A physician's aim should be to get patients off meds wherever possible.

@Joseph1NJ

Жыл бұрын

If only. I lost hope when I saw the new crop of young GP's still following the old medicate, refer, next, practice protocols.

@Better_Call_Raul

Жыл бұрын

Generally true but some medications have very little side effect. The diabetic medication Metformin is being considered for use for non-diabetics. 🤔 "The use of metformin by non-diabetics stems from some evidence that metformin can decrease inflammation, protect against cardiovascular disease and cognitive impairment, minimize cancer risk and progression, and prolong life."

@charleswhitehead5252

Жыл бұрын

Yes, but it's up to the patient to do his or her part as well. Proper diet, exercise, stop smoking, etc. The doctor can make us aware of all that information but can't make us do it. It's on us.

@farmtigered7605

Жыл бұрын

😂

@jagslab

Жыл бұрын

No, it should be to get patients as healthy as possible and medicate as needed

2.5 years ago, I was diagnosed with Type 2 and my doctor wanted to put me on meds. I did my own research and went keto for 8 months. I lost 70lbs and got my numbers in the normal range. I've transitioned into low carb and have kept the weight and A1C down. It makes me crazy that my doctor didn't even suggest this as an alternative.

@davidhitchen5369

Жыл бұрын

I had a similar experience. My doctor suggested metformin but I said I'd like to try to get it under control by changing my diet. In 3 months I got back down to 5.6 A1C from 6.7 when I was diagnosed. I lost 30lb.

@YamatoForever

Жыл бұрын

The weight lose is what made the difference. It wasn't the keto. You can go on a bread diet and with calorie restriction you'll lose weight and better your A1C. Losing weight is the key. Any reduced calorie diet will work. I've lost 115 pounds and lowered my A1C from 12.5 to 7.4 and not a day on keto.

@greensmoothieparty

Жыл бұрын

My mom is not statistically significant or peer reviewed but her experience has had real significance among her circle of friends and family. Nearly 3 years ago, my 84 year old mother finally had a follow up appointment with her physician which was delayed for months because her doctor has been in charge of treating Covid patients in the hospital and in nursing homes and was not able to meet with her. She had a full blood panel taken for this visit and her doctor was astounded at the progress she had made during the last year. She is now no longer diabetic and she was instructed to stop taking insulin after having been on it for 12 years. Her doctor also praised her kidney function which has never looked better. Also, she couldn't believe that her total cholesterol was only 139, with LDL of 67, HDL of 60, and triglycerides of 82 which is a big improvement for her. According to the Framingham Heart Study, these numbers mean that she is virtually "heart attack proof" as many plant based doctors have noted. Her physician (Johns Hopkins med school grad) mentioned that she is reconsidering the diet for her family based on this experience. She also asked my mom to share her experience with our community after the pandemic. All of these results are exactly what I had hoped would occur. Below is a typical day of eating for her. I plugged her bloodwork test values into the Levine Biological Age Calculator and she has aged minus 15 years during the last 3.5 years. I joke with her that she may be required to give up her Social Security benefits if she keeps going like that. She was able to get off of all blood pressure medications after 3 years, tapering off so as not to over-medicate which is dangerous because it can deprive tissues of necessary oxygen and nutrients. My understanding is that low carb diets are a workaround that do not address the root cause of diabetes which is excess intramyocellular lipids (also fatty liver/pancreas) and the resulting insulin resistance. Excess saturated fats and refined sugar/flour are the most common cause of this metabolic system failure. Unless a person can eat whole food complex carbs again without a prolonged spiking of their blood sugar, type 2 diabetes has not been reversed. Here is the menu for a typical day: Breakfast: Organic steel cut oats with some buckwheat and wild blueberries, raspberries, 1/2 banana, tablespoon of ground flax and ground chia seeds, tablespoon of hemp seeds, organic soy milk, Ceylon cinnamon. Lunch: Green smoothie heavy on the low-oxalate greens (frozen kale or collard greens, frozen pineapple, banana, orange, lemon wedge with rind, organic soy milk, avocado sliver, amla powder, dulse flakes, apple cider vinegar, blackstrap molasses, nutritional yeast, small scoop of hemp protein powder, fresh ginger, medjool date, fresh kale) with a small handful of almonds and walnuts - or - some soup and salad. Before dinner snack: one apple. Dinner: Variety of simple meals including spaghetti, chili, vegetable soup with beans, lintel miso soup with organic tofu cubes/onions/mushrooms/kale, split pea soup with onions/mushrooms/carrots/celery/potato, roasted vegetables (squash/carrots/potatoes), rice and beans bowl with onions/mushrooms/kale/peppers/salsa, organic tofu scramble with onions/mushrooms/peppers/kale/turmeric/nutritional yeast, broccoli, asparagus, green beans, etc. Dessert: frozen banana whip with papaya or strawberries topped some days with a couple of macadamia nuts or a Brazil nut - or - some red grapes. Make sure to include G-Bombs every day for optimal immune system (i.e. - greens, beans, onions, mushrooms, berries, seeds). Avoid most processed foods. Include tofu perhaps twice a week but not more. Stop eating after an early dinner except for a few pistachios before bedtime. Good luck and good health to you and your family!

@oolala53

Жыл бұрын

@@YamatoForeverCongratulations on the lifestyle changes you have stuck to for such a transformation!

@Nicole-xd1uj

Жыл бұрын

@@YamatoForever Congrats! That's amazing. I'm fairly convinced that carbs were the problem for me because when I did glucose testing my numbers would spike after any carb but not after a fatty food. I can tolerate a few more carbs now but my numbers start to rise if I eat too many carbs for too many days in a row. I do think that everyone has different sensitivities so if one thing doesn't work, something else could.

Putting your diabetes remission videos together, it seems these are most important: 1. Lose weight however you can to reduce fat in the liver and pancreas and restore normal function 2. Reduce calories 3. Increase protein to stimulate post prandial insulin release in the pancreas 4. Increase ketones to make the liver stop releasing glucose, either through a very low carb diet, fasting, or possibly taking mct oil or exogenous ketones 5. Reduce saturated fats and increase unsaturated fats for cardiovascular health 6. Increase fiber for insulin sensitivity 7. Exercise as much as you can.

