Forensic science
exists to answer the
00:00:01.50\00:00:03.63
question of who done it.
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Who's at fault for
a particular incident?
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What caused injury?
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Looking for clues to find
answers and solve mysteries.
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Well today we're going to do
a little physiologic forensics,
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gather some evidence of
what's behind the explosion
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of chronic health problems.
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Even more specifically, why is
over 1/3 of the adult population
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experiencing
pre-diabetes or type 2 diabetes?
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I'd like to know. Wouldn't you?
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A detective solves
problems, usually crimes.
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They gather evidence to support
decisions that need to be made.
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Their primary object is
to identify perpetrators,
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to establish motives,
and present a compelling case
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for prosecution.
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As you can imagine, they use a
variety of skills and techniques
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to conduct their investigations.
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They meticulously analyze
crime scenes, gather and analyze
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forensic evidence, interview
witnesses and suspects,
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and collaborate
with other experts
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like forensic
scientists or psychologists.
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They need to possess excellent
problem-solving abilities,
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critical thinking
skills, with attention to detail
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to connect the dots
and unravel the mysteries
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surrounding criminal acts.
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Detectives often work in
high-pressure environments.
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We may not know any personally,
but they play a valuable role
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in society,
maintaining law and order.
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Their expertise in gathering
evidence, and conducting
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interviews, and
analyzing information
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is essential in building strong
cases that can stand up in court
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with the goal of protecting
people's rights and ensuring
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that people make
decisions based on the truth.
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I learned that
detectives specialize.
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They can specialize in
homicide, fraud, cyber-crimes.
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There are narcotic detectives.
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Some specialize in
finding missing persons,
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or financial crimes.
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There are even pet detectives
like for recovering missing pets
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and tracking down animals.
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I entitled this
program, Physiologic Forensics,
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because today we're
going to be looking at
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gathered evidence to
help us solve for ourselves
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why we may be
struggling with our health.
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The goal of this information
is not to tell you how to live,
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so much as to provide
evidence that you can use
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to make better
decisions for yourself.
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We hear quite often how
type 2 diabetes is exploding.
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Statistics actually reveal...
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Compare that with the
incidents of pre-diabetes and
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type 2 diabetes in the 1960s
where it was more like 1 to 2%.
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That is shocking.
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What's going on?
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How can we change the
statistics for ourselves?
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Today we're going to
begin investigating this topic.
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It won't be exhaustive,
but it will get us thinking
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and help us solve the mystery.
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You know, there were
clues a hundred years ago as to
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what we might have expected
to happen in the 20th century,
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and what did happen
in the 20th century,
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with the explosion of chronic
diseases like type 2 diabetes.
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Clues? Hmm.
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Like, maybe the changes
we've seen in how we produce
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food in the modern world?
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The massive infiltration of
refined grains, fats, and sugar,
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animals being farmed
dramatically differently
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than they've been for millennia?
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The dumping of
chemicals in our food supply?
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We'd find a lot of clues if
we followed the money trail;
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like the subsidizing of certain
products making them inexpensive
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and easily
obtainable through fast food.
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Hmm.
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I always like to help
my patients to understand
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what's really going on
in the core, at the core
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of type 2 diabetes.
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In fact, what's happened
in the system in our body
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before type 2
diabetes that led to it.
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And so, that's
insulin resistance.
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The driving mechanism of
developing type 2 diabetes
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down the road is
insulin resistance.
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Have you heard the term,
insulin resistance, before?
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In order to
understand what that means,
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we're going to first
identify what insulin is.
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Insulin's job:
so what is insulin?
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It's a hormone that come from
the beta cells of the pancreas.
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Those cells are highly
specialized to recognize
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what's happening with the
blood glucose moment by moment.
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Is it rising? Is it falling?
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I think of it as, the
pancreas gland knows that its
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brother and sister
organs need glucose to absorb.
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Again, it's a gland
that's ready to give
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to the system
that it belongs to.
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So as we eat a good healthy
meal with some good complex
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carbohydrates,
our blood sugar rises.
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As it should. That's normal.
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The intent there is to
supply glucose to our tissues,
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our muscle, and other organs.
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It turns out, our cells
are designed to burn glucose
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as their primary fuel.
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That really is
the preferred fuel;
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energy source for our cells.
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So carbohydrates
are not a bad thing.
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They're a wonderful thing.
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And we need carbohydrates
in our diet because
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we need glucose for our cells.
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Alright, we have our
meal, our blood sugar rises;
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the pancreas gland
recognizes that fact.
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The beta cells recognize,
"Hey, blood sugar rising.
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I'm going to submit some
insulin to the bloodstream
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for my brother and
sister organs to utilize.
