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Is Type 2 Diabetes Reversible at Scale?

peterattiamd.com

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Re: Is Type 2 Diabetes Reversible at Scale?

#81

Post by virtuallynathan »

aaavl2821 wrote: post #68
turc1656 wrote: post #31

"...based on highly individualized carbohydrate restriction and nutritional ketosis" That's really the key to what is fixing the diabetes. And it's just a brief mention in the article. Nothing else about the nutritional aspects. This was extremely light on actual, real information. That being said, I'm also not sure why this stuff is still considered news. Many people, myself included, have been saying for some years…

Lack of information is certainly a problem but food insecurity and habits are also very important. A lot of people would have a really hard time, logistically, maintaining a ketogenic diet [0] I'm also somewhat skeptical of the evidence that the ketogenic diet can cure diabetes (or cancer / autism etc). I haven't looked into it in depth, so may be wrong, but all I've seen in the way of evidence are 1) anecdotal cases…

There are a ton of peer reviewed papers on Keto diets available on PubMed. Here's a collection and summary as a spreadsheet: https://docs.google.com/spreadsheets/d/1Ucfpvs2CmKFnae9a8zTZ...

Re: Is Type 2 Diabetes Reversible at Scale?

#82

Post by Floegipoky »

Someone1234 wrote: post #76
magic_beans wrote: post #50

Earlier quoted context omitted.

The article-writer states he is an investor in Virta Health because he actually believes their approach will work to reduce T2D at scale.

He has to believe that because he is financially vested on the outcome.

On the other hand, why would he financially invest in something that he didn't think would work; why would he put his reputation as a researcher on the line to back it?

Re: Is Type 2 Diabetes Reversible at Scale?

#83

Post by aaavl2821 »

virtuallynathan wrote: post #81
aaavl2821 wrote: post #68

Earlier quoted context omitted.

Lack of information is certainly a problem but food insecurity and habits are also very important. A lot of people would have a really hard time, logistically, maintaining a ketogenic diet [0] I'm also somewhat skeptical of the evidence that the ketogenic diet can cure diabetes (or cancer / autism etc). I haven't looked into it in depth, so may be wrong, but all I've seen in the way of evidence are 1) anecdotal cases…

There are a ton of peer reviewed papers on Keto diets available on PubMed. Here's a collection and summary as a spreadsheet: https://docs.google.com/spreadsheets/d/1Ucfpvs2CmKFnae9a8zTZ...

Thanks, that's helpful

Based on skimming that it looks like low carb diet can be as effective or more effective than low fat diet at reducing triglycerides, blood glucose and other metabolic markers, may not be as good at reducing LDL as low fat, and may pose additional safety risks compared to low fat. Some articles say no difference in blood glucose between low fat and high carb. Some say Mediterranean diet is better at glucose control than low carb diet.

Of the studies that show low carb has better a1c reduction than low fat, the reduction is ~0.5%. Clinically meaningful but certainly not a reversal of diabetes

So low carb may be better than low fat diet at reducing blood glucsoe. However that isn't conclusive. Also the Mediterranean diet may be better than both at improving glucose. And some evidence suggests low carb is worse than low fat for LDL levels and heart disease

However i didn't see any studies that showed reversal of diabetes, cancer or autism or any other disease. I don't doubt that a low carb diet can help people lose weight or better control their diabetes. I do doubt whether it can "reverse diabetes at scale", cure cancer etc. using preliminary findings that low carb is better than other diets at a1c reduction to claim this can "reverse diabetes at scale" seems not far from snake oil to me

Re: Is Type 2 Diabetes Reversible at Scale?

#84

Post by aoeusnth1 »

aborington wrote: post #33
djsumdog wrote: post #10

> The entire intervention is managed by physicians and the nutritional approach is based on highly individualized carbohydrate restriction and nutritional ketosis (which I’ve written about extensively in the past and throughout this blog). People like to hate on low-carb approach. They say things like "It causes liver problems" which don't have a basis in reality. Human beings survived for thousands of years on way f…

how does sugar contribute to heart disease?