@JoeARedHawk275

Жыл бұрын

I don’t believe in long term low carb. Maybe some forms of low carb, but like keto and similar diets with extremely low carbs from everything I’ve seen just seems dangerous in the long term. Other than that, your comment seems pretty good I will say that this needs more studies and research. As an Asian, I am probably more biased I guess. Perhaps gut micro biome and genetics are better predictors. However, your gut evolves with what you eat, and from studies, eating whole plants has never lead to a decreased life span

@jeffreyjohnson7359

Жыл бұрын

@@margarite60 Nicola Guess talks about ketones suppressing glucose production in the liver, she didn't specifically say mct oil, that was my extrapolation.

@Joseph1NJ

Жыл бұрын

I think #4 was from another channel, unless you can point to it.

@pragooutube

Жыл бұрын

Points 3 and 4 are not necessary apparently, to reverse diabetes, only the others are needed. 😊

@jeffreyjohnson7359

Жыл бұрын

@@JoeARedHawk275 I think extremely low carb is iffy. You have to make sure you get enough vegetables and other plants, and not too much saturated fats. I wouldn't be very low carb if I weren't diabetic.

I went totally whole food plant-based two years ago and all my numbers greatly improved. No longer T2D. But, because I take maeds that lower my metabolism, it's hard for me to lose weight, but still, I have lost 30 pounds in that timeframe. Plus, I've saved over 600 animals from being slaughtered thus far. Who knew that eating just plants could save my life, and the lives of so many animals, and wildlife, and marinelife, and the Amazon rainforest; and the list goes on and on and on. It's a HUGEE win-win!!

@davidr1431

Жыл бұрын

If you had only been eating beef, stopping would only have saved 2 animals in those two years, so credit for not eating a wider range of animals so saving even more.

@Vinegaroon

Жыл бұрын

Nice job OP! Went Plant based myself a few years ago and never felt better.

@cynthiab8404

11 ай бұрын

In 2017 I too went whole food plant based vegan and reversed T2 and also heart failure. My ejection fraction was 25% and now it's normal. I also continue for the animals.

@davedewsnap288

8 ай бұрын

I went whole food plant BASED, with supplements of Eggs (free range) and pasture fed Dairy (not plant exclusive). Lost 20 kgs and normalised my HbA1c. Also gained more muscle, w/o more exercise.

@cathihughes5433

6 ай бұрын

But, what about all the bugs and worms killed during the planting, growing and harvesting?

After a meta-meta-meta analysis of all the nutrition trials in the history it will be discovered that what matters actually is having someone else to cook and provide the right meals to you 😂

@subliminalfalllenangel2108

Жыл бұрын

Yeah, I find the hardest part of how to maintain the diet is to learn how to cook properly.

@michaelcolangelo6383

Жыл бұрын

Yes! We need to bring back some home economics to high schools. Or just cooking skills classes and even through college for those able to go. Bulk cooking is an option so we don't have to cook everyday but we have to learn how to do that too and it can be another obstacle.👨‍🍳

@penniroyal4398

Жыл бұрын

I don’t need anyone to cook for me, I prepare 98% of all my meals. I just glucose tested myself 2 hrs after a meal for 2 weeks and cut out everything that raised my blood sugar too high 😉 I’ll rest in 2 months just to keep an eye on my glucose and as the seasons change and most peoples diets change with the seasons I’ll still keep an eye on my health!

@ddesy

11 ай бұрын

@@daisy91954 you should look into meal prep and batch cooking your meals for the week, saves alot of work

@stechriswillgil3686

11 ай бұрын

There's an English guy called Dr Michael Mosely who has put his type 2 into remission on his 12 week ,800 cal per day diet plan . It helps that his wife is a nutritionist and chef who fixes his meals !

I found this channel after being confused by contradicting advice from Dr Cyrus Khambatta vs Dr Lustig+Dr Fung. I’m vegan. I’d already started tweaking my diet to neither follow either camp but be somewhere in the middle and being more active. This channel gives me courage to carry on with just common sense. My CGM is another valuable tool that is showing me that my interventions are working. This has been the best KZread channel to guide me adopt sustainable approaches to reversing prediabetes and more important use an approach to stay in remission.

I always enjoy your videos, interviews, a lot of info put in an entertaining way. Thanks, Former T2DM individual

Good to see you again, Doc. 😊

Gil, I appreciate your approach and the effort it must take to make these videos. From the way you describe scientific research and concepts, to the level of patience and humility you exemplify. We desparately need people like you to bridge the polarizing gap among practitioners and laypeople in this space. I learn so much from you and and I share your socials with my community. Are you willing to share others you suggest we follow, perhaps practitioners who you appreciate (like Dayspring)? 🤓

@NutritionMadeSimple

Жыл бұрын

sometimes it stuns me how timely viewer Qs can be. it's like we're all on the same wavelength. we just uploaded a video today with my top 10 recommended nutrition sources online. to be released maybe in 2 or 3 weeks :)

@michaelcolangelo6383

Жыл бұрын

Heck yeah! That is cool how that happens. I wanna be you when I grow up. Looking forward to that upload and more!

Doc, like so many of your others another fantastic video! Thanks a bunch.

For any age, especially over 50: I'd place exercise at the top of the list. I know some people who walk more than 2 hours a day. One of them eats pretty bad, has a fairly large waist, but he's 70 with no health problems. I had a knee injury knock me out for 3 months, that's when all my blood sugar problems started. Once I started exercising again everything went back to normal. I do believe in the fat threshold theory, extra body fat around the waist is bound to affect the liver and pancreas. It's possible the exercising keeps the waist/liver fat just low enough to prevent diabetes..but just barely. 5 Days a week I exercise 10 minutes 3x, for a total of 30 minutes, I used the clock face(9 12 3 6 9) to remind myself. I take off Sun/Wed. It takes 6 months to lose at least an inch(5 lbs. of fat) around the waist.

I just love ❤️ your videos. You make it so easy to understand 😊

Nice video, Gil! Looks like a good trial; I hadn't seen that yet.

Hello, Gil! :D Thank you again, for this amazing piece of information! I would be delighted if you would also create a video on resistant starches! Your channel is one of my favorites on KZread, and it saves me a lot of time! Thanks a lot!

Hi . This was very well done, sir. Just knowing that it is done, is a big result. Thank you so much ❤❤❤

Gill, I thank You from the bottom of my heart for your videos. I struggle with metabolic syndrome and have received incomplete information on treatment.

