PreKure Faculty member and New Zealand Primary Health Care GP of the Year, Dr Glen Davies has, at the time of writing, reversed 124 cases of type 2 diabetes and pre-diabetes. Health coaching is at the centre of helping and supporting people in changing their behaviour, alongside good nutrition, he says.
Glen was interviewed on Radio New Zealand about how he and his team are making a change. Listen to the full interview here, or read the summary transcript below.
Ambulance at the top of the cliff approach to preventing diabetes
Kathryn Ryan: We are welcoming New Zealand Primary Health Care GP of the Year, Glen Davies. Dr Davies has instigated what he calls an Ambulance at the Top of the Cliff approach in Taupō, focused on healthy eating. He established the Reverse Type 2 Diabetes Taupō Group, or RT2DT. It’s said to promote low-carbohydrate and nutrient-rich whole unprocessed foods front and centre and involves training Health Coaches, weekly meetings, and a popular Facebook group to help patients beat diabetes.
In total, Dr Davies and his team have reversed 124 cases of type 2 diabetes, and pre-diabetes. Glen is a member of the PreKure Faculty, a team of health professionals interested in the science and practice of lifestyle medicine.
KR: […] it was one patient who focused your mind on this. Who’d managed to reverse his own type 2 diabetes and said, “what are you doing?” Or words to that effect?
Glen Davies: He’d reversed his type 2 diabetes with a ketogenic diet. I’m sure I’m not allowed to swear on national radio, but he called me useless and he puts six books on my desk and he told me to read them, which I did. And that really changed the way that I’m practicing medicine. I’ve realised that nutrition is powerful, that diabetes is reversible and preventable.
I predict that Health Coaches will become one of the major providers of healthcare and primary care in the near future.
One, because they’re trained in lifestyle medicine. But secondly, because they really know how to bring about behavioural change.
KR: Could you explain a little bit more about the early onset of diabetes and how you know you’ve got it and what it means?
GD: So the test […] is called HbA1C, and basically it’s the amount of sugar that’s stuck to the hemoglobin molecule. If you’ve got low blood sugars, you’ll only stick a little bit, and if you’ve got really high blood sugars, you’ll stick a lot. So, 20-40 is normal, 41-49 is pre-diabetes, and 50 and above is diabetes. We’re seeing a lot of people in that prediabetes range. And what concerns me is that I think doctors need to be managing this much more aggressively. We don’t want it to become diabetes and we want everyone that’s pre-diabetic to go back to normal. And as far as I look at it, it’s actually very simple.
It’s about those pillars of lifestyle medicine – good nutrition, not to ignore exercise, not to ignore sleep, not to ignore mindfulness and breathing. And then I also look at pre-prediabetes. When I see someone that’s carrying their weight around the middle, or they’ve got high blood pressure or high uric acid, I think that they’re in that pre-prediabetes state. And they also need an intervention with lifestyle medicine.
Up [until] three years ago, I thought that diabetes was a gradual progression to insulin injections, to dialysis, to limb amputation, to blindness.
I’ve realised that exactly the opposite is true, that it’s actually very simple to turn it around and go back to normal.
KR: What are we learning about how things like intermittent fasting or particular types of diets can actually return those numbers to normal? There was previously an expectation that once you are a diabetic, you are likely going to be managing that one way or another for good.
GD: Up [until] three years ago, I thought exactly like you’ve described, that diabetes was a gradual progression to insulin injections, to dialysis, to limb amputation, to blindness. And then after [my patient] Wayne educated me, I’ve realised that exactly the opposite is true, that it’s actually very simple to turn it around and go back to normal.
[…] 126 patients at Taupō Medical Centre have reversed their type 2 diabetes or their pre-diabetes now. I’m not a statistician, but I did some maths on that. That’s about a million dollars saved.
The stats are actually 126 patients at Taupō Medical Centre have reversed their type 2 diabetes or their pre-diabetes now. I’m not a statistician, but I did some maths on that. That’s about a million dollars saved. That’s one GP in a little town, Taupō, with no extra resources and no extra funding. It saved a million dollars. The town of Taupō has just so got behind this. Now, every cafe’s offering keto options. You go into Suncourt Indian and Rahul will offer you cauliflower rice instead of rice.
The town’s got behind it. The town’s talking about nutrition. We’re reversing diabetes, and people are feeling so much better. Their joints stop hurting, they have more energy, it’s easy for them to exercise. People can get up and down off the ground easily. They can play with their grandchildren. This is really, really big. […] what I’m hoping will come out of this is that with good nutrition, we actually can make massive changes to many, many people’s lives. And that’s exciting. That’s positive. That’s solutions.
KR: What did [your patients] go through?
GD: […] nutritional advice is a large part of it, but change is not an event. It’s not like an arrow that goes directly from one place to another. Change is more like a tangled piece of wool, isn’t it? Sometimes you go forward, sometimes you go sideways, but eventually people get there if they have the right support. And I think health coaching is the key.
Health Coaches are people who are trained to listen with curiosity. Trained to really understand that person. They’re trained to not judge, they’re trained to find out what the client’s agenda is. Not what the doctor’s agenda is, but what’s important to the client. For example, it might be being able to play with your mokopuna sitting on the ground. It might be to be around for your grandchild’s wedding.
