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Diabetes

As the regulars here probably know, I take quite an interest in this. Diabetes Type 2, and all the horrible consequences that follow, is simply not taken seriously by the NHS, despite the fact that a large chunk of its budget disappears into that particular black hole. Metabolic Syndrome in general consumes about 30 billion pounds annually: that's £1000 per taxpayer. How much good, healthy food could be bought by each British family if it weren't being wasted in this manner? For whatever reason, the treatment of this terrible disease is still driven more by ideology and superstition than known science.

You will often see statements like "there is no known cure for diabetes" if you Google the subject. This is untrue, and I'd like to present some data showing exactly how untrue it is. That the people charged with our care should be telling outright lies just blows my mind; hence my frequent rants about it here.

I'll start with a persistent myth: that a vegan diet can reverse diabetes. To be clear, it's up to the individual what they choose to eat. If they don't enjoy meat, or find that it disagrees with them, or don't like the thought of eating dead animals, deciding not to eat it is their prerogative. However, the idea that a low-fat plants-only diet can cure diabetes is not supported by the evidence.

The graph at the top is copied from a study from Neal Barnard, who is one of the foremost proponents of low-fat, high-carb diets for diabetics. He's in good company: the NHS and all the major international diabetic thinktanks basically concur with his views. I've extended the Y-axis downwards to include the normal range of HbA1c, between 4% and 5.5%, indicated by the grey band. Barnard's original graph didn't bother to show this region, because none of his subjects went anywhere close to it. As you can see, over 74 days, their HbA1c decreased from 8% to 7.65%. The line "P=0.03" indicates that there is a 1 in 30 probability that this result might be pure chance. In any case, 7.65% is still diabetic. Not terribly so, but diabetic nonetheless.

A meta-analysis of similar studies supports Barnard's result: a small reduction in HbA1c which is statistically significant, but not clinically significant:

ncbi.nlm.nih.gov/pmc/articl...

Why doesn't it work?

Diabetes Type 2 is sometimes described as "extreme insulin resistance", but this isn't entirely correct. Insulin resistance is just an adaptive mechanism that your body uses to apportion dietary glucose between different subsystems. There's only one signal that tells your body's cells to take up glucose - that's insulin - so logically there must be something else that tells them how much. That something is insulin resistance: cells decide for themselves how much to take, and how fast. In other words, each cell in your body has its own little tap that allows it to say "that's enough for now". At the individual cell level, it's an on-off tap, but because you have so many cells, the net effect is that each organ has a soft threshold for glucose.

This works fine as long as the total rate at which your organs can take up glucose matches (or exceeds) the rate at which your pancreas wants glucose removed from the bloodstream. No "proof" is needed for this: it's as simple a statement as 1+2+3 = 6. By this mechanism, your body can ensure that (for example) your brain gets the lion's share of glucose: your brain has a fairly high requirement for glucose, whereas your heart and muscles have little to none (they can use glucose, but they prefer other fuels).

What happens if glucose comes in faster than your organs require? Well, they'll all switch off that incoming tap, and blood glucose will inevitably rise, because it has nowhere to go. Your pancreas observes this and cranks up insulin production, because persistently high blood glucose is a big, big problem. It "forces" your organs to mop it up, even though they don't want it. Fat cells are the main target, because they can swell (and multiply) almost without limit. In general, though, your cells respond to this by saying "no" even louder. If this continues over a period of years, everything maxes out. Your pancreas is asking for 1+2+3 to equal 15. That's diabetes.

It should be completely obvious that the way to reverse this situation is to back off on the glucose, and this works incredibly well in practice:

link.springer.com/article/1...

You don't need to read the whole thing. Just scroll down to the "Results" section. Under "Effectiveness", we see this:

60 ± 1.0 mmol mol−1 (7.6 ± 0.09%) at baseline to 45 ± 0.8 mmol mol−1 (6.3 ± 0.07%) after 1 year

In plain language, the subjects started off (on the average) about as diabetic as Barnard's patients, and ended up (on the average) in the 'prediabetic' range. This might seem somewhat unimpressive, but the average doesn't tell the whole story. Look at the scatterplots - figure (b). These show every single subject as a blob. On the X-axis is where they started off; on the Y-axis, where they finished up. A dot appearing above the sloping line means they got worse; a dot appearing below it means they got better.

With the experimental intervention (left-hand plot) nearly everyone showed some improvement. Only a handful of unfortunates ended up in a worse place. Notice how many dots are below the magic 40mmol/mol (5.8%) line: dozens of them. They're "cured".

The right-hand plot is the result of the "expert" recommendations - high-carb and low-fat. Two people are below 40mmol/mol after "treatment", and they were already well below 50 to begin with. A lot of them have blood glucose up in the stratosphere.

Notice also that in the intervention group, virtually nobody is above 60mmol/mol; this level, while still technically diabetic, is associated with a marked reduction in risk:

diabetes.co.uk/news/2014/De...

In the standard-treatment group, about half of the subjects are above that threshold.

So why aren't the health authorities piling onto this result with enthusiasm?

Well, you tell me. I have my own suspicions, but perhaps I'd better take off my tinfoil hat now and pass the debate over to the floor.

