Fasting Space

Today, I'm sharing the results

of a clinical study that we published
in the Wisconsin Medical Journal.

And I'm going to give you the details
of the protocol that we used

and that I continue to use
to help people with type two diabetes

get completely off insulin
in a safe and thoughtful manner.

People on our study were on insulin,
many of them for over ten years,

and they were able to get off
in under six months.

If you have diabetes, especially
if you have insulin, but any type of type

two diabetes, I think you're going to find
this very, very fascinating.

I think it can change
how you see this condition.

And if you don't have type two diabetes.

Stick around.

If you are trying to lose weight,
if you're interested in the metabolism.

Want to show you
that the exact same protocol that we use

to help people do this process

is the same thing that can help people
to lose weight, burn off excess body

fat, and make sure that you never develop
type two diabetes to begin with.

Do everything that we can to minimize
the impact of this condition.

Profound space.

We're going to be looking at
a profound space metabolism in the body,

to see how a fasting based
dietary protocol can get into

the root levels of our metabolism
and have broad influence on our health.

That's where we're going
today. metabolic health.

We are in a tight spot,
a difficult spot in society today.

Here is some information
just on prediabetes in America

115 million adults, eight out of ten
who do not know it.

So prediabetes, the type of thing that is
happening in the background so often.

And this is the start of the process

that is leading toward type
two diabetes, ultimately.

And this prediabetes space, the beginnings
of insulin resistance is happening.

And it's intimately wound in

with metabolic dysfunction of all kinds
and especially weight gain.

So anyone who is struggling with weight
gain, you can know

you've got some insulin
resistance happening.

And then there's a risk that pre-diabetes
and this whole process can be starting.

Now when we zoom in on age group

65 and up in
the US is up to 50%, about 50% of people

pre-diabetic by 65 and then 30% have type
two diabetes by that point.

So if you're a younger person and you're
in, you know, this society and you see

it can almost feel inevitable,
like this is where it's going.

And so if you're in an older group,
then you see like, oh,

like this is like a common thing
that is happening.

So this is the problem that we are at.

And this you can almost feel like it's
a conveyor belt.

It's just bringing people
along into this place.

And you say, how do we get off?

The problem is that we're told, well,
this is a one way street.

The conveyor belt runs in one direction.

This is just the type of thing
that happens to people as they get older.

This is what happens.

And you just got to take the medicine
and do the best that we can.

And especially insulin
is like the end of the line.

It's the most powerful diabetic medicine.

But then you know,
from a certain perspective, insulin

doesn't have so many side effects
because it's physiologic.

You know,

insulin is a natural hormone in the body,
but it has weight gain as a side effect.

And so this sets up
a very difficult cycle.

Start taking insulin to help blood sugar
go down.

And then it works.

But how does it make it go down.

So by jamming it inside of body fat cells
and then the total energy in the system

is increased and it drives insulin
resistance in a cycle.

And then that cycle
can feel impossible to break.

No one has the idea
to even think of breaking it.

That's the thing.
It's like almost invisible.

It's like it's not a problem
we could solve, but it is a problem

we can solve and we can significantly
push back against this.

So my good news for everybody, it's
not a one way street is a one way street.

Ever feel like this?

The sign is pointing down into the ground.

Not very encouraging. Okay.

The good news is that we have tools
that can push back

significantly against this,
especially when we open our mind to

some different ways of thinking about it
that we are going to do.

I am going to share this protocol

with you
that I developed over a number of years

while I was at the University
of Wisconsin, and really think

that it is extremely exciting, and

I just hope that we can spark
a bigger conversation about it.

There is a way
out of the metabolic dysfunction, both

for the future state means
preventing the situation from happening.

The conveyor belt, say, is not inevitable,
that we have metabolic dysfunction.

And if you are in a difficult place now,

even in the very most difficult space,
I say having to use insulin for type

two diabetes is the most difficult
metabolic space.

Very difficult this situation insulin.

Using type two diabetes,
we can use like a lens to see.

It lets you see the power of the protocol,
because to take even

a very difficult place and reverse it,
make it go away is possible.

I think most so many people
do not believe it is possible.

And so from my perspective, this research
a glimpse into what is possible.

So I want to give you a big message
of hope in this.

