Mark Bell's Power Project - Andrew Koutnik: The Truth About Diabetes, Insulin & Carbs

Episode Date: June 15, 2026

Andrew Paul Koutnik joins Mark Bell and Nsima Inyang to break down type 1 diabetes, type 2 diabetes, insulin resistance, glucose control, low-carb diets, GLP-1 drugs, obesity, and why the modern food environment is making metabolic health harder than ever.Andrew was diagnosed with type 1 diabetes as a teenager after a terrifying health scare that landed him in the ICU. Since then, he’s spent his life studying metabolism, nutrition, insulin, and performance — not just in the lab, but through his own daily experience managing the disease.This episode covers the difference between type 1 and type 2 diabetes, why glucose control matters so much, how carbs impact blood sugar, the role of insulin, why many people are metabolically unhealthy, and what people can do to better manage their health.Special perks for our listeners below!🥩 HIGH QUALITY PROTEIN! 🍖 ➢ https://goodlifeproteins.com/ Code POWER to save 20% off site wide, or code POWERPROJECT to save an additional 5% off your Build a Box Subscription!🩸 Get your BLOODWORK/TRT/PEPTIDES! 🩸 ➢ https://marekhealth.com and use code "POWERPROJECT" for 10% off Self-Service Labs and Guided Optimization®.🧠 Methylene Blue: Better Focus, Sleep and Mood 🧠 Use Code POWER10 for 10% off!➢https://troscriptions.com?utm_source=affiliate&ut-m_medium=podcast&ut-m_campaign=MarkBel-I_podcastBest 5 Finger Barefoot Shoes! 👟 ➢ https://Peluva.com/PowerProject Code POWERPROJECT15 to save 15% off Peluva Shoes!Self Explanatory 🍆 ➢ Enlarging Pumps (This really works): https://bit.ly/powerproject1Pumps explained: https://youtu.be/qPG9JXjlhpM?si=JZN09-FakTjoJuaW🚨 The Best Red Light Therapy Devices and Blue Blocking Glasses On The Market! 😎➢https://emr-tek.com/Use code: POWERPROJECT to save 20% off your order!👟 BEST LOOKING AND FUNCTIONING BAREFOOT SHOES 🦶➢https://vivobarefoot.com/powerproject

Type 2 diabetes is defined as insulin resistance, which is the overabundance of insulin, but type 1 diabetes made me obsessed. Type 1 diabetes was probably the most valuable real world experience. 90% of the obesity epidemic was explained by the diet. I think we'll eventually get to the point where you could drug away hunger almost entirely. Type 1 diabetes was probably the most valuable real world experience in the how-toes of metabolism. More so than honestly any textbook I've ever read, the more carbohydrates you consume, the more difficult it is to manage.

glucose control. What that means is that blood sugars are often more high and variable. The lower they are, the more controlled and easier it gets. We know the trigger for most of these people as a food environment of nine out of ten of Americans. They have an elevated waistline, elevated fasting blood sugar level, elevated triglycerides, or one other metric defines abnormal metabolic health. It's more common for someone to be unhealthy than it is healthy. So Andrew, we thought it would be a good idea to really just cover a lot of ground with diabetes. Killer. And I think we should talk about type one and type two talk about some of the differences and uh you know how you get it and all that stuff but i guess first off how did you get interested in diabetes well i got it that's the biggest

thing that caused me to be interested in i was uh 16 going on 17 on a family trip to washington dc started developing these really crazy symptoms my stomach started to really turn over and nuts and i was like man this is really weird and unfortunate we're about to get on a plane ride to fly to another city. And I started drinking like Gatorade's and sprites thinking like a sugar is supposed to help your calm your stomach, right? Or, you know, an old wife's tail. Crackers and stuff like that.

Exactly, yeah. But, you know, little did I know at that time. My pancreas was slowly shutting down and the amount of insulin my body was producing was drastically lowering in real time. Basically, my body was attacking the cells in our body that produced insulin and control. glucose. So the irony is that I was consuming glucose and sugar and excessive levels with the goal to calm my stomach not realizing the reason my stomach was starting to have issues was because I was clearly going into something called diabetic keto acidosis.

And around three days later after throwing up for 14 hours straight and extreme fatigue and lethargia, I went into the emergency room with my mouth feeling like cardboard because I couldn't consume anything. I couldn't keep anything down. and the doctor comes back and you know you have like 30 40 people in Washington D.C. in this emergency room and I get shoveled back instantly and I was like that's not well that's not a good sign even I knew that when I was 16 years old and they'd come and prick my finger take a little blood sample and walk away and I'm like man can I have some water or something to fix how dehydrated I'm like no no

no wait one second and the doctor comes back and she says you know Andrew your blood sugars 596, which is six times higher than normal, and it looks like you have type 1ibitis, and it means you're going to have this for the rest of your life. And at that time, I had zero idea of what that means, you know, meant for me. I was like, all right, whatever, let me go home and play some video games. Like, how quickly can we get out of here? But I ended up staying in the ICU or intensive care unit for a week because, as I had mentioned, I was dehydrated and I wanted water.

I didn't realize that at this time my brain was sweating. So just like when you add, you know, salt to a container and, you know, the balance of the water to sodium, same thing happens with the body trying to balance out things like glucose. So as glucose gets higher within the blood, the body starts to pull all this fluid into the blood, or in the blood vessels to balance out the balance between the amount of liquid and the amount of glucose. And that happens in the brain as well. So the brain actually swells. So if you correct blood sugars too quickly when they're very high,

it actually can cause this massive enlargement and shrinking. And that is a very strong stress to these brain cells. It can actually cause permanent brain damage. And so I had no idea the severity of what was happening, but it took about seven days and normalized. And the next seven days I was in the hospital. And the entire time, I was basically being taught in real time

how to be like an instant expert on all things, nutrition, metabolism, and insulin. And obviously in two weeks it's not sufficient time to do that. But it was enough time to understand the fundamentals to survive. Okay, if you eat carbohydrates, glucose is going to elevate proportional to the amount of carbohydrates you eat, blood sugar is going to go up and you're going to need a certain amount of insulin. If you eat twice as much, you're going to eat twice as much insulin.

Oh, by the way, exercise increases in sensitivity. So to sleep, medications, potentially caffeine, something. my type of activity, duration, intensity. All these things matter, but you figure it out, you know. And over time, I became kind of obsessed with this because I realized that while I have this diagnosis, this irreversible chronic metabolic disease in childhood, that would have for the rest of my life. And to this point, we don't yet have a cure.

And, you know, maybe we will at some point in my lifetime, but I'm not holding out hope. But that's why I became obsessed with diabetes in general, because I could see both the opportunity it gave. you have to become an expert of your own metabolism, everything you eat, the activity you do, all these factors in our life, you know, 40 plus on record that change insulin sensitivity, glucose influx to the, meaning entering into the blood, how it be utilized. You have to know all these things or your life with type of diabetes is going to be incredibly difficult and incredibly hard.

So I came obsessed. But I also knew that insulin was the most powerful animal hormone all metabolism. I knew that insulin overrides most other hormones in the body. I would call it the king of metabolism. When present, it starts to lower other hormones, change molecular signals, I mean instantaneously. And so now in my hands, I have the most powerful hormone in all metabolism that regulates how much fat or carbohydrates you're going to burn. Key cellular pathways turns them on and off instantaneously.

But now I don't have the body automatically controlling this in normal levels. I am now 100% having to figure this out on my own. It's like taking out your phone and you just do a phone call. You're like, oh, you know, call, call Betty or call, you know, whoever, right? Call Mark, you know, and see my, you know. Instead of it just being a one-two button punch, imagine you strip away all the algorithms that are there that automate these things. And now you're having to punch individual line code in to actually have a phone call,

you know, doing 10, 20 plus considerations. and code and algorithms. That's type 1 diabetes every single day. And so it produces something, you know, a lot of distress for people, a lot of work, but so is lifting weights. So it was doing jiu-jitsu. So it was doing anything worthwhile. And it really became, honestly, one of the best assets of my life.

And I told you guys before I got on here, I wouldn't even know you guys if I didn't become so obsessed with health and fitness. Not just because type 1-ibase was also obese, but type 1-ibitis obesity really wanted me to be bigger, stronger, faster. I actually watched that show was amazing. Very familiar with you and your brother from that show, way back when. But, you know, obesity made me interested in,

but type one of these made me obsessed. You know, that turned it from, okay, I just want to be, what are the things I can do to be bigger and stronger and faster and look better, to this is a science experiment almost every day. And I can learn incredible things from this. That can then translate into what I didn't realize at this time, studies, the science, the research that I ended up doing as a career. And so I would argue that alongside obviously the education that I had,

type on diabetes was probably the most valuable real world experience in the how-toes of metabolism, more so than honestly any textbook I've ever read. You mentioned you were diagnosed at 16, right? Yep. Okay. You know, I think when people hear that and let's say they have kids, there's going to be potentially a level of like, dang, you know what? What do I have to do to make sure that my kid isn't on a path for whether it's type 1 diabetes or any form of diabetes?

So what should parents just kind of start being mindful of? Do people even know how this happens to people? So I'm going to answer those in reverse because almost in the sequence because we don't necessarily know why someone gets type 1. right now. We know there's some contributors like we know that viral infections can be a trigger for autoimmune onset. We know that things like obesity or adverse health lifestyle habits. I wouldn't call obesity a habit, but you get the point. You know, things that happen because of lifestyle or adverse health attributes that we have increase the risk. But nothing tells us exactly why. And the best example of that is, let's say I had identical twin just like me. Okay. Genetics are

exactly the same. Knowing I have type one diabetes, the risk of my identical twin is only 50%. It's not 100% like in some other conditions. It's only 50%, which says that at most genetics can only explain up to 50% or less. Lifestyle explains the rest. It's the interaction between lifestyle and our genetics

that manifests that diagnosis. I think height is similar. Like height makes up like 30% of your genetics. which is, I don't know how they come to these numbers, but it's interesting, like you'd think, no, that's gotta be like 80 or 90%. Yeah. But not everybody that has tall parents is tall,

and not everybody that comes from shorter parents, it's short. Exactly, like your parents are seven foot, right? Exactly. Yeah, yeah. So that's the reality is that we don't know why someone gets it yet, but we know there are triggers.