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Hi AwfulToad, just picked up your post and started reading it. Unfortunately didn't get far as even on my extra large screen I can't read the detail of the graph - just wondering if it can be enlarged anyway, by me here, or by you reposting it? Edit - actually just double clicked on it and now it's readable if I peer closely!

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Sorry, it's a limitation of the HU platform - I don't know if there's any way to post a larger image?

You can see Barnard's original graph (from which this was taken) on Slide 44, here:

slideshare.net/ClevelandHea...

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Ok thanks, got it - I've split screen to read this with graph at the side.

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I put the scatter plots in split screen at the side too. I think I've basically understood everything , but in my case you're preaching to the choir anyway :)) Thanks for the read - I was awake in the night looking for something to take my mind off other things!

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I imagine my technical posts are quite effective at putting people to sleep :)

Anyway, it's nice to have such a receptive choir.

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I'm wide awake now, and singing :)

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Hi there, firstly there is a difference between reversal and a cure.

As for your claim about a plant based diet helping to reverse diabetes please see this recent article which showed that a plant based meal helped those with type2D produce more insulin than those who ate an equivalent meat based meal with the same calories and micronutrients, And of course its up to the individual what they choose to eat and in my opinion and not being and vegan nor having diabetes I see all options that help reverse such a serious condition as worth investigating. I'm not even pre diabetic so feel that I can be impartial on this and want to help raise awareness of the importance of a healthy diet with adequate exercise as the way to go for everyone.

Please see:

news-medical.net/news/20190...

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>> firstly there is a difference between reversal and a cure.

I agree that these terms are often used loosely. However, I was trying to point out that diabetes isn't exactly a disease (although it can quickly degenerate into one). The diabetic's body is working more-or-less correctly, at least in the early stages. It's just been backed into a corner by an excessive glycemic load, and has reacted in the only way it can. The correct word, I suppose, is "reversal".

>> As for your claim about a plant based diet helping to reverse diabetes

I wasn't claiming anything. I was simply reporting the results of Neal Barnard's experiment, which shows definitively that plant based diets have no significant effect on diabetes.

>> helped those with type2D produce more insulin

Type 2 diabetics are producing too much insulin (until their pancreas starts to fail). This effect:

"The results show that participants' postprandial secretion of insulin increased more after the plant-based meal than the meat-based meal"

is precisely what a T2 diabetic does not want. I find it absolutely shocking that people researching this topic have only the haziest notion of the underlying biology.

>>its up to the individual what they choose to eat

We're talking specifically of diabetics, and in this case a personal choice might not be entirely a choice, or purely personal:

1) Diabetics are currently being browbeaten into eating a diet that will cause them serious harm. The doctors know full well it will cause them harm. And yet they do it anyway. Why?

2) A diabetic who continues to eat carbohydrates (either because he's been told to do so, or because he refuses to change his diet) will develop serious chronic diseases. He will need a lifetime supply of drugs and several emergency interventions, including surgery. As noted, this costs a lot of money. So for every diabetic who remains diabetic, there is some other patient who can't get the treatment they need. Diabetes is eye-wateringly expensive if untreated, and very cheap to treat. It's low-hanging fruit. And yet it is not being treated.

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I think that the more information we as a society have regarding obesity and type 2 diabetes is very important and know that the more we all help to raise awareness of type 2D and its consequences is a vital piece of this jigsaw.

Sadly we have large groups of society who are over fed and undernourished and go on to develop type2D after becoming obese because of their dietary choices and too sedentary lifestyle. In the UK 1 in 10 aged 40+ have type2D. In the US there are 100 million who have type2D or are pre-diabetic In India there is a genetic predisposition towards type2D and the number of type2D sufferers is set to double in the next decade, these are shocking statistics.

So I feel that we all have to be open minded and encourage others not to become diabetic in the first instance and help those who do have it to realise that food can be their medicine.

The conclusion on the article I showed believe that a plant based diet diet can halve the chance of developing type2D and I don't believe that they are trying to force this on anyone.

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>> So I feel that we all have to be open minded and encourage others not to become diabetic in the first instance

Indeed. I think we can all agree diabetes is a lot easier to prevent than to cure. On the other hand, I'm going to point the finger of blame at current government policies in this regard, which actively encourage people (especially children) to snack and over-consume high-GI foods.

>> The conclusion on the article I showed believe that a plant based diet diet can halve the chance of developing type2D and I don't believe that they are trying to force this on anyone.

I only brought up the vegan aspect because the Barnard study was quoted in another another thread as proof that a vegan diet can ameliorate or reverse diabetes. The numbers show very clearly that this isn't so. I thought it might be better to include that critique here rather than clutter up the original thread, but it wasn't the primary purpose of my post. I was more interested in the complete failure of the medical establishment to provide effective treatment for diabetes when such treatments are straightforward, well-understood, and low-cost.

It may well be that a "plant-based diet" reduces your risk of diabetes (relative to the SAD plan promoted by governments), but I was specifically addressing the question of treatment for people who already have it.

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"Diabetics are currently being browbeaten into eating a diet that will cause them serious harm. The doctors know full well it will cause them harm. And yet they do it anyway. Why?"

