Health Explanations for Motivated Patients: Your Checkup
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Health Explanations for Motivated Patients: Your Checkup
Insulin Resistance: Early Warning Signs and How to Reverse It
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Insulin resistance often precedes diabetes by 5-10 years and serves as an early warning sign of potential damage to your cardiovascular system and other organs. We explore this common condition, its risk factors, and how simple lifestyle changes can reverse it before more serious health problems develop.
• Insulin resistance occurs when muscles, liver, and fat cells fail to respond to normal levels of insulin
• The pancreas compensates by producing more insulin, eventually leading to beta cell failure
• Clinical signs include dark skin patches in body folds (acanthosis nigricans), elevated triglycerides, and increased waist circumference
• One in three Americans have prediabetes, with many also experiencing insulin resistance
• Risk factors include central obesity, sedentary lifestyle, family history, PCOS, and certain racial/ethnic backgrounds
• Sleep disturbances, chronic stress, and fatty liver disease are emerging factors linked to insulin resistance
• A 5-7% weight reduction improves insulin sensitivity by over 50%
• Regular physical activity (150+ minutes weekly) helps glucose enter cells more efficiently
• Diet modifications focusing on whole foods, limiting refined sugars, and following Mediterranean or DASH patterns show significant benefits
• "The movement is the medicine, the food is the medicine" when addressing insulin resistance
Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski
Hi, welcome to your checkup. We are the patient education podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine doctor in the Philadelphia area, and I'm. Nicole Aruffo. I'm a nurse and we are so excited you were able to join us here again today.
Nicole Aruffo, RN:So which of the three topics should we start?
Ed Delesky, MD:off with. We have three topics we do. I only know of two of them, I think. Why don't we talk about what we're watching? It's the beginning of summertime, which invites a certain Summer's here. It's Love Island time, which invites a certain.
Nicole Aruffo, RN:Summer's, here, it's Love Island time.
Ed Delesky, MD:Can you tell our audience a little bit about, like what are they missing if they're not watching Love Island?
Nicole Aruffo, RN:Oh my gosh, what are you missing? Probably the best reality TV out there.
Ed Delesky, MD:Yeah, that's a great start.
Nicole Aruffo, RN:So they're all in Fiji. But the thing about Love Island is that it's practically in real time because they're there now and it came out this week, so, like, what you're watching is stuff that happened like two-ish days ago.
Ed Delesky, MD:That part's really cool because a lot of what we do and what we watch is from like last year, which I think is really restricting for the people who actually are participating in it, like the actors and so on. Actors, they're not actors, they're real people because it's reality, but the real life there's real life. Of course, there's no script, um, but yeah, like they're like summer house, for example, they're's last summer but it's airing this summer.
Nicole Aruffo, RN:And then they call them the Islanders. It's happening in real time, but they don't have their phones or anything, so all of this discourse is happening online and they don't know about it.
Ed Delesky, MD:Right.
Nicole Aruffo, RN:Right, it's not like they filmed this eight months ago and now they're home and reading everything online that's happening about it. That one girl got canceled and just got yeeted from the villa. She did and people like people on tiktok and stuff were, because she only lasted like one and a half episodes and people would be like, oh, she has no idea, like she's in this bubble in fiji and has no idea like she's, she's getting canceled and then they kicked her out of the villa.
Ed Delesky, MD:Yeah, absolutely crazy. And if we didn't say it? It's a dating show, yeah, where people are trying to quote find love, but there's also a prize after it. We joined on last season but we watched like after the fact, like all. I mean what 36 of the 42 episodes had already been out. Yeah, like all. I mean what 36 of the 42 episodes had already been out. Yeah, and we hopped in and we binged it. Look, a show hates to see us coming.
Nicole Aruffo, RN:Honestly, an entire season of a show hates to see us coming.
Ed Delesky, MD:Because we are. There's one thing we are really really good at is being on that couch and watching the heck out of something Really fast At one time speed. But there is some money at the end involved and, like the, one of the other cool pieces is that people vote so that when they're watching like they vote. I haven't participated in the voting yet, but they vote for the couple that they think but a lot of the couples from last season are still together.
Nicole Aruffo, RN:Really, yeah, they're had, they're doing like a whole spinoff from the season six people.
Ed Delesky, MD:So this begs for an argument.