We know obesity is a known lifestyle factor. Honestly, anything that's unhealthy increases the likelihood that someone has an autoimmune disease. In fact, when people get type 1 ibupitis, because it is an autoimmune disease, the body is attacking its own tissues. They often get other autoimmune disease, more likely to have a Hashimoto's or thyroid-based conditions,

celiac disease. So the factors seem to be overlapping, but we don't yet know exactly, which is also probably why we don't yet have a distinct cure. We have things that might help, but they're not quite there yet. But so we don't know, we don't know, but we know being healthier and living a better lifestyle, Probably going to decrease your risk, okay?

Not probably it will decrease your risk. Doesn't guarantee you will or won't get it. But a parent who's first, you know, they go to the hospital, they find out their kid was sick and throwing up and feeling terrible and having fatigue was actually because they now have type on ibupes for the rest of their life. What does that mean for them? Well, I'll tell you what I wish I would have known.

So I, the education you immediately need to get is essential. You need to know that the food you eat changes blood sugar levels. You also need to know how insulin affects it. What I wish I understood better was how the individual aspects of food change glucose levels differently and how the timing of insulin is really almost the entire game of managing type 1 diabetes. The faster foods go in, the faster you need insulin to be. The slower, the slower you need insulin to be. So as long as you're constantly focused on, I need to match the blood glucose elevating effect

of the food or lifestyle that I'm doing. with the insulin lowering effect of insulin, that's the focus. But that said, we know protein acts differently than carbs, that acts differently than fat, and we know we have an array of different insulins that have different timing, different peak levels of impact. And so it's really a very complicated game when it comes to type 1 diabetes. But that said, if I were to focus on the simplistic approaches for most people, And this gets almost instantly controversial, right?

Anytime you start talking about very low carbohydrate approaches, people think, okay, that's kind of fringe. And it kind of is. You know, most people don't do these diets. So by default, it is on the corner. But we've done a lot of research. I became obsessed with studying my own disease. I also became obsessed with becoming bigger, stronger, and faster.

And so a lot of our research was almost exclusively focused on how do I do those two things for myself. And as a result, researched it as well. But what we were finding in our research was that when you study, because we just have studied the largest analysis ever of type 1 diabetes. And what we've seen is that in over 47,000 patients with type 1 diabetes, both adult and children, that the more carbohydrates you consume, the more difficult it is to manage glucose control. What that means is that blood sugars are often more high and variable.

And the lower they are, the more controlled and easier it gets. But it makes total sense. You are losing the machinery to regulate glucose control. it impacts that most, more than anything in our lifestyle. Carbohydrates do, right? So if you can just pull those down, it's going to inherently introduce less variability and unknowns into the mix. And so that's one of the most effective ways to help managing glucose control. And I must acknowledge up front, you know, why are we caring about glucose control? Well, it is the primary risk factor for why someone with my disease of type 1 diabetes will have 10-fold higher risk for cardiovascular disease

at increased risk for basically every all 10 leading causes of death we know that at various percentages and various x-fold higher risk than general population and virtually all of them are dose-dependent and how good or bad your glucose control is the better your glucose control the less your risk is the worse your glucose control the higher your risk in fact we you know back in the day when glucose control was horrendous in people with type 1 diabetes. The incidence of something, you know, eye damage or nerve damage or kidney damage, which is the most risky because there's the small blood vessels and they're very vulnerable to high and variable glucose levels. You're basically expected to have some form of eye disease in the form of retinopathy within 20 years,

80 to 100 percent of patients back in the day around the 1990s would get retinopathy. 80 to 90 to 100%. So basically everyone was almost guaranteed to get eye damage within two decades. Considering that the peak age of diagnosis is 10 to 14 years of age, that meant by the time you're in 30s, you're going to have eye damage and potentially be blind.

So, you know, that's why the focus is on glucose because glucose was intimately linked to these outcomes. And we've known this since the 1990s. That's simply giving more insulin, which we know more insulin has health consequences also, and that's most known through type 2 diabetes because insulin resistance, high insulin levels and the risk that comes with type 2 diabetes.

But we know that higher and variable glucose levels in the context of type 1 is linked to a number of processes like oxidative stress, inflammation, and these tissues like the eyes, the nerves, the kidneys, and the overall cardiovascular system is very, very vulnerable. And if we don't correct glucose levels immediately, then the damage is cumulative over time. And that's three things that's worth noting in this context.

And this actually applies outside of type 1 diabetes as well, that the damage of glucose control or glucose dysregulation or mismanagement is not only cumulative, it's dose dependent. I mean, cumulative or time. So if I have bad glucose control for five years, 10 years is going to be worse than five years.

15 years is going to be worse than 10 years. It's a lot like smoking in that regard. The more you do it, just like smoking, the more likely it is to happen. And it's not completely reversible, just like smoking is. So we know that if you smoke 10 packs a day, 15 packs a day, you can't completely erase the metabolic damage that occurred. Same thing happens with poor and variable glucose levels.

So if my child got diagnosed with type 1 diabetes tomorrow, the very first thing I would be thinking is, how do I manage their glucose control as quickly as I can, while also ensuring are they getting adequate nutrients? Are they, you know, is it a balanced diet? You know, try to avoid as many extremes as you can because it needs to be sustainable. This is not something that they're going to have for a year or two.

They're going to have it for the rest of their life. And so how do you make whatever strategy you have sustain over time? And so that's the main thing I focus on for most people is just giving your grips, your bearings immediately. And once you get your bearings immediately, start to think, how do I really get glucose control? optimized because it's not only the primary risk factor for cardiovascular disease but almost every

major complication type on ibis and that extends even to the general population if you look at hbA1c numbers as a metric of the two to three month average glucose control that is often the number one predictor of many of the major complications that we get in today's society at least health Likewise, particularly cardiovascular disease, number one cause of death. So this applies to type one, but even outside of type one. Do you think, like what do you think the reason is why we don't know where it comes from?

Is it a first world problem? Type two diabetes, I think is a little bit more of a, we have a lot of it here in America and a lot of it in other areas where they have highly processed foods. Is type one diabetes potentially coming from the habits of the parents? perhaps. I know like, you know, putting blame on somebody is a very harsh thing to do, but

I'm wondering like, do we really know where this is coming from or we don't know where it's coming from? I mean, I believe it was, I'm not sure if it was Sweden or Finland, sorry to lump those two together. But one of those, I think, had a large percentage increase in type 1 diabetes, I believe. And so to me, it's like, man, we should be able to like, I don't know the answer, but I'm not a researcher or a doctor, but we should be able to get to some. some of these answers. Is it, is it 5G? Is it Wi-Fi? Is it bad sunlight? Like, what's going on here? Why is there a big increase in some of these other countries? That's a great question. It is, you asked this question as a first world problem. And it appears to kind of be.

We know that individuals in European developed countries, it has less to do with development, more to do with dissent, right? So individuals who have European descent are at much higher risk. Asian populations are increasingly much lower risk. African American population is much lower risk. Like it- For type one specifically. Specifically. Whereas type two,

we know black African-American descent, Pacific Islander, Hispanic populations, dramatically higher risk. So genetics are relevant. They're definitely relevant here. That's because white people are really good at being fat. Right?

We have a high fat threshold, right? Well, so. Or Caucasian, I should say. Very good, Mark. You fixed that. There you go. So actually, like, if you think about it from that vantage point, you would think that other ethnic backgrounds would have a much higher risk, incidents of type one diabetes, like Hispanic

populations being a prominent one where the risk of obesity is much, much higher. But it's not. And so it's, it's, what we know at this point is that there are specific components of our genome or genetics, specifically these components that called HLA, which are immune, parts of our genetics that regulate immune system function. And we know that when someone gets type 1 diabetes, there's often a regulation of this part of the genome and our autoimmunity. And then once the autoimmunity happens, there's this cascade and trigger of events that makes it, what I called it earlier, irreversible, right? We know that once you have an autoimmune attack to a tissue, you often cannot

undo that. You might be able to suppress how aggressive it is, but you're not undoing it. And so we don't entirely know, and we've had hundreds of millions of dollars trying to figure it out from the National Institutes of Health and Health Health. In fact, when I was at the University of South Florida College of Medicine there when I was in graduate school, one of the researchers there with us who I ended up working with, their research team who had the largest NIH grant in the United States of America. And they were studying triggers for predicting what causes type 1 diabetes.

And what they told me after having worked with them for a while, I was like, you know, the UDI just had your second round of like $75 million in funding. And you don't have an answer. What's going on here? What do you think is happening? And they said, look, the reason we don't have an answer yet is because science by default often tries to isolate individual variables and across an entire group.

When in reality, it's probably different pockets or different cohorts of people that it may be the fact that they weren't breastfed or had certain early onset triggers or something that happened when they were a fetus during maternal gestational periods of pregnancy. Or maybe it's over here that they had certain lifestyle habits that later on in life that triggered that effect. It's obvious that at this point, there's not a singular cause, number one, number two, that there are diverse cohorts and those diverse cohorts probably have differential triggers. Because even if you do have a twin, you're not guaranteed you're going to get it, because maybe you didn't have the same triggers in your lifestyle that shifted your genome to

cause autoimmunity to happen. And so that's why we don't know. It's inherently how science is done to be careful and rigorous to isolate out individual variables. And that's clearly not what's happening here. There's probably a complex array of variables that leads to a specific event that that event then causes type 1 diabetes and it's differential for different pockets of people. It is super interesting how, you know, you get, you know,

one genetic variant that could be positive against a potential disease, but then you might have something else that leads you to be more vulnerable to another. disease. Absolutely. And we know like what they did studies on viral infections, for example, like when COVID happened, the rate of incidents of type 1 diabetes went up very meaningfully during that window of time. And it wasn't just with COVID infection. It was also with like vaccine as well. But first only a certain people, a number of people. Wasn't everyone was getting it widespread, but it was just a higher incident. So things like viruses

are obviously triggers, but we think about this and try to understand it better, what causes our immune system to maybe make a poor decision or maybe be unable to regulate false signals? Well, usually our body being healthy and functioning well, which also makes sense why adverse lifestyle choices that lead to risk factors like obesity being a trigger for type 1 diabetes as well, because we know the excess adipose tissue the body holds, increases a number of factors that can cause almost this chronic level of inflammatory stress. Not the only thing that happens,

but that's one of the key things that happen. And when you see things like that, it dysregulates our ability to respond to immune attacks or to have resilience against a external environmental trigger that we want to combat. This is also a great example of what happened during COVID, where it wasn't necessarily, it was two groups of people who were highly vulnerable.

the age to have a low immune system and those who are the worst metabolic health. Okay? Why? It's a virus. Because those two people inherently, both poor metabolic health, it dampens your ability to respond to an immune attack,

okay, and be resilient against it. But so does age. We know that our immune system function fades with time. So we don't know, and I think it's a bit complex, and this is in part why we don't have an answer or cure at this point.

