How to Reverse Type 2 Diabetes, The Quick Start Guide

posted in: Diabetes, Health and Nutrition | 122

How to Reverse Type 2 Diabetes – The Quick Start Guide

VCR1200Twenty years ago, when you bought a brand sparkly new VCR machine, you would also get a thick instruction manual. Read this thoroughly before you start, the manufacturer would implore. There would be detailed setup procedures and troubleshooting guides.

Most of us ignored the manual, just plugged it in and tried to figure out the rest. That’s why we all had the blinking 12:00 on. Today, most new electronics now come with a quick start guide which has the most basic 4 or 5 steps to get your machine working and then anything else you needed, you could reference the detailed instruction manual.  Instruction manuals are just so much more useful this way.

Well, I don’t know much about VCRs, but I do know about type 2 diabetes. I can write an entire book about obesity (oh, wait, I did that already), or fasting (oh, wait, coming up) or type 2 diabetes (next up for 2018). But many of you will not want to go through the entire instruction manual. So this is the quick start guide for reversing your type 2 diabetes.

A Fully Reversible Disease

Most doctors, dietitians and diabetes specialists claim that type 2 diabetes is a chronic and progressive disease. The American Diabetes Association, for example, almost proudly proclaims this on its website. Once you get the diagnosis, it’s a life sentence. But, it’s actually a great big lie. Type 2 diabetes is almost always reversible and this is almost ridiculously easy to prove. This is great news for the more than 50% of American adults who have been diagnosed with pre-diabetes or diabetes. Recognizing this truth is the crucial first step in reversing your diabetes or pre-diabetes. Actually, it something that most people already instinctively recognized to be true.

Suppose your friend is diagnosed as diabetic, then works hard to lose 50 pounds. He takes himself off all his medications and his blood sugars are now normal. What would you say to him? Probably something like “Great job. You’re really taking care of yourself. Keep it up!” What you wouldn’t say is something like “You’re such a dirty, filthy liar. My doctor says this is a chronic and progressive disease so you must be lying to me” It seems perfectly obvious that diabetes reversed because your friend lost all that weight. And that’s the point. The disease is reversible.peter

We’ve  known all this along. But only diet and lifestyle changes will reverse it. NOT medications. The most important thing, of course, is to lose weight. But the diabetes medications don’t do this. Quite the contrary. Insulin, for example is notorious for causing weight gain. Patients intuitively sense that they are heading down the wrong path.

They would often say to me, “Doctor. You’ve always said that weight loss is the key to reversing diabetes. Yet you prescribed me a drug that made me gain 25 pounds. How is that good?” I never had a good answer, because none existed. It was not good. The key was weight loss, whereupon the diabetes often goes away or at least gets significantly better. So, logically, insulin does not help reverse the disease, but actually worsens it.

Other medications such as metformin or the DPP4 drug class are weight neutral. While this won’t make things worse, they won’t make things better either. Since weight loss is the key to reversing type 2 diabetes, medications won’t make things better. Medications make blood sugars better, but not the diabetes. We can pretend the disease is better, but that doesn’t make it true. That’s the reason most doctors think type 2 diabetes a chronic and progressive disease. We’ve been using the wrong treatment. We’ve been prescribing drugs for a dietary disease. No wonder it doesn’t work.

So, how can you reverse your diabetes?

The Sugar Bowl

The essential feature of type 2 diabetes and pre-diabetes is that our bodies are completely filled with sugar. It’s not just too much sugar in the blood. That’s only part of the problem. There’s too much sugar in our entire body. Imagine our bodies to be a sugar bowl. A bowl of sugar. When we are young, our sugar bowl is empty. Over decades, we eat too much of the wrong things – sugary cereals, desserts and white bread. The sugar bowl gradually fills up with sugar until completely full. The next time you eat, sugar comes into the body, but the bowl is full, so it spills out into the blood.sugar-overflow-grains-pouring-overflowing-bowl-41943543

Insulin is a normal hormone produced when we eat and its job is to allow glucose into the cells. When it is no longer able to do it, glucose piles up outside the cell in the blood, and it is called insulin resistance.

But why does this happen? The cells are already over-filled with glucose (see previous post – A New Paradigm, and Insulin Resistance is Good?). Like trying to blow air into an over-inflated balloon, it simply takes more force. The cell resists the glucose because it’s completely full. insulin resistance is an overflow phenomenon.

It’s like packing your clothes into a suitcase. At first, the clothes go without any trouble. After a certain point, though, it is just impossible to jam in those last 2 T-shirts. You can’t close the suitcase. The luggage is now ‘resistant’ to the clothes. It’s waaayyy harder to put those last 2 T-shirts than the first 2. It’s the same overflow phenomenon. The cell is filled to bursting with glucose, so trying to force more in is difficult and requires much higher doses of insulin.

Full-suitcaseWhen the insulin levels are unable to keep up with the increasing resistance, blood sugars rise and your doctor diagnoses you with type 2 diabetes and starts you on a pill, such as metformin. But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs – the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat.

The problem, of course, has not been solved – the sugar bowl is still overflowing. You’ve only moved sugar from the blood (where you could see it) into the body (where you couldn’t see it). So, the very next time you eat, the exact same thing happens. Sugar comes in, spills out into the blood and you take metformin to cram the sugar back into the body. This works for a while, but eventually, the body fills up with sugar, too. Now, that same dose of metformin cannot force any more sugar into the body.

So you go to your doctor. What does he do? Instead of getting rid of the toxic sugar load, he doubles the dose of the medication. If the luggage doesn’t close, the solution is to empty it out, not use more force to . The higher dose of medication helps, for a time. Blood sugars go down as you force your body to gag down even more sugar. But eventually, this dose fails as well. So then your doctor gives you a second medication, then a third one and then eventually insulin injections.

Over a period of years, you went from pre-diabetes, to diabetes, to taking one medication, then two then three and then finally large doses of insulin. Here’s the thing. If you are taking more and more medications to keep your blood sugars at the same level, your diabetes is getting worse! Even if your blood sugars get better, your diabetes is getting worse. This is unfortunately what happens to virtually every patient. The body is already overflowing with sugar. The medications only hide the blood sugar by cramming it into the engorged body.GettingWorseThe diabetes looks better, since you can only see the blood sugars. Doctors can congratulate themselves on a illusion of a job well done, even as the patient gets continually sicker. Patients require ever increasing doses of medications and yet still suffer with heart attacks, congestive heart failure, strokes, kidney failure, amputations and blindness. “Oh well” the doctor tells himself, “It’s a chronic, progressive disease”.

Imagine that you hide your kitchen garbage under the rug instead throwing it outside in the trash. You can’t see it, so you can pretend your house is clean. When there’s no more room underneath the rug, you throw the garbage into your bedroom, and bathroom, too. Anywhere where you don’t have to see it. Eventually, it begins to smell. Really, really bad. You needed to throw out the garbage, not hide it away. If we understand that too much sugar in the blood is toxic, why can’t we understand that too much sugar in the body is toxic too?

The End Game

What happens over time – 10, 20 years?GangrenousFoot

Every single part of the body just starts to rot. This is precisely why type 2 diabetes, unlike virtually any other disease, affects every part of our body. Every organ suffers the long term effects of the excessive sugar load. Your eyes rot – and you go blind. Your kidneys rot – and you need dialysis. You heart rots – and you get heart attacks and heart failure. Your brain rots – and you get Alzheimers disease. Your liver rots – and you get fatty liver disease. Your legs rot – and you get diabetic foot ulcers. Your nerves rot – and you get diabetic neuropathy. No part of your body is spared.

Medications and insulin do nothing to slow down the progression of this organ damage, because they do not eliminate the toxic sugar load from our body. We’ve known this inconvenient fact since 2008. No less than 7 multinational, multi-centre, randomized controlled trials of tight blood glucose control with medications (ACCORD, ADVANCE, VADT, ORIGIN, TECOS, ELIXA, SAVOR) failed to demonstrate reductions in heart disease, the major killer of diabetic patients. We pretended that using medications to lower blood sugar makes people healthier. But it’s only been a lie. You can’t use drugs to cure a dietary disease.

How to Reverse Diabetes

Once we understand type 2 diabetes, then the solution becomes pretty bloody obvious. If we have too much sugar in the body, then get rid of it. Don’t simply hide it away so we can’t see it. There are really only two ways to get rid of the excessive sugar in the body.

  1. Don’t put sugar in.
  2. Burn it off.

That’s it. That’s all we need to do. The best part? It’s all natural and completely free. No drugs. No surgery. No cost.

Step 1 – Don’t put sugar in

The first step is to eliminate all sugar and refined starches from your diet. Sugar has no nutritional value and can therefore be eliminated. Starches are simply long chains of sugars. Highly refined starches such as flour or white rice are quickly broken down by digestion into glucose. This is quickly absorbed into the blood and raises blood sugar. For example, eating white bread increases blood sugars very quickly. Doesn’t it seem self-evident that we should avoid foods that raise blood sugars because they will eventually be absorbed into the body? The optimum strategy is to eat little or no refined carbohydrates.Time-Fat-CoverDbl

Too much dietary protein is also converted into glucose by the body. Therefore, you should avoid eating too much protein as this, too will only add sugar to the body. Protein shakes, protein bars, and protein powders should all be avoided. Instead focus on eating lots of vegetables and natural healthy fats.

