The headline is broadly defensible, but the qualifications matter. Effect sizes vary by population, the strongest claims rest on shorter trials, and credible voices push back on how it's typically framed.
what about the mitogenic effects of insulin so insulin is a growth factor you can measure it for example with large for gestational age babies and you say that a woman is insulin resistance yet insulin is actually doing what it's supposed to do it's actually stimulating a lot of growth so there again insulin is super sensitive or say testosterone we know insulin has effect on testosterone and PCOS and there it's working again not just normally like super high
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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.
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it solves a problem of why you're having continued de novo lipogenesis even in the face of this so-called resistance because you actually have too much it's not just a theoretical thing it actually has huge implications for the treatment because your treatment now has to be getting rid of the sugar getting the insulin down so let's pause for a moment and talk about the treatment so you I want to just sort of synthesize this for the listener because what you're suggesting is quite radical let's be honest right the conventional view is going back to your analogy which I love by the way is that after your wife asking you enough times to put more t-shirts in you stop doing it and the consensus view is you just stop doing it for some reason you're not sensitive enough to her request you're being an insensitive guy look that's an easy thing to understand you're just an insensitive guy well the current approach is your wife walks over and opens the suitcase and gets a few of her friends and your friends to help jam those t-shirts in there because if you had enough people and you could put enough weight on the t-shirts you could probably sneak a few more in right in other words if you had more insulin or another analogy would be she yells louder is probably a better analogy right so her polite request is insulin then raising her voice is more insulin than yelling and screaming and then by the end she's gonna like take your favorite football and throw it at your head and at that point you're mainlining insulin into the patient let's talk a little bit about some of the other drugs because most of the approaches to type 2 diabetes pharmacologically are not actually aimed at reducing glucose metformin is one of the very few drugs you mentioned the SGO till to inhibit sglt2 inhibitors which want to come back to so will carve out the ones that actually lower glucose but most of them are trying to amplify the noise so walk us through the classes of those drugs so we have the sulfonylureas which stimulate insulin and there's insulin which stimulates insulin and the dpp-4 is for example which are also similar in terms of they increase insulin this