Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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False Scientifically refuted Certainty of evidence: high provisional C-INS-02

Injected insulin halts the Krebs cycle, blocks protein and DNA synthesis, starves the brain of glucose and causes seizures and blood clots.

Safety note: Do not stop or reduce insulin on the basis of this claim. In type 1 diabetes and other insulin-deficient states, stopping insulin leads within hours to days to diabetic ketoacidosis, which is life-threatening. Medically accepted position (ADA Standards of Care 2026): insulin treatment is essential for people with type 1 diabetes; people on intensive insulin therapy should not stop basal insulin even when not eating. Any change of diabetes medication should be made together with the treating physician.
In short: This claim is false. Human experiments show the opposite: lack of insulin reduces the cell's energy (ATP) production and increases protein breakdown, while insulin supports both; the only true part is that too much insulin causes hypoglycaemia, which can lead to seizures.
Conclusion: The Krebs-cycle and DNA claims are false; the only true part is that insulin overdose can cause dangerous hypoglycaemia.
  1. Original statement
  2. Scientific assessment
  3. Scientific evidence in detail
  4. In plain language
  5. Studies on this claim
  6. Regional context
  7. What applies in my country?
  8. References

Original statement

يقول الدكتور ضياء العوضي إن الأنسولين ... وإن حقنه يوقف دورة كريبس فيعيق تصنيع البروتينات والحمض النووي ويسبب تشنجات وجلطات.

not verbatim – paraphrase. Translation by the project; the Arabic wording is authoritative.

Translation

Injected insulin halts the Krebs cycle, blocks protein and DNA synthesis, starves the brain of glucose and causes seizures and blood clots.

Origin

Source status
Archive quote (no location given)
Attribution
Elawady (archive paraphrase; source video not given)
Origin
https://eltayebat.com/rule/insulin-injections/
Attribution uncertainty
The archive attributes this text to Dr. Diaa in its 'د. ضياء يقول' box but gives no video reference. Transcript check (the project's research files, keyword search of 307 archive transcripts): found_close_paraphrase (partial). Krebs-cycle blockade (9-ai4_JBX6c) and clots in insulin users (5H-C06AT55Q) are found as close paraphrases. 'Blocks protein and DNA synthesis', 'starves the brain of glucose' and 'seizures' were not checked verbatim.
Claimed mechanism

Insulin 'freezes' cells and stops the Krebs (citric acid) cycle so glucose cannot be used.

Claimed health effect

Impaired protein/DNA synthesis, seizures, clots, brain glucose deprivation.

Population concerned

People treated with insulin

Geographic restriction by Elawady

none found

Diverging source versions

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
المفاهيم المضللة عن الإنسولين ومغالطات شائعه حول الإنسولين #ضياء_العوضي (Open source)
Published
17 April 2026
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.

عدم القدره على اصلاح الاعطال عارف ليه عشان ما عنديش انتي اوكسدنت اما تحقن انسولين تعطل الكريبس الكريبس اتعطلت الكريبس اتعطلت اتعطل معاها انتاج الاي تي بي الاكس فوسفوريشن فالجسم يتلج ما عندكش انتاج حراره ولا انتاج

Injecting insulin disables the Krebs cycle and with it ATP production (oxidative phosphorylation), so the body 'freezes' and cannot produce heat.

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr Diaa Al Awady د ضياء العوضي is live! الكورتيزون حياتك (Open source)
Published
17 October 2025
Timestamp
1:44:41 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.

مش صدفه مش صدفه اللي بياخد انسولين دايما كل سنه يجي له جلطه في الشران بتاع عينيه ولا جلطه في شيران التاجي بالصدفه بالصدفه يضيق عليك وانت بتاخد

It is not a coincidence, not a coincidence that whoever takes insulin gets a clot every year in the artery of his eyes or in the coronary arteries - by coincidence? It narrows on you while you are taking [insulin].

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
الذبحة الصدرية ؟! (Open source)
Published
3 February 2025
Timestamp
1:13:35 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; YouTube original not checked; wording may contain recognition errors. Close paraphrase of the clots part.

Scientific assessment

False – The statement contradicts the robust evidence.

Certainty of evidence: high – Further research is very unlikely to change the assessment.

1. What was claimed?

Insulin stops the Krebs cycle, blocks protein and DNA synthesis and causes seizures and clots.

