Reversing Diabetes (Type 2)

[sustento]

The problem with 'leaving it to the experts' is that they (in the UK at least) recommend that diabetics eat 'plenty of starchy carbs' to include potatoes, cereals, pasta, rice and bread. Ask anyone who uses a BG meter what effect any of those have on BG levels.

http://www.diabetes.co.uk/diet/nhs-diet-advice.html

[SinglePot]

The problem with 'leaving it to the experts' is that they (in the UK at least) recommend that diabetics eat 'plenty of starchy carbs' to include potatoes, cereals, pasta, rice and bread. Ask anyone who uses a BG meter what effect any of those have on BG levels.

http://www.diabetes.co.uk/diet/nhs-diet-advice.html

point taken

It used to be called Sugar Diabetes so cutting down on sugary stuff seems to make sense.

I don't know.

SMBG sounds like a good idea though.

[chiang mai]

Reducing their intake of sugar is one of the first things that newly diagnosed people think of and of course it helps to some degree, but the bigger problem of course is refined carbs, high glycemic carbs and portion size.

In the first instance it's useful to avoid starch and carbs such as bread, rice and potato because for many westerners those items contribute heavily to the problem, avoiding those items in the first instance also aids the weight loss process. But longer term the body needs starch hence those dropped items need to be added back into the diet, albeit in smaller quantities thus I can understand why Diabetes UK recommends those things as a part of a balanced diet.

[chiang mai]

I use the word 'cure' advisedly. I think reversal means the same but I'm happy to stick with cure if it avoids confusion. 'Controlling' type 2 DM to me means improving glycaemic control to an 'appropriate' level ( usually agreed between patient and doctor). A LCKD will control blood glucose and in some (many!) will cure the diabetes. The individuals predisposition to the condition remains. Cured by a lifestyle change. No Doctors!

One question, are you diabetic?

[partington]

I use the word 'cure' advisedly. I think reversal means the same but I'm happy to stick with cure if it avoids confusion. 'Controlling' type 2 DM to me means improving glycaemic control to an 'appropriate' level ( usually agreed between patient and doctor). A LCKD will control blood glucose and in some (many!) will cure the diabetes. The individuals predisposition to the condition remains. Cured by a lifestyle change. No Doctors!

Seriously, paleodoc, I really want to know why you called yourself an "MD" when that is not a clinical qualification in the UK.

And I really want to know why you do not know the salient facts about insulin resistance - that high insulin is not the cause of , but the response to, insulin resistance.

And why you are saying that diet can 'cure' diabetes . Your claims ring hollow to me.

EDIT: To prove what I am saying about cause and effect of insulin resistance is accurate, and that you have it the wrong way round and so are mistaken :

From NIH site: http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/#relate

How does insulin resistance relate to type 2 diabetes and prediabetes?

Insulin resistance increases the risk of developing type 2 diabetes and prediabetes. Prediabetes usually occurs in people who already have insulin resistance. Although insulin resistance alone does not cause type 2 diabetes, it often sets the stage for the disease by placing a high demand on the insulin-producing beta cells. In prediabetes, the beta cells can no longer produce enough insulin to overcome insulin resistance, causing blood glucose levels to rise above the normal range.

Once a person has prediabetes, continued loss of beta cell function usually leads to type 2 diabetes. People with type 2 diabetes have high blood glucose. Over time, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, blindness, kidney failure, and lower-limb amputations.

Studies have shown that most people with prediabetes develop type 2 diabetes within 10 years, unless they change their lifestyle. Lifestyle changes include losing 5 to 7 percent of their body weight—10 to 14 pounds for people who weigh 200 pounds—by making changes in their diet and level of physical activity.

Edited June 28, 2013 by partington

[sustento]

I use the word 'cure' advisedly. I think reversal means the same but I'm happy to stick with cure if it avoids confusion. 'Controlling' type 2 DM to me means improving glycaemic control to an 'appropriate' level ( usually agreed between patient and doctor). A LCKD will control blood glucose and in some (many!) will cure the diabetes. The individuals predisposition to the condition remains. Cured by a lifestyle change. No Doctors!

One question, are you diabetic?

And one more - what are your medical qualifications?

