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Wednesday 30 September 2015

Statins ‘may only postpone death by three or four days’

Treatment with statins only improves people’s overall survival very slightly, postponing death by around three or four days, a new analysis of trials evidence has found.

The authors of the analysis – published in BMJ Open – said GPs should not push use of statins in people troubled by their side effects or in those with limited life expectancy.

The Danish researchers looked at 11 randomised controlled trials of statins that reported all-cause survival curves, with follow-up lasting between two and six years.

They found statins postponed death by a median of 3.2 days in the six studies where they were being tested for primary prevention, and a median of 4.1 days in five studies of their use for secondary prevention.

The researchers wrote: ’Statin treatment results in a surprisingly small average gain in overall survival within the trials’ running time.’

They said that as a result, when treating people with statin intolerance or in whom treatment is associated with unpleasant side effects, GPs ‘should not be too insistent on the patient continuing them’.

Meanwhile, ‘for patients whose life expectancy is short, the benefit of statin therapy in terms of survival gain may be quite limited’, they wrote.

The team added that explaining to people how much statin treatment is likely to postpone death, rather than using terms like numbers needed to treat, may help people weigh up the benefits and risks of treatment more easily.

http://www.pulsetoday.co.uk/

But lest we forget apart muscle pain and damage, liver damage, neurological side effects and Type 2 diabetes etc, the benefits of statins far outweigh the risks !!

Graham

Evelyn Cokur aka Carbsane aka the bloated blogger's latest stunt.

For those residing in the UK and have never heard of the CarbSane blog, run by a morbidly obese woman in the US called Evelyn Cokur, let me bring you up to speed. She has spent years rubbishing lowcarb and paleo. Everyone from A to Z literally, from Physician Dr. Andreas Eenfeldt to Nutritionist and best selling author Zoë Harcombe. The obvious question must be why? 

Well, not so long ago Cokur appeared on a Jimmy Moore podcast and stated she lost a huge amount of weight by low carbing, perhaps the first time in her adult life she had obtained a safe weight. But, the junk food she called "treats" namely Lindt chocolates proved irresistible, back on went the weight. Low carb was a failure for Cokur, and hence a failure for all, according to the font of all knowledge and self styled Professor Emeritus of all things dietary. Many millions of people would argue she failed low carb.  

In my opinion Carbsane is best avoided, and I do my best to do that, but a friend sent me a link to Kocur's latest stunt. The bloated blogger has organised a petition against the best selling author of the book 'The Big Fat Surprise' Nina Teicholz. What the font hopes to achieve can only be guessed at. 

Let's face it, taking weight loss lectures from Evelyn Cokur, makes about as much sense, as taking flying lessons from a Kamikaze pilot, it never ends well. Any straight thinker can spot a dud from a long way off. They can tell the difference between a blogger who wants to spread a message that may be of use or help someone, and a blog that has self aggrandisement, bitterness, and jealousy of others success written all over it. 

Am I right or am I right.

Eddie

Pan-Fried Lamb Chops with Red Onion and Braised Celery


Lamb can often be more expensive to buy... but it can make a welcome midweek meal. I often look for special offers, and get some nice lamb loin chops or cutlets and enjoy them with some red onion, celery and buttery mashed swede. 

Ingredients:

Serves Two
4 (lean) lamb loin chops or cutlets
1 packet celery hearts, cut in half length-ways
25g/1oz butter
150ml/¼pint hot vegetable stock
2 sprigs fresh thyme leaves
Salt
5ml/1tsp black peppercorns, crushed
15ml/1tbsp oil
1 large red onion, peeled and finely sliced

Method:
1.  Place the celery in a shallow pan with the butter, stock and thyme leaves. Bring to the boil, reduce the heat, cover and simmer for 15 minutes or until most of the liquid is absorbed and the celery is tender.
2. Meanwhile place the chops or cutlets on a chopping board and season on both sides with the salt and peppercorns.
3. Heat the oil in a large non-stick frying pan and cook the lamb for 10 minutes, turning once. Add the onion and cook for a further 2-4 minutes.
4. 
Transfer the lamb and onions to a warm plate, drizzle over any pan juices and serve with the braised celery and buttery mashed swede.

Recipe from here

Don't forget to also prepare your buttery mashed swede ...


... and then enjoy your meal


perhaps with a glass of wine - optional

All the best Jan

Tuesday 29 September 2015

Time For Diabetes UK To Unplug Ears and Respond To Chorus Of Disapproval Demanding U-Turn.

By Jane Feinmann
How much longer can the charity Diabetes UK continue to provide advice on diet to the UK’s 3.9 million people with type 2 diabetes that is based on the discredited Seven Countries Study carried out by Ancel Keys back in the 1950/1960s? The urgency of this question cannot be overstated.

On the one hand, type 2 diabetes is almost certainly the most poorly managed chronic disorder of modern times. Two out of three people with the disorder fail to control their blood glucose despite GPs handing out diabetic medication amounting to 10 per cent of the NHS drugs budget.   

The long-term consequences of this failure are staggering and tragic – both financially and at an individual level.  

Every year, 80 per cent of the £10bn that the NHS spends on diabetes is used to treat the consequences of poorly controlled blood sugar:  kidney and heart failure, increased risk of heart attack and stroke as well as blindness and nerve damage. Each week surgeons carry out more than 100 diabetes-related amputations – with 24,000 deaths every year because people with type 2 diabetes are not able to control their blood glucose.

A policy based on a discredited study
At the same time, there is virtually universal acceptance that type 2 diabetes is the classic life-style disorder where what you eat makes a crucial difference.   

So why does Diabetes UK (with the support of both Nice and NHS Choices) persist in sticking to a recommendation that everyone with type 2 diabetes should continue to consume ‘a normal’ healthy diet’ – ie.one that’s low in fat and with plenty of daily starchy carbohydrates including bread, rice and pasta, based on the now discredited 1950/1960s Keys study.  

Sure – as Diabetes UK continually points out – not everyone with type 2 diabetes is obese: some indeed are ‘skinny’. But eight out of ten people with the disorder have a BMI above 30 which suggests that a key factor is diet – with new evidence showing why there is no single BMI linked to type 2 diabetes.   

‘We now know that individuals have different levels of tolerate to fat within the liver and pancreas,’ explains Professor Roy Taylor of Newcastle University’s Diabetes Research Group. ‘Only when a person has more fat than they can cope with does type 2 diabetes develop. What’s more, we now know that when they successfully lose weight and go below their personal fat threshold, their diabetes will disappear,’ he explains.   

Trying to hold back the tide of evidence
The last two or three years has seen a growing pile of highly persuasive evidence showing the benefits of weight loss for people with type 2 diabetes who switch to a low carb diet.   Last year, the journal Diabetologia published a study of 19 patients with type 2 diabetes at the Southport surgery of Dr David Unwin, a GP and diabetes specialist.  

All the patients lost an average of 8.65kg (19lb) over seven months on a low-carb, high-fat diet, reducing their blood glucose levels by nearly a quarter. Later this year, Dr Unwin is set to publish a further study of 69 patients with non-alcoholic fatty liver disease, a precursor of type 2 diabetes as well as heart disease, showing a 46 per cent improvement in liver blood tests, and therefore a reduced risk of high blood glucose levels after an average of 13 months on a low-carb high-fat diet.  .

What’s more common sense supports the low carb protocol, according to diabetes specialist, Dr David Cavan, author of Reverse Your Diabetes. ‘We know that type 2 diabetes develops when blood glucose rises above a certain level – and whether it’s sugar, rice, bread or potatoes, these carbohydrates rapidly turn into glucose in your bloodstream,’ he says.  

His patients and many others are able to control blood glucose by becoming more active and switching to a low carb diet. Indeed under his influence, around 280,000 people with diabetes have signed up to the online forum, diabetes.co.uk where they are able to swap tips on low carb meals and provide comradely support to each other as they’re forced to ignore the advice from their GP or diabetes nurse.

Desperate patients forced onto dangerous diet
When I wrote about this dilemma in the Daily Mail recently, the piece triggered over 200 responses from readers caught in this invidious position.  

Mary Megan from London was ‘stunned’ last year when her GP ‘recommended eating carbohydrates as part of a ‘healthy balanced diet’ when I know for a fact from having tested my blood sugar over the years that carbohydrates are the exact cause of my high blood sugar.’

Bob from Sudbury, Suffolk has lost the sight in one eye and suffered kidney failure and nerve damage after being diagnosed with type 2 diabetes 12 years ago but given ‘little to no advice ‘. Sari from Hampshire says her mother ended up with a huge weight problem because her diabetic nurse insisted ‘you are getting it wrong by not eating enough carbs and that is the main cause of your problem.’ Poppy’s daughter in law was told she ‘must eat carbohydrates to use her insulin’.