SO GOOD!!! 👏 Thanks for putting together another crystal-clear video with such sensible advice. My only remaining question is whether Virta achieves exaggerated results by masking the symptoms and keeping everyone on Metformin for life no matter what their results were. 🤷

I would really like to see an overcoming IBS video I hope that is still on the radar. Thank you for doing this channel, I'm gonna show this video to my mom with Type 2 diabetes

@johnkenney7987

Жыл бұрын

Here is his IBS video kzread.info/dash/bejne/aqmg26mrYq2_p9o.html

@MichaelGGarry

Жыл бұрын

On the latest research that shows it is a localised allergy for at least some IBS patients? Or just IBS in general?

@NutritionMadeSimple

Жыл бұрын

IBS video probably coming out next Monday! :)

@DegenDavid

Жыл бұрын

​@@NutritionMadeSimpledelivering yet again. Glad to see you're back to posting regularly :)

Dr. Kempner in the 1940s treated T2DM with white rice and sucrose. A few even had the majority of their daily calories from sucrose. Yes, it hinged on restrictred calories, surprise surprise.

Quality content yet again. This applies to so many people. Needless to say this is gold dust. Thank you for highlighting this research 🙏

Great info. I was diagnosed as T2 3.5 years ago. I found a few facebook groups that lowered A1c and fasting glucose levels with diet and exercise. I was very skeptical. But when members posted their lab results that showed improvement time after time, I tried it. Sure enough, I now share my lab results of a 5.4 A1c and 103 average fasting glucose level. On top of that, my lipid panel is ideal and BP is returning to normal. The point that I want to make is that studies can take a long time to complete, sift data, and come to a conclusion. However, seeing results in real-time got me on the road to remission years ahead of recent studies. There had been a grassroots whisper campaign about controlling type 2d for quite a while. I'm glad to see 'medicine' is starting to catch on.

The lack of weight regain is the most questionable aspect of this study - 860 cal/day is *very* low, even for smaller people, so I'm not surprised to see that amount of initial weight loss even when restricting for only 1/3 of the time. However, there are a plethora of studies showing that once you remove an external restriction (without implementing a program afterwards) that regaining that weight is an almost certainty for the majority of study participants. Additionally, the more drastic the original intervention (in calorie restriction/time) the more pronounced this rebound becomes, and 5 day sprints of only 860 calories certainly qualifies. Something doesn't add up here.

@leykimayri

Жыл бұрын

Yeah because once the restriction is removed, people go back to eating carbs, especially refined carbs which must be avoided. However this study was done in China, so maybe people in that study don't live the same lifestyle as westerners do (like having a fast-food garbage in every corner)

@oolala53

Жыл бұрын

I disagree. I think the fact that they were not asked to live in a consistent calorie deficit made it a lot less likely that the mechanisms in the brain that turn on an increased desire for food, and turn off NEAT didn’t get stimulated as much. I think I also if the motivation is a very serious health condition, the stats show that the person is more likely to maintain a changed lifestyle. However, I do actually doubt that after five years, there won’t be a fair amount of relapse. I know they can’t mess with this study, but I think it would be interesting if they asked the people who did the five day protocol, if they would be willing to do that three months at the beginning of each year, and see what happens. Alternatively, if they would do it five days once every three months.

@elephantintheroom5678

Жыл бұрын

Referring after only 5 days makes the body reset its metabolism up to normal again.

Thanks for another great video !

I really appreciate all of your efforts and nutritional presentation! I am about to start nutritional coaching and I know information and positions such as yours would allow for the best unbiased discussions! 🙏🏾

About 15 years ago, my sister (4'11" 170lbs 1 liter of soda per day on several medications) had a stroke. Before she got home, I cleared every carb and every bit of sugar from her house. When she got home I developed a menu for her son to feed her. From the list I worked up, he could choose 2 veg, give her a small piece of meat, and if she ate all that, a small bit of fruit. I talked to him every day to check up on her. He complained that she wasn't eating enough, so I asked her about it. Turns out he was loading up a dinner plate and expected her to finish it. 😂 After a lesson on portion control with my nephew and downsizing portions to enough food to fit on a salad plate, things improved. At her 6 week follow up, she had lost 20 lbs, and the Dr took her off every medication except a blood thinner. After several months (and losing 10 more lbs) she was able to care for herself and resumed cooking and buying groceries. She was addicted to sugar. Literally addicted. Within 3 years she regained the weight and suffered a massive stroke that killed her.

The way I went about it was buying a glucose meter and I began eating individual foods that I normally ate, checking my blood glucose before I ate them and after I ate them. I went as far as researching how long certain foods take to digest. For example berries digest much faster than steak. So I would wait longer to check after eating slower digesting foods. If the food raised my blood sugar over 125 or so, I stopped eating it. Didn't take but a few months to get my a1c to normal levels as well as my fasting number to 100 or less. My a1c is 5.2, down from 6.4. I also began walking daily and light strength training. Went from 269 lbs to 157. Now off if my three blood pressure meds as well as my metaformin. Hypertension, pre-diabetes, and obesity. I beat all three. Mainly due to researching the glycemic index of individual foods as well as the glycemic load of each. Anyone can do it... it just takes diligence. I'm 65 yo

@clownbackpainrick6581

Жыл бұрын

Did I get you right: E.g. you ate that blue berries and they brought your glucose level to 130. Than after this you eliminated blue berries from your diet. Right? Which foods did you eliminate from your diet?

@charleswhitehead5252

Жыл бұрын

Correct ... For example shredded wheat. I'd been starting my day with a bowl of shredded wheat for the fiber content. Checked twice and both times it spiked my blood sugar over 160. Basically all foods that had complex carbs and/or added sugar were eliminated. I still eat around 40-50 grams of net carbs per day but only if they are in whole foods that also contain plenty of fiber. Only oils I use are extra virgin olive oil and avocado oil. That's what I add to food. I take fish oil caps for the omega 3's. Once I got hip to the importance of omega 6/omega 3 ratio I started feeling better. Alaskan salmon, a can per week, chia seeds, and ground flaxseed boosts omega 3's as well. Sometimes I'll skip a meal and just take a tbls of MCT oil. It's all saturated fat though, so ask your doctor before trying it. One last thing. Any time my weight tries to creep back up, especially in the winter, I grab my glucose meter and don't eat my next meal until my blood glucose is down in the mid 80's. Everyone is different I suppose. Lots of factors such as the individual's level of insulin resistance, etc, but using the method of not eating until my blood glucose is in the mid 80's ensures I drop around a safe 1 3/4 to 2 lbs a week. My doctor told me setting the bar at 125 for a glucose reading was a tad strict. So I asked him if it was unhealthy and he said no. So I'm sticking to it for life.

