Instant Genius - Simple ways to prevent (and reverse) type 2 diabetes

Episode Date: December 15, 2023

A staggering 415 million people around the world today are living with diabetes, with almost half of those cases undiagnosed. In fact, it’s perfectly possible for a person to have type 2 diabetes for decades without knowing it. This may sound scary, but recent research has suggested that type 2 diabetes is not only easily preventable but also reversible. How exactly? Our guest today, Dr Jason Fung, will explain all. Sometimes called the inventor of intermittent fasting, Jason is the author of The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally, and The Diabetes Code Journal. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Music just as the artist intended. Visit name audio. to learn more. And welcome to Instant Genius, the Bitesize Masterclass in podcast for, I'm Thomas Ling, digital editor at BBC Science Focus magazine. Around the world, it's estimated that a staggering 415 million people today are living with diabetes, with almost half of those cases undiagnosed. In fact, it's perfectly possible for a person to have type 2 diabetes for decades without

knowing it. This may sound scary, but recent research has suggested that type 2 diabetes is not only easily preventable, but also reversible. How exactly? Our guest today, Dr Jason Fung will explain all. Sometimes called the inventor of intermittent fasting, Jason is the author of The Diabetes Code, Prevent Amover's Type 2 Diabetes Naturally, and the Diabetes Code Journal. So a lot of your work focuses on diabetes type 2. Is it okay if you can outline what that actually is? Yeah. So just to be clear, there's two types of diabetes

and type 1 diabetes. I won't be speaking about much. But it's often seen in children and these people require insulin. It's really a deficiency of the hormone insulin. There's too little, so you have to replace it. And it's not a dietary disease. It's largely unknown what the cause is.

it's an autoimmune thing, which means the body's attacking itself, but why it is, I don't know. Type 2 diabetes is a much more common type. So this is sort of 90 to 95 percent of diabetes typically hits in adults, although we're seeing it younger and younger in children, and is largely related to the diet and largely related to obesity and being overweight. So the disease can be understood essentially as a disease of two. much sugar. So sugar in the scientific sense means not just table sugar, which is sucrose, but also glucose. So when we talk about glucose, blood glucose is the same as blood sugar,

and glucose is a component of not just sweet foods, but a lot of carbohydrate-containing foods, so bread, rice, potatoes, all those carbohydrates chemically are chains of glucose. And it can be understood as a sort of excess of glucose. Your body can store a certain amount of glucose. And when you exceed that storage, then it's going to overflow and then it's going to go into the blood and then you see the high blood glucose or high blood sugar. And that makes the diagnosis of type 2 diabetes. So why is that high blood sugar a bad thing? It causes all kinds of problems. essentially type 2 diabetes causes increased risk of virtually every other disease. So things like heart attacks, strokes, cancers, it leads to terrible infections,

it's the leading cause of blindness, kidney disease, nerve damage. Essentially, all that excess glucose, you can think of it as, you know, if you have too much of it, it's just going to rot away all the organs. And that's why, you know, unlike many diseases, it really affects every single part of the body. Almost any organ you can think of is affected by type 2 diabetes and the risk is increased. Even things like COVID, we know that being overweight and having type 2 diabetes increases your risk of severe disease, for example. Doesn't sound particularly pleasant then. So what exactly causes type 2 diabetes?

Earlier you were saying it's a bit unsure what causes type 1. What about type 2? Type 2 is largely a dietary disease. And we know this. Now there are genetic components to it, of course, but we know that the incidence of type 2 diabetes has increased significantly over the last 30 to 40 years. So since the 1970s, we've had an increase in obesity. And then about 10 years after that, we started to see the increase in type 2 diabetes, which is they're very closely related diseases, of course. So the cause of it is likely dietary or lifestyle. So because obesity is largely a dietary lifestyle disease, the type 2 diabetes, which sort of follows along with the obesity is as well,

which is both a good and a bad thing. So on the good news is that that means that if you can fix the diet and lifestyle issues, you can actually reverse this disease. on the bad news is that's really hard to do. So I think if a lot of people were just going to guess what causes type 2, they might just say, or too much sugar causes type 2 diabetes, is that a bit too simplistic? It's a little bit too simplistic. It's, you know, sugar is certainly a huge cause of it.

