Meet Mark

Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

Tell Me More
Stay Connected
June 27 2007

The Definitive Guide to Insulin, Blood Sugar & Type 2 Diabetes (and you’ll understand it)

By Mark Sisson
209 Comments

BITE ME, ADA

We all know by now that type 2 diabetes is an epidemic. We’re seeing words like crisis and runaway all over the news and in the journals. Heart disease rates have been cut in half since the staggering margarine days of the 1980s, but diabetes has swiftly risen to fill that gaping void and meet the challenge of Completely Unnecessary Disease Epidemic.

Here’s my ultra-simple explanation of the entire insulin/blood sugar/type 2 diabetes mess. Big Agra could really care less about you. That’s just business. The pharmaceutical industry is not in it for the love of life. If that were the case, drugs would be much cheaper. The FDA has to think about public health, but it also has to think about treading carefully on the toes of corporate interests, because that’s how it works when you’re the biggest economy in the world.

Print this explanation out, stick it on your fridge, email it to your aunt. And put down the pasta.

When you eat food, the body digests the macronutrients: carbohydrates, proteins – actually many different amino acids – and fats. (Anything it can’t digest, like alcohol or fiber or toxins, either passes right on through or, if it makes it into the bloodstream, gets filtered by your liver, a beast of an organ if there ever was one.) We measure these macronutrients in grams and calories, but your body operates in terms of fuel. If you eat more fuel than your body needs – which most people do – the body is forced to store this excess. This ability to store excess fuel was an evolutionary imperative in a world that was in a state of constant “feast or famine” 50,000 years ago. In terms of Primal Health and our DNA blueprint, humans became very efficient fuel storage specialists and were able to survive the rigors of a hostile environment and pass those very same genes down to you and me. Thanks a lot, Grok!

Bear in mind that every type of carbohydrate you eat is eventually converted to a simple form of sugar known as glucose, either directly in the gut or after a brief visit to the liver. The truth is, all the bread, pasta, cereal, potatoes, rice (stop me when you’ve had enough), fruit, dessert, candy, and sodas you eat and drink eventually wind up as glucose. While glucose is a fuel, it is actually quite toxic in excess amounts unless it is being burned inside your cells, so the body has evolved an elegant way of getting it out of the bloodstream quickly and storing it in those cells.

It does this by having the liver and the muscles store some of the excess glucose as glycogen. That’s the muscle fuel that hard anaerobic exercise requires. Specialized beta cells in your pancreas sense the abundance of glucose in the bloodstream after a meal and secrete insulin, a peptide hormone whose job it is to allow glucose (and fats and amino acids) to gain access to the interior of muscle and liver cells.

But here’s the catch: once those cells are full, as they are almost all the time with inactive people, the rest of the glucose is converted to fat. Saturated fat.

Insulin was one of the first hormones to evolve in living things. Virtually all animals secrete insulin as a means of storing excess nutrients. It makes perfect sense that in a world where food was often scarce or non-existent for long periods of time, our bodies would become so incredibly efficient. How ironic, though, that it’s not fat that gets stored as fat – it’s sugar. And that’s where insulin insensitivity and this whole type 2 diabetes issue get confusing for most people, including your very own government.

If we go back 10,000 or more years, we find that our ancestors had very little access to sugar – or any carbohydrates for that matter. There was some fruit here and there, a few berries, roots and shoots, but most of their carbohydrate fuel was locked inside a very fibrous matrix. In fact, some paleo-anthropologists suggest that our ancestors consumed, on average, only about 80 grams of carbohydrate a day. Compare that to the 350-600 grams a day in the typical American diet today. The rest of their diet consisted of varying degrees of fat and protein. And as fibrous (and therefore complex) as those limited carbohydrate foods were, their effect on raising insulin was minimal. In fact, there was so little carbohydrate/glucose in our ancestor’s diet that we evolved four ways of making extra glucose ourselves and only one way of getting rid of the excess we consume!

Today when we eat too many carbohydrates, the pancreas pumps out insulin exactly as the DNA blueprint tell it to (hooray pancreas!), but if the liver and muscle cells are already filled with glycogen, those cells start to become resistant to the call of insulin. The insulin “receptor sites” on the surface of those cells start to decrease in number as well as in efficiency. The term is called “down regulation.” Since the glucose can’t get into the muscle or liver cells, it remains in the bloodstream. Now the pancreas senses there’s still too much toxic glucose in the blood, so it frantically pumps out even more insulin, which causes the insulin receptors on the surface of those cells to become even more resistant, because excess insulin is also toxic! Eventually, the insulin helps the glucose finds it way into your fat cells, where it is stored as fat. Again – because it bears repeating – it’s not fat that gets stored in your fat cells – it’s sugar.

Over time, as we continue to eat high carbohydrate diets and exercise less, the degree of insulin insensitivity increases. Unless we take dramatic steps to reduce carbohydrate intake and increase exercise, we develop several problems that only get worse over time – and the drugs don’t fix it.

Ready for this? Let’s go:

1) The levels of blood glucose stay higher longer because the glucose can’t make it into the muscle cells. This toxic glucose is like sludge in the bloodstream clogging arteries, binding with proteins to form harmful AGEs (advanced glycated end-products) and causing systemic inflammation. Some of this excess glucose contributes to a rise in triglycerides, increasing risk for heart disease.

2) More sugar gets stored as fat. Since the muscle cells are getting less glycogen (because they are resistant), and since insulin inhibits the fat-burning enzyme lipase, now you can’t even burn stored fat as easily. You continue to get fatter until eventually those fat cells become resistant themselves.

3) It just gets better. Levels of insulin stay higher longer because the pancreas thinks “if a little is not working, more would be better.” Wrong. Insulin is itself very toxic at high levels, causing, among many other maladies, plaque build-up in the arteries (which is why diabetics have so much heart disease) and increasing cellular proliferation in cancers.

4) Just as insulin resistance prevents sugar from entering muscle cells, it also prevents amino acids from entering. So now you can’t build or maintain your muscles. To make matters worse, other parts of your body think there’s not enough stored sugar in the cells, so they send signals to start to cannibalizing your precious muscle tissue to make more – you guessed it – sugar! You get fatter and you lose muscle. Woo hoo!

5) Your energy level drops, which makes you hungry for more carbohydrates and less willing to exercise. You actually crave more of the poison that is killing you.

6) When your liver becomes insulin resistant, it can’t convert thyroid hormone T4 into the T3, so you get those mysterious and stubborn “thyroid problems”, which further slow your metabolism.

7) You can develop neuropathies (nerve damage) and pain in the extremities, as the damage from the excess sugar destroys nerve tissue, and you can develop retinopathy and begin to lose your eyesight. Fun.

8) Eventually, the pancreas is so darn exhausted, it can’t produce any more insulin and you wind up having to inject insulin to stay alive. Lots of it, since you are resistant. Congratulations, you have graduated to insulin-dependent Type 2 diabetes.

That’s the bad news. And it’s seriously bad. But the good news is that there is a way to avoid all this. It’s all right there in your DNA blueprint. First off, exercise does have a major impact on improving insulin sensitivity since muscles burn your stored glycogen as fuel during and after your workout. Muscles that have been exercised desperately want that glucose inside and will “up regulate” insulin receptors to speed the process. That’s one reason exercise is so critical for type 2 diabetics in regaining insulin sensitivity. It’s also the reason why endurance athletes can eat 400 or 600 grams of carbs a day and stay lean – they burn it all off and make room for more.

Resistance training seems to be as effective as aerobic activity, but a mix of the two is the best. And because you are now “insulin sensitive”, you don’t require as much insulin to store the excess, which “up regulates” all the fat burning enzymes, so you burn your stored fats at a much higher rate throughout the day. Important amino acids and other vital nutrients have access to the cells when insulin sensitivity is high, so you’re building or maintaining muscle and losing fat weight. Go team.

Second, cutting back on carbohydrates, especially the obvious sugars and refined stuff is absolutely essential. Make fresh vegetables the base of your food pyramid. I get rip-roaring furious when I see our government suggesting that we get 60% of our calories from carbohydrates. That’s ridiculous, bordering on criminal. Think about what is optimal for human health from a “primal” perspective. Look at the genetic blueprint. Look at the statistics and studies if you like – or simply observe what’s going on around you at restaurants, movie theaters and school cafeterias – and you’ll begin to understand the implications of a diet out of whack with our design. The evidence is nothing short of overwhelming: carbohydrate intake of the refined, sugary sort is enormously stressful to the body.

Not only should diabetics limit carbohydrate intake – everyone should. We are all, in an evolutionary sense, predisposed to becoming diabetic.

Mainstream opinion is, of course, partly correct in that sugar does not necessarily “cause” diabetes – increasingly, scientific evidence is showing that genetic susceptibility plays a huge role in individuals’ potential for developing diabetes. Well, no kidding! The entire mainstream argument boils down to this: sugar does not cause diabetes; it’s genetic. I couldn’t agree more. I would simply say that our shared genetic susceptibility to insulin resistance, inflammation, cardiovascular disease and obesity shows that any sort of refined sugar or grain is the last thing humans should be eating. Our genetic “primal blueprint” indicates that we are not meant to consume sugar.

Next week, I’ll be discussing cortisol, stress, and the adrenals in light of our “primal” blueprints. See you then. I welcome your comments and questions as always.

Further reading:

What I eat

My Carb Pyramid

More Primal Health columns

Sponsor note:
This post was brought to you by the Damage Control Master Formula, independently proven as the most comprehensive high-potency antioxidant multivitamin available anywhere. With the highest antioxidant per dollar value and a complete anti-aging, stress, and cognition profile, the Master Formula is truly the only multivitamin supplement you will ever need. Toss out the drawers full of dozens of different supplements with questionable potency and efficacy and experience the proven Damage Control difference!

Prefer listening to reading? Get an audio recording of this blog post, and subscribe to the Primal Blueprint Podcast on iTunes for instant access to all past, present and future episodes here.

[tags] evolution, DNA, blood sugar, type 2, diabetes, insulin, sugar [/tags]

If you'd like to add an avatar to all of your comments click here!

209 thoughts on “The Definitive Guide to Insulin, Blood Sugar & Type 2 Diabetes (and you’ll understand it)”

Leave a Reply

Your email address will not be published. Required fields are marked *

  1. Brilliant; Its about time someone laid out the over consumption of carbohydrates,and what it is doing to us, in simple easy to understand terms.
    I like it , thank you

    1. I think it is the word Carbohydrate that is misunderstood. Protein, Fat and Carbohydrate, simple.

      For most people it is as if it only describes grains and starchy vegetables and puts fruit and vegetable as another category altogether. Most people seem to get it if I call my way of eating low starch rather than low carb…….saves me getting on the defensive or them on the attack.

      When I explain I am [self diagnosed but I don’t tell them that….saving another argument] Lactose, Glucose and Gluten ‘intolerant’ the most common response is poor you what do you eat…..I have a laugh and tell them whatever was available before HI [Human Interference] food landed on the supermarket shelf……Everything our DNA was built on.

      And before you ask….how do I know I am ‘intolerant’ with out lab test….I am the Lab….those are the foods I Crave and can’t stop eating when I start even when I am not hungry any more and as I don’t think I have a famine in my foreseeable future there is no need to lay down the stores of fat my DNA thinks I need because of how I am eating. There is also a noticeable physiological, emotional, mental change for the worse.

      I don’t crave butter, beef or beetroot but body and soul sure knows the difference…..sigh….so I say No or just a little or share when the birthday cake is handed out.

      Thank you for this great site that I refer to whenever I think I can stray from my natural birthright and try to maintain good, natural health with un-natural food.

      1. So you see a shift in mental and emotional balance with some foods-including butter? Do you know the mechanics behind this?

  2. “Congratulations, you have graduated from Type 2 to Type 1 diabetes.”

    Great article, but the above statement is inaccurate. You never graduate from Type 2 to Type 1 diabetes. Though both are diseases of excess blood sugar, the mechanism is different. Type 1 diabetes almost always develops in childhood/adolescence/young adulthood. The pancreas stops making insulin (there is usually a honeymoon period where the body still makes small amounts, but eventually will make none). Insulin injections (or insulin via a pump) are always necessary. As you described, Type 2 diabetes is a disease of insulin resistance. We used to only see it develop in adults (usually middle-aged), but with our messed up world we are now seeing it, along with other lifestyle related diseases like heart disease, in children.

    Some people with T2D are able to manage their disease through lifestyle, some with oral medications that increase insulin sensitivity, and some need insulin injections. People with T2D who are insulin-dependent and make serious lifestyle changes are often able to come off of injected insulin. The thing is, very few people make the major changes necessary.

    1. I’m glad you wrote this correction Amy, though mentioning that Type1 Diabetes is an auto-immune disease would have clarified things a bit better. Type2 is an insulin resistance problem.
      In Type1, the body’s immune system attacks the insulin producing islet cells and destroys them. The body cannot make any insulin whatsoever. Complete dependence on an outside source of insulin is then required for life. No time off for good behavior, like exercise or eating right.

