Peter Attia: What if we’re wrong about diabetes?

As a young ER doctor, Peter Attia felt contempt for a patient with diabetes. She was overweight, he thought, and thus responsible for the fact that she neede…

25 Comments

  1. What a bad, bad actor.

  2. In 2005, I had a surgery done that rid my body of the scourge type 2 #diabetes 

  3. There are SO many factors that go into the development of diabetes, and most of the media, and physicians who do NOT specialize in endocrinology, are ignorant of the disease. The media, and therefore almost everyone else, are focused solely on obesity as the primary factor in contracting diabetes. Genetics play a factor, autoimmune disorders, metabolic deficiencies, self-induced obesity, unhealthy eating habits... all of these things need to be considered, and more. Type 1 diabetes, formerly called Juvenile Diabetes, USUALLY manifests at a young age and is caused by an autoimmune disease that completely shuts down the insulin production in the pancreas. Zip. Zero. Nada. Pancreas is dead to insulin production. Type 1.5 LADA is T1D which manifests at an older age. Type 2 diabetes is the one most talked about, bullied over, shamed... because it's associated with obesity. All the multiple factors I listed above have to be considered when dealing with this type of diabetes. It is not just ONE thing, especially since a good number of thin people also have Type 2. Yes, there is some personal responsibility involved in trying to avoid T2, but let's also put some blame where it lies. The food industry is a MAJOR contributor to diabetes with all the chemicals and processed crap put into what they are trying to pass off as food. It is FAR less expensive to eat the processed garbage than it is to eat healthy, and people are struggling financially. Restaurants in the United States need to take lessons from restaurants in Europe and not overfeed their patrons. Parents need to stop telling kids to "clean their plates." When you are full, stop eating. Period. Food should never be used as a reward. There are MANY changes needing to take place in the war against diabetes. Education about the FACTS is the first place to start. Making personal changes is the next step. Getting involved is another.

  4. Great video! One of the bests of TED Talks

  5. I felt a very similar way to Dr Attia when I was visiting my mother in hospital following her second or third heart 'episode'. Three years prior, she had had her first 'episode' and I was training as a personal trainer and following her brief hospital rehabililtation period (including exercise classes), I invited her to come on as my client..her doctor suggested I work with her to help her lose 10kg. My mother started with gestational diabetes with each of her 5 children and this was upgraded to type 2 a couple of decades ago. To cut a long story short, I sat beside her bed with tears of frustration because I 'knew' that she wouldn't be in there if she had just (like the Dr said) cared just a little. Now, 5 years on, she is now more overweight and her medications increased for her diabetes, heart and blood pressure. She might still have diabetes but her heart and the rest of her body would be a LOT better off

  6. Thank you for your humility and honesty on the topic of diabetes. I recently was diagnoised with type 2 diabetes and I'm trying to understand this condition. My levels can range at times from 195 all the way down to 76 and being that this is all new to me it can get very confusing. I have made big changes in my diet and I'm starting to see positive results in my readings on a consistant basis. Thank you for explaning how differicult it is to understand this condition for even educated doctors like yourself. Unfortunetely many doctors are more prone to just treat the condition without investing the time and energy in finding the causes. I pray that the medical industry and science become more interested in finding cures then just making millions from people pain. 

  7. He didn't say anything new. People have been trying to figure this out for so long. I thought he was going to present some evidence either way. Instead, he said "I'm going to study this from now on."

