Endocrine Abstracts

Dr David Unwin MbChB FRCGP Our GP practice of 9500 people has suffered an eight-fold increase in the number of patients with T2D since 1986. In addition, those affected now develop this condition decades earlier than was the norm back in 1986. A situation replicated all over the developed world. Nationally there are 122,780 children and young adults under the age of 40 years with type 2 diabetes, 1,560 (around 1.3 per cent) are under the age of 19 years. In 2013 our practice decided not to accept this epidemic as inevitable and determined to find novel solutions to this that have resulted in 20% of our entire T2 diabetes population achieving drug-free remission. Saving about £58,000 per year on our diabetes drug budget into the bargain(1). We started with the premise that for most patients a high blood sugar is most often related to something you ate as predicted by the glycaemic index(2) so it seemed logical to cut sugar itself and swap high glycaemic index foods like cereals, rice, potato and pasta with green veg, meat, fish, dairy, eggs, berries and nuts . At 30 months on this lower carb approach, 50% of those adopting this were in remission, also showing significant improvements in renal and liver function, lipid profiles and blood pressure. Over the nine years we have learnt a lot about improving diabetic care for our patients, some of which I hope to share in this presentation.

References

1. Unwin D, Unwin J, Crocombe D, Delon C, Guess N, Wong C. Renal function in patients following a low carbohydrate diet for type 2 diabetes: a review of the literature and analysis of routine clinical data from a primary care service over 7 years. Current Opinion in Endocrinology, Diabetes and Obesity. 2021.

2. David Unwin DH, Geoffrey Livesey,. It is the glycaemic response to, not the carbohydrate content of food that maters in diabetes and obesity: The glycaemic index revisited. Journal of Insulin Resistance. 2016;2016;1(1), a8.(https://insulinresistance.org/index.php/jir/article/view/8/11).