Carbohydrate Restricted Diet In Conjunction With Metformin And Liraglutide Is An Effective Treatment In Patients With Deteriorated Type 2 Diabetes Mellitus: Proof-of-concept Study
Go to: Abstract Type 2 diabetes mellitus is a chronic progressive disease. During the course of the disease intensive treatment is often necessary resulting in multiple interventions including administration of insulin. Although dietary intervention is highly recommended, the clinical results of the widely prescribed diets with low fat content and high carbohydrates are disappointing. In this proof-of-concept study, we tested the effect of dietary carbohydrate-restriction in conjunction with metformin and liraglutide on metabolic control in patients with type 2 diabetes. Forty patients with type 2 diabetes already being treated with two oral anti-diabetic drugs or insulin treatment and who showed deterioration of their glucose metabolism (i.e. HbA1c >7.5), were treated. A carbohydrate-restricted diet and a combination of metformin and liraglutide were instituted, after stopping either insulin or oral anti-diabetic drugs (excluding metformin). After enrollment, the study patients were scheduled for follow-up visits at one, two, three and six months. Primary outcome was glycemic control, measured by HbA1c at six months. Secondary outcomes were body weight, lipid-profile and treatment satisfaction. Thirty-five (88%) participants completed the study. Nearly all participating patients experienced a drop in HbA1c and body weight during the first three months, an effect which was maintained until the end of the study at six months. Seventy-one percent of the patients reached HbA1c values below 7.0%. The range of body weight at enrollment was extreme, reaching 165 kg as the highest initial value. The average weight loss after 6 months was 10%. Most patients were satisfied with this treatment. During the intervention no significant change of lipids was observed. Most patients wh Continue reading >>
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How The Ketogenic Diet Works For Type 2 Diabetes
Special diets for type 2 diabetes often focus on weight loss, so it might seem crazy that a high-fat diet is an option. But the ketogenic (keto) diet, high in fat and low in carbs, can potentially change the way your body stores and uses energy, easing diabetes symptoms. With the keto diet, your body converts fat, instead of sugar, into energy. The diet was created in 1924 as a treatment for epilepsy, but the effects of this eating pattern are also being studied for type 2 diabetes. The ketogenic diet may improve blood glucose (sugar) levels while also reducing the need for insulin. However, the diet does come with risks, so make sure to discuss it with your doctor before making drastic dietary changes. Many people with type 2 diabetes are overweight, so a high-fat diet can seem unhelpful. The goal of the ketogenic diet is to have the body use fat for energy instead of carbohydrates or glucose. A person on the keto diet gets most of their energy from fat, with very little of the diet coming from carbohydrates. The ketogenic diet doesn’t mean you should load up on saturated fats, though. Heart-healthy fats are the key to sustaining overall health. Some healthy foods that are commonly eaten in the ketogenic diet include: eggs fish such as salmon cottage cheese avocado olives and olive oil nuts and nut butters seeds The ketogenic diet has the potential to decrease blood glucose levels. Managing carbohydrate intake is often recommended for people with type 2 diabetes because carbohydrates turn to sugar and, in large quantities, can cause blood sugar spikes. If you already have high blood glucose, then eating too many carbs can be dangerous. By switching the focus to fat, some people experience reduced blood sugar. The Atkins diet is one of the most famous low-carb, high-p Continue reading >>
3 Things You Need To Know About Metformin
September 30, 2015 by Dr. Brooke in Be Better , Eat Better , pcos 3 Things You Need To Know About Metformin Metformin is recommended by doctors for women with PCOS that want to loose weight or otherwise manage their PCOS and insulin resistance. But there are 3 very important things that you need to know about it including the fact that it's not the only option! Let me first say, I dont hate Metformin for women with PCOS . For some women it really does help spur ovulation, control blood sugar and help with some weight management but.its not without its share of issues. And its definitely not the magic bullet for weight loss although its usually presented that way. How Metformin (or its generic form: Glucophage) Works Metformin is typically given with meals throughout the day, or more commonly now the extended release version is given once with dinner or at bedtime. While only having to pop a pill one time per day is always appealing, this once a day dosing (especially at bedtime) is where I see the most problems with my patients. It lowers both fasting and post meal glucose levels by decreasing the glucose absorption in your intestines after a meal; as well as decreasing the amount of glucose your liver makes for later use. It also does help improve insulin sensitivity by increasing glucose movement into a cell. All sounds good so far right? Not so fast, here are the most common issues I see in women using Metformin: Metformin is notorious for causing sometimes severe digestive issues including stomach pain or upset, nausea, vomiting, diarrhea and even a sense of body weakness or metallic taste in the mouth in some. And it is touted as not causing low blood sugar as many older blood sugar lowering drugs did, however I see it every day in my practice that Metformin can m Continue reading >>
Metformin And Low Carbing , Ketosis..
