Type 2 diabetes, metabolic syndrome and high blood sugar are caused by a lack of muscular glycogen storage capacity resulting from insulin resistance and excessive glucagon mediated hepatic gluconeogenesis. Diabetes progresses when HbA1c is above 6% and regresses when HbA1c is below 5.5%. Diabetes goes into regression (desugarization) the minute you take your blood sugar below 6.0 mmol/L or 108 mg/dl and it goes into progression (resugarization) the minute you sugar rises to 7.0 mmol/L or 126 mg/dl. Type 2 diabetes cure and reversal can be achieved through Ketosis resulting from a carb negative diet and exercise regime. Any sufficiently carb negative diet and exercise regime will significantly outperform all the following drugs: Metformin, Victoza, Januvia, Glipizide, Lantus, Janumet, Glimepiride, Humalog, Actos, Invokana, Diamicron, Amaryl, Pioglitazone, Onglyza, Gliclazide, Lucentis, Byetta, Galvus, Acarbose, Forxiga, NovoRapid, Exenatide, Apidra, Liraglutide, Repaglinide, Actrapid, Eucreas, Glucobay, Saxagliptin, Vildagliptin, Dapagliflozin, Canagliflozin, Prandin.
Most Orthodox Medicine practitioners both in the UK and in the US will tell you that Diabetes is a chronic progressive disease that has no cure. What is meant by that statement is that if you are not prepared to change your eating habits or your exercise habits then you will remain diabetic for the rest of your life and even if you are prepared to change them you may alleviate the symptoms to some extent but you will still be diabetic. Incidentally your life expectancy will also be decreased by 10 years (recent data from UK insurance companies). The Mayo Clinic in the US (their pre-eminent medical facility) says the following at http://www.mayoclinic.com/health/type-2-diabetes/DS00585
"Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's main source of fuel. With type 2 diabetes, your body either resists the effects of insulin - a hormone that regulates the movement of sugar into your cells - or doesn't produce enough insulin to maintain a normal glucose level. Untreated, type 2 diabetes can be life-threatening.
There's no cure for diabetes, but you can manage - or even prevent - the condition. Start by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to control your diabetes, you may need diabetes medications or insulin therapy to manage your blood sugar."
The out of date medical position is that you can control it for 5-15 years by diet and exercise and medications such as Metformin which decreases your liver glucose overproduction and supposedly decreases your muscle cell insulin resistance and Sulphonylureas which increase your pancreatic insulin production. Then another 5-15 years with insulin. Then you will probably die of a diabetic complication. This prognosis although largely true for the last 20 years, is now out of date, false and misleading for the following two reasons...
1. There are people who have successfully controlled diabetes for 20 years
with diet and exercise and periodic Metformin alone.
2. There are plenty of people who were on various medications for Type 2, but after reducing their carbohydrate intake and working out in the gym for few months, were able to come off those medications.
3. There are people who have put Diabetes into regression to the point where they are clinically no longer diabetic, i.e. their blood sugar is normal and they can pass any clinical diabetic test with a non diabetic result (I am one of these)
4. There are people who have put Diabetes into regression to the point where they are clinically non diabetic and remain so doing less than one hour of exercise per day on a 100 carb gram per day diet (Sami is one of these).
It is absolutely true to say that modern medical science has no drug therapy or surgical procedure that cures Type 2 diabetes except in the case where the disease is mild and caused by the patient being obese. Obese patients who are mildly diabetic can be cured with gastric bypass surgery. Likewise a low calorie diet can cure them - see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168743/. Better still a low carb diet can cure them (its the carbs that are the problem not the calories). Low calorie diets work on fat people who are only mildly diabetic because a fat person is eating for two essentially just as a pregnant woman is. We know that gestational diabetes is often cured when the baby is delivered. This is because the mother no longer has to eat for two - although lactating puts some extra pressure upon her metabolism. Likewise if a fat person loses his fat then he is back to eating for one normal sized person.
So the Mayo Clinic is correct for non obese people as regards a surgical or a drug therapy cure. But they are totally incorrect as regards a diet and exercise cure which regrettably is not recommended by many people in the medical community.