It’s not just the UK where people with type 2 diabetes are confused.   

Earlier this summer, the Academy of Nutrition and Dietetics, representing 90,000 US dietitians, ‘turned its back on decades of dietary dogma’ with a report to ‘de-emphasise saturated fat as a nutrient of concern’ while ‘recognising the strongest evidence that a reduction in intake of carbohydrates and added sugars will improve the health of the American public’.  

Nurse told to stop making diabetics well again
Yet at almost exactly the same time, administrators at a health district in Australia, Southern New South Wales, issued a warning to pro-low carb’  dietitian Jennifer Eliot that ‘nutritional advice to clients must not include a low carbohydrate diet’. When she refused to comply – ‘Can you imagine having to tell a client with diabetes, who has lowered his blood glucose levels, lost weight and come off all diabetes medications by reducing his carb intake, that he now has to start eating more carbs because SNSW Health says so !?  - she was sacked.

‘It’s not easy to be a dietitian in Australia advocating carbohydrate restriction, but even worse to be a person with diabetes in the SNSW Health district where you are denied the choice of a low-carbohydrate diet,’ she says on her website babyboomersandbellies.com.

Here too, it seems as though the health establishment is prepared to prevaricate indefinitely. Last month, Dr Aseem Malhotra, clinical associate to the Academy of Royal Colleges repeated a challenge to the charity Diabetes UK to explain why it continues to recommend ‘carbohydrates known to promote fat storage and hunger’ to a group of people most of whom urgently need to lose weight.

‘Given that type 2 diabetes is a condition related to an intolerance to metabolise carbohydrates, it is puzzling why Diabetes UK recommends as part of a “healthy balanced diet” the consumption of plenty of starchy carbohydrates and modest amounts of sugary food and drinks including cakes and biscuits,’ he said.  

An inspirational doctor who is helping diabetics
In a response on its website to the Mail article, Diabetes UK acknowledges that there is indeed ‘evidence that low carbohydrate diets can be effective and control blood glucose’. But the statement by its clinical advisor, Douglas Twenefour, adds the extraordinary assertion that ‘a healthy balanced diet’ (ie with plenty of carbohydrates) ‘is easiest to understand and will benefit the majority of people with diabetes’.  

It’s an assertion which assumes there can be no change to the current culture where refined carbohydrates are widely promoted and easily and cheaply available - a bit like a lung cancer charity saying that giving up smoking is a good idea but that it’s too difficult to get message across.

Making lifestyle changes to control blood sugar isn’t easy but it’s possible provided people are given detailed information – as the online community, diabetes.co.uk has shown.   Dr Unwin has described how, as a committed, informed GP, he has been able to help patients with type 2 diabetes to lose weight and gain control over the blood sugar with a low carb diet – at the same time saving £20,000 per year in prescription costs – an important factor bearing in mind that Diabetes UK has recently warned that type 2 diabetes will bankrupt the NHS.

As for those who can’t imagine an end to advertising and product placement of refined carbs, they should consider the impact of smoking cessation policies on both health and culture over the past five decades.    

For the sake of Mary, Bob and Sari’s mum and the three million other people diagnosed with type 2 diabetes in the UK, we need Diabetes UK to bring about a tipping point on carbs advice.  

http://healthinsightuk.org/

This is what DUK have to say in response to criticisms 

Diabetes UK is not against diets such as the low-carb diet. The low-carb diet is one of the many diets that we have reviewed in our nutritional guidelines to healthcare professionals so that they can support people with diabetes who want to try it

https://blogs.diabetes.org.uk

There you have from the horses mouth when your DSN, dietitian or doctor try to put you off LC cite the article from DUK though I think the dietitians will need some intensive education to be able to support us. Perhaps they should enrol Trudi Deakin to run some courses for them.

Graham

Tuesday Already ... and Feeling Fine ... How About A Chicken Bake?


Do you often feel Tuesday's can be a funny day? The day after Monday and the day before mid-week, what do we do with Tuesday's?

Whereas, Thursday's feels completely different, it is after all ... almost the end of the working week!

... but anyway I woke up this morning feeling fine ... I looked out of the window and saw the making of a glorious sunny day ... so I'm wishing everyone a Happy Tuesday...

I hope you may be feeling 'sparkling' as the image shows but if not, I hope you feel better as the day goes on ... and perhaps you may wish to consider this tasty dish for dinner tonight!