A big encouragement but no hype.

Okay, to do this protocol.

It is a commitment.

The incredible people
who did this protocol along with me,

anybody who comes to work with me,
it's a commitment, you know it is.

And so there's no magic to it.
There's just physiology.

And we're going to get into the physiology
of what is happening.

core concept for everybody.

Everybody who has a metabolism okay.

Fasting and insulin.

It's like a universal rule

that insulin is having the same types
of effects.

Insulin is a hormone.
It's a message to the body.

It is telling things to the body
telling the body,

hey, take extra glucose
that is in the bloodstream.

Get it in the cells where it's safer,

where it's not out in the blood vessels
reacting with things.

All right.

So if you're struggling with weight,
you're trying to get that down.

You're struggling with type two diabetes,
and you're taking synthetic insulin

to try to keep the blood sugar
under control.

We can see in both of these scenarios,

the way that insulin is working
is driving these things.

And so the other thing that insulin does
okay, insulin because it's

driving the energy in the fat cell,
you can think of it

like a cap over the fat
cell is blocking access to the fat cell.

You can see it's telling the body,
this is not the time to be losing weight,

not the time to be taking energy

out of the cell because we're
putting energy into the cell.

So if we want to reverse that process,

you see,
we need to bring the insulin level down

so that that will dissociate, separate,
make the body fat cell available,

and then we can start running
the system in reverse,

giving the body permission to get that.

That's what
the hormonal state of the body is doing.

So wherever we're at, diabetes,
weight issues,

maybe dealing with both of these things,
we see benefit can come

as we bring the insulin down
appropriately.

Right.

If you have type two diabetes,
you don't make any changes to it.

You don't have a protocol or a process.

Thoughtful.

You just stop your insulin and the blood

sugar blows up is like nothing good
going to come from that, right?

So it has to be done
in a very thoughtful manner.

So I'm not going to do a deep literature
review.

I just tell you many studies demonstrate
a improved insulin sensitivity,

mean the insulin that we have in our body,
whether it is so synthetically given

or naturally generated from our pancreas,

both a fasting period

and a period of low carbohydrate
eating in both people with diabetes

and people without diabetes
can help to improve

insulin sensitivity, make the insulin
go farther so we need less of it.

And as we need less of it, that's

what's taking away the pressure
to drive insulin resistance.

So I'm not going to review all those
studies because I want to review my study.

I've got links to my study
that I'm discussing,

and all of the papers
that I reference are outlined there.

So feel free to read them all
and we can have a detailed

discussion of it in the comments
of this video in the future.

So I want to dive in specifically
on insulin use.

So insulin using patients,

the most severe manifestation
of type two diabetes.

And so I just want to bring
a lot of appreciation to it okay.

Very difficult space to be in.

We've kind of the body
has used all of its compensation.

And then now we have to add insulin to it.

And therefore what I say about it, people

in this situation are in
the greatest need of help.

They have the very most to gain
from fasting based

process, from low carbohydrate eating,
especially very low carbohydrate eating.

We're trying to use
our most powerful processes

to give the body a break and some space
to let things come into balance.

And the unfortunate reality
is that people

who have the very most severe
manifestation of diabetes,

whose metabolism is very weak,
needing a huge amount of assistance.

These are the exact people that we tell
in standard

medical counseling
that you cannot use these processes.

And this is the big drive behind my
study, is like,

actually, these are the people that need
the help the most.

And we should be, as a health care system,

developing ways
to help people with this.

And then through that,
what I have seen with

it is through that process
we can come to help, you know, everybody,

so many more people to anybody
dealing with metabolic dysfunction.

So this is the core idea
and the question of the study.

Instead of conforming the lifestyle
of someone who is using

insulin to the medication,
what if we worked backwards?

And what if we conformed the medication
to a more effective lifestyle process?

So that's what we're doing in the study.

It's like we have

we've been so focused on the medicine
that everything has to revolve around it.

our study is different.

It shows a different way of doing it.

We paired this protocol low carb, time
restricted feeding.

I like to put a time restricted
eating protocol,

along with a proactive insulin titration,
to bring the power

of fasting and low carbohydrate
eating to the people who need it most.

So here's the thing insulin
is the most powerful medicine, right?