Dietary fat, long shunned for its purported effect of causing heart disease, is back. Natural fats, such as found in avocado, nuts and olive oil are well known to have healthy effects on both heart disease and diabetes. The Mediterranean diet, high in natural fats, is well accepted to be a healthy diet. Dietary cholesterol has also been shown to have no harmful effect on the human body. Eggs and butter are back.

Most importantly, stick to eating whole, natural, unprocessed foods.

Step 2 – Burn it off

Fasting is the simplest and fastest method to force your body to burn sugar for energy. Glucose in the blood is the most easily accessible source of energy for the body. Fasting is merely the flip side of eating – if you are not eating you are fasting. When you eat, your body stores food energy. When you fast, your body burns food energy. If you simply lengthen out your periods of fasting, you can burn off the stored sugar.

Since type 2 diabetes is merely excessive glucose in the body, burning it off will reverse the disease. While it may sound severe, fasting has been practiced for at least 2000 years. It is the oldest dietary therapy known. Literally millions of people throughout human history have fasted without problems. If you are taking prescription medications, you should seek the advice of a physician. But the bottom line comes to this.

If you don’t eat, will your blood sugars come down? Of course.

If you don’t eat, will you lose weight? Of course.

So, what’s the problem? None that I can see.

We can reverse type 2 diabetes and pre-diabetes today, right now, immediately. All without cost, without drugs, without surgery, with an all natural, time-tested healing method. We only need to lead our bodies down the healing pathway and have the courage to apply our hard-won knowledge.

 

 

 

122 Responses

  1. Dr Fung,

    Thanks for the reminder about excessive protein!

    For all of you out there that haven’t tried this diet… I know it’s difficult to start but honestly we love eating this way. Yesterday we fasted until dinner (a 24 hour fast) and then for dinner we had pork chops stuffed with Gouda cheese, mushrooms and spinach, roasted cabbage covered in butter, coconut oil and Parmesan cheese and a salad with lots of good veggies covered in olive oil, vinegar and feta cheese. Before when we ate potatoes and rice and noodles we would leave the table feeling heavy and lethargic. But now we feel energised and good! When we don’t eat, we don’t eat anything! But when we do eat, it’s rather a celebration of food! No guilt… because everything we put in our mouths we know is good for us… we eat until we are full, never count calories…. and the added fat makes everything taste so good and satisfying!

    When my husband was first diagnosed with T2D we went to the class that teaches you how to eat. WOW! So wrong. It’s really a shame doctors don’t direct us to people that are experts in this way of eating and get insurance companies to pay for the classes! My husband has completely reversed his diabetes with zero medication. All of his “numbers” are good. Blood pressure 117/77 (he is 54 years young) Good cholesterol very high! Bad cholesterol very low! Triglycerides very low! His A1C was 11.5…. in four months it was 6.0. We will have another A1C done soon and we are both certain it will be in the normal range. All, without medication. Just a LCHF diet and fasting.

    We owe it all to you Dr. Fung. You are a hero in every sense of the word.

    • Hi Sue,
      would like to know how your husband did it if possible.
      I am newly T2 & working hard to reverse my condition. I am the usual Mets twice daily at 500 mg each pill.
      I cut off 60% of most white flour & sugar drinks & eat 1/2 my plate with vegetables & run 40 km weekly.
      Progress seems very slow after 7 months of trying.

      • Domi, get the Dr. BERNSTEIN book it is amazing and apply fasting principles of Dr Fung and you will do amazing.

      • Marlene

        I suggest cutting out white bread and sugar completely! ?

        • KidPsych

          Agree completely with Marlene. I think once you’re at a maintenance stage, sneak in some refined carbs as treats, but if you’re serious about making changes right now, I’d cut out white bread and other refined starches completely.

          Once I started to view donuts as cigarettes and white bread as a treat, life became a lot easier.

        • Geoffrey Levens

          YES! Load up on above ground veg as your main volume of food and fill in with some good fats and a small amount of protein. And if you do some form of intermittent fasting things will go much faster; do whatever version appeals Fast 5 is what I do but Eat Stop Eat, Warrior Diet, etc, any way that will give your body significant breaks w/ lowest possible insulin production. That will give much faster reduction in insulin resistance which is the core problem. Soon you will be a lean mean fat burning machine!

      • Get off the Metformin and follow Dr. Jason Fung diet: FASTING ( no food ) READ UP AS MUCH AS YOU CAN ON THIS GUY; AS HE HAS THE ANSWER TO CURE TYPE 2 DIABETES. STAY AWAY FROM DOCTORS PUSHING MEDS ON YOU AS YOU ARE ONLY KILLING YOUR SHELF SLOWLY!!!!!!!!!!

      • Hi Domi! Let me try to walk you through what we do best I can.
        1. Only eat low-carb vegetables, meat and fish. For right now, don’t have any fruit or anything white! (Rice, potatoes, pasta or bread…. no bread whatsoever.)
        2. Add lots of good fat. Make sauces with whipping cream. Roast vegetables in olive oil. Add butter! Fat does not raise your insulin and that is what this whole process is about. Lowering insulin.
        3. Fast. The first time we fasting it was a 24 hour fast. I thought I was gonna die waiting for dinner. But then it really did get easier. We also did two 5 day fasts. Honestly it wasn’t that hard. It was boring! That was the worst part, but I think if you are really “stuck” then a longer fast has great benefit. So now we really don’t have a set protocol. Our bodes adapt quite quickly so we are always changing up when and how long we fast.

        Like I said, I know this is not easy to do, but once you are totally committed to it, it does get easier and now we are at a point that we will never go back to eating what we did before. We truly enjoy our food! If I may recommend a book that explains low-carb eating in great detail along with lots and lots of good recipes its call “Taking Out The Carbage” by DJ Foodie. Just google it.

        Hope this helps!

      • cut out all added sugar and refined carbohydrates. Use Fooducate app to help you barscan codes to determine how much sugar the food industry adds into your foods. That’s a great start!

      • robert lipp

        Domi,
        Start with a strict diet, then when that has worked = normal weight, normal blood pressure, normal blood glucose etc. etc. then you can experiment with what can be relaxed. You may find that you cannot relax anything because all the good work starts to undo. Do your own LCHF research.

        No cereals in any form. No fruit in any form, no fast food, No margarine or other Trans Fats, NO ADDED SUGAR or HIDDEN SUGAR (read the labels), no below the ground veggies except garlic and onions, no peas or pulses. Be careful of soy products. Have above the ground veggies (=fibre carbs), enough good healthy fats = coconut oil, extra virgin olive oil, fish omega 3, free range eggs, free range butter, cream in your coffee, free range saturated fat. Do the research for green orange red food lists. Get your gut biome right with healthy bacteria = real probiotics, full fat yoghurt with bacteria, pickles, sauerkraut. Try intermittent fasting. Eat Real Food. Do the research.

        Depending on your age that (40km/week) might be too much exercise. Exercise is not a good weight loss strategy Moderate age related exercise is good for health. Do the research.

        Research LCHF recipes for tasty food.

        Always use a LCHF (type) supportive medical advisor when you make drastic changes to your diet, there may be medical health reasons not to change such as jaundice or scarlet fever or whatever from the past.

    • Sue, a question I’ve asked that is yet to be answered, is how is a 24 fast possible if some time, presumably, greater than subsecond, spent each day eating. I, too, am on the ’24hr’ fast as described in Appendix A, but I (we) generally eat over the span of minimally 30min and if we have fruit for dessert that could span between 1 and 2 hrs. In other words, we don’t fast from 8pm to 8pm, rather 8pm to, say, 6pm the following day. I have been doing this everyday for the last month, as opposed to every other day. Kind of blending the Mosley/Taylor protocol with the Fung protocol, I try to maintain an 800 calorie budget which necessitates consuming more than a 400 calorie meal. For the last 30+ days there have been no sucrose or processed white carbs like flour. MFP does show about 15g of sugar on average per day but it is pulling that from fresh vegetables and fruits vs. ice cream or pop tots. I assume, as is suggested by OC and Dr Fung’s blogs, that sugar plus antidote is good, antidote by itself is silly and sugar with no antidote is bad.

      Would you elaborate on what you do consume when you do consume it? After 30 days, so far, my weight has just begun to drop noticeably.

      • Geoffrey Levens

        No need for 24 hours absolute. This is biochem. I do Fast 5 and have done for about 2 1/2 years. Many versions of intermittent fasting out there so just find one that works for you. F5 you eat during 5 hour window and fast the other 19 or so. Still gives plenty of time for body to clear all easy sources of glucose and drop your insulin production to its lowest possible which is what you are after.

      • Leaf Eating Carnivore

        Outside of the speed and ease of digestion, and therefore the height of your insulin spikes, it doesn’t matter where the digestible carbs come from. A glucose meter will help.

        Try: “The Art And Science Of Low Carbohydrate Living”, Volek and Phinney.

