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.

• Pathologic insulin resistance happens when you have high levels of insulin in your system.

Causes of Broken Fat Cells

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

• Studies demonstrate that acute and repeated exposure of adipocytes with physiologically low concentrations of HNE is sufficient to promote subsequent oxidative stress impaired adipogenesis 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 lower levels of linoleic acid (2-3%) compared to oils like olive or avocado oil which have higher levels.

• 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.

Use Fasting Insulin Levels to Diagnose Diabetes

• Fasting insulin levels should be used to diagnose 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.

• Fasting insulin levels of 3 micro IU per ml or lower are ideal.

Importance of Monitoring Fasting Insulin Levels

• Changing your diet can lower your fasting insulin levels.

• Knowing your fasting insulin level should be the metric that most people use to know when they're diabetic or pre-diabetic.

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 speaker suggests that there may be a connection between gut health, inflammation, and insulin resistance.