#149 - AMA #20: Simplifying the complexities of insulin resistance: how it's measured, how it manifests in the muscle and liver, and what we can do about it

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 15 February 2021

⏱️ 23 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

In this “Ask Me Anything” (AMA) episode, Peter and Bob discuss all things related to insulin resistance by revisiting the important points made in the fascinating, yet quite technical, episode of The Drive with Gerald Shulman. They devote the entire discussion to understanding the condition known as insulin resistance, how it’s measured, how it manifests in the muscle and liver, and ultimately, what we can do about it.

If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #20 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

Explaining the format of this AMA: Extracting insights from Gerald Shulman’s masterclass on insulin resistance (2:00);
The basics of insulin, defining insulin resistance (IR), and gold-standard methods of quantifying IR in the muscle (7:15);
Practical ways to test for insulin resistance in a normal clinical setting (15:45);
How insulin resistance manifests in the muscle (23:00);
The biochemical block in glycogen synthesis—drivers and mechanisms resulting in insulin resistance in the muscle (30:45);
The disparity in fat oxidation between insulin-sensitive and insulin-resistant individuals (44:45);
The fate of the ingested carbohydrate in someone who is insulin resistant (51:00);
The prevalence and clinical phenotype of insulin resistance (1:00:15);
The role of exercise in mitigating and reversing insulin resistance (1:05:00);
How insulin resistance manifests in the liver (1:09:15);
Biggest takeaways: what we can do to mitigate and prevent insulin resistance (1:20:45); and
More.

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Transcript

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0:00.0	Hey everyone, welcome to a sneak peek, ask me anything, or AMA episode of the Drive Podcast.
0:16.5	I'm your host, Peter Atia.
0:18.3	At the end of this short episode, I'll explain how you can access the AMA episodes in full,
0:22.9	along with a ton of other membership benefits we've created.
0:25.9	Or you can learn more now by going to peteratia-md.com forward slash subscribe.
0:31.5	So without further delay, here's today's sneak peek of the Ask Me Anything episode.
0:36.6	Hey everyone, welcome to Ask Me Anything, AMA episode number 20.
0:45.6	As always, I'm joined by Bob Kaplan.
0:48.2	And for this AMA, we do something a little bit different.
0:51.1	We actually devote the entire episode, which is a little bit longer than usual, to sort
0:56.4	of the deconstruction, reconstruction of a podcast that many of you have said was simultaneously
1:04.6	one of the most interesting and yet difficult to comprehend, specifically the podcast with
1:09.7	Gerald Schulman, which is the master class on insulin resistance.
1:15.0	We felt because this content is just so important, meaning understanding insulin resistance
1:19.9	is just paramount to being healthy.
1:22.6	As I hopefully make the case in this podcast, you simply can't be healthy if you're insulin
1:27.4	resistant.
1:28.4	And tragically about 88% of people harbor some amount of insulin resistance or metabolic
1:33.4	dysregulation, maybe more broadly.
1:35.7	This is something everybody really needs to understand.
1:38.0	So we go really deep on trying to explain a lot of the stuff that was discussed in this
1:44.2	podcast and hopefully doing so in maybe a slightly less technical manner and also spending
	...

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