        There is lots of good info out there, including Dr. Fungs blogs/book, Ketopia.com, Tuit Nutrition.com, etc, etc, and the very practical advice from VeryWell.com.

        The books that saved me initially were “Protein Power” and “Protein Power LifePlan.” And if you are really in deep Kimchee, Dr. Richard Bernstein’s book on Diabetes (although his main focus is Type 1, it’s worthwhile).

        And recognize that to get better, you have to change your life for the rest of your life, and stay tuned – it’s an evolving field. Maybe we will be able to go from reversal & remission to “cure”, whatever that may be.

      • Hi Walt!

        We only eat meat, fish, and vegetables. Last night I made Havarti cheese stuffed hamburgers. I topped it with some cream cheese, tomato and lettuce. I roasted asparagus, mushrooms, broccoli, garlic and zucchini in balsamic vinegar and olive oil. Go online and look for lowcarbyum.com. She has great recipes! At first I thought this “diet” was going to be so limiting, but there are so many “hacks” for bread and desserts that it really never is boring.

        In terms of counting calories we don’t at all. We just eat the things we know we can eat and eat until we are full. In the beginning my husband did eat too much… I think his leptin hormone was off. That’s the hormone that tells your brain your full. But over time he has just naturally consumed less food. I think it’s very important to really feel satisfied when you’re done eating.

        And honestly, we rarely ever snack. If we do it’s just some nuts or seeds.

        We have done a couple 5 day fasts, which was not that hard, just very boring! We sometimes fast 24 hours (we eat at 7 pm and don’t eat again until the next day at 7 pm) and every now and then 36 hour fasts. But we have no set thing that we do. I think changing things up doesn’t give your body a chance to adapt… we keep it guessing. 🙂

        I hope this helps! Best of health to you!

        • Sue,
          Thank you so much for taking the time to post and answer all the questions!
          Just noticing you say you only eat meat, fish and vegetables, but you also eat dairy. 1) Do you have any concern about how much protien you are eating? (do you measure/track?). 2) Is there any concern about dairy? do you eat any/all cheeses you want, plus cream and cream cheese?
          I guess I am asking, (for you) is it no big deal about any micronutrients since you are only eating once a day?
          My husband and I are only eating one meal a day for the past 10 days and like it, but our evening meal, though satisfying and healthy, is maybe too low calorie/fat and maybe too high in protein, causing me to lose weight slower. Maybe. That’s why I ask the above questions.
          We have been very low carb for several years but we are so glad to find Dr. Fung and Dr. Noakes, et al! This is changing our lives!

          • Hi Debra,

            It’s hard to know exactly what to do isn’t it! We sure haven’t gotten it down to a science plus we probably do have too much protein sometimes. Here is what I find. If we are good at eating less protein (like the size of your hand) and have more fat, blood sugar is better and we lose weight a little faster. Sometimes our weight doesn’t budge for a few weeks and then we lose some. Slow and steady wins the race. We eat all cheeses. (Just not processed ones like american cheese slices.) We have full fat cream (whipping cream) and sometimes 1/2 and 1/2. We eat lots of butter, coconut oil and olive oil. It takes time to wrap your head around adding so much fat to a meal but that is key. We never just eat a piece of meat, there is always a full fat sauce to go with it. I make homemade ranch and blue cheese dressings with whipping cream. I love green beans made with bacon. I wouldn’t worry one bit about getting all the nutrients you need because you’re only eating once a day. Have you ever made any bone broth? You get lots of good minerals when you have a cup of that! We use only Himalayan salt. It has 94 (?) minerals in it. It’s actually very good for you!

            Dr. Fung is a hero. We’re gonna just stay the course and enjoy our good health. Hope this answers your questions.

        • We eat similarly to Sue. I also vary my fasting, from multiple days to one or two to none. I generally don’t eat breakfast, but sometimes will. If I eat breakfast, I may not eat lunch. Or I’ll eat three meals. If we’re traveling to vacation, I’ll fast on the way. Once we get back, I’ll fast several days to get the carbs out of my system. I eat a LCHF diet, trying to eat as much fat as possible; now, I’m eating a ketogenic diet, though I did not always do so (and may not do so in the future).

          Example:
          1) This week, fasting 3.5 days;
          2) Next week, may not fast >1 day but will eat during a window (usually 8 hours, maybe just a few hours);
          3) The following week, might try another 3 day fast;
          4) The fourth week, will fast M, Tu, eat We, going on vacation Friday;
          5) Vacation! Will try to eat well, but will have pizza, some bread, maybe ice cream, chocolate, etc. Will try to eat during windows, but may eat 3+ meals one or two days.
          6) Fast several days after vacation.

      • Robert Victor

        24-hour fasting means you eat once each 24 hours.

  2. Elegantly simple as usual Dr. Fung. Thank you for selflessly
    sharing your thoughts. You have had a profound effect on my wellness.

  3. Another great post Dr Fung, you make so much sense to a layman like me. I don’t have T2 diabetes but my mother does and I can see it on my horizon as I am overweight and had a love of starchy refined carbs. I have started these protocols and already feel much better in myself. I went to a family party last weekend and did have some refined carbs, probably not as many as I would have done at one time but this time I was able to fast all the next day and just have one evening meal, when I did that in my low carbing past it would take me months to get back on track, but your videos about insulin spiking all day made so much sense to me. I bought your book The Obesity Code on Amazon and read it cover to cover and what a life changer it was for me.

    Thank you for all you do.

  4. Laura Joan Day

    Thank you once again. I have gone from prediabetic blood glucose readings, to perfect readings, by following your advice–and lost 40 lbs as well. [less than 6 months, shorter fasts 20 to 24 hrs] at my age 69 it has been working for me. We may never meet in person, but hold you in the highest regard. You have saved me from years of suffering and unnecessary drugs I am sure.

  5. Hello Dr Fung. If you in fact reverse T2DM this way (or with bariatric surgery like on that case of the 2g of fat loss in pancreas), one can return to a SAD (standard American diet) and be as tolerant as a kid to its damage? Or one would redevelop the T2DM very quickly? Is there any “permanent pancreas damage”? Or that person never was tolerant to that amount of sugars to begin with?

    Thanks, Your blog and your work is amazing.

    • Geoffrey Levens

      The SAD is basically poison. People vary (based on genetics, stress levels, other variables) on how fast it will kill them but it is toxic to humans. No one can eat SAD with impunity even if damage does not show immediately. You need to learn to love vegetables! And eat only real food i.e. very minimally processed, as close to as “from nature” as possible, no junk, no chems, no concentrated extracts. If you stick to it 100% for a few months your taste buds and brain will change and you will come to much prefer eating a healthy diet and be appalled at SAD.

      • Hi Ernani,

        Let me start with we will never go back to the SAD diet. But I too have wondered if this disease if fully reversed then it would seem that, for a while, you could go back to eating SAD, before you ended up with T2D again. I will say this. Twice my husband and I ate a couple of things that we never do. Once some potato salad and just last week a couple of ears of corn. We both tested our blood sugar to see if my husbands (who has T2D, I do not) blood sugar would be higher and stay higher longer than mine. We checked every 1/2 for 2 hours. Our blood sugar was basically the same. In fact mine was a little higher than his. LOL. I realize that this is just a little sample and in no way proves complete remission or a cured status but we were happy to see that those carbs had no ill effect on my husbands blood sugar.

    • Leaf Eating Carnivore

      As far as I can see, T2 mostly reflects a fundamental mismatch between an individual’s present physiology and her/his diet. So at the present time, the changes usually have to be seen as permanent, although individulized and evolving.

  6. Ahmad Luqman Alias Firdaus Bin Ab Patah

    Hey….
    How about the insulin resistance?
    What happen?

  7. Hello Dr Jason Fung, I’m from Brazil and a great admirer, I have read your blog entirely think fantastic.

    I follow a lot of his advice, I have 56 years old and had severe obesity, by first removed all sugar and flour, not consumption almost nothing industrialized, do 2-3 fasts of 24 hours per week.

    Over time I have seen my body turn, I lost weight 25kg, got a perfect health and an array of 20 years ago.

    I have read and heard many comments in the media about the use of Metformin for rejuvenation, I’d love to know your opinion below is a link to a publication on this subject.

    http://www.life-enhancement.com/magazine/article/2970-is-metformin-the-metabolic-holy-grail

    Sorry grammar errors I write in Google translator.

    Thank you, hugs!

  8. Jenny Froome

    Thank you for the protein warning / reminder. I knew there was a catch and must educate my now healthy son to cut down on these so called healthy protein options. Good information. Simple and makes sense.

  9. Hi Dr. Fung from Jerusalem,
    Thank you so much.
    I have watched all your youtube presentations and have just finished your new book.
    I was diagnosed T2 5 months ago with an HBA1c of 7% and a fasting blood sugar of 150.
    After 3 months of Low carb only (I “refused” medication), it was down to 5.9% and a fasting blood sugar of 100.
    I then stumbled into your youtube videos and blog, and started fasting twice a week for 20 hours. My average fasting blood sugar is now down to 88! My next HBA1C is a month away, and I am pretty sure it will be around 5%. (I also lost 11KG and qyadrupled my swimming distance, although these were just an unintended side-product)
    So what can I say? You’re amazing!
    Thanks!
    Eli

  10. Nice results Sue, well done to you and your husband.

    • Thank you Jin. I have read many of your posts and gleened good information from them. It’s nice that we can share our stories here.

