Coach's Notes

A few years ago, Octane CrossFit changed the sign in front of their building to read:

We cure Type 2 Diabetes.

The sign (showed in the image above) caused quite the kerfuffle within the community.

Type 2 diabetes is a devastating disease. While the diagnoses predominantly surrounds blood sugar management, the disease increases risk of heart attack, Alzheimber’s disease, stroke, peripheral vascular problems, and much much more. It’s typically classified as both chronic and progressive:

• Chronic meaning it persists over time
• Progressive meaning it only gets worse

These are obviously two words you don’t want to hear alongside a diagnoses. “You’ll have this forever, and it will likely get worse over time even with medical treatment.”

Today, we’re going to talk about why these classifications are largely proving incorrect based on new science and literature. We’ll draw on many new resources to put together a quick playbook for how and why it’s possible to reverse type 2 diabetes (based largely on research from The Diabetes Code and Virta Health).

First, a quick primer on type 2 diabetes – how it occurs and how it’s diagnosed.

Before we get started, a few qualifications:

• I’m not a doctor, and I don’t play one on the internet. This isn’t a substitute or medical advice. Rather, it’s an exploration into new research on the treatment of diabetes.
• There are two predominant forms of diabetes – type 1 and type 2. Whenever we refer to “diabetes” from now on, we’re referring specifically to type 2.
• If you have diabetes, we’d love to work together with your doctor to see what we can accomplish. Get in touch here!

A Quick Primer on Type 2 Diabetes

If you read our recent blog post on insulin, much of this will sound familiar.

At it’s core, type 2 diabetes represents a problem with blood sugar management. When you eat, the food you consume is broken down during digestion into molecules including sugar (also known as glucose). This sugar floods your bloodstream as an immediate source of energy for cells.

Insulin is a hormone that comes to the rescue when blood sugar levels are elevated. It shuttles the glucose out of the bloodstream and into your cells for the body to use thus lowering blood sugar levels.

If blood sugar levels are constantly elevated over time (typically from eating highly refined, sugary carbohydrates), your body becomes “insulin resistant,” which is the first step towards diabetes. Your cells are “full” of glucose so it’s not as easy for insulin to clear the existing sugar in your blood stream. As a result, your body releases more insulin to do the job.

This cycle continues over and over until at some point, no matter how much insulin is released, your blood sugar is constantly elevated. At this point, you’ll be diagnosed with diabetes (typically through either a fasting blood glucose or Hemoglobin A1C test).

The Diabetes Treatment Conundrum

The “standard of care” for treating diabetes is to lower blood glucose through insulin injections and medications like Metformin, which attempts (among other things) to reduce blood sugar by reducing the body’s own blood sugar production. In short, if the body is insulin insensitive and can’t control blood sugar on its own, we can inject more insulin to force the body to clear the glucose from the blood. To explain this a bit more, let’s draw on an analogy provided by Dr. Jason Fung in The Diabetes Code.

Your house is trashy.

Let’s say you have a house, and while you love having a clean house, you hate cleaning and taking out the trash. As a result, trash is accumulating around your house in fantastic amounts. Not so good.

Instead of taking out the trash, you decide to hide it. You shove it under your bed, in closets, in cabinets…anywhere that’s out of sight. Problem solved you think to yourself! Trash is gone.

There’s only one problem. Tomorrow, there’s more trash. This isn’t a huge problem yet because you have plenty more closets in your house. Before you know it though, you’ve filled every nook and cranny with trash, and you have more to deal with! As a result, you call your friends over to help you push, heave, and smash trash into more crevices around the house.

Okay – you get the point. Eventually, you’re going to run out of spots for trash, and even worse, your house is going to smell horrific.

Your “house” in this case is your body; “trash” is blood sugar; and “your friends” represent insulin injections. No one in their right mind would say that inviting friends over to help you forcefully stuff trash into smaller crevices is effective “treatment” for your dirty house yet that’s exactly how we treat type 2 diabetes right now.

How Would You Clean Your House?

Let’s say your best friend was the one shoving trash in closets to “clean” their house. Over a few drinks, they confess they have a major problem. They’re running out of spots to stuff trash, and their house is beginning to reek. What would you tell them?

You would probably tell them to do two things:

1. Find a way to minimize incoming trash levels and/or effectively deal with trash moving forward (aka take it out of the house and put it in a trash bin). We’ll refer to this approach as minimizing intake.
2. Clean up the existing trash stuffed in closets and under the bed so the house doesn’t smell so terrible. We’ll refer to this as maximizing clearance.