Nicole Aruffo, RN:I mean, love is blind, and like the money isn't like, it's like a hundred thousand dollars that at the end you decide. If I forget how you are, like whoever, I forget what the determining factor was of if you like, keep it all, or if you split it between like you and the other person, of if you like, keep it all, or if you split it between like you and the other person, I mean it's still like a hundred thousand dollars, but it's not like.
Ed Delesky, MD:you know, that doesn't go that far sure not these days, it's like a million right, it's not like yeah, there are other shows, I mean, and like they do with traders too, they're like oh, here's 250,000 dollars for like people who already have like what I imagine to be like a lot of money. Yeah, it's, it's really fun. Uh, it's late, though.
Nicole Aruffo, RN:I wish they moved the start time oh my gosh, I know well that's because they they do it at it's nine o'clock eastern time. So then, like the west coast people are watching it at six, so like they can't make it too early for them I don't know.
Ed Delesky, MD:I just wish everything was earlier I know, maybe we should like move to california like I by the time this gets cut out, like this put out nba finals last night started 8 pm and, like I'm barely awake, we're sleepy. We're sleepy at that point and like now we're doing this thing where we can't watch tv in bed on the projector, even though that was like a really cool moment for us.
Ed Delesky, MD:We have to watch it downstairs and both of us are sleeping so much better yeah, it's really annoying it's really annoying how that works, but nonetheless that's what we're watching recently and any other thoughts about love island?
Nicole Aruffo, RN:all right what else should we talk? We need to talk about dinner last night.
Ed Delesky, MD:Why don't you tell them about dinner a little bit?
Nicole Aruffo, RN:Because we always talk about things that I make and Eddie made restaurant quality mussels last night.
Ed Delesky, MD:I feel good about this.
Nicole Aruffo, RN:They were so delicious.
Ed Delesky, MD:Double garlic More garlic is always the answer.
Nicole Aruffo, RN:Oh yeah, always more garlic.
Ed Delesky, MD:So I just had the idea because I was like you, what I want to create something different. Put the biochem degree to use, as you would put it. Yeah, and so we go to the grocery store and I like this grocery store it's weigman's, what am I kidding? Um, and we go to the seafood section and they have all these mussels on ice and I'm just standing over there and I'm laughing and I have no sense about what I'm going to get myself into and I think I just got lucky is really what happened. But what do you mean? Well, cooking the muscles isn't the tough thing. It's like cleaning them and getting rid of what they call the beard. And the gravy is really where the finesse was, because it's that's what the muscle is in and I feel great about it. I mean, you routinely like make amazing meals, superlative meals for me all the time, so it's really nice that I was able to pitch in there and make some, some red muscles. I put the man to put it in the recipe book.
Nicole Aruffo, RN:Yeah, that has to go to the recipe book. And you were like I measured. What did you say? I measured with love.
Ed Delesky, MD:I measured with love this time.
Nicole Aruffo, RN:Well, now I feel like you finally get it, like you get what I'm talking about when I'm like, oh, just like a zhuzh of this, or you know, I like to cook based off vibes. But then we watched that movie and she was like measure with your heart or something, or measure with love. And then my mom said that to you like shortly after that, and then you did it.
Ed Delesky, MD:So now I feel like you get the cooking based on vibes yeah, but then there's moments where I worry like am I gonna put too much oregano in here and ruin it? So that's like I had a little bit of worry there because I was just like pouring it in there and I was like, is this too much oregano?
Nicole Aruffo, RN:but did the recipe you used? Did you put um? Did it call for any wine?
Ed Delesky, MD:yeah, it did, and I didn't feel like going to the store to getting some white wine we have cooking wine in the fridge that could have used it? Yeah, did you think that it would have added a layer of it? Did call for wine?
Nicole Aruffo, RN:yeah I was just curious. It brings out like the um, the aromatics, the garlic and stuff, that like reaction I guess. Well, even your biochem degree, like you put it in, like after the garlic, before the tomatoes, and then something with like the acidity of the tomatoes.
Ed Delesky, MD:It's the same thing with like vodka and a vodka sauce, you know oh well, I mean, you know, by the time this comes out, I will have a giant amount of fat rigatoni in my tummy. But this one's going to be extra because I'm pretty sure we're going to do shrimp and spicy pork sausage oh yeah, I forgot.
Nicole Aruffo, RN:We had the argentinian shrimp in the freezer yeah, so I mean those are also.
Ed Delesky, MD:Maybe we can use half and save the other half for your cumin shrimp that you love to eat, I do.
Nicole Aruffo, RN:What's the third thing?
