What Would Count as a Cure for Type 2?

midnightrider said:

I haven't had a FBG over 4.5 in over 6 months, and my last HbA1c was 31 despite averaging 180g/day of carbs.

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bulkbiker said:

I do however find that extended fasting has the greatest impact on my blood sugars. I get the lowest numbers (high 3's) on the third day of a liquid only fast (that's tea with lactofree milk, coffee with cream and water only) After the third day the seem to level out in the low to mid 4's. My fasting insulin levels are verging on normal so I'm hoping that with the other measures I have got this under control.

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(Bulkbiker the text I quote from you is from another thread, I hope you don't mind. I also wanted to find something you wrote about 'passing' an OGTT but that's in yet another thread which I can't remember. Either way it stuck in my mind as a remarkable example of control and success).

I just wanted to say to both of you, congratulations on your efforts and success.

It's great to know that there is more than one way to get amazing results when tackling this disease. I find it really inspirational. I mentally log all examples like that, to build up a sort of list of things to try, and things to fall back on if the current idea doesn't work for me.

Debates about optimal approaches are also very interesting and useful, but as with so many things, the approach that's the best for any of us is the approach that we can stick to and make work. And 'optimal' is likely to be very different from one person to another.

bulkbiker said:

I'm afraid I will respectfully disagree again. There is a whole psychology of exercise leading to the "I've been to the gym I deserve a treat" way of thinking which is in my view far more dangerous than an ultra low carb diet which should lead to weight loss and a general feeling of having extra energy.
These states of mind are what I experienced for the 30 years before my diagnosis when I went to the gym 3-4 times a week then stuffed my face afterwards "because I had been good".
However when on my ultra low carb diet and after significant weight loss I had so much extra energy that I re-joined a gym. Unfortunately the enthusiasm lasted about 4 months before I lapsed but I was well out of the "deserving a treat" way of thinking so had no adverse effects.
Exercise may be beneficial to general health but has been shown to be pretty useless for weight loss. Its far better in my opinion to get people in control of their way of eating and then recommending exercise rather than both at the same time.

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My concern is that when people are first diagnosed, they are more often than not overweight and physically inactive, eating too many carbs and too much fat and other processed food. A little physical activity (brisk walk for 30 minutes once or twice a day), and reduction in energy dense, processed foods have been demonstrated to reduce or eliminate insulin resistance / metabolic syndrome in many cases.
Your argument appears to be, 'don't bother as you will only binge afterwards, instead give up all carbs, eat as much animal fat as you like and don't worry about exercise as it isn't important and anyway will make you more likely to eat rubbish'.'
This may enable people to keep BG under control, because it is removing sugar/carbs from the body entirely. For people unable to control their BG through diet and exercise, by cutting carbs (but not eliminating them), and becoming a little more active (not hours of gym time, just moving about a bit more) this may be the only approach left.
But for most people with a new diagnosis, surely giving yourself a chance of eliminating insulin resistance and metabolic syndrome with modest and sustainable lifestyle changes is a more proportionate approach.

I'm happy to accept a lot of your arguments. Fat, particularly from unprocessed foods has been unfairly demonised and eating too much carbohydrate is harmful. I just think that the argument is taken too far. 'Fat is not as harmful as thought, so it is not harmful at all however much a person eats'. Evidence suggests that any high fat diet increases the likelihood of cardiovascular disease, it doesn't make it a certainty, but it does increase the likelihood. This may be too simplistic an argument, it may be that this is only the case when combined with other factors, but high fat has not as yet been shown to be without risk.

midnightrider said:

'Fat is not as harmful as thought, so it is not harmful at all however much a person eats'

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Have you ever sat down in front of a load of fat and tried to overeat it?
Imagine a block of butter and eating it by the teaspoon full. How much do you reckon you could eat?
Thta's the great thing with fat and no carbs your satiety triggers stop you over eating it.
That's more my point.
Also the psychology of the 'exercise reward", especially for the people you are talking about, is I believe a stronger factor than you think. I agree there will be those for whom either/both is beneficial but I also agree with the "can't outrun a bad diet".
In my view diet is 90-100% of the solution, exercise is a nice to have if wanted but is in no way essential.

bulkbiker said:

Have you ever sat down in front of a load of fat and tried to overeat it?
Imagine a block of butter and eating it by the teaspoon full. How much do you reckon you could eat?

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The same question could be asked of a bowl of sugar. I wouldn't fancy either.