  11. Dear Dr Fung. I have just finished listening to your podcast on Keyovangalist and reading this link.
    This is Fantastic information. I knew taking Insulin for my T2 diabetes was killing me!
    I was recently told I’m now functionally a T1.
    I recently had to have a Stent in my RCA as it was 80% blocked.
    I have just had a cataract removed from my left eye & in 3 weeks have cataract removed from my right eye. I have Diabetic retinopathy in both eyes requiring regular injections in both eyes so I don’t go blind.
    I have peripheral neuropathy in both feet working its way up toward my knees.
    I am 61 yrs old Female. Taking insulin now for 11 years as I’m gastro sensitive to metformin and anaphylactic to sulphur based diabetic meds so put on insulin.
    I have put on 20kgs of weight so the fat storing hormone insulin has really been doing its work by rotting me from the inside out.
    Can you please tell me will Keto diet reverse my diabetes in this instance. Your response to my comment will be gratefully appreciated as will your valued advice.
    With much anticipation.

    Deni

    • Hi Deni,

      I’m obviously not Dr. Fung, but I have come to know a lot of people in the same situation as you. Going Keto was one of the best things they tell me they’ve ever done. A very low carbohydrate diet not only will help you not put in so much sugar in your body but if you choose to cut out added sugar and only get carbohydrates from green leafy vegetables, you will also rid yourself (fairly quickly, perhaps a matter of weeks) of that sugar addiction.

      Though my case was not as advanced as yours, switching to Keto definitely helped me kick the habit. In addition, because I only learned about Dr. Fung and Intermittent Fasting after a few months of being low carb, though not quite very low carb/keto yet, adapting Keto and IF came very easily for me because I didn’t have those sugar cravings anymore. I have lost 40 pounds but this was never my goal. Feeling better was and it’s certainly done wonders for my health.

      I hope this helps and good luck to you on your journey. Oh, and thank you to Dr. Fung for your work in this area. I’ll reiterate what you already know, you are helping a tremendous amount of people with your blog and videos!

  12. Fortunately I have never been obese, nor do I have diabetes. There are cases on one side of my family, however. I came at this subject from the standpoint of sports performance, and affecting my lipid profile. I am 69 years old, and I ride a bicycle all day, say 50-60 miles and I never eat anything. I drink water if thirsty. I used to feed my face with starches and sugars, processed of course, from the “carb up” industry. Not any more. I have energy all day long, regardless of the difficulty of the ride. I don’t know what my respiratory quotient is, but I surmise that my fat metabolism is high and it stays there all day long.

    There was a documentary not to long ago about endurance athletes that became type II diabetics before the age of 30. I think it was titled “Cereal Killers II.” They were eating 8K kcal of carbs per day when they worked out. So much for exercise being some kind of cure all– My theory about exercise is that the main health benefit comes from a temporary lowering of glucose plus an increase in blood serum ketones and their metabolic effect on cell mitochondria. Of course you negate all this when you gulp down the Gator aid or stuff your face with power bars when you stop.

    I am beginning to suspect that there are a fair number of professional athletes that do not eat the crap they are endorsing and have switched to the high fat, low carb approach to sports nutrition. If I ever start seeing low carb, but not processed, food advertised as part of big time sporting events I will know that the tide has actually turned. Additionally, there are really bad implications for cancer when it comes to the high carb diet, and when that is actually recognized it will mark the end for the current nutrition dogma.

    • Wow Samuel thanks for your post. I am not anywhere within your realm of health or fitness. Just the opposite. But what you have posted has been very informative as I have been really seriously perusing the idea of starting a fitness campaign for myself which would include a daily bike ride.

      Deni.

  13. quote: But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver

    OMG…i was prescribed metformin today… since i am doing wonderfully fasting… maybe i shouldn’t take it?

    but i thought metformin is good for improving insulin sensitivity. i am confused ?

    • While I suspect it is problematic to ignore a doctor’s treatment, you might want to pursue the issue with them, in light of information depicted by Drs Fung, Mosley, Taylor, Kraft. As Dr Taylor has said, these doctors are taught in medical school (to the extent they are per Dr Fung) with texts still ascribing long held medical dogma and due to that he crafted a Dr to Dr letter, explaining in doctor lingo what his research has found. He went on to say, it would take time for new texts to be cycled into medical schools. If you are unfamiliar with the other Drs listed, I’d encourage you to review, esp Dr Taylor’s introductory letter to medical professionals. You likely don’t want to find yourself with no doctor.

    • Ben Wagenmaker

      Orit, When I was diagnosed with T2D back in late January, my doc also prescribed Metmormin. I chose not to take it, since I was told I needed to take it with food, and I wanted to fast. My plans to fast would have been hampered by having to take a medication that requires food. So I chose fasting instead. Five months later, here I am with normal blood sugar and 55 pounds lighter. I eventually told my doc that I chose to fast and go LCHF rather than medicate, and I told him why, and told him my results and how I felt. He told me to keep doing what I’m doing. But I’m lucky – I’ve been told of patients being scolded by their doctors for this. Ultimately it’s your decision and your body. Do what you feel you need to do, but above all else, listen to your body. If your body feels crappy, it’ll tell you and you need to listen. If your body feels good, it’ll let you know that you’re doing the right thing. Good luck to you!

      • thank you so much for your example and warm words.

        when i talked to my husband about the doctor”s indications… my husband almost begged me not to listen to him and give fasting a chance. he reminded me that we are looking for a solution and although he understands that i am afraid… i need to give fasting a chance.

        i think he is right and you are right and i decided to wait with the metformin. i have been fasting for three weeks but i feel wonderful. less hungry. i am starting to lose weight.

        there is always time for medications.

        good luck to us all ?

      • Hi Ben. Great post. My husband’s doctor told him to take 2000 mg of metformin a day, put him on a statin, a kidney medicine and low dose asprin. His A1C was 11.5 at the time. (YIKES) His fasting blood sugar was well over 300. His doctor told him that his goal was to have an A1C of 6 in 6 months but that he probably wasn’t going to be able to achieve that.

        He took all the meds for about 3 weeks until I found Dr. Fung. We were already NOT doing the recommended diet. We immediately went to a low carb plan. But finding Dr. Fung and truly understanding what we needed to do was key. Four months after doing this plan my husband had another A1C done. We asked to have an insulin test done, but his doctor refused to do it. We were stunned! We went in to get his A1C results ( which was 6!) his doctor was very, very pleased. He said he’d never seen such good results before in such a timely manner. At that point we let him know that Tony (my husband) was taking none of the medicine prescribed and that we were eating a low carb high fat diet. HE WAS LIVID! His response was truly amazing. We asked again, for an insulin test and his response was, “I will not be told how to manage your health”. WOW, so he thinks HE is in charge of Tony’s health, not Tony”. Needless to say, we fired him. I’m glad you have a supportive doctor! Best of health!

    • I think you are right to be confused. Even at the beginning of this article, Dr Fung says;

      “Other medications such as metformin or the DPP4 drug class are weight neutral. While this won’t make things worse, they won’t make things better either. Since weight loss is the key to reversing type 2 diabetes, medications won’t make things better. Medications make blood sugars better, but not the diabetes.”

      Which makes it sound like metformin is insufficient to reverse diabetes it’s otherwise harmless. As in “won’t make things worse. But the later description of metformin;

      “But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs – the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat.”

      Just isn’t how metformin works. Like Dr. Fung says in another blog post, metformin decreases blood glucose through decreased gluconeogenesis and increased insulin sensitivity (I’m not sure how the second works, but it makes sense that even just decreasing total system glucose by reducing gluconeogenesis would make glucose rarer and thus in slightly higher demand). This sounds more like how Dr. Fung usually describes the action of insulin or some other drug increases insulin secretion or something. So much so that I almost suspect some sort of second party editing problem or something.

      I very strongly doubt that Dr. Fung means to say that people shouldn’t take their metformin. This is one diabetes drug that can be taken during a fasting protocol or a drastic change to a low carb high fat diet without worrying that it will cause hypos. That it’s insufficient to stop the march forward of diabetes if somebody continues on the standard western eating pattern that likely caused it in the first place is probably true, that’s the message I take home, for reversal and non-progression you need something like the diet and fasting programs advocated by Dr Fung.

  14. Great Post, as usual, thank you for putting my pictures as example, I feel honoured for it. I just hope that many people get to read this.
    Greetings, Peter

    • Maura G

      Dr Fung’s including the photo of a gangrenous foot as an example of the ‘end game’ of diabetes is extremely eye-opening. I have never read a description of diabetes as clear, nor as sobering, as this one. I understood that diabetes affects circulation, but I could not visualize the consequences until seeing that photo.

      The juxtaposition of that foot photo with the idea of a soda + fries, or a cake lathered in frosting, is more than my mind can manage without serious cognitive dissonance. I’m confident that recalling that image will make it far easier for me to pass up my next over-the-top cake or dessert (!)

