# Drastic diet 'reverses' Type 2 diabetes



## Northerner (Jun 24, 2011)

It's a very small sample and I wonder if the restriction of calories means that the consequent restriction in carbs is a big contributory factor:

http://www.diabetes.org.uk/About_us/News_Landing_Page/Can-diet-alone-reverse-Type-2-diabetes/


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## Blythespirit (Jun 24, 2011)

A very interesting report. I agree with your comments about reducing carbs Alan. As you say a very small number involved and you wonder if the 5 who didn't atain a reversal stuck to the regime or not. I wonder if the liquid meal replacements are similar to Liter Life or similar diets. I would certainly be interested in hearing more about further trials. XXXXX


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## veganlass (Jun 24, 2011)

Just picked up this as well relating to it.

http://news.sky.com/skynews/Article/201106116017793


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## lucy123 (Jun 24, 2011)

My sons girlfriend just skyped me to say its okay all I have to do is eat 600 cals a day and I will be fine - diabetes will be gone!

I am struggling on 1300.

I do believe a good diet goes a long way towards getting good control though.


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## C*5_Dodger (Jun 24, 2011)

*Interesting*

I wonder if they did an OGTT?


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## redrevis (Jun 24, 2011)

They've just reported this on Daybreak saying that for type 2's if they eat this extreme diet of 600 calories a day for six months it will force the body into producing it's own insulin again and therefore reverse the condition.

So all type 2's don't produce their own insulin any more then


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## Mark T (Jun 24, 2011)

It would be interesting to read the research on this when it gets published.

Personally I would be sceptical and wonder if it only works for Type 2 that is predominately IGT/Insulin Resistance related.


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## Andy HB (Jun 24, 2011)

Quite interesting results were reported, even if the sample was very small. I'd like to see who was included in the sample and how progressed their diabetes was.

From my perspective, I'm also not entirely sure that such a restrictive calorie diet is necessary to achieve the same effect. I was running probably an 1800-2000 calorie diet and could claim the same results (but obviously I didn't have all the additional tests re: pancreas function that this sample has had).

Also, increased my regular exercise quite a lot. I wonder what they did with their test subjects?

Andy


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## bev (Jun 24, 2011)

Hi Northerner,

I think it would be worth a try - if it didnt work you havent lost anything - other than weight perhaps. I wonder if you started eating properly again whether it would put you at the same risk of becoming type 2.Bev


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## timbla (Jun 24, 2011)

this is excellent news. i am sure there will be some on here that take a very sceptical view on this research, but i for one totally buy into it. the chinese have been using food as medicine for thousands of years, through combining, reducing amounts, or cutting out certain things completely. 

this also goes some way to possibly explaining the success seen by some diabetics who go down the raw food route. a massive reduction in calorie intake and a total eradication of cooked and/or processed food has been shown to be very effective in lowering BG levels and helping participants to reduce and, in some cases eradicate completely, the need for medical intervention.

bring it on i say.


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## novorapidboi26 (Jun 24, 2011)

It talks about the beta cells regaining control after fat levels diminished in the pancreas, but what good is all that insulin if you are resistant to it........as many type 2 individuals are, as opposed to having higher fat levels etc....


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## Mark T (Jun 24, 2011)

novorapidboi26 said:


> It talks about the beta cells regaining control after fat levels diminished in the pancreas, but what good is all that insulin if you are resistant to it........as many type 2 individuals are, as opposed to having higher fat levels etc....


But what happens if you don't have huge amounts of Insulin Resistance and don't have huge amounts of fat?


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## grahams mum (Jun 24, 2011)

they are talking about it on channel 5 now(the wright stuff)


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## novorapidboi26 (Jun 24, 2011)

Mark T said:


> But what happens if you don't have huge amounts of Insulin Resistance and don't have huge amounts of fat?



Then this might work out for you......

I suppose you could still have higher fat levels in the pancreas but still be of normal weight..........!

If you didn't have problematic resistance or problems with beta cell function, then you wouldn't be worrying about diabetes, would you?


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## grahams mum (Jun 24, 2011)

the guest reading the article said this is about type 2 and not type 1


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## everydayupsanddowns (Jun 24, 2011)

My hope is that FINALLY it will change those HCPs who still insist on dishin tou 'eat lots of starchy carbs'/'base every meal on starchy carbs' advice which is so disastrous for so many (who are simultaneously denied the strips that would allow them to see what is happening).

M


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## novorapidboi26 (Jun 24, 2011)

grahams mum said:


> the guest reading the article said this is about type 2 and not type 1



Thats right....


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## Robster65 (Jun 24, 2011)

The more they learn, the more it seems that diabetes affects people differently and maybe has a 'spectrum' of effects like some other disorders (autism, etc).

The interesting comments on the BBC website report http://www.bbc.co.uk/news/health-13887909 come from the professor at Bristol University, who said that it will probably just delay the onset and they will develop symptoms eventually anyway.

So once again, it may not be a reversal, merely a remission. Taking the body back into the 'normal' range gives the pancreas a chance to catch up and sticking to a healthier diet thereafter will avoid overloading it. For some but not all.

Rob


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## everydayupsanddowns (Jun 24, 2011)

Not the first time in recent months I've read about the importance of reducing the fat around the organs themselves.


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## Mark T (Jun 24, 2011)

novorapidboi26 said:


> Then this might work out for you......
> 
> I suppose you could still have higher fat levels in the pancreas but still be of normal weight..........!
> 
> If you didn't have problematic resistance or problems with beta cell function, then you wouldn't be worrying about diabetes, would you?


This is partially why I would like to read the research  

What this article and some of the ones linked off from it seems to suggest is that has your BG goes up you tend to cause Beta cell death at an accelerated rate.  Even in a non-diabetic the beta-cells are dying, and at a faster rate then they are multiplying.  The non-diabetic corpses they looked at seemed to suggest that they had lost about 50% of the beta-cell by death.

I've not seen anything that suggests accelerating the multiplication rate of the beta-cells - which in order to reverse diabetes would be needed.

The article I linked did suggest that it was possible to get back normal beta-cell operation of your remaining cells - but it all depends how many you had left of course.


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## novorapidboi26 (Jun 24, 2011)

Mark T said:


> This is partially why I would like to read the research
> 
> What this article and some of the ones linked off from it seems to suggest is that has your BG goes up you tend to cause Beta cell death at an accelerated rate.  Even in a non-diabetic the beta-cells are dying, and at a faster rate then they are multiplying.  The non-diabetic corpses they looked at seemed to suggest that they had lost about 50% of the beta-cell by death.
> 
> ...



Interesting.....


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## MargB (Jun 24, 2011)

I came on to give the link to the BBC but see Robster has already done it.

Brilliant for those who could do something this drastic but people must never try a starvation diet like that without medical assistance/monitoring.

I, for one, because of other conditions could never do that plus my diabetes is genetic so it would come on anyway.

Because my diabetes is controlled, I do not have any symptoms, my HbA1C is in the 5s, does this mean I am no longer diabetic?  Or does it mean it is controlled?  I am on Metformin but plenty on here are diet and exercise and have good control - are they "if-you-don't-watch-out-you-will-become-diabetic" category???

I can see the possibility of T2 being reversed but early in the BBC report there was again the assumption that only obese people become a T2 diabetic.

Don't know whether to be hopeful or annoyed.  Are all the newspapers right and everyone on this forum wrong?


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## Andy HB (Jun 24, 2011)

MargB said:


> Don't know whether to be hopeful or annoyed.  Are all the newspapers right and everyone on this forum wrong?



I'd be hopeful, but only in that more research improves the knowledge of those who count (i.e. health professionals rather than journalists!).

The newspapers are often selective in what they report. They have to be otherwise the articles would be unreadable by most people!

Andy 'I'm always right' HB


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## HelenM (Jun 24, 2011)

http://www.springerlink.com/content/68rmr50h7j024525/fulltext.pdf

The  diet was basically liquid based (510 calories) 46.4% carbohydrate, 32.5% protein and 20.1% fat; vitamins, minerals and trace elements; supplemented by 3 portions of non starchy vegetables to make up the remaining 90 calories.
I make that as 59g carb, 45g protein. 11.3g fat + whatever is in the veggies .