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They're going to need
it to absorb that glucose."
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Sometimes we say that glucose
is the best source of fuel
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for the cell; it
needs to get into the cell.
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But a glucose
molecule is a polite molecule.
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It won't go into the
cell without an invitation.
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Normally when we are healthy,
the insulin is working properly.
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We eat a meal, our
pancreas will produce insulin,
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and the insulin will, as
a gentleman opens the door
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for a lady to come in,
so insulin opens the door
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for glucose to
come into the cells
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and do all the metabolic magic.
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Do all the cooking.
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Dr. Kahleova just likened
insulin to a gentleman who
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opens doors for others.
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I also like to use the analogy
of the Oregonian gas attendant.
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I lived in Oregon for many
years, and when I lived there
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it was a law that you
didn't pump your own gas.
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Nope, if you wanted gas in
your car, the gas attendant
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came to the car,
and opened the gas tank,
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and pumped the fuel
into the tank for you.
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You never had to
get out of the car.
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Now in my analogy, the
gas is your blood glucose
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and the insulin is the gas
attendant that opens the tank
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and puts the fuel in.
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So track with me.
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In order to get blood sugar out
of the blood and into the cells,
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insulin has to open
the door, as a gentleman,
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open the gas tank, as
the Oregonian gas attendant.
00:07:09.92\00:07:13.13
And when insulin opens
the gas tank, blood glucose
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can enter in, and once
inside the cell, it's combusted
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and produces energy.
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Energy for that cell to
perform all of its activities.
00:07:21.27\00:07:24.21
And we use these
analogies to help us understand
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in a simple way
how it all works.
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But there's more.
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What happens is, on the surface
of our cells, we have these
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receptors, and
they're kind of like antenna.
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They sit out on the surface
of the cell and they receive
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signals from
elsewhere in the body.
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The cell wants to know
what's going on around it.
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It's part of a system.
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The insulin receptor is designed
to receive the insulin signal.
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They sit on the cell
surface and they have a
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portion that's outside the cell,
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and then they cross through
the cell membrane to the inside.
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So it's like an antenna on
the outside and on the inside.
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I hope this isn't
getting too in the weeds.
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When an insulin molecule
finds its way and is bound by
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the insulin receptor,
it's like a hand and glove fit.
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There's no way
this isn't designed.
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They're made for each other.
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Insulin binds its receptor,
it actually stays on the
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outside of the cell, but
on the inside of the cell,
00:08:17.79\00:08:20.13
that receptor, at the moment
insulin is bound on the outside,
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the inside, like an
antenna on the inside,
00:08:24.67\00:08:26.63
sends a message to
the cell that says,
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"Hey, cell, we've got
some insulin out here.
00:08:28.24\00:08:29.90
You should absorb some glucose."
00:08:30.61\00:08:32.31
That's basically the message.
00:08:32.34\00:08:34.08
When everything is working
well, the cell will respond
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to that signal by
opening up these, they're called
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glucose transporter molecules.
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They're openings,
basically, in the cell membrane.
00:08:42.52\00:08:45.59
Again, perfectly
designed for glucose molecules
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to come through.
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Everything is very
specific in design.
00:08:49.89\00:08:52.56
Insulin brings the
signal, the cell responds,
00:08:53.80\00:08:56.83
invites glucose in,
glucose comes into the cell.
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It yields its energy to
the cell, it's broken down.
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That energy winds
up in the mitochondria
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for it to be
transformed into ATP.
00:09:06.14\00:09:08.41
In that way, the blood sugar,
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the blood glucose
level is regulated.
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It doesn't go too high.
It also doesn't go too low.
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The cell gets
the energy it wants.
00:09:18.85\00:09:20.52
And the muscles stay
strong and the body works well.
00:09:21.69\00:09:24.29
Okay, so did you catch all that?
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Just to say it again, you
can think of cell receptors
00:09:26.63\00:09:29.53
like designated parking places
that line the cell membrane.
00:09:29.56\00:09:33.03
Dr. Racine said that insulin
in its specific parking space,
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or receptor, are
made for each other.
00:09:37.14\00:09:39.47
Now when insulin
docks into its parking space
00:09:39.57\00:09:41.84
it sends messages into
the cell through the antenna
00:09:41.88\00:09:45.45
that causes the cell
to open up the gas tank
00:09:45.48\00:09:48.45
for glucose to enter
and allow its energy to be
00:09:48.48\00:09:51.32
transformed into the kind of
energy that the body can use.
00:09:51.35\00:09:55.62
It's wonderful how the
body was designed to work.
00:09:55.66\00:09:58.49
Very wonderful.
00:09:58.69\00:10:00.03
So we've just
described insulin sensitivity.