      I was diagnosed with Type1 at age 24. Most people assume I have type2, when I mention it, and question if I know which version I have. Believe me, Type1’s KNOW what they have. If they didn’t, they’d be dead.

      On a happier note, the primal way of eating is definitely a help with blood sugars and health, no matter what type of diabetes you have.

      1. So glad to see another type one who is trying this out. I’ve been looking for a good diet in which will give me energy and help me loose weight and gain some strength. I feel like so many other diets forget the Type 1’s. Have you been able to cut back on insulin? Have many lows?

        1. Amanda, please see the work of Dr. Richard Bernstein, himself a T1 diabetic who has lived a long and healthy life by keeping carbs to 30 and under a day.

        2. I am so glad to see T1 showing up – i too feel left out of every convo about healthy living as a diabetic- its all about T2 as they can “prevent” what is happening to them, wheres i am told i can only cope with mine (however, i have been CrossFit’ing for sometime and training for a marathon, and doing the paleo thing and my BS has been great)

        3. Many people who take our Argi+ supplement have reported significant cutting back on insulin injections. E-mail me for more info.

    2. In Type 2 DM your beta cells can eventually “burnout” making your disease behave like DM1. MOst of the confusion comes from archaic nomeclature for diabetes, ie insulin dependent diabetes mellitus (IDDM) , non insulin dependent diabetes mellitus (NIDDM).

      While it is true that some can off insulin in type 2 DM, there are other who cannot. Your doctor will test for protein C levels to ensure that your pancreas is functioning.

    3. You are absolutely correct in saying that Type 1 Diabetics can never suddenly change to Type 2, but they can become Type 1 AND Type 2, if they become insulin resistant.

      A Type 2 diabetic can ruin his/her pancreas to the point that it no longer makes insulin. He then would be Type 2 AND Type 1 at the same time. It could happen (theoretically).

    4. hiiiiiiiiii sir,
      i am from india . iwant some tables to decrease my glucose levels in my body i am type 2 diabetes boy pls help me out how to increse my insulin in my body

    5. I’m in the very small percentile of adults that develop Type 1, I found out when I was 34.

      1. Roxie,

        Do note that you may not be a true type I diabetic, even though that was the initial diagnosis. There are also LADA and MODY variants, the latter of which is what about 2-3% of diabetics actually are. It mimics the effects of type I, to an extent, and many patients are immediately put on insulin and can sometimes be switched over to sulphonylureas to stimulate insulin production. Diagnosis usually happens by 25, but it can show up through 50. If your doctor didn’t do a c-peptide test to confirm the natural production of insulin, you shoukd ask for one. If you have very hard to control glucose levels, especially after the typical “honeymoon” period, your body may still be producing insulin.

        In my case, my doctor put me on 5mg of Glyburide after my initial A1c of 16.9 and it nearly killed me with repeated BG crashes. I’m now maintaining on .5mg of Glimepiride. This is pretty rare, indeed, but being properly diagnosed is important and provides options for treatment.

        Take a look at the link, and good luck!

    6. Amy, Mark never stated, “Congratulations, you have graduated from Type 2 to Type 1 diabetes.” No. The actual quote is, “Congratulations, you have graduated to insulin-dependent Type 2 diabetes.”

      This is a very different statement from the one you claim he made. While the symptoms of a T1 diabetic are nearly identical to the insulin-dependent T2, they arrived at the same place through very different paths. But the outcome is the same–up a creek without a boat! Nice article Mark.

    7. ummm pretty sure he said “Congratulations, you have graduated to insulin-dependent Type 2 diabetes” not from T2 to T1 🙂

    8. He doesn’t say “from type 1 to type 2.” He says, “congrats you have graduated to type 2.” You put words in his mouth then formed an argument against something he didn’t say.

  3. Excellent breakdown of the insulin mechanism and very easily understandable. Thanks very much! 🙂

  4. i thing all diabetics should try to manage their diabetes not only with insulin, but natural cures can give one hand more in manage blood sugar lever in controll.

  5. Hi, Mr. Sisson. I enjoy your blog thoroughly as there is great overlap in our beliefs in the nutrition/exercise arena. I was wondering if you could provide a bit of clarification on this for me–“…In fact, some paleo-anthropologists suggest that our ancestors consumed, on average, only about 80 grams of carbohydrate a day…” I didn’t happen to see mention of any specific numbers concerning theorized carbohydrate intake in the clickable link provided. Is this data contained in one of Miller/Colagiuri’s full publications, or is it somewhere within the beyondveg site?

    Thanks in advance,
    Randy

  6. I am living proof that what you shared really works. Nine months ago I was diagnosed with Type 2 diabetes. At that time I began to walk an hour everyday and I seriously modified my diet. I basically followed a plan similar to the one you describe above. In three weeks my blood glucose levels dropped from over 400 down to 85 to 90. I have lost 57 pounds from the change in diet and adding daily exercise. I feel at least 10 years younger and plan to never return back to the old habits that made me ill. One of the best benefits is that I no longer have to take blood pressure meds and I also do not take any diabetes meds. I totally believe that many with diabetes 2 could have the same outcome if they would commit to permanent lifestyle changes. It is totally worth it!!!

    1. I was diagnosed with T2 on March 9th, 2010 with a BSL of 427. They told me to take metformin(500ml) twice daily and eat less sugar. THATS IT! I did some research on my own and decided to not take the pills. I modified my diet and started to exercise. To date (4/16/10) I have lost 64 lbs (298 from 360)and my BSL is never over 130. I will admit I do not eat refined sugar or sweets, and I try to eat lean meats and more fresh fruits and veggies. It is a life long change that needs to take place. Money is very tight for me, but I have found ways to eat healful food on the cheap, it just takes some effort. On my last visit my doctor he told me I should be fine to return to my normal diet. FAT CHANCE! I am into healthy eating from now on. No more McD’s for me. Everyone is different, and you should do what works for you, but a more balanced diet and moderate exercise can’t hurt!

      1. Congrats on the dropping weight (fat) and blood glucose. Now cut out the fruit and get into the normal range to speed up healing and further fat loss. Again…good job Brother.

      2. Jonathan,
        What you said above is that you lost 64 lbs in 5 weeks. That’s nearly 2 lbs/day! Are you sure your diagnosis date is correct?

        How have you done since you posted your comment?

    2. i would like to know how you did this .
      what sort of diet do you eat now ?can you show me your daily menu please.and what did you cut out ….other than sugars.
      thanks
      ken

  7. Happy,

    Thanks for sharing your story. If more people like you can provide testimonials like this, I bet the medical community would be much more willing to jump on board. Keep up the great work.

  8. I appreciate your encouraging words. Thanks for your wonderful website. I have gleaned alot of knowledge that I will use as I continue my journey to health.

  9. I loved reading this piece on diabetes. I’m sure much of what I misunderstand is the paradox of obese people who are not diabetic and normal weight people who have developed type II diabetes. I am certain genetics plays a large role in these situations, but is there something akin to a simple explanation?
    Thanks, Mel

  10. Mel,

    Some “thin” people have very little muscle mass. Muscles that are not used (atrophied) lose their sensitivity to insulin and become resistant, which leads to type 2. Typically these people are “skinny fat” meaning they look thin, but their percentage of body fat is higher than it looks. The fact that they don’t store as much excess toxic sugar in their fat cells can put them often at greater risk for damage done directly by excess sugar in the bloodstream

  11. I was diagnosed with T2 in 2000. The medication the physician put me on did no good and in the process of researching diet and diabetes I discovered many like me who did well with a lower carb diet. I quit taking the medications, started walking at least one mile twice a day, and followed a plan of 20 to 30 grams of carbs a day. I lost 45 pounds and controlled the blood glucose with diet and exercise alone for five years.

    Unfortunately, my efforts stopped working about three years ago and now I take two types of insulin, ever increasing amounts. And I weigh slightly more than I did when I was diagnosed. I’m increasing exercise and trying to wean myself off the insulins and am not having a lot of luck but I’m keeping at it.

    Thank you for such a great article. Hopefully more people will try exercise and diet before resorting to medication. It does work, even if for just a few years for some of us.

    1. You know, some people have a very slow onset of Type 1. Usually they are diagnosed adults, and they may or may not be overweight. It LOOKS like type 2, but it may not be truly Type 2. Sometimes it is referred to as LADA or Type 1.5. With these people, the oral medications work for a little while, but they eventually become ineffective. After a while (sometimes it takes years) they become a true Type 1 diabetic, and insulin is unavoidable.

      I’m not saying this is your case, but it is something to google and see if it fits.

      1. That happened with me! They only figured it out when I was sent to the hospital with a bloodsugar of over 700 and tested for antibodies from my body attacking itself. Best of luck though! Keep trying to lose the excess!

  12. Denise,

    Thanks for relating your story. I’m intrigued as to why your T2 would return with a vengeance despite all your efforts and the early success. If you would like to contact me privately, maybe we could discover a hidden problem that could be remedied.

    1. I’d immediately think about healing the gut, because Type 1 is an auto-immune disease. Our immunity resides in the gut and auto-immune issues are generally the result of a damaged gut. A protocol like the GAPS diet or SCD diet is ideal for gut healing and has resulted in the reversal of many issues, including auto-immune diseases. It’s very similar to a Primal way of eating, but specific starches are removed (that may be allowed on Primal/paleo/real food diets) for a time in order for the gut to heal.

      1. You cannot heal type 1 diabetes. It is incurable. Ask a type 1 diabetic. You cannot reverse autoimmune diseases. An autoimmune disease does not function via magical wands and fairy dust. It is a process in the human body. The immune system is not just in the gut but everywhere in the human body. Once the autoimmune attack occurs, what is left over is damage. The damage, which cannot be reversed, is the disease. The insensitivity and ableism of this specific comment is the same as walking up to a blind person and handing a twig with leaves on it and saying EAT. You’ll see again. It’s as arrogant as walking up to a man with no legs and saying here. It’s all in your gut. Now get up and walk. If you wouldn’t say those things in those situations, don’t you dare say them to someone with type 1 diabetes. I’ve had this disease for 34 years. It’s survival every day. There is no cure “in the gut” or anywhere else. Don’t say that to people with lupus or any other autoimmune disease. Just because a disability is hidden doesn’t give you the right to trivialize it.

        1. You can’t cure autoimmune diseases through diet, but you can take steps to proactively manage the illness and make its effects less severe.

          For a person with T1D, that’s insulin and dietary management. For somebody with celiac, it’s a lifelong gluten-free diet. For somebody with MS, there’s increasing evidence in both people and in animal models that by removing specific environmental triggers–foods–that predispose the person to an autoimmune flare-up. For people with RA, there’s solid evidence that removing certain foods does lead to more “good days.”

          So while the above poster did sound like they were waving about a lot of woo (I do agree with you on that), the science on using diet as a complementary (T1D, MS, RS) or even primary treatment (celiac) for autoimmune disease is well-proven.

    2. I realize this is a very old article and you may not see my reply but this has happened with my husband. He was diagnosed with type2 brought on by use of prednisone approximately 7 years ago. After stopping the prednisone he began taking metformin among other oral meds. These did not work approx 3 years ago after several med changes and frustrations we began the paleo diet changes. He stopped his meds exercised and lost alot of weight from 240 to currently 189 exercises daily mixing up cardio and weight training and has been consistent the last 3 years but mostly the last year religiously. His hba1c was over 14 3 months ago and he resumed metformin and glypicide. Yesterday his sugar after lunch was 300. This has been extremely frustrating. He’s doing all the right things but not seeing the results we are reading about. Any advice would be fabulous.

      1. Francine,
        This happened to my son in law. His insulin producing cells were being destroyed by his immune system. Since he was an adult they simply assumed that he was developing Type 2. Eventually his medication failed to work and then, after a year, they tested for antibodies and made a correct diagnosis. This autoimmune reaction against the pancreas produces certain antibodies. Have them test for those antibodies. If they are found, nothing he can do will eliminate the need for insulin because he is irreversibly being converted into an insulin-dependent diabetic.

        If there are no antibodies, then I have no idea.

  13. Hi Mark
    And thanks for the above article. I now understand what “fat” is blocking cells as there are doctors based in USA which say it is too much animal fat and putting people with type 2 diabetes on a strict vegan “low fat” diet.
    On another article you suggest eating 50-80 grams of carbs a day to effectively burn stored fat? Yeah?
    The exercise part makes sense and thanks for information. As I cant walk right now I have to increase my resistance training.
    Thanks again.

    1. please..! please..! see your dotcor again or get a second opinion .There are medical breakthroughs occurring within diebetes types recently and while doing this, follow a sensible diet you know what is good for you!I am not a medical practitioner and dont pretend to be one..so I was hesitant about your question. You need to speak with a professional and use your common sense untill you do!

