Also talks briefly about other conditions that have been helped by a keto diet. Interesting reasons why keto is not recommended by most medical professionals.
I started keto over two years ago. At the time, I was using both insulin and metformin and had an A1c of 7.3.
Since then, my A1c has been as low as 5.2 with no T2D medications.
By the Virta definition, I have reversed my diabetes.
But I don’t consider my T2D to be cured, reversed, or in remission. Keto is just an effective treatment of it. A far better treatment than the drugs I was being given.
A1c measures a symptom. A symptom that is kept under control by keto. Since when is actively treating and controlling a symptom considered a cure for the underlying disease? A1c isn’t even all that good a test. It’s just an easy one to administer. A recent study indicated the A1c failed to diagnose T2D in 73% of the cases that an OGTT (Oral Glucose Tolerance Test) diagnosed.
I use the analogy of a strawberry allergy. Someone that is allergic to strawberries doesn’t cure it, reverse it, or go into remission, simply by avoiding strawberries.
I do like the article and yes acceptance of a ketoish diet is important so we can actually get help from the medical world. As of now that is rarely the case proportionally. Most in the medical world just follow what they have been taught and push drugs as alternatives. People need nutritional help and education. Most nutritionists are all about the pyramid and balanced with carbs. So many are afraid or not smart enough to think for themselves. Book smart from the old books and establishments. Money has a lot to do with it all for sure.
@OgreZed I agree entirely… it’s a treatment. I have yet to read where anyone can go back to eating carbs and sugars without spikes, cravings and not be back into the vicious cycle.
It makes sense if you realize carbs are an inappropriate nutrient. The symptoms end when one stops ingesting the inappropriate nutrient.
Like having a super duper Diesel engine, but running it on gasoline. Kaboom. Replace the gasoline with diesel fixes it
Simple
Well, if by “cured” you mean “took a pill and now it’s all gone,” then no, you’re not cured. But “remission” is an appropriate term, because you are no longer seeing symptoms, and it leaves open the possibility that they might return. “Reversed” means more or less the same thing, so it would also be appropriate.
I suspect that the resistance to “cured” comes from the fact that the treatment consists of a dietary change, not a direct intervention on the part of a professional. But I would suggest that it’s possible to use the word “recovered” if “cured” sticks in the craw, in the sense of “I took some strychnine and had some bad symptoms, but I stopped taking the strychnine and eventually recovered.” Sure, if you take more strychnine, you’ll get more symptoms and probably die, but as long as you don’t do that, you’re fine.
The notion that a cure involves being able to engage in lethal behavior with impunity is probably not a good underlying assumption.
In medicine we’re taught the word “cure/cured” is properly only used to refer to things that once treated, will not recur; the tx eliminated the condition entirely EX: infectious disease, surgical removal of a benign mass.
Resistance to the term is correct in this context of an endocrinologic condition that’s under control via diet. Personally I’d choose the word “controlled” in the example of diabetes over “reversed” or “recovered” (the latter is p inaccurate imo).
I hadn’t thought about the terminology, so the above comments are very interesting. I think cured is the wrong word, remission or control seems to be along the right lines.
I am not diabetic, so this is an outside perspective. I am keto because I am obese and I’m finding the benefits to be a lot more than weight loss, so maybe I will always be keto, or at least most of the time.
By “cured” I would mean repairing the condition with one or more treatments, and no longer needing further treatments.
I had a pulmonary embolism in 1979, and have taken blood thinners ever since. Is my clotting problem “cured”?
I’m not sure that quite works either. Once a broken bone heals, there’s no guarantee it won’t break again. Now, you could amend it to “would not recur under normal circumstances”, but then the issue become what should be “normal” in terms of diet?
This is EXACTLY what I stress. Keto doesn’t cure anything. It removes the causes of your dis-ease. The hyperinsulinemia, the high levels of glycation in the brain, the excessive inflammation and so on.
I suspect you’ve put your finger on the real issue. That must be why, in my example above, I subconsciously chose a poison. The parallel with carbohydrate is obvious, now that you pointed it out.
And falling out of a tree would probably be another good analogy. Once your leg heals, it’s fine as long as you stay out of trees in future.