To be fair to GPs I don't think they do fully know. I think they mainly genuinely believe they are giving the correct advice. I work in community healthcare and like us GPs often work much longer hours than they're paid for without proper breaks, you can see literally anything and so you need to know the basics about most conditions and rely on more specialist services to pass on specific protocols for specific conditions. That's why it takes big NHS drives across the board ( like the recent ones for reduction in avoidable pressure ulcers and sepsis awareness) to make a significant difference. It needs to be government driven.

Different story for an endocrinologist though, it's their speciality their area of expertise and focus and they should be up to date on all recent research, I don't know enough about what goes on at that level to really comment.

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>> To be fair to GPs I don't think they do fully know. I think they mainly genuinely believe they are giving the correct advice.

I've heard doctors speak about this, and many of them do say something to that effect. But I don't entirely buy it. I design electronic products for a living, and if someone were to be electrocuted because I hadn't followed best practice for safety, it'd be a flimsy excuse to say "I didn't know that could happen". It would be an even flimsier excuse if I knew people were being electrocuted on a regular basis, by the same design flaw. Doctors see dozens of diabetic patients very definitely not getting better. Doesn't the penny drop at some point?

In a way I know what they mean. Sometimes we carry on doing something a certain way even though we know, intellectually, that it's incorrect. But it's not really good enough. A doctor is paid to know how bodies work - and they do know how bodies work, even if it's not uppermost in their mind as they write out another prescription for metformin and repeat the official spiel about low-fat diets.

Yes, they are horribly overworked, and put under a lot of pressure by the NHS to prescribe harmful treatments. I know a lot of them secretly resent what's going on. I'm sure you know far more about the inside story here than I do. But isn't it their job to kick back? If not them, then who? I hope it's not people like me, ranting on the internet, because then we're all in big trouble :)

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Yes you're right ideally those at the front line should try to kick back, in reality work pressures and the constant worry about complaints (about anything, not diabetes related) probably results in most keeping their head down and toeing the official line. Now I feel thoroughly despondent about our future health! Oh dear.

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Diabetic medication and supplies are expensive depending on the person’s medical insurance (if they have insurance). Without my medical insurance, I would have to pay out of pocket more than I can afford.

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Your situation is a little different though. You're basically T1, which of course is nothing to do with your diet or with the failure of the medical establishment to treat you properly.

My point above is that money wasted on palliative care for a treatable disease (I'd best stop using the word "cure" - Cooper27 is correct here) means there is less money to hand out for people who truly need it (eg., yourself). This is true even in an insurance system. The high rate of diet-related chronic diseases in the US may even be one reason why Americans are so afraid of socialized medicine; they know it'll be expensive.

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Within the last two days the NHS has agreed to adopt a low carb approach to dealing with type 2 diabetes. It’s going to take some time before it permeates through the system, but hopefully not too long. I haven’t read the details yet, very surprised to find any endorsement at all.

diabetes.co.uk/news/2019/ma...

Unfortunately the “Eatwell” plate is still out there as general dietary advice.

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Wow.

Never expected that. I figured it would be at least a decade before we saw any shift in the official stance. It remains to be seen, I suppose, whether this is just a token effort to keep the activists quiet, or a genuine attempt to make things better.

I wonder if this has anything to do with the presentations to the House of Commons that Concerned brought up recently?

Could also be something to do with Brexit. I've noticed that DEFRA are gearing up for some significant changes in farm policy (and about time too) which will in turn have an impact on the food supply - a positive one, I hope. If this all pans out, people will find it much easier to access high-quality local produce from sustainable farms.

It doesn't really surprise me that they're still equivocating. They can't come right out and say the official advice has been wrong all along, because the lawyers would smell blood. And to be fair, a rash of expensive and complex prosecutions targeting an already-embattled NHS may not be in the public interest.

Makes me laugh, though, how they present their incubator programme as the NHS leading the charge in a cutting-edge treatment :) Ah well, if they get there in the end, that's a good thing.

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TAD, following your analysis of what causes T2D, you state

>> It should be completely obvious that the way to reverse this situation is to back off on the glucose, and this works incredibly well in practice:

I certainly agree that backing off from taking in glucose will reduce the symptoms. And yes I agree that that is an obvious conclusion. However sometimes the obvious is not always the way forward. The question I ask is whether the ability to absorb glucose is a cause or a symptom.

So going back to 1927 a study of young, healthy people were taken and split into two groups — half on a fat-rich diet and half on a carbohydrate-rich diet — and within just two days, glucose in the fat group ended up with twice the blood sugar. jamanetwork.com/journals/ja... If true this goes against what you are arguing, or at the very least implies your position is an over-simplification.

I subscribe to the theory that although insulin exists in a T2D person the problem is caused by that insulin being unable to unlock muscle cells such that glucose cannot cross the cell barrier. This is caused by intramyocellular lipids blocking the pathway into the muscle cells. Studies have shown that high fat meal can begin insulin resistance, inhibiting blood sugar uptake after just over couple of hours.

So far from solving the problem, imply backing off actually increases the underlying problem of insulin resistence, high-fat meal after high-fat meal.

So yes, backing off from consuming sugars will reduce symptoms. And so it is common that low-carb is recommended as a solution. However it does not address the underlying problem, it only makes the problem worse. It's is just that people hide from the real problem and don't see it.

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However sometimes the obvious is not always the way forward.

True enough!

