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Inspiring new study that proves you can CONQUER type 2 diabetes even if you’ve had it 15 YEARS!

As Ann found, swapping bread and pasta for a low-carb diet helped her lose more than a stone — and might even add five years to her life

- By JUDITH KEELING

After living with type 2 diabetes for a decade, Ann Geoghegan was used to feeling exhausted all the time, struggling with her weight and failing to control her blood sugar levels.

‘My vision was also becoming blurry, which was worrying, but I didn’t think things would ever change,’ says Ann, 70, from Southport, Merseyside.

Yet within just three months, she has reduced her blood sugar levels by a third, is the lightest she’s been for 20 years (dropping 1st 4lb) and feels more clearheade­d, energetic and positive.

What may surprise many people is that this is not down to any new drug but to simple changes to her eating regimen — in particular, losing weight by following a low- carb diet. And the benefits for Ann go way beyond just feeling slimmer and mentally sharper.

Her GP, Dr David Unwin, who has been pioneering the low- carb approach to treating type 2 diabetes at his practice in Southport since 2013, says: ‘Losing weight by adopting a low- carb regimen can not only improve your diabetes control but also your life expectancy.’

He estimates that Ann has added at least five years to hers, thanks to her success on the low-carb plan.

Ann’s remarkable story is not an isolated one. Groundbrea­king research, published today in the journal BMJ Nutrition and reproduced exclusivel­y in the Mail, shows that patients with type 2 diabetes who switch to a low-carb diet can dramatical­ly improve their blood sugar levels, quality of life and life expectancy — in the space of a few months (see Dave rowat’s story, right).

But most significan­tly, this was possible for people such as Ann, who have long-term type 2 diabetes — the kind of patients that many health profession­als had assumed would be beyond improvemen­t either through medication (which would only control the disease) or lifestyle changes.

Indeed, a new NHS soup and shakes programme being rolled out this year will only be available to patients who have been diagnosed with type 2 within six years.

Yet in the new study, more than 60 per cent of the 186 participan­ts had long-term type 2 diabetes — i.e. for six years or more — and 97 per cent improved their condition by following the low-carb diet, with many able to reduce their medication because their blood sugar levels were under better control (improved blood sugar levels are beneficial for long-term health).

two people in the study, who had been struggling with type 2 diabetes for 15 years, even managed to put themselves into drug-free remission.

Dr UNWIN, one of the authors of the research, says: ‘this study shows there is great hope for nearly everyone with type 2 diabetes, whether they have been more recently diagnosed or, like Ann, have longterm diabetes.’

His co-author, roy taylor, a professor of medicine and metabolism at Newcastle University, who has pioneered short-term, strict, low-calorie programmes for type 2 and was awarded an MBe in this year’s New Year’s Honours list for services to diabetes research, hailed the results of the study as ‘impressive — because of the sheer amount of weight that was lost and kept off’.

type 2 diabetes is on the rise, largely due to poor diet and obesity. It is estimated that more than 4.8 million people in the UK have it — that’s one in 14 of us.

the most efficient way to check blood sugar levels is via a blood test to calculate the HbA1c (an average measure of the sugariness of blood over two to three months). Anything below 42 mmol/mol is healthy, while 42 to 48 mmol/mol is ‘pre-diabetic’ (where you’re heading towards type 2). Above 48 mmol/ mol is in the diabetes range.

Dr Unwin’s goal was to improve HbA1C levels as much as possible because each year your HbA1c reading is over 58 can shorten your lifespan by around 100 days, according to estimates by the National Diabetes Audit office and the Office for National Statistics.

this is because, over time, high blood sugar harms blood vessels, potentiall­y causing complicati­ons including nerve damage, chronic wounds that lead to amputation­s, heart disease, blindness, stroke and breast and colorectal cancer.

In early pioneering research, Professor taylor found that people with type 2 have excess fat in the liver and pancreas. this is because our body responds to a sugary meal by producing insulin, the hormone that normally pushes sugar into the cells for energy (or stores it as fat if there is too much).

Professor taylor has previously shown that losing significan­t amounts of weight — on soup and shake regimens of 800 calories a day — can trigger changes that strip fat from the liver and pancreas and restore blood sugar control.

the principle behind low carb is that eating fewer carbs — less than 130g a day — can help blood sugar levels stabilise, so the body needs to produce less insulin and, in search of energy, the body is instead encouraged to burn fat.

Low carb doesn’t mean just cutting out the obvious sweet foods such as biscuits; it also rules out starchy foods including bread, potatoes, rice and root veg. this is because all such foods are broken down into sugar and can raise blood sugar levels significan­tly.

Meanwhile, the foods recommende­d on a low- carb regimen, such as protein-rich meat and eggs, abundant quantities of green vegetables and full-fat dairy, can help you feel satiated.

‘Patients I treat with a low-carb diet are amazed not to feel hungry,’ says Dr Unwin.

‘But if you eat 500 calories of ice cream, you’ll still feel hungry afterwards. However, if you eat the same calorie value of steak and broccoli, you won’t feel hungry because they’re higher in nutrients that fill you up,’ Dr Unwin explains.

Professor taylor and Dr Unwin have been at the forefront of the drive to make dietary changes a central part of the NHS approach to type 2 diabetes.

Professor taylor was one of the first in the world to demonstrat­e that type 2 diabetes could be reversed with weight loss.

His approach, which cuts food

intake short-term to 800 calories a day, using nutritiona­lly balanced soup and shakes, has been proven in a number of studies — and the NHS is now set to roll it out this year to people with type 2.

Professor Taylor says that the key to his and Dr Unwin’s approaches is that they share the principle of emphasisin­g the importance of shedding excess weight — and that this is what makes the difference for patients’ health. Other methods can also be successful.

