The Peter Attia Drive #41 - Jake Kushner, M.D.: How to thrive with type 1 diabetes and how everyone can benefit from the valuable insights
02:07:31
Early Experience with T1D
- Peter Attia recalls a college friend, a seemingly healthy athlete, who developed concerning symptoms.
- These included fatigue, weight loss, and frequent urination, eventually leading to a type 1 diabetes diagnosis.
Prevalence vs. Experience
- Peter Attia notes the irony of his early experiences predominantly involving type 1 diabetes, despite type 2's higher prevalence.
- This highlights the potential for skewed perceptions based on limited exposure and the importance of considering prevalence rates.
Rising T1D Incidence
- Jake Kushner discusses the rising incidence of type 1 diabetes, which has doubled since 1960.
- Possible factors include environmental changes, increased obesity, improved diagnostics, and earlier diagnoses in infants.
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Introduction
00:00 • 5min
Type 1 Diabetes
05:08 • 3min
Type One Diabetes
08:29 • 2min
I'm a Dumb Engineer. I Don't Know Anything About Diabetes
10:58 • 2min
Adult Occurring Type One Diabetes
13:12 • 3min
The Pathophysiology of Type One Diabetes
15:48 • 3min
The Pancreas and Type 1 Diabetes
18:31 • 2min
Type 1 Diabetes
20:35 • 2min
Type 1 Diabetes - What Would Happen if This Guy Got Type One Diabetes?
22:18 • 2min
Type Two Diabetes - Is There a B Cell Response?
23:55 • 2min
Type 1 Diabetes and Autoimmune Thyroid Disease?
25:51 • 2min
Type 1 Diabetes
27:36 • 2min
Type 2 Diabetes - What's the Difference Between a BMI 16 and a 20?
29:33 • 2min
How to Prevent Type 1 Diabetes in Children
31:07 • 2min
Type 1 Diabetes
33:07 • 2min
Type 1 Diabetes - Is There a Chance Your Child Will Have Type 1?
34:41 • 2min
Type 1 Diabetes - How Did You Get There?
36:25 • 2min
Type 2 Diabetes - What Is the Hemoglobin A1C?
38:01 • 2min
Type 1 Diabetes - The Discovery of Insulin
39:46 • 2min
Is Insulin a Master Regulator of Your Metabolism?
41:16 • 2min
Type 1 Diabetes - Is There a Negative Nitrogen Balance?
43:15 • 2min
How Does Insulin Affect IGF?
44:46 • 2min
Type 1 Diabetes - IGF and Growth Hormone
46:54 • 3min
The Banting Invest Nobel Prize
50:17 • 2min
Is Recombinant Insulin Still So Expensive?
51:54 • 2min
Diabetes Control Complication Trial - Chapter Two
53:24 • 2min
Type 2 Diabetes - What Are the Most Common Causes of Preventable Amputations?
55:41 • 2min
Hypon Diabetes - Is Hypoglycemia a Cause of Kidney Disease?
57:22 • 2min
Type 1 Diabetes - How to Fly Off the Horizon
59:32 • 3min
The DCCT
01:02:33 • 3min
Type One Diabetes
01:05:22 • 3min
The Risk of Cardiovascular Disease and Death
01:07:58 • 2min
Is There a Cure for Diabetes?
01:09:30 • 2min
Diabetes Complications Are Increased With High Blood Glucose Levels
01:11:39 • 2min
Type One Diabetes - A Box of Mini Wheats in a Bowl
01:14:01 • 2min
Type One Diabetes - What's the Problem?
01:15:59 • 2min
The Ultimate Bio Hack
01:18:18 • 3min
Diabetes Distress Scale
01:21:21 • 2min
Type 1 Diabetes - What's the Median Score for a Teenager?
01:23:20 • 3min
The Continuous Glucose Monitor, a Black Hockey Puck
01:26:20 • 2min
The Dexcom Continuous Glucose Monitor
01:27:56 • 3min
Type One Diabetes - Insulin Dependent Versus AMP K Driven Glucose Disposal?
01:31:23 • 3min
Is There a Difference Between Aerobic and Strength Training?
01:33:55 • 2min
Dexcom and Type 1 Diabetes
01:36:11 • 2min
The Dr. Bernstein's So Diabetes Solution
01:38:07 • 2min
The Bernstein Method for Type 2 Diabetes
01:39:42 • 2min
Insulin Pumps
01:42:00 • 3min
Type 1 - What Is It, and How Can I Change My Practice?
01:45:04 • 4min
Type 1 Diabetes - Is CGM Essential?
01:48:41 • 2min
Type 1 Diabetes - How to Hack It Using Low Carb
01:50:55 • 2min
Type 1 Diabetes
01:52:54 • 2min
SGLT2 Inhibitors Cause Diabetes and Euglycemic Ketoacidosis in Patients With Type 1 Diabetes
01:55:01 • 3min
Hypoglycemic Awareness and Nutritional Ketosis
01:57:43 • 2min
Type 2 Diabetes - What Are the Most Important Lessons?
01:59:14 • 2min
Type 2 Diabetes
02:01:10 • 2min
Type 1 Diabetes - What Is the Best Proxy for What I Don't Have?
02:03:15 • 2min
The Peteratiamd Podcast
02:05:40 • 2min
In this episode, Jake Kushner, pediatric endocrinologist specializing in helping people with type 1 diabetes, discusses the best strategies to live and thrive with T1D, especially as it relates to diet and exercise. We also discuss why many patients who control their blood sugar with high amounts of exogenous insulin are at a substantially higher risk than people who can control their blood sugar at lower levels of insulin. This concept has great implications for non-diabetics as well considering the increasing prevalence of diseases related to insulin resistance. We also cover some of the basics, the history, the increasing prevalence of type 1 diabetes, and more importantly, what we can do to help kids with this disease, and their families. We discuss:
- How Jake became interested in type 1 diabetes [5:30];
- The pathophysiology of type 1 diabetes, the increase in prevalence, and the role of beta cells [17:00];
- The role of body weight and BMI in the risk of developing T1D [27:00];
- Genetics of T1D and the risk of inheritance [32:00];
- Hemoglobin A1c [36:15];
- Insulin: the amazing story of its discovery, its effect on cellular metabolism and IGF-1, and why the hell it’s so expensive [39:15];
- Diabetes Control and Complication Trial: blood glucose and the complications associated with diabetes [54:45];
- Cognitive impairment, epigenetic changes, and other dangers associated with high, peak blood glucose, and big swings in blood glucose levels [1:09:15];
- Depression, anxiety, and other challenges of living with T1D [1:15:30];
- Jake’s realization that the current standard of care of T1D is inadequate [1:26:15];
- Managing diabetes with exercise [1:30:15];
- The Bernstein method, and protein’s impact on glucose and insulin [1:36:15];
- Jake radically changes his approach to treating patients [1:45:00];
- What other tools are there for controlling T1D? [1:49:45];
- Is the ketogenic diet appropriate for those with T1D? [1:52:45];
- The most important lessons that can be applied by the non-diabetic population [1:59:00];
- The two dream measurements Peter wishes were available [2:04:00]; and
- More.
Learn more at www.PeterAttiaMD.com