 Hello everyone, I'm Dr. Ahmed Ergin and today we are going to talk about insulin resistance. It is a very commonly discussed topic, a lot of videos out there, a lot of people talk about it, although not a lot of people are really qualified to talk about it. You can read and learn about it, that's great, but when you advise you have to be really careful because there may be some inaccurate advice about this topic. So let's dive into it. Again today's topic is insulin resistance and I am Dr. Ahmed Ergin, I am the founder of SugarMds.com, basically we are a virtual diabetes clinic. So you guys can talk to us on the video, chat, email, and we can do everything remotely. We have the technology, we just tell you to download maybe a software or an app and then suddenly next thing you know we can know everything about you about your diabetes. So it's simple as that, it is extremely easy, effortless diabetes care for you guys. Of course before diabetes happens what happens is insulin resistance, right? So there are so many people with insulin resistance and so many patients with pre-diabetes and diabetes that we cannot take care of all of them. It's just there are too many and our job is to reduce the number of diabetes, get people of medications, and get diabetes under control and put into remission if possibly cure the diabetes, right? So in order to do that you really need to understand what insulin resistance is before it turns into diabetes. Polycystic Ovarian syndrome is for example an insulin resistance syndrome. Cardiovascular disease is an insulin resistance syndrome. There are so many things that the insulin resistance can cause including cancer that insulin resistance is something that you have to really, really avoid. If you are not insulin resistant you are going to have a very full life, you are going to enjoy your life much better than somebody with insulin resistance and diabetes. So as a result avoiding is the key. So what is insulin resistance? Your body will become insulin resistant when there is too much work for insulin, right? So if you cannot carry something with one person what do you do? You recruit two people, right? If you cannot do with two people you recruit four people. So our insulin resistance is determined by the demand by our body. So what is the demand? The demand is our body size. So if we are growing in size due to excessive calorie intake as a result you are going to end up needing much more insulin to take care of that bigger body and at some point you are going to make more and more and more insulin and your insulin curve will start to plateau because it's going to reach its maximum capacity to make insulin and it starts going down. When your insulin starts going down but your body size does not change then your sugar starts going up. So as a result that creates diabetes and high blood sugars. Now the diabetes actually is a term we just talk about the numbers. If you have certain numbers you have diabetes, right? We talked about in another video what is normal blood sugars. It's a very popular video recommend watching that as well. But before your blood sugar changes the insulin resistance has actually a lot of consequences. So what happens pathologically, again we have a blog post about this and a very extensive blog on our website at sugarnbs.com you can read about that. The pathology, the pathophysiology is very interesting. So what happens is you start making insulin and the job of the insulin is take the glucose, take the sugar and pack into fat. So if you're not utilizing that blood sugar it's going to turn into fat right away. So if you are making so much money that you cannot spend in, let's say you are a very simple person you only spend $2,000 a month but suddenly you start making $20,000 a month you're not going to just change your life right away and you may start the money accumulating in your bank too quickly. So now but when you think about this in the body, if fat accumulating in your body because of too much sugar being packed into fat is not necessarily a good thing. So that wealth of fat turns out to be problematic. So what happens is our body has fat cells, right? So the number of fat cells do not increase in number just because we are packing more fat. So the fat number of fat cells are the same. Similar to muscle, even when you work out you don't make more muscle, you just increase the volume of the muscle cells. So same thing with the fat cells when you are accumulating fat because of excess calories, excess sugar, that actually packs more fat into your fat cells. So think about this, let's say you have a room with two, three people. That is comfortable, right? So you can chat, you can have a good time but when you pack let's say 30 people to the same let's say 150 square foot room, then that's going to be really uncomfortable. Some people will try to get out, they cannot breathe, they want to, they're going to be like oh my god this is going to give me a panic attack, anxiety attack. Most people cannot take this crowdy situations, especially nobody has with the virus, some of them definitely not. So as a result what happens with your body with your fat cells, there is this inflammation starts happening. You know the fat starts creating inflammation and your cells, the fat cells start creating inflammatory cytokines such as interleukin 6, TNF alpha. So these are like as if like a signal, as if like they are like alarmed to the body saying that this is too crowded in here, I'm giving you a warning, inflammation signs. So as a result all these cells start making inflammation, it's like a rioting against the government saying that the hypothalamus to your brain, look there's too much stuff in here. So those inflammatory markers actually turns out to be very harmful because they end up damaging other tissues and they make you feel tired. The same way you feel tired when you have a flu, when your body's immune system is very