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is diabetes an incurable disease type 2 diabetes should it get worse all the time as it usually does or is that as simple is that because we're treating it totally wrong or not even treating it at all uh that's what i'm going to talk about with my guest today [Music] i'm andrea sanford from dietdoctor.com and i'm here with dr jason fang a methodologist from canada welcome oh thanks very much so i just uh watched a presentation by you i thought it was really fantastic it was about how we treat diabetics today in the medical system and you're a nephrologist you meet you meet uh diabetics uh when they're when they've had their disease for a long time and they're really sick right yeah so i treat people on dialysis that's a lot of what i do and it's very disheartening because what happens is that when they develop their disease they're so sick but the diabetes itself is actually quite reversible and that's one of the things that i realized a short while ago and that's what needs to be understood is that this is not a disease that needs to progress but we often tell people so that it's a chronic progressive disease and that's not simply me talking but if you go to the diabetes associations whether it's the american diabetes association or the diabetes australia they all put out there that this is a chronic disease and they tell people essentially that you have diabetes you'll have it for the rest of your life you might as well get used to it but the problem is that that's simply not true and it's actually pretty easy to to prove it because if somebody came up to me and said i've had diabetes i was told i had diabetes i watched my diet i lost 50 pounds i cut my carbs i cut my sugar and now they took me off of my medication i'm fine now that's obviously true nobody would say oh you're lying right so that patient who has lost the weight who has changed their diet has increased their exercise for instance their diabetes actually got better and the thing is that if that patient got better what happens to this idea that this is a chronic progressive disease well obviously it's not true because any time that happens every time it happens it means that the disease is actually reversible but you have to know how to reverse it if you don't know how to reverse it then you're just going to get worse and the thing is that the drugs don't actually do anything for the disease and this is also not controversial because the thing is that type 2 diabetes is a disease of too much insulin resistance and that's not controversial everybody acknowledges that right so if you have very high insulin resistance it's going to cause high blood sugar right but that's the symptom of the disease the disease is actually too much insulin resistance so the treatments that we give are all targeted at blood sugar right that doesn't make any sense because it's almost like to give an analogy if you have an infection if you have a leg infection well you need to treat that infection so what was causing it was bacteria you give antibiotics but that infection can give you a fever but that fever is not the disease if you start treating that fever as if it is the disease then that leg wound is going to fester because you're treating the symptoms of the disease and ignoring the disease but that's what we've done with type 2 diabetes we're treating the blood sugar but it's not a it's not a disease of the blood sugar it's a disease of too much insulin resistance so what happens is that because we're not treating the disease the disease tends to progress so if you look at what happens over a period of 10 years 15 years what happens is that you start off with one medication then you take two medications and three then you take insulin then more incident more insulin and after 10 years you started with one medication now you're on 100 units of insulin a day well you're taking more medication to do the same job to keep that blood sugar the same that means your diabetes is worse even if your blood sugar is better your diabetes is worse than it's ever been because you've never actually done anything about treating the insulin resistance so that patient who went and lost weight and exercised and cut out the carbs and cut out the sugars they actually reversed their insulin resistance and therefore their sugars came down which is far different than making your blood sugars go down by force by medication and ignoring the actual disease so that's the fundamental mistake that we've made over this last 20 30 40 years right we've treated the disease of type 2 diabetes which is too much insulin as if it was type 1 diabetes which is too little insulin so you got to understand that type 1 diabetes has too little insulin so that makes sense you should give them insulin type 2 diabetes is too much insulin you need to reduce their insulin but instead we're giving more insulin to a disease state that has too much insulin well of course that's crazy and you had an analogy there as well uh in in your talk you're saying it's like that would be like treating an alcoholic where the exactly so if you have a disease such as alcoholism where it is characterized by too much alcohol the very last thing you want to do is give more alcohol and that seems very obvious right but if you look in the short term as you take away the alcohol they might get the shakes they might get delirium tremendous if you give them alcohol they will feel better in the short term right but that doesn't mean you're going to make the alcoholism better right that's the real problem it's the alcoholism you can't treat the short-term thing at the expense of the long-term what we've done is treat the short-term we