Reversing Diabetes

Science has now proven that what we eat and when we eat has a direct impact on our metabolism and our blood sugar. By making specific changes to your diet we can flip a metabolic switch so your body starts burning fat, instead of glucose. This makes your body lose the fat that has been stored around your pancreas and in your liver. The result? Reversal of your diabetes! Your high blood sugar will then be in the normal range, you will be off all or at-least some of your medication, and generally feel better than you have in years. The answer is NOT more medication, the solution is to activate your natural healing, and reset your body’s metabolic pathways. This means you’ll no longer be hungry all time, and you can finally lose weight and keep it off. For most patients this metabolic approach also fixes your high cholesterol and high blood pressure. You need a step by step, Doctor led program to do this safely and effectively. That’s exactly what we offer. Read on to discover how it works.

Within the first week of our way of eating you will likely halve your insulin and stop at least one of your medications. Diabetes is reversed one meal at a time. Food CAN be your medicine.

Has this approach been shown to be safe and effective? Yes!

In a study by Hallberg [1] it was found after one year of treatment patients improved glycaemic control and markers of other chronic conditions. Tight glycaemic control (HbA1c <6.5%) was achieved in the majority of participants with less medications, while losing weight, and without severe hypoglycaemic events. Triglycerides, HDL-C, blood pressure, the need for diuretic medications, liver enzymes, and hsCRP also improved.

• 1% average reduction in HbA1c at 10 weeks and 1.3% average HbA1c reduction at 1 year! (From 7.6% down to 6.3%).

• 72% achieved HbA1c <6.5%, while 60% of patients reduced their HbA1c to under 6.5% while stopping medications or only taking metformin.

• 94% of patients reduced or eliminated the need to take insulin.

• 13.61kg (12%) average weight loss at 1 year, without counting calories or exercising!

Example case #1 after 1 week:

Example case #2 after 1 week

Rapid improvement of type 2 diabetes

Patients in another trial [2] rapidly improved glycaemic control through reductions in fasting blood glucose, HbA1c, and medication use after 10 weeks of treatment. Patients lost 7% of their body weight on average and reported less hunger.

In the UK this approach is becoming more mainstream. Recently a GP practice published their results using a more gentle approach than what we use with our patients, and yet the results were still incredible.

Significant positive impact on cardiovascular risk factors

For patients living with type 2 diabetes, the risk of cardiovascular disease (CVD) is higher than average and this is the leading cause of mortality. On average, this study found the Treatment improved or had no effect on most markers of cardiovascular risk [3]. For the subset of individuals whose key markers did not improve, the range of responses were similar to those observed in participants who pursued the usual care for their type 2 diabetes. This means this approach is safe, and can be quite beneficial at reducing your risk of heart disease. This is demonstrated in the graph below:

As you reverse your diabetes your Blood Pressure often improves and you lose weight

Insulin helps retain sodium from the kidneys - so when you change your diet and reduce carbohydrate intake you tend to lose more salt that lowers your blood pressure.

The same dietary approach has been used to improve Metabolic Syndrome[4], PCOS[5], Type 2 Diabetes[6], Overweight/obesity[7], Type 1 Diabetes[8], Cancer[9] and diverse neurological disorders.[10] It’s important to first discuss this diet with your doctor and implement it in a safe sustainable way.

Evidence of non-alcoholic fatty liver disease improvement

An estimated 60% of American adults living with type 2 diabetes have non-alcoholic fatty liver disease (NAFLD), and the only treatment currently endorsed by professional guidelines for NAFLD is weight loss. At one year, almost 80% of patients with type 2 diabetes who participated in the treatment lost more than 5% of their starting body weight, which is associated with improvement in fatty liver. Concurrent with 12% average weight loss, liver enzyme concentrations, surrogate scores for liver steatosis and fibrosis, and inflammation improved in these patients.[11]

Improved sleep quality

Poor sleep quality and sleep disorders are common in patients with obesity and type 2 diabetes, but the relationship between these conditions is not yet understood. Following one year of treatment, the global Pittsburgh Sleep Quality Index score and component scores related to quality, disturbance, and daytime dysfunction significantly improved among patients with prediabetes and type 2 diabetes. Further, the proportion of patients classified as poor sleepers was significantly reduced at one year.[12]

What causes diabetes?

