Diabetes & insulin resistance

Understanding Diabetes Physiology

In this section, Dr. Rhonda Patrick discusses insulin resistance and its connection to broken fat cells.

Insulin Resistance and Broken Fat Cells

• Insulin resistance occurs when cells in the body refuse to respond to the signals of insulin.

• Broken fat cells that cannot divide are at the root of insulin resistance physiology.

• Adipocytes in diabetic physiology appear to have broken hyperplasia, meaning they can only expand and not divide.

• As these fat cells expand, they become distended, release inflammatory mediators, lipokines, and free fatty acids which signal muscles and liver to become insulin resistant.

• Physiologic insulin resistance happens when you are in a ketogenic state or fasting because the fat cells will be releasing those free fatty acids into the blood. However, if you return carbohydrates to the system, you will regain insulin sensitivity.

• Pathologic insulin resistance happens when you have high levels of insulin in your body trying to signal tissues like fat cells, muscle cells, and liver to take up glucose but those tissues refuse due to broken fat cells sending out signals.

Causes of Broken Fat Cells

• HNE (hydroxy known), a breakdown product of linoleic acid is a major culprit in causing broken fat cells.

• Studies demonstrate that acute and repeated exposure of adipocytes with physiologically low concentrations of HNE causes oxidative stress impaired adipogenesis leading to hypertrophy and broken fat cells.

• HNE causes impaired adipogenesis which does not allow the fat cells to divide leading to hypertrophy and broken fat cells.

HNE and Linoleic Acid

This section discusses the relationship between HNE and linoleic acid, where linoleic acid comes from, and how to avoid high levels of linoleic acid in your diet.

HNE Comes from Linoleic Acid

• HNE comes almost exclusively from the breakdown of linoleic acid in the human body or outside of the human body.

• High levels of HNE can cause adipocyte differentiation, adipocyte hyperplasia, oxidative stress, up-regulation of lipolytic gene expression, increased free fatty acids, broken fat cells, and insulin resistance.

Sources of Linoleic Acid

• Linoleic acid comes from what we eat; we don't make any linoleic acid in the human body.

• Animal fats like tallow or ghee have 2-3% linoleic acid compared to higher levels found in oils like olive or avocado.

• Avoid oils with larger amounts than 2-3% of linoleic acid in your diet.

Fasting Insulin Levels

This section discusses fasting insulin levels as a metric for diagnosing diabetes and pre-diabetes.

Fasting Insulin Levels Should Be Used to Diagnose Diabetes

• Fasting insulin levels should be used to diagnose diabetes and pre-diabetes.

• The average fasting insulin for men is 8.8 micro IU per ml; for women, it's 8.4 micro IU per ml.

• The reference range for fasting insulin goes up to 15 or sometimes 20 micro IU per ml before it gets flagged, which is too high.

• Low fasting levels of blood glucose and hemoglobin A1c are also important metrics to consider.

Personal Experience with Fasting Insulin Levels

• Eating an animal-based diet with lots of saturated fat and carbohydrates often greater than 200 grams per day resulted in a fasting insulin level less than three micro IU per ml.

• Changing your diet can lower your fasting insulin levels.

Case Study

This section discusses a case study of someone who was diagnosed as pre-diabetic despite thinking a lot about their health.

Case Study

• A woman who thinks a lot about her health was recently diagnosed as pre-diabetic despite avoiding red meat, eating low-fat diets with lots of grains, and using oil on her salads frequently.

• Her hemoglobin A1c was 5.9, but the doctors didn't check her fasting insulin level.

The Flaws in Western Medicine's Approach to Insulin Resistance and Diabetes

In this section, the speaker discusses the issues with how insulin resistance and diabetes are diagnosed and treated in Western medicine.

Problems with Diagnosing Insulin Resistance and Diabetes

• Changing oils in her diet indicates that something is wrong with how insulin resistance and diabetes are diagnosed and treated in Western medicine.

• There is a need for a better understanding of the root causes of these conditions rather than just treating symptoms.

• The current approach to treatment often involves prescribing medication without addressing underlying lifestyle factors.

• A more holistic approach that considers diet, exercise, stress management, and other lifestyle factors may be more effective in preventing and managing these conditions.