Type 2 Diabetes

Description

Type 2 diabetes is a metabolic disease characterized by chronic high blood sugar caused by insulin resistance and impaired β-cell function.

Type 2 diabetes – insulin resistance and β-cell exhaustion: In Type 2 diabetes, chronic high-carbohydrate intake and repeated insulin spikes lead to insulin resistance—cells respond poorly to insulin. The pancreas compensates by producing excess insulin (hyperinsulinemia), driving fat storage, liver fat accumulation, and systemic inflammation. Over time, β-cells become stressed, dysfunctional, and partially fail, raising fasting glucose and HbA1c. Systemic inflammation (IL-6, TNF-α), leaky gut, and endotoxins (LPS) worsen insulin resistance and damage insulin-signaling pathways.

Carbohydrates, leaky gut, and inflammation: High carbohydrate loads repeatedly spike glucose and insulin, driving oxidative stress, endothelial injury, and increased gut permeability. Bacterial endotoxins enter the bloodstream and create systemic inflammation, which further impairs insulin signaling and exacerbates Type 2 diabetes progression. Chronic inflammation accelerates complications such as neuropathy, nephropathy, retinopathy, and cardiovascular disease.

Fasting, ketogenic, and carnivore diets in Type 2: These metabolically targeted interventions address the root mechanisms of Type 2 diabetes:

Lower glucose and insulin: Reducing carbohydrates rapidly lowers blood sugar and improves insulin sensitivity.
Reduce inflammation and repair gut barrier: Ketosis lowers IL-6, TNF-α, and endotoxin load.
Improve fat metabolism: Ketones supply stable, clean fuel and reduce oxidative stress.
Promote cellular repair through autophagy: Fasting enhances mitochondrial function and clears damaged cellular components.

In Type 2 diabetes, fasting and low-carbohydrate diets can significantly improve or normalize blood sugar, often reducing or eliminating medication needs under medical supervision. By lowering insulin levels and inflammation, these strategies also support long-term β-cell recovery and improved metabolic flexibility.

Root Causes

Carbohydrate consumption

[ 1 ] David S Ludwig et al. (2021) DOI PMID [ 2 ] Tian Hu et al. (2012) DOI PMID [ 3 ] Geoffrey Livesey et al. (2019) DOI PMID [ 4 ] Fenping Zheng et al. (2010) DOI PMID [ 5 ] Chris Moran et al. (2023) DOI PMCID PMID

Treatment Options

Carnivore Diet

[ 6 ] Chia-Wei Cheng et al. (2017) DOI PMID [ 7 ] Min Wei et al. (2017) DOI PMID [ 8 ] Delphine Tinguely et al. (2021) DOI PMID [ 9 ] William S Yancy Jr et al. (2005) DOI PMID [ 10 ] Andrea Mario Bolla et al. (2019) DOI PMID [ 11 ] Parisa Ghasemi et al. (2024) DOI PMID [ 12 ] Raghad A Alarim et al. (2024) DOI PMID [ 13 ] Belinda S Lennerz et al. (2021) DOI PMCID PMID

Ketogenic Diet

Fasting

[ 14 ] Michael Albosta 1,2, et al. (2021) DOI PMID [ 15 ] Anna Obermayer et al. (2022) DOI PMID [ 16 ] Suresh K Sharma et al. (2023) DOI PMID [ 17 ] Lixin Guo et al. (2024) DOI PMID [ 18 ] Wen Xiaoyu et al. (2024) DOI PMID

Susceptibilities

Systemic Inflammation

[ 19 ] G S Hotamisligil et al. (1995) DOI PMID [ 20 ] Steven E Shoelson et al. (2006) DOI PMID [ 21 ] B Balkan et al. (1999) DOI PMID [ 22 ] A D Pradhan et al. (2001) DOI PMID [ 23 ] Marc Y Donath et al. (2011) DOI PMID [ 24 ] Claus M Larsen et al. (2007) DOI PMID [ 25 ] Allison B Goldfine et al. (2013) DOI PMID

IGF-1 (Insulin-like Growth Factor 1)

