The Diabetes Challenge

Professor Roy Taylor’s diabetes diet and what went wrong for me

April 8, 2020 By Sue Moseley

If you’ve been following my blog you’ll notice things have been quiet since last July when I weighed up the results of my 8-week attempt to cure my diabetes using the principles of Professor Roy Taylor’s research. I followed his principles, not his method. I am pretty confident people would not run into these problems, if they used his method of nutritionally balanced meal substitute milkshakes. I stuck to the caloric restriction of 5,600 calories per week in the hope of reducing my body weight and in particular my visceral fat to a point where my insulin response became normal. I did this using a ketogenic, plant-based diet, plus supplements, in place of Professor Taylor’s milkshake alternative, which I think would be hard to stick to for most people, and for me, impossible unless there was a dairy-free equivalent.

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Improvements

I made overall improvements in my stats, including fat levels, bmi, weight, resting heart rate, and my blood sugar management was great, however I was completely disappointed to discover that my body’s ability to handle carbs hadn’t improved at all. A high-carb meal still provoked unacceptably high post-prandial blood sugar levels. I still believe though that Professor Taylor’s research holds a key to curing type 2 diabetes. I do think that if I can get my visceral fat down low enough my insulin response will return to normal and I haven’t given up on proving that yet. However I’m no longer going to try and achieve this using the drastic methodology of my 8 week experiment, and here’s why:

Unexpected complications

I was taking some supplements during the very low calorie phase, to make up for any nutrients I may be missing due to the severely restricted caloric intake. I thought supplementing would easily cover my nutritional needs, but I was wrong.

Because of the drugs I take for the Rheumatoid Arthritis I have regular blood tests and at the end of the 8 weeks my blood tests flagged a potassium deficiency. My hair also started to fall out in handfuls – masses of it every time I brushed my hair or took a shower. Clearly my body did not get sufficient nutrients to function properly as a result of what I was doing and so I don’t recommend that anyone should attempt to do what I did. Less drastic action, that is sustainable over the long term, is a better way to go in my opinion. I still consider fasting to be highly beneficial, the problem of nutrient depletion came from my sustained low-calorie intake over a period of weeks, which is the typical method of many weight loss diets. Short fasts and time-restricted eating, where I ate sufficient calories but limited the amount of time in a day when these were eaten did not result in the same negative consequences, and only bought me the beneficial results of less pain, more energy, more mental clarity, improved vision, lower CRP levels and lower cholesterol levels.

Why did I become potassium deficient?

I hadn’t really appreciated how much I needed to increase my electrolyte intake when on a very low calorie, ketogenic diet. When you’re in ketosis your body flushes out more electrolytes than it would when eating carbs. Advice given to ‘cut salt intake’ is based on people eating carbs, which cause you to retain excess salt and that results in water retention. When you get into ketosis you’ll notice all that excess water in the body goes away and that’s because you are no longer holding onto the electrolytes, including salt, therefore you actually need to add salt to food if you are in ketosis. I was losing potassium due to being in ketosis and I was not eating enough potassium in my diet because of the caloric restriction; I realised after I became deficient that the multivitamin and mineral tablet I’d been taking didn’t actually have any potassium in it at all. The diuretic drug I am on for high blood pressure also causes electrolytes to be flushed from the body, a problem I was aware of due to becoming magnesium deficient a few years earlier, but I hadn’t really thought about as far as potassium intake went, so I’d assumed all my minerals were covered by the supplement I was taking.

Every cell in your body needs minerals to function. Picture of Himalayan salt.

Hair loss

My hairdresser agreed with my assumption that the hair loss was caused by the nutritional deficiencies of my diet. He gave me some products to stop the hair loss, which I’m greatly relieved to find actually work and suggested specific nutrients that I might be deficient in. I have seen bloggers claim that hair loss on a ketogenic diet is normal and part of the process of the body adjusting and will correct itself in time. I disagree. It’s a result of not getting enough nutrients and the diet needs adjusting in my opinion. Using a site like www.cronometer.com to track your nutritional intake will help you to see which nutrients you might be short of, but bear in mind that if you’re in ketosis you may need a higher intake of electrolytes than indicated.

