How to properly use insulin in diabetes and the mechanism of insulin resistance

After 35 years as a primary care physician and now 5 years as a full time hospitalist, I have come to realize that at least 90% of physicians do not know how to properly prescribe insulin for diabetes. To properly dose insulin, you have to know the physiology of normal insulin release in glucose homeostasis and how that then relates to insulin dosing and then what happens in diabetes.

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Keto Diet Fundamentals

Here is an article on fundamentals of a ketogenic diet by @HVMN that is a good summary of the aspects of a ketogenic diet and how it compares to other low carb diet plans:

https://hvmn.com/library/ketosis/keto-diet-fundamentals

Keto Diet Fundamentals

Originally published on HVMN by Dr. Brianna Stubbs and Nate Martins.


You’ve heard of the keto diet. Everyone from Lebron James to the Kardashians has used the low-carbohydrate, high-fat diet for reasons like performance and weight loss.

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Low Carb Ketogenic Diet to Treat Diabetes

Low Carbohydrate, ketogenic, Atkins type diet should be the first step in treatment of all diabetics, both type one and two. Numerous studies and practice experience testimonies have confirmed this. See Eric Westman’s second video below. The most comprehensive review of the data supporting using LCHF to treat diabetes was cited in the tremendous article by R D Feinman PhD per this link:

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The Cause of Coronary Artery Disease

 

The conventional theory of the cause of coronary artery disease has been driven by the so called “Diet Heart Hypothesis.” This was the idea that diets that were high in saturated fats raised blood cholesterol which caused atherosclerotic blockage of arteries. This was started by several flawed studies. The first was done by Nikolai Anichkov in 1913. He found that when he fed rabbits diets that were high in cholesterol, that they developed coronary atherosclerosis. This was and still is considered a groundbreaking study proving the role of cholesterol in heart disease. The problem was that rabbits are herbivores, not accustomed to eating cholesterol as there is no cholesterol in plant foods. Hence their bodies were not adapted to consuming dietary cholesterol.

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What about cholesterol?

The main problem that mainstream medicine and cardiologists have with low carb high fat diets is concern that “eating all that fat” will increase risk for heart disease. This concern was so great that Atkins was called before a senate committee where witnesses said that his diet was malpractice and was like mass murder. The problem is that the “cholesterol, diet, heart” hypothesis was adopted without any substantiating proof. What lead to the diet heart hypothesis was that there is cholesterol in the atherosclerotic lesion in arteries so researchers therefore believed that dietary cholesterol caused these lesions. In 1915 a researcher named Nikolai Anitschkow did a study where he fed rabbits diets high in cholesterol and they developed atherosclerotic lesions in their arteries. The problem was that rabbits

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