Diabetes prevention and Reversal – T2D31

posted in: Diabetes, Health and Nutrition | 51

Diabetes associations repeatedly tell the story that type 2 diabetes is a chronic and progressive disease. It is inevitable, like getting older. As much as we would like to stop the process, it is impossible. There is no hope to change its course. It cannot be prevented and cannot be reversed. But multiple studies and common sense conclusively show that this assertion is false. It is only a carefully crafted deception.

In 1986, the World Health Organization helped to fund the China Da Qing Diabetes Prevention Outcomes Study, a randomized controlled trial of lifestyle interventions lasting over twenty years. During the first six years of active intervention of diet and exercise, the incidence of diabetes was reduced by 43%. This benefit persisted over the extended follow up period of twenty years. Onset of type 2 diabetes had been delayed by an average of 3.6 years with diet and exercise.

Similar randomized, controlled studies of lifestyle interventions have shown exactly the same benefit around the world. In the United States, the Diabetes Prevention Program reduced the incidence of type 2 diabetes by 58% while maintaining an average weight loss of 5% over 4.8 years. Ten-year follow up continued to show a substantial 34% benefit. The Indian Diabetes Prevention Programme used lifestyle modifications to reduce the incidence of type 2 diabetes by almost 30%. The Finnish Diabetes Prevention Program reported a 58% reduction. A Japanese trial was able to reduce progression by 67%.

The one factor of over-riding important to note is that all these successful prevention studies use lifestyle changes. Type 2 diabetes is overwhelmingly a lifestyle disease, so lifestyle interventions are required, not medications. You can’t use drugs to prevent a dietary disease.

Type 2 diabetes is not chronic and progressive. It is preventable. But can it be reversed?

Lessons From Bariatric Surgery

Virtually all diabetes specialists, doctors and researchers believe that type 2 diabetes is a chronic and progressive disorder. Once you have type 2 diabetes, it will eventually get worse, no matter what you do. No amount of dietary or lifestyle change will alter the natural course of this disease, so you may as well accept it. Medications may help manage the disease but there is no hope of actually curing or reversing type 2 diabetes.

This message of despair is found everywhere. The American Diabetes Association proclaims point-blank on its website that, “Fact: For most people, type 2 diabetes is a progressive disease”. Diabetes Australia carries a similar despondent message for patients. It says, “Over time most people with type 2 diabetes will also need tablets and many will also need insulin. It is important to note that this is just the natural progression of the disease”.

These organizations, supposed to represent the interests of diabetics, all pronounce that progression of this disease is both natural and normal. ‘Progression’ here is a euphemism for the blindness, kidney failure, amputations, infections, heart attacks, cancer and stroke that accompany late stage type 2 diabetes. With this message, the health professionals spread learned helplessness to patients. “Abandon hope, all ye who enter”, they roar.

But there is a major problem with these edicts of hopelessness. They are simply not true. They are only lies. Type 2 diabetes is actually a reversible, curable dietary disease. Further, I can prove it to you quite easily.

Bariatric Surgery

Bariatric surgery is devoted to developing procedures designed to help patients lose weight. The earliest endeavor to surgically cure obesity was to simply wire the jaws shut. The logic is obvious, if not very imaginative. This treatment though was ultimately unsuccessful. Patients could still drink fluids, and enough high calorie sugary drinks derailed weight loss. Dental infections and vomiting were also insurmountable problems.

Dr. Payne ushered in the modern age of weight loss surgery in 1963 with the jejuno-colic bypass operation. He had developed this operation after observing that patients who lost their small bowel for other reasons, such as trauma or tumors, would lose significant amounts of weight. The stomach is touched, but instead, the small bowel, which absorbs most of the ingested nutrients, is completely bypassed. Food was rerouted from the stomach directly to the colon. As expected, patients lost significant amounts of weight.

But side effects and operative problems became immediately obvious. Patients developed night blindness from Vitamin A deficiency, and osteoporosis from Vitamin D deficiency. Severe diarrhea and bacterial overgrowth, liver failure, and kidney stones were also common. Continual diarrhea from the mal-absorbed fat led to anal excoriations and hemorrhoids. No fun. Severe complications forced the switch in 1969 to the less intensive jejuno-ileal bypass. Even still, complications were not acceptable and this surgery is now simply a historical footnote. However, other surgeons were able to build upon its initlal success.