  8. Unfortunately, the development of Type II diabetes is far more complicated than people realize. As Dr. Attia explains, medical scientists still do not know or understand the many "nuanced molecular mechanisms" taking place. To make matters worse, medical professionals, as well as those in training, only learn bits and pieces without seeing the bigger picture. It's not simply "calories consumed vs. calories burned" or eating "unhealthy," processed foods. Yes, the incidences of metabolic diseases have increased in the past century; nobody can deny that. But to say our ancestors ate "healthier" is incorrect and if you, the Reader, open your mind, discard your current misconceptions, and contemplate some of the facts and ideas I explain here, you, too, will understand why this obesity epidemic has not been resolved yet. First, the process of digestion breaks down all foodstuffs consumed to its very most basic components. ALL carbohydrates (simple and complex, good and bad) MUST be broken down to either glucose, fructose, or galactose to be absorbed into the blood stream. After that, galactose is converted to glucose and fructose is converted to glucose or triglycerides in the liver depending on glycogen levels(stored glucose/animal starch). No matter what, ALL CARBS are converted to glucose. All proteins are broken down to individual amino acids; all fats (lipids) are converted to monoglycerides and packaged in chylomicrons before entering the lymphatic system; all ingested DNA/RNA is broken down into individual nucleic acids (this is why GMOs should be of no concern). Any foodstuffs like sugar alcohols/artificial sweeteners and fiber which cannot be converted or broken down appropriately pass UNABSORBED and enter the colon for the microbiome to enjoy and make you gassy. This means that the food you eat DOES NOT resemble the nutrients your body actually "experiences." Therefore, the body DOES NOT know the difference between "healthy/good" and "unhealthy/bad." Second, not everything you eat gets absorbed. A person's digestive efficiency greatly determines how many nutrients you actually absorb (bioaccessibility/bioavailability). If it's not absorbed, it's ignored. Refined/processed foods have smaller molecules so less time for digestion is necessary; that makes their digestion and absorption more efficient than unprocessed foods. However, as my first point states, the body doesn't know from whence nutrients came, only the amount it receives/absorbs. Third, every single cell in the human body (and there are trillions of them) can interconvert (transform) any one type of macronutrient into another type of macronutrient via the Kreb's Cycle (Citric Acid Cycle) with a few exceptions. This means any cell at any time can take a lipid molecule (fat) and make an amino acid (protein) or vice versa, as needed. Fourth, the level of each nutrient is regulated by a feedback loop (usually negative), and many feedback loops affect each other. These are the "nuanced molecular mechanisms." And lastly, cells produce energy (ATP) on an "as needed basis;" in fact, energy production is tightly regulated via a negative feedback loop from levels of ADP in the cell. If ADP cannot be made into ATP, then the entire electron transport chain and Kreb's Cycle can't proceed; however, via the Kreb's Cycle my fourth point can occur and excess amino acids and glucose can be converted to triglycerides and stored as body fat for later use. This is all basic information that every premed/med student, resident, and medical professional learns at some point in their career from anatomy/physiology, biochemistry, and bioenergetics. Given this information, one can see it's a one million piece puzzle and we have only a few hundred pieces and no completed picture to work with. Personally, I've hypothesized for some time that obesity and metabolic diseases are not cause and effect as many believe; rather, the two are coincidental byproducts of something else. One last thing: all these "studies" are a waste of time. Observational studies CANNOT show cause and effect; that's their very inherent nature. They can only indicate a POSSIBLE relationship and it's correlation (strength). That means these studies prove nothing conclusive and may actually signal false positives. Think of all the contradictory evidence! Without experiments (which are the only way to prove cause and effect), we would never know for sure. Why do you think all these nutrition studies use the words "may," "suggest," "recommend," possible link," "could," or "might?" It's because studies are potentially worthless.

  9. I'm a bit confused. Isn't insulin resistance an obvious threat to a person's well being. And that it can cause many other problems, including being a component or initiator of the cascade that leads to weight gain, poor health, and other issues. In disadvantaged populations you see quite a bit of this. Many people work their butt off but are still obese simply because the mechanics in their system function poorly.

  10. I have an Aunt that is in her 60s, eats a terrible diet, weighs over 500 pounds, is bedridden and doesn't have Type 2 Diabetes. Whatever causes Type 2 Diabetes it is not as simple as diet and weight. There is some other variable in play. 

