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…
Mar 08
Peter Attia: What if we’re wrong about diabetes?
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What a bad, bad actor.
In 2005, I had a surgery done that rid my body of the scourge type 2
#diabetes
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.
Great video! One of the bests of TED Talks
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
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.
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.”
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.
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.
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.
That may well have been the best speech I’ve ever heard!
@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?
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
Peter Attia what a nice person you are. Be strong , world need people
like you
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.
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
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.
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.
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.
Interesting. Similar conclusions to the movie Fat Head.
http://www.imdb.com/title/tt1333994/
Peter Attia is awesome.
This is what science is all about.
From an overweight woman with insulin resistance, taking Metformin, and
unable to lose weight – THANK YOU!!!!!!!!!!!!!!!!!!
New Perspective on Diabeties
With youth comes passion. With age comes wisdom. It looks like Dr.Peter
Attia has now put the two together.