Is Type 2 Diabetes Reversible at Scale?

"the nutritional approach is based on highly individualized carbohydrate restriction and nutritional ketosis (which I’ve written about extensively in the past and throughout this blog)."

I think there's at least a 75% chance that the whole cure is essentially contained in that sentence.

I've been keeping a bit of an eye on this area for a while, and watching the studies fling back and forth and such. My current pet theory that I think explains a lot of observations is "Carbohydrate-restriction diets (such as Atkins) work well on obesity caused by insulin resistance and metabolic syndrome, and may even be able to reverse the underlying causes, but may be ineffective for other causes." Basically, if you damaged your pancreas to some degree (or convinced them to stop working, or whatever; "damaged" them in terms of end result not necessarily "harm to the pancreas"), carb restriction may work well for you, but if that's not the core problem, it may not work for you at all. This may explain the variance in studies, if there is an unaccounted for variance in the populations being studied and how affected by metabolic syndrome they are, and why for some people low-carb diets work great and for others they fail completely.

I've also noticed as I've been getting into some intermittent fasting and such that when I'm doing it, I seem to be more able to consume a higher degree of ("good") carbs without it going straight to my waistline, as if I'm actually repairing or healing some things that I broke in my teens. (Where I considered a Coke and a king-sized package of Skittles a good after-school snack; it wasn't bad for you, there was no fat in it!)

(Perhaps slightly less controversially, what if the term "obesity" is actually like the term "schizophrenia"? We know the term "schizophrenia" is a catch-all term for what is almost certainly multiple distinct disorders that we currently lack the technology or know-how to distinguish. What if "obesity" is actually several distinct problems, with several distinct cures? In some sense, we already know this is true, because for instance thyroid malfunctions can cause issues with weight. But what if what's "left over" after those other cases is still three or four distinct things we're currently lumping together, and that we lack the tech or know-how to distinguish? It wouldn't really be that shocking.)

But note I label this "pet theory" for a reason. I'm not claiming to have Truth here, just a pet theory.

Thin people with T2D are probably “TOFI” — thin on the outside, fat on the inside. There is a concept of the “personal fat threshold” which is how much fat you can pack into your fat cells, and how many new ones you can grow. This concept explains why Asia and India have high rates of T2D at a much lower BMI.

An interesting way to show that this is likely the case is people with lipodystophy - they have no subcutaneous fat, and they are almost all diabetic.

This is just a native ad for Virta, a company operating in the diabetes technology space.

Depends how you define "works for":

    Disclosure: I am an advisor to Virta Health and I have invested
    in the company, because I believe their approach is the best one
    to solve this problem—not the other way around.

It might not necessarily be high in fat - it's probably the calorie restriction that works, as in this trial:

https://www.nhs.uk/news/diabetes/radical-low-calorie-diet-ma...