Tuesday, January 07, 2014

A diet to cure diabetes: Patients were able to come off tablets after two months on severe low calorie regime

The explanation given below for the good results is unduly complicated.  The results could simply be seen as the effect of giving the pancreas a rest

A crash diet that has been medically approved could help millions of Britons defeat diabetes.  Men and women suffering from the disease were able to throw away their tablets after going on an extreme low-calorie diet for just two months.

And 18 months later, some were still free of symptoms and said they were astonished at the dramatic improvement in their health.

So far the diet has only been tested on a handful of patients. But a £2.4million trial involving 280 diabetics is about to get under way.  These men and women will live on meal replacement shakes and soups. They will be allowed to take in only 800 calories a day – an amount many people will consume in their lunch.

Type 2 diabetes, which normally develops in middle age, is the most common form of the condition with 3million sufferers in the UK alone.  The disease occurs when the pancreas does not make enough insulin and the insulin that is made does not work properly.

Newcastle University’s Professor Roy Taylor believes fat surrounding vital organs could be the key to understanding the condition.  This fat is thought to clog up the pancreas and liver, cutting insulin production and stopping insulin from being used properly.

But crash dieting plunges the body into starvation mode, the fat is burned off and the vital organs are then freed up.

The original trial – involving 11 men and women – found consuming only weight loss shakes, salad and non-starchy vegetables for eight weeks could reverse diabetes.

Fat levels in the pancreas returned to normal and the organ was able to pump out insulin without running into any problems.

And three months after the end of the diet, seven out of the 11 participants were still diabetes-free.

Even 18 months later, at least four of the patients found that they had no signs of diabetes.

Gordon Parmley, 69, of Stocksfield in Northumberland, came off his diabetes tablets after taking part in the trial.  He said: ‘It’s astonishing really that a diet – hard as it was – could change my health so drastically.’

And Professor Taylor said: ‘I believe that this study will lead to a quantum leap forward in our understanding of how best to manage type 2 diabetes.’

The new, much larger trial, which will be co-led by Glasgow University researcher Mike Lean, will see if the success can be repeated in large numbers of people.

It will look at how easy they find it to follow the diet – and see how long they remain healthy after they have started to eat normally again.

Professor Lean said: ‘If our analysis shows this approach is both effective and cost-effective, our aim would be to produce a programme that could be implemented in the NHS as soon as possible.’

And Dr Matthew Hobbs from Diabetes UK, which is funding the trial, said: ‘Type 2 diabetes will always be a serious condition. ‘But perhaps it won’t always be seen as a condition that people have to manage for the rest of their lives and one that worsens inevitably over time.

‘If we can do this safely, on a bigger scale as part of routine care, then a low-calorie liquid diet would be a real game changer in terms of reducing people’s risk of devastating health complications such as amputation and blindness.’

However the research has no implications for people with type 1 diabetes, in which the pancreas is damaged by the body’s own immune system.

And the charity has advised people not to embark on the diet themselves, strongly urging anyone determined to try it to speak to their GP first.


Neurologist Richard Saul says ADHD does not exist

POP quiz: Is the proportion of American children suffering from the disease known as attention deficit and hyperactivity disorder ...

a) Less than 5%, as we believed before the early 1990s?

b) More than 11%, and rising, as suggested by CDC statistics?

c) Zero?

The correct answer is (c), says neurologist Richard Saul in his forthcoming book, ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactivity Disorder, which is sure to cause controversy when it hits the shelves in February.

After a long career treating patients complaining of such problems as short attention spans and an inability to focus, Saul is convinced ADHD is a collection of symptoms, not a disease, and shouldn't be listed in the American Psychiatric Association's Diagnostic and Statistical Manual.

Treating ADHD as a disease is a huge mistake, according to Saul. Imagine walking into a doctor's office with severe abdominal pains and simply being prescribed painkillers. Then you walk away, pain-free. Later you die of appendicitis.

Patients show up at the clinic with their own ADHD diagnoses these days, simply because ADHD is in the air all around us - and because they want to score some delightful drugs like Adderall or Ritalin, or because their parents want an easy way to get them to sit down and shut up.

Adderall and Ritalin are stimulants, though, and the more you take them the more you develop a tolerance for them, which can lead to a dangerous addiction spiral.

The term attention deficit disorder was made official in 1980, when it appeared in that year's edition of the DSM (the label changed to ADHD seven years later).

Subsequent editions have steadily loosened the definition, and diagnoses have skyrocketed accordingly - from 7.8% in 2003 to 9.5% in 2007 to 11% in 2011.

That's one in nine children, two-thirds of them boys, who are being slapped with the ADHD label. Two-thirds of these children have been prescribed a stimulant.

"ADHD makes a great excuse," Saul notes. "The diagnosis can be an easy-to-reach-for crutch. Moreover, there's an attractive element to an ADHD diagnosis, especially in adults - it can be exciting to think of oneself as involved in many things at once, rather than stuck in a boring rut."

In private practice, Saul found himself wondering, what other problems do these patients have besides being easily distracted? One girl he treated, it turned out, was being disruptive in class because she couldn't see the blackboard. Correct diagnosis: myopia. She needed glasses, not drugs.

A 36-year-old man who complained about his addiction to online games and guessed he had ADHD, it turned out, was drinking too much coffee and sleeping only four to five hours a night. Correct diagnosis: sleep deprivation. He needed blackout shades, a white-noise machine and a program that shut all his devices off at midnight.

A young man who asked, "Can't you just ask me a few questions and write me a prescription?" simply left the office when Saul started probing too deeply into whatever was ailing him.

One by one, nearly all of Saul's patients turned out to have some disease other than ADHD, such as Tourette's, OCD, fragile X syndrome (a genetic mutation linked to mental retardation), autism, foetal alcohol syndrome, learning disabilities or such familiar conditions as substance abuse, poor hearing or even giftedness. A boy who was disruptive and inattentive in math class (but no other) was, simply, bored by the material and needed to be advanced a grade to regain his concentration.

In a few cases, there was simply no diagnosis. One adult who thought she had ADHD and had been prescribed stimulants by another doctor got a different take from Saul. He advised her to instead return to her habit of exercising regularly and cut back on work hours.  "I now realise it wasn't ADHD," she told him later, pleased with the progress she made as a result. "It was just life."

The explosion in ADHD diagnoses and related prescriptions of stimulants is not without substantial costs. Potentially addictive drugs are not to be given out like Skittles.

"I know of far too many colleagues," Saul writes, "who are willing to write a prescription for a stimulant with only a cursory examination of the patient, such as the 'two-minute checklist,' for ADHD."

Two minutes to jot down a prescription may lead to years of consequences: short-term side effects of stimulants include loss of sleep, increased anxiety, irritability and mood problems. Over the long term, use of these drugs can lead to unhealthy weight loss, poor concentration and memory, even reduced life expectancy or self-destructive behaviours not excluding suicide.


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