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That’s some sage advice. People are often surprised when I tell them about the insane levels of pre-diabetes in the US: > The National Center for Chronic Dis

That’s some sage advice. People are often surprised when I tell them about the insane levels of pre-diabetes in the US: > The National Center for Chronic Disease Prevention and Health Promotion notes that approximately 96 million U.S. adults aged 18 years and older (38% of the adult population) have prediabetes, and nearly 80% of them are unaware that they have it. It’s honestly insane to continue a way of life that’s doing this to the majority of the population. https://www.uspharmacist.com/article/prediabetes-trends-among-us-adults#:~:text=Prevalence%20and%20Awareness%3A%20The%20National,unaware%20that%20they%20have%20it https://www.uspharmacist.com/article/prediabetes-trends-amon....

narrator 3y ago
The other insane thing is studies have shown that type 2 diabetes can be reversed by fasting. Fasting is problematic to the medical industry because it is zero cost. "Some studies found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician." https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-020-00116-1 https://clindiabetesendo.biomedcentral.com/articles/10.1186/...
- Aurornis 3y ago
  > Fasting is problematic to the medical industry because it is zero cost. No, fasting is problematic because people don't like it. Health conscious people don't understand how much resistance the average patient has to advice about lifestyle modifications, or how difficult it is to get patients to adhere to recommended lifestyle changes. A good example is sleep apnea and CPAP machines: In theory, a CPAP machine should provide life-changing improvements in sleep quality and daytime energy for someone with sleep apnea, yet patient adherence rates are shockingly low (even when covered by insurance). Many patients are simply annoyed by the machines and give up on it. That's not to mention the fact that weight loss is extremely effective in many (though not all) sleep apnea situations, but it's rare that patients will actually follow through with that.
  - psychlops 3y ago
    It's also rare for a doctor to tell a person they are too fat and to lose weight. The assumption (and most cost effective solution) is that patients just want a prescription for something and be sent on their way. US healthcare is crisis focused, not health focused.
    - TeaDrunk 3y ago
      > It's also rare for a doctor to tell a person they are too fat and to lose weight. Genuinely curious... have you ever been an obese person? Every fat person I've known have told me they're constantly shamed about being fat in medical settings, some to the point where they actively avoid going to a doctor anymore because they've given up on anything beyond being told they're fat.
      - porkbeer 3y ago
        It its a complicating factor in almost every ailment known to humankind. A doctor would be negligent not to address it. There is no healthy level of obesity.
        TeaDrunk 3y ago
        So... you get my confusion and skepticism at this claim that it is "rare" for doctors to bring up obesity to an obese patient!
      - psychlops 3y ago
        I'd say I'm obese, and never heard a word about it. Even through covid. I have a friend who is a doctor who has been brutally honest with me (it's appreciated), but even though I've gone to many paid doctors in the northeast US, not a peep. I don't want to confuse my experience with actual data. Also, I don't think it's shaming if it's a health issue and obesity should be recognized as such.
    - metabagel 3y ago
      > It's also rare for a doctor to tell a person they are too fat and to lose weight. I don't think this is true. Doctors do tell patients if they are overweight, and they do encourage them to make lifestyle changes including losing weight.
- staypegged 3y ago
  >Fasting is problematic to the medical industry because it is zero cost. Is this just an American thing? Every GP I've ever seen has asked me about my diet and exercise despite me being in the healthy BMI range.
  - epistasis 3y ago
    I don't think that fasting is problematic to the medical industry in the US. And if it is, it's not because it's zero cost. Doctors love zero cost interventions. The real challenge is just the standard medical challenge: 1) educating doctors as new evidence comes in, 2) doctors educating patients, and 3) patients complying with the intervention.
  - NegativeK 3y ago
    It's a pessimism thing. I've had doctors (in America) tell me to not worry about medical issues and others recommend a battery of tests to look for correlated but uncommon issues. My current GP recommends basic, palatable approaches to diet and exercise that have nothing to do with giving them money (and, presumably, reduce my medical costs with them down the road.) I've also had doctors suggest that I get an issue reclassified so they could do surgery. That could be viewed as them wanting money, but I view it as them seeing a problem that can be fixed by surgery because, as a surgeon, that's how they approach problems.
  - 1234letshaveatw 3y ago
    Are you asking if your anecdotal evidence is sufficient to make an inference for all of Europe and the US?
- nradov 3y ago
  Other studies have shown that type-2 diabetes can also be put into remission for many patients with nutritional ketosis. So, there are potentially multiple approaches to try. https://www.virtahealth.com/research https://www.virtahealth.com/research
- graeme 3y ago
  to be clear this isn't reversing T2 diabetes. Rather, it allows you to manage it. But the physical damage causing T2 diabetes generally remains
  - yurishimo 3y ago
    The American diabetes association admitted last year that T2 can be "reversed" with the caveat that you mentioned about existing damage. However, to actually damage things to a level where they are noticeable takes years and years. If you catch it early, T2 is entirely "reversible".
    - graeme 3y ago
      Ah, very neat, thank you!

narrator 3y ago

The other insane thing is studies have shown that type 2 diabetes can be reversed by fasting. Fasting is problematic to the medical industry because it is zero cost. "Some studies found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician." https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-020-00116-1 https://clindiabetesendo.biomedcentral.com/articles/10.1186/...

