Is Type 2 Diabetes Reversible at Scale?

59 点作者 toutouast将近 7 年前

16 条评论

djsumdog将近 7 年前

> The entire intervention is managed by physicians and the nutritional approach is based on highly individualized carbohydrate restriction and nutritional ketosis (which I’ve written about extensively in the past and throughout this blog).People like to hate on low-carb approach. They say things like "It causes liver problems" which don't have a basis in reality. Human beings survived for thousands of years on way fewer sugars and starches than we have today.It's particularly bad in the US due to the availability of high fructose corn syrup, which means America products tend to contain more sugar than their overseas counterparts.A few years ago I started going strong on a keto die, cutting out soda, pasta, bread, etc. and eating a lot more vegetables, meats, cheeses, etc. There an initial shock about two weeks in which some people can't get past, because your body has to get use to using fat as a primary fuel source instead of sugars/starches. Once I got past that though, I could cycling farther, my weight training sessions lasted longer with less fatigue, and I dropped from 72kg down to 63kg over the course of several months.My lowest was 60kg for nearly two years! Moving back to America has been difficult. It's hard to find the same quality of ingredients and I just got burnt out on cooking my own food all the time. There is very little healthy stuff off the shelf here. In the past two years I've slowly rose back up to 67kg and it's upsetting.I wish there were more low carb options when eating out. Salads at pubs are often loaded with croutons and fruits, there are lots of hidden carbs in salad dressing and there's just a lack of healthier options here.The food industry pushed hard against the Adkins movement in the early 2000s. Imagine if we had kept going down the route. Would obesity have dropped significantly in the US? We'll never know. But this article goes with a lot of the current research: fat doesn't make you fat. Sugars and starch do. They have a much higher energy density and sugar is huge contributor to heart disease.

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turc1656将近 7 年前

"...based on highly individualized carbohydrate restriction and nutritional ketosis"That's really the key to what is fixing the diabetes. And it's just a brief mention in the article. Nothing else about the nutritional aspects. This was extremely light on actual, real information.That being said, I'm also not sure why this stuff is still considered news. Many people, myself included, have been saying for some years now that low-carb is the way to go. I'm glad this stuff is getting press, but I'm just surprised that people seem to be acting like this hasn't already been known for quite a while.The real problem is that people can easily fix this themselves, but they either 1) don't know this information or 2) don't have the willpower. It's more of #2 though, because people generally know when they are eating garbage. There might be some foods that surprise people as having extremely high glycemic responses, but most of the time they know what they should be avoiding. The problem, I think, is that they don't quite know exactly how horrible what they are consuming really is for their metabolic processes. The one that seems to surprise people is potatoes. They know french fries are bad, but think it's because they are deep fried. When I tell them that a regular baked potato or red potatoes have glycemic index values of around 85-89 and that potato chips are around 50-55 they are stunned. I don't know why, but they are. If you are consuming the same mass of food for comparative purposes, the potato chips are loaded with fats where the regular potatoes are not so that makes sense to me that it would be lower. This tells me there is a serious lack of education on this topic and it is quite literally costing people their lives.

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nemo1618将近 7 年前

Based on the length of this article, I was hoping it would actually, you know, describe the method used to reverse T2D, but I didn't see any such description other than vague references to "nutrition." Frustrating.Also, I'm skeptical of the claim that obesity does not cause T2D. Is this backed up by good studies?

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SketchySeaBeast将近 7 年前

Does this read like an ad to anyone else?I can't help but notice their average BMI was 40. That's in the "extremely obese" category - pretty sure we're out of the "massively muscled" category (exception - monsters like Ronnie Coleman, but let's be honest here, his blood serum reading come back "minotaur" and the muscle is probably doing damage). I'd always assumed that for the majority of the population going from an obese BMI to a normal/overweight one largely does the trick.

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vfc1将近 7 年前

There are credible reports of reversal of type 2 diabetes using a whole food plant based diet - <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677007/" rel="nofollow">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677007/</a>Meaning the symptoms get better and in some cases diabetes disappears.

nabla9将近 7 年前

Remission is more accurate term.Remission is the state of absence of disease activity in patients with a chronic illness, with the possibility of return of disease activity.I'm relatively sure that if patients quit their new lifestyle, they get to back to diabetes symptoms faster than those who didn't develop diabetes. It's also possible that they just delay the progress and after 5-10 years changes of nutrition is not enough anymore. Even then the results would be huge improvement.

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olieidel将近 7 年前

The article is incredibly light on details except advertising the startup he's working for.The only link with some facts was this paper: <a href="https://asset.jmir.pub/assets/a2c0047f60bd77156d22029b8bdd5ca3.pdf" rel="nofollow">https://asset.jmir.pub/assets/a2c0047f60bd77156d22029b8bdd5c...</a>

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aaxe将近 7 年前

Don't trust this guy: <a href="https://www.wired.com/story/how-a-dollar40-million-nutrition-science-crusade-fell-apart/" rel="nofollow">https://www.wired.com/story/how-a-dollar40-million-nutrition...</a>

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jklinger410将近 7 年前

This is just a native ad for Virta, a company operating in the diabetes technology space.

