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The problem is that people do speak in terms of "reversing" diabetes, which is a tricky term. Even Jason Fung uses that term in his youtube presentations and books/articles. This leads people to think that diabetes is curable. It isn't. The underlying condition with the pancreas that causes insulin resistance will never go back to normal. Fung, and others, say you can restore insulin sensitivity, which you can, to a point. But as long as you have to go back onto his fasting regime, even just temporarily, to "maintain" insulin sensitivity, then you haven't cured the problem. You're only managing it. And he says you do need to occasionally do a sort of "tune up" fast, to maintain the new level of insulin sensitivity.
So this term, "reversing" diabetes is a little deceptive. What it means, as far as I can gather, is that you can dial back the insulin resistance a bit, but you can't eliminate it completely, and get a healthy, like-new pancreas and insulin function again. You'll always have to watch your carbs and avoid sugar, and do an occasional fast (if you take on the intermittent fasting as a strategy), to maintain the insulin sensitivity.
And even then, I'm not sure you'll be successful for the remainder of your lifetime, in avoiding diabetes. Someone here posted about an elderly relative or friend who didn't eat sugar or much starch, had a good healthy diet, but still got diabetes in her 80's. Someone else posted that they followed a low-carb sugar-free diet for years, after being diagnosed with pre-diabetes, yet is now taking metformin; he got diabetes anyway. This is worrisome. It means we can only slow the progression of the disease, we can't stop it, let alone reverse it, to say nothing of curing it.
It means we can only slow the progression of the disease, we can't stop it, let alone reverse it, to say nothing of curing it.
Good post.
So far, we can only slow the inevitable progression of DM, but the first rays of hope of reversing it are starting to show thru: http://www.medscape.org/viewarticle/544820_2 The newer class of drugs like Byetta or Trulicity (GLP-1 agonists) seem to be able to stimulate beta-cell growth and slow down beta cell death seen in diabetics.
So far, we can only slow the inevitable progression of DM, but the first rays of hope of reversing it are starting to show thru: http://www.medscape.org/viewarticle/544820_2 The newer class of drugs like Byetta or Trulicity (GLP-1 agonists) seem to be able to stimulate beta-cell growth and slow down beta cell death seen in diabetics.
What does this mean for pre-diabetics, though, who hope to avoid full-blown diabetes altogether? They can't take a med prescribed only for diabetics. So what can they do, other than stick to a low-carb diet, maybe do intermittent fasting, and hope for the best? I've very worried that someone here said they stuck to a diabetes-prevention diet for years, but diabetes caught up with them, anyway.
I've been studying Jason Fung's diet & fast program, since it was mentioned here, and I don't like the way he dismisses out of hand concerns about hypoglycemia while fasting, and glosses over the way fasting "engages the sympathetic nervous system" to give you energy while fasting. What that means, is, that when your blood sugar gets low, the adrenal glands get triggered, which is NOT a good thing! Too much adrenal hormone input is one thing that CAUSES diabetes. So unless Dr. Fung has a way of keeping the whole system stable, I'm going to be extremely wary of his program. There are safer ways to do a fasting program. He's way too cavalier in his lectures about these crucial details.
I'd beware of any advice given in a book intended for the popular audience, especially when it promotes some unorthodox method.
Secondly, diabetics are born with genes that "cause" diabetes just as Mediterranean people are born with genes that "cause" dark tan. But both need some environmental stimulus to allow the conditions to show themselves: DM needs hi carb diet and tans need sunlight. Some diabetics are more sensitive to diet than others. Some dark skinned people are more sensitive to sunlight than others.
Diabetics taking cortisone to treat some other medical condition will have a harder time controlling blood sugars and stressful conditions that increase natural cortisone production (and other things) will do the same. OTOH- non-diabetics who must take cortisone usually don't get BS elevations into the abnormal range nor do they seem to get complications of diabetes.
There are many hormones that interact to achieve your final BS level: insulin, glucagon, cortisone, GH, thryroxine, GLP-1 etc etc. It's a delicate balancing act and changing one will lead to changes in the others.
Research is apparently on-going as to when & how to use the new incretin analogs to try to save islet cells and maybe to eventually "cure" diabetes. Someday maybe they will be regularly prescribed to "pre-diabetics."
