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Metabolic health educator Kevin Whitt discusses his article “Insulin resistance is not a disease: a metabolic reframe.” Kevin argues that the skyrocketing rates of Type 2 diabetes are not the result of defective biology, but rather a predictable response to chronically elevated blood sugar. The conversation challenges the traditional medical view of insulin resistance, reframing it as a protective mechanism where cells limit glucose uptake to prevent damage from substrate oversupply. Kevin highlights how modern medical education structurally privileges pharmacological treatments over nutritional interventions, leaving doctors equipped to manage symptoms rather than address root causes. Discover why addressing the dietary carbohydrate load is the key to resolving this metabolic mismatch.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Kevin Whitt. He is a metabolic health educator. Today’s KevinMD article is “Insulin resistance is not a disease, it’s a metabolic reframe.” Kevin, welcome to the show.

Kevin Whitt: Thank you very much, much appreciated being here. Always good to share information with those who are interested.

Kevin Pho: All right, so tell us briefly a little bit about yourself and what you do.

Kevin Whitt: I was born in Ohio, so I am a Buckeye back in Ohio. Over the years I have become very interested in my own personal health. As I began to learn what I was not able to learn from the mainstream medical community, I began to understand that there were many things that were being left out of the information packet that the average Joe is being told in America. So I have made it a point to take information to people that they are not getting on a regular basis or at all from the medical community that I believe is extremely important that they know.

Kevin Pho: All right. And today we are going to talk about insulin resistance. For those that didn’t get a chance to read your article, just tell us what it is about.

Kevin Whitt: Insulin resistance is one of those phrases that is bandied about on a regular basis, and it conceals what is really going on at the physiological level in the human body. So it is a two-word phrase that in my opinion is quite confusing and misleading to the patients who are dealing with either pre-diabetes or type 2 diabetes. Therefore I think it is extremely important that that be cleared up.

Kevin Pho: All right, so tell us some of the confusion that led you to reframing insulin resistance.

Kevin Whitt: Well, there is a science called the Randle cycle that has been around for 63 years and was developed by a man named Randle. He and his team discovered this Randle cycle in 1963. It is not something that you hear anything about, and it is something that is not taught to any aspect of the medical community, whether it is doctors, nurses, et cetera. Therefore it never gets shared with mainstream America.

Of course, when you have 35 million type 2 diabetics, this is something they need to understand because type 2 diabetes is an epidemic in the United States, and it is quickly becoming a pandemic because this standard American diet, which we call the SAD diet, is now spreading all around the world and it is devastating to people. Here is another very important aspect of it. When people are told they have a disease, then the red flags go up and the alarm bells go up. They are told that this disease they have is progressive and chronic. Type 2 diabetes simply is not progressive and it is not chronic. Type 2 diabetes is easy to prevent, and type 2 diabetes can be reversed. It is a simple matter of knowledge.

One of the things I equate that to is back in 1965, cigarette smoking was becoming a problem. What did we do? We put a warning label on cigarette packages, and people then, once they had the information, took the bull by the horns. Slowly but surely they stopped smoking cigarettes, and we are down to about 14 percent of all adults in the United States smoking today. We can do the same thing with type 2 diabetes. The proper information has to be given to people and they can’t be convinced that they have a disease that they are going to have to live with and there is nothing they can do about it except be treated for it for the rest of their lives. That just takes away the hope of a normal life. It is important that people have the right information, and then they can take that information and use it or not use it. That becomes up to them. But preventing and reversing type 2 diabetes is totally up to the individual as long as they have the information to do it.

Kevin Pho: So you mentioned the Randle cycle. For those who aren’t familiar with that, what is it and how does it relate to the prevention of diabetes?

Kevin Whitt: Well, I will explain the Randle cycle this way. First I will use a vegan as an example, and then I will use a carnivore as an example because those are both ends of the spectrum. Then there are all those that fall in between that spectrum. So on any given cell, you have two receptors. One is called the GLUT4 receptor, and that is where sugar enters into the cell. You have a second receptor, it is called the CD36 receptor, and that is where fat and fat only comes into the cell.

When sugar is flowing freely into the cell and finally makes its way across the membrane and into that part of the cell where the mitochondria are, then the mitochondria are using sugar only to produce ATP for the purposes of energy. Because that vegan is eating fruits and vegetables, and all fruits are already sugar with no transition time, being 50 percent fructose and 50 percent glucose. And then all vegetables upon being put to digestion in the human body all convert to glucose. So the vegan is feeding the body totally sugar. Once that sugar gets down into the mitochondria, the mitochondria turn that into ATP on the way to becoming energy for the body. At that point, because of the Randle cycle, a signal is sent over to the fat pathway and shuts it down.

So quickly over to the CD36. That fat pours into the cell and goes down coming in on a protein-based transporter. Once it gets down to the membrane that separates the main part of the cell from the mitochondria, it jumps on board a transporter, and the CD36 is also a transporter. That transporter carries that fat over into the area where the mitochondria are. So the mitochondria then are using fat to make the ATP for energy purposes. So now we have jumped over from the vegan over to the other extreme, which is the carnivore.

