The diabetes debate

[TheAwfulToad]

"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."

- Arthur Schopenhauer

As part of my recent servings of spam (albeit entertaining and useful spam, I hope) I wanted to write a short post on the use of LCHF to prevent (or to 'cure') diabetes. It'll be shorter than intended because the two opposing sides are neatly summed up by these two almost-identically-named organisations:

diabetes.co.uk

diabetes.org.uk

I was a little confused when I came across the former site: I thought it was the official one (ie., the one endorsed by the NHS). It isn't. That's the second (.org) site.

What struck me most about the .co.uk site is that they describe the underlying biochemistry of diabetes accurately and simply, and when the science isn't clear they say "we're not too sure about this, but here's what we do know". They recommend a low-carb diet by drawing a fairly obvious inference: a body that cannot process carbohydrates without help is best not given carbohydrates. Even if you vehemently disagree with their position, it's hard to argue with their thread of reasoning.

The official site, by contrast, is dogmatic ("we know sugar doesn’t directly causes Type 2 diabetes"), contradicts itself, and is scientifically inaccurate. It touts the low-fat high-carb diet as both prevention and management policy without once mentioning why fat might have anything to do with your glucose-control loop, or indeed without explaining why it's OK for diabetics to eat carbs when glucose is fundamentally toxic to them.

Most relevant to this forum, perhaps, is diabetes.org.uk's position statement on low-carb diets:

diabetes.org.uk/professiona...

Which begins:

"The current evidence suggest that low-carb diets can be safe and effective for people with Type 2 diabetes. "

Well done. Finally! So you're recommending low-carb diets for diabetics?

"People should be encouraged to eat more vegetables, fruits, wholegrains, pulses, seafood, nuts, and to eat less red meat and processed meat, sugar-sweetened drinks, sugar-sweetened foods, and refined grains such as white bread."

Hmmm.

The statement then concludes:

"It is extremely important that dietary recommendations are based on good evidence rather than individual opinions."

So low-carb diets are safe and effective, and we can presume then that dietary carbs have SOMETHING to do with diabetes, even if we're still debating the mechanisms involved. But diabetics are nevertheless advised to eat a completely different diet, with energy derived predominantly from carbs.

I guess that's that cleared up then.

I should be clear that the aim of this post is not to start a flame war - I'm assuming readers of this forum are all broadly in the LCHF camp to begin with and will have no argument with the stated position of diabetes.co.uk. I have just two observations:

1) As a previous poster mentioned, the times they are a-changing. It is inconceivable that diabetes.co.uk would have achieved its apparent popularity even 15 years ago. It might even have been shut down. More than anything else, I'm elated that diabetics - or at least some of them - are going to have their lives improved and prolonged because someone is finally giving them accurate information.

2) What on earth has happened to scientific education in the UK? I have degrees in both soft and hard sciences, and I work (sometimes) as an engineer. To me, the content of diabetes.org is so transparently incorrect that I am baffled that apparently intelligent people could produce such a thing. Are there so few people with a background similar to mine that such egregious nonsense can go not merely unnoticed, but approved of and accepted as fact?

[gur1302]

Ohhhh

[gur1302]

Prevented

[Hidden]

diabetes.org.uk

Whilst I do not know enough about these organisations, I have seen other charities (non-diabetes ones) promoting healthy eating and posted these on the HE hub. This above site looks very undedicated to eating healthy, which I would have thought it would be one of the key areas to tackle this condition.

"We are the largest charity focused on diabetes research in the UK, and have invested nearly £60 million in the last ten years."

Maybe, the money is not used to get people better. It says, "research". That's an awful lot of money. Their priority is probably not to get people better. You do realise that they will lose money if people got better.

diabetes.org.uk/research/ou...

The other site is more informative and offers more detailed info worth browsing. The first one is probably making loads of money (tax-free, too) but for what? Perhaps, someone could enlighten us.

[MTCee]

Since quite a few people in my family have diabetes, I decided to have a look at the two sites on their behalf.

The co.uk site offers loads of good information, good advice, and good resources. The message is that diabetes can and should be controlled mostly through diet.