There are two general types of weight loss surgery, mal-absorptive and restrictive. Mal-absorptive surgeries alter the intestines so that ingested food is not properly absorbed. Dr. Payne’s early jejuno-ileal bypass is an example of a purely mal-absorptive type of surgery. Restrictive types of surgery place some obstacle to prevent food being eaten.

Earlier, in 1925, a report in the Lancet had chronicled that patients with partial removal of the stomach for peptic ulcer disease often demonstrated permanent weight loss and complete resolution of sugar in the urine, now known to be diabetes. Similar reports followed sporadically in the 1950s and 1960s. In 1967, surgical success improved when a restrictive component was added to conventional bariatric surgery.

In addition to the partial bypass of the small bowel, part of the stomach was removed as well. With the basic idea in place, further refinements were added over time, leading to the present day Roux-en-Y bypass surgery, which is still considered the most powerful weight loss surgery available. Some 140,000 such surgeries were performed in the United States in 2005.

Sleeve Gastrectomy

In the Roux-En-Y surgery, most of the healthy stomach is removed until the only portion remaining is approximately the size of a walnut. This severely restricted the amount of food that could be comfortably eaten. The second step of the surgery was to rewire the small intestines so that any ingested food could to be not properly absorbed. Because this is a combined restrictive and mal-absorptive surgery, it tends to be more powerful than simpler surgeries that target only one pathway. It is also associated with far more complications, but does tend to work well for weight loss, as you may well imagine.

Because of the complexity and complications of the Roux-En-Y procedure, simpler forms of surgery have since been invented. A popular recent surgery is called the sleeve gastrectomy. A large portion of the healthy stomach is simply removed with none of the intestines being surgically altered. This is a purely restrictive form of weight-loss surgery. Results were not quite as good as the Roux-en-Y, but still nevertheless very good.

Gastric Lap Band

The stomach’s capacity for holding food is reduced so much that it is often impossible to eat. A liquid diet is often necessary in the postoperative period. Eating any more than a thimbleful will result in severe gastric distention, ballooning of the miniature stomach. This causes persistent nausea and vomiting. Over time, the remaining stomach will often stretch out until it becomes possible to eat small meals.

Removing large portions of healthy stomach is not ideal, so the lap band was developed. This involves the surgical implantation of a band that simply wraps around the stomach. Like cinching a tight belt, the lap band restricts food from entering the stomach and eliminates the need to cutting anything out. The lap band can be gradually tightened or loosened as needed.

In the short term, all types of bariatric surgery are effective for weight loss and diabetes. Longer-term studies show varied effectiveness. As the stomach expands, patients often resume their previous eating habits, since surgery has not taught them proper weight loss techniques. However, my point is not to praise or condemn these surgeries. As with everything else in medicine, they do have their place. My main question is what happens to the type 2 diabetes? In virtually all cases, it simply disappears. Yes, it just goes away. The problem, it turns out, was not that the disease was not reversible, the problem was our treatment of the disease was incorrect.

51 Responses

  1. Dear Dr. Fung.
    I am living proof of Reversibility!
    Hi from Jerusalem. I’d like to share my latest success story.
    I am a 52 year old male.
    Last year in Feb. I was suddenly diagnosed Diabetes T2 with a HbA1C% of 7. JJust a regular yearly checkup.
    I immediately started LCHF. 3 months later I discovered this blog and your book, and added intermittent fasting. Without going into all the details, yesterday I had a periodic bloodwork panel – and scored HbA1C% of 5.2!! That’s down to the median score for healthy adults my age! My blood sugars are better than about 50% of the normal population. You can’t say that that isn’t a reversal, can you?

    No drugs. No deterioration.
    Nothing but Low Carb and Intermittent Fasting.
    And, BTW, I lost 15kg and my BMI is down from 32 to 25.5, Not part of my main objectives, but Hey, I’m not complaining…..
    Inflammation is down, fasting insulin is down, Triglycerides are down. HDL is up. Yes, my LDL is also high, but my doctor says we can ignore that. Good for him.

    So what can I say, Thank you Dr. Fung!!

    • Congratulations Eli, that is awesome! Good work!