So sugar, in the sense of table sugar or added sugars, for example, is one molecule of glucose, one molecule of fructose. So you can get it from too much sugar, but you can get it from too much other things as well. So if you have too much carbohydrates, then your glucose, you're not getting any of the fructose that you see in the sucrose, but you're getting too much glucose.

Being overweight for a number of reasons can also cause it. So if you have excessive intake of even things like fats and proteins, you can also do it, although it's largely related to carbohydrates. And of course, the idea is fairly simple if you're eating a lot of proteins and fats. Those are amino acids and triglycerize, which are fats. So that's not going to be as likely to cause an increase increase in blood glucose as compared to eating carbs, which is glucose. That is, if you're eating 2,000 calories of mostly glucose, then your blood glucose is going to go up.

If you're eating 2,000 calories of mostly protein and fat, your blood glucose is less likely to go up. We see this in a measure called the glycemic index, which is a measure of how certain foods affect our blood glucose levels. And they take a number of people, they do an average, and then they have an index. So, of course, the carbohydrate-containing foods are the foods that typically raise our glucose more than others, and specifically refined carbohydrates as opposed to sort of unprocessed carbohydrates. Proteins and fats, so meats and eggs and that sort of thing, barely raise our blood glucose at all. So if you think about type 2 diabetes, which is diagnosed by seeing that increase in blood glucose, well, you can see why eating carbohydrates may be worse than eating proteins and fats, for example.

I think it'd be good just before we go any further, just to explain one term that's banded around quite a bit when we're talking about diabetes, and that's insulin resistance. What exactly is insulin resistance? Insulin resistance is this term. So if you think about the hormone insulin, it has a specific job. So the cell has, you know, requires energy. So glucose is a source of energy. When you eat foods, your blood glucose rises. And what's supposed to happen is that insulin the hormone insulin is secreted by the pancreas, which allows the cell to take in this glucose and burn it for energy. So we see that in this syndrome of insulin resistance, that there's too much glucose in the blood. There's plenty of insulin around. So the cell is said to be insulin

resistant because even though there's lots of insulin is not moving that glucose into the cell so that it can use it for energy. The way to think of it is that if your cell already is stuffed full of glucose, well, then it's really hard for that insulin to work to move more glucose in. Just as, for example, if you have a bar and it's World Cup or Super Bowl Sunday or something, and you have all these people in the bar, well, the doors might be open, but no more people can go in because the bar is already full. There's just no room. Same thing. In this cell, if you've already stuffed it full of glucose, even if you open up the cell to allow glucose to go

in, the glucose can't go in. And that's insulin resistance. The body then produces more insulin to try and open up sort of more gates for the glucose to go in in an effort to sort of really force it in. So that's why insulin resistance in hyper-insulinemia or hyper is too much insulin is insulin and emia is means in the blood so hyperinsulinemia which is too much insulin in blood and this term insulin resistance sort of go hand in hand they're considered really two of the same thing although the term hyperinsulinemia is a little easier to understand because if you think the problem is too much insulin then the solution is let's lower the insulin if you say that the problem is insulin resistance then people say well what causes it then it gets you down this whole thing if

not understanding. If the point is that insulin's too high, let's lower insulin, you might say, well, how do we do that? And you might think of things like, well, hey, certain foods raise insulin more than other foods. So those refined carbohydrates, for example, raise insulin significantly, whereas dietary fats, dietary proteins do so much, much less. Here's a potentially scary question. Could somebody have type 2 diabetes and not know that they have it? Oh, absolutely. So you would never feel it. And that's why it's important to check your blood work because you could go really decades with type 2 diabetes without ever knowing it if you never checked your blood test. So there's standard blood tests that we do and it picks up pre-diabetes, so not quite diabetes. And we do use this

three-month average of blood sugars called the A1C. And it basically, there's a range that's defined for pre-diabetes, which means you're at risk of developing and then type 2 diabetes. But you are not going to feel anything if you have diabetes until it's really quite severe. And if you just have sort of diabetes, you could have it for 10, 15 years, doing all sorts of damage to your organs from the diabetes, from this sort of glucose rotting away your organs and really never know about it. So should everyone be going to their doctor asking to be checked, or is it just people with certain signs and symptoms?

