The Big Interview – Charlotte Summers

We caught up with Charlotte Summers at this year’s Diabetes Professional Care (DPC2017) conference. She is the chief operating officer of Diabetes.co.uk, the world’s largest online diabetes forum, and here she tells The Diabetes Times all about the pioneering Low Carb Program.

What is the Low Carb Program?

The Low Carb Program is a structured, evidence-based digital therapy helping address the global epidemic of type 2 diabetes, prediabetes and obesity. What’s even more exciting is that it’s helping to demonstrate type 2 diabetes and prediabetes don’t have to be chronic, progressive diseases as once understood to be.

Why have more than 250,000 people joined the Low Carb Program, has it filled a void?

We have been astounded by the global impact that the Low Carb Program is having on redefining the understanding of type 2 diabetes. It’s metabolic underpinning and the opportunity to put it into remission. The Diabetes.co.uk forum has been talking about low carb for well over a decade, and it’s been described as a grassroots movement. It truly has been.

In August this year the DT reported that seven out of 10 forum members improved their knowledge of diabetes within six months of joining the online community, have you got any other metrics that you can share?

A recent empirical research study published by Royal Holloway University on the Diabetes.co.uk Forum concluded that being a member of the community was empowering – they went further with this to explain what this meant for someone living with diabetes. It meant they had a better relationship with their healthcare professional, more confidence in managing their diabetes and improved quality of life. We’re really excited to do more on this, it’s a really interesting area.

Opponents of the low carb diet point to a lack of published research, how would you respond to this?

Current evidence base is relatively strong. There have been 57 RCTs comparing low carb to low fat approaches and outcomes are significantly better in terms of health outcomes and drop out rates in the lower carb groups. Quite simply, it’s sustainable and has a greater impact on overall health – not just weight loss, HbA1c and fasting blood glucose levels.

The evidence base around pharmacological approaches to managing blood glucose control is not actually as strong as we have assumed it to be. We are taking active steps working with a number of academic institutions to enhance the quality and access to evidence of this approach.

Nutritionists say people crave carbohydrates and if they cut them out they’ll only crave them more, can you counter this view?

There is a growing evidence base that suggests from a neurological perspective sugar is more addictive than cocaine and interacts with the same pleasure senses of the brain.

When people first start on a journey to a lower carbohydrate lifestyle there are a sub population of people who seem to be addicted to sugar and who actually show addictive tendencies, similar to someone with an alcohol addiction. We are working with the latest evidence-base and Dr Jen Unwin, a clinical psychologist, to optimise the Low Carb Program to help address the potential stumbling blocks associated with sugar addiction. This is something we will be presenting at next year’s Public Health Collaboration conference in May.

How is behaviour change facilitated within the Low Carb Program?

The Low Carb Program utilises a number of behaviour change pathways with the way in which the user views their health as a function of their family circumstances, social networks, and community. Grounded in goal-oriented therapy and utilising a solution-focused approach, the Low Carb Program places the focus on a person’s present and future circumstances and goals rather than past experiences. This helps ensure patients feel confident and motivated in modifying their health behaviour and subsequently ensures engagement and retention.

Tell us about some of the success stories from the Low Carb Program?

We keep in touch with all our members – here’s a selection of a few from our last few Low Carb lunches.

Tell us about the ketogenic diet and how is it different from the low carb diet or is it the same?

The ketogenic approach to health is stricter in terms of carbohydrate restriction than a lower carb lifestyle. Interestingly, we have seen a large community of people whose health has greatly improved through the adoption of a ketogenic lifestyle. The evidence base is particularly strong in patients with epilepsy and some cancers as well as type 2 diabetes.

We recognise this approach to health although still appreciate that the step from a traditional balanced diet to a ketogenic lifestyle may be initially too extreme. The Low Carb Program embeds the patient’s personal, intrinsic goals whilst facilitating their confidence and readiness to change.

Will digital health ever replace traditional face-to-face healthcare or it is supplementary?

One of the most important things about the Low Carb Program is despite the fact that it is a digital-only therapeutic, we do not disenfranchise the relationship between the patient and their health care team. On a number of key occasions within the program, we encourage patients to speak to their health care team in order to allow an informed and consensual journey to a lower carb lifestyle, but also to ensure that it is safe for the patient to progress.

We have been particularly encouraged by the ever-growing number of people who report that they have the approval and support of their health care team.

What is the future of type 2 diabetes treatment?

Precise, patient-centred choice – a lifetime of medication or the opportunity to be supported in achieving sustainable weight loss and HbA1c reduction through a nutrition-first approach. The Low Carb Program is a global solution for type 2 diabetes and we’re on a mission to reach all 375m of them. Type 2 diabetes does not have to be a chronic, progressive condition. How amazing is that?

If you only had one short sentence to persuade people about the benefits of joining the Low Carb Program, what would it be?

Join the Low Carb Program because it can change your life.