Our parents oftentimes reporting, like, you know, it was like not too long after a vaccine or not too long after they had a really bad cold or, you know, I'm getting divorced, you know, like something's happening in the house. There's like a stressful, I'd imagine there's probably some reporting of those things, but it's probably impossible to narrow down to one thing, as you're saying. Well, for sure, like a viral infection, maybe someone got the flu or they got COVID. And these can be triggers. There hasn't been much of a link to vaccines to any of these things.

Although during the time when COVID vaccines were being administered, the incidence was dramatically higher and there is an apparent link there. But it isn't vaccines in general. It's just the timeline of the stress induced by a viral induced infection. I don't know if you guys have had a flu shot before versus some of the COVID vaccines. Just personally, it was much more powerful, at least for me and how people subjectively reported it.

Maybe that's part of it. I don't know, to be totally honest with you. But yes, we do anecdotally, I'm a part of a number of type 1 diabetes community groups and try to do a lot to help that community as much as I can because there are solutions and things out there that can help people live better lives. And I try to share those things.

But what you often hear is like, oh, I just, you know, he got sick. Then he gets diagnosed with type 1 diabetes. And it isn't that necessarily gets sick from the symptoms of type 1 diabetes. It was, hey, I got a viral infection. And then it just persisted for much longer than his sister did. And now he's fatigue. He's urinating a lot.

And we took him to the hospital and he has type of diabetes. He's so brutal as a parent to get that news. You're like, well, what happened? My kids seemed to be fine the other day. Like what? It would probably blame yourself and the nutrition you have in the household and everything. And it might not have anything to do with that. Well, you bring up a really important point.

Mark, because you mentioned before that you don't want to blame someone. It's kind of a horrendous way to kind of describe it like, okay, you don't blame someone for something like this. But let's just be completely blunt and honest here. Like we know lifestyle affects it. The lifestyle absolutely affects it for sure. But we don't know what inherently. We know obesity does, right?

That's one great example in poor lifestyle. There's definitely probably more blame being passed around with type 2 diabetes. 1,000%. In fact, it is... Especially if a young kid at 13 has it and he's very heavy. I think a big part of this, Mark, and Encema is that you get diagnosed with this disease that is largely believe it would not be your fault. And so the universal blanket thing is it isn't your fault.

You didn't, it's not your fault that you have this. Because to the best of our knowledge, we don't necessarily know the trigger. Okay, the singular trigger, as we talked about, it's probably not one. It's probably one or more and different for each person. But they don't want to blame anyone. nor should they. Because at that point, you can't do much about it. You had to live with the rest of your life. So even focusing on the fact that it was or wasn't your fault, it irrelevant to the outcomes that were going to come from that point forward. But yeah, I mean, we know that

lifestyle does influence it and it devastates parents because it's a 24-hour disease. You know, if, you know, let's say your sibling or your child gets diagnosed tomorrow, what people often don't appreciate what type of diabetes is this invisible weight on your back. all the time. You know, let's say I woke up today. Okay, I'll say my four and almost seven-year-old. They get diagnosed. All right.

Well, today, I was just thinking about them waking up and behaving, okay? Maybe not punching each other in the face. That was a goal this morning. They got it. Excellent. Thumbs up. Get them some food. Did you do we were supposed to this morning to just get your backpack on,

get to school, get to school. They go to school, come home. Did they go to, like, go jiu-tiz-too? Or do we get them some food? But now let's think about this from a type of one diabetes perspective. Okay. Well, all night his alarm, he or she's alarm was going off. Why?

Okay, did I give too much insulin for the meal at dinner? Because if the insulin goes too much insulin goes in, blood sugar goes low, that can be life-threatening. At every meal, every single day, if you give too much insulin, you can die. Okay, that's how serious it is. So if you give too much, blood sugar goes low, you can cause a brain energy deficit. it. If it's low enough, you can deprive the brain and other tissues of essential nutrients to survive. And you can die. There's a phenomenon called dead in bed, which takes an unfortunate number, although small percentage of kids with type 1 diabetes at night. And so when you know that as a parent,

you're going to go sleep well at night or if you hear alarms or different things going up, going off with type 1 diabetes, you're going to be hypervigilant to protect your child. And it's hard to turn it off. For many, many parents, they live completely locked in all the time, hypervigilant. And obviously you can't just, you know, sustain this forever. There's burnout and other aspects of it. In fact, there's this whole condition called diabetes distress, which isn't attached to any other disease.

It's just, it's within the category of diabetes and itself. It's called diabetes distress, its own diagnosis within diabetes. The incidence for psychiatric conditions being diagnosed only after anxiety, depression, many of these psychiatric conditions that affect mental health, they're all dramatically higher post diagnosis. But for a parent, you're trying to regulate this all the time. And the consequences are massive. You know, you go high, okay, that's going to cause long-term consequences that continues to happen. But on the other end of the spectrum, if it goes low, they could die. And so oftentimes parents, not just parents, but by default, they run.

glucose levels higher. And running glucose levels higher is what is linked to these long-term complications. And the expectation of people with type 1 diabetes is that most physicians will say, hey, just try to get below like 7.5% HB.A.1C. So what does that mean for the average audience members? Okay, well, hey, just like if normal blood sugar is 70 to 120 and you really want to sit somewhere between 90 and 100 on a regular basis, on average, like sit 150, you know, 160.

And they accept that because the alternative is that you're potentially running the risk of it being too low. And this is unfortunately just an expectation of this disease. Now, it doesn't have to be that way. There are tools and strategies that can normalize this condition. It doesn't eliminate it, but you can normalize the key biomarkers that infect risk, quality of life, and how you feel every single day. but it is extremely difficult in most parents

and themselves get very burnt out from trying to manage this condition and sometimes just like throw their hands up and say like what the hell am I supposed to do here? And I don't blame them. It's hard. Before we continue, can we get a, just a level one explanation of what is type 1 diabetes and what is type 2 diabetes?

So that as we go back and forth between these two and this episode, people are like, okay, that's type two, type one, you know? Absolutely, yeah. Type 1 diabetes is often described as insulin deficiency. So the lack of the ability for the body to produce insulin and can automatically control your metabolism. Type 2 diabetes is defined as insulin resistance,

which is the overabundance of insulin that's no longer working effectively. Those are those distinguishing categories. Now, visually, we often think, used to, think of type 1 diabetes as diseases, underweight or just normal body weight. And so physique-wise, it's not a heavy person typically, whereas type 2 diabetes is almost always attached to poor lifestyle habits and heavier

weight because we know heavier weight, more obesity, triggers insulin resistance, and the cascade of things that lead to insulin not working effectively. So that's really the simplistic way of defining those two conditions. Got it. Sometimes people end up with quite a bit of insulin, and they end up being very overweight, but they still don't end up being diagnosed with diabetes. Is that because the population has gotten to be so heavy

that we have kind of raised some of our expectations of where people's glucose should be and stuff like that? I don't really know, I'm just asking. I lowered our expectations a little bit. Unfortunately, yeah, the stat often thrown around now, and it's real is that around nine out of 10 of Americans across multiple studies have shown this, have either one of these things that defines metabolic dysfunction.

They have an elevated waistline beyond normal size, meaning excess fat tissue, elevated fasting blood sugar level, elevated triglycerides, or one other metric defines abnormal metabolic health. Nine out of ten adults in America have that issue. And so it's more common for someone to be unhealthy than it is healthy. Actually, not normal than today's society based on numbers to be healthy. Okay. Now, when you ask the question around, you know, do they lower the standards or maybe they're just, it's not as detectable because people are maybe not paying attention or maybe they're

just saying, okay, well, when you get worse, maybe we'll pay more attention. It's based on the ability to capture it. So how do you capture it? You need to capture it by assessing glucose control. And there's a number of way to do that. You can do it based on an HBA1C test, which is a metric of looking at how much glucose is sticking to your red blood cells and the higher and more glucose in the blood, the more that will stick to the red blood cells, and you can detect that with something called HPA-1C. It's a blood test. But that's not always a normalized blood test for a lot of people.

And so a lot of times they may go undiagnosed for persistent elevations and glucose over time. In fact, we know because 90 plus percent of people with diabetes have type 2 diabetes, that pre-diabetes often takes years to manifest. and how does that happen? So the most common cause is excess body weight, okay, and obviously not exercising. Well, we know that just the elevation of body fat on our bodies beyond normal, okay, normal body weight starts to cause insulin levels to rise, okay?

Just the presence of more fat tissue can double, you know, a level of insulin. We also know that as you gain more and more weight, you can go up to, you know, six-fold higher. Basically, it's dose-dependent with the excess weight. And it's also over time. as that occurs, it's not just the excess insulin levels. Now you're resistant to that insulin. So initially when you start getting excess fat tissue,

you develop a degree of insulin resistance, both across multiple tissues, the liver, the muscle, and your whole body. And the insulin is supposed to help regulate your blood glucose and help clear it out in an efficient time frame, basically. Absolutely. So if insulin's not working properly, eventually glucose levels are going to rise. But that often takes years.

It's years of damage happening below the surface that manifest in eventually seeing a blood sugar level elevate above normal. So this is a very important point because when you look at large data sets in the general population, you don't have type 1 diabetes, just type 2 diabetes or don't have disease at all,

we see this dose-dependent elevation and risk with higher and higher fasting blood sugar levels, an illustration of what your blood sugar control is just at a normal level without lifestyle variables interacting with it, exercise or food, or other factors. And we see that as it starts to climb, risk in many of the major common diseases we see also starts to climb proportionally with it, obviously a dose dependently. Now, why is that? Well, because if blood sugar begins to change, it's usually a manifestation of this years of metabolic

changes that are occurring. And that means that insulin levels are starting to get higher. You now have insulin resistance. As you gain more weight, you become more. insulin resistant. It's not just excess glucose in the blood. It's excess amino acids, it's excess lipids that are also there, also termed energy toxicity. We also see elevations in inflammatory signals and oxidative stress signals. All this is starting to rise, but yet we don't see an elevation in glucose in the traditional biomarkers that we're normally looking at. Now you may capture it earlier with things like continuous glucose monitoring or something called

an oral glucose tolerance test, which is looking at your dynamic response to a meal, which is like a way of stressing the glucose input into the blood and seeing can your body actually tolerate this? That's actually a faster and earlier way to detect these things. In fact, we've done studies randomized controlled trials. Even in athletes who are normal body weight, high fitness levels, a percentage of them in middle age consuming higher carbohydrate diets can actually experience pre-diabetes.

