(1) A case report in BMJ, along with many personal reports given in the comments section:
A patient request for some “deprescribing”
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h4023 (Published 03 August 2015) Cite this as: BMJ 2015;351:h4023
Very unfortunately, the article itself is now only partially visible at this LINK . To see the full case report, one needs a subscription (you can get a free 14-day trail if you like). In the report, David Unwin, and Simon Tobin, both general practitioners in the UK, describe the outcome when a patient said he wanted to avoid taking any medication that was not absolutely required. He adopted a low carbohydrate (and thus low-insulin-demand) way of eating. The patient’s health improved substantially and he was very pleased with his new dietary lifestyle.
Fortunately, it is possible to read the many comments posted in response to this report. LINK A number of people have left comments describing their own experiences with both:
- the “usual” dietary advice they had been given and
- what happened when they instead adopted a low-carb diet.
The people leaving those comments include a wide range of people, at different ages, with various backgrounds including athletes and health professionals, and with type 1 or type 2 diabetes. Just a few examples:
- Allison M Herschede,RN Student, Associate Diabetes Educator, diagnosed with type 1 DM as an infant:
- On January 4, 2010, the day after my 30th birthday, I made a huge decision. I was 200lb, my diabetes was out of control, and I was taking a myriad of medications for cholesterol, high blood pressure and many other things due to my poor health.
- It has been more than 5 years now and I am the healthiest I have been in my entire life. I have maintained a healthy weight and my current a1c is 4.8 (4.8-5.2 for more than a year now!) This is a permanent way of life for me and I would never go back! I am currently in my 2nd year of nursing school. I’m getting my R.N. so I can become a Certified Diabetes Educator.
- A little over a year ago, I was able to participate in starting an awesome new Facebook group with R.D. Dikeman, Derek Raulerson, and Debbie Theriault called TypeOneGrit. It is my absolute privilege to be a part of this amazing community. My blood sugar management has done a complete 180 because of these people.
- Matt J Pasterfield
- I would like to add my own story in support of this article. I was diagnosed with Type 1 diabetes in 2005.
- To cut a long (ten year) story short, I have been limiting carbohydrate for a decade – around 30g a day. My A1cs have been consistently in the 5s and my most recent result was 4.7%. My blood test results have shown excellent levels of good cholesterol etc. All of my 10 year records and available as proof of these results. I have no signs of diabetic complications.
- Dr. Carrie Diulus, Orthopaedic Spine Surgeon
- LCHF plant rich diets are an extremely effective tool and I have had great success normalizing my patients A1c, BMI and decreasing the amount of medications they are taking. In the process of this, their musculoskeletal complaints often resolve. If they do not and the patient requires surgery, they are much better candidates and have a much lower rate of surgical complications related to their other comorbidities.
- This makes it worth all of the effort. This article pointed out and I couldn’t agree more, that quite honestly the effort is not that much, but the knowledge of “how” to do it and the physicians attitude is critical to the patient’s success.
- As a Type 1 diabetic myself I was initially placed on the standard “diabetic” diet which is low-fat and relatively high carbohydrate. My blood sugars were erratic and my insulin requirements were high. It was miserable. Using a LCHF diet myself has allowed me to normalize my blood sugars with relatively low doses of insulin. I am able to be very physically active and am an avid runner again. My most recent A1c was 5.3%.
- While there are studies indicating that “tight” blood sugar control for diabetics may not increase lifespan, these studies are looking at lowering blood sugars with aggressive medication management and frequently consider “good” A1cs to still be in an abnormally elevated range. We have not done an effective job at looking at longitudinal outcomes with the use of dietary changes for normalizing blood sugars. Surgical literature clearly supports improved patient outcomes when perioperative A1cs are less than 7.0%. Our patients can achieve these levels with dietary and lifestyle changes without or with minimal use of medications if we simply provide them with the tools and the motivation to do so. There is no reason to think that we are not improving life expectancy and decreasing complications of diabetes if the blood sugars and A1c are normalized with dietary strategies rather than with medication.
(2) Two Stories: An adult and a teen, both with type 1 diabetes:
An Adult: A doctor using very low carbohydrate diet to control his Type 1 diabetes.
This is an excellent video with succinct, clear information of profound importance to people living with diabetes.
In this presentation, a doctor who was recently diagnosed with Type 1 Diabetes as an adult reports how his health was when he was strictly following the standard dietary advice he was given. Then he did his own studying and switched to a very low carbohydrate ketogenic diet. He shows the many ways his health dramatically improved.
Next, he relates the similar experience of several other people with type 1 diabetes.
He moves on to give an over-view of the research on the topic.
Presenter: Dr. Troy Stapleton – on Twitter @drtroystapleton
Presented: August, 2014
“Carbohydrate Restriction in Diabetes Management”
A Teen: Lisa Scherger learned to use low carb nutrition as a vital part of the care plan for her son with Type 1 Diabetes.
Besides very useful information, she is well known for her recipes!
Video of presentation by Lisa Scherger, fall 2014,
“My Healthy Type 1 Son”
(3) A doctor with type 2 diabetes relates his health recovery with low carb nutrition.
This is a short video in which a family doctor in South Africa describes the many improvements in his health with adopting a low-carb, ketogenic diet.
At 8:40 minutes, this video is also a good choice for helping you communicate with friends, family and your health care team about low carbohydrate nutrition.
A comment I would make is that this does not at all have to be a high protein diet. He refers to an emphasis on meats, but this is a common misperception. There is no need at all to have a high intake of meats or even of meat at all. A high protein intake is not even the preferred way to go. In fact, some people do not get the full benefits of low carbohydrate nutrition if they embrace a high protein intake. A moderate protein consumption is usually best.
Also, note that he needed to pay close attention to his medications as he started the change in eating pattern. It would have been very dangerous if he had not reduced the diabetes medication and blood pressure medication as needed as his food intake changed.
Finally, I definitely do not recommend the Dukan diet, which he mentions briefly.
This video is included on my site to illustrate the important option of low carbohydrate nutrition in the management of type 2 diabetes. Weight loss is also mentioned a lot in the video. In terms of weight loss itself, there is no one dietary approach that works for all people. The conundrum of obesity is not fully solved. It is never possible to say that any one could simply choose to be at a “normal” weight if only they just followed “X” or “Y” program or diet. Having said that, my assessment is that, for people who have had a persistent tendency to gain weight and have been at a higher BMI for some time – it is important to consider a well-done trial of a lower carbohydrate approach.
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