Fasting Cures Type 2 Diabetes –technical version http://healthfully.org/rh/id17.html -- 3/18/17

Paragraph Outline:

1)   Insulin resistance and production of insulin by beta cells in Type-2 Diabetes T2D.  Insulin functions to drive glucose from the blood into cells, and cells respond by shutting down the metabolism of fats and storing them.  Insulin Resistance (IR) causes excess fat storage and fatty pancreas causes T2D.  Energy restricted diet with exercise metabolize the fat in the muscles and fat tissue, but not in the pancreas and liver.  .    

2)  With bariatric surgery the patient can’t eat (fasts) and thus insulin is very low.  The patient metabolizes the excess fat in the pancreas and liver to cure IR and T2D. 

3)  Fasting is easy & effective, Fung’s clinic with alternate day fasting (ADF) and low carb diet (KD). 

4) Starting with short-term fasting, skipping breakfast to extend fat metabolism

5)  Jk’s experience, fasting is easy, KD not so, health benefits.

6)  Customize approach, Back-dooring into KD through fasting 

7)  Adjusting medication while changing diet, and bad drugs that raise inulin..

8)  Approaches to taming the tiger:  knowledge and peer support

1)  Unlike T1D whose beta cells have been destroyed by their immune system, patients with T2D can still produce insulin, only their production is insufficient to maintain normal serum glucose on a high-carb western diet.  (Wouldn’t it make sense to avoid carbs instead of taking drugs with side effects to lower serum glucose?)  The path to T2D starts with a fatty liver, which causes first insulin resistance [1] in the liver, and later in the other tissues including the pancreas.  Since high level of glucose is in the long-term harmful to cells, it level is low in cells.  In our blood, it is only about 2 teaspoons.  To keep the level low in blood insulin is secreted.  Insulin causes in cells to open their receptors and transport glucose from the blood into the cell.  When the cells have above normal level of glucose, they promptly respond by metabolizing the glucose to the energy molecule ATP, or converting the glucose to storage from glycogen.  With glucose metabolism, fat metabolism stops and the fat is converted to the storage form triglycerides.  Thus, insulin causes fat storage, and insulin resistance (high insulin) causes an excess of fat storage.  Cells when stuffed with glucose become resistant to the signal of insulin to absorb more glucose.  Then more insulin is secreted by the pancreas to reduce blood glucose—this promotes even more fat storage.   The live plays many regulatory roles, as fat accumulates there the liver becomes inflamed and liver-functions decline, including the rate of the conversion of glucose to glycogen, the storage form.  At around 2-pounds of excess fat storage, the liver becomes inflamed and a condition known as NAFLD, non-alcoholic fatty liver disease develops.  A parallel event occurs to the pancreas, many years later, and the beta-cells’ production of insulin declines sufficiently to become pathological. Excess fat storage in the pancreas eventually hinders the production of insulin to cause T2D.  The fix is to metabolize the excess fat and this requires very low insulin.  Hyperinsulinemia is driving the secondary problems, the age related chronic conditions.  Most of the excess fat is stored in the adipose tissues and muscles and becomes available when glucose is low.  On an energy-restricted diet those sources of fat are metabolized first, thus simply losing weight won’t cleanse the pancreas and liver of their excess stored fat and thereby cure insulin resistance and T2D.  Simply dieting and exercising isn’t the cure. When fasting, the body goes into the healing mode as it does while sleeping, and the liver and pancreas stores can be metabolized.  So, what is the evidence that proves that insulin is the problem and that the low-insulin diet with fasting is the cure? 

2)  One way to cure T2D is through bariatric surgery; their cure rate is over 80%--they can’t eat following surgery.[1]  The IV source of nourishment avoids the increase in insulin caused by incretin hormones.  Incretins are secreted into the blood in response to bulk in the stomach and duodenum, especially to proteins.  (It is why pasta has a lower insulin index than fish or meat).  Thus a ketogenic diet (KD) is not a low insulin diet, and because of this it can be improved upon.[2]  The low insulin during (fasting) promotes healing through fat metabolism in those organs whose functions have been inhibited by excess fat--liver pancreas, and others.  Over half of the bariatric patients are drug free within 1 month, before significant weight loss.[3]  A study has shown that they have metabolized the excess fat in their pancreas.[4]  Bariatric surgery proves that there is a dietary fix for T2D.  Thus it would seem that fasting could cure T2D, what is the evidence?

