Diabetic nephropathy and the lost Swede

Chris over at Conditioning Research forwarded me the link to the PLoS paper demonstrating partial reversal of diabetic nephropathy in a couple of mouse models. This isn't exactly a world shattering finding as anyone with diabetes who is not eating a mildly ketogenic diet probably has shares in dialysis machines or is being grossly mismanaged.

Anyway, the first thing to do with a paper like this is to check whether the authors cited Nielsen's 2006 case report of a human being having their diabetic renal failure halted and partially reversed. I mean, this might be relevant...

They didn't.

The Swedish group simply fixed a patient without a mouse model in sight. They got ignored for their temerity. Shocking to fix a human without the death of a single leptin deficient mouse, but there you go. And it's not so hard to do either............


As a complete aside:

It turned out to be interesting to go back and see where the mouse folks were coming from. They cited this paper.


Here is part of figure 6, the line to follow is the open triangles.





Up to day 84 a high fat diet was fed. As happens so often, the high fat diet is 31.7% sucrose/maltodextrin by weight and (gasp) 20.7% lard.

From day 84 onwards these lazy, greedy porkers of mice were switched to a diet which was 47.5% lard and, utter horror, 19.95% butter. Of course this is not really a high fat diet as it has no sucrose or maltodextrin...

Look at the weight drop to below (ns) that of the mice fed crapinabag throughout........

Obviously this must be the satiating effect of protein, so often cited by idiots as the reason for weight loss of LC diets. Except it's not, the ketogenic mice had the lowest protein intake, 9.5% by weight cf 24% in the crapinabag and HF diets. That is very low in protein.

Here are the actual diets in Table 1:



A far more plausible explanation is that ketosis induces dissatisfaction in these mice concerning their body image due to their obese state so they then started to cut calories and go to the gym every night. Duh.

Now please don't make me put up the fasting insulin levels. Aw, okay, you twisted my arm.

Edit: I noticed that these are the FED insulin levels, we don't get fasting levels in the paper...



No comment.

Peter

Diabetic and hungry?

EDIT from later in the day. I put this comment up on Stan's blog after reading the full text:



Stan, I think we have to note that weight gain post study was almost a kilo a week (average gain 3.1kg in the first month post study) and three patients were clinically diabetic again by this time (a quarter of the participants). Long term there is no hope for any of them unless they keep themselves so hungry as to have a low carbohydrate intake while ever they eat a "balanced diet". Some might do it, the Iron Few... Most cannot live with this sort of hunger. The fact that the rise in insulin was statistically ns should not blind us to the fact this is a product of small numbers and the routine wide SD in plasma insulin levels. The p < 0.05 fall in FFAs says insulin is physiologically elevated and easily explains the weight gain.

And predicts catastrophe.

Peter

END EDIT

House move time again. Glasgow house is sold, time to buy in Norfolk. Not sure how much blogging will be happening and we're moving to a non broadband area. Dial-up here we come, but there will be a garden with room for chickens!


This one will be fun when the full text becomes available. At 600kcal/d this is a low carbohydrate diet in anyone's book. A low protein diet, a low fat diet, it has it all...

My immediate reaction is to ask what a type 2 diabetic of initial BMI 23 would look like after eight weeks on 600kcal/d! Dead skinny? Skinny dead?

Of course even if the diet was 50% carbohydrate it would only be 66g/d of carbohydrate per day. Some one should tell these folks they can do as well on this level of carbohydrate restriction without all of that nasty hunger if they ate some decent fat and protein along side their carbohydrate restriction.

Peter



From the Sky article:


Retired lorry driver Gordon Parmley, from Stocksfield in Northumberland, spent four years on daily medication for type 2 diabetes despite being only 2st overweight.

[and if he had not been overweight at all?????]

The diet worked and 18 months later he is still free of diabetes and does not have to take any tablets.

"It was very tough. I was hungry all the time. It was a starvation diet and food was on your mind all the time," he said.