      I loved “The Obesity Code”.
      I read it.
      Twice.
      I’m now making beef bone broth and starting to fast 12 hours each day.

      I’m very grateful to Dr. Fung for information and practical recommendations, plus examples of people whose lives have improved by following the intermittent fasting protocols.

    • That was you in the before and after? Great job, Peter!
      Do you have your success story posted somewhere? I’m wondering how long it took you to get to the after picture and how much IF you did?

  15. Thank you Dr. Fung. So many people will be helped and so many more need to hear this!

  16. Thank you Dr Fung, 49 years old, 4 weeks in, fast 24 hours every day so just eat an evening meal, which is Mediterranean style and tastes sooooo good after not eating all day and really easy to do. Dessert is a few squares of 90% chocolate and green tea, all done in less than 60 mins. Lost 10kg and cycle 40k 4 times a week easier than ever. My A1C was 6.0% which shook me up, so looking forward to next test in a few months. Thank you once again for not being a money grabbing drug pusher. May your God bless you.

  17. Good analogy Dr! I use another one, with regard to ‘reverse’ vs ‘cure’ vs ‘manage’. As I asked you once, the use of ‘reverse’ seems odd. One does not reverse a strep infection or a staph infection, or an STD. Nor do they manage it. I’ve had strep throat, likely several times in my life. If I saw a Dr that asked had I ever had that and concluded, it didn’t get cured, rather I’ve been successfully managing it for oh these many years, I’d laugh then leave. Even more pronounced for those that ever had an STD. Nope, still got it, just successfully managing it…for now. But, if you aren’t careful, you could get it again.

    Short of genetically caused hormonal disorders, should an hormonal disorder occur do to environmental causes, vs genetic, can it be cured as in should one ‘fall off the wagon’ it would come raging back vs, you’d become diabetic anew?

    While fasting does not impose adaptive thermogenesis, Yay!, would it unwind an existing adaptation, as in, as one for instance, contestants of season 14 of Biggest Loser, or the email I previously sent?

    Thank you for this post and I look forward to more in this series.

  18. A point of clarification please. Cheese, specifically, either cheddar or swiss, as I understand American cheese is the worst, dietary speaking. It was my understanding cheese, as it is largely fat based actually had protective properties, like whole fat milk vs skim, full cheddar/swiss vs low fat frankencheese. Am I understanding the Fat Phobia chapter (and blog post) correctly?

    I had assumed, given the low GL of Triscuits (actual true whole wheat grain) and a slice of cheddar was a low cost ‘healthy’ snack or ‘desert’ post dinner.

    • Similarly, half and half in morning coffee vs skim milk. I believe I am interpreting what you said and Dr Mosley said regarding cream/milk in morning coffee being acceptable.

  19. Maureen

    I have predawn phenomenon, I go to bed with healthy blood sugar but am higher then I should be after fasting. I am 10-15 pounds over weight. Usually only my morning reading is high. I have been told I am type II. Is there something else I should be looking at?

  20. Assuming you are not diabetic, do you have to be on a low carb diet for fasting to be effective in weight loss?

    Or during feeding days can you still eat occasional rice / pasta?

    • If I could, at least in part, answer your question. From Dr Fung’s book and 6 part You Tube series, and blogs, there are two components required for insulin resistance, the precursor to (pre)diabetes, 1) high insulin levels and 2) persistent insulin secretions. Processed wheat, white bread, pasta, rice, especially minute rice, are the worst, short of pure sucrose, in rising insulin secretions. A fast breaks that persistent component of persistent and high insulin secretions/levels. However, the one-two punch is fasting, which addresses the persistent level, to a degree, and no white food (sugar, flour, bread, rice, pasta, potatoes).

      Where it gets a little trickier is there is a rubicon that can be crossed where it no longer requires refined carbs to trigger insulin surges, that the resistance itself feeds the requirement for more insulin so a negative feedback loop develops. In this case, perhaps the best course IS to fast as well as cut out refined carbs.

    • Fasting is easier when you are fat adapted. If you are on a SAD diet after four hours of eating you will get hungry making a 24 hour fast difficult. Not just the mental battle but your body begging for glucose. That is why being low carb, actually very low carb is best as your fat stores can be accessed keeping the hunger away.

  21. Dr. Fung,
    What do you think about Victoza for weight loss and sugar control?

  22. I am a little disappointed in this post. I am one of the so-called “evil” dietitians you reference, who see people with Type 2 diabetes every day. I coach and implore them to change their diet and exercise. We show them all the benefits of adopting vegan/vegetarian lifestyles or at least more plant based foods. I wholeheartedly agree that the majority of patients with Type 2 DM can at least delay abnormal lab values. I take issue with some of your wording
    though:
    1. Lifestyle change does not reverse diabetes- as I tell patients, you always have the “potential” to have these abnormal lab values. If you lose 40 lbs but then regain it, you will still likely have the elevated blood sugars that originally got you in trouble. Likewise, sustained effort may delay diabetes, but I have seen the most diligent patient still have elevated blood sugars 10 years after a diabetes diagnosis and subsequent lifestyle change.
    2. I would say 5-10% of my type 2 patients are insulin deficient, and despite lean bodies, great diets and consistent exercise these people need insulin injections within 5 years of diagnosis or risk severe complications like diabetic ketoacidosis (this usually has a genetic component)

    So, although you have many valid points, I worry that some of your wording will result in patients feeling that they are at fault when their bodies need help. Diabetes can be progressive, and lifestyle (although the main factor and SO important) does not cure all in the long run.

    • Mr luqman

      How to measure insulin deficient?

    • No, lifestyle changes do not reverse diabetes. Becoming insulin sensitive again does. This is not new. I encourage you to research Dr Joseph Kraft, Dr Roy Taylor (New Castle Magnetic Resonance and New Castle University) and Dr Michael Mosley. Dr Taylor at New Castle has conducted several, of various sizes clinical trials that prove T2D is, in most cases, reversible. If you aren’t on medication and an A1C is in the low 5’s, consistently, what would you call it, reversed, cured, in remission? It’s as I said above, in remission implies the original cancer is still there simply not spreading. The key to the semantics game here is the old and unproven theory was that by the time you were diagnosed with t2d, 80% of your pacreatic beta cells have been killed off. So yes, by that measure, it is a progressive, chronic disease. However that theory lacked any way to actually test and, w/ Dr Taylor’s tests aided by specialized MRI equipment could detect that once insulin sensitivity had been restored and the visceral and intra-organ fat burned that ALL the beta cells were present and restored to full functionality. So SDP, what would you call it? Nothing there doesn’t mean the patient couldn’t ‘go off the wagon’ become, again, prediabetic.

    • Isn’t lack of insulin Type 1 diabetes?
      My understanding, from researching the above 4 Drs is T2D is too much insulin causing insulin sensitivity which, can itself, cause persistent and high insulin levels w/o the presence of fattening carbs. In fact Dr Kraft’s research over 30 years on subject indicate by the time the diagnosis is made via elevated blood sugars, the patient had been ‘diabetic’ for a very long time, decades perhaps, and the only sane test for diabetes is the glucose tolerance test of only if the pattern matches the type 1 (he defined four gtt patterns) was the patient safely nondiabetic.

    • To the “evil” dietitian (SDP) I would like to tell you that I don’t regard you as “evil” in any moral sense, but like you said, I too am a little disappointed with your post, and with most “dietitians” who present the objections you do. When I was diagnosed as a type 2 diabetic, I was very, very afraid. My endocrinologist referred me, as per his usual practice, to a PhD. nutritionist, who asked regarding my food choices. When I told her about my love for healthy granola, she said you don’t have to quit morning cereal, just make healthier choices, like cheerios or raisin bran. You don’t have to quit ice cream, just chose “sugar free” ones, and you can have a small glass of orange or apple juice in the morning as well. She also sent me to a class, where this type of food substitution was the norm, following ADA guidelines. After a year of desperation, exercise, following the food recommendations, I called her up following a typical frustration week of having BS numbers in the 180s to 200, and remembering her saying, “You did not become a diabetic overnight, and you are not going to improve overnight.” End of conversation. Some “layperson” referred me to a book called Power Protein, and from there I have progressed to low carb, to low carb unprocessed, and now introducing fasting into the equation. I still remember my PhD dietician telling me about cereals, ice cream, and juices, and exhorting me strongly to continue the ADA guidelines to prevent progressive development of my disease. It’s not that I regard her, or you, as evil, but as “misinformed” or helpful only for those who seek compromise with this disease. For me, compromise didn’t work!

    • There’s little scientific merit to this vegan/vegetarian stuff you’re pushing, it’s more of a religion. There are ethical and environmental arguments against meat consumption, but to present veganism as the solution to diabetes is not scientifically warranted.

      • I agree with you here. Coming from this so called vegetarian society , I know that it is not the bloody solution. Eventually I have become meat eater, pure protein means less carbs and help controlling the sugar level. This all vegetarian food this and that is total nonsense and in fact it has bad effect on health, especially those beg curries.