Ed Delesky, MD:well, the third thing was, uh, this awesome concert that we went to in camden, new jersey and it's not called bb and t anymore we went to luke bryan, yeah that was so fun. That was a blast um I. He had people standing up more than kenny did.
Nicole Aruffo, RN:No one sat down the entire time eddie was not ready for all of the screaming women around luke bryan.
Ed Delesky, MD:These women love luke bryan, oh my goodness, especially at the end, when he was like, he did a little thing, like. He was like oh, here's my like. I'm a country man, I'm a simple country man. Where are my country girls? And then he went into the song and then I thought the place was going to explode. I was like this is crazy Simple white t-shirt, light wash jeans and those cowboy boots and everyone's going nuts. I mean quite the performer, though. I mean literally everyone was standing the entire time. But we went to the bathroom for the second time and we came back and everyone was already standing and I was like, oh, how convenient. We're walking back to our seats and everyone's already standing for us. This is awesome, Thinking that there was a third like warm up act.
Nicole Aruffo, RN:Yeah, I don't know why everyone, why you guys all thought that.
Ed Delesky, MD:I don't know, but I was like, wow, because they don't turn all the lights off.
Nicole Aruffo, RN:It made sense because it was like nine o'clock For an opening act An hour and a half for like.
Ed Delesky, MD:Is that how it works? Like well, that's one question I have. Does the main artist get like an hour and a half, two hours?
Nicole Aruffo, RN:yeah, I mean, unless you're taylor swift and so what was taylor swift then? She was like over three hours is.
Ed Delesky, MD:Was that kind of like? Does anyone know that?
Nicole Aruffo, RN:going in or what like how long the artist is gonna be on for um, I think you can usually find like the set list online, sometimes okay and like figure out how long it is yeah but I'd say it's probably generally like an hour and a half two hours. Is that enough time?
Ed Delesky, MD:I think so, yeah yeah, that is enough time I did. I felt it. By the end I was like, yeah, this is good. It was like, very like it was all put together from start to end. High energy, pizza is everything. Those that's an expensive venue. Yeah, that was crazy. That's, that was more expensive than the link. I think I that was crazy. Those two beverages for that cost, and then pizza, a personal pizza, $28. I and it wasn't me, but I, oh my God, this place was that's. I get it, I get what they're doing, but wow, anyway, awesome concert, thank you. High energy, that was awesome, would you go back.
Ed Delesky, MD:I would go back absolutely yeah, luke bryan's fun.
Nicole Aruffo, RN:Yeah, I would definitely go back he also like um he like interacts with the crowd.
Ed Delesky, MD:I feel like the amount of eagles chants oh my god but there was a really cool moment where one of his like bassists, I think like got up there on the mic and led the chant.
Nicole Aruffo, RN:Oh yeah, because he's like from Philly or adjacent.
Ed Delesky, MD:Yeah, and that must have been a cool moment for him. As a Giants fan, I was just like look, have their moment. Like you're still champions? Yeah, do your thing. Poor kid's a.
Nicole Aruffo, RN:Giants fan.
Ed Delesky, MD:Look, I had my time, we won. Listen the.
Nicole Aruffo, RN:Eagles won the Super Bowl. You loved it. You were a part of the culture.
Ed Delesky, MD:It was cool living here. While that was happening. I had my time as a Giants fan. I'm still a Giants fan. The arrow's pointing up.
Nicole Aruffo, RN:Listen, we have pictures of us on Broad Street when they won the Super Bowl and they're going in our 2025 album, book and evidence of Eddie being an Eagles fan will live there forever.
Ed Delesky, MD:No look, am I going to sit here and be a grump and be like I'm not going outside when they won the Super Bowl to see what this place is like. I'm going to sit inside and hate like this.
Nicole Aruffo, RN:I'm going to be a hater.
Ed Delesky, MD:I'm going to be a hater. No, I'm going to go outside. I'm going to see what it looks like because I want to see it. So that's that looks like, because I want to see it. So that's that. Why don't we dive into what we're going to talk about today? It's a little follow-up from last week to give us a little advanced topic to get a better understanding of our bodies. So what are we going to talk about today, nick?