    • Reggie zu

      HI Eli, I am happy for you, I would like to know one thing, after your fasting… say now you go and eat like any one without any limits , drink some juice , have rice, have 3 meals with high carbs .. would that increase your blood sugar above 180 after 2 hours from eating or your blood sugar reading become less than 180 after 2 hours ?

      when Dr fung talk about cure .. does that mean that the person have T2D can enjoy any food without problems like before being diagnosed or it means the person have to continue the low carbs diet ??? if any one have answer also welcome to reply thank s

      • I may be another living proof. I lost almost 100 lb in 7-8 months going from 238 to 140 From June 1 2016 to Jan 13 2017 with a huge chunk of it coming in a relatively short time. 219 on sept 15 and 148 on Dec 14th. 3 months 72 lb.
        The thing I am trying to figure out is how to make it permanent. I believe visceral fat and getting rid of it is the key. I have a few lb left in the sub cutaneous belly area, but the visceral fat should go, then you get a true 18yr old body. I suspect that is the key to locking it in.

      • Sorry 1 more ting to add.
        100 gm of carbs in short period of time at the end of a High fat meal will still not kick me out of ketosis. I can repeat that day after day for over 10 days and if I am working out, I get ripped like crazy and drop body fat like a rock. and 100 gm carb at the end of a nice meal is near impossible to even eat.
        I ate over 400 gm carbs yesterday in another massive meal but this was not high fat, in fact it was mostly carbs, and no problem with high blood sugar. Though I did not measure it, let alone stay awake 2 hrs after eating. I’d say I was experiencing low BG by then. I was probably out of ketosis but I got back into ketosis in my sleep I’m guessing, cos I woke up with all the classic symptoms.
        On the intermittent fasting diet almost doesn’t matter if you eat carbs. Just as long as you don’t do it everyday. I’m a committed carnivore. Just watch the carbs, and if you’re carbing try to stay calorie deficient. On the non carb days you could overshoot the calories too.


        • Dylan Roberts

          Congratulations, Srinath! I enjoy reading about the success people have experienced following these principles. It’s very encouraging. May I ask what your blood sugar was before starting this way of life, and what it is now? Were you T2 diabetic?

      • Charlene

        As Dr Fung points out–T2D is a dietary disease, therefore must be fixed with diet. LCHF can reverse the T2D but if the old diet is put back into practice, it stands to reason T2D will return. Diet causes T2D and so only diet can truly fix it.

  2. My husband is living proof also. A1C 11.5. It is 5.6 now. All other health markers drastically improved! I follow a LCHF diet and IF right along with my husband and although I was not diabetic my general health has improved dramatically. Without a doubt, if you follow Dr. Jason Fung’s advice you will cure your diabetes. Go to dietdoctor.com and learn how to cook a LCHF meal plan. It really is a decadent way of eating. You’re going to love how you feel and how you look!

  3. Roger Bird

    “But multiple studies and common sense conclusively show that this assertion is false.” And don’t forget the many anecdotal reports that confirm that diabetes is reversible, like me. (:->) Remember that at one time the fact of manned heavier than air flight was anecdotal. The magazine Scientific American disputed manned heavier than air flight right into 1908, more than two years after it was merely anecdotal.

  4. Roger Bird

    It is not Jason’s job “to praise or condemn these surgeries”. I accept that. So I guess it has to be my job to condemn those surgeries. They are sick and degenerate. Even sicker are the people who KNOW that these surgeries heal diabetes but go on saying that diabetes is progressive and incurable.

  5. Thank you Roger Bird, well said.

  6. Ephesians 6:12 KJV
    We wrestle not against flesh and blood, but against principalities against powers against the rulers of the darkness of this world; against spiritual wickedness in high places.

    This truth and the fact that the love of money is the root of all sorts of evil explain why it is that people believe that T2 diabetes is irreversible and that if you don’t eat for a couple of days you risk your life. Fear mongering and brain washing is the norm today. Even with proof it is very difficult to convince people they have believed lies about these things.

    But the truth will make you free and who the Son makes free he is free indeed. Thanks for this excellent blog!

  7. Dr. Fung, I am currently doing a ketogenic diet and IF to help reverse insulin resistance. What are the signs of insulin sensitivity? For example, after I eat about an hour or so later I get sleepy. Is that insulin sensitivity? Please advise. Thanks.

