Joy of consulting and low-carb prescribing - Watch out for ‘pings’ says award-winning GP

Medtech GP of the Year Glen Davies hates the word pa­tient.

“I don’t encourage any of my patients to be patient: I think every single one of them should be a pain in the arse, basically,” Dr Davies says.

“They should be insistent they get what they want.”

It was a challenge from an impatient patient that turned the Taupō Medical Centre GP into an advocate for low-carbohydrate diets as a health interven­tion for type 2 diabetes.

His “passion for eradicating a major disease”, by encouraging a low-carb diet to reverse type 2 diabetes, was noted by the judges of this year’s MedTech GP of the Year Award, presented at last month’s New Zealand Primary Health­care Awards | He Tohu Mauri Ora.

The citation notes the “great impact and outcome” of the Reverse Type 2 Di­abetes Taupo (RT2DT) group, which he helped establish. Its Facebook following is close to 3000 people.

Fellow finalist GP Lily Fraser is also a passionate advocate of low-carb eat­ing, and Dr Davies regards the two of them as joint winners.

A GP for 25 years, he says medicine initially wasn’t on the cards.

“I had preferential entry into dentist­ry, so I figured, that’s easy,” he recollects with a laugh.

It was after a young psychiatry regis­trar visited his grandmother that he changed direction. The young doctor had a lovely bedside manner, wore a paisley shirt, and drove a Mini with a Union Jack on the roof: “He was just the coolest dude.”

After graduating in 1989 from the University of Otago, Dr Davies spent two-and-a-half years at Tauranga Hos­pital, before taking an obstetrics and gynaecology role at a Papua New Guin­ean mission hospital.

In his two years there, he had to “do whatever you needed to do”, including 80 caesareans, 80 breech births and 80 twin deliveries. He also managed to do 80 scuba dives.

“I always vowed that I would do more scuba dives than caesareans,” he laughs.

On his return, he was a GP locum for a year, including in Taupō. He bought into Taupō Medical Centre a year later, on April Fool’s Day 1997.

In the early days, he was busy balanc­ing 10-minute appointments and de­livering babies – often finding a large group of patients waiting when he re­turned from attending a birth.

He loved delivering babies and, with the expertise gained in Papua New Guinea, was reluctant to let go of ob­stetrics. He continued with obstetrics work well into the early 2000s.

For Dr Davies, the joy of general practice, and its strength over other specialities, is the art of the consulta­tion. “I compare it to a party, where you just sit down and talk to one person and move on, and have a rewarding conver­sation with the next person.

“It’s the one thing that can never be tampered with, as it happens in your room, with your client, behind a closed door,” he says.

But GPs are easily accessible these days to any patient savvy with technol­ogy, including texts, Facebook and messenger apps.

“That’s my struggle at the moment… the fact that, while you are with some­one, you can hear all those ‘ping, ping, pings’, and you are aware each ping is something that requires action.

“To me, that’s where we’ve gone off track in general practice, and that’s what we’ve got to dial back.”

He made it worse for himself by shar­ing his phone number with many pa­tients – because he is so keen to support them in reversing diabetes.

“And when you’ve been in general practice for a small town for a long pe­riod of time, you just end up with 3000 friends,” he says.

Treating hypertension just with drugs is like putting a sticking plas­ter over a warning light on your car’s dashboard, says Glen Davies.

It does nothing to find or fix the underlying cause, says this year’s Medtech GP of the Year.

“About 70 per cent of the consul­tations we do are for non-commu­nicable diseases (NCDs), and the majority of those are some manifes­tation of metabolic syndrome.

“And that all comes down to insu­lin resistance, which all comes down to eating processed foods, sugar and refined carbohydrates.”

Dr Davies, a co-owner of Taupō Medical Centre, is on a mission to encourage GPs to tackle insulin re­sistance with diet, not drugs.

It is about three years since a “road to Damascus” moment led to his advocacy of a low-carbohydrate, nutrient-rich, wholefood diet to re­verse type 2 diabetes.

He doesn’t know how his patients – and others in the wider Reverse Type 2 Diabetes Taupo (RT2DT) group he helped to set up – have fared in trying to stick long term to the diet recommended to them.

But a total of 103 of his patients have reversed their type 2 diabetes (42 patients) or pre-diabetes (61). After two years, 75 per cent of the former remained in reversal, and 81 per cent of the latter did so.

Dr Davies acknowledges other in­terventions successfully deal with insulin resistance. He points to the 2017 DiRECT trial in Scottish gen­eral practices, in which patients took a dietary supplement then reintro­duced food.¹

But advocating low-carb diets to treat insulin resistance and meta­bolic syndrome is his passion, and international evidence is growing that it can result in type 2 diabetes remission.²

“Medicine will be so different when doctors learn all of this – when they start prescribing low-carbohy­drate and ketogenic diets rather than medications,” Dr Davies says.

Hyperinsulinaemia and insulin resistance are behind not only dia­betes and obesity, but also condi­tions like hypertension, gout, Alzheimer disease, non-alcoholic fatty liver disease and some cancers, he says.

Ninety per cent of prescriptions for NCDs could be replaced by die­tary changes, he estimates. Poor diet, inactivity, stress and lack of sleep are all contributors, but it is poor diet that concerns him most.

“To me, it’s a no-brainer that we absolutely should be taxing sugar and refined carbohydrates.”