I live in England and earlier this year my gp recommended me for insulin since the metformin wasn't working as well. I had taken myself off the avandia when I gained over 5 pounds in a week when it was doubled by the diabetes nurse from the diabetes clinic.
The diabetes nurse said no to insulin and that's when she doubled the metformin to 2000mg a day and the avandia to 8mg a day.
Well, now I am anemic which seems to be raising my bs and my gp has raised my dose of metformin to the highest dose.
Last week I saw my gp and asked for Byetta. She can't give it to me because I have to have approval from the diabetes clinic.
My gp seems to want to help me but the local diabetes clinic doesn't care. In fact, my last appointment there had been canceled without them telling me. Why was it canceled??They are only seeing insulin users.
What do I have to do to get on insulin? I am constantly running close to 180, which isn't good.

I'm a type-2 who recently started once-a-day insulin, using the Pen. My prior (and unfounded) insulin phobia were related to concerns about injection risks (not pain) and and calculating insulin dosing. I thought that injections had to go into particular places because vaccines go into muscle and some drugs go into veins. That made me wonder if I could be careful enough to inject myself into the right tissue and hit or avoid blood vessles and not inject air, causing an embolism? The answer I found was that the needle on the pen is short enough to avoid the wrong tissue and my injection site solves the other issues. The tummy for example, doesn't seem to have as many nerve endings as some other places, so combined with the thin needle it almost can't be felt. As to dosing, one can start with a base dosage of slow-acting and up it or lower it based on BG reading.

The one issue I'm still working on is matching my dose to my BG reading and "getting my number down". ;-)

I'd recommend to all doctors that when they first tell a patient that they have diabetes, they should immediately expose them to BG meters and Insulin injections by making the patient use both tools for themselves (with 31/33 guage lancets and needles), even if they may be able to avoid insulin or testing. They will lose their concerns and get a glimpse of one treatment they can work to avoid or postpone.

HUH?

Allie. What are you trying to say? That, a controled diet & excersize ALONE will do the job. . .for EVERYONE?

I wish this were true in my case.

I tried that route years ago, counting every single carb, putting myself on, what my dietician said, was a "starvation diet" of 1500 cal. daily and excersizing in addition to the physical labor required of my profession.

For four months I did this when diagnosed and my BG meter sometimes could not display a number becouse it was so high! {But, I did loose alot of fatty weight and thined up which, isn't a bad thing for a "husky" diabetic guy.}

Only with the addition of oral meds and a normal diet, did my numbers come down to normal ranges and a few months ago, when they started an upward swing again, I started taking a long acting insulin which is working great.

So much for your big bad drug companies and their "pushed" medications theory. Not every diabetic responds the same way to ANY form of treatment(s).

I will, at least, check out your sites you've posted. Perhaps there is something I could learn within them.

Nick.
Ahhhhhh. Yeah.

Good article. I was diagnosed type 2 in March 07. I'm 36, 5'11" and weight 205 lbs.

Learning that my beta cells are already half-dead is sobering and depressing.

I'd like to avoid insulin as much as possible. My last A1C was 6%. Hopefully in "15 years" better treatments will be available so I can remain off of insulin.

Why are you still pushing Avandia. It is a high risk drug

Hi Nicholas,
Can you elaborate on your statement about insulin resistance? "In the continued absence of any such reference it it reasonable to suppose that every type 2 Diabetic 'complication' arises as a result of the treatment of the 'insulin resistance' that was actually keeping type 2 Diabetics healthy in the first place."
This is the first time I have heard that insulin resistance can keep a person healthy. I've only heard that insulin resistance is bad.

The latest research shows that type 2 diabetes is caused by inflammation and not obesity. Exercise and fish oil reduce inflammation. What else can be done to reduce inflammation so that diabetes can be reversed. Why continue to treat the "symptoms" of diabetes with drugs instead of getting to the root cause. What causes inflammation?

Regarding insulin resistance:
I had a GTT test 30 years ago when I was in my 20's because I complained of hypoglycemia. My blood sugar went from 80 at fasting to 200 and then dropped to 40. The doctor told me that when I got older I would gain weight and develop diabetes, which is exactly what happened. I was lean and fit, and now I am fat and diabetic. I control my diabetes with low carbs and exercise, but my body will not lose weight. I have always been insulin resistant, even when I was a lean athlete. I had problems with hypoglycemia, so it makes sense that insulin resistance is a protective mechanism for hypoglycemia.

A question for Nick:
If insulin resistance protects against hypoglycemia, and therefore drugs that increase insulin sensitivity are defeating the protective purpose of insulin resistance, as you stated, "Diabetics are more protected from sudden HYPOgycemia c/o more glucose / insulin resistance ie leaving more glucose in a Diabetic's blood circulation [for feeding brain / optic / nerve cells] rather than glucose being too rapidly shunted-off [eg by GM insulin] into fat / liver / muscle cells ..." Then is exercise counterproductive? When I exercise, my blood sugar plunges, sometimes down to 50. I am type 2 diabetic and control my blood sugar by diet and exercise alone. Apparently, I am under the misunderstanding that low blood sugar is better than high, and since I do not take any insulin or medication, I don't worry about hypoglycemia. Should I worry? Should I increase my carbs to treat/prevent hypoglycemia during exercise? If, as you say, there is zero requirements for carbs, how do I prevent hypoglycemia without eating more carbs?