2. What is demonstrably correct?

An overdose of insulin causes hypoglycaemia, which can cause seizures and loss of consciousness. Severe hypoglycaemia was more frequent with intensive treatment in ACCORD, ADVANCE, VADT, UKPDS and DCCT (A-INS-01, I-INS-01, A-INS-03, A-INS-16, I-INS-03) and was associated with later vascular events and death (A-INS-14, A-INS-15), although in ADVANCE it occurred mainly under sulfonylurea-based therapy in people not on long-term insulin (A-INS-15).

3. What is wrong or exaggerated?

Insulin does not stop the Krebs cycle; it increases glucose uptake into muscle and fat (via GLUT4) and promotes glucose oxidation and storage. Insulin is anabolic: it stimulates protein synthesis and inhibits protein breakdown; insulin deficiency (type 1 diabetes, ketoacidosis) causes muscle wasting. No study presented by the archive shows insulin causes clots at therapeutic doses. The hypoglycaemia studies the archive cites contain no evidence on the Krebs cycle, protein or DNA synthesis or clots: in ACCORD, of 431 adjudicable deaths hypoglycaemia was definitely involved in 1 and probably in 3, and excess hypoglycaemia explained only about 5 of 57 excess deaths in the intensive arm (A-INS-14); in ADVANCE associations were non-specific (also with respiratory, digestive and skin disease), without a dose-response, and the authors judged hypoglycaemia as likely a marker of vulnerability as a cause (A-INS-15).

4. What remains unclear?

Whether severe hypoglycaemia itself causes cardiovascular events or mainly marks frail patients is unresolved (A-INS-15).

5. Which studies support it?

None for the mechanistic claims. Mixed: A-INS-14, A-INS-15 (support only the kernel that severe hypoglycaemia under glucose-lowering treatment occurs and marks higher risk).

6. Which studies contradict it?

Standard biochemistry (I-INTB-01); I-INS-116 (insulin deprivation lowers muscle mitochondrial ATP production and raises protein breakdown and ketones in T1D); I-INS-07 and I-INS-08 (insulin is the cornerstone of treating ketoacidosis, a state of insulin deficiency with catabolism); I-INS-03; A-INS-14 and A-INS-15 (hypoglycaemia mostly a marker, rarely a direct cause of death).

7. What applies to Germany and Europe?

European (EASD) and German (DDG) guidance follow the same evidence base as the ADA/EASD consensus: individualised HbA1c targets, insulin as mandatory therapy in type 1 diabetes, and SGLT2 inhibitors/GLP-1 receptor agonists for people with cardiovascular or kidney disease. No country-specific difference changes the assessment.

8. What is known about Egypt?

Egypt has one of the highest diabetes prevalences in the region; the same drug classes and insulins are used. Access barriers and cost may make advice to stop medication attractive, which increases the practical risk of this claim. No Egypt-specific evidence changes the assessment.

9. What practical conclusion is appropriate?

The real risk of insulin is hypoglycaemia, which is managed by appropriate targets, dosing, glucose monitoring and education, not by stopping insulin.

Assessment details

Rationale for certainty of evidence

Textbook physiology: insulin stimulates glucose uptake and oxidation in muscle and fat and is an anabolic hormone that promotes protein synthesis; no evidence that insulin stops the Krebs cycle. The only correct kernel (seizures from insulin-induced hypoglycaemia) is well documented.

Source quality

Archive paraphrase plus own words in machine transcript.

Regional transferability

Universal physiology.

Individual exceptions

Hypoglycaemia (too much insulin relative to need) can cause confusion, seizures and, rarely, death; this is a dosing problem, not a property of insulin at physiological levels.

Regional scope of the claim
general (biological/medical)
Last reviewed
26 October 2026 provisional

Scientific evidence in detail

Scientifically refuted – High-quality evidence shows the opposite, or the claim contradicts well-established physiology.

Research question: Does therapeutic insulin halt the Krebs cycle, block protein/DNA synthesis, starve the brain and cause seizures and clots?

Research question in detail (PECO)
Population
People treated with insulin
Intervention or exposure
Insulin therapy / insulin action
Comparison
Insulin deficiency or no insulin
Geographic scope
universal biology
Outcomes
  • Mitochondrial ATP production (Krebs cycle/oxidative phosphorylation)
  • Protein breakdown
  • Hypoglycaemia/seizures
  • Thrombosis

Study results as reported by the authors. Our assessment follows below.

