I've been a Type 2 Diabetic for years. I'm 64 and had a triple bypass on 6/26/24. I've had a hard time getting a serious grasp of, and really understanding Diabetes, its underlying causes, and what actions I need to take to get better - until now. Sounds crazy, but it's true. What makes this video great is that Mike Haney asks all the right questions and Dr. Lustig's answers, although comprehensive and "scientific," are clearly spoken and easy for a layman like myself to understand. I can't thank you enough! Oh, and I'll be sharing it with my son who's 22 and who, unfortunatly, has learned bad lifestyle habits from me. I think this video will help him understand the life changes to make so he doesn't end like his dad. Blessings to everyone involved in making this video. Jose, Tampa, FL
Good for you ! 👏👏 You took your health seriousely and now you can be a healthy rolemodel. You did your best when he was younger based on what you knew then ❤
It’s always a pleasure to listen to Dr Lustig. I test his hypothesis daily in my cardiology practice and till now I am impressed how his advices are far more precious than the advices given by current guidelines.
He is not a national treasure! He is an INTERNATIONAL treasure! I’m learning tons of info that nobody else can seem to connect the dots on! (not even thinking about doctors)
@@patrycja2696 Fiber actually not a villain. And apparently you have not watched his podcast appearances since the one thing he is on a crusade for is getting rid of processed foods!
@@presiyangurin2280 lol You haven't watched enough of him. I have two of his books. Spent around 5000 hours on healthy food topic. Listened to lectures of above 100 doctors and professors. Have about 200 books at home. Work in that field around 20 years. He want to reingeneer ultra processed food... No thanks!!! About fiber... Tell that to all those who's gut is damaged because of fiber and have autoimmune conditions!!! We didn't evolve on fiber!
I'm a practicing medical doc of 35 years and I've never heard a conversation on blood glucose like this one. My light just went on after 30+ years in medicine. I always knew standard of care medicine was bad, hard to believe how awful it really is.
I am double boarded ER and IM Listing is the real deal and one of the few doctors that could even teach me something. He has raised Metabolic medicine to a new LEVELS ( Play on words)😂
This is amazing! I can just get these tests he mentioned NOW (before I start all the changes), and then 4 weeks later, and then I have a measure of success that is way more convincing than stepping on a scale. - fasting Insuline - uric acid - ApoB (LDL/Triglycerides) - Inflammation high-sensitivity c-reactive protein
My Lyme doc once did some kind of blood test that required me to go eat syrup laden pancakes and return for blood draw. I had been on Atkins for years and did not want to do it. She insisted. Within an hour and half of that horribly high carb meal, my blood sugar dropped like a bomb. I was weak, shaking, crazy. Family members had to help me 7:20 into a restaurant. Took me two days to recover. Have stayed basically low carb now years. A1C is 5.1.
The only thing that changed in 1980 was the food industry, switching to high fructose corn syrup, because it was government-subsidized and cheaper than cane sugar which has a tariff. Being so much cheaper, they decided to go by the tobacco industries playbook and used its addictive quality and put it in all foods. This pushed up the sale of snack foods while computer games reduced physical activity. The perfect storm.
@@TomSmith-cv8hk HFCS is absolutely world wide, and it is very likely the most significant factor in the accelerating incidence of metabolic syndrome. The low-fat nonsense accelerated the damage that HFCS did, but it was HFCS doing the actual damage.
@@homomorphic Fructose is actually a mitachondrial poison . Chronic damage to mitachondria can result in cells using fermentation of glucose/glutamine to make ATP , aka the Warburg Effect /cancer .
Hi everyone, based on the videos from Dr. Lustig I did the following: - removed fructose outside of fruit to almost 0 (zero sweets; also 0 artificial sweetener-beverages) - increased fiber in diet, took fiber supplement when I felt fiber had been "removed" (monchmonch, wheat husks) - kept "overeating", so I didn't use any willpower on reducing calories (i love my pasta, now it's wholegrain + fiber supplement, but still overeating once in a while) - increase in movement, but little and inconsistent This is what happened in 4 weeks, blood tests with 12 hrs fasting (just as Dr. Lustig described) - ~40 yrs old, male, 200 pounds - body weight - same - body fat % - same (from one of these intelligent scales) - blood pressure improved (low confidence, may have had outlier, measured only at start + end) - HOMA Index improved from 2.2 to 1.8 (in 1 month!!!! Without medication!!!) (5 is diabetic, in between is pre-diabetes) - Insulin dropped from 9.7 to 8.3 - C-reactive protein (inflammation marker) improved from 3.5 to 2.4 (
you don't need it. you know if you have blood sugar spikes and drops you feel shaky or weak. leave them for the diabetics. our grandparents never had them, lived to nearly 100 just didn't over eat.
Same. Although the more we remove sugar from our food source the less it seems relevant to get a cgm. Find out the glycemic load of what you eat and you're probably half way there.
Every time I hear Dr Lustig I learn something new about things I have heard before. I save them all and watch over & over. I do use a CGM, but unfortunately it is not as accurate as blood testing with a meter but it does show trends.
I agree about the better accuracy of finger sticks, but it’s hard to catch the peak of the spike. And to be fooled by the dips. Or how walking keeps my BG stable until I stop walking when it rises again. Also, there’s information that you can get during your sleep.
Did no one else in this thread actually watch the video where it was clearly pointed out that glucose level is almost useless? I never test glucose as it contains *absolutely* no information. I order an insulin lab 3× per year (and lots of other labs). The single most important lab is hsCRP.
There have been a few people wearing CGMs that were brushing up against pre-diabetes, made lifestyle changes, but had a carbohydrate bender before bedtime some time down the road. The CGM recorded a 6 hour plus long heavily elevated glucose level. Shocking. Can you imagine being at 180 to 220, for nearly 6 hours while you sleep? I know that I must have routinely experienced that in my earlier years.... uhg.
It's all a big scam. Just finished reading "Health and Beauty Mastery" - what an eye-opener! This book exposes so many hidden truths about the health industry that no one talks about! I completely changed my habits
What so discouraging is the amount so called health experts that doing youtube and most of them almost never say the same thing. I'm trying very hard to lose weight and get my blood sugars in check and using these youtube creators to get that info I need to do this but it seems that they more interested in monetization that being stringent about the content they put forth..
@@douglasgrant8315 Try eating beef, butter, bacon and eggs for 30 days. If you can’t be that strict yet, then try just eating Whole Foods - no processed foods.
I thought I was pretty well-informed about metabolism and interpreting test results, but I found this level of detail quite helpful, and the interviewer’s questions, such as about what one can infer from the shape of the glucose curve, or where in the body all the glucose goes if one is healthy or not, were very insightful
The insurance industry does not want to pay for the fasting insulin test, not because it is expensive in and of itself, but because it is not in their best financial interest. They want people to be metabolically unhealthy, otherwise who needs medical insurance companies?
I'd agree w/you, but this sounds quite conspiratorial for my comfort. You say you know their agenda, but actually you don't. This c/b your imagination trying to understand why fasting insulin testing is not regularly accessed through our medical system. That said - this could be true - but again may have no truth to it at all. Do your own due diligence & critical thinking, rather than repeating something you've heard or read. You'll be alot better off - more well-informed😊
@@barbarafairbanks4578 Critical thinking is what I do most. All the time. Thank you. I tend not to believe in conspiracies, unless they make logical sense and are quite out in the open for anyone to see.
@@arosalesmusic Dr Lustig has (in my poorly crafted words) mentioned that the health industry improves one death at a time as the old guard of medical doctors who the medical insurance industry relies upon to make their directives/decisions, passes.
Glucose use: transporters to cells. = glut 1 to glut 11 for various tissues. Brain uses gluT 1. Glut 4 is in fat and muscle= cardinal sign of ins rezist and also to fat. Muscle and fat swollen. It can cause illness.
How long fasting is required for fasting insulin measurements? What the upper normal limit of insulin? What time of the day blood should be drawn for fasting insulin ideally?
great video, thanks! What is the 'range' of markers for fasting insulin, uric acid and ApoB? What is good, fair, poor and dangerous readings of each? Thanks
Uric acid = breakdown of ATP> ADP >AMP > uric acid. It makes problems with BP > leads to Htn It inhibits ctp1 which makes carnitin to help fatty burning in liver> if not burnt > to fatty liver or fat in other arteries Meat makes uric acid and so does suger. Glucose and fruct > liver> increases uric acid which inhibits carnitine b transporter Uric. Acid level needs to be 5.5 not 7 as I is the standard now ALT tells a about fatty liver.