Ed Delesky, MD:Today Well, actually, I feel like this is a hot topic in the zeitgeist we're talking about insulin resistance today, right Today, we're talking about insulin resistance today, right Today, we're talking about insulin resistance, and not just what it is, but how it contributes to some of the biggest problems we face, including diabetes, heart disease, fatty liver and even some cancers. And we're talking about this because of our discussion last week about prediabetes and how common it is and the things we can do. So if you haven't taken a listen to that after you finish this episode out, why don't you go back and listen to that one? So we know that from last week, approximately one in three Americans have prediabetes and similar numbers is that a bunch of them also have insulin resistance. It just so happens that insulin resistance tends to be the most common etiology or cause of type 2 diabetes. There are other types of diabetes. There are other causes of prediabetes, those being autoimmune or other abnormalities in metabolism. We're just talking about what is most common here today, so we'll dive into what is insulin resistance.
Ed Delesky, MD:So some basic information about how the body works. Insulin is secreted or released by the pancreas and signals to the body's cells that and mainly by cells I mean like cells of the muscle, the liver and fat tissue and insulin says absorb glucose for energy or storage. So bring that glucose, that sugar from the blood into the cell and so in insulin resistance, these tissues muscle, liver, fat they fail to respond to normal levels of insulin. It's almost like someone's going in to wake someone up and they like, let's say, you have a light sleeper and you can just tap them a little bit or maybe even walk in the room and you're in their presence and they wake up and they're like, oh, I'm awake, but then you've got a really heavy sleeper and you got to like shake them to wake them up. That's sort of insulin resistance. Like it takes more to get the same response. We heard what goes right in the body when the pancreas is doing its thing and releasing insulin, but what happens when it goes wrong? So when there's insulin resistance, to compensate the pancreas produces more insulin and it's what something's called compensatory hyperinsulinemia. So because the pancreas is now working a little overtime, specifically the cells in the pancreas and this is a really cool thing when you do biochem you can really get in the nitty gritty and learn about, like what the little things are actually doing If I'm doing this little like dance over here Over time. The beta cells these are the ones that actually make the insulin. The beta cells fail, they don't keep up to the body's demands for insulin, and what that does is it leads to elevated blood glucose and eventually, maybe type 2 diabetes, and that's how that slippery slope goes. So there are some clinical clues.
Ed Delesky, MD:We talk about this complicated thing of insulin resistance but try to simplify it the best we can and there are certain signs or symptoms that your doctor may look for Something called acanthosis nigricans. What the heck is that? That is a velvety discoloration. It's usually hyperpigmentation or darkness that can happen in some body folds under the armpits, back of the neck. Sometimes they're associated with skin tags. Sometimes people get elevated triglycerides and a low HDL We've talked about this in prior episodes HDL for healthy cholesterol, so lower levels is worse. And the elevated waist circumference, which is no surprise because we've talked about how visceral fat is the worst type of fat, because that is fat that is around your organs, that is fat that is going in the liver, that is fat that is going around different places, and this what's called an ectopic distribution of fat, which is fat going in places that it shouldn't, also causes a lot of problems and bleeds into causing insulin resistance. So some of those things may cue in and say that even if your fasting, glucose is normal, that if you have those things, you may be dealing with insulin resistance. So then comes in the question of who is at risk, and there are certain risk factors that end up being really common for people. So we talk about visceral fat or central obesity. So in men, if waist circumference which is a particular measurement, is greater than 40 inches, or greater than 35 inches in women, that's a risk factor for insulin resistance.
Ed Delesky, MD:A sedentary lifestyle, a family history of type 2 diabetes we see this a lot online. It's a very common diagnosis that people are really trying to hammer down and understand is PCOS, and there are some estimates that over 70% of patients who have PCOS have insulin resistance and a history of gestational diabetes. And there are some other risk factors that are coming out and being more well understood, including sleep disturbances, including obstructive sleep apnea, and we even talked last week. Now the American Diabetes Association is looking at sleep and saying if you sleep less than six hours a night or more than nine, you're increasing your risk from prediabetes to diabetes conversion. Nine, you're increasing your risk from prediabetes to diabetes conversion.
Ed Delesky, MD:Chronic stress is being looked at as a cause of insulin resistance and a very important emerging, I would say, in the medical literature this is already well known and being tracked, but maybe in lay media and common understanding metabolic dysfunction, associated steatotic liver disease. If you ever hear your doctor say that, you can ask them to say it three times fast. But this is when there's fat in the liver and it's quickly becoming one of the most common causes of liver problems in America and deserves a lot of attention. But it's also intimately related to insulin resistance in a lot of ways, and what we're also seeing is that there are racial and ethnic risks, including people in these categories having increased risk Hispanic, black, native American and South Asian populations having higher prevalences of insulin resistance, likely due to a mix of some genetic and a lot of socioeconomic factors as well. So all of our discussion so far sort of invites why the heck does this even matter? And it matters because it's a very early warning sign that there might be silent damage happening already.
