Courtesy Carl Franklin/2 Keto Dudes Podcast I think we all know a friend or family member who has been recently diagnosed with type 2 diabetes—in most families, more than one. It’s a diagnosis so commonplace we’re inured to what has become a “global epidemic with devastating humanitarian, social, and economic consequences,” according to The International Diabetes Federation (IDF), an alliance of diabetes associations in more than 160 countries.
In the U.S. alone the incidence of diabetes has nearly doubled in the last 20 years, according to the Centers for Disease Control and Prevention. Nearly 30 million people have the disease—and 7.2 million don’t even realize it. The total costs of diabetes in the U.S. have increased from $245 billion in 2012 to $327 billion in 2017, estimates a recent study from the American Diabetes Association, and that number is projected to grow. “Diabetes imposes a substantial burden on society in the form of higher medical costs, lost productivity, premature mortality, and intangible costs in the form of reduced quality of life,” say the study authors.
As the cost of diabetes soars, a Canadian doctor has a solution that could save billions. In his book, The Diabetes Code, Jason Fung, MD, challenges conventional beliefs about the treatment of type 2 diabetes. While the majority of the medical community right now manages diabetes as a chronic and progressive disease, Dr. Fung views it as a metabolic derangement that can be halted, even reversed.
Let’s be clear; we’re not talking about type 1 diabetes, in which the pancreas fails to produce any insulin—a hormone the body depends on to process sugar. Type 1 requires the use of insulin. But type 2 diabetes—the most common form—is a result of the body producing so much insulin that receptors become desensitized to it and fail to use it properly; it’s this insulin resistance that Dr. Fung proposes patients can reverse, and his approach begins with intermittent fasting.
What’s intermittent fasting? “Basically, intermittent fasting is any period of time you are not eating,” explains Dr. Fung. “Generally speaking, only water is allowed. Variations of fasting include the use of tea, herbal tea, and coffee.” There’s quite a bit of flexibility around when you can fast and when you can eat, with several variations to choose from: Some folks eat only within a certain window of time each day—say, between noon and 8 p.m.—and then close down the kitchen for the next 16 hours. Others extend the 16 hour fast to 24 hours, 36 hours, and so on, a few days a week. For the toughest cases—those who’ve been insulin resistant for many years—a ketogenic diet is paired with fasting, to keep blood sugar low for an extended period of time and avoid raising insulin.
“Every time you eat, you’re going to stimulate insulin,” explains Dr. Fung in his video on insulin resistance. “If you stimulate insulin all the time you get insulin resistant, your fat cells get big, it turns on leptin. If you turn on leptin all the time, you get leptin resistant. …So how do you reset that? You need to keep your insulin low for a significant amount of time.”
Fasting to treat diabetes is not a new idea but rather one that fell out of fashion. Diabetes pioneers Frederick M. Allen and Elliott P. Joslin were treating patients with diet and fasting before the advent of insulin treatment in 1922. Dr. Joslin—of Harvard University Joslin Center for Diabetes fame—is one of the most eminent diabetes doctors in medical history, and he believed in fasting.
Fasting worked then, and there are a few in the medical profession who are starting to look at it with new eyes now. A pilot study last year on the effects of intermittent fasting on type 2 diabetes markers showed short-term daily intermittent fasting to be both safe and effective at improving body weight, fasting glucose, and post-meal blood sugar. In a small Canadian study that looked at three of his patients as case studies, Dr. Fung describes how the subjects were able to stop using insulin and lose weight by following a low-carb, ketogenic diet and intermittent fasting plan. “Diabetes is a dietary disease caused by our body’s insulin response to chronic overconsumption of carbohydrates,” he says. “The best and most natural way to reverse the disease is to reduce the consumption of carbohydrates.”
Dr. Fung has seen a great deal of success with this approach—as hundreds of before-and-after accounts from patients in his clinic and followers of the plan in his online support group attest. Take Desmond—a patient he sees in his clinic. Desmond was a type 2 diabetic for over 10 years, on multiple medications and insulin. Dr. Fung started him on a low carbohydrate diet plus intermittent fasting for 24 hours, three times a week. Desmond was able to reverse his diabetes in a matter of months and now maintains his health and weight with diet instead of medications. Another patient, Clive, found the program online after having been diagnosed with type 2 diabetes. He has reversed his diabetes, is no longer obese, and his cholesterol level dropped. Carl Franklin, of the 2 Keto Dudes podcast, was diagnosed with type 2 diabetes and weighed 366 pounds. He started on a ketogenic diet and added intermittent fasting and was able to quickly lose about 70 pounds and reverse his type 2 diabetes.
As promising as Dr. Fung’s results sound, some other doctors hesitate at claims of a cure, saying much more research needs to be done to verify his findings. “I consider diabetes a chronic disease, so I would not call it curable for that reason,” notes Anca Goller, MD, an endocrinologist at Emerson Endocrinology Associates. “It can certainly be controlled and sugars can be brought back to normal with treatment. In those situations, I prefer to call it ‘in remission’ instead of cured, because these patients are very likely to become hyperglycemic again once the intervention that worked is stopped—whether that is diet or exercise or medications.”
Dr. Fung’s goal is to wean patients off medications, especially insulin. “It’s the insulin that causes insulin resistance,” writes Dr. Fung, who, in his work as a nephrologist has treated some of the sickest patients and witnessed firsthand what happens to patients whose diabetes has been “managed” with insulin for years on end. “As we prescribe insulin to type 2 diabetics, patients don’t get better; they get worse. Their blood glucose is better, but they gain weight and they still develop all the complications—heart disease, stroke, kidney disease, blindness,” he says. “The correct treatment is to empty out the body, not just the blood, of excessive glucose. How? LCHF [low carb, high fat diet] and intermittent fasting. …As we start fasting type 2 diabetes patients, they lose weight, their medication requirements go down, and eventually it reverses.”
While many doctors will want to see the effects of fasting on diabetic patients observed in a controlled clinical study, we’re not likely to see such a study. In his article “The Corruption of Evidence Based Medicine—Killing for Profit” Dr. Fung is plainspoken about the conflicts of interest in the pursuit of evidence-based medicine today—what he terms “publication bias.” A controlled clinical study to investigate the efficacy of intermittent fasting over drug treatment at managing, even reversing, diabetes is unlikely to find funding. He doesn’t blame drug companies for this. “Doctors love to blame Big Pharma,” he says. “Big Pharma companies have a duty to their shareholders to make money. They have no duty to patients. On the other hand, doctors have a duty to patients. Universities have a duty to remain unbiased.”
As for the hundreds of patients in his clinic and the 50,000 more in his online support group, they’re not waiting around for a clinical study to confirm what they are seeing with their own eyes, experiencing in their own bodies, and witnessing in others in the network. Those living the protocol are fasting, shedding pounds, and weaning themselves off insulin and diabetes meds.
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