And so if you take
the most powerful medicine and you add

in the most powerful dietary practices,
can you drop your blood sugar too low?

Could it be dangerous?

Absolutely. It could be, right.

It's not the fasting from my perspective.

It's not the low carbohydrate eating
that is the true

danger is the medication in that
that is the true danger, right?

The body is built to be able
to practice fasting.

The body is built to eat healthy protein
and fat rich foods

and handle, you know, some vegetables.

Okay, is
when we put the body in that space.

That is a healing space.

It's the medicine that drives the too low.

And the medicine can be changed
so often in medicine to say, oh,

the medicine is be there. It has to stay.

Okay, so we developed a titration protocol
to help people to do it.

Here is our study.

Here is the link so you can review it.

Read the whole thing
I read the whole paper again last night.

I just love it.

I'm a little biased. I am a little biased.

Feasibility study of the protocol
for insulin using type

two diabetic patients is a safety study
as much as anything.

It took me multiple years to get this
approved by the Institutional Review

Board amazingly, which is really hard
to believe since it's essentially nothing.

It's essentially nothing.

It's like we're going to eat twice
in a day instead of 3 to 6 times, right?

And then we're going to thoughtfully
monitor the insulin and dial it down.

So here's the study six month study.

University of Wisconsin
patients had been using insulin

for average of over nine years,
some people over 13 years.

And we put them on the protocol.

Time restricted eating means
eating all calories in two meals

within a 6 to 8 hour
window is a classic 16 eight protocol.

But for insulin

using type two diabetes and paired
with a very low carbohydrate diet.

So our goal intake was 30g.

So we're getting toward that
keto sort of level.

And we provided people
with a lot of resources on how to do that.

So a close monitoring
proactive adjustment of medications.

Here's how we start.

Someone is taking a basal
meaning long acting insulin.

We cut that in half.

Basal insulin might last 24 or more hours.

And that is the type of thing
that if you start

fasting okay,
that medicine doesn't go away.

Powerful medicine still going to be
there can drop your blood sugar too low.

So the basal insulin is actually
the most dangerous.

Usually a basal is the first thing
that people will get started on,

but it's the first to go in our protocol.

So we get it out of the fasting window,

and then we eliminate any short
acting insulin doses.

When people are fasting,

that takes all the pressure
off that open space that would be driving

the insulin, the blood sugar too low,
and then the food.

In our study, this is how we have
people eat very low carb meals,

but ideally as tasty as possible.

And these would be
two very representative examples

of what we have people eating.

And if anybody is here,
is they trying to lose weight,

try to get an effect like this.

Hey, these are the types of meals
I would want people to be considering.

Now, if you say,
oh, it's a little too Spartan,

I say, look at the top one, have two eggs,
even three.

Okay, that's no problem.

And honestly, one of the benefits
of eating like this healthy,

tasty food is like,
think of this bottom one.

Okay, we're having some sort of protein,

some sort of veggie, but look,
no pile of rice and no role, right?

We're just getting
all the extra carbs out.

I say have double veggies

or even a double salmon,
and you're probably going to be okay.

You know,

portion control we talk a lot about
they don't have to be mini baby meals.

They don't have to be huge meals either.

We want something in balance.

Usually what I tell people is you want to
eat enough where you feel satisfied.

You want to eat slow enough
that you can find the point

where you can ask the question, like,

if I didn't take another bite,
could I just be okay here?

You know, that's a good spot.

Not waiting until the system is,
like totally crammed full.

Okay, so this is the study right here.

Eat one meal like this
and then you eat another one.

And we had people do it,

and we had them log their meals
and track it for six months.

And I say, wow. Results.

So over six months this is what people
experienced in our study.

The very most important thing in my view,
no adverse events

requiring medical attention.
This is the big thing.

People on the institutional review board
at the university just terrify the.

So you're going to hurt people.

People think fasting going to hurt people,

and people think that bringing it into
this space would be dangerous.

The thing that people don't realize
is how dangerous insulin is.

And we are creating,

eating and food environments
that make people have to stay on insulin,

and we are creating more
and more dangerous experiences.

Insulin,
one of the most common medications

that leads to hospitalization
and emergency department visits itself.

If you ask anyone who's taking insulin,
do you ever get lows?

People get lows, okay?

And lows are very, very hard on the body
and they can be very dangerous.

And so a protocol
that takes the insulin away

when it is done proactively
get the drug out of the way.

It is a way to

make our entire medical experience so much
safer for people in this situation.

So our protocol was very, very thoughtful.

We had huge patient contact.

We had patient contact either
with a physician or a nurse every day.

That patient was still on insulin
until they get off.

We are keeping close tabs
with the caveat.

I think I put it here
that if someone stabilize a couple,

you'll see the results by three months.

If people stabilize, it didn't
get completely off by three months.

We stopped talking to them every day
and they can call.

So you have to understand
what we are doing.

We don't just stop insulin on somebody.

We don't just
it doesn't just happen. Right.

Daily contact, very significant protocol.

You don't need the details of this.
I just put it here.

Here's the
the basal insulin titration protocol

from our hypoglycemia mitigation process.

You can just see we're seeing the doses
of insulin along the left hand side.

And then we're seeing the blood
sugar levels.

And you see if someone's look at that
second column from right 121 to 300.

We're not changing things.

If the blood sugar starts going under 120,

we're giving it a huge buffer right
way out in front of it.

We're either stopping it
or dose reducing at that point.

And then the more the sugar drops,
the more aggressively we cut back.

And if everyone's ever having a low,

it's like the insulin is straight
out of the way because that's telling you,

you know, in the standard sort
of thinking someone on insulin gets a low.

What is the advice?

Say, oh, you didn't eat enough.

This is how we drive
extra drive the cycles of weight gain.

And in the short term okay.

Everybody in our study got glucose tabs.

You can hit some sugar immediately
if you ever needed it.

Nobody needing to do it
because our titration,

you know, got way out of the way.

But yes,

if you get a low if you're using insulin,
if you're on other diabetic medications,

you get a low, of course,
get some sugar in, bump it right back up.

But then the message really should be
the medicine was too much, right?

Don't make people eat more.

Don't make somebody who is overweight
and trying to lose weight.

Eat more to keep up with the medications.

Get the medication out of the way.

This is the real paradigm
change that we need

to think about a lot more in my view.

So here's more results.

Okay, we had 20 participants in our study
and also completely incredible.

19 out of 20 participants who signed up
for this study completed it.

Only one person didn't do it.

And they basically they went through
kind of the onboarding.

They signed all this stuff,
they started it.

And then then they didn't do it at all.
They did.

They did nothing.
So it isn't for me. Okay.

But the 19 people who signed up
and started out,

everybody else finished, like,
you know, it's totally fine.

Nobody has to ever do it, of course,
but it's just incredible.

Like, if you were to just survey
people and say, who do you think are like

least likely to be able
to complete a six month fasting study?

I think people would say, oh, insulin
using type people with type two diabetes,

like, who are significantly overweight,
they're never going to do it right.

It's like,
but it's actually the complete opposite.

It's highly motivated.

Like you tell somebody who's using insulin
who having to give injections

to themselves all the time, like
there's a pathway where you might be able

to get your way out of it, and I'll help
you do it like people very happy about it.

So I just if you're in that scenario,
just stick around.

Come listen and talk to me, I help you.

We will help you.

14 out of the 19 who did the protocol
got completely off insulin by six months.

I mean, I think it's really
I say, wow, I just think it's amazing.

So here is total
insulin use across the study.

So this is average
across 19 people coming in.

The average insulin use
was 72 units of insulin a day.

And by three months at the mid check in
we're down to basically 11

and then nine and a half on average
by the end of the study.

So it just makes such a dramatic impact.

Total insulin use reduced by 86% over
six months.

What a safer space
is that okay from so much insulin

being brought in to minimal insulin
is just things coming into balance.

Do you see that this protocol, this way
of eating and going through it,

is bringing things back into balance
and into a significantly safer space?

So the people who remained on insulin,
five out of the 19, stayed on insulin.

Their dose was 72% less.

So even though they're on insulin right
there, dose is so much less.

Think of the chance
that they're going to develop

severe hypoglycemia
at some point is significantly less.

And think of the weight

gaining drive that these medicines
are giving them significantly less.

So here is breaking out all 19 study
participants by their total dose.

And so the highest insulin use at the top

one person 225 units a day,
and then it's all the way down.

And then, you know,
the lowest around 20 units a day.

And so these are our data points
where we are

just checking at one and three months.

So if you look everybody who got off

14 of the 19
people were off by three months.

And then the other five people,
you know, certainly

there is a trend through it
as you go through that.

It is also getting better.

And I have to tell you, I've worked
with many people in these situations.

Two is very likely over time

that even someone at 225 going to get off,
but it's not.

That didn't happen in six months, but
I bet you by another six months we would.

You know, if you stick with it,
it's going to keep working down.

And I pretty much
I believe in this protocol.

Anybody who sticks with it going
to be able to work the process over time.

Definitely not instantly, but I just
I think it's amazing to see it

just split out and see these lines
all converge and heading down.

Love it.

Here's here's the the best caveat of
all right, anybody can stop

their insulin who has type two diabetes
and their blood sugar can explode.

And if your A1 C is 13
like it's going to be terrible right.

So we did all of these things
all of this insulin out of the way.

And the A1 C did not change.

So I put in here
the asterisk for recruitment criteria.

So the, the IRA, b at the university

did not let us recruit any patients
who were well controlled.

Okay.

So everybody had to have an A onesie over
seven, which is very interesting.

So if we had recruited
a population of patients

whose A1 C was all 6.2, you know,

and then we would have, I'm
sure we could have kept it stable at 6.2.

So we ran the protocol to use
the dietary process to replace insulin.

Some people gave me some criticism
on the study.

They said, well, the A1 c
didn't improve too and is still 7.8.

I was like, look,
we very specifically designed

this study to isolate
the insulin effect of this protocol.

And what we showed is

we can replace the insulin that people are
using without changing the blood sugar.

And I just think that's very profound.

In six months is a very short
amount of time to accomplish that.

And I got to tell you,
we have huge ability

to dial in on this next part as well.

We also did not optimize.

The only changes we made were insulin,
and we did not optimize

non-diabetic medications
or 100 other ways that we can get at this.

We just isolated the insulin effect.

Here's a change in BMI.

Look at the scale on the left.

From 28 to 35 people lost
four points of BMI on average,

going from about 34.5 down to about 30.5.

And then that corresponded
with an average weight loss of about

26 pounds across the study over
six months for each person.

So this process, a powerful

process for weight loss as well.

We also documented significant improvement
in blood pressure.

On average, people lost ten points
on systolic blood pressure,

going from 134 to 124 on average
with the skew.

We did talk the other day,
the other month on blood pressure,

people whose blood pressure
was not significantly high

don't drop their blood pressure,
and people

whose blood pressure was significantly
high to start dropped it a lot.

And so within
that is how we get to the average.

But some people benefiting quite a lot.

Three patients
discontinued antihypertensive medicines

due to improvement in their blood
pressure over six months, too.

So it's like a bonus.

And then we did a quality of life

measurement appraisal of diabetes scale.

Significant improvement in those scores.

So people feeling better,
more energy happy they do it.

Most people wanted to continue.

Everybody want to continue the protocol
when they're done.

So how do we apply information
like this to our life?

If you're here for weight loss,
if you're moving toward it, okay,

if you're not on some sort of blood
sugar medication, I say, you know,

I'm a primary care doctor.

Historically, I always want to know
what my patients are doing.

I advise everybody talk about your dietary
and health routines

with your medical team.

A fasting process is out there,
this sort of thing, eating twice in a day.

You can do it to seeing the pictures of
the food is seeing what people are doing.

You know, a big part of our intervention

to is like food monitoring everybody
logging their food every day.

And I think that's probably part
of the intervention to,

you know, it's just bringing mindfulness
to it.

Read our paper,
look exactly what we did and

bring every good process of health
I didn't mention in here,

you know, everybody getting some baseline
exercise recommendations.

Get 20 minutes of walking in.

So this was a comprehensive process.

I say this is what I want to help you
try to do here on the channel.

We're building
comprehensive health process

to try to get incredible results
for people.

You know,
I think these results are incredible.

I've replicated them many times.

I was doing this before the study.

I used my case series of patients to help
get the grant to fund the study.

And then after the study, I just keep
helping as people come to me to consult.

