Ben Bikman - What is Insulin Resistance, Really? Ep 62

What a fascinating discussion with Dr. Ben Bikman about what Insulin Resistance really means.  He makes this statement towards the end but I would like to highlight it right here at the start, "We should be studiously avoiding dogmatic thinking and constantly be checking what we think we know, lest we become that which we have grown to despise in those who are very antagonistic towards a low carb diet."

There has been quite  lot of chatter around recently about what it means and whether or not Insulin Sensitivity is something we should be striving for or not. I agree with his take on it that it is extremely desirable for most of our cells and organs to be Insulin Sensitive and it is that insulin sensitivity and the absence of chronic hyperinsulinemia that leads to all the amazing benefits in metabolic health that we see with carbohydrate reduction.

We discuss his thoughts on where insulin resistance starts and he is quick to point out that this is opinion of how it based based on his knowledge of the biochemistry and basic logic.  It becomes really clear as the discussion continues about how important an enzyme insulin really is to our existence.  It's only when we become chronically hyperinsulinemic that trouble starts to surface.  At one point he talked about how in a type 1 diabetic where the beta cells in the pancreas are not producing insulin but the alpha cells are producing glucagon like crazy because there is no insulin to downregulate it.  So the liver is making more and more glucose under the effect of the glucagon.  He also explained that injecting insulin does not have the desired dampening effect since really high levels of insulin are required at the alpha cells to have the desired effect.  Since the beta cells are right next to the alpha cells in the pancreas, the levels of insulin right there at the site of production are high enough, but injected insulin is never in high enough concentrations to be effective by the time it reaches the pancreas.  So there is some research going into the idea that type 1 diabetes is just as much a disease of glucagon excess as it is of insulin deficiency.  Dr. Roger Unger has shown that there are other therapies like somatostatin and even leptin which can be administered to turn off glucagon production and you can possibly solve the type 1 diabetes without insulin at all.