>> I subscribe to the theory that although insulin exists in a T2D person the problem is caused by that insulin being unable to unlock muscle cells such that glucose cannot cross the cell barrier.

Sure, but it's not a theory. It's well-understood biochemistry. And it's not a malfunction. Under normal circumstances it's the way your body determines where glucose goes - to this organ or to that other organ. If one organ stops taking up glucose (because it's got what it needs) then logically there's more glucose available for something else. That's a good thing ... unless there's more glucose circulating than they need in aggregate.

>> This is caused by intramyocellular lipids blocking the pathway into the muscle cells.

No, it isn't. GLUT4 is deliberately withdrawn, along with the transport vesicles. The aim is to protect the cell.

>> Studies have shown that high fat meal can begin insulin resistance, inhibiting blood sugar uptake after just over couple of hours.

It might, but what does that mean? You're observing a short timeslice of an adaptive control system with a whole bunch of different time constants - some very short (seconds), some very long (months). It certainly doesn't show that fat molecules are blocking glucose transport vesicles like oil in a drain. One possible explanation is this: by switching off glucose transport, the circulating fat-based energy is used first; the intent, presumably, is to clear fat from the bloodstream at the same rate that it's coming in from digestive processes. If this didn't happen, you could potentially end up with an awful lot of circulating fat.

>> However it does not address the underlying problem, it only makes the problem worse.

In what sense?

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I do agree that I don't think there is really a cure for diabetes - all we can do is put it in remission. If we bring back the original trigger (poor diet) we'll simply end up back where we started.

There's been a lot of interest in fasting for diabetes, and I can't help thinking that diet must restrict carbs, because what I call "easy carbs" are calorie dense, and unsatisfying. At the same time though, this diet must limit fats too, for the same reason. What it does do, is encourage nutrient dense foods, and I think whatever route you choose, nutrient density has to play a big part.

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You're correct that the study I quoted doesn't definitively demonstrate a cure. To show that those patients achieving 40mmol/mol were cured in a real sense, you'd have to do a followup experiment showing that their glucose tolerance had improved.

That really does happen ... sometimes. If you look back at the Hallberg & McKenzie paper, the scatter plot shows 7-8 people who started off at 90-110mmol/mol (ie., at high risk of complications) who ended up below 45mmol/mol after 1 year. That simply wouldn't be possible unless (a) their pancreas had resumed normal function and (b) their insulin-resistant state had been reversed. I know, that's a mere 3% of the intervention group who have gone from the worst possible scenario to the best, but as far as I'm aware that's better than any competing treatment. And as you can also see from the chart (the cluster of points near the origin), those who started off in a less precarious position had an excellent prognosis.

Hence my use of the word "cured", albeit it in quotes. Ex-diabetics who follow a consistent low-carb protocol generally regain some glucose tolerance, especially if it's caught early. I'll try to root out a paper showing this. They rarely regain complete "normality", but it might be argued that they always had poor glucose tolerance in the first place - if that weren't so, they wouldn't have developed diabetes. The basic problem here is that nobody knows what their glucose tolerance was before they developed diabetes.

I certainly agree with you that if they were to go back to eating junk, they'd end up right back where they started ("If you always do what you've always done, you'll always get what you've always got").

>> At the same time though, this diet must limit fats too, for the same reason.

This is neither possible nor necessary. If you stop eating carbs then you must eat fat: your body has no other plausible source of energy. This works because, in the absence of lots of starches, you physically can't eat too much fat. Try it and you'll see what I mean :)

Carb-based meals are unsatisfying not because they're energy-dense. They're not, at all - rice and pasta have about 1kCal/gram, whereas pork belly (say) is about 5kCal/gram. And in fact they're not inherently unsatisfying. They become unsatisfying when your body loses its ability to store and retrieve fat efficiently: prediabetes.

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I know what you're saying, strictly speaking, you won't be avoiding carbs completely either. But everything you get will be locked in your food - you won't be wasting 100 calories on a spoon of olive oil, just as you're unlikely to waste it on a cereal bar. It's maybe a warped logic though!

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When all said and done, these hypotheses should have been tested years ago. We've been warned off eating saturated fat for (at least) half a century, and nationally we eat only 1% above what is recommended, yet it is still a priority of the national guidelines, whereas the only carbohydrate restriction is in terms of added sugars.

We are now in a ludicrous position where people are arguing that even if carbohydrate restriction is good for diabetes and/or the prevention of (because the quality of evidence is becoming hard to ignore), restricting ingested fat is still the priority for the majority (based on a long-held, flawed theory).

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I was particularly intrigued to find this video on youtube about someone trying vegan for 30 days - someone with T1D. Enjoy

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T1 is a whole different ballgame, andy. As you might know, some bodybuilders use insulin for its anabolic effect. If you're T1, you have complete control over your insulin - which is both a pain and an advantage if you want to achieve certain effects.