That might be another topic for another portion, but I'll just say that. But they were undiagnosed before that. do the traditional metrics, you weren't seeing it, you do these metrics and all of a sudden, boom, you're starting to see this phenomenon. So yeah, it's years of damage that goes often undetected before you see a rise in the metrics that will actually be assessed. Now, that's if they assess it. And if they assess it, oftentimes this initial increase in glucose levels aren't met with a level of fervor it should or concern because they're like, oh, you just have pre-diabetes. Like,

change a couple things. Like, no, no, no. This is your window of opportunity. to reverse this situation. Okay, we've seen that when people initially get into this window, that if they act very quickly early on, they can reverse it rapidly within days, okay, if they make the right modifications. But when you look at people who have longstanding forms of pre-diabetes, it can take months to almost over a year

of a lot of effort, diet, exercise, a ton of weight loss to see it slowly start to drop. Even harder once you get into type 2 diabetes when people are like, oh, now I actually need to, really do something about this. Well, that, not saying it's too late, you can reverse type 2 diabetes with a number of interventions.

Not, but it's very, very difficult. The percentage of just doing, going to the doctor and they give you traditional advice that people reverse type 2 diabetes is less than 5%, some numbers are 1 to 2%. So extremely rare once you get these conditions, the average person is going to ever reverse it. Even with the typical medications

that they give you when you go to the hospital, like things have changed. Okay, and the medications that they have has started to shifts. Okay. But in general, yes, what those medications traditionally have done has only managed the condition. They haven't, they cannot, they often do not reverse it. I almost say, I almost said cannot.

They can assist someone in managing it. But traditionally in diseases like type two diabetes, we started by talking about how weight is often to trigger for this cascade of events to happen over time before this, these changes happen. And they're harder to reverse as the far as you go. But oftentimes it's very hard for these medications. to regulate weight, which is why the emergence of GOP-1 receptor agonists have been so much more effective at regulating glycemic control and type-dibes management than many of the other diseases

that preceded it because and have increased the incidence of the ability to reverse the condition from a medication, okay? More so than any other medication has because it's also regulating weight. And that's a key component because a lot of people who are managing type 2 diabetes with the traditional drugs like sGLT2 inhibitors, which is a drug that just calls you to urinate out more glucose, metformin, which makes you

slightly more instant sensitive, may assist with weight loss. And some of these other drugs, they may assist marginally, but not majorly in weight loss. Okay. And as a result, reversal was very uncommon, but these new emergent drugs like GLP1 receptor Agnes are so powerful regulating hunger for people to the point where we used to run clinical trials. We used to run clinical trials on these drugs and some of the current and future ones. And I think we'll eventually get to the point where you could drug away hunger almost entirely. Now, whether you should do... I was going to say whether you should do that or not is a completely different question.

Because completely limiting hunger also eliminates one of the important cues. That's normal in biology. I've never seen a scenario in science being in it for almost two decades now. where completely altering a normal physiologic process doesn't come without some consequences, usually some negative consequences. I will never go to a doctor ever again about my general health. All they want to do is put you on pills.

Really well said there by Dana White. Couldn't agree with them more. A lot of us are trying to get jacked and tan. A lot of us just want to look good, feel good. And a lot of the symptoms that we might acquire as we get older, some of the things that we might have, high cholesterol or these various things, things, it's amazing to have somebody looking at your blood work as you're going through the

process, as you're trying to become a better athlete, somebody that knows what they're doing, they can look at your cholesterol, they can look at the various markers that you have, and they can kind of see where you're at, and they can help guide you through that. And there's a few aspects, too, where it's like, yes, I mean, no, no shades of doctors, but a lot of times they do want to just stick you on medication. A lot of times there is supplementation that can help with this. Merrick Health, these patient care coronators are going to also look at the way you're living your lifestyle because there's a lot of things you might be doing that if you just adjust that, boom,

you could be at the right levels, including working with your testosterone. And there's so many people that I know that are looking for, they're like, hey, should I do that? They're very curious. And they think that testosterone is going to all of a sudden kind of turn them into the Hulk. But that's not really what happens. It can be something that can be really great for your health because you can just basically live your life, little stronger just like you were maybe in your 20s and 30s. And this is the last thing to keep in mind, guys, when you get your blood work done at a hospital,

they're just looking at like these minimum levels. At Merrick Health, they try to bring you up to ideal levels for everything you're working with. Whereas if you go into a hospital and you have 300 nanograms per deciliter of test, you're good, bro, even though you're probably feeling like shit. At Merrick Health, they're going to try to figure out what things you can do in terms of your lifestyle. and if you're a candidate, potentially TRT.

So these are things to pay attention to to get you to your best self. And what I love about it is a little bit of the back and forth that you get with the patient care coordinator. They're dissecting your blood work. It's not like if you just get this email back and it's just like, hey, try these five things. Somebody's actually on the phone with you going over every step and what you should do. Sometimes it's supplementation. Sometimes it's TRT. And sometimes it's simply just some lifestyle habit changes.

All right, guys, if you want to get your blood work checked and also get professional help from people who are going to be able to get you towards your best levels, heads Americahealth.com and use code Power Project for 10% off any panel of your choice. But I'm also a big fan because, look, we talked about nine out of ten Americans have adverse metabolic health. And we know that virtually every study that's come out with GOP or one receptor agonist. When people lose weight, still no matter how it happened. Okay, like they get better. Their risk gets better. That's how terrible holding excess body weight is on our long-term health.

But if you could do that in a more normalized fashion and sustainable fashion, that may be a good thing. I think the biggest thing with these drugs is they're here to stay and they're going to be around. People are going to use them. But what's often happening is that they will lose the weight and then they'll say, okay, I lost the weight. Like, I don't really want to never be hungry again. I don't want to go to dinner and never actually want to eat with my family. Or, you know, I want to actually like, maybe that cue is actually kind of enjoyable. I remember when I, I never have been on GOP-WRone receptor Agniz,

but I did an approach called Whole 30 and I removed like all forms of like sweetener foods and other trigger foods. I would go into dinner and I suspect it was held that some of these patients described to me their response to GOP warmer receptor agonist. I was like, not even hungry. I'm like, I'm almost, I'm sad. I used to enjoy going to dinner and sitting down to me and looking forward to this. I'm not looking forward to it. Like I'm not even hungry.

Like I'm going to have to force myself to eat. I don't even want to. And that is a part of how these drugs work. And there's nothing free in life. There's always a pros and cons. There's always a choice of the positives and the negatives and what's the balance and what choice do you want to make? But yeah, I know we want a little bit of change

that they're talking about how to regulate. The desire side of things is interesting because some people are finding that they're significant others is becoming less desirable. Now, what's interesting about that is with some of these drugs, and I believe some of the studies have kind of reported that the people that are taking them that are losing weight feel more desired, which is interesting, right?

So someone might feel sexier, they might feel better about themselves because they lost some weight. But then that impulse, that desire isn't there, because it's part of the hunger. That's part of the whole system, right? You're taking everything out all at one time. Yeah, it's like the young male body bowlers in the gym who get jacked and realize it didn't quite translate

to the attention they wanted, at least from girls, maybe from boys, their peers, right? But yeah, so there is reports that it can affect other aspects of life in the drive to do something. So it doesn't just affect hunger. We know that these drugs also can affect motivation, although it's less commonly reported, but motivation,

it also seems to reduce addictive behaviors in other areas, alcoholism. I think there's some emergent studies coming out for drug use. And so when you don't, those are driven by the impulse to seek pleasure, right? You're seeking that response, that positive response that you had,

and obviously the more rapid those drugs hit and the more positive response initially, the more addictive they are. And so if you're subsiding that, and GOP1 receptor agonist, able to do that. They're not just for hunger, but it seems to trickle into these other forms of seeking behavior where you're looking for pleasure. And so, yeah, there's, there's, I think in today's society, though, what these drugs are largely doing is attempting to fight the food environment that

people find themselves over consuming food. And I sat in a presentation at the American Diabetes Association, listening to FDA commissioner, who said, it's not lost on me, the irony that we are promoting drugs that cost $10,000 to $20,000 that are artificially regulating hormone levels, but at the same time, not addressing the food environment that we know is almost certainly the trigger for most of these people needing these drugs. And it's such a powerful statement because the reality is like we're, we are putting Band-Aids on a system that could, we know the trigger for most of these people as a food environment.

In fact, there's a major study out of Duke and actually international is, United States, China, and many other organizations across 34 to 36 different countries. And they looked at all these different populations and looked at what was the cause of obesity across all these different populations. And what they were seeing is that in this study that it wasn't necessarily something like a lack of exercise.

90% of the obesity epidemic that they were observing across these populations international was explained by the diet. And the other 10% was not a lack of exercise. It was individual variability and energy expenditure. And so clearly the food is a huge component to this. It's overwhelmingly observed to be that way in the science, but it's not hard to understand that when you eat certain foods,

all of us have experienced this, I'm sure. Some foods, they taste a lot differently. You'll want more of them versus other foods. And the best example that most people give is you go to dinner, you're completely full, you feel completely stuffed. And they walk by with dessert and you're just looking at it. while you're full and physically felt. Second win, baby.

Yeah. Second wind, yeah. You could do anything at that point. Yeah, so many people have experienced something like that, and that's based on a food environment that is facilitating people to overconsume. But I don't think that's news to a lot of people nowadays. I think most people inherently know this

because they probably experienced it throughout their entire life. Big food will just keep coming up with more highly processed foods that tastes more delicious. So it's just going to make them more creative. is all it's probably going to do. It's a tough system, Mark. You know, if you want to come out with a product that's highly effective and people want to consume it, how are you going to compete with something else that people at their subconscious level are driven to seek? That's all, you know, like do people actively seek health? Yes, but you know, all of you know,

how much work goes into consciously going after that, right? It's this subconscious triggers that seek certain types of pleasures and desires that often drive most people's decisions, right? At least drive their initial reaction to want to make a decision. Now whether their body consciously stops that is a very different thing, right? But yeah, we're fighting our own biology in many ways.

