Turn back the clock on insulin resistance

This is Dr. Jason Fung. He’s a world-leading expert on intermittent fasting and low carbohydrate approaches to diet. He also co-founded the Intensive Dietary Management Program, later rebranded to the snappier title: The Fasting Method, a program to help people lose weight and reverse type 2 diabetes. Dr. Fung is certified with the Institute for Functional Medicine, for providing functional medicine certification along with educational programs directly accredited by the Accreditation Council for Continuing Medical Education (ACCME).

Why Intermittent Fasting?

Intermittent fasting is a well-established, well-evidenced, healthful practice for most people. In the case of diabetes, it becomes complicated, because if one’s blood sugars are too low during a fasting period, it will need correcting, thus breaking the fast.

Note: this is about preventing and reversing type 2 diabetes. Type 1 is very different, and sadly cannot be prevented or reversed in this fashion.

However, these ideas may still be useful if you have T1D, as you have an even greater need to avoid developing insulin resistance; you obviously don’t want your exogenous insulin to stop working.

Nevertheless, please do confer with your endocrinologist before changing your dietary habits, as they will know your personal physiology and circumstances in ways that we (and Dr. Fung) don’t.

In the case of having type 2 diabetes, again, please still check with your doctor, but the stakes are a lot lower for you, and you will probably be able to fast without incident, depending on your diet itself (more on this later).

Intermittent Fasting can be extra helpful for the body in the case of type 2 diabetes, as it helps give the body a rest from high insulin levels, thus allowing the body to become gradually re-sensitised to insulin.

Why low carbohydrate?

Carbohydrates, especially sugars, especially fructose*, cause excess sugar to be quickly processed by the liver and stored there. When the body’s ability to store glycogen is exceeded, the liver stores energy as fat instead. The resultant fatty liver is a major contributor to insulin resistance, when the liver can’t keep up with the demand; the blood becomes spiked full of unprocessed sugars, and the pancreas must work overtime to produce more and more insulin to deal with that—until the body starts becoming desensitized to insulin. In other words, type 2 diabetes.

There are other factors that affect whether we get type 2 diabetes, for example a genetic predisposition. But, our carb intake is something we can control, so it’s something that Dr. Fung focuses on.

*A word on fructose: actual fruits are usually diabetes-neutral or a net positive due to their fiber and polyphenols.

Fructose as an added ingredient, however, not so much. That stuff zips straight into your veins with nothing to slow it down and nothing to mitigate it.

The advice from Dr. Fung is simple here: cut the carbs. If you are already diabetic and do this with no preparation, you will probably simply suffer hypoglycemia, so instead:

1. Enjoy a fibrous starter (a salad, some fruit, or perhaps some nuts)
2. Load up with protein first, during your main meal—this will start to trigger your feelings of satedness
3. Eat carbs last (preferably whole, unprocessed carbohydrates), and stop eating when 80% full.

Adapting Intermittent Fasting to diabetes

Dr. Fung advocates for starting small, and gradually increasing your fasting period, until, ideally, fasting 16 hours per day. You probably won’t be able to do this immediately, and that’s fine.

You also probably won’t be able to do this, if you don’t also make the dietary adjustments that help to give your liver a break, and thus by knock-on-effect, give your pancreas a break too.

With the dietary adjustments too, however, your insulin production-and-response will start to return to its pre-diabetic state, and finally its healthy state, after which, it’s just a matter of maintenance.

Want to hear more from Dr. Fung?

You may enjoy his blog, and for those who like videos, here is his YouTube channel: