Reinstate Dr David Unwin's sugar infographics as a NICE endorsed resource

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In 2018, the National Institute for Health and Care Excellence (NICE) endorsed a set of infographics created by NHS Innovator of the Year 2016, Dr David Unwin. These infographics illustrate how certain foods may affect blood glucose in terms of equivalent teaspoons of sugar. The calculations presented on the infographics are based on the well-studied rating systems of glycaemic index and glycaemic load.

The infographics were published in the peer-reviewed Journal of Insulin Resistance , and were then hosted on the Public Health Collaboration (Charity no. 1171887) website. NICE linked to this website in the tools and resources section of its guidelines for type 2 diabetes in adults .

In line with NICE guideline NG28.1.3.3 - “Encourage high ‑ fiber, low ‑ glycaemic ‑ index sources of carbohydrate in the diet” - Dr David Unwin's infographics have helped hundreds of NHS healthcare professionals to educate their patients on how different foods may affect their blood glucose. This in turn has helped these patients to transform their health, while saving money for the NHS by reducing the volume of pharmaceutical drugs used for managing diseases such as type 2 diabetes. One of Dr Unwin's peer-reviewed published studies of patients within his own practice can be read in the International Journal of Environmental Research and Public Health .

Unfortunately, on Sunday 12th July 2020, The Mail on Sunday published an article that pushed NICE to remove the infographics from its website and assess its endorsement. Following this assessment, NICE decided to remove its endorsement, citing that such an endorsement implies support for a low-carbohydrate diet, which now has an ever increasing evidence-base of randomised controlled trials .

Following a freedom of information (FOI) request to NICE ( available in full here ), we discovered that The Mail on Sunday contacted NICE with a somewhat threatening email:

“If you don't give a full and relevant statement that doesn't simple [sic] reiterate what we have set out to be inaccurate and misleading advice, we will FOI you, and also highlight the fact you have been obstructive. It may not come to that, depending on your response. ”

One of the so-called inaccuracies claimed by The Mail on Sunday was as follows: “NICE state that doctors must only provide education to patients that is 'evidence based' - yet Dr David Unwin's claims, made in a study he carried out himself, were never published in a peer ‐ reviewed journal ” . As stated above, this is incorrect. The study upon which Dr Unwin's infographics are based was published in the peer-reviewed Journal of Insulin Resistance .

It's interesting to note that at no point was Dr Unwin asked by NICE for his input, nor allowed to defend his reputation from anonymous detractors concerning these unsubstantiated claims of 'inaccuracy' and 'misleading advice'.

In conclusion, this leads us to believe that the removal of the infographics was not because of any scientific inaccuracies, but because of a political view not to include Dr Unwin's infographics as an available option for patients. As champions of a variety of evidence-based options for patients, Public Health Collaboration and the signatories of this petition urge NICE to re-endorse Dr Unwin's infographics as a useful tool and resource to help adults with type 2 diabetes better understand the glycaemic consequences of dietary choices.


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