I was diagnosed with 60% fatty liver disease, I followed Dr. Lustig's advice, I am much healthier now The problem being, I can't find any doctors that are willing to help me with these guidelines
Ha. He didn't want to endorse Dr. Hyman's company. Haha. He probably did not get invited to participate. In all seriousness, Dr. Lustig is indeed a National Treasure. His book Metabolical and his famous frase "feed the gut, protect the liver" were key influencers in my move to a whole-foods, plant-dominant diet. Result: Fasting insulin down from 15 to 5, ALT down from 45 to 20, HsCRP down from 1.5 to 0.3, Triglycerides down from 100+ to 55, Urid Acid down from 7 to 6.1 (still working on that one), and APOB down from 90 to 65.
@@kenadams5504 My Trig are 55 and my HDL is 66, so that is in a good spot. I still need to work on waist circumference, which is more than half my height.
I eat a plant based whole food diet. Got a CGM just to track how the foods affect me. I eat a lot of beans & need lots of calories. Now struggling to see what I can eat that doesn’t shoot my BG up but Tofu is great.
@@thetackroomtx Try adding avocado to your foods, it reduces glycemic impact. Also, try adding cinnamon, and go for a walk immediately after eating. All of that will reduce the glycemic impact. Good luck.
@@bestdoom1236 Thank you for taking the time to reply. I eat avocado every morning still big spike. Did the walking - still big spike - will try the cinnamon ! I walking before I eat helps and Im tweeting what I eat but am now focused on healing the gut and liver. ( decades of bad food 😜)
Even fasting raises uric acid... because DNA repairing is purine metabolism ..i m struggling with it...i tried lemon..it didn't bring it much down but instead raised my heart rate
I would advise keep Dr appts, take meds as prescribed. Eat low carb no sugar diet, exercise 3 to 4 times a week, get 7 to 8 hours of good sleep a night, use CPAP if necessary.
Dr Lustig is a great teacher, what all doctors should be! But unfortunately I have to disagree about the approach to uric acid. I was a gout sufferer and when I changed my habits I found out that my gout flares disappeared. Remember that gout was called the king's illness. They had their huge tables full of turkey, pig, deer and other proteins. But what else was on their tables in large quantities: wine and beer, plus fruits and other carbs. When I started my healing process I was 266 pounds and had gout and very high tryglicerides. I started quitting starches, all of them. And quit fruits. Alcohol out!!! Basically my diet was fatty meats, all of them. And a little vegetables, salads. I switched from vegetables/seed oils to butter, lard and tallow. No grains, no sugar, no seeds and no cereals included. What was the wonder outcome: no more gout flares, tryglicerides below 100, uric acid 4,3 and basal glycemia at 79. Unfortunately I didn't take the basal insulin test. I went down almost 60 pounds. With regular BP of 120/80, which before was 140/90 testing it for 2 weeks 3 times a day. Then I started to introduce sugars again and little starches again. Surprise, surprise, gout flares came. And it was not due to meat consumption. It is really the sugar, the starches and the alcohol. Period. Period. Period. I have been detoxing my body from those 3. A d today I can say that all we need is meat, healthy fats and some veggies. Might add a very little amount off carbs when at ideal weight and health. Exactly the same my grandma did in her lifetime. She almost only lived in a natural surrounding and had a natural diet. Less inveronmental toxicity and cleaner life, without all the industrialized (no)foods. She lived on the land and ate from the land. Small personal farming. All day long out in the field, which was her exercise. Max. 3 meals a day in regular quantities. Some fruit. Vegetables and potatoes. Little bread. One small glass of sweet wine per month. She lived from 1886 to 1987, to almost 102. Without the starches and the fruits she would have probably lived to 112 or more. She lived in Hamburg , Germany. I live with her for 3 years and she always said that I would die young if I don't stop eating the way she saw me. Too much sugars, etc. Today I can only say that the basic alimentation is of what our bodies are made of, meat, fat, skin and bone, collagen and salt water. Just use your common sense. Add some veggies and fruit when healthy 1 or 2 times a week. Eat to heal and nourish yourself, not for pleasure. Salud y saludos
Food suppliers are not being checked as to what they are flogging. Is there an ombudsman or inspectorate? There are too many unhealthy foods on the market.
Great vid, great info. I notice Dr Lustig avoids going near no carb, just calls out lifestyle. I'd love to know what he thinks of HFG with LFI and good Hba1c.
"I'll be personally here my insulin is low it's under two good for you I'm a child of the 80s which means I grew up eating sugar cereal every morning for breakfast for 30 years which means daily and I know this now because I have a CGM on I would spike my glucose to 200 MH and it would come back down and yet in my late 40s my insulin is under two I'm delighted explain how that is to me" This is like a piece of anecdotal detail that show us, what can happen when we consume source of glucose and we be active, as a child you must have also been burning that glucose load by all the playing, and every other activity in the day. However, what i notice with me, i ate "bread" load of bread at nights - which is a terrible time to infuse glucose into the body.
I asked my doctor to add fasting insulin, hsCRP, homocysteine and lipid fractionation to by labs. None of those were done. There was a c-peptide result. How does c-peptide compare to an insulin measurement. Can c-peptide and fasting glucose be used to calculate HOMA IR?
Peptido C- Dice si las células beta del páncreas producen suficiente insulina y cuánto, si son valores al minimo servirà insulina para compensar el defecto, no servirán ayuno intermitente ni OMAD(one meal/di), en suma diabetes tipo 1. El Homa-r - es el producto de la insulina basal x la glucosa en sangre y éste resultado diviso entre 405, Valores de resist.insul: 3 resist.ins. (estos vals. rigen en Perú), en general no se puede determinar con solo un tipo de exámen, se estudian en el complejo o sea todos, aunque no creo tanto en los estudios definitivos médicos, mientras nuestros órganos permanezcan irrigados de sangre están vivos y se pueden regenerar completamente curandolo de raíz sin usar fármacos, es lento y requiere esfuerzo sí, no hay órgano muerto, pues es más fácil meter insulina en lugar de curar. Hay poca literatura cientifica en cura del páncreas pues los intereses de las farmacéuticas son muy altas, pero definitivamente hay muchos casos.
Ok, I don’t have a Cgm, but I do have a glucose monitor. Can anyone describe how I would use it to measure clearing. Do I take my fasting glucose in the AM, after coffee, before my first meal, then at certain intervals. Can someone describe that process and what the data will mean. Thanks
My cholesterol and Ldl was high but triglycerides and Hdl was great so doing they raport as doctor Lusting suggested I am in perfect health. And fasting insuline was great too. I tend to believe him because I feel amazing and I do train everyday. At first I was shook my cholesterol was high wtf I am in perfect health now I feel better. And I have fat friends that smoke who have normal cholesterol.
How about touching upon those that go on keto and don't have any significant change of their FBG? 90-100 I've found very little changes it. This includes wearing a CGM. Even a banana will make it go up to 135 and be back to normal in less than 1 hour.
Why would my glucose clear to 120 at 10:30pm, 70 at 3am, 120 10:30am 200 at 11:30. No food eaten and moderate exercise 1 hr stating 9am. Adult diabetic 25 years, fasting insulin 16. Love your talks and depth on knowledge.
Because exercise is a stressor and it spikes glucose. I mean cortisol does it, gives signal. I got fasting insulin under 2 and got 120-140 cgm glucose on my cgm during trening. Around 20-30 minutes into it, and goes down around 30-40 min after to around 100.
Are you using a CGM? If so, that 3 AM measurement of 70 may just be you sleeping in a way that's putting pressure on the sensor. I've seen multiple people discussing this online and then I got a CGM and experienced it myself on multiple occasions.
Aside from the A1C those numbers looks very healthy. The interpretation of the A1C value requires an assumption about the lifespan of your red blood cells. The standard ranges for healthy, prediabetic, and diabetic A1C assume an average RBC lifespan of around 120 days. If your red cells are living longer than that, your A1C value will be higher than expected based on your true glucose level. The point is, your glucose may be normal even though your A1C is high if your red cells are living longer than expected. If you want to know where you stand, you can get a test called fructosamine. It's another measure of average glucose over time but instead of a 3 to 4 month average it's more like a 3 week average and it doesn't involve red blood cells. If fructosamine level is normal (i.e. not prediabetic like your A1C value) then you're in good shape and probably not insulin resistant.