It would be something that would be important to check, sort of on an annual physical sort of thing. So it's a standard part of most people's blood work that they do every year. And unfortunately, it's a blood test. There's no sort of non-invasive measurement. So high blood pressure was much the same story. You could go decades without knowing you had it, and then all of a sudden have a big stroke. So they called hypertension the silent killer.

Type 2 diabetes is much the same because you could go decades without even knowing it. And until you check your blood work, you would simply not feel anything different. What are the symptoms that people should be looking out for, though? The symptoms, when it gets very severe, are going to be, you may pass a lot of urine. So the glucose spills into the urine. So it spills into the blood when it gets very high. It spills into the urine. So you may pee a lot and it makes me very thirsty.

So, you know, increased urination, increased thirst are the classic symptoms of type 2 diabetes. It can sort of go in severity. So as you get worse and worse and worse, you can get into even a coma called hyperasmalicoma. But that's a very severe sort of cases. And, you know, the symptoms, you really should be trying to pick it up much, much before the symptoms. What would you say to the people who might listen to all of that and be quite terrified that they might have diabetes but just not know? It's something that is legitimate and luckily easily diagnosed. So a standard blood test can do it.

If you don't want to do that, there are other ways to check your blood glucose, although they're not as accurate. So it's not the three-month average that we use for the diagnosis of type 2 diabetes. but there are finger prick things. There's machines that you can buy, and diabetics use these all the time, where you prick your finger, put a drop of blood onto this stick, and it'll read it for you. And that'll tell you what your blood glucose is. And from that, you can deduce whether or not you're at risk of having type

to diabetes, then you can go on and measure it. There's also these things called continuous glucose monitors, which are quite expensive, but it's a little sensor that you put into your arm, and I'll stay there for two weeks and give you continuous readings of what your blood glucose or blood sugar is, and they'll send it to your smartphone and you can just continually check them.

In some places in the world, you can buy that over the counter, and some places you require a prescription for that. How big a problem is type two diabetes around the world? It's actually a huge problem. And it's really affecting now everywhere in the world. It started the worst, was in the United States, where we saw the worst of the sort of obesity epidemic. Unfortunately, the obesity problem is very, you know, worldwide now.

So you see it in the UK, you see it in Europe, you see it in China. And along with that comes the type 2 diabetes. So type 2 diabetes is probably the single most important risk factor for non-communicable diseases. That is not things, not infections, but things like heart disease and cancer are the two biggest killers of people overall in the world. And probably the biggest modifiable risk factor is going to be type 2 diabetes. So, you know, if you think about heart disease and cancer, you know, there's risk factors that you can't modify, like your genetics. Like it puts you at higher risk, but you can't do anything about it. So there's no point really talking more about it.

Smoking was probably the number one risk factor for heart disease and cancer that was modifiable. And of course, decades of sort of smoking cessation programs have helped. So in many places, that's gone down. And everybody agrees with that. But now type 2 diabetes is probably the single most important risk factor that you can modify yourself to that. And the important thing is that it's a reversible disease. And it doesn't require drugs. It's a dietary disease.

So it's giving drugs. It doesn't fix the dietary problem. Only fixing your diet can do that. I understand not all experts might agree with you on that point, saying that conventional treatments and certain medicines might play a role. Have you sort of heard any sort of pushback on that point? There used to be a lot, but things have completely changed. So, for example, when I started talking about reversing type 2 diabetes in 2013 or so,

so almost 10 years ago, lots of people said, well, you know, that's not possible. You know, it's a chronic and progressive disease. In fact, all the diabetes associations said it was chronic as progressive, meaning that if you had type 2 diabetes, you would have it and there's nothing you can do about it. So, you know, go get your things in order, right? And I thought that was sort of a ridiculous statement because every patient, every doctor, every nurse, everybody knew at the same time that we're telling people that it's a chronic,