  14. Hi Mark,
    So I understand insulin resistance that results in elevated blood glucose levels and then diabetes. What about insulin resistance that results in a blunted blood glucose response and elevated insulin levels? For ex. on a 3 hour glucose test, insulin spikes but blood glucose rise to about 80 mg/ml, plateaus and then drops to below 60. Correspondingly, insulin continues to rise throughout the 3 hour test, resulting in hypoglycemia. Patient is healthy, (overly cardio-active :), 150 lb female with <20% body fat, diagnosed with PCOS on an 1800 cal diet with unrestricted veg/fruit/meat, limited carbohydrates.
    Thanks,
    Rebecca

  15. Hi Mark,

    I’m a naturopathy student in Australia. I’m looking for some credible evidence against the World Health Organisations ‘2 fruits’ per day recommendation.

    I’m convinced that 2 pieces of fruit A DAY is too little. I understand that fruits can be high in fructose (fruit sugar), however with all its benefits (rich in vitamins and minerals, antioxidants (anti-cancer), fibre (cholesterol lowering), etc, etc), should we not be eating more fruit?

    4-6 pieces of fresh fruit per day as healthy in-between meal snacks with daily exercise (min 1 hr per day) sounds like a much sounder recommendation to me.??

    Rick 🙂

  16. Rick, obviously you are new to this site. I would not espouse 4-6 servings of fruit a day nor 1 hr. minimum exercise. Sorry, I can’t help 🙂

  17. Awesome article. Thank you for helping people (like me!) understand.

  18. This post ought to be on the front page of the ADA and Diabetes UK sites (well except for the bit about Type 2 progressing to Type 1) replacing the anodyne crap about how we brought it upon ourselves.

    Some “thin” people have very little muscle mass. Muscles that are not used (atrophied) lose their sensitivity to insulin and become resistant, which leads to type 2. Typically these people are “skinny fat” meaning they look thin, but their percentage of body fat is higher than it looks. The fact that they don’t store as much excess toxic sugar in their fat cells can put them often at greater risk for damage done directly by excess sugar in the bloodstream

    ZING!!!

    That pretty much explains what happens in my family, “metabolic obesity”, the more overweight people tend to have lower BG and better lipids and BP presumably because they have the fat cells to store the excess glucose and lipids, which in us skinny ones stay rattling around in the bloodstream causing harm.

    Even high levels of exercise don’t help as much as they might in other individuals, the secret is in not eating toxic levels of carbs. We are genetic throwbacks designed to survive famines but feasts kill us.

    And in this context the dietician-approved Heart Healthy High Carb Low Fat diet is the worst kind of feast.

  19. …Not only is it nearly impossible to accurately gauge your exact meal-to-meal calorie and macronutrient requirements, doing so will drive you crazy…

    Thank you so much! I try to ‘zone’ but it makes me nuts. Now I know why.

  20. I’m sorry but it’s dietary fat that gets converted to body fat not carbohydrates.

    Dozen of studies has shown that de novo glucogenesis (conversion of carbs to fats) simply doesn’t occur to any significant extent in humans.

    A study even fed the subjected 400 grams of carbohydrates daily and no glucogenesi (carbs to fats conversion occurred) it was the dietary fat to be stored as body fat.

    De Novo Glucogenesis might be an efficient pathway in other animals but not in humans.

    1. Hi Daniel.

      I’m sorry, but first could you clarify/confirm the term you’re using.

      I’m not sure if you meant to say Glycogenesis (with a ‘y’) or Glucogenesis. Both of which are real terms, but neither of which mean what you say they do.

      Glycogenesis is the conversion of glucose into glycogen (not fat). Glucogenesis is the reverse: the formation of glucose via the breakdown of glycogen.

      Lipogenesis is the conversion of glucose into fatty acid (and then subsequently into triglycerides). And it is a key component of lipid metabolism.

      I’m not a doctor nor a nutritionist, but I’ve never ever heard anybody suggest that Lipogenesis doesn’t even occur in humans. The body couldn’t store energy effectively without it.

      1. Thanks for correcting me, I meant De Novo Lipogenesis. Lipogenesis is the convertion of fat to body fat (a very easy process for the body) De Novo Lipogenesis is the convertion of carbs to fats (a very unefficient process in humans)

        The body could store energy efficiently without lipogensis, since it is exceptially good at storing dietary fat.
        If your diet were lacking in dietary fat then indeed de novo lipogenesis would increase to the point that a good amount of sugar could be converted to body fat.

        But take a diet which is both high in fat and both high in carbs/sugar and the first thing to be converted into body fat is fat.

        Take a diet which is low in carbs/sugar and high in fat and still a good amount of that dietary fat will converted to body fat.

        The idea that the huamn body turns sugar into fat before storing dietary fats has body fat is one used by many nutritional gurus but it’s not true nor proved.

        The confusion is caused by looking at animal studies. While de novo lipogenesis is important in animals its contribution to fat deposition in humans is relatively unimportant

        There was a study in 1988 in which they fed a group of subjects 500 grams of carb and measured the convertion of sugars to fat. The researchers found out it was insignifanct and basically not occurring, the only thing being turned to body fat was dietary fat.

        Check this study:

        Am J Clin Nutr 2001 Dec;74(6):707-8

        1. Daniel, you are misinterpreting this information and the discussion at hand.

          First, nobody (that I see) is saying that “the huamn body turns sugar into fat before storing dietary fats as body fat.” At all. What is being said is that *excess* glucose will be turned to fat. And that’s a very important distinction that I’ll get to in a moment.

          Second, just to clarify, Lipogenesis is not the conversion of fat to fat. It is the synthesis of fat from acetyl CoA (a molecule which even glucose becomes on the way to being metabolized). Now, during the breakdown of fat for energy it is converted to acetyl CoA. At that point I suppose it could reverse course, and via lipogenesis become fat again (I’m not a doctor, so I don’t know for sure). “De Novo” is a prefix that indicates “anew”. So all that is saying is that it’s a new source—glucose.

          The study you cited and others I looked up do NOT support at all what you’re saying. In fact it seems to support this page’s content. You’re mixing up the significance of fat vs glucose in human digestion. Glucose is the body’s preferred fuel source. It’s what the body first uses from the food you eat each day. Fat on the other hand, is not and is almost always stored. And as your studies have shown, de novo lipogenesis (DNL) does not occur so longs as *carb energy intake remains less than total energy expenditure*.

          In fact the study you mentioned dealt with that very idea. It used two groups: one group was energy neutral (expended as much as they ate) and the other overate by 50%. And guess what? Those nice fit people who overate by 50% had a 2-3 time increase in DNL. But that wasn’t even the focus of the study. The focus was on Obese vs Lean and how that affects the rate. And it does. Obese people who weren’t overeating still had a higher rate of DNL. Perhaps due to resistant cells like Mark is talking about in his guide?

          The point of a lot of these studies, it seems, is to clarify the energy economy in our bodies. They show that fat and carbs are not interchangeable energy sources and they have certain roles. But they also bring to light a very important fact. The body has a pathway by which to turn carbs into fat. But it does *not* have the reverse. No fat to carb pathway.

          I find it rather interesting that the body has evolved to not allow for the creation of excess glucose in the system. Perhaps the body knows it’s detrimental to your health?

  21. Daniel –

    Your comment reminds me of a section in Good Calories Bad Calories that didn’t quite make sense (I’m not a scientist). Can you please provide a reference to the study involving the 400 grams of carb stuffing?

    And Mark:
    I’m new to your site and just want to congratulate you on a terrific achievement – I’ll certainly be back for more!

    Regards,
    D

  22. Hi there,

    I’ve been fighting a weight problem for the last three years, that I’m convinced was caused by an anti-depressant. No amount of exercise and healthy eating made any difference, although I did stop gaining weight when I came of the meds.

    As I’m also a woman in my mid forties, it certainly doesn’t help. Recently my menopause doc suggested I may be insulin resistant (My mum is type 2 diabetic) and I’ve been looking into insulin resistance more. That led me to looking into the part carbs play on this and I was trying to find out more about the amount of carbs I should be eating when I came across your site.

    This site is so informative I wanted to leave you a message to say thank you for providing such clear information, in real terms, not medical jargon.

    Lorrii

  23. I’m bewildered. I eat an extremely low protein diet, yet my glucose numbers are always around 98-101. Any thoughts?

    Thanks in advance!

  24. I’m bewildered. I eat an extremely low carb, high protein diet and my glucose numbers are always around 98-101. MY A1C is 5.6. I jog at least 1 hr. 6-7 days a week. Any thoughts?

    Many thanks in advance!

  25. 1. By “glucose numbers” do you mean fasting?
    2. Why are you jogging so much? Not a part of the primal thing. Start doing high intensity intermittent. Better results with much less time.
    3. Do you “lift heavy things occasionally”? If not, start. This is very important if you’re trying to burn sugar, especially those large muscle groups.
    I used to have blood sugar problems too. Totally solved with primal. You can do it!

  26. Yes, I learned today that my last fasting glucose was 101. Last year, it was 88. In the past, always around 98. What disturbs me is that it’s creeping up. My insulin level is well below 10…something like 4.5.

    I’m jogging so much to try and get an extra 10 pounds off that crept up after I began taking Synthroid for an underactive thyroid two years ago. I used to take Armour.

    I do moderate weight lifting (8 lb. free weights, 2 or 3 times a week for approx. 10 minutes. I just happened upon this site and am not familiar with “the primal thing.” Will start reading more.

    Right now, I’m just upset to learn that my glucose level is up to 101. It’s discouraging with all I do to optimize my health. Your support means a lot. Many thanks!

    1. I have the same problem. Ive only been primal for about 4 months and my blood work came back with fasting glucose at 109. Last Nov it was 87. I eat around 40g carbs a day and exercise (sprint, lift heavy things, walk) every day for around 30 min. I eat no dairy, no grains of any kinds, no sugars, high proteins and fats and minimal veggies/fruits and only drink water. My Doc told me to start “eating a healthy diet, exercising daily, and losing weight.”. I have been primal for 4 months and haven’t lost any weight. And even my blood pressure is high 0_0 How much more “healthy” in my eating can I get? And same for exercising? So frustrated!!

      1. Probably not good timing in my answer, but I see nobody is mentioning this: for the really insulin resistant people out there, it seems that you need to also restrict protein to a moderate amount. Part of the excess protein is converted to sugar by the liver. Look into “ketogenic diet” and the explanation behind it all.

  27. i think the author should focus on writing articles about running marathons instead, as this seems to be the area of his expertise…

    being a pre-med candiate with a degree in Biology is hardly enough credentials to postulate (without providing any proof) on the inner mechanics of Diabetes.

    1. @Erhan: an appeal to authority is not a good argument. As for proof, one can never prove a hypothesis, only disprove it. Anyway, Mark is not a lone voice in this, the web is full of papers and studies by scientists who make a convincing case, and as Mark’s work shows, the anecdotal evidence is increasing, and becoming too big to ignore.

    2. I think the author (Erhan) should focus on writing comments about children’s fantasy books on the Medical Health Industry instead, as this seems to be the area of his expertise…

      I am a Type 2 now insulin dependant precisely because I didn’t have Mark’s info available to me. Instead I worked with Top Endos in Los Angeles, followed the ADAs dietary recommendations and nearly died twice with blood sugars over 800 and 700.

      Erhan, put up your own blog and become part of the solution not part of the problem.

    3. I hear you loudly and clearly Erhan:
      It simply amazes me that there is such vehement hatred of and vilanization of carbs. Being inactive is criminal not carbs. I have had type1 diabetes for over 29 yrs. I eat at least 500g carb/day and fight to maintain 139lbs with extremely low body fat. My blood sugars are superb and my insulin doses quite low. My secret is tremendous daily activity. We evolved to be extremely active not to hide from HEALTHY carbs as if they were monsters.

      It really is scary that people today are so greatly afraid of being very active that they point at whole grains and lots of fruits daily as poison. The poison is your lack of MOVEMENT. Wow… laziness…

    4. As the author of the beauty book soon to be released on Kindle about yeast and aging, I feel that yeast, candida, is hidden in the mix;either in its yeast form or its fungal form ,most of us are destined to be yeastie beasties and we do not even know it.

  28. “If you eat more fuel than your body needs … the body is forced to store this excess.”

    In GCBC (p.300) Taubes argues against this supposition: “Just as we decrease energy expenditure in response to caloric surplus, we will also increase expenditure in response to caloric surplus.” (He also does a good job busting the “thrifty gene” hypothesis, and the “feast or famine” idea.)

    This makes sense to me, as it demonstrates that the body regulates fat deposition; it is not forced to store the extra calories, there is the option of burning them (or even excreting them).

    The real question is why the normal up-regulation of energy does not occur in obese people.

