Here's a fairly recent paper that I missed last year (hattip DuckDodger). Glycemic Control for Patients With Type 2 Diabetes Mellitus (Sept 2016). A release article was presented that seemed to imply that blood glucose control is not important at all. It seemed to say that drugs such as Metformin for blood sugar control did absolutely nothing. The article demands we get new drugs to treat diabetes!
There is a risk that all of the attention on blood sugar levels is distracting researchers from pursuing new leads. If doctors check the shelf for other medications that do something beyond glucose control, they will find that medical cupboard is bare.
Big Pharma to the Rescue!
Here's what the paper says, a little different than the fake news. They conclude:
The evidence summarized here requires us to explore factors other than tight glycemic control to explain this improvement and better address the diabetes mellitus epidemic. Exciting new questions and new answers may surface as we look beyond glycemic control.
The paper showed that if you have diabetes and you take blood sugar controlling drugs, you will have a slightly longer life than those who do not take drugs.
The researchers are asking: Could we spend our research dollars more wisely than developing more glucose lowering drugs?
The answer is YES!
Potatoes for the Win!
If you have Type 2 Diabetes, you need to make some MAJOR changes in your life. I assume that people who take drugs to control their BG may also decide to make some big lifestyle changes...like eating whole, unprocessed foods. Exercising. And more crazy ideas: Low Carb Diets, Ketogenic diets, high RS diets, Diabetes Warrior Diets, heck...[gratuitous Amazon Link warning]: The Potato Hack: Weight Loss Simplified which details the use of all-potato diets to cure diabetes.
Yes, yes. We need to look beyond treating T2D with drugs! The drugs work, though. Don't get me wrong. But why the drugs work may be bigger than tight blood sugar control. Maybe the changes are related to a change in gut flora after taking some drugs (ie. Metformin). In fact, Metformin in particular, is a really good drug for diabetics after it's too late to reverse normally.
2016 paper: Metformin and the Gastrointestinal Tract:
Metformin has a number of actions within the gut. It increases intestinal glucose uptake and lactate production, increases GLP-1 concentrations and the bile acid pool within the intestine, and alters the microbiome.
It's obvious that diabetes can be treated differently. Drugs are not the only option. T2D's need to completely give up sweets and breads, fried foods and fast-food. T2D's need to routinely check their blood glucose with a home test kit and strive to keep their fasting blood glucose under 130 and reduce post-prandial spikes. If diagnosed with pre-Diabetes or T2D, you HAVE to make changes. Most people's only change is to take drugs, and make no lifestyle modifications:
Here you have an obese, middle-aged person. Probably has high blood pressure, high cholesterol, and a host of auto-immune conditions. They take Glucerna, Metformin or Cycloset and their doctor is encouraged about their good blood sugar numbers. Chides to lose weight and eat whole-grain wheat and lean meat. This person only sees a slight advantage in life when compared to people whose blood sugar in not controlled in any way.
Conclusion
Type 2 Diabetes is common. Very common. It's easy to find diabetic test subjects. It's hard to find people with diabetes who are controlling their own disease progression with dietary interventions and lifestyle changes.
My contention is that everyone is at risk of developing T2D. All you have to do is eat the foods presented before you on TV and billboards. Eat all you want. Whenever you want. You'll soon be a candidate for diabetic drugs. Want it faster? Don't move around so much. Take antibiotics.
My contention is that everyone is at risk of developing T2D. All you have to do is eat the foods presented before you on TV and billboards. Eat all you want. Whenever you want. You'll soon be a candidate for diabetic drugs. Want it faster? Don't move around so much. Take antibiotics.
Once T2D sets in, it's pretty late to be starting to get healthy. Prevention is key. Pay attention to blood glucose levels. Take action at the first signs of Pre-diabetes. Persons with T2D can benefit greatly from different diet plans that control blood glucose without medicine. Low carb diets, high carb diets, and everything in between. It's not just the carbs, it's the quality and quantity.
The preferable option is to eat right, exercise, and get a good night's sleep. You'll never have to worry about diabetes.
Anybody here fighting diabetes or concerned about their blood glucose numbers? Tell me about it.
I am collecting data from 10 people who are tracking their blood glucose levels immediately after ingesting 2 spoonfuls of RS, as soon as they all get me their data, I'll write up a blog post that I think you will find very interesting.
The preferable option is to eat right, exercise, and get a good night's sleep. You'll never have to worry about diabetes.
Anybody here fighting diabetes or concerned about their blood glucose numbers? Tell me about it.
I am collecting data from 10 people who are tracking their blood glucose levels immediately after ingesting 2 spoonfuls of RS, as soon as they all get me their data, I'll write up a blog post that I think you will find very interesting.
Oh, and forgive me for the sensationalist post title. It seems to be the thing to do lately.
Later!
Tim
Reference:
Rodríguez-Gutiérrez, R., & Montori, V. M. (2016). Glycemic Control for Patients With Type 2 Diabetes Mellitus. Circulation: Cardiovascular Quality and Outcomes, CIRCOUTCOMES-116.
Click-bait, works every time (it worked on me anyway)
ReplyDeleteSlightly OT but I see the Diabetes Warrior has decided to go full on carnivore, nothing but meat. Should be interesting to see what happens there, yes?
I'm a sucker for a good headline myself. I can't help clicking those "one weird trick..." articles.
DeleteYeah...Steve is eating nothing but meat. I can't imagine that it's a good thing, long term. It won't cure his diabetes. I don't think he has any end-points other than keeping his BG low and feeling good. But, it's probably better than eating SAD, so I'll just keep my mouth shut.
