I wouldn't ignore the effect that having surgery and then two weeks of a strictly controlled food intake has. That might account for a large proportion of the success rate. I heard about a study that found that the fasting required for bariatric surgery actually provides a large proportion of the benefit of the procedure.
If you catch type 2 diabetes before it gets so bad that it has killed off the beta cells, then your best treatment is to fast for a while. After a couple of days, you should notice a massive improvement in glucose control. A week of fasting a couple of times a year might be all it takes to give you a complete cure. YMMV, but in my opinion (and that of a whole load of people who know what they're talking about) it's better than filling yourself with drugs.
After the beta cells have been killed off by overwork, yeah, you need insulin. But you can still reduce the amount you need by losing weight.
By “a week of fasting” you mean a week of intermittent fasting or something else? Can you give an example of such a regime (and are there different ways?)?
Don’t have type 2 yet but has family history and it spiked to 6.1 one right after a hospitalisation so I have been spooked since (been 2 years). I get super stressed even at the thought of sugar related tests.
>the fasting required for bariatric surgery actually provides a large proportion of the benefit of the procedure
Can confirm. My wife had surgery ~3 years ago. I supported her by eating the same things she was for prep and throughout the surgery. We lost about the same amount of weight, through ~1600cal a day and exercise. I wanted to get down about 25lbs lower than my lowest during that time. But, a year ago my wife was diagnosed with cancer, and that process totally screwed with our plans, and we both gained weight, her quite a bit less than me.
The last ~6 weeks I've been restricting calories again, and have started the journey back to where I want to be. I will say that the surgery really impacted her hair badly, which she didn't love. Despite taking all the best vitamins, her hair went from thick to somewhat thin.
If you can get rid of the things that trigger you and stick to low calories and exercise, you'll lose weight. The surgery helps, but committing to low calories is going to get the results. And a friend who got bariatric surgery but wasn't committed to lifestyle changes, within a year was back to her original weight.
For type-2 diabetes, various forms of dietary therapy such as nutritional ketosis have proven extremely effective in reducing or even eliminating many patients' need for exogenous insulin. But we usually refer to that as putting the condition into remission rather than a "cure".
> But we usually refer to that as putting the condition into remission rather than a "cure"
Because that’s accurate. Someone following this treatment plan is still at elevated risk of recurrence. Once you’re cured of the flu, your ex ante chances of catching it again are no higher. (We don’t have a cure for diabetes per se. Insulin controls but doesn’t cure it.)
I was diagnosed with type 2 diabetes about two and a half years ago. After doing some research, I put myself on a strict keto diet. Within about a month, my A1C went from over 13 to hovering around 6 and has stayed there. Never took any diabetes medication.
I do give myself a "vacation" from the diet about once a month, which I usually reserve for a special occasion.
I’m unsurprised that a large component of the treatment is effectively just “lose weight”. For many years I’ve heard accounts of significant weight loss reversing type 2 diabetes.
Even my allergies are tamed when I am at the right weight and physically very and consistently active. (It might just be coincidence though). Cutting off refined/white sugar almost completely has helped a lot I guess (I do have a sweets cheat day every 3-5 months. It’s not planned but somehow this is how it has worked with visits to friends and relatives).
Is type 2 a permanent disease? Or is like when you lifestyle is bad and your sugar remains high/etc you are suffering from type 2 diabetes, but when your lifestyle and weight and great and sugar is well under control you don’t have type 2 diabetes, but if that changes you can get it again? Or it’s like - once “marked with type 2” no matter the sugar marker results you are a type 2 patient forever?
Anecdotally, I've observed with my own body that there is a very direct correlation between weight and all of the health metrics. And it does not take as much weight change as you might think in order to see the metrics move.
Another thing is consumption. All of my metrics start moving immediately in the positive direction when I'm on a calorie restricted diet, even before I start seeing results on the scale.
I could be unique but I doubt it.
The problem, of course, is that just like CICO, observing the relationship between weight and health is educational but useless as a strategy. If it were that easy there would be no overweight people in the world.