3)  While fasting, insulin is very low and blood glucose.  There are no proteins and bulk of food causing incretins to stimulate insulin, or resistant carbs being digested by intestinal bacteria—a source of glucose.[5]  Fasting has been shown to cure T2D.  A large percentage of the patients following the program at Dr. Jason Fung’s clinic have been cured, and all of them have improved sufficiently to be off of insulin.[6]  His dietary treatment consists of a low-carbohydrate diet and alternate day fasting, with of course variation to suit the patient’s situation and thus promote compliance.[7]  

4)  It is easier to skip a meal than drastically restrict calories.  Getting started for most begins with the short-term fast, from 7 pm until 12 AM (skipping breakfast) and a reduction in carbohydrates, especially sugar, all sources:  low carbs (thus low insulin) to extend the period of fat metabolism.  Once started, then continue to extend the fast and carb reduction—some of Fung’s patients with significant weight do a 2-day fast.  Fasting is easy because it begins while sleeping.  While sleeping the small reserves of glucose are metabolized, and the body switches to fat metabolism (see graph).  The testimonials confirm that ADF with KD cures T2D, and there are journal articles.  The ideal intervention depends upon the severity of the diabetes and obesity.  But how much of a hurdle is ADF with KD? 

5)  My experience confirms that fasting is easy; easy because while fasting (metabolizing fats) one feels much better physically and mentally than on an energy-restricted diet.  Moreover, by missing a meal the daily calories are less.  This has been confirmed in studies.  For example, those on ADF on the food day they average an additional 10% in calories when compared to the average prior to starting ADF.  Moreover, by going low carb and thus increasing fat, there is a reduction in hunger.  (See appendix for an explanation of grazing & the insulin cycle).  By myself I often don’t feel like eating dinner, and would if I need weight to lose.  Numerous testimonials and small clinical trials confirm my experience.  Fasting is easy because mammals have evolved increased energy and alertness during periods when there is no food (forced fasting).  Moreover metabolizing fats is better than from glucose (carbs) for the health--and the best are the saturated fats and the worse are the polyunsaturated and trans fats.  Glucose attaches to proteins and hinders their functions, and fructose does the same at 7 times the rate of glucose.  An excess of the sugar fructose (one half of sucrose the table sugar) is a slow poison comparable to ethanol:  both overwhelm the liver when in long-term excess to cause fatty liver disease and age related chronic conditions:  “They [reactive sugars] can be a factor in aging and in the development or worsening of many degenerative diseases, such as diabetes, atherosclerosis, chronic kidney disease, and Alzheimer's disease.”  (If you wonder why we have been given the wrong dietary information and dieting information, it is not bad science, but rather of following the bucks.).[8]  Because fructose is metabolized only in the liver, it accumulates there, and is stored while the liver converts glucose to glycogen.  When in excess both glucose and fructose can be converted by the liver to fat and stored as triglycerides.  Thus, there is a one-two punch leading to liver dysfunction, the reactive sugars and insulin resistance causing excess fat in the liver.  A large number of journal articles support this causal pathway, and other articles support the simple solution of fasting with low carbs.  Fasting promote healing including the metabolism of the excess fat in the liver and pancreas; the method used in Fung’s clinic, and others.  Read my experience for insights.  I have come to doubt the need for the extreme low-carb, ketogenic diet.  Simply lowering carbs, especially those with a high insulin index, should be sufficient for most when coupled with fasting.  Some such as Dr. Michael Mosely and Prof. Roy Taylor have had success with this approach and 800 calories on fasting day.  The current popularity of the ketogenic diet I think is more of industry pushing a flawed model, one with a low success rate and thus reducing the number of patients trying fasting.[9]  I would use both low carbs and fasting, and add at least a yearly an extended fast of at least four days to lower the risk of cancer.[10] 

6)  I and others have found dropping the carbs far more difficult than fasting. One reason is the body’s adaptation to very low glucose whose complexity is beyond the scope of this paper.  It takes 5 days according to an often quoted 1982 study.  During that period some will feel mentally foggy, lack of physical energy, and thus their emotional consequences.  One way to get around this is to try a prolonged fast of over 2 days. Fasting keeps your insulin very low, which doesn’t occur with KD, because of the secretion of incretin hormones which stimulate the pancreas to release insulin.  Insulin regulates other hormone such as leptin make the transition to KD difficult.  Fasting will produce ketosis:  the metabolism of fats that results in the production of ketone bodies which are used to produce the energy molecule ATP.  Fasting hastens the complex process of conversion to just fat metabolism.  KD’s goal is to enter ketosis, thus fasting is a second avenue.  KD should be viewed as an adjunction to fasting, one which lengthen the period of fat metabolism.  The path to a cure depends on the situation.  I know some who upon diagnosis of diabetes have used just a low carb diet to be drug free, and other who after trying metformin, have gone to the KD.  But strong evidence of a cure through KD I haven’t found.  What is the best path to becoming drug free depends upon the degree of infirmity. [11]

