<p><span> 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</span> <a href="https://peterattiamd.com/geraldshulman/" rel="noopener noreferrer" target="_blank">The Drive with Gerald Shulman</a><span>. 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.</span></p> <div> <p>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 <a href="https://peterattiamd.com/members/private-podcast-feed/" rel="noopener noreferrer" target="_blank">private RSS feed</a> or on our website at the <a href="https://peterattiamd.com/ama20/" rel="noopener noreferrer" target="_blank">AMA #20 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href="https://peterattiamd.com/subscribe/" rel="noopener noreferrer" target="_blank">here</a>.</p> </div> <div> <p>We discuss:</p> <ul type="disc"> <li>Explaining the format of this AMA: Extracting insights from Gerald Shulman's masterclass on insulin resistance (2:00);</li> <li>The basics of insulin, defining insulin resistance (IR), and gold-standard methods of quantifying IR in the muscle (7:15);</li> <li>Practical ways to test for insulin resistance in a normal clinical setting (15:45);</li> <li>How insulin resistance manifests in the muscle (23:00);</li> <li>The biochemical block in glycogen synthesis—drivers and mechanisms resulting in insulin resistance in the muscle (30:45);</li> <li>The disparity in fat oxidation between insulin-sensitive and insulin-resistant individuals (44:45);</li> <li>The fate of the ingested carbohydrate in someone who is insulin resistant (51:00);</li> <li>The prevalence and clinical phenotype of insulin resistance (1:00:15);</li> <li>The role of exercise in mitigating and reversing insulin resistance (1:05:00);</li> <li>How insulin resistance manifests in the liver (1:09:15);</li> <li>Biggest takeaways: what we can do to mitigate and prevent insulin resistance (1:20:45); and</li> <li>More.</li> </ul> </div> <p>Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode: <a href="https://peterattiamd.com/ama20/">https://peterattiamd.com/ama20/</a> <br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Faceboo</u></a><u>k</u> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.</p>
Actionable Insights
Learn the five criteria for metabolic syndrome and aspire to have none of them present, as having three or more significantly increases your risk for metabolic diseases, cancer, cardiovascular disease, Alzheimer’s, and type 2 diabetes.
2. Get Oral Glucose Tolerance Test
To clinically assess insulin resistance, undergo an oral glucose tolerance test (OGTT), as it is considered by the hosts to be the best method for this purpose.
3. Monitor Postprandial Insulin Levels
Pay attention to postprandial insulin levels, as their elevation is the earliest indication of insulin resistance, even if glucose levels remain normal.
4. Avoid Fasting Insulin/HOMA-IR
Do not rely on fasting insulin, fasting glucose, or HOMA-IR as primary indicators for insulin resistance, as they are late players to the game and not considered great tests in isolation.
5. Seek Professional Medical Advice
Always seek assistance from healthcare professionals for any medical conditions and do not use podcast content as a substitute for professional medical advice, diagnosis, or treatment.
6. Re-listen to Complex Podcasts
If a podcast covers a complicated and important subject, re-listening to it can help facilitate understanding, especially if the initial listen was difficult to comprehend.
7. Utilize Playback Controls
When listening to complex podcasts, frequently use the ‘go back 15 second button’ to re-listen to sections and improve understanding.
8. Review Notes & Slides
When studying complex subjects, prepare by putting together notes and referencing figures or slides, as this can help in understanding and synthesizing information.
9. Remain Inactive During OGTT
During an oral glucose tolerance test, avoid any activity like exercise that could interfere with glucose uptake, as the goal is to measure the body’s response while at rest.
10. Chug Glucola During OGTT
During an oral glucose tolerance test, ingest the 75 grams of glucola as quickly as possible, rather than sipping it, to ensure accurate measurement of the body’s response to a rapid glucose load.
11. Exercise During Learning
Consider engaging in zone two workouts while listening to educational content, as this was a personal routine mentioned that may aid focus.
12. Become Podcast Member
To access the complete AMA episodes and other exclusive content (like comprehensive show notes and ‘The Qualies’), become a member of the podcast.
13. Utilize Member Show Notes
If a member, utilize the comprehensive podcast show notes to detail topics and access ‘The Qualies’ (short podcasts) to highlight key questions and tactics, especially for navigating past episodes.
14. Subscribe for Member Benefits
To learn more and access member-only benefits like full AMA episodes, show notes, and ‘The Qualies,’ visit peteratiamd.com/subscribe.
15. Download Member Podcast Feed
If you are already a member, download the member-only podcast feed from peteratiamd.com/members to gain full access to AMA episodes and avoid introductory segments.
16. Review Conflict Disclosures
Review the host’s conflict of interest disclosures and companies invested in or advised by visiting peteratiamd.com/about to understand potential biases.
17. Engage with Podcast
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