#1 Absolute Best Predictor Of When You'll Get Diabetes

Hello Health Champions today we're going  to talk about the number one absolute best  

predictor for when you'll get diabetes and  in order to understand this predictor we  

need to understand the diagnosis of diabetes and  unfortunately diabetes is becoming so prevalent  

so common that most people will probably develop  it as they get older but if you're watching this  

video chances are that you are on your way to  not becoming most people you can avoid this if  

you know how now fasting blood glucose is the  standard way that they diagnose this and they  

say normal is less than a hundred but we don't  ever want to let it get to a hundred because then  

we're already well on our way there pre-diabetes  they say is 100 to 125 on fasting glucose and  

that means they're measuring glucose when you  haven't eaten anything in about 12 hours and  

and diabetes they classify as anything over  126 milligrams per deciliter and if your blood  

work comes in millimoles then you just divide  these numbers by 18. the second measurement  

is hemoglobin A1c and it's also about glucose but  instead of just measuring what it is in a specific  

moment we're measuring something that evaluates a  three-month average so as glucose swims around in  

the bloodstream some of it sticks to the proteins  in the red blood cells and that's called the  

hemoglobin A1c and normal is anything less than  5.7 again I think a good range would be 4.8 to 5.3  

pre-diabetes would be 5.7 to 6.5 and diabetes  is anything over 6.5 so again it's a glucose  

measurement but it's measuring an average so it's  a whole lot better than just measuring fasting  

glucose the third one which is supposedly the  gold standard is an oral glucose tolerance test  

and what they do here is they have you drink  a solution of sugar something like a hundred  

grams of glucose dissolved in water so to make  your blood glucose rise very very quickly and  

then they have you sit down and they measure  every 30 minutes for how many hours and now  

they want to see at a certain point that normal  I think after two hours or after 90 minutes then  

your glucose should be less than 140. so your body  should be able to control this huge load of sugar  

pre-diabetes means that it can't quite get it  under 140 but it's between 140 and 199 and for a  

diabetic the glucose is still over 200 milligrams  per deciliter but there's a problem here in fact  

there's a couple of problems and the first is that  when we're talking about diagnosing that means  

that by the time you have a diagnosis you already  have it and that was the whole point of predicting  

it is to look for the signs and understand it  before it becomes a diagnosis so that you never  

get it the second problem is that all of these  measurements are about measuring glucose there's  

just three different ways of measuring glucose and  we're going to look a little deeper and understand  

that that's not what it's about in terms of  predicting that's the end result that we want to  

avoid and now we have to understand stand how it  works we have to understand some of the mechanisms  

in the body so there are three simple questions we  want to answer one is what brings the glucose up  

two what brings the glucose down and three  where does it go wrong where does it stop  

working because a healthy person should be able to  drink that glucose solution and have it go up and  

then come down in a timely fashion but where does  that go wrong let's answer the first question what  

brings glucose up and we're talking about blood  glucose and the first and obvious answer is that  

glucose brings up blood glucose and glucose is  a ring it's a six carbon ring and another name  

for that is dextrose or grape sugar it occurs in  natural things like fruit in small amounts but if  

you get pure glucose then it's been processed and  refined the next step is called sugar table sugar  

and the way we get that is we attach a ring to  it which is very similar but this one is called  

glucose and this is called fructose and if we link  the two then we have a disaccharide one is called  

a monosaccharide two is called the disaccharide  and the fructose still has six carbons but one  

is kind of hanging off to the side a little bit  and this is the foundation of all the sugar in  

fruit in high fructose corn syrup Etc it's just  different combinations of these two molecules  

and sometimes they're hooked up and sometimes  they're not and we're talking agave and honey  

and so forth it's all the same stuff but then the  next part of glucose is things containing glucose  

it's not glucose yet but it quickly turns into  glucose so anything from a plant basically fruits  

and vegetables for examples they have sugar they  have starch and they have fiber so this is the  

first portion this is the sugar portion and then  if you take this glucose part and I'll just draw  

a circle to keep it simple if you take dozens or  hundreds or even thousands of these and you link  

them together now you get a starch and if there's  a bond if there's a link between them that looks a  

certain way then we have enzymes to break it down  and now we can chop off these little units and we  