active and inflammatory cytokines are everywhere, you feel like down and drained. So the same way when you start developing insulin resistance, you start feeling very down and tired. So as a result it's a common complaint when the doctors say oh well you got to exercise etc. They're going to tell a dog, I don't feel good, I feel like so tired, I don't know how to exercise. So my answer to that is don't listen to your body sometimes even if you feel tired even if when you wake up and you feel tired, you need to actually exercise I guarantee you you're going to feel better after the exercise because then your inflammation is going to go down, your morphine level will go up so suddenly you're going to start feeling better. Just take my advice just do it, unless you're disabled and you have a broken leg or something you should be able to get up and do something although you feel tired overall like an achy whatever stretch out first and then we have an exercise video watch that like how to really get into exercise you cannot just jump into like super quick but you should be able to transition from a sedentary life to an active life easier. So back to the pathophysiology so as you make more inflammation and your body becomes more tired you end up basically sitting down more and feeling down and depressed and eating more etc and then that just becomes like a snowball effect and suddenly it starts growing and growing next thing you know that you are 300 pounds for 100 pounds again this is not necessarily this people's fault it's also there's a genetic component so some people become insulin resistant a lot easier and some people are not you know like some people are gifted and they know how to make money they become richer a lot easier than than the other people so it is genetic variability nothing you can do about it so with the body fat unfortunately some people tend to accumulate that body fat faster so they're not abnormal it's just a variation like just because somebody is five seven doesn't mean that they're super short or five five is not super short they're still a human being they still you know they still function well but they're the things that they can do if they want to play basketball that will be really hard so they need to modify their expectations compared to someone 6-4 right and there are things that the 6-4 cannot do 6-4 person may not be able to fit into small places where a 5-5 person can do so you should understand your strength in your health so God is fair most of the time I mean at least in at least overall he's fair right so he may not give you everything you wanted right now but he may have given you something else or he will give you something else later so if you're an atheist sorry about that but so I believe in Jesus I believe in I believe in religions I'm a Muslim person personally but I believe in God that's that's a uniting point right so so as a result you know you guys should be able to understand and that actually just because you're gaining weight easily is not a curse on you actually eating less has been recommended by many religions that's true for Christianity Judaism and Islam that if you eat less you're going to feel better overall and you're going to have more time to worship and so forth as well now the bottom line is if you are a person who tend to gain weight easily then you have to modify your diet of course if you're eating carbohydrates starches those those are things that really trigger insulin response now some people advocate going totally carbohydrate free keto diet right so well that's great you know that's for extremely motivated individual for some women who have extreme conscious about their appearance etc the image problems great it works out for them but the majority of people going car free is very very difficult it can be okay for a while but then in the long run it is really really difficult I mean if the carbs were not necessary God wouldn't have given to us but I would suggest that if you're eating carbs try to stay away from processed carbs I mean there are fruits out there that you can eat the God gave you right so so that's still make your body make insulin but for example when you eat apple your insulin production will be much less than if you are eating the same amount of carbohydrates in a cookie it's just different things yeah they both taste sweet but the things that are that comes in a package that is baked that's processed they're all not natural as a result your body gives excessive response of insulin and suddenly those things get packed into fat it gives a you know a short amount of pleasure but then you know even after eating a dessert you will feel like extremely tired sometimes I do the same mistake right sometimes you get to treat yourself so I end up going eating a dessert after a meal and the next thing you know oh my god I'm so tired I want to go to bed it's just insulin makes you feel that way and think about it if if your insulin resistance your insulin levels are so high all the time you will feel like oh I'm so tired all the time you know that's that's that's inevitable so as a result you know what I do personally I exercise a lot you know if you are if I'm eating carbs I want to make sure I burn it out because I know if I'm not burning that carb out it's not turning to fat and if you keep if you keep doing that if you don't exercise but eat carbs and or excessive carbs then you are going to end up basically packing that into fat so some people eat carbs they enter their carbs but they may have prolonged fasting periods so that also helps because during the fasting time you burn the fat so even if you pack fat sometimes from carbs but you end up burning them later because you have a prolonged fast but if you keep eating every couple hours and you're you keep eating carbohydrates and you're not really burning them out that's that's inevitable that's gonna turn into fat and that's the more fat