1. All Carbohydrates are digested to monosaccharides of glucose fructose and galactose.

2. Carbohydrates cause insulin levels to rise

3. Chronic insulin levels cause increase growth in fat

4. Insulin resistance is primarily caused by fat deposition in the liver and muscles

5. To overcome insulin resistance the body produces more insulin

6. Insulin’s primary function is to prevent the liver making more glucose; it prevents the breakdown of fat, and also prevents the breakdown of proteins.

7. When glucose levels rise excessively, insulin also converts glucose into fat, which exacerbates the problem, creating Non-alcoholic Fatty Liver disease and further weight gain.

8. New research has shown other factors also play a key role such as air pollution and the dietary intake of Linoleic acid (eg sunflower, safflower or peanut oil). Consuming this type of fat induces obesity and insulin resistance, and reduces activity levels in mice!

Long before your blood sugar is elevated your body became “insulin resistant”. We now know that the benefits from reversing diabetes really come about from reversing your insulin resistance, and that then causes your blood sugars to improve. Simply forcing the blood sugars down with medication is not fixing the root cause of the problem, that is why in the long run medication needs to be increased.

Carbohydrate causes blood glucose and insulin to spike in diabetic patients

Prove to yourself what makes your blood sugars spike

Measure your blood sugars before the meal then 60 and 90 minutes after eating different foods. Look for the TOTAL carbohydrate in 100grams. Eat something with lots of carbohydrates like white bread and measure. Then on another meal eat steak with mushrooms cooked in butter and some green leafy vegetables. Don't add any sauce as it likely contains sugar. Wait an hour and measure your blood sugar, measure it again 30 minutes later. Or try a handful of macadamia nuts or scrambled eggs with cream. You’ll soon learn what foods put your blood sugars up and which don’t.

High blood glucose is bad for cells and causes atherosclerosis

Dr Catherine Crofts’ research [13][14] at Auckland University of Technology has shown that the best predictor of insulin resistance and best predictor of who will or won’t develop type 2 diabetes is a two hour post prandial insulin level. Our approach helps change your body’s post meal insulin spikes thereby reversing your diabetes.

If you’re concerned you may be on the road to diabetes, ask your healthcare provider to test you using Dr.Croft’s proven method:

In adults (> 20 years old), eating > 150 g carbohydrate daily for 14 days: test plasma insulin concentration 2-hour post 100g glucose load. INTERPRETATION: 2 h insulin < 30 uU/ml (low to normal), > 50 uU/ml (99% chance of hyperinsulinaemia), 30-50 uU/ml (grey area - take other risk factors such as stress and age into account in determining chance of insulin resistance).

In adults consuming < 150 g carbohydrate daily, test plasma insulin concentration 2 hours after typical main meal. INTERPRETATION: If plasma insulin < 30 uU/ml then the patient is likely insulin sensitive. 

There is no need to test insulin in individuals with a BMI > 35 or high blood glucose or HbA1c concentrations. These individuals can be assumed to be hyperinsulinaemic and insulin resistant.

A low-carb diet has benefits for people at risk of developing type 2 diabetes even if they don't lose any weight, a new study suggests.[15] If you’re insulin resistant you can reverse it! The low-carb diet also decreased triglycerides and improved LDL cholesterol metabolism by decreasing small, dense LDL particles, thereby reducing some of the risk factors for heart attacks.

THREE studies have found some Type 1 Diabetic patients can stop their insulin entirely with this dietary approach!