Conclusions

I’m pretty much back to where I started and I’ve regained all the weight I lost. I don’t know what my current V02 Max readings are – due to the lockdown I’m spending most of my time indoors, and I have, in recent months had a few mild episodes of tachycardia again, which my Apple Watch alerted me to, and a mild angina attack. These have given me the motivation to get back on track with exercise and diet. A series of serious illnesses and injury in my family, plus my involvement in a business start-up have meant that diet and exercise took a back seat in my priorities for a while and I’m now reaping the results of that. Without health I have nothing and I’m no good to anyone if I’m dead, so I’m starting over. Being out of ketosis makes me feel constantly hungry and craving carbs, which makes it quite a challenge to be strict with my dietary choices, so burning off the sugar stores and getting back into ketosis (with plenty of electrolytes) needs to be high a priority for me. Starting over is tough though, especially as we are now in the midst of a pandemic which puts restrictions on my diet and exercise choices.

The real test is not whether you avoid this failure, because you won't. It's whether you let it harden or shame you into inaction, or whether you learn from it; whether you choose to persevere - Barack Obama

Maybe you didn't reach your goals last year. Don't let it stop you from trying again - Sue Moseley

The results are in from the first 8 weeks!

July 9, 2019 By Sue Moseley

The first 8 weeks of eating low to moderate amounts of carbs, one meal a day during the week and fasting at weekends, while sticking to 5,600 calories a week are over. Has my ability to process carbs returned to normal yet? Sadly no, not yet. However I’m not giving up hope of that happening, and here’s why I thought it was unlikely to happen in 8 weeks anyway:

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Professor Roy Taylor’s research

In Prof. Taylor’s study, the participants weren’t as heavy as I was when starting this, they were about the weight I currently am now, so it would seem logical that if they were diabetic at this weight, why would dropping to this weight resolve my diabetes? Also, only the participants who had been diabetic for less that 5 years saw their diabetes resolve in those 8 weeks. Although I’ve been diagnosed for less than 5 years I am certain I have had diabetes for longer than that. His trial only lasted 8 weeks and I have a hunch that if he’d carried on for much longer he would have seen even the long term diabetics resolve their diabetes. This is a mere hypothesis of course, but one I would like to prove to the point that a longer-term research study is justified.

So what are the stats?

Before eating, my blood sugar was a very healthy 4.6. This was a huge improvement on my baseline blood sugar level 8 weeks ago when I started this, which was 8.3. My ketone level was 2.8, showing that I was maintaining ketosis eating the food I’ve been eating and eating one meal a day. The idea that you can’t eat most vegetables because they ‘are not keto’ is a myth and an unhelpful myth at that because it makes it so much harder to stick to a vegan diet and do keto if you believe you have hardly any food choices open to you. Just cut the starchy food and limit the number of meals you have and it’s a cinch to stay in ketosis. It’s being in ketosis that matters, not the carb count.

Large Vegetable Deluxe, hold the mayo, add ketchup, with Diet Coke

I had the same high carb, highly processed meal as last time, with the deliberate intention of provoking a spike in blood glucose. If my body can handle this and have me back to normal blood sugar levels, two hours after eating, then that is a win for me – diabetic no more!

After eating so many delicious, filling and healthy meals over the last 8 weeks, eating this was remarkably disappointing. Many of the meals I’ve been making took less time than it would have taken to drive to McDonald’s, wait for the meal, and drive back again. They were cheaper too. The moral of the story is this if you want fast, delicious, cheap food … eat at home! Having an Instant Pot helps with the speed part.

One hour after eating

One hour after eating things were looking promising! My readings from last time led me to think that this would be the highest reading. My one hour reading last time was 14.8 and it went down from there. Last time the rise in blood sugar at one hour postprandial was 6.5 from the baseline and this time it was 5.4. I was beginning to get excited at this point!

Two hours after eating

OK, not what I was expecting at all! It’s gone up instead of down! I have no clue why. Last time my reading was 11.2 at this point, so I’m worse this time around!

Three hours after eating

It’s coming down at last, but it’s still higher than last times reading of 7.5 at this point.

Four hours after eating

Still too high after 4 hours, and still higher than the 6.0 last time at the same time.

My conclusions

I’ve clearly made no progress in these 8 weeks as far as my ability to handle carbs is concerned, even though on a day to day basis I am maintaining very healthy blood sugar and ketone levels. I am maintaining these through my dietary choices and fasting lifestyle and not because my pancreas is improving or beginning to function normally again. I’m not conceding defeat yet though. Onwards and upwards!

I have benefited in terms of overall health over these 8 weeks though. My weight has dropped by 12.6 kgs (almost 28 pounds, or 2 stone), my BMI has dropped from 40.7 to 36.2, my waist is down from 116 cm to 102 cm, body fat percentage is down from 55.5% to 52.3%, skeletal muscle percentage is remaining the same at 20.7% (although I am feeling stronger) and my visceral fat has dropped one point down to 12 from 13. I believe this is the key metric for resolving my diabetes. I expect to see some improvement in pancreatic function once it drops below 11, but not a full reversal of diabetes until it’s at least as low as 9.

