Excellent lecture here that everyone with Type 2 Diabetes (currently) needs to watch!

Im a 66 year old woman with 30 yr history of type 2 Diabetes. I've been shuttled from actos to Metformin to Victoza back and forth until I was put onto Lantus and Novolog. I continually gained weight with worsening symptoms. Im a cardiac patient due to the stresses in 2020, causing takotsubo cardiomyopathy. I started the keto diet recently and have seen a reduction in the needed insulin. However, I'm thinking carnivore is the only thing that is going to save my life. I have no one on my medical teams that agrees with Keto, let alone all animal products. I'm honestly going to have to nod my head at appointments and go home to do MY OWN THING. Thank God I know how to track my blood pressure, take my medications, and I wear a continuous glucose monitor. Please wish me luck, I'm going to seriously need it. My husband will do this diet, too.

Thank you for your research. 17 yrs ago I had a massive heart attack,(5 bypass surgery), my cardiologist almost in passing said did you know you’re diabetic? I had no idea. And treated my heart problems only 11 different meds. I walked into the hospital 183 lbs in shape. 9 days later walked out 224 lbs. six months later blew up to 265 lbs, walking 10 miles aday everyday. Then diagnosed with COPD and was put on prednisone. I blew up to 315 lbs. all my cardiologist & primary care doctors treated me with metformin, statins, high blood pressure meds, & Ozempic switched to TRULICITY switched to majourno . I started the carnivore diet 10 wks ago. I started at 316.8 lbs; waist was 62.5 inches & my average blood sugar was 134 daily. Today I’m down to 300.2 lbs, waist is 57.5 inches & my blood sugar is 112 average. You have helped me sooo much by teaching me about my insulin resistance. Sorry so long I

I took Metformin for about 8 years before I found out how it affects B12. No one informed me of a B12 deficiency caused by taking Metformin. Not taking Metformin anymore however. Diet controlled now.

I was so disheartened when a woman in her 70's with T2D was stuffing herself with sugar laden desserts and when she asked why I wouldn't eat this I explained briefly why. She then said, I want to enjoy my life and I'll take my metformin. I had to bite my tongue and walk away because I'm not her healthcare provider. As a board certified Family nurse practitioner with over 50 years of treating T2D I have heard this more times than I can count. Americans want to compensate for all their bad behaviors with a "PILL" because that's how medicine has socialized this culture. Just watch TV. There's a "Pill" or "Drug" advertised for everything, especially T2D!! When is this going to stop? I tell my patients, "You ate your way into this and you can eat your way out of this".

My blood glucose isn't terribly high but my doctor thought that I should be on metformin. For the last several weeks I've been working metal to fabricate new production equipment. In the past I always gained muscle when moving all that metal around. This time I'm actually getting weaker and I'm becoming very very sore. I'm starting to suspect that it's not age but the metformin that's causing it.

I bought your book “Why We Get Sick” and read it three times and have lots of yellow highlights.. this book helped me understand what I was already doing but NOW I UNDERSTAND WHY IM DOING IT! I gave it to a few people at work who are into fitness and they were wowed by it… one guy started reading it at 5pm and read it all the way through and went to bed at 3am! Thank you so much for your life long work for everyone to read! Just think about all the people you are helping!!!

I took metformin once a day and had diarrhea and upset stomach.I had urinary tract infections and Fournier Gangrene.

Dr. Bikman one of the Top Doctors in Diabetics! Thank You so much!

They make things worse because no one tells us that the only cure for T2D is a drastic and immediate dietary change so we think we are being fixed by what amounts to a chemical bandaid that masks the issue. Been there. Done that.

I used to have type 2 diabetes. It went away after 60 days on carnivore. My A1c didn't budge while I was (previously) doing plant based, whole food keto and intermittent fasting. Bonus positive was that my triglycerides also dropped 90 points in the same (1st) 60 days on carnivore. They only went down 10 points during the previous year on plant based, whole foods keto. Additionally, on plant based, whole foods keto, my gut issues were AWFUL. The gut issues have steadily improved on carnivore.