The first study involved a 19-year-old male with newly diagnosed T1DM who had their diet changed and after 20 days was able to discontinue insulin. Strict adherence to the diet resulted in normal glucose levels and a more than three-fold elevation of C-peptide level indicating restored insulin production. [18]

The second study was about a nine-year-old child with T1DM. Following a dietary shift glucose levels normalized and he was able to discontinue insulin. No hypoglycemic episodes occurred on the diet and several other benefits were achieved including improved physical fitness, reduction of upper respiratory tract infections and eczema. [19]

The third study [20] involved adults. Three different case studies, documented by French researchers at Dijon University Hospital, showed the benefits of low carb treatment among adult men with newly-diagnosed type 1 diabetes. The three men were aged between 36 and 40 years old at diagnosis. They all started a low carb, high fat diet (LCHF) shortly after being diagnosed. Clinical remission was defined as discontinuing insulin treatment for a period of at least three months. Referred to as Patient A in the research, the first case study was diagnosed with the condition aged 36. He had no medical history and was a non-smoker. He immediately began daily insulin injections, but a month after his diagnosis he decided to start a low carb, high fat diet diet, restricting his carb intake to just 50g a day. Within 15 days he was able to stop using insulin completely and at the time of writing has not had to since March 2015. The second case study – Patient B – had a similar experience and was able to discontinue insulin after following a low carb diet shortly after their diagnosis. Patient C started a low carb diet nine months after they were diagnosed aged 38. Two weeks after adopting the low carb approach insulin was no longer needed.

Our dietary approach also helps you maintain weight loss long term

A multi-centre study in the USA found that what you eat makes a major difference to your energy expenditure (the amount of calories you burn) and the hormones that regulate hunger!

Change in total energy expenditure was 209 kcal/d greater in those assigned to the low carbohydrate diet compared with the high carbohydrate diet! Ghrelin and Leptin were significantly lower in participants assigned to the low carbohydrate diet compared with those assigned to the high carbohydrate diet, meaning that by eating the right diet, your hunger signals and metabolic hormones work for you, helping you stay skinny long term. [21]

Your microbiome also matters

Using specific probiotics dramtically improved diabetes in a recent multicenter, double blind, randomized placebo-controlled trial. A growing body of evidence suggests that specific, naturally occurring gut bacteria are under-represented in the intestinal tracts of subjects with type 2 diabetes (T2D) and that their functions, like gut barrier stability and butyrate production, are important to glucose and insulin homeostasis.

Akkermansia muciniphila, Clostridium beijerinckii, Clostridium butyricum, Bifidobacterium infantis and Anaerobutyricum hallii significantly improved glcose and insulin. Hemoglobin A1c (HbA1c)improved by −0.6, without changing diet or medication.

The doctors at Evergreen Doctors are experts at optimising your gut microbiome, and our aim is always to cease medications where possible, and restore wellbeing. Read more about the microbiome and optimising gut health here.

You can reverse your diabetes and even put it into remission with our approach.

Book in and see one of the Evergreen Doctors today, and soon your blood sugar will consistently be in the normal range, and you can reduce or get off all medications entirely. It’s important to be guided by a healthcare professional to safely reduce your medication and have a sustainable, safe and effective management plan.

References

[1] Hallberg SJ, McKenzie AL, Williams P, et al. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at One Year: An Open Label, Non-Randomized, Controlled Study. Diabetes Therapy. 2018; 9(2): 583-612. doi: 10.1007/s13300-018-0373-9

[2] McKenzie AL, Hallberg SJ, Creighton BC, et al. A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes. JMIR Diabetes. 2017; 2(1):e5.

[3] Bhanpuri NH, Hallberg SJ, Williams PT, McKenzie AL, Ballard KD, Campbell WW, McCarter JP, Phinney SD, Volek JS. Cardiovascular Disease Risk Factor Responses to a Type 2 Diabetes Care Model Including Nutritional Ketosis at One Year: An Open Label, Non-Randomized, Controlled Study. Cardiovasc Diabetol. 2018; 17:56. doi:10.1186/s12933-018-0698-8

[4] Reaven, G.M., The insulin resistance syndrome: definition and dietary approaches to treatment. Annu. Rev. Nutr., 2005. 25: p. 391-406.

Volek, J.S., et al., Carbohydrate restriction has a more favourable impact on the metabolic syndrome than a low fat diet. Lipids, 2009. 44(4): p. 297-309.

