The type 2 Diabetes Cure, the Fix, the Program for Reversing Type 2 Diabetes

The Golden Rule

Diabetes Progresses when your spot sugar is above 6.6 mmol/L (120 mg/dl)
Diabetes Regresses when your spot sugar is below 5.6 mmol/L (100 mg/dl)

The Guiding Principles

Carbs are Poison. Exercise is the Antidote.

Going Calorie Negative fixes Obesity. Going Carb Negative fixes Diabetes.

Medium Intensity Exercise (brisk walking) fixes Blood Sugar

To fix insulin resistance we must eat more poly fat and less sat fat and mono fat. Go Low Carb High Poly NOT Low Carb High Fat.

Still not sure about High Intensity Exercise. It burns carbs but can increase adrenalin (until you get used to it). 

The History of My Cure

Here is the process I went through with this disease to reach my present understanding of how to fix it.

Firstly I read the Newcastle Diabetes Reversal paper and imagined that simply by losing a lot of weight  I could reverse my condition. I believed Prof Taylor's assertion that diabetes is caused by insulin resistance which is caused by a fat build up in the liver. So I went from a BMI of 26.4 (weight of 176 lbs) to a BMI of 21.0 (140 lbs) in 12 weeks. That improved my condition in that I could almost pass a 50% OGTT but I was still very much diabetic. I then wasted 3 months getting even thinner to no avail. In fact during this period I lost muscle mass which is very damaging to a diabetic since we all store sugar in our muscles as glycogen. So I no longer recommend ultra low calorie fasting unless you are obese (BMI in excess of 30).

Then I read that insulin resistance is caused by having the wrong type of fat in one's diet. Too much Omega6 and not enough Omega3. So I went on a Paleo diet for 3 months. I ate boat loads of Omega3 and as little as possible Omega6 in order to restore my muscle cell membranes to a non insulin resistant condition. That had very little measurable effect (at 3 grams of Omega3 per day - it may have helped - I am not sure). In fact saturated fat produces more insulin resistance than does Omega6 I now understand. 

Then one day I read a paper showing that the average person loses 10% of his muscle mass between the ages of 20 and 50 and a further 30% of it between the ages of 50 and 80. I had already read a paper explaining that around 100 gm of blood sugar is stored as glycogen in the liver and around 500 grams of blood sugar is stored as glycogen in the muscles. The muscle glycogen is only usable by the muscles which are storing it whereas the liver glycogen is used to ensure that the brain gets enough sugar. 

I already knew that diabetes is a progressive disease getting worse as one gets older and I wondered whether this losing muscle was a part of it since the muscles are our glycogen warehouse. I found other papers showing that insulin resistance (by which is meant apparent insulin resistance) is inversely proportional to muscle mass. In other words it would go up by around 10% between the ages of 20 and 50 and by around 30% between the ages of 50 and 80. Then the penny dropped. If a normal person's muscle mass decreases by 40% between 20 and 80 and his apparent insulin resistance increases by the same amount then since the muscles are storing the glycogen and since the insulin is the fork lift truck in the glycogen warehouse there was no deterioration in the fork lift truck performance between 20 and 80 there was just 40% less warehouse capacity because 40% of the muscles had gone. I mean it is not easy for insulin to force glucose into muscle that no longer exists!

So I realised that there is no variation at all in true insulin resistance between the ages of 20 and 80 in normal people. So Diabetes does not start with insulin resistance. 33% of normal people become diabetic after the age of 65. So type 2 diabetes is caused not by insulin resistance but by a lack of warehouse space, a lack of glycogen storage capacity. Your sugar battery is full up, it can no longer take the charge its gets from a meal and distribute it up until the next meal. It starts with a lack of glycogen storage capacity. But this then leads to too much sugar being around which somehow causes the insulin resistance. Perhaps the little capillaries in the muscles get all sugared up? Actually everywhere gets sugared up so that even when you have got your blood sugar back to normal you heal very slowly because even low sugar blood finds it hard to get through your sugared up tiny capillaries.

With this new understanding I could see why very fat or only slightly diabetic people could reverse their diabetes by losing weight. Imagine that your ideal weight is 150lb but your present body weight is 50% more at 225lb. Then crudely speaking you are eating 50% more than you would eat at 150lb. So you need to store 50% more sugar in your glycogen warehouse than you would need to store at 150lb. Imagine that your glycogen warehouse, your glucose battery, your muscles, can store 120% of what you would eat at 150lb to maintain your weight. Then you would be non diabetic at 150lb. But at 225 lb you eat 50% more and so need to store 150% of the glycogen that you would be storing at 150lb. Now your battery can only store 120% of your ideal weight glucose production. Therefore you are diabetic. 

Likewise with gestational diabetes. Before you are pregnant your sugar battery can store perhaps 120% of your glucose consumption. So you are fine. But during your pregnancy you eat for two, perhaps your food consumption goes up by 33%. So again it exceeds what your glucose battery can store and so you become diabetic until the baby is delivered at which point your battery is once again able to cope. 

Likewise with bariatric surgery - gastric band surgery. This forces the patient to more than halve his glucose production from food. Therefore his glycogen storage capacity may well by sufficient under the new regime but insufficient when he was eating for a 250lb person!!

When you look at the Newcastle Diabetes Reversal results you see that all the subjects of the trial were fat with a BMI of 33.6 and were only mildly diabetic in the first place with a blood sugar of 9.2 mmol/l (mine was 23). So they were selected to be good candidates for diet only reversal. The results therefore do not apply if you are not very overweight or if you are more than mildly diabetic as I found out to my cost.

Losing weight only fixes type 2 diabetes in obese people who are only mildly diabetic

So once I had realised that glycogen storage space in muscle was the issue I went about trying to clear some space so that I would cease being diabetic. I walked and walked and walked on my treadmill until my feet fell off. I was doing around 10 miles per day. This had the effect of ending all my neuralgia for a few hours after each exercise bout which was a new and wonderful experience for me especially as I have testicular neuralgia which I will not trouble you with further details of save to say that if that does not motivate me to fix my diabetes nothing will! (Actually it was a very bad thrush infection in that area - caused by diabetes - which I mistook for testicular neuralgia. It would give me more pain down there when my sugar went up because sugar is what the thrush=candida, yeast=fungus, eats!)

Also I could pass a 50% OGTT if I walked before the test to create enough storage space for the glycogen from 33 gm of glucose in half a bottle of Lucozade. So you can carry forward the storage space that you clear. This incidentally proves that the glycogen storage capacity model for diabetes is correct and the insulin resistance model is incorrect because walking for 45 minutes will not change your insulin resistance but it will clear glycogen storage space in your leg muscles and that is how you pass the OGTT. You are permitted to exercise before an OGTT but not during it because the medical community does not recognize that lack of glycogen storage capacity is the cause of this disease.

So I thought I had the cure and walked my little feet off. But every time I cleared some storage space it would just get filled up again. By now my muscles were in better shape than they were when I was 21. I was then 56 and was walking 9-10 miles per day and doing 100 sit ups per day. But I was still only breaking even with type 2. I was not winning.

