I've put together some information from Dr. Jan Kwasniewski about type 2 diabetes, for Debbie and others who might be interested (sorry it took so long!). Rather than just tacking it on to one of the mega-threads, I thought it would make sense to set up a new thread.

The information below is a summary of the relevant passages from his two books, Optimal Nutrition (1999) and Homo Optimus (1996, English translation 2000). The books are available from the publisher in Poland. There's more about diabetes in his articles on the web site at: http://www.dr-kwasniewski.pl , but I haven't sorted through it all yet. The catch with the web site is that it's in Polish (which I don't speak at all), but you can usually make some sense out of the articles if you use one of the following translation engines:

http://translate.google.com -- very convenient, translates entire pages as you load them
http://www.translatica.pl -- have to cut and paste, but seems more accurate

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Dr. Jan Kwasniewski on Type 2 Diabetes and "Optimal Nutrition"


Type 1 diabetes, like other autoimmune diseases, is caused by insufficient nutrition due to "pasture eating," i.e. a largely plant-based, high-carbohydrate diet. JK gives a vivid description of how this works:

If supply to all organs and tissues is proper, there is no rivalry and conflict of interests over nutrients and the whole organism works peacefully and well. If the food that a body receives is bad, not all tissues and cells can get everything that is necessary for their normal functioning, and undernourished tissues begin to work poorly. That is the main cause of almost all diseases because tissues, just like deprived social groups, act up, strike and revolt even though the organism as a whole, like a badly governed, impoverished country has nothing to help them with. But it can always afford to use its army, i.e. produce antibodies, just like even the poorest country can always find the money to buy or manufacture guns, put down demonstrations and maintain an army.

Type 2, on the other hand, is caused by a diet that mixes plant and animal products together -- the so-called "piggish" or "trough" eating. With this way of eating, there's an inappropriate mixture of fat and carbohydrates, but the major source of energy is from fats, whether they're eaten directly or manufactured by the body from carbohydrates or proteins. Although the mechanisms of type 1 and type 2 diabetes are different, the treatment for both is the same, i.e. Optimal Nutrition (aka the "Optimal Diet").

To be more specific:

- The diet should be started right away, with no gradual phase-in period.
- Fats should be fully saturated and of the highest biological value, such as egg yolk, beef tallow, pork lard, butter, and cream.
- Carbohydrates should initially come from potatoes fried in animal fat or boiled and served with butter, as well as non-sweet vegetables eaten raw, boiled in broth, or cooked and served with butter.

He says that the diet is always successful in curing type 2 diabetes, but it will take from 3 weeks to 3 months. This is because the body's enzymes have to be taken away and replaced with new ones, which are suited to the new role of fat-burning. Since enzymes are proteins, the unneeded ones are broken down to glucose, which will increase glucose levels somewhat in the early weeks. "Therefore, we consume very little sugar, but we make a lot of it. But only for the time being." Week by week, the level of conversion will decrease, until the change-over is complete.

He gives instructions for reducing medications, advising that blood glucose should be tested frequently in the first few days. The initial goal is to adjust the medication to keep glucose between 100 and 200. Once fasting glucose is below 140, he recommends stopping the medication entirely. JK says that people on the Optimal Diet tend to have a steady glucose level somewhere between 110 and 140, even when fasting. Although this is considered very high by mainstream standards, he considers it to be a good and normal thing, as it shows that the body has a consistent supply of energy, without the usual fluctuations.

He also gives a procedure for checking ketone levels, which he recommends especially between the 6th and 10th days, as ketosis tends to be most intense at this time. The instructions refer to a brand of test strips that display crosses as an indicator. He says that 1 or 2 crosses are okay, but with 3 or especially 4, that's a sign that the body is producing ketones faster than it's able to burn them. To avoid acidosis, the diet should be temporarily modified as follows:

- eat less fat, and make sure it's all of the highest biological value
- reduce exercise level, and try to stay in a warm environment
- temporarily reduce consumption of acid-forming foods like meat and nuts, and increase consumption of alkaline-forming foods like egg yolks, cream, and vegetables
- increase carbohydrates by about 10-20 g, to a maximum of 50-60 g per day.

(The above advice is written for diabetics only. JK emphasizes that there's no danger in ketosis for people with a normal metabolism. It's just not considered beneficial or desirable, and shouldn't be necessary if the correct amount of carbs are being eaten.)

