By losing 15 percent of their body weight, nearly 90 percent of those who’ve had type 2 diabetes for less than four years can achieve remission.
Fasting to Reverse Diabetes
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Currently nearly half a billion adults have diabetes, and a 50 percent increase is expected in another generation. I’ve got tons of videos on the best diets for diabetes, but what about no diet at all?
More than a century ago, fasting was said to bring about the cure of diabetes, speedily arresting its development, and causing complete disappearance of all its manifestations in several days or weeks. Even so, starvation is guaranteed to lead to the complete disappearance of you, if kept up long enough. What’s the point of fasting it away if it’s just going to come raging back as soon as you restart the diet that caused it in the first place? Might it be useful to kind of kickstart a healthier diet? Let’s see what the science says.
Type 2 diabetes has long been recognized as a disease of excess, a disease of the idle rich, by which they mean anyone that doesn’t practice sustained vigorous bodily exertion every day, and earning enough to regularly eat more than they need, so diabetes is preventable, but then maybe it’s also treatable. If we are dying of overeating, maybe we can be saved by undereating. Remarkably this was suggested about 2,000 years ago in an Ayurvedic text. Diabetics were encouraged to live like a saint, walk for oh, 800 to 900 miles, dig a pond, or live only on cow dung and cow urine.
That reminds me of the Rollo diet for diabetes proposed in 1797, composed of a diet of rancid meat. That was on top of the ipecac-like drugs he used to produce severe sickness and vomiting. Anything that produces sickness has a temporary effect in relieving diabetes by diminishing the quantity of food eaten—and his diet plan, congealed blood for lunch and spoiled meat for dinner, certainly had that effect.
Similar benefits were seen in diabetics during the siege of Paris in the Franco‐Prussian War, leading to the advice to “Mangez le moins possible;” eat as little as possible. This was formalized into the Allen Starvation treatment, considered to be the greatest medical advance in the treatment of diabetes prior to the discovery of insulin. Before insulin, there was The Allen Era.
He noted reports in the clinical literature of even severe diabetes clearing up on wasting diseases like tuberculosis; so, he decided to put it to the test. He found that even in the most severe type of diabetes, he could clear sugar from people’s urine within 10 days. Of course, that’s the easy part—it’s maintaining it once they start eating again, for which he stuck to two principles: keeping them underweight, and restricting the quantity of fat. A severe diabetic can be symptom-free for days or weeks, but add some butter or olive oil, and the disease can come raging back.
As I covered before, diabetes is a disease of fat toxicity. Infuse fat into people’s veins through an IV, and, by using a high-tech type of MRI scanner, you can show in real time the buildup of fat in muscle cells within hours, accompanied by an increase in insulin resistance. The same thing happens when you put people on a high-fat diet for three days, or even just one day…or even just a single meal can increase insulin resistance within six hours. Acute dietary fat intake rapidly increases insulin resistance. Why do we care? Because insulin resistance in our muscles in the context of too many calories leads to a buildup of liver fat, which leads to the buildup of fat in the pancreas, which is eventually what causes diabetes. Type 2 diabetes can now be understood as a state of excess fat in the liver and pancreas, and remains reversible for at least 10 years in most individuals.
Put people on a very low-calorie diet, 700 calories a day, and fat can get sucked out of your muscle cells, and you get a corresponding boost in insulin sensitivity. Fat is then sucked out of your liver, and if you keep it up the fat gets sucked out of your pancreas, and if you catch it early enough, that means a reversal of your type 2 diabetes, meaning normal sugars on a normal diet.
With the loss of 15 percent of body weight, nearly 90 percent of those who’ve had type 2 diabetes for less than four years can achieve remission, whereas it may only be reversible in 50 percent of those who’ve lived with the disease for longer than eight years. That’s better than bariatric surgery, where those losing even more weight only got 62 and 26 percent remissions. Your forks are better than surgeon’s knives. Here’s how much weight you have to lose to achieve various remission rates for those who’ve had diabetes for an average of three years. Lose about 30 pounds, and most newly-diagnosed type 2 diabetics can reverse their disease. So, an extended bout of physician-supervised, water-only fasting could get you there, but you have to maintain that weight loss. One of the things we can say with certainty is that if you regain the weight, you regain your diabetes.