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Discussion in ' Metformin/Biguanides ' started by Sutherlandlass , Mar 15, 2016 . Sutherlandlass Type 2 Well-Known Member Hi folks, I hope someone can clarify something for me please? I am on my second month of metformin, the first was called Gluciet sr, which mentioned nothing about ketosis itself, only ketoacidosis. Is this completely different from ketosis? The current prescription came and it's a metformin called metabet sr. I take the same dose just one 500mg tablet each day with or after my evening meal. The leaflet in this one says, do not take metabet sr if you have ketosis?! I am low carbing, and getting good by results, I drink plenty of water... Does anyone know if this "is" safe or not? I have a telephone consultation booked with my gp, but he doesn't seem to have as much knowledge as you folks on here sometimes! I don't want to be causing injury to myself!! Looking forward to hearing from you folks.. Many thanks, feeling really anxious about this! Probably should have done some basic research before jumping into all of this. These are things you should know beforehand so you don't worry yourself like you're doing now. Nonetheless, to answer your question nutritional ketosis and DKA (ketoacidosis) are completely different situations caused by completely different circumstances. Nutritional ketosis essentially means your body transitions into a state where it gets more energy from fat (ketones) rather than glucose. Most people are in glycolysis which means they get more energy from glucose. Ketoacidosis is essentially a condition where the pH of your blood becomes so acidic that you can basically poison yourself into a coma. You're talking Continue reading >>
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Question About Keto And Metformin?
Raynne413 Posts: 1,524Member, Premium Member Posts: 1,524Member, Premium Member I'm on metformin as well, and I would be curious as to what your doctor tells you, if you wouldn't mind reporting back, because I was wondering the same thing. I take my metformin first thing in the morning, after my lunch around 3, and then at bedtime, and I've noticed that by the time I get home from work in the afternoon, around 5, I'm usually feeling sick to my stomach, tired, and shaky, so now I'm wondering if it is from my afternoon dose. KnitOrMiss Posts: 9,918Member Member Posts: 9,918Member Member My doctor recommended staying on Met as it helped with my insulin resistance, but as I added more dairy, it wasn't worth the dumping complication for me personally. Not everyone has that. Since I am doing well staying with my diet plan, and my IR is minimal, I'm able to manage it to 90-95% of the Metformin levels through my Keto diet. I don't believe there is much risk of low blood sugar with it (there was some research a while back), but after adjusting dietarily, you may be able to reduce or stop your dosages eventually. But you may not. Some people's insulin resistance don't get better using diet or it may take a long LONG time to restore your metabolism's "health." So this is very much and individual situation, based on how your body responds. However, if you struggle to stay on plan, it is unlikely that you would ever be able to stop this medication, because low carb eating requires patience and persistence for success. It's not a quick fix... Metformin only works, as I understand it, by making your body see the insulin it has already created instead of making more and continuing the raging hunger cycle that is IR. So since Metformin doesn't create or increase insulin, there should n Continue reading >>
Starting Low Carb With Diabetes Medications