If you have type 2 and your pancreas has not yet burnt out then there is a combination of diet and exercise and if necessary medication which will stop diabetes progressing, and which will put it into regression rather than progression (by which I mean it will get better and better slowly each day) and which will reverse any neuralgia and will return all of your clinical symptoms to normal, providing you keep up the diet and the exercise. If you do this for long enough then you can get to the point where you remain clinically non diabetic on no medication, on less than one hour per day of exercise, with a 100 carb gram per day diet. The length of time you need to keep diabetes in regression for before you are 'cured' depends upon the length of time that it spent in progression before diagnosis and effective treatment.
All you have to do is return your muscles back to the condition that they were in before you became diabetic, get your brain off its subconscious sugar addiction so that it stops telling your liver to overproduce glucose, reduce your carb intake to around 50 carb grams per day and then burn those carb grams off with exercise, and reduce your insulin resistance significantly by desugarizing your body.
Drugs can reduce your HbA1c (Glycosylated Haemoglobin level - 3 month blood sugar average) by around 1%. But that is not enough to put diabetes into regression. All the drugs will do is slow down the rate of progression of the disease. To put the disease into regression you need to get your HbA1c down to 5.4%. Generally Diabetics have an HbA1c of anything from 7% to 12%. So you need to reduce your HbA1c not by 1% but by at least 1.5% and normally by 2%-5%. No drug combination can yet do that. So drugs will buy you a bit of time. But they will not cure you.
The only way to achieve a type 2 diabetes cure, a full reversal, presently, is by going on a carb negative diet and exercise regime. You must burn off more carbohydrate than you eat - with carb burning exercise. So the cure is to go on a very low carb diet (we recommend 40-50 carb grams per day maximum) - see http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext and see http://www.diabetes.co.uk/news/2014/jul/researchers-recommend-carb-restriction-as-primary-method-of-diabetes-control-91152031.html and to go on a brisk walk after every meal (preferably upon a treadmill) to burn off the carbs you have just eaten and the new glucose that your liver has made from the protein you have just eaten by hepatic gluconeogenesis. Here is the golden rule...
Diabetes Progresses when your spot sugar is above 7.0 mmol/L (126 mg/dl),
(HbA1c above 6%)
Diabetes Regresses when your spot sugar is below 6.0 mmol/L (108 mg/dl), (HbA1c below 5.4%)
And here is the philosophy...
Food is poison to a diabetic. Exercise is the antidote. Take the antidote every time you take the poison, and take it as soon as you can after poisoning yourself. Carbohydrate is 100% poison. Fat is not poisonous at all. Protein is 50% poisonous due to hepatic gluconeogenesis (the liver will turn around half of it into carbs on a very low carb diet). Do not worry about eating a high fat low carb eskimo diet. Excess carbs cause weight gain and cardio vascular trouble not excess fat - however counter intuitive that may seem or feel. Low fat foods have resulted in an epidemic of obesity. What we need is low carb foods!
This is all is easy to say (although it was not easy to deduce) - but extremely difficult to do (until you know how). However the writer has done it and he was badly diabetic and not obese at diagnosis on 2012November26 (spot sugar was 23.0 mmol/L 414 mg/dl and HbA1c was 11.4% with a BMI of 26.7). Also a friend of his has now done it completely in just one month following our latest techniques. He was diagnosed on 2014June10 with spot blood sugar of 13.9 mmol/l (250 mg/dl) and HbA1c of 10.6%, and had been extra thirsty for 2 months prior to that - so we assume he had been fully diabetic for 2 months.
We must make one thing clear. It does not matter how your reduce your HbA1c down to 5.4%. You can take every drug in the book and eat no carbs and sit on your butt all day long. You can eat a half a chocolate cake every day, take no drugs at all, and go jogging for 2 hours after the cake. You can combine any mixture of drugs exercise and diet you like.
But you MUST get your 2 hour post
prandial sugar down to 6.0 mmol/L, 108 mg/dl
Then you MUST get your fasting sugar down to 5.2 mmol/L, 94 mg/dl every morning
Then you MUST get your HbA1c down to 5.4% and keep it there.
Do not become a spectator at you own personal sugargeddon. Take some action!