irreversible disease, that if you lost weight, hey, 90% of the time that type 2 diabetes would either get better or go away completely. That is, if you had a friend who was diagnosed with type 2 diabetes, then he lost 50 or 60 pounds and that went off drugs, diabetes went away, you wouldn't say, oh, you're such a big liar, you know, it's a chronic and progressive disease. You can't do that. It's like you'd say, oh, great job, right? So therefore, it was obviously, it was obviously a reversible disease. And we're just lying to people that it was this chronic and progressive disease. Why? Because we didn't have any good treatments to try and reverse it. So we, you know, as doctors, we decided that, hey, you know, if we can't reverse it, it must be irreversible. But it wasn't. We're simply not focused on the right thing. We're focused on giving all sorts of drugs when we should have been focused on the diet instead. Once people started to focus on the diet, we have studies now, so Dr. Unwin, for example, David Unwin in the UK, he prescribes a low carbohydrate diet for his patients and of those patients who take it and he's published these results, of those patients

who follow that diet, a full 50% of people go into a drug-free remission, which means that he's taking them off all the drugs and their blood work results are. such that they are no longer classified as type 2 diabetes. So when you think about the prevalence of this disease, which affects millions and millions and millions of people, if you can put this disease into remission for 50% of people, that's a ridiculous amount of savings, not only in terms of money, but in terms of health.

And in fact, it was so obviously this idea that it was chronic and progressive, it was so obviously wrong that they actually had to change it. But they only changed it in 2021 in the American Diabetes Association, finally put together criteria for remission, which said that, hey, this disease is a disease you can put into remission. Most other places have followed suit. But that was only two years ago that this disease was considered to be reversible. For the past 80, 90 years, we thought that it's just,

This disease is a chronic progressive disease, not a reversible disease. So the mindset is completely different because if you have a chronic progressive disease, you just try and do your best. If you have a reversible disease, you should try very hard to reverse it because you're doing constant damage to your body the longer that you have this disease. So when you are talking about reversing diabetes, what does that mean biologically? Biologically, it means that you simply don't have that amount of glucose. in your body. So remember, the body has too much glucose, and you're basically emptying out

some of this glucose through dietary measures. And as you empty out this glucose, you don't suffer the damage that goes along with it. And it's a very slow progression of disease, but it's sort of constant. So if you think about, you know, changing the oil in your car, for example, you could go, you know, 10 years without changing the oil in your car, but you're constantly doing damage to the engine. If you then at that point say, okay, you get a, you know, your engine breaks down, then you say, okay, now I'm going to change the oil. Well, it's fine, but doesn't undo any of that damage. It's the same with type 2 diabetes. If that high, glucose load in your body is constantly doing damage and you leave it until you get a heart attack, then you say, okay, well, I'm going to do

something about it now. Well, that's great. But you've done a lot of damage that you simply cannot undo because, you know, the heart damage, the damage to your your vasculature, your cancer risk, your infection risk, your kidneys, your nerves, your eyes, they've all sustained damage. So you have to really get to it as soon as you can. It's peak pollination season and my business is scaling fast. To keep the nectar flowing, I need a phone plan with top priority data speed. That's why I chose GoogleFi wireless. My connections stay strong even when the hive is buzzing. Plus, I'm limited plans start at $35 a month. Now that's a deal that doesn't stay.

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Hilton, for the stay. This podcast is sponsored by Name, Audio and Focal. With over 100 years of combined expertise, Name and Focal have been bringing music to listeners just as the artist intended. Since day one, This mantra has shaped every innovation in hi-fi design, technology and acoustic engineering, balancing craftsmanship and tradition with pioneering thinking.

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I'm going to delve into the big question that people really want answering. What are the steps that somebody can take to prevent or reverse diabetes? Yeah, so if you think about the idea that this is just, a disease of too much glucose, right? Then you say, well, what are the strategies to reduce the amount of glucose that you're putting into your body? So one strategy, for example, is a low carbohydrate diet. So again, it's very simple. We know that when you eat refined carbohydrates, so bread and rice and potatoes, for example, we know that those foods raise your blood glucose more than other foods like salmon or eggs or vegetables, for example. So simply reduce the number of foods that

raise your glucose so high, which seems pretty obvious. And in fact, the American Diabetes Association just recently, again, within the last couple of years, finally said, well, this diet actually has the most scientific evidence to back it of any diet. So other diets can work as well. So Mediterranean diets, for example, tend to be fairly lower in carbohydrates and so but reducing refined carbohydrates is a very good strategy and again has has good evidence of it working. You can personalize this a little bit with these new continuous glucose monitors, of course. So these monitors that you put in, you leave for two weeks, you get continuous readings, you can check your blood glucose 50, 60, 70 times a day if you want to.

