Episode
Diabetes, Weight Loss, Remission or Cure
- Published
- May 28, 2026
- Duration seconds
- 1075
- Processing state
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- https://forku.com/episode/diabetes-weight-loss-remission-or-cure
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Summary
Type 2 Diabetes, Bariatric Surgery, Fasting, and GLP-1s: What We Finally Learned About a Disease We Thought We Understood For years, I watched something happen in bariatric surgery that made very little sense, according to the medical textbooks of the time. Patients with type 2 diabetes would undergo surgery, and within days, their blood sugars would improve dramatically. Some would leave needing far less insulin. Others would stop insulin entirely. Many of them would eventually remain off diabetes medications for years. Now here is the important part: They had not yet lost significant weight. That observation mattered enormously. Because if diabetes improvement were simply the result of fat disappearing from the body over time, then blood sugar should improve slowly over months as weight comes off. But that was not what we saw. Instead, patients barely eating — sipping broth and protein shakes while recovering from surgery — were suddenly metabolically different almost immediately. At the time, we knew it worked. What we did not fully understand was why. And honestly, that story tells you something important about medicine and science: sometimes clinical medicine notices the truth before biology fully explains it. For decades, type 2 diabetes was often taught in very mechanical terms. You gained weight. You became insulin-resistant. The pancreas worked harder and harder until it “burned out.” Then you needed insulin. That explanation was not entirely wrong. However, it was incomplete. Furthermore, it encouraged a kind of fatalism around type 2 diabetes, as though progression were inevitable and irreversible for everyone. Then, bariatric surgery complicated the narrative. Meanwhile, researchers like Professor Roy Taylor at Newcastle University began developing a much m…