@A DiabetesTeam Member

Yes, you can google the DiRECT Study (Diabetes REmission Clinical Trial).

It was conducted in the UK about 10 or so years back and they are into the multi-year follow-ups now - it was a larger study (few hundred Type 2 participants).

I guess they have enough additional information now that Diabetes UK has adopted most of the findings as their "prescription for lifestyle change".

The authors of the study have quite a bit up on line and there was an article (more condensed) in the Lancet (can google and find that on line if you google lancet and Direct Study).

Boiled down they were trying to see if they could come up with a (prescription) to get newly diagnosed Type 2's into remission.

Their method was, counselling, weight loss accomplished in short order by replacing breakfast and lunch with a meal replacement shake (and then stringent carb friendly meals when weight loss was achieved) and a scaling upward exercise program that started easy and ended up at (I think) 120 minutes a week

What they found was that if you started their program within 3 years of on-set (not diagnosis) and your A1C was never over 7.6, you lost at least 30 pounds (if you could afford to) and you didn't get more than 26% of your calories from Carbs you could achieve remission.

Initially they got pretty high success rates but like many things, patients get tired of "following the rules" and many fell off the wagon. But those that stayed committed were still in "clinical remission" (A1C under 5.5 and not taking meds) in the multi-year follow-ups.

If you kinda read around a lot of the technical information in the study itself or the reports (read the abstract at the start and the conclusions) you will get all the information you need if you want to try "their program".

I didn't follow it to the letter but worked the main points into my own (program) - replaced lunch with a Boost Diabetic Shake for about 10 months when I was in weight loss mode and have continued to follow the 26% of calories from carbs, and it has "worked for me" - never taken a med, A1C is 5.4 (since Feb 2017)

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A Diabete...

@A DiabetesTeam Member Low Carbs does not mean no fruits, maybe in the begining while you bring your diabetes in a more managed area. I now eat small fruits each day. I found 100 g of most fruits is OK for me, even a small clementine of 50 g is OK these days. I can safely eat raspberries. I stay away from other higher sugar content fruits. I do eat mostly berries. It depends what you eat with those fruits. I eat around 100 Net Carbs per day and still manage to eat a fruit for a snack with a protein source. I also eat 5 to 6 times per day but smaller quantities so if I have a fruit it will be a smaller snack, or if I eat a high protein meal with meats then I can take fruit as a desert as meat barely has any Carbs, so insted of adding potatoes or pasta I take a fruit. It is about combination and frequent testing. When I was diagnosed diabetic my A1C was 11.9 and my sugar levels were 17.5 (315) to 19.2 (345), so at first I omited fruits, but once my levels got better or when I get hypos I take a fruit. I pre measure fruits on kitchen scale and put in snack bags and freeze them, less waste and when I feel like having a fruit I stick to the pre portioned bag. If I have hypos I will eat higher sugar fruits, such as grapes which can also be frozen and are actually refreshing to eat frozen, frozen grapes brought my numbers up very well. I am now a retired nurse but the frozen fruit trick I got from working in dialysis as dietician gave this trick for the patients as it was a way to refresh the mouth without drinking fluids as they were fluid restricted patients, frozen fruits such as berries as you suck on them frozen they help you produce saliva and moisten your mouth, requiring less fluid. So freezing fruits can be advantageous. Berries are lower in sugar content. So if you wish to eat fruits or tomatoes etc... try and eat them with high protein such as milk products, or meat or even peanut butter, or cottage cheese and other firm cheese which are lower in Carbs. Over time you will find how much you can eat, but rule of thumb dietician gave our patients was just a handful. Now if you eat breads or pasta or rice or potatoes, then I would not add fruits with those. I do Carbs counting and after 9 months of diagnosis I was able to come off diabetic medications and since 20 months now I manage with diet alone. I eat a 2000 calories per day, but low Net Carbs of 100. It is possible to attain, just have to weight and measure stuff with kitchen scale and measuring cups or spoons.

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A Diabete...

@A DiabetesTeam Member it needs to be a bit of both

Counting the carbs and ensuring you don't consume too many helps with sugar control AND prevents adding any weight in the form of body fat.

But that would simply leave you "weight stable".

In order to lose weight you need to get your body to start burning up some of that stored body fat. The only way to do that is to "burn more calories then you consume" so that the rest of it's calorie needs start to use up that stored fat.

When I was diagnosed my BMI was just on 30 (I was about 230'ish pounds/6'1" tall). I was consuming about 2400 calories a day which was/is the guidance for an "active male" - I worked on my feet, in a warehouse 40 hours a week so considered myself "active" but did need to get my BMI down below 25 to help manage my diabetes if I wanted to avoid meds.

So my first "cut" on the calorie side was to drop to 1850 calories a day. As soon as I did the weight started coming off. That told me that 2400/day was too much but I actually was burning somewhat over 1850/day.

After a couple of months I noted that on some days I was eating as few as 1600 to 1700/day, had got to be losing 5 or so pounds a month steadily so decided to target a lower daily calorie total to accelerate my weight loss.

That worked and within a little under 10 months I had dropped 60 pounds (now BMI under 23) but I was still losing weight and didn't want to "get skinny", plus 10 months of reduced calories was starting to get on my nerves a bit.

Talked with my dietitian for advice and her words made total sense - add back 100 calories a day at a time for a period of a week or two and keep going until either you start to gain weight again or until you hit 2000 calories.

I got back to 2000 calories a day, was holding steady at 170 pounds (BMI 22.8) and have been there ever since (4 1/2 years now).

Since I follow the DiRECT guidelines for Type 2 (which attempts to put you into/keep you in remission) my daily carbs were tied to total calories in (at 26%). So when I was eating 1650 calories a day my carb allowance was 107. Once I moved back up to 2000 calories/day my carb allowance likewise followed moving up to 130 - the max allowed under the DiRECT guidelines.

They (carbs and calories) worked hand in hand to reduce my weight AND manage my blood sugar - one stone, two birds 😀

And that is the total secret to weight loss - eat less then you burn no matter what that number is - you just have to find that number for yourself....

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A Diabete...

thanks i meet with my nurse and dietcian Wednesday hopefully they will get me on the right path i do eat apple for breakfast. Snacks almonds hand ful small hand ful of sunflower seeds shelled, beef stick is another go too not everyday.

I calibrate my metabolism with a standard vegan diet and make some adjustments to add variety so that I am not bored eating the same foods. So, I tend to go to suggest individual calibration based on metabolism and checking with the pinprick method of monitoring BSL.