> Recellularization via electroporation therapy (ReCET) is a novel endoscopic procedure that uses electroporation to induce cellular apoptosis and subsequent reepithelization.
GLP-1s baseline eliminate insulin for about ~40% of people. This boosts that number to 86%.
Note that Tirzepatide also reduces the chance of developing type 2 in the first place by 94%, and I suspect that newer generation receptor agonists will see higher insulin discontinuation rates in general.
Very cool stuff all around. Might finally be able to put this whole obesity-and-diabetes thing to bed.
How long does this cure last until the unhealthy diet & lifestyle that originally caused the insulin resistance bring it back again?
It's frustrating, as Type 2 diabetes is 100% manageable through diet. You don't even have to exercise, just eat healthy. Today, with the use of continuous glucose monitors, you have all the data you need to make informed diet decisions - you know exactly what "eat healthy" means for your body.
Not sarcasm: I'm sure it would be frustrating to see so much scientific and commercial effort going into treating TIID pharmacologically when you believe the solution is trivial. But you could also consider all of these developments as evidence that the prescription of "just eat healthy" isn't broadly useful.
> But you could also consider all of these developments as evidence that the prescription of "just eat healthy" isn't broadly useful.
As programmers, we usually prefer to remove code to fix a bug than adding patches on top of buggy code. Let's not pretend that the same logic does not apply here.
That's clearly double unhealthy behavior and will bring unintended consequences. Which might be better than the current predicament but still let's not pretend this is not a "monkeypatch".
Considering the article mentions ReCET and semaglutide, presumably most people in the study weren't resuming the unhealthy diet.
Semaglutide is ozempic. By itself it can be enough to help people get their A1C down through healthier diets.
For me to find the study especially interesting, I'd have to see a comparison between ReCET + semaglutide vs just semaglutide. And upon re-reading I see that's their plan.
> “We are currently conducting the EMINENT-2 trial with the same inclusion and exclusion criteria and administration of semaglutide, but with either a sham procedure or ReCET. This study will also include mechanistic assessments to evaluate the underlying mechanism of ReCET.”
s/Broken ankles are 100% manageable by not walking where you could slip and fall. If only today's society made informed decisions about their walking habits, we wouldn't need all these artificial casts and surgeries. How long does a cured ankle last till the lifestyle of walking around breaks it again?/
>How long does this cure last until the unhealthy diet & lifestyle that originally caused the insulin resistance bring it back again?
Not Sarcasm:
1) We simply don't know. Effects seem durable while people take the drug, but we have limited long term data. We dont have large populations that have taken it for 10 or 20 years
2) When people go off GLP-1 drugs, about 50% of them bounce back to their original weight or gain more. about 50% of people hold steady or go on to lose more weight.
This demonstrates that individual behavior and actions play a critical role, even for people who have taken the drug.
A big part of the problem is that if you go to a doctor with diabetes, 90%+ he will tell you to use insulin. He won't tell you to loose weight and go on keto diet.
Still popular opinion is that eating meat and fat is bad for you (heart attack) but no many understand that eating sugar and carbs is a highway to diabetes).
In fact many people who go on keto and reverse diabetes report that doctors instead of congratulating them and telling other patients to do the same, tell them that keto diet (i.e. eating lots of meat) will give them heart attacks.
Most people don't know how bad sugar and carbs are because no one tells them.
I wouldn't ignore the effect that having surgery and then two weeks of a strictly controlled food intake has. That might account for a large proportion of the success rate. I heard about a study that found that the fasting required for bariatric surgery actually provides a large proportion of the benefit of the procedure.
If you catch type 2 diabetes before it gets so bad that it has killed off the beta cells, then your best treatment is to fast for a while. After a couple of days, you should notice a massive improvement in glucose control. A week of fasting a couple of times a year might be all it takes to give you a complete cure. YMMV, but in my opinion (and that of a whole load of people who know what they're talking about) it's better than filling yourself with drugs.
After the beta cells have been killed off by overwork, yeah, you need insulin. But you can still reduce the amount you need by losing weight.
> A week of fasting a couple of times a year
By “a week of fasting” you mean a week of intermittent fasting or something else? Can you give an example of such a regime (and are there different ways?)?
