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INSULIN RESISTANCE, OBESITY, DIABETES AND GLP-1 AGONIST MEDICATIONS….SEE DR CYWES GET REALLY PISSED AT BEING CALLED OUT FOR PRACTICING OUTSIDE THE GUIDELINES OF BEST PATIENT CARE. This video has value for everyone from rookies to carnivore veterans. These insights are not beliefs or conjecture. They reflect real data from an extremely busy clinical practice dealing with metabolic health transition. Know the scientific truth about how your body works. Ask and answer the right questions to optimize your health! Whether you agree or disagree with our content, if we’ve made you think and ask questions, we’ve done our job. Leave comments below.

Hi folks this is dr rob cyrus i am the cob addiction doc and one of the things that i’ve had to learn working in this space is to channel my anger and frustration into a solutionistic dynamic so um today we were actually going to talk about glp1 glucon-like uh peptide number one and what it does in the human body however here is just an interesting little story an

Interesting little anecdote before we talk about glp-1 agonists which are to my mind one of the most wonderful drugs that have been discovered probably since the discovery of insulin and a few other important drugs um but i’m sitting here i received this nasty notification notification from medicare because i i do take medicare patients and it is from their chief

Adherence officer and lovely titles bsn mha cphq i’m sure those are beautiful degrees on the on a wall behind this person and the letter tells me that i have for this particular patient practiced below the standard of care and that i have resulted in a gap in my patients care gap in cares the title of this is gap in care pharmacy claims indicate your patient

Has diabetes and is not taking a statin pharmacy claims indicate your patient has diabetes type 2 diabetes and is not taking a statin medication they go on to say statin therapy is recommended for diabetic patients age 40 to 75 regardless regardless of baseline lipid levels please add a statin medication for this patient if appropriate and the bizarre part is

They go on to give me some graphic information or not graphic but a graph of information where they talk about in reviewing our internal medication adherence data we found that 60 of patients um uh who use the medications were able to reduce hospital stays and cost and they break it down into three different diseases focusing on three goals consumers with high on

Three gold consumers hypertension high blood pressure diabetes and cholesterol we evaluated for medication adherence and hospital rates and they found a 50 57 reduction in hospital admissions for diabetic patients who do adhere to their medication regimen so if a diabetication takes their medication uh versus that group that doesn’t take their medication there’s

A 57 percent lower hospitalization rate and you can see that in this first graph beautiful numbers go down a little arrow that goes down the second one is hypertension high blood pressure and there is a 20 percent reduction in hospitalizations for patients who take their blood pressure medicate medication regularly versus those that don’t pretty obvious i agree

Completely with that and they show the little graphic and certainly the numbers are there then they look at cholesterol medication this third one and you see the graph here it’s going to fade it out but you see the graph there and i went back and looked at the original and they’ve what they’ve done here is they’ve drawn a little line from the top of the the black

Box down to somewhere um beneath the top of the gray box the gray boxes hospitalizations on people not taking statin therapy the black box is how many people avoided hospitalizations by taking statin therapy and they’ve included in this cohort but they’ve given the statistics for hypertension diabetes they failed to give the same statistic for hospitalizations

For people taking statins why because that difference is 0.9 percent point nine percent no difference no difference and yet they are sending me a letter of spankage telling me that i am not treating my patient correctly i’m falling under the guidelines of care despite the fact because i’m treating a diabetic patient despite the fact that they have never ever ever

Thought in any of their diabetic patients into remission with medication type 2 diabetes does not go into remission i’ll purely with medication and yet the objective of my therapeutic approach is to get my type 2 diabetic patients into a mission with an a1c below 5.2 of medication because they’re not eating carbohydrates therapeutic carbohydrate restriction with

The use of medications during that time that pisses me off but you know what we’re gonna let it go let it go gotta let it go but here’s really what the problem is so medicare this group of people pushing statins like crazy because everybody should be on a statin so you can get these expensive medications called statins pretty much anywhere anytime you want one

