Evidence of pancreatic recovery - a case report using Kraft Insulin Testing
Part 1 of a Case Study from Donal Collins of Barlow Collins in Havant, UK and of Meterbolic.
Mark (who has kindly allowed us to use his data publicly) has just turned 50 and has had the diagnosis of Type 2 diabetes for 15 years. His control of this condition declined gradually despite being exhorted to “eat less, move more”, “adopt a healthy Mediterranean diet” and “eat in moderation”.
Mark joined our coaching program in Havant in the UK 12 months ago when his HBA1C was 96, and his GP wanted to medicate him with gliclazide or insulin. A core goal of Mark’s was to avoid gaining additional weight, and the fact that he had read that these medications might cause weight gain, was for him a red line.
Mark’s measurements were:
And Mark underwent surgery 5 years ago for aortic valve stenosis.
Medication at the time of presentation: Metformin 2 g daily. Atorvastatin 10mgs daily (No ischaemic event, and recently produced a crystal clear angiogram), Ozempic injection 0.5mgs weekly, aspirin 75mg and warfarin as per INR.
Mark commenced a low carb coaching program aiming for 100g per day or less of carb intake, no calorie control, eat until satiety, avoid snacking. When hungry eat until satiety and repeat.
After 4 months we reviewed Mark’s measurements and the HBA1C had come down to 78mMol/mol.
We were pleased about this, but Mark was not! Mark was unhappy that he had put on 1.2kgs. As mentioned, one of his red lines was no weight gain. In addition, Mark was disappointed that his glucose finger prick measures were in their teens (they were in the 20’s). Mark wanted to have glucose measurements in single figures. Despite doing all that we told him, Mark was frustrated. So, we felt that we needed to understand more about the underlying physiology and arranged for Mark to attend our insulin response curve Clinic (Kraft curve).
Mark’s Kraft Curve before his intervention
What you can see in this Kraft response (following a 75g glucose challenge) is that glucose (yellow) goes to the high 20's and 4 hours later remains up at around 20 mMol. However, the insulin response to these high glucose levels is very weak. Our interpretation is that the pancreas is at an exhausted late stage of type 2 diabetes due to insulin resistance.
“In fact, I advised Mark during this consult that his pancreas is like a tired old donkey climbing a mountain!”
This confirmed the conclusion of Mark’s GP that Mark was deficient of insulin production and was the reason for the GP’s decision to add insulin as treatment for Mark. This is in accordance with prevailing and standard professional guidelines.(Mark’s antibodies were measured to test for suspected Autoimmune Type 1 Diabetes and these were negative).
Mark continued to resist to having insulin added to his therapeutic regime.He wanted an alternative option.
We discussed what was happening and suggested that Mark move to one meal a day (OMAD) to give the pancreas as much a rest as possible.
Mark reluctantly agreed, fearful of the prospect of just a single meal in a day but this was still a better a better option for him than insulin treatment.
Much to Mark’s surprise, he was managing with surprising ease on one meal a day and after two weeks his finger prick glucose levels were back in single fingers and his weight gain started to drop off.
“Mark’s lethargy began to improve and his party trick of falling asleep at the dinner table stopped. ”
After eight months, HBA1C was 48, Mark had lost his gained weight and his finger prick sugars were consistently between 6-8 mMol.
Mark noticed that if he slipped and accidentally eat carb laden food, his glucose after rising to 12-14, would rapidly return to his newfound baseline measure. Mark wondered whether his tired old pancreas was recovering some function and asked for a repeat measurement of his insulin response curve.
And here it is.
Pancreatic Recovery! Mark’s Kraft Curve after his invention
The vertical red dotted line at 8.26 shows time of 75g glucose drunk.
Glucose while clearly goes into diabetic ranges not as high as before.
And there now is a fantastic insulin response (green). Though clearly the insulin resistance is not allowing good control of the glucose challenge.
Mark’s measurements taken again:
To improve the insulin resistance, Mark has agreed to a 24 hours fast either once or twice per week and to maintain the current regime of one meal a day with occasional handful of nuts mid-afternoon if hungry.
“I have achieved one of my goals of not needing to go on Insulin, saving the system cost and saving me the risk of side effects from Insulin- hypos and weight gain.”
We plan to repeat measurement towards the end of 2022. Our target for then is to improve insulin resistance and the associated hyperinsulinemia.