So you have diabetes and you want to try a low-carb diet? Congratulations! It may be the single best thing you could ever do for your health. It can start to reverse your type 2 diabetes, and dramatically increase your blood sugar control with type 1 diabetes. However, you need to know what you are doing. Once you start eating low carb you may instantly have to lower any insulin doses, a lot. Avoiding the carbohydrates that raise your blood sugar decreases your need for medication to lower it. Taking the same dose of insulin as you did prior to adopting a low-carb diet might result in hypoglycemia (low blood sugar). You need to test your blood sugar frequently when starting this diet and adapt (lower) your medication. This should ideally be done with the assistance of a knowledgeable physician. No drugs If you have diabetes and you’re treated either by diet alone or just with Metformin there is no risk of low blood sugar on low carb. You can get started right away. Insulin As a general guide you may need to lower your doses by 30-50% or more when starting a strict low-carb diet. Unfortunately there’s no way to know the doses required in advance. You’ll have to test your blood sugar frequently and adapt (lower) insulin doses. This should ideally be done with the assistance of a knowledgeable physician. Note that as a general rule it’s easier to err on the low side, and take more insulin later if needed. That’s fine. If instead you overdose and get low sugar you’ll have to quickly eat or drink more carbohydrates, and that obviously reduces the effect of the low-carb diet. Insulin in type 1 diabetes The advice on insulin above generally applies to type 1 diabetes too. A low-carb, high-fat diet can be fantastic for empowering people with type 1 diabetes to get s Continue reading >>
Reversing Type 2 Diabetes With Nutritional Ketosis
Virta is a science-based online specialty medical clinic using continuous remote monitoring and intensive coaching to help our patients reverse type 2 diabetes and prediabetes. A unique contributor to our success in this is harnessing and sustaining the metabolic benefits of nutritional ketosis. Admittedly, reversing diabetes is a rather bold goal. By way of contrast, the American Diabetes Association defines type 2 diabetes as a progressive disease whose course at best can be slowed by lifestyle change and medication. Based upon solid sciencesome old and some newwe beg to differ. Perhaps its time for a paradigm change. There are few times in the lives of medical scientists where we have the opportunity to change the course of a major medical disease; and even fewer cases where we actually succeed in doing so. In 1920, Bantings discovery that injected insulin could control type 1 diabetes (T1D) was such an event. As a result, over the last century, millions of people with T1D have achieved long and productive lives; whereas before 1920 most of them would have succumbed to this insulin-deficiency disease within less than a year. Young insulin patient circa 1920s, before insulin, and 4 months after beginning treatment. Type 2 diabetes (T2D), on the other hand, is a very different disease that affects hundreds of millions of people. It responds very poorly to injected insulin. Whereas T1D patients cannot make insulin, people with T2D typically make lots of insulin but are resistant to insulins effects across a variety of cellular functions. Despite these facts having been known for 5 decades, we are taught that the core components of T2D management are to force the body to make even more insulin or to inject more insulin to overcome the insulin resistance that characteriz Continue reading >>
What’s The Difference Between Ketosis And Diabetic Ketoacidosis?
