Coming up on today's show.

I started as an ER doc.

I love doing emergency work, but most of these things coming into the ER should have never happened.

High levels of glucose or even high levels of insulin.

Iritate that lining of the artery wall.

What we're looking for is soft plaque, and here's why we really can't predict a heart attack or a stroke. Because it's not

slowly closing it off. It's when you have that inflamed plaque and it bursts through and touches

the flowing blood, it forms a clot. And if the clot's big enough and it goes to the heart,

that's a heart attack. If it goes to the brain, that's a stroke. If you look at a couple of trials,

some people, they went through

the full prep, took them into the cath lab, but never did a stint. Other people did the stint.

There was no difference in terms of a future heart attack. We got this now. Stints don't work.

You got to have a cabbage, coronary artery bypass grafts. So then they looked at that in a trial called the ischemia trial, and guess what they found?

Bypass didn't help either.

I think it's a good time to quit blaming each other and just realize the real truth, the real way out of this is not easy, but it's what we got to do.

Tell me about the insulin spiral of death and how that

connects to heart disease. That's a great question, and it's something that we talk about. We've been

talking about it for a year because it helps people begin to understand just how cruel some of

these metabolic spirals can be.

You know, most people, most doctors included, don't really know that high levels of insulin

actually stops your body from burning fat so well.

Now, why is that important? Why does that matter? What does that have to do with the insulin spiral of death?

...