The subjects  all had greater than normal BM1s and were withing 4 years of diagnosis, so doesn't include thinner 'type 2s' or people with longstanding diabetes.
There were 15 subjects (3 didn't comply, 1 dropped out for other reasons)

They measured pancreatic and liver fat by MRI scans.

they suggest
*The data are consistent with the
hypothesis that the abnormalities of insulin secretion and
insulin resistance that underlie type 2 diabetes have a
single, common aetiology, i.e. excess lipid accumulation in
the liver and pancreas [11].*
After the 8 weeks the subjects  went back to a normal 'healthy' diet with advice on portion size.
They gave them an OGTT after another 12 weeks, of the 11: 1 wasn't tested, 3 'failed'  inn that their levels rose above 11mmol, the others 'passed'


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## Vicsetter (Jun 24, 2011)

Being very sceptical I would like to point out that there are probably more T2s commenting in this thread than were involved in the 'trial'.  The money would be much better spent trying to find the reasons why people become diabetic and hence find a cure than these  impractical almost snake medicine cures, and absolutely useless for T1s.


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## cakemaker (Jun 24, 2011)

This is a very interesting article for us as my husband has recently been diagnosed. It suggests that diabetes 2 could be reversed by eating just 600 calories.  
Has anyone here dieted drastically and if so how did it affect you? 
I've changed my husband's eating habits; continuing all the good and cutting out the cakes etc. and have talked about cutting down the calories but 600 is a bit too drastic but if it works it might be worth a try.

I saw a docu-drama years ago about the pioneering doctor who found insulin. (Can't remember all the details) Before that, if I remeber rightly, Diabetic children were given just 600 calories to live on. I don't know why but it always stuck in my mind.
I wonder if this was this the starting point of this latest study?


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## Robster65 (Jun 24, 2011)

HelenM said:


> they suggest
> *The data are consistent with the*
> *hypothesis that the abnormalities of insulin secretion and*
> *insulin resistance that underlie type 2 diabetes have a*
> ...


 
I think this statement would help greatly to shed light on the causes, rather than just being a method of holding it back. It may lead to a larger scale study that can give more useful data and show a stronger link to fatty deposits in the organs causing some forms of T2. 

Rob


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## jaa7 (Jun 24, 2011)

*Carb free diet*

Someone asked me that if I didn't eat any carbs would I need to be on insulin!


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## novorapidboi26 (Jun 24, 2011)

jaa7 said:


> Someone asked me that if I didn't eat any carbs would I need to be on insulin!



And how did you answer?


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## Mark T (Jun 24, 2011)

HelenM said:


> http://www.springerlink.com/content/68rmr50h7j024525/fulltext.pdf...'



Thanks for the link HelenM  the site is being a little slow - I'm guessing that it is being somewhat overwhelmed.

From having a look at the details on the people involved, based on age, weight and c-peptide scores I would argue that they are all predominately insulin resistant.  It's notable that as the study progresses, each week there insulin and c-peptide is dropping - which I think means that the ammount of insulin they are producing is dropping.

Another interesting statement in the report was "These participants had no family history of diabetes, were taking no medication and had normal glucose metabolism as confirmed by a standard 75 g OGTT..." Edit: oops that was the control participants


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## Dizzydi (Jun 24, 2011)

whoo hoooo  so all I need to do is eat no fat, have 600 calories a day and develop anorexia  and I will be cured !! 

Or Dead 

Or am I missing the point here ? what ages? what weight? where these people actually diagnosed diabetics or showing the signs of becoming becoming / being diabetic (there is a name but I cant remember it as I know there is no pre-diabetes you either are or not)


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## Mark T (Jun 24, 2011)

Dizzydi said:


> whoo hoooo  so all I need to do is eat no fat, have 600 calories a day and develop anorexia  and I will be cured !!
> 
> Or Dead
> 
> Or am I missing the point here ? what ages? what weight? where these people actually diagnosed diabetics or showing the signs of becoming becoming / being diabetic (there is a name but I cant remember it as I know there is no pre-diabetes you either are or not)



11 individuals (nine male and two female, age 49.5 ? 2.5 years)
Weight: 103.7 ? 4.5 kg
BMI: 33.6 ? 1.2
Baseline HbA1c: 7.4 ? 0.3 %

It states that they have all had diabetes for less than 4 years


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## HelenM (Jun 24, 2011)

> Another interesting statement in the report was "These participants had no family history of diabetes, were taking no medication and had normal glucose metabolism as confirmed by a standard 75 g OGTT..."



Mike, that was the controls, these were matched for age, gender and weight with the subjects who  were, diabetic, diagnosed within the last 4 years , had HbA1cs 6.5?9.0% and  BMIs 25-45.

 Posted and saw your correction


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## Andy HB (Jun 24, 2011)

cakemaker said:


> This is a very interesting article for us as my husband has recently been diagnosed. It suggests that diabetes 2 could be reversed by eating just 600 calories.
> Has anyone here dieted drastically and if so how did it affect you?
> I've changed my husband's eating habits; continuing all the good and cutting out the cakes etc. and have talked about cutting down the calories but 600 is a bit too drastic but if it works it might be worth a try.



I refer the honourable lady to the answer I gave some moments before. 

Suffice to say I don't think that drastic diets are necessary to achieve the same effect. It's all about consistent weight loss ..... I think. Or atleast the removal of fatty deposits in the pancreas and liver (I had a fatty liver when diagnosed. That is now clear based on the last scan results).

Andy


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## Robster65 (Jun 24, 2011)

It would seem that the purpose of the experiment was to force fat deposits from the pancreas and liver by a drastic low cal diet and observe the outcomes. The hypothesis stated needed testing and this was a way of possibly showing some support for it.

It appears that it wasn't in any way a search for a cure or a means of reversing the symptoms for the general population. Merely a medical trial to see if a larger scale study or further research is justified.

The media, bless them, have clearly seen it as a chance for headline grabbing and inferred all sorts. But I wouldn't have thought that was the intention of the team involved.

I hope.

Rob


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## Mark T (Jun 24, 2011)

Looks like Jenny Ruhl picked up and blogged about the research: http://diabetesupdate.blogspot.com/2011/06/idiotically-dangerous-diet-reverses.html


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## wallycorker (Jun 24, 2011)

Northerner said:


> It's a very small sample and I wonder if the restriction of calories means that the consequent restriction in carbs is a big contributory factor:
> 
> http://www.diabetes.org.uk/About_us/News_Landing_Page/Can-diet-alone-reverse-Type-2-diabetes/



It's very much what happened to me by slightly different means as is well documented on this forum. 

In my case, I restricted my diet to around 1300/1500 calories and lost a lot of weight just over 5 stones over several months. 

The improvement in blood glucose levels came almost immediately I started my improvement programme.

As time went on, I found that my pancreas had started to work fairly normally again and could increasingly cope with foods that would have caused me problems in previous times.

I stopped taking metformin tablets altogether some time back now and that didn't cause me any problems. 

What's more, despite the fact that I have put on around 2 stones since that stage, I am still doing just fine.


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## HelenM (Jun 24, 2011)

I  actually thought of you when I read this Wally. You are one of the few people who I have read about that seem to have been able to resume eating at least some carbs without huge spikes. (not sure about the weight gain though)
Most of the people who adopt a very low carb diet seem to say that they cannot eat a few carbs without a spike.  I don't feel this shows an improvement in insulin resistance, merely an avoidance of eating the things that cause a problem.  I wonder  how they would do with a glucose challenge .  (so here I disagree with what Jenny Ruhl suggests) 
You adopted the Barnard  vegan programme, which is not low carb but  very low fat and relatively high carb and I suspect could be quite low in calories as a result.
 You say you didn't 'embrace it in it's entirety'  but that  nevertheless,   ' In approximately three months, my Hba1c has dropped from 9.4 to 5.7 and is still dropping and I have lost 15 kgs in weight. '  This is a  very similar result to those in this study.  You had also had diabetes for much longer than those in the study before you adopted the diet.
Recently you have reported eating quite high carb meals without high blood glucose levels.
It would be really interesting to see a food diary from back then (impossible now though, we don't report that accurately the day after eating, let alone 3 or 4 years later) 
and of course N=1 is just what it says and YDMV

PS , sorry for using you as an example, I'm glad you're doing 'just fine'


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## Mark T (Jun 24, 2011)

Having had a search back a read a bit, yours is an interesting story wallycorker and I'm glad you are doing well too. 