Insulin Resistance

Symptoms

Increased Thirst and Frequent Urination

Increased Hunger and Fatigue

Slow-Healing Sores and Frequent Infections

Recurring Infections

Sources

[1] The carbohydrate-insulin model: a physiological perspective on the obesity pandemic

[ 1 ] David S Ludwig et al. (2021) DOI PMID

[2] Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials

[ 2 ] Tian Hu et al. (2012) DOI PMID

[3] Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: Assessment of Causal Relations

[ 3 ] Geoffrey Livesey et al. (2019) DOI PMID

[4] Relationships between glucose excursion and the activation of oxidative stress in patients with newly diagnosed type 2 diabetes or impaired glucose regulation

[ 4 ] Fenping Zheng et al. (2010) DOI PMID

[5] Glycemic Control Over Multiple Decades and Dementia Risk in People With Type 2 Diabetes

[ 5 ] Chris Moran et al. (2023) DOI PMCID PMID

[6] Fasting-mimicking diet promotes Ngn3-driven β-cell regeneration to reverse diabetes

[ 6 ] Chia-Wei Cheng et al. (2017) DOI PMID

[7] Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease

[ 7 ] Min Wei et al. (2017) DOI PMID

[8] Efficacy of Ketogenic Diets on Type 2 Diabetes: a Systematic Review

[ 8 ] Delphine Tinguely et al. (2021) DOI PMID

[9] A low-carbohydrate, ketogenic diet to treat type 2 diabetes

[ 9 ] William S Yancy Jr et al. (2005) DOI PMID

[10] Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

[ 10 ] Andrea Mario Bolla et al. (2019) DOI PMID

[11] Impact of very low carbohydrate ketogenic diets on cardiovascular risk factors among patients with type 2 diabetes; GRADE-assessed systematic review and meta-analysis of clinical trials

[ 11 ] Parisa Ghasemi et al. (2024) DOI PMID

[12] Effects of the Ketogenic Diet on Glycemic Control in Diabetic Patients: Meta-Analysis of Clinical Trials

[ 12 ] Raghad A Alarim et al. (2024) DOI PMID

[13] Behavioral Characteristics and Self-Reported Health Status among 2029 Adults Consuming a "Carnivore Diet"

[ 13 ] Belinda S Lennerz et al. (2021) DOI PMCID PMID

[14] Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians

[ 14 ] Michael Albosta 1,2, et al. (2021) DOI PMID

[15] Efficacy and Safety of Intermittent Fasting in People With Insulin-Treated Type 2 Diabetes (INTERFAST-2)—A Randomized Controlled Trial

[ 15 ] Anna Obermayer et al. (2022) DOI PMID

[16] Effect of Intermittent Fasting on Glycaemic Control in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials

[ 16 ] Suresh K Sharma et al. (2023) DOI PMID

[17] A 5:2 Intermittent Fasting Meal Replacement Diet and Glycemic Control for Adults With Diabetes: The EARLY Randomized Clinical Trial

[ 17 ] Lixin Guo et al. (2024) DOI PMID

[18] The effects of different intermittent fasting regimens in people with type 2 diabetes: a network meta-analysis

[ 18 ] Wen Xiaoyu et al. (2024) DOI PMID

[19] Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance.

[ 19 ] G S Hotamisligil et al. (1995) DOI PMID

[20] Inflammation and insulin resistance.

[ 20 ] Steven E Shoelson et al. (2006) DOI PMID

[21] Inhibition of dipeptidyl peptidase IV with NVP-DPP728 increases plasma GLP-1 (7-36 amide) concentrations and improves oral glucose tolerance in obese Zucker rats

[ 21 ] B Balkan et al. (1999) DOI PMID

[22] C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus

[ 22 ] A D Pradhan et al. (2001) DOI PMID

[23] Type 2 diabetes as an inflammatory disease

[ 23 ] Marc Y Donath et al. (2011) DOI PMID

[24] Interleukin-1-receptor antagonist in type 2 diabetes mellitus

[ 24 ] Claus M Larsen et al. (2007) DOI PMID

[25] Targeting inflammation using salsalate in patients with type 2 diabetes: effects on flow-mediated dilation (TINSAL-FMD)

[ 25 ] Allison B Goldfine et al. (2013) DOI PMID