1. Any form of weight loss can lead to diabetes remission. (The right word to use here is remission and no reversal.) You DON'T NEED LOW CARB DIET for the same. The same can be achieved with any strategy which produces weight loss
2. Similar results can also be achieved with a balanced low-calorie diet, meal replacement (as shown in the DIRECT trial), bariatric surgery (as shown in several trials) and SGLT2i/GLP1 receptor agonist (as shown in several trials)
3. While we talk about "low carb" diet or any other fancy diet, how many patients do we know are able to sustain it over a long period of time ? Answer 0. Any form of unnatural diet cannot be sustained by any patient over a long period of time.
Anything sustainable requires a balanced approach.
4. The aim of diabetes management is NOT to correct the HbA1c alone. The aim is to prevent microvascular and macrovascular complications. Several drugs like SGLT2i have proven to reduce cardiovascular risk.
Denying these patients medications proven to reduce CV and microvascular risk over a fad diet is simply unethical. Diet is NOT a substitute for medications and vice versa.
5. The following infographic clarifies the various issues with such diets.
6. These are dietary fads. They come and ago. Low carb diet is basically a reborn version of the Atkins diet. The diet went into disrepute when Dr. Robert Atkins himself died of cardiovascular disease. This new fad is a old wine in new bottle.
7. We have 100s of patients who have achieved diabetes remission with even higher HbA1c using sensible evidence-based diabetes management. They are now off medications and doing very well. They are NOT on any special diet.
PS: A CGM of a recent patient. Came with HbA1c of 11.0 Started timely on Insulin + OAD. Gradually both insulin and OAD were stopped. This is the CGM after 3 months of stopping all medications. He was NOT on a balanced low-calorie diet and did not require any low carb diet

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More from @omlakhani

24 Jun
If Toto Wolff gives a contract to Russell instead of Bottas for 2022, and then Hamilton retires, what happens next?
a) Ocon is already locked with Alpine till 2024

b) Lando is locked with McLaren

c) Leclerc and Sainz are unlikely to move out of Ferrari

d) If Max wins his maiden title with Red Bull, he is unlikely to leave the seat
They can retain Bottas, but after the humiliation will he stay ? Perhaps he would, but what if he decides to move on. Williams may potentially be more competitive next year
Read 7 tweets
24 Jun
Q1. Do statins reduce the risk of heart attack and stroke ?

"Statin therapy significantly reduces the incidence of major vascular events and vascular mortality in a wide range of people."
"Reduction of LDL cholesterol using statin therapy reduces all-cause mortality by about one tenth for each 1 mmol/L (39 mg/dl) reduction in LDL cholesterol, principally reflecting a significant reduction in vascular mortality."

Ref: cttcollaboration.org/efficacy-web-p…
Q2. Does more intensive LDL reduction with more dose of statin or with more powerful statins have incremental benefit ?

"Further reductions in LDL cholesterol produce definite further reductions in the incidence of major vascular events"
Read 13 tweets
24 Jun
If you want to look about the use of Statins (Cholesterol lowering medications) to prevent heart attack and stroke, you don't need to look beyond the series of excellent meta-analysis conducted by the "Cholesterol Treatment Trialists' Collaboration"

A thread ....

#Medtwitter
This GIF sums up everything nicely. It tells us three things

1. Statins work
2. More LDL reduction - lower the risk of heart attack, stroke etc
3. More statins/ more powerful statins- more LDL reduction Image
Q1. Do statins reduce the risk of heart attack and stroke ?

"Statin therapy significantly reduces the incidence of major vascular events and vascular mortality in a wide range of people."
Read 14 tweets
24 May
Let us answer all the questions asked by this Dhongi Baba. I will try and answer 1 or 2 questions every day for the benefit of the general public. Please share so that the falsehood of this person is exposed on a daily basis.

Please retweet with the hashtag #RemoveRamdev....
Answer 1:

First, there is nothing like "Allopathy". Allopathy is a term used by the

Wikipedia says

"The terms were coined in 1810 by the inventor of homeopathy, Samuel Hahnemann. It was originally used by 19th-century homeopaths as a derogatory term for heroic medicine"
Q. What is "Heroic medicine" ?

"Heroic medicine was based on the belief that disease is caused by imbalance among the four "humours" (blood, phlegm, yellow bile, and black bile) and sought to treat disease symptoms by correcting that imbalance"

Ref: @Wikipedia
Read 16 tweets
23 May
Dear @verified

Please remove the verified status of one Mr Ram Kisan Yadav with the Twitter handle @yogrishiramdev . The person has violated the regulations of @Twitter and @TwitterIndia on several occasions. A suspension may also follow.

#SuspendRamdevfromTwitter
These are the policies that this person has violated on several occasions

help.twitter.com/en/managing-yo… Image
Recently the said person launched a video abusing doctors and health care professionals. This triggered the @IMAIndiaOrg and other organization to file official complaints against the person

timesofindia.indiatimes.com/city/ludhiana/… @TOIIndiaNews
Read 12 tweets
22 Apr
Q. What are steroids ?

Steroids are organic compounds with four rings in a very specific molecular configuration.

They are extensively found in plants and animals
Steroids have two main functions in a living thing:

a) They are part of the cell membrane
b) they act as hormones or signaling molecules in living things
Read 25 tweets

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