Intended for healthcare professionals


Hope for diabetes: five minutes with David Unwin

BMJ 2020; 368 doi: (Published 31 January 2020) Cite this as: BMJ 2020;368:m404
  1. Jane Feinmann
  1. London, UK

“My wife Jen and I were on a run in 2012 when we first got the idea of Hope for T2D (type 2 diabetes). I had been inspired by a patient who had put her diabetes into drug free remission by cutting sugar and starchy carbs. I wanted to see if what that patient had done could be replicated, but the practice was overstretched and understaffed. Jen, a clinical psychologist, thought that hope for a better future would be a better motivator than fear and suggested we try a hope based approach, including group consultations. In this way we could help twenty people at a time. We’ve been running the group sessions for seven years now and 71 people have achieved drug free remission of diabetes. The total weight lost has been over two metric tons.

“I have become obsessed with the idea that the terrible epidemic of diabetes and obesity blighting my community, the country, and even the world, does not have to be. In my lifetime I have seen an eight fold increase in the prevalence of T2D. I worry soon no one will remember a time before obesity and diabetes became normalised in society.

“A next step was to try and spread the word to the five GP practices in my primary care network (PCN). Seven ‘patient experts’ from our group helped me prepare a video presentation showcasing how their lives have been transformed. The sincerity of their stories and the hope it represented, along with my data, helped convince all five practices to try a community experiment. Luckily our PCN had a little money left that needed spending and the chair, David Smith, was prepared to do something unorthodox. We booked a large church hall and used the practice diabetic registers to send an invitation to every person with T2D in the area. We didn’t know if people would be interested in attending an evening educational event but there were two incentives: the idea of hope for better health and a free low carb buffet.

“In the event, the demand proved overwhelming. We were booked solid within 10 days of sending those letters. Our community event took place on a damp, foggy January evening. The buffet started at 6 pm and soon afterwards a huge crowd was queuing to get in. We had allocated 230 places and had to put in 20 extra seats. Firstly, we showed the video of patient successes to demonstrate how local people like them had benefited. When a dietitian, Tara Kelly, explained how starch is ‘soon to be sugar’ I could see people were amazed that breakfast cereals are sugar too. At the end there was a long queue of people wanting to find out more. Our next event is on 12 March.”


  • David Unwin is a GP in Southport, Lancashire. The next low carb meeting for people with type 2 diabetes is in March and open to invitees only. To find out more see @lowcarbGP

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