I've been studying Jason Fung's diet & fast program, since it was mentioned here, and I don't like the way he dismisses out of hand concerns about hypoglycemia while fasting, and glosses over the way fasting "engages the sympathetic nervous system" to give you energy while fasting. What that means, is, that when your blood sugar gets low, the adrenal glands get triggered, which is NOT a good thing! Too much adrenal hormone input is one thing that CAUSES diabetes. So unless Dr. Fung has a way of keeping the whole system stable, I'm going to be extremely wary of his program. There are safer ways to do a fasting program. He's way too cavalier in his lectures about these crucial details.
I can only speak for myself. When I started intermittent fasting I was already doing low carb. It was just a natural extension of that. I had already cut the dose of my medication in half. My A1C numbers were the best I had ever had at 5.1. I don't test myself all day every day. Once I find a pattern, I stick with it. with the reduced carb intake AND the reduced dosage of medication I found that I was still in the normal range. Even when not eating for a good part of the day I found my BG pretty much normal. This is me, everyone is different. My point is that you have to reduce your medication or insulin to match your diet, otherwise you will go low. This is pretty much common sense to me. It may not be to others. This is the same thing that Dr. Bernstein teaches. If you reduce your carb consumption you have to lower your dose of insulin to match. Obviously no doctor will do it for you as most of them probably do not even recommend intermittent fasting but for many T2's on medication it is totally doable if you reduce your meds AND monitor yourself during the initial phase. For T1's it is different and I can't speak for them.
If you don't eat your BG will not go up so you do not need to bring it down very much or at all. My BG goes up overnight so my fasting numbers are always a bit elevated. You would have to adjust the timing of you meds to account for this. If you wake up normal and you plan to fast DO NOT take your BG lowering medications or insulin till you are going to start eating.
I can only speak for myself. When I started intermittent fasting I was already doing low carb. It was just a natural extension of that. I had already cut the dose of my medication in half. My A1C numbers were the best I had ever had at 5.1. I don't test myself all day every day. Once I find a pattern, I stick with it. with the reduced carb intake AND the reduced dosage of medication I found that I was still in the normal range. Even when not eating for a good part of the day I found my BG pretty much normal. This is me, everyone is different. My point is that you have to reduce your medication or insulin to match your diet, otherwise you will go low. This is pretty much common sense to me. It may not be to others. This is the same thing that Dr. Bernstein teaches. If you reduce your carb consumption you have to lower your dose of insulin to match. Obviously no doctor will do it for you as most of them probably do not even recommend intermittent fasting but for many T2's on medication it is totally doable if you reduce your meds AND monitor yourself during the initial phase. For T1's it is different and I can't speak for them.
If you don't eat your BG will not go up so you do not need to bring it down very much or at all. My BG goes up overnight so my fasting numbers are always a bit elevated. You would have to adjust the timing of you meds to account for this. If you wake up normal and you plan to fast DO NOT take your BG lowering medications or insulin till you are going to start eating.
I'm looking into this method in part for myself, being pre-diabetic, but also for a diabetic friend. I've been forwarding Dr. Fung's info to him, and Dr. Fung says that diabetics trying his fasting program should only do so under the guidance of a doctor, to get help lowering their meds safely. But it sound like you were able to do it yourself, without a doctor's guidance. Is that right? I've been wondering where anyone is supposed to find a doctor who would be agreeable to supervising the program, since it's not something most primary care docs or endocrinologists are familiar with.
I'm looking into this method in part for myself, being pre-diabetic, but also for a diabetic friend. I've been forwarding Dr. Fung's info to him, and Dr. Fung says that diabetics trying his fasting program should only do so under the guidance of a doctor, to get help lowering their meds safely. But it sound like you were able to do it yourself, without a doctor's guidance. Is that right? I've been wondering where anyone is supposed to find a doctor who would be agreeable to supervising the program, since it's not something most primary care docs or endocrinologists are familiar with.
