For morbidly obese patients Fung uses initial fasts of 7 to 21 days. The longest known medically supervised fast is over 1 year in a male weighing more than lbs. Micronutrients, ample water, and electrolytes are provided during the fast, and coffee and tea are allowed.

Fung describes how many of the drugs used to treat type 2 diabetes, while lowering the blood sugar, make the underlying disease worse by increasing body fat and increasing insulin resistance. The biggest culprit here is the use of insulin.

In the United States, over 23 billion dollars were spent on drugs for type 2 diabetes in With The Diabetes Code , Fung provides a simple lifestyle approach to preventing and avoiding what has become the most expensive of all chronic diseases.

The food industry and the drug industry will not be excited by his method, but it is long overdue for the public to curb the epidemic of obesity and diabetes, and lower the costs of medical care. The methods described by Fung should be taught to medical students and residents, and used in family medicine offices as part of a lifestyle approach to promoting health.

Scherger JE. The Diabetes Code. Fam Med. Citation files in RIS format are importable by EndNote, ProCite, RefWorks, Mendeley, and Reference Manager.

All Rights Reserved. STFM Journals. PRiMER Family Medicine Annals of Family Medicine STFM. Toggle navigation. Home About Issues Recently Published Collections Authors Reviewers. BOOK AND MEDIA REVIEWS The Diabetes Code Joseph E. Scherger, MD, MPH. Return to Issue Article Authors Metrics Comments Book Title :The Diabetes Code Book Author : Jason Fung Publication Information : Vancouver, Canada, Greystone Books, , pp.

References Duignan B. In: Encyclopaedia Brittannica. Accessed July 27, Fung J. The Obesity Code. Vancouver, BC: Greystone Books; Overall, fiber from whole foods appears to be more effective at reducing insulin than fiber in supplement form, although results are mixed.

One study found that insulin decreased when people consumed black beans but not when they took a fiber supplement Soluble fiber, especially from whole foods, has been shown to increase insulin sensitivity and lower insulin levels, particularly in people living with obesity or type 2 diabetes.

The distribution of fat throughout your body is determined by age, sex hormones, and genetic variation An overabundance of belly fat — also known as visceral or abdominal fat — in particular is linked to many health issues.

Visceral fat can promote inflammation and insulin resistance, which drives hyperinsulinemia 59 , 60 , A small study from suggests that losing visceral fat can lead to increased insulin sensitivity and lower insulin levels Interestingly, another small study from found that people who lost abdominal fat retained the benefits for insulin sensitivity even after regaining a portion of the belly fat There is no way to specifically target visceral fat when losing weight.

Furthermore, studies show that when you lose weight, you lose a higher percentage of visceral fat than fat throughout the rest of your body If your doctor has advised you to lose weight, talk with them about the best weight loss program for you. If your doctor advises you to do so, losing visceral fat can increase insulin sensitivity and help reduce your insulin levels.

Green tea contains high amounts of an antioxidant known as epigallocatechin gallate EGCG , which may help fight insulin resistance 65 , 66 , In a study, postmenopausal individuals living with obesity and high insulin levels who took green tea extract experienced a small decrease in insulin over 12 months, while those who took a placebo had increased insulin levels following the intervention In a review, researchers reported that green tea appeared to significantly lower fasting insulin levels in high quality studies However, there are other high quality studies on green tea supplementation that have not shown a reduction in insulin levels or increased insulin sensitivity Several studies have found that green tea may increase insulin sensitivity and decrease insulin levels, but results are mixed.

There are many reasons to consume fatty fish like salmon, sardines, mackerel, herring, and anchovies.

They provide high quality protein and are some of the best sources of long-chain omega-3 fats, which offer many health benefits Studies have shown that the omega-3s in fatty fish may also help reduce insulin resistance in people living with obesity, gestational diabetes, and PCOS 70 , 71 , According to the U.

