Bangkok doctor who believes diabetes remission is possible?

[aledarrkie]

I was obesed (I am just 1.5 kilo away from the ideal weight) and was a smoker. I have diabetes type 2 and working on reversing my condition with diet and nutrition and exercise.

In the US and the EU, diabetes remission have been recorded: rare but possible for obesed diabetics who relied on nutrition and exercise alone, but more successful cases have been registered for those who underwent bariatric or weight loss surgery. I want to try the first option.

I have been to three different doctors from different hospitals and two thought it was not possible and one dodged the question by saying my medication helps fight cancer. I would like a doctor to work with me towards my preferred direction.

My current diabetes doctor asked me months ago to double my medication from 750mg XR nightly to twice a day despite my HbA1C of only 6.1 at that time. I said I I was afraid to double the dosage and maintained my original dosage. Came back three months later with an HbA1C of 5.1. I am able to maintain my post-meal glucose to: around 109 mg/dl 30 mins after meals, 116 after 60 minutes and 107 after 90 minutes. This has been my weekly reading for the past 6 months.

You can PM me in case you don't want to show his or her name.

Thanks.

[oncearugge]

That Type II diabetes can be successfully controlled with a combination of weight loss, diet and exercise is widely acknowledged by the vast majority of Endocrinologists.

Instances of complete sustained remission from Type II diabetes. AFAIK. are rare.

I am personally unaware of any Endocrinologist who would meet your stated requirements but most would work toward minimising if not eliminating the need for medication.

[aledarrkie]

That Type II diabetes can be successfully controlled with a combination of weight loss, diet and exercise is widely acknowledged by the vast majority of Endocrinologists.

Instances of complete sustained remission from Type II diabetes. AFAIK. are rare.

I am personally unaware of any Endocrinologist who would meet your stated requirements but most would work toward minimising if not eliminating the need for medication.

eliminating medication is ok. I just want to have an open communication with the doctor, unlike with my current doctor who is so preoccupied with giving me more and more medications. If you have a particular doctor in mind, please give me his contact info.

[jvs]

My brother was type 2 and a lot overweight,took all kinds of medicine and never felt good.He started to lose weight and a new doctor cut neatly all of the poison his former doctor gave him and now he is not using any medication but he strictly controls what and how much he eats.He still get a check-up often but so far so good.

He feels a lot better and more than that he feels he is back in control.

[mommysboy]

Reversal of the condition is rare. I think it is possible with some people with prediabetes by way of a strictly controlled diet with eliminates fat from the pancreas. After the diet people resume a normal diet.

But it is possible to keep diabetes 2 at bay, or control confirmed diabetes 2 by maintaining a good diet.

Medicine has definitely helped you so far. My uncle took it for decades. Lived a full life.

[aledarrkie]

Reversal of the condition is rare. I think it is possible with some people with prediabetes by way of a strictly controlled diet with eliminates fat from the pancreas. After the diet people resume a normal diet.

But it is possible to keep diabetes 2 at bay, or control confirmed diabetes 2 by maintaining a good diet.

Medicine has definitely helped you so far. My uncle took it for decades. Lived a full life.

Good to hear your uncle did well. As much as possible I would like to get rid of my diabetes meds. I have an underlying more dreadful health threat that doesn't go well with diabetes meds that I am trying get rid off. I do know that whatever I do, diabetes condition can or will return or can progress to a worse secondary condition as the damages have been done. I just hope to live a full life without facing an even worse enemy.

[aledarrkie]

My brother was type 2 and a lot overweight,took all kinds of medicine and never felt good.He started to lose weight and a new doctor cut neatly all of the poison his former doctor gave him and now he is not using any medication but he strictly controls what and how much he eats.He still get a check-up often but so far so good.

He feels a lot better and more than that he feels he is back in control.

Would like to get in touch with his doctor (in Bangkok?)

[PocoLoco]

Reversal is possible. I recommend you to see doctor specialised in "functional medicine".

PM me if you'd like to know a good one in Bangkok.

[aledarrkie]

Reversal is possible. I recommend you to see doctor specialised in "functional medicine".

PM me if you'd like to know a good one in Bangkok.

Already sent.

[Sheryl]

The condition cannot be "reversed" and the term "remission" is not used to describe successful control through diet and exercise so for starters I suggest you stop using that terminology. It is frequently possibly to control the condition through diet and exercise alone, so what you want is an endocrinologist who will work with you on that. Talk to them about "control through diet alone" rather than using the terms "reversal" or "remission" and at least they will understand what you after.