Personally I think this approach is good for those that it will work for, but not when it doesn't.  My personal issue is that I see others regaining normal glucose function and I sit on the side frustrated because I don't although I've worked at it by loosing weight and limiting carb in my diet.  Possibly I'm just being unreasonable


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## Lilies (Jun 24, 2011)

So who ot a phone call about this article from a well meaning person? My mother called me earlier to say so and SOS husband had seen this on the BBC website and did I know about it.... Firstly doh... And I had to tell her why i wasn't going to do it.... But it made me so angry, she's been going rou d telling all and sundry about something that is private to me and for me to choose who I tell....


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## am64 (Jun 24, 2011)

it concerns me that people will suddenly rush to such a drastic cut in calories and will not be able to tolerate such a diet and will fail ....
at times i felt hypo and had the symptoms ..in fact my bs werent at a dangerous level.... just my body getting used to lower levels made it feel that way 
....the best advice i got was about moderation and food swapping ..eg a simple change from white bread to seeded ...
...cut out on the obvious sugar culprits ...such as full sugar drinks ...and remember the so regarded 'healthy' fruit drinks and smoothees low fat yohurts breakfast cereals  etc they all have high sugar ....good luck x


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## donnarob (Jun 25, 2011)

Hi Everyone, 

In the middle of moving house, so haven't been paying that much attention to news headlines and newspaper reports.  A well meaning friend made me aware of the story and I immediately logged in to find out more about it.  I didn't think there was a "cure" for diabetes and I felt myself feeling very sceptical about the whole article.  As you all know, my Hba1c has reduced from 10.5 to 6.2% in 6 months and, at my last doctor's visit last week, he told me to continue to work at reducing carbs and to take plenty of exercise, he subsequently questioned whether or not I had diabetes now as my levels were within the normal range!!  

What makes me question the research, is that any diet which drastically restricts carbohydrates will reduce blood sugar.  Is is really necessary to go on such a starvation diet when gradual, improved, eating habits will reduce blood sugar levels.  

It's the people sitting on the other side of the fence which get to me.  I know they are well meaning but I'm fed up being labelled "morbidly obese" which I am not, I have relatives in the family with diabetes which means it's hereditary and let's face it, not every overweight person gets Type 2.  It's the labelling which gets to me the most and I can fully understand why people don't want to advertise the fact that they've got the disease.

My doctor has told me on numerous occasions, if I keep my blood glucose levels down to the level they are at, I will suffer no complications from the disease, however, my friend suggested that it would be prudent to go on the diet if it was going to counteract the nasties which are bound to happen.  Surely if I went on a 600 calorie diet today, my blood glucose levels would plumment to God knows what!  Even eating carbs, I can go as low as 3.6 and that's only with one Metformin per day!  I would be interested to see what everyone else thinks, one minute I feel on top of the world and then I'm reminded constantly that I am not normal.  Time to be proactive again and Thank goodness for the support of this group, I would be lost without you. 

Donna and sorry about the Rant!


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## C*5_Dodger (Jun 25, 2011)

*Don't do it*



donnarob said:


> Hi Everyone,
> 
> In the middle of moving house, so haven't been paying that much attention to news headlines and newspaper reports.  A well meaning friend made me aware of the story and I immediately logged in to find out more about it.  I didn't think there was a "cure" for diabetes and I felt myself feeling very sceptical about the whole article.  As you all know, my Hba1c has reduced from 10.5 to 6.2% in 6 months and, at my last doctor's visit last week, he told me to continue to work at reducing carbs and to take plenty of exercise, he subsequently questioned whether or not I had diabetes now as my levels were within the normal range!!
> 
> ...



Dear Donna,

At 600kcals/d I would avoid this diet like the plague. It should not be attempted without close medical supervision! 

Regards   Dodger


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## Northerner (Jun 25, 2011)

It's being presented far too simplistically in a lot of the reports. You would definitely need very close (and therefore costly) medical supervision and even then it may not actually work for a large number of people - the sample size is far too small to draw any real conclusions.

Donna, the problem we people with diabetes have is that none of the 'prevention' campaigns are concerned with us - they are concerned with scaring the non-diabetic people into reducing their risk. To try and get through to as many people as they can, they keep the message highly simplistic which then sets a misleading impression that there is only one reason you become diabetic, and it is avoidable.

I very rarely read anything in the media that presents a positive view of how people with diabetes manage it well and achieve great things. the vast majority are shock horror scare tactics that are often incorrect in their facts and see people with diabetes as easy targets.


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## Carina1962 (Jun 25, 2011)

Like probably many people yesterday, i bought a copy of the Daily Express which headlined 'Wonder Cure for Diabetes'.  I am due for my Hbaic again in July and feel pretty confident that i will get a good result again as i have been getting regular excercise by going to the gym since April and and slowly and steadily losing weight by sticking to about 1250 calories a day (which includes cutting out most (but not all) carbs).  I am finding that by doing this, my BS levels are looking good and which has led me to reduce the amount i test, from every day to about 3 - 4 times a week.  I have run out of test strips and do not feel a sense of 'panic' for not having any which i used to have as i feel i have lots more control and that is all due to good old fashioned diet and excercise   I do look forward with great interest to hearing more news about this trial in the not too distant future though


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## Carina1962 (Jun 25, 2011)

One question has just sprung to mind - if a T2 is not overweight and within normal weight range, what happens if they decide to do this 600 cals a day diet?


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## tracey w (Jun 25, 2011)

Northerner said:


> It's a very small sample and I wonder if the restriction of calories means that the consequent restriction in carbs is a big contributory factor:
> 
> http://www.diabetes.org.uk/About_us/News_Landing_Page/Can-diet-alone-reverse-Type-2-diabetes/



Yes, i read this earlier. i just thought how awful only 600 cals a day to live on, cant be healthy in the long term. and yes 11 people is very small scale.


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## cherrypie (Jun 25, 2011)

We are not talking about living a normal life with this diet.  600 calories is a starvation diet which mean that for 8 weeks you would have to be practically immobile and under medical supervision.

I am an underweight Type 2 so in all probability I am not suitable.  I would fade away before the 8 weeks was over.
The media, as always have misrepresented this story and now everyone you meet who knows you are a Type 2 will have the answer for you.  You will have to explain, as I did twice today, that it is not as simple as it seems.

The only good to come out of this is that we might get the true message across about Type 2 if enough people think they know the answer for us and we can tell them differently.


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## Northerner (Jun 25, 2011)

cherrypie said:


> We are not talking about living a normal life with this diet.  600 calories is a starvation diet which mean that for 8 weeks you would have to be practically immobile and under medical supervision.
> 
> I am an underweight Type 2 so in all probability I am not suitable.  I would fade away before the 8 weeks was over.
> The media, as always have misrepresented this story and now everyone you meet who knows you are a Type 2 will have the answer for you.  You will have to explain, as I did twice today, that it is not as simple as it seems.
> ...



Newspaper editors take note: See how simple it is to explain, as cherrypie has done here? And that it's not a cure-all suitable for everyone that they can just take it upon themselves to try out?


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## wallycorker (Jun 25, 2011)

HelenM said:


> I  actually thought of you when I read this Wally. You are one of the few people who I have read about that seem to have been able to resume eating at least some carbs without huge spikes. (not sure about the weight gain though)
> Most of the people who adopt a very low carb diet seem to say that they cannot eat a few carbs without a spike.  I don't feel this shows an improvement in insulin resistance, merely an avoidance of eating the things that cause a problem.  I wonder  how they would do with a glucose challenge .  (so here I disagree with what Jenny Ruhl suggests)
> You adopted the Barnard  vegan programme, which is not low carb but  very low fat and relatively high carb and I suspect could be quite low in calories as a result.
> You say you didn't 'embrace it in it's entirety'  but that  nevertheless,   ' In approximately three months, my Hba1c has dropped from 9.4 to 5.7 and is still dropping and I have lost 15 kgs in weight. '  This is a  very similar result to those in this study.  You had also had diabetes for much longer than those in the study before you adopted the diet.
> ...