And so it often takes, you know, back in the day before these drugs existed, I had obesity as a kid. And I tried for five years to do everything I could to lose weight. And nothing was working. I even remember this. Very memorable moment. I was in a grocery store.

And you hear about all these drugs and like, as you know, the supplement world, like fat burners at this time. And I was like, I was looking at all these magazines and body builders. And like, I want to look like these guys. And they're promoting fat burners and other things. And so I go in the grocery store. And I was so embarrassed. But I grabbed this fat burner off the shelf and like snuck it into the cart. And it was going through beep, beep, beep.

And we're almost at the end. I'm like, yes. My mom doesn't even know. Like it's just gonna go through like yes at the time man I must have been like 13 Yeah yeah yeah yeah and and I was the very like two things like I got like three or four things left it kind of was like mixed in there on purpose like I put it on there right in the middle of things so like no one would see it Yeah beeps through and it goes beep everything just pause and like fuck like keep keep going like keep the the girl stops looks at it and say is are you sure you want this and I was like I did before, like now that you're embarrassing in front of me, I was so embarrassed.

I was like, uh, uh, no, but in reality, I was like, hell yet. How did I get in there? Uh, I was so embarrassed. I didn't even have a good response to be like, oh, no, I don't know. I picked the wrong thing. I was like, uh, uh, uh, you know, I was like, damn, man, like, um, it was brutal. I still remember like which lane I was. at the exact grocery stores, Publix in Florida and Tallahassee.

I remember everything about the lane and everything where I was standing in the green vest, like everything about that moment. And yeah, like I know how powerful that can be for people. I've experienced it myself. But back in the day, we didn't have, even though it was going to fix your problem, right? We didn't have, but people still saw them. It was like a, it's why there's a billion dollar industry and still is growing. supplement industry by the way i just heard recently and i don't know if this is a fact so do your

own research but the supplement industry is uh bigger than big pharma i i wouldn't be surprised i mean uh i wouldn't be so people demonize big farm do you mean like the wellness industry uh i don't know supplements in general i i need to like probably look this stat up so i can give people uh better information but it's uh it's like two or three fold above uh what the pharmaceutical companies are making. Okay, yeah, the wellness economy. Yeah, I've heard those numbers as well. And I'm not going to be surprised at all

because big pharma requires, they're often so expensive and they had to recoup their costs that the only way you're getting a hold of them is through a prescription, seeing a doctor that provides a prescription, and they're only going to do that based on their medical license

if it's deemed necessarily within standard of care, and then it's prescribed, and then you need insurance to cover it. There's like four or five steps and barriers to getting that supplement, you can go to the grocery store right now and we can go buy it right now. So the barriers are so far removed

and the marketing's really constrained for the pharmaceutical industry. You have to be, you know, even though they do a lot more than they probably should, but it's quite constrained in what they can and can't say and they have to also state all the side effects where you can say,

hey, look at this and you have these guys who are super jacked and like, you know, you take this and you're going to get super, super jacked. I mean, I almost don't even want to admit this, But I remember when I was like 18 years old, I was spending like $150,200 of the money I was making from the job I was working a month.

Let me guess on pro hormones. I almost did. So this is actually at the time. It's funny. It was almost at the time when that had, those started to get banned. Yeah, yeah. Once I got like in it enough and I was like,

oh, I'm obsessed. I was like, now I'll do it. And now they banned it. I'm like, oh, that sucks. but before that I was taking creatine now I'll tell you I was taking some creatine back in the day I knew it

I but like let me tell you something that creatine really worked I wish that was still available because whatever else was in there besides the creatine the lack of like control I mean I was taking it I'm like that's not just creatine

and now some products that straight up had like Diana Ball in that stuff yeah well that might have actually People like walking around the face is a little puffy, like, man, I'm getting way stronger off this stuff. That's exactly what happened. Oh my God. I remember the one I. Like, yeah, creatine bloats you.

It's like, oh, I think there's something else. Probably. I don't think it bloats you that much. Yeah. I remember distinctly because I was at the point where I was trying to lose weight when prohomers were at a peak level. And actually this kind of ties to my type one diabetes journey because I remember when I had type 1ibis and I got to this point when I was 18 years old and prohormone's, were basically cut off the market, because I was at this point where now I'm obsessed.

Like, I lost the weight eventually, and now I just want to get as big as possible, as quick as I possibly can. Like, and I was like, man, they cut these off the market. What can I get? And I'm looking up everything. I was really knowledgeable. I started following like bodybuilding.com,

RX muscle, Dave Palumbo, all these guys. Like I was obsessed with this world for, man, almost like a decade. And I remember looking into it. I'm like, you know what? What happens if I were to take some stirruits? And I had the consciousness at that, at 18 years old to think I probably should reach out to find out how it's going to affect my diabetes.

And so I reached out to, I won't say their name, I don't think it's fair. But they are very pro steroids at this stage, but I'm not going to say I'm name. Either way, I reached out to them and say, hey, look, type 1 diabetes. I don't think I should do this without some cautionary notes. Like, what's going to happen? Not that I had access to it anyways, but they said they forwarded it to someone else who is a professional bodybuilder with type 1 diabetes. And I thought it was the coolest thing ever.

They reached out to me and said, hey, look, this is what we know is probably going to happen with insulin sensitivity with these various compounds that most people take. But then they said, look, let me get on a phone call and talk to you.

And they got on the phone call and they said, look, you're 18 years old. I wouldn't touch a single one of these into your 25. I'm so grateful for that advice. I almost wish I could shout them out. They probably don't want to be shout out right now. But they walked me away

from doing that. And when I was 25, I'm like, up to around 23, I was obsessed with as big and as lean as I possibly could. And I got 24, 25. And then my PhD program, I'm like, I don't have time to be obsessed. And if I had, you know, pushed it to the limit at that point, I probably wouldn't even be in a PhD program. I'd probably be pursuing that dream. Maybe I would have the transformation you did, hopefully. But if not, I would have like just been seeking to be as jacked as possible. And I know where my mindset was at that point, especially being obese as a kid and having these like self-image issues. I don't know when I would have got off that train until something hit me in the head or punch me in the face and my health to alert me,

hey, hey, do something different. What switched things around for you? Because at 13, you were still kind of heavy, but it sounds like 16, 17, you start to maybe find your path, maybe somewhat through learning about diabetes and stuff like that. Did you start to get on a particular diet? Like what started to like work for you and what age were you? So my obsession with, I guess, you know, optimizing and looking at start when I really started in childhood all the way back to having weight issues. When I got diagnosed with type 1 diabetes at 16, I had already lost weight a year prior.

So I lost weight at 15 years of age and then I'm going into I'm 16 years later and I get this diagnosis and I was so obsessed with health and nutrition because I see how powerful it regulate both my weight but also managed my diabetes. It was very clear how important those factors were and both those things. But my obsession with understanding how to optimize it really started, honestly, it was a carryover effect because I thought, man, if I, because I was so obsessed with it, and the more I obsessed with it, the more I learned, the more I learned, the more I applied, the I applied the more I got out of it. Yeah.

And so I just continue to carry that over into my other aspects of my life. And initially, what was interesting is that I became very experimental when it came to type 1 diabetes. I knew there was a big opportunity if I could like leverage this powerful hormone I have to take. You know, I don't know if it's true or not, but, you know, Lance Armstrong, some of his documentaries, he had testicular cancer. And so he had to take testosterone. room. I don't know if that's why he ended up taking more or not, but when you have access to

something like that, maybe, you know, it's a lot easier to regulate it to optimize your outcomes. Yeah. And trust me, I had, like, I was, if I could, I would, you know, that was my, my mindset. But I, when I realized that I had to do a career and, like, I couldn't just, I had to make money somehow. Couldn't just blast insulin. Ha! Yeah, like, I could, yeah. Blast insulin and, like, eat, like, real specific. and it's post-workout to be as big as possible. Well, so there's actually some logic to this actually. When people and some bodybuilders

will anecdotally acknowledge they have done this and it actually has caused some deaths in the bodybuilding community where they will, I'm not saying I can't say any particular names but it has been at least anecdotal reported whether it's true or not, I don't know. It's huge in bodybuilding.

Yeah. And it's huge for a reason because we know that injecting insulin is inherently different than insulin that's released within the body. They're both the same molecule, but where it goes, affects tissues differently. So if you eat, let's say, I ate, you know, two bagels right here.

We all eat two bagels. You know, I have type of diabetes, you guys don't, okay? When you eat those two bagels and you digest it and glucose starts to rise in your blood, your pancreas is going to release insulin instantly and start shuttling that in for storage. Well, it's going to go to the liver first and store that glucose levels in the liver.

Then after around anywhere between 50 to 75%, the numbers are usually 66 to 75% of that insulin binds to the liver, the remaining 33 to 25% is going to go to the peripheral tissues like the muscle and fat to then store it for energy or future use. Well, imagine you're working out and you know that if you have these kind of leverages, well, it's going to be kind of complicated. I'm avoiding myself going too far out of tangent here. Let's just say that when type 1 diabetes, because I have to inject it artificially external to my body,

it's going to go to the muscle and fat tissue first because it's going to enter the peripheral vasculature or blood vessels first and only a small portion of it gets to the liver. So it flips the ratio to around 60, 60, 70% goes to the muscle and fat and the rest goes the liver. Well, those are storage spots

for energetic use for performance, right? And so there are some advantages to actually administering these molecules because of the key tissues they hit at disproportionately higher levels. And it has been utilized in a number of settings to take advantage of that in some sports context or non-sports context, depending on how you frame things like bodybuilding. But yes, it is an incredibly powerful yet dangerous tool.

Because I think, you know, having lived with type 1 diabetes and knowing how dangerous a single dose that's mismanagers can go. And let's say you're an athlete and you take this molecule or drug, my goodness. and the risk you're taking is crazy. Because you don't even know how you can respond. So, but it can kill you. So it can kill you. You don't know how you're going to respond to it.

And I'm sure most of these people are starting like, what should I take? Like how much should I take? First of you have no idea. You know, like you have no idea you're going to probably do something you were told. And if it doesn't go well and insulin levels are too high, it's going to bring glucose levels potentially so low

that it can cause brain energy deficit. And if you have a brain energy deficit, you can die. So, yeah, the consequences are quite huge. But despite that, some, although more rare, people still do this in some sports-related domains. So now I'm kind of curious about the nutritional protocols for people who have type 1. Because, I mean, I know you talk about the ketogenic diet quite a bit. Do you go about a ketogenic type diet with what you do? Is that something that you recommend to people with Type 1?