And what you can see is exactly the effect of the food on your blood glucose and the effect of moving, of exercise, of stress, of sleep, of all of these things. And then you can start to see, hey, if I eat this food, say you eat a sandwich with a lot of white bread, and you see that your blood glucose goes up, then you can say, oh, well, let me try without it. Let me have a salad instead of the sandwich, right? And then you can start to play around and say,

hey, what happens when I eat eggs? What happens when I eat salmon? And you can then personalize your diet to see exactly what foods raise your blood glucose, which is a very powerful tool because it gives you, immediate feedback and to tell you that, hey, your body's not reacting so well to this specific food because you and I are different people. You and I actually react differently to different foods. The glycemic index is an average of people. So it averages out the effect, but it doesn't tell you

specifically. So that's one tremendously powerful strategy. In fact, again, the most scientific evidence backing in. The second strategy that works very well is intermittent fasting. So intermittent fasting is simply giving your body a period of time when you don't eat. And people think it's really weird, but in fact, it's actually a natural thing. So remember that your body should really have two sort of phases. You have a phase where you're feeding. And when you eat, you're going to take in calories. You're going to store calories. When you don't eat or when you fast, you're going to use those calories. So if the feeding and the fasting are completely out of whack,

if you're always feeding and never fasting, then you're going to continuously be storing food and not burning foods. You're storing calories, not burning calories. You're storing glucose, not burning glucose. Well, what's going to happen? Well, you're going to get too much glucose, right? It's like a one-way valve. It just keeps going in, it never comes out.

So that's why you're supposed to have a natural period of fasting every day. That's where the word breakfast comes. from. You're supposed to do fast. Then you break your fast. You don't eat all the time. And in the last 20, 30 years, we had this idea that you should eat all the time. You should eat as soon as he got up in the morning and constantly eat throughout the day and graze and graze and graze until bedtime. Well, what's going to happen? Well, when you eat, you're going to store calories. You're going to store glucose. You didn't give your body a chance to burn except the period of time that you're sleeping. So therefore, your feeding and fasting periods are continuously out of whack. And we're not

meant to eat that way. That's why our body stores calories. I mean, if we were meant to grace, we'd be like cows, right? So the whole point is that if you simply give your body a break from eating, right? Fasting is a period of time that you're going to allow your body to burn off some of its stored energy, which is glucose. So your body has too much glucose. You give it time to burn off the glucose and, hey, you can actually reverse your type 2 diabetes. Is it fun? No, of course, it's not fun. But is it good for you? Yes, it can be very good for you. In fact, you can completely reverse your type 2 diabetes. In fact, again, there was a recent trial within the last couple of years that said that using this sort of strategy, again, could reverse type 2 diabetes in about 50% of

people. I mean, 50% remission rates are virtually unheard of in any of clinical medicine. So when you're talking about intermittent fasting, which obviously quite fashionable at the moment, what sort of timing is you talking about? You might be recommending that people move back their breakfast till much later than the day, maybe beyond midday or around midday? Yeah, it can be any period of time. So there's no, you know, there's no rules, right? So any period of time that you're not eating. If you think about how people used to eat in the 70s, okay, they ate breakfast, they at 8 a.m. And they ate dinner at 6 p.m. for example.

And they didn't eat after dinner. So from 6 p.m. till 8 a.m., that's a 14-hour period of fasting that people did every single day without even thinking about it. Right? They didn't call it anything special. That's just a normal day. 14 hours. Now people think that if you go more than 10 hours, you know, without eating, that's ridiculous, right? Like every 20 minutes you're supposed to eat something, right?

