DR MICHAEL MOSLEY: Evidence that we CAN turn back the diabetes tsunami
DR MICHAEL MOSLEY: Convincing evidence that we CAN turn back the diabetes tsunami (but it’s hard when hospitals keep giving patients sugar-packed breakfasts)
As someone who writes regularly about the dangers of having raised blood sugar levels, I was dismayed, but not surprised, to read last week that the number of Britons with type 2 diabetes continues to soar.
There was a seven per cent rise last year to well over four million people. That’s more than the combined populations of Manchester and Birmingham.
Even more concerning is that about a million people have type 2 diabetes but don’t even know it – and they won’t find out until they develop significant problems such as eye damage.
Doctors describe a ‘tsunami’ of cases, costing the NHS billions.
Breakfast in hospital can comprise of white bread, cornflakes and fruit juice. Consuming that would have a similar effect on your blood sugar as 21 teaspoons of sugar
So that is the bad news. But there is also some good news. A few days ago I was at the House of Commons, where there is now political interest in supporting new approaches to this hugely expensive chronic disease.
I was at a meeting which included MP Tom Watson, who spoke movingly about how he had managed to reverse his diabetes, get off all medication and bring his blood-sugar levels back to normal by losing an incredible 7st.
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His starting point was reading my books, including The Fast Diet and The 8 Week Blood Sugar Diet. He also cut back on sugar and processed food, took up exercise and now maintains his weight through a lower-carb approach.
Over the last few weeks, I have also been travelling around the country as part of my live tour, talking (among other things) about the benefits of rapid weight loss, particularly for conditions like type 2 diabetes and pre-diabetes. Pre-diabetes is condition where you have raised blood sugar levels which are not yet in the diabetic range.
As someone who writes regularly about the dangers of having raised blood sugar levels, I was dismayed, but not surprised, to read last week that the number of Britons with type 2 diabetes continues to soar, writes Dr Michael Mosley (pictured)
I was at a meeting which included MP Tom Watson (pictured), who spoke movingly about how he had managed to reverse his diabetes, get off all medication and bring his blood-sugar levels back to normal by losing an incredible 7st
Some estimate this affects about one in three adults in the UK. But unless you’ve been tested, you won’t know you have it because there are rarely symptoms.
The good news, again, is that there is now a lot of interest in dietary approaches to treating diabetes, not least among doctors and nurses who come to my talks. They tell me they are now convinced that type 2 diabetes can not only be managed, it can also be treated and put into remission, reversed, or whatever word you care to use.
CRASH DIET THAT CAN REVERSE THE DISEASE
Behind this revolutionary change has been a number of big studies. They have shown that rapid weight loss can help get people off their medication and transform their lives.
I call it revolutionary because the official NHS position is still that type 2 diabetes is a lifelong condition, that most people need to be on medication for life, and that things will usually get worse, even if people are on medication. And if you are one of those people, your chances of having a heart attack, stroke or developing dementia roughly doubles.
Perhaps just as frightening, there is a risk of loss of vision, kidney disease, and you also have a 20-fold increased risk of having all or part of a limb amputated.
If you have diabetes, then you are at much higher risk of developing problems in your feet than the rest of us because having raised blood sugar levels damages the vessels that provide blood to your feet and legs
A recent report showed that nearly 27,000 amputations below the knee have been carried out by the NHS over the last three years due to diabetes – a rise of 19 per cent on the previous three years.
I recently visited Geoff, who is my age (61), and about to have his foot amputated.
If, like Geoff, you have diabetes, then you are at much higher risk of developing problems in your feet than the rest of us because having raised blood sugar levels damages the vessels that provide blood to your feet and legs.
Geoff’s surgeon told me that the operation and aftercare would cost around £60,000. Because Geoff wasn’t in great shape, there was also about a 50 per cent chance that he would die within the next 12 months from complications of the operation.
What made my visit particularly poignant was seeing Geoff’s breakfast. He told me that during his time in hospital, breakfast comprised white bread, cornflakes and fruit juice. Consuming that would have a similar effect on your blood sugar as 21 teaspoons of sugar.
One of the most significant is the Diabetes Remission Clinical Trial, or DiRECT for short. Funded by the charity Diabetes UK, it was set up by Professor Roy Taylor, of Newcastle University, and Professor Mike Lean (pictured), of Glasgow University
So what of the new studies? Well, one of the most significant is the Diabetes Remission Clinical Trial, or DiRECT for short.
Funded by the charity Diabetes UK, it was set up by Professor Roy Taylor, of Newcastle University, and Professor Mike Lean, of Glasgow University. They have long been trying to prove to sceptical colleagues that type 2 diabetes can be reversed with the help of a rapid weight-loss diet.
For the DiRECT study, nearly 300 patients were put on either an 800 calories-a-day diet for up to 20 weeks, or on conventional diabetes care, which doesn’t involve a weight-loss plan. The patients were then followed for at least a year. Those on the rapid weight-loss diet lost an average of 22 lb and nearly half of those in the 800-calorie group managed to put their diabetes into remission. Those receiving conventional care lost 2 lb and four per cent went into remission.
As Prof Lean pointed out to me: ‘Given our results, it should be considered unethical NOT to give people with type 2 diabetes access to the necessary support for at least a good try at remission.’
Since then, the two professors have continued to track the patients for a further year and the results will be released on Thursday. We won’t know what those results are until then, but both men looked cheerful when I saw them last week.
GOING LOW-CARB MIGHT HELP TOO
Patients in the DiRECT study took meal-replacement shakes for the first eight weeks, before gradually introducing real food. Shakes are not to everyone’s taste, so how would a low-carb approach, based on real food, work?
My wife Dr Clare Bailey, who is a GP, has been involved in just such a study with a team led by Susan Jebb, Professor of Diet and Population Health at Oxford University.
Results have not been fully analysed, but the good news is that the patients stuck to the diet (a low-carb diet is pictured), lost decent amounts of weight, and brought down their blood sugar levels.
They recruited 30 overweight people with type 2 diabetes and gave them either standard care or asked them to go on a low-carb, 800-calorie diet for 12 weeks, followed by a four week maintenance programme.
Results have not been fully analysed, but the good news is that the patients stuck to the diet, lost decent amounts of weight, and brought down their blood sugar levels.
If the Oxford team get funding, they will soon move on to a full- scale randomised controlled trial of this approach.
I do believe that when it comes to type 2 diabetes and weight loss, good things are happening. I only hope these new approaches get proper support before too many more people lose their limbs, their eyesight and their future.
Ask Dr Mosley: Your questions answered
I lost weight eating 800 calories of meal replacement bars and shakes every day, but handfuls of my hair fell out. Will I experience this on your low-calorie diet?
It is normal to lose about ten per cent of your hair every day. But when this increases to a more noticeable amount, usually in clumps, it is a condition called telogen effluvium.
It can happen on some low-calorie diets if you aren’t getting enough protein or other vital nutrients, including iron.
If it happens, don’t panic – it is usually temporary. Your hair will regrow but it may take up to six months.
To prevent loss you need to eat at least 45g of protein a day (about two palm-sized portions of fish, meat or tofu), plus essential vitamins. Recipes in my books provide this. I also recommend taking a good quality multivitamin.
Do you have a question for Dr Mosley?
Email [email protected] or write to him at The Mail on Sunday, 2 Derry Street, London W8 5TT.
Dr Mosley can only answer in a general context and cannot give personal replies.
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