Dr David Unwin on his Top 10 Strategy Tips for HOW Clinicians can successfully embed Low-Carb Nutrition into their work.
Professor Grant Schofield and Dr David Unwin at Low Carb Down Under on the Gold Coast, Australia, 2019.
This advice is straight from the mouth of the smiling assassin himself – Dr David Unwin.
Charming but quietly determined.
1. Case Studies. Firstly, start by documenting with one patient a case study of what you did and the results.
- Additionally, get informed consent from the patient to share their data and story.
- Showcase – ”I am a GP and I have had a case that went like this”.
- Then, Tweet about it and tag Dr David Unwin (@lowcarbgp) and I will retweet it!
- Informed consent means they know that it is going on twitter.
- Also, I always give them a week to change their mind before I publish it.
- Photos are OK as long as patent has consented including a ‘cool off’ period, as mentioned above.
2. Start collecting data. Do an audit of ‘service provision’.
- Then, ask for consent from patients for the sharing of their anonymised data.
- Next, use an excel spreadsheet to store the data. It can automatically calculate the averages for your cohort
Waist circumference; before, after, and difference.
Weight; before, after and difference. And so on.
- Next, make friends with a statistician. All academic departments will have one. They could work out your p values.
- Lastly, reflect. What have you learned?
- I wrote my first paper with just 18 patients.
- You could even publish a case study.
- Next, do a review of service.
- Lastly, ask an academic for help with the stats.
4. Public Speaking
- Do it!
- Next, take a patient with you as a patient expert.
- Also, start with an easy audience.
- Moreover, if you base what you say on your clinical experience you will be fine.
- Lastly, if you can’t get invited to a conference that you would really like to speak at then submit a poster in the first instance.
5. Social media and Twitter
- Just do it!
6. Set up a private google hangout or closed Facebook group just for other clinicians in your area to support each other
7. Don’t talk about FAT
- The Colleges and Cardiologists are still scared of Fat. Instead, say low-carb.
8. Be useful to Royal College of GP’s or other influential groups
- Volunteer to help with things.
9. Read the papers and learn to understand statistics
- Learn what are important academic papers and studies and what are not. Furthermore, I learned a lot about this, and so much else, by subscribing to Zoe Harcombe’s weekly newsletter – worth every penny.
- See my list of resources below.
- Get it and use it. This is software that easily stores your personal treasure trove of academic papers so that you have easy access when you need to defend your position.
We host a peer support group for GP’s wishing to help their patients with low-carb or ketogenic diets. If you’re a GP and want to know more about the group email firstname.lastname@example.org.
Dr David Unwin’s Resources List
- It is the glycaemic response to, not the carbohydrate content of food that matters in diabetes and obesity: The glycaemic index revisited | Unwin | Journal of Insulin Resistance http://insulinresistance.org/index.php/jir/article/view/8
- A simple model to find patient hope for positive lifestyle changes: GRIN. Unwin D, Unwin J. Journal of holistic healthcare Volume 16 Issue 2 Summer 2019. https://bhma.org/a-simple-model-to-find-patient-hope-for-positive-lifestyle-changes-grin/
- Murdoch C, Unwin D, Cavan D, Cucuzzella M, Patel M. Adapting diabetes medication for low carbohydrate management of type 2 diabetes: a practical guide. Br J Gen Pract. 2019;69(684):360-1. https://bjgp.org/content/69/684/360
- Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care. International Journal of Environmental Research and Public Health. Unwin, David J.Tobin, Simon D.Murray, Scott W.Delon, Christine Brady, Adrian J. July 2019 doi:10.3390/ijerph16152680 https://www.mdpi.com/1660-4601/16/15/2680
- Most patients experience a significant improvement in HbA1c after 8 weeks, so more frequent testing may be necessary and the results can be enormously encouraging feedback for your patients. In fact Of HbA1c change toward treatment goal value, 50% is reached in about 30 days. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094338/
- Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report by the American Diabetes Association April 2019 https://www.ncbi.nlm.nih.gov/pubmed/31000505
- The amount of carbohydrate intake required for optimal health in humans is unknown. Although the recommended dietary allowance for carbohydrate for adults without diabetes (19 years and older) is 130 g/day and is determined in part by the brain’s requirement for glucose, this energy requirement can be fulfilled by the body’s metabolic processes, which include glycogenolysis, gluconeogenesis (via metabolism of the glycerol component of fat or gluconeogenic amino acids in protein), and/or ketogenesis in the setting of very low dietary carbohydrate intake
- Consensus recommendations: Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.
- For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic medications is a priority, reducing overall carbohydrate intake with low- or very low-carbohydrate eating plans is a viable approach.
- NICE have endorsed 7 of my teaspoon of sugar infograms as appropriate resources to support their guidance for adults with type 2 diabetes find them via the link from NICE to the PHC here: https://www.nice.org.uk/guidance/ng28/resources/endorsed-resource–sugar-equivalent-infographics-6725426077
- The Royal College of General Practitioners Type 2 diabetes and the low GI diet peer-reviewed, evidence-based eLearning course, written by me is live and can be accessed here: http://elearning.rcgp.org.uk/course/view.php?id=291
- Diabetes.co.uk there is a huge on-line low carb self-help community here for your patients: Low-carb Diet Forum
- My RCGP screencast called Type 2 diabetes in adults: management, Watch free via the RCGP website here. elearning.rcgp.org.uk/mod/page/view.php?id=8734
- Also for your patients – In response to interest from people with diabetes I helped to produce this Diabetes.co.uk on-line, low carb diet program which was launched in November 2015. Over 450,000 folk have signed up to date. It now includes a smartphone App. Find it at; http://www.diabetes.co.uk/lowcarb
- From a cross-section of 5,000 people who have completed the evaluation survey, after 6 months self-reported:
- Average weight loss is 8.4kg (15% mean decrease)
- Average HbA1c reduction at 6 months is 1.1% or 12mmol/mol (13% mean decrease)
- Average waist size reduction of 4.45inches or 11.3cm (11% mean decrease)
- Also https://www.dietdoctor.com/ a clear well organised website with loads of recipes and advice for people with Type 2 diabetes wanting low-carb advice.