For me the real danger is when you combine flour, fat and sugar and put something like a 'Greggs' label on it.

bulkbiker said:

Thta's the great thing with fat and no carbs your satiety triggers stop you over eating it.
That's more my point.

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Is that good in that you aren't eating too much fat, or good in that you aren't eating too many calories?

AdamJames said:

The same question could be asked of a bowl of sugar. I wouldn't fancy either.

For me the real danger is when you combine flour, fat and sugar and put something like a 'Greggs' label on it.



Is that good in that you aren't eating too much fat, or good in that you aren't eating too many calories?

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You know my views on the simple calories in calories out fallacy...

bulkbiker said:

You know my views on the simple calories in calories out fallacy...

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So it's good that you aren't eating too much fat? On a LCHF diet? Sounds like a paradox, and one which is likely to help with calorie restriction.

Losing weight does seem to be a thing talked about often, whether people are eating LCHF or whatever.

So even if calories-in / calories out is an over simplification, it seems that most people agree that excess body fat is good to avoid, and that diet is a good way to avoid it.

AdamJames said:

So even if calories-in / calories out is an over simplification, it seems that most people agree that excess body fat is good to avoid, and that diet is a good way to avoid it.

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Body fat not dietary fat though.
Its all insulin at the base though.
Avoid triggering insulin responses and you should find weight loss is easy.
Eating fat has a minimal trigger on insulin.. eating nothing (intermittent fasting) is of course even more powerful but not because of calorie restriction but because of no trigger of insulin. A feasting and fasting regime should prove better for you and your body than calorie restriction. Eat to satiety not to an artificial level of "calories".

The maths involved in thermodynamics is erroneous, it doesn't add up. See Dr. Zoe Harcombe's walk through explanation on youtube.

bulkbiker said:

Body fat not dietary fat though.
Its all insulin at the base though.
Avoid triggering insulin responses and you should find weight loss is easy.
Eating fat has a minimal trigger on insulin.. eating nothing (intermittent fasting) is of course even more powerful but not because of calorie restriction but because of no trigger of insulin. A feasting and fasting regime should prove better for you and your body than calorie restriction. Eat to satiety not to an artificial level of "calories".

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You've been very helpful in pointing out the importance of insulin, as have other members on this forum - a point easily missed for someone just starting to look into ways to improve their T2.

I don't have the tools to measure what's going on inside myself, and I'm certainly not going to argue against the point you make about insulin.

I'd go back to my point about individuals, however:

bulkbiker said:

Avoid triggering insulin responses and you should find weight loss is easy.

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Anything to make the loss of excess body fat easier has to be good. At some point I am likely to be trying the VLCHF and fasting approach you suggest - you are certainly a good advertisement for it.

But for now, and I know this may be hard to believe, but I'd find fasting hard, and I find sitting still hard.

It sounds silly because of course to "fast" requires that you do precisely nothing, where as to exercise requires time and effort. But that's just the way it is for me at the moment. I think we all need to play to our own strengths. Right now, body fat loss is my first-order problem to solve.

Eating small amounts of food, 'to my meter' rather than LCHF, and enjoying walks, is working very well. I'm not even going to argue that it's optimal. Maybe VLCHF and fasting would be even better, but I really don't think I could stick to it anything like as easily as my current approach.

Dragging this back to the OP's question

If, upon death, you have no 'complications', BG readings within range, and an HbA1c within range, I guess you were cured at some point

That way the advice to take 10 minutes walk after a meal works so well, as people tend not to reward themselves with more food for doing the walk.

Guzzler said:

The maths involved in thermodynamics is erroneous, it doesn't add up. See Dr. Zoe Harcombe's walk through explanation on youtube.

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I've just watched this, not sure if it's representative of what you mean:


I suspect the laws of thermodynamics are rock-solid.

The problem comes when applying them to the metabolism of living things, and trying to use them to assess calories and mass. We don't (and probably can't) measure all the energy exchange process accurately in that scenario. we'd need to measure heat loss to the environment, heat gain from the environment, the energy still available in what is excreted, carbon lost in breath, the energy used in chemical reactions etc etc.

So I agree in principle, when applied to life forms, energy in / energy out is a big simplification if we just look at things like calories input via food, and the mass of the individual.

However, to "first order", the simplification works very well.

For someone in my position, and for many overweight people with T2, focusing on calories in / calories out will get them great results. When they have lost so much weight that it starts to become difficult, then it's time to be less simplistic.

And if they want to tackle something other than body fat, such as insulin resistance for other reasons (though it does seem strongly correlated to body fat among other things), then certainly calories is not the only thing to focus on. But from a purely fat-loss perspective, thermodynamics is a great place to start.