00:10:00.06\00:10:03.23
The way things
are supposed to work.
00:10:03.57\00:10:04.90
And it doesn't take very much
insulin to make that happen.
00:10:04.93\00:10:07.20
If you're insulin
sensitive, your pancreas
00:10:07.47\00:10:09.44
puts a little bit of insulin.
00:10:09.47\00:10:11.14
Just as much as what is needed.
00:10:11.17\00:10:12.61
Not very much.
00:10:12.64\00:10:13.98
So it was just described how
things are supposed to happen
00:10:14.31\00:10:17.81
when we are insulin sensitive.
00:10:17.85\00:10:20.25
Insulin
resistance is the opposite.
00:10:20.62\00:10:22.88
Start picturing a gas tank lid
the gas attendant can't open.
00:10:22.92\00:10:27.46
It's stuck.
00:10:27.49\00:10:28.82
Insulin resistance is a
condition where our body,
00:10:29.72\00:10:33.80
specifically the brain cells,
or any cells for that matter,
00:10:33.83\00:10:38.33
has the inability
to consume glucose
00:10:38.53\00:10:43.00
as the primary energy source.
00:10:43.04\00:10:45.81
Insulin resistance then
is a problem that's going on
00:10:46.01\00:10:49.04
inside our cells in which
our cells, and I'm speaking here
00:10:49.08\00:10:53.62
first off primarily
about our muscle cells,
00:10:53.65\00:10:55.82
our skeletal muscle.
00:10:55.85\00:10:58.15
Which is where most of the
glucose from our bloodstream
00:10:58.19\00:11:00.52
winds up; our muscles absorb
it more than any other organ.
00:11:00.56\00:11:04.69
Our skeletal muscle is the
main destination for most of the
00:11:04.73\00:11:09.10
glucose in our bloodstream.
00:11:09.13\00:11:10.53
And so, it's what
happens in the skeletal muscle
00:11:10.97\00:11:13.57
way back before
diabetes develops
00:11:14.24\00:11:15.94
that eventuates or
leads to type 2 diabetes.
00:11:15.97\00:11:18.87
It's been going on for
probably years, maybe decades,
00:11:19.07\00:11:22.34
prior to the
development of type 2 diabetes.
00:11:22.44\00:11:25.31
By the time we see
blood sugar rising,
00:11:27.35\00:11:29.28
we're now aware of a
problem that has been
00:11:29.32\00:11:30.99
going on for quite some time.
00:11:31.02\00:11:32.65
In insulin resistance,
what they figured out was,
00:11:34.62\00:11:37.39
it was in the 1990's
when this was worked out
00:11:38.16\00:11:41.13
in great detail, they finally
figured out what exactly is
00:11:41.16\00:11:43.97
going on in the cell that
interferes with that process.
00:11:44.00\00:11:47.10
It interferes with
the ability of insulin
00:11:47.37\00:11:50.37
to convey its
signal to the cell.
00:11:50.47\00:11:52.34
And what they found out, of
course, was actually a surprise.
00:11:52.37\00:11:55.78
It surprised me
when I learned it.
00:11:55.81\00:11:57.18
What happens when
insulin binds the receptor
00:11:58.81\00:12:01.78
on the outside, and then
the receptor on the inside,
00:12:01.82\00:12:04.29
the same structure on the inside
is supposed to send a signal,
00:12:04.32\00:12:07.69
that signal is
interfered with somehow.
00:12:07.72\00:12:10.33
It's as though
there's a roadblock
00:12:10.83\00:12:12.53
or some kind of impairment
on the insulin receptor
00:12:12.56\00:12:15.03
on the inside of the cell.
00:12:15.06\00:12:16.56
And since the message
isn't sent through the cell,
00:12:16.87\00:12:20.80
the cell doesn't
ask glucose to come in.
00:12:20.84\00:12:23.30
Glucose isn't invited
in, it doesn't come in.
00:12:23.71\00:12:26.04
Glucose, in that
case, just builds up outside
00:12:26.64\00:12:29.81
the cell in the bloodstream.
00:12:29.84\00:12:31.21
This becomes what we all
think of as type 2 diabetes.
00:12:31.41\00:12:34.48
But this underlying
process of insulin resistance
00:12:35.58\00:12:38.15
has been going on for
probably years, maybe decades,
00:12:38.65\00:12:41.82
prior to the
development of type 2 diabetes.
00:12:42.02\00:12:44.96
Personally, I find
roadblocks so frustrating.
00:12:45.83\00:12:49.43
I'm trying to get somewhere and
a roadblock is holding me back.
00:12:49.46\00:12:52.43
The roadblock Dr.
Racine referred to is
00:12:53.03\00:12:55.14
occurring inside of the cells.
