed remission of diabetes, meaning blood sugar had returned to healthy levels, as well as weight loss. The researchers found that patients on low-carb diets achieved higher remission rates at six months compared with patients on control diets, and had no other arising problems.

Eight of the trials, involving a total of 264 participants, showed that eating a small amount of carbohydrates each day cut risks from diabetes at six months by 32 per cent. But researchers also warned that following the low-carb diet for 12 months and longer may do more harm than good, and even increase mortality rates.

Dr Bradley Johnston, associate professor at Texas A&M Universityís department of nutrition, said: ďModerate to low certainty evidence suggests that patients adhering to low-carbohydrate diets [LCDs] for six months may experience greater rates of remission of diabetes without adverse consequences compared with other diets commonly recommended for management of type 2 diabetes [for example, low-fat diets].

ďThese benefits diminished at 12 months, and, although LCDs seem to improve triglycerides [fatty acids combined with glycerol] in a clinical meaningful way, some evidence shows clinical worsening of quality of life and low density lipoprotein cholesterol. Clinicians might consider short-term LCDs for management of type 2 diabetes, while actively monitoring and adjusting diabetes medication as needed.Ē

Type 2 diabetes is a cause of premature death for about 22,000 people each year in England.


Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data

BMJ 2021; 372 doi: (Published 13 January 2021)


To determine the efficacy and safety of low carbohydrate diets (LCDs) and very low carbohydrate diets (VLCDs) for people with type 2 diabetes.

Design Systematic review and meta-analysis.

Data sources Searches of CENTRAL, Medline, Embase, CINAHL, CAB, and grey literature sources from inception to 25 August 2020.

Study selection Randomized clinical trials evaluating LCDs (<130 g/day or <26% of a 2000 kcal/day diet) and VLCDs (<10% calories from carbohydrates) for at least 12 weeks in adults with type 2 diabetes were eligible.

Data extraction Primary outcomes were remission of diabetes (HbA1c <6.5% or fasting glucose <7.0 mmol/L, with or without the use of diabetes medication), weight loss, HbA1c, fasting glucose, and adverse events. Secondary outcomes included health related quality of life and biochemical laboratory data. All articles and outcomes were independently screened, extracted, and assessed for risk of bias and GRADE certainty of evidence at six and 12 month follow-up. Risk estimates and 95% confidence intervals were calculated using random effects meta-analysis. Outcomes were assessed according to a priori determined minimal important differences to determine clinical importance, and heterogeneity was investigated on the basis of risk of bias and seven a priori subgroups. Any subgroup effects with a statistically significant test of interaction were subjected to a five point credibility checklist.

Results Searches identified 14 759 citations yielding 23 trials (1357 participants), and 40.6% of outcomes were judged to be at low risk of bias. At six months, compared with control diets, LCDs achieved higher rates of diabetes remission (defined as HbA1c <6.5%) (76/133 (57%) v 41/131 (31%); risk difference 0.32, 95% confidence interval 0.17 to 0.47; 8 studies, n=264, I2=58%). Conversely, smaller, non-significant effect sizes occurred when a remission definition of HbA1c <6.5% without medication was used. Subgroup assessments determined as meeting credibility criteria indicated that remission with LCDs markedly decreased in studies that included patients using insulin. At 12 months, data on remission were sparse, ranging from a small effect to a trivial increased risk of diabetes. Large clinically important improvements were seen in weight loss, triglycerides, and insulin sensitivity at six months, which diminished at 12 months. On the basis of subgroup assessments deemed credible, VLCDs were less effective than less restrictive LCDs for weight loss at six months. However, this effect was explained by diet adherence. That is, among highly adherent patients on VLCDs, a clinically important reduction in weight was seen compared with studies with less adherent patients on VLCDs. Participants experienced no significant difference in quality of life at six months but did experience clinically important, but not statistically significant, worsening of quality of life and low density lipoprotein cholesterol at 12 months. Otherwise, no significant or clinically important between group differences were found in terms of adverse events or blood lipids at six and 12 months.

