The Biggest Lie – T2D 2

The Big Lie

There are many things untruths said about type 2 diabetes (T2D) but the biggest lie of them all is this: T2D is a chronic and progressive disease. This message has been spread so far and wide and repeated so often that people do not even perceive that there is any controversy. Of course it is true. Everybody says so. If you develop T2D, you will have it for life. It will get worse and then you’ll go blind. You will soon be on insulin, get used to it!

In fact, the ‘authorities’ all agree. They have been one of the loudest voices proclaiming T2D a chronic, progressive disease. You had T2D, you can’t get better so don’t even try! It is on the website of the American Diabetes Association and others such as diabetes australia.

A ‘natural progression’ is how diabetes australia puts it. Makes it sound pretty good actually. Don’t worry if you go on insulin, that’s just the way it is. Just accept it. It will get worse, but don’t worry, you can always go on dialysis if your kidneys fail.

There is only one small problem with that statement that T2D is chronic and progressive. It is just not true. It is a purely and simply a lie, and a big one. There are many people that want you to believe this big whopper of a lie. There is money to be made and shareholders to keep happy. And it certainly won’t do if you find out that T2D is actually a fully reversible, curable, dietary disease. How can you sell drugs if people stop getting the disease?

So where does this idea come from? Let’s back up a bit and explore this in detail.

T2D is a disease that is characterized by high blood sugars or blood glucose (BG). In type 1 diabetes, the BG rises due to a lack of insulin to push this BG out of the blood and into the cells.

However, T2D is not a lack of insulin. Rather, insulin levels are quite high and the problem is felt to be due to insulin resistance. That is, there is plenty of insulin around, but it doesn’t seem to work very well. 

If you look above at the natural history of type 2 diabetes, you can see that there are two phases. There is a gentle rise in blood sugars almost 15 years before the diagnosis of T2D. This parallels the increase in insulin resistance.

As people become obese, the insulin resistance develops over time. This is also in evidence as pre diabetes or impaired fasting glucose develops. From the accompanying figure, you can see that as you measure normal, lean people to obese to T2D, the insulin resistance progressively goes up. The reason for this progression we have covered previously in our posts on insulin resistance.

Essentially, persistent high levels of insulin lead to the development of insulin resistance (IR). This high IR leads to higher insulin levels to ‘overcome’ this IR. However, in the long term, this higher insulin only leads to higher IR. This is a vicious cycle, and the longer you go round it, the worse it gets. This is the so-called time dependency of obesity. This high insulin, of course leads to obesity.

As you develop more and more insulin resistance, you may eventually be diagnosed as IFG (impaired fasting glucose). This refers to a standard test (oral glucose tolerance test – OGTT). In this test, you are given a very sweet drink and blood glucose is measured at various times afterwards. Sometimes, it lasts for 2 hours, sometimes for 5.

In the normal condition, the BG rises quickly after the sugary drink but soon afterward, it drops back into a normal range. In IFG, the BG rises higher and is much, much slower to come back down into the normal range. However it is not so high that T2D is diagnosed. So it is considered a sort of mid way stage to T2D. Recently, there has been a preference to call this ‘pre-diabetes’ in order to emphasize the fact that this is the same disease as T2D, but not to the same degree.

It also subtly reinforces the notion that T2D is a chronic and progressive disease and that eventually, you will become diabetic. However, this is only a lie, but these big whopping lies are often buttressed by these littler, smaller deceptions. It is like saying my son is ‘pre-medical school’ or ‘pre-CEO’ or ‘pre-real estate tycoon’. It seems to imply that these things are inevitable even if they are not.

There may be a stage even before the IFG stage that is detectably abnormal. Ivor Cummins at www.thefatemperor.com has recently been writing of some of the work of Dr. J. Kraft, who measured the OGTT in over 16,000 patients, but instead of only measuring glucose, he also measured insulin levels.

What he discovered was that there were several discernible patterns that identified abnormal glucose metabolism. In the normal situation, after the sugary drink, insulin and glucose both rise and come back down to normal. In the IFG situation, the blood glucose rises above normal.

However, in between those two stages is a situation where blood insulin rises far above the normal situation and this keep blood glucose levels down. In other words, the compensatory hyperinsulinemia prevents the hyperglycaemia which would alert us to the condition of ‘pre-diabetes’. So, if you were to look only at the blood sugars, you would miss the fact that the body is working hard to pump out insulin to keep those sugars in check. In essence, this is a pre-pre-diabetes.

