We have an epidemic of diabetes in the United States. An estimated 30.3 million Americans, nearly 1 in 10, have Type 2 diabetes.1 Another 84 million American adults — about 1 in 3 — are prediabetic, and most are unaware of this fact. Prediabetes2 is defined as an elevation in blood glucose over 100 milligrams per deciliter (mg/dl) but lower than 125 mg/dl, at which point it formally becomes Type 2 diabetes.
However, any fasting blood sugar regularly over 90 mg/dl really suggests insulin resistance, and seminal work by the late Dr. Joseph Kraft, author of “Diabetes Epidemic and You: Should Everyone Be Tested?” suggests that 80 percent — 8 out of 10 — Americans are in fact insulin resistant,3 which means they’re already on their way toward developing diabetes.
That's the bad news. The good news is Type 2 diabetes is curable, and the cure is less than free. It actually saves you loads of time and money. In his book, “The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally,” Dr. Jason Fung details how to address this exceptionally common problem.
Fung is a nephrologist (kidney specialist) with a practice in Toronto. Two years ago, I interviewed him about fasting, which is one of the most powerful interventions for Type 2 diabetes and insulin resistance. Fung was also one of the experts who peer reviewed my book, “Fat for Fuel,” which integrates some of his work.
Why Identifying Insulin Resistance Is so Important
There are two types of diabetes, Type 1, or insulin dependent diabetes, and Type 2 diabetes, which is lifestyle related. Type 2 diabetes accounts for 90 to 95 percent of all diabetes cases and is the topic of this particular discussion. Prevalence of Type 2 diabetes started to rise in the 1980s, at a time when obesity had yet to become a significant trend. However, as obesity became more prevalent, so did Type 2 diabetes.
“But the fundamental underlying problem of Type 2 diabetes, which is insulin resistance, is actually much more widespread than that,” Fung says. “And the innovative thing Kraft did was that he took a standard glucose tolerance test, and measured blood insulin levels instead of blood glucose. Because if you think about what's happening, when you ingest 75 grams of glucose [the amount administered prior to the test], your blood glucose may stay normal.
But, your body may be producing a huge amount of insulin to really shove that glucose into the cell. Because one of the functions of insulin is to move the glucose from the blood into the cell. Insulin resistance refers to the fact that blood glucose is simply not getting in there. So, if your body needs to produce two, three, four, five times the amount of normal insulin to get that glucose in there, you have a problem, which is not detectable if you just measure blood glucose.
Because, yes, you are shoving all that glucose into the cell, but it took you a huge amount of effort to do so. And by [using the] Kraft assay, which looks at how much the insulin goes up, you can detect [insulin resistance] at a much earlier stage. This is important because there are things we can do about reversing … insulin resistance, and the sooner we get to it, the sooner we can get on the path to wellness.”
Ultimately, diabetes is just one symptom. Insulin resistance, which results in mitochondrial dysfunction, is also at the heart of cancer, heart disease, Alzheimer's and other degenerative diseases, and it all starts because your body is unable to burn fat as a primary fuel. When your body relies primarily on sugar instead, more reactive oxygen species (ROS) are generated, which damage the mitochondria in your cells.
Why Fasting Resolves Insulin Resistance, the Cause of Diabetes
Fasting has been used for thousands of years to keep us well. Once you understand what insulin resistance actually is and what Type 2 diabetes is, then you'll understand why something so simple as abstaining from food for a period of time can be such a powerful intervention. Contrary to infectious diseases, you cannot treat metabolic disease with a pill, because metabolic diseases such as diabetes are predicated on lifestyle, primarily diet. As explained by Fung:
“You have to use metabolic treatments, which is why using fat for fuel is so important. It really gets to the point that you cannot follow this old paradigm [of drug treatment] because you're going to fail … Remember, the glucose goes into the cell, and insulin resistance is when the glucose doesn't go out of the cell. So, for years we’ve used this paradigm of lock and key.
That is, the cell is sort of gated off. Outside the cell there's blood, and when insulin comes around it turns the key, opens the gate and glucose goes in. So, if insulin is there, why is the glucose not going in? … You can measure the insulin and the insulin level is high. You can look at the insulin receptor, the gate is completely normal.
So, [conventional medicine] said something like, ‘Well, maybe there's something gumming up the mechanism. It's stuck in the lock so it doesn't open properly, therefore the glucose can't get into the cell. There's a huge problem with this sort of paradigm, because if that is happening, the cell has no glucose and should be starving.
You should be losing lots of weight; you’d have a very thin liver. All your fat should just melt away, because if you think about untreated Type 1 diabetes, where you don't have enough insulin, that's exactly what happens. The cell literally starves and everything just wastes away … But that's not what's happening here.
In Type 2 diabetes you see that people are generally obese, they have large abdomens … What's happening instead is that it's actually an overflow syndrome. The cell can't accept any more glucose because it's jam packed full of glucose already. That's the reason you have insulin resistance. Insulin is trying to move glucose into the cell but the cell is full … So, it's really an overflow mechanism …
That's also why your liver is full — it's a big fatty liver. The liver is busy trying to get rid of all this glucose by turning it into fat … Now, if Type 2 diabetes and insulin resistance are the same sort of thing, it's really about too much sugar. That's the bottom line.
And if you understand that the whole problem is too much sugar, then the solution is not to use more insulin to jam more glucose into an already full cell. The key is to get rid of it all. So, what you want to do is: 1) Don't put more sugar into your system, because you have too much sugar in already, and 2) Burn it off.”