Have We Had Diabetes Backwards - The Randall Cycle

February 12, 2024

Have We Had Diabetes Backwards all These Years?

This is huge. This is why you are fat and can't get "unfat". Let's explore.

Our current standard teaching of diabetes is that you are diabetic because you are insulin-resistant. You are insulin-resistant because you are too fat. Avoid carbs like the plague and eat nothing but fat and protein and don't touch sugar, fruit, pasta, rice, or bread or you will spike your sugar. That's the standard line everyone is familiar with. The problem is, no one gets better. The logic has an inherent flaw. You can't blame the disease on a symptom. It's like saying you got pneumonia because you have a fever. In the standard model, insulin is the uber enemy.

Maybe that model is backward. Let me start with the Randle Cycle as explained by Philip Randle back in 1963 in the Journal Lancet laid out his hypothesis. It goes as follows. When you eat a fatty meal with lots of carbs: (meatloaf, mashed potatoes, and gravy) you absorb the fat first in your duodenum. The fat globules go straight into your lymph system and show up in your circulation hours before glucose shows up. In that time, cells all over your body see the fat and take it on as the fuel of the day. They turn off insulin receptors. When glucose shows up, cells are already resistant to it. The more saturated fat you eat, the more insulin-resistant you become. Your cells can't turn fat absorption off and as you fill up all the standard places to store fat, you start packing in fat in all the unusual places, like your liver. Even your beta cells in your pancreas get stuffed with fat, and start to die.

The enemy and cause of all this trouble is the saturated fat. Consider the following experiment. This is just what Cyrus Khambetta did with his insulin-dependent diabetes. Start eating a very low-fat diet, with less than 15 grams of fat a day. All the fruit you want. Bananas, papayas, mangoes, grapes. You name it, you get it. Just no fat. Over the course of a month or two, your insulin resistance will disappear. Khambatta had his insulin-to-carbohydrate ratio change from 1:3 to roughly 1:33. That means his insulin resistance disappeared and now is in a normal range with normal function. His A1c is now in the low 5s and he eats his heart out on fruit. Just no fat. Included in that no fat means no meat, no dairy, no eggs, no cheese, and very limited nuts.

There have been dozens of authors who have published supportive studies that show the same thing, again and again. Esselstyn proved that you could reverse coronary artery disease with this approach. His book Prevent and Reverse Heart Disease proved the same hypothesis.

As the years have gone by, more and more research supports this cause of diabetes and fills in much more detail about the cause. I found one good review article to do a nice deep dive if you have a long, lazy afternoon and are in the mood.

www.What will Work for me. I'm frustrated by how rigid my own glucose metabolism is. I have been eating "keto" by and large, avoiding carbs and sugar like an angel. But lots of butter, fat, meat.....and vegetables with olive oil. Switching to a no fat diet is no small challenge. I think I found a clue in my Goodenowe Prodrome Scan. It has "Ceramides" on its list and mine are quite high. I want to explore that. There is a link with ceramides, high fat and diabetes. That may be a further unpacking of the real, root cause of insulin resistance and then visceral fat, inflammation and obesity all as secondary, downstream effects. The problem is not small. How do you have friends and go to a restaurant that cooks with NO FAT and NO ANIMAL? You can do it if you have no friends.

References: Frontiers Endocrine, Mastering Diabetes by Cyrus Khambatta, Am Jr Phys Endo Metab., Lancet,

Pop Quiz

1. What is the Randle Cycle?                      Answer: You absorb fat faster than carbs and cells, presented with fat, turn off their insulin receptors, making the later arriving carbs stuck in the blood.

2. Insulin resistance is where in the Randle cycle?                          Answer: Insulin rises as a secondary effect. Not a primary effect.

3. How does the Randle Cycle differ from today's traditional diabetes teaching?                    Answer: The method of response is diametrically opposite. Remove the fat and your insulin resistance goes away. You can eat huge amounts of carbs, to satiety, and not get fat and not have high glucose.

4. What is the principal drawback of this method?                          Answer: You have to get to below 15-30 grams (1/2 to 1 oz) of fat. That includes the fat in the banana, the apple, the mango etc - all of which do have some fat.


5. What role does linoleic acid have in this approach?                          Answer: Its reduction might be the most important or not. Research will tell. We do know that with modern agriculture's ability to grow soy, corn, canola etc, our linoleic acid consumption increased from 1% of our diet to 9-10 %, and in some cases, even greater. It gets oxidized with high heat cooking and becomes a poison.