Then I noticed that even if I ate nothing for the whole day, my blood sugar would go up and up from the minute I got out of bed. It did not go up much in bed thank God! I realised that my liver was over producing glucose the whole time. The medical community recognize this as a feature of diabetes but they put it down to a malfunction in the liver. I do not see how that can be the case because prior to my diagnosis I was eating one chocolate bar a day, one quarter of a chocolate cake a day, drinking one litre of fruit juice a day, stuffing my face with carbs and spending all day sitting down in front of a computer doing absolutely no exercise at all. This awful modern western lifestyle obviously caused my diabetes. But during the 30 years that I was doing this my body had plenty of blood sugar without my liver having to produce any. So I do not believe that my liver was malfunctioning or over producing glucose prior to my diagnosis. So the liver was not the cause. In fact there is a paper looking at the outcome on diabetics and non diabetics who have were given liver transplants. The diabetics with the new liver remained as diabetic after the transplant as they were before it - http://www.ncbi.nlm.nih.gov/pubmed/11679959. So diabetes is absolutely not caused by the liver. So there is another reason why it is making so much sugar all day, long after my diagnosis, even when I eat nothing. 

Well the only organ that absolutely needs sugar and cannot store it is the brain. When diabetics go hypo (on drugs or on insulin) it is the brain that conks out not the muscles or any other organ. So it is the brain that is demanding sugar from the liver on a very low carb diet. So in my case it is plainly demanding too much sugar. Yes its addiction is exposed by my ultra low carb diet. The thing that had changed since my diagnosis was my diet. The brain was telling my liver to compensate for that.

My brain has become subconsciously addicted to blood sugar during my 30 year sedentary carb fest prior to diagnosis. The human brain is an addictive mechanism. Why would it not become addicted? I now understand that there is nothing wrong with my liver. My trouble is that my brain is telling my liver to make sugar all day long. I am on a 20 gram per day max carbs diet. I eat no sugar and virtually no carb. I never have to brush my teeth any more (although I do about once a week) and yet my blood is full of sugar if I do not walk or swim or exercise it off. 

So now I had finally got there - or so I thought. My brain was addicted to a blood sugar level of 7 or 8 or 9 mmol/L (125, 144, 162 mg/dl) or worse and it tells the liver to produce sugar until it gets what it wants. In the meantime the pancreas is saying wooah! I had better make some insulin - the sugar is too high. So the pancreas is making the insulin which is perfectly good stuff and forces the blood sugar into all the available muscle warehousing space. But when all my muscles are full the brain is still telling the liver to make sugar and there is the problem. So I could have the muscles of Arnold Schwarzenegger but I would still be diabetic because my liver would just fill up their entire storage capacity and then produce more sugar until the brain was satisfied. But when is an addict ever satisfied?

Well the good news is that once you normalise your sugar numbers and reduce your systemic inflammation by getting your Omega3:Omega6 EPA/ARA blood ratio down to 1, which is the level of the traditional Japanese fish diet, and you get your Vitamin D level to above 100 nmol/L, then all these problems go away and you will regulate well between meals and halve the amount of walking required (in my case - it all depends how inflamed you were and how high your Omega6:Omega3 ratio was),.

But that is not the end of this epic battle. Next you have to end your insulin resistance and reduce your capillary plaque. This is done by increasing the carbs a bit and by going high poly fat. 

Diabetic Drugs: Metformin (GlucoPhage) and the new Forxiga (dapagliflozin) and other SGLT2 inhibitors (Invokana - Canagliflozin, Jardiance - Empagliflozin)

The American College of Sports Medicine and the American Diabetes Association: Joint position statement..

"Diet and Physical Activity are central to the management and prevention of type 2 diabetes because they help treat the associated glucose, lipid, Blood Pressure control abnormalities, as well as aid in weight loss and maintenance. When medications are used to control type 2 diabetes, they should augment lifestyle improvements, not replace them."   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/  

I have never taken any diabetic drugs - mainly because the SGLT2 inhibitors were not available when I was diagnosed and Metformin which was a possibility can cause hypoglycemia with a lot of exercise and does not increase life expectancy at all. It gives better blood sugar for a couple of years but does not prevent pancreatic beta cell attrition. It does not therefore stop the progression of diabetes. 

Metformin primarily restricts hepatic glucose production - it reduces liver sugar production from protein - a process called gluco-neo-genesis. The trouble with this is that if you then do some sugar reducing exercise and get to the point where your blood sugar is too low for your brain to function, the brain will desperately tell your liver to make more sugar and your liver may not be able to do it. So you will go into a hypo - which is very dangerous.

In any event you can achieve better results than Metformin through diet and exercise alone. I have a friend (Ian) who is diabetic and has been on Metformin for 3 years. I finally persuaded him to go to the gym and after 16 trips to the gym over a period of 3 months his HbA1c went down from 7.2% to 6%. The instructor at the gym told him that several people there stopped taking Metformin after they had done some regular exercise.

The best way to handle this is to do exercise in the day before you take the Metformin. Better still keep up the exercise and ditch the drugs - see the testimonials page.

The SGLT2 inhibitors are different. They stop the Kidneys re-aborbing glucose from the urine back into the blood. So you end up urinating glucose. This will not cause a hypo. It may cause a bacterial (enterococcus) or fungal/yeast (candida/thrush) urinary tract infection (UTI). But this is not a direct side effect of the drug. It is a side effect of the effect of the drug which is to load your urine with sugar which makes it a nice attractive meal for bacteria and fungi such as Thrush or Ringworm (Athletes Foot).

I have not yet tried Forxiga (AtraZeneca's SGLT2 inhibitor). But I think that drug enhanced exercise and diet is now a real possibility with these new drugs which do not cause hypos. http://www.forxiga.eu/clinical-efficacy/consistent-reductions-over-24-weeks

The trouble with Metformin alone or even with Metformin and Forxiga alone is that although they significantly reduce your HbA1c (long term blood sugar) in the first 6 months, the effect eventually wears off because they do not reduce your sugar enough to put diabetes into regression - see http://www.forxiga.eu/clinical-efficacy/sustained-efficacy-up-to-4-years/4-years-forxiga-metformin-vs-su-metformin 

So after 4 years (208 weeks) you are worse than when you started with Glipizide+Metformin and you are almost back where you started with the latest Forxiga+Metformin. These are the results obtained from a constant dosage of Metformin and Forxiga. If you increase the dosage then you can maintain a 1% decrease in HbA1c for 3 years - see http://www.nutritionandmetabolism.com/content/7/1/83

The above is the best that Metformin can do. But it is not enough to put diabetes into regression. Even the best sugar level candidate (at the bottom of the vertical lines) ended up with an HbA1c that was 5.3% after 12 months, which was fine, but then it increased to 5.7% after 36 months (even with an increased metformin dose). 

So the best drugs will slow down the rate of progression of diabetes compared with no drugs. But the disease will still progress as will your symptoms and your neuralgia - to the point where statistically you die 10 years earlier than normal due to diabetic complications. Furthermore there is clinical evidence that most diabetic drugs rob Peter to pay Paul. They improve your blood sugar at the expense of speeding up the failure of your pancreas and your heart in some cases. This indeed is why you end up back where you started after a few years. Diabetic progression is increase insulin resistance due to increased muscle cell oxidative stress and pancreatic failure.