  29. I cant belive there exist people like you who care about our health and give us informations for FREe.

    Long life Mark, you are really special man.

  30. This is great. After my mom and two brothers were diagnosed with Type 2 diabetes, I cut out most grains. I soon lost the 10 pounds I’d been struggling with for about 10 years. I finally feel like I’m the weight I should be. I can’t believe I fed my kids so many carbs as they were growing up. Gov’t said to. Shame on them

    1. Well Anne, usually it pays to always (let me stress this ALWAYS) double-check anything the government tells you. Their interests are usually not congruent with ours (the regular folks).

      You are responsible for yourself and your family. Not the government. Regardless of what the leftist establishment tries to tell you.

      As an individual with free will it is up to you to proofread anything that’s presented to you. (This post of mine included).

      I’d like to think that most folks on this website are here because they like to think for themselves. They like to question and evaluate issues instead of just blindly following someones directives. Especially when it’s from any governmental body.

      So I’d like to applaud you for cleaning the cob webs off of your critical thinking skills! 🙂

      No offense was meant in typing this post. Mea culpa if I cam across a little too strong…

  31. Question: Is there a way to reverse/or to halt the progression to Type II diabetes before you get there? If you’re at pre, initial or type I, can dietary changes help?

    If you’re already at Type II diabetes can dietery changes help?

    1. The answer is yes! Change your food and change your epigenetis. Epigenetics is the music your genes play. They either play the music for diabetes or health. What you eat controls the music. Bring your carbs down below 50 grams per day or less, up the beneficial fats, coconut oil, ghee, butter, Sat fats, olive oil, mono fats. Keep your protein adequate…divide your LEAN mass (you without fat) in half. If you are 100 lbs LEAN…then eat 50 grams of protein. Veggies, Beneficial Fats (lots) and some protein. You will reverse the damage by having healthy normal adult blood sugars, fasting 83 and after meals never over 130. That gives you normal insulin, leptin and better than normal health. Go get your health…it is waiting for you.

      1. Hi, does anyone know if neropathy can be reversed..My feet have been burning terrible and they put my on Nerotin..I don’t like taking any meds..does anyone know of any natural remedies?…I do control my type 2 diabetes with diet…no meds…very low carbs..Thanks

        1. I have been diabetic type 2 (insulin dependent for 5 years) and for several months I had increasing numbness/burning in my feet and toes and twitchy/ sometimes sharp little stabs of pain in my lower legs. and I felt like I had to stretch my feet a lot. ( especially in bed- kept me from sleeping.) I read about horse chestnut extract for edema lower extremeties and butchers broom for circulation. I can’t speak for anyone else but my foot /ankle edema is gone and I have had no pain/twitching in my lower legs for a few weeks now. no numbness in toes. my doctor was thrilled.
          maybe that will help you.
          my doctor was very pleased with those results and 12 lb weight loss since 1st of june. and I gave her a copy of primal blueprint and she said she would read it 🙂 she is a md- internal medicine.
          good luck to you

        2. Thank you Carol!! This burning has been horrible..have not been able to sleep.I am going to try these..thanks again!!

        3. According to Dr, Bernstein, neuropathy can be reversed, but it can take years with normal blood glucose. By normal he means an A1c between 4.2 and 4.6 with a tight average blood glucose of 85 mg/dl.

          Dr Bernstein is now 80 years old and has been living with type I since 1946. In the 70’s he had so many complications that he was not expected to live much longer. That is when he got access to a meter and started ‘eating to his meter’. His book is Diabetes Solutions.

          I was diagnosed last December and am close to meeting his requirements for normal blood glucose. Most of the symptoms that I had at diagnosis, including mild neuropathy (phantom itching on my feet), have either gone or are going.

  32. Question:

    The article was very informative, and sounds like very sound information. My question is that whenever I decrease my sugars too low, my bloodsugar goes up! I theorize that my Liver is somehow sensing that it’s not receiving no sugars, and pumps it into my bloodstream!

    Or if I exercise without eating enough carbs before, my sugars GOES UP!!! That’s even if my sugars are high before I start. Can anyone help with this delima????

    1. Yes. You are burning sugar for fuel and not ketones. Thru metabolic momentum, you body wants to do what it has done. Up the beneficial fat, Ghee, coconut oil, grass fed butter, monos and Sat fats, cold water fatty fish, bring your carbs below 50 to kick you into ketosis. Now your body prefers to burn ketones (fats) instead of sugar. This will also calm your brain and moods down so you reduce the adrenaline output. Less chance to punch your liver into releasing stored sugars.

  33. I thank the internet Gods for directing me to Mark’s website, especially this article. My fasting glucose is 97 and very alarmed with it. I’m trying to get pregnant but with no success for more than a year now and my ob-gyn said, it could be because of insulin resistance.

    I’m physically active, working out 45mins, 6 days/week and have totally cut out wheat/gluten, sugar, caffeine, processed food in my diet since Jan 2009. We have the diabetic genetic factor, however. I’m going for Primal living because all I’ve read here makes a lot of sense.

  34. Dearest Mark,

    I really need your help. My mom is type 2 diabetic. She does not take care of herself! She gets sicker each day as well has a very hard time walking because her feet are so bad. Here is the problem, she drinks coffee all day long with 4 sugar in each cup. She is always eating something with chocolate. I have told her a thousand times it is killing her but i always get ” Stop harping on me. who is the mom here” she does not listen to me about how serious her surgar intake can be on her body. Please I need you to tell her in terms she can understand because she does not understand docters terms how serious her diet is. I almost need someone to scare the heck out of her to make her understand!! I love my mom with all my heart and soul and it is killing me to see her so sick when there is something she can do about it!!! Please help!!!!!!!!!!!!

  35. Cheryl, I’m sorry, but there’s not much I can do from where I sit. Health is about personal responsibility, and until your mom is willing to learn and make adjustments, all you can really do is lead by example, show her (and tell her) you love her and offer your support when she is ready.

  36. i still cant understand the sugar readings everybody seems to talk 90 to 100 my accu check readind says 6.9 or 11 . or 15.5 what is correct ???????

    1. Bernard, to convert blood sugar from mmol/l to mg/dl multiply by 18.

      My girlfriend is diabetic and I’ve taken a some readings using her meter. I am trying to follow a low carb diet but my fasting blood sugar is around 115 but this drops to around 85 1 hour after a low carb breakfast.

      Should I be worried ? Has anyone got any ideas on reducing my fasting blood sugar? Incidentally my triglycerides are also high.

  37. Wow, thank you thank you thank you for the most concise, readable, and comprehensible guide to how the whole carb/insulin thing works. It’s worth passing on to the universe.

  38. All of you people with diabetes should check out knowthecause.com I got rid of my diabetes by taking anti-fungals and staying on Doug’s diet.

  39. Men with type II diabetes would do well-in addition to diet change, of course!- to verify that their testosterone levels are at or near optimal ranges-not normal, optimal. If you just google ‘low testosterone diabetes’, you’ll find all manner of articles-from LEF.org, to CBS. Well-publicized link.

    Another thing to look at is cancer markers. I lost my father to cancer three years ago; He was a normal, healthy man (albeit with undiagnosed AI and celiac)with normal testosterone levels…yet by the time he was actually diagnosed with cancer, it was stage IV. Had they done a full cancer marker workup with the tests that are currently available when he was diagnosed with ‘idiopathic NIDDM’ (current meaning 2006) he might still be alive. Cancer cells have as many as 40 times the insulin receptors as normal cells, and can cause type II diabetes through that mechanism. It isn’t quite type II, but as there is no other ‘type’, that’s what it’s referred to. Dad was very active, not overweight, well-muscled, and ate a good-by these standards, even-diet. Obviously, his immune system wasn’t up to snuff, but on the outside, he wasn’t a diabetic type.

    You’ll probably have to really push for it, but the alternative is much worse.

  40. All of this makes sense and sure does reveal a lot of truths about the diabetes problem. I was searching the internet on insulin resistance, though, and found some sites claiming that fat leads to insulin resistance. This is obviously contradictory to what you have said, and I was wondering if you could shed some light on this.

    Once site says that “Obese people have been found to harbor proteins called branched-chain amino acids (BCAAs) at far higher levels than non-obese people. The suspicion has been that these amino acids, in combination with a high-fat diet, contribute to insulin resistance . . . Because obese humans tend to ingest high-fat diets, the combination of high-BCAA and high-fat intake might contribute to insulin resistance in obese humans, but additional studies are needed. BCAAs constitute as much as 25 percent of amino acids in dietary protein, and are particularly enriched in diets high in animal (meat) proteins. . . Rats on a high-fat diet gained substantially more weight than rats that ate BCAAs with high-fat chow or those that ate standard chow. However, the rats eating the high-fat diet with BCAA became as insulin resistant as rats fed a high-fat only diet, even though they weren’t eating as much. . . Studies showed clear insulin resistance in the high-fat and high-fat with BCAA groups, but not in the rats eating less of the high fat chow or those eating standard chow. This proved that moderate fat intake was not a cause of insulin resistance.”

    Here is the link for the full article: http://www.emaxhealth.com/2/23/30380/too-much-protein-fat-lead-insulin-resistance.html

    I know the study was done on rats, lol, but I just wanted to make sure that eating fat doesn’t make you fat, or become insulin resistant. I totally agree with the excess amount of carbs doing just that, but can fat do that too? Sorry for the long post, and thank-you for your time and all of your great articles.

    1. umm…. I’m no expert here, but did that abstract just say that they fed rats animal fats/high-fat diets? Hmmm… could the reason why they had problems be because rats don’t normally eat that much fat in their native diets? Maybe those rats need to get on a Primal Blueprint plan too!

      Besides, just read the “Success Stories” on this site – many stories come from T2 diabetics who now have healthy blood glucose levels.

      It just doesn’t make sense for a diabetic to use sugars (grains, carbs) as a primary source of fuel when we’ve spent hundreds of thousands, even millions of years evolving on fat-based diets that primarily burned ketones for fuel… If aliens invaded and put us in petting zoos they’d feed us mostly veggies and nuts/fish/meat, our natural diet – NOT grains or processed sugar, in the same way you don’t feed bananas to a cow, even if those bananas might cost less and offer a higher profit margin than what they normally eat…

    2. Great comment, great question.

      First, we are not rats. The best a rat study can do is to turn our heads in a direction of study that looks interesting. Rats do not eat a high fat diet. They have not evolved on it. We are not rats. Secondly, the obese and high fat diet humans get that way because they eat a high fat high carb diet. It is the carb that forces the body to store excess fat and sugar. It is the worst diet. Everything in context…correlation is not causation with everything, including fat.

      http://drrosedale.com/blog/tag/insulin-resistance/#axzz2bdeQp8NS

      To understand more about fat and insulin resistance read…

      http://high-fat-nutrition.blogspot.in/2009/09/physiological-insulin-resistance-and.html

      “Everything must be looked at theu the lens of burning fat efficiently, not sugar. “Your health and longevity is detyermined by 1 equation :The more fat you burn inb your lifetime the healthier you will be…the more sugar you burn in your lifetime, the less healthy you will be.”

      Burn fat not store it. You do that by eating fat and very low carb, under 50 grams per day. That is the starting place of health.

  41. One thing that is being overlooked here is insulin’s role in the anabolic process. Insulin’s role goes much further than just aiding in the muscles’ uptake of glucose. Of all the hormones, except testosterone, insulin is the most anabolic. So while it does have a role in fat deposition in the adipose tissue as well as glucose uptake, it is very important in post exercise muscle building. After a workout, your body is in a catabolic state. The main factor at work here is FoxO. In a catabolic state, FoxO is transported into the nuclease where it activates the formation of catabolic factors such as Murf that will break down muscle. While most of the research into this pathway has dealt with muscle wasting in patients with certain disease states, its role in post exercise muscle breakdown is just now being realized. At the same time however, there are anabolic factors working to increase muscle deposition and repair damaged muscle tissue. But, these gains in muscle deposition are negated by the breakdown. Insulin leads to the activation of a kinase called Akt. Akt then adds an inorganic phosphate to FoxO, barring it from entering the nucleus, thus negating its catabolic actions. There is a classic study looking at the effects of a post exercise insulin spike. In subjects who worked out and did not receive an insulin shot, the levels of muscle deposition and breakdown were basically the same, leading to net gain in muscle. In the subjects who did receive an insulin shot post workout, the muscle deposition was the same as the no shot group, but the muscle breakdown was much much lower, leading to an overall positive net gain.

    While I do agree that type II diabetes is a terrible disease that can be reversed non medically by lifestyle change, and that insulin spikes throughout the day are indeed bad, I feel it is unwise and unfair to demonize insulin the way you have. If anything, eating a decent amount of simple sugars immediately post exercise, the resulting insulin spike is extremely beneficial (and not only for muscle gain but as well as increasing glycogen storage, but that is another story).