00:12:55.17\00:12:57.17
The on-ramp for glucose to
get into the cells is shut down.
00:12:57.21\00:13:01.04
And since glucose
can't get off the freeway,
00:13:01.08\00:13:03.51
which is your blood vessels,
because it can't get off the
00:13:03.55\00:13:06.11
freeway, congestion occurs.
00:13:06.15\00:13:08.32
We call it, high
blood sugars stuck
00:13:08.35\00:13:11.19
because of the
cellular roadblock.
00:13:11.22\00:13:13.29
What a mess. Can you picture it?
00:13:13.32\00:13:16.02
What's causing the roadblock?
00:13:16.49\00:13:18.23
Insulin resistance.
00:13:18.43\00:13:20.16
And just like freeway
roadblocks, problems are
00:13:20.20\00:13:22.93
created in other locations.
00:13:22.96\00:13:24.63
And when it comes to our
body, problems start brewing
00:13:24.67\00:13:27.54
in other places
like the pancreas
00:13:27.57\00:13:29.54
where insulin is produced.
00:13:29.57\00:13:31.11
To control the blood sugars, the
pancreas is having to kick out
00:13:32.54\00:13:36.14
more and more insulin.
00:13:36.18\00:13:37.51
And the cells literally
become resistant to the insulin
00:13:38.51\00:13:42.08
so that you have to
have more and more insulin.
00:13:43.02\00:13:44.95
And the pancreas
gets to a place where it
00:13:44.99\00:13:46.45
can't put out any more.
00:13:46.49\00:13:47.82
We have receptors, insulin
receptors that essentially
00:13:48.02\00:13:51.36
open up the gates for the cells
to be flooded with glucose.
00:13:51.39\00:13:56.26
And you know, it's really picky.
00:13:56.30\00:13:57.63
We have a certain number
of receptors on each cell,
00:13:57.67\00:14:01.24
and depending on their function,
the amount of receptors differ.
00:14:01.27\00:14:04.74
When we are exposed to
a lot of glucose molecules
00:14:05.51\00:14:09.78
in our circulation, the body
essentially starts secreting
00:14:09.81\00:14:15.25
insulin to allow for each and
every cell to consume glucose
00:14:15.28\00:14:19.49
as a source of energy.
00:14:19.52\00:14:20.86
However, when there's too much
of it, it completely shuts down.
00:14:20.89\00:14:24.73
Or what happens is our
body is not able to produce
00:14:24.76\00:14:28.30
enough insulin for
that glucose to be consumed.
00:14:28.33\00:14:31.80
So not to go into a
whole lot of chemistry,
00:14:31.83\00:14:34.44
but what happens is the body
develops insulin resistance,
00:14:34.47\00:14:38.41
and the amount of insulin
that is already in the system
00:14:38.44\00:14:42.01
cannot allow for this glucose to
be used and to enter each cell.
00:14:42.04\00:14:46.31
So this means a lot of glucose
molecules in the circulation.
00:14:46.35\00:14:50.35
And what happens is, when
our tissue, whether it's the
00:14:50.39\00:14:53.39
capillaries or any cells
that come in contact with that
00:14:53.42\00:14:57.53
incredible amount of glucose,
they start getting damaged.
00:14:57.56\00:15:01.10
And so you see cascade
of inflammation, oxidation,
00:15:01.13\00:15:05.00
oxidative stress
causing the formation of
00:15:05.03\00:15:08.54
reaction oxygen
species that go and damage the
00:15:08.57\00:15:11.84
walls of cells and tissue.
00:15:11.87\00:15:14.24
And that results
in a lot of damage.
00:15:14.28\00:15:16.71
So there's an
episode in, I Love Lucy,
00:15:16.75\00:15:19.21
which is an ancient TV program,
where Lucy and Ethel have a
00:15:19.25\00:15:22.98
new job wrapping chocolates that
are coming down a conveyor belt.
00:15:23.02\00:15:26.62
They're wearing these cute
aprons and happily wrapping
00:15:26.65\00:15:29.26
each chocolate, until more
and more and more chocolates
00:15:29.29\00:15:33.36
come down the conveyor
belt, and they can't keep up.
00:15:33.40\00:15:36.70
Aagh!
00:15:36.73\00:15:38.07
They start stuffing the
chocolates in their apron
00:15:38.10\00:15:39.83
pockets, in their mouths, and
everything starts falling apart.
00:15:39.87\00:15:43.51
The result of insulin
resistance in the body
00:15:44.34\00:15:47.08
and the eventual
build-up of blood sugar
00:15:47.11\00:15:48.88
is not unwrapped chocolates.
00:15:48.91\00:15:50.71
It's ROS.