"Type 1 diabetes, like other autoimmune diseases, is caused by insufficient nutrition due to "pasture eating,"
I don't really think anyone can put a finger on one single cause
of diabetes.I should also point out that young children contract
type 1 diabetes very early in life.
Regardless of advice from Bernstein,JK and whoever,I think each
individual diabetic must tailor their own diet for optimum results.
In some cases herbal and prescription meds are appropriate.
Eddie

Thanks for the post. As an experiment of one I can say that eating the Optimal way has restored my blood sugar to quite normal levels, with fasting numbers running in the range of 90-110, and post-meal "spikes" never going higher than 130ish, so as long as I eat Optimally I seem to have a pretty steady numbers (this is without any medications, only diet).

I do know children as young as 3-5 who have been diagnosed as Type 1, so am not completely sold that T1 has a single cause of "pasture eating" as surely these very young T1s don't eat much differently from their peers who *don't* become diabetic!

But I do feel the Optimal plan is a good one for *controlling* the diabetes. I hesitate to say "cure" as I suspect one would immediately be in bad shape again if one went back to one's "piggish" eating ways.

I also don't think being in ketosis is an issue for diabetics, it's ketoacidosis (totally different animal) which is deadly. Maybe his concern is that if you find you are throwing off ketones how do you, as a layperson, know whether it is ketosis or ketoacidosis?

Well, I believe high blood sugar is one sign of ketoacidosis, so if it's not high then it's probably not a problem. Extreme thirst seems to be another.

I think of it more as a T1 concern, but Wikipedia says T2s can fall prey to it also, under conditions such as " mismanagement of acute gastroenteritis, the flu, or the development of a serious new health problem (e.g., bacterial infection, myocardial infarction)."

So, as usual, your meter needs to be your friend. I admit I don't know enough about it to see if his suggestions for avoiding acidosis are valid, though don't see how eating alkaline foods could hurt.

I do check my blood sugar pretty frequently, but admit I never bother checking to see if I am in ketosis or not.

I do agree that the OD plan seems to be a good one for normalizing numbers for both T1 and T2. I had better control on a regular LC diet, but did not achieve what I call "real" control until I went on the OD plan and cut my protein and increased my fat.

I still can't get my head around eating potatoes though. Though I suppose if I *liked* potatoes I would learn to accept it, but I have never especially liked them. Non-sweet veggies cooked with butter are a fine treat though!

JK says the same thing about all autoimmune diseases, including Crohn's and celiac, which are also found in very young children. There's clearly got to be some sort of innate weakness in the affected organ, but he says that it takes a certain type of incorrect diet to set it off. In the US, "poor pasture eating" is very common. It's found among people who are literally poor and can only afford to fill up on carbs, as well as among affluent people who try to eat "healthy" grain-based, low-fat meals, as per the recent nutritional dogma.

If anyone would like to hear more of the T1 information, there's a ton of it. Basically, it's a two-pronged attack: use Optimal Nutrition to put the autoimmune condition into remission, and keep carbs very low so the remaining ~10% of beta cells (which are still present in most T1 diabetics) can do the job. He does recommend that people who are insulin dependent should follow the diet under the supervision of their doctor, and children should preferably be in hospital for the early weeks. Of course, outside Poland, good luck finding a doctor or hospital who will supervise this!

He never uses the term ketoacidosis in the books (maybe a translation issue?), but it's pretty clear that this is what his concern is. I'm not sure I'd call diabetic ketoacidosis a "totally different animal" from ketosis, though.

Wikipedia says:

Ketoacidosis is a type of metabolic acidosis which is caused by high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and β-hydroxybutyrate.

Ketoacidosis is an extreme and uncontrolled form of ketosis, which is a normal response to prolonged fasting. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased.

So it seems as if this is only a risk for those who have a metabolic disorder. Most people's bodies aren't going to let the ketone levels get into the danger zone.

I think this may be an example of Wikipedia being only as good or bad as its contributors. Because Merpig is right: ketosis and ketoacidosis are completely different.

It is simply not possible for dietary ketosis to somehow cause ketoacidosis. Diabetic ketoacidosis is caused by high blood sugars - never by simply producing ketone bodies.

So if a diabetic is on a low carb plan, they can be as ketotic as they like - even showing "high" on ketostix - and still not go into ketoacidosis... as long as their blood sugars are under control.

