“The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally” is a book by Dr. Jason Fung, a Canadian nephrologist. He challenges the traditional approach to diabetes management and advocates for addressing the root causes of the disease through dietary and lifestyle interventions. The book builds on the premise that type 2 diabetes, while often regarded as a chronic progressive condition, can be reversed naturally without relying on medication.
This was right up my alley. I’m all for reversing diabetes and if I can do it without medications, all the better. Dr Fung actually did a pretty good job of explaining why he thinks diabetes is a lifestyle disease and dietary disease and how medications, especially insulin, is making the disease worse.
It took me almost a week to listen to the audiobook. My attention span is limited and I found some of the topics covered to be quite basic. Bear in mind I’m knee deep in diabetes knowledge. To a newbie, all the effort he went through to build your knowledge base and understanding is priceless.
However, I waited and waited for the fun part to start. You know, the part where he talks about all the practical things we can actually do in real life. It never really did. In the last few chapters, Jason talked about a few strategies to help treat diabetes and the research behind it but he never went into the nitty gritty of how we can actually implement these lessons in our lives.
In a nutshell, The Diabetes Code is an excellent starter book for newbies to understand the mechanism of diabetes and why medication is not the answer to treating this disease. However, if you’re pretty well versed with why diabetes happens and just want to get on with improving your health, you can skip this one (or read this review/summary to get the gist of it).
Let’s take a deep dive:
Introduction
Through “The Diabetes Code,” Dr. Fung provides a comprehensive guide on how you can take control of your health by understanding the relationship between insulin resistance and type 2 diabetes. His insights are grounded in years of clinical experience and supported by scientific research. The book serves as an informative resource, distilling complex medical concepts into understandable terms.
Chapter Summary
Dr Fung divdided the book into 5 parts with a few chapters in each. The few chapters discussed the fundamentals of diabetes, differentiating the mechanisms behind Type 2 diabetes, as well as the distinctions among various forms of diabetes, including Type 1 and gestational diabetes.
He then went out to talk about hyperinsulinemia and insulin resistance, which is the root cause of the problem. This second section is a must-read even if you already have some basic knowledge about diabetes. You’ll probably still learn a few things. 
As expected, a whole section was then dedicated to the evilness of sugar (glucose and fructose). There was nothing new in this section for me. I already knew sugar was bad. So do you, that’s why you’re here.
Part 4 then focused on how not to treat Type 2 Diabetes. Diabetics on medication should read this section thoroughly. There are lots of gems here that your doctor would never have told you, not because they were trying to hide secrets but because I don’t think they actually know these facts.
Part 5 was where it got more interesting for me. Jason delved into how we can take matters into our own hands by making some significant diet and lifestyle changes to reverse diabetes and get off diabetic medications for good.
Main Messages From The Book
Jason’s book was filled with important facts and very easy-to-understand medical explanations. You’ll need to read the book to get the full picture but to give you a taste of what is to come, these were the main messages I gleaned from The Diabetic Code:
Why type 2 diabetes occurs
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- The medical community thought and still thinks that Type 2 diabetes is is a chronic and progressive disease and they are worsening the disease by treating it wrongly.
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- Hyperinsulinemia (high insulin) often precedes full-blown type 2 diabetes by many years. It is an early warning sign. Measuring fasting insulin levels, instead of just glucose, can help identify insulin resistance before diabetes develops.
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- Type 2 diabetes is characterized by high blood sugar and insulin resistance. It develops gradually over many years. During early stages, the pancreas can compensate for insulin resistance by producing more insulin. Blood sugars remain normal. Over time, insulin resistance increases to the point where the pancreas can no longer secrete enough insulin to overcome it. At this tipping point, blood sugars rise and type 2 diabetes is diagnosed. However, insulin resistance has been building for years prior.
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- Obesity is a major cause of insulin resistance and type 2 diabetes. However, diabetes is not simply caused by obesity alone. There are many non-obese people who develop diabetes due to insulin resistance.
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- High insulin is toxic and causes damage over time. Understanding insulin resistance as the root cause of type 2 diabetes is critical for developing more effective prevention and treatment strategies.