Hey Ben, great talk. My personal experience with metformin is that during training (cycling to be precise) I would get insane hypos when training time exceeded 2 hours. I experimented a lot, but I couldn't keep up with glucose intake. I did a lot of experimentation on myself to figure this out nothing worked. Then I had a talk with my diabetes practitioner and I explained my hypothesis that the hypos were caused by the metformin. She didn't understand a word I was saying and telling me it probably it was something else and we should stick to the protocol. A few months later I was pulled metformin and I never had a hypo since. This happened in April 2020. You exactly explained my hypothesis in this talk. By the way during long endurance training blood glucose tends to go down, but never into the hypo territory.

Before I started my carnivore journey 3 years ago, I was T2D taking Metformin and I was not happy with what it was doing to me. My doc was blaming me for my worsening health as in his opinion I was not doing enough exercise, but I was doing regular resistance exercise as I hated aerobic. Over time I found that I wasn't getting the results that I was expecting in the gym, and I was hurting myself more often. I also felt that whilst my weight wasn't reducing, I just felt that I was getting fatter, and this was borne out when I realised that Metformin was causing my fat cells to be less resistant to the effect of insulin, thereby allowing more fat to be stored. Once I stopped taking Metformin and by changing my diet to low carb, I started losing weight and all other issues disappeared along with the meds I was taking ie high blood pressure and the statin. 3.5 years later, no meds and on a carnivore diet - I haven't felt better although my doc doesn't approve. He keeps on harping on about my high LDL, but I ask him about my HDL / Triglyceride ratio which is a truer indicator of heart disease than high LDL.

I am physician and teacher myself,love your class ❤

Good for you Dr. Ben for emphasizing the opposite nature of HYPOinsulinemia (I) vs HYPERisulinemia (II). This is something that the general public *really* needs to understand.

Thanks to you Dr. Bikman I know more than my Dr.

Going to class is fun and exciting. I finally )ketovore 3.5 years) have the mental clarity to take the info in and process it.

Brilliant lecture. What a gentle and kind professor, full of wisdom. Thank you for your vids and all the diligent work you do to bring health knowledge to all. Extreme appreciation.

~8:00 Please also mention at some point another important set of effects of hyperglycemia: First, in addition to raising HbA1c, it also significantly raises the glycation of ApoB-100, the signaling protein attached to LDLs, and this renders those proteins unrecognizable by their receptors. This can eventually lead to an increase in pattern B LDL, which is an increase in SDLDL, which is a big chronic problem. The American Diabetes Association knows about this; they have published papers about the glycation of ApoB-100. Second, please go into details about the effects of hyperglycemia on the kidneys. There are at least 4 areas on the nephrons with glucose receptors. One of those areas is on the acending loop and distal tubules, and is responsible for sodium concentration. High insulin causes sodium retention by increasing reuptake, and low insulin results in loss of sodium to the urine. Please also look into the details of the other three insulin receptor areas in the kidneys and describe their functions. Thanks!

Type 2 and have been confounded why my muscles can't build and haven't been what I consider "normal" for years. I've been on metformin for years... I've been afraid to stop it in large part because of having PCOS. I think I need to take another look at how I'm handling everything.

Thank you very much, am physician and diabetic, iall you interviews and lectures are helping me, eitger in my practice as primary care phtsician and myself being diabetic

They induced my wife's pancreatic cancer. It was prescribed, apparently four months later pulled from approval, I determined that a year later and four months after she died..

I created a Dr. Bikman folder in my saved KZfaq videos and this one is especially key.

Thank you from Ethiopia, I am a diabetic and need such explanations badly.

Great informative episode Ben, thanks a lot.

41:30 - It seems to me that metformin prevents the uptake of fluids from the intestines, so fluids, glucose and B12 will be lost that way. A high dosage can give you diarrhea. KenDBerryMD said in a quick video that a lack of B12 could lead to "irreperable damage," but as far as I can recall he didn't get more specific. Anyway, if you take metformin, you have better monitor the level in your blood and make sure you can supplement with exogenous B12. According to some you can have too much B12, but others say any surplus will go out with the urine.

Thanks for an excellent presentation!

Very informative session. Thank you for sharing 🙏

What is suggestive when insulin doesn’t lower blood glucose? Diagnosed T2 two weeks ago and started metformin and 10 units of Basaglar. With low carb diet, first morning after 10 units, BG was 274. Dr. Has since increased to 36 units at night and morning BG is 270. Not eating after 6 PM. Low carb, exercise, etc. Can’t figure it out. A1C was 14.3. 35 year old male, athletic build, not overweight.