I help people do things like this.

So if someone has type two

diabetes,
you know, then you especially need

a lot of help with it
and especially insulin, right?

Because it's the medications
that interact with this lifestyle.

I like to look at it that way.

It's not that the lifestyle
is getting in the way of the medications.

So you absolutely
if you are taking medicines

for blood sugar, you have to connect
with your medical team.

Absolutely.

Before you do something like this
so that you can take away any risk.

And then the issue is, you know,
this is like most

doctors are like a prescription service.

It's not a D prescription service.

And so most doctors much more comfortable
writing the script than taking them away.

And a lot of what I do is kind of a D
prescription service because as

we implement powerful practices

into our life, open up fasting space,

cutting out the processed foods, start,
you know, an exercise routine.

All of these things are so good.

Bringing in beautiful mindfulness
practices to help

bring the stress level down.

Do you see that in your blood sugar?

You're stressed out by things
like you see the blood sugar go up.

Okay, the opposite is also true.

We bring in really a lot of mindfulness
practices.

Get that blood sugar
flowing in a better way.

I made the doctor Z method specifically
to help people with this process.

It's an educational program
where you can learn in detail

everything we do in the study,
all the protocols.

I've got tools to help people communicate
with your medical team.

I'm not prescribing
or prescribing anything in that service,

but I'm teaching people
all of the knowledge about it

so that when you are interacting

with your doctor, you have the words
and the knowledge to use

so that you can have a good relationship

with your medical team
and they can help you to do it.

And then I've got a lot of support
built in there.

It's like we can meet on a zoom call
every week, and you can meet other people

who are doing it.

And I think it's
a beautiful, beautiful program.

So do you have friends or family

or are you personally dealing with type
two diabetes?

I would love to help you out.

I have a large capacity
to help with a situation

a great deal of out of the box

thinking, and I can help people
to have very good results with it.

So that is my study.

I would love to hear your thoughts
and reflections and perspectives.

Share them in the chat.

Share them in the comments if you are here
on the replay, glad to have you here.

Throw your questions in the comments

and we can have an ongoing discussion
about it.

Also, if you head to Simple Fasting

com you can learn
more about my perspective there.

I have writing there
and you can send me an email.

You want to have a private discussion
about it?

I put my email in the chat DRC

at simple fasting dot

send an email and I'd love to have a chat

and also head over to the doctor
Z method Dr's

method and you can check out that.

And if you are dealing
with any sort of metabolic issue,

I think you really like it. It's nice.

We've got a wonderful course,
wonderful people you can chat with.

And I would love to chat with
So that was my experience doing the study.

Doing the study, I say, is one of
my favorite things that I did in medicine.

It was a very fascinating thing
to do and experience.

I'm extremely grateful for everybody
who helped me do it.

At the university.

Linda Bayer, incredible supporter.

Thank you so much for that.

Fauci Osman, who did all the statistical

analysis,
couldn't have done that without you.

Really appreciate that.

And then Doctor Feldstein,
fantastic researcher.

If by any way you find this,
I say a big hello to you.

I hope you're doing so well.

Very grateful for all the hours
and support and meetings and,

helping me
to get this through the IRA process

and be able to such a beautiful thing
into the literature.

I think it's, you know, really cool.

I would love to be able
to have a broader discussion about it.

I think it's an incredible process.

I think in my vision of the future,

it's the type of thing
that would scale into a huge process.

You saw the data I presented is
millions of people are in a situation

that can really benefit
from these processes.

I think we need humongous studies of it.

Many more studies.

I'm going to do a follow up study
about one of my favorite studies.

There is one randomized controlled trial
that took a protocol similar to what I do.

Not quite as cool, similar though

still cool, and did it
in a randomized controlled trial.

And I'm going to give a talk on that
because I feel like my study

is just another arm of that study in You
know, this many limitations to this study,

tiny study, not randomized
observational study, one clinic.

It's helpful when you have a seat.

That is helps to confirm results
that you find in an observational study.

Helps to add some validity to it.

And so that'll be the next step.
That'll be another talk.

Nice to be with you today.

Thanks for checking out this information.

Let it roll around,

think a little bit about it
and let me know your thoughts,

and I will look forward
to talking with you again soon.

Be well everybody.