Two Big Lies of Type-2 Diabetes
And The Power of LESS FOOD
I just listened to an amazing YouTube video called, “The Two Big Lies of Type 2 Diabetes” by Dr. Jason Fung, a nephrologist (kidney doctor) from Canada. He has been reversing this disease, often very rapidly, within weeks or months, even in those who have had this disease for decades and are on multiple meds.
In this blog, I am paraphrasing his talk in order to spread the word.
I’ve been writing about the reversibility of Type-2 Diabetes for a few years now, but this amazing lecture by a doctor dedicated to accomplishing this and teaching this to other doctors is most extraordinary. Click here to hear this talk – Dr. Fung’s talk.
Dr. Fung says the Two Big Lies of Type-2 Diabetes are:
- Diabetes is a chronic progressive disease. This is the present philosophy taught in medical schools. Then doctors pass this forward to their patients; that they’ll have this disease for the rest of their lives. The message is “get used to it.” Patients are taught and encouraged to have “learned helplessness.”
- Lowering blood sugar is the primary goal of therapy. The treatment is focused on using meds like metformin, insulin, or sulfonylurea medications to lower blood sugar. But Dr. Fung emphasizes that this is only treating the “symptom” of high sugar. The true cause of Type-2 Diabetes is “insulin resistance”, which gets worse over time, even on these meds. Patients on the conventional treatment for Type-2 Diabetes most often do not get better and usually get worse with more and more severe complications down the road.
The fact, or truth, Dr. Fung points out, is that diabetes can be cured. It’s reversible. It is not a chronic progressive disease. This has been replicated again and again. It’s curable. But it has a lot to do with what you do or do not put into your mouth to make sure your liver an/or pancreas are not obese (stored with fat) and causing you to have on-going (chronic) and severe insulin resistance which is the “root cause” of Type-2 Diabetes.
Cases where Type-2 Diabetes has and is being reversed or greatly improved:
- Bariatric surgery (stomach stapling or belting; stomach is cut into the size of walnut so you can’t eat as much). It’s well documented that within about a month after getting these types of surgeries diabetes often goes into remission, or is amazingly improved.
- This is in contrast to the typical scenario of a patient with Type-2 Diabetes. On conventional medications, within a year, type-2 diabetics are still on medication and not getting rid of the disease.
- But not so if the stomach was made smaller and folks ate less. Within a year after bariatric surgery, patients often have no more diabetes or are on many less drugs and faring much better. The reversal, blood sugar levels normalizing or going way down, occurs mostly quickly, over a matter of weeks. The weight loss takes longer so it is not just the weight loss that is causing these improvements.
- Intermittent fasting. The use of fasting for diabetes was mentioned 100 years ago by a famous diabetologist who wrote in the Canadian Medical Journal in August 1916 that temporary periods of under-nutrition (intermittent fasting) help diabetic patients improve to the point of sometimes reversing the disease. Fasting methods in this old-school medical approach would have the diabetics fast on zero calories, once a week. This was a classic part of medical care for diabetes way back when. It got lost as medications entered the clinical arena.
During various times of war, pockets of humanity suffered with severe food rationing. When that happened, the documented incidence of diabetes went down substantially. When caloric intake goes down, so does the incidence of diabetes. This affected prevention, but also reversal, in those that had the disease. So bariatric surgery and fasting are similar in that the benefits appear to be due to severe caloric restriction.
- Ketogenic low carbohydrate food consumption. One patient of Dr. Fung’s had a very high level of blood sugar with a HA1C (a maker of blood sugar over a 3-month period) at 10%. Her MD recommended 3 different diabetic medications. Instead this patient refused all medications and started eating a ketogenic diet, which is very low carbs along with lots of healthy fats and veggies. Within a few months her diabetes was completely reversed even though she had only lost twenty pounds.
Dr. Fung points out that all three of the above methods have been shown to be able to “cure” Type-2 Diabetes and these have been replicated on various patients around the world. Often the patient can get off all if not most of their medications.
The typical treatments for Type- Diabetes such as drugs and low fat-diet diets never lead to a cure. But this is how most of the Diabetic Associations around the world direct doctor’s and patients to treat their disease. People are not cured and mostly over time they get worse.
The American Diabetes Association emphasizes that Type-2 Diabetes is a progressive disease. Dr. Fung says this is a non-truth. Many Type-2 Diabetics are being reversed.
Diabetic Associations across the world also say that when a Type-2 Diabetic is treated, there likely comes a time when oral medications aren’t enough. Then the patient goes on insulin shots.