Once sugar is being used by the mitochondria, a signal is sent over to shut down the ability of fat to move into the mitochondrial area of the cell. The same thing though happens when fat is the main thing that is being fed to the cell. It sends a signal up to the GLUT4 entry for sugar and shuts it down because the cell, if it is using all sugar, likes to continue using all sugar. If it is using all fat, it likes to continue using all fat.

But here is the main point as it relates to type 2 diabetes. When fat is being used and the signal is sent from the mitochondria up to the GLUT4 entry point for sugar, it works like a rheostat. It can leave that door open, it can close it slightly, or it can close it off. It is a natural physiological function that allows that sugar flow to be stopped. That is what is called insulin resistance. There is no insulin resistance going on because “insulin resistance” makes it sound as though the body is having a problem. It is not having a problem. It is simply doing what it has learned to do over the eons of us becoming human beings so that sugar flow is shut down intentionally because too much sugar in the cell becomes poisonous or toxic to the cell.

Fat can come into the cell and it can hang out in the cell and it is not toxic. In the bloodstream, it is not toxic. In the cell, sugar however, in the form of glucose in this particular case, is toxic to the blood, which is why our body makes such an effort to remove it from the blood. It is also toxic at high levels in the cell. So this notion of insulin resistance is a non-starter. If a person understands the Randle cycle, then they understand that the GLUT4 door is being slammed shut. It doesn’t make any difference, Dr. Kevin, how much insulin is thrown at that GLUT4 pathway, that door simply will not open. That is because of the physiological response and the signaling that is coming from the mitochondrial area of the cell. It has nothing to do with the cell ignoring the insulin. Therefore, people have to understand that their body is only doing what it has learned to do over the eons as we developed as more efficient and higher-form human beings.

Kevin Pho: Now, if patients know this information and the Randle cycle that you just described, what kind of changes can they make to hopefully prevent the onset of any diabetes?

Kevin Whitt: Well, I have what is called the 14-word solution, and it sums everything up very nicely. That 14-word solution is simply this: Over the next six weeks, slowly but surely remove all carbohydrate from your diet. What happens then is you are decreasing the sugar load, and therefore you are decreasing the amount of insulin. Obviously, as blood sugar increases, insulin increases. If you are constantly eating sugar all day long over and over and over again several times, which is what we do in the United States, the vast majority of people are eating that standard American diet. They are eating a load of carbs and they are doing it multiple times per day. Week after week, month after month, and year after year, the next thing you know the doctor gives you a call and says your blood work came back and you are a type 2 diabetic.

What folks have to understand is that there is no such thing as an essential carbohydrate for the human body. So my body lives on protein and fat. The vegan lives on 100 percent sugar. However, there is then that middle area, which is the standard American diet where people are eating a combination of protein, fat, and carbohydrates. This is very important also. When a person is eating that mixed diet, you create a conflict at the cellular level because of the Randle cycle, which is constantly being activated over and over and over again.

The key element to remember is when this Randle cycle is being activated, inflammation is being created in abundance in every single cell of the body. That inflammation is the very thing that is part of all of these major diseases that we get through the course of our lives. The other thing that is important to remember is just like cancer, the best way to deal with cancer is to prevent cancer. And the way you prevent cancer, heart disease, strokes, kidney disease, et cetera, is to not allow yourself to become a type 2 diabetic.

So back to the Randle cycle for a second. When vegans are feeding only sugar, the Randle cycle has very little reason to activate because it is getting a sugar flow on a regular basis and there is no conflict going on in the cell. It is the same thing with the carnivore. They are feeding the cell fat, the cells are living off of fat, and there is very little Randle cycle activation. It is when you eat that mixed diet that the Randle cycle is activated. How do we know that that is happening here in the United States? Well, as I have already mentioned, there are 35 million people who are type 2 diabetics. We also know that 90 percent of the American population is either metabolically challenged, which is a nice way of saying you are well on your way to becoming a type 2 diabetic, or you are already a type 2 diabetic.

So it is an epidemic and what we must do is inform the people now on as large a scale as possible because like the old saying, you ain’t seen nothing yet. Over the next five to 10 years, we are not going to have 35 million type 2 diabetics. We are going to have 50 million type 2 diabetics, and it is a huge profit center, which unfortunately has to be taken into the equation. If you convince people they have a disease even though they don’t have a disease, and we can clearly explain to people that it is not a disease, which leaves them in total control, then they end up being treated for the rest of their life. They are told like our neighbor who is a type 2 diabetic to eat 55 grams of carbohydrate with every meal and then turn around and take the insulin to offset the carbohydrate they have just eaten. It is a foolish effort at dealing with type 2 diabetes. However, it makes no attempt to prevent it or to reverse it. It simply tells the patient that they are going to be treated for this for the next 10, 15, or 20 years for as long as they live.