Thanks for the amazing video❤

Love the awesome information. I need to be able to speed up your videos so I can make time to listen.

Love your book Dr Ben Helped me so much Thankyou

I am so excited for the uptick in videos as of late!! I could watch and learn every day! I cannot thank you enough.

Thank you

Another great episode… thank you.

Great lecture. I tapped into your lecture today and was very glad I did. Thanks for sharing this phenomenal information.

Thank you Ben.

Fantastic Ben thank you. I am watching everything you post now and particularly like your book.

I love Dr Ben! Thank you for the great info you provide, Doc 🙏🌷🪻🕊

Really appreciate your lectures!!!!

This is such a valuable lecture! Thank you Dr. Bikaman!

thank you Dr!

You rock sir ! Keep up a great job.

I listen t o every word and every video. Thank you very much!

Great information, thank you

Appreciate your talks so much, Dr. Bikman, and your analysis -- especially the discussion of how Type 1 autoimmune diabetes compares and contrasts with Type 2 insulin resistance. You clearly think about this topic a lot, and are looking for optimal solutions. I do have a bit of a disagreement with what you said about "LADA" as being "rare" and "late onset." No, sorry, that's not correct. New cases of autoimmune diabetes are mostly diagnosed in adults, but we are stuck with this lingering belief that "Type 1 diabetes happens mostly in children." Nope, it happens in every decade of life, and if adults were tested more, we would all see that autoimmunity is actually more prevalent than "the medical establishment" has led us to believe. What would "late" be anyway? Teens, 20s, 30s, 40s, 50s, 60s, 70s, 80s. I've talked to many individuals and seen reports of all these ages. So, there's no dividing line between "Type 1" and "Late onset Type 1." As you say: LADA is just Type 1 diabetes. But you mentioned it in context of Type 2, and saying people are also developing autoimmunity. No, I don't see this at all. Mostly adults are simply being misdiagnosed as Type 2 from the start. And generally that is because of this old belief about Types are determined by age. Or that "gestational diabetes predicts Type 2 diabetes in 50% of cases" -- um, except sometimes it isn't Type 2, and is again autoimmune diabetes that was going to show up eventually, if the pregnancy hadn't revealed it. One can can have "double diabetes" -- with both autoimmunity and resistance. But that isn't LADA (nor is that the so-called "Type 1.5"). Type 1 are not immune from developing insulin resistance and developing fatty deposits, for all the same reasons as you discuss. So, would appreciate a clarification that "LADA" is not related to Type 2 in any material way; autoimmunity is the problem. And also that saying "late" is misleading and potentially harmful to patients, because they end up delaying essential insulin therapy, either because they don't want to believe they have Type 1 autoimmunity; or because their doctor doesn't want to believe it. (They might also get this nonsense diagnosis of "Type 1.5.") So, another reason medications don't work for some diabetics is because they are being treated for the wrong disease. When in fact, they cannot make enough insulin, and do absolutely need insulin injections. But these people are getting exposed to all of the wrong messages: "Insulin for Type 2 is life threatening." Okay, for too many genuine T2D patients -- but people with the incorrect T2D diagnosis walk away with an aversion to taking insulin, and may end up hospitalized with DKA; or otherwise thinking they "failed" to take care of themselves properly, and remorsefully need insulin. All of the other medications would be masking the reason for the high glucose. So, what you say here is well-reasoned for Type 2; but please also emphasize that patients first need the correct diagnosis -- autoantibodies and C-peptide. If the insulin levels are not ever measurably high, then increasing possibility that the patient does not have Type 2 insulin resistance, and may be misdiagnosed. Autoantibodies are found in "Type 1" diagnosis in 90% of people with that diagnosis. Insulin therapy shouldn't be made into the boogeyman; people need proper testing to be given the proper drugs. But too many times, they don't get it. Thanks for your work. I have so many questions on other diabetes issues.

Thanks for your series on diabetes excellent

I am really enjoying all of the information that I am gathering from listening to you Dr. Bikman. Thanks for posting your videos. I was curious as to if you are going to ever have a KZfaq lecture on Anti-Diabetic supplements and how they work, etc.? I am a type2 with an a1c in remission standards and take Berberine, as well as I have taken other supplements that affect blood glucose levels. I have also read that Berberine can improve lipid metabolism and lower cholesterol. It would be really great to hear some of the science explained by you behind how Berberine and others work concerning blood glucose management. Thanks again for your lectures Dr. Bikman and I look forward to listening to more as you post them, as well as seeing more of the interview type KZfaq videos with you in them.