But Dr. Fung teaches that this disease is already a condition of excess insulin (as you will soon hear more of this). Giving insulin as a therapy does not treat excess insulin. It often makes this condition worse. Insulin replacement is treating the “symptoms” of diabetes (high blood sugar) but not the cause. The patient often gets worse; they fatigued, fatter and are at the risk of serious complications.
People develop a sense of learned helplessness. You can’t fix this. Don’t even try. You need to be on life-long meds. You may end up with eye disease, kidney disease, and artery disease, lose your limbs, or be put on dialysis. Don’t even try anything other than moving more and perhaps attempting to lose some weight and doing what you diabetologist tells you to do. Losing weight becomes a serious issue with those on insulin as insulin makes many patients gain more weight. So the Type-2 Diabetic is kept in a helpfulness self-fulfilling prophesy of more and more illness.
Second big lie according to Dr. Fung: lowering blood sugar is the entire goal of the treatment of type-2 diabetes. Dr. Fung points out several studies demonstrating this is inaccurate and that lowering blood sugar should not be the only goal, doesn’t help like we are told it should, and is avoiding addressing the true underlying issue.
Studies that show that tighter control of blood sugar doesn’t get Type-2 Diabetics healthier:
ACCRD study – this was a randomized study on over 10,000 patients whose treatment achieved what is called a “tight control of blood sugar”. But as researchers followed these patients whose blood sugars were tightly controlled (lower levels) they turned out to have a 20% increased risk of death and worsening of their severe obesity. Why? Insulin makes most diabetics gain weight. Also, it does not cure the cause of the diabetes, but rather worsens the insulin resistance, which goes hand-in-hand with excess insulin.
Advanced Collaborative Study –This is another study that showed that taking diabetics and keeping their blood sugars more controlled into what has been thought to be a healthier level of blood sugar, did not find an improvement in these patient’s overall health.
Hemoglobin A1C is a ticket-tape readout of blood sugar over a three-month period. It is more sensitive that taking your fasting blood sugar in the morning at a one-time blood test. But now multiple studies show that improving HA1C is not necessarily good for Type-2 Diabetics. Dr. C. J. Currie demonstrated (in the Lancet in 2010) that Type-2 Diabetics on medications that lowered their blood sugars did not result in improved health. Even though they had lower blood sugars, they had as much all-cause mortality (death from all kinds of causes) and adverse cardiac events (like heart attack and stroke) as those with higher levels of HA1Cs. Even with using medications to achieve lower HA1C levels, these folks had the same risk of dying as Type-2 Diabetics had with excessively high blood levels of HA1C!
This demonstrates that lowering blood sugar levels is not keeping diabetics healthier.
Why, asks Dr. Fung? Because the conventional treatment of type-2 diabetes is “chasing the wrong thing!”
High blood sugar does not cause type-2 diabetes. It’s a SYMPTOM of it. You have to really understand what causes diabetes to treat it to the point of getting rid of it. This is agile thinking. It is going after the “root-cause” of diabetes to try to get rid of the disease, not just treat the symptoms to live life long as a continual victim of this disease.
The root cause of Type-2 Diabetes is insulin resistance. In physiologic reality, high blood sugars are the result of chronic, long term, high insulin resistance. If you do not treat the insulin resistance, patient gets worse and has no hope of putting the Type-2 Diabetes into remission.
Conventional care starts the newly diagnosed type-2 diabetic on metformin. Soon other drugs are needed. Why? The cause of the disease has not been addressed. Then the patient is given insulin, and then more and more insulin. The diabetes is getting worse. At no point in the entire conventional insurance-reimbursed treatment is the disease getting better.
To get patients well, to reverse type-2 diabetes and have a truly higher quality of life, one must start with what causes insulin resistance and beta cell failure: the pancreatic cells that manufacture insulin.
The answer is to look at where type-2 diabetes is already being cured. This is where this blog started, with the three conditions that have led to reversal of this disease.
How does bariatric surgery work to reverse type-2 diabetes? Is it a gut effect? One theory was that the rewiring of the intestines might be the answer. But this doesn’t make sense as some surgeries, like the band and stapling, don’t re-wire or cut the stomach.
Is it the weight loss secondary to the bariatric surgeries? But this doesn’t answer the question as the diabetes after these surgeries usually goes away within 2-3 weeks, yet it may take two to three years to lose most of the weight.
Liposuction has been done to vacuum 10 to 20 kilos of fat away, but this doesn’t change diabetes status. The only thing that makes a difference is acute caloric restriction.
