The fuel for enabling our muscles to move us around is glucose (a simple sugar). Dr. Neal Barnard has called insulin the key that allows glucose to enter the muscle cells. But when the body has got enough sugar for its immediate need, the sugar is turned, in the muscle cells, to fat for storage – and this fat is stored in the cells themselves (intramyocellular lipids).

When the cells start to have too much fat, insulin is prevented from guiding sugar into the muscle cells. Dr. Barnard says that the insulin receptors are "gummed up" when there is too much fat in the cells. Insulin is there, but it can’t do its job, when there is already too much fat in the cells. And sugar builds up in the blood.

The medical system’s historical response is to use a bigger hammer: add even more insulin.
The better response is to eat so as to reduce the amount of fat in the muscle cells. Eating this way will also reduce the amount of subcutaneous fat.

Eating a low-fat, whole-food, plant-based diet cures diabetes – and a host of other diseases, that might not even seem to be related.

When a disease is defined by a number, rather than by clinical manifestations, changing the number, by any means (even a drug designed to change the number), affects the disease by definition, even, perhaps, with no change in clinical manifestations. This sets up a situation where a disease can be "managed". And the medical establishment gets to provide the formal definitions of diseases.

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