This is particularly useful information because the earlier you treat the insulin resistance, the easier it is to treat, because it is a vicious cycle. However, this insulin measurement is not currently routine on screening tests, and this idea has not generally caught on in conventional medical approaches.

But there is a second phase to the development of T2D. During the period of increasing insulin resistance, there is a gentle creep upwards of the blood sugar. The body keeps producing more and more insulin to ‘overcome’ the insulin resistance, which keeps the BG in a relatively normal range.  After a decade of so, there is then suddenly a change, where the slope of the curve steepens tremendously. At this point, the amount of insulin produced by the body no longer keeps up with the resistance and actually starts to fall. This is considered beta cell failure.

This refers to the beta cells in the pancreas, which produce insulin. As you can see in the graph “Beta Cell Dysfunction”, the amount of insulin produced initially goes up and up, and then starts to drop. Because the body is now producing less insulin, even as there is increased insulin resistance, the blood glucose rockets upwards. Very soon afterwards, the diagnosis of T2D is made.

Why do the beta cells suddenly fail? It is considered a ‘burnout’ of the cells. The theory is that the beta cells have been forced to overproduce insulin in order to overcome the insulin resistance. Heavy insulin production over long periods of time (a decade or so) leads to ‘burnout’ of the beta cells and insulin production then falls. The beta cells start to burn out one after the other and this leads to the chronic progression of T2D. Therefore this disease is chronic and progressive and there is nothing you can do about it. Learn to accept it. You will be on medication for life.

A nice, neat story. Too bad that for the majority (98%) of people, it is simply a lie. Stay tuned….

Start here with ‘My Journey’

Continue here to T2D 3 – “Surgery Reverses Diabetes”

Watch the lecture ‘The Two Big Lies of Type 2 Diabetes’

 

 

2017-10-27T22:18:06-04:0025 Comments

About the Author:

Dr. Fung is a Toronto based kidney specialist, having graduated from the University of Toronto and finishing his medical specialty at the University of California, Los Angeles in 2001. He is the author of the bestsellers ‘The Obesity Code’ and ‘The Complete Guide to Fasting’. He has pioneered the use of therapeutic fasting for weight loss and type 2 diabetes reversal in his IDM clinic.

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Insuliiniresistenssi – kaikkien elintasosairauksien äiti, osa 5 | TurpaduunaribachcoleP OneBook Review - The 8-Week Blood Sugar Diet - Intensive Dietary Managementinflammation and T2D Recent comment authors
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Pat
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Pat

No comments yet? Am I the first to comment? This post means so much to me as at 27 years of age, just after the birth of my twins, my family doctor ordered a GTT. He said that I did not have diabetes but that my glucose took a long time to go down. He said he did not understand it, that he did not understand what it meant. Now that was a long time ago and doctors did not know of pre diabetes, syndrome-x, and metabolic disorder. At the time, I was a slim 130 lbs. Thank you for… Read more »

David M
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David M

There is another elephant in the type II’s room aside from insulin. It is glucagon and hyperglucagonemia and it is a very large elephant. When I was first diagnosed with T2 in 2005, I got my blood sugars under control in 6 weeks just by reducing my carbs from about 600 grams a day (seriously) down to about 120 grams a day. But in running blood glucose profiles where I would read my BG at intervals ranging from half an hour to an hour, I noticed that when I went for periods without eating my BG levels would climb. Now… Read more »

bob
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bob

I found your story very interesting. Could you please explain what HIIT means. When you started a sentence with IF, you meant Intermediate Fasting, right? Thanks.

Sarah
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Sarah

HIIT – High intensity interval training (type of exercise program)

BobM
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BobM

HIIT = high intensity interval training.

Kathy
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Kathy

Unger’s talk (https://m.youtube.com/watch?v=VjQkqFSdDOc) seems to suggest that hyperglucagonemia results from IR alpha cells (due to lipotoxicity) so reducing IR remains the key. Evolutionarily, it makes sense that glucagon is “on” by default – the need to keep blood sugar UP was much more critical throughout most of human history. Only relatively recently has the need to keep it DOWN been the problem. So having a pulse of insulin in response to high blood sugar inhibit the otherwise ‘on’ glucagon action make sense. I do hope Dr. Fung discusses glucagon more, including the large contributions of gluconeogenesis and glycogenolysis to abnormal… Read more »

Mike Williams
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Mike Williams

Great Post.
It is a progressive disease in their world..because they insist the patients follow a protocol that insures the disease is progressive and will get worse.
Seriously one of the worst iatrogenic disasters in modern medical history..