00:15:50.75\00:15:52.08
Remember him from
a previous program?
00:15:52.11\00:15:54.05
Oxidation,
inflammation, and damage;
00:15:54.15\00:15:56.55
that's what ROS leaves behind.
00:15:56.58\00:15:59.05
Let's take a look
at the level of damage
00:15:59.32\00:16:00.99
that we're talking about.
00:16:01.02\00:16:02.36
Because if those
blood sugars are off,
00:16:03.09\00:16:05.03
all kinds of things can occur.
00:16:05.69\00:16:08.10
And it's all kinds
of diseases are affected
00:16:09.86\00:16:12.07
by blood sugar problems.
00:16:12.10\00:16:13.94
Type 2 diabetes where
you have insulin resistance.
00:16:13.97\00:16:16.47
It could be
circulation, it could be lung,
00:16:17.14\00:16:18.87
it could be
cardiovascular, you name it.
00:16:18.91\00:16:21.54
Almost everything
is involved with that.
00:16:22.78\00:16:24.81
Yeah, so insulin resistance
clearly causes type 2 diabetes.
00:16:25.51\00:16:29.42
Meanwhile, it's causing
a lot of other problems.
00:16:30.05\00:16:32.15
So most of us have heard of
a disease that affects women
00:16:32.52\00:16:37.03
called,
polycystic ovary syndrome.
00:16:37.06\00:16:38.99
Next to pregnancy, it's the most
common cause of absent periods.
00:16:40.70\00:16:43.77
And so, it's a pathological
state of absent periods.
00:16:44.13\00:16:46.94
Classically, it's
a woman with months
00:16:46.97\00:16:49.54
and months between periods.
00:16:49.57\00:16:51.04
Usually heavy, but not always.
00:16:51.07\00:16:52.64
And with a
higher risk of diabetes.
00:16:54.04\00:16:56.88
It turns out that insulin
resistance is an important part
00:16:56.91\00:16:59.75
of the cause of
polycystic ovary syndrome
00:16:59.78\00:17:01.92
happening in the ovaries.
00:17:01.95\00:17:03.49
Insulin resistance also
increases one's risk for
00:17:04.35\00:17:06.82
heart disease and cancer.
00:17:06.86\00:17:09.52
It's closely related to obesity.
00:17:09.56\00:17:11.76
Obesity and insulin resistance
probably have a kind of a
00:17:11.79\00:17:14.76
circular relationship
where they promote each other,
00:17:14.80\00:17:17.70
and they both get
worse the more obese we are.
00:17:17.73\00:17:20.80
Several cancers are known to be
related to insulin resistance...
00:17:21.20\00:17:23.94
Cardiovascular diseases are
related to insulin resistance.
00:17:32.15\00:17:35.48
Neurodegenerative
diseases are also associated
00:17:35.52\00:17:39.49
with insulin resistance:
00:17:39.52\00:17:40.86
Alzheimer's and types of
dementia that are involved with
00:17:40.89\00:17:45.09
insulin resistance in the brain.
00:17:45.39\00:17:47.13
Even ear, nose, and throat; a
person who has type 2 diabetes
00:17:48.00\00:17:51.33
where their blood
sugar is out of control,
00:17:51.43\00:17:53.30
you can't get
infections under control.
00:17:53.34\00:17:55.34
What happens is, the high
blood sugar is devastating
00:17:55.90\00:18:00.01
to really
everything in the body.
00:18:00.04\00:18:01.78
Every cell in the body is
damaged by high blood sugar.
00:18:01.81\00:18:04.71
Called glucose toxicity.
00:18:04.75\00:18:06.31
Even the pancreas
has struggles and becomes
00:18:07.22\00:18:11.89
damaged by high blood sugars,
00:18:11.92\00:18:14.12
that causes more
free radical damage.
00:18:14.69\00:18:17.03
So then, high blood sugars
are really bad for the brain;
00:18:17.13\00:18:20.80
endomucin and everything.
00:18:21.43\00:18:23.06
Okay, then the high
insulin levels is even worse
00:18:23.10\00:18:27.24
for their
brain, and their heart.
00:18:27.27\00:18:28.60
You know, one of
the number one causes
00:18:28.64\00:18:30.11
of heart attacks and strokes?
00:18:30.14\00:18:31.67
Insulin resistance as
evidenced by excess insulin
00:18:32.41\00:18:35.84
floating
through the bloodstream.
00:18:35.88\00:18:37.28
We actually tend to
see the development of
00:18:37.58\00:18:40.45
inflammatory changes, plagues,
hardening of the arteries,
00:18:40.48\00:18:44.69
which we see a lot on
MRI images or the scans,
00:18:44.72\00:18:47.92
you know, of the
carotid arteries,
00:18:47.96\00:18:50.53
resulting in vascular
dementia, stroke, etcetera.