The only diabetic drugs which do not rob from Peter (Panreatic beta cells) to pay Paul (Short term blood sugar) significantly, and therefore have a chance of extending your life, are Incretins such as Exenatide/Byetta or Sitagliptin and SGLT2 inhibitors such as Forxiga or Invokana.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661582/#!po=33.8384 (Sulphonureas are no good, they rob the pancreas of beta cell lifetime in order to get short term HbA1c benefit)

http://www.soc-bdr.org/rds/archive/3/4_winter/diabetic_perspectives/type_2_diabetes_and_pharmacological_interventions/index_en.html?showfulltext=1 (TZDs do not protect pancreatic beta cell function. Incretins preserve beta cell function and reduce HbA1c without increasing congestive heart failure)

The only way to keep your HbA1c below 5.5% indefinitely is to use a very low carb diet and carb burning exercise either by themselves or in addition to drug therapy. But since diet and exercise are more powerful than drugs. And since present diabetic drugs have not been shown to increase your life expectancy at all and some have been shown to cause congestive heart failure - I would recommend the former rather than the latter.

There is a very important study, the ACCORD study which found that diabetic drugs reduce your life expectancy! A great paper which grasped this concept is http://nutsci.org/2009/12/23/insulin-resistance-as-a-protective-mechanism-a-paradigm-shift/. This paper discusses the ACCORD study which discovered that drugs which decrease HbA1c or which increase insulin production actually lower your life expectancy! This is because they add further stress to already overstressed muscle cells. So do not take those drugs  - do the post prandial exercise instead!

"In this randomized study, 10,251 patients (mean age, 62.2 years) with a median glycated hemoglobin level of 8.1% were assigned to receive intensive therapy (targeting a glycated hemoglobin level below 6.0%) or standard therapy (targeting a level from 7.0 to 7.9%). Of these patients, 38% were women, and 35% had had a previous cardiovascular event. The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes. The finding of higher mortality in the intensive-therapy group led to a discontinuation of intensive therapy after a mean of 3.5 years of follow-up."

Insulin resistance is a defensive muscle cell response to the toxic waste products of oxidative stress (which are called ROS for Reactive Oxygen Species). Drugs which force the muscle cell to ignore its defence mechanism - which is to decelerate ATP production which decelerates Glycogen storage, since Glycogen is a branched chain of Uridine diphosphate glucose, with the two phosphate ions coming from two ATP molecules - get you better sugar numbers at the expense of stressing out an already overstressed cell to a very dangerous level and this can cause the death of that cell and the death of you -  See Insulin Resistance.

The 1st Golden Rule

Diabetes Progresses when your spot sugar is above 7.0 mmol/L (126 mg/dl), (HbA1c above 6%)
Diabetes Regresses when your spot sugar is below 6.0 mmol/L (108 mg/dl), (HbA1c below 5.4%)

Putting this another way...

Pancreatic beta cell function deteriorates when your spot sugar is above 7.0 mmol/L (126 mg/dl), (HbA1c above 6%)
Pancreatic beta cell function recovers when your spot sugar is below 6.0 mmol/L (108 mg/dl), (HbA1c below 5.4%)

Essentially a blood sugar of more than 7.0 mmol/L will sugarize you and damage your pancreas a blood sugar of less than 6.0 mmol/L will desugarize you and help the pancreas to recover. High blood sugar is toxic to the pancreas. No diabetic drug therapy can keep your spot sugar below 6.0 mmol/L (108mg/dl). Hence no drug therapy can cure diabetes. But diet and exercise can. And with the new SGLT2 inhibitors, drug assisted diet and exercise will be able to keep your spot sugar below 6.0 mmol/L and your HbA1c below 5.4% without having to do too much walking and without running the risk of hypos. Just make sure you have some good anti thrush cream for possible fungal infections and get your doctor to test your urine regularly for bacterial UTIs.

The 2nd Golden Rule

Exercise does not fully fix Insulin Resistance. Eating the right fat and not eating the wrong fat is how you change the fat content of your muscle and blood cell membranes which cause insulin resistance. 

A. 1 gram of fish based EPA/DHA defrays around 7 grams of Omega6 (because Omega6 is eaten in the form of Linoleic Acid which is converted by the body into Arachidonic Acid which competes with EPA. But only one seventh of ingested Linoleic Acid is converted to Arachidonic acid in the blood. So you only need to eat around one 7th as much EPA as Linoleic Omega6. 

B. 1 gram of Plant based Omega3 (ALA, C18:3ω3) defrays around 2 grams of sat fat in humans in the author's experience (9 grams in rats). Fish based long chain Omega3 does not defray sat fat.

C. 2 grams of Omega6 Poly (Linoleic18:2 cis) defrays at least 1 gram of mono (which is 90% of all mono).

So we need lots of Poly fat, Plant based Omega3 (ALA, linolenic Acid, 18:3ω3), Fish based Omega3 (EPA, Eicosapentaenoic Acid, 20:5ω3 and DHA, Docosapentaenoic Acid, 22:6ω3) and Vegetable oil or nut based Omega6 (LA, Linoleic Acid, 18:2ω3) and less sat fat and even less mono fat. We need to balance our fat intake. 

Low Carb diets are way more effective than Low Calorie Diets or Low Glycaemic Index diets

Here is the graph that says it all from a paper in Kuwait with a large sample of obese subjects both diabetic and non diabetic - see Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes by Talib A. Hussain, et al Unfortunately the full text is paid for as of 2014 August1. But it is nicely presented in the 12 pieces of evidence for low carb diets being the default treatment for Diabetes paper - see http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext which is free. The diabetics were in general on various medications.

 

The results above are fantastic. It looks like if the treatment continued for another 8 weeks then everyone on the VLCKD (Very Low Carb Ketogenic Diet) would be cured. But bear in mind that these people were obese with a BMI of around 39 to start with and were not too badly diabetic and lost on average 11 kgs in the 24 week period and were on diabetic medication too. However clearly low carb is better than low calorie. So now we can state clearly what Diabetes is all about...

Diabetics are carboholics who have overloaded and damaged their carb metabolism. Hence the best thing to do is to eat fat instead. Now you might think you will get a heart attack from the fat rather than from the diabetes but you would be wrong. Eating carbs causes more cardio vascular trouble than eating fat - however counter intuitive that may seem. I eat fat all day and my blood lipids and cholesterol just get better and better- again see http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext and for a consumer version see http://www.diabetes.co.uk/news/2014/jul/researchers-recommend-carb-restriction-as-primary-method-of-diabetes-control-91152031.html  

Finally in the test some of those on the VLCKD halved their diabetic medications in the latter stages of the testing period (because they were doing so well). So plainly a low carb diet can be added to medication for a greater effect. The same is also true of exercise. 

Gluconeogenesis

I now have enough experience in eating protein of different sorts to advise on which foods result in gluconeogenesis (where your liver converts protein into sugar) and which foods do not.

Fatty meat, not meat with fat around it but meat with fat within it, do not cause much gluconeogenesis. So bacon, lamb, chicken thighs and legs are fine.
Lean meats, such as turkey, chicken breast, crustaceans (prawns, crabs, lobsters) are not good - they will be turned into sugar by the liver.

If you eat meat which is very lean (not so much a lean cut but a lean meat itself), then your metabolism will produce sugar from this meat for energy. Whereas with fatty meats, your metabolism can get all the energy it needs from the fat and so converts less of the protein into sugar for energy. Turkey has very little fat within the meat. And eating a lot of cheese or other fat with turkey does not help in my experience. Turkey and prawns will put up your sugar a lot more than lamb or beef or pork or chicken legs and thighs.