Don’t have type 2 yet but has family history and it spiked to 6.1 one right after a hospitalisation so I have been spooked since (been 2 years). I get super stressed even at the thought of sugar related tests.
>the fasting required for bariatric surgery actually provides a large proportion of the benefit of the procedure
Can confirm. My wife had surgery ~3 years ago. I supported her by eating the same things she was for prep and throughout the surgery. We lost about the same amount of weight, through ~1600cal a day and exercise. I wanted to get down about 25lbs lower than my lowest during that time. But, a year ago my wife was diagnosed with cancer, and that process totally screwed with our plans, and we both gained weight, her quite a bit less than me.
The last ~6 weeks I've been restricting calories again, and have started the journey back to where I want to be. I will say that the surgery really impacted her hair badly, which she didn't love. Despite taking all the best vitamins, her hair went from thick to somewhat thin.
If you can get rid of the things that trigger you and stick to low calories and exercise, you'll lose weight. The surgery helps, but committing to low calories is going to get the results. And a friend who got bariatric surgery but wasn't committed to lifestyle changes, within a year was back to her original weight.
For type-2 diabetes, various forms of dietary therapy such as nutritional ketosis have proven extremely effective in reducing or even eliminating many patients' need for exogenous insulin. But we usually refer to that as putting the condition into remission rather than a "cure".
https://doi.org/10.1530/EDM-22-0295
> But we usually refer to that as putting the condition into remission rather than a "cure"
Because that’s accurate. Someone following this treatment plan is still at elevated risk of recurrence. Once you’re cured of the flu, your ex ante chances of catching it again are no higher. (We don’t have a cure for diabetes per se. Insulin controls but doesn’t cure it.)
This.
I was diagnosed with type 2 diabetes about two and a half years ago. After doing some research, I put myself on a strict keto diet. Within about a month, my A1C went from over 13 to hovering around 6 and has stayed there. Never took any diabetes medication.
I do give myself a "vacation" from the diet about once a month, which I usually reserve for a special occasion.
6 replies →
I need someone who control his type 2 diabetes with the ornish diet which is fat vegetarian no sugar or simple carbs...
And maybe the secret is the no sugar nor simple carbs
I’m unsurprised that a large component of the treatment is effectively just “lose weight”. For many years I’ve heard accounts of significant weight loss reversing type 2 diabetes.
Even my allergies are tamed when I am at the right weight and physically very and consistently active. (It might just be coincidence though). Cutting off refined/white sugar almost completely has helped a lot I guess (I do have a sweets cheat day every 3-5 months. It’s not planned but somehow this is how it has worked with visits to friends and relatives).
Is type 2 a permanent disease? Or is like when you lifestyle is bad and your sugar remains high/etc you are suffering from type 2 diabetes, but when your lifestyle and weight and great and sugar is well under control you don’t have type 2 diabetes, but if that changes you can get it again? Or it’s like - once “marked with type 2” no matter the sugar marker results you are a type 2 patient forever?
Anecdotally, I've observed with my own body that there is a very direct correlation between weight and all of the health metrics. And it does not take as much weight change as you might think in order to see the metrics move.
Another thing is consumption. All of my metrics start moving immediately in the positive direction when I'm on a calorie restricted diet, even before I start seeing results on the scale.
I could be unique but I doubt it.
The problem, of course, is that just like CICO, observing the relationship between weight and health is educational but useless as a strategy. If it were that easy there would be no overweight people in the world.
Note: This is about diabetes type 2, not type 1. Might be worth to editorialize the heading in this case.
I really wish the two diseases had different names.
Something that works for 95% of people with diabetes then. Fantastic!
They really should be called different names. The diseases are really not all that similar other than (sometimes) the need to take insulin.
Don't only something like 25% of type 2 diabetics take insulin?
1 reply →
eh, I had a brief glimmer of hope
As a T1D I empathize so strongly with this comment.