    • Hi Paris… what you are experiencing is perfectly normal and known as postprandial somnolence (aka “Rest and digest”).

      As far as an indicator of insulin sensitivity, it may not be.

      • Thanks, Steve. I just switched back to a multivitamin I used to take that contain chromium which is known to help lower blood sugars and carb cravings. I’m not diabetic or prediabetic so I am in prevention mode and want to get a handle on my health being proactive. Thanks to Dr. Fung for he does.

  8. What’s interesting is I didn’t see one mention of Dr Roy Taylor and his pioneering work at the New Castle Magnetic Imaging Centre. This is a must see web presentation.
    Working on what it was about Bariatric surgery that made T2D mysteriously vanish Dr Taylor and 2 Computer Science PhDs rewrote the software for the MRI machine to differentiate fat from water and over several peer reviewed studies conclusively proved it need not be chronic or progressive. What they did was put patients on a 8 week 600-700 cal diet, much like Dr Michael Mosley’s except powder not Mediterranean. I did something different and took my A1C from 8.5 to 5.5. The main take away is ADA claims, and people are told by the time you are diagnosed 80% of your pancreatic beta cells are destroyed. Nope, once you lose the intra organ fat, they go back to full insulin production. This coupled with the work of Dr Joseph Kraft means it’s really important for people to become away of both, T2D is diagnosable upwards of a decade before it shows in blood work and you can rid the pancreas of fat and return to normal if you catch it in time. The webinar covers that aspect.

    • RIchard Fish

      Fascinating. Is Valter Longo seeing the same result with his “fasting mimicking” research at USC when he reports beta cell rejuvenation? Did Ron Taylor mistake simple fat reduction in the pancreas as the cause of improved insulin production, for autophagy and cell rejuvenation?

  9. On Feb 7 my Doctor explained to me I now have T2D (A1C=6.7). I told him my plan was to go on the Atkins diet to fight it. He informed me of a close friend of his who lost 65 pounds on Atkins and died a month and a half later. Scared me…. for a little while. But within a few weeks after research I felt that was my only hope. Went completely LCHF on March 6. Have since lost about 10 pounds. Am on my third day of IF. Dinner at 6pm. Fasting till the next day dinner at 6pm. Repeat. I hope to continue on this path and have a glorious success story like so many others I’ve read. Thank you Dr. Fung and so many others who have pioneered this path of truth and healing.

    • sten bjorsell

      Well done! Atkins is too much protein so your doctor may not have been untruthful. Proteins are also insulin promoting, around 50% of carbs.
      Natural fats from outdoor GMO-free animals are best. The fat is then loaded with natural stuff, plus vitamin D! Today’s CAFOs must stand out as some kind of animal torture in the future.

    • Stephen T

      Don, your low carb diet and fasting will send all your bio-markers in the right direction, including insulin. Take a look at the improvement at 26.20 of the attached talk by Jeff Volek.


  10. Stephen T

    The diabetes charities are a disgrace. They are either stupendously stupid or only interested in keeping donations coming in. Would an easy dietary cure suit these charities and their pharma friends?

    The American association used to tell people to snack on candy to avoid anything with fat. The breathtakingly compromised Diabetes Australia has a long list of pharma sponsors and still advocates a low-fat and high carb diet. This is part of their dietary advice:

    To help manage your diabetes:
    • Eat regular meals and spread them evenly throughout the day.
    • Eat a diet lower in fat, particularly saturated fat.
    • If you take insulin or diabetes tablets, you may need to have between meal snacks.
    • It is important to recognise that everyone’s needs are different.

    Well, that should keep their pharma friends happy and the link below shows their sponsors. The disease is going to be ‘progressive’ and ‘irreversible’ for anyone unfortunate enough to listen to these so called health charities.


    • Roger Bird

      Stephen T, thanks for that from Australia.

      I have reversed my diabetes greatly, like perhaps 80%, and I did it by:
      * I eat very irregular meals as I intermittently fast.
      * I eat very high fat, and I go for that saturated fat with glee and gusto.
      * I do not and never would take a diabetes pill and probably any other pharmaceutical, and I eat as little as possible.
      * I recognize that everyone’s needs are different, and that includes some people’s need to be greedy and stupid.


