#149 - AMA #20: Simplifying the complexities of insulin resistance: how it's measured, how it manifests in the muscle and liver, and what we can do about it

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By Peter Attia, MD, Peter Attia, and MD. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

In this “Ask Me Anything” (AMA) episode, Peter and Bob discuss all things related to insulin resistance by revisiting the important points made in the fascinating, yet quite technical, episode of The Drive with Gerald Shulman. They devote the entire discussion to understanding the condition known as insulin resistance, how it’s measured, how it manifests in the muscle and liver, and ultimately, what we can do about it.

If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #20 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

  • Explaining the format of this AMA: Extracting insights from Gerald Shulman’s masterclass on insulin resistance (2:00);
  • The basics of insulin, defining insulin resistance (IR), and gold-standard methods of quantifying IR in the muscle (7:15);
  • Practical ways to test for insulin resistance in a normal clinical setting (15:45);
  • How insulin resistance manifests in the muscle (23:00);
  • The biochemical block in glycogen synthesis—drivers and mechanisms resulting in insulin resistance in the muscle (30:45);
  • The disparity in fat oxidation between insulin-sensitive and insulin-resistant individuals (44:45);
  • The fate of the ingested carbohydrate in someone who is insulin resistant (51:00);
  • The prevalence and clinical phenotype of insulin resistance (1:00:15);
  • The role of exercise in mitigating and reversing insulin resistance (1:05:00);
  • How insulin resistance manifests in the liver (1:09:15);
  • Biggest takeaways: what we can do to mitigate and prevent insulin resistance (1:20:45); and
  • More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/ama20/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

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