have glucose again so when you eat starch we need  bread and potato and rice Etc these things break  

off rather quickly they start within seconds in  the mouth and within minutes these are in your  

bloodstream to some degree not all of them that  takes a little while but they start within minutes  

and that's why things like bread and pasta and  potatoes have a higher glycemic index even than  

table sugar it gets into your bloodstream faster  and fiber is really the same exact thing again  

almost exact not quite because we have the same  glucose units making it up only in this case  

the link goes it's like a mirrored link it goes  the other way so now humans don't have the enzymes  

to break that down cows can do it they can eat  cellulose that's what fiber is and they have  

bacteria that can break down that have enzymes  to break down that Bond but humans can't so we  

can make energy out of sugar and out of starch and  out of glucose by itself we can't make energy out  

of cellulose and our bacteria can't either it just  passes straight through there are other types of  

fiber that are bacteria can use so most of the  time you're going to hear people say the the  

official guideline a mainstream belief is  that sugar is a bad thing which it is but  

that complex carbohydrates like grain and rice  and potato are really good for you that they  

should be the foundation of your food intake  so let's look at that let's try to understand  

a little bit how these relate in different foods  so if we Mark starch with red sugar with yellow  

and fiber with gray then if we take a look at  grain and fruit and non-starchy vegetables so  

these are things like leafy greens and onion  and broccoli and cauliflower and green beans  

whereas starchy vegetables would be  something like potato or sweet potato  

Etc so let's look at grain first and grain if we  look at it from zero to a hundred percent it's  

mostly starch it's going to be in many cases  cases 75 to 80 percent starch there is a tiny  

tiny little bit of sugar that's why it doesn't  taste sweet right away but bread has kind of a  

sweet taste because there's a trace of it but then  it starts breaking down so fast in the mouth that  

it tastes a little bit sweet and it does have  some Fiber especially if we don't refine it  

then we look at fruit and fruit is kind of  the opposite it has virtually no starch in  

it there's some some fruits like banana has  a little more starch but most of the really  

juicy fruits they they don't have hardly any  starch they do have most of their carbohydrates  

as sugar and it's going to be a combination of  glucose free glucose free fructose and combined  

as sugar so there's three different ways that it  presents but overall it's about 50 percent of each  

and then it also has some Fiber usually not quite  as much as the whole grain and then we look at  

the non-starchy vegetables and we see that it has  tiny tiny tiny virtually no starch at all it has  

very very little sugar it's usually two to three  grams of sugar and it's going to be a combination  

of glucose fructose and sucrose table sugar and  then we look at fiber which we can't break down  

and we see that there's a little bit of this so  now what we want to understand is that inside the  

yellow dotted Circle here Square these are the  things that we can turn into energy this is what  

becomes blood glucose at some point and with the  grains in many cases it's 75 and up there are some  

grains that have a little more protein so they  might be 50 60 but a lot of the popular grains  

like bread and rice wheat and rice they're going  to be 75 and up fruit is mostly sugar and it's  

going to fall somewhere between 12 to 15 percent  for most fruits there are some berries that are a  

good bit less but when we're talking about apples  and oranges and bananas they're going to fall in  

that range of how much of that substance  of that fruit of that food that will turn  

into blood glucose that potentially turns into  blood glucose and then we look at vegetables and  

we see that the things we can turn into energy  are almost non-existent they're tiny tiny tiny  

so a lot of times people think that I advocate  zero carbs and I don't I think carbs are okay but  

they need to be mostly from non-starchy vegetables  where we get anywhere from two to four percent of  

that food can turn into glucose and because  it's also balanced by more fiber there's more  

fiber in there that's going to slow it way down  plus we have to chew it a lot so it takes time  

to chew it so that's why non-starchy vegetables  are going to raise your blood glucose extremely  

slowly and basically not to any noticeable or  significant degree whereas grain will have the  

greatest impact and fruit has many many times  the impact of non-starchy vegetables but also  

this sugar is half fructose which if you are  insulin resistant and you have some degree of  

fatty liver then half of that Sugar being fructose  is going to be kind of hard on your liver and slow  

down the reversal so this is what brings glucose  up and next what brings glucose down and the first  

