There is a distinct difference between Type 2 diabetes "cure" and "reversal".
Reversal: what is being described here. Symptoms go away, and the longer you pursue the treatment, more difficult it becomes to clinically determine you ever had the metabolic disorder in the first place. However, the latent characteristics that made you first susceptible still exist.
Cure: you not only reverse, but you could stuff your face with pizza and Ho Ho pastries, wash it down with a gallon of Mountain Dew, and your blood sugar hardly budges, like normal people.
We do not have a cure. Short of genetically rewiring in vivo, or similar advancement, we won't see a cure. However, ongoing improvement of our understanding of how our bodies work continue to make it simpler than ever before to reverse Type 2. Simple doesn't mean easy, though.
Be careful with even homemade smoothies. Part of satiety is the speed of consumption, closely-linked to convenience of imbibing.
In other words, it is easy to drink too much smoothie because drinking is far easier and faster than preparing and eating raw fruits. Our hormonal systems are not geared to the speed of eating/drinking that our technological capabilities deliver. With processed foods it is easy to overrun actual caloric needs before your hormonal systems realize it has happened, our satiety mechanisms are fooled, and before you know it, you're way over your reasonable caloric budget.
If you engage your children in preparing, then eating raw fruit as-is, and reserve smoothies as a dessert-treat, then that establishes a timeframe their hormonal systems can easily accommodate. Even the youngest with minimal manual dexterity can "help" wash and/or dry fruits, and be an assistant by picking up fruits from the colander and placing on a cutting board for you.
It takes far more time, but personally that is my choice (YMMV), since I advocate a slow parenting movement similar to the slow food movement, because when you direct time and attention to a child, they flourish.
> ...I find it difficult and almost impossible to deny my kids of sweet treats few times a week.
Children model their behavior off their parents and peers.
> Also I am addicted to fake sugar (Truvia/Stevia etc). I use them almost everyday.
Young children do not comprehensively understand the difference between actual caloric versus non-caloric sweeteners. If you are talking about young (<10 yo) children, that have known no other life than watching parents and peers down sweet foodstuffs their entire lives, daily in your case, then they will accept that as normal.
> Are they bad than natural sugar or worst or same?
Behaviorally, I believe non-caloric sweeteners are worse for children. It is setting up a norm for them in their later lives that puts them at a disadvantage understanding nutrition, as they then ingrain into their habits a sweets throughout every day and every food norm that is increasingly difficult to dislodge when they grow into young adults and older.
Teaching my children nutritional balance is my goal. Balance to me personally is not the American or American-derived food pyramid, though. You will have to fumble your way through this, as pediatric nutrition research is as much all over the map as adult nutrition. Personally, I'm genetically deficient with an extremely strong family history of Type 2 diabetes, and I have very likely passed that onto my children, so my choices won't be your choices. In a developed-world context however, it is relatively safe to let them free-range (as much as they want) green leafy vegetables with minimal to no dressing. Free-range up to reasonable amounts of other vegetables that are predominately or contain lots of complex carbohydrates (like carrots, celery, etc., as long as the diet is filled with a diverse range). Sufficient proteins and fats depending upon what pediatric research you subscribe to that defines "sufficient" for pediatric developmental goals. Fill remaining caloric budget with complex carbohydrates with low glycemic values. As little processing as possible for everything. Tap water for hydration; not bottled, not ultra-filtered, not carbonated, not oil-flavored, not iced, not diluted juices.
6 years-old is when I was able to teach mine to simplistically read a nutrition label; at that age, they were able to see that a particular packaged food for example is overwhelmingly sugar, with little to no proteins, fats or complex carbohydrates, and willingly place it back on the shelf. It helps in my case that they are terrified of needles, then see me testing my blood sugar many times a day, and remember that I told them when I was younger, I ate too much sugar, and now have a disease that requires I eat as little sugar as possible. They don't want to have to poke themselves to draw blood now, so they are much more moderate in their sugar consumption compared to many peers.
If you didn't start them out as infants along this path, take very small steps over a long period of time, and model your own behavior for them. How small the adjustments, and how long a time period, is governed by the individual child, your creativity, and your parenting time/effort. Your tolerance to whining and fits over the world is going to end if they don't get what they want, as well. Offer two choices, both representing a moderately reasonable adjustment. Fasting for even up to a full 24 hours two times a year separated by 4-6 months each time is not developmentally harmful for children 5 years old or older if you encounter refusal to choose one of the alternatives; many children will do that just catching a really bad stomach bug.