@zhuhaibaker7816

Жыл бұрын

I think if you keep a food log with their macronutrients , most likely you are in lower carbs diet compared to what you were used to ?

@charleswhitehead5252

Жыл бұрын

@@zhuhaibaker7816 Definitely less carbs, especially refined carbs. Before I started eating right, I was eating a lot of fast food as well.

It's all about life style in wich diet plays a crucial role. Thank you so much Dr. Gil !

Superb. I have lost two members of my family to complications arising from T2. At no point was either told about diet and lifestyle changes to treat their condition. Just ever larger doses of medicines which, ultimately, failed to save them.

Thanks for getting such good people onto your channel! It was fascinating to hear some of the theoretical underpinnings of T2D remission/reversal. The protein mechanism fits nicely with a comment made by a Dr in the WFPB community some years ago, stating that protein can cause a large spike in insulin levels.. It'll be interesting to see how each of the different AAs work! I'd love it if you could now get Dr Cyrus Khambata on and see where he (as a nutritional biochemist - and a diabetic!) his strategy fits mechanistically and what the evidence is to support it. Thanks again for, as always, a well balanced unbiased episode.

@tanyasydney2235

2 ай бұрын

Yes it's time Cyrus got on this channel for an interview with Gil!

Very interesting. It’s heartening to consider that even with a rebound effect people who make these interventions and see improvements are reducing or delaying the risks of complications.

@robertusga

Жыл бұрын

Add glp-1/gip and skip the rebound 😃

I love your videos and the effort you put into making them scientifically accurate abd sound, can you also please make a video on alleviating pcos, some of my family suffers with it and id like to know the ways to treat/manage it. Can these same lifestyle changes also help with pcos?

Keep it up the great work

Nice to see this guy grow.

For me the big improvement with just a change in diet is controlling my glucose levels (I'm T2). A low carb, low sugar diet gets my numbers down but I don't necessarily lose weight by diet alone. I struggle with appetite control. If I want to lose weight I have to do some light resistance, light cardio as well. Just enough to make up for some extra calories I eat during the day so I can be in a deficit.

Thanks, Gil Questions: During the 5-day restriction periods, not only were the kcals reduced but the ratios of fats and proteins to carbs changed quite a bit, fat going up and proteins down. Your thoughts on this increase in fats as a percentage of the whole during the 5-day restriction period? Were saturated fats similarly restricted,

A bit strange that the study group was placed on a rather drastic hypocaloric diet of just 860 calories for 5 days, followed by 10 days of unrestricted calories. Wonder what the reasoning was for this rather extreme protocol that people in the real world are unlikely to follow. Not even sure how they got the participants to follow this extreme diet.

@Drgluee

10 ай бұрын

It sounds like they are weening people off calories with the restriction. Say you Eat 2,500 to 3,000 and your not very active, then you are put on 860 for 5 days. Sure day one after the 5 days, you might binge eat past 3,000, but your average after might be 2,400 to 2,900. So cycle after cycle, your uninhibited average may go down to 1,800 to 2,300 or even more an ideal of 1,500 to 2,000. Just what I think, I could be wrong.

@joshgullicksrud3444

9 ай бұрын

I’d say the average Americans diet is rather extreme. How would you reverse that extremity? Idiocracy

@bradturner7678

Ай бұрын

Probably doable when you know its only 5 days followed by 10 days unrestricted.

Low carb down under has been talking about carb restrictions for ages

Woow this is really interesting! Did the participants adhere to the intervention for the whole year??

Great, but they also should measure fasting insulin levels.

Thank you

Love these videos. Reasonable, rational, and address human realities and frailties as well. Awesome! Here's a challenge. I'm caught between a rock and a hard place. I have extremely high cholestrol levels and high A1C levels in the pre-diabetic range. The dietary recommendations seem to be in contradiction. Are there any studies that addresses both of these at the same time?

@arvidlystnur4827

11 ай бұрын

Perhaps you have a genetic predisposition for high cholesterol. Lowering and maintaining weight, while keeping saturated fat below 6 or 7 percent of the total caloric daily intake improves cholesterol as well as decreases diabetes. You may need medication.

Great overview, thanks! I imagine Dr. Guess wishes they had a third arm with the same restrictions but higher protein. The 8% was pretty low, especially when you consider what she discussed regarding higher protein being beneficial for T2D.

@oolala53

Жыл бұрын

The 8% was only for five days a month, a total of 15 days. If I understand Dr. Longo right, that’s because higher protein negates some of the fasting like benefits of the lower calories. I can understand if you might wish that the diet that the people were encouraged to follow in between the short fasting periods could be higher protein. Then again, I can’t remember exactly how much proteins she was recommending. It’s possible that obese people who might be attracted to a lot of ultra processed foods are getting even lower protein and wouldn’t need to raise it by much.😊

@jeff.howard

Жыл бұрын

@@oolala53 I wouldn't really trust anything Dr. Longo says without reading the research myself or getting an expert consensus, but I agree that you're probably right that there might be more nuance to it since Dr. Guess's protein recommendation was not discussed in the context of intermittent fasting. It would be interesting to hear her thoughts!

Blood type diets would be an interesting topic to touch on. I think that your dismantling of the topic would be fascinating.

Another appreciated piece, Dr Gil. Thank you. Note, Look AHEAD and DPP were massive multi-center, NIH coordinated RCT’s of lifestyle in T2D and pre-T2D for which we have decades of follow up. We also have > 3 decades of analysis from Da Qing (Asia based diabetes prevention trial). So this study, while nice, is small and adds little new to what we know (which you essentially said, thank you) - cutting calories and losing weight helps improve insular sensitivity (especially during acute weight loss phase) and provides some “kicking can down the road” of pancreatic beta cell burnout. I do agree that our public health “marketing” of lifestyle to promo the fact that much T2D can be prevented or massively mitigated sucks. Lifestyle change is not a corporate money maker (though it sure could save many self-insured fortune 500 companies in the billions if they got serious!) nor “sexy” (do I make the case that it sure can extend the healthy sex life of individuals as part of the benefits!). If US had taken the opportunity, particular early on in the pandemic, to promo the power of therapeutic lifestyle change for Metabolic Health, who knows how many thousands, maybe even hundreds of thousands of lives, could’ve been saved? Instead, the leader in promoting lifestyle change to mitigate Covid risk?… El Salvador. So which country acted acted more “third world” in regards to public health and safety during a pandemic?