      • Terry teh

        Great stuff. Dr fung talks about a thing call the incretin effect and how it affects blood glucose. The incretin effect is primarily;y about stress. So, being stress free, it actually works better for me and my group of friends. We do not feel guilty when we carbo binge or go off keel. These are just holidays before we go back onto the wagon again. This is what dr fung call call ,’fast and feast’.

        Morever, stress free promotes telomeres growth and inhibit IGF 1. The CDC admits that almost 80% of all diseases are cause by stress. So, you are on to good thing. This incretin effect is seldom elaborated upon as it is kind of fuzzy. But it works for us.

      • Stephen T

        Roger, it’s good to hear about your huge improvement. What a scandal it is that we have to take the opposite course to that recommended by our health systems and charities. We pay their wages to help us, but they just only improve pharma’s share price.

    • Steven, I suspect the same dynamics are at work with the charities as with the ADA. In the later case it is drug companies that make up the board etc. Sure, lots of money to be made selling insulin and when sales go soft there sell other drugs that don’t cure it but ‘treat’ it. The larger point of Dr Fung though is insulin, for T2D, actually makes it worse, not better. Type 2 Diabetes is a condition of too much insulin, not too little.

      I do have one issue with what Dr Fung has promoted though. Dr Taylor, I believe, coined the term reverse. Interesting he doesn’t use cured. My doctor, who finished residency in mid 80’s told me congrats I was successfully ‘managing’ my T2D with diet and exercise. I viewed IF as more a way to restore insulin sensitivity by breaking persistence and high levels. However, and this is the crux, if IF is required to maintain that reversal then maybe reversal is a synonym for manage, as opposed to a synonym for cure. I’ve used, hopefully correctly, the analogy of an STD. Penicillin cured it but that doesn’t mean you cannot re-acquire it. This verses HIV where the cocktail is required forever to keep it in remission. I hope that distinction makes sense to people.

      • Maybe it makes sense if you view diabetes as a body prone to hormonal imbalances whereas in an STD the organisms that caused it might be completely gone from the body?

      • The reference of my dr at that time was that he was ‘old school ‘chronic/progressive’ so congrats for managing simply meant I was pre-insulin dependent. What the lab marked on my blood work including a1c was literally “not diabetic”. I’d like to think that means not diabetic. If unclogging the pancreas to enable full beta cell functionality I’d guess until and unless you so mistreat your body that your liver and pancreas return to fat clogged, one remains ‘not diabetic’ but I am waiting for Dr Fung to confirm that. In other words, it’s the STD example not the HIV example. FWIW, I never had an STD, being part of the 60’s sexual revolution I thought it was an apt analogy.

    • sten bjorsell

      Stephen T, it is worse than that!
      Already in the 1920’s the Rockefellers started with what they call(ed) “effective philanthropy”.
      They the started to give money to US universities promoting research and education to coincide with their business interests.
      Each University that took the “gifts” also got a Rockefeller liaison on the board, effectively a “moneyman” that naturally got huge power to direct research towards “suitable” medicines and education of doctors towards the use of same medicines.
      Naturally “patient organisations” were also sucked into similar dependency. Any university that did not comply, promoting for instance homoeopathy or natural medicines did not get any of the easy money.
      Before this de facto hijacking of both medical education and research, great progress had been made with deficiency diseases, but what I can make out also this research was interrupted through accepting the industry funding.
      Before this time major landmarks had been made finding root causes of diseases: Vitamin C -scurvy, Beriberi -Vitamin B1, Pellagra-Vitamin B3, Bone strength -Vitamin D. And today at least sub clinical deficiency syndromes are often treated with medication as doctors are not trained to recognise even the old known deficiencies, at the same time as the research on other deficiencies that still need to be chartered isn’t being done.

      The difference between taking medication for a problem and correcting a deficiency is huge:
      1/ Medication removes symptom, the right supplement acts on the root cause.
      2/ Medication use increases over time while supplementation usually reduces when the shortage is corrected.
      3/ Symptom-curing means continuous increasing profits while curing a root cause often means the loss of a customer.

      The first Rockefeller started out as a snake oil salesman, promoting fake cures under a false identity.
      Is that the key reason why our health care today is profit-driven instead of health-driven?