In this article, Dr. Tanenberg correctly states that oral medications fail in those people in whom antibodies destroy beta cells (in people with type 1, misdiagnosed as type 2). But then the author incorrectly states that, “many people with type 2 diabetes experience progressive loss of beta cell function.” The studies that show progressive loss of beta cell function did not exclude those people who have slow onset Type 1 but have been misdiagnosed as having Type 2 diabetes. When slow onset Type 1’s are excluded from studies looking at beta cell function in Type 2 diabetes, no loss of beta cell function is seen. According to the American Diabetes Association’s own peer-reviewed scientific journal Diabetes (Borg et al. “A 12-Year Prospective Study of the Relationship Between Islet Antibodies and Beta Cell Function At and After the Diagnosis in Patients With Adult-Onset Diabetes,” Diabetes 51 (6): 1754. (2002)) “None of the patients who were islet antibody–negative at diagnosis developed complete beta cell failure during the 12-year period. Indeed, 12 years after diagnosis, fasting P-C-peptide levels in islet antibody–negative patients were not significantly different compared with the levels at diagnosis.” In other words, if you remove the antibody positive patients (people with autoimmune diabetes who have been misdiagnosed as having Type 2 diabetes) from a study of beta cell failure in Type 2 diabetics, no beta cell failure occurs in the true Type 2 diabetics (i.e., those who do not have immune-mediated destruction of the beta cells).

Hi Dr. Tanenberg,
You said, "Insulin resistance typically precedes outright diabetes by several years, appearing in adults and children who are overweight, sedentary, and have a genetic predisposition to diabetes."
However, some people who are sedentary and obese never develop diabetes and others who are lean and physically active do develop diabetes. There must be a reason for "insulin resistance" if so many people have it. Taking drugs to make the body more insulin sensitive, and adding more insulin to someone who already has too much, seems to be assaulting our bodies, like force feeding someone who is already full and is screaming, "No more!" Why is there a diabetes epidemic anyway? Why won't anyone get to the root cause?

Hi Dr. Tenenberg,
Regarding your statement, "When the pancreatic beta cells can no longer overcome the insulin resistance, blood sugars begin to rise. Initially, only the post-meal glucose values are elevated, but in time the fasting glucose levels also increase. When fasting glucose tops 125 mg/dl, a patient is considered to have diabetes."
That is exactly what happened to me. I was insulin resistant at age 23, my postpranial glucose at a diabetic level, even though I was very lean and physically fit. Later I developed gestational diabetes but returned to normal after delivery. Years later, my fasting blood sugar went to 150 and my Aic was 7.6%. I am no longer diabetic. My A1c is down to 5.9%. This mornning, my fasting BS was 84. I am improving, not getting progressively worse. When I get lots of sleep, exercise, and eat low carbs, my diabetes disappears. Sleep seems to be the main factor, because when I am sleep deprived, my fasting blood sugar continues to rise regardless of exercise and diet. I wonder if the diabetes epidemic is caused by people being stressed by overwork and sleep deprivation.

Thanks Nick!
Perhaps many people with diabetes get progressively worse because they work too hard at trying to control their blood sugar (by way of starvation diets and strenuous exercise) rather than getting adequate sleep and relaxation. I feel much better after a relaxing walk and a good night's sleep. I can even eat more carbs if I take a 20 minute walk after meals.

I was Diagnosed Type 2 since 1984, my A1c is at 7 since last year 2006. I found by my own "common sense" 2 Years ago that "Exercise" AFTER meals for 20-30 minutes "LOWERED" my sugar back to 80-100 range! For "YEARS" I WASNOT Exercising AFTER meals: just taking oral meds plus Metformin LIKE MOST Diabetics I have met in my life! Now that my A1c is at 7; I will start some type of insulin because by my own reading diabetic news articles over the years I DIDN'T KNOW I WOULD SOMEDAY HAVE TO START INSULIN! My Doctors "NEVER" mentioned that possibility to me! How MANY other type2's in the world are living like this who "won't admit" they "WILL NEED TO START INSULIN" one day or get COMPLICATIONS as they get older and simply shrug thier shoulders and say quiely: it's my "Diabetes" getting worse!

Good article, but I worry about prolonged hyperinsulinemia and its effects on blood vessel disease, macro and micro. Also it causes weight gain as people snack and eat more to cope with a constant fear of hypoglycemia with barely concious feelings of sugar dropping too low triggering adrenalin and other alarms in the brain. Weight gain causes abdominal obesity increasing destructive hormone levels of hunger hormones, etc making many paradoxically more hungery for carbs and fat after they start a meal. Clearly exercise and insulin sensitizers like actos and glucophage help the resistance part but this alone cannot counteract the weight gain caused by the insulin. Gastroparesis would seem a problem for taking incretins. Is simply going on a strict carbohydrate weight loss diet a few days a month a better approach as I always feel incredibly better physically even though hungry and shaky when I do it in a way the medicines never come close. But as soon as I start to eat fully again, even with the meds, I begin feeling sluggish and gaining weight again. Also omega 3 and 6, vit e, c, and b's,(artificial and fish, veggie, fruit sources) and aspirin should in theory help blood vessel disease along with activity, but does it really?

Dear Nick (and anyone else reading this),
In answer to your question, I don't know how many people use diet and exercise alone (without drugs) to control diabetes. I think that when diet and exercise become too frustrating in keeping blood sugars in the normal range, some people resort to drugs because their doctors scare them into believing that they will have a stroke or heart attack. (My doctor scares me so much that it gives me high blood pressure whenever I visit him. I told him that if I were going to have a stroke, it would be in his office and he would be the cause of it.) In addition, I know of people who use drugs as an easy way out, so that they can eat whatever they want.
Yes, it is my opinion that proper rest between meals does help to control blood sugar. Most of us eat on the run and don't take time to relax. We go to bed too late and are jolted out of bed in the morning by alarm clocks, which in itself is distressing. (On weekends, when I sleep in, my blood sugars are normal.)
It makes perfect sense to me that the real disease is hypoglycemia. Basic biology teaches kids about homeostasis, so why can't doctors accept the fact that the human body is able to keep everything in equilibrium? I believe that if we take proper care of our bodies, our bodies will heal themselves.
I agree with your statement, "Any 'WORK' at trying to reduce a blood glucose concentration ... which is raised, by that body, as an adaptative mechanism [to PROTECT that body] is DISTRESSFUL."
You could probably say the same thing about using drugs to control blood pressure and cholesterol.
Here's question for you: If Alzheimer's disease is being called type 3 diabetes because of insulin resistance in the brain, what protective mechanism is at work here? Why would the brain, which depends on glucose, and which makes its own insulin, want to keep out glucose?