(This is BTW more than a matter if semantics. A reversal would mean that the person could eat anything, even go on a diet of nothing but processed carbs, and still have normal glucose metabolism. And a remission is simply a temporary reversal i.e. same thing just not necessarily permanent. Neither is possible....the condition will return eventually)

It is hard to find a Thai doctor skilled in this. For one thing, they have very little training in nutrition. For another, most Thais eat as a group and are unable therefore to readily change their diet (the whole family would have to change) plus there is the very strong attachment to rice. Thai doctors in general tend to assume it is useless to tell patients to change their diet or lifestyle. They also assume that people want medication, and among Thais this is in fact usually true. Doctors who spend significant amount of time working in a Western country will be better in this regard.

You can try this one, who s US trained and did a fellowship in clinical nutrition https://www.bumrungrad.com/doctors/Chorthip-Phattanasri

You can also get a lot of help online from the American Diabetes Association and similiar groups http://www.diabetes.org/food-and-fitness/food/planning-meals/diabetes-meal-plans-and-a-healthy-diet.html

And there are useful books - steer clear of extreme diets though, even if they work you won't be able to maintain them and what you are after is a pattern of food intake you can stick to for life. http://www.shopdiabetes.org/Categories/8-Diabetes-Books.aspx

Basically it boils down to: (1) eliminate processed carbs from your diet, (2) limit/control the total amount of carbs you consume daily, and (3) get regular exercise, the more the better but the regularity of it is important so as with diet avoid extremes you can't keep up. Along with this of course, maintain a healthy weight, but if you do 1-3 a health weight will usually be automatic.

For #2 it is best to get a small food scale so you can calculate the grams of carb you are eating each day. With time and practice that will become less necessary but it is very helpful in the beginning.

And remember that alcohol is a highly processed carbohydrate. So basically no drinking beyond a glass of wine a day. Definitely no beer or hard liquor.

[aledarrkie]

The condition cannot be "reversed" and the term "remission" is not used to describe successful control through diet and exercise so for starters I suggest you stop using that terminology. It is frequently possibly to control the condition through diet and exercise alone, so what you want is an endocrinologist who will work with you on that. Talk to them about "control through diet alone" rather than using the terms "reversal" or "remission" and at least they will understand what you after.

Thanks. I will contact the doctor you listed. Bit embarrassing as my doctor is from that same hospital.

Sorry about the confusion. Actually I did not use remission or reversal when talking to my doctor. I asked if it was possible to control my diabetes through proper diet and exercise alone and no medication. I was truly expecting I would get a positive answer, which I did not get.

Edited October 19, 2015 by aledarrkie

[kkerry]

Reversal of the condition is rare. I think it is possible with some people with prediabetes by way of a strictly controlled diet with eliminates fat from the pancreas. After the diet people resume a normal diet.

I was at 112mg sugar (fasting) in 2008 which is prediabetes. I hadn't been in the habit of adding sugar to anything for years and wasn't much of a drinker but did have a poor diet, drank lots of soft drinks and juice. Reduced soft drinks, junk food, cakes and juice to almost zero, lost 10kg with exercise and now drink a lot more water. Since 2011 I've been 92mg or lower so change of lifestyle without any medication can help improve things.

[spidermike007]

The condition cannot be "reversed" and the term "remission" is not used to describe successful control through diet and exercise so for starters I suggest you stop using that terminology. It is frequently possibly to control the condition through diet and exercise alone, so what you want is an endocrinologist who will work with you on that. Talk to them about "control through diet alone" rather than using the terms "reversal" or "remission" and at least they will understand what you after.

Thanks. I will contact the doctor you listed. Bit embarrassing as my doctor is from that same hospital.

Sorry about the confusion. Actually I did not use remission or reversal when talking to my doctor. I asked if it was possible to control my diabetes through proper diet and exercise alone and no medication. I was truly expecting I would get a positive answer, which I did not get.

Don't even bother talking to a medical doctor about diet. They are prescription machine in human form. Talk to a nutritionist, a trainer, or someone with knowledge and expertise in this area. Doctors know very little about food, and the effect it had on the body, other than fats and cholesterol.

[aledarrkie]

Reversal of the condition is rare. I think it is possible with some people with prediabetes by way of a strictly controlled diet with eliminates fat from the pancreas. After the diet people resume a normal diet.