7)  While fasting as a start, and then on alternate day fasting and KD, you will need to adjust your medication to avoid hypoglycemia (low serum glucose) by reducing drugs.  Pharma of course attributes the side effects of the drugs to type-2 diabetes (T2D) and they ignore the quality studies which show that insulin and thus drugs which raise insulin increase mortality.  This includes sulfonylureas, insulin injections, and very like the other classes including  thiazolidinediones, dipeptidyl peptidase-4 inhibitors, SGLT2 inhibitors, and glucagon-like peptide-1 analogs. For example in a rare case of a drug being evaluated for endpoint outcomes:  “Rosiglitazone, a thiazolidinedione, has not been found to improve long-term outcomes even though it improves blood sugar levels.  Additionally it is associated with increased rates of heart disease and death.” Wiki.[12]  Most critical studies are done when off patent, and thus is tool to promote sales of patented medications.  Those who tightly control with drugs their glucose with Rosiglitazone have over twice the death rate of those who don’t.  The way to healthfully manage diabetes is to reduce drugs with a low carb diet.  Watch the lectures of Dr. Richard Bernstein[13]—click on link.  High insulin (insulin resistance) is the cause for the comorbidities associated with T2D thus the FDA accepts the surrogate endpoint lower serum glucose for giving a patent, and doesn’t include those long-term consequences.  (Yes, the FDA acts an extension of pharma while pretending to regulate in the public’s interest.)  Pharma of course sells lower serum glucose as a proof, but they are in the business of treating the comorbidities long-term, and physicians are just car mechanics consulting pharma’s treatment guidelines, textbooks written by pharma’s KOLs (Key Opinion Leaders), and attending for free continuing education class funded by pharma. 

8)  Over and over again, I talk to people, and watch them attempt to change their behavior, but fail.  I suggest a two-step approach, one of studies, the other social.  Of studies:  Watch and take notes on the documentaries and lectures, read the 2 books by Dr. Jason Fung, and engaging people in conversations on diet and diabetes. WITH STUDIES COMES MOTIVATION.  I recommend writing a log of what you have done, experiences, and technical question. You are involving the rational portion of your brain.  This will increase motivation.  The second part involves changing behavior by appealing to our social nature (we are a social animal).    Because we are a social animal, you should persuade a friend or relative to try fasting and low carbs with you.  Even better would be to involve a friend with serious obesity or diabetes to try the fasting-low carb cure.  (I have 5 programs depending on condition at http://healthfully.org/rh/id8.html)  The social environment is very important.  A number of services offer counseling and/or group meetings.   Medfast and Weight Watchers are the best known.  Dr. Jason’s clinic has an out-patient program.  He will work with your doctor.  Check it out and see if it is a fit.  Think of the good you will do if your doctor through your efforts discovers that T2D can be cured through diet, possible he will go public like Dr. Jason Fung and Dr. Sarah Hallberg.

MORE BY Dr. FUNG IN DIABETES SECTION; and his blog is excellent with link to his diabetes clinic and book. 

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Small meals and snacking

Two problems with the small meal high carb-sugar diet, especially when it causes an insulin spike (see link with insulin peak graph following a meal), and insulin graph at middle section of article.  This spike clears the high serum glucose in about 75 minutes, and longer when eating a meal high in fats, proteins, and complex carbs such as legumes.  When the glucose dips, there is an increase in hunger, as the body hormonal system kick in to promote behavior resulting in nibble to restore blood glucose to normal level and thereby continue to store fat and metabolize carbs.  This behavior of frequent snack is term appropriately grazing.  Such behavior reduces the window of time in which fat is metabolized.  Grazing reduces the amount of fat metabolized, thus reducing the rate of weight loss on an energy-restricted diet, and with low blood glucose appetite increases.  To avoid this cycle replace carbs when hungry with  green vegetables low calorie beverages.[1]  I nibble on bell peppers and celery, and drink tea with lemon.  A good guide is the Insulin Index table at diet; those foods above fish should be limited.  One is that with a high level of insulin precipitated by certain carbs[2] and sugars, there is a rapid lowering of glucose (versus a

Dr. Fung’s lectures. 

***** How to Reverse Diabetes Naturally, 35 min, 29,000 views, Dr. Jason Fung, on treating the symptom high sugar instead of the disease insulin resistance. Very important way to break the reliance on drugs with diet and exercise, with testimonials, https://www.youtube.com/watch?v=mAwgdX5VxGc  excellent

***** Insulin Toxicity and How to cure Type 2 Diabetes, 61 min, 31.000 views Dr. Fung. On hyperinsulinemia & its role in diabetes, similar to the previous, but for doctors treating diabetes.  Based on clinical trials that prove insulin, not glucose is the problem.   https://www.youtube.com/watch?v=4oZ4UqtbB_g  very good  

***** The Two Big Lies of Type 2 Diabetes 54 min,10,5000 views, Dr. Fung, latest lecture 11/14, similar to the first diabetes video and with two patients re-accounting their experience on one day fasting, one day off cycle.  https://www.youtube.com/watch?v=FcLoaVNQ3rc&feature=youtu.be https://www.youtube.com/watch?v=FcLoaVNQ3rc  excellent