Nicholas,
Thanks for all the excellent information and links. I've just finished reading most of the studies you referred to and am very excited about it. I'm going to try eating less often and see how I do. My father recently died of Alzheimers at the age of 90. I want to prevent it from happening to me!

Nicholas Dynes Gracey,

I've very curious in your comments. I notice that you keep asking for evidence of the scientific postulates used by doctors in their treatments and yet you seem to keep using references from a BLOG. Indeed very scientific, yes, very evidence based. I hope those credentials you use serve you well, because your concepts on diabetes seem to be a throw-back to the days when the treatment for type 1 diabetes was starvation (qouting your comment: "UNdrugTREATED type 2 Diabetics and other healthy People should test daily with ChemStrips and pause from eating, and drink just water, until their urine is glucose free. The less carbohydrate eaten ... the less time between meals. That is how to CURE type 1 & type 2 Diabetes."
I recall a very interesting outcome of those patients...THEY ALL DIED!!!!!!

To bird54,

Your comments are very well founded, although there are a few other theories to explain insulin resistance...As you indicated glucotoxicity (too much glucose at the level of the cells - note that this is significantly different from "eating too much carbohydrate") is one of the theories. Another one is the concept of lipotoxicity (too much lipid or fat) in which the breakdown products called free fatty acids change the way that the cells respond to the insulin. A third idea (and one that parallels the gluco and lipo-toxicity theories on a molecular level) is that of inflammation, which is in itself a very difficult entity to describe (although we all seem to know what it is...). Some of the chemicals that are increased in the setting of inflammation are cytokines which can also be increased directly by the presence of high glucoses (so I'm not sure why Nick implied earlier that hyperglycemia is safe since these cytokines are very harmful to the body). The bottom line is that the chemical structures that float around in the blood come in contact with the cells of our body and some of these chemicals (be it glucose, free fatty acids, cytokines, something scientists have yet to identify, or some combination thereof) enter the cells and interact with the proteins that are in our cells. These interactions include changing the physical structure of the protein making it so it is unable to do its job (think of it like putting a big wad of gum on a bicycle chain and then trying to go for a ride) - for those who want the science behind this, I encourage you to read about tyrosine phosphorylation of both the insulin receptor and the insulin receptor substrate type 1 (IRS-1) and then compare it the serine phosphorylation which is caused by the free fatty acids and cytokines. The unfortunate reality is that our bodies are very complex organ with lots of things there to try and protect itself from anything that it perceives is "not normal". Indeed that will include both hypoglycemia and hyperglycemia. Perhaps the best question to be asking is what does the body (or more specifically our own body) consider to be "normal"???

To Nick and Anonymous,

Nick, Did you read the comments made by "anonymous" dated Dec. 5? I would like your opinion on it.

Anonymous, You said, "The unfortunate reality is that our bodies are very complex organ with lots of things there to try and protect itself from anything that it perceives is 'not normal'. Indeed that will include both hypoglycemia and hyperglycemia. Perhaps the best question to be asking is what does the body (or more specifically our own body) consider to be "normal"???

It would seem that our bodies already know what is "normal" and that is why I think medications can be dangerous. Our bodies have a wisdom of their own and are so complex that researchers have only seen the tip of the iceberg. Every time researchers discover some new enzyme or hormone in the body, they try to find a new drug to counteract it, or mimic it, (or whatever they do)and by interferring in one area, they create a problem in another area, because scientists do not know how the whole organism works. It is like the analogy you used of the "wad of gum in the bicycle chain," except that I am using that analogy to explain how medications gum up the workings of the human body.

The body is always trying to find balance (homeostasis), so my quesion is, "Why does the body get out of whack?" The human race has survived a long time on this earth without the need for medications. Of course, some died, but most adapted and thrived, otherwise we would not be here today. So my opinion is that we have deviated from nature and have consumed far too many calories, eaten too many refined junk foods, been exposed to toxins, and by so doing we have thrown our bodies out of balance. So diabetes and hypoglycemia are reactions to an unnatural lifestyle.

In the mice study, the mice who were fed the "normal" diet had average blood gluoses of 150. The mice that were fed a restricted calorie diet, and the mice that were fed on alternate days, both had blood glucoses of 100. So what is normal? It depends on their diet. Normality changes depending on what one eats. When I fast all day, my blood sugars range from 60 to 80. Is that normal? Yes, it seems so for my body, because that is how my body reacts to fasting. When I eat, my blood sugar rises according to what I eat, and how much I eat. Is that normal? It seems so. Blood sugar fluctuations are a normal response to eating and fasting. So the real question is, "What is healthy?" The results of the mice study show that eating less and eating less often both result in healthier mice.

However, I think type 1 diabetes has a different cause. It is caused by inflammation which causes the body to stop producing insulin. Without insulin, people die. The Toronto study showed that it was inflammation that caused the pancreas to stop producing insulin, and that when the inflammation was reversed, so was the diabetes. If type 1 is solely an autoimmune disease which destroys the beta cells, then how can dead beta cells produce insulin again AFTER the inflammation is gone? That tells me that the beta cells are not destroyed, but just inflammed, which makes them unable to produce insulin. So the cure to type 1 diabetes is to find a cure to inflammation.