Ed Delesky, MD:Insulin resistance often precedes diabetes by even five to 10 years, and even during that time some damage might already be happening, especially to the cardiovascular system, which is the most common cause of mortality in America, and so there are downstream associated conditions that people with insulin resistance something that isn't so easily detected is talked about type 2 diabetes, atherosclerosis, which is that plaque buildup in the arteries of your heart or your other blood vessels, coronary artery disease, hypertension, the massal D or metabolic associated liver dysfunction and some cancers like endometrial cancer, colorectal cancer, breast cancer, are intimately related to these insulin pathways as well, and so far, we've talked about who's at risk, we've talked about why it matters and, nikki, can you take us through?
Ed Delesky, MD:A lot of this conversation ends up being similar to pre-diabetes, but can you hit the highlights about what people can do if they're starting to think like huh, I looked at my labs and some of those are a little messed up, or I do have a sedentary lifestyle, or maybe my waist circumference is. I'm a man and my waist circumference is greater than 40 inches. What can someone do?
Nicole Aruffo, RN:Well, we're probably going to sound like a broken record here, because I think we've talked about this in almost every episode relating to this, so we're going to say it again, because it works. Apparently. Number one weight loss. We've said it once, we've said it twice, maybe even thrice, and we're going to say it again because just a five to seven percent weight reduction improves insulin sensitivity by over 50 percent. Second, if you can't guess physical activity.
Ed Delesky, MD:Yeah, Getting to that 150 minutes something greater than 150 minutes per week is so important. And what we're actually seeing is that there are receptors that increase and allow glucose to go into the cell more when you exercise. They are upregulated when you exercise. So go exercise because you're reducing your insulin resistance when you do so. And then what about some diet changes?
Nicole Aruffo, RN:Third is diet change, again sounding like a broken record, emphasizing whole grains, unsaturated fats, leafy greens and our favorite legumes. We're actually going to make a dense bean salad later today to have for the week Low glycemic index foods, which you can Google Basically, foods that are reducing your insulin demand and not like spiking that blood sugar, limiting refined sugars, especially liquid calories.
Ed Delesky, MD:Looking at all of the soda drinkers, yes, and juice, and juice yeah, seemingly good fruit in liquid form, but a lot of juice can cause some problems and then the mediterranean or dash style diets are both evidence-based.
Nicole Aruffo, RN:Um to help with this.
Ed Delesky, MD:Yep, all of that put together can really help and I think we're going to limit a lot of the medication talk.
Ed Delesky, MD:There are a lot of medications out there that can help insulin resistance, but because insulin resistance is sort of like a yellow flag of things that are happening in your body, a very early warning sign, I feel like talking about medicines would invite over-medicalizing it and say like, yeah, let's use medicines to detect this thing that's happening so early, when it's in the things that you're doing every day. I've been trying to say this a little bit more in visits that, like the movement is the medicine, the food is the medicine when it comes to things like this. So we won't talk about medicines as much today. There are some other lifestyle factors that affect your insulin sensitivity, like getting the right amount of sleep helps. We talked about this last week, we'll say it again, and so, leaving all of that out there, what are you seeing online? Or I want to to like this is now, we're just chit chatting. I want to talk about like I'm seeing this a lot online and people are saying like I'm having a tough time losing weight because of my insulin resistance.
Nicole Aruffo, RN:So everything we just said, you know kind of points to that A lot of people may have this or struggle with this. People are like oh, I can't lose weight. I have it's my insulin resistance or it's my high cortisol. Like I can't lose weight, it must be peace. Like and like I have painful whatever. Like I must have pcos right when, like that, could be the case. Right it might be the case, but like I don't know. But then if you you like, do all the things.
Ed Delesky, MD:Yeah, I think there's.
Ed Delesky, MD:I think there's a healthy effort for people to understand what they're going through and this insulin resistance in particular, I think, toes the line between disease and like pathology that is happening and like I think the earliest form of like what we can describe is like the classes of obesity, class one, two and three. Like these two things are very intimately related. Two and three like these two things are very intimately related. Another another point to get at here is that like yes, these things happen to people and at some point people have to choose to live in the solution instead of sitting in the the problem that is happening to them yeah, and I guess my thing with like all the people online, they'll be like I.