The org.uk site is very light on information and takes a very simplistic approach. It also seems to encourage people with diabetes to eat absolutely anything they want, which is quite shocking. It claims there is no such thing as a diabetes diet and lists lots of high carb recipes. The emphasis seems to be on non dietary treatments. Perhaps that is also the main aim of the research. So basically the charity is raising money for medical research into diabetes and encouraging people with diabetes to rely on medical treatments and eat whatever they want. Quite an irresponsible message.

I'll only be recommending the first site.

[TheAwfulToad Ambassador]

Hidden , MTCee : that was precisely my impression. The private site is forthright about its intent to make money (although purely from advertising, which isn't going to make anyone rich). It has a stated mission to use their profits to benefit diabetics. Well: anyone can say that, but the bottom line is it's a well-constructed site, easy-to-navigate, and full of sensible, useful information that doesn't talk down to the reader.

The charity site seems dedicated to sustaining its own existence by creating more diabetics.

>> It also seems to encourage people with diabetes to eat absolutely anything they want, which is quite shocking. It claims there is no such thing as a diabetes diet

Indeed. 'Shocking' doesn't even start to cover it. You'd think after £60m worth of research they would have come up with something a bit more substantial than that.

[Hidden]

I agree with you. Maybe, there are some financial discrepancies (?) in 'org.uk' one? It does look like a very cheaply made website, too.

I was thinking about this last night. When I was a student, a Medical school student says pharma funds the Med schools and someone else working in medicine also told me a few years later. The end result of any diagnosis/investigations leads to the medicine/making the industry richer. This whole pattern never changed. Have you looked at their financial activities/accounts that the Charity Commission may hold? You could look at how much these charity staffs are earning. It is probably managed and run by the wrong kind of people, who have no idea as to what they are doing.

I quite agree. It is rather hard to believe that the website of this poor quality is run by the major charity (Diabetes UK) with £60 million worth of "research". The website also has a similar, bland look to NHS websites as if it is a subsidiary of NHS department.

[ceejayblue]

I'm a member on both those diabetes sites and they are different but the Diabetes.org.uk one is in the process of working with Newcastle University on the system of putting diabetes into remission that was on the recent ITV programe Fast Fix : Diabetes. I wish they'd distinguished between T1 and T2 more but essentially the people on the liquid only diet did make huge changes to their HbA1c levels and lost weight and fat around their livers. Personally, I'm not sure that I would be able to do that but having said that I've lost a bit of weight and lowered my Blood Glucose by eating healthier lowering my carb intake I have gone from low fat eating to medium good fat eating but cannot do a full high fat diet because of issues with my stomach (I've had countless arguments with people on the LCHF way eating on the fact that they think my stomach issues are down to low fat, they aren't as I had them before going low fat!). Truth is, not everyone can go high fat so eating in moderation is the key for most of us

I joined an online subscription club last year run by a nutritionist on Facebook and have found it really helpful in giving up processed foods (rarely eat shop bought pizzas and never have ready meals anymore) and giving up added sugars and the support from the other ladies on the group is brilliant. Not saying that I'm totally there yet as I still have the odd treat and my OH doesn't believe in it but I'm getting there.

Waiting for my latest HbA1c result so will see if I'm still down in the pre-diabetic range.

[Hidden]

I wonder whether these websites are, to a degree, informed by history and their function. The diabetics of the past were primarily type 1 s (who often seem to be completely ignored at the moment). The Diabetes UK (org) was (?is) therefore focussed on finding treatments and developments for these folk. I have to say that technology has improved fantastically since my husband was diagnosed type 1 about 10 years ago, what with monitors and apps and implants. Quite a lot of the research is looking for the next big leap forward; the artificial pancreas. This would transform lives, especially for the children and young people who can really struggle with compliance.

Type 1 is of course a medical condition that has nothing to do with what you eat.

Now, with the rise of type 2, the focus has shifted to the behavioural aspects of the condition and the debate around diet comes from there. Perhaps .org is still focussed on all of the people who have type 1 (and maybe need to shift a bit). I find the idea that the charity is somehow promoting it's own existence by creating diabetics a bit far fetched tbh

[TheAwfulToad Ambassador in reply to Hidden]

>> I wonder whether these websites are, to a degree, informed by history and their function. The diabetics of the past were primarily type 1 s (who often seem to be completely ignored at the moment). The Diabetes UK (org) was (?is) therefore focussed on finding treatments and developments for these folk.