    Again, I must emphasize that I have been a frequent visitor to this site for well over a year (a practitioner of the teachings for only a short time) and I agree with 95% of the information given, I do believe that insulin, while potentially bad, is very much necessary to achieve full fitness potential.

    And if anyone wants to inquire about my credentials, I am currently a grad student in exercise physiology where my thesis work deals with, you guessed it, post exercise supplementation and FoxO/muscle damage response.

    1. It all depends on what your goal is. If you want to add muscle and improve athletic performance at the expense of longevity…then increase insulin and sugars. If you want a healthy, long, post reproductive life…then decrease insulin, leptin and sugars. We Diabetics want to get healthy first and foremost, not improve our athletic performance. When I was diagnosed, after 30 years as a Personal Trainer, all I wanted was the pain and impending death to go away. After normalizing my sugar, insulin and leptin, as a Type 1, the desire to work out and get stronger came back. It is a mental balancing act as well as physical.

  42. Hey Mark,

    Awesome post! I was wondering, since you say fat doesn’t get stored as fat, but sugar does (which I totally agree with), what does excess fat, and protein for that matter, get stored as? I know it’s not too important to focus on calorie counting, but let’s say you consume an excess amount of fat and/or protein…. what does it get stored as? Thank you 🙂

    1. I am also curious about the same thing….so much talk about the carbs and sugars, but not on the fat and proteins. What happens to them in this process? Thank you to all for all of this wonderful information!

  43. I found this site after looking for info on making pemmican,anyhow some good info kind mirroring all this is diabetes 101,an older gent wrote much about diabetes and the caveman diet.Think of what god would make,no twinkie trees or pizza plants!

  44. I think you can argue that its even more of an epidemic that more people don’t know that eating a raw food diet can completely reverse most diseases since they aid in repairing the bodies function and expel the toxins of our lifestyle which cause the micro-inflammation.

    Has anyone read “The China Study” by T Colin Campbell? I think his findings deserve national coverage.

    1. I have read “The China Study”, however the conclusions Campbell published in his book were not really supported by the actual scientific data of his research. He basically sifted through the mountain of data searching for anything that could be construed to support his pet hypothesis, and ignored the rest of the data; including data that directly contradicts his published conclusions.
      For detailed critiques check these links: http://rawfoodsos.com/the-china-study/
      http://www.westonaprice.org/blogs/cmasterjohn/2010/09/22/the-curious-case-of-campbells-rats-does-protein-deficiency-prevent-cancer/

  45. I tried giving this to my parents because I think this is an EXCELLENT analysis of how this process works, in plain English – here is what happened.

    The phrase should read “Big Agra really couldn’t care less about you.” Right now it reads, “Big Agra could really care less about you.” – if they could care less, they would.

    The first things out of their mouths were along the lines of, “how can we trust someone who doesn’t get his grammar right?” I know it’s really off topic, but just wanted to put that out there.

    1. Their loss, I guess. (And I know that wasn’t a complete sentence)

      http://dictionary1.classic.reference.com/help/faq/language/g09.html

      “…There are other American English expressions that have a similar sarcastic inversion of an apparent sense, such as Tell me about it!, which usually means ‘Don’t tell me about it, because I know all about it already’. The Yiddish I should be so lucky!, in which the real sense is often ‘I have no hope of being so lucky’, has a similar stress pattern with the same sarcastic inversion of meaning as does I could care less.”

      1. Hi Mark,
        As a “grammar nazi” I just wanted to chime in to support your use of the phrase “could care less.” While literally it does seem more logical to say “could not care less,” your wording is indeed an accepted colloquialism…In any event, thanks for all you do, and I for one have been very impressed with your grammar and syntax!

        1. I know I come very late to this discussion. I can’t help but add my 10 cents-worth anyway. The remark makes sense if you read it with an unspoken caveat:

          “I could care less (but not much, so do go on, tell me your troubles. Soon I will care not at all.)”

          And thank you, Mark. Just found your site and loving the good sense it all makes.

      2. I want to add that my parents are now true converts, and dad is off of statins. Thanks for that link – I showed them that and they laughed and think you are clever. Thanks for all that you do!

    2. I’m an Aussie and we certainly say we “couldn’t care less” but I read a lot of books, and it appears that Americans say they “could care less”. Just like they say “look it” whereas in Australia we might say, “Look”. Anyway it seems a little silly to denounce something that is obviously written to not only inform but entertain. I wish more non-fiction used a bit of humour or conversational language to promote the message. It may make things easier to learn.

  46. My niece linked your article on facebook quoting “paste it on your frig…send it to your aunt…” Since I am her aunt, I thought I should check it out. (But she has another aunt, my sister, who is a brittle diabetic, and she has a brother and a sister and a cousin who are also Type I diabetics!) Anyway, I thought I should check the article out. Excellent. I was just reading a book about how we need less carbohydrates so your article lined right up with that. Thanks, Amy

  47. I am a stumbler having stumbled across this Malibu cave site and now can’t even remember how or why. This odd interweb thing eh? I stopped watching TV and movies about 3 years ago when I realized it was all propaganda aimed at dumbing down the people. Prepping us for the great fall of the Republic is hard work as they love to say in their mighty halls. So it goes.
    I have struggled with being overweight, nay… FAT all my life. I would swing up and down in weight regardless of what I ate or how I lived. When I lived a frugal, simple life chopping wood, using wood stoves and walking with a big dog I felt good despite carrying a bit more weight. Last summer I spent my time clearing tons of dead shrubs, rose bushes and vines at this Addams family house I was renting n the Valley and draining, repairing and maintaining a pool that resembled a swamp when I began. I grilled steaks nearly everyday and lost a good 30 pounds and felt great. When I have a girlfriend I tend to lose the weight as well for obvious reasons, less eating and more sex. In between girlfriends or when I am busy with my car service here in LA I tend to put it all back on despite eating what I have been told are good things like fiber, vegetables and fruit. Usually they go bad before I can even get to eating them. Then I end up eating pasta, crackers or grain bread because I am told that is good. Now the weight is back on although for some reason my body doesn’t turn into those soft rolls of lard you see on the average obese Amerikan. Mine seems to go into solid masses probably due to my caveman past where I pretended to be living off the land cutting the aforementioned wood and exploring the wild parts of the midwest Ohio territories.
    I have come to the conclusion everything we are being told is simply more propaganda from the very corporate scumbags you describe like big agribiz, the chemical/pharma swine and the aristocracy who now seem intent on depopulating the planet for some insane reason. Long story short I want to lose this weight once and for all but find myself procrastinating for one reason or another. I go to the grocery and end up buying whatever is cheap and have to make a supreme effort to NOT pick up cheese and salami when my brain craves it. I am living on the other side of the Santa Monica Mountains from you and should go walking right up Mulholland to the Federal lands above me [a huge wilderness area of roads that NOBODY ever uses there] but again find myself hesitating because if my phone rings I have to zoom off to take some traveler to LAX or I don’t pay the rent. There always seems to be some mental block I create for myself that I just can’t get around. Even after reading your information I still have trouble digesting it although it speaks to me on a very primitive level as being the absolute truth, especially the hunter-gatherer aspect of eating and simple day to day physical effort. Last summer swimming in the pool and groundskeeping, eating steak and the occasional veggie proved that to me. I felt great but slid back when I moved back into the city from that place in the Valley. Now being out in the mountains I should be more active but its the nature [or anti-nature I should say] of the biz I am in that keeps me from going off every other day to commune with the coyotes up the road. I know I need another active girlfriend to inspire me as well as someone like Grok to remind me I am still the same big, hairy guy I was at 19. Just now I am turning 54 and shouldn’t be the lazy, big, hairy guy I tend to turn back into. Give me a boost here. That’s usually all I need, a challenge of sorts. How about this. You book my struggling car service occasionally over there in Malibu and keep me out of the poorhouse and I will document my attempt to follow your advice and get back to the Grok that I know is still within me.
    I realize I missed the big cow giveaway having just stumbled into your cave here. I await the next challenge.

  48. I have everything you cited regarding Type 2 Diabetes, with the neuropathy, retinopathy and hypothyroidism. I find doctors only write many prescriptions, buit say nothing about nutrition or supplements.
    My pancreas was badly damaged with acute pancreatitus in 1995 and the outer portion was largely removed with an enveloping cyst in early 1996. That was the beginning of my diabetic journey. I have a “fatty liver” and also lost my gall bladder and other bits of plumbing along with the partial pancreotomy. Nephrology is present also.
    I am managing my diet about as well as I can. Any suggestions?

    1. Please buy Dr. Richard Bernstein’s book, The Diabetes Solution. Dr. Bernstein actually reversed the diabetic nephropathy (as well as many other complications) he had by getting his A1c down to 4.5. Do whatever it takes to get your A1C down to 4.5-5.0.

      1. I second Kathleen. Buy Dr. Bernstein’s book and buy his CDs on Type 1 or Type 2. Listen to them till you have them memorized and you will know more than your Endo about diabetes. He not only reversed his nueropathy but he was going into end stage kidney failure. HE is 76, Type 1 since childhood, started normalizing blood glucose at age 39, and to this day is still seeing reversals of complications he never thought would go away. Then read Dr. Ron Rosedale’s book for an explanation of the dangers of excess insulin. Keep reading Mark for the best, simplified understanding of these and all related problems.

  49. I have a family history of Diabetes.
    Four years ago, I had a FBG of 118.
    A1C of 6.
    The doctor tells me not to worry.
    Huh ? WTF ? Is he kidding me ?
    I saw what they did or didn’t do for my dad.
    I’ve been exercising 3x+ a week since.
    And have also watched my diet.
    Vit D — at about a 60 level.
    Doing BHRT also.
    About three months now I’m 90% primal.
    My FBG this morning was 75.
    No thanks to the Medical Community btw.
    It’s sad that they’re so “preventitively” negligent.

  50. Also, eating a high protein meal after exercise has shown to increase insulin sensitivity in your body.

  51. Can anybody tell me about how long it takes to normalize fasting blood glucose after adopting a very-low-carb primal diet? I know that it will take 3 months to see an improvement in HbA1C (due to the lifespan of the red blood cells), but how quickly can fasting blood glucose get down to normal levels? Thanks in advance for any input.

  52. Thank you. A very informative article. But do you have to add the snarky comments such as..”Woo hoo”, “Fun” and, “Congratulations, you have graduated from Type 2 to Type 1 diabetes.”? Some of us are in pain and want to do the right thing for ourselves. We are already scared enough and a little compassion along with your knowledge would be greatly appreciated. Really though, I do appreciate your site, just not the attitude.

  53. I am so grateful that I found Mark’s website. I knew my way around the insulin and glucose discussion, but this took it to a whole new level. I have PCOS and am insulin resistant and am trying to live a healthier life and conquer insulin resistance. I’m definitely bookmarking this as a reminder to exercise even on days that I don’t feel like it! I may even print it out and stick it on my fridge.

  54. Hi Mark,
    this is all very good stuff here. Thank you.
    I was wondering if you are familiar with Dr. Mercola’s website and the 3 Nutritional Types? #1 carb type, #2 protein type and #3 the mixed type. You seem to be suggesting that we are all protein types. I took the free test and found out that I am and hence can relate to your diet. But I can also imagine that other people from southern lattitudes are more of a primordial vegan, if you will. Have you ever considered such a thing?

  55. Hi Mark,

    I am a type 2 and have been controlling it with diet and excercise alone since i was diagnosed in 2008 with an a1c of 9.7. It is now 6.9, but there is still room for improvement. I’ve been eating about 180 g of carbs a day on average and excercising at least 4 days a week, big on recovery days, etc. My question is how can i get my fasting blood sugar down? Nutritionist recommended apple with peanut before bed. Something to do with protein and carb working together throughout the night, but i didn’t understand it.

    Can you go into how protein w/carb work differently than alone in your system in a way that I and others can understand?

    and, thankyou! I’ve started the “no grains” way just yesterday to see if it will help me get my weight down even more since I seem to be stuck at the same weight for over a year now even with excercise and diet.

    Susie

    1. Susie, an apple is sugar and peanut butter is high in sugar. It is not a true nut but a legume. You should not be eating sugar or things that turn to sugar. Eat high fat/moderate protein/low carb. How low carb? Depends on how low you need to go to normalise blood glucose. Normal fasting…round 83. Keep it under 130 after a meal (1 hour). If it is over that, you ate too many carbs. Keep reading MDA and lets get you healthier than you have ever been in your life. You deserve “NORMAL” blood sugar.

  56. I have been diagnosed with T2 and working hard to exercise and change my diet thank you for explaining as doctors seem to put u on metforrin hate the thought .have only started 3 weeks ago on low carb and
    thanks so much

  57. CORRECTION:
    Being on insulin does not make you a Type 1 diabetic. T1s do not make insulin, or make very tiny amounts of it.