I was at 112mg sugar (fasting) in 2008 which is prediabetes. I hadn't been in the habit of adding sugar to anything for years and wasn't much of a drinker but did have a poor diet, drank lots of soft drinks and juice. Reduced soft drinks, junk food, cakes and juice to almost zero, lost 10kg with exercise and now drink a lot more water. Since 2011 I've been 92mg or lower so change of lifestyle without any medication can help improve things.

I am a firm believer, too in the role of nutrition, exercise and lifestyle change to treat, control or cure many illnesses. Sad I only took that option seriously after my diabetes was already full blown. I have gotten two recommendations on doctors I can contact from the forum. I will contact them immediately.

Edited October 19, 2015 by aledarrkie

[h90]

The condition cannot be "reversed" and the term "remission" is not used to describe successful control through diet and exercise so for starters I suggest you stop using that terminology. It is frequently possibly to control the condition through diet and exercise alone, so what you want is an endocrinologist who will work with you on that. Talk to them about "control through diet alone" rather than using the terms "reversal" or "remission" and at least they will understand what you after.

Thanks. I will contact the doctor you listed. Bit embarrassing as my doctor is from that same hospital.

Sorry about the confusion. Actually I did not use remission or reversal when talking to my doctor. I asked if it was possible to control my diabetes through proper diet and exercise alone and no medication. I was truly expecting I would get a positive answer, which I did not get.

Don't even bother talking to a medical doctor about diet. They are prescription machine in human form. Talk to a nutritionist, a trainer, or someone with knowledge and expertise in this area. Doctors know very little about food, and the effect it had on the body, other than fats and cholesterol.

One doctor told my mother that experience shows that anyway no one follows the diet recommendations (which were exercise and reducing bodyweight) so he prescribe the medicine.....

Very cynical....but when you read here about how impossible it is not eat "normal", he might be right. Tell a fatty to loose 30 kg and his blood pressure and sugar will be OK.

Than you wait 6 month and he'll come back with maybe 5 kg more. So better to start with the medicine immediately...

[aledarrkie]

One doctor told my mother that experience shows that anyway no one follows the diet recommendations (which were exercise and reducing bodyweight) so he prescribe the medicine.....

Very cynical....but when you read here about how impossible it is not eat "normal", he might be right. Tell a fatty to loose 30 kg and his blood pressure and sugar will be OK.

Than you wait 6 month and he'll come back with maybe 5 kg more. So better to start with the medicine immediately...

I know it won't be easy.

I have seen many people attempting to lose weight but they are like a yoyo. I believe I have what it takes to succeed. I am using the same thing I used in quitting smoking since 2012. That is "if the person trying to quit smoking or reduce weight to ideal level does not see and feel happy about the changes quickly" they will give up.

I was able to quit smoking because I realized and felt the benefits early: able to sing a complete song without running out of breath; able to walk one kilometer without panting; before my mouth smelled like ashtray, then I felt more confident to talk fronting another person; etc. Small things at first followed by bigger things.

I was 89 kg in March this year, now I am at 69.5kg, just 1.5 kg from my ideal weight. Honestly to lose the last 4kg will be the hardest. Losing the first 5 kg was the easiest, and it got harder as you closed down the gap to your ideal weight.

Now I am attempting to control diabetes without medications. Good luck to me.

Edited October 19, 2015 by aledarrkie

[h90]

One doctor told my mother that experience shows that anyway no one follows the diet recommendations (which were exercise and reducing bodyweight) so he prescribe the medicine.....

Very cynical....but when you read here about how impossible it is not eat "normal", he might be right. Tell a fatty to loose 30 kg and his blood pressure and sugar will be OK.

Than you wait 6 month and he'll come back with maybe 5 kg more. So better to start with the medicine immediately...

I know it won't be easy.

I have seen many people attempting to lose weight but they are like a yoyo. I believe I have what it takes to succeed. I am using the same thing I used in quitting smoking since 2012. That is "if the person trying to quit smoking or reduce weight to ideal level does not see and feel happy about the changes quickly" they will give up.

I was able to quit smoking because I realized and felt the benefits early: able to sing a complete song without running out of breath; able to walk one kilometer without panting; before my mouth smelled like ashtray, then I felt more confident to talk fronting another person; etc. Small things at first followed by bigger things.