As long as you don't react emotionally to tantrums, acknowledge their feelings that it is hard to change, etc., then change is difficult but doable.
> My idea here is that perhaps some of the issue here is that people like you (and to a non-clinical extent, me) who may have had a very bad diet in the past kick our bodies into this "mode", for lack of a better word, we find we have to watch our carbs relatively closely. Or perhaps for some people, their genetics simply start them there.
For me there is a strong genetic component. Practically every member of my extended family on one side of my parents is either pre-Type 2, or is full-blown Type 2. Did not know this growing up, and dutifully ate a diet laden with starches, which came to bite me in the ass in a big way as an adult. The rest of the immediate and extended family is now aware, and knows that I'm living proof that if they catch the same subtype, it can be prevented and (if too late) reversed without resorting to medication, and hopefully I stop it dead in its tracks with my generation, and it never gets even a toehold in future generations of my family.
> As an individual, the 3% isn't really interesting,...
This is why open source and open data is so critical to scientific research moving forward. My hope is either JupyterLab or some project like it with massive collaboration and scaling becomes the standard way to present scientific findings in the future, and all raw data and software tooling used becomes accessible by anyone. Then we could definitively answer questions like yours.
> Interpretations vary, but giving up on fruit or grain and starch is obviously not part of it.
For typical genetics, this is true. However, I've yet to find any sources that show prevention and/or reversal of Type 2 that holds over 5+ years that includes a significant (>20g) of net daily carbs from fruit, grain and/or starches. I'm not alone, but in a definite minority of people who control their Type 2 through only diet and exercise, not even metformin, but all of our diets, while varied, have one characteristic in common: we restrict net carbs to various degrees, many at 20-50g net daily.
If you know how Type 2 diabetics like myself can keep our condition reversed while adding grains, starches and fruits in greater quantities, then please shoot a pointer my way. My plants intake these days is limited to very low carb green leafy vegetables like Romaine hearts.
I used to be that guy; brush and floss after every meal from one checkup to another, and there was still buildup. Very morale-crushing. No longer.
Only habit change: I dropped net carbohydrates to 20g per day. I did that for a chronic condition, but the change in dental health was a pleasant side effect. My dentist told me he's never seen such a dramatic difference. Gum-inflammation was causing gaps between my teeth, and that receded to where he couldn't detect it any longer. I went from a teeth cleaning once every other month to once every four months, and that is only by personal choice to get what little buildup he can find (the cleanings are nearly perfunctory, about 10 minutes now). Yet my dental routine has worsened, as I no longer brush and floss after every meal (going to one meal a day at the end of the day also gave me time to brush and floss after that).
YMMV. I suspect a large genetic component, and dropping carbohydrates will impact dental health for some even with a modest drop to 1-200g net carbs per day, and not at all for others even down to 20g net carbohydrates.
Depends on the individual person, when they measure, and how they measure.
First, you're not going to get really accurate measurements unless you've calibrated your meter against a set of venous-based lab blood draw results, across bands of glucose levels. Second, unless someone describes that they are taking their measurements on the same time of day each day, under the same contextual conditions, then it's tough to separate out the measurements independent of the context.
Example: someone says they take a measurement at 11 am every day. Sounds good, except if they don't reveal they drink a Starbucks sugar-coffee a couple hours earlier on their way into work, then it gives the wrong impression. On the other hand, if someone says, first thing in the morning, I wake up and take a measurement, eat nothing, only drink water, do no activity more vigorous than getting ready for work, and measure again one hour and two hours later, then you have a better baseline to compare against.
What you really want to see to establish your impressions as data are multiple keto-adapted people wearing Dexcom 5 CGMs, calibrating periodically with a meter that meets your typical glucose testing range with the greatest accuracy [1]. Then throw those people out of keto-adaptation, measure their ketones as they come back into keto, and compare their glucose levels.
I'm only a data point of one, but I've been keto-adapted so long that the Ketostix urine test strips can no longer detect my acetoacetate-based ketone levels (when you are keto-adapted long enough, you need to measure beta-hydroxybutyrate and not acetoacetate as ketone markers). I'm Type 2, but controlled without medication through diet and exercise. My one and two-hour post-prandials are below 100 mg/dL, usually below 90 mg/dL. I test upon waking up, two hours after waking up to measure dawn phenomena, then every 1-2 hours while water fasting until I break the fast, some time between 1100-1500h, when I use a six-hour feeding window to get in at least 200g of protein and as much leafy greens as I can handle. Then I test again before going to bed.