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TheAwfulToad,

Type 1 Diabetics don’t always have control of the insulin. Even when you are correct about the dose that is needed, sometimes, a person can drop low for no apparent reason and need medication to help raise the blood sugars quickly so the person doesn’t have other severe issues. I’m a brittle diabetic who can drop fast even without any symptoms of a low. I use a CGM 24/7 for this main reason— especially when I’m sleeping during the night hours. The CGM alarms when I’m 80 mg/dl and below so I can do something fast.😀

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What I meant was that control is external to your body. It is a "manual" process as opposed to an automatic one. A normal person (or a T2 for that matter) cannot introduce any change to his body without eliciting an endogenous response. A T1 diabetic can do absolutely anything he likes, because his body doesn't have any internal process for producing insulin. Of course, that doesn't necessarily mean he's going to get it right.

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Thank you for the explanation.😀

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Let's add this Bob Blackburn's story to the mix of reversing t2d using wfpb.

masteringdiabetes.org/rever...

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And Eric Adams T2D story of reversing type 2 diabetes using a whole food plant based diet. Lowering His A1C From 17 to 5.7 Percent.

foodrevolution.org/blog/rev...

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Here is a facebook group focusing on reversing t2d using wfpb diet.

facebook.com/wfpbdiet/

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This web page has a list of around 10 success stories of t2d reversal. All using wfpb.

wholefoodsplantbasedhealth....

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Have you seen this posting? healthunlocked.com/diabetes...

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From India sharan-india.org/people/dr-... practitioner Dr Nandita Shah has a book reversing t2d in 21 days using a whole food plant based diet.

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What about this one. A woman with lung issues as well.

nutritionstudies.org/how-i-...

How can ANYONE could ever argue that a whole food plant based diet cannot reverse type 2 diabetes seems patently silly. Do you want me to post some more?

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Here is one from facebook. I would have like to post a screen capture but you will have to do with the text as written by someone called Kenda

"I have been a type 2 diabetic for the last 15 years and on oral meds all 15 years! I started insulin 5 years ago because I couldn’t get my sugar levels under control. This picture is one year apart in the same dress (aug. 2017 & aug. 2018)!!! 8 months of plant based diet... lost 20 pounds, and reduced my insulin in half. The picture on the right in the orange dress is before the 6 weeks of eat to live... NOW, the picture of me in green is the most recent one. After 6 weeks, I’ve lost 13 additional pounds, completely off insulin, and reduced one of my meds! I am now my best self!"

I think you can guess the before / after pictures.

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Here's another one from Facebook from a guy called Brian

"I KICKED DIABETES ASS !!!

4 months ago I was diagnosed with type II diabetes. I left my doctors office in a slight state of shock. I knew that many Americans suffer from type II diabetes and have known some people that have had to take insulin shots. But other than that I knew very little. My blood work at the time showed that I had an A1C level of 8.7. My cholesterol was high I had elevated liver enzymes, my blood glucose test showed that I was at 162. In doing my research on the Internet I discovered Dr. Fuhrman’s book “Eat to Live… the End of Diabetes”. The diet consist of lots of raw and cooked vegetables, berries, beans, seeds and nuts. Absolutely no animal, dairy or highly processed foods. (I won't get into a whole lecture about the diet)

So today I went into my doctor to review my latest blood work. I have been on the diet for three months. I've been increasing my activity mostly by taking longer walks.

Today's results: my A1C level is 5.6 that is in a the normal range and considered fully in control. My cholesterol was normal, blood pressure is great!! My liver enzymes are back to normal suggesting no more fatty liver. And my blood glucose test usually range from 82 to 98.

Oh yeah….. And I've lost 45 pounds!!!!

This has shown a complete reversal of diabetes and many other related health issues. This by no means suggest that I am cured. This means I have it fully in control with diet and exercise. I’m on the road to reversing many of my health issues, feeling better and living longer."

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Here's another reported by Mastering Diabetes that hasn't made it to their success page yet masteringdiabetes.org/success/

"Raj thought that he was too busy building a successful career on Wall Street to focus on his health – until he found himself confronted with type 2 diabetes, fatty liver disease, and obesity at the age of 30.

Discover how Raj lost 65 pounds, reduced his A1c to a non-diabetic 5.2%, dropped his fasting blood glucose by almost 100 mg/dL, lowered his LDL cholesterol by more than 50 mg/dL, and reversed fatty liver and type 2 diabetes simultaneously.

Coming from a vegetarian family in which ghee, oil, and cheese are found in almost every dish, Raj knew that type 2 diabetes "runs in the family," but he never considered that it might happen to him.

His stressful career on Wall Street had him feeling like he didn't have time to exercise, and he ended up taking solace in fatty comfort foods to try and deal with the stress. After his diagnosis of type 2 diabetes and fatty liver, Raj's doctor said he would need Metformin for the rest of his life.

When you hear Raj's story about how he transformed his health and his relationship with his family, it might just bring you to tears."

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Here's another reversediabetes2.com/amy-jo... recounting Amy Johnson's story following watching forks over knives.

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I'm on a roll...

eatplant-based.com/diabetes... is someone who had a near fatal stroke and used to be on 18 pills.

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drfuhrman.com/library/succe...

Scott's story from hypertension (201/110), diabetes (blood sugar of 385, Ha1c of 11), cholesterol (270)

More success stories on the same website.

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Here are a couple from The Guardian website

theguardian.com/lifeandstyl...

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Why on earth have I posted all of these. Because it shows clearly that the model posted by TAD and others is wrong. It is far too simplistic and misses key points.