    • SPD, thanks for reading and questioning. This is how we all move forward. I am an MD, and did not know how to roll back diabetes until I began to study functional medicine (a systems-based approach to chronic illness). Now I measure my patients’ insulin and glucose both, and I agree that many people (some prediabetics too) have a combination of insulin resistance and inadequate insulin secretion. For example, the fasting insulin is 12 (ideal would be under 7) and the fasting glucose is 112. So why does the pancreas not do more to get the blood sugar to normalize?? One such patient has responded very nicely to intermittent fasting. I have more work to do to actually measure what happened but by her report, fasting sugar has dropped to 88. Even if the pancreas remains sluggish, now the cells are responding better.

      So the way I understand it is that we have pancreatic beta cell damage (this can occur from pollutants, PCBs and pesticides for example, as well as heavy metals, such as mercury – measure whole blood mercury routinely and you will get 5-10% positive). We also have insulin resistance, with the major player there being excessive exposure to insulin. You should go ahead and google all this on pubmed and read a few articles. It’s a lot more fun than blindly following guidelines.

      As for the vegan/vegetarian guidelines, they actually work well for some people, but for others will make things a lot worse. The experiments showing development of diabetes with exposure to fat were done using very unhealthy processed fats. Presumably avocados, nuts and grassfed butter/meat will not do that. There is little attention on this blog to factory-farmed products, but theoretically, they do provide more pesticide exposure and inflammatory fats than should be healthy.

      Also, while losing weight, the intake of many many vegetables is crucial, as we need to detoxify chemicals that were stored in the fat. So bone broth, lemon water, green tea during the fast, and then 75% of the plate by volume being colorful produce (not just burgers and cheese, I personally disagree with that) is the ideal approach.

      Thanks all for great discussions, and thanks Dr. Fung for spreading this knowledge.

  23. Joanna; do you want the side effects that come with taking Victoza. For the weight you lose; the side effects are far worse

  24. […] How to Reverse Type 2 Diabetes, The Quick Start Guide – Intensive Dietary Management […]

  25. Any advice for someone with T2 and gout? My husband is attempting fasting and LCHF but has gout flare-ups. His Indomethacin intake is beginning to worry me. And, we are currently living overseas in an area where medical care is strictly conventional.

    Thanks!

  26. Ainslee

    Hi. I am an RN and recently had a diabetic patient I was admitting to our unit. He had a wound on his rt foot that was wrapped in kerlex. I unwrapped it so I could asses it and all his toes were black and half of the top portion of his foot was also black. What surprised me the most was he seemed to not realize he would need to have his foot amputated. When he ordered his dinner I felt completely sad seeing the ADA diabetic diet our hospital provides. More carbs then he should injest in 2 days much less 1 meal. He really wanted out of the hospital the next day to get back to work stating he needed to work a few more years to have a good retirement. I was thinking not having your rt foot is going to delay those plans. Our system completely fails these patients. Before dinner when I checked his 280 blood sugar and gave him his insulin I mentioned to him if he wanted to learn how to improve his blood sugars and health to read Dr Fungs website. I’ve also mentioned Dr Fung to a couple diabetic co-workers. Somehow I’m going to work his name into my conversations with diabetics because I know he is correct in his teachings. How I know is I have healed myself with the knowledge I’ve learned from his blogs.

  27. I love this website and have been practicing IF for the past few months. I don’t have T2D but have gained some weight over the past year. The weight is coming off slow and steady. Fasting is much easier than I thought it would be. My FB friends now think of me as “that crazy fasting woman”. 😉

    But just to play devil’s advocate, I could see someone asking if the weight loss achieved during the fast wouldn’t be offset by fat storage afterwards. In other words, if the body gets more used to burning its fat, would it also respond to feeding periods by storing more fat? I don’t think this is the case, given the lowered insulin produced by fasting and the weight loss benefits. I’m not sure anyone has studied fat storage and metabolism post-fasting, or at least if they have, I can’t find it.

    On another note I wonder why no one (to my knowledge) has created a computational model of obesity. I work in the environmental sciences, and we use modeling extensively to forecast all sorts of environmental outcomes. Climate change and weather models are so sophisticated now that one run on a supercomputer can take months. Why is there no model of obesity? That way, we could take all of the disparate results of these studies and test them against the model. If the model predicts the observed outcomes, great! If the model does not predict them, we can tweak it until we get it right. It just seems like obesity and diet research is groping around in the dark and making very little progress.

    • Robin, look into Precision Nutrition and their blogs. They make the case determining the caloric content of food I’d imprecise, the thermic expenditure of food varies, one metabolism varies due to adaptation it is difficult to pin down exact protocols. Much of the a that was my wording. So can they broke it into simply!e terms like one fist-full of the per meal and two fist-fulls of that per meal. How does one model ‘fist-fulls’? And is that a woman’s fist or a man’s fist. But, to your point, I totally agree. I did, however, happen across a ketone diet calculator which produces a really intricate chart. I believe in the last blog I made reference to the URL. If you can’t find D it let me know as I am on my tablet now.

  28. Anyone know how to break a long fast, such as 30 days for example, without complication? I’ve read that it should be with fruit or juice. That doesn’t really make sense to me though because wouldn’t that spike insulin like crazy? I am actually very concerned because I don’t want to get sick or die or end up in the hospital. Anyone know what to do? Dr Fung?

    • Hi Wendy,

      You kind of sound like me. All or nothing. 🙂 Have you ever fasted before? Are you following a LCHF diet? Why do you want to fast for such a long time? So here is my uneducated advise. Do some small fasts first. 24, 36, 3 days. Follow the diet. The couple of longer fasts (5 days) that Tony and I did we ended the fast with a little bit of cream of broccoli or asparagus soup. Maybe a cup. We waited a couple of hours and had a small meal. Maybe a pork chop and a small salad. We had absolutely no problems. I have read where people stuff themselves the first time they eat and end up very sick. Just break the fast slowly with fat…. And here is a little bit more advise. Fast for as long as you feel good. If you start feeling poorly then break it. Listen to your body, it’s smart! Have you read all of Dr. Fung’s posts on fasting. Definitely do that before you begin. Best of luck and health!

      • I’ve fasted 4.5, 5, and 5.5 day fasts and many 3.5 day fasts (e.g., stop eating Sunday night and don’t eat again until Thursday at lunch). Every time, I ate something to end the fast. i typically eat a full meal. I never get “sick”, but I do go to the bathroom many times the following say 8 hours or so. And it’s all water. After that, I’m OK. My wife has less problems with this, but eats the same as I do.

        Personally, I would find it difficult for these “shorter” fasts to not eat at the end. Once you mentally say you’re stopping the fast, it’s difficult not to eat.

        For 30 days, though, I would try easing into it.

        I agree about listening to your body — if you feel overwhelmingly like eating, it’s probably a wise thing to do.

    • Wendy, you need to read up on breaking a fast of that duration as complications can develop. Your digestive system has totally shut down by then so dumping in a bunch of food is not good. You always read that you should be medically supervised on a fast that long but try finding a doctor that has a clue about fasting. You could watch some You Tube videos by Dr Alan Goldhamer of TrueNorth Health Center which is a fasting clinic in northern CA.

      Fasting cures were popular in the late 1800’s to early 1900’s but never became main stream. Hard for the drug companies and doctors to make money when the treatment is just drink water. Look up Bass, Shelton, Tanner, Sinclair, and Dewey. Dewey’s book “Fasting and the no breakfast cure” is available for free on Google Books. He started as a doctor in the Civil War and it is an interesting and scary insight into medicine at the time. He conducted many fasts in excess of 30 days.

  29. Marlene Zwiebel

    This was very good to hear how other people are trying to improve their lives with this new method of fasting. It was great to hear how success it has been for many. I working my way through Dr. Fung’s book. It great to know it will make such a difference in my life.

  30. Marlene Zwiebel

    I am learning a great deal by taking my time to read the book and let it soak in.

  31. Marlene Zwiebel

    I am working at changing my soft drinks and not eating cereal or white flour and sugar.

  32. […] How to Reverse Type 2 Diabetes:  https://intensivedietarymanagement.com/reverse-type-2-diabetes-the-quick-start-guide/ […]

  33. During the fasting period can you have water and/ or bone broth?

    • Lots of water! And yes some bone broth… makes fasting very doable!

  34. charles grashow

    Dr Fung

    What about studies showing reversal of T2D with a high carb low fat macrobiotic diet?

  35. One of your best pieces so far. I read your blog regularly. And your newsletter. Keep up the good work.

    Cheers,

    Etienne Juneau, PhD
    Doctor of Public Health

  36. My problem is beer. I genuinely love beer. I can do fasting on lime water but its beer that is casing me a problem. How do I manage it?

    • Gary! Haha…. mine is wine. My husband drinks Mich Ultra…. 2.3 carbs. It’s hard to give up so much about what we love! But I do believe in short term sacrifice, long term goals…. Here’s to good health~Cheers!

      • Sue, exactly and I very well understand what you mean. I am still in early 40’s and just now got detected for T2D so all of a sudden doing all these changes to lifestyle is kinda getting overwhelming. Moreover here in Canada we hardly have Summer so much harder to stay away from beer and BBQ. But as you said perfectly “Short term sacrifice, long term goals for good health”
        Cheers

  37. “If you don’t eat, will your blood sugars come down? Of course.

