In this episode, Dr. Scott and Tommy discuss encouraging scientific findings that point to actual long-term reversal of blood sugar imbalances and full-blown diabetes. The "management" of blood sugar disease processes simultaneously acknowledges and ignores the possibility of reversal through weight loss, due to extremely low success rates through standard caloric deficit dieting. With a more effective plan that results in significant fat reduction, long-term balance can be restored.
Predictors of type 2 diabetes remission in the Diabetes Remission Clinical Trial (DiRECT)
Fasting For Life Ep. 41
[00:00:01] Hello, I'm Dr. Scott Watier, and I'm Tommy Welling, and you're listening to the Fasting for Life podcast, and this podcast is about using fasting as a tool to regain your health, achieve ultimate wellness and live the life you truly deserve. Each episode is a short conversation on a single topic with immediate, actionable steps. We cover everything from fat loss on health and wellness to the science of lifestyle design.
[00:00:25] We started fasting for life because of how fasting has transformed our lives, and we hope to share the tools that we have learned along the way.
[00:00:40] Everyone, welcome to the Fasting for Life podcast. My name is Dr. Scott Watier. I'm here, as always, with my good friend and colleague, Tommy Welling. Good afternoon to you, sir. Hey, Scott. How are you doing? Awesome, man. I'm excited for today's episode, a really cool study that we came across. And we want to make sure that we land the plane today with a ton of hope, encouragement and control for the average for the average person. And by average, I mean you, me and everybody else that struggled with weight loss or or blood sugar issues in the past, diagnosed undiagnosed, doesn't really matter where you fall on the spectrum. But today's Take-Home message, I think, is going to be really impactful.
[00:01:19] Yeah, I think so, too. And I was I was really excited to see that this study was even done because I haven't seen anything quite like it and just the focus of it. And the results were were huge and I am excited to get into it.
[00:01:32] Yeah, and it's recent, too. So this was the direct diabetes or mission clinical trial. And this is kind of a review of some of the research and stats that have come out. And it the Take-Home message is going to be one of. Reversal for current diabetics, but a lot of the people that listen aren't in a position of having diabetes or having to worry about it, and that's where we want to make sure that we we empower to the point that you and I are on the path to end up as a type two, pretty much like our body type, our energy or labs, like all the stuff that we were doing. We were on that path and. When we look at the statistics of thirty five million people having diabetes and other seven to 10 million people that are undiagnosed, the cost of six to eight thousand dollars a year of extra money that you have to spend out of your pocket, and never mind the decreased lifespan and life expectancy due to all of the other health related issues that come with being diagnosed as a diabetic. One thing that's frustrating for the people that we talk to, especially that fall into this category, is that very rarely are the is the conversation about reversal or to use a term that's used in this study, remission, which in my mind always goes to like cancer, like cancer remission, but for diabetes, remission or reversal where you no longer have that diagnosis.
[00:03:07] And this is what we've seen in some of our one on one client and some of the people that have been following us and just sending us random testimonies about they read the book, they listen to the podcast. I'm like, man, that's amazing, where you no longer have that diagnosis. But yeah, the frustrating part is that it's never talked about. You can go to the ADA website, you can go to the major websites that that have diabetes support. And it's always talking about the management. Right. And not the reversal, the management and the control of it, which is one of the things that stood out to me about Dr. Funk's research. Was it you you're literally like accelerating the process when you get to the point of using insulin and diabetes medications and stuff, you're not getting to the cause of the problem. You're treating the symptom. So the frustrating piece for those people is that it's OK to do X, Y and Z, but you actually get worse, not better.
[00:03:57] Yeah, and there's no end point in mind either. It's just keep doing these things. They'll make some of the symptoms a little bit better. But all the while, the disease is getting worse and with with no end point in mind. And by the way, if you can lose the weight, that may make things a little bit better. It's almost an afterthought because that's that's so far away from the focus of the treatment that that most people don't ever get there and they don't even really have hope for it in the system as a whole.
[00:04:33] Yeah, the recommendation should first and foremost be change your diet, lose the weight, and then we'll talk about medication. Right. But it's not in that way. And I think it's just the system and a common misconception on what diabetes is and how to get how to get results. And by no means are we giving medical advice here. But looking at this study where it's talking about the predictors of Type two diabetes, so the outcomes, things that they can look at that will allow them to say to a patient, and then meaning the health care providers say to a patient, you have a good chance of remission, where I think the goal for everyone that's on a path to blood sugar problems and diabetes and pre diabetes should be let's get control of this thing now. And that's what really stood out to me about this, is that the outcomes were absolutely mind blowing in terms when you look at the percentages of when you lose a certain amount of weight, this literally gives you a concrete percentage. Right. And there's a lot of factors here, but a concrete percentage that you have a really good chance to reverse it or never even get it right.