My keto diet level is 20g net carbs per day. Empirically, when I break out of keto to verify whether or not it is still a factor in my ongoing treatment, I can go as high as 150 post-prandial, and I get a headache. There are definitely diabetics who test higher on keto than off keto, but they are in the minority; it would be interesting to find out if the keto community participants who you read about are diabetics or not. I'm convinced that based upon my personal experience that was guided by the outcomes reported by other Type 2's however, that most (not all) pre-diabetic and diagnosed Type 2's can revert their condition and control it with significant lifestyle changes for a long time before resorting to medication at a very late stage in life, if ever.
What I see happening is many morbidly obese people who adhere to keto will initially drop weight, roughly until their BMI reaches around the upper normal range. Then CICO kicks in with a vengeance, and they have to be much more careful compared to before. Keto is a useful on-ramp for many to a fitness (or at least more-fit) lifestyle, but not a magic bullet, and I don't see anyone claiming you can skip counting calories while on keto, then still reach 12-15% body fat, and reveal abs. If you see someone writing that, then yes, they're quacks.
My personal rough rule of thumb is once you reach the low 20s percentage body fat, you either keep increasing cardio (preferably HIIT), or dropping counted calories, until your moving average weekly weight keeps trending down. Fit keto around that or even drop it, and it won't matter (unless you're the same subtype diabetic like me, and then keto is an essential ingredient to avoiding medication).
If you go in once a quarter for a VAP lipid panel (the most extensive lipid panel I could find), then as long as those numbers trend in the right direction, keep on doing whatever works for you. After being diagnosed with Type 2 and having to figure out myself how to beat the fucker into remission, I've concluded that medical science can give rough guidelines for describing metabolic processes, but it is up to each of us to hack our own bodies. Try one change, test the change with measurements, and repeat; commit the changes that work, fork away from the changes that don't, accept failures and setbacks as signals of what not to do, and move on.
For most newly-diagnosed Type 2's, the disease management information out there, especially on the ADA, is terrible. Meter and strip accuracy is more off-kilter than many realize; calibrate against a venous draw-based blood glucose test. To calibrate my meter on a fine scale, I manipulated my glucose into multiple ranges, and went in for a venous draw each time on my own out-of-pocket money: 120+, 70-120, 60-69, 50-59, 40-49, 20-39. The last four required a water fast at one, two, three and four weeks, respectively. My meter and strips have to be adjusted +20 for 70 and up readings, but only +10 for 60-69 readings. If you're just curious, buy a starter meter kit over the Net (cheaper than what you can usually find in the pharmacies), and whatever reading you get, fudge it by about 10-15 points; you really want to see the trend, not an individual specific number at a single point in time.
Most doctors won't know about various antibody tests that can help refine a diagnosis, and avoid a mis-diagnosis of Type 2 when you really have adult-onset Type 1. If you test pre-diabetic, search on diabetes antibody tests.
Fastest results back to "normal" for most (not all) Type 2 and pre-diabetics come from cutting out net carbohydrates (far below what the ADA recommends), combined with strength training (weightlifting) and supplementing with HIIT cardio. It takes a serious time commitment to do that: 90-120 minutes a day, 3-5 days a week. While I'm diagnosed Type 2 for over three years, for the past two I've not been on any medications, my post-meal ("post-prandial" in medical lingo) glucose stays below 90 at one and two hours after the meal, A1c is 5.3, and cholesterol numbers are in the normal range; I keep my net carbohydrates below 20g per day, roughly half a single, unadorned bagel (my diet is mostly animal protein and green leafy vegetables). Intermittent Fasting helps, as does outright water fasting for 24 hours or longer, for many (again, not all) people.
My personal big revelation was learning the difference from limbic and true hunger, and my personal satiation patterns. Calories In Calories Out is true, but a vast over-simplification because it doesn't address the satiation issue. For me personally, I've settled on hitting at least 200g of animal protein per day, and as much Romaine hearts as I want, with 28g of grated Parmesan and a tablespoon of Caesar dressing on the side, mixed together and used a dip for the Romaine hearts. After that, I can manage the satiation issue with ancillary food. YMMV.
There isn't one single treatment path for everyone, though there are lots of commonalities; I suspect diabetes is a catch-all for a class of a multitude of metabolic disorders, either that or our individual body metabolisms are more wildly different than medical science admits so far. The key to getting back into the normal ranges is apply the scientific method to your body, try one change at a time, measure, repeat.