Chicken, leek and Cheddar bake

Chicken, Leek and Cheddar Bake


Easy to make and ready in half an hour, this chicken, leek and Cheddar bake recipe is the perfect Tuesday evening (or midweek) chicken bake for the family. This delicious recipe serves 4 people and will take about 35 mins to rustle up. Packed with plenty of flavour, thanks to the buttery Cheddar cheese sauce and tangy leeks. This recipe uses chicken breasts but you could use other cuts of chicken too including thigh or wings to cut the cost down. 

Ingredients:
1tbsp oil
4 chicken breasts, diced
2 leeks, washed and sliced
25g butter
150ml double cream
150ml full fat milk
125g Cheddar cheese, grated

Method:
Heat the oil in a large, non-stick frying pan and fry the chicken for 5 mins. Add the leeks and fry for 10 mins, covered.
Meanwhile, melt the butter in a small saucepan (low heat) and stir in the cream. Cook for about 1 min. Off the heat, gradually whisk in the milk then bring to the boil, keep stirring. Season and add half the cheese and stir until melted.
Place the chicken in a heatproof serving dish and pour over the cheese sauce. Sprinkle over the remaining cheese and place under a preheated grill for 2-3 mins until golden and bubbling. Serve with a green salad.

Recipe adapted from original idea here

Such an easy bake recipe - hope you enjoy it !

All the best Jan

The Stream - Feeding into our sugar addiction

On The Stream: We discuss why food is making us fat, the power of the food industry and why it’s so difficult to consume healthily.

New On-line Free Newspaper "Healthy Eating" Out Now.


Check it out here.

Eddie

Monday 28 September 2015

Dr. Troy Stapleton : Six Days, One Dozen Eggs, Two Insulin Pens and GRIT


Dr. Troy Stapleton has spoken about his experiences at a number of our Low Carb Down Under events and inspired many people with Type-1 Diabetes to go Low Carb. He has recently returned from six days hiking in the Tasmanian wilderness. Here’s how he did it.

Where did you hike and how long did it take?

I am just back from the walking the Overland track in Tasmania. This is a 65-kilometre walk through a wilderness area from Cradle Mountain to Lake St Clair. We walked the track over six days, staying in basic National park huts.

This winter in Tasmania has been the coldest in 30 years and there was deep snow on the track. We spent three of the days walking in snowshoes (my first time), which made it quite slow going. We were the first non-guided group to get through the track in the last six weeks. This was quite a milestone for me. I last walked the track in 2006 and I remember thinking soon after my T1D diagnosis that managing my diabetes would make such a trip difficult to do again.

We were well prepared for any adversity. In our group we carried an EPIRB, a GPS with the track details and a “yellowbrick” which allowed us to send out SMS messages via satellite and tracked our exact movements.

What food did you take?

I took eggs, salmon, tuna, salami, cheese, nuts, and beef jerky, tomatoes, onions, zucchinis, snowpeas, spinach, chilies, ghee and spices. I prepared all my meals from scratch and maintained low steady blood glucose throughout (I did cut my basal insulin from 14u to 10u as well).

How did you manage packing enough low carb supplies, including fresh food, for six days?

Carrying fresh food was not too much of a problem. The temperatures varied between about -2 degree and +10, so the food was easy to keep cool. The huts only have a small gas heater, so don’t go much above +10 degrees.

I carried one dozen eggs. I had a special egg carrier to protect them, and I kept them in the top of my pack. For breakfast I made scrambled eggs with ghee and salmon. Lunches/snacks included cheese, nuts, beef jerky, salami and salads. Dinners were salmon or tuna with salad or fried with snowpeas, zucchini, onion, chili, tomato and capers.

What was your base pack weight and your food weight carrying fresh food?
The pack weighed 20-25 kg but the bulk of that weight was from the sleeping bag, tent (for emergency shelter), sleeping mat, warm dry clothes, stove, fuel, EPIRB, water and utensils. Carrying fresh food rather than dehydrated was only a minor addition and made the trip so much better. The only carbs I had for the entire journey were small amounts in the vegetables and nuts.

Did you take any dehydrated foods?

No. Except for the beef jerky, I suppose. Interestingly fat is more efficient to carry than carbs because it is more calorically dense at 9 calories/g rather than carbs and protein which are only 4 calories /g. The early explorers and the military knew this and carried pemmican (70% fat/30% protein). I carried a 400g tin of ghee, which is clarified butter. This is solid at room temperature and is a good fat to cook in. I used the ghee in my morning scrambled eggs and to fry the vegetables and salmon in.