I am exercising every day now and my Apple Watch makes a great data-driven personal trainer. I have been closing my rings daily for the past month and getting up at 5 am most days to work out. I am competing with my daughter on the Apple Watch, so even if we can’t work out together in the same place at the same time I still have the exercise buddy element to keep the motivation up. The exercise has made noticeable improvements to my heart. At one point I had a resting heart rate in excess of 120 all the time and was diagnosed with super ventricular tachycardia, though apparently not the kind that can cause sudden death (phew!). I worked out that was caused by one of the RA drugs, which I have since stopped. My heart rate dropped but it was still a bit too high. My resting heart rate today is 54, down from the 72 it was at 8 weeks ago. My heart rate variability was a healthy 65 yesterday (healthy for my age, in case any athletes are looking at this and thinking that’s pathetic). Earlier in the year, my HRV dropped to 7 after a particularly stressful situation happened. I felt really ill at that point. My VO2 Max is also improving, up from 18.52 back in December when I had huge difficulty in completing the 20-minute outdoor walk necessary to get a VO2 Max reading, to 21.14 yesterday when I easily completed a 1-hour outdoor walk. For my age 18.52 is considered ‘poor’ and 21.14 is considered ‘fair’.

Fasting glucose – my DIY method

May 12, 2019 By Sue Moseley

My own GP no longer carries out fasting glucose testing, instead, relying on the HbA1c test to indicate if a patient is diabetic. The HbA1c test will show an accurate picture of a patients blood sugar levels over the previous 3 months (providing they don’t have any inflammatory disease as mentioned in my previous post), but it will not show how the patient responds to carbs in a particular moment in time.

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Why does this matter?

Well, if all that matters to you is good blood sugar control, then it doesn’t matter, but if you’re looking for a cure for diabetes and not just good blood sugar control, then you want to know whether you’re having a normal insulin response to food or not, and you can’t rely on the HbA1c test for that. If you go on a low-carb diet, which I highly recommend if you are diabetic, then you could be getting a good HbA1c result, but still have an abnormal insulin response to food. For example, you can have your blood sugars under control for months because you’re eating low-carb, but then eat some rice or potatoes, test your glucose levels and find that they are sky high and take hours to come down, showing that you are still very much diabetic, even if your HbA1c test gives readings in the normal range.

My DIY method

When you take a fasting glucose tolerance test, you have blood drawn after fasting from the night before, to get a baseline blood glucose reading. Then you’re given a drink containing a specific amount of glucose, and then an hour later more blood is drawn, from which they can gauge how your body has responded to the glucose. So what I have decided to do before starting my diabetes challenge is to eat a high-carb, highly processed and refined meal, testing my blood sugars before the meal and every hour after for 4 hours, to see how my body responds. I intend to repeat this test every 8 weeks and compare the results. If I can cure my diabetes, then my tests should show improvement over time, eventually culminating in a completely normal response to the carbs. When that happens, I am cured, and not just merely maintaining good blood sugar control.

McDonald’s!

So, my source for my highly processed high-carb meal is McDonald’s. The McDonald’s app makes it easy to work out how many calories I’m getting (around 800) and having a set meal allows for consistency at every testing. In the week before I started my diabetes challenge, I ate at McDonald’s and tested my blood sugar before and after it. I had a large vegetable deluxe meal, holding the mayo, and adding ketchup, with a diet coke. This was it:

Vegetable deluxe meal, hold the mayo, add ketchup

My reading before eating the meal

This was in a fasted state from the day before, so too high to begin with.

1 hour after eating

2 hours after eating

3 hours after eating

4 hours after eating

Still too high!

I was hungry and didn’t want to carry on testing to see how much longer it was going to take to get back to normal. I was hungry even in the first hour after eating. Eating highly processed, high-carb food is not filling and seems to make me crave more food.

This was a useful exercise to give me a snapshot of how my body is currently dealing with carbs, which shows clearly that my body can’t cope with them at all well. I’m looking forward to seeing this change over the coming months.

First week’s results

May 12, 2019 By Sue Moseley

Although I have lost 2.1 kgs (4.6 pounds) this week and dropped my BMI by 0.8 my body fat percentage has increased by 1.1 to 56.6% and my skeletal muscle percentage has dropped 2.0 to 18.7%. My visceral fat remains the same at 13 and I can’t measure my waist having lost my tape measure (I’ve just ordered a multi-pack of them, so hopefully this won’t happen again). Update: I’ve found my tape measure and sadly haven’t lost a smidgen on my waistline.

