There is now overwhelming evidence that Type 2 Diabetes (T2D) can be reversed by simply altering the diet by reducing the intake of sugar and carbohydrates, which can be replaced by healthy fats (1). One of the latest developments is a case study from the general practice of Dr David Unwin and Dr Simon Tobin in the North of England. Details are given in a paper in the BMJ (British Medical Journal) (2).
The person involved was a 52-year old man with a history of T2D for 14 years and hypertension for 9 years. He was taking 4 drugs, namely aspirin (75 mg per day), metformin (500mg three times per day), perindopril (4mg per day) and simvastatin (40 mg at night). Because of the adverse side effects he was experiencing, he was keen to explore ways of reducing or eliminating his use of drugs.
It was clear to the doctors that the patient had Metabolic Syndrome (MS), which is a constellation of diseases/conditions which include T2D, hypertension, fatty liver, insulin resistance and obesity. They fully appreciated that there was research which demonstrated that the MS could be overcome by reducing the dietary intake of sugar and foods which contain starch that is broken down to glucose during digestion.
It was considered that none of the drugs were essential because they had all been prescribed to reduce the risk of cardiovascular events and the complications of diabetes rather than to treat an actual disease.
An evaluation of the various lifestyle strategies led to the conclusions that:
- Physical activity is as effective as low to moderate intensity statins at reducing our patient’s risk of cardiovascular disease and outperforms aspirin.
- The Mediterranean diet is nearly as effective as metformin.
- Both of these (physical activity and Mediterranean diet) have a low risk of harm compared with the drugs listed and reduce the risk of comorbidities such as osteoarthritis, some cancers, and gallstones.
At this point it is interesting to note that weight loss was identified as one of the objectives. It is highly significant that the patient himself had decided that he should adopt a diet which was low in foods containing carbohydrates, namely sugar, rice, pasta, potatoes and bread. This is in direct contrast with the conventional approach which is to focus on lowering the intake of fatty foods (because they are a concentrated source of calories). Equally important is that it also conflicts with the usual advice from dietitians to those with T2D which is to reduce fat (in order to lower the risks of heart disease) and increase the intake of complex carbohydrates (not processed).
The patient stopped consuming sugar as far as possible. He had been used to eating lots of bread but cut this out completely as well as potatoes, rice, pasta and cereals. Instead he increased his consumption of green vegetables, eggs, full fat Greek yoghurt, and cheese. Over a period of 7 months the patient reduced his weight from about 109 to 93kg and this enabled him to take more exercise, join a gym, and take up yoga. The goal of coming off all drugs was achieved in a stepwise manner as he lost weight—first metformin, then perindopril, followed by simvastatin and aspirin.
His HbA1c (a measure of his blood glucose) was reduced from 6.9% to 6.2%. His blood pressure and various indicators of his general health all improved.
All the nasty side effects have gone, he now needs an hour and a half less sleep a day and reports feeling “just much younger again.”
There is nothing particularly novel about this result. There are hundreds, if not thousands, of other individuals who have achieved similar success (3, 4). What is significant is that this has been published in one of the leading medical journals and that the strategy adopted contradicts the official policy of the NHS.
The NHS Choices website tells us that with respect to T2D:
“There is no cure for diabetes. However, treatment aims to keep your blood glucose levels as normal as possible, which will control your symptoms and minimise the risk of health problems developing later on.” (5).
Furthermore it continues:
“….. as type 2 diabetes is a progressive condition, you may eventually need to take medication to keep your blood glucose at normal levels. You may need to take tablets initially, but move on to injected therapies, such as insulin, at a later stage.”
To put it bluntly if your GP/ dietitian goes along with this, you will have to accept there is no cure for the disease, it will get worse and you may expect to be on drugs for the rest of your life.
This is a policy of absolute despair which is utterly and completely wrong as the above case study proves!
The official position is an example of appalling ignorance. The fundamental reason T2D develops is because there is far too much glucose in the blood, which causes the pancreas to produce large amounts of insulin to remove the glucose. This excess insulin damages the internal organs, which can result in chronic conditions such as heart disease and cancers. Ultimately the pancreas cannot produce sufficient insulin and further damage is caused by the glucose. This is full blown T2D. One does not have to be a genius to understand that the answer is to remove the cause which is to cut down the amount of glucose which is coming into the blood. This is readily achieved by eating less foods which contain sugar and carbohydrates.
It follows therefore that the only logical and sensible way forward is to look for a solution based on changing the diet as the first approach. Provided the correct changes are made this should bring about an immediate improvement in the vast majority of people. Obviously there may be some who have severe permanent damages s that there is little scope for much improvement.
It is to be hoped that many GPs will take note of this case study and have a complete re-think about their approach to T2D. For the time being at least, they seem to have the freedom to do so.
From the perspective of national policy, it is evident that the current approach is a total failure. It is scandalous that most patients are not even being advised a change in diet could well be extremely beneficial. It is unbelievable that the official advice to reduce fat and increase carbohydrates will actually make things very much worse. So we have immense suffering which could be avoided, not to mention the enormous costs incurred for drugs, other treatments and care.
T2D has already doubled in the UK in the past 15 years and it is projected that the numbers afflicted will continue to increase. There is not the slightest doubt that if there is to be any progress, there will have to be a major shift in the patterns of national food consumption. The fact that the recent report from the Scientific Advisory Committee on Nutrition (SACN) recommended that 50% of the energy intake should be carbohydrates shows just how far away we are from any kind of rational policy (6).