@@martarico186 you're welcome. And I just remembered something. If your fructosamine comes back _abnormal_ there's one other explanation I can think of. There's a type of diabetes called "MODY" that is genetic. There are like 14 different sub-forms of MODY, each one based on a different genetic mutation. A few of them are very mild and for at least one of them ( MODY 2, aka GCK-MODY ) the only symptom is mildly elevated blood sugar. It's very rare, and your doctor may not even know about it, but it's definitely a remote possibility. Look it up if you're curious.
According to Danielle Brandman, MD ( hepatologist at UCSF) ALT for males: under 35 ALT for females: under 25 According to multiple low-carb docs and PhDs, including Ken Berry and Ben Bickmann: Fasting Insulin between 5 and 10 is pretty good Fasting Insulin under 5 is optimal
Hb A1c is the one to change before FBs changes. The fasting BS changes last. Those people canbe obese and may have protein urea. They are pre-diabetic. Metformin improves ins sensitivity.
I am a huge fan of Dr. Lustig, but understanding his message is sort of analogous to reading your blood lab results - that is, understanding his overall message sometimes means filtering out the random confusing comments much like reading your lab results is better thought of as an overall picture, rather than putting value in each data point. Case in point, at 5:59 he says a fasting blood glucose of 91 is "not doing great" and is "already a problem." Utterances like that are like verbal clickbait. Let's say (real case) a 44-year-old female has a fasting blood glucose of 91 along with ALT of 10, AST of 16, waist circumference of 23 inches, A1C of 4.3%. Are we really going to put her in the category of normal-weight people with metabolic disease? It's almost hypocritical of him to say that, as he prefaces the first interview by saying that the overall picture is nuanced and complicated, but then goes on to say that 91 mg/dL is a problem. The cynic in me wonders why he would make this kind of statement, and I'm guessing it has to do with selling something.
no, I don't think he's saying that 91 mg/dL is an automatic metabolic issue. I think he's saying if that is consistently in the 90s then it's best to watch it. it will creep up overtime. It's a warning, that's what I think he's saying.
@@callofthewildbuck You're giving him a generous interpretation in the timestamped comment. He in fact says that fasting blood glucose is not the right metric to use as a warning for metabolic function, but that it's the "last marker to change." He recommends fasting insulin and ALT as examples of better warning markers, and I am inclined to agree. In my real example above, I admittedly don't know her fasting insulin (wasn't tested), but given all her other metrics, it's almost certain that her 91 mg/dL was simply dawn effect or mild fasting rise, etc. Having it "creep up over time" is definitely a concern, but that will only happen as a result of the overall metabolic picture getting worse (especially in the metrics that Dr. Lustig mentions as better for demonstrating metabolic health). My (only) problem with him is that he doesn't qualify such simplified statements and thereby dilutes his own message.
@@samblackwell9839 thanks for the discussion. I understood from his book Metabolical that the tests you mention are best but what about home testing? I was thinking of it from that perspective. As a person I’d only have the ability to watch my glucose. So if I see it go up overtime I’m going to be sure to watch it. From a clinical perspective I think you’re right.
@@samblackwell9839 thanks for the discussion. I’m taking it from a lay person monitoring glucose at home. Clinically you’re correct but I’m not going to see those labs drawn at a CLIA lab everyday. I will see my daily finger prick glucose or CGM readings. This is why I think he’s saying what he’s saying. I think he’s taking it straight from his book Metabolical.
@@callofthewildbuckI admit that waist circumference is impressive . To clarify if there is the beginnings of a metabolic problem I suggest repeating the fasting blood sugar with a fasting insulin( insist on fasting insulin if you are doing ng this with a doctor).
such an interesting interview. can someone tell me what it means if glucose rises very slowly and comes down slowly as well. my glucose peaks (very rarely over 120) at the 2 hour mark & then takes one or even 2 hours to come back down. my A1C is 5.2 and fasting insulin is 5. tia.
Is it possible to establish the Sugar ceiling? (overall max of all sugars combined; sucrose, fructose, lactose, etc) in a day? For example if an ideal day would consumed less than 10g of sugar, is it possible to establish a safe limit from dietary approach?
Hello and thanks for this video. I've been on a ketogenic diet for over 2 and a half years, I eat less than 20g of sugar a day, I'm very strict on my diet and yet I have a uric acid level of 6-7... I've never had gout, but I have rheumatoid arthritis and when my uric acid rises, I feel inflammatory pain in my affected joints... What should I do to get rid of my problematic uric acid? I also have type 1 diabetes, which is very well monitored, and otherwise I'm perfectly healthy. Is the solution to take allopurinol? I suspect I really do have a genetic disorder because everyone in my father's family has uric acid... However, I'm very afraid of having a taste attack when I start treatment, because I've heard that's what happens... Ty
I am vegan and take 80-85% complex cabrs. My uric acid is 2.5 mg/dL. I follow Dr Essyltein diet. No fat (~10% calories). All vegan, no oil, My LDL dropped from 130 to 83 mg/dL, non-HDL is 96 mg/dL (earlier it was 143 mg/dL)
Liver and other organ meats such as kidney and heart are high in purines. There are other foods, such as sardines, that have high purines as well. Google search for "purine content of foods" and find a chart to find all of them. I myself do not have an issue with uric acid, but I once tried eating cod liver (comes in a can like sardines) and found I really enjoyed it. Then I ordered a case of it and was eating it regularly. About a month into that I started getting severe pain in both of my big toes. I did not get my uric acid tested but I knew what it was and what was causing it. I stopped eating the cod liver and the pain went away.
I'm having an A1C panel done in the next week or so. I've been keto for three years. Last time it was 5.2 but with two hurricanes and comfort food...it may be a little higher this time. I live by the 6/9 rule Dr. Lustig turned us on too. 6 tsp/day of sugar for babes, 9 tsp/day for dudes. Any more than that the liver can't process it fast enough when the next day is piled on. It's a layman's explanation but the way I understand the chemistry is the liver has its limits on what it can process in a day without stashing the excess as fatty liver/visceral fat in and around the organs. The kidneys become clogged, hypertension city follows.. Keep flooding the liver with sugar and wheat/starches, edema and uric acid starts wearing away cartilage. Add to the erosion with glyphosate in sugar, wheat, corn, rice and soybean/oil and the 'chelator' part robs us of the minerals needed for collagen. The cascading effect trickles down into the arms of Pharmakia. The ultimate Solution...single payer healthcare, quack science from the likes of Ancel Keys and Fauciesk protocols.
Kraft curbs = speaks about what food give what ins spikes. In diabetes type 1 = cannot make insuline not ins rezistense Type 2 = can make excessive insuline but tissues resist
The GTT : the height of BS tells about the B cell function The delay and plateau talk about insuline resistance. Exercise turns you to baselinenormal in 2 weeks Avoiding glucose turns you N in 2 weeks. What counts are spikesand how long the return toN is.
The point is not about to detect and fix insulin resistance. The point is not getting insulin resistance. How did it happen? From not using keytone and too much glucose intake. Glycation, caused by high glucose, is a protein damage process. hbA1C is to measure your glycation process. This glycation will damage all your proteins.
CGMs are useless.I have Free Style Libre on one arm and Dexcam on the other.I check both and finger stick at the same time All are very different. I believe my finger stick more than eitherbof the CGMs.
Great discussion. One question though. He states that the fasting glucose can be changed on two weeks. I started one year ago with improved lifestyle changes, low healthy carb, higher protein, IF 16:8, 250 mins a week of exercise. The results have been good and I feel great. I was not bad but at 68 I wanted to prepare further aging effects, So the bottom line is I dropped 25 lbs ( BMI 23.5) . Triglycerides 36, blood pressure 108/78. I do not eat any added sugar but my A1c has stayed at 5.5. My fasting insulin is under 6 ( as low as 4.4) but my fasting glucose stays in the low 100’s . I wore a CGM and my glucose may spike to 140 but drops immediately to under 90 then drifts back to 100 within a hour. At night after last meal at 6pm I will drift up to 98-100 all night long in a tight range then upon waking it will go up to 105 post exercises. How can I not be insulin sensitive with fasting insulin under 6 and spikes showing quick response. I would think my A1c would be closer to 5 but I have read theories that because of low reserves the liver keeps the glucose at 100 in reserve for the brain. Any truth?