Yes, it is clear that Diabetes can be "cured" on a low-carb diet. Equally true diabetes can be cured on a high-carb diet. Curing on a low-carb diet is done by avoiding the problem. Curing on a high-carb diet is done by solving the problem.

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Andy, that's a lovely basket of cherries, and I won't argue that they're all lying. But I was asking for an experiment showing the successes AND the failures. Like Neal Barnard's. Given 100 diabetics eating a plant-based diet, how many will have success and how many will not?

If the failure rate is higher than 40%, it's unethical to not give them the alternative option.

To give Barnard his credit, he does at least accurately report his numerical results, even if they don't support his conclusions.

What is my "missing key point"? I described the mechanism of diabetes (in a non-technical fashion). That's not even in dispute. You can find a detailed description in any medical textbook. The problem with mainstream treatments is not that the theory is wrong, but that the treatment is mandated by busybodies at NICE, the BDA, and DiabetesUK (many of whom have no scientific or medical background) and therefore ignores basic biology.

I'm not saying carbohydrates per se are the cause of diabetes. To make this absolutely clear: I'm saying that the cause is a glycemic load that regularly exceeds the body's ability to dispose of it efficiently, over a period of years. That's not the same thing at all, and it's why a low-GI diet can sometimes work.

The key point you have failed to address is the one I asked benwl: what's the intervention?

If a T2D patient were to come to a high-carb proponent having developed diabetes on a high-carb diet, then what, precisely, is the doctor going to change?

How, indeed, does your diet differ from (say) the ADA advice, which advocates exactly what you're advocating: lots of "whole grains", vegetables, low fat, and minimal meat? You can look at both of the studies I quoted (Barnard and Halberg) and and see that the standard treatment has precisely no effect on diabetes. You've got two people there on opposing sides saying that high-carb low-fat diets don't work.

So: what's your intervention?

If you wish to stick with your theory that "fat blocks GLUT4 transport vesicles" then you need to explain why this doesn't result in instant death (which is what ought to happen - the effect would be similar to ingesting cyanide, which works by blocking energy transport).

You need to explain why the low-fat ADA diet doesn't work as well as your plant-based low-fat diet.

You need to explain why vegans and vegetarians still have high absolute rates of heart disease and diabetes:

ncbi.nlm.nih.gov/pmc/articl...

ncbi.nlm.nih.gov/pubmed/253...

You also need to explain why a low-fat high-carb diet - which results in much higher circulating triglycerides than a high-fat low-carb diet - doesn't have the same effect, or worse.

You need to show some evidence for your fat-in-the-drainpipe hypothesis, allowing for the fact that a whole bunch of clever biologists have elucidated the precise mechanism for insulin resistance already.

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This should satisfy you. Will it? Not holding my breath.

"An acclaimed European diabetes researcher at a National Institute in Slovakia, Dr. Emil Martinka MD, PhD started a study earlier this year that tests the effects of a specific plant-based approach to eating called the Natural Food Interaction (NFI) diet.

The early results have now come out showing a 97.4% full remission rate from type 2 diabetes. That’s right - the vast majority of type 2 diabetic patients that have followed the NFI diet have gone into remission. This high of a success rate has never been seen before in the scientific literature."

Meal plans and more about it here:

plantbasednews.org/nfi/meal...

nutritionstudies.org/medica...

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Interesting, but do you have some hard data? Where is this 97.4% remission rate demonstrated?

The NFI sample meals on their website are not remarkably different to the ones recommended by, say, the ADA, so I'd like to know in detail why the NFI meals work and the ADA ones don't. They are almost identical to Neal Barnard's meals, and his don't work either. So what's the deal with that? In other words, what's the unique feature that differentiates Barnard's failed treatment from the NFI's incredible success?

The woman in the video is asserting not just remission but rapid regeneration of beta cells. As far as anyone knows, that's completely impossible, and I'd want to see a bit more data before accepting that.

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1st, I believe that Dr Barnard's many studies show that a plant-based diet can successfully treat t2d. From pcrm.org/health-topics/diab...

"In a 2003 study funded by the NIH, we determined that a plant-based diet controlled blood sugar three times more effectively than a traditional diabetes diet that limited calories and carbohydrates. Within weeks on a plant-based diet, participants saw dramatic health improvements. They lost weight, insulin sensitivity improved, and HbA1c levels dropped. In some cases, you would never know they’d had the disease to begin with."

A list of follow-on studies: pcrm.org/clinical-research

The latest study was in 2018: mdpi.com/2072-6643/10/2/189

2nd, the ADA diet is not plant-only or non-processed (i.e. they allow processed oils). It even includes milk and yogurt, not to mention chicken and fish! So, no, I wouldn't expect it to work very well at all. In fact it's so different, I don't know why you even bring it up. You do understand that Barnard and NFI are both WFPB, right? main.diabetes.org/dorg/PDFs...

3rd - NFI

Here's a link to another article about NFI: livekindly.co/slovakian-res...

The quotes below are from this article (dated Jan 23, 2019):

"Late last year, the organization presented Professor Martinka of the National Institute for Diabetes in Slovakia with the results of diabetic patients who were treated with the NFI Diet. He agreed to begin a clinical trial of 100 qualifying patients this month (January 2019). 'Currently patients are still following the diet and we will be publishing updates as the trial progresses,' said Hickman."