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hyoogle将近 7 年前

Dr. Eric Berg has a great Youtube channel where he explains his take on how a ketogenic diet and also intermittent fasting (and the two together) can help to reduce insulin resistance (and type 2 diabetes) and improve metabolism. I personally find his explanations very helpful:His channel: <a href="https://www.youtube.com/channel/UC3w193M5tYPJqF0Hi-7U-2g" rel="nofollow">https://www.youtube.com/channel/UC3w193M5tYPJqF0Hi-7U-2g</a>One video: "Can Diabetes be reversed?" <a href="https://www.youtube.com/watch?v=NdpnAkYlWwo" rel="nofollow">https://www.youtube.com/watch?v=NdpnAkYlWwo</a>

InTheArena将近 7 年前

Gary Taubes and Peter Attia where championing Ketogenic diets at a time when people where violently opposed to it. In fact, they are a big reason why my doctor now tells everyone working with weight loss to start there. There have been reports for years on /r/keto and other places of people "accidentally" forcing diabetes into remission. So none of this is surprising. Yes, there is a lot of marketing here, but Taubes and Attia have earned the right to try and change people's minds about things.

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rcdmd将近 7 年前

As I understand it, the story here is DM2 has recently been shown to be "put in remission"[1] by lifestyle changes and Virta Health pairs type 2 diabetics with doctors and a system to help patients make those changes. Primarily that involves a low-carbohydrate diet from what I read about the startup online. In my opinion, Virta can help people who (1) can afford it, and (2) are motivated to implement the changes long-term. This system could scale, for sure-- there are enough people with DM2 and enough of them will be motivated and affluent. Reaching the non-affluent would be harder, but not impossible with say, charity care or medicaid reimbursement. In my mind, seeing all the sequelae of diabetes in my patients, even moving the needle a little bit can do a great good. [1] <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext?elsca1=tlpr" rel="nofollow">https://www.thelancet.com/journals/lancet/article/PIIS0140-6...</a>

Someone1234将近 7 年前

This seems like an ad for "virta health." Which itself seems to be a pile of supplements, a scale, and a Keto Diet plan.Keto Diets (and intermittent fasting) have been shown to help "reverse" type-2 diabetes, since it moves people out of the medical criteria for the disease. But if the original lifestyle returned that individual may become classified as a type-2 diabetic again.

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jvagner将近 7 年前

My friend is a doctor. He works with patients to reverse T2D every day of the week. He's amazed that there's any debate whatsoever.So, pro-tip from me: find a doctor who answers "yes" to the question and work with them, if you have T2D and want to reverse it.(ignoring the "at scale" part of the OP question... for various reasons)

mindcrime将近 7 年前

I'm starting to believe that calorie restriction is the key, with carbohydrate restriction playing a role as well.For context, I'm a T2 diabetic, whose diabetes has "progressed" to the point that I take insulin. I'd recently had to adjust my dose to 100U / day (I only use a once a day, long-acting insulin at the moment).Then a buddy of mine mentioned a book on fasting[1] and said that some diabetics had had great results from fasting. I ordered the book, but haven't read it yet. But I did start a sort of psuedo-fasting routine of my own design. Basically, I allow myself a normal sized meal, and then for the next 48 hours I an aggregate total of maybe 1000 calories. A typical meal during that time is a thin soup made of chicken broth, jalapeno peppers, banana peppers, cherry peppers, cactus and onion, with some spices thrown in for flavor. Note that jalapeno peppers, banana peppers, and cherry peppers, and cactus share a common trait: extremely low calorie content, and low carbohydrate content.Anyway, after doing this for about 2 weeks, I can already see a pronounced difference (for the better) in my blood sugar numbers. And that's even after lowering my insulin dose a bit.I don't know that the protocol I'm using is anything close to what the experts recommend or not. But it definitely seems to be having a positive impact. I'm really looking forward to seeing how this works out long-term. Especially once I can start lifting weights again (I hurt my arm a few weeks ago doing some bench presses and haven't been able to lift for a while). Resistance training has been shown to help with insulin resistance, so I'm hoping the combination of regular lifting and this dietary approach will yield some good results.[1]: <a href="https://www.amazon.com/Complete-Guide-Fasting-Intermittent-Alternate-Day/dp/1628600012" rel="nofollow">https://www.amazon.com/Complete-Guide-Fasting-Intermittent-A...</a>

tshanmu将近 7 年前

this is a thinly disguised ad for virta health! why is it on HN first page?