[chiang mai]

I use the word 'cure' advisedly. I think reversal means the same but I'm happy to stick with cure if it avoids confusion. 'Controlling' type 2 DM to me means improving glycaemic control to an 'appropriate' level ( usually agreed between patient and doctor). A LCKD will control blood glucose and in some (many!) will cure the diabetes. The individuals predisposition to the condition remains. Cured by a lifestyle change. No Doctors!

You've already been told by the Mods in post 54 that use of the word "cure" is inappropiate, I'll remind you that it's actually against forum rules hence you need to stop using it.

And in case you're wondering whether I have some personal vendetta against you, I can assure you that I do not. But you need to understand that I and my fellow T2 sufferers on this forum regularly come across posts similar to yours, some are selling supplements, many offer holsitic advice and others just want attention, goodness, some even claim to be doctors <deleted>!

Given that there is likely to be many thousand views of this "discussion" over time, it's fair to presume that many of those readers will be people drawn by the title and looking for a cure for their T2 Diabetes. I am massively against anyone making false claims about cures for this disease, unless it can be supported by mainstream medical reference from a reliable and verifiable source.

Do you get the picture?

[paleodoc]

Here is the quick rationale for the claim that effective dieting but in particular a LCKD can 'reverse' 'cure' 'control' Type 2DM.

The diagnosis is made when blood glucose is elevated over a period of time ( at least 2 measures and it is better that one of these should be a fasting measurement).

That is not how a diagnosis of diabetes is made in the UK.

yes it is.

Use of Haemoglobin A1c (HbA1c) in the diagnosis of diabetes mellitus

The implementation of World Health Organisation (WHO) guidance 2011

Professor W Garry John, Clinical Biochemist, Norfolk and Norwich Hospital

Dr Rowan Hillson MBE, National Clinical Director for Diabetes

Professor Sir George Alberti, Chair, Diabetes UK and expert group*

Most patients

HbA1c ≥48 mmol/mol can be used to diagnose diabetes in most situations. In

patients without diabetes symptoms repeat venous HbA1c in the same lab within 2

weeks. If the second sample is <48 mmol/mol (6.5%) treat as high risk of diabetes

and repeat the test in 6 months or sooner if diabetes symptoms develop. In

symptomatic adults with relatively slow onset of symptoms a single result ≥48

mmol/mol will suffice.

http://www.acb.org.uk/docs/Article%20Summary%20Use%20of%20HbA1c%20WHO%20guidance%20251111[1].pdf

[paleodoc]

I use the word 'cure' advisedly. I think reversal means the same but I'm happy to stick with cure if it avoids confusion. 'Controlling' type 2 DM to me means improving glycaemic control to an 'appropriate' level ( usually agreed between patient and doctor). A LCKD will control blood glucose and in some (many!) will cure the diabetes. The individuals predisposition to the condition remains. Cured by a lifestyle change. No Doctors!

You've already been told by the Mods in post 54 that use of the word "cure" is inappropiate, I'll remind you that it's actually against forum rules hence you need to stop using it.

And in case you're wondering whether I have some personal vendetta against you, I can assure you that I do not. But you need to understand that I and my fellow T2 sufferers on this forum regularly come across posts similar to yours, some are selling supplements, many offer holsitic advice and others just want attention, goodness, some even claim to be doctors &lt;deleted&gt;!

Given that there is likely to be many thousand views of this "discussion" over time, it's fair to presume that many of those readers will be people drawn by the title and looking for a cure for their T2 Diabetes. I am massively against anyone making false claims about cures for this disease, unless it can be supported by mainstream medical reference from a reliable and verifiable source.

Do you get the picture?

Not selling anything. You seem to want to stifle debate. I have already defined the term. In fact your ref from wikipedia supports it!

I have given you a perfectly good reference. You have not read it. Please read it and then look up some of the references (87 of them).

Remember, I accept that remission means that only the signs and symptoms are absent but the underlying disease is present. When cured, the disease is absent, not just the signs and symptoms.

I reiterate: A low carbohydrate ketogenic diet can very quickly control type 2 diabetes and in some (many if not most...this is not known), it will result in normalisation of the blood glucose and a normal HbA1c. This is a lifestyle change that results, by definition, in a cure of type 2 DM.