Ketosis and ketoacidosis sound similar and are sometimes confused, but don’t mistake these conditions for one another. These involve two different sets of circumstances with considerably different outlooks. Both are triggered by an increase of ketones in the body, which are acids released into the bloodstream when the body burns fat for energy instead of carbohydrates. But it’s how the body responds to this increase that sets ketosis and ketoacidosis apart from each other. RELATED: How to Tell the Difference Between Good and Bad Carbs What Is Ketosis and How Does the Process Work? “Ketosis is a natural state that occurs when you start to metabolize fat instead of sugar,” says Michael Greenfield, MD, endocrinologist and chief medical officer at El Camino Hospital in Palo Alto, California. “It occurs often when people fast and use up the stores of sugar in their body." To understand ketosis, it helps to understand how the body burns energy. Carbohydrates and fat are both energy sources, and the body typically burns carbs (sugar or glucose) first, and then fat. If there aren’t enough carbohydrates in your system, it begins to break down fat for energy, which puts your body into a state of ketosis. While in this state, the body becomes a fat-burning machine. For this reason, ketosis is the goal of many diets, particularly those that restrict carbohydrate intake and rely on fat for energy, such as the ketogenic diet. Understanding the Relationship Between the Ketogenic Diet and Ketosis “The ketogenic diet is a high-fat (60 to 80 percent of your total daily calories), moderate-protein (10 to 15 percent of your total daily calories), and low-carbohydrate diet (less than 10 percent of your total daily calories) that forces your body into ketosis, where it burns fa Continue reading >>
Metformin And Ketosis
Another twist in my never-ending saga. I started Metformin about 11 days ago and worked my way up to 1500mg so far. I haven't noticed any difference in BG (yet), but I have a lower level of urine ketones. If anything I'm eating LESS carbs and less food in general (Metformin is suppressing my appetite); I used to eat 30gram of carb or less, now I make sure I eat my protein first and often don't feel like eating anything else, so I'm probably down to 15-20 grams of carbs/day. Yet ketones have dropped to a 'trace' level (they've been consistently 'small' to 'moderate' levels since I started testing last summer). Any idea why? Sometimes metformin can take up to 3-4 weeks to build up in your system. I'm not sure about the ketones, since I never test mine. I had to raise my metformin over 2 years to 2550 before I saw significant bg dropping. I have found though that my appetite is much smaller at meals, so I tend to eat more mini meals througout the day. 115 pounds, Breast Cancer dx'd 6/16, 6 months of chemo and 6 weeks of radiation 2000 metformin ER, 100 mg Januvia,Glimperide, Prolia, Gabapentin, Meloxicam, Probiotic with a Prebiotic, , Lisinopril, B-12, B-6, Tumeric, Magnesium, Calcium, Vit D, and Occuvite mostly vegan diet, low fat and around 125 carbs a day, walk 5-6 miles every other day and 1 hour of yoga and light weights. Sometimes metformin can take up to 3-4 weeks to build up in your system. I'm not sure about the ketones, since I never test mine. I had to raise my metformin over 2 years to 2550 before I saw significant bg dropping. I have found though that my appetite is much smaller at meals, so I tend to eat more mini meals througout the day. I did find some posts on low carb forums saying that people couldn't get in to ketosis on Metformin until they went to th Continue reading >>
Approach Keto (very Low Carb) Diet With Caution
In a second study,2 a Harvard-led research team evaluated the benefit of a ketogenic diet in both children and adults with type 1 diabetes despite concerns about a possible negative effect on growth and development in children following such a restricted diet.These researchers report "exceptional" glucose controlwith little adverse effects. However, the participants were recruited from a closed Facebook group, TypeOneGrit, for people who follow a diet and diabetes program based on the recommendations in the Diabetes Solution,3a book by Richard K Bernstein, MD, who devised this program tomanage his own type 1 diabetes. The ketogenic diet focuses on lean meat and lots of vegetables to promote weight loss. Too good to be true? Many experts are pushing back and raising questions about whether the keto diet itself is responsible for the improvement in weight and blood sugar or maybe the dieters' successes are due to other components of the