00:18:50.56\00:18:54.36
Whoa, wait a second.
00:18:54.66\00:18:56.77
Dr. Sherzai and Dr. Youngberg
connected insulin resistance
00:18:56.80\00:19:00.20
with the number
one killer in America.
00:19:00.24\00:19:02.70
Cardiovascular
disease, heart attacks, strokes.
00:19:02.74\00:19:05.47
This is way bigger
than just type 2 diabetes.
00:19:05.77\00:19:08.44
We were just provided a
new piece of the puzzle.
00:19:08.74\00:19:11.81
A very crucial piece.
00:19:11.85\00:19:13.62
And that's not just high
blood sugar that's the problem.
00:19:13.65\00:19:16.99
High insulin levels,
not just high blood sugars,
00:19:17.65\00:19:20.22
are a major
perpetrator of disease.
00:19:20.26\00:19:22.72
Putting on your detective
hat, you can ask the doctor
00:19:23.02\00:19:25.89
to test your
fasting blood insulin levels
00:19:25.93\00:19:27.96
before even
blood sugars are off.
00:19:28.00\00:19:29.70
Lab results may reveal
normal blood sugar levels
00:19:29.90\00:19:32.60
for years, even decades.
00:19:32.63\00:19:34.80
Dr. Racine
mentioned that earlier.
00:19:34.84\00:19:36.81
Yet, insulin
levels may be elevated,
00:19:36.84\00:19:39.11
signaling that
there's a problem.
00:19:39.14\00:19:41.71
For instance, in insulin
resistance or diabetes syndrome,
00:19:41.74\00:19:47.22
or even in cognitive
concerns like Alzheimer's,
00:19:47.42\00:19:51.79
one of the main problems
that drives cognitive decline
00:19:52.09\00:19:56.22
is insulin resistance
that drives sugars high,
00:19:56.52\00:20:00.40
which then drives insulin high.
00:20:00.70\00:20:02.80
That's the main hormone
we've got to fix, by the way.
00:20:02.83\00:20:05.37
And exercise is a
key way to do that.
00:20:05.40\00:20:07.97
Once insulin levels go
high, then what happens next?
00:20:08.50\00:20:11.54
After a while the blood sugars
come down crashing too low,
00:20:11.94\00:20:15.58
and we get this
reactive hypoglycemia
00:20:15.61\00:20:19.21
that then stresses
out the adrenal gland,
00:20:19.41\00:20:22.08
because the amygdala of
the brain is going like,
00:20:22.12\00:20:24.35
"Wow, blood sugars are crashing.
00:20:24.39\00:20:26.55
We're going to
be shutting down."
00:20:26.59\00:20:28.09
The brain can't work without an
appropriate amount of glucose.
00:20:28.12\00:20:31.39
And so, the amygdala basically
forces the weak adrenals
00:20:31.69\00:20:36.77
that are already tired
and don't want to do any work,
00:20:36.80\00:20:39.30
forces them to
kick in really hardcore.
00:20:39.50\00:20:42.57
And now cortisol levels
go from too low to too high
00:20:42.67\00:20:46.94
in a matter of
just a few minutes.
00:20:46.98\00:20:49.04
And that swing in
cortisol that goes up
00:20:49.34\00:20:53.52
really messes with our system.
00:20:53.62\00:20:55.55
Of course, it tells
the liver to dump sugar.
00:20:55.58\00:20:57.72
That's the
reason it's happening.
00:20:57.75\00:20:59.25
It's trying to bring
the blood sugars back up.
00:20:59.29\00:21:01.82
But in doing so, we go
through this rollercoaster
00:21:01.86\00:21:06.19
of hormonal fluctuation
that involves too much insulin,
00:21:06.23\00:21:11.63
too little cortisol, too
much sugar, too little sugar,
00:21:12.47\00:21:17.44
and then too much cortisol.
00:21:17.47\00:21:20.21
So we go through
this rollercoaster
00:21:20.24\00:21:22.34
throughout the
day, day after day.
00:21:22.44\00:21:24.78
That is really
bad for the brain.
00:21:24.81\00:21:27.02
It's really bad
for the immune system.
00:21:27.22\00:21:29.32
It's really bad for the
cardiovascular system as well.
00:21:29.35\00:21:32.39
Now I used to
love rollercoasters.
00:21:32.89\00:21:35.89
Emphasis on "used
to." When I was young.
00:21:35.92\00:21:38.56
Now that I'm not so young,
you couldn't pay me enough
00:21:38.66\00:21:41.33
to go on one.