Makes sense right? You probably wouldn’t say the following:

It sounds like you need to recruit some bigger, stronger friends to help you stuff trash in the tighter spots around your house.

Pulling this all together.

You get the idea. The current method for treating type 2 diabetes (primarily through drugs and insulin injections) simply masks the symptoms (high blood glucose) and doesn’t address the underlying condition (insulin resistance). This is largely why diabetes is currently accepted as chronic and progressive.

As Dr. Fung notes, the key is to recognize that diabetes is a dietary disease and should be treated as such:

Drugs won’t cure a dietary disease. They’re about as useful as bringing a snorkel to a bicycle race.

Dr. Jason Fung, The Diabetes Code

A Game Plan for Reversing Type 2 Diabetes

Let’s apply the same intuitive logic you used to help out your best friend. If type 2 diabetes is largely a condition of too much “trash” or “blood sugar”, a rationale approach would be to:

• Minimize input by improving your diet and eating foods that don’t cause jumps in blood sugar (and therefore insulin levels).
• Maximize clearance through exercise in order to clear existing glucose and “free up” some of the over-stuffed cells.

Again, this approach makes logical sense both in terms of cleaning up excess trash and excess blood sugar.

Minimize input.

There are numerous approaches one could take here including fasting, adhering to a strictly ketogenic diet, and more. The core of this approach is to recognize that foods have different effects on blood sugar levels.

Carbohydrates (particularly heavily processed carbs) cause a spike in blood sugar and therefore insulin. Protein has a moderate effect. Fat has little to no impact on blood sugar levels.

CrossFit has a pretty simple dietary recommendation:

Eat meat and vegetables, nuts and seeds, some fruit, little starch, and no sugar. Keep intake to levels that will support exercise but not body fat.

Part of the “Fitness in 100 Words” manifesto from CrossFit

Adhering to this approach necessarily removes processed carbohydrates from your diet and therefore reduces blood sugar spikes.

As a general recommendation, we’d advise cutting out refined carbohydrates, sticking to whole foods, and shifting more of your calories to come from fat. That’s a fantastic starting point.

Maximize output.

Alongside reducing the amount of incoming blood glucose, we can work on clearing existing stored glucose from cells. To do that, we’d follow the other piece of the CrossFit paradigm:

Practice and train major lifts: Deadlift, clean, squat, presses, C&J, and snatch. Similarly, master the basics of gymnastics: Pull-ups, dips, rope climb, push-ups, sit-ups, presses to handstands, pirouettes, flips, splits, and holds. Bike, run, swim, row, etc, hard and fast. Five or six days per week mix these elements in as many combinations and patterns as creativity will allow. Routine is the enemy. Keep workouts short and intense.

Part of the “Fitness in 100 Words” manifesto from CrossFit

So Type 2 Diabetes is Reversible?

It’s important to understand the distinction between “reversed” and “cured” in this context.

Type 2 diabetes can never be “cured.” If the underlying causes (poor diet, lack of exercise, excessive refined carbohydrates, etc) aren’t addressed, it will resurface.

However, we believe (and others have showed) that it can largely be “reversed” through the methods covered above. “Reversed” in this context means patients can get off medication and get back to normal levels of blood glucose.

Additional Resources

Like I said before, I’m not a doctor so don’t rely solely on my word for all of this. I’d recommend checking out Dr. Jason Fung’s video series here:

He’s a fantastic resource on the topic, and I’d recommend his book The Diabetes Code if you want to learn more!

Ben Bergeron is a bit of a celebrity in the CrossFit space. He’s the owner of CrossFit New England, but he’s more known for training elite athletes like CrossFit Games champion Katrin Davidsdotter and running the programming over at CompTrain.

On a recent podcast, he broke down a typical day of eating for someone that might seem to be eating healthy.

How familiar does this look?

• Breakfast – 2 cups of Kashi cereal with skim milk and iced mocha coffee from Starbucks
• Mid-morning Snack – Fat-free yogurt
• Lunch – Turkey on whole wheat plus a smoothie from Panera Bread
• Afternoon Snack – Nutri-grain Bar
• Dinner – Burrito bowl with chicken, lettuce, beans, rice, cheese, and sour cream plus chips and salsa

As an outsider looking in, that’s fairly healthy right? There eating whole wheat, opting for fat-free yogurt, etc.

That’s a total of 2,720 calories with a grand total of 392 grams of carbohydrates. You’re also likely short of protein and pretty far over on sugar. To put this in perspective, Katrin (CrossFit Games champion and athlete that works out 2-3x per day) is eating in the mid-200s for carbohydrates.

Let’s see how we can drastically improve the day with a few small changes.

Improve the day with a few small tweaks