In fact i bet you most doctors offices if they could would have them sitting beside the candy so they’d have m m’s they’d have uh hershey kisses they’ve had some skittles and then they have their statins because they’re awful and they’re all harmful drugs and they all come in pill form okay as it may the treatment of diabetes we know absolutely radically reduces

Cardiovascular risk the treatment of cholesterol does not and there’s strong evidence i’ve got a beautiful statin video on this uh just from a few weeks ago so but here’s the issue statins you can get freely anywhere there is a very very very powerful wonderful class of medication called glp-1 agonists that are taken as pill form or by injection preferred by once

A week injection that treat insulin resistance which is the causative backstory together with chronic excessive carbohydrate consumption of diabetes which causes at a 14 1 to 14 risk ratio of a cardiovascular disease so an absolute causal relationship whereas lower your ldl has an absolutely non-causal relationship 1.43 verses 14 risk relationship however glp-1

Agonist drugs are impossible to get medicare won’t prescribe them unless you’re already on insulin unless you have a diagnosis of type 2 diabetes because they’re so expensive and i don’t care what your politics are they have an opportunity to reduce the cost of insulin insulin-like medications a few months ago in congress and they failed to do it so we are depriving

Our patient population who are insulin resistant who could prevent diabetes by getting on this medication and for our diabetics we could potentially together with a therapeutic carbohydrate restriction diet use this medication as a tool to help them and perhaps for those obese patients to avoid costly and dangerous bariatric surgery that i do that i do that i

Wish i didn’t and my code of patients to get these glp-1 agonists are able to reduce the need for bariatric surgery their type 2 diabetes their insulin resistance that medication should be available like candy in every doctor’s office in my opinion but you cannot get this damn indication for patients that desperately need it that could do really well with it that

Could reduce their cost radically because of that cognitive dissidence in medicare and so many other places where we will give you a statin anywhere anytime in fact if you don’t take a statin you’re a bad bad person and a bad doctor but we cannot give you access to glp-1 agonists and i write these prescriptions i beg people uh to go not beg people to go on them

I beg insurance companies to give them and they say no no no no no no no no no because they don’t give a about you they care about their money and they won’t listen to what we have to say funny little story another funny little story i was hanging out with some friends of mine on friday night in in jacksonville and i haven’t seen them for a while man he and her

Looking fantastic husband wife couple lost weight looking great looking fit and i know them well they eat they bought carboholics and we’ve talked a lot about this we’ve butted heads a little bit i’ve agreed to let it go lost weight doing well they believe in exercise not diet which is fine i’m not gonna fight that good friends of mine despite that sometimes we

Have these differences but they’ve lost a ton of weight and they both are on glp high doses of geography and agonists that they received on the black market it’s become the new fenfen it’s become the new phentermine it’s become the new adderall it’s become that new drug that’s on the market all the public knows that this drug makes the weight melt away gets

Rid of the insulin resistance or radically improves it makes you healthier doesn’t restore complete health and it’s become this undercurrent of access of glp-1 agonists in south africa you cannot buy ozympic it doesn’t exist anymore it is off the shelves because of so much non-prescribed use the drug is available but it doesn’t the manufacturers have run out

They say they’re not going to have more supply till next year because everybody’s using it and yet the people that should be covering it for my poorer patrons for use it with a medical doctor the insurance companies will not cover the cost of this medication and it’s not an innocuous medication but it is incredibly effective and people are buying it everywhere

On the street and they’re not using it well because in my opinion it is malpractice to use a glp-1 agonist without therapeutic carbohydrate restriction so let’s help you one do what are the what are these glp-1 agonists do well glp-1 is a glucose like peptide it’s something that we’ve known about for a long time but kind of pushed it off to the side because we

Didn’t understand it very well i didn’t understand how it works uh glp-1 is produced in the upper intestine and in the lower the lower end of the small intestine um at two different periods and it is produced in response to what you’re eating primarily fat and sugar and what glp wonder it has effects in a variety of different places in the body but we’re gonna

We’re gonna limit ourselves to a few effects so the glp-1 agonist medication is a medication that you do that triggers an excessive release of glp-1 an excessive and prolonged release of glp1 um when you’re eating so the first thing it does is it increases your taste sensation in your mouth it also gives you very very early satiety that is mediated both in your

