So I really started to think about it kind of like me it wasn't a good fit for me who to see my patients getting worse and worse and worse at a VA hospital and I have to say it doesn't seem your personality is so great and bubbly you want the happiness to have that as a daily drudge I can this is a common theme among doctors who who went into medicine to actually fix things or or make people feel better yeah it's not satisfying for the doctor yeah

Actually in 2014 and on one of the big YouTube early YouTube videos I did um I said it was one of the big lies of type two diabetes because if you think back then 2014 you would go to the American Diabetes Association website and they'd state to you pla's day this is a chronic disease which means you're G to get worse until you die right not a great feeling for the patient not a great feeling for the physician and the thing is that it was obviously and clearly a lie there was no possible way it was true because you and I knew and everybody else knew um patients knew that hey if you lost weight that type two diabetes would either get better or go away everybody knew somebody who was like oh I got diagnosed with type two diabetes I went on Metformin but I got serious about my diet exercised lost you know 20 pounds got off all my medications now my blood work is perfect right so like clearly like the clinical experience was that this was a reversible disease

So I mean as it became more and more um of a problem type two diabetic kidney disease of course you know it was it was sort of the wrong thing to be doing because if it was a reversible disease compared to a progressive disease then of course we had we should have been trying to reverse it and prevent people from getting kidney disease as opposed to just sort of managing it or treating it right it's a totally different mindset I mean it's it's it's it's you know it's totally different and the focus of course was weight loss right that was the key when you look at all these people who are doing very well you know what were they doing and a lot of them wind up losing weight um and that was the real key so if and and again it's one of these things that's sort of so bloody obvious when you think about it so if you lose weight your type two diabetes often gets better or goes away so think about this chain of events type two so diabetic kidney disease is caused by type two diabetes treatment got to reverse the type two diabetes how do you do that well you got to lose weight

So the cause of insulin resistance right so they imagine a similar situation right so they said that hey there there's insulin around so people have the key they're trying to open the door but something's block right so the door is not opening the glucose now cannot get into the cell and you're going to get this similar situation where the glucose is piled up outside the cell and and the problem with that is that if you think about this overflow uh Paradigm of type two diabetes it makes perfect sense if you have we too much glucose in the cell you're going to have de novo lipogenesis you're going to have fatty liver as you as the liver fills up with fat it's going to try and get rid of that fat

Now if you have a situation where insulin is high all the time and it's way too high it's much higher than normal levels well what's going to happen well you're going to store more energy because you basically told your body to store more energy

I was thinking but I thought about it's like well wait a second so I think that it's really bad to not eat for you know 14 16 hours of the day but wait a second as a physician I tell people to do that all the time right so if you want to you know you come into Hospital you have pancreatitis NPO right nothing nail Paro you don't eat if you're preop you don't eat if you're posttop you don't eat if you go for a colonoscopy you don't eat

The idea is that if you normally eat three meals a day and you drop one of them, you should the other one should stay the same or as close to the same as you can get it

Low-carb used to be this sort of you know very fringe sort of way to do things if you actually read the guidelines they State that low-carb diet or cutting down the carbs is the diet with the most evidence

The goal of type 2 diabetes care is not management, it's reversing it, you should try to not have this disease