Benedict Jephcote: Dr David Unwin: Are we blaming salt for what the sugar did?
A diabetes community favourite, Dr David Unwin presents his talk as an ‘old fashioned detective story’.
Who is to blame for a serious condition among the UK and world? Is it salt, or is there another suspect on the loose?
Dr David Unwin, also known as the “low carb GP”, is a GP based in Southport who is helping people at his surgery to put type 2 diabetes into remission through a low glycemic load, low carb approach.
He is founder of the ‘teaspoons of sugar’ graphics, now adopted by the National Institute for Care and Health Excellence (NICE).
In 2016 Dr Unwin was named NHS Innovator of the Year and his approach is now being taught to GPs across the country through the Royal College of General Practitioners.
David presents his talk as part of the Public Health Collaboration Conference 2019 which took place at the RCGP.
An amazing change
Before going in the detective work, Dr Unwin lays out some of background to the investigation. He starts with a predicament facing his own practice as well as many practices round the country. His Norwood Avenue practice in Southport experienced an 8-fold increase in people with type 2 diabetes in 30 years.
“One patient changed that,” he states. “She put her type 2 diabetes into remission and taught me how she’d done it.”
The answer to this was the woman had undertaken to cut out starchy carbohydrate and sugar from her diet.
After much investigation, this led Dr Unwin to collect data within his surgery from other patients who were also keen to try a low carbohydrate approach.
His data shows that 46% of patients with type 2 diabetes, if they choose low carb, went into remission and came off their drugs.
“The improvements in diabetic control were amazing!” he adds.
Dr David dons the deerstalker
With this background laid out, Dr Unwin, or we might say here ‘Detective Unwin’, goes into his investigation starting with; high blood pressure (also known as hypertension).
He outlines how high blood pressure is a condition linked to millions of deaths and yet the cause has been unknown for so long. This hasn’t stopped doctors treating the symptom of high blood pressure with drugs though.
Dr David Unwin asks, “How do you know you’re using the right treatment if you don’t know what the cause is?”
David then takes us through a history of thought on the possible causes of hypertension. Is it ageing? Is it weight? Or salt?
Through this journey, David includes a selection of graphs of patients he’s observed. One of them struck him as significant in the question of whether ageing or weight affects blood pressure. A woman of healthy weight, not elderly (50 years old), yet with high blood pressure.
As detective, this questions the idea that ageing or weight as being a cause of high blood pressure.
Next, the detective examines physical evidence, urine! “When carbohydrates are reduced in the diet, you then wee more to start with, but why?”
What is it that links the urine to blood pressure improving and improvement in swollen ankles together?
With this question, David moves onto salt and, importantly, a specific hormone, insulin, involved in the interplay of both salt and hypertension.
“We have known it for a very long time, and funny it is not talked about. Just odd.” he exclaims.
With this, David reaches the crux of his investigation, “are we blaming salt for what the sugar did?” he asks.
To find out his answer to the question, have a watch through of the video, which is a real treat to follow
What do you think?