So with bacon and with fish try not to cook it so much that all the fat runs out of it. Get your energy from fat, not from carbs and not from lean meats which are effectively 50% carb after the liver has converted their protein.

Here is the Low Carb High Poly plan. I wish I had known this 4 years ago. But you do know it today...

Consult your diabetic doctor before you go on this diet/exercise regime!

For obese diabetics (BMI over 30) we recommend the work of Dr Eric Westman at Duke University North Carolina (20 carb grams per day), whose work is related to that of Dr Bernstein (30 carb grams per day) see http://www.diabetesdaily.com/voices/2010/03/interview-dr-bernstein-on-low-carb-diets-treatments-politics/ and see http://lowcarbdiets.about.com/od/bernsteinsdiabetesdiet/p/bernsteinintro.htm. Low carbohydrate diets began with the Atkins diet - see http://en.wikipedia.org/wiki/Atkins_diet 

But for non obese people, please be aware that ultra low carb diets (less than 30 carb grams per day for weeks) can result in muscle loss which causes apparent insulin resistance (because there is reduced capacity in which to store sugar) and they can result in increased gluconeogenesis and cause insulin resistance as a cerebral protection mechanism (the brain panics a bit and tells your muscle cells leave what little sugar we have for me!) 

Also ultra low calorie diets (less than 600 kcals per day for weeks), will result in muscle loss which is a disaster for a diabetic. 

We presently therefore recommend starting with a 40-50 carb gram per day diet in order to prevent muscle loss (since diabetics find it extremely difficult to put muscle back on) and to have a bit of variation in what we can eat. Dr Westman at 20 carb grams and Dr Bernstein at 30 carb grams are too low in our new opinion because the brain needs between 50-70 grams of glucose each day and the body will make it from protein if it does not get enough carb. So a 20 or 30 carb gram diet is a bit of a fantasy due to gluconeogenesis of ingested protein. 

1. The diet must be low carb to limit blood sugar, but have enough carb to enable sensible nutrition - So 40-50 carb grams per day. This will give the pancreas a Sabbath from excess glucose metabolising, to enable it to recover. The body normally recovers if it is given a holiday just as we ourselves do. Type 2 diabetics produce loads of insulin all the time but it has less than its normal effect due to both insulin resistance and a lack of glycogen storage capacity. So the pancreas has been working overtime for decades! It needs a break. 

Normal diets are 40% carb, 30% protein and 30% fat by calorie content. 
This equates to 48% carb, 36% protein and 16% fat by grams.

There is a brilliant gram ratio to calorie ratio calculator at  http://www.freedieting.com/tools/nutrient_calculator.htm

Very low carb diets are considered to be lower than 10% carb, 45% protein and 45% fat by calorie content.
This equates to 13% carb, 60% protein, 27% fat by grams.

We are recommending an ultra low carb diet as follows: 
8% carb, 46% protein, 46% fat by calorie content (2000 kcals).
40 gm carb, 230 gm protein, 102 gm fat per day
11% carb , 62% protein, 28% fat by gram weight (fat has 2x the calories per gram of carb and protein)

2. Do not eat any individual food which has more than 10% carb content by gram weight. So no rice, no potatoes, no pasta, no pizza, no noodles, no grains, no grain based bread, no wheat, no barley, no rye, no oats, no corn, no maize, no millet, no doughnuts, no cakes, no pastries, no biscuits, no cookies. Obviously no sugar. 

3. To avoid gluconeogenesis of protein - eat well structured meat with fat within it such as pork, lamb, beef, chicken, duck and turkey but NOT seafood such fish prawns crab or lobster - which just fall apart. Also do not eat old meat or processed meat, which means, smoked, salted, cured or preserved with chemicals. So avoid sausages, salamis, hams, bacon, hamburgers, hot dogs, etc. The Harvard School of Public Health did a definitive study showing that these meat increase the chances of heart disease by 42% and of type 2 by 19% - whereas unprocessed meat have no detrimental effect -   https://www.hsph.harvard.edu/news/press-releases/processed-meats-unprocessed-heart-disease-diabetes/. Also the liver will take one look at old or processed protein and say I am not going to build any body parts from this garbage - melt it down for sugar - its neoglucogenesis for you! Low fat mince is fine. Do not eat separable fat. But do eat the fattier cuts of meat. Fish is good for you due to the fish oils EPA and DHA, not the fish protein itself. So take the oils as supplements and avoid fish at the first stage of your cure.

4. FAT BALANCE - see Insulin Resistance

5. 200 grams of any of the following leafy green and superfood raw vegetables per day for artery cleansing and general health and immune function which helps insulin resistance. Spinach, Kale, Swiss Chard, Broccoli, Rocket/Aurgura, Green Cabbage, Red Cabbage, Asparagus, Fine beans, Carrots. Use a NutriBullet or other fast blender to make a raw vegetable Smoothie every day. 

6. Replace roast potatoes or mash potatoes with carrots and swedes and turnips (celeriac and cauliflower are a bit too carby for me). Replace potato fries with fried onions - mmmmm. Fry everything in sunflower oil sparingly

7. High Fibre because this reduces insulin resistance and helps health in general and improves bowel movements and slows blood sugar absorption.

8. Take the following supplements...

a. Vitamin C (preferably Ester C)  500 mg per day (to make up for lack of fruits in the diet due to sugar content).
b. Vitamin D3: 2500-7500 IU or 62.5-187.5 micrograms per day (not more) and NO vitamin K2 (MK7). D3 helps regulate sugar between meals and helps the body to deal with glucose spikes. Try to get your blood level to 150 nmol/L
c. Magnesium malate or citrate:  200 mg per day of elemental magnesium (following Dr William Davis)
d. Take No vitamin B supplements at all (they increase neuralgia). 

Take Cinnamon from day one if it helps. It certainly can help with neuralgia. One teaspoon per day is sufficient - but every day or every other day. Just have a teaspoon of cinnamon in your tea rather than sugar. Or rather make a tea from a teaspoon of cinnamon instead of the tea bag. Remember what Mary Poppins said...

Just a spoonful of cinnamon helps blood sugar go down, blood sugar go down, blood sugar go down.
Just a spoonful of cinnamon helps blood sugar go down, in the most delightful way!

WARNING: Do not take Vitamin B6 in the Pyridoxine or P5P forms. These both cause/exacerbate peripheral neuralgia. The Pyridoxamine form of Vitamin B6 may be OK. It also helps to remove capillary plaque.

9. NO SNACKING! NO SNACKING! 

10. Most importantly of all, GET A SOFT TREADMILL ... GET A SOFT TREADMILL. Get the best impact absorbing trainers and the best impact absorbing insoles (Sorbothane and Noene) and follow the exercise routine below. WALK THE SUGAR DOWN AFTER EVERY MEAL!! Or if preferred get a spin bike and use that after every meal. It is better to eat a large meal and then burn off the carbs with exercise than to snack and fail to burn off the carbs from the snack. 

Whatever you do watch these three videos. They will change your view on diets...

Dr Eric Westman Ketogenic Diet video http://www.youtube.com/watch?v=dSLf4bzAyOM 
Dr Mercola Diabetes sermon http://www.youtube.com/watch?v=pXE4aVIJXIw 
Dr Wortman Big Fat Diet interview https://www.youtube.com/watch?v=zjUdtK6ukqY 

As said above, eating 100 grams of a carb such as potato or bread or rice or pasta or pastry at midday is essentially the same as eating 100gm of sugar at 12:45 pm since the body metabolises all starch into Glucose 6 phosphate (which is sugar). Galactose, Fructose and Lactose based carbs are only half metabolised into Glucose. Sucrose, table sugar, is fully metabolised into Glucose.