Those are all things that are actually important to people and Health Coaches are trying to actually get to that value, or get to that feeling. And that’s where the change occurs. So, you mentioned at the beginning, I’m a faculty member of PreKure. PreKure is an organisation that trains really high-quality Health Coaches.
I predict that Health Coaches will become one of the major providers of healthcare and primary care in the near future. One, because they’re trained in lifestyle medicine. But secondly, because they really know how to bring about behavioural change.
When I’m talking about keto, a lot of people describe it as a fad diet. It’s actually the opposite. It’s the way that we’ve eaten for 6 million years.
The fad has been this little blip since 1977 when the US Department of Agriculture told us we should be eating 6 to 11 servings of grain per day.
KR: […] how many people are on the [RT2DT] Facebook page?
GD: It’s just hit 3000. So, there’s keto nutritional advice, there’s the health coaching, but then you need the ongoing support, because I’m sure you’ll be aware of this, that particularly with weight loss, a lot of people lose weight and then they gain it again. And it’s that ongoing support that the Facebook group provides. It’s allowing people to keep those changes going for years. Because we don’t talk about a diet. We’re talking about a lifestyle that people keep the rest of their life.
When I’m talking about keto, a lot of people describe it as a fad diet. It’s actually the opposite. It’s the way that we’ve eaten for 6 million years. The fad has been this little blip since 1977 when the US Department of Agriculture told us we should be eating 6 to 11 servings of grain per day.
That’s when it went wrong. You look at just about every health statistic, it goes wrong from about 1980, about three years after they changed the advice.
You might’ve been told that breakfast is the most important meal of the day. I totally 100% disagree with that.
All I’m asking people to do is go back and eat the way that we used to eat. And particularly true for Māori. Māori have only had exposure to the colonial diet for about 200 years. You go back and you look at what Māori were eating before the Europeans arrived it was kai moana, it was birds. There was very little access to carbohydrates. And so I talk about kai Māori and I ask people to go back and eat the traditional diet, whatever that tradition is.
KR: The role of the intermittent fasting, is that part of the process for someone trying to reverse, or does it work for some and not for others, or indeed do some people keep it as a constant, at least part of the week?
GD: Most people who do keto move to intermittent fasting. You might’ve been told that breakfast is the most important meal of the day. I totally 100% disagree with that. Breakfast is breaking the fast. Fasting as when the repair and recovery and recycling occurs. And when you’re in the fed state, that’s when you’re building. So if you’re an infant or a bodybuilder or a teenager, you want to grow. The rest of us, we want to stop growing. So you stop growing by narrowing that eating window. If you can miss breakfast, and maybe have your first meal at midday and your last meal at six, that’s really an awesome way to be eating. A lot of people who are using this form of nutrition to deal with more serious problems like the obesity-related cancers, for example, they might do longer fasts as well as the intermittent fasting.
KR: What of the other supports that you’ve built with other practices in the region? Who else is involved?
GD: [RT2DT] is completely a voluntary group. We just meet each week, and we just support each other because that behavioural change is hard. Carb addiction is a major problem and it’s really just around a group in the community that supports each other. And then they’ve gone out and they’ve become advocates. They assist their family, they assist workmates, they set up little pods within their work. That’s how the message is spreading. A bit like dropping a pebble in a pool, it’s that ripple effect. And I think this bottom-up change is really going to be the solution. I’d love government to say we’re going to put a sugar tax and we’re going to take GST off whole foods, but do you know what I can influence? We can start as a community and we can create that bottom-up change. So that’s what Reverse T2 Diabetes is doing. It’s spreading the message.
I see a huge gap [in healthcare]. I see the NGOs and the government agencies that are really looking at the upstream determinants of health, but then there’s a big, big gap until you get to primary care in our hospitals.
KR: And with tremendous success so far, that reach as we see on the Facebook page, the community events as well as successful cases of actually reversing diabetes and pre-diabetes. If you wanted to see this become the norm, in other parts of the country, what would you say you’ve learned as part of the journey that others can model?
GD: We just started a little peer group that was Wayne, myself and a few others, and we just started meeting weekly and talking about it, and then it grew and it grew, and it grew, and we got kicked out of our fist venue because we had too many people. And then we used Marae because they were a much bigger venue. So I would say, just start with the group of three or four interested people and it will grow, because people see the success, they want the success and it just happens like that.
I see a huge gap. I see the NGOs and the government agencies that are really looking at the upstream determinants of health, but then there’s a big, big gap until you get to primary care in our hospitals.
So what we’ve set up is a health provider, which we’ve called Reversal NZ, where we’re providing keto nutrition, we’re providing health coaching. We’re trying to fill that gap where we’re doing true prevention and we’re doing reversal.
It’s sort of the ambulance at the edge of the cliff. So, that’s another thing that we’re doing, and I hope that that will influence. We’re really looking to partner with iwi around this Reversal NZ programme.
Be part of the change!
Get the world’s best health coach training. At home, from credible medical, nutrition, coaching and wellness experts.