Why Knowing Your Blood Sugar Level Matters - Latest What Your GP Doesn't Tell You Podcast

GP Dr David Unwin reveals the huge impact that dietary changes have made to his patients' lives

The latest episode of the What Your GP Doesn’t Tell You Podcast - Why Knowing Your Blood Sugar Level Matters is now available on Apple, Spotify and other podcast platforms. And you can sign up to the podcast mailing list at What Your GP Doesn't Tell You, where you can also find out more about the pod. The next podcast episode will be available on Tuesday 19th September.

This week, I am talking to British GP Dr David Unwin, who has pioneered the use of low carb diets in the UK to treat type 2 diabetes, and in 2016, he won the national NHS Innovator of the Year award for his work. His approach has transformed the treatment of type 2 diabetes for his patients and today his surgery now spends £68,000 less a year on diabetic medication than the average GP practice in his area. Through his patients’ experiences, Unwin says he has also witnessed and learnt the huge impact that diet can have on a range of other health conditions too.

10 years ago, Unwin was fed-up, demoralised, and thinking about early retirement. Today, his innovative work in the use of lifestyle medicine has transformed not just many of his patients’ lives but his own too:

One of the biggest issues for medical professionals today is the prevalence of type 2 diabetes, a disease that threatens to crash healthcare systems around the world. Diabetes already takes up 10% of the NHS budget for England and Wales¹ and future projections suggest this figure will rise sharply. Globally, it’s estimated that by 2040, 642 million people could have the condition².

Since he first became a doctor, Unwin has seen a huge increase in type 2 diabetes in his surgery and has found it a deeply frustrating disease to treat. He says despite following the recommended best practice, he was not really seeing any improvement in the health of his patients. Then in 2008, a study called the Accord trial³ was published, this gave the first significant clue that the current treatment for type 2 diabetes wasn’t working:

But everything changed for Unwin on the day a patient with type 2 diabetes came into see him. She told him she had come off all her medication and had gone on a low carb diet. Initially, he was convinced she had put herself at serious risk but when he tested her blood sugar level, Unwin was astonished to find it was normal. After decades of treating patients with type 2 diabetes, this was the very first time, he had ever seen a case of type 2 diabetes in remission.

Almost overnight, Unwin began to completely rethink his approach and during the course of his research found that many other people online - in what was largely a patient driven initiative - had put their diabetes into remission using diet alone. So, he started offering a low carb approach to his patients. His recent paper⁴ reporting the latest results from his surgery, reveals that 50% of type 2 diabetic patients following this diet had put their illness into remission - something unheard of using the standard medical approach:

But as Unwin has continued to treat patients using low carb diets, he has also found this doesn’t just have significant benefits for his patients with type 2 diabetes, but for many other illnesses too. That’s because as our blood sugar levels rise, gradually our bodies have to produce more and more insulin to cope with this, which over time can lead to a condition known as insulin resistance:

With the remarkable results, Unwin and his GP colleagues have obtained, he is increasingly exasperated that lifestyle approaches are not being adopted more quickly in the UK. He argues there is a complete lack of interest from the British government and that rather than considering other factors like diet, drugs are still seen as the main solution.

The charity Unwin set up with colleagues to improve public health through better lifestyle information - that he mentions in the clip above - the Public Health Collaboration, has a website containing further information on this subject. And if you would like to know more about the diet that he uses, you can find the relevant sheet on page 29 in the supplementary material⁵ of Unwin’s recent BMJ Nutrition paper.

Dr David Unwin is a NHS GP. He’s a senior partner at the Norwood Surgery in Southport where he has worked since 1986 as a family doctor. For the past few years, Unwin has been a Royal College of General Practitioners expert clinical advisor on diabetes. As a result of his interests in both better communication with patients and Type 2 diabetes, he was made Royal College of General Practice National Champion for Collaborative Care and Support Planning in Obesity & Diabetes in 2015.

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1. https://www.diabetes.co.uk/cost-of-diabetes.html

2. https://www.diabetes.co.uk/diabetes-prevalence.html

3. https://www.nejm.org/doi/full/10.1056/nejmoa080274

4. https://nutrition.bmj.com/content/6/1/46

5. https://nutrition.bmj.com/content/bmjnph/6/1/46.full.pdf?with-ds=yes