Report published study of virta health on eating keto diet

Sustainability is key for sure. I'e gotten my Hba1c below pre-diabetic ranges over the last year, but I rebounded into the pre-diabetic range this last test. Will have to see if my most recent tweaks will get me back to normal range on the next blood work. Thanks for a look into this study!

@PhysiqueFuel

Жыл бұрын

Do you take any medicine?

@les3539

Жыл бұрын

@@PhysiqueFuel Yes, oral medications.

@PhysiqueFuel

Жыл бұрын

@@les3539 ok, cool, what medication are you taking if you don’t mind me asking? Also, what was your diet like? Did you lose weight? How long did it take for your A1C to lower? Thx

This seems consistent with Roy Taylor's work at Newcastle, yes? But were these rebounds from the effects gradually wearing off? Does that mean the liver and pancreas wore out? You said in this study, rebound happened even though the participants kept the weight off, but did the same thing happen to Dr. Taylor's subjects, or only if their weight rebounded as well?

Dear Dr Ad Libitum, in future, please do your presentations entirely in Latin, without subtitles, of course.

I think it’s first time I see you more excited rather then you know - not believer - I am dealing with 26 years T2D in similar way. I am 57 years old man and I got my life back since November 2021 which I stopped dieting and started changing my lifestyle. No insulin no meds except Metformin no BP no CPAP. Tons of activity and happiness. I got CGM and started to understand how my body responds to food exercise sleep and stress. By managing those four my average 3 months glucose is 115 and time in range between 70 and 160 is %100. No low at all even with 6 hours hike or 50 miles bike. My weight came down from 238 to 190 as well. My point is , it is possible to teach new tricks to even very old dog.

@clownbackpainrick6581

Жыл бұрын

I do not get, what you want to express with your very first sentence. Did you change your diet?

@oolala53

Жыл бұрын

Kudos!

@zhuhaibaker7816

Жыл бұрын

what is your latest Hba1c and fasting BG ?

@m-hadji

Жыл бұрын

@@zhuhaibaker7816 I have CGM and I am not relying on fasting glucose and A1C numbers. My average glucose after 12 hours fasting is around 100 and A1C which can be meaningless 5.4. There are some indicators I am managing my diabetes with them. Like glucose response to food or activity which shows variability and in mathematical term standards division. And most importantly AGP reports. You can search yourself and see how useful CGM is for you. I hope it helped.

I started a keto diet 6 months after being diagnosed with diabetes. Before that, the start of 2021 I was put on meds almost immediately and made to eat 3 meals and snacks all throughout the day to counteract the low blood sugar that the glucophage would create. I took myself off all my meds including for depression and anxiety and have been doing great to this day. From my experience with the health care system, doctors get funded from the American Diabetes Association that promotes a very specific diet that also forces the patients to use medications as well as going down the path of constant blood tests, and eventually leads all patients down the path of kidney failure and dialysis.

The metabolic and bariatric surgical team at the hospital I work at take a holistic approach with the patients they treat. The patients presenting there are morbidly obese, and so the definitive treatment is usually bariatric surgery, however, they also go through a comprehensive workup that lasts several months. They not only meet with the surgeon, but a registered dietician and clinical psychologist. The goal is to both prep the patients for surgery, but more importantly to help them establish nutrition and physical activity habits that will, hopefully, allow them to come off of the slew of medications they are currently on, including their diabetic meds. Honestly, not sliding back into the old habits is the hardest part.

Been a year since I was diagnosed with Type 2 diabetes, it's early enough that I only need metformin 1/day to manage it, but been making some serious lifestyle changes to hopefully reverse it. Annoying thing is the diabetes specialist I'm seeing never mentioned the possibility of reversal, nor did he bother mentioning the statin he placed me on (don't have high cholesterol, but LDL/HDL ratio was poor due to low HDL levels) is associated with an increase in insulin resistance, I had to learn this on my own and I'm glad this study reinforces the possibility of reversal. Fortunately he did order a blood lipid test for my next followup, hoping HDL's improved enough that he eases me off the statin, then next followup I can see what my HbA1C without the possible statin influence, and see where it goes from there.

@jeffreyjohnson7359

Жыл бұрын

HDL and ratios don't matter much, it's the non-HDL cholesterol, or better yet ApoB, that is the best indicator of AS-CVD risk.

@karoshitv7506

Жыл бұрын

Statins have been shown to reduce CVD risk in people with type 2 diabetes and generally outweighs the small increase in insulin resistance that it confers. The thing that typically kills diabetics is not necessarily the diabetes itself but rather the downstream effect on cardiovascular health (Around 65% of people with diabetes die of heart disease or stroke). The diabetes specialist is trying to do you a favor, not trying to harm you.

@blarghmcblarghson1903

Жыл бұрын

​@@jeffreyjohnson7359 While I'm aware of the mechanisms that explain how ApoB is a better indicator, I hesitate to conclude the HDL/LDL ratio doesn't matter; HDL has a role in transporting LDL back to the liver for recycling, so it stands to reason that a poor ratio means the LDL - or rather the ApoB - has more time to float around in the bloodstream and attach to artery walls. Also the labs here don't test for ApoB yet, so gotta work with the tools we're given. 🤷

@stechriswillgil3686

11 ай бұрын

I'm like you. But I think it's a disgrace that we've had to resort to doing our own research online. What's wrong with doctors that they seem to be so ignorant or adopt a one size fits all approach ? I've researched this that much I'm probably not far off being a qualified Endrinologist !

What are your thoughts and concerns on Insulin Resistance and it's being a prediabetes marker? And how accurate is HOMA-IR in asserting a person's IR?

My grandfather has diabetes, and he has worked on himself and his diet a lot. He tells me his HbA1c is much better now. I hope he also can achieve remission.

@zhuhaibaker7816

Жыл бұрын

How long is his diabetes and what diet is he on, Med diet ?

@stellasternchen

Жыл бұрын

Since 4 years. And he is not on a specific diet I think, but he reduced calories by reducing portion size and lost some weight. I don‘t know if I could convince him to do Mediterranean, since he is not a big fan of fish.

@zhuhaibaker7816

Жыл бұрын

@@stellasternchen FYI I have never met any T2D that uses the Med diet to put their diabetes into remission, only prediabetes. When you see the headline of clinical researches done by especially Prof Gardner do take the trouble to read all the finer details of how they carry out the trials and not just the conclusions or headline news from there you will understand what I am saying.

