Author Topic: Good study  (Read 213 times)

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Offline Pattidevans

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Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


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Offline sedge

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Re: Good study
« Reply #1 on: 06 April 2017, 12:15:35 PM »
Hee hee! - the Newcastle Diet works!

If the ADA really are taking notice, it will be another 5 years at least before we catch up .....

Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Alan

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Re: Good study
« Reply #2 on: 07 April 2017, 11:10:35 PM »
Hee hee! - the Newcastle Diet works!

If the ADA really are taking notice, it will be another 5 years at least before we catch up .....

It wasn't Newcastle diet. I am not a fan of that ultra-low-calorie (600-800 per day) diet. This study was ultra-low-carb (sufficient for individuals to induce ketosis) but not intentionally low calories as far as I can determine from the study papers: http://diabetes.jmir.org/2017/1/e5/#Methods

It is worth reading the full study but this part of the introduction clarifies the main differences between their approach and the Newcastle diet, among others:

Quote
There have been many reports of short-term improvement in glycemic control with very low-calorie diets (VLCDs) consisting of either common foods or chemically defined formulas, ranging in energy from 400-800 kcal·day−1. Bistrian et al [8] administered a common-food 600-800 kcal·day−1 VLCD to 7 insulin-using subjects with type 2 diabetes for inpatient and outpatient durations of 2-12 months. All 7 subjects achieved rapid improvement in glycemic control despite the cessation of insulin therapy, and 6 of 7 subjects experienced substantial weight loss. Bauman et al [9] hospitalized 64 patients with type 2 diabetes, including 42 patients taking insulin, and administered a VLCD for a mean of 23 days. After 19 months, 10 patients remained in remission. Wing et al [10] randomized 93 obese individuals with type 2 diabetes to either a low-calorie diet or an intermittent formula VLCD for 1 year. The VLCD group achieved greater initial weight loss and greater hemoglobin A1c (HbA1c) reductions, but these differences between the 2 diet arms were not sustained over the duration of the study. In a recent study by Steven et al [11], 13 of 30 individuals with type 2 diabetes but not using insulin achieved normal blood glucose values after 8 months of lifestyle intervention. In this case, a chemically defined, liquid, low-carbohydrate VLCD was prescribed for 8 weeks, followed by 6 months of an unspecified energy maintenance diet.

These 4 studies [8-11] used VLCDs to control blood glucose level while stopping or reducing diabetes medications. The limitation of using a VLCD to manage a chronic disease is that this type of diet is necessarily temporary, given that it provides less than 800 kcal·day−1 and thus is unsustainable in the long term.

Alternatively, nutritional ketosis, defined as a dietary regimen resulting in serum beta-hydroxybutyrate (BOHB) levels between 0.5 and 3.0 mmol·L−1 [12], may yield similar or better results over longer periods of time by not explicitly prescribing caloric restriction. Nutritional ketosis is often achieved by reduced carbohydrate, moderate protein, and increased fat intake. In this setting, moderately reduced energy intake may occur in association with the proportionately high fat intake, reduced circulating insulin due to reduced carbohydrate consumption, and potential metabolic benefits of mild ketonemia. For example, Boden et al [13] reported that in patients with type 2 diabetes fed a ketogenic diet to satiety improved insulin sensitivity by 75% within 2 weeks. When given free access to a ketogenic buffet, daily energy intake dropped by about one-third, resulting in a total weight loss of 2 kg over 2 weeks. The authors concluded that this modest weight loss in and of itself could not explain the improved insulin sensitivity.

There have been a number of studies using low-carbohydrate, high-fat dietary strategies in the management of type 2 diabetes [14-20], but these group sizes have been small and often excluded subjects taking insulin. In addition, the dietary interventions used in these studies frequently were not sufficiently low in carbohydrate or protein to induce sustained nutritional ketosis. However, multiple studies of ketogenic diets prescribed without energy restriction have demonstrated both tolerability and effectiveness of this dietary approach to improve a broad range of cardiometabolic markers in prediabetic and dyslipidemic outpatients [21-23]. And finally, recent studies have identified BOHB in the nutritional ketosis range as a potent epigenetic signal that decreases oxidative stress [24], hepatic glucose output [25], and insulin resistance [26].

We therefore hypothesized that a comprehensive program with individualized nutritional recommendations that supports participants in achieving sustained nutritional ketosis while eating to satiety may have unique benefits in the management of type 2 diabetes. Specifically, this study was designed to assess the practical utility of an intensive digital intervention supported by medical management, continuous digital health coaching, nutrition education, behavioral support, biometric feedback, and peer support via an online community. We refer to this technology-enabled medical service as the Virta Clinic.
Cheers, Alan, T2, Australia.
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Everything in Moderation - Except Laughter.
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