Insurance and doctors don't test it because they don't have drugs to sell you or guideline practice to fix it. Imagine you are a clinical doctor patient comes to ask you what do I do on the test results report for all things abnormal?
LIFE EXTENSION OFFERS FULL TESTS FOR Lipid tests , insulin , ect CMP LP CBC Vit D A1C T4 B12 all hormones. Once a year off metabolic panels . In Florida only but other tests are available thru lab corp & Quedt. Total cost less than 300. 00 better than any dr visit. You call a dr after your results. Now you have your numbers for your Dr. I’m 63 been doing this after my third child at 40. Very helpful
Yes. To prevent this from messing up the lab result, it’s best to draw your blood for fasting glucose 4 hours after you wake up. Drawing the blood too early will cause the dawn phenomenon to influence your result. Another best way to measure glucose is to use the at home kit and measure real time before and after meals to see which meal is spiking you the most and adjust accordingly. HBA1C combined with Fasting Insulin is better for long term view of glucose metabolic health status. Throw in Leptin & C-peptide for additional insights.
My father dealt with gout for years. I've eaten animal based for eight years and my uric acid is 4.0, so I'm not buying the meat causation hypothesis. There are functional medicine doctors that strongly disagree with Dr lustig with the caviout that you stay metabolically healthy.
I am vegan and take 80-85% complex cabrs. My uric acid is 2.5 mg/dL. I follow Dr Essyltein diet. No fat (~10% calories). All vegan, no oil, My LDL dropped from 130 to 83 mg/dL, non-HDL is 96 mg/dL (earlier it was 143 mg/dL)
@@bscsmscs1578 LDL in a metabolically healthy person is irrelevant. VLDL matters as does HDL to Triglyceride ratio. Your HDL is probably not optimal which means your ration is also not optimal. Saturated fat raises HDL and LDL ( usually). As Dr Lustig said, LDL hazard ratio is 1.3 and the only reason it's that high is because it does matter somewhat if you're metabolically broken, which most people are. There is no way you're getting adequate bioavailable protein especially as you age if you're at 80% carbs, unless you're using vegan protein powders. I've been a high level athlete all of my life and did low fat, moderate carb for years, but have been low carb, high fat for eight years I'm 60 now and can outperform most men half my age. That is largely due to my diet. I've never felt better. I've done both types of diets and have spent my life in the field of health and wellness. I may periodically tweak my diet, but I will forever live a low carb lifestyle.
@@bscsmscs1578 there are many studies( the biggest being the Copenhagen Study) showing that lower LDL ( especially as you age) is associated with higher all cause mortality. The ideal LDL for longevity according to the Copenhagen Study is 140. LDL helps regulate your immune system. Lower isn't better. Higher HDL is much more important than low LDL, in otherwise healthy individuals
I just read a comment , that said. The insurance companies did not want to pay for fasting insulin test? Well I’m getting one done on 9/30 2024 . Paid by the insurance company. But I have severe back pain that cause my legs and feet to burn. And I think their not wanting to replace my pain pump. If they can just get by with cheap meds!
@arnie1005 Well, it's more like (imo) they suspect IR - thus the covered Fasting Insulin test, imo. ...because your symptoms can indicate nerve damage in lower extremities due to chronically high blood insulin. (& glucose, which could go hand-in-hand). However, your back pain kinda points to spinal nerve damages, & these nerves help regulate feeling in lower extremities- of which burning sensations - could indicate spinal nerve damage, and NOT from high blood insulin. Being that the fasting insulin test is so much cheaper than CTs, or MRI or whatever testing would assess possible spinal nerve damage- they may FIRST want to rule out, (or rule in) high Insulin as causative of your symptoms. So, in my pov, their strategy would be FIRST rule-out Insulin Resistance - then proceed with the more costly Spinal testing...to determine cause of your symptoms.
If you don't have any physical damage, You need to do physical therapy to release the muscle knots in your lumbar spine . It must be dome by hand🫳 . You need a STRONG 💪expert physician.
One can have spikes it is N but only 2 or 3 a day. Intermittent fastin- only 2 spikes. Ingested gluc goes to liver and 20 % transf into glycogen. The rest goes to blood . Over 80 it goes to kidney and reabsorbed. If too high goes into blood vessels.endotheliu one test is new. It ca cause HTn.
I disagree to the cause. You said fatty liver is "because of defective mitochondria. It is because of the so called "food" in the grocery store that we are forced to eat. It is because of the "drugs" we are giving at the doctors' offices, and it is because of lack of proper exercise due to computer, TV, and phone access.
Who is “forcing” you to eat a particular food from the grocery store? It sounds as if you’re a victim and as such, maybe you should file a police report.
@@chadmartinez459 the population with longrst life expectancy is in hong kong ,and they eat one of the biggest amounts of meat,per year ,on the planet .
So tests from obesity: FBS, GTT. Fasting Insuline levels. Fi levels are not standardized. The AMa rejects it because it is not When beta cells are stressed they release proinsuline 2 leading to B cell exhaust. If insuline fasting is high we know it is a dinamic problem Fasting ins does not corelate with obesity but it tells you about pancreaticB cell health.
I've been a Type 2 Diabetic for years. I'm 64 and had a triple bypass on 6/26/24. I've had a hard time getting a serious grasp of, and really understanding Diabetes, its underlying causes, and what actions I need to take to get better - until now. Sounds crazy, but it's true. What makes this video great is that Mike Haney asks all the right questions and Dr. Lustig's answers, although comprehensive and "scientific," are clearly spoken and easy for a layman like myself to understand. I can't thank you enough! Oh, and I'll be sharing it with my son who's 22 and who, unfortunatly, has learned bad lifestyle habits from me. I think this video will help him understand the life changes to make so he doesn't end like his dad. Blessings to everyone involved in making this video. Jose, Tampa, FL
Hope your recovery is going OK,
Good for you ! 👏👏 You took your health seriousely and now you can be a healthy rolemodel. You did your best when he was younger based on what you knew then ❤
It’s always a pleasure to listen to Dr Lustig. I test his hypothesis daily in my cardiology practice and till now I am impressed how his advices are far more precious than the advices given by current guidelines.
Nice to hear!
Dr. Lustig is a National Treasure!!!!!!!
World Treasure
No, he's not! He advocates fiber and processed foods!
He is not a national treasure! He is an INTERNATIONAL treasure! I’m learning tons of info that nobody else can seem to connect the dots on! (not even thinking about doctors)
@@patrycja2696 Fiber actually not a villain. And apparently you have not watched his podcast appearances since the one thing he is on a crusade for is getting rid of processed foods!
@@presiyangurin2280 lol
You haven't watched enough of him.
I have two of his books. Spent around 5000 hours on healthy food topic. Listened to lectures of above 100 doctors and professors. Have about 200 books at home.
Work in that field around 20 years.
He want to reingeneer ultra processed food... No thanks!!!
About fiber... Tell that to all those who's gut is damaged because of fiber and have autoimmune conditions!!!
We didn't evolve on fiber!
Dr. Lustig is by far the best source of information I have found. Can't thank him enough.
I'm a practicing medical doc of 35 years and I've never heard a conversation on blood glucose like this one. My light just went on after 30+ years in medicine. I always knew standard of care medicine was bad, hard to believe how awful it really is.
Thanks for your comments, especially since you are a practicing physician.
Thanks for sharing your perspective.
I am double boarded ER and IM Listing is the real deal and one of the few doctors that could even teach me something. He has raised Metabolic medicine to a new LEVELS ( Play on words)😂
So glad that someone with impeccable credentials like Lustig decided the truth is more important than money.
Pun intended.
Glad to have found a real expert in this field as Dr. Lustig.
This is amazing! I can just get these tests he mentioned NOW (before I start all the changes), and then 4 weeks later, and then I have a measure of success that is way more convincing than stepping on a scale.
- fasting Insuline
- uric acid
- ApoB (LDL/Triglycerides)
- Inflammation high-sensitivity c-reactive protein
Dr Lustig is just my no. 1 reference ever. I can't get enough of his explanations.
When you listen to him, suddenly everything becomes so clear ❤
He is amazing, the professor you would love to have.
The Professor is amazing. I have learned so much on the subject. Thank you.
