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

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

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 👍

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👇 2/11 Think carefully about your choice of restaurant - some may be easier to manage than others

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/…

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🤔

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 )

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

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

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 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

https://twitter.com/DocRunner1/status/1273970819992096769

1/8 In the midst of a pandemic that predominantly affects people with poor metabolic health, why is nobody talking about nutrition?

A Twitter thread..

This is the ELEPHANT IN THE ROOM discussed in the fab @EuropeScientist article by @DrAseemMalhotra 👍

europeanscientist.com/en/article-of-… 2/8 Evidence (refs at end) tells us some medical conditions are strongly associated with poor outcomes and death ⚠️in #Covid_19 eg:

Hypertension (high BP) 2.5x⬆️
Diabetes 10x⬆️
Overweight/obesity (accounts for 73% of 🇬🇧hospital admissions with #COVID19 )
Heart disease 10x⬆️risk

1/16
Ever wondered why doctors and people with type 2 diabetes are getting so excited about low carbohydrate diets? 🤔

73 patients at my surgery have now reversed their type 2 diabetes 🙌

#medthread #tweetorial #medtwitter

Here's a tweetorial of how it's done👇 2/16
As Diabetes Lead GP at my surgery for 25 years I achieved little/no success with @PHE_uk recommended "Eatwell Plate"
One day @lowcarbGP shared some success he had with offering LCHF (low carb, healthy fat) eating to people with type 2 diabetes

Does it work?🤷‍♂️

How? 🤷‍♂️

I’ve been “lent” a #cgm (continuous glucose monitor) so I’m fascinated to see what I can learn over the next 2 wks about how my life affects my sugar
I’m NOT diabetic or pre-diabetic and plan to monitor the impact of different foods and activities
@grahamsphillips @Diabetescouk 1st observation is that application of #cgm is painless and adherence to skin is secure
Surprised my ave glucose is 6.3mmol/l
3 x glucose by finger prick finds #cgm over-reads by 0.9-1.5mmol/l (have allowed for 10min delay in #cgm but assumes sticks accurate) 🤔
@DrScottMurray