Hi Helen,

I think that many people are missing the important message to come out of this scientific study. I quote Professor Roy Taylor from the article in the Daily Express:

"_*We have been able to put diabetes into reverse by a very low-calorie diet over a short period of time.

What  is really important and very new is the changes in the body that go along with this. Specifically, the insulin-producing cells in the pancreas have gone to sleep in Type 2 diabetes, they are not really doing very much.

As the level of fat in the pancreas has reduced, we have seen these insulin-producing cells come completely back to normal, and that is truly remarkable.

This represents a radical change in our understanding of the condition*_."

From what I read, I understand his message to be that what most of us Type 2s have been told - i.e. that Type 2 cannot be cured or reversed is wrong and the pancreas can recover in some cases simply by dietary changes.

I don't consider that they are saying that the 600 calorie diet that they have used in their experiment is the only way that this reversal can be achieved. I know from my own personal experience that a diet of 1300-1500 calories achieved a similar improvement in my case. I've always said that my improvement came about by diet alone because I didn't ever change my execise regime to any great extent - this is in fact what Dr Neal Barnard states happened with his patients in the USA.

I re-iterate that the important message message to comprehend is that such improvements can be made at least in some Type 2s. 

Just like Dr Barnard and the scientists at Newcastle University say, I came to the conclusion from my own situation that the important thing has been to remove fat from the cells. In my opinion, the most important measure of whether this is being achieved is by the lowering of one's triglyceride level - i.e. a test that is carried out as part of most diabetics annual check up. Perhaps even more important still is the triglyceride/HDL ratio. 

My biggest step forward seemed to come when my HDL suddenly jumped to its highest ever reading and my triglycerides are now lower than they have ever been. Both of these numbers have changed markedly since I started my improvement programme - triglycerides have dropped in just over over two years from 2.56 > 1.18 > 0.93 and 0.84 mmol/l last time and my HDL has jumped from 1.1 > 1.52 > 1.44 in just over the last year. 

I ask people not to get bogged down with just considering the 600 calorie aspect. Just work at getting fat out of the cells. I did that by initially adopting a very low fat (almost vegan) die by following Dr Barnards approach and then also being increasingly mindful of the importance of keeping starchy carbohydrate intake - i.e. cereals, bread,potatoes, pasta, pizza and to a lesser extent rice - to a low level.

What I did to effect my improvement is well documented elsewhere in other posts on this forum - particularly in this thread:

http://www.diabetessupport.co.uk/boards/showthread.php?t=6435&highlight=reversal


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## Doghouse (Jun 26, 2011)

As a type 1, I have not spent much time understanding T2, however I find this result strange. I thought T2 was a disease of cell resistance, and that the pancreas was capable of producing loads of insulin, but not enough to overcome the higher than normal cell resistance. Initially drugs can be used to lower cell resistance, but in the end B-cells get warn out from the high demand, and the sufferer has to resort to insulin.

A very low carb diet will reduce the amount of glucose being fed into the blood, into the range that the insulin available can cope with, therefore no diabetes. Is this why communities that have low carb and calorie intakes, and high physical work loads, do not have a high incidence of diabetes?

If you want to cure T2, would have thought it necessary to fix the cell resistance problem, rather than do things to the pancreas. Alternatively adopt a low carb/calorie high workload lifestyle.

These results suggest something different, so where is my understanding wrong?
Mike


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## wallycorker (Jun 26, 2011)

Further to my post above, I've just been taking a look at the full report as published in Diabetologia Journal:

http://www.diabetologia-journal.org/Lim.pdf

To re-inforce what I said above, I would draw attention to the very final paragraph and, in particular, to the very last sentence in the report:

"_*This study demonstrates for the first time the time course of a return of normal beta cell function and hepatic glucose output by acute restriction of dietary energy intake in individuals with type 2 diabetes. The changes occurred in association with decreases in pancreatic and liver triacylglycerol concentrations. This new insight allows an understanding of the causality of type 2 diabetes in individuals as well as in populations. It carries major implications for information to be given to newly diagnosed patients, who should know that they have a potentially reversible condition and not one that is inevitably progressive*_."

i.e. unlike what almost all of us have been told, *Type 2 diabetes is not necessarily progressive and in some cases can be reversed*.


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## Mark T (Jun 26, 2011)

The question here is how did they determine that a normal response has been achieved?  All the paper says is that those people taking part were <11 on the OGTT.  A non-diabetic would be <7.8 on the OGTT.

And the OGTT result at 12 weeks - 10.1!  That still leaves them as pre-diabetic - so the diabetes is in remission not reversed.

I would only regard myself as reversed if I was getting the normal levels on the OGTT. 

The reference range for blood glucose is supposed to be  between 3.6 and 5.8 mmol/L.  That would tend to correlate with the fact that I've never seem my wife outside the 5's regardless of what we eat.  How many of us non-insulin diabetics would stay in the 5's after eating sugary carbs?


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## cherrypie (Jun 26, 2011)

I think there is some confusion here between a chronic and an acute condition.

An acute condition is of sudden onset sand has a finite duration.

A chronic condition is long lasting and may progress.

When I see some research that says that Type 2 can be cured as opposed to reversed then I will jump for joy.

Having been diagnosed for 8yrs and always had an HBA1c in the 5's and never having used medication, I am well aware of what I can and cannot eat.  Some of the food choices that Type 2's make here would have me in double figures proving that we are all different.

I think there will come a day when Type 2 is not used as a blanket term and there will be sub groups within this definition.

I also think to be cured you would have to be able to eat anything and everything for at least 5yrs with no ill effects and keep non diabetic numbers and until I see some research that agrees with this then I will carry on doing what I am doing.

Type1's have always been told that there is a cure on the horizon but to date there is nothing.  We all want a cure.

Carry on managing this condition and don't get your hopes up that a small study is going to change the outlook for Type 2's.


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## HelenM (Jun 26, 2011)

> If you want to cure T2, would have thought it necessary to fix the cell resistance problem, rather than do things to the pancreas. Alternatively adopt a low carb/calorie high workload lifestyle.



I'm not sure they've 'fixed' it but they have certainly reduced, maybe only  temporarily the levels of circulating  NEFA (free fatty acids)   These are believed to a major factor in producing  insulin resitance.   
I don't know  if you want to read  the evidence for this but if you google free fatty acids cause insulin resistance you'll find the major papers.


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## Carina1962 (Jun 26, 2011)

You know what will happen next?  so called 'companies' will pop out of the woodwork and start selling the 'diet' used in the study, don't you think?


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## Robster65 (Jun 26, 2011)

carina62 said:


> You know what will happen next? so called 'companies' will pop out of the woodwork and start selling the 'diet' used in the study, don't you think?


 

...or some miracle substance that dissolves fat.

Washing up liquid anyone ? 

Rob


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## HelenM (Jun 26, 2011)

> You know what will happen next? so called 'companies' will pop out of the woodwork and start selling the 'diet' used in the study, don't you think?


The frightening thought is that I know of one fad diet with a very similar nutrient profile to the one used in the study. 
The only thing is everyone I know that's tried it couldn't manage it for more than a few days let alone 8 weeks.


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## Northerner (Jun 26, 2011)

HelenM said:


> The frightening thought is that I know of one fad diet with a very similar nutrient profile to the one used in the study.
> The only thing is everyone I know that's tried it couldn't manage it for more than a few days let alone 8 weeks.