Some nuts or something. And it's like, that's ridiculous. That's not the way the human body is meant to develop. And of course, in the 70s, people are not watching their calories. They're not watching their foods particularly, yet everybody's staying relatively slender. One of the reasons might be because they're not eating all the time. So, you know, if you think that 14 hours is sort of a baseline of probably what people should do, that's not enough to make you lose weight or reverse diabetes.

So you may elect to push it up to, say, 16 hours. You might elect to push it up to 24 hours. Or you could do more or less however you feel. So there's no sort of set answer. Some people will do better with longer. Some people will do better with shorter. But again, it is, you know, some people do a 12-hour fasting period and say, oh, I'm doing fasting, but I'm not losing weight.

It's like, well, you're doing what you're supposed to be doing. you're not doing more than that, so therefore you're not losing weight. What do you think about this new diet fad that's emerged of just the one meal per day? So obviously you're fasting for quite a long period and you're just eating that one meal? I think it's a perfectly legitimate strategy. And as with all dietary strategies, they don't work for everybody. They work fantastically for some people and not so well for other people. So if it works for you, great.

So the key is that if you simply eat one meal, meal, it's generally harder to eat sort of three meals worth of energy or calories in that one meal. So you're generally going to be eating less and you're going to be eating less often. Again, giving your body that break to lose weight. So if you're trying to lose weight, then it's a perfectly legitimate strategy. But again, some people find that they get very, very hungry and that's going to make it very difficult for them to stick with that strategy. some people are going to wind up overeating or they're going to feel like, for example, that, hey, now I can eat whatever I want because I'm only eating one meal a day.

Well, it doesn't work that way. So you could eat easily, you know, two, three thousand calories at a single setting if you have, say, food addiction or if you're eating a lot of refined foods. So it's a valid strategy. But again, you have to see what it is you're eating when you're eating because you still have to pay attention to those foods. just simply cutting the time is fine, but it's, it sometimes isn't enough. And you have to see how you respond to it, how your body responds to it, because not everybody's going to do well. But some people do fantastic. And there's no reason why you can't do that. People have done that throughout, throughout history, really. So just to confer me, think it's like an okay strategy

to delay your sort of breakfast for midday and have a big breakfast slash lunch at midday and then maybe have dinner around sort of 7 p.m. That would be a good way to prevent diabetes. Yeah, it would be certainly a start. It may or may not be enough because you have to see, again, it's important these days to individualize your treatment because we have that technology. So see how you're doing.

You check your weight. You check your blood sugars. And if it's working well for you, then do it or maybe increase it. You know, you could go down to one meal a day. But yeah, it's a perfectly legit. strategy. Remember that everything comes down to sort of what you're eating and also how often you're eating it or when you're eating it. So if you focus simply on what you're eating,

so for years we just talked about what should you eat. You know, we didn't pay attention to how often are you eating it? Are you eating this all the time, right? Are you giving your body that break it needs to use the glucose, right? So both are important. It's not like some people say, well, you know, you can ignore what you eat as long as you're fasting, you know, X number of hours. And that's not really true. Both are very important parts of the strategy. What would you say to some people who are worried they would feel too tired, especially in the morning if they're skipping that meal? Yeah, mostly these things are habits. So if you get in the habit very quickly your body adapts to it. This idea, there's a lot of fast, there's a lot of myths around

fasting and I cover them a lot in my book, the complete guide to fasting and the obesity code. But essentially, if you think about fasting, it actually doesn't cause a decrease in energy. All you're doing is you're switching your body from using food as your source of energy to stored food, which is body fat and blood glucose. That's how your body stores food, right? If you've eaten a lot of food, your body stores it as body fat and as blood glucose. When you're not eating, you're using body fat and historic glucose. So you're letting your body use that.

It's not that you have less energy. Your body, if you're overweight, if you're, you know, one pound of fat has, you know, 3,000-four-ish calories, 3,500, 3,800-ish calories. So most people are carrying 100,000, 200,000 calories of energy on their body. So the idea that you need to eat, you know, 1,800 calories instead of 1,500 calories, when you have, you know, 150,000 sitting in your body fat stores is ridiculous. What you need to do is allow your body to use that 150, 200,000 calories stored away, right? That's the real problem, not that 300 or 400 that you use on a daily basis.