@stellasternchen

Жыл бұрын

@@zhuhaibaker7816 I do read the papers, but maybe I‘ve overlooked something since I‘m not a professional that reviews studies. I‘ll look into it again. I do have to admit that the study I read did not prove that the diets (Mediterranean vs Keto) causes diabetic remission, but good glucose control, and both diets have been proven effective. As far as I‘ve understood, weight loss plays the biggest part in remission, correct me if I‘m wrong. And that you can do on any diet, if you restrict calories. But I try to look at some numbers.

That reduced calorie 5-days sounds very much like Valter Longo’s protocol for fast mimicking diet. Longo calls it periodic fasting, not intermittent. It wasn’t actually 3 months of solid deficit, but actually only three weeks of purposeful deficit. Kind of amazing.

@garydinmore1598

Жыл бұрын

Maybe that’s where they got the idea from! I was thinking the exact same thoughts watching this video

@oolala53

Жыл бұрын

@@garydinmore1598 I wonder if Longo was involved and if they used the ProLon product.

Excellent. The 5 day restriction period is very close to Valter Longo's Fasting Mimicking Diet which a lot of physicians have started recommending to patients. I've done it a few times, and one thing that happens is that by day 3 glucose dropped to 70s and I was in ketosis most of the day. Mentally very clear with plenty of energy. BTW, I had normal glucose and HbA1c going into the fasting and was already on a high quality pescatarian diet (lots of vegetables). Each cycle I would loose a few pounds. Some people combine this with Time restricted eating (See Satchin Panda of Salk and Mark Mattson formally of NIH on benefits of TRE)

Definitely been frustrating over the years telling docs my problem is my diet control/eating and that's where I need help, but instead it's always "uh huh, here's another medication to try for blood sugar". Nothing else ever suggested or even mentioned.

Gil, I have heard some say high protein diets increase insulin resistance and risk of Type 2 diabetes, while others say it improves insulin sensitivity. What are your thoughts on this?

The 5 days of almost fasting looks a lot like Dr. Valter Longo's Fasting Mimicking Diet (FMD). Is there a connection?

I always have dificulties with this idea that a diet doesn't work for everyone. This is not true. All that you can say is that people don't stick to a diet. But the diet itself does work. Like when you travel by car from city A to city B, and you get lost on the way and end up in city C, it does not mean that the car didn't work. The car works just fine.

Loving your search for nuggets of truth from all these variously constructed trials which inherently use and/or depend on so many measurements and metrics. I have been searching for information and/or studies which go beyond the vastly-oversimplified global BMI metric and take into account the highly-varied capacity for individual humans to store excess energy. From example lipodystrophy sufferers with metabolic disorder, to the stereotypical healthy (metabolically speaking) sumo wrestler. In effect, the notion of each of us having a personal “fat” threshold, whether genetic or otherwise. The idea that we have something of a cascading excess energy storing capacity, from subcutaneous to visceral to organ to muscle to worse places as the insulin signal increases. This model would help explain why anybody with D2 or metabolic disorder (who haven’t burned out their pancreas yet) would benefit from losing enough weight to free up healthier excess-energy storage mechanisms within their body, whether for them it means they drop their BMI from 40 to 36, 33 to 30, or say 25 to 22. The important point is that it’s primarily relative, and BMI, while at the coarsest level would relate positively with individuals likely to have reached their personal fat threshold, misses the point and the good news that they may regain significant metabolic health by losing 10% of their weight, and don’t necessarily need to achieve a “normal” BMI. There are some studies on NIH, and occasional online doctors that subscribe to this, but overall I feel like this variable is not taken into account which leads to so many spurious study results. Please debunk or otherwise provide context 😊

Well no kidding. Type I is not Type II. Have always managed my Type II by not doing what got me into the mess ... not overeating, not eating refined flour or sugar, not failing to get some exercise, etc. "Reversed" the problem in 6mos, A1C from 14 to 6, and have been lower since. No medications; piling insulin on top of an insulin excess is detrimental.

Could you please recommend the best up to date textbook on nutrition you know of for a fellow fan and medical student!

I went in remission in 2012 and have been normal range ever since. I initially lost 30kg and have now put back on 10 kg. I decided last week to go back on the direct style diet 800-1000kcal/ day. I must say after the first 2days it's so easy to stick to because there's no hunger for me. I think this is the key. I've already lost 3kg in a week feeling great. I can now squat and get up from sitting with no struggling with just this loss, i know I'll feel great after 10kg. I'm aiming for 75kg at 5ft 11 so I'll diet to 73kg to account for glycogen weight on refeed.

@stechriswillgil3686

11 ай бұрын

But the problem with crash diets is that it's very difficult to stick to them . Transitioning from 800 cal per day to a normal diet of 2,500 ( for a man ) is very, very difficult. Most find they quickly put the weight back on that they lost. It's dangerous to try and survive on 800 cal per day for more than 4 weeks without medical supervision.

Sounds like the 5 day restricted period in the intervention group was following a fast-mimicking diet similar to Longo’s FMD. Is this correct?

@tobitobi5496

Жыл бұрын

Correct. Not exactly the same, but quite similar.

My old doctor, who by now is 80, once told me that " once diabetic, always a diabetic". I called him on it. I am down to H1AC 6.1 - 6.2 range. Granted with medication, but also with exercise AND changes in diet, like no more bread and sweets

I've seen more often studies that show that losing weight is very effective to help against diabetes 2, even for people who are not overweight.

@oolala53

Жыл бұрын

It might be affective, but I would wonder how easy it is. Maybe if they never lost weight before. I lost from the low obese range, which I have gotten to in adulthood, not earlier in my life, down into the normal BMI range, and even into the middle of it, but over a period of years as I aged, my A1c was going up. It’s not in the danger zone yet, but honestly with what it’s taken to maintain my weight where it is, and the few times that it’s gotten lower, the precision to keep it. There is way more Exacting. The closer you get to the bottom part of your setpoint range, the harder it will be. But I’m also not diabetic, so if I were, maybe my incentive would overcome the obstacle.

@zhuhaibaker7816

Жыл бұрын

@@oolala53 what is your A1C is I may ask ?