Young children should eat less. People who are pregnant or breastfeeding should eat 8—12 ounces of a variety of seafood per week, choosing options that are lower in mercury These supplements contain the same long-chain omega-3 fats as the fish itself, but the effective dosage has not yet been determined One small study in individuals with PCOS found a significant 8.

Another study from found that children and adolescents with obesity who took fish oil supplements significantly reduced their insulin resistance and triglyceride levels Finally, a review of 17 studies found that taking fish oil supplements is associated with increased insulin sensitivity in people living with metabolic disorders The long-chain omega-3s in fatty fish may help reduce insulin resistance and insulin levels, especially in those with metabolic disorders.

While fish oil supplements are sold widely and often used in studies, the effective dosing has not yet been determined. Consuming adequate protein at meals can be beneficial for controlling your weight and insulin levels.

In a small study from , premenopausal individuals living with obesity had lower insulin levels after consuming a high protein breakfast compared with a low protein breakfast. They also felt fuller and ate fewer calories at lunch However, protein stimulates insulin production so that your muscles can take up amino acids.

Therefore, eating very high amounts over a prolonged period may lead to higher insulin levels in otherwise healthy individuals A larger study from sheds some light on these diverging results: When it comes to protein, dietary patterns are important.

For instance, researchers found that individuals who ate a majority of plant proteins were less likely to develop type 2 diabetes, while individuals who ate a lot of protein in the form of red meat had a greater likelihood of living with or developing type 2 diabetes Eating a variety of nutritious protein sources may help with insulin sensitivity, but moderation is key.

If your doctor has advised you to find ways to lower your insulin levels, they will most likely have a plan to help you accomplish that goal. Eating fewer refined carbs and sugars, eating more fibrous and nutrient-dense foods, getting enough exercise, and occasionally supplementing with natural helpers like green tea and cinnamon can help you get on track and stay there until you reach that goal.

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But patient…. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. Alternate-day fasting lowered levels of fasting insulin and insulin resistance to a greater degree than calorie restriction among adults with overweight or obesity and insulin resistance, according to findings published in Obesity.

Varady , PhD, associate professor in the department of kinesiology and nutrition at University of Illinois at Chicago, and colleagues wrote.

During the 12 months, alternate-day fasting was practiced by 11 participants mean age, 43 years; The researchers further noted that those assigned to alternate-day fasting did not thoroughly adhere to the regimen, with intake on fast days higher than recommended and intake on feast days lower than recommended.

Gabel K, et al. Healio News Endocrinology Obesity. By Phil Neuffer. Read more. August 01, Add topic to email alerts. Receive an email when new articles are posted on.

Several variations of the FSIVGTT have been published. One recently published study infused 0. The SI was calculated by a computer-based program. Tolbutamide administration can also be used during FSIVGTT to augment endogenous insulin secretion and is particularly useful in women with diabetes.

Continuous infusion of glucose with model assessment CIGMA : Like ITT, CIGMA requires fewer venipunctures and is less laborious than clamp techniques.

A constant IV glucose infusion is administered, and samples for glucose and insulin are drawn at 50, 55, and 60 minutes. A mathematical model is then used to calculate SI. The results are reasonably compatible with clamp techniques; however, few laboratories have used CIGMA for insulin sensitivity testing in diabetic patients and there is no substantive data using the CIGMA technique in women with PCOS.

Oral glucose tolerance test OGTT : OGTT, a mainstay in the diagnosis of impaired glucose tolerance IGT and diabetes mellitus in pregnant and nonpregnant women, may be used to assess insulin sensitivity as well.

Because no IV access is needed, OGTT is better suited for assessment of large populations than the other techniques we outlined. A modified OGTT that uses a or g glucose load and measures glucose and insulin at various intervals over 2 to 4 hours has been used in clinical studies.