Nicole Aruffo, RN:You know whether they self-diagnose themselves with insulin resistance or not. But then, they, you know, make all these tiktoks of what they're doing for that and, you know, making all these healthy lifestyle modifications which, like with or without insulin resistance or with or without whatever kind of like diagnosis, whether it's actual or self-made those lifestyle modifications are good for you and healthy regardless of any of that. So excellent point, Right, that's also you know I guess they're not doing anything like super damaging online and putting things out there.
Ed Delesky, MD:Right and this is also I think this gets at a point of the like the speed that information flows again, because there are not a lot of mainstream tests that are described and endorsed by a lot of medical societies at this point but are used in practice. Like when I was reading about this, that, like we didn't include in the formal like breakdown was measuring fasting insulin, like people ask for that. I've been asked for that and at the time I didn't know much about it. But, like, if it's a very fluctuating level, is one to the different labs that run. Labs don't have a standard reporting system for it and it's all related to like individual moments in time and so a lab like that is fraught with misleading information. It could be very helpful.
Ed Delesky, MD:It could not be and there isn't a lot of guidance out there right now to say one way or the other. Neither is the triglyceride to HDL ratio, which I'm sure some people are using and may be helpful, but triglycerides fluctuate throughout the day and so, yeah, you get it when it's fasting, but once again, there's not a lot of formal recommendation out there to discuss this because it's so early on. We're just talking about pre-diabetes a lot and it covers so many people, and the earlier step upstream of pre-diabetes in a lot of circumstances is insulin resistance, and it's more the pathophysiology than a active condition. It's like describing a process that's happening in your body that your body compensates for until it can't, and when it's done, compensating prediabetes, and then when it's further, decompensating diabetes. In a lot of cases, like we said earlier, it doesn't always shake out that way. People end up doing the things that they're supposed to anyway.
Nicole Aruffo, RN:No one's going to say, like no doctor's going to say, it's bad if you increase your activity and start eating a healthier, more balanced diet.
Ed Delesky, MD:An analogy comes to mind when car maintenance is a topic that I think about a lot, with delivery of news and service, but also like taking care of it. And if you know that every so many 10,000 miles you're supposed to replace your brakes and you're driving your car every day you're going around and you're just driving and you're like, yeah, maybe at some point I need to replace my brakes. But then you go see a professional and, let's say, in a different arc of life, you go see the professional, you go see the mechanic and then the mechanic says, based on this sign, this sign and this sign, you need to get your brakes replaced. There's a lot more weight behind that. Like now you're getting advice from someone. They're throwing up the yellow flag saying, based on this information I have, you need to go get your brakes replaced. So now you get your brakes replaced, brakes replaced, so now you get your brakes replaced, Whereas before you didn't see the professional, you didn't pay attention to the signs and symptoms and you didn't get your brakes replaced and you just kind of fell by the wayside or didn't get your oil changed, didn't take care of your car.
Ed Delesky, MD:In a lot of ways I think like seeing this like. We've known that people have metabolic disturbances, metabolic syndrome, which has a very wide definition, and people are just out there living like this, and the best ways we can describe this pathology is class 1 obesity. Class 2 obesity, prediabetes. This captures it even earlier than all of that, and maybe it's like going to the mechanic and people are like oh yeah, you have come to the doctor's office. I'm concerned, you have some level of insulin resistance. We need to be really thoughtful about this. So that's where we're taking it. Today, we're talking about insulin resistance. Hopefully you're able to learn something. Recognize that insulin resistance isn't a disease. It's more like an alarm bell, and the good news is like this is totally reversible and we don't need perfect change. We just need something consistent and something positive. So so thank you for coming back to another episode of your checkup. Hopefully you were able to learn something for yourself, a loved one or a neighbor. Make sure you check out our website, send us an email, find us on Instagram, Make sure you follow the show so that you can get notifications when our next episode comes out and, most importantly, stay healthy, my friends. Until next time. Make sure you follow the show so that you can get notifications when our next episode comes out. And, most importantly, stay healthy, my friends, Until next time. I'm Ed Dolesky. I'm Nicole Rufo. Thank you and goodbye Bye.
Ed Delesky, MD:This information may provide a brief overview of diagnosis, treatment and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for complete information tailored to you. In short, I'm not your doctor, I am not your nurse, and make sure you go get your own checkup with your own personal doctor.