    If you don’t eat, will you lose weight? Of course.

    So, what’s the problem? None that I can see.”

    Hmmm. I’m pre diabetic, but NOT overweight. In fact, i need to increase my weight (in terms of muscle mass)! So my problem is that if i don’t eat, i will lose weight which is precisely what i don’t need or want to do. Also i need to eat plenty of protein to both maintain and increase my muscle. I would be interested in knowing what Dr Fung would suggest to do since i don’t want to become a diabetic but i do want to increase my weight. Thanks.

    • Thru the years I went from trim to obese and developed d2.

      With Dr. Fung’s fasting protocol I got rid of my d2, now have healthy blood markers, got skinnier, reached my 8th grade weight and I’m loving it.

      I’d rather be skinny and healthy than d2 and sick, which is deadly. It’s your call.

  38. Hello Dr Jason Fung, I’m from Brazil and a great admirer, I have read your blog entirely think fantastic.

    I follow a lot of his advice, I have 56 years old and had severe obesity, by first removed all sugar and flour, not consumption almost nothing industrialized, do 2-3 fasts of 24 hours per week.

    Over time I have seen my body turn, I lost weight 25kg, got a perfect health and an array of 20 years ago.

    I have read and heard many comments in the media about the use of Metformin for rejuvenation, I’d love to know your opinion below is a link to a publication on this subject.

    http://www.life-enhancement.com/magazine/article/2970-is-metformin-the-metabolic-holy-grail

    Sorry grammar errors I write in Google translator.

    Thank you, hugs!

  39. Dear Dr Fung, I am biochemist and I have been following your post and videos on the subject. There are people who loose weight unintentional as type 2 diabetics. recently I read somewhere that if you are able to loose 0 .6g of fat from the pancreas it will start to reproduce insulin. my question is, why is it that people who loose weight unintentionally not reverse their diabetes automatically.

    Thanks for your insights

  40. Great article – it really gives me a simple way to look at getting rid of sugar. I am forwarding it to people I think will be helped, and I actually linked to this particular article in a book review of The Obesity Code I just posted on my book review blog (I link the review below).
    The picture of the blackened toe – I wish I could un-see that.
    I’ve been steadily losing weight after reading articles here that demystified IF. I skip breakfast, drink coffee with butter instead. I don’t have T2 but it runs in our family and just low-carbing wasn’t working for me anymore (it used to). Thanks Dr. Fung!

    http://www.bookhorde.org/2016/07/the-obesity-code-by-dr-jason-fung.html

  41. I have been struggling to manage T2 Diabetes having been diagnosed several years ago at a young age. I find the vast amount of information and advice provided from Dieticians, Doctors and the web extremely confusing. My father whom is T2 has practiced various forms of fasting which for over 18 months had a positive effect on weight loss, insulin levels and blood sugar levels. However he recently experienced elevated levels of Cholesterol which was impacting and elevating his blood sugar levels. Dieticians and medical staff put down to his liver creating cholesterol and said it was reacting to the fasting and was in a sense experiencing a feeling a starvation. They’ve since informed him to stop fasting.

    As someone whom was looking to this method as a way of weight mgmt./insulin/T2 Diabetes mgmt. – I’m wondering if anyone else has witnessed these effects?

    Does fasting wear the body down over time?

    Do you find you have to fast for longer periods the longer you have been practicing?

    My father was informed that due to the age of his body/organs that they thought fasting was putting stress on aged areas of his body which was what was having the impact.

  42. I’m old, and I work out intensively. I have a congenital back misalignment condition that depends on strong body and back muscles for me to function. I don’t have Diabetes 2.

    Will fasting be safe for me? I don’t want to deplete muscle.

    • Richard S Stone

      Ronny: I’m 71, and I’m not sure if that qualifies me as old or not, but I think you should read more of Dr. Fung’s posts and listen to/watch more of his lectures.

      The idea is that fasting does a number of things, only one of which is to minimize (stop?) insulin production. There are other hormonal and different changes caused by fasting, also known as “not eating.” As Dr. Fung points out many of these changes relate to the body trying to deal with nutrient deprivation and the meaning of that deprivation. Thus, as he points out, if fasting made you weak you would die before you could find food… similarly, if fasting impaired brain function you would get the same unfortunate result.

      My own experience is that fasting does seem to result in some minimal muscle or strength loss, and I do not know for sure, but I think that can be addressed through maintaining a strong full body work-out program while fasting. I have been reading the various sites on exercise and fasting and the people who actually work out while fasting seem to be doing fine, as opposed to the people who talk about it but don’t do it….

      But my favorite issue, for old people, is that fasting leads directly to autophagy. And autophagy leads to cleaning out fat/plaque deposits in arteries and the liver and plaque in the brain, etc. This has to be considered in combination with the reduction of insulin and insulin growth factor in terms of heart and arterial damage. IGF leads to vascularization, a very bad outcome in terms of tumors and vision and arterial issues.

      I was not “overweight” in any overt way, but I lost 15 lbs with a 20-4 IF program, still drinking wine. ( I think beer is a problem in an IF program.) The idea, as I see it, and I don’t know about Dr. Fung, is that if you are on that kind of IF program you can almost (note, almost…) eat what you want in that 4 hour window. I would still aim for a LCHF diet.

      And as to not eating: I am mystified as to why so many people try to eat a few calories just to satisfy their cravings when the whole concept is built on not eating for many hours. No one of normal weight is going to die from a few hours of not eating. Or even a day or two of not eating. Or even three.

  43. What do you do if (1) you already lost 40 pounds, (2) eat a low-carb diet, (3) run 60-70 miles a week, and (4) still have an A1C in the low-mid 6s and fasting sugars up to 130 and never below 100?

    • i was wondering the same thing….fasting morning numbers are always the highest for me due to the so called dawn phenomenon. i checked my glucose level for 2 days at 2:30 in the a.m. and they were 101 and 103, normal at that time. when i got up 3 hours later they were higher. by the way i am not overweight.

  44. […] That doesn’t mean eat anything you want. He clearly says (How to Reverse Type 2 Diabetes, The Quick Start Guide): […]

  45. Dr Fung – the enemy of Big Pharma, Big Drug Store, Big Food, Big Endocrinology, and the ADA. A menace to society!

  46. SUSHRUT CHAUDHARY

    i am a diabetic since last 20 years ,started eating one meal a day at 8pm everyday,i have discountinued my diabetic pills my ketones in urine are high i lost 13 pounds in 20 days my post meal sugars are 125 with LCHF AND FASTING SUGARS ARE 120

    I AM CONCERED HOW MANY CAN I GO ON WITH ONE DAY MEAL ?

  47. Dr Fung,

    I look forward to you publishing statistics of T2D patients that your practice has helped to achieve HbA1c < 6% 😀

  48. Hi, what about people who are not overweight?

    My mom has been taking insulin for over a year now, and the dosage has increased over the past year. I’d like her to give fasting a try and see how it affects her sugar levels.

    How do you recommend fasting for people who are not overweight or almost in the category of being underweight? How do we manage energy levels for such people?

    Any advice ?

  49. kazi md. akbar hossain

    i love it and i read almost all of your article and i listen most of you lecture and I love it if I get what should I eat and how I start my fasting then I am highly satisfied on you . So please give me the guide line where I get it thank you

  50. How much carbs can I eat a day? Can I drink carrot juice? or carrot apple juice? or eating raw carrots? how much carrots can I eat? Thank you!

  51. vishnu budhu

    Hi Dr Fung can i drink water during fasting

  52. How do I balance the “fasting fasting fasting” suggestions here with the boatload of “women have problems with fasting” reports all over the HFLC/primal/paleo world? I spent three years on low doses (“physiological” doses) of cortisol (hydrocortisone) for exhausted adrenals before I could wean off without a return of symptoms; and then worked on treating my hypothyroid. (Not done with thyroid yet, alas.) The last thing I want to do is cause thyroid / adrenal problems again by fasting.

    Can’t start the “don’t eat sugar” cause I started that several years ago. Can’t start the “stop high carb and grains” cause I started that several years ago. Am planning to try the “apple cider vinegar before meals” (with huge trepidation because I hate vinegar/sour foods, but I’m at my wit’s end!). Doubt I’d have any trouble fasting, because — being so long low carb, I’m not hungry till mid-day anyway. I do Doug McGuff’s “Body by Science” weightlifting weekly (and LOVE it!); I am trying to add walking on the elliptical treadmill. (I’m 60 and weigh 300 pounds; it’s not easy, but I’m working at it.)

    So, fasting for women or not?

  53. Fr. Tom Pomeroy

    I have watched many of your videos on line, and have been reading your blog. One question: What sort of fasting do you suggest? 24 hour fast once a week? 2 day fast once a week? 16/8 daily intermittent fast? Multiple day fasts? You mention your diabetes book coming out in 2 years. For my diabetes I was curious now about this practical: How to?