  11. That may well have been the best speech I've ever heard!

  12. @2:54"...Yet, when it came to a disease like DIABETES, that kills Americans eight times more frequently than MELANOMA, I never once questioned the conventional wisdom....I actually just assumed the pathologic sequence of events was settled science." This is EXACTLY WHAT'S WRONG WITH DOCTORS! In April 2013 my 12 year old son almost died when his cardiologist prescribed him a BETA BLOCKER (as in blocking the beta cell from sending out the signal, or 'KEY' to open the door and let in the sugar from the blood stream). Immediately after taking his first dose he looked wrong, but I am his mom-so I wasn't surprised when no one listened the first week or two; but by his 1st "AUTOMATIC" refill (no doctor follow up required) my son was noticeably ill, and half way through his 2nd auto-refill he was in DKA and for the next three weeks I told doctors I thought he was dying, but they just said "he's fine, mom". My son lingered in DKA for weeks while I BEGGED DOCTORS to consider the possibilities of an allergic reaction to the beta blocker, but all the doctors did was focused in on his heart problem (SVT) running EKG's and X-rays, (but NO blood work). My son spent 16 days in Children's Hospital Madera and UCSF while every doctor that saw him REFUSED TO TAKE HIM OFF THE BETA BLOCKER; my son was actually discharged during a fainting spell. Doctor, can you please tell me how is it that a "mom" (with no medical training at all) can instinctively know a beta blocker is so deadly, yet hundreds of thousands of highly trained medical professionals in the United States cannot deduce that a BLOCKED beta cell MIGHT functions as well as a beta cell that isn't functioning at all? Just how deep does your medical programming run?

  13. TEDMED Talk: So profound on many levels about the core values of healing and the art and science of being a physician. The summary thought by Dr. Peter Attia is as essential as an inquiring mind. As a young surgeon, Peter Attia felt contempt for a patient with diabetes. She was overweight, he thought, and thus responsible for the fact that she needed a foot amputation. But years later, Attia received an unpleasant medical surprise that led him to wonder: is our understanding of diabetes right? Could the precursors to diabetes cause obesity, and not the other way around? A look at how assumptions may be leading us to wage the wrong medical war. #physicians #corevalues #healing #artofmedicine #biomedicine #science #lifescience #insulinresistance #diabetes #wholefoods #nutrition #newstart #healthreform #healthministry #dlwillis11

  14. Peter Attia what a nice person you are. Be strong , world need people like you

  15. I believe that insulin resistance is caused by obesity. I was doing some research and came across a very interesting article about how and obese person has a large accumulation of visceral adipose tissue which causes an impairment in insulin signaling. the article explains the mechanisms between tissue, insulin, etc. http://www.ncbi.nlm.nih.gov/pubmed/22327367 @nutritionunibe #obesitycrisis #nutrition Jesenia H.

  16. Peter is one of the smartest most interesting minds working in Medicine. We are wrong and arrogant more than we care to admit. I look forward to results from Nusi. If you want to learn more about nutrition check out pater's blog the War on Insulin

  17. For me, this talk presented a medical perspective to understanding that individuals are largely not responsible for their life outcomes (Eg. Obese individuals with Type 2 diabetes) and why we shouldn't pass swift judgement about anyone based on a narrow perspective of their identity. We should always aim to rationalise causes and effects more broadly considering social, environmental and genetic influences. 

  18. Plant Based Diet is the answer. Is not that hard, to see how heathy vegans are. Read the China Study, it will give you all the answers. 

  19. When I first spotted the title of this clip, I was anxious to view it as soon as possible. Then after clicking on it, I found out that the main thrust of the talk concerns type-2 diabetes. I am a type-1 diabetic (have been so for over 47 years). So, while interesting, this clip simply did not have the personal relevancy that I initially expected. I still watched and admired the video, but I wish that the medical profession would finally come around and seriously consider the need for re-naming. Type-1 diabetes and type-2 diabetes seem to be different-enough diseases to warrant this change. I personally don't care which condition retains the word "diabetes"; you can call what I have "Great Caesar's Ghost Syndrome", and keep the word "diabetes" for all the type-2ers. But please, let's do something about this mish-mash.

  20. Interesting. Similar conclusions to the movie Fat Head. http://www.imdb.com/title/tt1333994/

  21. Peter Attia is awesome.

  22. This is what science is all about.

  23. From an overweight woman with insulin resistance, taking Metformin, and unable to lose weight - THANK YOU!!!!!!!!!!!!!!!!!!

  24. New Perspective on Diabeties

  25. With youth comes passion. With age comes wisdom. It looks like Dr.Peter Attia has now put the two together.

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