I am thoroughly delighted by the knowledge that Dr Lustig expounded in this clip. I will forward this to my colleagues
My Lyme doc once did some kind of blood test that required me to go eat syrup laden pancakes and return for blood draw. I had been on Atkins for years and did not want to do it. She insisted.
Within an hour and half of that horribly high carb meal, my blood sugar dropped like a bomb. I was weak, shaking, crazy. Family members had to help me 7:20 into a restaurant. Took me two days to recover. Have stayed basically low carb now years.
A1C is 5.1.
You have every right to decline!
The only thing that changed in 1980 was the food industry, switching to high fructose corn syrup, because it was government-subsidized and cheaper than cane sugar which has a tariff. Being so much cheaper, they decided to go by the tobacco industries playbook and used its addictive quality and put it in all foods. This pushed up the sale of snack foods while computer games reduced physical activity. The perfect storm.
This is definitely part of it, arguably the largest part, but the problem has its origins much earlier than 1980.
Low fat push done the most damage to modern health in my mind. High Fructose Corn Syrup isn't World wide.
@@TomSmith-cv8hk HFCS is absolutely world wide, and it is very likely the most significant factor in the accelerating incidence of metabolic syndrome. The low-fat nonsense accelerated the damage that HFCS did, but it was HFCS doing the actual damage.
@@homomorphic Fructose is actually a mitachondrial poison . Chronic damage to mitachondria can result in cells using fermentation of glucose/glutamine to make ATP , aka the Warburg Effect /cancer .
True
Hi everyone, based on the videos from Dr. Lustig I did the following:
- removed fructose outside of fruit to almost 0 (zero sweets; also 0 artificial sweetener-beverages)
- increased fiber in diet, took fiber supplement when I felt fiber had been "removed" (monchmonch, wheat husks)
- kept "overeating", so I didn't use any willpower on reducing calories (i love my pasta, now it's wholegrain + fiber supplement, but still overeating once in a while)
- increase in movement, but little and inconsistent
This is what happened in 4 weeks, blood tests with 12 hrs fasting (just as Dr. Lustig described)
- ~40 yrs old, male, 200 pounds
- body weight - same
- body fat % - same (from one of these intelligent scales)
- blood pressure improved (low confidence, may have had outlier, measured only at start + end)
- HOMA Index improved from 2.2 to 1.8 (in 1 month!!!! Without medication!!!) (5 is diabetic, in between is pre-diabetes)
- Insulin dropped from 9.7 to 8.3
- C-reactive protein (inflammation marker) improved from 3.5 to 2.4 (
Been listening to Dr. Lustig for years and always learn something new. I plan to get a CGM someday, but unfortunately Levels is too costly.
you don't need it. you know if you have blood sugar spikes and drops you feel shaky or weak. leave them for the diabetics. our grandparents never had them, lived to nearly 100 just didn't over eat.
Same. Although the more we remove sugar from our food source the less it seems relevant to get a cgm. Find out the glycemic load of what you eat and you're probably half way there.
Every time I hear Dr Lustig I learn something new about things I have heard before. I save them all and watch over & over.
I do use a CGM, but unfortunately it is not as accurate as blood testing with a meter but it does show trends.
If you listen to Lustig and act on what he says, you're gonna be ok!
would you be willing to share which CGM you use? and it's better to stick with a traditional glucose meter?
I agree about the better accuracy of finger sticks, but it’s hard to catch the peak of the spike. And to be fooled by the dips. Or how walking keeps my BG stable until I stop walking when it rises again. Also, there’s information that you can get during your sleep.
Did no one else in this thread actually watch the video where it was clearly pointed out that glucose level is almost useless?
I never test glucose as it contains *absolutely* no information. I order an insulin lab 3× per year (and lots of other labs).
The single most important lab is hsCRP.
@@callofthewildbuck Libre Freestyle 2
So good you brought Dr Lustig to your podcast.
There have been a few people wearing CGMs that were brushing up against pre-diabetes, made lifestyle changes, but had a carbohydrate bender before bedtime some time down the road. The CGM recorded a 6 hour plus long heavily elevated glucose level. Shocking. Can you imagine being at 180 to 220, for nearly 6 hours while you sleep? I know that I must have routinely experienced that in my earlier years.... uhg.
Thanks you very much Dr Lustig for your clear and brillant interview !🙂
Great podcast with new info from dr Lustig. Thank you!
The only person that says based on research and not just some latest health ideas.
It's all a big scam. Just finished reading "Health and Beauty Mastery" - what an eye-opener! This book exposes so many hidden truths about the health industry that no one talks about! I completely changed my habits
Thats true
Truly a good book
It’s the food
What so discouraging is the amount so called health experts that doing youtube and most of them almost never say the same thing. I'm trying very hard to lose weight and get my blood sugars in check and using these youtube creators to get that info I need to do this but it seems that they more interested in monetization that being stringent about the content they put forth..
@@douglasgrant8315 Try eating beef, butter, bacon and eggs for 30 days. If you can’t be that strict yet, then try just eating Whole Foods - no processed foods.
I thought I was pretty well-informed about metabolism and interpreting test results, but I found this level of detail quite helpful, and the interviewer’s questions, such as about what one can infer from the shape of the glucose curve, or where in the body all the glucose goes if one is healthy or not, were very insightful
Dr Lustig is such an inspiration. I just love to listen to him.
Omg! Dr Lustig is a legend!
The insurance industry does not want to pay for the fasting insulin test, not because it is expensive in and of itself, but because it is not in their best financial interest. They want people to be metabolically unhealthy, otherwise who needs medical insurance companies?
I'd agree w/you, but this sounds quite conspiratorial for my comfort.
You say you know their agenda, but actually you don't. This c/b your imagination trying to understand why fasting insulin testing is not regularly accessed through our medical system.
That said - this could be true - but again may have no truth to it at all.
Do your own due diligence & critical thinking, rather than repeating something you've heard or read. You'll be alot better off - more well-informed😊
@@barbarafairbanks4578 Critical thinking is what I do most. All the time. Thank you. I tend not to believe in conspiracies, unless they make logical sense and are quite out in the open for anyone to see.
@@arosalesmusic Dr Lustig has (in my poorly crafted words) mentioned that the health industry improves one death at a time as the old guard of medical doctors who the medical insurance industry relies upon to make their directives/decisions, passes.
For everyone reading this, finding the banned book called the hidden herbs by anette ray should be your top priority
You are everywhere ... Are you a bot?
Amazing video. Thank you for doing this Dr Lustig.
Love to hear Dr Lustig explaining glucose etc
Glucose use: transporters to cells. = glut 1 to glut 11 for various tissues.
Brain uses gluT 1.
Glut 4 is in fat and muscle= cardinal sign of ins rezist and also to fat. Muscle and fat swollen. It can cause illness.
Very beautiful ❤️ exceptional presentation in few words bravo 👏 thanks 👍 Doctor 💊 for your honesty 🙏!!!!
How long fasting is required for fasting insulin measurements? What the upper normal limit of insulin? What time of the day blood should be drawn for fasting insulin ideally?
Fasting window is between 12-14 hrs.
great video, thanks! What is the 'range' of markers for fasting insulin, uric acid and ApoB? What is good, fair, poor and dangerous readings of each? Thanks
Uric acid = breakdown of ATP> ADP >AMP > uric acid.
It makes problems with BP > leads to Htn
It inhibits ctp1 which makes carnitin to help fatty burning in liver> if not burnt > to fatty liver or fat in other arteries
Meat makes uric acid and so does suger.
Glucose and fruct > liver> increases uric acid which inhibits carnitine b transporter
Uric. Acid level needs to be 5.5 not 7 as I is the standard now
ALT tells a about fatty liver.
Fascinating interview 🎉 Dr. Lustig. Genuis. Reading his book Metabolical 💜
This was very good. Enjoyed listening and learning from the Dr, already bought his book metabolical ❤
I love this guy
I was diagnosed with 60% fatty liver disease,
I followed Dr. Lustig's advice,
I am much healthier now
The problem being, I can't find any doctors that are willing to help me with these guidelines
We need to send DR ROBERT LUSTIG TO BE ON RFK JR , health and steering committee to overhaul the health system😊
Great guest and great interview!
Ha. He didn't want to endorse Dr. Hyman's company. Haha. He probably did not get invited to participate. In all seriousness, Dr. Lustig is indeed a National Treasure. His book Metabolical and his famous frase "feed the gut, protect the liver" were key influencers in my move to a whole-foods, plant-dominant diet. Result: Fasting insulin down from 15 to 5, ALT down from 45 to 20, HsCRP down from 1.5 to 0.3, Triglycerides down from 100+ to 55, Urid Acid down from 7 to 6.1 (still working on that one), and APOB down from 90 to 65.