I wish to inform not mislead. I have no pill or anything else to sell. Arguments should be settled on the basis of the evidence presented. I have given you a first reference. As I said in a previous post, please read it and then the debate can move forward. Some of the posts are very good and do just that. Yours do not.

[paleodoc]

I use the word 'cure' advisedly. I think reversal means the same but I'm happy to stick with cure if it avoids confusion. 'Controlling' type 2 DM to me means improving glycaemic control to an 'appropriate' level ( usually agreed between patient and doctor). A LCKD will control blood glucose and in some (many!) will cure the diabetes. The individuals predisposition to the condition remains. Cured by a lifestyle change. No Doctors!

One question, are you diabetic?

And one more - what are your medical qualifications?

MB ChB (1988), MRCP (1993), FRCP

[partington]

I think you should stop posting. You are a fake, and you don't understand what you are posting about.

[sustento]

Here is the quick rationale for the claim that effective dieting but in particular a LCKD can 'reverse' 'cure' 'control' Type 2DM.

The diagnosis is made when blood glucose is elevated over a period of time ( at least 2 measures and it is better that one of these should be a fasting measurement).

That is not how a diagnosis of diabetes is made in the UK.

yes it is.

Use of Haemoglobin A1c (HbA1c) in the diagnosis of diabetes mellitus

The implementation of World Health Organisation (WHO) guidance 2011

Professor W Garry John, Clinical Biochemist, Norfolk and Norwich Hospital

Dr Rowan Hillson MBE, National Clinical Director for Diabetes

Professor Sir George Alberti, Chair, Diabetes UK and expert group*

Most patients

HbA1c ≥48 mmol/mol can be used to diagnose diabetes in most situations. In

patients without diabetes symptoms repeat venous HbA1c in the same lab within 2

weeks. If the second sample is <48 mmol/mol (6.5%) treat as high risk of diabetes

and repeat the test in 6 months or sooner if diabetes symptoms develop. In

symptomatic adults with relatively slow onset of symptoms a single result ≥48

mmol/mol will suffice.

http://www.acb.org.uk/docs/Article%20Summary%20Use%20of%20HbA1c%20WHO%20guidance%20251111[1].pdf

No it isn't. The information that you've dug up on the internet says that an HbA1c test can be used as a diagnosis for diabetes.

If you actually knew anything at all about how diabetes is handled by the NHS you'd know that if your GP (that's GP not MD) suspects that you are diabetic either s/he or the local hospital will conduct a fasting blood glucose test in the first place. If there's further cause s/he will then send you for a 2 hour glucose tolerance test using 75 grams of glucose at the local hospital. HbA1C tests are not used for the diagnosis of diabetes. I know these things because I have personal experience of the way the NHS diagnoses diabetes.

Now you claim to be a UK doctor. What's your GMC number?

Edited June 28, 2013 by sustento

[SinglePot]

Paper is here for people who want to read it:

http://www.diabetologia-journal.org/Lim.pdf

I hadn't seen this - thanks for pointing it out. It does look extremely interesting, but the size of cohort in the trial is really, really really, small. With so few subjects it is hard to know if it's something of a fluke. And they do point out that all their patients had diabetes for 4 years or less, so there's no guarantee the same effect would occur in people with more advanced disease.

Still, if it proves to be repeatable in a much larger group it's very exciting, raising the possibility that, in principle, the condition is really reversible.

Practically, though 600 calories a day is an extraordinarily low intake (7or 8 slices of white bread say), and most people would find it almost impossible to sustain for two months at a stretch.

It seems to be important to be in a state of negative energy balance for the entire period of the diet, i.e. you must be eating fewer calories than you use in energy every day, so that you are forced to use stored body fat to make up the shortfall.

For that reason I'm guessing a moderate diet or intermittent fasting just won't be effective.

Looks like this was published in 2011.

What is the current medical opinion on this issue?

There must have been a lot of discussion about this already.

[chiang mai]

I think you should stop posting. You are a fake, and you don't understand what you are posting about.

I totally agree, the poster does not begin to understand the subject and he detracts from the subject..