@elisenieuwe4649

Жыл бұрын

Hmm yes, I don't think it's easy to do for a long period of time. It takes sacrifices. I need to lose some weight myself and it hasn't been easy since I lost the first 5 kilo 😑

“Remission” is such a slap in the face term. You work SO hard and your doctor is like “don’t worry, you’ll fail and it’ll be back”

I have never been given medication for my type 2 diabetes I just reused carbs and fats and cut processed sugar so far I have a fasting blood sugar between 4.9>5.5 mmols. So I am happy with that

Almost like fasting mimicking diet but with higher frequency. Or something in between DIRECT and FMD. (FMD was once a month in the first human trial.)

@michelangelobuonarroti916

9 ай бұрын

I noticed that right away. Looks like the researchers decided to plug in Dr Longo's 5-day FMD with a 2X recovery period. Interesting.

When did the meal delivery end? If it ended after three months, did the data depend on self reporting?

Do you have a video planned about the 'Greens powders' that are popular as supplements these days? Especially the ones with spirulina and chlorella? Are they good for daily consumption? They seem to be jam packed with so many nutrients as advertised.

I tried calorific restriction some years ago and found I could lose about 1-2lbs a week provided I did some good exercise during the week (most days). But the carbs in the diet meant that my energy levels soon crashed and I was often hungrily waiting for the next meal. Recently I injured my leg and whilst waiting for it to heal was told I had to lose weight. So I tried low carb & high fat and never felt hungry and was easily able to lose 16lbs in just a few weeks. My blood pressure has also fallen by 10 points (both systolic & dyastolic). Now that my leg is recovering well I am looking forward to doing some swimming again. Removing bulk Carbohydrates (Grains Pasta & Rice) seems a lot easier than counting calories because the increased Fat satiates.

@oolala53

Жыл бұрын

I’m glad it was for you, but I found that even when I cut carbs, incredibly, I would not feel hungry, but I rarely felt really satisfied after the meal. I did it for months, and I still always wished that I could have more of the texture of the starches. I also wasn’t able to lower my A1c very much, so I have cautiously gone back to more carbs, and I’m concentrating now on lowering LDL, which rose while I was doing my low-carb stuff. However, my cholesterol numbers have been rising as I aged, even though I weigh 45 pounds less than I did 10 years ago. No rest for the weary!

@sharonjuniorchess

Жыл бұрын

@@oolala53 I remember tentatively trying out a coffee with a knob of butter and being pleasantly surprised by the taste and feeling of 'satiety' that I felt able not to eat anything till lunchtime. Obviously disconnecting from Carbs takes some adjustment. My physio-nurse put it quite well when she described low-carb as "having to avoid all the nice things". I understand that it is hard to break from something that underpins every meal you have had but after a few weeks I can honestly say you just get used to it. The fats provide the feeling of being full. The craving is the body wanting to return to Carbs for that sugar spike. Whereas I am chasing the production of ketones and fat burning.

@oolala53

Жыл бұрын

@@sharonjuniorchess Those are not my goals. Best wishes.

@simonround2439

Жыл бұрын

This is exactly my experience. I tried the 5:2 diet a couple of years ago and I dreaded the fasting days. I just couldn't sustain it. Last year I tried low-carb high-fat and it was like a miracle. No hunger, I loved the food and the weight dropped off. I'm a regular runner and my performance had started to deteriorate since I hit my 50s. I was absolutely staggered to find my times returned to those I was achieving 20 years before. I know several people who have reversed their type 2 diabetes doing the same as me. I'd love Gil to interview Dr David Unwin, who is a family doctor here in the UK. He has had spectacular success with his type 2 diabetic patients.

@stechriswillgil3686

11 ай бұрын

I did the same thing but found my lips started turning blue ! My heart rate had dramatically dropped from 89 BPM to 54 BPM in 6 weeks. I nearly fainted after getting up out of a chair. Fat accumulation around the heart can happen on keto diets . I went back to normal balanced diet and things normalised.

Hi can you do a video on PSSD (Post SSRI Sexual Dysfunction)? Europe Medicine Agency recognises persisting sexual dysfunction after discontinuation of SSRIs as does the BNF (British National Formulary - what doctors in UK use to prescribe/check for interactions etc.)

It would be interesting to know how long the responders vs non responders had been diabetic. Or even better, it would be great to know a bit more about their beta cell function.

@rachelsnee8926

Жыл бұрын

Indeed, I know the DIRECT study, a major trial of an 800 calorie diet funded by Diabetes UK showed that the people who lost the most weight were most likely to put their diabetes in remission, but I think they also found that the people who had been diabetic for less than 5 years had much higher rates of success. Which is why health providers should be offering support for this kind of program at the pre-diabetes stage, and not waiting until people have got onto meds and have full blown diabetes.

Changing my diet seems to be working for me. I guess all the health books on nutrition I used to read were wrong. My morning average readings went from 103 to 90 in three months so far. I wish I had known this fifteen years ago.

@clownbackpainrick6581

Жыл бұрын

What books did you read? What did you change your diet? And how lead this to the point, that you consume less (or none) excess calories?

I think many doctors know that type 2 diabetes can be reversed with diet, it's just that they don't believe people will follow the necessary diet and they're right. In my personal career, I'm not a trainer anymore, I've never met anybody willing to do what was necessary to achieve anything, especially on nutrition. People are dopamine pumps on legs and will NOT change if there's not pleasurable alternative, and there's not. I've stopped a long time ago to try to help people with nutrition and fitness, no point.

Interesting stuff... wonder if it's due to the weight loss or the fasting itself

@jacvanderspuy5618

Жыл бұрын

Both probaly

Really wish there was a cure for T2D.

Agree that it wouldn’t work for everyone body, but I wouldn’t say that the intervention didn’t work for 47% of the people in the study group. After 3 months of intervention, other than the 18 out of 36 people who withdrawn medication(17 and 16 of which achieved remission at 3 months and 1 year follow up respectively) there’s also a further 13 out of 19 people who were able to reduce their medications. I would argue that despite not going off medication completely, being able to reduce med is a remarkable achievement as well!

Interesting but I'd like to see this study done with diabetics who have a BMI > 40.

I know I’m making a lot of posts here, but this was a big issue for me for a long time out of fear. But I also remember the woman I knew in a weight loss group that I was in who is much heavier than I was and you had diabetes, lost weight and went into remission and she ate cookies and different kinds of foods that I have eventually removed from my diet. I saw that she was continually grappling with them and over eating, but she still lost enough weight to reverse her diabetes. She never went low, carb, or keto.

Seems to me that long Term support and follow-up is crucial.