00:21:41.36\00:21:42.70
We may not even be
aware that we are on this
00:21:42.76\00:21:44.93
metabolic
rollercoaster when we're young.
00:21:44.97\00:21:47.60
But in time, the body starts
letting us know that it can't
00:21:47.80\00:21:51.61
tolerate the crashes and the
force surges like it used to.
00:21:51.64\00:21:55.44
The body compensates for
the highs and lows at first,
00:21:55.74\00:21:58.58
but over time it
becomes a hot mess
00:21:58.61\00:22:01.58
that, as we've learned,
is related to our weight,
00:22:01.78\00:22:04.95
obesity, to different
cancers, heart attack,
00:22:04.99\00:22:07.72
stroke, hypoglycemia,
00:22:07.76\00:22:09.89
and neurodegenerative
concerns like dementia.
00:22:09.92\00:22:12.79
In neurodegenerative conditions,
insulin resistance plays a
00:22:13.70\00:22:17.23
major role because in certain
circuits Alzheimer's disease
00:22:17.27\00:22:23.07
is actually tiled as
type 3 diabetes because of the
00:22:23.10\00:22:26.41
predominance of
insulin resistance.
00:22:26.44\00:22:28.64
And one thing that's
important to understand
00:22:30.08\00:22:32.01
is that people always
think that diabetes is bad,
00:22:32.05\00:22:34.95
but insulin resistance, which
is a pre pre-diabetes stage
00:22:34.98\00:22:39.15
where the body has
difficulty metabolizing glucose,
00:22:39.19\00:22:42.32
at that moment too people
tend to have cognitive changes.
00:22:42.62\00:22:46.59
As a matter of fact, one
of our researches showed that
00:22:46.63\00:22:49.26
in a large, very large
nationwide sample of the
00:22:49.30\00:22:52.57
population, individuals
who had insulin resistance
00:22:52.60\00:22:56.10
compared to those who
didn't have insulin resistance
00:22:56.14\00:22:58.24
had lower cognitive state.
00:22:58.34\00:23:00.11
When they did neuropsychological
testing on them, they actually
00:23:00.14\00:23:02.64
scored poorly.
00:23:02.68\00:23:04.11
So obviously this can advance
to pre-diabetes and diabetes,
00:23:04.15\00:23:08.82
but insulin resistance
is a very important concept.
00:23:08.85\00:23:12.55
And it's something
that is reversible.
00:23:12.59\00:23:14.76
Neurodegenerative
diseases are also associated
00:23:14.79\00:23:18.93
with insulin resistance.
00:23:18.96\00:23:20.30
Alzheimer's and types of
dementia that are involved with
00:23:20.33\00:23:24.53
insulin resistance in the brain.
00:23:24.73\00:23:26.50
And there's some evidence
that high blood pressure
00:23:27.30\00:23:29.10
is also related to
insulin resistance.
00:23:29.14\00:23:31.27
So yes, it causes a
lot of problems on the way
00:23:31.31\00:23:33.44
to developing type 2 diabetes.
00:23:33.48\00:23:35.28
And that high insulin
now has to be broken down.
00:23:35.88\00:23:40.92
Otherwise, we
would go into coma with
00:23:42.02\00:23:44.05
super low blood sugars, right?
00:23:44.09\00:23:45.72
But did you know that
the very enzyme called,
00:23:45.75\00:23:49.96
Insulin Degrading Enzyme,
IDE, so the same enzyme that
00:23:49.99\00:23:57.33
breaks down
insulin, appropriately so,
00:23:57.37\00:24:00.00
is also the one that
removes beta-amyloid plague
00:24:00.04\00:24:02.90
from the brain?
00:24:02.94\00:24:04.27
And so, if somebody
is in a constant state
00:24:04.77\00:24:08.44
of hyperinsulinemia,
excess production of insulin,
00:24:08.64\00:24:13.28
which happens years and decades
before the full diagnosis
00:24:13.48\00:24:17.19
of diabetes, or even
pre-diabetes in many people.
00:24:17.22\00:24:19.99
This is fascinating.
00:24:20.19\00:24:22.02
Elevated insulin levels may
be keeping blood sugar levels
00:24:22.06\00:24:25.29
down, but having to deal
with the elevated insulin level
00:24:25.33\00:24:29.50
costs the body a lot.
00:24:29.53\00:24:31.37
Elevated insulin levels
lead to sex hormone imbalance
00:24:31.57\00:24:34.47
where estrogens and
testosterone don't have a
00:24:34.50\00:24:37.11
healthy ratio with each other.
00:24:37.14\00:24:38.94
It affects immune
function, promotes weight gain,
00:24:39.14\00:24:41.84
and cancers, inflammation.