[chiang mai]

Here is the quick rationale for the claim that effective dieting but in particular a LCKD can 'reverse' 'cure' 'control' Type 2DM.

The diagnosis is made when blood glucose is elevated over a period of time ( at least 2 measures and it is better that one of these should be a fasting measurement).

That is not how a diagnosis of diabetes is made in the UK.

yes it is.

Use of Haemoglobin A1c (HbA1c) in the diagnosis of diabetes mellitus

The implementation of World Health Organisation (WHO) guidance 2011

Professor W Garry John, Clinical Biochemist, Norfolk and Norwich Hospital

Dr Rowan Hillson MBE, National Clinical Director for Diabetes

Professor Sir George Alberti, Chair, Diabetes UK and expert group*

Most patients

HbA1c ≥48 mmol/mol can be used to diagnose diabetes in most situations. In

patients without diabetes symptoms repeat venous HbA1c in the same lab within 2

weeks. If the second sample is <48 mmol/mol (6.5%) treat as high risk of diabetes

and repeat the test in 6 months or sooner if diabetes symptoms develop. In

symptomatic adults with relatively slow onset of symptoms a single result ≥48

mmol/mol will suffice.

http://www.acb.org.uk/docs/Article%20Summary%20Use%20of%20HbA1c%20WHO%20guidance%20251111[1].pdf

One tip, when you cut and paste then be sure to change the formating/paragraphs, that way it looks like you wrote it!

[paleodoc]

I use the word 'cure' advisedly. I think reversal means the same but I'm happy to stick with cure if it avoids confusion. 'Controlling' type 2 DM to me means improving glycaemic control to an 'appropriate' level ( usually agreed between patient and doctor). A LCKD will control blood glucose and in some (many!) will cure the diabetes. The individuals predisposition to the condition remains. Cured by a lifestyle change. No Doctors!

Seriously, paleodoc, I really want to know why you called yourself an "MD" when that is not a clinical qualification in the UK.

And I really want to know why you do not know the salient facts about insulin resistance - that high insulin is not the cause of , but the response to, insulin resistance.

And why you are saying that diet can 'cure' diabetes . Your claims ring hollow to me.

EDIT: To prove what I am saying about cause and effect of insulin resistance is accurate, and that you have it the wrong way round and so are mistaken :

From NIH site: http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/#relate

How does insulin resistance relate to type 2 diabetes and prediabetes?

Insulin resistance increases the risk of developing type 2 diabetes and prediabetes. Prediabetes usually occurs in people who already have insulin resistance. Although insulin resistance alone does not cause type 2 diabetes, it often sets the stage for the disease by placing a high demand on the insulin-producing beta cells. In prediabetes, the beta cells can no longer produce enough insulin to overcome insulin resistance, causing blood glucose levels to rise above the normal range.

Once a person has prediabetes, continued loss of beta cell function usually leads to type 2 diabetes. People with type 2 diabetes have high blood glucose. Over time, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, blindness, kidney failure, and lower-limb amputations.

Studies have shown that most people with prediabetes develop type 2 diabetes within 10 years, unless they change their lifestyle. Lifestyle changes include losing 5 to 7 percent of their body weight—10 to 14 pounds for people who weigh 200 pounds—by making changes in their diet and level of physical activity.

You are quite right. In the UK the letters MD usually refer to Doctor of Medicine, a post graduate diploma granted to those who have done a thesis in a particular area. In the rest of the world it means 'medical' doctor as opposed to 'PhD' doctor. As this is an international site I assumed that the term MD would be widely understood. My qualifications are MB ChB, MRCP and I am currently studying an MSc in Human Nutrition. Having answered your question, I would urge you to ignore all qualifications and consider only the evidence from the scientific literature.

In reference to your other point, which is a good one. Chicken or egg. In actual fact the debate around this subject ( high insulin in response to insulin resistance or insulin resistance in response to persistently high levels of insulin) is ongoing and has generated a lot of scientific heat as well as light.

You believe the former (as do many others), I believe the latter.

[paleodoc]

Here is the quick rationale for the claim that effective dieting but in particular a LCKD can 'reverse' 'cure' 'control' Type 2DM.

The diagnosis is made when blood glucose is elevated over a period of time ( at least 2 measures and it is better that one of these should be a fasting measurement).

