What if we’re wrong about diabetes? By Peter Attia (Transcript)

Peter Attia

Is the obesity crisis hiding a bigger problem? Asks Peter Attia at this TED talk presentation: What if we’re wrong about diabetes?

Listen to the MP3 Audio: Peter Attia- What if we’re wrong about diabetes-

TRANSCRIPT: 

I’ll never forget that day back in the spring of 2006.

I was a surgical resident at The Johns Hopkins Hospital, taking emergency call. I got paged by the ER around 2 in the morning to come and see a woman with a diabetic ulcer on her foot. I can still remember sort of that smell of rotting flesh as I pulled the curtain back to see her. And everybody there agreed this woman was very sick and she needed to be in the hospital. That wasn’t being asked. The question that was being asked of me was a different one, which was, did she also need an amputation?

Now, looking back on that night, I’d love so desperately to believe that I treated that woman on that night with the same empathy and compassion I’d shown the 27-year-old newlywed who came to the ER three nights earlier with lower back pain that turned out to be advanced pancreatic cancer. In her case, I knew there was nothing I could do that was actually going to save her life. The cancer was too advanced. But I was committed to making sure that I could do anything possible to make her stay more comfortable. I brought her a warm blanket and a cup of coffee. I brought some for her parents.

But more importantly, see, I passed no judgment on her, because obviously she had done nothing to bring this on herself. So why was it that just a few nights later, as I stood in that same ER and determined that my diabetic patient did indeed need an amputation, why did I hold her in such bitter contempt?

You see, unlike the woman the night before, this woman had type 2 diabetes. She was fat. And we all know that’s from eating too much and not exercising enough, right? I mean, how hard can it be?

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As I looked down at her in the bed, I thought to myself, if you just tried caring even a little bit, you wouldn’t be in this situation at this moment with some doctor you’ve never met about to amputate your foot.

Why did I feel justified in judging her? I’d like to say I don’t know. But I actually do. You see, in the hubris of my youth, I thought I had her all figured out. She ate too much. She got unlucky. She got diabetes. Case closed.

Ironically, at that time in my life, I was also doing cancer research, immune-based therapies for melanoma, to be specific, and in that world I was actually taught to question everything, to challenge all assumptions and hold them to the highest possible scientific standards.

Yet when it came to a disease like diabetes that kills Americans eight times more frequently than melanoma, I never once questioned the conventional wisdom. I actually just assumed the pathologic sequence of events was settled science.

Three years later, I found out how wrong I was. But this time, I was the patient. Despite exercising three or four hours every single day, and following the food pyramid to the letter, I’d gained a lot of weight and developed something called metabolic syndrome. Some of you may have heard of this. I had become insulin-resistant.

You can think of insulin as this master hormone that controls what our body does with the foods we eat, whether we burn it or store it. This is called fuel partitioning in the lingo. Now failure to produce enough insulin is incompatible with life. And insulin resistance, as its name suggests, is when your cells get increasingly resistant to the effect of insulin trying to do its job.

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