Like other minimal approaches to diagnosis, OGTT provides information on beta cell secretion and peripheral insulin action, and various mathematical equations have been used to provide an SI value. Insulin resistance has also been assessed qualitatively if one or more insulin values exceed an upper limit of normal at appropriate intervals.

Researchers have compared various methods for assessing insulin sensitivity in type 2 diabetics using the OGTT and found good correlations between AUCinsulin, insulin level at minutes I , and the steady state plasma glucose concentrations derived from a modified ITT.

As mentioned before, the search for uncomplicated and inexpensive quantitative tools to evaluate insulin sensitivity has led to development of fasting state homeostatic assessments. These tests are based on fasting glucose and fasting insulin, and use straightforward mathematical calculations to assess insulin sensitivity and beta cell function.

Several homeostatic approaches have been developed in recent years, each with its merits and deficiencies. One of the weaknesses of these models is that they assume the relationship between glucose and insulin is linear when in fact it's parabolic.

Fasting insulin I0 : Fasting serum insulin is an inexpensive assay, and does not require any mathematical calculations. At least one researcher has advocated averaging two or three readings to account for day-to-day variability. Although I0 is less variable than other fasting procedures in normoglycemic patients, clinicians must still interpret results cautiously.

Remember that insulin sensitivity is the ability of the hormone to reduce serum glucose. If fasting glucose is high—for example, in a patient with impaired glucose tolerance—that may indicate a diminished effect from circulating insulin or in severe cases of insulin resistance, diminished quantity of the hormone.

Hence I0 should not be used in glucose-intolerant or diabetic patients. The ratio of glucose to insulin is easily calculated, with lower values depicting higher degrees of insulin resistance. Homeostatic model assessment HOMA : HOMA has been widely employed in clinical research to assess insulin sensitivity.

The constant should be replaced by The HOMA value correlates well with clamp techniques and has been frequently used to assess changes in insulin sensitivity after treatment.

Quantitative insulin sensitivity check index QUICKI : Like HOMA, QUICKI can be applied to normoglycemic and hyperglycemic patients. It is derived by calculating the inverse of the sum of logarithmically expressed values of fasting glucose and insulin:.

Many investigators believe that QUICKI is superior to HOMA as a way of determining insulin sensitivity, although the two values correlate well.

As the SI decreases, QUICKI values increase. McCauley et al. An ISI of 6. The authors present two formulae for estimating ISI; one uses I0, BMI, and TG, and the other uses only I0 and TG. In comparisons with the euglycemic insulin clamp technique the first formula with BMI has a specificity of 0.

The second forumula without BMI has a specificity of 0. Home Departments Family Medicine Research RCMAR Insulin Resistance. Family Medicine. Medical Student Education. Rural Clerkship. MUSC Family Medicine Residency. Transitional Year Residency. This panel, by offering early detection, can be instrumental in guiding lifestyle and dietary changes, including intermittent fasting, to prevent the progression of metabolic disorders, emphasizing the importance of proactive health management.

Starting an IF routine can be a positive step towards better health, but it's important to approach it safely and tailor it to your individual health needs. IF isn't one-size-fits-all; it's crucial to consider personal health status and lifestyle before beginning.

Firstly, consult with your primary care practitioner before starting IF, especially if you have a chronic condition. Certain individuals should avoid IF, including children and teens under 18, pregnant or breastfeeding women, and those with type 1 diabetes, due to the risk of hypoglycemia with insulin use.

Additionally, people with a history of eating disorders should steer clear of fasting practices. Once you have the green light from a healthcare provider, start slowly. Begin with shorter fasting periods and gradually increase the duration as your body adjusts.

Listen to your body as you implement IF. Remember, IF can have different effects on different people Lastly, sustaining an IF routine requires adapting it to fit into your daily life without causing undue stress or anxiety. Balance is essential, as is ensuring you're consuming nutrient-rich foods during your eating windows to maintain overall health.

With a thoughtful approach, IF can be a safe and effective way to improve health and well-being Intermittent fasting comes with potential risks that warrant consideration, especially for those with certain medical conditions.