The writer is not against diabetic drugs. He is just pointing out that they will not, by themselves, stop diabetes killing you. They will not, by themselves, stop you developing painful and debilitating diabetic complications. Do whatever combination of drugs and exercise and low carb dieting works for you. Drug assisted diet and exercise is fine (although certain drugs carry the risk of hypos with high intensity exercise). However for those of you who, like the writer, are wary of the profit driven offerings from the modern pharmaceutical industry, the good news is that diet and exercise is more powerful and more effective than drugs in the case of type 2 diabetes and further that a sufficiently carb negative diet and exercise regime will in our experience immediately put diabetes into regression without the need for any drugs at all.
the writer cannot over emphasize that it is not in general the case that merely by losing weight you can reverse type 2. A Low Carb Ketogenic diet is for a fact more beneficial than a Low Calorie Diet even if you were obese upon diagnosis - see http://www.nutritionandmetabolism.com/content/5/1/36 and see http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext . If you were clinically obese and only slightly diabetic at diagnosis, then losing weight should do it. But type 2 is caused by your body having insulin resistance and insufficient glycogen storage capacity in its skeletal muscles for your typical carbohydrate consumption. It is not caused by being fat. Being fat just increases your metabolic load and so requires your body to have a larger glycogen battery.
If you diet below a BMI of 24 for a man or below a BMI of 22.5 for a woman then you are just eating up your own muscles. But these are critical in storing sugar as glycogen and preventing diabetes from progressing. Sami, a fried of the writer, was fixed in 30 days with no weight loss whatsoever. The writer himself made the mistake of following the Newcastle Reversal concept that if you lose 15% of you body weight you cease to be diabetic. I lost more than that and destroyed my muscles and locked myself in a weak and sick and diabetic state for months. It was a DISASTER. The Newcastle Reversal Technique (low calorie weight loss diet alone) only works on obese people who were mildly diabetic on diagnosis. Prof Taylor chose people with an average BMI on 33.6 and a fasting sugar of 9.2 mmol/L (166 mg/dl). My BMI was 26.7 on diagnosis and my fasting sugar was 18.0 mmol/L (324 mg/dl) and I dieted down to a BMI of 21.0. I mistakenly thought that there was a weight at which I would become non diabetic. Nothing could be further from the truth. Weight loss only helps if you were very overweight upon diagnosis.
Around 100 grams or 1/6th of your glycogen is stored in the liver and around 500 grams or 5/6th of it is stored in your muscle cells - see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248697/. So eliminating all the fat around your liver by losing weight is unlikely to fix the problem as Prof Taylor of Newcastle University suggests. I tried it. I went from 176 lbs to 138 lbs in 14 weeks. This improved my diabetes to the point where I could almost pass a 50% OGTT. But it did not fully reverse my diabetes. In fact it damaged me and increased my neuralgia, by eating away some of my muscle tissue. In general to fix type 2 you need to fix not only your diet and your weight but also your muscles and your insulin resistance. In my case I had to reverse 30 years of muscular degeneration caused by a high carb sedentary lifestyle! That does not happen overnight and there is no pill which gives you fitness. Neither can it be achieved by diet alone. As of August 2014 my BMI is now 23.5, which is still a little low given the amount of muscle I have put on from brisk treadmill walking and pull ups.
For mankind's latest understanding of "The Role of Skeletal Muscle Glycogen Breakdown for Regulation of Insulin Sensitivity by Exercise" published in Frontiers in Physiology in December 2011 - see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248697/
Here is what happened in Sami's and my cases...
Prior to diagnosis. 2/3 bottles of lucozade per day, 3 cans of coca cola per day, 4/5 pieces of coffee shop cake, and a snickers bar every day!!
Diagnosis Day1 (2014June10): Spot sugar 13.9 mmol/l, HbA1c 10.6% (92 mmol/mol). He had been fully diabetic for 2 months, normal weight, sedentary high stress fast food high carb lifestyle (London minicab company owner and driver 32 years old). His doctor told him he must go on Metformin immediately. He declined. Height 5ft 8½ inches, 70 Kg. BMI 23.
Day2: He called me and I said walk for 20 minutes after every meal and stop eating sugar and carbs.