      • So well said, thank you! This is exactly my feelings not just about diabetes, but also cancer research: why search for a cure when you can create a “treatment” so you can have continual “customers”? It’s ALWAYS about the money . . .

  11. Thanks Dr Fung, for continuing your amazingly good educative work, promoting good health, free to all comers. From Australia, I tip my hat to you, and sincerely hope that our diabetes association will sit up and take notice sooner rather than later.

  12. Dr, Jason Fung,

    First of all i would like to appreciate your works.

    I have read your book complete guide of fasting. From last three months I am following 16-8 fasting regime daily and 24 hrs fasting twice in week. Feel full of energy. I got following number from my blood work without any medication.
    HbA1C 6.9 mg/dl (date 22/12/2016 when i was diagnosed as TD2)
    current 6.1 mg/dl (26/03/2017)
    HDL was 52 now 59. VLDL was 12.4 now 10.4. LDL was 80.6 now 78.6 mg/dl.
    current fasting insulin is 5.9. Vitamin B12 is 161 and HsCRP is 1.89.

    Now i am not a diabetic .If you see the fasting insulin(ideal ?),vitamin B12 (ideal range?), HsCRP(how to lower it?) are disappointing me.
    I would like to ask you,should i continue my LCHF diet and FASTING regime.

    Jayesh Chopade.

  13. Please give me advice on
    current fasting insulin is 5.9. Vitamin B12 is 161 and HsCRP is 1.89.

    Now i am not a diabetic .If you see the fasting insulin(ideal ?),vitamin B12 (ideal range?), HsCRP(how to lower it?) are disappointing me.
    I would like to ask you,should i continue my LCHF diet and FASTING regime.
    Jayesh Chopade.

    • fasting glucose or insulin is merely a snapshot at the time. A1C is a running 2-3 month avg which is more informative as it is less prone to being ‘good’ the day before.

  14. Hi Dr Fung, I was diagnosed last September with HbA1c of 103 (11%) and after searching on the internet, found your website which explains the science behind the LCHF, which I did adopt, as my previous diet led me to diabetes. It was an experiment without cheating and in Jan, my HbA1c was 37 ( 5.5%) and all LFTs and lipids changed for the better, and a drop of 15kg (80kg to 65kg) – It was hard at first, eating so much butter, double cream and fat as I felt guilty going against the government guidelines, but I am so grateful for the messages you and all the other LCHF healthcare professionals give for free so that patients like me can change our lives just by simple dietary modifications, and going back to what our grandparents ate.
    Once again, thank you for giving me the tools to improve my life. This is one the benefits of the internet where in UK, I can listen to you, Sarah Hallberg, Gary Fettke, Tim Noakes and Drs Unwin, Chatterjee and Malhotra and many others without bias and hidden messages from Big Pharm .

    • Stephen T

      Excellent sources, Leena. I’d add Dr Joanne McCormack in Warrington. I think some of these doctors will be at the Public Health Collaboration conference in Manchester in June. I think they’re beginning to turn the tide.

      You’re obviously on the right track.

    • Yes, and Dr Joanne McCormack’s Twitter Tweets are great.
      There is help close by: https://phcuk.org/map/ (map of “woke” MDs in GB).
      Dr Fung’s “Obesity Code” has allowed me to logically and calmly deal with my own health:
      he explains that “Calories In minus Calories Out” is a useless (and cruel) anachronism.
      I am now BMI 25.2. (I had been up to BMI 28 @XMas.)
      I will persist (now with IF) until the stubborn remaining 5 pounds
      (@loin and belly-button, an indicator of intra-organ internal fat) are gone.

  15. I was diagnosed Type 2 diabetic 5 years ago and have been on metformin since. Over the last couple of years I have maintained a low carb, high fat and protein(just realizing that I might want to cut back on the protien) diet and have been able to keep my A1C in the 6-6.5 range. I have really never been overweight and am now 155 lbs with a BMI of 22.

    I ran accross Dr Fung’s videos on youtube and was very excited about his message. I have been IF for a few weeks and have done a three and seven day fast.

    Here is my question. I stopped taking metformin completely a couple weeks ago and for the last 4 days while doing 22 hr fasts(Dinner to Dinner) my average blood reading has been ~150. The lowest readings in the last 4 days has been 124 and the high was 175. I really want to keep off the drugs but did I jump the gun on quitting Metformin? I am optomistic that eventually my numbers will go down but should I be concerned about potential damage caused by short term elevated blood glucose levels?