Thank you!!!❤

Another good one dr Ben🙏

Great lecture 😊😊

You truly are a blessing❤ you bring so much truth and knowledge to all of us, I thankyou from the bottom of my heart🎉❤

I am same as Jackie with ketone, ketovore, and SGL2. Xigduo. I quit taking, w/o doctors help, but I am so sick of this, BG coming down avg 14 days 157, quit measuring ketone bc I moved and never found my tester. PS was on Metformin 14 years, slowly creeping up, Xigduo for 4 years.

Excellent info! Thank you for taking the time to share. I particularly wanted to ask about exercise and protein consumption relative to insulin secretion. I have read your informative book, but noted that you seem to be saying that protein -in the absence of sugar- does not have a significant effect on insulin production. I understand the importance of protein in conjunction with exercise, but am concerned about rhino testing my pancreas every time I consume protein.

Thanks!

Any thoughts on dihydro berberine?

52:00 nice explanation, it helps me understand better.

I understand the mechanism of insulin resistance leading to hyperglycemia / diabetes type 2. Therefore I have been thinking why surgery / transplant patients are injected with insulin because of corticoids induced hyperglycemia / diabetes. Is it not that in this case , insulin is still ample but not effective rather than a lack of it? While it sounds insensible, the insulin injection has been done everywhere worldwide and has proved to be helpful. I have been scratching my head on this, and would appreciate your explanation.

Hi from paris, you are such a great professeur,

Once again- brilliant!

WOW! So much to unpack...grab a notebook & rewatch many times.

I saw an interview where Peter Attia has changed his stance on metformin if you are not using it for insulin resistance.

I'm trying to understand the role of cortisol and its impact on insulin and metabolic flexibility. Will you be discussing this in a future session?

Super Video, as a lay person trying to understand it is very easy to get caught up in social media arguments that one cannot really unpick because of a lack of education or IQ probably. Once such area is the idea of insulin resistance being poo pooed in favour of 'the Randle cycle'. Is it possible to unpick this? My super simplistic understanding is that insulin resistance is about the signal from insulin being less effective because hyperinsulinaemia causes tolerance, so more is required i.e shouting louder. The Randle cycle saying that it is not 'resistance'. It is the fact that the cells are already full of energy and have chosen to close the doors. They won't accept any more 'energy'? Is this just nitpicking does it matter anyway consequentially? (to a lay person of course, to somebody interested in the actual biochemistry there will be an answer, I assume?) But for myself, I would like to understand in broad terms which is the right way of thinking about it.

This whole lecture is very informative - great to know the in’s and outs (as far as we know!) about metformin and muscle and other side effects. I was curious about you saying glucose doesn’t taste sweet, when I see it as dextrin on ingredient lists as a sweetener. (i saw online with a quick google search, that it was described as tasting 70% as sweet as sugar, or tasting starchy. Not sure which is correct or if both, and I know quick google searches aren’t always accurate)

I admire your ability to explain this complex processes in plain language. It's so interesting to know how our body works.😊❤

Dr. can you cover the Randle Cycle? We can not get a good straight answer.

Was symbella the name of glp 1 u talked about last a better alternative to other glp1s

Very informative lecture. It did not touch upon Teneligliptin ? Our doctors are prescribing. Any thoughts on these please ?

Great Lecture . An example of the brand name for the scientific names would be great. thank you .

About metformin. I tend to have quite a few days in a row in which I'll do a lot of endurance and strength training, and then several days of none. Is metformin's half-life short enough to conform with my exercise schedule? I generally won't take MF for 30 hrs post hard workout.

What about Berberine?

I'm not sure about the "glucose isn't sweet" statement. I know that fructose is something like 7 times sweeter, but I had a Kraft test and drank 75g of glucose. It was sweet. Did they add something to make it sickly sweet?

~8:00 Fatty liver disease appears to be a consequence specifically of high dietary consumption of *fructose* which is almost completely intercepted by the liver and converted into glyceraldehyde (toxic) and dihydroxyacetone-phosphate, and not directly related to hyperinsulinemia.

