Insulin Resistance is Futile

For decades, Type 2 Diabetes Mellitus (T2DM) was viewed by the medical establishment as a chronic, progressive disease. The prevailing belief was that once a patient was diagnosed, the trajectory was a one-way street toward increasing medication dependency and eventual organ dysfunction.

However, modern metabolic science has radically shifted this paradigm. We now understand that Type 2 Diabetes - along with Pre-diabetes and Insulin Resistance - is not necessarily a life sentence. It is a physiological state that, in many cases, can be put into remission.

As someone who recently achieved a Hemoglobin A1c of 4.5% - a number that signifies high insulin sensitivity - I want to explore the science behind how lifestyle protocols like Intermittent Fasting and a Ketogenic diet can effectively reverse the metabolic clock.

The Spectrum of Dysfunction: It Starts Before You Know It

To understand reversal, we must first understand the progression. T2DM does not happen overnight. It is the end stage of a long continuum.

Decades ago, pathologist Dr. Joseph Kraft conducted over 14,000 insulin assays and identified a pattern now known as "Occult Diabetes" or Hyperinsulinemia.

1. The Hidden Phase: Long before blood sugar rises, the body develops Insulin Resistance. To compensate, the pancreas overproduces insulin to keep glucose levels normal. On a standard blood test, this person appears "healthy," but their insulin levels are chronically high.

2. The Tipping Point: Eventually, the pancreas cannot keep up with the demand. The "dam breaks," and blood glucose begins to rise. This is when a diagnosis of "Pre-diabetes" is usually made.

3. The Diagnosis: When glucose remains chronically elevated, Type 2 Diabetes Mellitus is diagnosed.

A Honeyed History

Interestingly enough, diabetes itself was a condition recognized by the Egyptians as early as 1500 BCE. In Greece in the 2nd century AD, Aretaeus of Cappadocia first accurately described the disease, using the Greek word diabetes ("siphon" or "to pass through") for the excessive urination. In 1675, Thomas Willis added the Latin word mellitus ("sweet") after noting the urine's honey-like sweetness, creating the term diabetes mellitus. As a result, the full name for "Type II Diabetes" (the type I am talking about) is "Type 2 Diabetes Mellitus (T2DM)".

The Mechanism of Reversal: The Twin Cycle Hypothesis

The most compelling research on reversing this process comes from Dr. Roy Taylor of Newcastle University. His "Twin Cycle Hypothesis" posits that T2DM is caused by excess fat clogging the liver and pancreas.

• Cycle 1 (The Liver): Excess carbohydrates are converted into fat in the liver. When the liver becomes full, it exports this fat to other organs.

• Cycle 2 (The Pancreas): This "spillover" fat accumulates in the pancreas. This toxic fat essentially "stuns" the beta cells (the cells that make insulin), causing them to go dormant. They are not dead; they are simply non-functional due to metabolic stress.

The Solution: Emptying the Stores

The protocol I follow - 22:2 Intermittent Fasting combined with Clean Keto - is designed to target this specific mechanism.

1. Stopping the Inflow: By restricting carbohydrates (Keto), we stop the production of new fat in the liver.

2. Draining the Outflow: During the 22-hour fasting window, the body rapidly depletes its glycogen stores and is forced to burn stored fat for fuel (ketones).

According to Dr. Taylor’s research (specifically the DiRECT Trial), when enough visceral fat is stripped from the liver and pancreas, the beta cells "wake up" and resume normal function. The patient effectively returns to a non-diabetic physiology.

Important Distinction: Type 1 vs. Type 2

It is critical to be precise in our terminology:

• Type 1 Diabetes is an autoimmune condition where the immune system destroys the beta cells. This is currently irreversible; these individuals require exogenous insulin to survive.

• Type 2 Diabetes is a disease of storage. The machinery is intact; it is simply clogged. This is the form that is responsive to lifestyle intervention.

The Takeaway

My recent blood work demonstrates that this is not theoretical. An A1c of 4.5% indicates that my body has exited the insulin resistance continuum entirely. By controlling insulin and reducing visceral fat, we do not just "manage" the disease; we can potentiality reverse the underlying cause.

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References and Further Reading:

• The DiRECT Trial (Diabetes Remission Clinical Trial): A landmark study demonstrating that weight loss (specifically reduction of liver and pancreatic fat) can put Type 2 Diabetes Mellitus into remission. Lean, M. E., et al. (2018). The Lancet.

• Virta Health / Dr. Sarah Hallberg: A controlled clinical trial demonstrating that a ketogenic diet can reverse Type 2 Diabetes Mellitus and eliminate the need for insulin in the majority of patients. Hallberg, S. J., et al. (2018). Diabetes Therapy.

• Diabetes Epidemic & You: The seminal work by Dr. Joseph R. Kraft detailing the prevalence of undiagnosed hyperinsulinemia.