    I am a T2 on insulin. I still make insulin (verified by labwork), I just don’t make the huge amounts required to overcome insulin resistance after over 20 years as a diabetic.

    You CAN be both a T1 and a T2 – but just requiring insulin shots does not make you a T1.

    QUESTION: You said, “When your liver becomes insulin resistant, it can’t convert thyroid hormone T4 into the T3, so you get those mysterious and stubborn “thyroid problems”, which further slow your metabolism.”

    References? I found some a while back showing that all diabetics, both T1 and T2, seem to have elevated reverse T3 on diagnosis. But nothing about liver involvement per se…

  58. So I guess all those Chinese, Indians, and Asians are going to die off since they eat so much rice?

    1. Yes…India is now number 1 in Diabetes and heart disease and China is number 2. Same villians, wheat, corn, O6, sugar,, fructose, cutting sat fat and coconut for the Indians. Once you are sick…cut out the rice. You can no longer tolerate it. Obesity is exploding here in iIndia and China has an obesity epidemic of 6 months old. Yes…it is happeneing in both places.

  59. Why is it that when Westerners eat grains like rice, they seem to suffer from various diseases, while Asians on the other hand have been eating rice for centuries and have never suffered such problems in similar quantities?

    Is the Asian body more capable of handling carbohydrates than the European one?

    1. Historically, they have eaten low levels of calories, while spending little time sitting, and utilizing their own bodies for transportation.

      However, obesity rates are rising for Asians.In only one generation, many Asians have gone from consuming between 1,500 and 2,000 calories a day to between 2,000 and 3,000 calories. Cars are becoming more common, with fewer people using mass transit, walking, and cycling.

      It’s a pretty simple equation involving caloric input, output, and activity level. I don’t think it has much to do with eating rice. If you burn off the carbs and calories that you ingest, they don’t get stored. And insulin production is affected by energy output (activity).

    2. Westerners eat rice with fried eggs and butter in it along with a huge slab of chicken and maybe a salad with olive oil and a dessert, maybe a coke too. Asians eat rice with some seasoning and a bit of meat or fish for flavor. Thats changing though with beef and western style diet growing. But its not the “rice”.

  60. Hey There!

    I have been reviewing your blog post and absolutely am loving it. Great discussions too. I being Type 1 for close to 30 years see amazing results from adhering to a primal lifestyle. When I am strict, my blood Glucose levels fall to that of a non-diabetics range. I would also suggest to those who are insulin dependent to review Dr Bernsteins Diabetes Solution for insulin adjustment advice. This coupled with your site and book are LIFE CHANGING! I am blogging my progress as well. Thanks again Mark!

  61. Just found this on google randomly searching for blood glucose levels after eating an apple; have to say, an excellent lay-mans definition of diabetes and the best way to get around it.

    Good job.

  62. You said it yourself “eat too many carbs”. The reason you overeat on carbs is you either eat processed carbs (sans the fiber) or you eat carbs in addition to high calories foods like fatty foods (meat). In addition excess fat blocks the insulin receptors. Every cell runs on sugar, even if you “burn fat” you turn it into sugar. And btw the only reason you burn fat is you’re cells are starving for sugar! Simple formula, body (liver, muscles) stores about 2000 calories of glycogen. Now isnt that amazing that happens to be the same amount recommended for sedentary men to eat? Eat more than 2000 than it gets converted to fat. Exercise and you need more than 2000 calories per day based on how much you exercise. Thats it. This detail on carbs and insulin only has to get analyzed because modern society eats so much fat, overeats really. This is always missing from paleos so called analysis. Every study including the only scientific study on diet, concluded none of the bad things happen when you eat mainly carbs as long as fat is 10% of total calories, meaning whole plant foods. As soon as you eat fatty foods, whammo. So I applaude the advice for those who will refuse to eat very low fat, but its not the healthiest nor the fittest advise.

  63. Martinella you sound like a lot of nutritionists I have talked to, but I have tried, very hard, that way( fat>10%, plant based) and my blood sugar still crept up- yet it dropped when I started eating 0 carbs and 0 fruit..would love to read something documented based on what you say, in practice it didn’t work for me..

  64. I LOVE this article. This information is not new to me but reading about it again is very helpful. I have PCOS (polycystic ovarian syndrome) and in addition to the many unsightly symptoms (hair loss, weight gain) is insulin resistance! I am lucky that my weight has never been as bad as other women with PCOS but I was entering the overweight category when a specialist explained the insulin resistance issue to me. I was never a junk food eater and I thought I was being healthy eating according to the food pyramid. I only ate when I was hungry and I exercised. I couldn’t understand why my weight kept going up! After my “realization” I stopped eating refined sugar and starches and only eat whole grain. I also pair my carbs (grains and fruits) with a protein to try to control my blood sugar. I lost 13 pounds without making any other changes, it was amazing. I can’t believe I never realized how unhealthy I really was, I wasn’t hungry because I needed food, I was hungry because all that extra insulin in my system told me to “eat more carbs!”. I feel different, I have more energy, I do not get tired after meals anymore and have’t experienced any hypoglycemia. I am stuck though and still want to lose ten pounds. Reading this has reminded me of some things. I am still eating too many grains, even if they are whole grain, I need to monitor my carb intake more and I need to increase the veggies even more. Thanks for this information, it is a great motivator. Cake is just not worth it!

  65. Mark,

    I’ve just been reading your piece on insulin resistance and diabetes. Quite good indeed and very clear.

    One small error though… You state: “Eventually, the pancreas is so darn exhausted, it can’t produce any more insulin and you wind up having to inject insulin to stay alive. Lots of it, since you are resistant. Congratulations, you have graduated from Type 2 to Type 1 diabetes.”

    This is not exact. Type 1 and type 2 diabetes are two different diseases.
    In type 1 diabetes, because of an auto-immmune reaction (a virus at the wrong place and the wrong time, exposure to cow’s milk [there is a protein in milk that looks nearly identical to a protein in the pancreas] and the immune system develops antibodies against that milk protein. Because of their similarities, the antibodies get confused and attack the pancreas protein as well, destroying it. An hypothesis, but evidence in its favour is that kids that develop type 1 diabetes are heavy milk drinkers.

    You can read this in this article: N Engl J Med. 2010 Nov 11;363(20):1900-8.
    Dietary intervention in infancy and later signs of beta-cell autoimmunity.
    Knip M, et al. Abstract
    BACKGROUND: Early exposure to complex dietary proteins may increase the risk of beta-cell autoimmunity and type 1 diabetes in children with genetic susceptibility. We tested the hypothesis that supplementing breast milk with highly hydrolyzed milk formula would decrease the cumulative incidence of diabetes-associated autoantibodies in such children.

    This other article found on PUB MED can show you this interesting link: “Nestle Nutr Workshop Ser Pediatr Program. 2011;67:187-95. Epub 2011 Feb 16.
    Milk A1 and A2 peptides and diabetes.
    Clemens RA.

    Abstract
    Food-derived peptides, specifically those derived from milk, may adversely affect health by increasing the risk of insulin-dependent diabetes. This position is based on the relationship of type 1 diabetes (T1D) and the consumption of variants A1 and B ?-casein from cow’s milk. It appears that ?-casomorphin-7 (BCM-7) from ?-casein may function as an immunosuppressant and impair tolerance to dietary antigens in the gut immune system, which, in turn, may contribute to the onset of T1D”

    So, having type 2 diabetes (insulin resistance with an EXCESS of insulin) is quite different from having type 1 diabetes (ABSENCE of insulin due to auto-immune destruction of the beta-Langerhans cells of the pancreas).

    The eventual need for insulin in type 2 diabetics is due to increased insulin resistance to the point where blood sugar levels are totally out of control – rather than working at the input (nutrition), we give MORE insulin to the body to force sugar into the cells. But this does not resolve the diet issue… Eventually, due to chronic overstimulation, the pancreas collapses and produces less and less insulin (but never to the point of type 1 diabetes). Because of the North American diet just pumping in more carbohydrates, there is then a need for extra insulin.

    So what you should have said is: “Eventually, the pancreas is so darn exhausted, it can’t produce any more insulin and you wind up having to inject insulin to stay alive. Lots of it, since you are resistant. Congratulations, you have graduated to insulin-dependant Type 2 diabetes.”

    Otherwise, an excellent article, clear and to the point. Cheers for your excellent work!

    1. To correct you , a simple C Peptide test can determine the loss of beta cells to the point of needing insulin. Not because you are resistant to insulin but because you have killed off enough betas by chronically high BS, high insulin, or taking sulphonreas. I happen to be one of those new Type 1.5s or Type 3s…I have been labled both. You can kill off enough betas and slip into insulin dependance because you dont produce enough. Better terms are Insulin Dependant and Non Insulin Dependant. Better umbrella terms.

  66. I got type2 – that’s type 2 – in 1977, when I weighed 150 lbs (5’8″) and had run three miles a day for five years. My research points to at least three types of Type 2. Mine’s all genes. I’m now 315 lbs and insulin-dependent.

    I have been to the best specialists that America can afford and a couple of German geniuses, too. But it may be too late. Why? Because, I followed the instructions of the best dieticians in the business, who have basically told me to eat carbohydrates. They almost killed me.

    It is possible that the turnaround I have experienced by eating lots of lean red meat, fish, chicken, and green vegetables, and doing as much exercise as a 65 year old fat guy can do will keep me going a few more years. But your readers MUST understand, if you haven’t already convinced them; For many people carbohydrate intake, as proffered by the American Diabeties Association, is a death sentence.

    No two people are alike.

    Keep up the good work reminding people that pasta is not the way. And that exercise, a SMALL amount of carbos, and lean protein are.

  67. I love this, like loving the game of basketball. This is a complete i opener.Thanks a lot.

  68. I love this, like loving the game of basketball. This is a complete i opener.Thanks a lot.I will stay close to this site for more

  69. This is the best description i’ve seen yet on type 2 diabetes… I’d like to know the role weak adrenals might play in the onset of type 2 diabetes. The same symptoms I have now with diabetes are the same (but on a smaller scale) as when I was a child. Is it possible to be born with weak adrenals?

  70. Thank you so much for the clarification. I was diagnosed as a type two diabetic and eventually was prescribed two different types of insulin. As it got worse, the insulin doses began to rise. For the world of me, I couldn’t understand why more insulin was the answer to the type two diabetic. My body was not utilizing insulin, why pump more into my body. Second, I exercise, try to eat right and turn into the muchie monster at night. Hence, great legs and a beer belly (no beer drinking involved). Still not clear on what this disease is doing to me. Any input? Thank you!

  71. Great site
    However, you Americans REALLY need to get to grips with the phrase “could care less”.

    It’s “COULDN’T care less”.

    If you COULD care less, then you DO care.
    Get it?

    Back to topic ….

  72. I want to know when insulin inj is resortd to. My wife has recently become type 2 diabetic, with postparadial 300 and fasting around 200. She takes GP 2 and Glvus 50 twice, but when given the3rd dose after lunch, sugar level came to 220. She has dementia and aged 81.

  73. Are there any animated-type videos or visual aides out there which could be used as a teaching aide to help people understand this whole process a little better?

  74. what is the average amount of insulin in body of person with diabetes and what is average amount of insulin in a insulin shot

  75. I have been browsing on-line greater than three hours today, yet I by no means discovered any fascinating article like yours. It’s lovely worth sufficient for me. Personally, if all webmasters and bloggers made just right content material as you probably did, the internet can be much more helpful than ever before.

  76. Im 38. Take four tablets a day. Eat well. My sugar levels are still around the 20 mark when fasting. Im only fifty five kg. so need to put weight on. Hard when I cant eat carbs. Very frustrating. Any help?

  77. I am diabetic taking metformin, diet, exercise to manage my blood sugar, and my parents are also diabetic. Recently my 13 year old daughter diagnosed as Type 2. She lost 4-5 kg weight before the diagnosis. Dr. put her under two type of medication, Gucovance 500/5, Januvia 100, levothyroxin 50 mcg. I think she has insulin resistance. When she was diagnosed 1 month before, her HA1C is 12.4, c-peptide – 2.65, TSH – 7.5, T2 and T3 was normal, and slightly overweight BMI -26. After 1 week medication, she was frequently reaching low sugar and felt very bad during school hours. When we asked our Endocrinologist, he insists continue with the same medication. So we stopped her medication for last 10 day because of her frequent complaint of low blood sugar. After the diagnosis, she completely changed her life style. Now she eats more vegetables, fruits and whole grains, a-zinc mineral tablets and fish oil. Every day she is doing 30 minutes walk after dinner. Now her fasting sugar is OK, and the average is around 110, but her sugar elevated after each food reaching 210 in 2 hrs time, but come down to 140 in 3 hrs time. My question is how long she can continue with this practice? Should she require any additional supplementary? or she requires metformin? I would appreicate your answer to this regard.
    Thanks.

