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Is It Alright To Manage Diabetes Only With Lifestyle Changes?

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Posted on Sat, 10 Jan 2015
Question: I have been a diabetic since 4 years now. Best part is I do not take drugs -- no not even MF -- as I manage my diabetes through LCHF diet. All my LIPID/CARDIAC/KFT/LFT/Sugar Control/A1C/BP/apoA1/B are just too fine to scare me away from taking a fat loaded diet (but restricting carbs to 20%). In fact my TG and LDL have dropped after LCHF. LCHF diet is a boon for diabetics and there are many diabetics living this life on http://www.forums.dlife.in/

So, why is medical establishment still focused on blaming saturated fat (Just because Ancel Keys fabricated a lousy study 6 decades back to enable McGroven to push grains) when huge number of studies have proved it to be innocent and good for health. It is the CARBS that kill. Would need a unbiased answer and not just what ADA preaches as ADA is doing nothing but defending the interests of the DRUG industry.

Don't you think that entire diabetes care is biased in favor of drug industry and medicare establishment rather than the diabetic?
doctor
Answered by Dr. Niranjan G (2 hours later)
Brief Answer:
I accept, Lifestyle changes remain the main stay.

Detailed Answer:
Dear sir,

Greeting from HCM .. I appreciate your question ..

That's great to hear that you are managing your diabetes with lifestyle changes .. To certain extent I too agree to what these committees are doing to boost the pharma industries ..

We need some studies from local research and scientific organizations pertaining to the diagnosis and management .. Just we can't accept what is proved elsewhere on different population, environment and lifestyle ..

Regarding your diet .. Yes, carbohydrates are dangerous as they contribute glucose and then if we don't assimilate and use the energy that is produced by them ....

In turn, if we take proteins and fatty acids .. Our body still gets energy out of them .. Even glucose through a process known as gluconeogenesis .. Which occurs only if the glucose levels are very low ..

Regarding your thought on saturated or PUFAs/MUFAs .. Even all our cells can produce saturated fatty acids i.e., palmitic acid .. PUFAs/MUFAs are nutritionally essential. We need to take in diet as they are required for synthesis of some important compounds in us also helps in metabolism of Good cholesterol that is HDL, They also prevent fatty liver ..

So better to take MUFAs and PUFAs rich diet than saturated fat ..

Yes in the early stages when there is insulin resistance we can control sugar levels with JUST LIFESTYLE MODIFICATIONS but at some stages later we need help of drug or even insulin when our beta cells get exhausted from pancreas .. Even then lifestyle changes are very essential with drugs ..

We cannot suggest non pharmacological management is sufficient .. We need to assess each patient and follow up later...

In your case as you told you are OK with non pharmacological management .. As of now please continue and do follow up with your investigations ..

Thanks for an excellent query and appreciate your knowledge on diabetes and its management ..

Thank you and Contact us for more discussion..
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Niranjan G (29 minutes later)
Isn't PUFA one of the wost inflammatory component in diet? All these n-6 PUFA loaded vegetable oils -- so called heart healthy oils -- are the biggest culprit and recently it has been proved that in Sydney Diet Heart study the whole study back then was fudged (by secretly trashing data which did not fit the end result which perhaps was decided ell before the study started) to favor the vegetable oil industry:

http://www.forums.dlife.in/threads/sydney-diet-heart-study-a-revisit-shows-saturated-fat-better-than-pufa-loaded-vegetable-oils.521/

and it has been proved again and again that SFA is not dangerous :
http://www.forums.dlife.in/threads/saturated-fat-doesnt-cause-cardio-vascular-or-coronary-heart-disease.7/

http://www.forums.dlife.in/threads/doubling-saturated-fat-in-diet-does-not-increase-saturated-fat-in-blood.1137/

http://www.forums.dlife.in/threads/low-carb-high-fat-diet-is-beneficial-for-diabetics-is-it-official.5/

and high carb low fat diet + exercise study proves that it does nothing to prevent CVD/CHD in case of diabetics on ADA -- High Carb Low Fat -- diet
http://www.forums.dlife.in/threads/high-carb-diet-experiment-fails-on-type-2-diabetics.17/

VCO (virgin coconut oil) is MCT and yet experts group it with LCT and put the blame on SFA, knowing very well that MCT's aren't processed the same way as LCT's.