There is be a cliff, over which the damage is permanent. If you change habits soon enough, then we know many avoid it the permanent damage altogether. This is due to the beta cells in the pancreas; destroy to many, and go below a critical threshhold, then they don't seem to be repaired/regenerated enough forever more.
> The link between meat and...diabetes...is very well established now.
There is a group of Type 2 diabetics in remission who are doing just fine on meat-based and keto-based diets, with no medication. If meat was a causal contributing factor to diabetes, I wouldn't expect to see that. We do eat a lot of leafy greens, it isn't like all-meat-all-the-time. But fresh meat, simply prepared, eaten to the protein macros appropriate for your body, does nothing to exacerbate these already-diagnosed Type 2 patients from going back into Type 2.
A contributing factor to diabetes is surplus calories creating excess body fat. You can do that with meat, vegetables, fruit, and breads. Harder to do with vegetables if you eat the veggies raw; if you eat only leafy greens for vegetables, I'd say it is nearly impossible.
There are vegan/vegetarian Type 2 patients, but I have yet to run across one in remission on no medication, for two years or longer, so they might be rare. It is much harder to get your proteins while carb restricted to manage blood sugar levels, eating only vegetables; I'm sure there are vegetarian Type 2's in remission out there, likely using soy-based products and protein powder to get their protein, it's just not as popular a method of going into remission.
Personally, I switched to preparing meals using as unprocessed as possible foods. If I could eat raw beef (like a tartare), I would; I don't because it is too time-consuming to prepare. This rules out tofu and other soy-based products, and protein powders as well, for me personally. I can manage to build muscle and keep my blood sugar markers in a normal non-diabetic range as long as I keep my daily net carbohydrate intake to 20g or less. If you are familiar with vegetarian diets and can suggest a way for me to switch to a vegetarian approach that observes that, supports about 2500 calories per day, and is made from unprocessed ingredients, then please let me know, thanks.
Congratulations on your hard work! Head on over and join fellow Type 2's at the Diabetes Daily site. They were the community whose discussions gave me the tools to bring my HbA1c to 5.7 for 2.5 years running. Without any medication (I was on Metformin and statins when initially diagnosed).
If you refuse to consign yourself to the fate that most MD's in the US describe for their diabetic patients (mine told me, "there's nothing you can do to improve it, other than some exercise, take the medicine, annual check ups, and then hope there aren't complications as you age"...I got another general practitioner), then self-support groups like this are the only way to go to find what works for you, IMHO. The Reddit group is also helpful when starting out, but I found them not as hardcore about control as I wanted, which I found in some members of the DD group.
> Without knowing anything about that book or its author...
He is a well-known proponent of cutting carbs for all diabetics, even Type 1's, see his Wikipedia entry for an intro [1]. He's been open about his own Type 1, and:
"As of 2006, Bernstein had an HDL cholesterol of 118, LDL of 53, Triglycerides of 45, and average blood sugar of 83 mg/dl.[3] By 2008, at 74 years of age, Bernstein had surpassed the life expectancy of type 1 diabetics."
I wouldn't go as far as to say any carbohydrates is "wrong and deadly". However, OP you're responding to is correct: there is a metabolic pathway [2] that generates the necessary carbohydrates from fats and proteins in your diet if you don't eat enough. There are challenges with the ketogenic diet if not carefully followed, and it doesn't work for everyone [3].
0.14% of the diabetic population have qualified for a diagnosis of complete remission [4]. There is no cure, but some Type 2's can manage without medication and still diagnostically show no sign of Type 2 via blood glucose and HbA1c tests; those that maintain it for over a couple of years qualify as complete remission. I've found more of these people or diabetics approaching that level of control at the Diabetes Daily site than any other location on the Net [5]. Overwhelmingly, carb restriction is the first go-to they recommend all newly-diagnosed who want to join this small club try as among the first treatment protocols. Even many Type 1's report benefiting from not requiring nearly as much insulin after restricting carbs. It's worth investigating, if only to rule it out if it doesn't happen to work for your wife.
Reversal: what is being described here. Symptoms go away, and the longer you pursue the treatment, more difficult it becomes to clinically determine you ever had the metabolic disorder in the first place. However, the latent characteristics that made you first susceptible still exist.
Cure: you not only reverse, but you could stuff your face with pizza and Ho Ho pastries, wash it down with a gallon of Mountain Dew, and your blood sugar hardly budges, like normal people.
We do not have a cure. Short of genetically rewiring in vivo, or similar advancement, we won't see a cure. However, ongoing improvement of our understanding of how our bodies work continue to make it simpler than ever before to reverse Type 2. Simple doesn't mean easy, though.