Worth taking a look at Dr David Unwin's results with his general practice patients. Practical real-world stuff. There are quite a few videos on KZread. If you are technically inclined the one of his talk given to the Manchester primary care conference is well worth a look.

Yes, agreed - has to become general knowledge

As someone who just stopped OMAD & doing a 48 hour fast once a month, this diet sounds absolutely miserable. Having only 850 calories a day for 5 days would just put me in a mood 😅

@clownbackpainrick6581

Жыл бұрын

Why did you stop OMAD? Did your blood levels or BP show negative signs?

@jongo666

Жыл бұрын

@@clownbackpainrick6581 because of my cholesterol. I was also doing low carb & adding more carbs on OMAD wouldn't work with my blood sugar. The sugar spike was way too much.

@mjgrant1515

Жыл бұрын

@@jongo666 I’ve been IF for 7 1/2 years using different windows. I found OMAD the hardest. I now do flexible windows, the longest (rarely) being 17/7 & the most common being 20/4 with 2 meals. I also found low carb Mediterranean to be the best for my triglycerides, HDL & fasting insulin.

@oolala53

Жыл бұрын

Probably the same mood. I was in when I did things like OMAD. Hated them! I keep trying to convince myself to eat in a 10 hour window, and after all my experiments with different protocols, it’s as if the body goes no way!

Please, can you do a video on prebiotic oligosaccharides and their ability to improve sugar metabolism, including lactose, which means milder lactose intolerance. I found this out by accident when I consumed a sweetener with POS in it and my sugar crashes stopped and my lactose intolerance decreased massively...

This data fits Roy Taylor method. Losing weight. But their personal fat threshold was low so even 24 bmi was too high.

Interesting results. Very surprised this could happen with the amount of carbs eaten. Looks like diets must be individually tailored. Chinese have eaten major amounts of carbs for years though and maybe they’re more carb adapted, so I wonder if westerners would have the same results, especially those from Northern Europe.

The fact that doctors for years in medical school did not learn to use lifestyle interventions, and really help patients implement them not just tell them to do it is one of the reasons people don’t trust doctors. But I saw Longo interviewed once, and he was not very optimistic about anything changing in medical school very soon.

In retrospect I am very annoyed that I was not tested for hba1c as soon as I was obese rather than incidentally when exhaustion from influenza kept me off my bike long enough to get a bad reading. Nor was I told about my high lipid scores. 25 kilos lost I seem to have suffered no lasting ill-effects ,,, At 63 and in near-perfect health, Looking around at my own obese and sick family, I guess I just wasn't on the radar... So much apathy out there, with medics as well as patients resigned to chronic ill-health in later life....

The restricted diet period is very similar to the Fasting-mimicking diet protocol.

I have a 6-pack and I am considered close to obese on the BMI scale. It doesn't seem very accurate.

What i don't hear is that the startind A1C was

Does this mean that some people are just pre-destined/susceptible for diabetes which get set off by food/lifestyle overtime? As soon as the intervention stops they are right back to the start so a cure is really not possible?

I reversed my D2 with intermittent fasting and keto.

@m_m991

Жыл бұрын

Great 👍

@yangtse55

9 ай бұрын

And you plan to eat that way for the rest of your life ?

@jaswats9645

9 ай бұрын

@@yangtse55 5 years now and doing great.

out of everything i have done so far, prolonged water fasting is still the most insane one out of everything, after i did the 10 day one i noticed my psoriasis in some areas were drastically more clear, headaches were less but i wasn't sure, did a 21 day one recently and this one was massive my eyesight was better, my migraines were drastically less during and after only intense exercise made me have them and even then it was half the amount of time and like half as painful, the amount of dead skin was quite a bit less and ofc psoriasis is now mostly gone except for a small area at the back of my head, even this is mostly gone if i don't workout, workouts for some reason especially the more intense or longer they are the worst i get but even so helps, to all those thinking its just the weight loss , no its not i lost 8kgs with just slow calorie restriction and exercise, and most of these issues continued even if they became less of an issue it was to small to tell if it did or didnt get better, no idea what happens during but the more extreme the calorie restriction the faster metabolic issues go back to normal, so i can easily see why 800kcal a day would help more , my guess is 400kcal would have even more effect and when you reach 0 like i do .. well that's the limit you can exercise during to get it below 0 but anyone who does that will probably regret it a lot if its a very prolonged water fast, at the end of the 21 water one i was so weak i wasn't sure i can go up the stairs at my normal pace my legs felt empty and extremely weak, also none of this matters unless you make permanent diet and lifestyle changes, if u eat high glycemic carbs like i did like a fucking idiot not even water fasting will help you much, if your wondering about my starting point i was 160-180 blood sugar for 5hours i would reach 100-110 around 6hours, so i was probably very close to type 2 when i started, most issues related to diabetes i had them probably even more that are not very known like extreme dry skin at night, i would simply wake up and i would feel like i was burning alive but if i took my temperature it was normal or slightly below normal as it should be during the night

@vanessac1965

8 ай бұрын

You have a parasite

Correlating decreased body weight to diabetes remission is like looking at total cholesterol and atherosclerosis. It would be great if they'd measured changes in body *fat* (or even better, visceral fat) because this should be much more tightly correlated with responders vs non-responderd. Also, length of time each participant had diabetes prior to the trial should explain much of the variability, since the longer one has had diabetes, the more difficult it is for the pancreas to resume fully normal endocrine function despite no longer being clogged with excess fat.

@troy3423

Жыл бұрын

This might be a fair criticism if body weight was the only metric used for remission of diabetes. Lower fasting glucose, less medication, and lower A1c all point towards improvement when there is intermittent energy restriction. Do you have data that says long-duration diabetes is associated with delayed recovery of pancreatic function? Cheers.

@davin8r

Жыл бұрын

@@troy3423 the lower fasting glucose, HbA1C, etc are the *result* of the diabetes remission. The reversal of excess fat deposition in pancreas/liver/muscle is the cause of the remission. I'm just saying that measuring visceral fat likely would have helped explain the apparent mystery of the responders vs non-responders.

What does it take to lower insulin levels?

I always feel like being in the control group for these trials is kind of a raw deal.

@someguy2135

Жыл бұрын

It is voluntary. If they planned to make a change in lifestyle to fight the effects of diabetes, they wouldn't have volunteered for the trial. In the case of medications, I would agree with you.

@oolala53

Жыл бұрын

But again, there are some trials where the group being tested show negative effects, and the trial is canceled, in which case the control group never got exposed to anything dangerous.