research methods, such as lifestyle differences or physiological changes. "First, the studies are too small to make sense of the differences between the groups," says Michael J Gonzalez-Campoy, MD, PhD, medical director and CEO of the Minnesota Center for Obesity, Metabolism, and Endocrinology, in Eagan, Minnesota. And, it's important to recognize that both study teams acknowledge that as exciting as their findings seem,a large,randomized controlled trial is still needed to more closely assess a variety of components that may be contributing to the successes found in both studies before the findings can be recommended to anyone outside the study groups1,2he says. "We recommend against 'dieting',which is invariably a short-termsolution," Dr. Gonzalez-Campoy, tells EndocrineWeb, "and since weight loss may be accomplished by a reduction in c Continue reading >>
Ketogenic Diet And Pcos
PCOS (polycystic ovary syndrome) is a common disorder among reproductive-aged women. Emerging research suggests that a ketogenic or low-carb diet may improve hormonal regulation, weight control and other PCOS-related issues. This article takes a detailed look at PCOS and how carbohydrate restriction combined with other lifestyle changes may be helpful for women struggling with this condition. PCOS was originally named Stein-Leventhal syndrome for the researchers who first described it nearly 100 years ago. It's a common endocrine disorder that typically begins in adolescence or early adulthood and is one of the leading causes of infertility. Up to 20% of women of childbearing age are estimated to have PCOS, including as many as 70% that are undiagnosed ( 1 ). In PCOS, a woman's ovarian follicles fail to release an egg every 28 days as a result of hormonal imbalance: too much luteinizing hormone (LH) and not enough follicle-stimulating hormone (FSH). Therefore, instead of the egg maturing, it remains in the ovary and forms a small cyst. This process is repeated on a monthly basis, alternating between the two ovaries, leading to the formation of dozens of cysts over time. High levels of LH stimulate the production of excess androgens (male hormones, including testosterone), which suppress ovulation. In addition, women with PCOS have low levels of sex hormone binding globulin (SHBG), which normally binds to testosterone in the blood. When SHBG is low, free testosterone rises. Besides interfering with ovulation, high levels of free testosterone can cause symptoms of masculinization. Finally, low levels of SHBG promote insulin resistance, and vice versa. 3 free diet plans to help you kickstart your diet, lose weight and get healthy Recipes, giveaways and exclusive deals del Continue reading >>
Does The Drug That ‘fixed’ My Diabetes Have A Dark Side?
A while back, I wrote about how dapagliflozin revolutionised my glucose control. Almost overnight, I changed from a morbid and morbidly obese failing diabetic to a nearly new fifty-something with a rejuvenated lust for life. My HbA1c returned to normal levels and my retinopathy disappeared. I was advised to stop taking gliclazide as my glucose control seemed to be perfect, and I didn’t want to experience hypoglycaemia. I even stopped pricking my finger to measure my blood sugar. I felt my diabetes was behind me. I had also discovered a low-carb diet I could live with: bacon and eggs, kebabs, lamb chops and steaks with mustard, hummus and delicious cheeses, all accompanied by lots of salads in mayonnaise, and non-starchy veggies. Yumm! I lost three stone effortlessly. It became embarrassing how many people remarked on how well I looked, having been a sickly fat blighter for all the time before. I felt strong enough to take on a big project helping to plan and implement the regeneration of healthcare in my very rural locale. It involved lots of travelling to meet the public and speak frankly to them while thinking on my feet. I attended endless meetings and video conferences where I had to learn the tiresome new lingo of management-speak. All of this was done alongside my day and night job as a resident consultant in intensive care and anaesthesia. Before even six months were up, I began to feel a bit flakey. My memory and concentration were not good. I was having difficulty keeping up with the meetings. I was prone to emotional lability, most noticeably at home, and, most worrying of all, I was drinking too much alcohol to get to sleep. And then I noticed the smells of scrumpy and pear drops in my breath, sweat and urine. Not everyone can detect these smells. My blood Continue reading >>
Why Anyone Will Want To Get Out Of Taking Metformin?