  54. I first came upon Jason Fung’s video on YouTube last year (2015), at the beginning of the year. I’d just been to a mainstream doctor, tried to panic me into taking meds for my very high levels of sugar, although I had no symptoms. I saw my beloved Mum with T2D pass away having been on meds to try and control it, and failed. I was determined to find a way to reverse it for myself.

    Having come across Jason’s video so soon after seeing that doctor, was amazing for me!! I immediately started to try and implement it, and incorporated it as much as I could which I did intensely ( skipping breakfast, and sometimes lunch), and avoiding refined sugar and grains. My resolve started breaking down as winter approached, as I was getting hunger pangs for good ‘ole “solid winter fare”, not a good choice, and I mainly stuck to gluten free bread, cos I missed bread. Well you could imagine what happened!! ( Although I still stuck to the 24 hr regime)…

    Sooo, when I came across the website again and read all the way through the fasting blogs and all your replays on the weekend, I was reinspired!! So here I am, understanding so much more and I’m on day 3 of 24 + hrs, trying to stretch out the hours to do a very long fast as I’m somewhere between 100 – 110 kg (not game to weigh myself, and don’t know lbs)..

    Thanks everyone, you’re helping to keep me inspired as there’s no one that understands what I’m trying to do, not husband (he thinks I’m starving myself, or my grown children), so I’m going to prove to everyone this can be done, when it’s done the right way. I’m also going back to that doctor and show him that diabetes can be reversed!!!
    Thanks again everyone!! …

  55. […] ​https://intensivedietarymanagement.com/reverse-type-2-diabetes-the-quick-start-guide/ […]

  56. I’m happy to be a new subscriber to Diet Doctor’s newsletter. I’m 68, diagnosed with T2DM almost 20 yr ago and about 40-50 lb overweight. I’m on metformin 1 gram twice daily; also lipitor and synthroid. Last cholesterol was 203, triglycerides were elevated, A1C 7.5–usually it had been 6.7-6.8. Dr. wants me to follow a 1500 cal ADA, and when I saw that it allows for 200+ carbs a day I thought–no way am I doing that!

    I have given up white potatoes, pasta, breads; and would like to do LCHF. My concern with LCHF is…what effect does it have on blood cholesterol and cardiovascular risk for MI, stroke, etc. Does it increase the risk for those illnesses?

    Thank you and I look forward to someone to answer me.

  57. vimal v raval

    Hi Guys…. this is a great blog…. hats off to you for this site. Im a diabetic for almost 15 years and my doctor put me on metformin 3 times a day… When I took metformin 3 times a day, I can barely get up and walk the next day.So I stopped taking them all together. Now im intermittant fasting, having nothing but nuts and very low carbs –eating every 16 hours and I feel as if someone is ” sticking needles in my hands and feet and I have tingling sensation on my toes and fingers ” is this supposed to happen I eat lots of cheese…. could eating cheese generates needle pain in my hands and feet??. Pardon my ignorance. Im new to this. Didn’t mean to upset anyone. The last time i checked my A1c was about 10.5, which was 2.5 years ago. After that I lost my insurance and couldn’t afford the lab blood tests due to limited income.
    Any thoughts would be appreciated. !!!!

    Love
    Vince

  58. i truly enjoy reading the comments. I am new to the Ketogenic diet. My wife has adopted to this lifestyle change now for a challenging 4 days now. Here is my story. I am a 57 year old man who has had type 2 diabetes since 1998. I recently have had a toe amputated due to an infection. My blood sugars were running 300 – 400 and my most recent A1C was 10.4 (July 2016). My wife and I have started eating whole foods that consist of leafy green veggies, healthy oils, nuts seeds and some meats. What advice can you (or any of the LCHF arena) can share with me to get my numbers under control. I am not an obese man, but I do have existing health challenges (high blood pressure, high cholesterol, multiple mylemona currently in remission, etc). I am on a short term insulin (novolog) and a long acting insulin (lantus). My immediate question is: Can I stop taking the insulin due to the high fat, low carb diet I am currently on? I welcome any and all comments

  59. Dr Fung, why many people doesn’t IR even though they are highly obese, sedement and taking high GI foods for many years.

    Further, as per your recommendations, if we are on fastening, is there any counter problem would arise like digestive, ulcers etc.,
    Pls suggest another method to rid out the excessive cell glucose.

    Furthermore, why wounds or cuts are not healed in diabetic patients.

    Finally, I request you to suggest healthy weight gain methods as I am under weight and loosing weight though I am eating more vegetables and fruits. I am diagnosed as T2D in 10 months back. I am not under any medication from past 6 months exept spending 1 hr in gym/day/5 days/week.
    How to get muscle mass.

  60. Dr Fung, any recommendations or suggestions as to how I need to proceed moving forward? I wrote the comment earlier (1/20/2017). Also, I started (1/16/2017) the intermittent fasting for 24 hours / 3 days a week. While my insulin meds have lessen, my numbers are still in the 150 – 180 range. Do I need to get more aggressive on IM or do I need to increase my long acting insulin (Lantus)?

  61. I’ve been eating keto and I have had some fairly good results. I’m not diabetic, but I assume that the reason I gained the weight in the first place is because I was insulin resistant.

    So if the whole body is full of surplus glucose, how much are we talking about? Is there a grams / kilogram of lean body mass or some figure like that?

    How much fasting does one typically have to do, to consume this surplus?

    Is there a point where one can reintroduce starchy carbs and digest them like a child without insulin resistance.

    In Gary Tabues’ book, The Case Against Sugar, he suggests that some of the negative effects of fructose consumption may not be easily reversed. Can you speak to that?

    What does reversal mean?

  62. I just found out I have type 2 diabetes. Someone suggested Dr. Fung’s book. I have Hashimotos, PCOS and sensitivities to yeast, gluten, cane sugar, casein (all dairy plus some other things) and more. I’m told to eat breakfast no later than one hour after I get up and to make sure I eat a little bit every 3-4 hours. Can I safely do this program having hashimotos and PCOS?
    I take many excellent quality supplements chosen for me by my functional medicine Dr.
    . My sleep is terrible.
    I was thin and fit for much of my life. In my mid 30s my young son passed away. It’s been chronic stress for various reasons since then and I slowly packed on tons of weight. In my late 40s I decided to get a personal trainer. Then I also started seeing a functional medicine Dr. I was on a very restrictive low glycemic diet for over a year and was working out hard with a trainer 5 days a week at the same time and my weight just barely budged. and my blood glucose was consistently over 100. I worked with a few different trainers for about 8 years, did the paleo diet, went down to training 3 days a week because my doc thought I was stressing my body, and finally had bilateral total knee replacement 2 years ago. Since then I haven’t been able to train because of some complications. Just doing PT. After surgery complications I just gave up and in the last 9 mos have eaten junk. Now I have Diabetes. ?

  63. Jesse Hendrickson

    Thank you Dr Fung.

    I am an 8 year combat veteran, the VA “veterans administration” recently diagnosed me as a T2 diabetic, they did this off a single A1c test and never retested me to confirm. I had not fasted for the test as I was not aware they were going to perform it. I was there to get an acupuncturist what a day….

    In lieu off that I was scared to death I was handed a death sentence and told there is nothing I can do I’ll get worse need more meds and slowly die. At that moment I figured might as well be prepared to check out. My mind was made up time to join the 22 the moment I felt death was knocking I end it all, I had so many negative thoughts it was unreal.

    But in light of all that something just wasn’t right I had 0 symptoms of a T2D I argued with the VA saying they made a mistake, I still think they did, in the back of my mind it kept saying this is bullshit how can you not undo damage done these ass hats want me to friggin give up and die no way no friggin way I said to myself. I went out bought a blood glucose monitor told them they can keep their damn pills and hit the gym and I mean hit it hard, next I scheduled an appointment with a civilian doctor.

    I got the VA to retest me and my fasting glucose came back at 114 my a1c dropped 0.7 points went from 8.8 to 8.1. All this happened in 6 days and every time from first diagnosis to that 6 days later I had normal readings from the glucose monitor which is why I deny the T2D diagnosis. 1-2 hours after I eat every day is between 82-110. All I did was ditch all soda and fast food at first.

    One thing I noticed is every morning my fasting glucose is always pre diabetic I attribute this to the many combat nightmares. If I fast the day away it goes down to 75-82 I don’t see that until noonish.

    I want you to know a few things you may find this interesting. Upon initial diagnosis I did not really eat for 3 days I’m fairly certain I restricted my calories down to about 500 for those first 3 days. Also I started working out 30 min a day. I have a feeling that shocked my body into getting my blood glucose levels normal after meals. Almost like the gastric bypass or lapband procedures.

    I’m so glad I found the information you provided in 5 weeks I’ve had a real profound change you saved a combat veterans life. I’ve gone from 226lbs down to 207lbs and everyday my glucose levels are normal the mornings are still high but not in the diabetic range.

    I’ve got my civilian doctor appointment coming up on mar 30th I’m looking forward to seeing what my a1c returns as. It’s going to be a hell of a lot lower that’s for certain even though it hasn’t been 3 months. But anything lower than that damn starting number is good to go.

    More to come I’ll share my progress.

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