I was 89 kg in March this year, now I am at 69.5kg, just 1.5 kg from my ideal weight. Honestly to lose the last 4kg will be the hardest. Losing the first 5 kg was the easiest, and it got harder as you closed down the gap to your ideal weight.

Now I am attempting to control diabetes without medications. Good luck to me.

One problem will be also when you reached your target....you must continue your diet, but of course watered down. I find holding the weight is somehow more difficult than loosing it. As you need to balance things.

Edit: yes getting rid of weight is slow, and sometimes strange effect happen....you eat very little and every day you are a bit more heavy without reason. But than for the same no reason you'll loose weight. It is just fluctuating a bit.....

Edited October 19, 2015 by h90

[aledarrkie]

One doctor told my mother that experience shows that anyway no one follows the diet recommendations (which were exercise and reducing bodyweight) so he prescribe the medicine.....

Very cynical....but when you read here about how impossible it is not eat "normal", he might be right. Tell a fatty to loose 30 kg and his blood pressure and sugar will be OK.

Than you wait 6 month and he'll come back with maybe 5 kg more. So better to start with the medicine immediately...

I know it won't be easy.

I have seen many people attempting to lose weight but they are like a yoyo. I believe I have what it takes to succeed. I am using the same thing I used in quitting smoking since 2012. That is "if the person trying to quit smoking or reduce weight to ideal level does not see and feel happy about the changes quickly" they will give up.

I was able to quit smoking because I realized and felt the benefits early: able to sing a complete song without running out of breath; able to walk one kilometer without panting; before my mouth smelled like ashtray, then I felt more confident to talk fronting another person; etc. Small things at first followed by bigger things.

I was 89 kg in March this year, now I am at 69.5kg, just 1.5 kg from my ideal weight. Honestly to lose the last 4kg will be the hardest. Losing the first 5 kg was the easiest, and it got harder as you closed down the gap to your ideal weight.

Now I am attempting to control diabetes without medications. Good luck to me.

One problem will be also when you reached your target....you must continue your diet, but of course watered down. I find holding the weight is somehow more difficult than loosing it. As you need to balance things.

Edit: yes getting rid of weight is slow, and sometimes strange effect happen....you eat very little and every day you are a bit more heavy without reason. But than for the same no reason you'll loose weight. It is just fluctuating a bit.....

I agree that maintaining the target weight will be a challenge. The secret remains the same: the person doing it should have seen and should already be enjoying the benefits of what he has accomplished -- even before reaching his goal.

Weight loss doesn't really mean eating less. I am on a modified Ketogenic diet with higher than normal fat than recommended in RDA (recommended dietary allowance) , low carb and getting my carb needs mainly from apple, unripe banana, nuts, etc not from grain or wheat, and my protein input is almost double than those not on ketogenic diet (eating lots of fish and meat ,whey or casein protein supplement especially during exercise), I am taking 1.2g of protein per kg of my ideal weight, RDA requirement is only 0.8g per kilogram of ideal weight), eat daily some 350g of vegetables and 150 grams of mainly apples, unripe bananas, avocados and other fruits, did portion control on other fruits as I am diabetic. Non-diabetics should have less difficulty losing weight as they can eat fruits without massive limitations.

In the beginning I craved for grain and wheat bread, which is remedied by eating lots of apples and nuts, and uncooked flaxseed meal grounded, sometimes made cookies out of them and others. There are so many delicious recipes for Ketogenic and Paleo diets, pure or modified

Reliance on eating less is a self-defeating strategy as nobody can fight hunger when all the food are available just waiting for the picking. In fact one will immediately hit a plateau even just after losing 5% of their weight. The long-term variable for weight loss is exercise and natural adjustment of the body to the new type and volume of food being consumed.

I don't get hungry for long because I eat when I am hungry -- just eat the right food. Forgot: I love low-glycemic peanut butter spread on unripe banana and avocado, (I avoided low fat mayo), used chocolate flavor casein protein or whey protein as my coffee creamer and sweetener, and used Vanilla flavor whey for my before-breakfast lemon juice.

I hope these pointers help anyone reading our posts.

Edited October 19, 2015 by aledarrkie

[h90]

One doctor told my mother that experience shows that anyway no one follows the diet recommendations (which were exercise and reducing bodyweight) so he prescribe the medicine.....

Very cynical....but when you read here about how impossible it is not eat "normal", he might be right. Tell a fatty to loose 30 kg and his blood pressure and sugar will be OK.