Eating less—eating much, much less—is what constitutes the holy grail of reversing the fate and future of type-2 diabetes.
CounterPoint Study – This showed that acute negative energy balance—severe restriction of calories—was the main thing that caused a reversal of BOTH HA1C as well as insulin resistance. And with severe caloric restriction, the initiation of reversal of Type-2 Diabetes happens rapidly, often within just one week!
The cascade of root cause healing all proven by MRIs monitoring patients as they start to restrict caloric intake:
- First you eat a lot less.
- Your blood sugar levels come down to a healthier level.
- This starts a progression of stored fat marching out of the liver. This happens within the first week of caloric restriction. Up to 30% of excess stored fat in the liver can move out of the liver within just a week by implementing severe caloric restriction.
- As the liver becomes less fatty, insulin resistance comes down, meaning the patient is getting healthier at the root level.
- Excess fat then starts to come out of the pancreas.
- As the fat leaves the pancreas, the beta cells that make insulin turn back on. They had stopped working because they were clogged with fat, not that they were dead. Beta cells that make insulin can be rebooted once you eat less and this causes fat to come out from these organs as you then live on this fat instead of meals that you prepare and swallow.
Nature is very forgiving. The study from the Institute of Cellular Medicine in the UK concluded: Normalization of both beta cell function and hepatic insulin sensitivity in Type-2 Diabetes is achieved by dietary energy restriction alone. This was associated with decreased pancreatic and liver triacylglycerol stores, meaning these organs were chock full of fat and as you eat less, the fat rapidly leaves and these organs start to function better rapidly.
The abnormalities underlying Type-2 Diabetes are reversible by reducing dietary energy intake. This means using the duct tape diet. Tape you mouth, metaphorically speaking, and eat less. The fastest way to accomplish this is by intermittent fasting.
Intermittent fasting. Not eating for so many days a week, or every other day, or whatever works for the patient and for reversing this disease. Often Dr. Fung has his patients eating every other day and fast every other day on zero calorie healthy beverages like coffee, tea or bubbly water. He makes sure they avoid synthetic chemicals found in artificial sweeteners.
Diabetics have excess stored fat inside the liver and the pancreas. This means they suffer with fatty liver and fatty pancreas. With intermittent fasting and/or severe calories intake, all this reverses.
The working hypothesis is that fatty liver and fatty pancreas are causing type-2 diabetes. And this happens long before the diagnoses of type-2 diabetes occurs.
West of Scotland Coronary Prevention Study – In this study, the researchers froze blood from patients who didn’t have diabetes, but eventually over time they developed it. Those who got diabetes demonstrated identifiable fatty liver long before the diagnosis. Dr. Fung says, knowing this, we can use it to reverse the disease. As you reverse the hepatic fat, the insulin sensitivity goes back to normal. Then the blood sugar normalizes and the patient gets well. And off meds. And loses weight easier. And has lots more energy and quality of life.
Liver fat goes down with only a modest reduction in weight, as fat in the liver is more accessible than fat out of actual fat cells (adipocytes). As unhealthy fat migrates out of the liver, liver sensitivity gets healthier. This starts the healing of the disease.
Type-2 diabetics have low insulin sensitivity. This is insulin resistance. My mentor, Dr. Jonathan Wright, taught me back in the 1970s to measure insulin levels as well as glucose levels. At my Berkson Clinic in Palo Alto, CA, patients would come in for 6-hour glucose/insulin tests. We could identify insulin issues even before blood sugar issues showed up. Then, by reducing calories that reduce liver fat, this reduces insulin insensitivity, brings blood sugars back to normal, and the patient starts to get well from the inside out.
How does a liver get fatty in the first place?
- Eating more calories than your body needs. High insulin levels: when you eat food, insulin goes up; when you eat excess calories, insulin goes up way too much. This causes sugar to get stored in your liver as fat. Then in your pancreas as fat.
- Eating too many carbs, more than your body needs.
When you eat a lot less, all this reverses.
One study gave folks 1,000 extra calories as sugar a day. These people only gained 2% increase in weight, but a 27% increase in liver fat.
- The excess calories you eat, the more you get a fatty liver.
- The more sugar you eat, the more you get a fatty liver.
- Excess carbs give you extra insulin and your liver gets obese.
Conventional medicine gives insulin to help treat some type-2 diabetics. Yet, the more insulin you give a type-2 diabetic, the more fatty their liver becomes, which is why treating Type-2 diabetics in the conventional manner makes their disease worse. This is the opposite in type-1 diabetes, because they do not have enough insulin nor enough fat in their liver.