You may well be right about that. For Type 1 diabetics - who inevitably use SOME insulin - it's not entirely unreasonable to eat carb-based meals. Not because carbs are useful for them, but simply because it makes insulin calculations easier.

Nevertheless, that's no excuse for an organisation that's supposedly at the forefront of research to conflate Type 1 and Type 2 (they are, as you said, fundamentally different conditions). The passage I quoted regarding low-carb diets contradicts itself within the space of three paragraphs: at best it's a refusal to even convey an opinion, and at worst people are going to read it and wonder what on earth they're supposed to be doing.

>> find the idea that the charity is somehow promoting it's own existence by creating diabetics a bit far fetched tbh

There are really only two other plausible explanations: a) pure incompetence or b) a quasi-religious belief in the value of carbohydrates, even for those who have no physiological ability to process them.

[Hidden in reply to TheAwfulToad]

They are not alone of course, many medics/diabetic nurses and even the NHS 12 week weight loss programme continue to advise low fat, calorie counting approach.

[Rex1000]

Low Carb High Fat changed my life.

A special hello to anyone embarking on a low carb high-fat diet, and to the ones who are already on this journey keep it going you have so much to gain. Before I went on the journey I was in a sorry state, I had diabetes 2 breathing at times was an effort, walking any kind of distance was too painful. my weight was 17 st 3lbs I am a male 5ft 8" tall and at the time I was 67 years of age. I went for my annual checkup with the diabetic nurse and my blood sugar was 19! So she said I was on the maximum metformin 500gx4 and it was looking like I would have to start having insulin injections, this frightened me enough to change.

I was lucky enough to come across a video on YouTube the Diet Doctor, and it convinced me my lifestyle was killing me. well, the good news is I am no longer on medication for diabetes, my blood sugar is averaging 4.5, I can now walk over distance pain-free, I am, no longer breathless, and my weight is averaging 11 stone 11 lbs, and I feel like a million dollars! I am 70 now I hope you will find my story encouraging. PS I had a hbc1 test, 3 months after stopping the medication and the result was normal yippee

[TheAwfulToad Ambassador in reply to Rex1000]

That's a fantastic story Rex1000. It's simulataneously heartening and depressing to read about turnarounds like yours: depressing, because there are so many people being warned away from low-carb by people who should know better and should have their best interests at heart: their doctors and nurses.

Hope your good health continues for a very very long time

[Coyley]

Thank the stars for this post, TheAwfulToad . Brilliant. Also, sorry for the upcoming long post

I know exactly what you are talking about. Last year I even went on Twitter to ask diabetes.org.uk exactly why they are giving the advice that diabetics should include carbs (grains, bread, etc). And they replied saying that we should be eating a healthy, balanced diet.

What does a healthy balanced diet even mean anyway? One diet for one person isn't the same for another. We are all different and require different nutritional macros. ESPECIALLY diabetics.

I know what they are getting at though (even though they are wrong). Ever since the 7 countries study (actually 22 countries) by Ancel Keyes theorised that saturated fat gave you heart disease, and the subsequent hoohaa that followed, and the destruction of any counter-science to this theory, we have been told that we should not eat fat and the bulk of our diet taken up by carbs. Because carbs are heart healthy (sic).

And thus grains, and quinoa and other such foods are meant to be part of a healthy balanced diet because they won't give you a heart attack. Even for diabetics

This is also why you will walk into a diabetic clinic and see the food pyramid poster on the wall showing carb-rich foods at the bottom, and minimal fats at the top.

The organisations simply don't want to listen to the science that shows that foods like grains are essentially sugars. Sugar is glucose, but how can a grain also be glucose. They are simply not willing or are unable to understand, that the body doesn't care about how it gets its glucose. IT treats it all the same. Sugar, starch, fibre; they all get converted into glucose... etc.

Finally, they also go on about the fact that we NEED carbs as an essential macro. Because it is what provides us with energy. Without explaining, or indeed learning for themselves, that carbs are not the only energy source a human body can use. But try talking to them about Ketones and watch their eyes glaze over!