Day5 (2014June15): He came to see me after having partially followed my instructions - his spot sugar was now 10.3 mmol/l (185 mg/dl). I told him to get on the treadmill. He walked for 30 minutes at 5.6 kph. Then his sugar was 7.1 mmol/l (128mg/dl). This astonished me because if I walk for 30 mins at 5.6 kph my sugar will go down by 1.5 mmol/l not 3.2. So then I said to hell with it, let's finish this, and he walked another 30 minutes at 5.6 kph for the first half and at 5.8 kph for the second half. This took his sugar down to 4.9 mmol/l (88 mg/dl). That astonished both of us. We had got his sugar to normal in one day. I then told him he must walk for 30 minutes after every meal on the treadmill at his local gym and he must eat a very low carb diet, nothing with more than 10% carbs in it.
Day11: He followed some of my instructions and walked for 30 minutes after every meal on the pavement not on the treadmill. He was still eating porridge for breakfast. His sugar was normally around 6.2 when he got up and around 6.2 after each walk. I told him he must walk upon the treadmill not upon the pavement.
Day18: Having walked upon the treadmill as instructed although still eating some porridge and drinking fully caffeinated coffee and having the odd wholemeal bread starbucks sandwich his sugar was now around 5.5 mmol/l (99 mg/dl) in the morning and after every walk. So now his diabetic symptoms have gone and he is clinically non diabetic as of June29. We will carry on with this program for another week and see what happens next.
Day 30 (2014July15): Walking 30 minutes on the treadmill each day and a further 20 mins after dinner outside, for a total of 50 minutes per day, and eating a 100 carb gram per day diet (still eating porridge for breakfast - bad idea!) he now has a morning sugar of 5.2-5.5 mmol/L (94-99). So that is it. He is clinically cured and can maintain the cure on less than an hour's exercise per day with a 100 carb gram per day diet. He got there in 30 days.
Day 36 (2014July21): Starting a new regime for 4 weeks of walking 45 minutes on the treadmill once per day. Breakfast is porridge + milk in morning with a quarter of a grapefruit, and vegetable juice. Lunch Salmon or Sardines or Cod or Sea Bass + Salad, Green Tea or Mint Tea. Dinner: Peanut butter on low carb bread and salad and soup, or lamb chops and salad (kidney beans, cheese, cucumber, avocado, lettuce, cabbage, tomato, olive oil, vinegar), glass of semi skimmed milk. This is a weight maintaining diet.
Day 40 (2014July25): Regime is going fine. His morning sugar is still between 5.2 and 5.5 mmol/L (94-99 mg/dl) walking once for 45 minutes each day on the treadmill and taking a 100 carb gram per day diet.
I was diagnosed on November28, 2012, with a spot sugar of at 23 mmol/l (414 mg/dl), a fasting sugar of 18.0 mmol/L (324 mg/dl) and an HbA1c of 11.4% and BMI of 26.7. I had been extra thirsty for two years and had had neuralgia in the 4th toe of my right foot for 12 months - which I mistook for an in growing toenail. So I was very badly diabetic type 2. I had plenty of insulin but no glycogen storage space in my muscles and I had significant insulin resistance (internal sugarization).
Here is a letter from my Doctor confirming my journey...
19 December 2013
Mr Gordon Ritchie
By Email: firstname.lastname@example.org
was a pleasure to catch up with you again the other day.
I thought the research you have performed in relation to diabetes and
muscle mass was very interesting. You
have successfully cured the diabetes which was identified in November 2012 by
a combination of diet and exercise. Originally
the random blood glucose was 18 with a haemoglobin A1c of 11.4% (101 mmol/mol).
You told me that you had also been found to be deficient in vitamin D
and had been taking a supplement, although at a relatively low dose by the
sounds of things.
am pleased to inform you that your haemoglobin A1c is now 5.3% (35 mmol/mol).
This is well within the normal limits.
Your lipid profile is favourable with regards to future risks of heart
disease with a total cholesterol of 3.9, 31% healthy HDL (absolute value 1.2),
leaving an LDL of 2.2. The only
fly in the ointment is the vitamin D level is still low at 36.
You know that you need to keep it up.
I think you need a significantly increased dose of vitamin D and would
suggest for a month that you take 2000 international units daily (available
over the counter) before reducing the dose back to 1000 international units
Christmas and happy New Year.
Nick Sawyer MBBS MRCP (UK) DFOM
reference number 2709985