NOTE: This article doesn't say what "organization" other than "researchers", in particular "David Hickman, one of the co-founders of the NFI Diet." It also doesn't give details about the data they gave Professor Martinka, only that based on it he's agreed to do his own study (which night be completed soon). I'll keep looking.

"A recent research review conducted at the University of London showed that a plant-based diet can improve physical and mental symptoms in type-2 diabetes patients...

"The clinical trial of the NFI Diet is currently underway. An additional pilot study is set to begin at the Imperial College London this year."

Finally, here's a link to an explanation of how the creators of NFI found food combinations that are the most effective at removing the tiny intracellular lipids (fat) particles covering the insulin receptors, which are the main cause of Insulin resistance: nfidiet.com/how_nfi_diet_wo...

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I think it was andyswarbs who posted a link to Barnard's raw data. Hats off to him, he does actually publish his data. Sadly, his data do not support his claim. His diet does not have any practical effect on blood glucose control (in fact the effect barely reaches the threshold for statistical significance). I wrote a full critique of Barnard's paper a couple of months back.

The main problem I have with the NFI diet is the woo-woo about "tiny intracellular lipids (fat) particles covering the insulin receptors". It's just the most mindless pseudoscientific rubbish. An insulin receptor is a protein; you can't "cover" it with a "fat particle" (whatever that even means), and even if that were actually happening, why would you suppose that a low-fat vegan diet would have any effect on that? Apart from anything else, the insulin-resistance mechanism is already well-understood; it doesn't happen at the insulin receptor itself, but further down the signalling chain.

However if the diet works then it works, even if they're wrong about why it works. I'm not going to argue with empirical results. I'll follow up your links and see if there's some hard data there, but the unheard-of success claims and the faith-healing explanations suggest a classic nutritionism scam.

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I'm curious to learn what the NFI diet involves, but I can't find anything that shows how the diet works, without a pay wall - do you have any other links?

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I find it hard to accept the conclusions that:

1. Diabetes can be cured by high carb diet

2. High carb diet cures the diabetes by solving the underlying problem/s.

Why? Because these conclusions are in serious conflict with well established facts of medical science -

CARBOHYDRATE GIVES MAXIMUM RISE IN BLOOD SUGAR, FOLLOWED BY PROTEIN AND RISE IN BLOOD SUGAR IS MINIMAL (NEGLIGIBLE) DUE TO FAT.

The above is well known fact and that is the reason medical professionals introduce the carb counting for T1D and those T2D who need external insulin. Accordingly, they calculate insulin dose to be injected. More carb means bigger rise in bs which will require larger insulin dose.

How come high carb can fix high BS?

This does not mean l do not believe in the experimental results entirely. I do not accept the above conclusions about high carb.

It may be that some of the carbs has/have such ingredients which has hypoglycemic effect. That needs to be investigated further if researchers believe in the results. It would be highly irresponsible to conclude that high carb diet will resolve the diabetes.

Now regarding LCHF/KETO: This has solid backing of medical science. It does not violate any theory of medical science. It does not claim to fix the underlying cause e.g. loss of beta cells in the pancreas. What it does - it makes use of available resources (beta cells) more efficiently by limiting the rise in BS. In addition, losing weight on this diet results in losing fats deposited around vital organs ( liver and pancreas) which improve insulin sensitivity.

The question that should be asked here is: Is it safe to consume low carb? What is the minimum carb required to thrive for human? Again medical science says: The minimum dietary carb required for surving and thriving of human bodies is ZERO provided sufficient protein and fat are consumed. There are only essential fatty acids and essential amino acids but no essential carbs.

Does it mean we should stop eating carb altogether? No, not all. What we are saying is eat carb as per body's requirements. T2D cannot metabolize carb efficiently, hence it makes solid sense to reduce the carb to a a level where their blood sugar levels are in non-diabetic range. Non-starchy vegetables are excellent choice in terms of vitamins and minerals contents and the amount of carb. A total of 500- 700 gm of various vegetables will provide only 20-25 gm of carb . Rest of the energy should be derived from the essential macronutrients I.e. protein and fat. Again, keep protein to modest level to meet the minimum requirements ( remember protein also raises a BS and insulin). Which means let fat be the major source of our energy.

Now the question that should be asked - Is it healthy to consume high amount of fat? Recent research/studies do indicate that it is safe though there is still no consensus on this at present.

Just think about it, why carbohydrates being nonessential should provide 60 - 75 percent of our energy requirements? And we have accepted this as Balanced Diet!

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Praveen, you may find it difficult to believe. But all the instances I have cited (and I can follow up with many more) and the research shows that it is possible.

You say "CARBOHYDRATE GIVES MAXIMUM RISE IN BLOOD SUGAR, FOLLOWED BY PROTEIN AND RISE IN BLOOD SUGAR IS MINIMAL (NEGLIGIBLE) DUE TO FAT." This ignores, for instance the fact that complex carbs are called that because they are difficult to access. This complexity provides at least two benefits. Firstly release of sugars from complex carbs is slower. Secondly the body operates at a higher metabolic rate, thus helping people lose weight more easily.