Your trigs to hdl ratio is a measure of insulin sensitivety/ metabolic health .The ratio is ideally 1:1 ,and >1:2 is something to improve .
@@kenadams5504 My Trig are 55 and my HDL is 66, so that is in a good spot. I still need to work on waist circumference, which is more than half my height.
I eat a plant based whole food diet. Got a CGM just to track how the foods affect me. I eat a lot of beans & need lots of calories. Now struggling to see what I can eat that doesn’t shoot my BG up but Tofu is great.
@@thetackroomtx Try adding avocado to your foods, it reduces glycemic impact. Also, try adding cinnamon, and go for a walk immediately after eating. All of that will reduce the glycemic impact. Good luck.
@@bestdoom1236 Thank you for taking the time to reply. I eat avocado every morning still big spike. Did the walking - still big spike - will try the cinnamon ! I walking before I eat helps and Im tweeting what I eat but am now focused on healing the gut and liver. ( decades of bad food 😜)
This is a great video showing the scientific readings etc,…. Would love to see the 2nd video showing what to do in these situations.
Protect your liver, brain, feed the gut, lower insulin.
Amazing 👏 love Dr Robert Lustig
Thank you Dr , how low you think the good number for fasting. How high after food and how long it stay in ? Would you please explain more ❤
Even fasting raises uric acid... because DNA repairing is purine metabolism ..i m struggling with it...i tried lemon..it didn't bring it much down but instead raised my heart rate
Thank you for humble chat. Instead of technical discussion's amongst medical professionals, can you please tell me step by step how to remain healthy.
I would advise keep Dr appts, take meds as prescribed. Eat low carb no sugar diet, exercise 3 to 4 times a week, get 7 to 8 hours of good sleep a night, use CPAP if necessary.
@@EileenGarcia-j7iWHAT IT STAND FOR CPAP ?
Inflammation how to determine.
C reactive protein tellsabout it.
HScrp test tells that something is wrong but not specific.
Dr Lustig is a great teacher, what all doctors should be! But unfortunately I have to disagree about the approach to uric acid. I was a gout sufferer and when I changed my habits I found out that my gout flares disappeared. Remember that gout was called the king's illness. They had their huge tables full of turkey, pig, deer and other proteins. But what else was on their tables in large quantities: wine and beer, plus fruits and other carbs. When I started my healing process I was 266 pounds and had gout and very high tryglicerides. I started quitting starches, all of them. And quit fruits. Alcohol out!!!
Basically my diet was fatty meats, all of them. And a little vegetables, salads. I switched from vegetables/seed oils to butter, lard and tallow. No grains, no sugar, no seeds and no cereals included. What was the wonder outcome: no more gout flares, tryglicerides below 100, uric acid 4,3 and basal glycemia at 79. Unfortunately I didn't take the basal insulin test. I went down almost 60 pounds. With regular BP of 120/80, which before was 140/90 testing it for 2 weeks 3 times a day. Then I started to introduce sugars again and little starches again. Surprise, surprise, gout flares came. And it was not due to meat consumption. It is really the sugar, the starches and the alcohol. Period. Period. Period. I have been detoxing my body from those 3. A d today I can say that all we need is meat, healthy fats and some veggies. Might add a very little amount off carbs when at ideal weight and health. Exactly the same my grandma did in her lifetime. She almost only lived in a natural surrounding and had a natural diet. Less inveronmental toxicity and cleaner life, without all the industrialized (no)foods. She lived on the land and ate from the land. Small personal farming. All day long out in the field, which was her exercise. Max. 3 meals a day in regular quantities. Some fruit. Vegetables and potatoes. Little bread.
One small glass of sweet wine per month.
She lived from 1886 to 1987, to almost 102. Without the starches and the fruits she would have probably lived to 112 or more.
She lived in Hamburg , Germany.
I live with her for 3 years and she always said that I would die young if I don't stop eating the way she saw me. Too much sugars, etc.
Today I can only say that the basic alimentation is of what our bodies are made of, meat, fat, skin and bone, collagen and salt water. Just use your common sense. Add some veggies and fruit when healthy 1 or 2 times a week. Eat to heal and nourish yourself, not for pleasure. Salud y saludos
What is a good APOb level or range? Also homocysteine? Thanks!
Food suppliers are not being checked as to what they are flogging. Is there an ombudsman or inspectorate?
There are too many unhealthy foods on the market.
Is there a full video?
Great show
Great vid, great info. I notice Dr Lustig avoids going near no carb, just calls out lifestyle.
I'd love to know what he thinks of HFG with LFI and good Hba1c.
"I'll be personally here my insulin is low it's under two good for you I'm a child of the 80s which means I grew up eating sugar cereal every morning for breakfast for 30 years which means daily and I know this now because I have a CGM on I would spike my glucose to 200 MH and it would come back down and yet in my late 40s my insulin is under two I'm delighted explain how that is to me" This is like a piece of anecdotal detail that show us, what can happen when we consume source of glucose and we be active, as a child you must have also been burning that glucose load by all the playing, and every other activity in the day. However, what i notice with me, i ate "bread" load of bread at nights - which is a terrible time to infuse glucose into the body.
I asked my doctor to add fasting insulin, hsCRP, homocysteine and lipid fractionation to by labs. None of those were done. There was a c-peptide result. How does c-peptide compare to an insulin measurement. Can c-peptide and fasting glucose be used to calculate HOMA IR?
Yes there is a correction algorithm to accommodate c peptide. The Fasting Insulin is far superior to use
c-peptide is actually a better test than insulin - the beta cells create equal amounts of insulin and c-peptide but the latter is more stable.
Peptido C- Dice si las células beta del páncreas producen suficiente insulina y cuánto, si son valores al minimo servirà insulina para compensar el defecto, no servirán ayuno intermitente ni OMAD(one meal/di), en suma diabetes tipo 1.
El Homa-r - es el producto de la insulina basal x la glucosa en sangre y éste resultado diviso entre 405, Valores de resist.insul: 3 resist.ins. (estos vals. rigen en Perú), en general no se puede determinar con solo un tipo de exámen, se estudian en el complejo o sea todos, aunque no creo tanto en los estudios definitivos médicos, mientras nuestros órganos permanezcan irrigados de sangre están vivos y se pueden regenerar completamente curandolo de raíz sin usar fármacos, es lento y requiere esfuerzo sí, no hay órgano muerto, pues es más fácil meter insulina en lugar de curar. Hay poca literatura cientifica en cura del páncreas pues los intereses de las farmacéuticas son muy altas, pero definitivamente hay muchos casos.
Ok, I don’t have a Cgm, but I do have a glucose monitor. Can anyone describe how I would use it to measure clearing. Do I take my fasting glucose in the AM, after coffee, before my first meal, then at certain intervals. Can someone describe that process and what the data will mean. Thanks
Hi 👋 Excellent question! Please visit levels.com/blog and keyword search “fasting glucose” to learn more
My cholesterol and Ldl was high but triglycerides and Hdl was great so doing they raport as doctor Lusting suggested I am in perfect health. And fasting insuline was great too. I tend to believe him because I feel amazing and I do train everyday. At first I was shook my cholesterol was high wtf I am in perfect health now I feel better. And I have fat friends that smoke who have normal cholesterol.
Me too… check LMHR or high cholesterol out
How about touching upon those that go on keto and don't have any significant change of their FBG? 90-100 I've found very little changes it. This includes wearing a CGM. Even a banana will make it go up to 135 and be back to normal in less than 1 hour.
Why would my glucose clear to 120 at 10:30pm, 70 at 3am, 120 10:30am 200 at 11:30. No food eaten and moderate exercise 1 hr stating 9am. Adult diabetic 25 years, fasting insulin 16. Love your talks and depth on knowledge.
If your a1-c is 16 you are lucky your still alive
Because exercise is a stressor and it spikes glucose. I mean cortisol does it, gives signal. I got fasting insulin under 2 and got 120-140 cgm glucose on my cgm during trening. Around 20-30 minutes into it, and goes down around 30-40 min after to around 100.