My main thought on that video btw was that she seems to have a lovely kitchen.

That wasn't the presentation I had in mind. When an equation/formula is wrong that is more than mere oversimplification. How far has CICO got us over the last 4-5 decades? Eat less move more may work in the short term but countless members will agree that weight lost using CICO is regained in the long term for the majority of people.

Your comment on staying still while fasting has me perplexed, nowhere have I read or heard that one must not partake of any activity while fasting. Can you elucidate?

Guzzler said:

That wasn't the presentation I had in mind. When an equation/formula is wrong that is more than mere oversimplification. How far has CICO got us over the last 4-5 decades? Eat less move more may work in the short term but countless members will agree that weight lost using CICO is regained in the long term for the majority of people.

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If the formula under question is calories in / calories out then I'd agree that either it's wrong, or that we aren't measuring calories in / calories out accurately. I wasn't sure if the laws of thermodynamics was what was being questioned - those I'm willing to stand up for completely!

Guzzler said:

Your comment on staying still while fasting has me perplexed, nowhere have I read or heard that one must not partake of any activity while fasting. Can you elucidate?

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I was comparing two extremes for myself. If I had to choose between fasting or exercising, I'd find exercising much easier. Similar to the question of whether I'd rather eat pure fat or pure sugar. It wasn't a comment about anything anyone has suggested!

Guzzler said:

Your comment on staying still while fasting has me perplexed, nowhere have I read or heard that one must not partake of any activity while fasting. Can you elucidate?

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I've just re-read the bit that I wrote and I see what you mean.

Where I wrote:

"I'd find fasting hard, and I find sitting still hard."

What I was thinking and meaning to convey was:

"I'd find fasting hard, and I find not exercising hard."

As in, I really enjoy exercise and if I spend hours sitting still, I get frustrated. Therefore I might as well make the most of that, and that gives me less need to fast, from a purely weight loss perspective.

AdamJames said:

Losing weight does seem to be a thing talked about often, whether people are eating LCHF or whatever.

So even if calories-in / calories out is an over simplification, it seems that most people agree that excess body fat is good to avoid, and that diet is a good way to avoid it.

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Agree CICO is an oversimplification of a complex biodynamic, but it is a pretty good place to start.

Calories in are either burned in bodily functions such as exercise and keeping warm, excreted unused, or incorporated into the body as muscle, fat etc. There is no magic here.

bulkbiker said:

Have you ever sat down in front of a load of fat and tried to overeat it?
Imagine a block of butter and eating it by the teaspoon full. How much do you reckon you could eat?
Thta's the great thing with fat and no carbs your satiety triggers stop you over eating it.
That's more my point.
Also the psychology of the 'exercise reward", especially for the people you are talking about, is I believe a stronger factor than you think. I agree there will be those for whom either/both is beneficial but I also agree with the "can't outrun a bad diet".
In my view diet is 90-100% of the solution, exercise is a nice to have if wanted but is in no way essential.

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I can understand the LCHF diet as a balancing of the risks of damage due to high BG/insulin, and the risks of cardiovascular disease, the first being more easily envisaged for an out of control diabetic. I don't agree with it until other options have been explored but can understand and respect it so long as risks are considered and weighed.

However, the idea that exercise is unnecessary for anyone, but particularly a diabetic is extremely dangerous. I haven't suggested 'outrunning a bad diet', (indeed I have always said that cutting carbs and monitoring BG after eating are vital) just that a moderate amount of fairly light exercise such as a brisk walk is beneficial. Lack of activity is one of the worst things for a persons health, particularly a diabetic and is possibly the single most important factor in why people develop the condition.

midnightrider said:

I can understand the LCHF diet as a balancing of the risks of damage due to high BG/insulin, and the risks of cardiovascular disease, the first being more easily envisaged for an out of control diabetic. I don't agree with it until other options have been explored but can understand and respect it so long as risks are considered and weighed.

However, the idea that exercise is unnecessary for anyone, but particularly a diabetic is extremely dangerous. I haven't suggested 'outrunning a bad diet', (indeed I have always said that cutting carbs and monitoring BG after eating are vital) just that a moderate amount of fairly light exercise such as a brisk walk is beneficial. Lack of activity is one of the worst things for a persons health, particularly a diabetic and is possibly the single most important factor in why people develop the condition.

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Taking genetics aside, the single most important factor in why people develope T2 is the western diet imo. I do not think that anyone is advocating that excercise be completely avoided only that it is secondary to dietary change.