I am not saying that one should just through carbs, any carbs, at the problem and all will be fine. Similarly people who advise low-carb diets define low carb in particular ways, for example I read in the last day or so that less than 50% is definitely not low-carb!

To resolve any chronic illness in the safest and fastest way possible one should work with best practice, keeping the illness in mind all the time. With my own illness, arthritis, I have often stated that had I simply adopted a high-carb low-fat diet that I would be as ill today as I was two years ago. Surely the same is true for each and every chronic illness.

The starting point for diabetes is indeed to reduce the glycemic load, otherwise consequences can be dire. But that does not mean that one cannot address the core problem of why insulin is not working and proceed to correct the problem.

If a whole food plant based diet can be introduced carefully and if, as a consequence insulin begins to process more and more sugars properly, then problem solved.

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>> I read in the last day or so that less than 50% is definitely not low-carb!

As Praveen pointed out, your body has no biological requirement for carbs, so the lowest possible limit is zero. The meaning of "low", then, must surely be "somewhere close to zero".

But that does not mean that one cannot address the core problem of why insulin is not working and proceed to correct the problem.

That's precisely what low-carb does. If the pancreas is undamaged, the patient will recover some or most of his original glucose tolerance. The paper I quoted does suggest this on the scatterplot, even if it doesn't do an explicit test.

To resolve any chronic illness in the safest and fastest way possible one should work with best practice

Quite so. And unless you are able to show a higher success rate with WFPB, best practice would be LCHF :)

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"I won't argue they are all lying". That's very generous of you TAD! Can you readers a percentage you think are lying. My guess is 0%. Even to imply that someone is lying needs justification. Do you have evidence of just one lying? You have your perspective on the cause & cure of diabetes, but there is no guarantee either you or I have the full picture.

Let me be generous to you. By lying perhaps you mean they are deluded? That they THINK they are recovered, reversed, whatever, but in reality you expect diabetes to bite them back in the butt sometime soon. Or do you mean by lying that they intentionally are over-egging their state of recovery. Or indeed that their supposed recovery never really happened and some of these are totally made up stories? Perhaps you think these are just click-bait, false news.

Who knows? Well only you can say.

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Let me rephrase that: I don't think any of them are lying. However, this doesn't help your argument. The internet is a big place, as is the population of diabetics. Unless you can show me an experiment that gives better results than Neal Barnard's - which shows 0% recovery - it's a fair assumption that these people are statistical outliers.

I notice you completely ignored all of my other objections.

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TAD

I was replying on my phone at the time. In reply to your request to find another study what about Kiehm TG, Anderson JW, Ward K. Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men. Am J Clin Nutr. 1976 Aug;29(8):895-9.

I thought you did not like observational studies?

Nevertheless I am not surprised that a study titled "Adherence to a Vegetarian Diet and Diabetes Risk: A Systematic Review and Meta-Analysis of Observational Studies" shows a heightened diabetic risk." I think dairy consumption contributes to many chronic illnesses. Historically vegans have been a small group that has made studies poor. To increase the number of vegans some studies have included fish eaters, for example. Fortunately because there are a lot more vegans today, and increasing, so in future studies will give a more statistically relevant answers. This study of vegetarians included vegans to bolster the size of the study.

Similarly your second study entitled "The association between a vegetarian diet and cardiovascular disease (CVD) risk factors in India: the Indian Migration Study." I would never argue that a vegetarian diet is going to reduce CVD risk, in fact rather the opposite.

Or am I missing something?

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>> Am J Clin Nutr. 1976

I have nothing against observational studies as long as people don't draw conclusions that aren't warranted by the results. Mainly, I don't like 43-year-old experiments that have never been replicated. You keep bringing up that single experiment and the debate never goes anywhere.

Basically, you need to find something that shows that Neal Barnard's results can be radically improved upon. Preferably from this century.

>> I think dairy consumption contributes to many chronic illnesses.

Your goalposts are moving so fast here I can't keep up with them. First it was dietary fat. Then benwl said it was calories. There's been an underlying implication that the problem is mostly meat. Now it's dairy.

So which is it? You can't tick "all of them", unless you have a very good hypothesis for the mechanism.

>> Or am I missing something?

What you're missing here is that there is already a very effective intervention for diabetics - whether they are technically "cured" or not is completely beside the point, since a LCHF diet is neither unpleasant nor difficult to stick to. Funnily enough, even the NHS finally agrees, as Penel mentioned in my other thread.

I'm making a fuss over this because it isn't purely academic. When people come here they want advice that works. Diabetes is not a trivial condition: it's potentially life-threatening. Your advice is downright dangerous, because you either don't understand, or won't accept, that a diabetic has lost the biochemical engine for converting carbs to energy. All that stuff about "complex carbs" is not only wrong in the substance (what dieticians call "complex carbs" have about the same GI as glucose), it doesn't apply to diabetics even if it were accurate.

>> Fortunately because there are a lot more vegans today, and increasing, so in future studies will give a more statistically relevant answers.

It'll give more answers related to vegans specifically. It won't give you much information about people who are non-vegan diabetics who subsequently become vegan.

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I have made many points and tried to be fair to any substantive arguments you make. Rather than trying to continue debate perhaps we should simply agree - to disagree. Not sure if we will debate any more. Neither of us like seeing an "untrue" statement go unchallenged...

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