There is no point in cutting our sugar from your diet and then eating carbohydrates which your body will immediately convert into sugar.
Do not eat protein without fat (such as prawns - your liver will make energy from them through gluconeogenesis - what other choice does it have?). Do not start with day without some fat to teach the liver to get calories from fat rather than carbs.

Here is a table from a cureddiabetes reader showing the power of carb burning exercise in fixing blood sugar and curing diabetes...

Date Evening Spin Bike mins Average BPM % of Max BPM (169) Pre spin Sugar mmol/L Post spin mmol/L Difference Rate of decrease per min Morning Fasting Sugar mmol/L
                 
January19 25     16.7 9.5 7.2 0.29 9.5
January20 30     11.8 6.3 5.5 0.18 8.8
January21 30     8.3 6.8 1.5 0.05 7.8
January22 30     9.1 4.8 4.3 0.14 6.8
January25 20 132 78% 8.0 5.2 2.8 0.14 6.2
January26 35 135 80% 9.2 4.3 4.9 0.14 n/a
January27 23 131 78% 6.2 4.6 1.6 0.07 6.0
January28 25 136 80.5% 7.6 4.1 3.5 0.14 6.0
January29 25 135 80% 5.9 3.9 2.0 0.08  
January30 25 132 78% 5.9 4.0 1.9 0.08  

Mark Quade lives in Canada and was on 2500 mg Metformin and 120 mg Gliclazide (a sulphonylurea) during this period. That table is the story of how he fixed his diabetes in 10 days. He had not seen his sugar in the 5s or the 4s for 10 years!! He achieved this with low carb (50 carb grams) and just with 25-30 mins of high intensity spin bike exercising every evening. His fasting sugar show his progress towards a cure. 

Spin bike exercise at 80% or max heart rate is much more effective at burning carbs than walking on a treadmill at 50% Vo2 max (around 50% of max heart rate). But one has to be careful about adrenaline release with high intensity exercise. 

If fact if you exercise at 80% max heart rate which is roughly speaking 80% max breathing rate (VO2 max) then you burn 80/50 more energy and you burn 80/50 more carbs in that energy. So you burn 80x80/50/50 or 64/25=2.56x more carbs.

So 30 mins at 80% max heart rate is equivalent to 77 minutes at 50%. But the high intensity will produce more adrenaline which will produce more sugar so you may not get all of that theoretical advantage. I would say that Mark got most of it. 

So there it is folks. How to fix the worst type2, when on the max possible pre-insulin dependent drug regime with diabolical sugar (16.7 mmol/L = 16.7x18=300 mg/dl) having had it for more than 10 years! How to fix it in 10 days. Then you have to keep that up for 1-2 months to fix your HbA1c. Then you are clinically non diabetic.

Then you have to fix your residual insulin resistance. This we do by dietary supplements which reduce capillary plaque, which is the cause of slow healing and peripheral neuralgia and insulin resistance and cardio vascular events in Type 2 patients. Eating fat does not deposit fat in your arteries, high blood sugar from excess carbs causes that.

Warning: Mark got worn out in February because he made the mistake of doing High Intensity exercise on the same muscle group every day. Muscles which have been used in high intensity workouts need a day off after each workout to recover and rebuild. So if you are going to go high intensity then do the legs one day and the upper body and arms the next. 

My Exercise plan

This is how it worked at first for a severe diabetic like me. The figures for a 100 carb gram diet are extrapolations from the 40 gram and the 70 gram figures which I have actually tried.

For Normal Eating Times and Proper Carb Burning Exercise (so that you are slightly out of breath and breathing through you mouth not your nose and sweating slightly and not able to sing Whitney Houston during the exercise). Here is what to expect during the first 2 months (HbA1c is a 1-3 month average of glycosylated haemoglobin).

Treadmill CBE Treatment per day After Breakfast: After Lunch: After Dinner: Before Bed HbA1c on a 0-40 carb gram per day diet 0-40 gm/day Sugar Regulation HbA1c on an 70 carb gram per day diet HbA1c on a 100 carb gram per day diet
30 mins (Carb Burning Exercise)  10: 10: 10: 0 7.0% Diabetes in bad progression Diabetic 7.5% 8%
50 mins CBE 15: 15: 10: 10 6.5% Diabetes in progression Diabetic 7.0% 7.5%
Metformin typical dose Metformin 6.0-7.0% Diabetes in progression Intolerant/Diabetic 6.5% 7.0%
75 mins CBE 25: 20: 20: 10 6.0% Diabetes in slow progression Glucose Intolerant 6.5% 7.0%
100 mins CBE 30: 30: 25: 15 5.75% Normal but high end of range 6.0% 6.35%
120 mins CBE 35: 35: 30: 20 5.5% Diabetes in slow regression Central Normal 5.75 6.0%
150 mins CBE 45: 40: 40: 25 5.25% Diabetes in regression Neuralgia reversed 5.5% 5.75%
180 mins CBE  50: 50: 45: 35 5.0% Diabetes in good regression Perfect 5.25% 5.5%

If you eat an extra 30 grams of carb during the day then you make an extra 120 kcal of carb energy. For perfect sugar regulation you will have to burn this off by mouth breathing walking which will burn 50% carb and 50% fat over the entire day. So you will need to do an extra 240 kcal walk to burn 120 kcal of carbs, which will take you around 55 minutes. But taking in more carb reduces the gluconeogenesis a bit so in fact you probably only have to do a further 30 mins of carb burning mouth breathing exercise to fix your sugar. That is how we deduce the 100 carb gram column and how this all works. The crazy thing is that breathless walking for 150 minutes will burn around 650 kcal of which around 375 will be carbs. So for perfect sugar control you effectively burn 94 carb grams every day. Then if you eat say 30 grams of carb during the day, you are still negative by 64 carb grams. But your idiot metabolism will overproduce sugar mainly from ingested protein at a rate which matches this!

If you just walk off your 30 gram carb intake and no more then you would only need to walk for a maximum of 55 mins per day. But doing this is insufficient. The body will overproduce blood sugar for your brain and you will get a high HbA1c and diabetic neuralgia with this low amount of exercise - which is absurd. 

So most of your sugar reducing walking will be to absorb your hepatic sugar overproduction from gluconeogenesis of ingested proteins

Why does the liver not simply produce the correct amount of sugar through gluconeogenesis? Why does it make more than you actually need?

The answer must be that either your brain has become carboholic or that the feedback loop telling the liver to stop making sugar does not work properly when you have insulin resistance.

Then after 2 months of at least 2 hours CBE per day things should improve and it should work more like this..