Nick, You say that hypoglycemia is the real disease but that diabetes is the body's preferred state as a protective mechanism against hypoglycemia. Could you define "hypoglycemia"? By that, I mean, how low is low? Most of my hypoglycemic symptoms are from rapid dropping of blood sugar and not from being low. For example, while fasting, my blood sugar can be in the 60's with no symptoms. Yet, if I eat a high carb meal, my blood sugar will spike and then drop suddenly, resulting in shaking, sweating, irritability, at 70. It is the rapid drop that gives me my symptoms. I also get symptoms when my blood sugar is rising. Once after exercising, I was surprised to find my blood sugar at 50. I ate some glucose tablets and then the shaking started, as my blood sugar rose quickly to 90.
Does this mean that I am NOT insulin-resistant?

To Nick and Anonymous,
Diabetes is a normal response to an abnormal lifestyle.

To Anonymous,
I got so caught up in thinking about "what is normal" that I forgot to say "thank you" for your response regarding all the theories on insulin resistance. I will certainly look into "tyrosine phosphorylation" compared to "serine phosphorylation". I have no idea what that means, but I am curious to find out!

To Nick,
You said, "PLEASE really do this ... have each & every One of your Doctors identify ANY Peer-reviewed scientific reference, with an UNdrugTREATED control [ie comparing a Diabetic Group entirely UNdrugTREATED], ever been produced, that has ever evidenced that type 2 Diabetics are less healthy UNdrugTREATED ?"
I will ask, however, I don't believe that anyone will ever compare UNdrugTREATED diabetics, because most of the research is funded by drug companies, and all they care about is making money by treating the chronic diseases they invent (like diabetes). If they can label it, then they can treat it.

Nick,
How do you define eating "too often"? In the mice study, they fed the animals on alternate days. In your opinion, how often and how much should a person eat? In the mice study, the mice consumed twice as much food on the days they ate, thereby making up the lost calories for the previous day in which they had fasted. For a person with relative hypoglycemia, eating too much can result in huge blood sugar swings. In that case, wouldn't the standard treatment of six small meals be more beneficial in order to stabilize blood sugar? In other words, fast one day, and then graze the next day?

In the human study involving fasting diabetics, they discontinued the fast for those with either hyper or hypoglycemia. Again, HOW low is too low?

There's a book by titled, Adrenal Fatigue, by James L. Wilson. He states, "We have known for almost a century that people who suffer from low blood sugar frequently suffer from adrenal fatigue." Wilson's solution (among other things) is to get eat more often.

In your opinion, was I better off two years ago when my fasting blood sugars and A1c were higher? I thought that by improving my blood sugars I was "reversing" my diabetes, but have I in fact made my disease worse by increasing my episodes of relative hypoglycemia? I have to say honestly that I felt better when my blood sugar was higher than I do now, but as I mentioned earlier, my doctors scared the crap out of me when they diagnosed me with diabetes. It was like a death sentence, so my reaction has been to starve myself and overexercise in order to save my own life.

To Nick and others,
If diabetes is caused by relative hypoglycemia, and hypoglycemia is caused by eating too often, then food is the cause of disease. Therefore, eating less often is the cure because it gives the body time to detox.
The question is: Is "food" the cause of this disease, or is food "intolerances"? It is known that many type 1 diabetics also have other autoimmune diseases, namely Celiac Disease (intolerance to the gluten in wheat, barley, and rye.) Studies have also suggested that casein (from milk) may trigger type 1 diabetes. Certain adenoviruses may trigger diabetes. The body mistakes these proteins and viruses with its own organs, triggering an autoimmune response.
In addition, many people react to the proteins in other foods such as eggs, soy, seafood, and corn. People with food allergies/sensitivities also suffer from adrenal fatigue/exhaustion. Food allergies cause relative hypoglycemia. That is one reason why they tell diabetics to test their blood sugar after meals. Some diabetics can tolerate some foods, while others can't. Food sensitivities cause rapid rises in blood sugar followed by rapid falls, resulting in hypoglycemia. Food intolerances also cause inflammation. Inflammation is the cause of all diseases, including cancer, arthritis, and diabetes.
Therefore, eating less often reduces inflammation, thereby curing these diseases.

rDNA insulin CAUSES more inflammatioon throughout the body. Why would you CONSIDER introducing MORE inflammation to *reduce* blood sugar -- when in Type 2 diabetes -- it is INFLAMMATION that caused it in the first place?

Nowadays, a doctor is expected to prescribe a *fix* for his or her patient and send them on their way. However, taking into consideration NO INSULIN will HELP a TYPE 2 recover -- but rather IMPAIR a person with Type 2 diabetes -- why are people immune to understanding this?

The fact that we look upon insulin treatment for a person with Type 2 diabetes as an *OPTION* completely defies the HIPPOCRATIC OATH -- which states: "To please no one will I prescribe a deadly drug nor give advice which may cause his death."

Folks, even though what Nick says is very complex in wording -- it makes sense!!

The human body is the most miraculous machine on Earth! Allow it to heal itself and you will be gifted with the health He intended you to enjoy.

To AllieB2,
You are right. Nick's writing is very complex. I am still trying to comprehend it.

Hi Nick,
I'm still reading and thinking about all of this information, so I'll get back to you. In the meantime, I have another question. You said, "PLEASE really do this ... have each & every One of your Doctors identify ANY Peer-reviewed scientific reference, with an UNdrugTREATED control [ie comparing a Diabetic Group entirely UNdrugTREATED], ever been produced, that has ever evidenced that type 2 Diabetics are less healthy UNdrugTREATED ?"
I understand and agree that there is no evidence that un-drug-treated diabetics are less healthy than drug-treated diabetics. My question: Is there evidence that un-drug-treated diabetics are less healthy than non-diabetics? Is there any evidence that hyperglycemia actually causes complications? If hyperglycemia is the cure to hypoglycemia, does there need to be a cure for hyperglycemia? If you were to list the types of diabetes on a spectrum, what order would you put them and what would come BEFORE type 0 diabetes?

