Dr Anita Lowe is a GP in Townsville (regional) with an interest in weight loss management at a large private practice with 10 GPs. Her patients are slightly skewed towards females but are split across the age spectrum. Townsville mainly comprises of families, and there is a large defence and mining population here. There are significant obesity issues, especially in the adolescent population. Here’s how she transformed her practice to a low carb clinic.
Why I started low carb
I learned about Defeat Diabetes Low Carb Progam (DD) through a health education talk with DD founder Dr Peter Brukner OAM. I did the research and went on low carb myself. I lost a kilo a week, and my reflux disappeared. I recommended this way of eating to my family, and they saw similar results – since then, I have become a strong advocate of low carb and TCR.
How I implemented low carb in clinic
1. Recalled all patients with T2DM and obesity. Pitched TCR as a new weight-loss approach; it was particularly effective as patients couldn’t get Ozempic. Saw 30 patients in the first month, about the same in the second month, and a steady stream of other patients since.
2. Started using Defeat Diabetes as an allied health branch and completed revised care plans, which I shared with patients in a 30-minute session:
a. Goals for patients, how to achieve, what they will use (DD)
b. Talk patients through the Defeat Diabetes Low Carb Program highlights
c. Provide a checklist for patients (all adapted from the DD Low Carb Progam) e.g.:
i. Patient to join DD
ii. How many carbs to aim for
iii. Red/Amber/Green Food list
iv. How to read labels
v. Tips to manage hunger, eating to satiety
3. Nurse appointment for weight, height, and blood pressure.
4. Inform the primary care team (physiologist, pharmacist, dentist, optometrist, podiatrist, etc.) that the patient is following a low carb education plan (DD as the source) and align treatments.
5. Initiated 3-monthly bulk-billed review to improve compliance.
6. Joined the Defeat Diabetes clinical study through La Trobe.
7. Expanded recall into other chronic conditions that benefit from TCR, such as hypertension, high cholesterol, autoimmune, and reflux.
Results of implementing TCR
- Around 85% of T2DM patients are now on the Defeat Diabetes Low Carb Program.
- First two audits showed an average 3-4 kgs of weight loss in the first month of compliance and 4 cm from the waistline.
- One 89-year-old patient on insulin reduced her HbA1c from 12 to 9.6 in 3 months. She suffered from chronic ulcers, which also healed.
1. Some GPs in my practice were nervous about going against the nutritional guidelines, but the guidelines are for healthy Australians, not those battling chronic diseases.
2. Win sceptical GPs and other HCPs by printing off the latest clinical studies that challenge a belief and leaving them in the staff room. I also host a monthly practice meeting where I regularly share my case studies of patients achieving remission and other health benefits from low carb so my colleagues can see the benefits.
3. I am lucky to have a low carb nutritionist, neurologist and gastroenterologist I can work with, but you need to look for them! The Defeat Diabetes directory is a good resource for this.
4. To get patients on board, try a brief intervention, e.g. weighing someone. If they are in the obese range, advocate a new program (DD) and suggest if the patient would like to learn more, make a 30-minute appointment for more information (long intervention).