00:24:41.88\00:24:43.78
And it worsens
insulin resistance.
00:24:43.81\00:24:46.08
And here we just learned
that it can distract the body
00:24:46.35\00:24:49.02
from clearing out
toxins from the brain,
00:24:49.05\00:24:51.72
these beta-amyloid
plagues that are associated with
00:24:51.75\00:24:54.82
dementia and Alzheimer's.
00:24:54.86\00:24:56.56
Wow.
00:24:56.59\00:24:57.93
Insulin resistance is
a very important concept.
00:24:58.03\00:25:00.83
And it's something
that is reversible.
00:25:00.86\00:25:03.23
So let's recap.
00:25:03.90\00:25:05.97
There's been so
much information today.
00:25:06.00\00:25:08.00
What did we learn from our
investigation into this topic?
00:25:08.04\00:25:11.27
First, we saw some shocking
statistics that this problem
00:25:11.74\00:25:15.94
is a whole lot more relative
than we might have thought.
00:25:15.98\00:25:19.28
Diabetes is not just a disease
for a specific group of people.
00:25:19.51\00:25:23.85
It's affecting young and
old, overweight, normal weight,
00:25:24.15\00:25:28.69
people who eat a lot of sugar,
00:25:28.89\00:25:30.39
and people who
don't eat a lot of sugar.
00:25:30.43\00:25:32.56
We learned that insulin
resistance is a major mechanism
00:25:33.56\00:25:36.90
that is driving the body's
inability to process blood sugar
00:25:36.93\00:25:40.60
like it once did.
00:25:40.64\00:25:41.97
Insulin was defined
as the polite gentleman,
00:25:42.14\00:25:45.74
or Oregonian gas attendant,
that opens the cell up
00:25:45.77\00:25:49.14
for blood glucose to enter in.
00:25:49.18\00:25:50.98
And just to avoid confusion,
blood glucose and blood sugar,
00:25:51.25\00:25:55.15
they're the same thing.
00:25:55.18\00:25:56.52
You can use the
terms interchangeably.
00:25:56.55\00:25:58.45
Do you remember what we
likened your blood glucose to?
00:25:58.85\00:26:01.22
It's the fuel. The
gasoline of your body.
00:26:01.59\00:26:04.33
Once it enters the cell,
it is used to make energy
00:26:04.59\00:26:07.70
for the cell to
function optimally.
00:26:07.73\00:26:09.66
We all want good
energy production.
00:26:09.86\00:26:12.03
Then we learned that the first
signs of insulin resistance
00:26:12.53\00:26:15.20
aren't necessarily
elevated blood sugar levels.
00:26:15.24\00:26:18.37
No, they can be
normal for years.
00:26:18.41\00:26:21.21
You go to the doctor,
get your yearly check-up,
00:26:21.24\00:26:23.71
your fasting
blood sugars are normal.
00:26:23.75\00:26:25.48
Good to go.
00:26:25.51\00:26:26.85
But maybe you have
elevated blood cholesterol
00:26:26.88\00:26:29.25
or triglycerides.
00:26:29.28\00:26:30.62
Or you're gaining weight
or blood pressure is higher.
00:26:30.65\00:26:33.09
Or you've developed PCOS.
00:26:33.39\00:26:35.06
In other words, there are other
clues that insulin resistance
00:26:35.36\00:26:38.99
is simmering in the background.
00:26:39.03\00:26:41.06
Insulin resistance leads
to elevated insulin levels
00:26:41.53\00:26:44.70
in the blood; and
this is what can drive
00:26:44.73\00:26:46.80
a lot of these imbalances.
00:26:46.84\00:26:48.77
The jaw-dropping part for me
was how these elevated insulin
00:26:49.50\00:26:53.38
levels can also
affect brain health
00:26:53.41\00:26:55.64
and increase our risk of
neurodegenerative diseases.
00:26:55.68\00:26:59.11
Are you scared?
00:27:00.32\00:27:01.65
It would be hard not
to be with the realization
00:27:01.75\00:27:03.75
that nearly 50% of us
are experiencing this.
00:27:03.79\00:27:06.92
Except that there are a
whole lot of other words
00:27:07.26\00:27:10.26
that begin with "R"
other than "resistance."
00:27:10.29\00:27:13.36
Like, reversible,
renewable, recoverable,
00:27:13.56\00:27:18.27
restoration, redemption.
00:27:18.37\00:27:21.30
These are powerful
words that I believe
00:27:21.50\00:27:24.14
every cell of our body
has the ability to experience.
00:27:24.17\00:27:27.94
They describe what
is possible for you.
00:27:28.24\00:27:30.78
Evidence that you
were made for health.
00:27:31.11\00:27:33.75