Conclusions On the basis of moderate to low certainty evidence, patients adhering to an LCD for six months may experience remission of diabetes without adverse consequences. Limitations include continued debate around what constitutes remission of diabetes, as well as the efficacy, safety, and dietary satisfaction of longer term LCDs.
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  #2   ^
Old Thu, Jan-14-21, 11:34
Demi's Avatar
Demi Demi is offline
Posts: 23,488
Plan: Low Carb
Stats: 217/203/160 Female 5'10"
Progress: 25%
Location: UK

Tom Watson has been featured here before, but this article is relevant to the thread

Tom Watson: ĎHow I lost 8 stone, reversed type 2 diabetes, and kept fit in a pandemicí

As a new study shows a short-term low carb diet can put type 2 diabetes into remission, hereís how I managed to conquer the disease

The birthday card said ĎFab at 50í, but all I could think was Iím fat at 50. I was morbidly obese at 22st, with added hypertension and type 2 diabetes, yet like millions of others, Iíd spent years in denial about the seriousness of my situation. When I finally addressed the illness and put diabetes into remission, I transformed.

I celebrated my half-century partying in the company of good friends and woke up the next day the loneliest man in Britain. Hungover, sleep-deprived, blood sugars crashing, deep despair enveloped me. I was going to die young, and I was frightened.

As Iíve just turned 54, I look back on that point as the day I hit rock bottom. The change has been so significant that it feels like Iím looking at someone elseís life. I no longer take diabetes medication and fall asleep in afternoon meetings. I think in the present more often. Yet it took years, possibly decades, to adequately address my failing health.

Iím incredibly thankful that I dealt with my chronic ill health before the pandemic hit the UK.

A January lockdown with most gyms shut down by a global pandemic is not the most comfortable starting point on a health journey. Yet with increasing evidence that people who suffer from chronic inflammation tend to be hit hardest by the virus, there is no more important a time to consider lifestyle changes that improve our resilience.

Even after a formal diagnosis of type 2 diabetes, I remained in denial. I hid the prescription of diabetes drug Metformin. I felt shame collecting the box of white pills from the pharmacy.

Yet by the time I was 50, Iíd started to read as much literature as I could about nutrition and weight loss. I narrowed my diet options down to two very different approaches. I could adhere to an ultra-low calorie diet that Professor Roy Taylor at the University of Newcastle had shown could put type 2 diabetes into remission. My other option was to significantly reduce carbohydrate intake to no more than 20g a day. That means no chips, pasta or rice. I chose the latter option, often described as a keto diet.

Tom Watson: ďThis yearís resolutions are all about leading an active lifeĒ
A ketogenic diet is where you restrict carbohydrate intake to around 5 per cent of your total consumption of macronutrients. The dietís critical aspect is a significant increase in your use of Ďgoodí fats like olive oil and butter. Having read The Art and Science of Low Carbohydrate Living by Dr Jeff Volek and Dr Stephen Phinney, I understood our bodies to run on two sources of energy Ė glucose or fat. This process is often simplified to explain that carbohydrate restriction allows our bodies to become fat adapted, meaning our body uses fat reserves to generate energy.

I found increasing fat intake difficult. For decades our thinking has been shaped by government advice and industry advertising. Using even an extra teaspoon of butter to cook food felt irrational for weight loss. To establish a nutritional programme that defied Public Health Englandís guidance was uncomfortable, though in the end, having read the research, I took a leap.

When youíre wrestling with something as necessary as a shopping list, you have to be clear about your objectives. Mine was to lose weight and reverse diabetes. As I was breaching public guidelines, I became obsessive about measuring weight and blood sugar.

After clearing out the cupboards and stocking up with eggs, bacon, steaks and olive oil, I started on the new regime. I lost 1lb a day in the first week. My daily finger-prick blood test showed signs of progress before the end of the week.

More importantly, I started to sleep better. Many people with type 2 diabetes have to use the lavatory a couple of times a night. I began to sleep through until morning. Poor sleep increases insulin resistance Ė a disaster for Type 2 diabetics. By the end of the first week, I was jumping out of bed each morning with a spring in my step.

Within a year, Iíd lost 100lb and reversed type 2 diabetes.

Could a low carb diet be an effective treatment for diabetes?
Dr Arun Thiyagarajan, medical director of Bupa Health Clinics, explains...

Is a low carb diet an effective treatment for diabetics?

We carry out thousands of diabetes tests every year, and are often asked by patients whether cutting carbs can help manage or prevent the condition.

While a low carb diet isnít an effective treatment for diabetes on its own, when implemented as part of a wider plan it can have effective results. These include improved blood sugar management and weight loss, decreased medication needs and reduced the risk of diabetic complications.