You will have a hard time finding a doctor that will go along with the fasting part. That is not to say it is not possible. My doctor however does know I am on a low carb diet. He noticed my A1C numbers right away and I mentioned my diet. He nodded and lowered my dose. I still take the same amount of metformin as that does not generally cause lows. Metformin treats insulin resistance and does not increase insulin production. The other pill I was taking (glipizide) he told me to cut in half and then on the next visit he switched me to an even better one (glimepiride) and at a low dose. I only see him for a short time so as far as the monitoring part you have to take it upon yourself. A glucose meter is an essential tool to help you do this. The glipizide and the glimepiride are sulfonylureas and with those you have to be careful. Are you on medication? Since you are a pre I would assume not? If that is the case, it is completely safe to fast. If you are on meds than it depends on the type to see what course of action you can take.
You will have a hard time finding a doctor that will go along with the fasting part. That is not to say it is not possible. My doctor however does know I am on a low carb diet. He noticed my A1C numbers right away and I mentioned my diet. He nodded and lowered my dose. I still take the same amount of metformin as that does not generally cause lows. Metformin treats insulin resistance and does not increase insulin production. The other pill I was taking (glipizide) he told me to cut in half and then on the next visit he switched me to an even better one (glimepiride) and at a low dose. I only see him for a short time so as far as the monitoring part you have to take it upon yourself. A glucose meter is an essential tool to help you do this. The glipizide and the glimepiride are sulfonylureas and with those you have to be careful. Are you on medication? Since you are a pre I would assume not? If that is the case, it is completely safe to fast. If you are on meds than it depends on the type to see what course of action you can take.
Thanks. So you actually were/are under the care of a doc, for help or feedback in lowering your insulin? I'm inquiring on behalf of my insulin-dependent friend.
I wouldn't say it's safe for me to fast, because I can get hypoglycemic. But from the standpoint of insulin-control meds, yes, you're right; that's not an issue for me. I hope it never becomes in issue, but I'm concerned. Thanks for all your info. I'm going to share a summary of it with my friend.
One more question. So, you maintain a low-carb diet all the time, and that allows you to stay off insulin, I gather. Are you using metformin only, at this point? It seems to me the regime would work only for people who are able to maintain a strict discipline, and stay with the diet long-term. People who can't control the urge to "cheat", or to give themselves a treat now and then, wouldn't be successful at staying off insulin? What about alcohol consumption? Would that be a problem, once someone weans themselves off of insulin?
I think you misunderstood me? I am not on insulin and never have been. I take 1000mg of Metformin and 2mg of Glimepiride a day. As I mentioned the metformin does not cause lows even without food. It is used to treat insulin resistance. The other pill I take (Glimepiride), stimulates insulin production and is in a class of drugs called sulfonylureas and I take the lowest dose available. I do a low carb diet but I am not super strict or anywhere close to a true ketogenic diet. Some days out of the week I do intermittent fasting where I skip breakfast and lunch and eat dinner with snacks in the evening. I probably average 50g of carbs per day. I do have my "cheat" days every once in a while. Not often but every now and then. I mention Dr. Bernstein in a previous post. I highly recommend his book to any and all diabetics. His diet is a bit too strict for me but that is only a small part of the book. He recommends cutting way back on the carbs and insulin. If your eat less carbs, your blood sugar stays low and you would need less insulin to bring it down to normal levels. That should be the aim for all diabetics, to lower blood sugar AND insulin whether it's produced by the body or injected. In my case, my body (pancreas) still produces it, I just have to push it a bit to do so.
As for the alcohol, it is possible to remain low carb as long as you drink low carb drinks. Beer is basically liquid bread and generally high in carbs. I will drink a couple of low carb beers (2g each). Wine in limited amounts is not too bad. Most distilled spirits are low or zero carb. What you have to be careful with it what you mix it with. Many mixers are full of sugar.
You mention you are a pre-diabetic but you didn't say if you took medication? I assume you don't. Unless you have some other problem besides being a pre-D, there should be no reason for you to go hypo. Diabetes is a problem with high blood sugar, not low. Fasting alone will not do it as is mentioned in Dr. Fungs video. When you hear of diabetics going low it is because they used too much insulin or over medicated. As I mentioned, I use a glucose meter to test myself when necessary. By the way, I started doing intermittent fasting way before I ever heard of Dr. Fung. I took it upon myself to try it and got great results with weight loss and BG control. Being on a LCHF diet eliminates cravings it makes intermittent fasting much easier. I can post the video if would like.
Last edited by gguerra; 09-20-2017 at 10:14 PM..
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