A flooded house
If you are unlucky enough to be flooded at home because of a burst water pipe, the first thing you would do is to locate the source and stop the water coming in as fast as possible. You would be absolutely astounded if you were told that this could not be done.
There are uncanny parallels between this household disaster and Type 2 Diabetes (T2D). The only difference is that the flooding is caused by excessive amounts of sugar in the body.
- Water is essential if a house is to function effectively while the body needs some glucose.
- A household has a plumbing system to ensure that the water is controlled. Similarly the body uses the hormone insulin to control the glucose.
- If these systems are defective, then the water and glucose can no longer be controlled.
- As a consequence the water causes extensive damage to the property and the glucose does exactly the same in the body.
Tackle the source
So the obvious way to treat T2D is to cut down on the quantity of glucose that enters the body. This is easily done by reducing the amount that enters the body in the diet by eating much less sugar and foods, which contain starch that is broken down to glucose.
All of this is perfectly logical and reasonable. Yet unbelievably, this advice is rarely given by doctors and dietitians. Patients are invariably told that T2D cannot be cured, it will probably get worse and they can expect to be on drugs for the rest of their lives. If the same approach was adopted for dealing with a burst water pipe it would mean the householders being told that nothing could be done to stop the water coming in, they would have cope with the excess water as best they could as long as they remained in the house. Some mops and buckets would be provided to deal with all the water.
Official policy is crazy
This analogy with a house flood makes it very clear the absolute stupidity of current official policy. In fact the conventional advice makes things worse for the unfortunate patient. This is because the recommendations for diet are to reduce the intake of fat and INCREASE that of carbohydrates. This, of course, exacerbates things because the body will be faced with even more glucose. To revert to the water analogy, you would be advised to increase the water pressure of the main supply. The analogy also makes it crystal clear that the way to treat T2D is to cut down the supply of glucose to the blood by altering the diet.
Conventional treatment makes things worse
In the light of this, it is no wonder that T2D does not respond to the conventional treatments. There is total failure to address the fundamental cause and most of the emphasis is on the treatment of symptoms. So it is not in the least surprising that patients do not improve and usually experience a steady deterioration in their health.
Despite the appalling lack of success in coping with T2D, the healthcare professions seem to be incapable of recognising that this current approach is not working.
No change from the Government
I recently wrote to the Prime Minister expressing my concern at the failure of current policies (1) and eventually received a reply from the person in the Department of Health who is responsible for “Ministerial Correspondence and Public Enquiries”. Here is an extract from the response:
“Preventing diabetes and promoting the best possible care is a priority for this Government. The NHS Five Year Forward View committed to introducing the first diabetes prevention programme to be delivered nationwide. As a result, NHS England, Public Health England and Diabetes UK have been working together on The Healthier You: the NHS Diabetes Prevention Programme (NDPP). Learning from the seven demonstrator sites that tested different approaches over the last year, the NDPP will offer at least 10,000 places on an evidence-based behaviour change intervention shown to reduce the risk of type 2 diabetes. By 2020, the programme will support 100,000 people at risk of diabetes each year across England. Those referred will get tailored, personalised help to reduce their risk including education on healthy eating and lifestyle and bespoke physical exercise programmes”
Despite the claims to be based evidence, this strategy is doomed to failure because the official line on “healthy eating” is based on a diet which is low in fat and high in carbohydrates.
“Base your meals on carbohydrates”
is the advice offered by the NHS Choices website (2). I have provided more detailed reasons why the programme will not be effective here (3).
Essential to identify and address the primary cause
The message that comes through loud and clear is that the key to dealing with T2D is to focus on the primary cause of the disease. This can be illustrated very clearly by consideration of bacterial infections. A specific pathogen is the fundamental cause of diseases such as typhoid, cholera or measles. The elimination of the organism is the key to curing the disease. Similarly recognition of this enables effective prevention strategies to be devised.