It reminds me of the diet followed by Elizabeth Evan Hughes, who was Type 1 before the discovery of insulin - her diet was often as low as 400 calories a day, but not just for weeks - for years  Her story is fascinating, highly recommended!

http://www.diabetessupport.co.uk/boards/showthread.php?t=4974


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## C*5_Dodger (Jun 26, 2011)

wallycorker said:


> my improvement programme - triglycerides have dropped in just over over two years from 2.56 > 1.18 > 0.93 and 0.84 mmol/l last time and my HDL has jumped from 1.1 > 1.52 > 1.44 in just over the last year.



Dear wally,

Nice to see you posting again, how are you doing? Just an additional thought: My last HDL was 1.6mmol/L and my last Trigs were 0.8mmol/L and *I eat a very high fat diet*. Does it not seem feasible that our excellent figures are due to low carb? The excellent results seen in this trial, are probably, as Northerner observed, due to the low carb also.

Warmest Regards Dodger


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## Jill (Jun 26, 2011)

HelenM said:


> I'm not sure they've 'fixed' it but they have certainly reduced, maybe only  temporarily the levels of circulating  NEFA (free fatty acids)   These are believed to a major factor in producing  insulin resitance.
> I don't know  if you want to read  the evidence for this but if you google free fatty acids cause insulin resistance you'll find the major papers.



I've just looked up 'NEFA' and the definition was non-esterified ('free' or unsaturated) fatty acids.  I though unsaturated fats were the good guys?  The more I learn, the more confused I become.


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## HelenM (Jun 26, 2011)

Help, I thought Wiki would explain but that explanation is very chemical. 
http://en.wikipedia.org/wiki/Fatty_acid_metabolism

Basically, in this case these are fatty acids in bloodstream. 
  When fat in the form of triglycerides, is  broken down it forms glycerol and 3 molecules of fatty acid. (hence the name) These can be used in various ways to provide needed energy. They can also recombine and be stored in the liver and fat cells, to be broken up again. Your stored fat doesn't just sit there doing nothing!
 Elevated levels of  FFAs  are linked with insulin resistance.(and why they might be elevated is another essay ) but it's noticeable that in this study they rose initially, then fell and then fell even more in the 12 weeks after the diet.


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## woolstone2 (Jun 26, 2011)

doing my best to be a good neighbour and give lifts to friends stood at bus stop, (thin and non diabetic), i was advised to read and follow the news item as i could get rid of my diabetes didnt i know.......mmmmm....me said through gritted teeth..... i already  have dieted my way to great control by v low carb/high fat diet thanks very much.
Came back home to a long diatribe by my mother on the phone saying the same thing.  the school playground mums did the same?? I am pis**d off, but not sure why so much! big hugs to all....(jeese its hot tonight!!!)julie


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## Caroline (Jun 27, 2011)

I wonder if the people in the trial were all working? I am away from home for 12 hours every day because I work full time and with so few calories I think I'd be asleep at my desk....


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## FM001 (Jun 27, 2011)

Would anyone want to follow such a restrictive diet where you are in near starvation mode, as the article is unclear on what the calorie consumption is after the reversal takes place it is difficult to comment on whether you could personally maintain it for life, but I suppose in some respects this research and its findings are a step in the right direction.


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## everydayupsanddowns (Jun 27, 2011)

As a reminder from the original reports: The starvation period was 8 weeks and was only under strict medical supervision (it is not suggested people should 'try this at home').

Following the trial some (but by no means all) participants seemed to recover normal-ish pancreatic function and could pass(ish) an OGTT. 

From the BBC: http://www.bbc.co.uk/news/health-13887909


> Three months after the end of the diet, when participants had returned to eating normally and received advice on healthy eating and portion size, most no longer suffered from the condition.



It is not clear how long the reversal/remission might last and it clearly won't work for everyone.

Type 2's should eat "lots of starchy carbohydrate at every meal" though? Errrrm. No!


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## Mark T (Jun 27, 2011)

everydayupsanddowns said:


> ...Following the trial some (but by no means all) participants seemed to recover normal-ish pancreatic function and could pass(ish) an OGTT...
> 
> ...It is not clear how long the reversal/remission might last and it clearly won't work for everyone...


From the report, re-formatted for clarity (number in brackets are values at 8 weeks);

At follow-up 12 weeks after completion of the dietary intervention, 
- Mean weight gain was 3.1 ? 1.0 kg. 
- fasting plasma insulin concentrations increased 65 ? 15 pmol/l (was 57 ? 11) 
- fasting plasma NEFA  dropped to 0.54 ? 0.05 mmol/l (was 0.72 ? 0.06).  
- HbA1c increased to 6.2 ? 0.1% (was 6.0 ? 0.2)
- fasting plasma glucose increased 6.1 ? 0.2 mmol/l (was 5.7 ? 0.5 
- 2 h OGTT plasma glucose was 10.3 ? 1.0 mmol/l (no 8-week figure given)

Three participants had recurrence of diabetes as judged by a 2 h post-load plasma glucose >11.1 mmol/l. F


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## Northerner (Jun 27, 2011)

Mark T said:


> ...- 2 h OGTT plasma glucose was 10.3 ? 1.0 mmol/l (no 8-week figure given)
> 
> Three participants had recurrence of diabetes as judged by a 2 h post-load plasma glucose >11.1 mmol/l. F



So if the OGTT was plus or minus 1, then it could have been 11.3? Not that short of diabetic at 11.8? And with such a small sample of participants how reliable are the numbers? 

Whilst the findings about the increased insulin production are really good I think it is a huge leap to start talking about having cured Type 2 diabetes, as many/most of the reports have been doing. Having such an extreme diet for so long is bound to affect the body in many ways - there are many examples of ways that we can have a quite sustained impact on the way our bodies work by treating it in an extreme way, and I would think it was far too early to suggest that the benefits would be maintained indefinitely.

It seems that every tiny new finding, in whatever area of health it occurs, these days is blown up out of all proportion. Maybe, eventually, the public will get so used to hearing these health scares/wonder cures that they will just start ignoring them as works of fiction, especially as most of them appear to be headlines today and either gone, disproved or contradicted the next.


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## Jill (Jun 27, 2011)

HelenM said:


> Help, I thought Wiki would explain but that explanation is very chemical.
> http://en.wikipedia.org/wiki/Fatty_acid_metabolism
> 
> Basically, in this case these are fatty acids in bloodstream.
> ...



Oh my brain hurts!


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## AlisonM (Jun 27, 2011)

I suspect there are as many ways of developing T2 as there are T2s. Some folk's systems may kick back in if they give it a shock such as this diet, but what happens when the shock wears off? I'd be interested to see how all of these folk are doing ten years from now. Any bets on how many of them will have re-acquired the diabetes?


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## HelenM (Jun 27, 2011)

A review of the study on the NHS site
http://www.nhs.uk/news/2011/06June/Pages/type-2-diabetes-and-low-calorie-diets.aspx


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## Northerner (Jun 27, 2011)

HelenM said:


> A review of the study on the NHS site
> http://www.nhs.uk/news/2011/06June/Pages/type-2-diabetes-and-low-calorie-diets.aspx



An excellent assessment, and reveals just how wrong and misleading the headlines were. Not a cure, or even (at this stage) a feasible treatment for the millions of people with diabetes. The fact that several of our members here have related how friends and relatives have interpreted the story shows just how the message has come across to the general public. Even DUK themselves are guilty of implying this message in the opening paragraph of their website story on the subject:



> Research funded by Diabetes UK and carried out by a team from Newcastle University has discovered that Type 2 diabetes can be reversed by an extremely low-calorie diet alone.



http://www.diabetes.org.uk/About_us/News_Landing_Page/Can-diet-alone-reverse-Type-2-diabetes/

What seems to be missing is the fact that, whilst some beta cell function may have been restored, there is no knowledge of how long it will take for the subject's pancreas to become under stress again and start to fail - would the diet need repeating? We all know the dangers of crash/yo-yo dieting. No-one should be able to get away with calling this a 'cure'. I wonder how many people will think that, whilst they may be in danger of getting Type 2 diabetes, it's no big deal because they can cure it by making a bit of effort for 8 weeks?


