Peter Attia· MD
so the obvious way to think about this is consider the most extreme state of metabolic dysregulation which should be something like type 2 diabetes so you think of this as a continuum and at one end of the spectrum you have unregulated type 2 diabetes which by definition is a situation in which the patient is completely unable to partition fuel even at the most basic level which is to get glucose out of the circulation in that situation a person's risk of the pillar diseases goes up significantly in fact as we've discussed in the past you would now argue that obesity and type 2 diabetes probably represent the second leading cause of cancer second only to smoking and of course there's no disputing the relationship that type 2 diabetes has on alzheimer's disease and on cardiovascular disease so we absolutely no as sure as god made little green apples that if you want to further reduce your risk of alzheimer's disease cancer atherosclerosis in addition to doing all of the quote unquote disease specific things you must be the most metabolically flexible metabolically healthy person imaginable so to your question what does that mean peter well part of it is what we just talked about part of it is you better be able to dispose of glucose really really efficiently and that's why more and more and more of our patients wear cgm that's why i still wear cgm five years later in part because of it's an accountability tool but in part because i'm always tweaking things in exercise and nutrition things like that and i always want to make sure i'm able to stick to that standard of hey average glucose is always going to be below 100 standard deviation is always going to be below 15 which gives me a sense of how much it's cycling and therefore how low i'm keeping insulin levels