cells the more inflammation the more inflammation more insulin resistance is it's a vicious cycle so how does insulin resistance really cause heart attacks that's an interesting question right some people actually will get heart attacks before they become diabetic just because they're insulin resistant so what happens is inflammatory cytokines and the fatty acids that comes that's gonna pushed out of your fat cells start circulating in your system and then it messes the whole cholesterol metabolism so as a result your body will start making a lot of bad cholesterol a lot of triglycerides a lot of LDL VLDL these are all the bad cholesterol and then your HDL will go down because your HDL is the good one that actually picks up the cholesterol from the vessel walls from the liver etc but when there is a dominance of bad cholesterol your good cholesterol will go down and as a result you know these people will eventually develop cardiovascular disease even before they become diabetic sometimes so it is very important now keto diet for example you have to be extremely careful if you're going very low carb then I would suggest increasing lean protein instead of just increasing fat again I have seen some YouTube videos where people say oh fat is good for you well not every fat right so if you're eating saturated fat or trans fat these fats are exactly the fat that's going to sit down on your vascular system and go going to cause heart attacks so sometimes my patients will go on a keto diet and when I check their cholesterol their cholesterol the back cholesterol doubled up I'm yeah your diabetes is better but your cholesterol now screwed up so you don't want to do that either so if you are going on a low carb diet very low carb diet that's okay if you're if you can maintain that but you have to be very careful that you are keeping your saturated fat less than 10% and you are getting no trans fat no trans fat at all if you see trans fat on a label put that down if you are seeing saturated fat more than 10% of the daily value put that down so Mediterranean diet is the best way to actually reduce your cholesterol and control your diabetes and as long as you keep your calories down then you are going to be okay in our in another video we discuss about how much calories you need most people actually underestimate overestimate how much actually they they need so for example your body so as a young individual you need way more calories and then it also depends on your body weight and depends on how active you are so if you're an active young men you may need up to 15 calories per pound right but if you are a menopausal or post-menopausal women are not very active you only need 10 calories per pound so if you are 120 pound women you're only gonna need 1200 calories to maintain your weight so sometimes patients come to me they say I'm down to 1200 calories or 1500 calories a day I am still not able to lose weight just because you know they're not very active they're older especially women tend to consume less energy because of a less muscle mass so as a result you know that becomes a problem and that becomes almost a conflict with the patient I'm trying to tell them you need less and they think I'm crazy but it is what it is unfortunately that is a widespread problem everybody seems to think that they need more calories than they should and that's why 70% of America is overweight unfortunately this is what it is so we have to change that again you know when you have carbs that turns into fat right away so what happens though then then there is no carbs in your system so you end up getting hungry again the problem with the carbs is that you eat the carbs and then you get hungry again so the reason people like keto diet is because when you eat fat fat keeps you full for a long time so that because it slows down the absorption of the food so like for example if you eat pizza then you know that's gonna keep you full for a long time because of the fat content a lot of fat in that food right so but most people just avoid the carbs totally in keto diet and just eat fat hopefully they are eating good fat right so good fat not the bad fat as we discussed but then you know that that fat amount if it is too much in calories that can also cause a weight gain so most of the time the fat is satisfying especially good fats if you're eating that and that can actually help you to keep your appetite in check but if you're addicted to the sugar which like a lot of people are that that takes a little extra effort it's a mental game to try to say no to the carbs a lot of people eat carbs is a comfort food they're available they're bored etc so if you can avoid that and you just substitute that carb with something healthier it could be a fruit it could be a something fatty with high protein but still healthy definitely will help that as well but bottom line if you want to improve your insulin resistance you need to really cut the carbs avoid processed carbs by all means and reduce your total calories and stick with it for for a while now weighing yourself every day is not a bad idea some people think it is but actually it's not Harvard study this and they show that people who weigh themselves every day they end up losing 7% extra weight than people who do not weigh themselves every day so I know it sounds like an obsession but keeping a track of your weight by looking at it every day with a sensitive scale I think will help as well and don't be distracted don't be discouraged if your weight is going up and down a little bit bottom line is if within a week or two if you're overall losing weight that should definitely help again but sugar MDs we help you to manage your weight to avoid diabetes if you have diabetes reduce your insulin resistance and reduce the medications that is all we are about and I hope this video is going to help you see you in the next one make sure you subscribe and make sure you give a thumbs up