Today’s podcast episode is a bit different than usual because I’ve solicited questions from the Optimising nutrition, managing insulin Facebook group for kidney expert Dr. Jason Fung. If this is the first time you’ve heard of Jason, you might be better off starting with his Sigma Nutrition Radio interview and also The Aetiology Of Obesity YouTube playlist. The questions are great - they cover the topics of blood glucose levels, type 1 and type 2 diabetes issues, fasting, muscle loss, what Jason recommends as an effective treatment for diabetes and much more. Before we get into the Q&A, let’s start out by clarifying some things about diabetes that Jason was very insistent that we understand... The difference between type 1 and type 2 diabetes. Many people think that type 1 and type 2 diabetes are closely related but Jason insists that’s wrong. They are “completely different diseases” and “you can’t even talk about them in the same sentence.” Type 1 diabetes is a problem of not enough insulin. The proper course of treatment is to give insulin to the patient. That makes sense. But type 2 diabetes is a disease of too much insulin. Yet, what do we typically do for a type 2 diabetic? We give them insulin. Why? To control what we consider to be high blood sugar levels. But giving insulin to a type 2 diabetic doesn’t address the underlying cause that is the insulin resistance. Giving insulin as medicine drops blood sugar levels but the disease remains. Jason likens this method of treatment to giving an alcoholic a drink of whiskey because he’s experiencing withdrawal symptoms. Sure, the symptom will go away temporarily but the disease is still there… and it’s actually getting worse. On this episode you’re going to hear Dr. Jason Fung answer these specific questions: Q: Which is worse, insulin toxicity or glucose toxicity? Q: At what percentage of A1C could we expect the person to have diabetes? Q: Various questions about blood sugar levels and what is the right number to shoot for. Q: When is a low carb diet not enough to help with diabetes? Q: What are the benefits of fasting for type 2 diabetes? And what are the benefits of intermittent fasting? Q: Do you use fasting protocols or work with patients on a case by case basis? Q: Does fasting cause too much stress on the adrenals? Q: Is fasting different for men and women? I’ve heard it isn’t good for women to fast. Q: What happens when someone lean begins to fast? Do they begin to burn muscle? Q: Gluconeogenesis in lean individuals: Where is the substrate for glucose coming from? Q: Is there any fear of protein intake causing gluconeogenesis? Here’s the outline of this interview with Jason Fung: [0:19] Christopher’s introduction of Dr. Fung and this Q&A episode. [1:09] Jason’s background of kidney specialization and interest in type 2 diabetes. [8:03] Q&A with Dr. Fung. [45:03] Addendum with Dr. Tommy Wood. [52:29] In a week of fasting, you will likely lose a pound of lean muscle. RESOURCES AND PEOPLE MENTIONED IN THIS EPISODE The Aetiology Of Obesity YouTube playlist Jason’s website Sigma Nutrition Radio podcast Optimising nutrition, managing Insulin Facebook group Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes (VADT) trial Basal Insulin and Cardiovascular and Other Outcomes in Dysglycemia (ORIGIN) trial Minnesota Starvation Experiment George F. Cahill, Jr.