What speaks for the claim?

What speaks against the claim?

What does the overall evidence say?

Editorial assessment based on the studies above – not itself a study result.

Which position is better supported?

Insulin promotes glucose oxidation, ATP production and protein synthesis; its real risk is hypoglycaemia from excess dosing.

Why some studies weigh more

Human physiology experiments and textbook biochemistry contradict the mechanism; only the hypoglycaemia kernel is supported.

Is a causal relationship established? Yes, established Insulin overdose causes hypoglycaemia and seizures; insulin does not stop the Krebs cycle (insulin deficiency impairs it).

Remaining uncertainty

Whether severe hypoglycaemia causes cardiovascular events or marks frailty.

Justified conclusion

False, except the hypoglycaemia kernel.

Does this depend on the country?
General biological effects
Insulin physiology, autoimmune type 1 diabetes and ketoacidosis are universal human biology.
Eating habits
Egyptian and European diets differ, but no dietary pattern replaces insulin in insulin-deficient diabetes.
Origin of the food
Not relevant.
Contaminants
Not relevant.
National production conditions
Not relevant.
Legal rules
Insulin is an essential medicine (WHO list) in Egypt and the EU; prescription rules not relevant to the scientific question.
Actual monitoring data
Egyptian/Middle Eastern data show severe DKA is common at presentation in children (I-INS-115, I-INS-114); no data on outcomes among Tayebat followers.

A regional difference that changes the conclusion is not supported by robust data.

Statistical re-check
  • CI symmetry for severe hypoglycaemia RR – RR 1.70 (1.51-1.91) log-symmetric recalculated
Certainty of the overall evidence (GRADE, simplified)
Main outcome
Effect of insulin on cellular energy metabolism and protein synthesis
Starting level
high (randomised trials)
Result
high

Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.

Clinical guidelines and official statements checked
  • ADA: 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026 (2026) · Original publication
    People at risk for DKA should have ketone testing tools and sick-day advice; people on intensive insulin therapy should not stop or hold basal insulin even if not eating; caution with near-normal A1C goals in long-standing T2D using hypoglycaemia-prone drugs (ACCORD).
  • ADA/EASD/JBDS/AACE/DTS: Hyperglycemic Crises in Adults With Diabetes: A Consensus Report (I-INS-07) (2024) · Original publication
    Insulin is 'the cornerstone of DKA management'; isotonic fluids 500-1,000 mL/h initially; potassium replacement; treated DKA mortality <1%; glucocorticoids can precipitate hyperglycaemia.
  • ADA/EASD: The management of type 1 diabetes in adults: updated 2026 consensus report (2026) · Original publication
    'Lifelong insulin therapy is essential in type 1 diabetes'; all individuals need glucose and ketone testing supplies; insulin omission or under-dosing is a DKA precipitant.
Search strategy

Documented literature searches for this review (search strings in the original database syntax).

DatabaseDateSearchLooking forHitsIncluded
PubMed26 October 2026(insulin[ti]) AND ("citric acid cycle" OR "Krebs cycle" OR "TCA cycle" OR "tricarboxylic acid cycle") AND (inhibit* OR suppress*) AND humansupporting evidence21
PubMed26 October 2026(insulin therapy OR exogenous insulin) AND (venous thromboembolism OR thrombosis) AND (cohort OR meta-analysis)supporting evidence105
Europe PMC26 October 2026(TITLE:"insulin") AND (TITLE:"seizure" OR TITLE:"seizures") AND hypoglycemiasupporting evidence10
Europe PMC26 October 2026(TITLE:"insulin") AND (TITLE:"protein synthesis" OR TITLE:"muscle protein") AND human AND (TITLE:"type 1 diabetes" OR TITLE:"insulin deficiency")supporting evidence0
PubMed26 October 2026"insulin deprivation" AND mitochondrial AND ATP AND "type 1 diabetes"contradicting evidence2
PubMed26 October 2026(insulin deficiency OR insulin withdrawal) AND "type 1 diabetes" AND (protein breakdown OR proteolysis OR "protein synthesis") AND leucinecontradicting evidence5
PubMed26 October 2026Erpeldinger S[au] AND insulinboth directions2

How deeply was this checked?

8 linked studies: 4 checked in full text (3 of them with a structured risk-of-bias assessment), 4 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.