And that leads me to propose another term, “heal.” How about “I healed my pre-diabetes by going keto”—can I correctly say that? Because all the disease indicators are normal, but if I “break my leg” again (i.e., by returning to a carb-laden diet), I’ll surely get sick again.
Hmmmn. I suspect the missing element here, is that you can allegedly cure/revert the symptoms we call diabetes – because really in western medicine most of our disease names just label symptoms more than causation (to be fair, this definition is better than most, though it functions a bit better for type 1 than type 2, since the first doesn’t change even when you deal with symptoms but the second does) – but we may or may not cure – or it may take as much as many years longer – the underlying hyperinsulinemia that may have been present for years prior to blood glucose finally showing the result of insulin resistance, and that may be a somewhat separate (though interrelated obviously) condition.
That underlying, still-present-to-whatever-degree condition may cause any return to high-carb-eating to bring about diabetes symptoms again (sooner, or later, or to varying degrees). I would say that this is not a matter of the diabetes ‘re-verting’ but rather occurring again from scratch.
Like the broken leg analogy, as opposed to say, a cancer growing in the same spot the last one was removed; the first is two separate events, the second they are likely related/continuous. The true underlying cause of the broken leg may be problems with risk-taking behaviors and clumsiness 
so there really IS a single, primary cause behind that; but the symptoms of it, are the broken bones. In this analogy, hyperinsulinemia is the behavior and clumsiness. You can cure the broken leg. You may not have cured the other. So the odds of it – or something like it – happening again are pretty high.
Until we are able to decently measure insulin and fatty acids in our blood – preferably at home with a meter – I think a lot of this is going to remain black-box to some degree.
I agree, but would take it a step further. A question I’ve asked before is even if the known symptoms are being successfully treated, could the underlying disease still be slowly ravaging the body?
Since Diabetes is not a “disease”, but a “condition” you eat yourself into, IMO the best word for reversal is “alleviated”. You alleviate it by eating youself out of it.
Indeed, diabetes, obesity, CVD, dementia/Alzheimer’s and maybe even Cancer are symptoms of hyperinsulinemia and this poisonous WOE we call the SAD guidelines. But we CAN cure hyperinsulinemia by adopting a Keto WOE, or even by just time restricted eating a la Jason Fung.
As for removing the poison that is embodied in the SAD guidelines, backed by the USDA, Big Pharma, Big Food, and all the AMA ADA types - who knows where the cure will come from. Enough public noise about people getting cured by not eating the crap will probably force congress’ hand. Big Food, Pharma and Medical PACs will bribe the esteemed legislators to delay this as long as possible, maybe decades. Eventually, Congress will feign outrage and start throwing past legislators under the bus for having created this train crash that we call the SAD. I bet, in the end, congress will claim kudos for having solved the health care crisis.
TL;DR - KCKO, KCFO
I still like the analogy of a modern high compression diesel engine (us) being fueled by gasoline. The engine may start, but it will cough and smoke like a coal fired locomotive and gradually damage the interior till it finally dies an early death.
However, diesel engines are built quite well (eg humans after millions of years of evolution), and if restored to diesel fuel, (evolutionarily correct WOE) can resume normal healthy operation.
Cure, remission, alleviation - who cares what those deadbeat doctors wanna call it.
KCKO KCFO
That totally depends on circumstance. For example, an acute fever is part of the body’s healing process when we are infected, and treating the fever does nothing for the infection, which is why many doctors now recommend letting a fever run its course, unless the fever itself is doing damage. But your point is well-taken: the reason many of the childhood diseases need to be vaccinated against is that they are capable of doing long-term damage, quite apart from the immediate symptoms. Rheumatic fever caused heart damage in many children, measles can cause cognitive impairment, blindness, etc., even if you treat the immediate symptoms.
In other cases, however, the symptoms are the disease. For example, the best treatment for cholera was discovered to be simply assisting the patient through the symptoms, because the biggest problem was dehydration from the diarrhea. Get patients through that, and they’re fine.
The disease of which diabetes, Alzheimer’s disease, obesity, cardiovascular disease, hypertension, and fatty liver are all symptoms already has a name, btw: metabolic syndrome, also known as insulin resistance. Dr. Lustig suggests calling it “processed-food disease.” I like the name carbohydrate intolerance, myself. Fortunately, we know what the root cause is, and we know that the cure is simple: remove the root cause! 