BTW, I am an engineer from IIT by profession so my inquisitiveness knows no bounds and this is one reason why i rejected what ADA/AMA/AHA preaches.

Your inputs on above would be appreciated and maybe one more follow up and I consider this thread as accepted.
doctor
Answered by Dr. Niranjan G (1 hour later)
Brief Answer:
TOO MUCH OF PUFA s IS NOT ADVICED

Detailed Answer:
Dear frieand, great to have discussion with you.

I appreciate your knowledge and critical way of looking things, even renowned institute s are following what has been documented else where and in different population. We need to have data generated for our population.

Regarding PUFAs .. They are not produced in our body we need to take them .. As they are involved in production of eicosonoids which include our prostaglandins, prostacyclins and leucotrienes, yes many of these local hormones are the systemic inflammatory mediators..
But many are useful and beneficial too .. So we to avoid excess consumption of PUFAs. May not be visible oils as such but invisible oils in fish and some nuts do contain enough PUFAs. Required..
Regarding your thoughts on saturated fatty acids ... I can tel small amount s are better than carbohydrates as they give enough energy .. but think of the sources of saturated fatty acids all are animal source s we do take cholesterol also with that which is harmful.. MUFAs are good as they help in HDL metabolism.

More of these unsaturated fatty acid s are susceptible for oxidative rancidity the same happens inside that is lipid peoxidation which is atherogenic ..

Another problem with these oils rich in PUFAs is that difficult to store and repeated use may cause formation of trans fatty acid s which are atherogenic again so I recommend 1:1:1 for saturated: PUFAs:MUFAs...


With little carbohydrates and also micro nutrients so what we call BALANCED FOOD .. Ready for your question which are very interesting .. Thank you sir ..
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Niranjan G (2 hours later)
Ok. But we still do not agree on something that has been lied upon year after year by a lousy and flawed study of Ancel Keys six decades back where he fudged by cherry picking data of just 7 and rejected 15 odd countries.

Saturated Fat improves HDL, makes LDL fluffy, reduces TG which reduces the notorious VLDL. It's the bread (brown/white/multigrain doesn't matter as all have 70% + carbs) with butter that causes the damage and not butter alone, necuse it is the CARBS that kick up TG by and large. Masai tribe survived only on animal fat and milk and they had the best lipids as compared to Americans or population that consumes so called "Balanced Diet". Today's milk is not even a good dog food as it is low fat.

So shouldn't diabetics be concerned more about TG/HDL ratio, apoB, apoA1, hsCRP, homocystein, sub LDL fractions as cardiac markers rather than plain TC number which has been proved to be just a number good for selling already over-prescribed class of drugs -- Statins? More than half (in a study of over 100,000 in-hospital patients) the persons who died of heart failures had normal cholesterol and Statins have been proved to be useless drug as a preventive medicine. It maybe ok for people with CVD/CHD but statins are prescribed indiscriminately.

WRT 20% Carbs +20% Proteins + 60% Fat (LCHF diet), with major coming from SFA, isn't it a better alternative than pushing MF, Sulphonylurea drugs that drives one to insulin shots finally? It's the 60% CARBS that cause uptick of TG (which is the fat in blood and not the butter or coconut oil that we eat) and TG is one of the worse thing to have on higher side.

We on LCHF maintain TG around 100 and diabetics on a ADA recommended -- so called balanced diet -- more often than not have TG to north of 200.

If I take just my case, had i gone by the so called "balanced and healthy diet" (as per ADA), I am sure I would be on 1000 mg MF at least and slowly driven to Sulphonyl urea drugs as higher TG == Higher Insulin resistance. So, my question is -- If we don't treat alcoholics by pushing more alcohol, why are we diabetics being forced to resort to maintain higher levels of insulin in blood? Insulin resistance gets worse everyday by that treatment. Insulin is a vaso-constrictor which means if we go by ADA's "Balanced Diet" we are sure to end up with high BP too which in tun leads to problems with kidney, ED etc.