To bring it full circle, the initial euphoria about “medicine’s greatest miracle,” the discovery of insulin in 1921, soon gave way to the realization that while it was literally a life-saver for type 1 diabetics, the use of insulin on its own in type 2 diabetics would not be enough to prevent the later onset of complications like kidney failure, blindness, stroke, amputations; so, as argued by one the most famous diabetes pioneers, Elliot Joslin, self-discipline on diet and exercise, as it was in the days prior to insulin, should be central to the management of diabetes.
Please consider volunteering to help out on the site.
- Cho NH, Shaw JE, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice. 2018;138:271-81.
- Guelpa G. Starvation and Purgation in the relief of disease. BMJ. 1910;2.
- Emerson H. Sweetness is Death. The Survey. October 1924:23-5.
- Tatar E, Karan C, Kircelli F. The dilemma of subclinical hypothyroidism and renal complications in Type 2 diabetes. Diabetic Medicine. 2016;33(1):135.
- Marble A. John Rollo. Diabetes. 1956;5(4):325-327.
- Allen FM, Frederick M, Stillman E, Fitz R. Total Dietary Regulation in the Treatment of Diabetes. New York, The Rockefeller Institute for Medical Research; 1919.
- Gacquin M. Historical perspectives of dietary recommendations for diabetes. In: Goff L, Dyson P, eds. Advanced Nutrition and Dietetics in Diabetes. Chichester, UK: John Wiley & Sons, Ltd; 2015:13-21.
- FREDERICK MADISON ALLEN 1879-1964. Metab Clin Exp. 1964;13:383-5.
- Allen F. Studies concerning diabetes. JAMA. 1914;63:939-43.
- Allen F. Prolonged fasting in diabetes. Amer J Med Sci. 1915;150:480-5.
- Bachmann OP, Dahl DB, Brechtel K, et al. Effects of Intravenous and Dietary Lipid Challenge on Intramyocellular Lipid Content and the Relation With Insulin Sensitivity in Humans. Diabetes. 2001;50(11):2579-84.
- Parry S, Woods R, Hodson L, Hulston C. A Single Day of Excessive Dietary Fat Intake Reduces Whole-Body Insulin Sensitivity: The Metabolic Consequence of Binge Eating. Nutrients. 2017;9(8):818.
- Nowotny B, Zahiragic L, Krog D, et al. Mechanisms Underlying the Onset of Oral Lipid-Induced Skeletal Muscle Insulin Resistance in Humans. Diabetes. 2013;62(7):2240-8.
- Hernández EÁ, Kahl S, Seelig A, et al. Acute dietary fat intake initiates alterations in energy metabolism and insulin resistance. J Clin Invest. 2017;127(2):695-708.
- Taylor R. Calorie restriction for long-term remission of type 2 diabetes. Clin Med (Lond). 2019;19(1):37-42.
- Taylor R. Calorie restriction and reversal of type 2 diabetes. Expert Rev Endocrinol Metab. 2016;11(6):521-8.
- Lara-Castro C, Newcomer BR, Rowell J, et al. Effects of short-term very low-calorie diet on intramyocellular lipid and insulin sensitivity in nondiabetic and type 2 diabetic subjects. Metabolism. 2008;57(1):1-8.
- Taylor R, Barnes AC. Translating aetiological insight into sustainable management of type 2 diabetes. Diabetologia. 2018;61(2):273-83.
- Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541-51.
- Taylor R, Barnes AC. Can type 2 diabetes be reversed and how can this best be achieved? James Lind Alliance research priority number one. Diabet Med. 2019;36(3):308-15.
- O'Donnell S. Changing social and scientific discourses on type 2 diabetes between 1800 and 1950: a socio-historical analysis. Sociol Health Illn. 2015;37(7):1102-21.
Video production by Glass Entertainment
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Currently nearly half a billion adults have diabetes, and a 50 percent increase is expected in another generation. I’ve got tons of videos on the best diets for diabetes, but what about no diet at all?