thing is insulin so that's a hormone that we  release anytime that we eat carbohydrates blood  

sugar goes up insulin is also released because  it acts like a key it unlocks the little gates  

in the cells that allow glucose to get out of the  bloodstream and into the cells so insulin is the  

number one number two is exercise because when  you exercise at a moderate Pace or high Pace but  

moderate is better because it's more stable for  your metabolism and your energy consumption the  

exercising muscle if you even just walking if you  get to heart rate up from 60 or 70 to 110 120 now  

the muscles act like sponges and they suck up that  glucose out of the bloodstream without the help of  

insulin or with a microscopic amount of insulin  so exercise can be helpful to do that as well  

and the third thing is lipogenesis that means  making fat and the thing that we make fat from  

is glucose so when the glucose goes too high this  is one more way that the body can bring down blood  

glucose especially if you're insulin resistant  then the cells are resisting the glucose to come  

from the bloodstream and then another option  is for the body to take that glucose and turn  

it into fat instead and then also glucose urea  and that's something we definitely want to avoid  

this is like a safety valve when the glucose gets  so high when it gets over about 180 then that's  

exceeding the renal threshold the kidneys usually  reabsorbs all of the glucose but when it reaches  

a certain level then it starts spilling out in  the urine like getting rid of it as a safety  

valve now where does it go wrong if there are  things that bring up blood sugar and the body  

has ways of bringing it back down where does  it break does that mean that we can never have  

any carbohydrate at all some people think that  carbs are evil and that should everyone should  

have zero carbs and I don't agree with that I  think carbs are great however historically our  

ancestors based on our DNA and our ability to  process foods they had carbohydrates seasonally  

carbohydrates are plants they grow during  a growing season they don't grow year-round  

typically they also ate them unprocessed we never  had any processed carbohydrates or food at all and  

they had very very limited grains they might have  been walking around they found a handful of grains  

and they pulled them off the straw and they chewed  on them or made a little soup or cooked something  

with them but it was very very limited right so to  that extent carbohydrates were good because they  

could stimulate a little bit of insulin they  could stimulate a little bit of fat storage  

they helped us put on a little extra weight  during the plentiful season and all of those  

factors would help us survive the famine and their  carbohydrates would be a good thing however today  

it's not very limited we have a grain based diet  after the Advent of Agriculture we created a  

foundation that everything was based on grains  so now we had a lot lot more than we ever had  

before and then of course that lasted for a  few thousand years and then very recently in  

the last few Generations we've started processing  everything removing nutrients making the starches  

more available and so forth and in addition to  that it's not just grain but now we process some  

of those things into sugar that has fructose  so now we have an abundance of fructose as  

well something that we never had before we had  a gram or two or three in fruits that we found  

occasionally but now we have an abundance of  those things and we have them 365 days a year  

they fly the these things all around and ship them  across the globe so we have everything from every  

part of the world all the time and now carbs are  not a good thing if we have broken the machine  

if we have overwhelmed the system then we have to  back way off on the amount of carbohydrate so the  

problem is too much too long your body can handle  an abundance of carbohydrates for months a couple  

of years even but when we have it decade after  decade that's just too long and eventually the  

system breaks down now it's just not only carbs  it is also other factors but we're not going to go  

into much detail here things like seed oil other  things that create inflammation like stress and  

corticosteroids all of these things also promote  insulin resin distance and metabolic problems and  

either way it happens once you are insulin  resistant and have metabolic resistance now  

you are carbohydrate intolerant you just like you  have an allergy some people can't tolerate peanuts  

or fish or strawberries well your body doesn't  know what to do with carbohydrates at this point  

so now the question is how do you measure that  how do you measure when you have become insulin  

resistant when it has become a problem is it by  measuring glucose and the answer is no and here's  

the big problem that the diagnosis of diabetes  is based on glucose alone but glucose is not  

the thing we're looking for glucose is the end  stage results we have to understand a couple of  

more things about how to measure that so when we  get diagnosed with diabetes the glucose is high  

but then it's already too late glucose is not the  thing that we want to measure we want to measure  

a predictor so here's how this works we have to  understand a basic mechanism that once you eat  