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- High blood insulin is associated with a number of problems including increased hunger and weight gain, high blood pressure, high cholesterol and triglycerides, and inflammation.
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- Insulin causes fat accumulation by converting excess calories into body fat. Chronically high insulin drives obesity. When insulin levels are elevated, dietary fat is stored in adipose tissue rather than used for energy. Fat burning is suppressed. High insulin signals the body to keep producing and storing fat even when plenty is already stored.
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- Insulin resistance is more directly related to increased fat accumulation in the liver and muscle cells. Fatty liver and intramyocellular lipid (fat inside muscle cells) interfere with insulin signaling and cause resistance.
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- Fat accumulation inside liver and muscle cells is driven by chronic hyperinsulinemia (high insulin levels). Lowering insulin levels reduces fat influx into tissues and allows stored fat to be released for energy.
Why a low-calorie diet is not the answer
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- During weight loss, dropping insulin levels is key. Otherwise, the body defends against fat loss by increasing hunger and slowing metabolism. After weight loss, the body tries to regain the lost fat by increasing insulin. This causes rebound weight gain.
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- Low-calorie diets and exercise alone often fail because they cannot override the fat-storing signals from high insulin long-term. To sustain weight loss, insulin levels must be lowered first. This allows fat to be released and used for energy.
Why diabetic medications fail
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- Diabetes treatments have focused on lowering blood sugar through medications, but this does not address the root problem of insulin resistance. Blood sugars become difficult to control over time as diabetes progresses.
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- Insulin resistance is the key driver of type 2 diabetes and must be addressed to reverse or halt progression of the disease.
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- Medications like insulin and sulfonylureas lower blood sugar by increasing insulin levels even higher to overcome the resistance. However, chronically high insulin levels are toxic and actually worsen insulin resistance over time. This starts a vicious cycle.
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- Drugs like metformin reduce blood sugar by decreasing glucose production in the liver, not by increasing insulin. Metformin helps manage diabetes but does not address the core problem of insulin resistance so disease progression continues.
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- Exogenous insulin therapy causes weight gain, hypoglycemia risk, and increased insulin requirements over time.
Dietary and lifestyle changes to reverse diabetes
- Losing weight can often improve insulin resistance and blood sugars. However, long-term weight loss through calorie restriction is very difficult. Most people regain lost weight.Sustained weight loss is more successful when insulin levels are first lowered through carbohydrate restriction.
- Eliminate fructose and refined carbohydrates, which are known to spike blood sugar, from your diet.
- Instead of increasing insulin dosage when blood sugars are uncontrolled, reducing insulin resistance should be the goal.
- Lowering insulin levels through carb restriction and metformin can help sensitize cells and improve glycemic control.
- Bariatric surgery can rapidly improve type 2 diabetes, sometimes even before major weight loss occurs. Bariatric surgery works by lowering insulin levels.
- Studies show low-carb and ketogenic diets outperform low-fat diets for weight loss and diabetes management, even with no calorie restriction.
- Very low-carbohydrate, high fat diets are effective for treating fatty liver and insulin resistance because they lower insulin. Ketogenic diets are particularly effective for reducing liver and intramyocellular fat content and reversing insulin resistance.
- On ketogenic diets, blood fatty acids and ketones replace glucose as the main fuel source for muscles and organs. Less dietary glucose means less insulin is needed, and fat can exit muscle and liver cells. Insulin resistance improves.
- Intermittent fasting allows the body to utilize stored glucose more efficiently, thus lowering high blood sugar levels. This approach, paired with a healthy diet, can contribute to weight loss and improved insulin sensitivity
- Remission is defined as achieving non-diabetic glucose levels without needing diabetes medications for at least 3-6 months. Remission can last years with maintenance of low-carb diet, exercise, weight control but relapse is possible.
- For reversal or remission of type 2 diabetes, sustained dietary carbohydrate restriction is essential to maintain low insulin levels. Even if remission is not achieved, low-carb diets are beneficial for controlling blood sugar long-term.
I hope this review helps you decide if you should spend the time reading Jason Fung’s The Diabetic Code. While he doesn’t focus much on non-obese diabetics, the fundamentals of why Type 2 Diabetes occurs are the same and we can still learn lots from Jason. Highly recommended as your starting point.
