As I have said in the last three posts, diet is the bedrock foundation of treating type 2 diabetes. Exercise is very important too, but if you rely on diet and exercise alone, you are missing out on the benefit of precision medicine.
Science has advanced to the point that we know how diet and exercise work. Reduced calorie diets and exercise both activate a master metabolic genetic switch called AMPK which coordinates all kinds of environmental factors to enhance survival. Think of AMPK as a dimmer switch. It is never completely on or completely off, it is just more or less active. The most important factor for a species to live on and prosper is for the fetus and young to survive long enough to reproduce and nurture their offspring until they can survive on their own. One of the greatest threats to survival in most animals is starvation. When there is no food, AMPK signaling is maximally switched on to mobilize calories from muscle and fat stores to allow the fetus to survive until there is food again. A low-calorie diet makes the survival switch brighter. Intermittent fasting and exercise do the same thing. AMPK is that primal regulatory switch that brings these signals all together. AMPK promotes cell and organ survival in multiple circumstances through regulatory pathways that are quickly becoming better understood.
Metformin and Jardiance mimic caloric restriction and fasting by directly activating AMPK to promote cell and organ survival. That is the clear reason that their impact on clinical outcomes is so much greater than their impact on the blood sugar level. Their benefits have much less to do with sugar control and much more to do with AMPK activation. Other drugs also amplify AMPK by reducing oxidant production and growth factor signaling. These include drugs like lisinopril or losartan and spironolactone or eplerenone for hypertension. The method used to lower the blood pressure is at least as important as the blood pressure level achieved. Statins to lower cholesterol also work like this. The best treatment for type 2 diabetes comes from understanding the genetics, epigenetics, and molecular biology that causes the disease and its complications.
When research scientists brought this all together over 20 years ago it dramatically reduced the number of heart attacks, strokes, and other serious complications compared with the care that most people receive. (See table 2). At that time, we only understood that some medicines developed to treat blood pressure, high cholesterol, and diabetes were much more protective than other medications. That is why they were used together in a protocol. Today, we understand why those drugs are so much better. They are precision medicines that interfere with the mechanisms that cause type 2 diabetes and its complications. There is no other intervention for type 2 diabetes that can document the kind of reduction in diabetic complications that you see in the last link. As it stands now, very few Americans have access to this protocol-driven, precision medicine type of care. Several of us are working together to make it more available.
Maybe you should get a certification in T2D reversal, instead of preaching it cannot be done?
https://lifestylemedicine.org/project/remission-of-type-2-diabetes/
The success rate is through the roof.