[00:05:40] And that's that's an important point right there. Never even get it. Because remember, when we talk about insulin sensitivity, we talk about blood sugar, we talk about pre diabetes and diabetes and then going into remission from there. This is a sliding scale.
[00:05:57] So if you're in your 20s or 30s and you're you're not having these issues just yet, if if the weight's ticking up and any of the symptoms are getting a little bit, they're increasing over time. Remember, this is a that's a long path to actually have full blown diabetes. It starts way before you get the diagnosis, way before you're injecting insulin or anything else like that. So this this study was specifically focused on reversing the whole process. So in order to do that, they're using patients who do have full-blown diabetes, but to bring them back all the way, we're talking decades back in time. And that was the goal.
[00:06:40] And so one of the clarifications there is, yes, this process takes decades to happen. And I was the centripetal weight gain, the decrease in energy, the labs that weren't making sense, the feeling of malaise, the brain fog, the the weight loss fluctuations, the body mass index ticking up over the years. So all of the people in this study were between 20. Sixty five. And for clarification, they all had type two diabetes. So we're not talking about type one diabetic or insulin dependent diabetics, but type two diabetics. Right. Which is a lifestyle type condition. So funny that the lifestyle. Rotations are always kind of like the after thought of like, oh, yeah, just lose some weight, start walking, change your diet. But these were all people change your life maybe of less than six years and the BMI ranged between twenty seven to forty five. So we're talking from the overweight to the severely obese. And these were people that were not receiving insulin at the time.
[00:07:38] But I can tell you, even if you're on insulin, that this is going to work because we've seen it and the science makes sense. So, again, if you're not there, just just think the stats don't typically lie. So if we've got you've got the telltale signs and the blood pressure's ticking up and all of these things, then we want to encourage you that you never have to reverse it if you just prevent it. Right. And that's what health care should be about, is prevention, not about treatment or reversing.
[00:08:07] Right, absolutely. 100 percent. And we've gotten several several responses and questions just recently here. People in their 20s and early 30s just starting to see this. And they're realizing, oh, well, I'm going to need to change something now because I know how this would end up. And usually that's in their family. They've seen it. Everyone knows people who are who are who are having these these issues way later in life and they don't want it to be them.
[00:08:31] So a couple of really cool things about this was weight loss ended up being the number one predictor that they looked at some other predictors. They looked at it like BMI, fasting, insulin, fasting, C peptide, the duration that they had diabetes. None of those predicted remission nearly as well as weight loss. I'm going to talk about specific numbers in just a second. They looked at the study and they used they used a diet that that I wasn't I was not familiar with at first. And when you look at the type of diet, it's called a counterweight plus and it's a low calorie diet. And interestingly enough, some of these numbers look really familiar to us. If you're following our one meal a day plan and you're at 40 to 50 percent reduction in your daily caloric intake, so is eight hundred and twenty five to eight hundred and fifty kilocalories a day for about three to five months. And it was the weird thing was it was all shakes and soups. So like that to me is just not sustainable, right?
[00:09:36] Yeah. I never like when when you're when you're doing extreme differences from what your normal day to day eating would look like. But just just to keep it clinical, to keep it scientifically clean, they use the same foods for everybody, soups and shakes. But I don't think there was any any real, like, transition into normal food. I know they increase the calories over time later, months later. But I think some people had some trouble probably adjusting to regular life after just soups and shakes, which we've heard about from from weight loss, from Weight Watchers and things like, yeah, yeah, you stop using the food, you stop restricting and it comes back.
[00:10:18] So but not not a hundred percent in this case. So they went through three to five months of this shakes and soups and then slowly calories were back, increased 12 months. They looked at the remission and then the predictors of remission at 12 months. And then also at twenty four months, they used the typical HVA one. See if you are between six and six point five percent or forty two and forty eight millimoles, then you are prediabetic. If you are over forty eight millimoles or that six point five percent mark, then you are diagnosed as a diabetic and everybody listening right now.
[00:10:52] That's not like there is. There is a Take-Home point here. And when we look at the total amount of weight loss, these are numbers that aren't mind boggling in terms of, you know, these are things that you will hear people say, oh, I lost and I'm not going to say, yeah, oh, I've lost this amount of weight. Oh, I feel great. Oh, I lost this amount. In the last six months, and I feel wonderful, and the percentages of people that had success at the end was was incredible, the 12 month mark. Forty six percent of the people in the study had achieved remission or reversal of diabetes and then thirty six percent. So one out of every three had maintained that over twenty four months. And there's some things that we'll talk about in terms of why we feel that people that just couldn't stick to the diet, people that dropped out of the study. But really, it's because you went back to and in our opinion looking at it, you went back to eating the way you used to, which means it wasn't sustainable. And, you know, it just points to the fact that blood sugar related issues are a time sensitive sliding scale, which fasting addresses better than than anything else that we've that we've seen up until this point.