I had a shot at eating really nothing but meat due to gut issues maybe 5 years ago. Needless to say things went from bad to worse!
DeleteIf you're theory above is that improvements from T2D come from modulating gut flora - an all meat diet will probably make things worse?
Rob - I can't really say what an all-meat diet would do to gut flora. If the meat was mainly raw, and mainly fish, it would possibly be better than cooked red meats. I should also think that processed/cured meats would really cause some harm, but someone needs to study the effects of all-meat diets. However, there are no ancestral precedents for eating JUST meat. I cannot imagine a place on Earth where people would be forced to abandon all plant matter and just eat meat, except by choice.
DeleteYes I suppose the raw meat would be better (I seem to remember the Inuits not being low carb due to the glycogen which quickly degrades), I wouldn't want to be trialling it though, especially with my genetics (mthfr etc)
DeleteCan't wait to see the BS/RS data!
ReplyDeleteYou will be pleasantly unimpressed, lol. I have about half the reports in so far. Bread/potatoes spike BG, RS does not. It makes an interesting case-study, though, and you'll see some interesting trends with regard to FBG and postprandial responses.
DeleteTim, I have a friend who is T2D, kidneys working at 3%, undergoing dialysis. I know not to ask for medical advice, just curious your thoughts on his kidney doc telling him to avoid foods with potassium?
ReplyDeleteI'd say listen to the doc. Here's a little pampplet from the NIH on potassium and kidney disease. Sounds like the problem is that the kidneys cannot excrete excess potassium and some meds they take might raise it. Safest to check levels and follow doctors advice. https://www.niddk.nih.gov/health-information/health-communication-programs/nkdep/a-z/nutrition-potassium/Pages/nutrition-potassium.aspx
DeleteThank you for the link, very much appreciated!
DeleteThis comment has been removed by the author.
DeleteDidn't Diabetes warrior use to do resistant starch before? Why did he stop?
ReplyDeleteSteve seems to be in non-stop experimental mode. He has a great back-story, and he's a great guy. His focus is on living with diabetes. He wrote a couple blog posts about his RS experiments, which lowered his BG if I remember correctly.
DeleteI did the RS Experiment and it did lower my average fasting blood sugars from 81 to 77 (as I recall). From reports I've had from others, it helped them lower their fasting BG as well, some it had no affect.
DeleteWhy did I stop? Prior to testing RS my fasting BG was awesome. If I needed it to maintain normal BG I would certainly still be taking it.
Yes, RS did mute the BG response after multiple heating and coolings of potatoes, beans etc... but the spike was still more than I wanted.
Finally, I did an OGTT with RS and I was REALLY disappointed, my numbers did not improve even after re-adapting to carbs.
I weaned off of the RS and my BG stayed well within normal ranges. I saw no reason to continue.
Experiments: I do love to experiment. I've done low fat, high fat and all points in between.
My current carnivore experiment is ... tasty. :)
Thanks for the kind words and for the shout out. :)
Hey, Steve - For the record, I think it's great what you do. It gives other diabetics the courage to go a different direction than drugs and crappy diet. Just like the article I was talking about in the blog post, "look beyond drugs and the cupboard is bare." Doctors and dieticians have no imagination. FBG is above 130? Metformin for life, no other changes needed. Will it help you live longer? Nope. Will I lose weight? Nope. Ludicrous!
DeleteHere's a comment from Angelo Coppola who cannot post here for some odd reason:
ReplyDeleteHeya, Tim. I don't recall if we've ever discussed the Newcastle Research. It's the first place my mind goes when T2D comes up. The approach, in a nutshell, is to reduce food intake to 800 calories per day for 60 days. This, the researchers believe, reduces fat stores in the liver and pancreas (by just a gram or so!), allowing them to function normally again. When totally successful, this is a *cure*. And, if I recall correctly, the success rate is something like 2 out 3. They even have long-term T2Ds (10+ years) who have returned to normal.
800 calories a day for 2 months doesn't sound fun, but the pay off is big if it works. I wrote about it here: http://www.humansarenotbroken.com/reversing-type-2-diabetes-the-university-of-newcastle-research-with-diet-plan/
It's the first thing I'd try if I had Type 2 Diabetes. And hopefully the last. Of course, after reversing the disease, people can't just go back to their old diets that got them into trouble in the first place.
So, yeah, 800 calories per day from taters could be a really good way to go, since they are nutritionally complete and satiating. The researchers say it doesn't really matter what people eat, though, and they're probably right. Rapid weight loss (15% of starting bodyweight or more) in 60 days or less is probably key.
I know a T2B diabetic who tried the Taylor experimnt for 8 weeks, and then continued it for over a year. She thought she would get off insulin, which never happened. She is a long term insulin injector. In my opinion experiments like Taylor's work when you are newly diagnosed and have never dieted before. Every time you change your diet in whatever way, you change your gut flora (and often not for the better)which can makes the situation worse.
DeleteJo tB
Thank you Steve for your comment. And all your good work. My dad has T2D, so did my grandfather, and I guess I'm next in line if I don't watch myself.
ReplyDeleteMy dad started LCHF and that helped a lot, and now is on to fasting, which seems to be even better for him. He's off almost all his meds, and has lost lots of weight.
I recommended resistant starch as well, and he sees lower FBG when doing it. There is a good video on dietdoctor.com about the microbiome and the danger of not feeding it on an LCHF diet.