My main grouse with entire regimen of handling diabetics is that we are forced to be "drug addicts" first rather than switch to something which has been globally proved (on all diabetes forums) to be the most effective way of dealing with diabetes. The researchers are also so heavily biased that they will spend millions (on HCLF + exercise study on diabetics they spent a cool $120 million for over 10 years and failed to come up with a result that they set out to hopefully achieve) but will not spend even a million on conducting trials with LCHF because this diet kills profits of pharma industry and entire medicare business.

Humans aren't designed to be consuming more than 150 gms carbs/day (diabetics still less), unless one is an athlete.

Don't you think that at least the young generation doctors in XXXXXXX should at least change the way diabetics are handled. If yes, what stops them? If no, then why?

Thanks!
doctor
Answered by Dr. Niranjan G (2 hours later)
Brief Answer:
Future is based on the genetic susceptibility.....

Detailed Answer:
Dear sir, all that you have stated is true .

Yes the younger researchers need to look in to these aspects as well as the genetic susceptibility of an individual in that population and the mutations, snps and the epigenetic mechanism s ..in that particular area and people .. We can't keep applying same old principles of management even in this era .. No wonder our are is one regarded as the diabetic capital yes lifestyle is changing and even the environment but how to take this ? Lack of leaders at the highest level to encourage and accept modern ideas rather than supporting them !! ..

Your thoughts on LDL CHOLESTEROL .. Yes its not the number but the size of the molecules that matter ... TAG/HDL is an indirect way to assess the particle size of LDL.. numerous modified LDL molecules like thiolated/oxidized/ small dense etc.. But we just don't have set up to estimate all these ..
Lipoprotein (a) .. Most dangerous but not routinely screen ed ..
Your thoughts in loading insulin but not worried about the resistance !! Finally we end up giving more but not bothered about the weight gain and Blood pressure ... But keep telling all diabetic s will have hypertension!! We need to adopt personalized medicine as each individual us different than evidence based management .. But feasibility is a big question !!!

Molecular diagnostics and nutrition and genomic interaction s need to be studied in detail..
We are just have to accept current generation doctors are treating future diabetic s with older thought s !!! Based Pharmaceutical companies dictations

Only way out is supporting the younger researchers and novel ideas ..by the way very nice conversation with you and thank you very much ..
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Niranjan G

Diabetologist

Practicing since :2003

Answered : 633 Questions

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Is It Alright To Manage Diabetes Only With Lifestyle Changes?

Brief Answer: I accept, Lifestyle changes remain the main stay. Detailed Answer: Dear sir, Greeting from HCM .. I appreciate your question .. That's great to hear that you are managing your diabetes with lifestyle changes .. To certain extent I too agree to what these committees are doing to boost the pharma industries .. We need some studies from local research and scientific organizations pertaining to the diagnosis and management .. Just we can't accept what is proved elsewhere on different population, environment and lifestyle .. Regarding your diet .. Yes, carbohydrates are dangerous as they contribute glucose and then if we don't assimilate and use the energy that is produced by them .... In turn, if we take proteins and fatty acids .. Our body still gets energy out of them .. Even glucose through a process known as gluconeogenesis .. Which occurs only if the glucose levels are very low .. Regarding your thought on saturated or PUFAs/MUFAs .. Even all our cells can produce saturated fatty acids i.e., palmitic acid .. PUFAs/MUFAs are nutritionally essential. We need to take in diet as they are required for synthesis of some important compounds in us also helps in metabolism of Good cholesterol that is HDL, They also prevent fatty liver .. So better to take MUFAs and PUFAs rich diet than saturated fat .. Yes in the early stages when there is insulin resistance we can control sugar levels with JUST LIFESTYLE MODIFICATIONS but at some stages later we need help of drug or even insulin when our beta cells get exhausted from pancreas .. Even then lifestyle changes are very essential with drugs .. We cannot suggest non pharmacological management is sufficient .. We need to assess each patient and follow up later... In your case as you told you are OK with non pharmacological management .. As of now please continue and do follow up with your investigations .. Thanks for an excellent query and appreciate your knowledge on diabetes and its management .. Thank you and Contact us for more discussion..