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Type 1 diabetes is caused by failure of the pancreas to produce insulin, typically caused by destruction of beta cells by the immune system. This is not the kind that’s caused by diet.

Type 2 diabetes is caused by (or defined as) insulin resistance, meaning that the cells of your body stop responding properly to insulin. It’s not primarily caused by dysfunction of the pancreas, although there can be secondary pathological effects on the pancreas. Diet is a big contributing factor. If someone is well fed all the time, then the insulin levels in the blood are always high and never drop to zero. The fact that cells become insulin resistant could be related to the fact they have been swimming in high levels of insulin for as long as they can remember. Fasting will drop your insulin level to basically zero after maybe 18-24 hours (or longer depending on activity level). If your cells have forgotten what it feels like to exist without high levels of insulin around, that’s probably not a good thing, and fasting / decreasing carbs in your diet will probably improve insulin resistance.

Mike Dilger ☑️ 1y ago

Yes I didn't make myself clear. I am referring only to Type 2.

Insulin resistance by your cells which are overfed while you still have more food for them is a core part of the pathology. I would have defined Type 2 like you did, based on insulin resistance, before I read the book I'm reading "Living without Diabetes", the COUNTERPOINT study and related work (counterpoint reflections, counterbalance), the DiRECT study, etc.

So the theory that seems to have borne out is called the "twin-cycles theory":

First of the twin cycles - the vicious cycle in the liver. An extra mouthful of food daily over a long period of time causes fat in the liver to build up. This makes the liver unable to respond properly to insulin. Blood glucose starts to creep up and this causes higher background levels of insulin. This insulin then oils the wheels for glucose to be turned into liver fat.

Second of the twin cycles - the vicious cycle in the pancreas. The normal fat export from the liver can deal with the high liver fat - until the safe storage depot under the skin is full. Then blood levels of fat rise. The pancreas is one of the tissues susceptible to the increased fat. Eventually, after several years, this causes the insulin producing cells to shut down. Over a short time, blood levels then rise.

Some people genetically have tissues that are more insulin resistant from birth. These people are more susceptible. But cellular insulin resistance is mainly a reaction to a state of being over-fed. It can change fairly quickly once you stop eating. Whereas the pancreatic switch into diabetes needs a more drastic dieting to overcome.

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