Simon Tobin Profile picture
Jan 3 11 tweets 7 min read
1/10 Something to celebrate:

New research gives #hope for *EVERYONE* with type 2 diabetes🎉

Our study finds that >3/4 of people with #T2D diagnosed in the previous 12 months can achieve drug-free remission simply by improving their diet

A Twitter thread on our findings...
2/10 This "real world" study covers 8 years and looked at 186 people with T2D in a typical 🇬🇧general practice who decided to try a low carbohydrate approach

Mean duration of low carb diet was 33 months although many have continued to cut out carbs for years more
3/10 The paper is published today in @BMJNutrition
Authors: @lowcarbGP (Lead), @jen_unwin , @ChrisDLDN , @DocRunner1 and Prof Roy Taylor (world-leading expert on reversing T2D and an author of #DiRECT study)

Here's a link to the paper 👇
nutrition.bmj.com/content/early/…
4/10 RESULTS:

Perhaps most important is that *51% of people with T2D* of any duration can achieve drug-free remission by ⬇️ carbs

BUT this rises to a whopping *77%* 🤯 if they do this within a year of diagnosis 👏

Clearly, the earlier you cut the carbs, the better - don't wait
5/10 Is weight loss necessary to achieve remission?

THIS IS A REALLY IMPORTANT QUESTION

Everyone who achieved remission lost some weight BUT 3 people only lost a tiny amount (1kg or less)

It's very hard for me to believe that a tiny weight loss of ≤1kg can achieve remission🤔
6/10 I believe our research suggests that some degree of weight loss will always accompany cutting carbs

BUT...

IT'S CUTTING THE CARBS THAT CAUSES REMISSION OF TYPE 2 DIABETES AND NOT THE WEIGHT LOSS PER SE

I realise this is contentious but I cannot see any other explanation
7/10 Our results also show that year on year we're getting better at helping folk achieve remission

When we started offering low carb 8 years ago, 31% of people with T2D achieved remission

It's now 51% !!!...

...climbing to 77% remission rate if diagnosed within the last year
8/10 There's also a huge improvement in metabolic markers of health. We found cutting out the carbs caused:

Systolic BP ⬇️8mmHg
Weight ⬇️11kg
Diabetes control improved (HbA1c⬇️17mmol/mol)
Total cholesterol ⬇️by 0.6mmol/l
Triglycerides⬇️by 0.7mmol/l
9/10 As you'd expect, using a dietary approach to reverse diabetes is so much cheaper than medication

My surgery (10k patients) saves >£68k/year compared to similar practices

Just imagine how much the #NHS could save if all practices in the 🇬🇧 offered this @SteveBarclay 🤔💷
10/10 Key Messages:

There's #hope for everyone with type 2 diabetes if they choose to⬇️ carbs

The majority can achieve drug-free remission

For those who do not achieve remission there still hope as overall, *97%* will improve their diabetes control (HbA1c)
11/10! Several people have asked for resources to support folk who want to ⬇️ their carbs

The Freshwell app + website is fab: lowcarbfreshwell.co.uk and follow @LoCarbFreshwell
As is this site: newforestpcn.co.uk/low-carb/
And Infographics from @lowcarbGP
phcuk.org/sugar

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More from @DocRunner1

Jun 4, 2021
1/6 Really important study by @kfitzgeraldnd highlights the importance of diet + lifestyle in slowing ageing

It even suggests lifestyle changes can reverse ageing by 2 years *IN ONLY 8 WEEKS* by triggering changes in DNA 😲

A short thread...

Article👇
aging-us.com/article/202913…
2/6 The study:

A randomised, controlled trial of 43 healthy men age 50-72. Those in the treatment group had an 8 week programme of:

Diet (more info in next tweet)
Sleep
Exercise
Relaxation
Supplemental probiotics + phytonutrients
3/6 The diet:

A large amount of green, leafy veg👍
Some nutrient-dense animal protein (liver/eggs)👍
Low in carbs #LCHF 👍
Included intermittent fasting👍

The lifestyle changes:

Exercise 5 x 30min/week
Relaxing breathing exercises twice a day
>7 hours sleep/night
Read 6 tweets
May 6, 2021
1/7 This my patient, Bill - I made him cry today 😢

He's said it's OK to share his story

He's 56. 9 years ago Bill had a big stroke affecting his mobility
His weight⬆️⬆️, he struggled to get out of a chair, ate an unhealthy diet + developed type 2 diabetes

A short thread...
2/7 Bill burst into tears😢when I told him he had reversed his type 2 diabetes👏

He had worried about another stroke, wanted to ⬇️his risk + even reverse his T2DM if possible

It was!

Supported by his wife, he reversed his diabetes in only 11 weeks by cutting out sugar #LCHF 👍
3/7 With @lowcarbGP our little practice (9,800 patients) in Southport 🇬🇧has helped nearly 100 people reverse their Type 2 diabetes in the last 5 years
It's not rocket science 🚀

It's simply about cutting out the sugar + starchy carbs (cereals, bread, pasta, rice + potatoes)
Read 7 tweets
Apr 8, 2021
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
Read 11 tweets
Feb 6, 2021
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
Jan 18, 2021
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
Nov 14, 2020
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

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