Why anyone will want to get out of taking metformin? I read some are trying to get out of taking metformin, I dont understand. Maybe there is something I dont know? Why anyone will want to get out of taking metformin? I had to battle my doctor for the prescription because my A1C was only 6.1 even do I was low carb for a few years. It took me a while to get adapted, I needed berberine to control the diarrhea and mint teas for the nausea. Why once adapted will anyone want to stop taking it. It have read so many good thinks about it and has so many health benefits some Drs and Life Extension Magazine recommend them for anyone over 40 as an anti-aging, anti-cancer supplement. They say blood sugar regulation goes down with age and that everyone over 40 years can benefits from metformin, since most are mildly diabetics. 1. It can block the absorption of vitamin B12. This is very serious. It is not just a "deficiency" but blocking. It is not even known whether supplementing B12 can solve the problem. B12 is an extremely important and vital nutrient. 2. Reduction of testosterone in men. Real deal-breaker! 3. It does nothing useful in the context of my BG management strategy. The only thing Met is known to do is it causes the liver to "hold" and not dump its stores of glucose. Although there is conflicting data and nothing conclusive, it is believed in some quarters that it may reduce insulin resistance. I have no use for either of these. My objective is to deplete my liver stores of glucose and keep them that way. This requires getting it to "dump" and then not replenishing it. On a ketogenic approach, I want my cells to prefer other fuels over glucose and to accept them. This involves a "physiological" or intentional (diet-induced) insulin resistance. The pathological insulin Continue reading >>
Is Keto The Cure For Type Ii Diabetes?
A keto-compliant salad featuring collard greens and bacon crumbles. Photo courtesy of Brian Ambrozy/FlickrType II diabetes is one of America's most ubiquitousand expensivechronic diseases. Patients often require a suite of pharmaceutical products to manage high blood glucose levels, and the complications that arise over the long term, ranging from loss of vision and limbs to kidney failure and coronary artery disease, strain the resources of patients, their families, and the health care system. The financial strain on insurance companies, employers, and Medicaid and Medicare is even more enormous. A 2013 study in the American Journal of Preventive Medicine put the lifetime direct medical costs for type II diabetes treatment at $124,000 for patients diagnosed in middle age. With nearly 30 million Americans affected by the disease, the American Diabetes Association estimates the national cost of direct diabetes care to be roughly $176 billion per year. But unlike type I diabetes, which is an autoimmune disorder that destroys insulin-producing cells in the pancreas, type II diabetes is a lifestyle disease, and thus reversible. Over time, people with type-II diabetes can be made more receptive to their own insulin, which in turn allows their bodies to effectively clear glucose from the blood without insulin medication. The trick for the vast majority of type II patients is as simple as losing weight. ("The relationship between obesity and diabetes is of such interdependence that the term 'diabesity' has been coined," two diabetes researchers wrote in 2005.) But that "trick" is actually pretty hard. Permanent weight loss without bariatric surgery is practically impossible at the population level. A 2014 study by Kaiser Permanente that looked at incidents of non-surgical dia Continue reading >>
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Ketogenic Diet For Type 2 Diabetes: Does It Work?
Type 2 diabetes is a condition affecting blood sugar levels that can be managed by following a healthful diet and maintaining a healthy weight. People who are obese can reduce their risk of developing diabetes by eating a balanced, nutritious diet. Following a diet that is full of vitamins and minerals and low in added sugars and unhealthful fats can help people to lose some of the extra weight. People who lose 5-10 percent of their body weight can lower their risk of developing diabetes by 58 percent. For people with diabetes or people with pre-diabetes, losing the same amount of body weight can help provide a noticeable improvement in blood sugar. For some people, the ketogenic diet is an effective way to control their diabetes. It has been shown to lower blood glucose levels as well as reduce weight. Contents of this article: What is the ketogenic diet? Foods containing carbohydrates, such as bread, pasta, and fruit, are the body's main fuel source. The body breaks the food down and uses the resulting sugar (glucose) for energy. A ketogenic diet is a high-fat, very low carbohydrate diet. It was initially developed and recommended for children with epilepsy. The diet recommends that people eat 30 grams (g) of carbohydrates or below per day. The goal is to eat 3 to 4 g of fat for every 1 g of carbohydrate and protein. Impact on blood sugar levels Because the ketogenic diet restricts carbohydrates, there is not enough sugar available for the body to use as fuel, so it resorts to using fat. The process of breaking down fat is called "ketosis," and it produces a fuel source called ketones. A ketogenic diet helps some people with type 2 diabetes because it allows the body to maintain glucose levels at a low but healthy level. The reduced amount of carbohydrates in the diet Continue reading >>