Than you wait 6 month and he'll come back with maybe 5 kg more. So better to start with the medicine immediately...

I know it won't be easy.

I have seen many people attempting to lose weight but they are like a yoyo. I believe I have what it takes to succeed. I am using the same thing I used in quitting smoking since 2012. That is "if the person trying to quit smoking or reduce weight to ideal level does not see and feel happy about the changes quickly" they will give up.

I was able to quit smoking because I realized and felt the benefits early: able to sing a complete song without running out of breath; able to walk one kilometer without panting; before my mouth smelled like ashtray, then I felt more confident to talk fronting another person; etc. Small things at first followed by bigger things.

I was 89 kg in March this year, now I am at 69.5kg, just 1.5 kg from my ideal weight. Honestly to lose the last 4kg will be the hardest. Losing the first 5 kg was the easiest, and it got harder as you closed down the gap to your ideal weight.

Now I am attempting to control diabetes without medications. Good luck to me.

One problem will be also when you reached your target....you must continue your diet, but of course watered down. I find holding the weight is somehow more difficult than loosing it. As you need to balance things.

Edit: yes getting rid of weight is slow, and sometimes strange effect happen....you eat very little and every day you are a bit more heavy without reason. But than for the same no reason you'll loose weight. It is just fluctuating a bit.....

I agree that maintaining the target weight will be a challenge. The secret remains the same: the person doing it should have seen and should already be enjoying the benefits of what he has accomplished -- even before reaching his goal.

Weight loss doesn't really mean eating less. I am on a modified Ketogenic diet with higher than normal fat than recommended in RDA (recommended dietary allowance) , low carb and getting my carb needs mainly from apple, unripe banana, nuts, etc not from grain or wheat, and my protein input is almost double than those not on ketogenic diet (eating lots of fish and meat ,whey or casein protein supplement especially during exercise), I am taking 1.2g of protein per kg of my ideal weight, RDA requirement is only 0.8g per kilogram of ideal weight), eat daily some 350g of vegetables and 150 grams of mainly apples, unripe bananas, avocados and other fruits, did portion control on other fruits as I am diabetic. Non-diabetics should have less difficulty losing weight as they can eat fruits without massive limitations.

In the beginning I craved for grain and wheat bread, which is remedied by eating lots of apples and nuts, and uncooked flaxseed meal grounded, sometimes made cookies out of them and others. There are so many delicious recipes for Ketogenic and Paleo diets, pure or modified

Reliance on eating less is a self-defeating strategy as nobody can fight hunger when all the food are available just waiting for the picking. In fact one will immediately hit a plateau even just after losing 5% of their weight. The long-term variable for weight loss is exercise and natural adjustment of the body to the new type and volume of food being consumed.

I don't get hungry for long because I eat when I am hungry -- just eat the right food. Forgot: I love low-glycemic peanut butter spread on unripe banana and avocado, (I avoided low fat mayo), used chocolate flavor casein protein or whey protein as my coffee creamer and sweetener, and used Vanilla flavor whey for my before-breakfast lemon juice.

I hope these pointers help anyone reading our posts.

Well I am usually on a similar diet as you are (minus the fruits and more aware on not to eat too much fat). I actually didn't crave much on the beginning but as longer it last as more I get bored about only eating meat, cheese, eggs, etc. And it is more expensive. Point is that with that you are less hungry and in fact eat less.

So it is a great method to control weight!

But of course you can just eat less....my father did it....yes it is more hard as you are all the time hungry. And it doesn't make much sense to be all the time hungry if there is an easier way.

[WonnabeBiker]

Well, it will be up to you to stay motivated and just do it.

There's a ton of useful videos on Youtube. (I just discovered the hip flexor exercises as my ability to move leaves a lot to be desired).

Lots of movement, exercise and appropriate nutrition. Shun the white rice, lay off sugary juices, sodas and sauces (ketchup often contains more sugar than ice cream).

Any doc (or you might find a blood lab, cutting out the middle man) can do a test which reveals the sugar levels over the last month or longer. Not just the level ATM. That way, you can monitor your progress month by month.

Personally, I've learned to believe that about 80% of weight loss is linked to nutrition. More but smaller meals. Drink before you eat... YMMV. But you would have to do the work and then s h o w the progress. And with a little test machine and a diary, you could check the daily impact of what you are doing and reduce the meds.