Last scientific review: 26 October 2026

History of the verdict
  1. 25 October 2026 · Phase 1 · Initial assessment: False (high)
  2. 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: False (high)
    Karakelides 2007 adds direct human evidence that insulin deficiency, not insulin, impairs mitochondrial ATP production; no supporting evidence for Krebs-cycle blockade or clots was found.
    New sources: I-INS-116 I-INS-122

In plain language

Insulin does not stop the cell's energy engine. It helps muscle and fat take up sugar and it helps build protein. The real danger of insulin is a dose that is too high, which makes blood sugar fall too low; this can cause confusion and seizures. That risk is handled by careful dosing and checking blood sugar.

Studies on this claim

Studies supporting the claim (0)

No studies in this group.

Studies contradicting or limiting the claim (5)

  • International guideline on diabetic ketoacidosis

    Umpierrez GE et al.. Diabetes Care 2024 · PMID 39052901 · DOI 10.2337/dci24-0032
    Guideline / position statementindependent cross-checkfull text checked★ key study

    Insulin, fluids and potassium are the core treatment; with this, fewer than 1% of adults die.

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Diagnosis and management of DKA and HHS in adults

    How was the study done?

    International consensus report based on systematic examination of literature since 2009 (ADA, EASD, JBDS, AACE, DTS)

    How many people, animals or samples were studied?

    not applicable; Adults with diabetes

    What was actually found?

    Insulin is the cornerstone; glucocorticoids worsen hyperglycaemia.

    How large was the observed effect?

    Mortality <1% with treatment

    What do the results mean in everyday life?

    Ketoacidosis needs hospital treatment with insulin.

    What are the study's limitations?

    Consensus, not trial

    What does it say about Elawady's specific claim?

    Directly contradicts C-INS-08; supports danger in C-FAST-03; contradicts C-INS-07, C-INS-10.

    Do the results apply to Germany and Europe?

    EASD and JBDS (UK) co-authored; directly applicable.

    What can explicitly not be concluded from this study?

    Outcomes of untreated DKA quantitatively.

    Scientific details →

  • Review on diabetic ketoacidosis

    Dhatariya KK et al.. Nat Rev Dis Primers 2020 · PMID 32409703 · DOI 10.1038/s41572-020-0165-1
    Narrative reviewindependent cross-checkfull text, structured risk-of-bias assessment

    DKA is an emergency that can kill; it is treated with fluids, insulin and salts, and insulin must not be stopped in type 1 diabetes even when not eating.

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Epidemiology, pathogenesis, diagnosis and management of DKA

    How was the study done?

    Narrative expert review (Nature Reviews Disease Primers)

    How many people, animals or samples were studied?

    not applicable; Adults and children with diabetes

    What was actually found?

    DKA is diagnosed by high glucose, ketones and acid; it kills <1% when treated in rich countries but up to 26-41% where treatment is lacking; treatment is fluids, insulin and potassium, and insulin must never be stopped in type 1 diabetes even when not eating.

    How large was the observed effect?

    not applicable

    What do the results mean in everyday life?

    DKA is an emergency.

    What are the study's limitations?

    Narrative expert review without systematic methods; one author has research support from insulin makers.

    What does it say about Elawady's specific claim?

    Contradicts C-INS-08, C-INS-02, C-FAST-01, C-FAST-03.

    Do the results apply to Germany and Europe?

    International.

    What can explicitly not be concluded from this study?

    Quantitative estimates.

    Scientific details →

  • DCCT: better insulin treatment in type 1 diabetes

    Diabetes Control and Complications Trial Research Group; Nathan DM et al.. N Engl J Med 1993 · PMID 8366922 · DOI 10.1056/NEJM199309303291401
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    Intensive insulin cut the risk of eye damage by three-quarters and nerve damage by 60%, with more low-sugar episodes.

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Does intensive insulin therapy reduce long-term complications in type 1 diabetes?

    How was the study done?

    Multicentre RCT (DCCT)

    How many people, animals or samples were studied?

    1,441; Insulin-dependent (type 1) diabetes

    What was actually found?

    Large reductions in all microvascular complications.

    How large was the observed effect?

    Retinopathy -76%

    What do the results mean in everyday life?

    Insulin protects eyes, kidneys and nerves in type 1 diabetes.

    What are the study's limitations?

    Open-label; Selected young population

    What does it say about Elawady's specific claim?