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## FM001 (Jun 27, 2011)

One of the reasons why I don't get excited anymore when I see a headline - Diabetic Cure


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## Northerner (Jun 27, 2011)

toby said:


> One of the reasons why I don't get excited anymore when I see a headline - Diabetic Cure



I can imagine toby - you've seen a lot more of them than me!


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## wallycorker (Jun 28, 2011)

C*5_Dodger said:


> Dear wally,
> 
> Nice to see you posting again, how are you doing? Just an additional thought: My last HDL was 1.6mmol/L and my last Trigs were 0.8mmol/L and *I eat a very high fat diet*. Does it not seem feasible that our excellent figures are due to low carb? The excellent results seen in this trial, are probably, as Northerner observed, due to the low carb also.
> 
> Warmest Regards Dodger


Hi Dodger,

I'm absolutely fine thanks.

Despite the impression that many people have of how I eat, I can't ever say that I've been what people understand to be low-carb - i.e. 40/60g of carbohydrate per day. I've always eaten far too much fruit for that to be the case. 

I say that I've been eating a lowish fat (very low at times but not these days) and a low starchy carbohydrate diet.

I agree entirely, I am sure that reducing carbohydrate significantly played a very significant effect on improving my triglyceride and HDL numbers. In my opinion, it is the TG/HDL ratio that matters most - whatever it is that reduces that is the most important thing.

As I have said previously, the important thing about the work at Newcastle University isn't the actual diet used for the study. In my opinion and I think that of Professor Taylor also. it is the fact that the Type 2 situation need not be necessarily progressive as we have all been told many times - it is that the process can be reversed. 

Best wishes - John


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## FM001 (Jun 28, 2011)

Northerner said:


> I can imagine toby - you've seen a lot more of them than me!




Far to many to recall, I hated diabetes with a vengeance in my younger days and always got my hopes built up when reading Diabetes Cure headlines, my poor consultant must have got sick of me asking if there was any truth in these stories



wallycorker said:


> Despite the impression that many people have of how I eat, I can't ever say that I've been what people understand to be low-carb - i.e. 40/60g of carbohydrate per day. I've always eaten far too much fruit for that to be the case.
> 
> I say that I've been eating a lowish fat (very low at times but not these days) and a low starchy carbohydrate diet.
> 
> I agree entirely, I am sure that reducing carbohydrate significantly played a very significant effect on improving my triglyceride and HDL numbers. In my opinion, it is the TG/HDL ratio that matters most - whatever it is that reduces that is the most important thing.




Always read your posts with interest Wallycorker, my recollection is that you stated that you ate on average 130g of carbohydrate a day mainly consisting of fruit and low fat foods, such a healthy diet would only serve to promote good cholesterol levels as you are achieving now, fruit has many health benefits one of which is protecting the heart against cardiovascular disease.


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## Ellowyne (Jun 29, 2011)

*I might give this a go?*

Having read the article, which states the drastic diet is for '8' weeks, as opposed to what I had previously read...6 months?

If the 8 weeks of 600 calories is correct, and then going on to a portioned controled healthy diet, then I might just give this a go...Of course, I will speak to my Dr first and get the go ahead. 

But for me, it may be a last option...I can not excercise and, for , Insulin has made it difficult for me to lose weight and,well, I have gained alot of weight in the process. Apart from this, I am desperate to get to a weight where they would be willing to remove this god awful Gall baldder of mine...I was in Hospital again last week...Liver function at 226!

It is ok for thoses that can excercise and go for a walk ect...But I find just the walk aroung the supermarket exhausting and I suffer with Chronic pain all the time...Perhaps, if I can find the Will power, perhaps this could work for me?

I will let you know what my Dr says...and, if I do embark on this, then I would dearly love some support here...I think I would need it!

Hope you are all keeping well, love Ellowyne xXx


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## Northerner (Jun 29, 2011)

Hi Ellowyne, I don't think that this is something that would be approved, except as part of a research project, as this was. It is wrong of all the papers to start talking about a cure and getting people's hopes up when the treatment is not fully proven, to say nothing of knowing whether it is safe long term. 

By all means ask your GP whether he thinks it is feasible, or he may be able to suggest something more appropriate, and your enquiry may spark some possibilities when he sees how determined you are.


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## bev (Jun 29, 2011)

Hi Ellowyne,

Reducing your calorie intake is worth a try if you really want to lose weight - I suppose it depends on how much your daily intake is now and whether this is drastic in comparison. Perhaps your GP might set a slightly higher target to see what effect that may have to begin with. I am sure you would get support if you made the decision to try it.Bev


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## Northerner (Jun 29, 2011)

This diet is drastic by anyone's standards bev, it's a starvation diet that needs everything that is eaten or drunk to be carefully prepared for the individual in order to meet their own personal nutritional needs. Even when being closely monitored several of the study participants dropped out and of the remaining 11, 4 showed no benefit. Of those that did there is no data about whether the beneficial effects will actually last, or if participating has caused any other damage - such an extreme diet can cause damage to the heart as muscle protein is used to fuel the body.

Really, it's an interesting observation that can be the basis of future study, it is not a feasible cure right now.


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## Ellowyne (Jun 30, 2011)

I guess I am just cluching at straws...My diet really is not that calorie fuelled now, I can only eat small amounts at a time as my Gall Bladder has caused alot of pressure in my tummy, so I just feel bloated all the time!....Like I have explained before, I just feel lost and my DSN says they can not help me...600 cals is really low, perhaps if I aim for, say 1000 cals, see how I go with that? 

I don't want to have a Gastric BYPASS....I am too scared! Now, with this research all over the TV, I've just had my family statically explaining to me that 'I can be cured' All because of the Paper and TV reports that jsut glorify that this IS  a cure for Diabetes...Well type 2 that is...And of course, this fuels the notion that this condition is all my fault because of what I eat!!...It creates just More predjudice against Fat people!

I am just at a loss and willing to try anything to get my weight down...even if I can just reduce my Insulin intake, that would be something.

Thank you for your posts...Ellowyne


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## Northerner (Jun 30, 2011)

I am sure you are not alone Ellowyne, which is why the reporting of such stories is very irresponsible in the way the research has been presented, peppering it with the word 'cure' when it is nothing of the sort. I do wish there was something I could suggest, but I'm really not qualified. As I said before, it could be worth going to your GP and asking him about the diet and if there is a safe alternative that you could try. It's clear that you are highly motivated and it is his/her duty to help find a way that fits with your physical difficulties.


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## Northerner (Jul 5, 2011)

A (surprisingly!) much more sober and factual report on 'The Diet' from today's Daily Express:

http://www.express.co.uk/posts/view/256823/Plan-to-halt-diabetes


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## Andy HB (Jul 5, 2011)

Northerner said:


> A (surprisingly!) much more sober and factual report on 'The Diet' from today's Daily Express:
> 
> http://www.express.co.uk/posts/view/256823/Plan-to-halt-diabetes



I'm particularly interested in the bit which described one person who didn't end up on the trial who lost two stones under her own (presumably less strict) efforts and had 'reversed' the symptoms anyway.

I rest my case yer honour!


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## Robster65 (Jul 5, 2011)

That does imply Andy, that the 600 cal diet in the trial was merely a means to an end.

ie. they could have put them on a 1200 cal diet and may have acheived the same outcome but would have taken a lot longer and may have needed more vigorous exercise.

It's something that may be of relevance to anyone, obese or thin, active or sedentary, who has fatty deposits in or around their organs.

No idea how the layman goes about measuring said deposits, or whether we just have to remain active and eat less saturated fats ? 

Rob


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## Andy HB (Jul 5, 2011)

Robster65 said:


> That does imply Andy, that the 600 cal diet in the trial was merely a means to an end.
> 
> ie. they could have put them on a 1200 cal diet and may have acheived the same outcome but would have taken a lot longer and may have needed more vigorous exercise.



I must say that is my take on things given my personal experience (but I may be wrong!)