Dr Aulakh here.a diabetes specialist from india
I have seen many patients where HbA1C is more than 10,but everytime there FBS comes below 180 mg/dl {capillary}for last 2-3 months.WILL HbA1C be the absolue indication in all these cases for starting insulin therpay.

Hi NIck,
WOW! Impressive!
You have convinced me. I've read the links you listed, but I'm not done analyzing them yet, so I may have more question later. As the saying goes ..."inquisitive minds want to know..."
I've been fasting all day (just drinking water) and eating in the evening when I get home from work, Last week I lost 5 pounds. I feel fine--more relaxed and less irritable, probably due to less blood sugar swings.

Hi Nick,
I will definitely share this information with others. I have already shared it my friends and coworkers. Keep it up!

Hi Nick,
Have you thought about writing a book explaining your theory and cure for diabetes?

Hi Nick,
You said, "What (?) would my writing a book add to what Dr Bernarr is already offering RIGHT NOW ... ie a 100% bona-fide cure for type 1 & type 2 diabetes."

I think that a book, explaining all the research to back the claims would seem more credible to anyone who would want the scientific basis for the cure to diabetes.

You said, "How is your understanding of my work different from your understanding of Dr Bernarr's work?"

Dr. Bernarr's website says, "Fast only when you are symptomatic, i.e., when you have symptoms. Eat only when you are genuinely hungry....When you fast, drink only water, lie down and close your eyes. Keep your eyes closed every moment of the 24 hours, every day that you water fast. During a water fast, you must have total physiological rest."

That seems a lot different than eating less OFTEN, as you propose. You imply that a person should eat only one meal a day, to give time for complete digestion, and to allow time for the urine to become glucose-free, before consuming another meal. If, as Dr. Bernarr suggests, a person should rest completely with the eyes closed, that could only be accomplished when one is not working. I have been fasting all day while working, and eating when I get home. I have been ignoring my hunger pangs during the day. I never have glucose in my urine, even after a meal, so what would be the benefit for me to fast, except to cleanse my body, reduce the inflammation, and lose excess body fat?

Dr. Bernarr suggests fasting as a cure to all diseases, not just diabetes. The Bible says, "WHEN you fast", not IF you fast, so it was common practice 2000 years ago for people to fast, whereas nowadays health care practitioners say, "Eat small meals more often, and make sure you eat a nutritious breakfast..."

Dr. Bernarr also suggest strenuous anaeorbic exercises to build muscle because glucose in stored in muscle.

I think that Dr. Bernarr's cure for diabetes is very simple and straighforward. However, I think that many people want more scientific basis for a cure.

How much more simple can "eat right and exercise" be? Yet, people refuse to do it. They would rather take drugs. Sad, huh?

Nick said,
"Please summarize, in 5 short paragraphs, the most important issue raised in each of the 5 'diabetes breakthrough' references 2000-2007 [listed immediately above]."

1. Rats that fasted for 72 hr had a reduced plasma insulin level. However, insulin levels in the brain were elevated after a 72 hour fasting period.

2. In mice, hyperglycemia was induced after 48 hours of fasting, but not after 24 hours. Serum insulin levels were low. However, after refeeding for 12 hours, the mice were hyperinsulinimic, insulin resistant and had impaired impaired glucose tolerance. (What is this suggesting--that one should fast no longer than 24 hours?)

3. Intermittent fasting resulted in reduced serum glucose and insulin levels and may protect the brain from disorders such as epilepsy, strokes, Alzheimer's and Parkinson's diseases. Intermittent feeding can enhance health even if the fasting period is followed by a period of overeating.

4. Glucose restriction extends life span of (worms?).

5. Prolonged fasting is safe for type 1 diabetics as long as they reduce their insulin dosage. They had lower insulin levels but higher A1c's (I thought the goal was a lower A1c)

To answer Nick's questions:
1. I was diagnosed with type 2 diabetes in 2005. My fbs was 150 and my A1c was 7.6%
2. I was never given a C-peptide test.
3. My physician told me that I had worn out my beta glands but never did any kind of test to determine the condition of my beta glands.
4. I never had glucose in my urine.
5. Upon diagnosis, I immediately went on a low-carb diet, against my physician's advice, and lowered my A1c to 5.9%, so I was never prescribed any diabetic drugs.
However, in 1990, I had gestational diabetes. They put me on a high carb, low fat diet, which made my diabetes worse. Then I was put on insulin, without a C-peptide test to determine that I needed insulin. I had a bad reaction to insulin. It made my heart race and I felt horrible. When I exercised, I got hypoglycemia. The diabetic nurse told me that my reactions were worse than her "brittle diabetics." They had to keep lowering my dose until I was down to 2 units. Then the physician told me that at that dose, I really didn't need it. When I went into labor, the nurse tried to give me my morning shot of insulin, without even checking my blood sugar, but I refused. I knew that on an empty stomach, and with all that exercise (contractions of labor), I would have gone into insulin shock. I can't believe how ignorant they were. As it was, my baby got stressed, was born with hypoglycemia, and had to be put into ICU for a day.
I don't trust the medical profession any more. They could not prevent my diabetes, even though they knew I was at risk. In fact, one physician told me, "You cannot prevent diabetes. You will get it no matter what you do." Doctors have not given me any good advice about how to treat it. Everything I know about diabetes, I have learned on my own. Whenever I have a check-up, they want to put me on statin drugs and ACE inhibitors. I have more faith in my own body's ability to regulate itself than I do in physicians and prescription drugs.