Yes, the NHS and other medical practitioners need to wake up, research this for themselves, read other peoples research into the subject, stop relying on a 50-year-old theory to guide our nutrition, and start providing the correct advice to people to whom a healthy balanced diet will ultimately kill.

p.s. diabetes.co.uk/ is a superb website on which to get knowledge and advice on diabetes and proper nutrition. Can't recommend it enough.

oh, and it seems to me that, like a lot of charities, if the correct advice and care were give to diabetics (especially reversing T2D) then there wouldn't be a need for the charity. And charities make a lot of people very rich. And I don't think these people would like to see their source of richness and power to go away due to people recovering from their ailments.

[TheAwfulToad Ambassador in reply to Coyley]

grr .. so I wrote a long reply to you the other day and HealthUnlocked lost it with an error message. I'll give it another go. First, thanks for the nice comments. I'm pleased to see people are interested in a bit of contentious content here (as opposed to 'what I had for dinner today' ... not that there's anything wrong with that).

>> we should not eat fat and the bulk of our diet taken up by carbs. Because carbs are heart healthy (sic).

>> What does a healthy balanced diet even mean anyway?

>> Finally, they also go on about the fact that we NEED carbs as an essential macro. Because it is what provides us with energy. Without explaining, or indeed learning for themselves, that carbs are not the only energy source a human body can use.

To me, this sort of thing is a prime demonstration of the Dunning-Kruger effect. The problem with mainstream diet advice is that it's been put together mainly by liberal-arts types who don't realise that it's very, very complicated. They imagine they're qualified to hand out diet advice after completing a two-day course and getting a certificate. Hey, it's just eating, everyone knows about eating, right? How hard can it be?

The best articles are the ones that include the line "It's not rocket science". Sorry guys, it absolutely IS rocket science, and if you think it isn't, you're just betraying your ignorance (or laziness). After several years of study, I've found it's incredibly hard to boil it all down to a few simple truths. This system interacts with this system that depends on that pathway that ... etc. When you introduce drugs into the picture it all gets 10x more complicated still. I still have so much to learn. I'm still struggling to conceptualize how NAD+/NADH redox fits into the big picture, unlike the average nutritionist, who thinks all that stuff is irrelevant because "as long as you eat fewer calories than you burn, you'll lose weight".

Anyway, I feel a rant coming on, so perhaps I'll put together another article on this topic.

[Titania70 in reply to TheAwfulToad]

I agree human physiology is just as complex as rocket science. And despite knowing that, I’ve suffered about 30 years at the hands of dietitians advice to eat plenty carbs and have several snacks a day to even out blood sugar. At about 3 stone overweight my GP sent me to the dietitian. It just didn’t help me lose weight. In fact I became more and more obese until I was about 10 stones overweight! Then there was a weight loss clinic etc, leading to yo-yoing up and down the same two stones, and suffering the side effects of weight loss prescriptions. When someone in authority in NHS advises you, you do what they say. But not anymore. I am amazed they are still giving the same advice as if it works for everyone. There has been research showing there are better ways for reversing diabetes and obesity, yet the NHS and diabetes.org.uk still advise as if one size fits all.

I am fortunate not to be diabetic yet, but, with a blood sugar putting me in prediabetes according to some scales, and a family history of diabetes T2, I am glad I finally can be confident that there is proof that LCHF works without harming my health, no matter who says what.

About 10 years ago I was castigated by doctor and dietitian alike because I lost 3 stones using the Atkins diet, which is essentially LCHF. It left me thinking there was something very dangerous in a low carb diet. I’ve fought to keep that weight off and lose more. I couldn’t figure out how my weight would suddenly jump up a couple of pounds when I’d stuck to a conventional low-fat diet as advised.

Looking for something different, I was ducted to HealthUnlocked, to the weight loss NHS forum. Someone there gave me this link regarding a report on diet recommendations in the UK. phcuk.org/wp-content/upload...

I’d seen a number of TV programmes recommending Low carb diets to reverse diabetes, but still was brainwashed into thinking they might be harmful over time (like being obese isn’t 🙄 ). But this report was what I needed to convince me this was the way that would suit my physiology.

It’s 4 weeks now since I have been using LCFH. I’ve lost 10 pounds. I had a week of holiday in that, and stayed with LCFH. I no longer feel the urge to binge or crave certain foods. In fact, I feel much better nourished.

phcuk.org/wp-content/upload...

[TheAwfulToad Ambassador in reply to Titania70]

>> It just didn’t help me lose weight. In fact I became more and more obese until I was about 10 stones overweight!