That is not how a diagnosis of diabetes is made in the UK.

yes it is.

Use of Haemoglobin A1c (HbA1c) in the diagnosis of diabetes mellitus

The implementation of World Health Organisation (WHO) guidance 2011

Professor W Garry John, Clinical Biochemist, Norfolk and Norwich Hospital

Dr Rowan Hillson MBE, National Clinical Director for Diabetes

Professor Sir George Alberti, Chair, Diabetes UK and expert group*

Most patients

HbA1c ≥48 mmol/mol can be used to diagnose diabetes in most situations. In

patients without diabetes symptoms repeat venous HbA1c in the same lab within 2

weeks. If the second sample is <48 mmol/mol (6.5%) treat as high risk of diabetes

and repeat the test in 6 months or sooner if diabetes symptoms develop. In

symptomatic adults with relatively slow onset of symptoms a single result ≥48

mmol/mol will suffice.

http://www.acb.org.uk/docs/Article%20Summary%20Use%20of%20HbA1c%20WHO%20guidance%20251111[1].pdf

No it isn't. The information that you've dug up on the internet says that an HbA1c test can be used as a diagnosis for diabetes.

If you actually knew anything at all about how diabetes is handled by the NHS you'd know that if your GP (that's GP not MD) suspects that you are diabetic either s/he or the local hospital will conduct a fasting blood glucose test in the first place. If there's further cause s/he will then send you for a 2 hour glucose tolerance test using 75 grams of glucose at the local hospital. HbA1C tests are not used for the diagnosis of diabetes. I know these things because I have personal experience of the way the NHS diagnoses diabetes.

Now you claim to be a UK doctor. What's your GMC number?

Good for you. The diagnosis can be made with an OGTT, random glucose levels and HbA1c. I showed you the evidence but insist on suggesting that your individual experience trumps the World Health Organization.

[paleodoc]

Here is the quick rationale for the claim that effective dieting but in particular a LCKD can 'reverse' 'cure' 'control' Type 2DM.

The diagnosis is made when blood glucose is elevated over a period of time ( at least 2 measures and it is better that one of these should be a fasting measurement).

That is not how a diagnosis of diabetes is made in the UK.

yes it is.

Use of Haemoglobin A1c (HbA1c) in the diagnosis of diabetes mellitus

The implementation of World Health Organisation (WHO) guidance 2011

Professor W Garry John, Clinical Biochemist, Norfolk and Norwich Hospital

Dr Rowan Hillson MBE, National Clinical Director for Diabetes

Professor Sir George Alberti, Chair, Diabetes UK and expert group*

Most patients

HbA1c ≥48 mmol/mol can be used to diagnose diabetes in most situations. In

patients without diabetes symptoms repeat venous HbA1c in the same lab within 2

weeks. If the second sample is <48 mmol/mol (6.5%) treat as high risk of diabetes

and repeat the test in 6 months or sooner if diabetes symptoms develop. In

symptomatic adults with relatively slow onset of symptoms a single result ≥48

mmol/mol will suffice.

http://www.acb.org.uk/docs/Article%20Summary%20Use%20of%20HbA1c%20WHO%20guidance%20251111[1].pdf

One tip, when you cut and paste then be sure to change the formating/paragraphs, that way it looks like you wrote it!

Sorry. I hope you don't think I wrote it. It is from the paper which is referenced. I take your point. Thansks

[sustento]

Good for you. The diagnosis can be made with an OGTT, random glucose levels and HbA1c. I showed you the evidence but insist on suggesting that your individual experience trumps the World Health Organization.

No I'm saying that although it is possible to diagnose diabetes with an HbA1c test the NHS (which you claim to be familiar with) actually uses OGTT. What's your GMC number?

BTW I agree with much of what you say about low carb diets. I follow one myself. My last HbA1c was 5.8%. I don't believe it has "cured" my diabetes though. If I and a non-diabetic were to eat a high carb meal and do a BG test 2 hours later his would be back in the normal zone whereas mine would still be high.

Edited June 28, 2013 by sustento

[paleodoc]

Reducing their intake of sugar is one of the first things that newly diagnosed people think of and of course it helps to some degree, but the bigger problem of course is refined carbs, high glycemic carbs and portion size.