Robster65 said:


> It's something that may be of relevance to anyone, obese or thin, active or sedentary, who has fatty deposits in or around their organs.
> 
> No idea how the layman goes about measuring said deposits, or whether we just have to remain active and eat less saturated fats ?
> 
> Rob



My snazzy set of scales does provide a measure of visceral fat (i.e. that surrounding the internal organs ... it probably also gives a 'guide' to that deposited in pancreas and liver, but that is a supposition on my part). Anyway, as my weight decreased, the level of visceral fat was also decreasing according to the measure (it's just a number. I started at 11, 12 or 13, I think. I'm now down to 8 (and was at 7 before putting on weight again).

Andy


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## Ric in China (Jul 5, 2011)

Hi, I'm totally new here, this is my first post.  I have been in the hospital for 30 days until my release last Tuesday.  I started on 600 calories a day last Thursday.  I went to the hospital to try to get one of my arteries propped open with stents in combination with stem cell therapy.  The artery they are working on was totally closed.  They have worked half way through the clog and will finish up when I return in 8 weeks.  I have called my self pre-diabetic for years but I have had my doubts about being entitled to the 'pre' prefix anymore.  First day in hospital I had fasting glucose of 14.  The nurses totally freaked about the fat too.  One nurse came into my room holding a vial of my blood up showing me the deep layer of fat floating on top.  Actually scolded me! During my stay the article appeared about the 600 cal diet study.  Talked my doctor into supervising me on that instead of starting all the meds he was pushing on me.  I got lots of optifast on hand now and salad fixins.  Tonight my post-prandial reading was 5.5.  That's cool.  No idea the last time I had blood sugar that low.  Anyhow, I had all the blood tests and scans etc. like in the study.  Gotta go in each week for repeat testing as the doctor wants to know my progress step by step.  Doctor calls me each evening at 8 to check on me as well.  I know the article was dressed up pretty nice as a cure and that it's way too soon to know how well this could work in general and how long it lasts, but I gotta give it a try.  Before now every time i  start any diet or exercise I get incapacitated by a gallstone attack.  But no one will operate because of my poor hear function.  I need my life back.  Wish me luck.


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## Robster65 (Jul 5, 2011)

Hi ric. Welcome to the forum.

Has all of this occurred in China or elsewhere ?

Obviously, the 600 cal diet will merely burn off the excess fat while you're on it but surely it will return once you go back to normal eating ?

Rob


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## Ric in China (Jul 5, 2011)

Thanks for the welcome Rob.  All this is happening in China.  I wouldn't say merely burn off excess fat.  If I lose the fat from my liver and pancreas maybe I can have restoration of insulin production and sensitivity.  Regarding the return of the fat, I think I stand a chance of not letting that happen.  In eight weeks they will finish putting the stents in my artery then they will remove the gallstone I have, and that combined with the weight loss should allow me to have a more active life.  I've changed my work conditions so I don't have to sit at a desk all day anymore.  Found some bowling and tennis partners.  Been learning some delicious low-carb recipes.  I aught to change my name because I'm not going to be the same old Ric.   In fact, you can call me Ric2.0!  hehehe


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## Northerner (Jul 5, 2011)

Hi Ric, welcome to the forum  I'm surprised your doctor is permitting such an extreme diet, given your other health problems. I would have thought it would place extra stresses on you and potentially compromise your heart further since your heart is a muscle like any other and starvation diets have a tendency to leech protein from muscle tissue. I wish you success, but doubt you would find a doctor here who would approve such a treatment outside of a clinical trial.


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## Ric in China (Jul 5, 2011)

Thank you for the welcome Northerner.  Actually very low calorie diets (VLCD - http://en.wikipedia.org/wiki/Vlcd) are quite common in the US and often used by doctors where problems from obesity are greater than the risks.  At the University of Washington in Seattle where I am from, a study was done on some fellow fatties using a 660 cal. diet for 3 months to see what effect that had on heart function and there was no change.  Additionally, my doctor here consulted with my doctor in America who did my heart bypass some years ago (which is why there are weekly blood tests, etc, during this). So I feel fairly safe considering the scrutiny I'm under.


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## FM001 (Jul 5, 2011)

Northerner said:


> Hi Ric, welcome to the forum  I'm surprised your doctor is permitting such an extreme diet, given your other health problems. I would have thought it would place extra stresses on you and potentially compromise your heart further since your heart is a muscle like any other and starvation diets have a tendency to leech protein from muscle tissue. I wish you success, but doubt you would find a doctor here who would approve such a treatment outside of a clinical trial.





Just wouldn't happen here unless under strict medical supervision, the diet suggested here are near starvation diets and would impede on the ability to function both physically and mentally, without professional supervision the diet would not normally be authorised and find it surprising that the Chinese Medical Profession are allowing this to happen.


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## Northerner (Jul 5, 2011)

Ric in China said:


> Thank you for the welcome Northerner.  Actually very low calorie diets (VLCD - http://en.wikipedia.org/wiki/Vlcd) are quite common in the US and often used by doctors where problems from obesity are greater than the risks.  At the University of Washington in Seattle where I am from, a study was done on some fellow fatties using a 660 cal. diet for 3 months to see what effect that had on heart function and there was no change.  Additionally, my doctor here consulted with my doctor in America who did my heart bypass some years ago (which is why there are weekly blood tests, etc, during this). So I feel fairly safe considering the scrutiny I'm under.



It does sound as though you are getting a good level of support Ric, I hope it works out for you, it sounds a very tough option. I think that, under our health system it would be unlikely that a doctor would be able to provide that level of individual support.


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## Robster65 (Jul 5, 2011)

I would imagine the reduction in physical stress from the fat loss around the organs (including the heart) would balance out the reduction in available calories. And once the body is in fat burning mode, it should tick over provided you don't try to do too much. 

Hope it gives you the opportunities you hope for.

Maybe it will become a drastic measures procedure over here.

Rob


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## rhall92380 (Jul 5, 2011)

Ric in China said:


> Thanks for the welcome Rob.  All this is happening in China.  I wouldn't say merely burn off excess fat.  If I lose the fat from my liver and pancreas maybe I can have restoration of insulin production and sensitivity.  Regarding the return of the fat, I think I stand a chance of not letting that happen.  In eight weeks they will finish putting the stents in my artery then they will remove the gallstone I have, and that combined with the weight loss should allow me to have a more active life.  I've changed my work conditions so I don't have to sit at a desk all day anymore.  Found some bowling and tennis partners.  Been learning some delicious low-carb recipes.  I aught to change my name because I'm not going to be the same old Ric.   In fact, you can call me Ric2.0!  hehehe



Hi and welcome, Ric! Good luck with the change of diet. As you already are aware there are healthier food options - you may find that you enjoy the healthier options more than those you have been eating. I certainly did.

Richard


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## Carina1962 (Jul 7, 2011)

Does anyone know how this trial has now been left at?  are they going to continue with it?  is it worth emailing DUK to find out?  i wonder if it would work on say 800 cals or maybe 1000?  i think i could possibly manage that but definately not 600


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## Northerner (Jul 8, 2011)

carina62 said:


> Does anyone know how this trial has now been left at?  are they going to continue with it?  is it worth emailing DUK to find out?  i wonder if it would work on say 800 cals or maybe 1000?  i think i could possibly manage that but definately not 600



This is the problem I think - it was only a very small study to test a hypothesis, or rather just to see what would happen - I imagine it will be quite a while before another, bigger study is established so that greater confidence in the results can be obtained. If indeed they increase the calories then we are likely to end up with a diet that thousands of people already know can be effective in many cases - a low-carb weight-loss diet that reduces insulin resistance to a point where medication can be stopped and levels come within range.


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## HelenM (Jul 8, 2011)

> a low-carb weight-loss diet that reduces insulin resistance to a point where medication can be stopped and levels come within range


 I think that there is a difference, people on a VLCarbdiet may still  have insulin resistance but are not challenging it, they  have to continue to eat very few carbohydrates.  Anecdotally many say that they can't eat a small portion of starchy carbs without a big rise in levels.
  After the initial 6 weeks,the people on the trial ate 'normal healthy diets' and one would assume that means the diets with a relatively high proportion of carbs. During that period, their insulin levels continued to fall.