    • sten bjorsell

      What did your blood sugar drop down to on your 3-day and 7-day water fasts?
      I would expect down to 75 or less after 3 days. But in the first few days of a water fast, the blood glucose in a diabetic-2 often rises due to lower insulin, because the lower insulin causes the liver to empty stored sugar. Same what happens every diabetic morning!
      High (diabetic) insulin keeps sugar and fats inside the liver. But after 3 days, or at least 5 days water fasting most livers are “empty”, causing blood glucose to drop. Mine now goes below 60 after 2 days. 5 days fasting is the standard fasting time for the operations Dr Jason described above. A few days before op., the day of the operation and another few days to heal up. The result is typically 100% medicine free and diabetes gone on those five days. Then it is of course backed up by the new tiny stomach.
      But we can equally back it up with LCHF, as no risk for raised blood sugar, as long as more fat and minimum protein, at least the first few weeks.
      Best to start LCHF before fasting. Then almost the same fuel, fat all along. But body fat instead of external fat.

      • Hi Sten! Do you recall us talking about your 2-5 fast (as opposed to 5-2 fast)? From your vantage point, is that protocol a ‘forever’ thing or did you find once you declogged your pancreas (and liver) you could be more ‘relaxed’ regarding the aggressiveness which you attacked the original problem?

        Hope all is going well for you!

  16. sten,

    4 days into the 7 day I settled in a range of high 70’s to the mid 90’s. I had gone off and have stayed off metformin since. So bottom line – I wondered what the risks of short duration elevated bs in the 140-160 range.

    I sometimes have trouble figuring out how all the stuff I read applies to me as I am one of the more rare skinny diabetics. BMI of 22. ( Got down to bmi 20 on the fast- weight loss is not my goal.


  17. Ron Hunter

    The problem is still the horrible almost criminal dietary advice given by the money grubbers at places like the American Diabetes Association. A number of years ago I had a silastic ring (stomach stapling) procedure. It was remarkably effective and I was almost off insulin. However, I continued to eat a high carb, low fat diet and eventually the pounds crept back (no where near as high as prior to the surgery) and my A1C started creeping up. It took some time and the convincing of my wife to get me to use the LCHF diet. However, the results have been remarkable. Now I really am off insulin and my weight is very close to my all time low.

  18. Ben Wagenmaker

    Believe it or not, the American Diabetes Association recently (and very quietly) posted a study whereby they finally admit that diabetes is “potentially reversible” – see the conclusion in the articles linked below:

    1) http://care.diabetesjournals.org/content/early/2016/02/24/dc15-1942.short
    2) http://care.diabetesjournals.org/content/39/5/808

  19. Good study Ben, however the Conclusion makes a valid point:

    “T2DM can now be understood to be a metabolic syndrome potentially reversible by substantial weight loss, and this is an important paradigm shift. Not all people with T2DM will be willing to make the changes necessary, but for those who do, metabolic health may be regained and sustained in just under one-half.”

    A person has to take responsibility and make the change in order to see change.

    • Paris, you should listen to the Roy Taylor presentation, “Reversing the Irreversible”. Dr Taylor was the dr proving it was reversible/curable. In his trials it was simply a strict diet for 8 weeks, hardly ‘substantial’ weight loss. He notes that for many of the subjects within a few weeks they normalized, not requiring the full 8 to be technically not diabetic. Of course, within a few weeks an A1C would not reflect much change. To my recollection he tested subjects with T2D diagnoses up to 10 yrs that successfully reversed. However the longer one had been a diabetic the longer the odds were for a full recovery. But they did see successful results after a 10 yr or so period of being diabetic.

      • Sorry, I see in those study Taylor is now up to 30yrs out. In my case, as soon as I was diagnosed I jumped right on it and did not do his 8 wk 600-700 cal diet, rather followed a normal diet via MFP losing, on avg, 2.5-3.0lbs/wk ~ 10lbs/mo. In Dr Taylor’s talk, mentioned above, in summation he states the first thing a diabetic needs to do is decide if (s)he really wants to be non-diabetic. Dr Taylor is currently in a study, ending in 2018, to test the efficacy of achieving similar results in a primary care environment, i.e not in a hospital bed for 8 weeks. That, to paraphrase Dr Fung, will be “the gold standard baby”. As I said, I merely told MFP I wanted to lose 2lbs/week and I did LOTS of cardio which equaled roughly 1lb/week. I’ve been pretty much doing 24hr IF since but have regained about 30lbs. A 30lb delta off the low is lots better than a 125lb starting delta from high weight.

