1/11 Many people cut out sugar + carbs as a way of reversing type 2 diabetes, pre-diabetes or improving their health #LCHF
At a recent group consultation many of my patients shared worries about how to avoid carbs in restaurants as 🇬🇧emerges from lockdown

Here are my top tips👇 Image
2/11 Think carefully about your choice of restaurant - some may be easier to manage than others Image
3/11 Put aside time to think about the meal in advance

It's hard to think clearly when arriving in a busy restaurant

"If you fail to plan, you plan to fail"

Try looking at the menu online before you go and have a think about your food and drink choices before you arrive Image
4/11 Think carefully about what you'll drink

Beer has a lot of carbs, wine/spirits far less BUT watch the mixers
A small can of tonic water has about 4 tsp sugar - even diet tonic has 1 tsp
Diet Coke is better than Coke but I wouldn't put either in my body!
Soda water = no sugar Image
5/11 And remember that alcohol lowers your inhibitions and can affect your decision making Image
6/11 Watch out for those pre-dinner nibbles. How about some olives? Image
7/11 Don't worry about being a bit awkward when ordering, it's OK - you're the one that's paying the bill

Think about asking for a salad instead of chips or potatoes or ask for a burger but without the bun Image
8/11 Swap out the starchy carbs, potatoes, sweet potatoes, pasta and rice for vegetables grown above ground like cauliflower, courgette, peas, broccoli, cabbage, spouts etc Image
9/11 If you're eating Asian food/curry, Thai etc watch out for the rice and the naan bread. Instead think about having another meat/fish curry or a vegetable side dish (without potatoes) instead. Chickpeas (chana) and lentils (dhal) are good alternatives for many people Image
10/11 Desserts are always tricky. Options for me include cheese (but no biscuits) but I often simply order a different starter rather than a dessert - I don't mind if the person serving thinks I'm weird! 🤪 Image
11/11 Lastly, don't worry if you fall off the wagon and are disappointed with yourself

Take it as an opportunity to learn how to handle it better next time, put it behind you and move on

It's not a catastrophe, just a bump in the road to better health

Enjoy your meal out 🍽️😋 Image

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More from @DocRunner1

6 Feb
1/8 Continuous Glucose Monitors (CGM) and *type 2* diabetes - can they help?🤔

A short thread...

Over the last 2 years I've found a 2-4 week opportunity for my patients to learn how their body reacts to different foods can be invaluable

But @NICEComms don't recommend in T2DM☹️
2/8 CGMs have revolutionised monitoring of type 1 diabetes. Currently recommended by @NICEComms only for some *not all* with type 1 eg:

Frequent asymptomatic hypos >2x/week
Severe hypos >1x/yr
Loss of awareness of hypos
Very poor control

See 👇nice.org.uk/guidance/ng17/…
3/8 My practice has now helped 92 people reverse their type 2 diabetes using dietary change; cutting out sugar + starchy carbs

It's not rocket🚀science, see my previous thread on how it can be done👇

Here's our published research👇
nutrition.bmj.com/content/early/…
Read 8 tweets
18 Jan
1/4 A baffling type 2 diabetes mystery

Can anyone help?

A brief thread..

This patient of mine is 55 and has mysteriously reversed her type 2 diabetes with a huge drop of HbA1c from 77➡️32mmol/mol (9.2-5.1%) in only 3 months

She is not on any new medications for her diabetes..
2/4 She swears she has NOT made any dietary changes EXCEPT cutting out all sources of sugar like sweets🍬, biscuits🍪, chocolate, cake🧁, fruit juice🧃 + avoiding starchy carbs such as bread🍞, cereals🥣, potatoes🥔, rice🍚+ pasta🍝

I really believe she is telling me the truth🤔
3/4 It's particularly spooky👻because she's the 88th person at my practice to whom this has happened

@lowcarbGP is baffled too🤔

Neither of us can explain it apart form the curious coincidence they've all⬇️their sugar + carb intake

Guess it may just have to remain a mystery 🤷‍♂️
Read 4 tweets
14 Nov 20
1/10 Pre-Diabetes 🤔

On #WorldDiabetesDay perhaps we should spend some time thinking about *preventing* type 2 diabetes

Here's a short thread on what I think folk should know about pre-diabetes

References at end

#MedTwitter #tweetorial #LCHF
2/10 Pre-diabetes has many names, often with subtle differences in definition

It's often called:

Impaired glucose tolerence, IGT
Impaired fasting glycaemia
Intermediate hyperglycaemia (preferred by @WHO )
High Risk State of Developing Diabetes (preferred by @AmDiabetesAssn )
3/10 Pre-diabetes is *NOT A DISEASE*

This is really important

It's a *RISK FACTOR* for developing type 2 diabetes

Other risk factors include:

Age >40 (>25 if S Asian)
Family History
Being overweight
People of Asian, African-Caribbean or black African origin, even if born in🇬🇧
Read 10 tweets
3 Nov 20
1/11 I think that the most important piece of research since 2017 about putting #type2diabetes into remission was published today in @BMJNutrition

The results are simply astonishing 😲

A twitter thread.... #MedTwitter #LCHF

Here's the paper👇

nutrition.bmj.com/content/early/…
2/11 The study is by @lowcarbGP @jen_unwin + others and looks at reversing T2DM and pre-diabetes by lifestyle change, in particular by ⬇️sugar and starchy carbs
3/11 The study builds on the work of Prof Roy Taylor's DiRECT Study which found that *severe* calorie restriction could put T2DM into remission👍
More info here 👇
directclinicaltrial.org.uk

This was great news but SO many people find calorie restriction IMPOSSIBLE TO SUSTAIN 🤔🤷‍♂️
Read 11 tweets
30 Jun 20
1/11 WHAT IS THE BEST DIET FOR HUMANS?

A Twitter thread...

I've spent the last 10 years wondering about this. A TED Talk and paper by @segal_eran (refs at end) has completely blown my mind 🤯
He provides some of the answers - but they may not be what you think

Here goes....
2/11 The incidence of diet-related disease has ⬆️⬆️ in last 30 years

In 🇺🇸 70% of population are overweight, diabetic or have NAFLD (fatty liver)

38% are obese 😲

10% have type 2 diabetes 😲

Diet and lifestyle are the major drivers
3/11 So why don't we know what is the best diet for humans?

It's because we are asking the wrong question

Much of what constitutes the best diet depends on the individual human every bit as much the food

Nutrition needs to be personally tailored to each individual
Read 11 tweets
19 Jun 20
1/8 Use of defibrillators in the community. Is it worth it?

5 years ago I wasn't so convinced but now I've changed my mind. Here's why

A short Twitter thread....

#MedTwitter #TeamGP @rcgp @k8coleman24 @DrAbdulZubairu @Trisha_the_doc @irishayesha @Mummydoc1 @DrAmirKhanGP Image
2/8 I've been prompted to tweet about this after hearing some wonderful news today. A year ago @DrPaulaPowell1 and I assisted at a cardiac arrest on the beautiful but remote Isle of Lewis. David survived and posted a really moving video on FaceBook
Image
3/8 David's was the 3rd community cardiac arrest I have been involved with in the last 5 years

All 3 people required defibrillation (electric shock) and all 3 were conscious and talking by the time they left the scene 👍
But that's unusual....
Read 8 tweets

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