How did you keep your insulin at safe temperatures?

I was worried about the insulin freezing and my meter doesn’t work when it is cold. I took two meters, two sets of insulin pens and back up batteries for my meters. When the temperatures dipped, I stored the insulin and meters in my jacket pockets to receive some body heat. At night they were in my sleeping bag.

Would you do anything different next time?

My one luxury item on the trip was some freshly ground coffee. I under catered and had to ration this towards the end of the trip. Otherwise I would not change anything.

http://www.lowcarbdownunder.com.au/

Graham

Autumn Mix : Flowers, Berries and a Fruit and Almond Clafoutis


Take some wonderful Autumn Flowers to brighten up your home


Take some low carb fruits and enjoy with some double cream for a tasty dessert


Or why not be be a little more adventurous and make a ...

Lowcarb fruit & almond clafoutis

... one of our low carb favourites

Ingredients:
50 grams of ground almonds
1 tablespoon of plain flour
250ml of double cream
2 egg yolks
100 grams of raspberries
100 grams of blueberries

Serves 4-6
Mix the almond flour, plain flour, egg yolks and cream in a bowl or pyrex jug.
Pour into a non stick baking dish 8" x 1.5" and place the fruit.
Place into a pre heated oven at 190c and cook for twenty-five minutes. Remove, cover with foil and cook for further twenty minutes. Allow to stand for 1 hour.

This gorgeous French pudding is sublime. Lowcarb and so easy to make.
Serve with double cream.

Enjoy your Monday

All the best Jan

How to reverse type two diabetes.

Self management of Type 2 diabetes

My first year to April 2015

Summary

  • Diagnosed Type 2, March 2014 (HbA1c 65 mmol/mol, 8.1%) 
  • No medication 
  • Self-testing 
  • Low-carb diet 
  • Now in non-diabetic range (HbA1c 38 mmol/mol, 5.6%) 
  • 20 kg weight loss 
  • Improved lipid profile

Highlights
 

March 2014
March 2015
HbA1c
65 mmol/mol (8.1%)
38 mmol/mol (5.6%)
Weight (BMI)
90 kg (31.5)
70 kg (24.5)
Waist
116 cm
94 cm
Liver Function ALT
51 iu/l
14 iu/l
Blood Pressure
160/90
115/65





Introduction and diagnosis

I had blood tests in March 2014 following reported listlessness and exhaustion. There were none of the ‘classic’ T2 symptoms of excessive thirst, need to urinate, blurred vision etc. 

Diagnosis was confirmed on 24 March with an HbA1c of 65 mmol/mol (8.1%). (It later transpired that in 2008 a blood test showed I had an HbA1c of 44 (6.2%), i.e. prediabetic. Apparently the trigger criterion was different then. Nothing was mentioned anyway, pity.) 

No guidance was given, I was just told this was life-changing, to lose weight (I was 90 kg, BMI of 31.5), exercise more and make an appointment to see the diabetes nurse. The earliest appointment available was for 16 April, over three weeks away. Because of elevated blood pressure (spot reading of 160/90 when blood samples taken) I was told to take two weeks of readings to take to this appointment (how? where? – at a chemist or buy yourself a meter, great, thanks). 

Because of total cholesterol of 6.9 I was prescribed Simvastatin without any explanatory discussion and without my prior agreement. More on this later (I never took them). 

Something about me

I’ve never been one for taking medication if I can help it. The human body is often underestimated as a self-healing mechanism. A few paracetamol a year is normally more than enough for me.

I’m a scientist by training so when faced with something like this my first reaction is to find out about it and not take anything at face value without assessing it myself. 

On the other hand the T2 diagnosis was a wakeup call and the kick I needed to sort my weight and well being out. Immediately I started walking for about 30 minutes every day (average). 

I got on the internet and found the diabetes.co.uk website and forum; learned about carbohydrates and the impact on blood sugars; could understand the logic of low-carb high-fat (LCHF) diets; and just went for it at 50 g carbs per day – no bread, no potatoes, no rice, no pasta. Fortunately I didn’t suffer the withdrawal symptoms sometimes experienced by changing so abruptly. I bought a blood glucose monitor and started testing myself. I started losing weight straight away as I got into ketosis and my body started to preferentially burn stored fat for energy. 

I also read about cholesterol and statins and determined that I wasn’t going to touch them with a barge pole. 

First DN appointment

Three weeks in and I was already making progress on diet and exercise alone. 