Professor Bart Kay states there is never a case of insulin resistance but only a situation in which the mitochondria is full of glucose and has just “closed the door” on any more insulin but has not built up any so called “resistance” to insulin. I realize this is somewhat of a semantics debate but would like to get Dr. Bikman’s opinion.

Have been a diagnosed DIABETIC for 6 years, oh after today I have to go on this diet for six months. I cannot take metformin very bad side effects .. so I was put on 50 units of humulin 3 (isophane) KwikPen BD..9am & 4pm daily before I eat two meals a day.. IF after 7pm-9am. Can I come off insulin immediatly, continue on Low carb keto diet, eating below 50 grams of carb..I have gained weight (10 kgs in two years..

So I know this is anecdotal and I may be wrong. But I feel very strongly that when I first started taking metformin that I put on muscle.

SGLT-2 blocks the re-uptake of glucose? What happens to the sodium? Are there ramification to that?

Very helpful session. Thank you. My only concern is when you answer a question with information you aren’t totally familiar with or haven’t researched (example vit B12 and metformin). Why not just say you aren’t sure, instead of answering in a way that adds a negative connotation to the drug? As scientists and experts, we should state the limitations to our opinions and not be afraid to acknowledge what we don’t know or aren’t sure of. Thanks for considering this.

Thanks dr .

Thank you Dr. Bikman for clarifying the mechanism employed by GLP1-RAs like Semaglutide. I've been on Ozempic off and on (due to shortages) and found that after some time it becomes ineffective. What could be the reason in your expert opinion?

Does metformin interfere with vitamin B12 absroption? Answer to this question may greatly help me.

Does Invokana work like Metformin?

very interesting..thank you.. so my husband is a bit of a quandry to me and to his doctors.. he has low insulin ( it was 3.5 before he started taking insulin which in functional medicine is actually considered optimum) but he had high blood glucose.. we thought he had LADA but his bloodwork does not have any of the markers that differentiate this diagnosis.. so he has been taking insulin and i have had an issue with this because i know too much insulin is a problem.. any thoughts on how we should tackle this..

Increased Headaches, after aged 34 in women are possibly linked Female Hormone contraceptives to PCOS and Or To Peri-Menopause( ie meaning NORMAL lowering of thyroid, Progesterone levels etc .. etc ) in women!

Glucose does not taste *as sweet* as honey, sucrose or fructose but it does taste sweet. I have consumed many pure glucose tabs. Tastes sweet to me.

Love u Dr. Ben

Metformin destroyed my bone marrow.

Dr. Ben, Is there any glucagon inhibitor without causing side effects? Is it possible that stevia or similar products here glucagon reducing effect? It will be a great help for diabetics if such thing exists. I’m not talking about GLP1 agonists which have their own problems. Nagi Reddy, India. Ps. I read your book. Most comprehensive and informative for the people who can understand some biology.

Any thought on DPP-4 inhibitors such as Januvia?

I use a glucose monitor Agamatrix Jazz. Is there a similar device to monitor Insulin. I'm a type 2 diabetic.

If, after years of eating the SAD diet, one eats low carb but still cannot lower glucose to normal levels, what drug, if any, would you recommend. I am aware you are a researcher, but curious…

Genuine question, but doesn't metformin increase insulin sensitivity of the liver - i.e improving impaired fasting glucose. Exercise improves postprandial blood glucose, i.e peripheral insulin sensitivity muscles and fat. so exercising with metformin is actually good?

I have diabetes but struggling to control it because I have hemochromatosis my ferritin is very high my iron overload is still high I just don't know what to do I'm doing the carnivore diet but my blood glucose is very high I'm not loosing weight nor feeling better ..have you any videos on diabetes and hemochromatosis?

I've had exercise-induced hypoglycemia a few times. It was when I'd pushed intermittent fasting further than was healthy for me, to the point of developing some slightly disordered thoughts and behavior around food. I'm fine, no permanent damage, but that was a thoroughly uncomfortable experience and I don't recommend it.

Just bought your book why we get sick just to support u. Also to listen.

my friends mother had type 2 diabetes she never went to the drs she lived for years with out treating diabetes then years later she died atleast she lived a good quality of life not suffering from the negative effects of diabetes meds she never got any serious problems from diabetes untill years later and she died she was my friends grandmother

What you you know about Janumet, please?

Would have been good to hear some brand names of the drugs described..

Listened to it several times to get at extra tib bits.