Individuals using antidiabetic medications such as insulin and sulfonylureas must be cautious, as fasting can increase the risk of hypoglycemia.

Those with a history of eating disorders, specific chronic diseases like heart failure, or conditions where dehydration poses a significant threat, such as stroke, should also approach IF with caution.

Pregnant and breastfeeding women, children, and older adults with frailty are advised against fasting due to unique nutritional needs and risks. Therefore, easing into IF with professional medical advice and ensuring adequate hydration and nutrient intake is crucial for safety.

Medical guidance becomes particularly important when managing insulin resistance with intermittent fasting. Healthcare practitioners can offer tailored advice on medication adjustment, monitoring blood glucose levels, and ensuring adequate fluid intake. For those interested in exploring IF, engaging in this dietary pattern under the supervision of healthcare professionals such as physicians, certified diabetes educators, or dietitians is recommended.

This careful approach can help mitigate the risks of intermittent fasting, allowing individuals to explore its potential benefits while minimizing adverse effects and ensuring it aligns with their health needs and lifestyles 10 , Adopting intermittent fasting can offer several health advantages, including aiding weight management and potentially improving heart health by positively influencing blood pressure and cholesterol levels.

Personalizing fasting methods to fit individual health profiles and needs is key, and for those with insulin resistance, IF may help reset insulin sensitivity.

However, it's crucial for anyone considering IF to consult with healthcare professionals to tailor the practice to their unique health situations and to adjust any medication accordingly.

With proper guidance, IF can be a valuable component of a health-conscious lifestyle. Documents Tab. Redesigned Patient Portal. Simplify blood panel ordering with Rupa's Panel Builder. Sign in. Sign in Sign up free. Subscribe for free to keep reading! If you are already subscribed, enter your email address to log back in.

Are you a healthcare practitioner? Yes No. Search All Content Magazine Podcasts Lab Companies Lab Tests Live Classes Bootcamps Health Categories. Basic Lab Markers. Case Studies. GI Health. Herbal Medicine Fact Sheets. Lab Interpretation.

Men's Health. Mental Health. Metabolic Management. Nutrient Fact Sheets. Research Studies. Running Your Business. Women's Health. A Root Cause Medicine Approach. Mechanisms: How Intermittent Fasting Might Counteract Insulin Resistance The underlying IF mechanisms on insulin sensitivity may involve a variety of biological processes, including autophagy, hormonal adaptations, and enhanced fat utilization.

The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.

Lab Tests in This Article Diabetes Panel. The Diabetes Panel measures six biomarkers associated with the diagnosis and management of diabetes.

References 4 Science Backed Health Benefits of The Mediterranean Diet. Rupa Health. Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians.

Clinical Diabetes and Endocrinology , 7 3. PubMed; StatPearls Publishing. Intermittent Fasting: 4 Different Types Explained.

Health Essentials from Cleveland Clinic; Health Essentials from Cleveland Clinic. Cleveland Clinic. Intermittent Fasting: A Heart Healthy Dietary Pattern? The American Journal of Medicine , 8. Clinical Management of Intermittent Fasting in Patients with Diabetes Mellitus.

Nutrients , 11 4 , Effects of Intermittent Fasting in Human Compared to a Non-intervention Diet and Caloric Restriction: A Meta-Analysis of Randomized Controlled Trials. Frontiers in Nutrition , 9. Harvard Health. Diet Review: Intermittent Fasting for Weight Loss.

The Nutrition Source. Intermittent fasting: What is it, and how does it work? Johns Hopkins Medicine. A Functional Medicine Treatment Protocol for Metabolic Syndrome: Testing, Nutrition, and Supplements. Intermittent Fasting: Benefits, Side Effects, Quality of Life, and Knowledge of the Saudi Population.

Cureus , 15 2. Beneficial effects of intermittent fasting: a narrative review.