More than a century ago, fasting was said to bring about the cure of diabetes, speedily arresting its development, and causing complete disappearance of all its manifestations in several days or weeks. Even so, starvation is guaranteed to lead to the complete disappearance of you, if kept up long enough. What’s the point of fasting it away if it’s just going to come raging back as soon as you restart the diet that caused it in the first place? Might it be useful to kind of kickstart a healthier diet? Let’s see what the science says.
Type 2 diabetes has long been recognized as a disease of excess, a disease of the idle rich, by which they mean anyone that doesn’t practice sustained vigorous bodily exertion every day, and earning enough to regularly eat more than they need, so diabetes is preventable, but then maybe it’s also treatable. If we are dying of overeating, maybe we can be saved by undereating. Remarkably this was suggested about 2,000 years ago in an Ayurvedic text. Diabetics were encouraged to live like a saint, walk for oh, 800 to 900 miles, dig a pond, or live only on cow dung and cow urine.
That reminds me of the Rollo diet for diabetes proposed in 1797, composed of a diet of rancid meat. That was on top of the ipecac-like drugs he used to produce severe sickness and vomiting. Anything that produces sickness has a temporary effect in relieving diabetes by diminishing the quantity of food eaten—and his diet plan, congealed blood for lunch and spoiled meat for dinner, certainly had that effect.
Similar benefits were seen in diabetics during the siege of Paris in the Franco‐Prussian War, leading to the advice to “Mangez le moins possible;” eat as little as possible. This was formalized into the Allen Starvation treatment, considered to be the greatest medical advance in the treatment of diabetes prior to the discovery of insulin. Before insulin, there was The Allen Era.
He noted reports in the clinical literature of even severe diabetes clearing up on wasting diseases like tuberculosis; so, he decided to put it to the test. He found that even in the most severe type of diabetes, he could clear sugar from people’s urine within 10 days. Of course, that’s the easy part—it’s maintaining it once they start eating again, for which he stuck to two principles: keeping them underweight, and restricting the quantity of fat. A severe diabetic can be symptom-free for days or weeks, but add some butter or olive oil, and the disease can come raging back.
As I covered before, diabetes is a disease of fat toxicity. Infuse fat into people’s veins through an IV, and, by using a high-tech type of MRI scanner, you can show in real time the buildup of fat in muscle cells within hours, accompanied by an increase in insulin resistance. The same thing happens when you put people on a high-fat diet for three days, or even just one day…or even just a single meal can increase insulin resistance within six hours. Acute dietary fat intake rapidly increases insulin resistance. Why do we care? Because insulin resistance in our muscles in the context of too many calories leads to a buildup of liver fat, which leads to the buildup of fat in the pancreas, which is eventually what causes diabetes. Type 2 diabetes can now be understood as a state of excess fat in the liver and pancreas, and remains reversible for at least 10 years in most individuals.
Put people on a very low-calorie diet, 700 calories a day, and fat can get sucked out of your muscle cells, and you get a corresponding boost in insulin sensitivity. Fat is then sucked out of your liver, and if you keep it up the fat gets sucked out of your pancreas, and if you catch it early enough, that means a reversal of your type 2 diabetes, meaning normal sugars on a normal diet.
With the loss of 15 percent of body weight, nearly 90 percent of those who’ve had type 2 diabetes for less than four years can achieve remission, whereas it may only be reversible in 50 percent of those who’ve lived with the disease for longer than eight years. That’s better than bariatric surgery, where those losing even more weight only got 62 and 26 percent remissions. Your forks are better than surgeon’s knives. Here’s how much weight you have to lose to achieve various remission rates for those who’ve had diabetes for an average of three years. Lose about 30 pounds, and most newly-diagnosed type 2 diabetics can reverse their disease. So, an extended bout of physician-supervised, water-only fasting could get you there, but you have to maintain that weight loss. One of the things we can say with certainty is that if you regain the weight, you regain your diabetes.
To bring it full circle, the initial euphoria about “medicine’s greatest miracle,” the discovery of insulin in 1921, soon gave way to the realization that while it was literally a life-saver for type 1 diabetics, the use of insulin on its own in type 2 diabetics would not be enough to prevent the later onset of complications like kidney failure, blindness, stroke, amputations; so, as argued by one the most famous diabetes pioneers, Elliot Joslin, self-discipline on diet and exercise, as it was in the days prior to insulin, should be central to the management of diabetes.