"So if a diabetic is on a low carb plan, they can be as ketotic as they like - even showing "high" on ketostix - and still not go into ketoacidosis... as long as their blood sugars are under control."
I agree,Rosebud.Your point about Wikipedia is also very true-
lots of good info and some bad info there.
Cheers
Eddie

Are you at all suggesting that this diet can cure T1?

V.

Which really makes one wonder why the authors advice was to worry about the ketostix. Maybe erring on the side of caution to encompass those with Metabolic Syndrome as well? Just strange and a tiny bit confidence shaking.

I'm trying to help my mother's research into what is the best diet for her as she's had a stubborn T2 for a long while now where counting calories seems to have only sporadic effects if any. She's moving on to a LC WOE and we're trying to nail what's best for her and the OD seemed very appealing before this "check your level" panic.

I would not shy away from the OD just because of that. As I said the OD is the best thing that has happened to be for blood sugar control - *far* better than when I was just eating "regular" low carb - but more protein and less fat.

My own results not quite as good as Debbie's. No real change in blood sugar yet.

Has your mum read Dr Richard Bernstein's Diabetes Solution? If not, I do think she will find it very helpful. Here is his website: http://www.diabetes-solution.net/

Having said that, I do also think that any diet plan where carbs are controlled (including the Kwasniewski plan) will help her enormously.
But before starting any low carb plan, it is always best to read the book first.

I'm not suggesting anything, just passing along information. I had originally posted it in the General forum -- as Debbie had expressed an interest in hearing about it -- but it got moved here.

The creator of the Optimal Diet, Dr. Jan Kwasniewski, claims to have an 80% success rate with putting T1 diabetes into remission (i.e., no need for insulin as long as the diet is followed closely). He says that in the remaining people, there aren't enough beta cells left to do the job -- but their need for insulin will be reduced, and their overall health will be much better. He's been using these methods for 40 years, and says that there are thousands of successful cases, with "hundreds of pieces of evidence" to prove his claims. There are over 200 doctors using his methods, mostly in Poland.

So, if this is true, why isn't it widely known? He says:

"No facts, not even the most spectacular and apparent, are able to make modern medicine change its views. (....) One doctor from a western country, knowing and using my methods to treat diabetes, told me of his success in curing several diabetics. When he spoke publicly within the medical establishment in his own country, he caused a storm of anger and they even thought about revoking his medical license, thinking that he must be some fraud. The only argument they had their mantra that 'diabetes is incurable.'"

He speculates that until the doctors themselves start following the diet, they won't realize what a powerful thing it actually is.

If you're willing to deal with Google Translator, there's a great deal more material available in Polish. Many of the articles are about diabetes. T1 is called "cukrzycy typ. 1" in Polish.

http://www.dr-kwasniewski.pl

Regarding all the testing in the beginning, I think his concerns are twofold:

- The possible dangers of excessive ketosis/ketoacidosis, especially around days 6-10 on the diet. (I know people are saying that JK is wrong about this, but given that he and Wikipedia say the same thing -- and I'm pretty sure he's not getting his information from there! -- it's something I'd be inclined to take seriously and investigate further.)

- As the body adapts to be an efficient "fat-burning machine," the unnecessary enzymes will be broken down and turned into glucose. This could potentially cause unforeseen fluctuations in blood sugar.

Reading between the lines, it seems as if these problems are relatively uncommon. I think, as others have said, he's just trying to be cautious. Optimal Nutrition says:

"As a doctor, I sometimes face a dilemma: to tell the diabetic that he or she will not be able to be self-cured at home, because he or she is somehow unable to constantly keep track of blood sugar or, oppositely, to risk failure by telling my patient how home cure is possible. It is especially problematical when this methodology is given in print, because I can never know if the reader understands everything, does not overestimate his or her own skills and has access to the right instruments. That is why long-term diabetics and people in advanced stages should consult a doctor."

Something else that's emphasized for T1 is that the protein has to be kept as low as possible (to avoid conversion to glucose), and thus only the most biologically available proteins should be eaten. He says that the very best quality proteins are found in egg yolk, liver, and kidney.

Just did a tiny bit of reading, and figured out that the ketones that JK is referring to, which might reach problematic levels in the early stage of the diet, are what's called "starvation ketones" in the medical literature. There seems to be some dispute as to whether or not they're dangerous for diabetics, but most of the sites I've found seem to say that they're something that should be strenuously avoided, especially in children.

I can see how the other type of ketones -- "diabetes ketones" -- would be accompanied by very high blood sugar, but I'm not seeing how this would necessarily be the case with "starvation ketones."