something your glucose goes up and when glucose  goes up your body releases a little bit of insulin  

and if your insulin sensitive it just takes a  small amount of insulin to control a moderate  

amount of glucose but if we go a few years forward  in time and we check again then probably glucose  

won't have changed much but if we've eaten a bunch  of processed foods and sugar and bread Etc then it  

will probably take more insulin because the cells  have started resisting this overload and the body  

has to work harder it has to make more insulin to  keep that glucose at a controlled level and if we  

go another five years forward in time then glucose  might be up a point or two but it really wouldn't  

have changed much and yet we could see that  insulin is much higher it takes three four times  

more insulin to control the glucose and bring  it within that healthy range and then eventually  

that glucose goes up a little bit higher and  it doesn't look like much but this is basically  

the difference between a very healthy level and  diabetes so it's like from 90 to 125 and at this  

point when the body fails to keep the glucose  within that very tight range now the body is  

making tons of insulin and we might be up at  2025 we might be at seven eight times higher  

than we started out so what are we supposed  to measure well in glucose is not the thing  

that we want to measure because it only goes  up when it's too late and I keep saying this  

because it's so important and yet that's  the only thing that they measure whereas  

if we measure the insulin it we see that it's  more of a linear growth so in this scenario we  

might have had glucose go from 90 up to 125 or  125 plus see that's only a 40 percent increase  

and it barely increased at all until it was in  the very late stages and this is why we can't  

just measure glucose whereas the insulin went  from three to 25. that's an 800 percent increase  

so this is what we need to measure we need to  measure the thing that is controlling it we need  

to con measure the body's effort at controlling  it so there's some very simple blood markers to  

measure this efficiently we already have glucose  that's measured on virtually every test and all  

we have to do is to make sure that we also get  insulin measured so now glucose is the thing that  

we want to control insulin is how hard the body is  working at controlling it so now when we multiply  

them we have a much better marker of what's really  going on then we just divide by a constant of  

405 and they just pick that so they would get a  nice even number of a really good level is a 1.0  

if you get your blood results in millimoles  for glucose instead of milligrams then you  

divide the 405 by 18 and you get 22 and a half  either way a good number should be 1.0 and this  

is called Homa IR which stands for homeostatic  model assessment of insulin resistance and this  

is one of the best and simplest and easiest  way to measure and monitor and keep track of  

insulin resistance so if you're at 1.0 you're  really good if it's starting to creep up then  

you want to start watching it and you can catch  these things very very early because this would  

be a home IR of one and this would be a Homa IR  of two even though the blood glucose is the same  

so you can catch these things very very early so  a mild insulin resistance might be if your blood  

sugar of 90 but your insulin has crept up to eight  now you'd be at a 1.8 if you have a moderate level  

your blood glucose probably starts creeping up  a few points but not enough to be a flag on your  

blood work and now your insulin might be up at  12. that would put your home IR at 2.9 and if  

it's severe you could be at 115 with blood glucose  which means that now you are pre-diabetic as they  

call it and your insulin would be a bit higher and  your home IR at 4.3 and if you're full-blown type  

2 diabetes now we know that your blood glucose  would be over 125 but also typically that insulin  

is going to be way way high the blood sugar isn't  High because there's not enough insulin there is  

plenty of insulin but it doesn't work properly and  now your home IR would be way way up there like a  

8.6 I've seen these at 10 and 12 as well and the  other thing to keep in mind is that these are not  

exact numbers these are examples right so this is  a typical example some people are going to have a  

normal blood sugar and they're like they still at  90 but their insulin might be 15 or 18 and other  

people might have a higher blood sugar but a lower  insulin so there are other factors but this is to  

illustrate the general Trend also these are not  the only things these are great Foundation but  

if we truly want to understand insulin resistance  there are more markers and the next most important  

would be triglycerides because like we said one  way that the body can reduce glucose is to turn  

that glucose into fat if we're very insulin  resistance then the body will have greater  

tendency to do that as well but these are things  that everyone needs to understand the very Basics  

and if you want to dig a little bit deeper then  I created a blood work course so you can learn  

everything that you need about virtually every  marker you can find on a blood test and I'll put  

some information for you down below if you enjoyed  this video you're going to love that one and if  

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