Fasting BGs were down from over 10 mmol/l to around 6.5; pre-dinner BGs in the high 5s; and BGs two hours after eating in the high 6s and mid 7s, so I was learning what I could and couldn’t eat in terms of blood sugar control. 

My weight was down from 90 kg to 84.5 kg, and blood pressure was down to around 140/80. 

It was agreed for me to carry on with diet and exercise alone, no medication, with a review in three months time.

Interim progress

In July 2014 my HbA1c was 45 (6.3%, down from 65), so I was now in the prediabetic range.

Total cholesterol was down to 6.0, but more importantly triglycerides were down from 5.66 to 1.97 mmol/l, and HDL-C was up from 1.22 to 1.62, with total/HDL and triglycerides/HDL ratios both dropping into normal range. 

ALT liver function was down from 51 to 17 iu/l, indicating a reversal of fatty liver condition. 

My weight was now 76 kg (BMI 26.6), a percentage loss of over 15%, and BP stable around 125/70. 

I had also invested in a rowing machine to supplement the walking. 

By October 2014 my HbA1c was 42 (6.0%), weight was 72 kg (BMI 25.2) and BP around 120/65. 

One year on, March 2015

A picture speaks a thousand words, so rather than more dull text some more graphs follow covering the period from March 2014 to March 2015. 

My HbA1c is now 38 mmol/mol (5.6%) which is within the non-diabetic range. I am still diabetic of course but I am protecting the remaining beta cell function in my pancreas as best I can, and avoiding exacerbating my insulin resistance. This is all due to carbohydrate restriction, which has also reduced triglycerides significantly, and the fat component of the LCHF diet has helped raise my HDL-C to 1.95. In this context my total cholesterol of 6.1 is of no concern to me. 

The slight rises and falls in fasting blood sugar (the points are two-week averages) reflect life conditions such as work stress – but at least through testing I know what is going on. 
My weight is now stable at 70 +/- 1 kg (BMI 24.5), which represents a 22% loss in 12 months; and BP around 115/65. My waist is now 37 in (94 cm) having been 45.5 in (116 cm) a year ago.









What do I eat?

I’ve done all this without any medication, and just with diet and exercise. So what actually do I eat with LCHF? This is a typical day’s meals:

  • Breakfast – cooked breakfast of bacon, eggs, mushrooms and tomato; occasionally full fat Greek yoghurt with a few berries. Tea and/or coffee with double cream.

  • Lunch – ‘tapas’ style platter, choose from salami, olives, a little hummus, guacamole, cheese, mackerel pate, tomato, salad leaves.

  • Dinner – avocado vinaigrette, meat or fish with above-ground vegetables or salad, berries and double creamglass of red wine.

  • Snacks if necessary – cheese or brazil nuts.

  • Plenty of water. Decaffeinated tea or coffee after midday.

Commentaries

The content to this point has comprised factual descriptions of what I have done and achieved.

The following content represents my own commentaries on various diabetes-related issues. You may not agree with all of them but they underpin my decision making and management of my condition.

I’m not medically trained but I am a scientist and well used to research, analysis and empirical procedures.

I know that what I have done works, and that I have the willpower to carry on with it indefinitely and thereby defeat the commonly-held perception that T2 diabetes is inevitably a declining condition with increasing medication and often unpleasant complications.

The good thing about T2 diabetes is that you can manage it perfectly well yourself if you have the incentive (health and active life) and the tools (knowledge and a test meter). It’s depressing to me that so many diabetics are failed by the current system and doomed to more medication and declining health when in principle all T2s could do the same. As it is, the people who benefit the most are the drugs companies.

What causes Type 2 diabetes?

Despite popular perception (even held by some medical professionals) Type 2 diabetes is not caused by obesity - there are many thin T2s and many obese people who will never develop diabetes.

Some people are just genetically predisposed to developing the condition due to impaired insulin sensitivity, which is then exacerbated by the wild fluctuations in blood sugars resulting from sugar and carbohydrate consumption. In fact obesity in diabetics is more likely to be caused by the diabetes - due to the insulin resistance resulting in excess insulin in the system - not the other way round.

Type 2 diabetes is not a disease as such, just a condition with elevated blood sugars as a common denominator. It can be caused by pancreatic beta cell impairment, enhanced insulin resistance, problems in communication between the stomach, brain and pancreas concerning insulin release and so on.

It is a pity that the medical profession cannot get this message across to the media more effectively.