Treadmill CBE Treatment per day After Breakfast: After Lunch: After Dinner: Before Bed HbA1c on a 0-40 carb gram per day diet 0-40 gm/day Sugar Regulation HbA1c on a 70 carb gram per day diet HbA1c on a 100 carb gram
per day diet
30 mins (Carb Burning Exercise)  10: 10: 10: 0 7.0% Diabetes in bad progression Diabetic 7.5% 8%
50 mins CBE 15: 15: 10: 10 6.5% Diabetes in progression Diabetic 7.0% 7.5%
Metformin typical dose Metformin 6.0-7.0% Diabetes in progression Intolerant/Diabetic 6.5% 7.0%
75 mins CBE 25: 20: 20: 10 6.0% Diabetes in slow progression Glucose Intolerant 6.5% 7.0%
100 mins CBE 30: 30: 25: 15 5.75% Normal but high end of range 6.0% 6.35%
110 mins CBE 30: 30: 30: 20 5.5% Diabetes in slow regression Central Normal 5.75% 6.0%
125 mins CBE 35: 35: 35: 20 5.25% Diabetes in regression Neuralgia reversed 5.5% 5.75%
150 mins CBE  40: 40: 40: 30 5.0% Diabetes in good regression Perfect 5.25% 5.5%

Then there is a trick we can employ which results in having to walk less. If we eat our dinner late and exercise not long afterwards and then go straight to bed after the exercise then we can skip the before bed routine. This works because sleep or just lying down effectively freezes your blood sugar unless you are really badly diabetic (with a low carb diet and a reasonable amount of exercise you will not be).

Treadmill CBE Treatment per day After Breakfast: After Lunch: After Dinner: HbA1c on a 0-40 carb gram per day diet 0-40 gm/day Sugar Regulation HbA1c on a 70 carb gram per day diet HbA1c on a 100 carb gram
per day diet
Metformin typical dose Metformin 6.0-7.0% Diabetes in progression Intolerant/Diabetic 6.5% 7.0%
75 mins CBE 25: 25: 25 6.0% Diabetes in slow progression Glucose Intolerant 6.5% 7.0%
90 mins CBE 30: 30: 30 5.5% Diabetes in slow regression Central Normal 5.75% 6.0%
105 mins CBE 35: 35: 35 5.25% Diabetes in regression Neuralgia reversed 5.5% 5.75%
120 mins CBE  40: 40: 40 5.0% Diabetes in good regression Perfect 5.25% 5.5%

The above recommendations are the optimum use of whatever walking time you can manage in my experience. Moderate intensity exercise such as brisk, that is brisk, walking upon a treadmill at zero incline will burn mainly carbs for the first 30 minutes for a non diabetic person with good sugar levels and thereafter it will burn mainly fat. If you are diabetic and have higher sugar or if you exercise just after a meal then you can go for 40 minutes before you start burning mainly fat. And if you keep increasing the speed of the exercise you can go for 55 minutes before burning mainly fat in my experience. 

The table above was deduced from my experience with my less than optimal journey since it took me a long time to learn how to do this. My friend Sami was moderately diabetic on diagnosis with a blood sugar of 13.9 mmol/l (250 mg/dl) and had only been extra thirsty for 2 months and had no diabetic neuralgia. He started the correct diet and exercise program on day 5 after his diagnosis. With him it works more like this...

Treadmill CBE Treatment per day After Breakfast: After Lunch: After Dinner: HbA1c on a 0-40 carb gram per day diet 0-40 gm/day Sugar Regulation HbA1c on a 70 carb gram per day diet HbA1c on a 100 carb gram
per day diet
60 mins CBE 20: 20: 20 5.5% Diabetes in slow regression Central Normal 5.75% 6.0%
75 mins CBE 25: 25: 25 5.25% Diabetes in regression Neuralgia reversed 5.5% 5.75%
90 mins CBE  30: 30: 30 5.0% Diabetes in good regression Perfect 5.25% 5.5%

As mentioned on the home page his sugar was 5.5 mmol/L (99 mg/dl) in the morning and after every walk by day 18 after diagnosis. So we expect him to be fully cured in the sense that he only has to exercise for an hour per day on a 100 carb gram per day diet by the end of July. And actually he was fully cured on 2014 July 15th. By that time he had morning sugar of 5.2-5.5 mmol/L (94-99 mg/dl) from only walking 50 minutes per day (30 minutes upon a treadmill in his health club and 20 minutes outside) on a 100 carb gram per day diet. So whole cured took him 30 days. On 2014October16 (day 122 after diagnosis) his HbA1c was 40 mmol/mol or 5.8%. A clinical cure is 6% or below. So he is now clinically cured although his HbA1c is slightly too high because during the last 30 days he failed to do much exercise due to pain in his feet.

So the amount of exercise that you need to do depends upon how diabetic you were upon diagnosis and what progress you have made since then. I used to have to do 180 minutes per day to have perfect sugar (on a 40 carb gram per day diet). Now I can get perfect sugar on 120 minutes per day. Sami started with 90 minutes per day (on a 70 carb gram per day diet). So the day will come when he can regulate perfectly with less than one hours exercise. And we all should do one hours exercise per day anyway. Well yes, that day came on July 15th 2014! 

I make Cinnamon tea as follows. 

1. Boil some water and pour it into a cup
2. Add some milk to cool it down a bit
3. Add a teaspoon of good aromatic cinnamon
4. Stir thoroughly for 30 seconds

That is it. No tea bag is needed. Cinnamon has a very nice and strong and actually quite sweet taste of its own. Do not boil the Cinnamon or you will kill some of its power.

If you are working and there is no gym at work then eat a carb light lunch and go for a walk as fast as possible in the vicinity of your office immediately afterwards. Try to find a park or some other soft surface. Or just skip lunch and have a big breakfast.

The Perfect Diabetic Treadmill Exercise Routine

So what is the best exercise routine to use? I have been researching this and actually doing it now for 15 months and I have finally got there. The amount of carbs you burn is proportional to the amount of oxygen you burn/breath during the exercise because carbs are burnt aerobically with oxygen. So the idea is to be slightly out of breath the whole time. One does not want to be very out of breath because stress will put up your sugar. One does not want to be breathing through the nose and singing Whitney Houston because then you are achieving very little from a carb burning standpoint. The idea is to stretch yourself - but not to stress your self. So find the speed of walking that begins to make you have to breath through your mouth. 

Technically you need to walk so that your breathing is 50% of VO2max (i.e. half of your maximum possible oxygen intake).

This corresponds to a heart rate of 121 bpm for a 50 year old person.

Age Heart rate in bpm for 50% VO2 max
20 135
25 133
30 130
35 128
40 126
45 123
50 121
55 118
60 116
65 113
70 111
75 109
80 106
85 104
90 101
95 99
100 96

For a precise bpm to % VO2 max conversion please see http://www.shapesense.com/fitness-exercise/calculators/heart-rate-and-percent-vo2max-conversion-calculator.aspx 

When I started this in March 2013 that speed was 2.8 mph or 4.5 kph. You ramp up to that speed in the first 5-10 minutes and keep the speed for half of the workout and add another 0.1 mph or 0.2 kph for the second half. So in the first month my routine should have been the following...

0-1 mins  2.5 mph
1-3 mins  2.6 mph
3-5 mins  2.7 mph
5-25 min  2.8 mph
25-40 mins 2.9 mph

Then you will find as the months go by that you get fitter and can walk faster. You will soon be able to do the above routine without getting out of breath at all. Before getting to that point you should up the speed to the next level to ensure that you are slightly breathless and stretching yourself but not stressing yourself. Here is my present routine as of March 2014.

0-1 mins 2.8 mph
1-2 mins 3.0 mph
2-4 mins 3.2 mph
4-6 mins 3.3 mph
6-8 mins 3.4 mph
8-10 mins 3.5 mph
10-25 mins 3.6 mph
25-40 mins 3.7 mph.