    1. Why on earth is she eating whole grains? Read the article, again.

      Ditch them and she will improve, out of sight. Report back.

      1. Whole grains don’t spike bloodsugars as fast for diabetics… But I got to say it still kicks them up, just doesn’t give us the huge roller coaster bloodsugars that simple carbs like white bread simple sugars give. I haven’t tried this diet yet but I am going to start! I’m so excited to see what it does!

  78. No, actually, I don’t think heart DISEASE rates have been cut. It was my understanding that the heart attack DEATHS have decreased, but that the disease RATES have *increased*. And the only reason deaths have dropped is we’ve got better heroic medicine to treat someone who’s had a heart attack.

    Mind you, some of the increased diagnosis probably has to do with better diagnostic medicine and perhaps the standards for diagnosis have gotten pickier. But still.

    And with the increase in diabetes you’re going to see a lot more heart disease from *that*, too.

  79. Reading this, I became nauseated and tearful. My mother recently passed away from a heart attack at the age of 55, but she might as well have been dead for years before that. Type II diabetes had ravished her body. She couldn’t see, couldn’t walk, was continually on dialysis, and in-and-out of the hospital several times per year. Despite her health issues, she still ate like there were no consequences. There was never a time that she wasn’t sipping on soda. Since her death, I’ve been researching various diets and lifestyle changes to make certain I don’t follow in her footsteps. I have become convinced that this blog will save my life. Thank you, thank you, thank you! I am passing on this particular article to my siblings in the hopes that they will join me. We are all terrified of diabetes and I hope that this will kick us into gear towards real life changes.

  80. I am a type 2 diabetic.. I am eating like I should to keep my glucose level down lately I cant keep it down in the morning its over 200 it will go down slowly until noon to about 145 I am taking Januvia, glyburide, & Metformen my Dr says to stay on the same track for 4 more months. I need more help can you tell me your plan?

  81. i have t2 i take 4 shots a day can you tell me if i loose weight and exercise i can get off these shots i just had a tripple bypass done,,i was on metformin 500 x2 daily then i started to have to take shots please help i dont like needles is it possiable ??

  82. Hello Mark (and the Primal Community)

    Thank you so much for this site and all the information on it. I really appreciate your unbiased and evidentiary based approach to understanding how our bodies work – and that fact that you are making a real difference in peoples lives.
    In your article you said:

    “But here’s the catch: once those [glycogen] cells are full, as they are almost all the time with inactive people, the rest of the glucose is converted to fat. Saturated fat.”

    We’ve had difficulty tracking down evidence for this and would LOVE IT if you or anyone else could help us get to the bottom of this.

    So far, we have found evidence that where individuals have an energy surplus, DNL (de novo lipogenesis) does convert glucose from Carbohydrate to fat.

    However, in most cases, the amount of carbohydrate converted to fat makes up only a very small amount of the total fat stored – i.e. the majority of fat stored in a calorie surplus situation is coming from somewhere other than carbohydrate.

    For example, in the study below, McDevitt reported that, in all settings, the total de novo lipogenesis flux represented a small fraction of both the surplus carbohydrate energy ingested and the total fat stored in the body.

    http://www.ajcn.org/content/74/6/737.abstract?ijkey=be05a00f703d80a7f12451f8f95de95e41917112&keytype2=tf_ipsecsha

    Now there are some exceptions, such as when people eat LOTS of carbohydrates – see the Guru Walla Men study here:

    http://www.ajcn.org/content/56/3/483.full.pdf+html

    But otherwise, for the most part, when we have a calorie surplus, only a small amount of additional carbohydrate that is digested is converted to fat.
    Does anyone have any evidence which says that the majority of carbohydrate consumed in a calorie surplus scenario is converted to fat (aside from the small amount accounted for by DNL)?

    If no one has any evidence to support the above, then where does the rest of the stored fat come from?

    Does it from dietary fat?

    Thanks for your comments.

    p.s. please provide references to existing studies to support your argument.

  83. I just found out that I have PCOS with insulin resistance. I already do HIIT as a part of my gym rotation, but I’m planning on stepping it up (more often/more intensity). My question for Mark is: what’s the best post-workout recovery meal for someone with insulin resistance? I think I understand how a workout taps the glycogen stores in the muscles, and as a result, cells draw glucose from the blood. But what happens if I drink a protein shake right after an intense workout? Does my blood glucose shoot right back up again, negating all my hard work? If you can help me understand this, I would be most grateful!

  84. Hey there

    Just thought people would be interested in seeing what the Australian health authorities are currently saying about the link between sugars & starches and diabetes. Here’s the link: http://ginews.blogspot.com.au/2012/02/gi-update.html

    There still seems to be many misconceptions and basic errors about the status of saturated fat and the link between sugar consumption and diabetes!

    Cheers
    Richard

  85. Dear Sir, I just got out of the hospital again. They claim I am a brittle type 2 diabetic. I try to control everything. I learn 14 months ago about it and I have currently lost 70 pounds but nothing helps. Today I have been in hospital all day with levels around 600. I am now at home and levels won’t register on my machine. I wish I knew what to do. I took
    1000 metformin and 42 units and 10units of fast acting and nothing is happening. I think no one cares and i am only 40 with 3 kids. GOd Bless…

    1. Tammy, you should definitely talk to Steve Cooksey: http://www.diabetes-warrior.net/

      He is a type II diabetic that has managed to reverse his symptoms and medication with diet.

      He has a lot of experience dealing with the medical community. Maybe he can help.

      Hope that helps,
      Kristjan

    2. Hey bro….dont despair. Get Dr. Richard Bernstein’s book…”The Diabetes Solution”. In it you will read that there is no such thing as a brittle diabetic. I know, because I was labeled the same thing by top endos in the US. Dr. Berstein says” you are just eating too many carbs”. As a Type 1, insulin dependant diabetic, the next day after reading this I followed Dr. Bernsteins recommened carb count…6 in the morning, 12 for lunch and 12 for dinner…my blood sugars reab
      hed normal ranges for the first time in 10 years. Caution…you must reduce and adjust your medication to fit the lower carb count. I suggest giving your self a month to reduce down to normal and stairstep your meds down at the same time. FIRST..get the book. Read it . Show it to your doc. Get him/her one. Do it together. THen …after you know diabetes…get Marks books and become primal and leave diabetes in your past. Contact me at andreboco@yahoo.com….lets get you healthy for your kids and you.

  86. is is possible with diet and exercise to come off Type 2 diabetes where due t illness I had to go on Insulin injections

    1. YES! Read on, my friend. Read on. This is exactly what you were looking for!

      Read some success stories. There are some specifically about just that.

      You were born perfect and you can get pretty damn close again.

  87. YES! Read on, my friend. Read on. This is exactly what you were looking for!

  88. I’m worried that I have diabetes or pre-diabetes. I’m a 14 year old guy and I don’t have any symptoms (except that I can’t really gain muscle but that could also be my workout) I have never been overweight. However, I’ve been eating high carb my entire life. Which I stopped since I learned about paleo about a month ago.
    I even had a blood test done. You could say it was a fasting blood test because I didn’t eat for 8 hours except some low carb vegetables 2 hours before the test. My blood sugar was 4.2. The doctor said this was fine. How big is the chance I have diabetes? (I don’t have any symptoms, my blood sugar was normal at the test but I’ve been eating high carb for 14 years and my grandpa has diabetes 2.)

    Thanks

    1. William, stay alert. Keep on a high fat/moderate protein/low carb diet and you won’t “get” diabetes. You are not your genes as much as you are you epigenetics (the tune your genes play). You will heal any damage you may have done. You do not know enough yet to stay healthy but that is something we will have to remedy. Keep reading MDA…let him lead you to further study when you are ready.

  89. It simply amazes me that there is such vehement hatred of and vilanization of carbs. Being inactive is criminal not carbs. I have had type1 diabetes for over 29 yrs. I eat at least 500g carb/day and fight to maintain 139lbs with extremely low body fat. My blood sugars are superb and my insulin doses quite low. My secret is tremendous daily activity. We evolved to be extremely active not to hide from HEALTHY carbs as if they were monsters.

    It really is scary that people today are so greatly afraid of being very active that they point at whole grains and lots of fruits daily as poison. The poison is your lack of MOVEMENT. Wow… laziness…

    1. Please pass on your exogenous insulin injection numbers, your C Peptide numbers too. If you have had your leptin done, send it in. If you eat 500grams of carb a day, as a Type 1 and you maintain “normal”, round the clock blood sugar levels, I will get both Dr. Ron Rosedale and Dr. Richard Bernstein to speak to you. If this is true, lets examine your results.

  90. Gee…It really would have been nice to at least consider that some of us are diabetic because a medication (Seroquel) damaged our pancreas’ so badly that they had to be removed thus thrusting us into a life consumed with blood testing, two types of insulin five times a day, exercising like never before and watching everything we eat. It’s not always “consumer’s remorse” that causes diabetes. Thanks for the rest of the information, though. Have a great day!

  91. Hi Mark, my brother sent me your article as I just discovered 3 days ago that I have gestational diabetes, currently 28 weeks pregnant (i found it so easy to understand unlike the other articles that ive been trying to wrap my head around!!) I had no idea what it was and was so surprised that I had it. Well actually, when I look back I’ve always had a sweet tooth but I’m not overweight so I thought all was good. I was wondering if it is the same or similar to type 2 diabetes? What foods should I be eating and avoiding? My gynecologist said to stay away from all sweets, desserts, juice, salty foods, and to only have an equivalent of 3 spoons of rice a meal. Only have green apples, guava for fruit (I live in Thailand), basically nothing sweet. I’m worried the baby won’t get a variety of vitamins and minerals from food. What about whole wheat bread like complex carbs? It would be great if you would advise me. Thanks

  92. Wow This is making me think more than what’s the next Sonic The Hedgehog video game. Thanks for the thinking idea i’ll be sure to link to your website on my blog.

  93. hi everyone, just read this article and makes sense to me. Just wondering if anyone has any experience of what the diet might do to my insulin needs. I don’t eat many carbs anyway but do have oatbran porridge with raisins for breakfast and then maybe a slice of rye bread for lunch, 40g buckwheat noodles evening meal, 4 oatcakes supper this is with loads of veg and lean protein.. I am wanting to try the diet to see if it helps my Hidrenitis Suppurtiva but I am just a bit worried that it will affect my insulin levels and cause me loads of hypos… Am on 26 units of long acting and about 15 units of short acting a day at the moment … any suggestions or experiences would be great.. cheers.. 🙂 clair

  94. WOW What a fantastic article. Just wish I’d seen this 40 years ago before my love affair with pasta began:(
    I’ve searched for other descriptions of Type 2 and this is by far the most lucid. The med wed sites seem to fear Big Ag and HFCS producers.
    THANKS Mark

  95. Hello Mark. Trying to find an answer to a question about insulinemic food, I came across your website and read your beautifully written article about diabetes type 2. Very clear and thankfully non-technical. I wonder therefore if you can you help me with my question.

    My husband, D., is Type 2 insulin resistant. I encourage him to reduce the amount of carbohydrates he eats but now discover that foods high in protein, especially dairy products, create insulin spikes. Surely D. does not need any more insulin in his system as he cannot cope with the amount he’s got already as he is ‘resistant’. This is puzzling me. Can you help? Your web article states that too much insulin in the system is toxic!

  96. I was eating a dish of ice cream while reading the article. The description of symptoms with the progression of insulin resistance (which I didn’t understand till now) is me.
    I just turned 60. The cycle of sweets, lack of energy or motivation and craving more sweets, has left me heavier than I have ever been.
    I’m afraid to give up my friends – cookies, ice cream, candy and pastries – but now I realize that the insulin resistance is likely already in motion.
    I think I just had my last dish of ice cream. Wish me luck. I’m scared to death. I want to live.

  97. Hello Mr. Sisson, I am very interested in what you teach. My chiropractor has been eating a paleo diet for years. I receive a newsletter from holistic.com. The writer had T2D, high BP, etc. basically metabolic syndrome. On to me, T2D since 2004, high Bp and Cholesterol, psoriasis, depression. I take so many pills, I rattle when I walk. I am obese in my mid section to the point that people ask when my baby is due and I am def. not pregnant. I have been eating sugar free and low carb (fruits, only) for about a week. Yesterday I was so hypoglycemic, I was scared. I understand your book and agree. I also know that I am having trouble because of the meds. (glyburide 10mg and Metformin 1000mg daily). I need info on how to come off the meds safely. Can you please advise. Thank you, Rita

  98. I’m currently a univeristy student of complementary medicine, specifically acupuncture. We also study a 60-70% course content of Western clincial medicine anantomy, physiology and pathology. I’m SO glad to have happened upon your site as it explains in simple lay terms the metabolism process of sugars and insulin. I’ll definitely be recommending this info to all family and friends and future patients. Keep spreading the word…it’s a modern day gospel that needs to read.