Or does it vary from person to person? That's a great question. So I found my way to lower carbohydrate-style diets. But I didn't start there. In fact, I actually was coached by Lane Norton a period of time. If anyone knows him, he's a proponent of flexible dieting, right? And so I've done that with Type 1 diabetes before. You know, reducing calories, wherever you do, it's going to be effective, right?

but the thing about type 1 diabetes though is that how your glucose and insulin is managed has such a powerful effect on how you feel in your quality of life at every meal every single day and what you find is that on the average people with type 1 diabetes consume less carbohydrates than the general population there's no doubt that's because of a conscious awareness that if I consume more things don't tend to go as well and that's evidence based again we've conducted the largest ever study in type 1 diabetes looking at at prior analysis since the 1980s to now, over 47,000 individuals with type 1 diabetes and over 130 different individual studies. And what we see is that, again, the higher the carbohydrate amount, up to a certain point, the worst the glucose control. And this all makes sense because, again, the one aspect of our machinery in type 1 diabetes that we're missing is the ability to rapidly metabolize glucose and carbohydrates. These aren't terrible foods. Like they, We have done studies in a performance high-level athletes, and we see that a certain amount can be very beneficial, okay?

Like, it's not like these are terrible things. I used to consume them. In the context of diabetes, though, the rules are different. This is not at all appreciated. In fact, a lot of how people approach managing lifestyle and also performance in the context of type one diabetes, literally one-for-one mirrors what the general population is. In 1970s, the first guidelines of our nutrition from the American Diabetes Association came out.

and verbatim, the Ameri-so, this is when the dietary guidelines had also come out, okay, in the 1970s. It was commissioned by a senator at that time. And this is when the first dietary guidelines came out and they said you need to consume more complex, carbohydrates in your diet. It started around 45%, eventually went up to 55, 65%,

but the ADA basically said, and their original guidelines, people with diabetes should just eat the same diet as those in the general population, despite the fact that They cannot, either they're insulin resistant in type 2 diabetes or they lack insulin to be able to process them quick enough. The guidelines were, say, do the same thing. But it never worked.

It never worked. We know that actually the technique in type 1 diabetes called carbohydrate counting, most standard approach, doesn't actually reliably improve glycemic control in a number of meta-analysis. So studies that look at a group of multiple studies. It obviously can be helpful if you apply it the right way, but just giving it to someone and say, count carbs and give insulin doesn't appear to dramatically improve glycema control in people with diabetes. We also know the American Diabetes Association, while in the 1970s just recommend match it, you know, around five, 10 years ago said, hey, just do an individualized

approach, mostly because there was such a harsh pushback on them kind of promoting 45 to 55 to 65 and it wasn't working. I mean, the results, the incidence of diabetes didn't go down. It was getting worse. And so when we also saw at this same time that there was an emergence of studies that we're showing, hey, look, if I consume carbohydrates is the most potent impact on glucose and both type 1 and type 2 diabetes are defined by a diagnosis of high glucose levels. What if I just eat less? And we've known since 1796 by John Rollo, first physician to look at this in diabetes, that it could put type 2 diabetes in remission. We've known for over 200 years that it can put type 2 diabetes in remission. We've known for over 200 years

that it can put type 2 diabetes in remission. Just by eating less. Just by eating less carbohydrates. Okay, very simple. It cut breads, pastas, potatoes. It wasn't like you need to do a prescriptive 75% fat, 20, 25%. You know, there's no prescription here is cut carbs in the diet. That's it.

And it put type 2 diabetes in remission. 1860s. We know that it was used for putting obesity in the remission. It was standard of care for type 1 diabetes. before the discovery or a Nobel Prize of Insulin in 1920s. So actually the most prominent institutes in the United States, Jocelyn, Allen, these were the physicians at the time that harbored names an entire hospital after

that were actually administering very low carbohydrate approaches and individuals with type 1 diabetes to extend their life. Because what was happening is if you consumed high amounts of carbohydrates, glucose would go higher, that excess glucose would cause toxic issues. within the body, okay? High and variable glucose levels through a number of pathways

dramatically increase oxidative stress, inflammation, and through a number of other pathways, directly damaged tissues. And so just by removing that stressor on the body, patients were going further, okay? Because you did at least have one mechanism by which you could release glucose from the body, and that was through the urine.

But a lot of these patients, when they were first diagnosed, if they were put on a very low carbohydrate approach, they were making it over a year. When we're talking, it would be days to weeks and they would die. Very rapidly from that, what they call diabetic ketoacidosis. So I say all this to say,

these approaches such as low carbohydrate diets I think are unfortunately very controversial, despite being around for over 200 years of the original standard of care for these diseases. But I worked at an institute in Santa Barbara, California, that was founded by a gentleman named William Sanson. He was the first individual and communicated. I actually saw the letters in my hand.

I read them between Banting and Best and McLeod, who discovered insulin in Toronto, Canada. They were communicating covertly, it wasn't public knowledge, with each other on how to formulate insulin and isolate it. So what they would do is they would have cattle that were being butchered and he would go to local butcher shops and get tissues and Banting and Best, McLeod,

and William Sanson were communicating via telegraph about how to effectively isolate that and purify it. And William Sansom was the first person in the United States to ever synthesize it and administer into a person with hypodibitis and save their life. And so I worked there at this institute and seen all the Biles, flask, note pads that went back and forth. Well, William Sansom, ironically,

was the first prominent name in diabetes in 1925 after it was discovered to say, hey, look, we have insulin now. Why are we restricting carbohydrates anymore? If you have insulin, you should be able to eat what you want, right? And so the place I work was actually the first position to really change the guard, so to speak, on what you should consume if you have diabetes. Although there's no rigorous evidence at this time to promote this. It was just a hypothetical, if you have insulin, why are we restricting anymore?

It should work. Did it work? No, it did not work. But recently since 1980s onwards, despite it being standard of care and then going out of standard of care because of the hypothetical concern around not needing to restrict,

the interest shifted away from nutrition and managing diabetes. This is not just type one, type two as well, shifted away from the focus on nutrition. Instead, it was started to focus on the emergence of novel new forms of insulin, technology to monitor glucose and maybe administer insulin. In fact, I did a search around two years ago and still the case now looking at terms

like technology or pharmaceuticals in type on diabetes and how many scientific studies have been produced. And the number was fourfold higher, actually four and a half fold higher than anything related to diet or nutrition. That's how much focus has gone into publishing and working on technologies and pharmaceuticals despite nutrition. But this is all despite the fact that the number one variable, including pharmaceuticals, technology, lifestyle that affects glucose control is carbohydrates above every other lifestyle

invention. This is not up for debate. Carbohydrates, increased blood sugar in a dose-dependent manner more so than any other lifestyle factor, pharmaceutical, anything else does, period, full stop. Despite that, there's very little interest and has been for a long time to just maybe lower them to a level where it makes managing easier. But there have been a ton of studies in type 2 diabetes because that simple logic has been studied. Okay, you reduce the thing that causes glucose elevation. You're diagnosed from a high glucose level with type 2.

Let's just reduce the thing that causes input of glucose, lower carbohydrates. And I'm sure you guys have talked about this before. It's not new information that low carbohydrate diets are incredibly effective at managing type 2 diabetes. Okay. In fact, in 2019, a consensus report from the American Diabetes Association, Everett at all, they indicated that the very low carbohydrate approach was the most evidence-based strategy

for managing type 2 diabetes both from a glycema control, weight, and blood pressure perspective. The three most important variables of her risk in type 2 diabetes. So it was the most evidence-based diet in type 2 diabetes. They never said anything about type 1 diabetes.

But there were some recent reports the last two or three years that came out in like pediatric organizations and other American Academy of Pediatrics that indicated, hey, you should be cautious against these approaches if you're a kid or and there was these case reports coming out where people were like, hey, look,

what about these adverse effects we're seeing if people restrict carbohydrates? Well, there was no serious evidence showing that lowering carbohydrates had any harm, but there was an emergence of evidence, again, going back 200 years, that it could be incredibly effective at managing glucose levels.

I do want to add that if a type 1 diabetic is to take a shot of insulin, they need some carbohydrates, correct? Not necessarily. Okay. So the reason I say not necessarily is because if you administer, if you look at the glucose and insulin impact of every macronutrient, fat has almost an undetectable impact on insulin,

but it still has an effect. And it's dose-dependent, but it's very small and almost undetectable. Protein does have an effect on glucose elevation and insulin, but it is 2.5 times lower than carbohydrates per gram. carbohydrates have a dose-dependent elevation on glucose and insulin. So you can eat protein, people who are doing these very low-carbohydrate diets or carnivore diets, which are void by definition from these vegetables, they still require insulin. If you have zero insulin, the diet and theoretically required zero insulin, you would die.

Everyone has to have insulin in the body. In fact, we know this best from fasting studies back in the 1960s, a gentleman named George Cahill, discovered that if you fast someone for 30 days, that, okay, you shift from glucose-based metabolism to fat metabolism. Didn't he fast somebody for like a year or something? I don't think it was George C. Hill, but there is a report of an individual who's 450 pounds who fasted for over a year

and came down into a normal body weight over that window of time. He didn't live very long, though. The stress of just eating no food in the, probably the, because we know that fasting is an acute stressor. But if you do it forever, doesn't seem like it. Yeah, might not have a good response. He might have been the guy that actually did it. Maybe he did it to himself.

Maybe he studied himself. I do know the report. I think you lived into his 50s, but who knows, maybe it's the cumulative. What do we got here? What does it say? That's the guy. Angus Barbary, the man who notoriously fasted for 382 days from June, 1965 to July, 1966.

That's it. Dying 90. Yep, so for over a year. Damn. Yep. But he, and this is his age that he passed away? Let's see. I think it was in his 50s.

38 to 60. Yeah, well, also too, did he die from the fasting or did he die from being so heavy for so long? We have no idea. Yeah, that's the question. We have no idea. And we know that those aren't completely reversible. You can dramatically improve your health at any moment,

but we know there's this effect in metabolism called metabolic memory that you accumulate adverse effects over time. And with Barbie area, though, I believe he was, because I was looking into this a few months ago, he was able to keep a majority of that weight off. He also was under medical supervision. He didn't just fast him by himself. He didn't just fast by himself. And he died at like 53, I believe.