Stomach as well as in your head so it’s a centrally acting satiety medication gives you early satiety and more prolonged satiety so you eat less and you eat less often and if you eat a lot of carbohydrates it makes you feel like it gives you reflux gives you cramping gives you nausea funny little anecdote i tried some of the ozempic myself to see what it feels

Like but i overdosed i double dosed and my god for a week i felt terrible queasy miserable had reflux and i don’t need carbohydrates so it is a very powerful medication there at a hormonal level glp-1 triggers insulin release so if you look at insulin when you release insulin you have the first little bump a tiny little bump from the secretion of sugar so when

Sugar gets into your bloodstream a small there’s a small ins uh insulin trigger small amount of release of insulin but the bigger release of insulin is related to glp-1 so glp1 gives you that secondary bigger release of insulin but the other thing that glp-1 does is it blocks glucagon it blocks the release the production and release of sugar by the liver so you

Get a reduction in inherent sugar production and sugar release and you get an increase in insulin which helps you to clear that sugar and by increasing sugar you decrease the blood sugar you decrease the gradient between your bloodstream sugar and your intracellular sugar so you by that the cell automatically recruits insulin receptors because it needs sugar to

Come into the cell and that is the way you break insulin resistance that is the way we break insulin resistance so and i’m in in one of the new future videos i’m going to talk about that theory when it comes to treating diabetes with insulin however these glp-1 agonist medications are absolutely wonderful and occasionally they can cause a drop in blood sugar you

Want to be very careful about that particularly you try not to drink a lot of alcohol when you’re on these medications because that’ll that’ll drop your blood sugar quite a bit so hypoglycemia is an issue and it’s probably a good idea to monitor with a cgm or a needle stick and that’s why a finger stick that’s why i think the uh illicit use or the non-prescription

Use or the black market use of these medications has the potential to be somewhat dangerous and the way to the way to combat the black market uses to allow physicians to prescribe it in a monitored setting more freely allow the insurance companies to change away from supporting statin use to supporting glp-1 that’s the way to do it statins are not only useless

They’re harmful we have evidence of that glp-1 medications we have strong evidence of very powerful beneficial but then you have to change your theory away from lipid heart toward uh carbohydrate insulin model of obesity diabetes and metabolic syndrome once you make that shift it’s so obvious the glp-1 should be freely available or available by prescription fee like

Statins are and we should reduce our use of statins that’s coming folks that has to because the answer is there and it’s absolutely true how long it takes depends on how long the pharma industry and physicians support the statin industry and keep sending me this spanking of a doctor by some person with a bunch of degrees on the wall because they read a paper from

2016 pisses me off and will not rejection letter after rejection letter after rejection letter for using glp-1 as a physician that works in the space that directs patients directly they should be saying you have a patient with diabetes why are they not on a glp-1 agonist not why they’re not on a statin that’s the letter i should be getting that should be standard

Of care and you know what i’ll never get that letter because they’re all on glp-1 agonists if they’ll have it because it works so darn good folks we really need to help we need to become the tail that wags this farmer dog now we’re trying we’re trying i am the carb addiction doc if you want help with your diabetes if you want help with your insulin resistance

If you want realistic evidence-based therapy not those who have statins or if you’re worried about your doctor said you must be on a stat and you don’t want to take a statin we can compare the evidence we can look at your blood work give us a shout but if if you enjoyed this rant if you sympathize with a rant if you hate this rant if you think i’m an idiot if

I’ve made you think leave some comments but hit the subscribe button we depend on that to keep our content free and if you want to consult look in the show notes down below but text us whatsapp us 561-517-0642 but keep our show alive if you buy into it if if i’m full of it if you don’t like what i’m doing if you don’t like my content if you think i’m dangerous

Or terrible leave the comments not gonna go away i’m not going away we’ll see you next time i am the club election duck

Transcribed from video
Ep:258 INSULIN RESISTANCE AND GLP1 MEDICATIONS – A WONDERDRUG? by Robert Cywes By Dr. Cywes the #CarbAddictionDoc