My present slightly out of breath speed is 3.5/3.6 mph. Just make sure that after the 5-10 minute ramp up you have to breath through your mouth and have to work slightly.

If during any stage after the ramp up you find yourself breathing happily through your nose - then you are going too slowly, raise the speed up by one notch. Do not increase the incline that does not help for diabetic exercise.

History of my exercise routines

I initially thought that I could not walk much faster than 3.1 mph comfortably. Actually I discovered (thanks to Fool for you loving no more by Whitesnake) that I can walk at 3.7 mph at a push (6.0 kph). And then thanks to Madonna (Cherish) that I can actually walk at 6.4 kph (4.0 mph). And increasing the speed of the walk has a disproportionately good effect on sugar. If you increase the average speed of you walk by 10% then obviously you burn 10% more energy due to the speed increase. But in addition you burn a larger percentage of Carb and less Fat so this gives you around another 10% (see the graphs below). So increasing the speed of the walk by 10% decreases the time you need to spend walking by around 20%. So as from October 10th I have been using Higher Carb Burning Exercise with an average walking speed of 3.3 mph or more. In order to maximize carb burning and minimize fat burning I used the following routine in October 2013...

4.4 kph for 2-3 mins
4.6 kph for 2-3 mins
4.8 kph for 2-3 mins
5.0 kph for 2-3 mins
5.2 kph for 2-3 mins
5.4 kph for 2-3 mins
5.6 kph for 2-3 mins
5.8 kph for 2-3 mins

24 minutes of the above (8x 3 mins) nails sugar to the floor. So in October I never had to do more than 96 minutes per day. Here is the table for CBE (average walking speed of 3.3 mph (5.2 kph) as best as I can fathom.

In November 2013 I started using this routine...

4.4 kph for 4-6 mins
4.8 kph for 4-6 mins
5.2 kph for 4-6 mins
5.6 kph for 4-6 mins
6.0 kph for 4-6 mins
6.4 kph for 4-6 mins

My December 2013 regime was as follows...

10 minutes after breakfast (staged high intensity glycogen clearing)
3 minute warm up
0-5 mins 4.8 kph
5-15 mins 5.2 kph
15-30 mins 5.6 kph
30-40 mins 6.0 kph
40-45 mins 6.4 kph

Average speed is 5.6 kph. The first time I tried this routine on December27 my sugar went down to 4.3 mmol/l, 77 mg/dl when I had finished it. But really the routine was too fast to be sustainable for me.

20 minutes after Lunch (staged medium intensity sugar reducing)
0-5 mins 4.4 kph 
5-10 mins 4.8 kph
10-20 mins 5.2 kph
20-30 mins 5.6 kph
30-35 mins 6.0 kph
35-40 mins 6.4 kph

Average speed is 5.4 kph. 

30 minutes after Dinner (staged medium intensity sugar reducing)
0-5 mins 4.4 kph 
5-10 mins 4.8 kph
10-25 mins 5.2 kph
25-35 mins 5.6 kph
35-40 mins 6.0 kph

Average speed is 5.25 kph

This is a total of 125 mins walking per day.

It seems that by stepping up the speed with time the body does not have time to get into fat burning mode and so burns more carbs than it wants to. With diabetes, everything you do to try and fix the disease the body reacts against. If you try and burn carbs and it has time to learn what you are doing, it will start burning fat instead - to protect your carb reserves - doh! But by stepping up the speed before it has time to settle down, you force it to burn carbs.

Here is a graph showing blood sugar versus spin bike exercise time for a normal person and for a group of Type 1 diabetics. Inclining the treadmill does not help with Diabetes.

The dotted line is for a normal person. He starts burning fat at the 40 minute point when his blood sugar starts rising. The solid line is for the diabetics who continue to burn carbs and sugar until the 90th minute. This is because if you have high blood sugar then exercise will burn that first. The clearest illustrations I have seen which help us to determine when fat is burnt and when carbs are burnt are these two hand drawn graphs...

   

These graphs are designed to help weight loss dieters to burn more fat but we can equally well use them to help diabetics to burn more carb.

However, as can be seen from Type 1 versus no diabetic sugar graph, diabetics burn sugar and carbs for longer. So I suggest a maximum of 60 minutes for any exercise session and a minimum of 15 minutes. If you are on a treadmill then ramp up the speed as you go. Do not keep walking at the same speed for 30 minutes. Start moderately fast and then get faster. That is the optimal way to burn carbs without stressing yourself out too much. Walking at a slow pace achieves very little for blood sugar.

The industry standard paper of the ratio of fat to carb burning during exercise is the rather over complicated http://ajpendo.physiology.org/content/ajpendo/265/3/E380.full.pdf  

To cut a long story short, the metabolic effect of types of exercise were investigated in fit, yes very fit people (who were used to regular exercise)...

1. Low intensity - where your breathing rate is 25% of VO2 max (breathing rate).  
2. Medium intensity - where your breathing rate is 45-65% of VO2 max (so you will be breathing through your mouth rather than your nose)
3. High intensity - where your breathing rate is 85% of VO2 max (so you will be out of breath)

The results were that in low intensity exercise from 15 minutes to 2 hours 0% of the calories came from muscular glycogen, 10% came from blood glucose and 90% came from fat.
In medium intensity exercise from 15 minutes to 2 hours 30% of the calories came from muscular glycogen, 10% came from blood glucose and 60% came from fat.
In high intensity exercise from 15 minutes to 30 minutes (they could not keep it up for longer - consistently)  60% of the calories came from muscular glycogen, 15% came from blood glucose and 25% came from fat. To summarize this in tabular form...

Intensity  Breathing  Speed % VO2max Sugar Glycogen Fat Duration in minutes Grade
Low Through nose Slow walk 25 10% 0% 90% 120 Useless
Medium Through mouth Brisk walk 65 10% 30% 60% 120 Effective and Sustainable
High Out of breath Jog 85 15% 60% 25% 30 Very effective but not sustainable

Burning muscular glycogen is fine because the gycogen is replenished from blood sugar. Burning fat does not help a diabetic unless one is overweight. High intensity exercise such as jogging is by far the most effective but one cannot do that after every meal. It is too taxing and not sustainable as a long term diabetic therapy. So plainly the answer is moderate intensity exercise. In fact, it is as brisk as possible a walk that you are able to sustain.  My latest as of October 2014 is that I eat two large meals a day, a brunch and an evening meal. Then I walk for 45-55 minutes after each meal as follows...

4.4 kph 2 mins
4.8 kph 2 mins
5.2 kph 2 mins
5.4 kph 4 mins
5.6 kph 10-15 mins
5.8 kph 15-20 mins
6.0 kph 10 mins

Zero incline. 

The really good news is that even with fit people who do a lot of training and even with walking for 120 minutes at a time, one still burns 40% carb, so long as one is just on the borderline of having to breathe through the mouth rather than the nose. the figures from the paper shows that you burn around 45% carb after 15 minutes and around 35% after 120 minutes of a brisk walk at 65% VO2max.

However swimming lengths of a pool continuously burns 50% more energy than a moderate walk on a treadmill - http://www.health.harvard.edu/newsweek/Calories-burned-in-30-minutes-of-leisure-and-routine-activities.htm and burns a good percentage of carbs since it is higher intensity. So rather than 45 mins of treadmill CBE one could do 30 minutes of continuous swimming lengths (which I cannot yet manage) or 40 minutes of lengths with a break at each end to get your breath back.

