Simon Tobin+ Your Authors @DocRunner1 NHS GP and Trainer, parkrun UK Ambassador for Health & Wellbeing. Passionate about lifestyle medicine, reversing diabetes, deprescribing. #LCHF Wild swimmer Dec. 06, 2019 2 min read + Your Authors

1/16
Ever wondered why doctors and people with type 2 diabetes are getting so excited about low carbohydrate diets? 🤔

73 patients at my surgery have now reversed their type 2 diabetes 🙌

#medthread #tweetorial #medtwitter

Here's a tweetorial of how it's done👇

2/16
As Diabetes Lead GP at my surgery for 25 years I achieved little/no success with @PHE_uk recommended "Eatwell Plate"
One day @lowcarbGP shared some success he had with offering LCHF (low carb, healthy fat) eating to people with type 2 diabetes

Does it work?🤷‍♂️

How? 🤷‍♂️

3/16
Important to understand if there's > 1 teaspoon (5g) sugar/glucose in your blood then insulin PUSHES it into cells where it is deposited as FAT and TRIGLYCERIDE

4/16
We ALL agree that refined sugar is a really poor choice in diabetes. Sources include:

Added table sugar (obvs)
Honey
Sweets
Biscuits/cakes
Milk Chocolate
(non-diet) fizzy drinks
Fruit juice - 200ml apple juice contains the equivalent of 8.6 teaspoons sugar 😲

5/16
What many people don't appreciate is how much sugar is released from starchy carbs

Starch is a string of glucose (sugar) molecules "holding hands" which our bodies rapidly break down into glucose

6/16
Is #lchf recommended by @NICEComms ?

Here's NICE advice from August 2019 👇

7/16
Does it work?

Meet my lovely patient Mary (shared with her consent). She was an early phenomenal success. 85 years old and has type 2 diabetes and taking gliclazide
Her sugars were sky high so I called her into to the surgery to discuss options

8/16
Mary was adamant she did want to take more tablets (she had hated metformin - gave her diarrhoea) and would not consider insulin

Instead she wanted to try changing her diet

In only a few month of giving up starchy carbs and biscuits she achieve astonishing success 👇

9/16
Foods high in starchy carbs include:

Potatoes 🥔
Rice 🍚
Bread 🍞
Pasta 🍝
Bananas 🍌

Teaspoon of sugar infographics available free at:  https://phcuk.org/sugar/ 

10/16
Breakfast cereals are amazingly sugary. Just look 👀at 30g of cornflakes. Converts rapidly to 8.4 teaspoons of sugar.
And 30g wouldn't feed a sparrow!

I've foolishly recommended porridge for years - never again!

11/16
If I eat more healthy fat, won't my cholesterol go up?

No, with @lowcarbGP and @DrScottMurray our peer-reviewed, published data shows a LCHF lifestyle results in:

Total cholesterol ⬇️ by 0.5mmol/l
Triglyceride ⬇️by 0.9mmol/l

 https://www.mdpi.com/1660-4601/16/15/2680 

12/16
We also found that with LCHF in type 2 diabetes:

Mean HbA1c ⬇️ by 21 mmol/mol (1.9% DCCT)
Mean BP ⬇️ 11/6mmHg

There's no drug on the market that can deliver outcomes anywhere close to that and THIS IS FREE

We also stopped 154 BP meds as a result !!!

13/16
And of course using LCHF saves a fortune. My typical UK NHS general practice cares for 10,000 people and spends £52,000 per year less on diabetes meds than similar practices locally

14/16
If people on meds for type 2 diabetes ⬇️ their carbs will they go hypo?

YES, they can. They will almost always have to reduce their diabetes meds

This great paper from @CampbellMurdoch and @lowcarbGP explains how to do it safely

 https://bjgp.org/content/69/684/360 

15/16

16/16
Huge thanks to @lowcarbGP for many of the slides and for the inspiration


You can follow @DocRunner1.



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