        • Thanks, Walt. I know of individuals who have been diagnosed as either prediabetic or have been diabetic for a while and they refuse to make the necessary dietary/exercise changes. No matter what scientific data or YouTube videos from doctors who specialize in diabetes management, it is a no go. But, people will blame the ADA, AHA, and any other acronyms as to why people are losing limbs and that is half truth, the other half are those individuals who refuse to better themselves when they have the resources and opportunity to do so. I’ll give Dr. Taylor a listen.

          • Stephen T

            Paris, you make a good point and I have a friend who refuses to alter his diet. Professor Taylor is absolutely right to ask patients if they really want to be non-diabtetic. However, there are many people who have done everything the system has told them to do and got a little bit worse every year. When they find the low-carb ‘cure’ these people are often very angry indeed at the terrible advice they were given.

            People like my friend hide behind the current guidelines. They can say, “I’m following my doctor’s advice.” When our system finally gives diabetics good advice, the ones who want to continue eating junk will have to admit that the fault lies with them.

  20. Here’s something I find very interesting. When we look at beta cell function in T2 we find that our beta cells have a muted response to infused glucose, and there’s no doubt at all about that, you can infuse a certain amount of glucose with a non diabetic and it will produce a certain insulin response, and when you do that with a type 2 you will see a reduced insulin response.

    So I was watching a presentation on this the other day and the idea of this particular one was to explain the lack of phase 1 response, which the presenter did a pretty good job with, then I thought, well why are our insulin levels so high? Well it could only be one thing, gastric response. So we hear about how big a deal the gut may be, and we do know that the stomach secretes glucagon, and there may also be an issue with GIP. They talk about the other incretin hormone a lot but one of them is secreted in the stomach and the other in the small intestine, it doesn’t make sense that it could have much to do with GLP-1 but it sure does with GIP. GIP of course increases both insulin and glucagon levels and that’s exactly how T2DM presents, and that’s exactly the problem with the disease.

    I don’t know if I want to say that gastric bypass reverses T2, just because something normalizes blood sugar doesn’t mean it reverses the disease because this is of course just one of the symptoms. I’d be curious to know how this affects insulin levels but I would expect that would normalize too. I’ve seen data that this improves insulin sensitivity so that is probably the case. So now we’re on to something, aside from just eating a diet that normalizes insulin levels, which is how carb restriction helps us. I don’t know where this might lead but if we could figure out what the hell goes wrong here we may be able to come up with a way to replicate this somewhat without surgery.

  21. Isn’t there a difference in outcomes depending on whether the surgery bypasses the duodenum? What’s happening there?

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  23. Two years ago now, I had a routine blood test. It showed my glucose to be 7.4 mmol/L and A1C at about 7. I convinced my doctor to let me diet, lose weight and have another test. He agreed and gave me 6 months.
    I went on the Atkins diet (didn’t know about Dr Fung at that time). 6 months later had another blood test. My glucose was 5.2mmol/L and A1C 5.3. A year later (still on the diet mostly and lost a lot of weight) the readings were the same.
    Pre diabetes or diabetes revered? A lot of people on these blogs would say YES!!
    I had to go to a birthday party and the next morning, by chance I checked my glucose (it was about 7.5). Insulin resistance reversed – hell NO. A couple of weeks on low carb diet and the markers were good again. The diet just controls the situation because I don’t eat much carbs so the insulin does not have to rise much. Insulin resistance reversed? NO.
    I think that only the way to check if insulin resistance has reversed is to do an oral glucose tolerance test (OGTS). I did this at home and I was highly pre diabetic or even diabetic.
    I did some searching on the internet and found Dr Fung’s website, and here I am. I am now doing IF as well.
    I have a question for Dr Fung – when you say that T2D can be reversed , do you mean that an OGTS returns to normal or that just the markers mentioned return to normal?

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