So, yeah, the idea that you're tired, it actually doesn't play out because, in fact, fasting increases sympathetic tone. So when you fast, your body actually naturally releases hormones that stimulate energy, gives you energy. That's why when you talk about the hungry wolf, that hungry wolf is extremely dangerous because it has a lot of energy. Why? Because its sympathetic nervous system has been revved up. The body essentially says, okay, you know, I'm going to. to increase, rev up the body, but I'm going to switch fuel sources to stored energy or body fat. That's what the human body does. So it actually gives you energy. It doesn't take away energy. What other big strategies that someone should follow if they're looking to prevent diabetes?

Prevention of diabetes and treatments are much the same. So if there's too much dietary glucose is the underlying problem, then you've got to either put less in, right? So, this is like a sink, for example, that's overflowing, right? You either have to sort of turn off the tap, so put less glucose in, or you have to increase the amount going out. So increase, you know, or like pull the plug, right? Let it drain out. So the way that your body uses glucose is by, say, intermittent fasting because your body needs energy. So it's going to burn glucose because that's the most easily accessible energy. You could also increase exercise, for example. It's a relatively inefficient way because you have to do a lot of exercise. So if you ever, if you've ever gone on the

treadmill, for example, and watch that calorie counter, it moves up very, very slowly, as most people who have done it, will attest it. So if you eat sort of, you know, and people always say, well, you eat a couple of cookies and it's 150 calories, that's like 45 minutes of, you know, slow walk you know quick walking or slow job right so it's a relatively inefficient way to use up that glucose but it's it's the same thing so if you think about that overflowing sink it's either turn off the tap which is put less glucose into your body or you increase the amount that's going out which is increase the intermittent fasting or increase the exercise both are good strategies what you don't want to do which is what we've done in the past is simply you know keep mopping up the glucose and you know let it overflow

and then mop it up with drugs, mop it up with drugs. That strategy just didn't work. If someone was pre-diabetic, how long would it take for these strategies to reverse that? Oh, you can reverse it very quickly. I mean, we see reversals within like a month. I mean, I wrote a paper on using intermittent fasting on three of my own patients that before I knew all this were being treated with insulin. And within a month, all three of these patients, they got off all their insulin and now are considered not diabetic.

So they had high doses of insulin for years and within a month completely reversed with intermittent fasting. So it can be extremely quick. So you should see results immediately. In fact, if you have a continuous glucose monitor, you'll see results within days. Changing your diet will immediately impact your blood glucose. What do you think some of the biggest mistrubes or misconceptions are about diabetes? I think the biggest one is that it's chronic and progressive. And the reason, of course, is that it's been promoted so long that not even a lot of doctors

or dieticians or nurses even know that everything's changed. Because it's only since 2021, only two years ago, compared to the 25, 28, 30 years that they may have been in practice. So I've been in practice 25 years. You know, officially for 23 of those years, it's been a chronic and progressive disease. For the last two, it's been a reversible disease. So you see that the messaging, what doctors think, how dietitians think, how nurses think, has been shaped by this idea that it's chronic and progressive. So that's the biggest, I called it the biggest lie of type two diabetes is that it's chronic and progressive. The truth is that's reversible. The second thing, which I called the second big lie of type 2 diabetes, is that you

need drugs to do it. And in fact, it's a dietary disease. So using drugs to treat a dietary disease is like, you know, bringing a snorkel to a bicycle race. It's a useful thing, but not for the bicycle race, right? Same thing. Drugs have lots of uses. Obviously, I prescribe lots of drugs, but you got to fix the diet. Now we have drugs that sort of blur the two. That is there are drugs that suppress your appetite, therefore change the diet. So therefore, there are drugs now that sort of blur that line. But if you're giving things like insulin, for example, which is the classic treatment for type 2 diabetes, it simply didn't work.

That was Dr. Jason Fung, author of The Diabetes Code, Prevent and Reverse Type 2 Diabetes naturally, and the Diabetes Code Journal. Thanks for listening to this episode of Instant Genius. to you by the team behind BBC Science Focus magazine, which you can find on sale now in supermarkets and newsagents as well as your preferred app store. You can of course also find us online at sciencefocus.com. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal. Name audio believes you can have digital precision with analogue warmth.

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