- Big fatty liver means lots of insulin resistance.
- More insulin therapy keeps sugars bottled up in the liver.
- And low-fat foods often have higher glycemic indexes, which means they worsen the issue, too. Low-fat processed foods, historically recommended to Type-2 Diabetes, are more a culprit than a helpful tool.
We must avoid two vicious cycles:
- High insulin leads to fatty liver, which leads to insulin resistance, which leads to higher insulin, which makes everything worse; it’s a classic vicious cycle.
- Extra calories causes extra fat, which leads to fatty pancreas. A fatty pancreas causes beta cell dysfunction. Sugars go up and insulin goes up; another vicious cycle.
- High insulin is at the heart of driving both of these unhealthy cycles.
- Insulin (in excess) causes type-2 diabetes.
- Insulin is not a solution; it is a problem.
- It worsens the Type-2 Diabetic’s health.
A cure requires a decrease in insulin plus a decrease in dietary carbohydrates.
These actions, severe caloric restriction, “pull” fat out of the liver, reduce insulin resistance, and drive the nasty cycles backwards.
- Fat gets pulled out of the liver.
- Fat gets pulled out of the pancreas.
- This reverses beta cell dysfunction.
- Your own body starts making optimal amounts of insulin once again.
- You get well.
Do not give a person more insulin for a disease caused by too much insulin. This is like giving an alcoholic more alcohol—another beer, or two beers, or three—to get rid of their shakes. It makes you worse. This is the problem with conventional care, yet this is how diabetics are treated.
At the integrative clinic I worked at in Tulsa for years, we did ran ultrasounds of the liver of all adult patients every few years to track liver fat. And, bless him, Dr. Block only charged $45. I tried to order these exact same ultrasounds in Austin, Texas, and they wanted $600. But tracking the fat in your liver is a healthier thing to do than just taking your blood sugar and HA1C levels, as this is where the diabetic rubber meets the diabetes road.
Physiologic truth: As you lower the insulin, you drive the type-2 diabetes disease cycle back toward normalcy. You lower the insulin by strategically lowering calories and/or carbs with bariatric surgery, intermittent fasting and/or the ketogenic diet.
And all of this is available at no cost! It’s not accomplished with expensive drugs or fancy surgeries. It’s merely EATING LESS and SMARTER.
What is needed is “knowledge” and “courage” to challenge conventional thought.
Caloric restriction, says Dr. Fung who has done this with his own patients, also is effective for treating the complications of this disease—nephropathy, vascular insufficiency, dialysis, etc.
Dr. Fung’s experience on thousands of patients demonstrates that it is possible to get rid of diabetes in 90% cases and often within a month!
This treatment is not a matter of funding. It is a matter of knowledge.
Knowledge is power.
Here is the power of LESS food.
One of Dr. Fung’s patients was a diabetic for 47 years. He was on 75 units of insulin. He took a little longer to improve and get off more meds, but with intermittent fasting, he is now on only metformin, his sugars are better, and his disease is better. It is not the weight loss that is making the difference as much as the decrease in calories and carbs that made his liver healthier, his insulin sensitivity healthier and his life get back on track.
Less calories is easier to do than you might imagine. Some patients say it’s even easy.
Folks don’t realize that you do not need to eat every meal, or every day. Some of Dr. Fung’s patients eat one day and fast the next, but they are also closely monitored. So this should all be done under the supervision of a practitioner that knows how to track your body’s health.
Your hunger disappears within a couple of days. As the body starts to pull the fat out from the liver and pancreas, it feeds itself with that fat. You already have enough calories stored inside these organs to feed you!
N Engl J Med. 2012 Aug 23;367(8):695-704. doi: 10.1056/NEJMoa1112082.Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects.
Lancet. 2010 Feb 6;375(9713):481-9. doi: 10.1016/S0140-6736(09)61969-3. Epub 2010 Jan 26.Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study. Currie CJ, Peters JR, Tynan A, Evans M, Heine RJ, Bracco OL, Zagar T, Poole CD.
Diabetologia. 2011 Oct;54(10):2506-14. doi: 10.1007/s00125-011-2204-7. Epub 2011 Jun 9. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol.
Circulation. 2001 Jan 23;103(3):357-62. Pravastatin and the development of diabetes mellitus: evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study. Freeman DJ, Norrie J, Sattar N, Neely RD, Cobbe SM, Ford I, Isles C, Lorimer AR, Macfarlane PW, McKillop JH, Packard CJ, Shepherd J, Gaw A.