By Dr. JohnPoothullil
Type 2 diabetes (T2D) is a major health threat that is challenging the public health and health-care systems worldwide. WHO has identified the condition as one of three target diseases in its WHO Global Action Plan for the Prevention and Control of non-communicable diseases (NCDs).
The International Diabetes Federation (IDF) estimated 589 million adults (ages ~ 20–79) worldwide were living with diabetes in 2024. The figure is projected to rise to 853 million by 2050. In addition, studies of “youth‐onset type 2 diabetes” suggest that type 2 diabetes is rising among youth and young adolescents and adults ages 30 or less.
According to the IDF, diabetes prevalence rates are driven almost entirely by T2D, which accounts for more than 90% of diabetes cases worldwide.
Dr. John Poothullil has spent more than 25 years studying the cause of high blood sugar and Type 2 diabetes. He proposes an alternative theory that is more scientifically logical than the theory of insulin resistance which is currently the basis for the diagnosis and treatment of Type 2 diabetes in most patients.
The Real Cause of High Blood Sugar and Type 2 Diabetes
Type 2 diabetes is commonly explained through the lens of insulin resistance—the concept that cells in three sites—muscle, fat, and liver—no longer respond effectively to insulin, resulting in elevated blood sugar levels. While widely accepted, critical questions remain that challenge the scientific foundation of this theory:
Causative Factor: Unknown. Insulin is just one of approximately 50 hormones controlling metabolism, growth, reproduction, mood, and more. Why would the body become resistant only to this one hormone? Despite decades of research, no clear causative factor has been identified.
Selective cellular response: Out of 200 cell types in the body, only three types of cells are implicated in this “non-responsiveness” to insulin. Are millions of cells all independently deciding to become insensitive to insulin?
Contradictory energy utilization: Many adults diagnosed with Type 2 diabetes maintain normal muscle function, despite supposed insulin resistance. How do muscles produce sufficient energy without proper glucose entry?
Liver and fat cell paradox: Liver cells continue to produce fat, and fat cells continue storing it, even under “insulin-resistant” conditions. How are these processes sustained if insulin signaling is impaired?
Treatment paradox: Insulin is prescribed to patients who are theoretically resistant to it. The rationale for this approach lacks robust evidence.
Long-term complications despite insulin injections: Even when blood sugar is controlled via insulin-based therapies, diabetic complications—neuropathy, nephropathy, retinopathy, and limb loss—remain prevalent among Type 2 diabetic patients.
These questions highlight critical gaps in the insulin resistance model, which are overlooked in conventional care. Dr.Poothullil believes that patients and healthcare providers alike could benefit from reconsidering the insulin resistance theory in light of these unresolved issues.
The Fatty Acid Burn Switch: A New Perspective on Hyperglycaemia and Type 2 diabetes
Dr.Poothullil proposes an alternative model based on nutritional overload, which is an increasingly common consequence of the global modern diet. This model can be viewed as the fatty acid burn switch, meaning that cells, mostly in muscle tissue, begin burning fatty acids rather than glucose. This concept reframes the argument on the cause of high blood sugar by recognizing the body’s ability to toggle between burning glucose or fatty acids for energy.
Here’s an overview of the main biological processes that explain high blood sugar and the eventual development of Type 2 diabetes:
Causative Factor: The modern diet throughout much of the world consists of a large component of refined carbohydrates, which in digestion produce voluminous amounts of glucose.
Clear Biological Mechanism: The majority of cells in the body use glucose as their fuel. Excess glucose not used immediately after digestion is converted to fatty acids for storage in fat cells. However, each person has a limit to the number of fat cells their body can produce. Nutritional overload can thus fill fat cells over time. Unsorted fatty acids remain in blood stream. Muscle cells begin burning fatty acids rather than glucose, leaving glucose in bloodstream. Thus high blood sugar.
