Day 166: What if we’re wrong about diabetes?

A number of years before this talk, Dr. Peter Attia was asked to assess an obese lady in the emergency department. His patient had type 2 diabetes and an ulcerated foot that required amputation and Attia tells us, he judged her. Why couldn’t she just have exercised more, or eaten less. He admits that while he gave her the best possible medical care, his level of empathy left a lot to be desired.

Several years later Attia, who exercised for several hours daily and followed the food pyramid to the letter, began to gain weight. It turned out he had metabolic syndrome. He had become insulin resistant, and was on his way to getting diabetes and all the associated conditions that accompany it. Attia began to change his diet radically, adding and subtracting things. He lost forty pounds and reversed his insulin resistance, while exercising less. This made him wonder; if the conventional dietary wisdom was failing him, who else was it failing?

Most researchers believe obesity is the cause of insulin resistance. Attia began to wonder if we have the cause and effect wrong. Perhaps obesity can be a symptom of some underlying cause. Insulin acts by regulating the fuel demands of the body. If something goes wrong with the system and insulin suddenly tells cells to burn a dangerous amount of energy, the body may react by deciding to store it instead. The logical place to store this excess fuel is in the fat cells, causing weight gain.

There are more suggestive facts. In some 30 million obese Americans, insulin resistance doesn’t exist and these people are at no greater risk of disease than lean people. Conversely, six million lean people are insulin resistant, and at risk of diabetes and other co-morbidities. 

Attia hypothesises that it is our increased intake of refined grains, sugars and starches that are responsible for this epidemic. But he wants to prove this, and to do so, he has surrounded himself with a team of the best diabetes and obesity researchers. 

Attia makes an emotional plea to his diabetic patient for forgiveness at the end of this talk. He wishes for a day that the medical profession can cure themselves of their new ideas resistance and help the many patients suffering from insulin resistance. We must question everything and understand that scientific research isn’t static but constantly evolving. And the research from Attia’s group promises to be exciting indeed.

 

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