Adapted from BMJ 23 April 2023 and Medscape 20% of patients with Diabetes in Drug Free Remission with Low Carb Program by Becky McCall Nov 21 2022.
Diabetes UK say that the number of people with diabetes in the UK has reached 5 million for the first time. They say there is ” a rapidly escalating diabetes crisis”. They want the government to limit junk food advertising to children. 90% of those diagnosed have type two diabetes. The major risk factor for this is overweight and obesity. 64% of the adult population have this risk factor.
148,000 people under the age of 40 have been diagnosed with type two diabetes. The rate has increased by 23% over the last five years. Diabetes UK think that more people need to be referred to the NHS Diabetes Prevention Problem to reduce the year on year increase in the disease.
My comment: It is a pity that Diabetes UK did not heed the advice to ignore the detrimental Food Standards Agency so called “Eat Well Plate” recommendations decades ago. We are suffering the effects of pushing high starch, high fruit/juice diets that contain refined vegetable and seed oils and not enough protein and full fat dairy on the general population. With the increase in food prices, energy and housing in the last few years, that wages have not kept pace with, we are seeing more people sink into poverty. This means that they work longer hours to compensate, with less time to make healthy, non processed meals, and to undertake physical activity, and get sufficient restful sleep. I can’t see the situation being reversed for the foreseeable future.
At the Diabetes Professional Care Conference in 2022, Dr David Unwin presented the results of the low carbohydrate approach. 20% of his diabetic patients have gone into remission and no longer need any glucose lowering medication. His practice is in Southport. He has found that 50% of his patients will go into remission if they adopt a low carb diet. He has saved £68,000 on these drugs a year.
Weight dropped 10.3%, HA1c dropped by 33%, and blood pressure by 8.6%. Blood lipids also improved.
Remission was achieved in 77% if they started the diet in the first year after diagnosis. Rates after this fell, probably due to declining beta cell function, but 11% still went into remission even after 6 to 15 years after diagnosis.
Dr Unwin’s practice had 57 patients with type two diabetes in 1986 out of a list of 9,000. This is now 530, a tenfold increase. (Some of this could be due to better case finding). The UK spends around £10 billion a year on diabetes, 80% of this is to treat complications, and this is 10% of the health budget, similar to the budget for treating cancer.
Dr Unwin has been using the low carb approach since 2012, I was using it in my own practice about eight years before that. Without any extra funding, he has been educating his patients about this approach. He has found that the higher the person’s blood sugars, the more they improve on a low carb diet. He has had patient stay in remission for over ten years now. His oldest patient in remission is 92 years old. To his surprise, he has often found that older people do better on the diet, because they are organised, have time, and know how to cook.
His wife Jen Unwin, a psychologist says, “Older people are motivated to stay well. They don’t want to be ill. Their memory, energy and sleep, all improve remarkably. Some young people understand the diet and can implement it without too much trouble. But for others carbohydrate addiction really gets in the way. They are markedly affected by the obesogenic environment that has changed dramatically since the 70s. If you are really addicted to bread, as many people are, you can’t moderate it. Same for chocolate. Some people can’t have one biscuit. They have to eat the whole packet. They only way for these people is abstinence.
Jen continues, “Eating carbohydrates makes you hungrier. It also raises your blood sugar. When patients understand this they can sometimes make great improvements but teaching and learning takes effort and resources.”
The Public Health Collaboration have an online course that teaches the fundamentals of a healthy food approach. There is a link to the programme in a previous article in this blog site.
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