Dr. Tenanburg,
Why do you recommend insulin during pregnancy? On your chart, you listed:

"Indications for Starting Insulin"
"Absolute"
"During pregnancy"

My grandmother had three, fat, healthy babies, all 10 and 12 pounders, with no complications or defects.
My second baby, born in 1993, was a HEALTHY 10 pounds 10 ounces. He was born at 42 weeks. During labor, he showed no signs of distress. His heart rate did not drop during contractions. The nurses kept commenting how much endurance he had. His delivery was natural with no drugs and no epidural. The doctor was surprised to find that he did not have hypoglycemia or a broken collar bone. He was so strong that he could hold his head up. They commented, "This is no newborn--This is a three-month-old!
I'm glad I did not take insulin. My OBGYN did not give me insulin, even though I had glucose in my urine. I just ate healthy foods and exercised.

To Nick and anyone else,

Nick's "I-eat-less-OFTEN-I-fast-more-OFTEN" method really does work.
I lost 10 pounds in 2 weeks!
They all say, "Lose weight (if you can) and your diabetes will go away." Easier said than done. I tried low carbs and exercise, but it didn't take off the pounds like "eating-less-often-fasting-more-often."

Merry Christmas Nick and Anyone Else!
I've been reading back on all the comments, and wow! There is a lot of information to absorb.
The research supporting “eating less often, fasting more often” is astounding. I think that if one looks at a meal as a "reward" for a hard day's work, then it is easy to fast all day. Now that I eat less often, I get excited about eating dinner, and I look forward to it all day, whereas before, it was a chore--I had to eat breakfast whether or not I was hungry because I didn't want to “ruin my metabolism” by not eating the "most important" meal of the day. I often ate snacks and meals, not because I was hungry, but because I wanted to make sure I got all my nutrients to prevent disease. Now when I look at all the research, it makes sense not to eat so often.

The tinyurl.com/3aypqg link states that “…nutritive calorie restriction increases life expectancy. Accordingly, treatment …with different antioxidants and vitamins prevents extension of life span...questioning current treatments of type 2 diabetes as well as the widespread use of antioxidant supplements.”

Recently I watched an advertisement on TV: A neurosurgeon was promoting his product of antioxidants for brain health. He stated that to get as many antioxidants as were in his product, one would have to consume an enormous amount of food. He showed plates and plates piled full of meats and vegetables-- more than anyone could possibly eat in a day without becoming sick or morbidly obese. And I remember thinking: This does not make any sense to me at all. If humans were meant to eat that much food or take that many pills to get the necessary nutrients, then the human race would have died out long ago.
I think that our hunter-gatherer ancestors survived on a lot less food than we eat today. I’m sure they didn’t have 4-6 meals a day. And they certainly didn’t have grocery stores or fast food restaurants to run to whenever their cupboards were bare.
Modern man abuses his body and then looks for quick fixes in the form or pills and drugs, instead of relying on the wisdom of the ages.

Hi Nick and Anyone Else,
A while ago I read an interesting book which explained the genetic reasons for many diseases including type 1 diabetes. The book is titled:
Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease (Hardcover)
by Sharon Moalem (Author), Jonathan Prince (Author)
If memory serves me correctly, the book states that diabetes actually served a purpose in the last ice age--it allowed the body to burn sugar for energy--and that is why type 1 diabetes is more common in Northern Europeans. Using the theories of this book in addtion to all the research you listed, it seems reasonable to conclude that all types of diabetes serve some purpose. We should not view diseases as negative, but attempt to find the reason for them. The book talked about "jumping genes" and how your grandmother's lifestyle had more influence on your genes than your mother. Nowadays scientists are looking for the genetic causes of diseases, as if these "mutations" are harmful, rather than focusing on how these genes benefited us and allowed us to survive the conditions during a particular time in history.

The most ridiculous thought of the day:
One should not skip meals or go on a ketogenic diet without their doctor's supervision, yet one can eat unlimited amounts of junk food and candy without any supervision at all!

Hi Nick,
It makes sense that eating one meal a day will benefit an overweight type 2 diabetic, but what about an underweight diabetic who needs more calories? Or what about an underweight non-diabetic teenager with Celiac disease (my son)who needs every extra bite of food just to stay alive?
In one of your comments, you referred to a link where fasting improved the symptoms of people with autoimmune diseases, but when they were put back on food (vegan diet) their symptoms returned. If fasting (eating less often) "cures" autoimmune diseases, then the symptoms should not return upon re-feeding. Perhaps, fasting (eating less often) does not cure diseases but only improves it when the offending foods are removed for a period of time.
What will happen to me if I continue to fast until I reach my ideal weight? At what point will I need to eat more often to maintain weight?

Hi Nick,
You stated, "For some 30 years Dr Jan Kwasniewski has been successfully treating type 1 Diabetics, without insulin, with a DPP (diabetes dietary protocol) called the "Optimal Diet". '...Type 1 diabetes can almost always be cured. You must reduce the quantity of carbohydrates consumed to 50±15 grams per day. Because 100 grams of protein can produce about 56 grams of carbohydrates. Therefore, it is necessary to consume protein of the highest biological value which is contained in egg yolks, livers and kidneys."
Then you said, "WHY CHOOSE A DPP TO MINIMIZE INFLAMMATION WHEN SOME LOW CARB DIETS CAUSE WEIGHT LOSS BY INFLAMMATION?"
Can you explain what you mean by your last statement, "...some low carb diets cause weight loss by inflammation."?
I thought low carb diets "reduced" inflammation. Low carb diets reduce insulin production/requierements diabetics. Fasting also reduces insulin levels.
I totally agree with you on intermittent fasting, but I am confused about your statement on inflammation and low carb diets.
By the way, you absolutely have to write a book. I just read Good Calories Bad Calories by Gary Taubes. He is a journalist, not a scientist, and all he does is quote other people--so none of his ideas are his own--yet his book is fantastic!