So that, yeah. Anyway, so you don't necessarily need carbohydrates if you're type one and you take a shot of insulin. Correct, because even when individuals completely fast and don't eat food up to 30 days, if you look at the studies that George K. Hill produced, you still see there's this little bit of insulin always around. Because it's self-regulating. You need some amount of insulin to just regulate metabolism in general. If you don't have any insulin on board, you'll have this production of these molecules called ketones, which are a byproduct of fat metabolism.

Now, what's fascinating about ketones is that they got a really bad rap because of my disease in type 1 diabetes. Now we see them as is emergent, fascinating molecules that potentially improve cognitive function, physical performance. Maybe we did studies funded by special operations command and all sorts of different settings showing remarkable effects from these. But over 100 years ago, ketones were viewed as a death sentence for type 1 ibupedes, this terrible molecule that causes adverse effects. But it was never the ketone bodies that were the problem. It was the acid load that was attached to the ketone bodies, which when it was uncontrolled, cause too much of an acid imbalance. That doesn't happen in a normal environment where you fast

or do a very low carbohydrate diet. It's not a thing. But we know that some amount of insulin, back to the main point, is always around, even when you eat nothing, absolutely nothing, you still require some insulin. So just to give a point that insulin's always around, it's always required, it's always there to regulate metabolism within range. But if you eat fat, you're going to require maybe slightly more.

eat protein, you're definitely going to require a decent amount more than if you didn't eat protein or anything at all. You get carbohydrates, it's going to require 2.5 times more. And so it's all dose dependent, right? So when people typically go from a higher carbohydrate diet to a lower carbohydrate diet, we've looked at this in this big analysis we did, that they typically, on average, go from the average intake. And most people with type of diabetes around 224-ish grams, 20020 grams, all the way down to less

than 50 grams per day, the drop in insulin requirements around 50, So 50% less insulin, but it's not zero. And they're eating less than 50 grams for net carbohydrates per day. So it's not even actually, it's not net carbonsors total. So it might be even less than that. So you still require insulin no matter what

to have to exist as a human being. But the amount is contingent on the type of macronutrients, calories, and overall metabolic health. What about things like the rice diet and the repeat type stuff? I'm sure you're pretty familiar. I have heard people talk about the rice diet being utilized on people that were diabetic, but I don't remember if it was type 1 or type 2.

I also remember looking at the rice diet a little bit and recognizing that it was, it was very low calorie. Yeah. Which is something that like, you know, people don't always share like all the facts, but it was like something like 1, 200 calories. And I'm like, well, you're probably going to get pretty good results. If you can get people to lose weight because the GLP 1s and whether the GLP 1 is healthy for you or not, is probably a different discussion,

but for someone to lose 50 pounds is probably in their best interest, almost regardless of how they lose the weight. Oh, absolutely. In fact, that's why we see so many positive scientific reports on very low carbohydrate intake, particularly in the ketogenic diet range

where insulin's low enough to cause this major physiologic change in the body to shift from sugar and carbohydrates towards fat predominantly as a fuel, to this other end of the spectrum, which is these very high carbohydrate, fat diets. There's tons of positive evidence for both of them. Why is that? Because both of them reduce overall insulin requirements through different mechanisms. And sometimes overlapping. When

you reduce the overall glucose load on a keto-jank style diet or low-carb diet, you're just lowering the inputs. You require less insulin for that. Whereas in the other end of the spectrum, you have a ton of carbohydrate's internet system, but fat is so low that you have this really peak level of insulin sensitivity. So you have huge glucose loads, high, insulin sensitivity okay and so it's regulating glucose and insulin in different ways right and everyone thinks about insulin sensitivity is like okay like that's health versus not health more sensitive more health less sensitive less health it's actually the balance okay it's the balance of multiple key biomarkers together that maturates and what we know is health

it's not one versus the other right and so however someone gets there as long as they're getting there is what they want to in my opinion what they should try to achieve but you know, back to the point about insulin being required across the board. If you take insulin, like if I were just taking a shot of insulin right now, I'm going to have to do something to correct for the blood sugar lowering effect. Whether it be carbohydrates, if I took protein far enough earlier, I could do it, but protein slower, right, has less of an effect, which is why a lot of studies, if I would strap a CGM on both you guys right now.

Okay, so I have a CGM on my stomach right here. I'll see if I don't administer more insulin when I eat protein. my blood sugar is going to stay elevated over time, okay, until I correct it with insulin. For you guys, you may never see a blood sugar elevation from that. So people say, oh, protein doesn't require insulin because, like, look at my CGM number didn't change. What's missing often with just looking at a CGM is you don't see the background fluctuations and changes in insulin with every single meal.

And I would put money on, in fact, a lot of all my, I would put all my money on this, actually, is that when people eat food, insulin goes up. You know, it doesn't go down. When you eat food, you require in that moment more insulin to metabolize that food, whether it be small or large. We don't have a gauge for that yet. You have to like run it through a lab or something and it takes a while. You can't monitor insulin on the go. When someone develops a continuous insulin monitor, they're going to be a billionaire.

Because what we get in type 1 diabetes is 24-7 access to everything that affects both glucose and insulin insulin sensitivity. You see everything that affects it. The average person doesn't have that opportunity because we do not have a continuous insulin monitor. It's not like people haven't been aware of this opportunity. But if I strap a CGM on both you guys, continuous glucose monitor and monitor your glucose levels and also had a way to monitor your insulin levels,

you would be able to understand everything in your lifestyle that affects your insulin sensitivity, glucose input and interaction with insulin because I would contend that glucose and insulin of the two most important molecules, higher arc early, ranked wise, in metabolic health. But most people only get access to one of those, and that's only if they pay a lot of money. But if they had access to both, you would see early signs of changes and things like risk for pre-diabetes, leading to the type 2 diabetes. And then people would have the ultimate,

you know, biohack, whatever you want to call it, opportunity to intervene sufficiently early enough to actually regulate and modulate health. Well before, you know, or a biomarker that we traditionally look at in a lab tells you. And I think that that's the future as having the opportunity to actually see things well in advance of them coming. And a lot of blood tests are attempting to do that. But if you had insulin 24-7, that would change everything about how we look at metabolic.

That's got to be coming soon, right? The difference with a CGM monitor is that, you know, you have continuous glucose monitors. people are looking at other metabolites of continuous ketone monitors. I'm sure they're going to, well, there is more coming. Okay. But why not a continuous insulin monitor if we figured out glucose? Glucose, ketones and some of the other ones that are merging, they're metabolite-based. Individual molecules that, you know, glucose is, you know, a ring-based structure of carbons. Ketones is, you know, one, two, three, four, five carbon molecule.

There's individual carbon molecules, whereas insulin is a, you know, polypeptide. It's a totally different structure. Actually assessing that in a continuous format, it's a totally different monster, technologically speaking, why it hasn't happened. But it will happen.

And when it does, man, things are going to change dramatically, but we're not there yet, which is why people rely on a fasting insulin test to get a gauge of at their baseline level. Is it just higher than it typically should be? Imagine if you could just see all your hormones all the time,

like from your watch or something, you just look at it, your testosterone, on your insulin. That'd be pretty badass. It was in my, when you ask, you know, there's got to be some pros and cons. Before we even got on here,

you're asking about a lot about type 1-2s when we're outside and I was, you know, talking to you guys a little bit about this. And I described type 1st, one of the best assets of my life. And I would say that because the career I went into and research and science, the things I learned from just daily lifestyle habits

and just paying attention, not just to glucose, but also the insulin and how it interact. And then the textbooks I was learning, the knowledge I had on top of that metabolism, the research were doing just solidified a better understanding of why I was seeing what I was seeing. So it wasn't like, oh, I just see it up and down on these two molecules. I now understand why it's happening. And that has arguably been one of the best assets and what I do from a research perspective

over maybe anything I have done because it's objective key molecular changes of two of the most important molecules and all metabolism and the direct effects we see in so many different aspects of lifestyle. As a great example, I think it was around 20 years ago. We first discovered maybe 10 that insulin, a poor sleep affects insulin sensitivity, at least one of the more prominent clinical physiology studies. I could ask someone with type 1 diabetes

that 50 to 100 years ago, you know, because they know. I have to inject two units of insulin. Now I'm given three. What happened? Anything changed? Well, I just got poor sleep last night. Nothing else changed. Okay, what about you?

That happened to you too? Okay. Now we get 20, 30 people. Okay, this might be more consistent than we think. You know, you see this stuff in real time. It's incredibly valuable. But this is probably also why, you know, I assume you,

I was talking to you about movement earlier. Mark, I heard you talk a lot about all these things that you guys are fascinated because you're passionate about it, right? It matters to you. You know, if you understand how to be healthier, move better, be more functional, whatever your focus is, you're going to put more time into understanding it, right?

And imagine if you had, like every time you did movement patterns, you're having like a 3D image of the body that's instantly analyzed, looking at a certain type of force production, angles, all these, it outputs everything, right? Or let's say that you're focused on health

and it gives you all your biomarkers you're talking about. The opportunity there would be insane. I mean, I think that it's much more viable when you come with AI, but you also need things that allow you to monitor other molecules within the body like you monitor glucose with CGMs. It will come. We're not there.

yet. There are challenges to technology, but they all get broken or all those barriers get broken down eventually. So you have a insulin thing too? Like something's like you hit a button and you get more insulin or is it automatic and is it linked to your CGM? Yeah. I don't know if I can actually show this on. If I can, I'll, we'll see. I'll show it either way. But what, so I have a CGM on my stomach. So right here I have a continuous glucose monitor under this blue patch. That goes to a signal in my phone. that says, okay, here's, I don't know if you guys can see this very well, but I'm looking at a screen right now that shows my glucose level in green, okay? And then below that are these blue triangles and blue boxes. These represent changes in the insulin requirements of my body. You'll see

that it kind of goes up and down like a wave does in the ocean. Okay, we call these synodal waves. It's a lot like how biology works. Circadian patterns work this way. Insulin works this way. way, glucose works this way. There's these up and down windows. The body's keeping you in this homeostatic state. But what's happening is it's actually an average of ups and downs that happen throughout the day for most of biology. So when I look at this, I'm not only seeing a continuous glucose number, but I'm also

seeing the change in ups and downs and insulin requirements. This is the total insulin load down here on the bottom. That total insulin load is a reflection of what you guys have had a CGM on you, you eat a meal. If it's lower carbohydrate, when I see a bump at all, higher carbohydrate, depending on if you exercise or didn't, might see a little bump or a lot of bump. Well, for me, what I'm, I might see the same thing if I give the right amount of insulin at the right time. At the bottom, you're seeing these fluctuations in insulin, which is really telling you the metabolic story

behind the scenes, because I can also look in here and say, okay, statistics, I can see the total amount of insulin I'm giving every single day. And, you know, previously my average was around 40 to 45 I use per day, 235 pounds, convert it to KGs, I don't know, roughly like 0.4, I use per KG. That's a relative insulin sensitivity metric and type 1 diabetes. But now it's in the 30s. Well, what am I doing? Well, I came out here to visit you guys. I've been on my feet more, walking around more, exercise frequently. So I'm moving more. I'm more active. My total exercise volume is higher. And it's harder to get as much food in when I'm out and traveling. So I'm eating less food and I'm exercising more. What does that tell me? Okay, well, these are the key

variables that are likely affecting insensensitivity. And I can see by how much. It looks about about 5% here, 10%. So yeah, you can learn quite a bit. But to your original question, you have a CGM, I have an insulin pot on the back of my arm right here, which houses, again, the most important molecule of all metabolism in there. Life-threatening, but life-saving as well, insulin. And when glucose levels change on here, it goes into my phone.