  99. Someone asked a question: ‘why do grains exist?’ I answered: ‘they’re for birds ‘Laughing out Loud’ =D’
    I’ve been doing low-carb for about three weeks, I can’t believe how much stronger I am. I’ve lost a lot of fat and the thing is, I don’t look malnourished cos I eat a lot of proteins and fat. So the muscle tone is showing. I’m so happy, this is something I can stick to for life. Thanks Mark for opening my eyes to the lies the government give us. I’ve been on several low fat diets since I can remember. But now, I don’t even crave carbs.

  100. I just finished reading the above article.I’m having a difficult time trying to figure out all the hidden sugars in all the sugar free sweeteners.I am a type 2 diabetic.I was diagnosed 2 years ago and am on Janumet, twice a day.One of my sisters, who was very concerned about my new found health situation, longed to find a better way to keep blood sugars lower for me.She found a book by Dr.Richard K. Bernstein.And started the diet herself,2 years ago and as of yesterday is 112 pounds lighter.she sent me the book, which sat and collected dust for almost 2 years.This past April, when I knew I would be visiting her for 5 weeks in Alaska, I figured “When in Rome, do as the Romans do.” Since than, 12 weeks yesterday, I have lost 30 pounds and 11 inches.If I get to my goal weight, I need to lose another 70.I figure if I lose just 1 pound a week, over a years time, that’s 52 gone.All days are not easy. I still want sugar and baked goods.My goal is to get my blood sugars where they need to be. So far, they are more normal than ever before.I go back to my doctor next month for my yearly appointment.Last year my LDL was high enough that he wanted to start me on medication.I asked him to give me a chance to get in under control with diet.
    I’ll see if it’s worked then.Reading this article has peaked my curiosity. I’ll read more and find out what it’s all about.
    I believe knowledge is the key to it all.Thanks for listening.

  101. There’s a typo in there – DNA blueprint tell it to -> tells it to

  102. This is THE definitive guide to insulin. Thank you for putting it in easy to understand terms Mark!

  103. Very interesting and educational, i do still have some doubts over some of the foods you have said not to consume but i think i will try the diet as best i can and look a lot further into the philosophy. I have Hemacromatosis and the damage my diet could be doing to my liver is extremely interesting as i dont need any more impact on it like my high iron levels, i do wonder about digestive health and bowl issues with a high protein diet over long periods??

  104. I appreciate the information you provide. However how do we cope with GMO’s and codex alimentarius, herbicides, pesticides, fluoridated water, etc.? Whom can we trust? Certainly not governments!

  105. As I type 1 diabetic, I am wondering if anyone can give me a couple of “starter lessons” on this. I have very high cholesterol and even tho I’ve read a ton on the website, I’m getting info overload and its all beginning to get jumbled together. I’ve started reading the daily posts (on day 2), but I’ve yet to read how to start this lifestyle! Help! and Thanks!

    1. Your best bet is to click on the icon marked “Start Here” at the top left of the page. That should get you going in the right direction.

    2. I’ve worked with thousands of chronic T2’s over the years and here’s our “6 do’s and 6 don’ts.” You might find them helpful.

      Here are 12 critical “lifestyle” recommendations for anyone serious about their health. If you make these changes in your everyday activity, you will see and feel dramatic positive changes in your health.

      Restrictions
      1. Don’t drink soda (regular/diet). Ever. Soda is a modern day scourge.
      2. Limit refined sugar intake. We all know what these are: cookies, cake, candy, ice cream, honey, molasses, maple syrup, etc. There is no place in a healthy person’s life for these health-destroyers.
      3. Don’t eat fried or deep-fried foods. Ever. These “foods” are perhaps the most damaging of any in the long-term.
      4. Don’t drink milk and or fruit juice. Commercial milk is an abomination. Don’t drink it. Ever. Fruit juice is nearly 100% carbohydrate.
      5. Limit consumption of grain-based foods (bread, cereal, pasta), rice, or potato. These foods are concentrated carbohydrates (corn is 82% carbohydrate). Never eat anything made of white flour. Eat only whole grain-based foods, and then in VERY limited quantities.
      6. Eat limited amounts of whole fruit (no more than one small serving/day). Any phytonutrients found in whole fruit can be found in vegetables without excess carbohydrates.

      Additions
      1. Eat vegetables with every meal. Eat raw as much as you can. Concentrate on the above-ground, dark, leafy greens and other colorful vegetables.
      2. Eat healthy fats every day. These are: flax meal/oil, borage oil, fish oils, extra-virgin olive oil. Eat these raw, not cooked.
      3. Eat some protein with every meal. Breakfast should be predominately protein and healthy fats. Primary protein sources are: meats, eggs, cheeses, nuts, and beans.
      4. Eat 3 meals/day with no snacks ?between. Eat your last meal of the day at least four hours before bedtime.
      5. Get fit. Our bodies are designed to work and sweat. There is simply no substitute for exercise. Get as close to your ideal weight/height ratio as possible.
      6. Find a good diabetes-support product with HydroxyCitric acid in it and a good multiple vitamin/mineral supplement. Other good choices would be plant-based digestive enzymes and probiotics.

      Making these changes in your life will bring rewards that you can now only imagine. This is the only life we have, so treat it like it’s the most valuable thing in the world. It is. Remember, healthy people do healthy things.

  106. I absolutely love your site Mark!

    At 18, I was diagnosed with PCOS but as my weight continued to creep up(from previously never going over 70 to 90kg). Doctors just kept telling me to exercise more and eat Low GI carbs etcetc… the usual spiel. At 21 and having fallen pregnant with my daughter my weight continued t spike without me changing my eating habits, following a conventional diabetic diet(my mother in non-genetic Type 1) and no one could tell me why that was. They sent me to what they called obese pregnancy groups (which let me tell you as the ladies there were eating ad excess of 2 packets of Tim tam’s a day by their own admission, was not the solution to the problem). At full term I weighted in at 120kg, nearly double my original max weight of 70kg. I have been taking metformin since then and by slogging it out and clean eating(still having a large amount of low GI carbs) I had gotten down to 90kg. However 2 hours of cardio and weights daily was ridiculous considering by watching my consumption I should have been loosing weight without any exercise(calories in calories out)! I decided there has to be a better way to eat in a manner which was more intuned with my personal body consumption requirements. I researched and by analysising the way insulin reacts to the body and the manner in which insulin intolerance comes to be and how fats are not consumed in the body the same way I deduced that carbs were BAD for me in large quatities. I have been eating in a manner the same as is described here and am utterly relieved I have now been validated! Thankyou! However the question remains, I am down to 85 kg, another 15 to lose but I do not know if metformin for the time being will assist this or hinder this way of eating with insulin intolerance? Can you give me some guidance on this?

  107. Hello Mark. Just read this post. Read because of my recently re-thinking a same thing. I have few minor corections.Ghrelin and leptin may also be added. More fat > more leptin from fat > less insulin should work IMHO. That may be a cause why not all sedementary faty sugar eating humans have insulin resistance. One of possible causes.

  108. Interestingly many of these comments seem rather old. I have come across evidence pointing to Metformin as a very useful medication, unlike many others.
    My blood sugar has dropped a point ( from 6’s to 5’s) since starting the medication. The latest evidence shows drop in lipids, weight, sugar of course, and a whopping drop in cancer diagnoses in diabetics on Metformin. Google it up for yourself to see other benefits it seems to have. I am a survivor of endometrial cancer and breast cancer as well. Also surprisingly a survivor of Chemo treatments as well!! The Metformin recommended is the slow release prescription. No one will get me off this one!!!

  109. Of concern is that a high protein diet of meat and other animal foods is not recommended for diabetics as they have a big risk of kidney damage.

    So would this primal type diet be safe for diabetics?

  110. Thank you! Very informative and understandable. I am at the pre-diabetes stage and my doctor has strongly recommended a lower carb primal or paleo type diet .

  111. This is so misleading. Read reversing diabetes by Dr. Neal Barnard. He got funding from the US government to do research on diabetics. He grabbed 2 groups and put 1 on the American Diabetes Association’s guidelines and with the other group, he told them to stop eating any animal products, any oils and overt fats like nuts and seeds and to eat all the carbohydrate from whole foods that they wanted, with no restriction. They could eat all the fruits, grains, tubers and vegetables that they wanted. They also were told not to do any change in their current excercise routines so that excercise wouldnt be a factor in the results. What happened? All type 2 diabetes patients got cured and type 1 diabetics cut their insulin usage up to 75%!! Our body uses glucose for energy, when you eat stuff you are not supposed to eat (like overt fats, meats, oils) it causes insulin resistance. Everything you can possibly eat has already fats in it, do you know that the RDA for omega 3 is only 1.6g a day? A head of romaine lettuce has 0.7g! All fruits and veggies have omega 3 and 6 and in the ratios that we need, and the body produces all essential fatty acids from omega 3 and 6. We are fruguivores by nature. The fact that we may once have been hunters might be true, but we were merely surviving, not thriving, try the 80/10/10 raw vegan diet and thrive! Seriously!

  112. What if my blood glucose level reading is 5.5 do i still to continue injecting 15units of insulin?

  113. “Not only should diabetics limit carbohydrate intake – everyone should. We are all, in an evolutionary sense, predisposed to becoming diabetic.”

    Man, this article breaks down the whole diabetes/insuline/carbohydrate issue so elagantly!

  114. I think it’s not just glucose in the blood from a recent meal that is to blame.
    Dr. Robert Lustig mentions in “Sugar: The Bitter Truth” that protein glycation happens 7 times faster with fructose than with glucose. The HbA1c measurement detects this in the blood — from either source I believe.
    Dr. Ken Sikaris at the Low Carb New Zealand 2014 talks (aired on Jimmy Moore’s Livin’ La Vida Low-Carb Show #822) revealed that the body treats glycated protein in the blood as if it were glucose, and so insulin levels rise in response. And just as the HbA1c indicates blood sugar control over the past 3 months, this condition lingers — forcing the pancreas to maintain higher insulin levels 24/7.
    This puts insulin resistance and pancreas exhaustion into overdrive. A situation that could take a month or more of sugar fasting to reverse.
    Regular doses of fructose in processed foods and sugar-sweetened beverages will prevent exit from this state.

  115. Excellent explanation, Mark. My mom has been dealing with Type 2 Diabetes for 20+ years. Now into her 80s she has renal issues and I have stepped in to do some nutritional cooking for her. It is only now that I realized she had no understanding of carbohydrates. She doesn’t eat cupcakes or candy but does eat bread, cereal, oatmeal, melba toast, potatoes, fruit juice…… I hit the roof when I finally discovered no one has explained their effect on her sugar levels. I am going to go through your explanation with her — one more time. Thanks Mark!

  116. I am insulin resistant and I had a triple bypass last June. Dr said I didn’t have a heart attack, I was told not to eat eggs or fat. Dr wants to put me on statins but they give me muscle pain. Would the primal diet help with my cholesterol?

  117. I dont eat much sugar or carbs–mostly meat and veggies. I exercise and move around a lot. All my other numbers are great (triglycerides, blood pressure, etc) but my fasting blood glucose was 100 today, and it was 99 about a year ago. I recently had my DNA analyzed, and it shows I am predisposed to T2. What else can I do (since I eat few carbs or sugar and get movement) to lower my blood glucose?

  118. Dear Mark,

    In this article, you refered to the 4 ways that the body produces glucose vs. only one way that the body releases fat. I have tried searching for more posts to understand this, I understand glyconeogenesis is one way of creating glucose when needed, but I am not clear on understanding the other ways. Can you direct me to a post where you have explained this bit of physiology in more detail? Thank you.

  119. I am a diabetic and to follow all of your advise would make me spend money for the more expensive items of which I really can’t afford because all the things you mention are more costly ,so there is a catch 20 here and how do you make it work.

  120. Can someone shed light on the connection in having history of low weight, NAFLD, and insulin resistance/PCOS? And how macros should be managed? Then gaining weight and glucose, liver enzymes, red blood cell and H1Ac levels worsen during a stressful season? TIA

  121. Hello Mark~I’m a 53 yr old woman, and have just recently concluded I have type 2 diabetes. About 3 or 4 yrs ago I thought I was fairly healthy for my age…I was active, hiked around often and was entirely clueless about the right way to eat.
    Thsse past yrs my health greatly declined, and I have had struggles. My daughter pointed me in your direction, and everything I have absorbed from your advice makes perfect sense to me. I don’t even read the mainstream ‘so called diabetic’ advice…it’s a joke. I am trying to follow your blueprint for eating, and have felt better. It was an up and down journey at 1st, but everytime I see something that would’ve formerly tempted me, I consider how it will make my body feel after, and that outweighs the urge. I truly believe that we were given these bodies to nurture, and I don’t want mine to be a trash can! Thank you for your dedication to healthier eating and encouragement!