Hi Nick,
I'm going to try to summarize your theory of the cause and cure of diabetes. Let me know if this is correct:
Diabetes is caused by relative hypoglycemia. Relative hypoglycemia is caused by eating often, especially meals high in carbohydrates. When one eats, the blood stream is flooded with glucose. The pancreas releases insulin. Insulin transports the glucose into tissues and/or fat cells. As a result, blood sugar drops, resulting in relative hypoglycemia. Relative hypoglycemia causes the brain and nerve cells to be deprived of glucose. The body compensates by becoming insulin resistant, thereby not allowing the glucose to enter the tissues, but instead to remain in the blood stream to supply the brain and nerves. The more one eats, the higher ones blood sugar rises in order to prevent hypoglycemia. Therefore the cure to diabetes is to eat less often so that there are fewer fluctuations in blood sugar and therefore fewer episodes of relative hypoglycemia.
Eating also causes inflammation (due to glucose intolerance and/or food intolerances) When the pancreatic beta cells become inflamed, they stop producing insulin, as a protective mechanism because insulin is what causes hypoglycemia. So diabetes is a vicious cycle that can only be broken by intermittent fasting.
Is this correct?

Hi Nick,
I've been eating-less-often, fasting-more-often for about a month now. I'm not hungry. I mostly eat meat and fat with a small amount of carbs. Gary Taubes book, Good Calories, Bad Calories, convinced me (once and for all) that meat and fat is not harmful. I'd always had some doubts about low carb diets because there is so much misinformation out there about the evils of meat and fat. Therefore, I tried to limit my meat and fat consumption, and in effect I was eating less food altogether. I find that one meal a day of sufficient meat and fat is enough for me. Like Joel Kauffman said, "Just remember that fat has a GI of naught, and protein is low; only carb can be very high."
I have a question: Why do I need to test my pH? I am type 2 diabetic, never have sugar in my urine, and only occassionally have trace amounts of ketones in my urine. What would testing pH tell me, and what would I need to do or eat in order to remedy the situation if I found that my urine was too alkaline or acidic?

Nick and Anyone Else,
If the Inuits eat only meat and fat, wouldn't their urine be acidic, since they eat no vegetables or other sources of food to balance their pH? They seem to do fine on their diet.

PS. I forgot to say that last night's glucose/ketones was a one-time occurrance. I tested my urine several more times last night and it was normal. So my body seems very efficient in dumping glucose quickly and then being done with it. I wonder if I've had sugar in my urine in the past and have never known it because I never tested at the right time, which is a very small window of opportunity for me. Usually, after meals, my blood sugar spikes quickly and then drops.
Another thing I had forgotten about was that when I was first diagnosed with diabetes 2-3 years ago, I would go all day without eating. I was so obsessed with having normal blood sugars that if it was high in the morning, I would fast all day until it was normal, and then I would eat. That was how I lowered my A1c from 7.6 to 6.0 in the first 3 months. It seemed like common sense to me at the time that eating was the cause of high blood sugar and fasting was the answer. I never asked my doctor's advice. I just did what I believed was right. My doctor was amazed at my A1c at my return visit, which I attributed to low carbs, but it may have been benefit of the fasting too.

Hi Nick and Anyone Else,
I bought Joel Fuhrman's book, "Fasting and Eating for Health." While I agree with Fuhrman about fasting, I do not agree with his diabetes diet, which is vegetarian. He says that "fat is the chief enemy of the diabetic." He quotes the study where medical students were fed egg yokes, cream, and butter, which resulted in hyperglycemia and insulin resistance.
Nick, you state that insulin resistance is beneficial, so therefore, it is beneficial to eat fat and become insulin resistant. If you don't eat carbohydrates, then you are burning fat for energy, so you don't need much insulin.
Dr. Bernstein's "Diabetes Solution" is a low carb, sufficient fat and protein diet, not a vegetarian diet.
The Atkin's diet is also a meat and fat diet.
Gary Taubes, "Good Calories, Bad Calories" explains how in the 1920's V. Stefansson lived with the Inuit for five years eating only fat and meat. He did not develop any deficiency diseases, and contrary to what others said, he stated that the Inuits cooked their meat and boiled their fish.
The Optimal Diet, used in Poland, recommends high quality protein like eggs and organ meats.
The ADA has for years recommended a low fat, high carbohydrate diet, which has made diabetes worse.
It confuses me when I read one hypothesis based on research, and then read the exact opposite view based on conflicting research. Then I wonder, what am I supposed to eat, nothing at all?! Okay, I'll do that then. I'll fast. I know that is beneficial. But then when I do eat, what am I supposed to eat? I believe that a low carb, high fat diet is the right way to go based on how I feel. I feel better when I eat fat. I feel lousy when I eat carbohydrates, including low carb vegetables. Fats make me feel relaxed and satisfied. Carbohydrates make me feel hyper and irritable, like I am going to jump right out of my skin. After I eat carbs, I have to exercise. I can't sit still, or I fidget and wiggle. Based on how I feel, I'd say that I am extremely glucose intolerant.