Kevin Pho: OK, so I am a primary care physician. What are some of the things that I can tell my patients short of stopping taking all carbohydrates? What are some realistic things that we can get patients to accept in the exam room?

Kevin Whitt: Well, the way I approach that is simply this. On the one hand, you can tell the patient that if they want to allow themselves to be as healthy as their DNA will allow them to be, then you take the time, the six weeks or maybe eight weeks, to slowly but surely remove those carbohydrates and get rid of all of them because they are not essential. Or you can tell the patient they can continue on as the average American does eating 275 grams of carbohydrate a day and continue being a type 2 diabetic or become a type 2 diabetic.

Or you can choose something in between. So if you drop from 275 grams of carbs a day down to 200, are you going to be better off? Yes, but marginally. What if you drop that carb intake to 150 grams? Well, you are going to be a little better off, but are you going to reverse the type 2 diabetes? No. So if you want to reverse the type 2 diabetes, you have to remove the vast majority of those carbohydrates. Now, like I said, you can max out your health by removing all carbohydrates, and it is very doable. It is not difficult at all. I eat zero carbohydrates and I get along just fine. It was easy for me to make that transition once I began learning all of this.

So the patient then has to decide for themselves where they are going to take that carbohydrate intake level. Are they going to take it to 100 grams, 50 grams, or 20 grams? Now, if they really want to give themselves a chance to become as healthy as they can be, they have got to get that carb intake down to at the very least less than 100 grams of carbs a day. Fifty is better, 20 is great. I eat about six grams of carbs a day. And the reason is because you cannot go zero carb. The reason why is because there are small amounts of carbs in meat and in eggs. So if I could go zero carb, I would, but I am at two, four, or six grams of carbs per day.

That is my daily routine, and another thing that makes it that easy for me is the fact that I eat only one meal a day. So I am considered an OMAD carnivore, and that one meal a day is high-quality food every night for dinner. However, that doesn’t mean expensive food. It means primarily beef and eggs, along with some dairy if you can deal with it. There are many types of meat that you can eat. Beef just happens to be the one we have in our society today that gives us the most nutrition from a meal.

So it becomes the patient’s decision. Do you want to get away from needing any insulin at all? Drop those carbs, and if you want to go to zero, that is fine. There is nothing wrong with that. Or you can get it down to 20. It depends on the patient, but they have to have the information so they can make the decision, understanding that they are not locked into a situation where they are being medicated for the rest of their lives when it is unnecessary.

Kevin Pho: Do you ever get hungry eating one meal a day?

Kevin Whitt: No, I do not. And the reason is because the food I eat for my dinner is high-quality food, not expensive food, but high-quality food. Therefore my body reaches satiation relatively quickly, and I simply don’t get hungry during the next day. Now, for instance, when we get done here, Marsha and I will be heading to the gym and we do two intense workouts a week. I call them HIST, high-intensity strength training. It means minimum time and maximum effort gives you maximum result. I never carbo-load in any way, shape, or form before going into exercise, but the vast majority of people who go into a gym believe that they have to carbo-load in order to get through those workouts. Even long-distance runners are finally realizing that they do not need to carbo-load for several days before going out and running a marathon. Because when my body needs glucose, which it does occasionally for red blood cells, muscle cells, and brain cells, even though I eat no carbohydrate and I eat no glucose, my body makes it. Obviously it makes it for itself, which is called gluconeogenesis. You of course know that, and most of your listeners may know that. So when I need the glucose, my body makes it. How much does it make? Exactly what I need. When does it make it? When I need it.

Kevin Pho: We are talking to Kevin Whitt, metabolic health educator. Today’s KevinMD article is “Insulin resistance is not a disease, it’s a metabolic reframe.” Kevin, let’s end with briefly sharing your takeaway messages to the KevinMD audience.

Kevin Whitt: The take-home message is that the individual in the United States must understand that insulin resistance is a fabrication and it really doesn’t exist. We know that because of the Randle cycle effect on the body. If you want to maximize your health, then you must begin slowly but surely reducing the carb intake for your body. Instead of eating seven times a day including snacks and all that, reduce it down to one or two meals per day. Remember that it is the inflammation that is causing all of the diseases. Once a person becomes a type 2 diabetic, they open that door for cancer, heart disease, and all those diseases that we deal with on a regular basis in the United States. So you have got to reduce the carbs and you must do it slowly over the six to eight weeks because you must give the microbiome a chance to adjust to the fact that so many of those microbes are living on something that you should not be eating. As you reduce those carbs, there is going to be a little bit of a war going on because those microbes and bacteria want to live just as much as a human does or as much as an animal does. You must give the gut microbiome a chance to adjust to your dietary changes.

Kevin Pho: Kevin, thank you so much for sharing your perspective and insight. Thanks again for coming on the show.

Kevin Whitt: I thank you very much and I hope today finds you and yours very well.