The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally

by Jason Fung

In studies, all exercise programs produce substantially fewer benefits than expected. There are two main reasons: First, exercise is known to stimulate appetite. This tendency to eat more after exercise reduces expected weight loss. Second, a formal exercise program tends to decrease non-exercise activity.

In the end, the main problem is that type 2 diabetes is not caused by lack of exercise. The underlying problem is excessive dietary glucose and fructose causing hyperinsulinemia.

When Elena joined the IDM program, we discussed low-carbohydrate, healthy-fat diets and she began a fasting regimen of 36 hours, three times per week.

Following the IDM program, he began a low-carbohydrate, healthy-fat diet and a 24-hour fast three days per week.

As we’ve seen, the focus on dietary therapies for diabetes shifted with the momentous discovery of insulin. While insulin was indeed a miraculous cure for type 1, it was no panacea for type 2 diabetes.

When the American Diabetes Association says there is no cure for type 2 diabetes, what they mean is that there is no drug cure. However, these are two entirely different statements.

strictly reducing food intake has the potential to entirely reverse type 2 diabetes. Once again, this seems self-evident. As you lose weight, type 2 diabetes disappears.

Remember that at its very core, type 2 diabetes is simply too much sugar in the body. Thus, reversal depends upon two things: 1.Stop putting sugar in. 2.Burn remaining sugar off. A low-carbohydrate, healthy-fat diet reduces the incoming glucose load but does little to burn it off. Exercise may help, but the impact of compensation also limits its effectiveness. Further, exercise only benefits the skeletal muscles and not the fatty liver that is the cornerstone of this disease.

It sounds good, but the simple answer is no. Continuous mild calorie restriction is not at all the same as intermittent, severe restriction. Let me explain.

In all these examples, it’s obvious that averages represent only one facet of the story. The frequency of the event is of paramount importance. So why would we assume that reducing 300 calories per day over seven days is the same as reducing 2100 calories over a single day?

The portion-control strategy of constant caloric reduction is the most common dietary approach recommended to treat both weight loss and type 2 diabetes. For example, the American Diabetes Association’s main dietary recommendation is “focus on diet, physical activity, and behavioral strategies to achieve a 500–750 kcal/day energy deficit.”2

After all, who hasn’t tried the portion-control strategy? Does it work? Just about never. Data from the United Kingdom indicate that conventional advice succeeds in only 1 in 210 obese men and 1 in 124 obese women.

But why doesn’t it work? Because restricting calories causes a compensatory increase in hunger and a decrease in the body’s metabolic rate. This effect derails weight-loss efforts and ultimately ends in failure. Intermittent fasting succeeds because it produces beneficial hormonal changes that chronic caloric deprivation does not. Most importantly, it reduces insulin and insulin resistance.

Intermittent fasting prevents the development of insulin resistance by creating extended periods of low insulin that maintain the body’s sensitivity to insulin. This is the key to reversing prediabetes and type 2 diabetes.

Remember, in the longer term insulin levels are the key driver of insulin resistance and obesity.

Those on a daily calorie-restricted diet saw their insulin levels drop but quickly reach a plateau. The intermittent fasting group, on the other hand, continued to reduce their fasting insulin levels, a key marker of improved insulin resistance, despite similar total caloric intake. Since type 2 diabetes is a disease of hyperinsulinemia and insulin resistance, the intermittent fasting strategy succeeded where caloric restriction did not. It was the intermittency of the diet that made it effective.

The fasting group not only lost more weight, but also almost twice as much of the more dangerous visceral fat. The portion-control group lost lean mass in addition to fat, but the fasting group did not.

by 2.2 percent with fasting compared to only 0.5 percent with portion control. In other words, fasting is four times better at preserving lean mass. (So much for that old “fasting burns the muscle” myth.)

One of the biggest deterrents is the starvation myth.

This is the classic “Eat Less, Move More” approach endorsed by all the nutritional authorities, which is why The Biggest Loser diet scores well on the 2015 U.S. News & World Report ranking of best fast weight-loss diets.8 And it does work—but only in the short term.

That’s amazing. Over the long-term, season two contestant Suzanne Mendonca said it best when she stated there is never a reunion show because “We’re all fat again.”9

But this is not exactly news. This metabolic slowdown in response to caloric restriction has been scientifically proven for over fifty years.

The secret to long-term weight loss is to maintain your basal metabolism. So what doesn’t put you into starvation mode? Actual starvation! Or at least the controlled version: intermittent fasting. Fasting triggers numerous hormonal adaptations that do not happen with simple caloric reduction. Insulin drops sharply, preventing insulin resistance. Noradrenaline rises, keeping metabolism high. Growth hormone rises, maintaining lean mass.

Many other studies have confirmed these findings. Twenty-two days of alternate daily fasting also did not result in any decrease in basal metabolic rate.13

Fasting works because it keeps basal metabolism high. Why? It’s a survival mechanism. Imagine you are a cave dweller in the Stone Age. It’s winter and food is scarce. If your body goes into starvation mode, you will not have the energy to go out and find food. Each day the situation will get worse and eventually you will die. The human species would have become extinct long ago if our bodies slowed down every time we didn’t eat for a few hours.

During fasting, we first burn glycogen stored in the liver. When that is finished, we use body fat.

