The hyperinsulinemic-euglycemic clamp, considered the gold standard for testing insulin sensitivity, is based on a flawed physiological understanding of insulin's primary job.

“the thing that really drives me crazy when people talk about insulin resistance is that they they base this all on essentially um what we call the u-glycemic hyperinsulinemic clamp which is basically that this is like the gold standard of testing insulin sensitivity and what what that involves is hooking you up with multiple drips um putting uh both glucose and insulin straight into your circulation and seeing how you know if if i give this boatload of carbohydrate how much insulin does it take to to clear that glucose to like shove it to shove it into cells and like when when you do that then physiological insulin resistance or glucose sparing and type 2 diabetes will look very similar but it's all based on this flawed concept that the job of insulin is to shove glucose into cells so you're using the wrong test to to really to really understand this or you're not using it you're not re really using it in context and i think that's that's where the big problem comes from that the the main test that we use the gold standard is based on a flawed physiological understanding of what insulin does or a limited understanding”