Master class on insulin resistance

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Tincup
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Master class on insulin resistance

Postby Tincup » Tue Dec 08, 2020 1:40 pm

Peter Attia interviews Gerald Shulman, M.D., Ph.D on insulin resistance
This is a technical podcast. My bottom line - fasting, low intensity (Zone 2?), long duration exercise and caloric restriction to prevent IR.

Gerald’s background and interest in metabolism and insulin resistance (4:30);
Insulin resistance as a root cause of chronic disease (8:30);
How Gerald uses NMR to see inside cells (12:00);
Defining and diagnosing insulin resistance and type 2 diabetes (19:15);
The role of lipids in insulin resistance (31:15);
Confirmation of glucose transport as the root problem in lipid-induced insulin resistance (40:15);
The role of exercise in protecting against insulin resistance and fatty liver (50:00);
Insulin resistance in the liver (1:07:00);
The evolutionary explanation for insulin resistance—an important tool for surviving starvation (1:17:15);
The critical role of gluconeogenesis, and how it’s regulated by insulin (1:22:30);
Inflammation and body fat as contributing factors to insulin resistance (1:32:15);
Treatment approaches for fatty liver and insulin resistance, and an exciting new pharmacological approach (1:41:15);
Metformin’s mechanism of action and its suitability as a longevity agent (1:58:15);
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aphorist
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Re: Master class on insulin resistance

Postby aphorist » Fri Dec 25, 2020 8:57 am

I was pleasantly surprised to find this Shulman interview in my podcast list for Attia. I've gone through it once, but need to do it at least 1 more time.

I would add going for a walk after a meal (i.e. AMPK-mediated GLUT4 translocation) as a recommendation to insulin resistance. Additionally other alternatives that raise mitochondrial uncoupling (i.e. cold exposure, eating a hot pepper) improve glucose homeostasis.

I've read several of Shulman's papers and they are pretty interesting. This is the best overview/review he's written. I will leave it here in case anyone else comes across this thread.

Samuel VT, Shulman GI. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. J Clin Invest. 2016 Jan;126(1):12-22. doi: 10.1172/JCI77812. Epub 2016 Jan 4. PMID: 26727229; PMCID: PMC4701542.

https://pubmed.ncbi.nlm.nih.gov/26727229/


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