Type 2 Diabetes, a Dietary Disease #388: “A Piece of Cake!”

Jason Fung’s recent post, “Towards a Cure^©” must have garnered a lot of hits. Dr. Fung is a Toronto-based nephrologist with a busy clinical practice. In addition, his office operates in parallel an on-site and on-line clinic, Intensive Dietary Management (IDM), headed by Megan Ramos. Besides this, Dr. Fung blogs weekly under the aegis of the Institute of Kidney Life Science. He’s a busy guy. He is also a thinker whose hypotheses about the etiology and pathophysiology of type 2 diabetes are shaking things up a bit. It’s pretty exciting stuff.

In “Towards a Cure,” after a brief review of his hypothesis, he gets right to the point with these excerpts:

“The treatments that are known to lead to a cure – fasting, bariatric surgery and low carbohydrate diets – all share one feature in common. They are all treatments that lower insulin. Here’s comes the sudden, horrifying realization. The treatments we have been using for type 2 diabetes were EXACTLY wrong. Too much insulin causes this disease. Giving insulin or drugs that raise insulin will not make the disease better. It will only make it worse!

“This is precisely what happened. Type 2 diabetic patients are generally started on one medication at diagnosis. This only treats the symptoms, so over time the disease gets worse, and the dose is increased. Once the maximum dose is reached, a second, then a third drug is added. After that, insulin is prescribed in ever increasing doses in a desperate bid to control the blood sugar. But, if you require higher and higher doses of medications, your diabetes is not getter better, it is getting worse. The treatment was exactly wrong.

“In type 2 diabetes insulin levels are high, not low. Injecting more insulin is not going to help treat it. Yes, in the short-term, the symptom of high blood sugar is better, but the disease, the diabetes, was continually getting worse. How did we expect that giving more insulin to a patient with too much already would help? Our standard accepted treatments were precisely how NOT to treat type 2 diabetes.”

Of the 3 three treatments that “are known to lead to a cure,” bariatric surgery, which he is NOT advocating, is fraught with unnecessary risk. The other two, fasting (for which he is a strong proponent), and low or very low carbohydrate diets, are not risky…and they are patient controlled. You are in charge. You decide what to eat.

Jason Fung doesn’t have an editor (or a proof reader, apparently).  His posts frequently have typos. As my editor counseled me years ago, let a post percolate for a day and then edit it, and then edit it again the next day and the next. Jason Fung doesn’t have the luxury of time to do that. And neither does he have the benefit of an outside editor. For example, I would have counseled him to edit the penultimate sentence of the first paragraph above to read, “Giving insulin or eating foods that raise insulin will not make the disease better.”

I’m not nit-picking or carping really. Jason Fung is the most refreshing voice out there at the moment. And I think he has the best of all worlds. I’m jealous. He has his nephrology practice. He has a broad-reaching clinic focused on weight management and metabolic syndrome, including insulin resistance, pre-diabetes and type 2 diabetes. And he has his Institute in which, as a 1-man think tank he morphs into a research PI (Principal Investigator) each week. What fun! I think his blog title this week, “Towards a Cure,” is less a hook to garner internet hits than a reflection of his own excitement that he may just be on to something.

Maybe his weekly exercise in researching and writing is a ritual that is getting him closer to understanding why “(o)ver 50% of American adults are estimated to have prediabetes or diabetes,” as the lede of this week’s column states. Maybe as more people incorporate low carb or very low carb eating, and fasting, either intermittent or all-day fasting and very low carb eating as I do, it will also enable others to lose weight easily and without hunger, and greatly improve their general health too, as I have. Just maybe…

But that’s up to you. You are in charge of what and when you eat. You decide if you want to try it. I’ll tell you this much: Full-day fasting is easy, when you are KETO-ADAPTED. No hunger. Easy weight loss. “Piece of cake!”