We want to do Carb Burning Exercise to reduce blood sugar and to clear glycogen storage space. The most effective CBE is high intensity exercise but that raises blood sugar because it stresses out the body so I cannot recommend it. I can recommend the following as being great at lowering blood sugar.

1. Slightly out of breath treadmill exercise. Start at a nice moderately fast pace and increase to a brisk walk as fast as you can reasonably go - hold on to the rails if necessary. 70 minutes max duration. After meals and before bed (the best).
2. Lengths of the pool with stops to catch ones breath when needed.

Try to work all your muscle groups. You can certainly beat the liver with your legs alone but give your legs a rest occasionally. I used to have to walk between 9 and 10 miles per day to reverse my neuralgia in August 2013. Now I can do it with 5-6 miles per day in October 2013 (that was due to some fast high intensity walking at 6.0 kph after 40 mins of sugar reducing exercise). But less miles on the treadmill and a bit of swimming is a better idea. 

Do not worry if you have worse diabetes than me so long as your pancreas is still working. The liver only stores around 100 grams of glycogen - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248697/. There is a limit to what it can produce in a day. 100 grams of glycogen is 400 calories. So you may need to do do around 700 calories of mainly carb burning exercise to beat it. But that is the most anyone will have to do I think. However if you eat a lot of protein and no fat, the liver may decide to turn much of that protein into sugar so do eat the fat as well.

Clinical results showing that you need both low intensity and high intensity exercise

http://www.time.com/time/health/article/0,8599,1662683,00.html is a really important paper. It is a big study of Type 2 diabetics. It compares 45 minutes of walking with 45 minutes of weight training with 45 minutes of both together. The results are astonishing and point forward to the cure proposed above.

Activity 45 minutes of treadmill walking 3 days/week 45 minutes of wieght training 3 days/week 45 mins of Both The sum of the individual reductions
HbA1c reduction 0.51% 0.38% 0.97% 0.89%

The whole is plainly greater than the sum of the parts. This shows that exercising all muscle groups gives added bonuses to diabetics over concentrating on only one group. If these guys had done 45 minutes of both 7 days a week rather than 3 then they would have been well on the way to fixing their diabetes!! The American Diabetes Association now bases its exercise recommendation http://www.diabetes.org/for-media/2010/exercise-can-help-tame-type-2.html conservatively (150 mins per week) on this paper.

But you are definitely not going to beat your liver with 150 minutes per week. That will burn 600 kcals around 33% of which is fat. So actually you end up burning 400 kcals of carb per week or 57 kcals per day. Honestly you might as well scatter that around the room. Your liver stores 400 kcals of glycogen which it can convert into sugar at any time. Really you do not want to be conservative when treating Diabetes with exercise! So rather than recommending 150 minutes per week, the Gordon Diabetic Association would recommend 150 minutes per day!

High Intensity exercise does not fix short term blood sugar. but it does I think improve long term blood sugar by reducing long term insulin resistance. 

Final Recommendations

Type 2 Diabetes is a disease caused by being full of sugar due to a lack of exercise and the wrong diet. You are not going to cure it by pussy footing about. A nice 30 minute walk every evening will help but not fix it. A few 30 second bursts of high intensity training every day will help but will not fix it.

You have to grasp the bull by its horns.

1. You will need to walk upon a treadmill for at least an hour per day (or spin bike or elliptical trainer).

So to be clear we are recommending 3x-7x as much low intensity sugar reducing exercise as the American Diabetic Association (not 150 minutes a week but 60-120 minutes per day of medium intensity walking). And we are recommending 2x as many carb grams as the 20 gram per day ultra low carb diet of Dr Westman. 

It has taken me a year to get this right. But most of this time was spent working out what to do rather than actually doing it. I could have become effectively non diabetic in 14 days, and clinically non diabetic in 2 months (since the glycosylated Haemoglobin measure is effectively a 1-2 month average). I would also have not had the neuralgia so badly (or at all). But that has mainly gone now thank God.

For a more on the cure please see the conclusion.

2. You need to get the fat balance right. FAT BALANCE - see Insulin Resistance

As of June 2014, I am doing 150 minutes of brisk walking on a treadmill ramping up to 5.6 kph (50 minutes after each meal), and then a further 40 minutes of walking around my neighbourhood. A bit of real walking helps me with my joints.
As of July 2014, I am doing 135 minutes of brisk walking on a treadmill ramping up to 5.6 kph (45 minutes after each meal), no walking around my neighbourhood - joints are better. 
As of October 2014, I am doing 105 minutes of brisk walking on a treadmill ramping up to 5.8 kph (50 and 55 minutes after two large meals), no walking around my neighbourhood. Joints are perfect. Sugar is perfect. 
As of July 2015 I am doing 120 minutes of brisk walking on a treadmill ramping up to 5.8 kph (55 and 65 minutes after two large meals), no walking around my neighbourhood, HbA1c was tested on 2015July20 at 5.1% (32 mmol/mol). I have been walking a bit more than necessary to help treat my Candida infection which is still persisting. 
As of December 2016, I am now doing around 75 minutes per day of brisk walking upon a treadmill after one very large daily meal. 

If your knees are killing you or your feet, then try two huge meals per day rather than 3 smaller meals, then you only need to walk twice.

Since diabetic food is poison and exercise is the antidote. The antidote should be taken immediately after the meal. Do not wait. Fat is not poisonous but carb is 100% poison and protein is 50% poison since the body will treat much of it as carb. To treat type 2 properly you simply have to burn off more sugar than your liver is being told to produce by your addicted brain. Any exercise which burns carbs and does not stress you out too much so that you do not make adrenaline in significant quantity will work in this regard. In non diabetic people, the sugar is stored the minute it is absorbed. Diabetics must burn off the sugar that they cannot store, the minute it is absorbed. 

If you walk 10% faster then you burn 20% more carbs per unit time and 10% more carbs per unit distance (roughly speaking). So if 40 minutes at 5.5 kph burns off the sugar from your lunch then 32 minutes at 6.0 will achieve the same result. Or you could do 48 minutes at 5.0 kph. The idea therefore is to go as fast as your legs can manage. But be careful...

DO NOT DO HIGH VERY INTENSITY EXERCISE WITH YOUR LEGS (NO JOGGING). It is very counterproductive to do a lot of low and medium intensity walking and then add high intensity with the same muscles. High intensity should only be done in spurts in intervals and not with muscles that are also doing a lot of low or medium intensity work.

If burn off more carbs than you liver can produce in a day then you put exercise in the bank. I have successfully done this. In this condition you will pass any clinical diabetes test. But you are still diabetic, because your bank account will leak. In fact really that is what a type2 diabetic is. It is someone with a leaky exercise bank account. The glycogen storage space cleared by the exercise just becomes filled up with over produced glucose and you eventually go bankrupt in storage space again and return to being a diabetic. I have managed to have a positive exercise balance for 5 days. During those 5 days I could eat a meal without have any kind of post prandial sugar spike. But eventually my liver caught up and bankrupted me again. However the more you do this the less leaky your bank account becomes and that is presently how I believe I can totally cure my diabetes. I think I will need to add swimming to the walking to be able to burn enough carbs to stay positive in glycogen storage space.