Mikael
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Mikael

Insulin is the symptom of glucose not the cause. Diabetes type 2 can never be cured since the destruction of the cell are at DNA level. And since all our cells are replaced every 7 years you still have t2d after the cells are replaced. You can manage t2d with low carb but not cure it.

bob
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bob
Mikael
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Mikael

Insulin resistance is not caused by insulin. Insulin resistance is caused by fructose and omega 6. What kraft describes is the symptom of what happens to our body when our metabolism have been destroyed by fructose. What happens is that the insulin receptors on the cells get worn out, one by one out of the 20000 receptors each cell have.

David
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David

Yes David M it would be interesting to read Dr. Fung’s analyis of the role of Glucagon. Here is a discussion here:

http://drmalcolmkendrick.org/2015/08/04/turning-diabetes-upside-down/

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[…] according to this article appearing in The Intensive Dietary Management this & the myth that it is a chronic and progressive disease is one of the biggest lies […]

Bobbyw
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Bobbyw

My biggest problem and I’ve had T1 23 yrs, is time to take right while also working and having to keep the job which puts diabetes number 2.

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[…] Jason Fung refers to this work recently. I’ve linked a PDF summarising Kraft’s work at the top. Otherwise, the book is available on Kindle for £5 and there are a few posts by Ivor Cummins (The Fat Emperor) about it including an interview. Otherwise, nothing. […]

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[…] Type 2 Diabetes really be a disease that reverses? We’ve outlined in our previous post how most specialists, doctors and researchers view T2D as a progressive chronic disease. That means […]

Sandy
Guest

I am following Dr.F’s protocol and its been 9 weeks now. Doing great so far.. lost 11 inches and 8 pounds.. I have a closed group to lend support while fasting and losing weight to lower our blood sugars and A1c.. if anyone cares to join…https://www.facebook.com/groups/1490509581270886/1495729797415531/?comment_id=1495764524078725&notif_t=like

Sandy
Guest

OOPS sorry posted wrong group.. Its called Fung Sweigh at ..https://www.facebook.com/groups/459769974182105/

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[…] el problema, pero sí medir los niveles de insulina. En la gráfica que hay más abajo (ver) se muestra cómo durante el desarrollo de la diabetes tipo 2 los niveles de glucosa pueden […]

Kok-Hong
Guest

My father who had type 2 diabetes for over 30 years just had his toe amputated after a year long battle against a foot ulcer. 2 recent vascular surgery did not improve his condition enough for the toe to heal. I got my Accuc-CHEK Nano on 1st Sep. and the first reading was 302 mg/dL. I know what that meant. Over the week I searched the internet and tried various TCM herbal remedy, and tried fasting…nothing seems to work reading ranged from 151-419..ran out of test strips. Visited an Endocrinologist to have my HbA1c and other tests. Was given initial… Read more »

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[…] Aja, ko smo pa že ravno pri diabetesu in njegovi kao “kronični, neozdravljivi naravi, kjer edinole dodatni inzulin in zdravila upočasnijo napredek”, priporočam odličen blog dr.Jasona Funga. Zelo nazorno in enostavno opiše zgrešenost sodobnih smernic. https://idmprogram.com/the-biggest-lie-t2d-2/ […]

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[…] Continue to T2D 2 – The Biggest Lie […]

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[…] reason I call this one of the most important books of the year is that it exposes what I call the Biggest Lie of Type 2 Diabetes. This is the idea that T2D is a chronic and progressive disease. This is, after all, what all your […]

P One
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P One

Outside of Dr Fung’s clinic, which can only see people in Ontario, how does one identify an endocrinologist or diet clinic which uses insulin – instead of glucose – as the marker for type 2 diabetes? I have met with endocrinologists and almost all of them dismiss the need to measure insulin, and I have never had one of them that does this give me a good reason for it.

Finding a doctor even half as enlightened as Dr Fung is just difficult. How does one go about locating such an individual close to home?

bachcole
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bachcole

I wonder if anyone has sat down and tried to figure how many people have died horrible agonizing deaths over the past 100 years only from this one big fat lie, to say nothing of all of the other con med lies. I am going to guess that the number approaches the number of deaths in all of the wars and governmental pogroms in the twentieth century. This puts con med in the same league as the Nazi Party and the Communist Party, combined. And still the public kisses their a$$e$ relentlessly.

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[…] T2 diabetes on etenevä sairaus? […]