    Contradicts C-INS-07, C-INS-09, C-DIAB-01; shows insulin efficacy and hypoglycaemia cost (C-INS-02 kernel).

    Do the results apply to Germany and Europe?

    North American; universally accepted.

    What can explicitly not be concluded from this study?

    Effects in type 2 diabetes directly.

    Scientific details →

  • Review: how insulin works and how insulin resistance arises

    Petersen MC, Shulman GI. Physiol Rev 2018 · PMID 30067154 · DOI 10.1152/physrev.00063.2017
    Narrative reviewindependent cross-checkabstract checked

    Insulin resistance in muscle, liver and fat is a central process in type 2 diabetes; some mechanisms are still debated.

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Summarise insulin action and resistance

    How was the study done?

    Narrative review

    How many people, animals or samples were studied?

    Literature

    What was actually found?

    Insulin resistance is a key process in type 2 diabetes

    How large was the observed effect?

    not applicable

    What do the results mean in everyday life?

    Doctors and scientists treat insulin resistance as a real, measurable state.

    What are the study's limitations?

    Narrative; abstract only

    What does it say about Elawady's specific claim?

    Contradicts 'there is no such thing as insulin resistance'.

    Do the results apply to Germany and Europe?

    Universal physiology

    What can explicitly not be concluded from this study?

    Does not settle which mediator causes insulin resistance.

    Scientific details →

  • What happens to muscle energy when insulin is withheld in type 1 diabetes

    Karakelides H et al.. Diabetes 2007 · PMID 17660267 · DOI 10.2337/db07-0378
    Otherindependent cross-checkabstract checked★ key study

    Stopping insulin for about 9 hours reduced the muscle cells' energy (ATP) production and raised ketones and protein breakdown.

    Insulin deprivation lowers mitochondrial ATP production and increases protein breakdown.

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Test how insulin lack affects muscle energy production.

    How was the study done?

    Insulin withdrawal vs insulin, muscle biopsies.

    How many people, animals or samples were studied?

    9 adults with T1D.

    What was actually found?

    Less mitochondrial ATP production, more ketones and protein loss without insulin.

    How large was the observed effect?

    Not given in abstract.

    What do the results mean in everyday life?

    Insulin keeps the cell's energy engine running; lack of insulin slows it.

    What are the study's limitations?

    Very small study.

    What does it say about Elawady's specific claim?

    Contradicts 'insulin stops the Krebs cycle'.

    Do the results apply to Germany and Europe?

    Universal physiology.

    What can explicitly not be concluded from this study?

    Cannot quantify long-term effects.

    Scientific details →

Studies with mixed or unclear results (3)

  • Severe low blood sugar and death in ACCORD

    Bonds DE et al.. BMJ 2010 · PMID 20061358 · DOI 10.1136/bmj.b4909
    Cohort studycited by the Tayebat archivefull text, structured risk-of-bias assessment★ key study

    People who had severe low-sugar episodes died more often, but this did not explain why the intensive group had more deaths.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Link between severe hypoglycaemia and mortality in ACCORD

    How was the study done?

    Retrospective epidemiological analysis within an RCT (ACCORD)

    How many people, animals or samples were studied?

    10,194; ACCORD participants with hypoglycaemia assessment

    What was actually found?

    Deaths were more common after severe low-sugar episodes (adjusted HR 1.41 and 2.30), but only 1 of 451 deaths was definitely caused by low sugar, and it explained only about 5 of 57 extra deaths in the intensive group.

    How large was the observed effect?

    aHR 1.41 (1.03-1.93) intensive arm

    What do the results mean in everyday life?

    Severe hypoglycaemia is a danger sign to avoid.

    What are the study's limitations?

    Post-hoc observational analysis; Confounding by frailty

    What does it say about Elawady's specific claim?

    Supports C-INS-04 (hypoglycaemia is a marker of risk); limits causal interpretation.

    Do the results apply to Germany and Europe?

    Multinational/US/UK/European data; directly transferable to Germany/EU clinical practice.

    What can explicitly not be concluded from this study?

    That hypoglycaemia caused the ACCORD excess mortality.

    Scientific details →

  • Severe hypoglycaemia in ADVANCE

    Zoungas S et al.. N Engl J Med 2010 · PMID 20925543 · DOI 10.1056/NEJMoa1003795
    Cohort studycited by the Tayebat archivefull text, structured risk-of-bias assessment

    Severe low-sugar episodes were followed by more heart events and deaths, probably partly because frail people get them.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Severe hypoglycaemia and vascular events/death

    How was the study done?