There was a promising example in China where Scientists cured a single woman who had T1D. It's n=1, but the first step to a cure is curing someone :)
Source: https://www.nature.com/articles/d41586-024-03129-3
3 replies →
Paper: https://pubmed.ncbi.nlm.nih.gov/38692517/
> Recellularization via electroporation therapy (ReCET) is a novel endoscopic procedure that uses electroporation to induce cellular apoptosis and subsequent reepithelization.
... plus GLP-1.
GLP-1s baseline eliminate insulin for about ~40% of people. This boosts that number to 86%.
Note that Tirzepatide also reduces the chance of developing type 2 in the first place by 94%, and I suspect that newer generation receptor agonists will see higher insulin discontinuation rates in general.
Very cool stuff all around. Might finally be able to put this whole obesity-and-diabetes thing to bed.
Tirzepatide side effects sound pretty nasty, though less so than dying in a diabetic coma.
https://en.wikipedia.org/wiki/Tirzepatide
10 replies →
How long does this cure last until the unhealthy diet & lifestyle that originally caused the insulin resistance bring it back again?
It's frustrating, as Type 2 diabetes is 100% manageable through diet. You don't even have to exercise, just eat healthy. Today, with the use of continuous glucose monitors, you have all the data you need to make informed diet decisions - you know exactly what "eat healthy" means for your body.
Not sarcasm: I'm sure it would be frustrating to see so much scientific and commercial effort going into treating TIID pharmacologically when you believe the solution is trivial. But you could also consider all of these developments as evidence that the prescription of "just eat healthy" isn't broadly useful.
100% agree, it's a modern cultural problem. We look for drug and technology solutions because "doing the right thing" is hard.
10 replies →
> But you could also consider all of these developments as evidence that the prescription of "just eat healthy" isn't broadly useful.
As programmers, we usually prefer to remove code to fix a bug than adding patches on top of buggy code. Let's not pretend that the same logic does not apply here.
That's clearly double unhealthy behavior and will bring unintended consequences. Which might be better than the current predicament but still let's not pretend this is not a "monkeypatch".
Considering the article mentions ReCET and semaglutide, presumably most people in the study weren't resuming the unhealthy diet.
Semaglutide is ozempic. By itself it can be enough to help people get their A1C down through healthier diets.
For me to find the study especially interesting, I'd have to see a comparison between ReCET + semaglutide vs just semaglutide. And upon re-reading I see that's their plan.
> “We are currently conducting the EMINENT-2 trial with the same inclusion and exclusion criteria and administration of semaglutide, but with either a sham procedure or ReCET. This study will also include mechanistic assessments to evaluate the underlying mechanism of ReCET.”
s/Broken ankles are 100% manageable by not walking where you could slip and fall. If only today's society made informed decisions about their walking habits, we wouldn't need all these artificial casts and surgeries. How long does a cured ankle last till the lifestyle of walking around breaks it again?/
>How long does this cure last until the unhealthy diet & lifestyle that originally caused the insulin resistance bring it back again?
Not Sarcasm:
1) We simply don't know. Effects seem durable while people take the drug, but we have limited long term data. We dont have large populations that have taken it for 10 or 20 years
2) When people go off GLP-1 drugs, about 50% of them bounce back to their original weight or gain more. about 50% of people hold steady or go on to lose more weight.
This demonstrates that individual behavior and actions play a critical role, even for people who have taken the drug.
Well, shit. I can't believe it never occurred to these obese people to just eat right!
You, sir, are a modern messiah. Well done.
A big part of the problem is that if you go to a doctor with diabetes, 90%+ he will tell you to use insulin. He won't tell you to loose weight and go on keto diet.
Still popular opinion is that eating meat and fat is bad for you (heart attack) but no many understand that eating sugar and carbs is a highway to diabetes).
In fact many people who go on keto and reverse diabetes report that doctors instead of congratulating them and telling other patients to do the same, tell them that keto diet (i.e. eating lots of meat) will give them heart attacks.
Most people don't know how bad sugar and carbs are because no one tells them.
14 participants
I didn’t seem to get this from the article but this this involve taking semaglutide for the rest of your life or the diabetes returns?
[flagged]
sir this is not reddit