It's just bizarre, isn't it? In any other industry, if you were charging 100 pounds an hour to dispense advice, your clients would fairly expect that your advice ACTUALLY WORKS. Not if you're a dietician. You can say absolutely anything you like and if it doesn't work, that's the client's fault. And that'll be 100 pounds please.

>> I was castigated by doctor and dietitian alike because I lost 3 stones using the Atkins diet, which is essentially LCHF. It left me thinking there was something very dangerous in a low carb diet.

I'm heard this several times, and I'm just so curious what happens in these dressing-downs. I'm imagining something like this:

Nurse: Well, your cholesterol panel is perfect, you've clearly lost a lot of weight, and you have no obvious risk of diabetes.

Patient: that's great! But I have to tell you ...

Nurse: yes?

Patient: it's just ...

Nurse: yes?

Patient: I've been eating ... a low-carb diet.

Nurse [trembling, grabs a copy of the British National Formulary and holds it out like a shield] : verily you have sinned! Here, take this rosary of whole-grain Job's tears, and say five Hail Merck's. May the CEO of Capita have mercy on your soul. Doctoooor! We've got another one!

I'm planning to get a full checkup next time I go back to the UK, just to see how it pans out

The PCHUK site is great. It's really encouraging to see this sort of professional outfit trying to get good information out there.

Good luck with the diet. Please keep us updated on your blood-sugar situation; I really hope that resolves itself on LCHF. It does for a lot of people.

[Coyley in reply to Titania70]

You know what they think? If you put on weight, and you are following their advice, they actually think you are lying to them about what you eat. They think you are clearly weak-willed and it's all your fault. There's no way their advice could actually be the cause of the problem.

Well, they are the problem. Like AwfulToad said, they do a 2 day course or something, and they think they have all the answers without doing further research.

I'm glad you have found the HealthUnlocked forum, and hopefully we'll see more good posts about LCHF.

P.S. I would also recommend dietdoctor.com

There is superb advice on low carb eating, recipes and interviews and presentations about the subject.

[Titania70 in reply to Coyley]

Oh yes Coyley I know that’s what they think. Of course they don’t actually say it, but it’s clear from their manner. Yes, I’ve seen dietdoctor.com Lots to explore there.

[Coyley in reply to TheAwfulToad]

Thanks

It's also annoying that the advice and alleged science behind our nutrition is 40 to 50 years old, and many of the decision makers are still using this old dogma. If every establishment thought the same way we'd still be using DOS 6.1 as our computer's operating system, we wouldn't have mobile phones and we'd still be driving round in rusty old Ford Escorts. Oh, and disco and punk would be only thing in the charts!

If the decision makers actually read the science, and indeed the more modern studies, they would see they have been incorrect about their nutrition advice for decades.

Then again, there's no money to be made in a healthy population

[Hidden]

Do not trust anybody, who makes her/his profits (a hefty amount, especially) out of your own ill health. Some of them are just death merchants that try to leach your blood whilst you are still alive. Not all of them, but increasingly, I became far more aware of the huge greed driven by the whole healthcare industry.

They don't care how well you are going to be, they are only after one thing. They want money coming in, lots of it, preferably. There are decent ones, but mostly, they are just making a nice living out of people's misery. They don't "fix" things, they just keep you hanging around chronically sick (or/and fat).

And, importantly, they make sure that they are free from any sort of legal recourse and they are, indeed, untouchable. This diabetes discussion is just an example of how a charity is making millions whilst they can't care less about the patients' health without providing up-to-date accurate dietary information.

No use of spending millions for "studies" whilst they ignored people not getting any better and importantly, ending up losing limbs or faced with any other major complications. Are they responsible? I doubt they would feel that's their business. It has to be their business as it's meant to be supporting the patients to GET BETTER, not keeping them chronically sick, dependent on so many medications to keep the industry richer whilst you get poorer.

[TheAwfulToad Ambassador in reply to Hidden]

On that topic, you might enjoy this:

youtube.com/watch?v=I_j-tBJ...(Not working as expected?)

It's hard for me to accept that the people running these charities and NGOs simply have their feet under the table and don't care how much mayhem they cause. I much prefer Carlo Cipolla's theory:

en.wikipedia.org/wiki/Carlo...

[Coyley in reply to TheAwfulToad]

Love this video. Thanks for sharing.