Aurornis 3y ago
> Fasting is problematic to the medical industry because it is zero cost. No, fasting is problematic because people don't like it. Health conscious people don't understand how much resistance the average patient has to advice about lifestyle modifications, or how difficult it is to get patients to adhere to recommended lifestyle changes. A good example is sleep apnea and CPAP machines: In theory, a CPAP machine should provide life-changing improvements in sleep quality and daytime energy for someone with sleep apnea, yet patient adherence rates are shockingly low (even when covered by insurance). Many patients are simply annoyed by the machines and give up on it. That's not to mention the fact that weight loss is extremely effective in many (though not all) sleep apnea situations, but it's rare that patients will actually follow through with that.
- psychlops 3y ago
  It's also rare for a doctor to tell a person they are too fat and to lose weight. The assumption (and most cost effective solution) is that patients just want a prescription for something and be sent on their way. US healthcare is crisis focused, not health focused.
  - TeaDrunk 3y ago
    > It's also rare for a doctor to tell a person they are too fat and to lose weight. Genuinely curious... have you ever been an obese person? Every fat person I've known have told me they're constantly shamed about being fat in medical settings, some to the point where they actively avoid going to a doctor anymore because they've given up on anything beyond being told they're fat.
    - porkbeer 3y ago
      It its a complicating factor in almost every ailment known to humankind. A doctor would be negligent not to address it. There is no healthy level of obesity.
      - TeaDrunk 3y ago
        So... you get my confusion and skepticism at this claim that it is "rare" for doctors to bring up obesity to an obese patient!
    - psychlops 3y ago
      I'd say I'm obese, and never heard a word about it. Even through covid. I have a friend who is a doctor who has been brutally honest with me (it's appreciated), but even though I've gone to many paid doctors in the northeast US, not a peep. I don't want to confuse my experience with actual data. Also, I don't think it's shaming if it's a health issue and obesity should be recognized as such.
  - metabagel 3y ago
    > It's also rare for a doctor to tell a person they are too fat and to lose weight. I don't think this is true. Doctors do tell patients if they are overweight, and they do encourage them to make lifestyle changes including losing weight.
staypegged 3y ago
>Fasting is problematic to the medical industry because it is zero cost. Is this just an American thing? Every GP I've ever seen has asked me about my diet and exercise despite me being in the healthy BMI range.
- epistasis 3y ago
  I don't think that fasting is problematic to the medical industry in the US. And if it is, it's not because it's zero cost. Doctors love zero cost interventions. The real challenge is just the standard medical challenge: 1) educating doctors as new evidence comes in, 2) doctors educating patients, and 3) patients complying with the intervention.
- NegativeK 3y ago
  It's a pessimism thing. I've had doctors (in America) tell me to not worry about medical issues and others recommend a battery of tests to look for correlated but uncommon issues. My current GP recommends basic, palatable approaches to diet and exercise that have nothing to do with giving them money (and, presumably, reduce my medical costs with them down the road.) I've also had doctors suggest that I get an issue reclassified so they could do surgery. That could be viewed as them wanting money, but I view it as them seeing a problem that can be fixed by surgery because, as a surgeon, that's how they approach problems.
- 1234letshaveatw 3y ago
  Are you asking if your anecdotal evidence is sufficient to make an inference for all of Europe and the US?
nradov 3y ago
Other studies have shown that type-2 diabetes can also be put into remission for many patients with nutritional ketosis. So, there are potentially multiple approaches to try. https://www.virtahealth.com/research https://www.virtahealth.com/research
graeme 3y ago
to be clear this isn't reversing T2 diabetes. Rather, it allows you to manage it. But the physical damage causing T2 diabetes generally remains
- yurishimo 3y ago
  The American diabetes association admitted last year that T2 can be "reversed" with the caveat that you mentioned about existing damage. However, to actually damage things to a level where they are noticeable takes years and years. If you catch it early, T2 is entirely "reversible".
  - graeme 3y ago
    Ah, very neat, thank you!