Please consider volunteering to help out on the site.
- Cho NH, Shaw JE, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice. 2018;138:271-81.
- Guelpa G. Starvation and Purgation in the relief of disease. BMJ. 1910;2.
- Emerson H. Sweetness is Death. The Survey. October 1924:23-5.
- Tatar E, Karan C, Kircelli F. The dilemma of subclinical hypothyroidism and renal complications in Type 2 diabetes. Diabetic Medicine. 2016;33(1):135.
- Marble A. John Rollo. Diabetes. 1956;5(4):325-327.
- Allen FM, Frederick M, Stillman E, Fitz R. Total Dietary Regulation in the Treatment of Diabetes. New York, The Rockefeller Institute for Medical Research; 1919.
- Gacquin M. Historical perspectives of dietary recommendations for diabetes. In: Goff L, Dyson P, eds. Advanced Nutrition and Dietetics in Diabetes. Chichester, UK: John Wiley & Sons, Ltd; 2015:13-21.
- FREDERICK MADISON ALLEN 1879-1964. Metab Clin Exp. 1964;13:383-5.
- Allen F. Studies concerning diabetes. JAMA. 1914;63:939-43.
- Allen F. Prolonged fasting in diabetes. Amer J Med Sci. 1915;150:480-5.
- Bachmann OP, Dahl DB, Brechtel K, et al. Effects of Intravenous and Dietary Lipid Challenge on Intramyocellular Lipid Content and the Relation With Insulin Sensitivity in Humans. Diabetes. 2001;50(11):2579-84.
- Parry S, Woods R, Hodson L, Hulston C. A Single Day of Excessive Dietary Fat Intake Reduces Whole-Body Insulin Sensitivity: The Metabolic Consequence of Binge Eating. Nutrients. 2017;9(8):818.
- Nowotny B, Zahiragic L, Krog D, et al. Mechanisms Underlying the Onset of Oral Lipid-Induced Skeletal Muscle Insulin Resistance in Humans. Diabetes. 2013;62(7):2240-8.
- Hernández EÁ, Kahl S, Seelig A, et al. Acute dietary fat intake initiates alterations in energy metabolism and insulin resistance. J Clin Invest. 2017;127(2):695-708.
- Taylor R. Calorie restriction for long-term remission of type 2 diabetes. Clin Med (Lond). 2019;19(1):37-42.
- Taylor R. Calorie restriction and reversal of type 2 diabetes. Expert Rev Endocrinol Metab. 2016;11(6):521-8.
- Lara-Castro C, Newcomer BR, Rowell J, et al. Effects of short-term very low-calorie diet on intramyocellular lipid and insulin sensitivity in nondiabetic and type 2 diabetic subjects. Metabolism. 2008;57(1):1-8.
- Taylor R, Barnes AC. Translating aetiological insight into sustainable management of type 2 diabetes. Diabetologia. 2018;61(2):273-83.
- Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541-51.
- Taylor R, Barnes AC. Can type 2 diabetes be reversed and how can this best be achieved? James Lind Alliance research priority number one. Diabet Med. 2019;36(3):308-15.
- O'Donnell S. Changing social and scientific discourses on type 2 diabetes between 1800 and 1950: a socio-historical analysis. Sociol Health Illn. 2015;37(7):1102-21.
Video production by Glass Entertainment
Motion graphics by Avo Media
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Fasting to Reverse Diabetes
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Content URLDoctor's Note
Check out Diabetes as a Disease of Fat Toxicity for more on the underlying cause of the disease.
For more on fasting for disease reversal, see:
- Fasting to Treat Depression
- Fasting for Irritable Bowel Syndrome
- Fasting for Post-Traumatic Brain Injury Headache
In 2022, I released my fasting and cancer series. Check it out, starting with Fasting for Cancer: What About Cachexia?. All fasting videos can also be found in a digital download.
Fasting is not the best way to lose weight. To learn more, see:
- Benefits of Fasting for Weight Loss Put to the Test
- Is Fasting Beneficial for Weight Loss?
- Is Fasting for Weight Loss Safe?
What is the best way to lose weight? See The Best Diet for Weight Loss and Disease Prevention.
For all of my videos on fasting, see the topic page.
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