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So it looks as though the weight loss has been water and muscle. The water loss is noticeable around my ankles, but the muscle loss is disappointing. I am however now in ketosis, with a reading of 3.1, so hopefully, if I maintain a ketogenic state the fat burning can begin in earnest. This coming week I will try to increase my protein intake through green juices and beans, and increase the amount of exercise, specifically weight-bearing exercise to see if I can stop the muscle loss for future weeks.

Ketosis is the state where the body is using ketones for fuel rather than carbs. If your blood sugar is at normal levels this is completely healthy, if however you have high blood sugar levels and are in ketosis, this is a life-threatening emergency called ketoacidosis and generally only happens to type 1 diabetics, or some type 2 diabetics who are on certain drugs that can cause this as a side effect. My blood glucose reading this morning is a very healthy 4.5, so I have no worries about ketoacidosis.

That is perhaps the biggest win from this week. My morning blood glucose reading has dropped from 7.5 to 4.5, which is pretty awesome!

What is diabetes?

April 26, 2019 By Sue Moseley

There is more than one type of diabetes and although they carry the same name they have very different causes and/or outcomes.

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Type 1 diabetes

Type 1 diabetes is an autoimmune disease where the body attacks the islet cells in the pancreas that produce insulin, resulting in the body not producing enough insulin. Because there is not enough insulin to control blood sugar, blood glucose levels can rise very high. Without injectable insulin, these patients will die. Currently, there is no cure for type 1 diabetes, but there is ongoing research into stem cell transplantation, which looks promising.

Type 2 diabetes

In type 2 diabetes there’s an abundance of insulin present as the body tries to compensate for high blood sugar levels by pumping out more insulin to try, unsuccessfully, to pack the excessive amounts of blood sugar into cells that are already saturated with sugar. This inability of insulin to get sugar into cells is known as insulin resistance. When insulin levels are high the body will not burn its own fat for fuel, this results in weight gain, increasing visceral fat levels, a fatty liver and fat in the pancreas. The fat in the pancreas prevents the hormone-producing cells from functioning normally. Unless this pattern is interrupted, there will be an inevitable decline in health over time as every part of the body is subjected to sugar damage. Treating type 2 diabetes with insulin does nothing to deal with the root cause of the problem. What is needed is not more insulin, but less, so that the body can lose the fat that is causing the abnormal hormonal response to food. In order to have lower insulin levels, there needs to be a lower intake of sugar or foods that turn to large amounts of sugar once eaten, in other words, sugary foods and high-carb foods such as starchy vegetables, grains and some fruits. Refined and processed foods are often among the worst offenders.

It is possible to be type 2 diabetic for years and not be aware of it, meaning that sugar would start causing damage to your body long before you have symptoms bad enough to make it obvious there’s a problem. You can also be in a prediabetic state for a long time – not quite full-blown diabetes, as determined by the guidelines given to doctors, but still, high enough levels of blood-sugar to be causing long-term damage. So, even if you’ve not been diagnosed diabetic there is good reason to be aware of the damage that can be caused by eating a high-carb diet. If you are gaining weight steadily and find it hard to lose weight, you need to pay attention to your blood sugar levels, because you could be prediabetic or even diabetic without knowing it. Visceral fat is the real problem as far as weight gain goes and it is possible to have high visceral fat levels while looking slim on the outside, and it is also possible to look obese on the outside but have normal visceral fast levels – so weight gain should be taken as a warning rather than proof of diabetes. Blurred vision was one of the first symptoms that made me think I had diabetes. I also realised other things were happening, like massive weight gain and oedema, but I went undiagnosed for a long time because I had normal HbA1c readings. It is apparently not common knowledge yet among medical staff that inflammation causes an abnormally low HbA1c result, which does not accurately reflect blood sugar levels during the previous 3 months, which means that many patients with inflammatory diseases are quite possibly undiagnosed and therefore untreated diabetics. My next blog post will be about this dilemma because I find the situation quite upsetting. By the time I was diagnosed, I already had retinopathy and peripheral neuropathy (I was initially told that was just a trapped nerve – obviously it wasn’t, as it spread to all four limbs). There is no excuse for not disseminating crucial information like the ineffectiveness of the HbA1c test for patients with active inflammation to medical staff when so much is at stake for the patients affected.