@@beth2500 he reffers to insulin not Hba1c 2 diffrent things
Are you using a CGM? If so, that 3 AM measurement of 70 may just be you sleeping in a way that's putting pressure on the sensor. I've seen multiple people discussing this online and then I got a CGM and experienced it myself on multiple occasions.
So if my a1c is 6, my fasting insulin is 1., my triglycerides 67, my uric levels normal, my bp is 90/57, I am insulin sensitive or resistant?
Aside from the A1C those numbers looks very healthy. The interpretation of the A1C value requires an assumption about the lifespan of your red blood cells. The standard ranges for healthy, prediabetic, and diabetic A1C assume an average RBC lifespan of around 120 days. If your red cells are living longer than that, your A1C value will be higher than expected based on your true glucose level. The point is, your glucose may be normal even though your A1C is high if your red cells are living longer than expected.
If you want to know where you stand, you can get a test called fructosamine. It's another measure of average glucose over time but instead of a 3 to 4 month average it's more like a 3 week average and it doesn't involve red blood cells. If fructosamine level is normal (i.e. not prediabetic like your A1C value) then you're in good shape and probably not insulin resistant.
@chaz6399 thank you for taking the time to respond with such detail
@@martarico186 you're welcome. And I just remembered something.
If your fructosamine comes back _abnormal_ there's one other explanation I can think of.
There's a type of diabetes called "MODY" that is genetic. There are like 14 different sub-forms of MODY, each one based on a different genetic mutation. A few of them are very mild and for at least one of them ( MODY 2, aka GCK-MODY ) the only symptom is mildly elevated blood sugar. It's very rare, and your doctor may not even know about it, but it's definitely a remote possibility. Look it up if you're curious.
@chaz6399 oh ok. Many thanks. Is there a treatment for it?
@chaz6399 knowing my genetic background l, I wouldn't doubt it.
thank you!
What should be real level for ALT and fasting insulin?
According to Danielle Brandman, MD ( hepatologist at UCSF)
ALT for males: under 35
ALT for females: under 25
According to multiple low-carb docs and PhDs, including Ken Berry and Ben Bickmann:
Fasting Insulin between 5 and 10 is pretty good
Fasting Insulin under 5 is optimal
Both insulin and glucose are measured in the OGGT test.
False. The OGTT only measures glucose.
Fantastic video. I am anMD.
Hb A1c is the one to change before FBs changes.
The fasting BS changes last. Those people canbe obese and may have protein urea. They are pre-diabetic.
Metformin improves ins sensitivity.
What about NMR Lipid Profile test? That will show the small dense LDL count.
He talked about it at 1:06:45
Excellent content & presentation. Learn 30 Wellness Secrets to prevent or reverse Lifestyle Disorders
So how fast should your blood sugar go down after a meal
I am a huge fan of Dr. Lustig, but understanding his message is sort of analogous to reading your blood lab results - that is, understanding his overall message sometimes means filtering out the random confusing comments much like reading your lab results is better thought of as an overall picture, rather than putting value in each data point. Case in point, at 5:59 he says a fasting blood glucose of 91 is "not doing great" and is "already a problem." Utterances like that are like verbal clickbait. Let's say (real case) a 44-year-old female has a fasting blood glucose of 91 along with ALT of 10, AST of 16, waist circumference of 23 inches, A1C of 4.3%. Are we really going to put her in the category of normal-weight people with metabolic disease? It's almost hypocritical of him to say that, as he prefaces the first interview by saying that the overall picture is nuanced and complicated, but then goes on to say that 91 mg/dL is a problem. The cynic in me wonders why he would make this kind of statement, and I'm guessing it has to do with selling something.
no, I don't think he's saying that 91 mg/dL is an automatic metabolic issue. I think he's saying if that is consistently in the 90s then it's best to watch it. it will creep up overtime. It's a warning, that's what I think he's saying.
@@callofthewildbuck You're giving him a generous interpretation in the timestamped comment. He in fact says that fasting blood glucose is not the right metric to use as a warning for metabolic function, but that it's the "last marker to change." He recommends fasting insulin and ALT as examples of better warning markers, and I am inclined to agree. In my real example above, I admittedly don't know her fasting insulin (wasn't tested), but given all her other metrics, it's almost certain that her 91 mg/dL was simply dawn effect or mild fasting rise, etc. Having it "creep up over time" is definitely a concern, but that will only happen as a result of the overall metabolic picture getting worse (especially in the metrics that Dr. Lustig mentions as better for demonstrating metabolic health). My (only) problem with him is that he doesn't qualify such simplified statements and thereby dilutes his own message.
@@samblackwell9839 thanks for the discussion. I understood from his book Metabolical that the tests you mention are best but what about home testing? I was thinking of it from that perspective. As a person I’d only have the ability to watch my glucose. So if I see it go up overtime I’m going to be sure to watch it. From a clinical perspective I think you’re right.
@@samblackwell9839 thanks for the discussion. I’m taking it from a lay person monitoring glucose at home. Clinically you’re correct but I’m not going to see those labs drawn at a CLIA lab everyday. I will see my daily finger prick glucose or CGM readings. This is why I think he’s saying what he’s saying. I think he’s taking it straight from his book Metabolical.
@@callofthewildbuckI admit that waist circumference is impressive . To clarify if there is the beginnings of a metabolic problem I suggest repeating the fasting blood sugar with a fasting insulin( insist on fasting insulin if you are doing ng this with a doctor).
such an interesting interview. can someone tell me what it means if glucose rises very slowly and comes down slowly as well. my glucose peaks (very rarely over 120) at the 2 hour mark & then takes one or even 2 hours to come back down. my A1C is 5.2 and fasting insulin is 5. tia.
It’s the food.
Is it possible to establish the Sugar ceiling? (overall max of all sugars combined; sucrose, fructose, lactose, etc) in a day? For example if an ideal day would consumed less than 10g of sugar, is it possible to establish a safe limit from dietary approach?
Hello and thanks for this video.
I've been on a ketogenic diet for over 2 and a half years, I eat less than 20g of sugar a day, I'm very strict on my diet and yet I have a uric acid level of 6-7... I've never had gout, but I have rheumatoid arthritis and when my uric acid rises, I feel inflammatory pain in my affected joints... What should I do to get rid of my problematic uric acid? I also have type 1 diabetes, which is very well monitored, and otherwise I'm perfectly healthy.
Is the solution to take allopurinol? I suspect I really do have a genetic disorder because everyone in my father's family has uric acid... However, I'm very afraid of having a taste attack when I start treatment, because I've heard that's what happens... Ty
I am vegan and take 80-85% complex cabrs. My uric acid is 2.5 mg/dL. I follow Dr Essyltein diet. No fat (~10% calories). All vegan, no oil, My LDL dropped from 130 to 83 mg/dL, non-HDL is 96 mg/dL (earlier it was 143 mg/dL)
Liver and other organ meats such as kidney and heart are high in purines. There are other foods, such as sardines, that have high purines as well. Google search for "purine content of foods" and find a chart to find all of them.
I myself do not have an issue with uric acid, but I once tried eating cod liver (comes in a can like sardines) and found I really enjoyed it. Then I ordered a case of it and was eating it regularly. About a month into that I started getting severe pain in both of my big toes.
I did not get my uric acid tested but I knew what it was and what was causing it. I stopped eating the cod liver and the pain went away.
I'm having an A1C panel done in the next week or so. I've been keto for three years. Last time it was 5.2 but with two hurricanes and comfort food...it may be a little higher this time. I live by the 6/9 rule Dr. Lustig turned us on too. 6 tsp/day of sugar for babes, 9 tsp/day for dudes. Any more than that the liver can't process it fast enough when the next day is piled on. It's a layman's explanation but the way I understand the chemistry is the liver has its limits on what it can process in a day without stashing the excess as fatty liver/visceral fat in and around the organs. The kidneys become clogged, hypertension city follows.. Keep flooding the liver with sugar and wheat/starches, edema and uric acid starts wearing away cartilage. Add to the erosion with glyphosate in sugar, wheat, corn, rice and soybean/oil and the 'chelator' part robs us of the minerals needed for collagen. The cascading effect trickles down into the arms of Pharmakia. The ultimate Solution...single payer healthcare, quack science from the likes of Ancel Keys and Fauciesk protocols.
I love this guy!😃
Kraft curbs = speaks about what food give what ins spikes.