How does it work?

For those who donít have diabetes, when we eat carbs, theyíre broken down into small units of glucose, which become blood sugar. When blood sugars go up, the pancreas produces the hormone, insulin, which then enters cells. For those with diabetes, the system doesnít work in the same way. People with diabetes are deficient in insulin or resistant to its effects. When individuals eat carbs, their blood sugar can rise this will trigger insulin release, which if persistent can render the bodyís cells less sensitive to insulin itself.

Therefore, reducing carb intake or following a low carb diet can help to manage the effects of diabetes, but should be used as part of a wider treatment plan to ensure sustainable changes.

What do you need to consider before commencing a low carb diet either to treat or to prevent diabetes?

Itís important that you speak to your doctor before making changes to your diet or significantly reducing your carbohydrate levels. Theyíll be able to advice you on the best treatment plan and take into account the type of medication you are on to manage diabetes. For example, if you are on medication such as insulin Ė which can cause hypoglycaemia Ė it is important that you donít cut out carbs. If you want to start reducing your carb intake, start with unhealthy sources such as pizzas, cakes and chips. To ensure youíre still getting healthy carbs, look to replace them with healthy, high-fibre foods such as pulses, nuts, vegetable and whole grains.

For those who donít have diabetes, does losing weight via a low carb diet help to reduce risk of developing it in later life?

Being overweight is known to put you at greater risk of developing type 2 diabetes. As such, even for those who arenít diabetic, losing excess weight can help reduce the risk of developing the condition in the future.

Diet is an important factor, but itís not just about cutting down on carbs. A balanced diet can include carbohydrates, while cutting down on excess sugars and saturated fats. It should also be complimented by regular exercise, to ensure youíre staying fit and healthy, while burning off calories from your diet. Our health advisors often hear from clients who are interested in trying out crash diets, and our advice is always the same.

Typically, these diets have short-term results, meaning people often put the weight back on. As such itís important that to make sustainable lifestyle changes, which will help maintain a more constant healthy weight, ultimately reducing the long-term risk of diabetes.
Even though the most significant contribution to turning around my health was changing the food I put in myself, I set myself two very tiny exercise targets. Five thousand steps a day may seem a small number for many, but it was a hard target and physically taxing for me. I rigidly applied a rule to walk up every staircase rather than take the lift. The first time I climbed the steps to reach the Commons committee corridors I thought Iíd need oxygen halfway up!

Within weeks Iíd upped the steps target to 10,000 a day and took a few tiny journeys on a second-hand hybrid bike. I rewarded myself with a new kit for the bike every time I hit a weight target. I put a basket on the handlebars, which led to me using the bike on trips to the shops. I began to feel more energetic and took a few walking meetings with my teamís younger members in parliament. Outside the hours of planned exercise, I was more active. I just did more tiny things, like tidying up the flat or walking into work if the sun was shining.

I plucked up the courage to sign up with a personal trainer. Clayton, a quietly spoken but thoughtful trainer, took me through my paces in Kennington Park each week. On our first meeting, I couldnít complete a single press-up. Within weeks he had me boxing and skipping, much to the amusement of the Labour party members of Lambeth who spotted me as they walked their dogs and took their kids to school.

Now that Iím on maintenance, I donít have weight targets. My goal is an active life. Iím part of a group of friends who hold each other accountable for being more active. We call ourselves the PoP Club Ė Persons of Positivity. One of the challenges we set ourselves last November was to walk, run or ride 5k a day. I think I managed 26 days of running. Yet the rules are loose. For some, just getting out of the house to walk is a feat of will and organisation. Our only group rule is that we look after each other.

This yearís resolutions are all about leading an active life. I want to learn to ski. Iím hoping to take part in an organised bike ride and raise some money for charity. I want to join a running club or sign up to parkrun. Iíve still got a 12,000 daily steps target, which is quite hard to complete within the lockdowns but helps maintain my focus.

Covid has given us all time to reflect on the essential things in life Ė personal health being top of the list.

If I have one political mission left in me, itís to work with the 3.5 million people in the UK who have type 2 diabetes. Research suggests that with a change of nutrition and exercise, at least two million of them can completely reverse their condition. That really would be a game-changer to achieve.

Downsizing: How I Lost 8 Stone, Reversed my Diabetes and Regained my Health by Tom Watson is published by Kyle Books.

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