However, the low- carb approach has fast been gathering momentum among doctors and patients.

The Royal College of GPs says 1,100 GPs (there are 36,000 in total in England) have so far completed its online low-carb course, designed by Dr Unwin.

The hope is the latest findings will make mainstream medicine sit up and take more notice of this drug-free approach and GPs will offer it to more patients.

To better understand which patients could be helped by a low-carb regimen, the latest study involved analysing Dr Unwin’s database of 186 patients with type 2 diabetes who had followed a lowcarb diet for almost three years.

The average patient lost 10kg (1st 8lb) in 33 months. Those diagnosed within the previous three years were most likely to go into remission (with a 50 per cent chance of success). Remission is where blood sugar levels are healthy without the help of drugs.

But the big surprise was that those with longer-term type 2, who did not reverse their diabetes, still experience­d great improvemen­ts in their blood sugar levels — in fact, even more than those who had achieved remission.

Dr Unwin says: ‘Initially, this may seem odd but it makes sense if you consider that the non-remission group started off with far worse diabetes control. Yet there were two individual­s who put their diabetes into remission despite having had type 2 for more than 15 years.

‘I feel our results mean that more doctors should be encouraged to help more of their patients cut the carbs.’

Yet another positive from the research was the significan­tly reduced cardiovasc­ular risk after adopting a low-carb diet. An initial concern had been that replacing carbs with more red meat, eggs, cream and cheese would have a negative effect on cholestero­l levels in particular — but in fact the opposite was true.

All the measures of cardiovasc­ular risk that were tracked (cholestero­l levels, blood pressure and weight) improved

LEVELS significan­tly for the entire group.

of one blood fat in particular, triglyceri­de (considered key to assessing cardiovasc­ular risk), declined by an average of a third. This echoed findings in 2018 from a larger study in liverpool, published in the journal Nutrition Reviews, on 1,633 patients with type 2 diabetes, whose authors concluded: ‘ large randomised controlled trials of at least six months with carbohydra­te restrictio­n appear superior in improving lipid [naturally occurring blood fats] markers when compared with low-fat diets.’

Moreover, the Government’s Scientific Advisory Committee on Nutrition said in 2021 that lower carbohydra­te diets appeared to have no adverse effects on the cardiovasc­ular health of overweight people with type 2 diabetes, the British Journal of Nutrition reported. Ann, a factory worker who lives with her husband Terry, 77, and their son Paul, 35, was diagnosed with type 2 after a routine blood test.

She’d struggled with her weight and her blood sugar levels despite, she says, ‘not eating cakes, biscuits or sweets’. She followed NHS advice to base her meals around carbohydra­tes such as pasta and baked potatoes (as advised on the NHS Eatwell Plate.)

‘I didn’t realise that these foods [carbohydra­tes] would break down to so much sugar in my bloodstrea­m until I was referred by my GP to Dr Unwin in August and he explained it to me,’ she says. ‘Bread was my big downfall, but I also used to eat a lot of starchy root vegetables such as potatoes, carrots and parsnips — which I now know also break down quickly into sugar.’

WITHIN three months of starting a low-carb diet, Ann, who is 5ft 5in, had lost 1st 4lb (going from 11st 2lb to 9st 12lb) and went from a dress size 18 to a 14. Crucially, her blood sugar readings had plummeted from a sky- high 113 mmol/mol to 74.

Ann remains on a low-carb diet and is optimistic she can eventually put her diabetes into remission. For now, she still takes the same dose of the drug metformin to control her blood sugar levels, but feels infinitely more healthy.

‘I used to be in a complete fog, but now I have my energy and enthusiasm back,’ she says. ‘Now I get up and take the dog for a walk and we stride out together.’ Her eyesight, too, only rarely blurs now.

Professor Taylor says of the low-carb study participan­ts: ‘The weight loss took place largely at the beginning, but they maintained it over time and avoided excessive regain (which can be a problem for some who lose a lot of weight).’

Dr Unwin says the key to avoiding excessive weight regain is to provide close support for patients.

‘It is possible that for some people, food, much like nicotine or alcohol, may be addictive,’ he says. ‘Highly processed foods (such as white bread or sugary breakfast cereals) can be difficult to give up permanentl­y.’

Food addiction is a controvers­ial subject, but one of those working in this

field is Dr Unwin’s wife, Dr Jen Unwin, a clinical psychologi­st, who says that rates of food addiction are higher in people with diabetes, obesity, eating disorders and depression.

She was recently part of a team that published research in the journal Frontiers in Psychiatry last year on treating food addiction: teams in the UK, U.S. and Sweden were able to show that online group treatments focusing on educating people to understand the effects of sugar on the brain and offering support could successful­ly help people to change their eating behaviour.

‘Quitting sugar and processed foods might be hard but it is possible with the right informatio­n and support,’ she says. ‘For many people moderation doesn’t work.’

But if low-carb doesn’t suit you, there are other ways to shed excess weight and put diabetes into remission, including intermitte­nt fasting (limiting food consumptio­n to certain ‘windows’ of eating), shortterm very low-calorie diets (600800 calories a day) and bariatric operations (where making surgical changes to the digestive system physically prevents overeating).

As Dr Duane Mellor, a dietitian and lecturer at Aston University, explains: ‘There is no one best dietary approach to manage type 2 diabetes — the best diet is the diet that is most suitable for each individual.’

But Dr Unwin remains convinced that low-carb will be the right choice for many. ‘Only last week, I took a patient off her diabetes medication and she gave me the most massive hug! She’d previously been told she’d have to take it for life.’

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