There's a system or app that has the background software that I have tweaked to say how much insulin I wanted to give at a certain time at certain levels. and then it will automatically administer it here. And that helps auto-regulate glucose control and insulin together. Again, it's working like the algorithm we spoke about earlier. But they call it a functional pancreas. The reality is that this system I'm using, it's called OPEN APS,

because it's on an Android system. There's other versions of it. But most of the automatic insulin delivery systems, what they call it hybrid closed loop, closing the loop between the glucose monitoring and the insulin monitoring, these systems are not nearly as effective for most people. In fact, if you look at the major randomized control trials and you look at how glucose control changes in patients

who use these devices, what you see is that at night, everything is better. During the day, it doesn't do anything. Why? Why is that? Well, because they're not eating at night, but they are eating during the day. These systems by themselves do not correct the problem of the food environment. They assist when food is absent and getting you into range.

But in the context of diabetes, particularly type 1 diabetes where you administer insulin, some people with type 2 have to as well, the insulins we administer are anywhere between three to four times slower than what happens in normal physiology. As a result, we're never able to be fast enough to match the rapid nature of traditional forms of sugary, even starchy complex forms of carbohydrates. This is why in the context of type 1 diabetes, it's incredibly hard to manage higher carbohydrate diets. Very, very hard. Are hard carbohydrate diets the devil? No. But in the context of diabetes, they're incredibly challenging because of these issues in type 2 with insulin resistance and glucose input

and you're just resistant to higher insulin, higher carb requires more insulin. And in type 1 diabetes, the more glucose into the system, the faster it is, particularly with carbohydrates, our insulin that we have, the best technology in the world that we have available to us isn't fast enough to metabolize it. So you're always reacting after the fact. So what happens when you react after the fact? Glucose will go up. It slowly comes down later.

This is why when you look and someone can Google this, a continuous glucose monitor in type 1 diabetes and just Google it. You'll see what looks like an absolute chaos of roller coaster ups and downs. That's a normal life for most people with type 1. on diabetes. But let's just say we choose a different diet composition. Let's say we reduce the one food in the diet that our insulins are too slow to manage.

Lower the carbohydrates. Not even like eliminate them, just shift them over to, let's say, fibrous forms of carbohydrates. Starches, or not starches, spin it. Or something with fiber. Well, it has to be high enough in fiber. So potatoes will still be too quick.

They peak at around 30 minutes. and the peak of most insulins we have available to us is going to be 60 to 90 minutes. So it's still about 30 to 60 minutes slower than a potato is. But if you think about spinach, broccoli, asparagus, cauliflower, these are mostly fiber-based, much slower, very little impact on net glucose anyways. And then you also have protein, which is much slower as well. Its peak is around an hour and a half, two hours, okay, depending on what study you look at. and it's much slower of impact or smaller of impact on glucose and more prolonged.

Well, the insulins that we have available to us are inherently slower and more prolonged and are able to match these slower forms of food much easier. So it isn't that carbohydrates are bad. It's just that the kinetics, the physics of insulin and glucose from carbohydrates makes it nearly impossible to reliably control glucose levels with normal mixed meals. That is why the vast majority of patients, in fact, 99% of patients will never see normal glucose control again upon diagnosis. But we know of a number of case reports, case series observational analysis, and now

emergent kind of uncontrolled interventional studies scientifically published shows that individuals with type 1 diabetes can reliably completely normalize or glycema control and get in that top 1% by lowering carbohydrates and prioritizing other forms of fuel the body doesn't require specific rapid forms of insulin that we don't have available to us and so that's as simple as it gets it's about prioritizing how we know the physiology and kinetics of glucose and insulin work with specific foods and shifting towards ones that are more manageable to get the net output of normal glucose levels. And that's really the game when it comes to type 1 diabetes.

But the same tools and strategies we know can reverse type 2 diabetes and have known that for 200 years. That is some amazing information. Do you or did you have to carry around like sugary stuff with you in the beginning? and if so, do you still do the same thing. There we go. I have smarties. Smarties.

I don't know what sweetarts. I don't know if I've tried those. I think they're bigger. Okay. Mark is sponsored by sweet tarts. And big sugar. So I have smarties here. I carry them everywhere I go because if my blood sugar goes low,

just because I do something to control my blood sugar level, doesn't mean that I have, I'm free of all forms of risk. when it comes to lower high blood sugar levels. And so I still have to be careful. If I were to, we're all like, oh, Andrew, we're all going to go exercise out there right now, like instantly. Well, normally I'd have to slow down the insulin

and the amount that I'm giving 30 minutes prior to doing that, right? Like, we'll do jit-su later. And so I'll have, I know 30 minutes before I get there, I'm going to bring it down. Based on the anticipated intensity of that, I have to regulate it a certain way, right? So, but if I don't do that in time, the insulin, because it takes so long to go in,

you're going to have it linger. And when you start exercising, it absorbs really quickly and you can run the risk of low. So no matter what, like I'm in the airport, I'm running to catch a flight. I didn't know I was going to run. And now it's getting even faster. I'm more sensitive.

You always need to have sugar on you at all times with type of NIPs or you run the risk that that's going to be the day or the time where you have a low blood sugar moment and you don't have anything to correct it. Luckily, sugar's everywhere. So you cruise over to the Starbucks

and get the sugar packet in the raw and just down it, right? I know. You're in the drinking water, I think nowadays. Orange juice. I mean, you can use anything just about? Yes. So I only carry these around because they're pure forms of dextrose, which is the most rapid acting.

They don't require digestion to get into the, to get through the large intestine. They just need to be broken down to individual components. Orange juice is a great option. It's often highly recommended to rescue glucose levels if you have low blood sugar levels. But basically any form of racted acting carbohydrates will work great. I always do smarties though or dextrose because actually the things you buy in pharmacies are other areas that are the chalky things that people consume to rapidly increase it, kind of pharmaceutical grade,

they're just pure dextro, so are smarties. Smarties taste better. And they're cheaper. And you can carry around in your pocket, no problem. You know, so that's what I do to each their own. But yeah, if you need to correct with orange juice, you could correct with a fruit. The only problem with fruits is that now you're moving from somebody

that doesn't require my suggestion. It's so rapid to something that now has structural, structural components that you have to now chew, digest, it's going to compete for digestion with the fibrous components, structural components. You have to break it down to individual molecules. Only a portion of that is actually sugar, which is why oranges work better and bananas work better because they have less fiber and other structural components, they'll get it quicker. But the other forms, the more fibrous components, the slower as suggested, the less it actually effectively can rapidly correct hypoglycemia. But yes, any form of sugar can,

do it. Even protein can theoretically, but it's usually not recommended because when people get into a low blood sugar moment, they don't want to sit there for an hour or two before protein will bring it up. I'd imagine that you have injectable insulin with you in case this other stuff isn't working the way he needed to. And that backpack over, well, on the other side of that door, I have a blood sugar capillary meter where I can poke my finger and test my blood sugar level because what happens that the CGM gets ripped off happens often in Jiu-Sut. So So I bring secondary supplies like two to three because if I insert it and it goes wrong, you're basically packing a pharmacy sometimes when you travel with type 1 diabetes, technology and pharmacy.

So you're always prepared for anything that can go wrong. But I have a blood sugar meter that I always use as a backup to the CGM. And then I also contain injectable insulin in case this pod gets ripped off. Then I can immediately inject into correct blood sugar levels. So that pod stays on while. you do everything you do like you can't just take it off before you have to keep it on while exercising stuff absolutely because like for example I went into some dujitsu tournaments and you're like oh you can't have anything on on your body uh I won't name the tournament but like there's some of the

prominent ones are like you can't I like hey I have diabetes like I need to have like no no no nothing and I was like okay so I took it off and then it just becomes way harder to regulate you get in the bullpen right before you go out and compete um and you're kind of you know imagine I'm coming under the bullpen I'm like, hey, someone give me my insulin injection. You know, like I'm over here injecting intramuscular in my shoulder right before I compete, you know, I win and then no one thinks I won for any good reason. So that wouldn't work out too well. So, you know, and even having Diipone diabetes,

I almost could practically have type one diabetes tattoo on my forehead like Mike Tyson, you know, that people know I have this disease. But even still, I don't necessarily want to pull us for into all moments and inject it. Yeah. And so actually I started competing. just not telling them, I just keep it on, but like, what are you going to do? You know?

No one likes to be like, hey, take off your medical device. It's life-saving for you. And by the way, according to the American Disability Act, like, no one can actually technically stop you from doing those things. I don't know if policies have caught up with that. I'm not the one who's going to fight that. But all said, yeah, you need to keep it on. I keep it on at all times because if you take it off

and you have to shift over to injections and it becomes complicated. Yeah. But they've been ripped off more times than I can think of. when it comes to particularly grappling and other martial art environments for sure. What can people find to Andrew? Andrew Kootenik.com. If someone actually wants to reach out to me, they can go to the website. There's a contact form there where they can reach out.

I'm also on Twitter. Well, okay, X technically, but who calls it X? So X, Instagram and YouTube, but I typically respond to most people from the contact form or on Instagram. That's where I put a little bit more time and effort. X, I used to respond a lot to, but man, it's so negative. You know, it's like walking into a shit show. And you stick around, you know what you're getting.

So that's where I tend to place my efforts. Strength is never a week. This week, this never strength. Catch you guys later. Bye.