In the first instance it's useful to avoid starch and carbs such as bread, rice and potato because for many westerners those items contribute heavily to the problem, avoiding those items in the first instance also aids the weight loss process. But longer term the body needs starch hence those dropped items need to be added back into the diet, albeit in smaller quantities thus I can understand why Diabetes UK recommends those things as a part of a balanced diet.

The body has no requirement for starch in the short or long term. It needs a certain amount of glucose but this can be made by the liver from amino acids and possibly from triglycerides.

[paleodoc]

Good for you. The diagnosis can be made with an OGTT, random glucose levels and HbA1c. I showed you the evidence but insist on suggesting that your individual experience trumps the World Health Organization.

No I'm saying that although it is possible to diagnose diabetes with an HbA1c test the NHS (which you claim to be familiar with) actually uses OGTT. What's your GMC number?

No it doesn't it uses all of these tests...discuss it with your GP next time you see him/her

[chiang mai]

The poster is an attention seeker and a fraud, my advice is to stop giving him any more oxygen, I'm appalled that TV allows the thread to continue in this manner..

[sustento]

Good for you. The diagnosis can be made with an OGTT, random glucose levels and HbA1c. I showed you the evidence but insist on suggesting that your individual experience trumps the World Health Organization.

No I'm saying that although it is possible to diagnose diabetes with an HbA1c test the NHS (which you claim to be familiar with) actually uses OGTT. What's your GMC number?

No it doesn't it uses all of these tests...discuss it with your GP next time you see him/her

What's your GMC number?

[SinglePot]

Paper is here for people who want to read it:

http://www.diabetologia-journal.org/Lim.pdf

I hadn't seen this - thanks for pointing it out. It does look extremely interesting, but the size of cohort in the trial is really, really really, small. With so few subjects it is hard to know if it's something of a fluke. And they do point out that all their patients had diabetes for 4 years or less, so there's no guarantee the same effect would occur in people with more advanced disease.

Still, if it proves to be repeatable in a much larger group it's very exciting, raising the possibility that, in principle, the condition is really reversible.

Practically, though 600 calories a day is an extraordinarily low intake (7or 8 slices of white bread say), and most people would find it almost impossible to sustain for two months at a stretch.

It seems to be important to be in a state of negative energy balance for the entire period of the diet, i.e. you must be eating fewer calories than you use in energy every day, so that you are forced to use stored body fat to make up the shortfall.

For that reason I'm guessing a moderate diet or intermittent fasting just won't be effective.

Looks like this was published in 2011.

What is the current medical opinion on this issue?

There must have been a lot of discussion about this already.

Bump

[partington]

You are quite right. In the UK the letters MD usually refer to Doctor of Medicine, a post graduate diploma granted to those who have done a thesis in a particular area. In the rest of the world it means 'medical' doctor as opposed to 'PhD' doctor. As this is an international site I assumed that the term MD would be widely understood. My qualifications are MB ChB, MRCP and I am currently studying an MSc in Human Nutrition. Having answered your question, I would urge you to ignore all qualifications and consider only the evidence from the scientific literature.

In reference to your other point, which is a good one. Chicken or egg. In actual fact the debate around this subject ( high insulin in response to insulin resistance or insulin resistance in response to persistently high levels of insulin) is ongoing and has generated a lot of scientific heat as well as light.

You believe the former (as do many others), I believe the latter.

This is simply not true. It is not a matter of ongoing debate, but generally accepted that insulin resistance precedes enhanced insulin secretion.

You can make out that it is, and you will even be able to find a few papers if you look hard enough, but matter of current debate it is NOT.

I quote from the Oxford Textbook Of Medicine (where you will see that they even mention insulin resistance from birth caused by a genetic mutation in the insulin receptor is able to cause huge increases in insulin secretion):

Oxford Textbook Of Medicine

edited by David Alan Warrell, Timothy M. Cox, Edward J. Benz, John D. Firth OUP 2003

p 326

Aetiology

Type 2 diabetes is due to the combination of insulin resistance and beta-cell failure, the latter preventing sufficient insulin secretion to overcome the insulin resistance....

p327

Beta cell failure in Type 2 diabetes

Beta-cell failure is an obligatory defect in the pathogeneses of type 2 diabetes: near normoglycaemia can be maintained even in severe insulin resistance (due for example to mutations in the insulin receptor), as long as the beta-cell can respond to the challenge and secrete enough insulin to overcome the resistance ...

