This article was previously published April 1, 2018, and has been updated with new information. We have an epidemic of diabetes in the United States. An estimated 37 million Americans, or 11% of the population, have Type 2 diabetes.1 The numbers have become so grave that diabetes deaths topped 100,000 in both 2020 and 2021— up from 87,000 in 2019, before the pandemic. Another 1 in 3 American adults 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% — 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. A few 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 ImportantThere 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% 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.
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. Fasting Resolves Insulin Resistance, the Cause of DiabetesFasting 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:
Why Exercise Cannot Replace FastingTo avoid adding sugar into your body it is important to adopt a cyclical low-carb, high-fat diet, which I detail in “Fat for Fuel.” Then, to burn off the sugar already in your system, intermittent fasting or time-restricted eating is a powerful tool. Exercise is not the solution for diabetes, and cannot replace fasting. Remember, you can’t out-exercise your mouth. The reason for this is because you not only have insulin resistance in your muscles, but in all your tissues and organs, and to eliminate the excess glucose in your organs you need to temporarily “starve” the cells. Clearly, you should exercise, but that will only burn the glycogen in your muscles. It’s not going to address your fatty liver. As noted by Fung, fasting “gets rid of all the sort of excess nutrients. That's why, historically, people called it a cleanse or a detox, because that's really what it is.” In his practice, Fung has used fasting for many years and can attest to the dramatic turnarounds possible. “We have people coming in with the most severe diabetes; they’re taking hundreds of units of insulin a day, and within three to four weeks we have them off everything.” Oftentimes, a severe diabetic can revert back to being nondiabetic within as little as two months. Taking Insulin Worsens Type 2 DiabetesThis is not to say it’s easy. Fasting can be difficult when you’re used to eating multiple times a day. But it’s a natural way that will allow your body to heal itself. Meanwhile, taking insulin for Type 2 diabetes is about the worst thing you can do. As explained by Fung:
How Fasting Benefits Your MitochondriaFasting is the most profoundly effective metabolic intervention I’m aware of. It's like getting a free stem cell transplant, and it massively upregulates autophagy and mitophagy. It also stimulates mitochondrial biosynthesis during the refeeding phase, which allows your body to naturally regenerate. For these reasons, fasting is not only beneficial for Type 2 diabetes and obesity but also for health in general, and likely even longevity. There’s even evidence to suggest fasting can help prevent or even reverse dementia, as it helps your body clean out toxic debris. As noted by Fung, “It's fundamentally one of the keys of wellness.” By lowering insulin, you also increase other important hormones, including growth hormone (aka the fitness hormone), which is important for muscle development and general vitality. Other ailments that can benefit from fasting include polycystic ovaries, polycystic kidneys and fast growing cancer cells. The reason for this is because when autophagy increases, your body starts breaking down old protein, including fast growing cells. Then, during the refeeding phase, growth hormone increases, boosting the rebuilding of new proteins and cells. In other words, it reactivates and speeds up your body’s natural renewal cycle. Getting StartedMost people fear being hungry and avoid it like the plague. Here, intermittent fasting can make the process a lot easier. Before I tried my first five-day water fast, I increased my intermittent daily fasting to the point that I was fasting for 20 hours a day for a few months, but one month is likely sufficient. At that point, going several days without food was easy, since my body had had gained metabolic flexibility and was able to burn fat as my primary fuel. Most people get really hungry by Day 3 on a water fast, yet I had no hunger at all. Fung agrees, saying:
How to Minimize Side EffectsGradually easing into longer fasts will naturally minimize most side effects associated with fasting, as will transitioning over to a high-fat, low-carb diet, to help your body to adjust to using fat as a primary fuel. The so-called “keto flu” is often related to sodium deficiency, so it’s recommended to take a high-quality unprocessed salt each day. I typically pour salt in my hand and lick it throughout the day when fasting, as I obviously can’t put it on food. This will also help reduce the likelihood of intractable muscle cramps at night. Headaches are also common when you first start water fasting. These too can often be minimized by taking salt. An alternative to eating salt straight, or putting it in water, is to add it to a bit of bone broth. Another important mineral is magnesium. It’s particularly important if you are diabetic, as magnesium deficiency is very common among Type 2 diabetics. This is another possible culprit if you’re getting muscle cramps. There are several types of magnesium, some of which are more poorly absorbed than others. During water fasting, your best bet is to use Epsom salt baths, as this allows your body to absorb the magnesium through your skin rather than your digestive tract. Magnesium has a laxative effect in high doses, and when you’re not eating anything, oral magnesium can easily result in “disaster pants.” Multivitamins can also be useful during extended fasts, especially if you’re doing them regularly. It is also important to understand that if you are on a multiday water fast you will liberate many toxins from your fat stores, so using an infrared sauna and taking effective binders, like chlorella, modified citrus pectin, cilantro or even activated charcoal can help eliminate these liberated toxins from your body and prevent their reabsorption. Work With a Knowledgeable Physician if You’re on MedicationsWhile fasting is a profoundly effective intervention for Type 2 diabetes, you do need to use caution if you’re diabetic. If you are taking medication, especially for your blood sugar, you have to make sure you talk to your doctor, because there's a risk your blood sugar may end up dipping too low. If you're taking insulin, and keep taking insulin while fasting, you could get into trouble.
Why You Need Not Fear StarvationLast but not least, one of the greatest fears people have about fasting is the concept of starvation and the loss of lean muscle mass. In his book, Fung explains why such fears are overblown. Your metabolic rate is the energy your body uses to generate body heat and keep your organs working. Your body basically needs a certain number of calories a day. People have a tendency to think that skipping a meal means your metabolic rate will decrease. In reality, the exact opposite occurs. In studies looking at basal metabolic rate, people’s metabolic rate is actually 10% higher at the end of a four-day fast than at the beginning. So, your body is not shutting down, it's actually ramping itself up. The reason for this has to do with counterregulatory hormones. As insulin drops, counter-regulatory hormones go up. Some of these activate your sympathetic nervous system (the so-called fight or flight response). “So, as you fast, all these hormones are going up, your sympathetic nervous system is going up, your adrenaline is going up, your growth hormone's going up,” Fung says.
More InformationIf you’re among the 80% of people who are insulin resistant, get yourself a copy of Fung’s book, “The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally.” Another of Fung’s books, “The Complete Guide to Fasting,” is another excellent resource. As Fung says, we’ve known that fasting is beneficial for thousands of years. We just strayed away from it, and we need to re-embrace this foundational aspect of health.
from http://articles.mercola.com/sites/articles/archive/2022/02/25/fasting-for-diabetes.aspx
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