This video has a entertaining overview of the effects sugar has on your body: https://www.youtube.com/watch?v=f_4Q9Iv7_Ao

Re: Is Type 2 Diabetes Reversible at Scale?

#85

Post by virtuallynathan »

aaavl2821 wrote: post #83
virtuallynathan wrote: post #81

Earlier quoted context omitted.

There are a ton of peer reviewed papers on Keto diets available on PubMed. Here's a collection and summary as a spreadsheet: https://docs.google.com/spreadsheets/d/1Ucfpvs2CmKFnae9a8zTZ...

Thanks, that's helpful Based on skimming that it looks like low carb diet can be as effective or more effective than low fat diet at reducing triglycerides, blood glucose and other metabolic markers, may not be as good at reducing LDL as low fat, and may pose additional safety risks compared to low fat. Some articles say no difference in blood glucose between low fat and high carb. Some say Mediterranean diet is bett…

I think you then have to ask the question of "Is LDL cholesterol level a good measure of risk?" -- it seems like it is not. That spreadsheet is pretty focused on diabetes and weight, searching pubmed for Ketosis, or Ketogenic will yield many papers about the benefits for neurodegenerative diseases, cancer, etc. There's still a ton of research to be done, but it looks promising.

Re: Is Type 2 Diabetes Reversible at Scale?

#86

Post by virtuallynathan »

SketchySeaBeast wrote: post #36
virtuallynathan wrote: post #13

Earlier quoted context omitted.

Thin people with T2D are probably “TOFI” — thin on the outside, fat on the inside. There is a concept of the “personal fat threshold” which is how much fat you can pack into your fat cells, and how many new ones you can grow. This concept explains why Asia and India have high rates of T2D at a much lower BMI. An interesting way to show that this is likely the case is people with lipodystophy - they have no subcutaneo…

I might just be matter of being "skinny fat" - someone is an average weight, but because they opt completely out of physical activity, they have basically no muscle mass, and the majority of their structure is composed of fat tissue.

That's sort of what TOFI is, its the term used in medical literature.

Re: Is Type 2 Diabetes Reversible at Scale?

#87

Post by Someone1234 »

Floegipoky wrote: post #82
Someone1234 wrote: post #76

Earlier quoted context omitted.

He has to believe that because he is financially vested on the outcome.

On the other hand, why would he financially invest in something that he didn't think would work; why would he put his reputation as a researcher on the line to back it?

Depends what the rate of return is.

Re: Is Type 2 Diabetes Reversible at Scale?

#88

Post by t2dthrowaway »

magic_beans wrote: post #37
turc1656 wrote: post #31

"...based on highly individualized carbohydrate restriction and nutritional ketosis" That's really the key to what is fixing the diabetes. And it's just a brief mention in the article. Nothing else about the nutritional aspects. This was extremely light on actual, real information. That being said, I'm also not sure why this stuff is still considered news. Many people, myself included, have been saying for some years…

I have a dumb question. Can diabetes actually be "fixed" with a keto diet? What if a T2 diabetic does carb restriction and keto for a year and "reverses" their diabetes. If they eat cakes and cookies for a week at Christmas, does the T2D come crashing back?

As someone who has come quite close to reversing their T2D, I will say that as I've lowered my a1c (the main measure of diabetes) and dropped from 3 drugs to 1, I've noticed two things from blood sugar monitoring: not only have overall sugars gone down drastically, but the time to recover from "cheating" has greatly decreased as well. When I was at my worst, I couldn't even eat a piece of fruit without a huge sugar spike. After 3 years on a lower carb, calorie constrained diet (~130g carb/day and ~1900 calories), combined with some exercise, I can now eat an occasional small piece of cake or the like without a huge concern. My sugar will spike for an hour or two, but then normalize. Before i might be high for almost a day before I'd drop back to my baseline.

So it does improve, but it's unlikely to completely go away. In my case it's likely from improved insulin resistance.

To answer your question, I wouldn't say it "crashes" back. It's still a concern, but if it's controlled, you can eat some cake and cookies and you'll stabilize in a few days. It's when it's a long term habit, that it's uncontrollable (at least on my case study of one).

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