Low-carb case report: Patrick

*TT = waist circumference

Patrick is in his 40’s and has been my patient since November 2016. He came to me with a diagnosis of type 2 diabetes and was overweight.

Within a few weeks, I diagnosed and started treating Patrick for hypertension, gout, and dyslipidemia. I also suspected sleep apnea and fatty liver.

Medication: Viacoram (combination of amlodipine and perindopril) 2.5+3.5mg, Metformin 500mg TID, and Januvia 100mg.

At that time, I was personally eating low carb, and I had just completed my training with Intensive Dietary Management. But I wasn’t ready to start giving it to my patients as a therapeutic option.

So, I sent Patrick to see our clinic’s diabetes nurse. She is paid by pharmaceutical companies to help us optimise our diabetic patients’ medication. This is standard treatment.

In February 2017, she suggested we replaced Januvia with Saxenda if his insurance covered it, so that the patient would lose some weight and get better control on his blood sugar levels. His insurance, however, did not cover it, so we gave him Victoza instead.

February 2017 is also the month I launched my low-carb clinic, Clinique Reversa.

In April, Patrick saw the nurse, and she was satisfied with his blood sugar levels and blood pressures, so I didn’t even see him.

Towards the end of the month, he had a very debilitating gout episode. He was used to having episodes every 3 to 6 months.

In May, I did a follow-up for his gout. I seized this opportunity to discuss eating habits, and their relationship with certain chronic diseases, like type 2 diabetes and gout. I invited him to come to my next free general public conference on reversing type 2 diabetes and obesity with a low carb diet. I also suggested he read The Obesity Code.

Patrick came to my conference. He had read the book. But I didn’t hear back from him for a few weeks.

In June, Patrick walked into my office with a huge smile. His blood sugar levels were all in the 4’s and 5’s. His blood pressure was getting too low. He had lost 5 kg (11 lbs) already, and was feeling fantastic. We stopped Victoza and Viacoram, and he was instructed to keep good records of his blood pressure and sugar levels, and to contact me quickly if they went back up too high.

In August, he came for a follow-up. Again, he walked in with a huge smile. He looked different. He had lost another 9 kg (20 lbs), and 10 cm (4 inches) off his waist. His blood sugar levels were getting too low, so we reduced his Metformin. His blood pressure values were all normal, on no medication.

In October, he came back with beautiful blood sugar levels. He had lost more weight, and more cm off his waist. He was on fire! Seeing how dedicated and convinced he was, I had no problem stopping his Metformin completely. He was ecstatic!

Below is a graph of his weight loss, in kilos.

And what about his blood work?

Below is his HbA1c.

*Note that 0.060 was achieved with Januvia and Metformin.

Below are two graphs of his TG’s and HDL’s in mmol/L:

In Patrick’s words: “I read The Obesity Code, and it all made sense to me. It was logical. Then I came to your conference, and I realised that it was easily doable. I just keep it simple: eggs for breakfast, and meat and green veggies with butter or olive oil for supper. For lunch, I can never figure out what to eat, so I fast, and it’s fine. My energy level is amazing. I no longer take any medication. I am never going back to the other side!”

As a doctor, I am also ecstatic with Patrick’s results. I’m thinking of all the pills he won’t have to take anymore. Or the diabetes complications he will never get. Of the numerous medical appointments he will not need with the diabetes nurses for escalading blood sugar levels, the ophthalmologist for retinopathy, the nephrologist for nephropathy, the orthopedist for limb amputations, etc.

This patient was presented with a wider range of therapeutic options than just the standard treatment. He chose to try the lifestyle treatment. He chose to do the work. I simply accompanied him along the way. He got results. He got his health back.

Perhaps low carb isn’t for everyone, but everyone deserves to know it’s a therapeutic option, and that it is safe and evidence-based.

—
Dr. Èvelyne Bourdua-Roy