[00:12:09] Yeah, absolutely. Because, you know, controlling the insulin spikes is is the name of the game. That's what we're that's what we're looking to do. And that was one of the things that we were talking about. As far as, you know, why couldn't they get to one hundred percent here? Let's say if everyone was able to stick to what they were doing, why not get to one hundred percent? Well, they were still eating throughout the day, so they weren't even deliberately trying to control insulin spikes. So these eight hundred or eight hundred and fifty calories, they were they were consuming. We're not in a mad type type fashion. They were throughout the day two, three or four times a day, as far as we can tell.
[00:12:49] Yeah. And so when we look at that, the the caloric restriction is great. But if we can compound those those outcomes by, like you just said, by spacing out those insulin spikes and giving your time more time in the unfed state, in the insulin low state where your body's going to be in a higher fat burning state and the weight loss numbers just at one year. So at the one year mark, 70, you have a seventy three percent chance of remission if you've lost 10 kilograms, which is about twenty two pounds.
[00:13:24] So a seventy three percent remission, predictor of remission, predictor of reversal one year if you've lost twenty two pounds. We've had people that have lost twenty two pounds in a one month challenge with us. Right. Not over the course of 12 months. Eating soups and shakes. It's crazy. But this, this study is super powerful and that's why we love it when we want to talk about it at even higher. You have an eighty six percent chance if you've lost fifteen kilograms, which is about thirty three pounds.
[00:13:55] Well, so go ahead. Let me interrupt you for a second. Remember, this wasn't from this wasn't from like an every day kind of just I have a few pounds to lose starting point. Either we have an average BMI here going well into the severely obese part of the spectrum. Yeah. Thirty five is the average and they're still within coming down thirty to thirty five pounds going into remission from their diabetes. I mean a huge change, not needing the medications and just with, with that amount of weight loss.
[00:14:30] And that's a good point of clarification. There too is it's a smaller percentage for those heavier people, but even that smaller percentage was able to achieve remission and it was done. These these these remission statistics were without anti diabetes medication. So without the metformin, there was no insulin. There were no diabetes medications used at this point, which is great, because that shows that the body was actually doing what it was supposed to do, which is normalize when we talk about people that have had the condition for longer periods of time than, yeah, it might take longer. And there's some new research out there that talks about how long does it take to increase your insulin sensitivity, which is your body's ability to take the glucose that's in your body and shuttle it into the cell for an energy source rather than storing it as fat? Right.
[00:15:22] So there's still that's a whole nother conversation for another day. But really with this study, it should give everyone an empowering feeling that using fasting. Right.
[00:15:35] With a combined strategy of decreasing your caloric intake, which allows your body to normalize, which decreases your hunger, increases your energy, increases your hormone balance, has all these autophagy, all these other health effects. Never mind. Are you getting all of those benefits you look, feel and just act better, like your day to day life gets better, but you never have to worry about being, you know, the one of the thirty five million or ten extra million people that are going to get diagnosed with this and then have all the other complicating factors. You literally have the tools to never have this happen. We're speaking outside of genetic pre genetic anomalies. All those different types of things like you are the average person.
[00:16:17] This should be encouraging that, OK, if if I can space my meals out and watch my intake, then I've got those two simple tools to be able to never end up in this situation.
[00:16:29] Absolutely. And one of the other things I love about this study was the fact that they they kept people on the eight hundred or eight hundred fifty calories per day. They kept them on that for four months, for a three to five months, three to five months, and then and then took them up from there. But even at that point, most people with with this level of carbohydrates and this many insulin spikes throughout the day had not reached their goal weight at that point. They they weren't tracking like a lot of the people that we see following a more precise regimen and precise schedule. But even all that being said, at eight hundred fifty calories a day, they didn't see any issues with with slower metabolism or any any issues that people are worried about, especially before they start a nomad. And like we saw an example just this morning, we were talking about where someone was was recommending an add type of schedule, but with one hundred percent of the calories of their daily calories in like one one meal setting because they were afraid to to restrict the calories at that point. But there was no negative effects from that in this study. Yeah, there were a couple other complicating factors.
[00:17:44] You know, people that had higher alcohol consumption, liver enzymes are elevated and then also the use of anti depressants was shown to drastically reduce the remission or the outcome. So there are some other things here that no study is perfect and no application is perfect. Right.
