FUTURE HEALTH SUMMIT

2016 Dr. Eva Orsmond, MD, MPh

Reversing Type 2 Diabetes

CAN TYPE 2 DIABETES BE REVERSED?o Can it be reversed?o Typical Definition:

Type 2 Diabetes is a chronic condition that cannot be cured,

just managed.

This statement only applies to someone at a set weight and unchanged lifestyle.

While T2DM can not be cured, it can be resolved!

WHAT IS DISEASE?

o In medicine, a Disease is said to be ‘incurable’ if there is always a chance of the patient relapsing.

o As T2 Diabetes is a lifestyle related disease, relapse is hard to avoid, but even if relapse occurs, this disease can still be reversed !

o But to do this we need to start to TREAT the disease and not the SYMPTOMS

EXTRACT FROM MIMS

Glucophage (metformin) is used to treat patients with type 2 diabetes when diet and exercise alone have not been enough to control blood glucose levels. It is used particularly in overweight patients.

TREATING TYPE 2 DIABETESoWeight reduction is the most

effective initial treatment for T2DM

o Low carbohydrate diet is the most effective for glucose control

o Approaches Include:o Very Low Carbohydrate Ketogenic Diet

(VLCKD)o Low Carbohydrate High Fat Diet (LCHF)o Sustained Low Carbohydrate Diet (LCD)o Intermittent Fasting with LCHF or LCD.

CARBOHYDRATES & INSULIN

Decrease Carbohydrate intake

Glucose goes down

Need less Insulin

VLCKD – A DIET APPROACH FOR T2DM

(very low calorie and carbohydrate ketogenic diet)

o Low in carbohydrates (<50g/day)o Allows medication reduction (oral

& insulin) followed by immediate improved glucose control

o Excellent compliance as pt feels empowered. Ketone bodies, high fibre and adequate protein ensures satiety

o 10% weight loss in 40 days (~22lb)

WEIGHT MAINTENANCEo A new way of looking at food.

Traditional food Pyramid.Too many Carbs - the cause of the problem

New healthy food Pyramid.Vegetables and fruit form the foundation

DIABETIC DRUGSo Required in OW Patients who

are unwilling to lose weight.o Benefits of prescription drugs

needs to outweigh the negative side-effects!

o Drugs do nothing or even worsen the progress of the disease.

A quote from one of my patients GP’s“If the diabetes doesn't kill you the

drugs will”

THE PROOFoProf Taylor (2011 study) – “the twin defects of beta cell failure and insulin resistance that underlie type 2 diabetes can be reversed by acute negative energy balance alone.”

oThe Look AHEAD (Action for Health for Diabetes) 2012 study – “an intensive lifestyle intervention was associated with a greater likelihood of partial remission of type 2 diabetes compared with diabetes support and education. However, the absolute remission rates were modest.”

CONCLUDING REMARKS

So, can type 2 Diabetes be reversed?In most cases it can be reversed if

you want it.

1. Lose weight with VLCKD or other low carbohydrate diet

2. Change the lifestyle that caused it

3. Maintain the weight loss and new lifestyle