Burn, baby, burn. And since there is plenty of fuel, there is no reason for basal metabolism to drop. That’s the difference between long-term weight loss and a lifetime of despair. That’s the knife edge between success and failure. Simply put, fasting provides beneficial hormonal changes that are entirely prevented by the constant intake of food, even when the calories in that food are reduced. It is the intermittency of the fasting that makes it so much more effective.

BOTH INTERMITTENT FASTING and low-carbohydrate, healthy-fat (LCHF) diets effectively reduce insulin, and thus can cause weight loss and reverse type 2 diabetes. Fasting lowers insulin maximally, so it is quite simply the quickest and most efficient method. Still, the very low–carbohydrate diet does remarkably well, giving you 71 percent of the benefits of the fasting without actual fasting.15 Compared to the standard 55 percent carbohydrate diet, low-carbohydrate diets reduce insulin by roughly half, despite similar calorie intakes. Fasting reduces that by another 50 percent.

The more we eat ultra-processed, insulin-stimulating food, the more we need to fast to bring those insulin levels back down. And nothing beats fasting for bringing down insulin. But should we fast or follow a LCHF diet? It’s not a question of either/or. We can incorporate both fasting and a LCHF diet for maximal benefits.

Certain general principles apply to fasting with type 2 diabetes. How long it takes to reverse the disease depends on the intensity of the fasting regimen and the length of time you’ve had the disease. More intensive fasting will give quicker results, but if you have had type 2 diabetes for twenty years, it is unlikely to reverse in several months. It will take longer, though the exact time differs from patient to patient.

YOU ARE taking medications, then you must speak with your physician before starting a fast. Diabetic medications are prescribed based on your current diet. If you change your diet without adjusting your medications, then you risk triggering hypoglycemic reactions, which are extremely dangerous.

Your physician can direct you on how to reduce or hold diabetic medications, and especially insulin, during fasting days. They can be taken on an as-needed basis when blood glucose goes too high. Modestly elevated blood glucose is not often a problem, since it can be expected to come down with fasting. In my Intensive Dietary Management (IDM) program, for example, the target blood glucose is 8.0 to 10.0 mmol/L while fasting, if you are taking medication. This range is higher than the non-fasting norm. Mildly elevated blood glucose levels are not harmful in the short term, and this higher range creates a margin of safety to prevent the far more dangerous hypoglycemic reactions. I consider this to be an acceptable trade-off. The long-term goal is to successfully reduce and then stop all medications and still be able to maintain your sugars in the normal range.

NO SINGLE FASTING regimen is correct. The key is to choose the one that works best for you. Some people do well with an extended fast whereas others have better results with shorter, more frequent, fasts.

In my Intensive Dietary Management program, we often start with a thirty-six-hour fasting period three times per week for type 2 diabetes. During the eating periods, we prescribe a low-carbohydrate, high-fat diet.

Some people will do a classic water-only fast, others a modified-fat fast, and still others a bone broth fast. It is important to drink fluids to stay hydrated and monitor yourself. If you feel ill at any point, you should stop and seek professional advice. Regardless of the regimen you choose, monitor your body weight, waist circumference, medications, and blood glucose. If everything is moving in the right direction, continue with the regimen. If your results stall or are getting worse, you must change the dietary regimen. Talk with your doctor about other options.

ADJUSTING TO A fast can take a bit of time. It’s not unusual to get hunger pains or headaches or even to experience muscle cramps or skin irritations.

What to expect after a period of fasting: The dawn phenomenon AFTER A PERIOD of fasting, and especially in the morning, some people experience high blood glucose. This dawn phenomenon (DP), or dawn effect, was first described about thirty years ago.

As an analogy, think about a time when you really, really needed to urinate. You had drunk too much water and there was no bathroom nearby. When the time finally came to pee, there was no stopping that large, fast flow. That’s the dawn phenomenon.

If your blood glucose rises during fasting, ask yourself where that glucose came from. The only possibility is that it came from your own body. You are simply moving some stored food energy out from the body and into the blood for you to use.

IMAGINE A WORLD without obesity, type 2 diabetes, and metabolic syndrome. No more diabetic kidney disease. No more diabetic eye disease. No more diabetic nerve damage. No more diabetic foot ulcers. No more diabetic infections. Fewer heart attacks. Fewer strokes. Fewer cancers. No more need for diabetic

So type 2 diabetes is not only a treatable disease, but a preventable one.

OBESITY, FATTY LIVER, metabolic syndrome, and type 2 diabetes are the twenty-first-century equivalents of the Bubonic plague that killed an estimated fifty million people in Asia, Europe, and Africa during the fourteenth century.

The treatments that cure all show one common characteristic. They lower insulin. Since type 2 diabetes is a disease of hyperinsulinemia, it is only logical that these treatments are beneficial. And what do all the treatments that do not cure type 2 diabetes have in common?

the fasting period, you do not take any meals. You can consume fasting fluids such as water, green tea, herbal tea, and coffee during this time.

The following meal plans provide two sample schedules for a 30- to 36-hour fasting regimen complemented by a low-carbohydrate, healthy-fat diet. Remember to consult with your doctor before you begin this or any new regimen. Sparkling or still water, green teas, or herbal teas are excellent drinks to accompany these meals.