[00:18:06] But you and I are sitting here going, well, OK, if if if they did the reduction short term and then they slowly let people get back on back to their old ways and they still had like thirty six percent remission, like thirty six percent walk into any diabetes clinic or any general provider and say, hey, I know what to do to get you one third of your diabetes patients off of their medications if they've had diabetes for six years or less.
[00:18:34] Like this is information that people need to hear for the just overall health reasons, like the people that have this need to hear this. Never mind the people that now know they don't ever have to worry about ending up in that position.
[00:18:48] Yeah, for sure. Because this just this just isn't happening in most provider's offices. They they they go down this route and they don't see most people dropping 10 or 20 or 30 pounds and being able to come off it because that that's just not part of the treatment plan. It's based around management and it's based around most people not ever losing the weight. So not ever really reversing it. But it can be done. It's it's fairly simple to do. There's a good study to back it up right here.
[00:19:20] In conclusion, remissions are frequent across all variables, examine the strongest predictors for greater weight loss and being prescribed fewer. And this is huge. And being prescribed fewer anti diabetes medications at baseline like disease, duration, fasting, insulin, c peptide did not influence the likelihood of remission nearly as much as the weight loss. So when your doctor says lose the weight, well, how are you going to do it? I don't want to eat shakes and salad or whatever it was. Shakes and soups for three to five months, then have to do a two week plan. I want a 60 or 90 day plan to get the 20 or 30 pounds off and let my body normalize, just like my dad. He's done it. No more insulin off. Two of the major diabetes medications down 30 plus pounds and is he had his goal weight yet? No, but these are his numbers now in the pre diabetes range rather than the diabetes range.
[00:20:15] Absolutely. Living a completely different life now than it was four months ago. Yeah, I've got a whole list of stuff for him to do when he gets down here. That's all. Something to worry about him anymore. Michael, let's go. Let's go, man. Come on. We've got to put a floor in things to do. Yeah, yeah. We've got a whole granpa to do list. So just just really cool. And it just reaffirms my belief, Tommy, that what you stumbled upon, what we've stumbled upon, what others before us and in the fasting insulin model have stumbled upon, is that sometimes you've got to do something a little bit different to get different results. And it's just great to see that there's research being done out there, which will probably take a long time to get disseminated down to everybody. Who knows, it may not due to the fact that there's potentially some competing interests and pharmaceutical companies and lobbyists and there's a lot of money in in the health care system, it may never get out. So, I mean, I don't know about you, but this reaffirms my desire and belief and want to deliver this message to as many people as possible.
[00:21:18] Yeah, I'm just going to start I'm going to print out a thousand copies of this and we'll just go around the town, just kind of tacking it up on all the light posts and everywhere else we can find.
[00:21:28] That's 20, 20. Right. Let's do it happen. Cool. So take home message action, step time if you want to land the plane here for everybody. What we can do now in order to either encourage someone that is in this situation where they have diabetes and they want they're struggling with it or someone that is really just kind of in the earlier decades of of the process and and not knowing where to go or or how to maintain how not to see that BMI tick up every year as the holidays approach and how not to see that 10 to 12 pounds fluctuation year after year.
[00:22:05] Yeah, if if you're sitting there and you have five pounds to lose or fifteen or fifty or one hundred and fifty, it doesn't really matter because. There is a way to reverse it, and it's the same no matter which camp you find yourself in and it's as simple as starting today. So go get the fast guide. Go take the mini master class, go get started on Omed.
[00:22:29] It's super simple. It's easy to follow. It's it's easy to maintain it. It gets you going with habits that you can use for a lifetime. It's not soups and cakes and stuff like that. It's you can have fun with it. You can enjoy the foods that you're used to eating and you can see real progress starting today.
[00:22:52] Yeah, it I couldn't have said it any better, so I'm not going to elaborate on anything else because I think that was a perfect dismount. It's easier than you think it is, is one thing I will say it gets easier as you go, but you got to start. So with that being said, Tommy, appreciate the conversation as always. If you guys are listening, you're new to the podcast. Go to our website. Be Fasting for Life Dotcom. You can download the podcast, our guide, the time you just mentioned, shoot us a message at info at the Fasting for Life Dotcom info at the Fasting for Life Dotcom. Feel free to rate, subscribe, review, share with a friend. But if you guys honestly need anything from us, please reach out. Let us know how we can help. No matter where you are on this journey, you have options, you have the control. And let us help you get let us help you get there. We are on this journey with you and as always, Tommy. Thank you, sir. And we'll talk to you soon.
[00:23:48] Thank you. Bye.
[00:23:50] So you've heard today's episode and you may be wondering where do I start?
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