Tuesday, March 10, 2020

Retrospective #388: “A Piece of Cake!”

Dr. Jason 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. His 2017 post, “Towards a Cure,”© excerpted and commented on below, must have garnered a lot of hits.
In “Towards a Cure,” after a brief review of his hypothesis, Dr. Fung gets right to the point:
“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.”
To be clear, Dr. Fung is NOT advocating one of the 3 three treatments that “are known to lead to a cure,” bariatric surgery. It 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 even a proof reader).  He’s a very good writer – as the excerpts above illustrate – but his posts sometimes have typos. He 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 hope I’m not perceived as nit-picking or carping. Jason Fung is easily the most refreshing voice out there. And I think he has the best of all worlds. I’m jealous. He has his nephrology practice. He has a broad-reaching and very successful 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 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 actually be on to something.
Maybe his weekly exercise in researching and writing is a ritual that is getting him closer to understanding why “over 50% of American adults are estimated to have prediabetes or diabetes.” Maybe as more people incorporate low carb or very low carb eating, and fasting, either intermittent or all-day fasting together with 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 FAT-ADAPTED. No hunger. Easy weight loss. And myriad health issues, including “high cholesterol,” resolved, simply by changing what and when you eat! It’s that easy.  “A Piece of cake!”

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