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## Robster65 (Jul 8, 2011)

WOuld I right in thinking that the combination of ultra low calorie diet and the exercise regime was aimed at 'flushing out' the fat from around/in the organs and once acheived, they could then eat carbs as normal, but if they went back to saturated fats, they would find their resistance returns due to deposition around the organs again ?

ie. as diabetics we concentrate on carbs, but this is more about calories and fat. Once the fat is gone, the carbs are not an issue in themselves.

Rob


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## mcdonagh47 (Jul 8, 2011)

HelenM said:


> I think that there is a difference, people on a VLCarbdiet may still  have insulin resistance but are not challenging it, they  have to continue to eat very few carbohydrates.  Anecdotally many say that they can't eat a small portion of starchy carbs without a big rise in levels.
> After the initial 6 weeks,the people on the trial ate 'normal healthy diets' and one would assume that means the diets with a relatively high proportion of carbs. During that period, their insulin levels continued to fall.



Have you found the full article text yet helen ?
11 people took part in the trial and only 7 benefiited i.e. its not the cure all that has been touted.
The 7 who showed improvement had insulin production improved at 3 months after the 12 week test. But the trial was in 2009 (?) - what was the position them six months after and a year after ? and now Its a temporary fix not a "reversal".


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## mcdonagh47 (Jul 8, 2011)

carina62 said:


> Does anyone know how this trial has now been left at?  are they going to continue with it?  is it worth emailing DUK to find out?  i wonder if it would work on say 800 cals or maybe 1000?  i think i could possibly manage that but definately not 600



Hi carina,
the test just didn't involve cutting down to any old 600 calories. It was a highly calculated mix of essential nutrients in three liquid drinks a day plus salad leaves. Slurp three sachets of gunge a day and have a bit of rabbit food.
And as one medical comnmentator said, starvation has long been known to help with diabetes.


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## Robster65 (Jul 8, 2011)

As said before, I believe the aim was to prove the link between fatty deposits in/around the organs and diabetes (insulin resistance/impaired function).

If the symptoms didn't stay 'reversed', it would be presumably because the organs had clogged up again, thereby providing stronger evidence for the hypothesis.

For a widescale 'cure'/'reversal' to happen, they would need to find a way of clearing the fat deposits without such drastic measures. Someone may develop a pill to flush out the nasties, unless this is how current medication works.

Rob


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## HelenM (Jul 8, 2011)

> But the trial was in 2009 (?) - what was the position them six months after and a year after ? and now Its a temporary fix not a "reversal".


No idea if and when they will publish a follow up, this ones only just been published.


> As said before, I believe the aim was to prove the link between fatty deposits in/around the organs and diabetes (insulin resistance/impaired function).
> If the symptoms didn't stay 'reversed', it would be presumably because the organs had clogged up again, thereby providing stronger evidence for the hypothesis.
> 
> For a widescale 'cure'/'reversal' to happen, they would need to find a way of clearing the fat deposits without such drastic measures. Someone may develop a pill to flush out the nasties, unless this is how current medication works


.
I agree, but  I also think it may have something to do with the reduction in circulating fatty acids. These are implicated in  peripheral insulin resistance ie in the muscle cells  as well as in the liver and pancreas.
 The amount of insulin released when food is eaten isn't just dependent on the glucose level +amount of carb-protein.It also depends on the level of circulating fatty acids.  If  free fatty acids are high  then more insulin will be released.  They decrease when insulin is released with a meal.    Metformin may have an effect on decreasing free fatty acids  but even more so thiazolidinediones like  Avandia and Actos... but they have been found to have other problems!
This is a very general article, and a bit old. There's loads of papers on insulin resistance and fatty acids  but most are very very difficult to read without a specialist background. I can just about manage the intros and conclusions of many of them
http://www.medicinenet.com/script/main/art.asp?articlekey=52045


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## Northerner (Jul 8, 2011)

Helen, I just wanted to thank you for all your input on this thread (and all the others too, of course!). I wouldn't know where to start looking for a lot of this stuff and I'm learning a lot


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## timbla (Jul 8, 2011)

i too am really encouraged to note that this topic is still being discussed. i dont want to refer to specifics here, but i have seen on past occasions, posts about 'cures' and diets and remedies perhaps more holistic in nature, snuffed out with negative commentary before they have had a chance to develop. i concede that there must be a thin line dividing those in denial with those who are generally more optimistic about research which suggests a reversal of the big D is possible, perhaps i belong more to the former group, but still, all this talk about the 600 calorie diet suggests to me that there is a lot more optimism out there than i initially thought, and even if some are still discrediting it, i for one am buoyed by this, albeit tenuous link to hope that it reflects.


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## Robster65 (Jul 8, 2011)

Northerner said:


> Helen, I just wanted to thank you for all your input on this thread (and all the others too, of course!). I wouldn't know where to start looking for a lot of this stuff and I'm learning a lot


 
I agree. Thanks Helen for interpreting some of the technical details. 

Some of the insulin/weight gain matters make sense now. All we need is a sure fire way of reducing circulating free fatty acids.

I presume lowering saturated fats would be a start. Plus an increase in exercise. 

I feel sometimes that there is too much emphasis put on the carbs we eat, when the processing of those carbs is merely sympomatic of our sensitivity to insulin. If we could lower the resistance, ie. lower the free fatty acids, maybe low carbing wouldn't be so necessary ?

Just thinking out loud.

Rob


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## mcdonagh47 (Jul 8, 2011)

Robster65 said:


> to insulin. If we could lower the resistance, ie. lower the free fatty acids, maybe low carbing wouldn't be so necessary ?
> 
> Just thinking out loud.
> 
> Rob



Insulin Resistance in Type 2s often has a physical basis. Insulin grabs a molecule of glucose and takes it to a cell. The insulin pops the glucose into a receptor base. The insulin then has to tether itself to the insulin receptor port and when it does that, signals go down to the nucleus of the cell and Glucose Transporters (GLUTs) swarm up to punch a hole in the cell wall and take the glucose into the cell. The insulin tethjered to the receptor port is either released to flaot off again or is taken apart and assimilated into the cell wall.
Powerful scanning microscopes have shown that in some T2s the insulin is malformed, lacking the tethers or just having stubby tethers, that it needs to tie itself to the cell and signal the cell that a delivery of glucose is waiting. With no signal being given, both the insulin and glucose just drift off.
So some IR in T2s is created by physically defective insulin - that's one reason injected insulin works well for most T2s - its always perfectly formed.

Other research into IR has looked at the GLUT transporters inside the cell and the signalling to them. One of them, GLUT4, has been suggested as a culprit that's not doing its job in some instances of IR.

The current research on the 600 calorie diet just looked at production of insulin in the Beta cells and didn't address IR at the level of the cells (presumably). That might help explain why the drastic diet didn't work for 40% of the participants.

The other issue with it is that T2s have no problem making insulin, they are awash with it, but it isnt being used. So why reduce the fat  in the pancreas if IR will still cause major problems at the cell level ?


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## Mark T (Jul 8, 2011)

mcdonagh47 said:


> ...The current research on the 600 calorie diet just looked at production of insulin in the Beta cells and didn't address IR at the level of the cells (presumably). That might help explain why the drastic diet didn't work for 40% of the participants.


Interesting and a very informative post.  I always assumed that this research was predominately concerned with insulin resistance - which was why I mostly discounted it.  Certainly the test demographic was the 50+ obese insulin resistant type not the 30ish type like me (not saying that you can't have 50+ that are not insulin resistant or 30ish that are of course).



mcdonagh47 said:


> ...The other issue with it is that T2s have no problem making insulin, they are awash with it, but it isnt being used. So why reduce the fat  in the pancreas if IR will still cause major problems at the cell level ?


The research I've read seems to indicate that not all Type 2's have no problem making insulin.  I'm certainly not convinced that I'm awash with insulin - certainly my urine c-peptide test seemed to indicate that I was lower then expected (but not a Type 1).

Many of the low carbers go for high unsaturated ketatonic fat diets and if my understanding is correct - this would lead to higher levels of free fatty acids circulating.  If this is the case, shouldn't the low carbers have more insulin resistance?  Or possibly it matters what type of fat is floating about.


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