Consistent with the Science of the Randle Cycle: This switch aligns with the Randle cycle, a metabolic process that recognizes the competition between glucose and fatty acids for energy in muscle cells. High levels of fatty acids inhibit glucose use, whereas low levels promote glucose metabolism.
Consistent with Clinical Experience:This is a common-sense explanation that matches what many clinicians already see: when patients reduce their consumption of refined starches and sugars and eat fewer calories, they lose weight (fat cells empty out), liver fat falls, and blood sugar levels improve.
Solves Insulin Resistance Inconsistencies: Using this alternative theory, it now becomes clear that muscle cells are not resisting insulin; they simply do not need glucose since they are burning fatty acids. Cellular insensitivity to insulin is only the appearance of resistance, not an actual biological occurrence.
New Treatment Implications
Dr.Poothullil’s fatty acid burn switch offers a science-based model for patients, clinicians, and researchers to explore alternatives to conventional insulin-centric treatment approaches. This alternative theory makes it clear that doctorsand patients need to focus on making dietary changes the first step in preventing or even reversing type 2 diabetes. By managing carbohydrate consumption combined with exercise individuals who already exhibit high A1c levels can lower their blood sugar and improve their glucose metabolism without relying solely on insulin-targeted interventions.
Results may vary based on the stage of an individual’s high blood sugar, medical history, access to medical care, and other factors. Always consult your physician before making changes to your medications, diet, exercise, or treatment plan for Type 2 diabetes.
Type 2 diabetes (T2D) is a major health threat that is challenging the public health and health-care systems worldwide. WHO has identified the condition as one of three target diseases in its WHO Global Action Plan for the Prevention and Control of non-communicable diseases (NCDs).
The International Diabetes Federation (IDF) estimated 589 million adults (ages ~ 20–79) worldwide were living with diabetes in 2024. The figure is projected to rise to 853 million by 2050. In addition, studies of “youth‐onset type 2 diabetes” suggest that type 2 diabetes is rising among youth and young adolescents and adults ages 30 or less.
According to the IDF, diabetes prevalence rates are driven almost entirely by T2D, which accounts for more than 90% of diabetes cases worldwide.
Dr. John Poothullil has spent more than 25 years studying the cause of high blood sugar and Type 2 diabetes. He proposes an alternative theory that is more scientifically logical than the theory of insulin resistance which is currently the basis for the diagnosis and treatment of Type 2 diabetes in most patients.
Common-sense explanation that matches what many clinicians already see: when patients reduce their consumption of refined starches and sugars and eat fewer calories, they lose weight (fat cells empty out), liver fat falls, and blood sugar levels improve.
Solves Insulin Resistance Inconsistencies: Using this alternative theory, it now becomes clear that muscle cells are not resisting insulin; they simply do not need glucose since they are burning fatty acids. Cellular insensitivity to insulin is only the appearance of resistance, not an actual biological occurrence.
New Treatment Implications
Dr.Poothullil’s fatty acid burn switch offers a science-based model for patients, clinicians, and researchers to explore alternatives to conventional insulin-centric treatment approaches. This alternative theory makes it clear that doctorsand patients need to focus on making dietary changes the first step in preventing or even reversing type 2 diabetes. By managing carbohydrate consumption combined with exercise individuals who already exhibit high A1c levels can lower their blood sugar and improve their glucose metabolism without relying solely on insulin-targeted interventions.
Results may vary based on the stage of an individual’s high blood sugar, medical history, access to medical care, and other factors. Always consult your physician before making changes to your medications, diet, exercise, or treatment plan for Type 2 diabetes.
Dr. John Poothullill is MD, FRCP, Retired Physician, Portland, America. He has the following book in medicine:. 1) Diabetes- The Real Cause and the Right Cure (2) Beat Unwanted Weight Gain (3) The Diabetes-Free Cookbook and Exercise Guide (4) Eat, Chew, Live (5) Beat Diabetes with Indian Vegetarian Cooking (6) Your Health is At Risk (7) Surviving Cancer (8) When your Child Has Cancer
Comments are closed.