In diabetes type 1 = cannot make insuline not ins rezistense
Type 2 = can make excessive insuline but tissues resist
The GTT : the height of BS tells about the B cell function
The delay and plateau talk about insuline resistance.
Exercise turns you to baselinenormal in 2 weeks
Avoiding glucose turns you N in 2 weeks.
What counts are spikesand how long the return toN is.
The problem is not meat it’s high fructose corn syrup.
Insuline : if it goes up gluc not utilized and mitochondria is not working = mitoc dysfunction.
The mitoc damage from toxins.
The point is not about to detect and fix insulin resistance. The point is not getting insulin resistance. How did it happen? From not using keytone and too much glucose intake. Glycation, caused by high glucose, is a protein damage process. hbA1C is to measure your glycation process. This glycation will damage all your proteins.
I am carnivore and have normal uric acid levels. Please explain
Wish they had a cgm for kidney disease
Stay is baseline?
CGMs are useless.I have Free Style Libre on one arm and Dexcam on the other.I check both and finger stick at the same time All are very different. I believe my finger stick more than eitherbof the CGMs.
Great discussion. One question though. He states that the fasting glucose can be changed on two weeks. I started one year ago with improved lifestyle changes, low healthy carb, higher protein, IF 16:8, 250 mins a week of exercise. The results have been good and I feel great. I was not bad but at 68 I wanted to prepare further aging effects, So the bottom line is I dropped 25 lbs ( BMI 23.5) . Triglycerides 36, blood pressure 108/78. I do not eat any added sugar but my A1c has stayed at 5.5. My fasting insulin is under 6 ( as low as 4.4) but my fasting glucose stays in the low 100’s . I wore a CGM and my glucose may spike to 140 but drops immediately to under 90 then drifts back to 100 within a hour. At night after last meal at 6pm I will drift up to 98-100 all night long in a tight range then upon waking it will go up to 105 post exercises. How can I not be insulin sensitive with fasting insulin under 6 and spikes showing quick response. I would think my A1c would be closer to 5 but I have read theories that because of low reserves the liver keeps the glucose at 100 in reserve for the brain. Any truth?
Until our government decides to be on the side of the people, we will never win health! Shame on our protectors!!! Until when, will this happen/
Insurance and doctors don't test it because they don't have drugs to sell you or guideline practice to fix it. Imagine you are a clinical doctor patient comes to ask you what do I do on the test results report for all things abnormal?
LIFE EXTENSION OFFERS FULL TESTS FOR Lipid tests , insulin , ect
CMP LP CBC Vit D A1C T4 B12 all hormones. Once a year off metabolic panels . In Florida only but other tests are available thru lab corp & Quedt. Total cost less than 300. 00 better than any dr visit.
You call a dr after your results.
Now you have your numbers for your Dr.
I’m 63 been doing this after my third child at 40. Very helpful
Changes in FBs do a second after 1 mo.
Do the test of FBS x 1 / y.
Finally the lower the FBS is the better u are. It tells how long u will live.
You can get it to N in 2 weeks with exercise and gluc abstinence.
But could fasting glucose be influenced by the "dawn phenomenon "?
Yes. To prevent this from messing up the lab result, it’s best to draw your blood for fasting glucose 4 hours after you wake up. Drawing the blood too early will cause the dawn phenomenon to influence your result. Another best way to measure glucose is to use the at home kit and measure real time before and after meals to see which meal is spiking you the most and adjust accordingly.
HBA1C combined with Fasting Insulin is better for long term view of glucose metabolic health status. Throw in Leptin & C-peptide for additional insights.
@@livix3989 thanks
My father dealt with gout for years. I've eaten animal based for eight years and my uric acid is 4.0, so I'm not buying the meat causation hypothesis. There are functional medicine doctors that strongly disagree with Dr lustig with the caviout that you stay metabolically healthy.
I am vegan and take 80-85% complex cabrs. My uric acid is 2.5 mg/dL. I follow Dr Essyltein diet. No fat (~10% calories). All vegan, no oil, My LDL dropped from 130 to 83 mg/dL, non-HDL is 96 mg/dL (earlier it was 143 mg/dL)
@@bscsmscs1578 LDL in a metabolically healthy person is irrelevant. VLDL matters as does HDL to Triglyceride ratio. Your HDL is probably not optimal which means your ration is also not optimal. Saturated fat raises HDL and LDL ( usually). As Dr Lustig said, LDL hazard ratio is 1.3 and the only reason it's that high is because it does matter somewhat if you're metabolically broken, which most people are. There is no way you're getting adequate bioavailable protein especially as you age if you're at 80% carbs, unless you're using vegan protein powders. I've been a high level athlete all of my life and did low fat, moderate carb for years, but have been low carb, high fat for eight years I'm 60 now and can outperform most men half my age. That is largely due to my diet. I've never felt better. I've done both types of diets and have spent my life in the field of health and wellness. I may periodically tweak my diet, but I will forever live a low carb lifestyle.
@@bscsmscs1578 there are many studies( the biggest being the Copenhagen Study) showing that lower LDL ( especially as you age) is associated with higher all cause mortality. The ideal LDL for longevity according to the Copenhagen Study is 140. LDL helps regulate your immune system. Lower isn't better. Higher HDL is much more important than low LDL, in otherwise healthy individuals
I just read a comment , that said. The insurance companies did not want to pay for fasting insulin test? Well I’m getting one done on 9/30 2024 . Paid by the insurance company. But I have severe back pain that cause my legs and feet to burn. And I think their not wanting to replace my pain pump. If they can just get by with cheap meds!
@arnie1005
Well, it's more like (imo) they suspect IR - thus the covered Fasting Insulin test, imo.
...because your symptoms can indicate nerve damage in lower extremities due to chronically high blood insulin. (& glucose, which could go hand-in-hand).
However, your back pain kinda points to spinal nerve damages, & these nerves help regulate feeling in lower extremities- of which burning sensations - could indicate spinal nerve damage, and NOT from high blood insulin.
Being that the fasting insulin test is so much cheaper than CTs, or MRI or whatever testing would assess possible spinal nerve damage- they may FIRST want to rule out, (or rule in) high Insulin as causative of your symptoms.
So, in my pov, their strategy would be FIRST rule-out Insulin Resistance - then proceed with the more costly Spinal testing...to determine cause of your symptoms.
If you don't have any physical damage, You need to do physical therapy to release the muscle knots in your lumbar spine . It must be dome by hand🫳 . You need a STRONG 💪expert physician.
Do those following a low carb/carnivore diet have a great incidence of gout compared to those on a standard processed Western diet?
Nope
@@wdahoi3153 That's what I assumed. Any diet's less harmful than the Western (bag of sugar a day with a generous helping of seed oils) diet
One can have spikes it is N but only 2 or 3 a day.
Intermittent fastin- only 2 spikes.
Ingested gluc goes to liver and 20 % transf into glycogen.
The rest goes to blood .
Over 80 it goes to kidney and reabsorbed.
If too high goes into blood vessels.endotheliu one test
is new.
It ca cause HTn.
I disagree to the cause. You said fatty liver is "because of defective mitochondria. It is because of the so called "food" in the grocery store that we are forced to eat. It is because of the "drugs" we are giving at the doctors' offices, and it is because of lack of proper exercise due to computer, TV, and phone access.
Who is “forcing” you to eat a particular food from the grocery store? It sounds as if you’re a victim and as such, maybe you should file a police report.
Just eat a meat based diet and feel satiated enough to abstain from packaged food .
The most long lived people don’t eat a meat based diet. They eat a plant based diet
U r wrong @@chadmartinez459
You need fiber from plants
@@chadmartinez459 the population with longrst life expectancy is in hong kong ,and they eat one of the biggest amounts of meat,per year ,on the planet .
@@WatchingPlanesnbirds Actually, thats untrue .The healthiest demographics live in Antarctica where plants/fruit don't grow because of the climate .
While Dr Lustig makes the most sense, why is his waistline appearing bulkier?
To know and not do 💯
@@lindapestridge3073 to know and not do is to not know 💯
"Do as I say, not as I do."
The mantra of every father ever.
As it's said: shoemaker without shoes
So tests from obesity:
FBS, GTT. Fasting Insuline levels.
Fi levels are not standardized. The AMa rejects it because it is not
When beta cells are stressed they release proinsuline 2 leading to B cell exhaust.
If insuline fasting is high we know it is a dinamic problem
Fasting ins does not corelate with obesity but it tells you about pancreaticB cell health.