said wow your blood sugar is high let me get it down right but it's like well what's happening to the disease who cares what's happening to the blood sugar what's happening to the disease it continues to get worse so it's just like that alcohol too much alcohol the disease is too much alcohol the cure cannot be to give more alcohol right so to be clear giving insulin to right type 2 diabetics it's like giving alcohol to an alcoholic exactly exactly so this is too much it's insane in fact it's not simply that it's not treating it it's going to actually make it worse just like giving that alcohol you have a disease which is characterized by too much insulin you're giving more insulin you're not making it better you're actually making it worse so the patient will gain weight and they will their insulin resistance will get worse exactly yeah and the funny part is that the patients all know this because this is what happens and i talk to a lot of patients and they say they go to their doctor they start insulin then they gain 15 pounds 20 pounds right which is we we all know that happened that's not a secret because insulin is what really drives weight gain so what happens is that they take the insulin they gain weight and they go back to the doctor and say doc what's this you tell me i need to lose weight to get better then you go and give me a medication that makes me gain 20 pounds this is not good and the doctor always says something like well what are you gonna do you need to take the insulin go exercise right but the problem is that it was not the lack of exercise that made them gain weight it was the insulin that made them gain weight so you need to treat that you need to reduce it so what do you do what do you do if you're a type 2 diabetic well the thing is that it's a dietary disease right and if you're a type 2 diabetic it's a dietary disease it's a disease of essentially too much sugar so if you understand it like that then the answer is to get that sugar out get it down so the first thing you need to do is cut out all the sugar cut out a lot of these refined carbohydrates which are just sugar so the breads in the pasta right so they're all chains of sugar that's all carbohydrates are chains of sugar as you eat them they get broken down into sugar so if you have too much sugar if diabetes is essentially too much sugar you got to stop taking sugar otherwise you're going to make it worse so that's probably the first thing you can do more exercise try and burn it off and the other thing that you can do is try to do something more extreme such as fasting for instance you can actually more extreme than a strict low carb diet i love it okay fasting tell me more about it so fasting is actually the most efficient and the most effective way to lower insulin there's really no drug that does it there are actually two but they're not very effective to lower insulin but if you understand that the disease is too much sugar too much insulin then you gotta say well if it's too much sugar too much let's get rid of the sugar let's get the insulin down how am i going to do that right so the thing about the sugar you can go on a very low carb diet a ketogenic diet and that will get your sugars down but it doesn't necessarily get your insulin down because the proteins and the fats still raise insulin not to the same degree that carbohydrates do but they still raise insulin so you can get that sugar down but you won't get that insulin down so you can actually put people on various periods of fasting because you're not taking anything uh it's it's not simply low carb it's low protein and low fat right it's nothing nothing at all so think about what's going to happen here the body is not going to have anything coming in so what is going to happen is it's going to start burning that sugar and that's perfect that's exactly what we want it to do it starts burning sugar burning sugar after it burns the sugars your sugars come down you don't have to take medications you don't have to take insulin after that it starts burning fat that's perfect that's exactly what we want to do and there's always two questions that come up when you talk about fasting one can i do it and the thing is you have to understand is that literally billions of people around the world fast on a regular basis through their entire lives right so the muslims the hindus the buddhists the catholics almost every major religion in the world prescribes fasting not because it's super harmful because it's very beneficial and what they what happens during the fast is that your insulin levels go down perfect that's exactly what we want but so what we're doing is we're burning off all that sugar and getting it out of the system right as opposed to just getting it out of the blood we're actually getting it out of the entire body so the fasting does both things it lowers the insulin and it lowers the sugars the other thing that always comes up with fasting is is it harmful and this is what always comes up am i going to go into starvation mode and what's interesting when you look at fasting is that studies of fasting show the exact opposite you don't have less energy you have more energy so there are certain things that get activated when you're fasting so growth hormone goes up for instance to preserve lean muscle then you'd start burning just fat adrenaline goes up to give you more energy and you're fueling all that energy with fat because you can measure free fatty acids in the blood and they go up so what's happening is that you're burning fat you're preserving your muscle and you've got plenty of energy perfect that is like the perfect treatment [Music] [Applause]

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