How NOT to treat diabetes – T2D 38
By the mid 1990s, the landmark DCCT trial has established the paradigm of glucotoxicity, in type 1 but not in type 2 diabetes. Still euphoric from the trial’s success, it seemed only a matter of time before tight blood glucose control was proven beneficial in type 2 diabetes as well. Nobody stopped to consider exactly...
Vitamins and Calcium
One of the more common questions is whether I recommend any supplements. I recommend very few of them. For longer fasts, I recommend a general multivitamin, although there is scant evidence that it is beneficial. In fact, almost all vitamin supplements have been proven to be useless. In some cases, like vitamin B, worse than...
Insulin toxicity – T2D 37
Insulin Toxicity The rosiglitazone debacle and the shocking 22% increased risk of death found in the ACCORD study focused researchers on the potentially harmful effects of some of these blood glucose lowering medications. Insulin was the oldest and most powerful and the time had come to consider the paradigm of insulin toxicity. Making the diagnosis...
The Fed and the Fasted State
In order to understand how the body gains and loses weight, you must understand how it uses energy. The body really only exists in one of two states - the fed and the fasted state. When we eat, the hormone insulin goes up and insulin is released. Now all foods stimulate different amounts of insulin...
Glucotoxicity and Double Diabetes- T2D 36
The glucotoxicity paradigm For as long as I have practiced medicine, the mantra of excellent diabetic care was tight blood glucose control. All the diabetes associations, the university professors, the endocrinologists, and diabetic educators agreed. The prime directive was "Get those blood sugars down into the normal range at all costs, soldier!" The only acceptable...
Towards a Cure – T2D35
Protective Responses Over 50% of American adults are estimated to have prediabetes or diabetes. The twin cycles (hepatic and pancreatic) are not simply rare metabolic mistakes leading to disease. These responses are almost universal because they serve as protective mechanisms. Protective? I can almost hear you gasp. Insulin resistance and beta cell dysfunction are protective?...
Jason – Patient Profile
Dr. Jason Fung: A follower on Facebook recently posted some before/after pictures with the following caption: Today was a big...no scratch that a huge mile stone for me.. the scale says 284! This means I am officially down 150 lbs!! I went from a size 50, to a 36 (34 in some brands) a size...
Fatty Pancreas – T2D34
Fatty Pancreas The English friar and philosopher William of Ockham (1287-1347) is credited with developing the fundamental problem solving principle known as lex parsimoniae or Occam’s Razor. This principle holds that the hypothesis with the fewest assumptions is most often right. The simplest explanation is usually the most correct. Albert Einstein is quoted as saying,...
Natural History Phase 2 – T2D 33
Type 2 diabetes actually happens in two phases. The first phase, which lasts approximately 10-15 years shows a slow increase in insulin resistance. However, the body compensates by increasing insulin levels. This keeps blood glucose relatively normal. But something suddenly changes after approximately a decade of rising insulin resistance. Hyperinsulinemia can no longer keep up...
Sarah – Patient Profile ‘Thin diabetic’
Dr. Jason Fung: I received a letter from reader Sarah, who has successfully used a Low Carbohydrate High Fat (LCHF) diet and Intermittent Fasting (IF) to reverse her type 2 diabetes. Interestingly, she is not particularly overweight as measured by Body Mass Index, yet still suffered from T2D. At her heaviest, she only had a BMI of...
‘Medical’ Bariatrics – T2D 32
What happens when a severely obese, diabetic patient undergoes weight loss (bariatric) surgery? If type 2 diabetes is truly a chronic, incurable progressive disease, then surgery will not alter the natural history. According to conventional medical wisdom, long standing type 2 diabetics have very high insulin resistance provoking increased insulin secretion from the pancreas. Over...
Fasting and Ghrelin – Fasting 29
Ghrelin is the so-called hunger hormone. It was purified from rat stomach in 1999 and subsequently cloned. It binds to growth hormone (GH) secretagogue receptor, which strongly stimulates GH. So, for all you people who thought that eating makes you gain lean tissue, it is actually the opposite. Nothing turns off GH like food. Of...