 [5] Mavropoulos, J.C., et al., The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study. Nutrition & Metabolism, 2005. 2(1): p. 35.

[6] Huntriss, R., M. Campbell, and C. Bedwell, The interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials. European journal of clinical nutrition, 2017: p. 1.

[7] Mansoor, N., et al., Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr, 2016. 115(3): p. 466-79.

[8] Turton, J.L., R. Raab, and K.B. Rooney, Low-carbohydrate diets for type 1 diabetes mellitus: A systematic review. PloS one, 2018. 13(3): p. e0194987.

[9] Seyfried, T.N., Cancer as a mitochondrial metabolic disease. Frontiers in cell and developmental biology, 2015. 3: p. 43.

[10] Stafstrom, C.E. and J.M. Rho, The ketogenic diet as a treatment paradigm for diverse neurological disorders. Frontiers in pharmacology, 2012. 3: p. 59.

[11] Vilar-Gomez E, Athinarayanan SJ, Adams RN, et al Post hoc analyses of surrogate markers of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis in patients with type 2 diabetes in a digitally supported continuous care intervention: an open-label, non-randomised controlled study BMJ Open 2019;9:e023597. doi: 10.1136/bmjopen-2018-023597

[12] Siegmann MJ, Athinarayanan SJ, Hallberg SJ, et al. Improvement in Patient-Reported Sleep in Type 2 Diabetes and Prediabetes Participants Receiving a Continuous Care Intervention with Nutritional Ketosis. Sleep Medicine. 2019; 55: 92 - 99. doi: 10.1016/j.sleep.2018.12.014

[13] Crofts, C. (2015). Understanding and diagnosing hyperinsulinaemia. AUT. Retrieved from http://aut.researchgateway.ac.nz/handle/10292/9906

[14] Crofts, C., Zinn, C., Wheldon, M., & Schofield, G. (2015) Hyperinsulinemia: A unifying theory of chronic disease? Diabesity, 1(4), 34-43. doi:10.15562/diabesity.2015.19

[15] Parker N. Hyde, Teryn N. Sapper, Christopher D. Crabtree, Richard A. LaFountain, Madison L. Bowling, Alex Buga, Brandon Fell, Fionn T. McSwiney, Ryan M. Dickerson, Vincent J. Miller, Debbie Scandling, Orlando P. Simonetti, Stephen D. Phinney, William J. Kraemer, Sarah A. King, Ronald M. Krauss, Jeff S. Volek. Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss. JCI Insight, 2019; 4 (12) DOI: 10.1172/jci.insight.128308

[16] SJ Athinarayanan, RN Adams, SJ Hallberg, AL McKenzie, NH Bhanpuri1, WW Campbell, JS Volek, SD Phinney and JPMcCarter, (2019) Frontiers in Endocrinology: Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: A 2-Year non-randomized clinical trial, https://www.frontiersin.org/articles/10.3389/fendo.2019.00348/full

[17] Lennerz BS, Barton A, Bernstein RK, et al. Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet. Pediatrics. 2018;141(6):e20173349

[18] Tóth, Csaba, Clemens, Zsofia, (2016), A child with type 1 diabetes mellitus (T1DM) successfully treated: A 19-month insulin freedom, International Journal of Case Reports https://www.researchgate.net/publication/285152979_A_child_with_type_1_diabetes_mellitus_T1DM_successfully_treated_with_the_Paleolithic_ketogenic_diet_A_19-month_insulin_freedom

[19]Clemens, Zsofia, (2014) Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet, Int Journal of Case Reports https://www.researchgate.net/publication/267810000_Type_1_diabetes_mellitus_successfully_managed_with_the_paleolithic_ketogenic_diet

[20]Bouillet B, Rouland A (2019) A low-carbohydrate high-fat diet initiated promptly after diagnosis provides clinical remission in three patients with type 1 diabetes, https://doi.org/10.1016/j.diabet.2019.06.004

[21] Ebbeling, Feldman, Klein, Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial, BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4583