Rethinking Diabetes – interview with Gary Taubes
Debate over Gary Taubes’ new book on diabetes quickly broadens into a wider argument over how Type 2 (and to a lesser extent Type 1) should be treated: primarily with low-carb or ketogenic diets, or through more conventional calorie control, plant‑based eating, medication and exercise. Commenters share personal experiences reversing or improving Type 2 markers via very different approaches, from strict keto to whole‑food plant‑based regimens and intermittent fasting, while also highlighting tools like continuous glucose monitors and the importance of sleep, strength training and fiber. Underneath the practical advice runs a strong skepticism about the quality of nutrition science, the incentives of the medical and pharmaceutical establishment, and the risk of conflating Type 1 and Type 2 in public narratives.
Low‑carb, keto, and other dietary approaches
- Many commenters report strong personal success with keto or low‑carb for weight loss and Type 2 diabetes control (including coming off insulin or meds), citing simplicity, appetite suppression, and improved energy.
- Others find keto too hard to maintain socially and long‑term; regaining carbs often reverses benefits.
- Several people use moderate carb restriction (e.g., reducing sugar and refined starches, “cheat days,” slower incremental changes) with gradual, sustainable weight loss.
- Some emphasize that overall calorie deficit drives weight loss regardless of macro split; they report better results and exercise performance on higher‑carb, higher‑protein diets.
Type 1 vs Type 2 diabetes
- Strong concern about language that appears to blend treatment ideas across Type 1 and Type 2; commenters stress that Type 1 is unmanageable without insulin and that diet can at best reduce insulin doses.
- Some see discussion of low‑carb in Type 1 as useful but worry about misinterpretation by patients as “insulin optional.”
Measurement and monitoring
- A1C is described as a lagging 3‑month metric; continuous glucose monitors (CGMs) and finger‑sticks are praised for real‑time learning about food effects.
- There is discussion over whether A1C or CGM‑derived metrics better predict long‑term outcomes; no clear consensus.
Foods, nutrients, and mechanisms
- Comments highlight:
- Simple vs complex carbs and the impact of fiber and glycemic index.
- Fat accumulation in muscle cells as a driver of insulin resistance.
- Cooling and reheating starches to increase “resistant starch.”
- Effects of vinegar, unsaturated fat, and possibly melatonin on glycemic control.
- There is tension between low‑carb/keto advocacy and whole‑food plant‑based approaches; both camps cite success stories.
Healthcare system and guidelines
- Experiences with doctors vary widely by country and individual provider: some push low‑carb from day one, others discourage it and favor insulin plus “complex carbs.”
- Several commenters perceive misaligned incentives or conservative, drug‑centric practice patterns.
Expertise, evidence, and skepticism
- Some view the interviewed author’s hard‑science background as a plus; others criticize previous work as selective or undermined by subsequent trials.
- Broader skepticism about nutrition science appears: observational studies, conflicting findings, and media hype are recurring complaints.
Lifestyle factors beyond diet
- Exercise (strength and endurance) is repeatedly cited as crucial for insulin sensitivity and weight control.
- Sleep quality and caffeine metabolism are raised as under‑appreciated contributors to insulin resistance and cravings.