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Diabetes – a low carb approach
“Coming out” as a low-carb doctor
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Public figures with Type 2 Diabetes
Steve Redgrave
Tom Watson
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Public figures with Type 2 Diabetes
Steve Redgrave
Tom Watson
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Patient stories
• 76 year old man, T2D for 30 years. On 32 units Mixtard twice daily
Now on just 6 units twice daily and is really pleased• 80y new onset T2D wondering what he should do
Has now reversed his diabetes and lost 2 stone in 4 months
• 45yo woman with FHx T2D getting heavier and more tiredHas lost weight in 6 months, and no longer falls asleep in the afternoon
• 66yo woman diabetes secondary to PMR on prednisolone, increasing doses of gliclazide but glucose staying around 20
Has now stopped her gliclazide, glucose around 8
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Patient stories
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Patient stories(weight loss is a side-effect)
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OK, so it’s the diet. But which one?
Low fat, healthy whole grains, 5 portions of fruit and veg a day
Heart healthy
Vegan
Flexitarian
5:2 diet
Low carbohydrate high fat
Newcastle diet
Plant based
Vegetarian
Atkins
Clean eating
Gluten free
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What else gets better on LCHF?• Acne• Psoriasis• Eczema• Asthma• Allergies• Inflammatory arthritis• IBS including constipation• IBD• Tendon disorders eg frozen shoulder
• Sensitive teeth• Anxiety• Depression• Epilepsy (ketogenic diet)• ADHD spectrum• More severe MH disorders• Memory and mental alertness• Muscle pains eg post exercise• Gout
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Issues to take into account
with a low carb diet
This is a really powerful treatment. For those on insulin and hypoglycaemics it is really important to be very careful*Explain to people not to change their diet without a careful discussion about medication
Halve the insulin
Stop hypoglycaemics (metformin is OK)AND Check in regularly, every day initially
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Minor problems of a low carb diet: Solutions:
• Temporary side effects while the body adjusts
• Keto flu – headache and lethargy
• Keto rash
• Craving for sugar and starch
• Cost
• Drink more water, add a little more salt and magnesium salts.
• These get better, brain fog lifts
• Go more gently, a meal at a time
• Keep going! The cravings will stop!
• Tips at phcuk.org
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Disclosures:
1.The 4 year Norwood Surgery low-carb T2D project has been entirely self-funded by the partners, apart from a single £7,000 grant from The Southport & Formby CCG.
2.The Norwood Surgery is an NHS only practice, we do not see any private patients
3.Dr David Unwin is an unpaid, voluntary medical adviser to both The Public Health Collaboration(charity) & Diabetes.co.uk
4.Dr David Unwin has not received any payments or gifts with respect to his low carb work
Dr David Unwin FRCGP
Partner Norwood Surgery
Southport
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Low Fat High Carbohydrate breakfast
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So what can you eat?
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It’s not just low carb
Relaxation, meditation
Prioritise sleep
Time restricted eating
Just eat real food!
Exercise is great for your health and insulin sensitivity
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Resources
• RCGP• https://www.rcgp.org.uk/clinical-and-research/resources/bright-
ideas/working-on-weight-loss-with-type-ii-diabetic-patients-dr-david-unwin.aspx
• http://elearning.rcgp.org.uk/course/info.php?id=291
• Diet Doctor• https://www.dietdoctor.com/uk-family-doctors-will-be-trained-in-low-carb-
diets
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