Symptoms of type 2 diabetes

There are a few symptoms, which are potential indicators for type 2 diabetes. Obesity is generally considered a cause, not a symptom, but I disagree. It’s a chicken and egg argument, but in my opinion, the early changes (long before diabetes would be officially recognised) start the cycle of weight gain, and therefore obesity should be regarded as both a symptom and a cause. Other symptoms can include weight loss, blurred vision, needing to get up in the night to urinate, feeling tired, impotence, weight gain around the middle (again generally referred to as a cause, not a symptom). Many of these could easily be mistaken for general problems with ageing, but that’s because many older people have a problem with blood sugar control and are unaware of it. Type 2 diabetes is most common in the middle-aged and the elderly, so these aren’t symptoms of ageing, they’re symptoms of type 2 diabetes. Cure their diabetes and these problems will go away.

Type 3 diabetes?

Researchers at Warren Alpert Medical School at Brown University, in Rhode Island, USA, have found that insulin resistance can happen in the brain, leading to speculation that Alzheimer’s disease is actually type 3 diabetes. It’s already known that type 2 diabetics are at a 50% to 65% increased risk of developing Alzheimer’s disease (source: www.diabetes.co.uk) and that many type 2 diabetics have amyloid beta in their pancreas, similar to the amyloid plaques found in the brains of Alzheimer’s sufferers. There is currently no solid proof as far as I’m aware that Alzheimer’s is type 3 diabetes, but given what is known for sure, maybe it’s time to take a much stronger stance over sugar, starches and processed foods if we want to hang on to our minds in old age.

Further resources

An excellent resource for diabetics is www.diabetes.co.uk This has input from Doctor David Unwin, a British GP who has been using a low-carb diet, very successfully, with his diabetic patients. A side note: David was originally banned from the site because he was ‘handing out advice like he was a doctor’ – he responded ‘but I am a doctor!’ They were surprised that a doctor would take an interest in what they were doing. Of course, once they knew who he was, they welcomed his support on the site.

What’s the plan?

April 24, 2019 By Sue Moseley

Given that I’ve managed to get rheumatoid arthritis and asthma into remission, stopped acid-reflux permanently, reversed retinopathy and made an almost complete recovery from peripheral neuropathy, you might think it strange that I’m going to start the blog off by devoting the coming weeks to something I haven’t yet been successful with – curing type 2 diabetes. I’ve made some progress, learning how to maintain good blood sugar control, but I still sometimes fall off the wagon dietary-wise, and it’s not a cure; I still don’t have a normal hormonal response to food.

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So why am I doing this?

Right now my health needs are to focus on losing weight and curing diabetes. I will be making a lot of changes, so I might as well document these as I go, along with the outcomes of these new life choices, and hopefully, this will help others facing metabolic diseases. I’m mentally ready to do this now; it will take an enormous amount of discipline and self-control and I feel able to commit to this now.

Sticking to a plant-based diet and daily time-restricted eating has been critical for conquering my RA and pain has been the motivator that kept me on track. I would have caved in to my cravings for cheese many times if it wasn’t for the fact that I knew I’d be in extreme pain if I ate even the tiniest amount. Having something that keeps you on track when you feel like caving in makes the difference between success and failure, so going public with my plans to cure diabetes will bring accountability that will hopefully provide the motivation I need on the days when I just want to cave in and eat. Those days will inevitably come, they always do; tiredness, emotional upset, running out of the right food, just not fancying a green vegetable juice, not feeling in the mood to cook, all sorts of things will heckle from the sidelines and try to get me to quit the race. Photographing everything I eat, knowing that people will see absolutely every bit of food I consume will force me to stick with this plan and keep going until I have reached my goal. My goal is a complete cure from type 2 diabetes (determined by a normal blood sugar response to eating a high-carb, processed meal), a BMI of 24 or less (currently 40.7), a body fat percentage of 30 or less (currently 55.5), a waist circumference of 89 cm (35 inches) or less (currently 116 cm), a visceral fat level of 9 or less (currently 13) and a skeletal muscle percentage of 30 or more (currently 20.7).

Metric	Current – May 2019	Target – October 2019
BMI	40.7	≤ 24
Body fat %	55.5	≤ 30
Waist circumference	116 cm	≤ 89 cm
Visceral fat	13	≤ 9
Skeletal muscle	20.7	≥ 30

I know that it’s entirely possible to get type 2 diabetes into remission and maintain it with a low-carb diet and fasting, the work of many low-carb doctors, endocrinologists and fasting experts have demonstrated that, but the work of Professor Roy Taylor, of Newcastle University in the UK, demonstrates that a complete cure is possible for some patients by using a radical reduction in calories for a period of time, resulting in a rapid 10% decrease in body weight. It is of course still possible for the patient to get type 2 diabetes again in the future if they increase their visceral fat levels. Monitoring weight regularly and taking swift action when there is weight gain will prevent this from happening.