NICE and the Eatwell Plate

Medical professionals are legally obliged to advise on the basis of NICE guidelines. This includes recommendations to eat carbohydrates with every meal in accordance with the Eatwell Plate.

Even a cursory study of how the body deals with food will show that eating carbohydrates is a disaster for diabetics unless they are so determined to eat them that they are happy to take as much gliclazide, insulin etc to allow it.

Carbohydrates metabolise quickly to glucose in the bloodstream, some quicker than others, but the idea that there are ‘good’ carbohydrates is generally incorrect. ‘Wholemeal’ products will still spike you, especially wheat-based ones.

Would you give a Snickers bar to someone with a nut allergy? Would you suggest an alcoholic has a can of lager with every meal? Of course not – so why recommend carbohydrates to diabetics?

There is nothing new in managing T2 diabetes with low-carb diets. The Edwardians knew this – see 

http://archive.org/stream/diabeticcookeryr00oppeiala#page/12/mode/2up

Ancel Keys and the low-fat dogma

The American Ancel Keys in the 1950s hypothesised that high cholesterol was a significant cause of CVD. He carried out a survey of total cholesterol vs rate of CVD in many countries. Basically there is no systematic relationship overall. 

But Ancel Keys decided to cherry pick seven countries that backed up his hypothesis. This is about the worst piece of supposed science I have ever encountered, especially given the consequences of this study. You could pick a different set of populations that show exactly the opposite (Switzerland, Australian aborigines for example). Unfortunately Keys’ work provided the basis of the dogma that went on to underpin health guidelines in most countries – cholesterol causes heart disease > cholesterol increases when you eat fat > therefore fat is bad for you and you must reduce cholesterol. 

So without fat where do you get energy from? Protein? (but watch out for your kidneys (also a fallacy in most cases)). That just leaves carbohydrates – the sugar and processed food industries must have been laughing themselves all the way to the bank.


Consequences of low-fat

Recommendations to eat a low-fat diet were supposed to reduce incidence of CVD and tackle obesity. But in the years that low-fat has been religiously promoted, obesity has exploded.

Fat is natural. Breast milk is full of it. It’s an efficient source of energy, and is well capable (with protein) of being processed by the body to provide the brain with the glucose it needs. You don’t need carbohydrates for this (if you did how did the human species ever survive?).

Eating fat does not make you fat. Sugars and carbohydrates make you fat. But when the food companies remove the fat they find that the texture and flavour are affected, so what do they do? Add sugar! Check out the sugar content of so-called healthy low-fat products and compare with the full-fat versions. Check out the sugar content of cereals like Special K.

Industrial trans-fats found in margarine etc. are undoubtedly harmful due to the Omega 6 content amongst others, but are still promoted as healthy alternatives to natural saturated fats like butter.

What's natural for humans?

Early man as hunter-gatherer would have lived on fatty meat, fish, eggs and occasional seasonal vegetables and fruits. Bread on a subsistence basis developed with agriculture, but it is very recently in evolutionary terms that sugar and refined carbohydrates became such a major part of our diets. The human body is simply not geared to process such a diet, and can’t evolve to do so in just a few hundred years.

Nevertheless, sugar producers and food processing companies are pushing more and more sugar and refined carbohydrate products at us. It’s cheap and very profitable, but the consequences in overall population health are clear to see. The NHS is in financial meltdown yet so much could be saved if people ate real food and not sugary carb-heavy junk.

Cholesterol

About 80% of cholesterol is produced by the liver, and only a small proportion comes from diet. If we get more from food, the liver cuts back to compensate. Cholesterol is everywhere in the body and particularly the brain. As with fat, if it is so essential why would we want to reduce it?

Yes, cholesterol is present in plaques at the sites of constricted arteries, but that’s not to say that cholesterol is the cause of CVD. Cholesterol is there because the body is trying to alleviate the symptoms of chronic inflammation caused by other factors. There is in fact no systematic evidence that high cholesterol actually causes heart attacks – CVD fatalities are just as likely to be associated with normal cholesterol as elevated cholesterol.

Total cholesterol is fairly meaningless as a marker. It’s the components (the lipid profile) that are important. HDL-C ‘hoovers’ the bloodstream and should be maintained, and triglycerides (associated with carbohydrate consumption) should be reduced. LDL-C is also of limited value since it contains both small dense particles (bad) and large ‘fluffy’ particles (good).

If you eat low-carb high-fat then HDL-C is boosted, triglycerides are reduced and LDL-C is likely to be dominated by the larger particles.