Hi Nick and Anyone Else,
I bought the Rosedale Diet a few years ago when it first came out. It is very similar to Atkin's and Dr. Bernstein's Diabetes Solution, in that it is a lower carb, higher fat diet (the exact opposite of the ADA recommendations from a few years ago.) It works for me. The only question I have about all of the above-mentioned diets is that they recommend eating several meals a day, as opposed to your Gracey Hypothesis of eating less often. I believe that intermittent fasting/eating is the best way to prevent/control/reverse diabetes. The only question I have is WHAT to eat. I like your idea of using CGM, but that is not yet covered by insurance. Your idea of eating eggs is fine for some people, but eggs is high on the list for allergies. I think that everyone has to experiment with foods with a rotation diet to see which foods can be tolerated. For example, broccoli has a low glycemic index, yet whenever I eat broccoli, my blood sugar spikes. I don't know why I can tolerate some foods and not others.
My sister is allergic to almost everything. She gets severe hypoglycemia, yet she does not have diabetes. I am the only person in my family to ever have diabetes.
My son also has multiple allergies. He does not have diabetes, but he does gets all the symptoms of hypoglycemia: hungry, dizzy and shakey. I had hypoglycemia for years before developing diabetes. Don't food allergies cause a release of adrenaline, resulting in hyperglycemia, followed by a surge of insulin, leading to hypoglycemia?

Hi Nick,
I think that you could add to your Gracey Hypothesis something about how food allergies can cause hypoglycemia, and that perhaps over time lead to diabetes(?) What about stress/distress? Can chronic or acute stress (too much cortisol, adrenaline, etc) wear out the beta glands? (That is what my physician told me.) How about toxins(mercury, lead poisoning)? What about mineral deficiencies (magnesium) and other nutritional deficiencies? What about viruses triggering diabetes?
The reason that fasting appeals to me is that regardless of the multiple causes that can trigger hypoglycemia/diabetes, fasting can enable the body to detoxify and heal itself, so that regardless of the cause, it can be reversed.

Hi Nick,
Regarding your Gracey's Hypothesis of the cause and cure of diabetes, what do you think of this analogy: Celiac Disease is caused by eating gluten which causes antibodies and can trigger an autoimmune response which damages the intestinal villi. Over time, by removing gluten from the diet, the intestines can heal themselves.
In the same way, type 1A (autoimmune) diabetes is caused by something (possibly a virus) that triggers the body to attack its own beta cells. Over time, if the virus or other trigger is removed, will the beta cells rejuvinate themselves?
Both Celiac Disease and Type 1A diabetes have similar genetics: Most have HLA DQ2 or DQ8. If Celiac Disease can be cured by removing gluten, then why can't Diabetes 1A be cured by removing the cause?
Is this why you believe that diabetics can be weaned off insulin after sufficient time and with fasting?

Hi Nick,
Regarding Dr. Bernarr's approach: I know an 8 year old girl who was severely near-sighted. She couldn't see anything without her "coke bottle glasses." Her parents/church prayed for her and her eyes were INSTANTLY healed. She never wore glasses again. I also know a little girl who was born with a heart defect. Her parents went to France and brought back some water from a river. She was instantly healed. So I know that miracles happen. The question is, why don't miracles happen more often, or why isn't everyone healed? Also, when healings happen, why doesn't the news media jump all over it and broadcast it all over the world? They just sweep it under the rug so that nobody hears about it. I don't believe everything I hear, but in these two instances, I knew these girls personally, so I KNOW these stories are true.
I think that people put more faith in medical science because miracles are so unpredictable. Some people are healed and others aren't, so people don't want to get their hopes up and be disappointed. They want a "sure" thing. So they put their faith in medicine, but that also disappoints. Drugs have side effects. Surgery leaves scars. Cures that are "just around the corner" never come within reach. A lot of diseases can be prevented by following the laws of nature, ie proper nutrition and rest. However, some diseases/accidents cannot be prevented. In that case, where does one put his faith? In medicine? In prayer? In both? Everyone wants hope, but hope is a fragile thing.

Hi Nick and Anyone Else,
Do you realize we have come full circle in these comments? The article above is titled, "Insulin for Type 2 Diabetics..." And here we find from the latest study that INSULIN IS THE PROBLEM! So, why in the world would any doctor give insulin to a type 2 diabetic, when it only makes the disease worse?!

If distress causes the digestion to stop so that no nutritients are getting to the cells, then the body would want to raise its blood sugar and become insulin resistant in order to nourish the brain and nerves. Right? What about ketones to nourish the brain? Why doesn't the body burn fat instead of raising the blood sugar? When a person fasts, the body switches from a glucose burning machine to a fat burning machine. Yet, even during fasting, when one is distressed, the body releases hormones: adrenaline and cortisol to raise the blood sugar. During distress, does the brain require more glucose?

Hi Nick and Anyone Else,
I am experimenting with the Gracey Hypothesis to see how it affects my diabetes. First I spent 2 weeks eating only once a day. I lost 10 pounds and my blood sugar dropped into the normal range. Then for the next few weeks I got very busy with my job, got less sleep and ate more often (still low carb meals). My fbs crept up into the 120's and my weight crept up about 2 pounds. Next I rested and fasted for 2 days straight and then ate one meal. My blood sugar dropped again to normal and I lost the 2 pounds. I plan to keep using the intermittent-fasting-intermittent eating program. The nice thing about this program is that if you go off the plan, it is very easy to get back on. In addition, eating less often works better for me than eating more often with a low-carb diet.

Hi Dr. Tanenberg,

I recently read a book about a type 2 diabetic who completely weaned himself off insulin and all other diabetic drugs.

The book is: Death to Diabetes by DeWayne McCulley. DeWayne went into a coma with a blood sugar of 1337. He was put on insulin and drugs. In four months he was able to reduce his insulin from 60 units to zero and get off all diabetic drugs. He completely reversed his diabetes by diet and lifestyle changes.

If, as you claim, diabetes is a "progressive" disease and therefore most diabetics will eventually require insulin, how do you explain how someone can "regress" from diabetes to become a healthy individual in just FOUR months?

P.S. I just think it is ridiculous that people use the word "progressive" when describing diabetes, as if diabetics are "making progress" when they are TOLD that their beta cells have burnt out and they MUST be given drugs and insulin. Dr. Tanenberg states, "The GOOD news is that today, seven totally different classes of m