Edited June 28, 2013 by partington

[paleodoc]

The poster is an attention seeker and a fraud, my advice is to stop giving him any more oxygen, I'm appalled that TV allows the thread to continue in this manner..

You wish only to stifle debate. Some people do that when the debate gets a little too complicated for them. I think I have contributed to an interesting debate of vital importance to many of the subscribers to this site. It is easy to call someone a fraud...bit cowardly if you ask me. But name calling doesn't get us anywhere. Look at the evidence and my arguments not my qualifications.

[partington]

I also agree with chiang mai, this poster thrives on responses to be taken seriously, and so I also won't be replying to him anymore.

[paleodoc]

You are quite right. In the UK the letters MD usually refer to Doctor of Medicine, a post graduate diploma granted to those who have done a thesis in a particular area. In the rest of the world it means 'medical' doctor as opposed to 'PhD' doctor. As this is an international site I assumed that the term MD would be widely understood. My qualifications are MB ChB, MRCP and I am currently studying an MSc in Human Nutrition. Having answered your question, I would urge you to ignore all qualifications and consider only the evidence from the scientific literature.

In reference to your other point, which is a good one. Chicken or egg. In actual fact the debate around this subject ( high insulin in response to insulin resistance or insulin resistance in response to persistently high levels of insulin) is ongoing and has generated a lot of scientific heat as well as light.

You believe the former (as do many others), I believe the latter.

This is simply not true. It is not a matter of ongoing debate, but generally accepted that insulin resistance precedes enhanced insulin secretion.

You can make out that it is, and you will even be able to find a few papers if you look hard enough, but matter of current debate it is NOT.

I quote from the Oxford Textbook Of Medicine (where you will see that they even mention insulin resistance from birth caused by a genetic mutation in the insulin receptor is able to cause huge increases in insulin secretion):

Oxford Textbook Of Medicine

edited by David Alan Warrell, Timothy M. Cox, Edward J. Benz, John D. Firth OUP 2003

p 326

Aetiology

Type 2 diabetes is due to the combination of insulin resistance and beta-cell failure, the latter preventing sufficient insulin secretion to overcome the insulin resistance....

p327

Beta cell failure in Type 2 diabetes

Beta-cell failure is an obligatory defect in the pathogeneses of type 2 diabetes: near normoglycaemia can be maintained even in severe insulin resistance (due for example to mutations in the insulin receptor), as long as the beta-cell can respond to the challenge and secrete enough insulin to overcome the resistance ...

I can't see in this quote where it says that insulin resistance precedes hyperinsulinaemia. I have no qualms with anything it says. But it was published in 2003 and most of the research it basis its conclusions on will have been published long before this, as is the nature of textbooks. The idea that Beta cell failure is an obligatory defect in type 2 DM is accepted. Just when it occurs during the disease process is a matter for ongoing research.

[chiang mai]

The poster is an attention seeker and a fraud, my advice is to stop giving him any more oxygen, I'm appalled that TV allows the thread to continue in this manner..

You wish only to stifle debate. Some people do that when the debate gets a little too complicated for them. I think I have contributed to an interesting debate of vital importance to many of the subscribers to this site. It is easy to call someone a fraud...bit cowardly if you ask me. But name calling doesn't get us anywhere. Look at the evidence and my arguments not my qualifications.

You told us earlier that you had to go to work, what happened, Biggee Burger Bar not open tonight, doctor!

[sustento]

The poster is an attention seeker and a fraud, my advice is to stop giving him any more oxygen, I'm appalled that TV allows the thread to continue in this manner..

You wish only to stifle debate. Some people do that when the debate gets a little too complicated for them. I think I have contributed to an interesting debate of vital importance to many of the subscribers to this site. It is easy to call someone a fraud...bit cowardly if you ask me. But name calling doesn't get us anywhere. Look at the evidence and my arguments not my qualifications.

What's your GMC number?