***** The Aetiology of Obesity, the Fast Food Solution (Part 4 of 6):  Dr. Fung’s college level lecture on biology behind obesity and the biology behind alternate-day fasting, which is a sure way to cure type-2 diabetes and obesity. Explains its parallel to bariatric surgery.  https://www.youtube.com/watch?v=pG89j432w-Y   very good

§***** Therapeutic Fasting—Solving the 2-compartment problem, 38 min, 59,900 views, Jason Fung staying in fat burning mode and why energy restricted diets don’t work.  Fasting is the important addition to the Atkins/ketogenic diet.  It is easy, especially for the overweight.  Being thin, I have for over 30 years been using the short-term 16-18 hours fast.  Fasting--the long-term fix--causes liver cleansing of the stored 2 to 3 pounds of fat which causes the assorted comorbidities, https://www.youtube.com/watch?v=tIuj-oMN-Fk Excellent

§***** Richard Story:  How To Beat Diabetes 9 min, 21,000 views, Dr. Jason Fung, interview with Richard and his wife, both have had a major life change in 5 months https://www.youtube.com/watch?v=YyUwiF4Zoc8 and a similar lecture and testimonial https://www.youtube.com/watch?v=2ifN_aVwEZk  both excellent      

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Below are the best of lectures on the medical issues you face:

From my video page

***** Why We Get Fat 3 min, 1,455,000 views, clip from movie Fat Head.  The best explanation on the process of accumulation of fat, https://www.youtube.com/watch?v=mNYlIcXynwE a good foundation WATCH

§ Catherine Croft PhD on Hyperinsulinemia and Kraft 13 min, 2,500 views, lecture on fasting glucose does not reveal insulin resistance; best method is glucose tolerance test with measure of insulin at 2 hours, if above 30 mu/mL than 90% chance of insulin resistance https://www.youtube.com/watch?v=pCtwgAAuyBE Good

§ Insulin Signaling 5 min, 160,000 views animation presentation, college level https://www.youtube.com/watch?v=FkkK5lTmBYQ very good

§***** Session 2. The Problem With The ADA Diet 11 min, 6,000 views, Dr. Richard Bernstein, informative for both Type 1 and type 2 diabetes, on how to go drug free.  The ADA guidelines and what nearly all doctors hold is wrong.  He explains why, as does Dr. Fung above, https://www.youtube.com/watch?v=SCzk66CQKEg  VG       

Insight Beating Diabetes 52 min, 83,600 views, 2016  Dr. Mosely & Prof. Roy Taylor interview, using Taylor’s 800 calories diet for reversing diabetes, in which those who have T2D for under 1 years have success, while those over 10 years are not so likely on a small sample of 4 who all failed.  Strong on human interest, well organized and moving-entertainment, quality interview, but not what US media covers. https://www.youtube.com/watch?v=hDEw561NFto#t=2.990076  Very Good

*****Diabetes the Hidden plague, BBC Panorama  58 min, 22,000 views, focuses on all the major health consequences (hospital) value information, full of sad human interest, will motivate the viewer, best watched alone to feel the pain,  the problem but little on the fix. 11 billion pounds cost https://www.youtube.com/watch?v=NGJ6cTWyMfg  very good

*****Reversing Type 2 diabetes starts ignoring the guidelines 18 min, 1,290,000 views, by Sarah Hallberg MD, TEDx PurdueU, passionate on treating diabetes and insulin resistance with low-carb high-fat diet, and on the viscous cycle of taking medications which require carbs to prevent the side effects with hypoglycemia, high carbs is strongly associated with heart attacks https://www.youtube.com/watch?v=da1vvigy5tQ  

***** The Secrets of Sugar 45 min,484,000 views, CBC (Canadian Broadcast Corp) program; starts with a young family and show that at the heart of the weight problem with impending health consequences lies high sugar diet.  It also shows experiments on college students, uses interviews to drive home the point that sugar is the health issue, http://www.youtube.com/watch?v=xDaYa0AB8TQ most entertaining, SECOND CHOICE

Sugar, The Bitter Truth ”, 82 min. 5,100,000 views, Prof. UCFS Robert Lustig MD, university level lecture on sugar, fructose, obesity which needs background preparation and note taking.  Made me a believer after I researched the issues he raised. http://www.youtube.com/watch?v=dBnniua6-oM also at http://www.youtube.com/watch?v=ceFyF9px20Y, called Fat Chance: 296,000 views.  The graphic in Dr. Lustig’s lecture are at file:///C:/Users/Jerry/Files/Downloads/Lustig+Sugar.pdf   very convincing

And yes, Dr. Fung office will work with your local diabetes doctor: