Silent Assassin: GP Liz Fraser on reversing type 2 diabetes

There is no reason for it to end this way as diabetes is often avoidable.

Decades before full-on diabetes strikes, people can be pre-diabetic. There are no symptoms for this but blood tests show ominous signs.

Being overweight is a risk factor, particularly when the fat is around the waist. And so is being physically inactive.

Diabetes Australia said that type 2 diabetes "can be prevented or delayed in up to 58 per cent of cases by maintaining a healthy weight, being physically active and following a healthy eating plan".

There is agreement among doctors about this but not about the foods which are best for us.

Canberra GP Liz Fraser is on a mission to help people cut carbohydrates - bread, potato, pasta, rice, sugar and the like.

Dr Fraser says type 2 diabetes can be reversed with a low-carb diet. Instead of the medication which some doctors prefer, shunning carbs is an alternative in her book.

Part of her argument is that eating meat and eggs instead makes you feel fuller than if you eat starchy foods like potatoes.

It's not quite weight loss without pain but her argument is that it offers full stomachs and satisfied appetites for most people.

In contrast to conventional advice, she advises patients to eat "real food".

"It's not the fat that we eat that's the problem. It's the sugar and starch that we eat," Dr Fraser said.

"The point is to eat real foods - meat, nuts, dairy, cheese, sea food. It's not about deprivation. It's about choosing the quality of what you eat."

Co-founder of a group called Low-Carb Canberra, she's a devotee of cutting out carbohydrates like potatoes, rice and pasta, or at least cutting them down drastically.

These foods get quickly digested into glucose so they are very efficient at bumping up the amount of glucose in the blood (and remember the problem for diabetics is that they don't produce enough insulin to cope with the sugar, so the more sugar in the blood, the bigger the problem).

And, of course, one way to reduce sugar in the blood is to cut down the amount of sugar you eat. That almost goes without saying.

There is widespread agreement among doctors that hyper-sweetened fizzy drinks are one of the causes of diabetes among young people - something which didn't happen a generation or so ago.

Instead of rice, pasta and potatoes in particular, Dr Fraser suggests meat - yes, steak and roast chicken - and oily fish. Cheese also fits into her recommended diet. It is, she says, "healthy fat".

Diabetes experts have passionate arguments and disagreements about diets. Those who blame carbs are annoyed at doctors who in their view haven't seen the light.

But all agree that the most important thing is to stop eating junk food and get away from sweetened beverages.

"That's a no brainer," according to Professor Christopher Nolan of the ANU Medical School.

"Get away from high calorie foods like biscuits, cakes, chips, take out foods, pastries. A lot of take-out food is really bad.

"Instead, eat healthy food - fresh food. Go to the vegetable section of the supermarket, the meat section. Take it home and cook it yourself."

It's true that fruit has sugar in it but because fruit takes effort and time to digest, it isn't as bad as mainlining sugar through fizzy drinks, fruit juices, or sweets.

"The important thing is that you move from that junk diet which is too easy to get. That's the best thing you can do - and then add exercise."

Exercise helps you lose weight - but the amount of exercise you need to compensate for a Tim-Tam is substantial (about half an hour of brisk walking, depending on your weight).

But exercise has another benefit: it heightens the ability of the body to make good use of the insulin it needs.

"Exercise gets you fitter and improves your insulin sensitivity, meaning you need less insulin to process glucose" Professor Nolan said.