However, T2D is not the only disease where the focus of treatment is on the symptoms. This is certainly true of cancer, where there is huge effort directed at the removal of tumours and very little interest in or concern about the underlying cause. So it follows that even if a tumour is taken out, the conditions which caused it form remain. Hence there is every possibility that another one will develop.
Right across medicine, we can see that there is much effort directed at symptoms or other factors which are believed to be a symptom or risk factor. The classic is cholesterol. Because cholesterol was identified as a risk factor for heart disease, it was argued that if a drug could be shown to reduce cholesterol, then it would automatically also reduce the risk of the developing the disease. There has been enormous resources based on this assumption, although there is now compelling evidence that this was not true. But the fact remains that this type of rationale has been used very successfully to have drugs approved and prescribed in a wholesale manner. There are many more examples of this practice that could be cited.
Conclusion
The reality is that much of modern medicine is totally ineffective. There is widespread failure to conduct proper hard-nosed evaluation of many procedures. This suits the pharmaceutical very nicely but the benefits to patients are all too often non-existent.
References
- https://vernerwheelock.com/227-letter-to-the-prime-minister-on-diabetes/
- http://www.nhs.uk/Livewell/Goodfood/Pages/eight-tips-healthy-eating.aspx
- https://vernerwheelock.com/244-is-it-any-wonder-the-diabetes-prevention-programme-in-the-uk-is-a-disaster/
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Back in the day when I used to read diabetes newsgroups, forums and blogs, going back nearly 15 years, success stories were so commonplace as to be unremarkable. On the ADA Forum drops of HbA1c of 5 – 8% were common and 13% or more were seen, all with no or minimal medication, and usually accompanied by reductions in medication and hugely improved weight and other “health markers”. Meanwhile their official pages were headed by “Eat More Starch!” and claims that the maximum reduction from “Medical Nutrition Therapy” was 1.9%
While John Buse was briefly in charge, they admitted that “low carb” diets could be a valid way of losing weight but must not contain less than 135g carbs and must not be maintained for more than a year – and must not be used to reduce BG, that was purely the province of drugs. “MNT” was then suggested to reduce A1c by up to 2.9%
Several of their sponsors pulled out their money and John Buse went away.
Meanwhile right under their noses patients continued to report “unbelievable” successes and were written off as “just anecdotes” and LCHF was denigrated because there were no “long term studies”. Meanwhile such patients were NOT studied, and in fact several, in several countries, were turned down for studies because they were “too well controlled”. Most studies rejected subjects with A1c below 8%, some rejected subjects below 6.5%
Much the same with other forums, including the commercial forum diabetes.co.uk and without fail from low carbers. There were not a few Type 1 diabetics, some with better A1cs than a lot of “nondiabetics” and greatly reduced insulin requirements a la Richard Bernstein and more recently Type1Grit. There was also a huge amount of antipathy, including a dietician who spent hours on DCUK warning of the “extreme dangers” of LCHF, which mostly amounted to scurvy and halitosis, while amputations, dialysis and the -opathies were seen as inevitable, and many posts and entire threads were deleted and low carbers banned, including Dr Jay Wortman who was accused of being a troll. More recently Dr David Unwin was also accused of being a troll. Today you’d almost believe DCUK had singlehandedly invented LCHF.
Meanwhile the official site diabetes.org.uk has VERY quietly revised their advice on their “professional” pages, though the customer-facing pages do not reflect this change at all. Dr Joanne McCormack pointed out that at the end of 2015 even NICE guidelines were quietly changed to accept low carb, though of course not high fat. I suspect this has not been rolled out to doctors as advice, they are left to discover it for themselves.
Perhaps the biggest irony of all is that hundreds (or more) of people have been doing this successfully for anything between ten and thirty years, and both online and In Real Life there have been elderly diabetics dating back to when low carb was the standard advice and who were never switched to HCLF, or chose not to follow this advice. The record holder known to me died at 89, by which time he had had Type 2 for 42 or 43 years, and in all that time he had “failed to progress” in the expected way. Not many current diabetics are going to achieve this mainly because they are not intended to.