Statins

As soon as Ancel Keys’ ‘Seven Countries’ report was published, the drugs companies wanted to develop something that would reduce cholesterol. They found it in statins.

Statins undoubtedly lower cholesterol, but why would we want to do that? Cholesterol is natural and essential to the functions of the body, we just need to make sure we have the right lipid profile.

Statins are a blunt instrument. In lowering cholesterol they take out essential co-enzyme Q10 and dolichols as collateral damage. The drugs companies know this full well but don’t want to upset the cash cow.

Despite being of very limited value as a diagnostic marker, and despite there being no proof of a causative link between cholesterol and CVD, statins are being pushed at more and more people with less and less medical justification.

Statins are far from being free of side effects, ranging from muscular pain to memory loss and impaired cognitive function. They are a ticking time bomb that will one day explode in the faces of the drugs industry. And yet there have been proposals to administer them to all healthy adults! That is just insane.

Back to Type 2 diabetes

According to the National Diabetes Audit 2010-2011 only 27.5% of T2s achieve non-diabetic or prediabetic HbA1c numbers. It doesn’t say how many of the 27.5% are dependent on medication to do that.

39.9% have HbA1c between 48 and 58 mmol/mol; 25.8% between 59 and 86; and 6.8% 87 and above.

These figures could be drastically improved if the crazy recommendations to eat carbohydrates with every meal were dropped. No wonder the condition is so often perceived as an inevitable decline. Collectively NICE should be ashamed of themselves and could be regarded as culpable in promoting unnecessary suffering and early death in thousands of people.

There is a diabetes epidemic and the NHS is in crisis. How much does all the medication cost? How much does treating complications cost? Does anyone care?

I pay for my own test kit and I don’t intend to burden the NHS coffers with any diabetes-related treatment. If I can do it why not more?

What I would like to see done


  • Instruct NICE to drop the Eatwell Plate and promote low-carb or lower-carb diets for diabetics 
  • Provide all T2s with test kits and as many strips as they require (within reason) from money saved from reduced medication and complications treatment 

  • Educate T2s on blood sugars, insulin, diet and how to understand their test readings 

  • If necessary scare them with what can happen if they don’t manage their condition 
  • Tell them that medication is not a silver bullet and they can’t just continue eating cakes etc. in the belief that the drugs will fix it (it won’t work for all – some people just won’t be told – but it will be a vast improvement on the current situation) 
  • Promote to the media that T2 is not caused by obesity 

Some questions for health professionals

If you were diagnosed with Type 2 diabetes, would you follow the Eatwell Plate recommendations?

Would you take statins for the rest of your life? Would you prescribe them to your families?

Do you follow the Hippocratic Oath? Especially the bit about ‘causing no harm’?

What is the main objective of the pharmaceutical industry (hint: it’s not to make us healthy)?

How many members of NICE are independent of all connections to the pharmaceutical industry?

Conclusions

Being diagnosed with Type 2 diabetes has certainly been a life changer for me. Not because of any NHS advice but because it kicked me into researching it and working it out for myself. Just as well, because otherwise I would now be in decline and probably on an increasing cocktail of medication.

Within a year I have got my HbA1c down from 65 mmol/mol to 38, i.e. in the non-diabetic range. I am still diabetic of course but I am minimising the risk of any complications later. I did this with LCHF diet and exercise alone, no medication. As a consequence my weight, blood pressure and liver function are now also in normal ranges. The medical profession might consider my cholesterol to be high, but I know my lipid profile is good so I am not worried by my total cholesterol and LDL-C numbers.

As a body, the medical profession and government health bodies need to confront the pharmaceutical and food industries head on. They are making vast profits at our expense and slowly but surely damaging our health in the process. Medical professionals should promote truly independent research and not just accept what glossy brochures produced by the drugs industry say.

Thank you

If you have got this far, thank you for your attention, even if you are thinking ‘who the hell does this guy think he is?’.

This just started as the story of my first year as a Type 2 diabetic, but inevitably along the way I have developed a number of views on diabetes management and the guidance currently available. You may or may not agree with it but you cannot deny that my approach has worked. And if it works for me it can work for virtually everyone.

UK health professionals are obliged to follow NICE guidance, but if this encourages them to think a bit more about what this is doing for diabetics and how pernicious the influence of the drugs companies is, then that will have made my effort worthwhile.

Meanwhile I’ll continue to pass on my experience to others and hopefully help to improve the quality of some lives under this condition.

The above the work by Rod aka Sanguine