    Post-hoc cohort analysis of an RCT (ADVANCE)

    How many people, animals or samples were studied?

    11,140; ADVANCE participants with type 2 diabetes

    What was actually found?

    aHR 2.69 death.

    How large was the observed effect?

    aHR 2.69 (1.97-3.67)

    What do the results mean in everyday life?

    Avoid severe hypoglycaemia.

    What are the study's limitations?

    Only 231 people had severe hypoglycaemia; links also seen with skin and digestive disease (suggesting frailty); no dose-response; intensive treatment was a sulfonylurea, not insulin; funded by the drug's manufacturer.

    What does it say about Elawady's specific claim?

    Supports C-INS-04; kernel of C-INS-02.

    Do the results apply to Germany and Europe?

    Multinational/US/UK/European data; directly transferable to Germany/EU clinical practice.

    What can explicitly not be concluded from this study?

    Causation.

    Scientific details →

  • Insulin in type 2 diabetes: what randomised trials show

    Erpeldinger S et al.. BMC Endocr Disord 2016 · PMID 27391319 · DOI 10.1186/s12902-016-0120-z
    Meta-analysisindependent cross-checkabstract checked★ key study

    In 20 trials with 18,599 people, insulin did not change the risk of death but caused more severe low blood sugar.

    Confirms the true kernel: insulin increases severe hypoglycaemia (RR 1.70).

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Summarise RCTs of insulin in T2D.

    How was the study done?

    Meta-analysis of 20 RCTs.

    How many people, animals or samples were studied?

    18,599 patients.

    What was actually found?

    Mortality unchanged; severe hypoglycaemia +70%.

    How large was the observed effect?

    RR 0.99 death; 1.70 severe hypoglycaemia.

    What do the results mean in everyday life?

    Insulin does not kill, but low sugar is a real risk; use it carefully.

    What are the study's limitations?

    Older trials; heterogeneity.

    What does it say about Elawady's specific claim?

    Refutes 'insulin doubles mortality'; supports caution.

    Do the results apply to Germany and Europe?

    Applicable.

    What can explicitly not be concluded from this study?

    Cannot address insulin in type 1 diabetes, where it is essential.

    Scientific details →

Regional context

Germany / EU

European (EASD) and German (DDG) guidance follow the same evidence base as the ADA/EASD consensus: individualised HbA1c targets, insulin as mandatory therapy in type 1 diabetes, and SGLT2 inhibitors/GLP-1 receptor agonists for people with cardiovascular or kidney disease. No country-specific difference changes the assessment.

Egypt

Egypt has one of the highest diabetes prevalences in the region; the same drug classes and insulins are used. Access barriers and cost may make advice to stop medication attractive, which increases the practical risk of this claim. No Egypt-specific evidence changes the assessment.

What applies in my country?

General scientific assessment

False The Krebs-cycle and DNA claims are false; the only true part is that insulin overdose can cause dangerous hypoglycaemia.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. Hyperglycemic Crises in Adults With Diabetes: A Consensus Report.. Umpierrez GE et al.. Diabetes Care 2024 · PMID 39052901 · DOI 10.2337/dci24-0032
  2. Diabetic ketoacidosis.. Dhatariya KK et al.. Nat Rev Dis Primers 2020 · PMID 32409703 · DOI 10.1038/s41572-020-0165-1
  3. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.. Diabetes Control and Complications Trial Research Group; Nathan DM et al.. N Engl J Med 1993 · PMID 8366922 · DOI 10.1056/NEJM199309303291401
  4. Mechanisms of Insulin Action and Insulin Resistance.. Petersen MC, Shulman GI. Physiol Rev 2018 · PMID 30067154 · DOI 10.1152/physrev.00063.2017
  5. Effect of insulin deprivation on muscle mitochondrial ATP production and gene transcript levels in type 1 diabetic subjects.. Karakelides H et al.. Diabetes 2007 · PMID 17660267 · DOI 10.2337/db07-0378
  6. The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study.. Bonds DE et al.. BMJ 2010 · PMID 20061358 · DOI 10.1136/bmj.b4909
  7. Severe hypoglycemia and risks of vascular events and death.. Zoungas S et al.. N Engl J Med 2010 · PMID 20925543 · DOI 10.1056/NEJMoa1003795
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