One additional test that has fallen into disuse, is better to detect insulin resistance before elevated fasting glucose evolves: the 2h oral glucose tolerance test (OGTT).
Is a lengthy test requiring adequate timing between blood draws, it takes at least 2-hr to complete and for those reasons is not as popular as it once was. If you have risks factors — strong family history and/or obesity — and so far the fasting glucose and HbA1c remain normal, this test is helpful in detecting the post-meal glucose elevation the others are not well suited to track.
Having said that, of you have risk factors you should be addressing your lifestyle with progressive dietary changes and increased physical activity, regardless of what your laboratory tests reveal, even if those are normal.
The OGTT is not necessarily a health-promoting experience for people who already have insulin resistance, however. And it can sometimes also be read as normal (by blood sugar measurement) even in the presence of abnormal symptoms—such as symptoms of reactive hypoglycemia, for instance.
Food, Agriculture, and the Relationship with Big Food
Due to decades of fraudulent research conducted to protect the food industry, we are currently facing an unprecedented wave of OBESITY and CORRUPTION in human history.
All vegetable oils should be obtained through cold extraction (cold-pressed), but there are exceptions in the industry because cold extraction (room temperature) yields 50% less than hot extraction (approximately 70 degrees Celsius, refined oil) with additives, known as Soxhlet extraction. All vegetable oils available in supermarkets, such as extra virgin olive oils, should state "cold-pressed" on the label. Therefore, we must ensure that olive oil and all other seed (vegetable) oils are cold-pressed, and this should be printed somewhere on the packaging. Coconut oils should also be obtained by cold pressing. Vegetable fats (seed oils) not obtained by cold pressing are fattening and harmful to health, some because they are poisonous (soybean), others because they are obtained through hot extraction (refined) with additives (e.g., canola, corn, sunflower, rice, peanut, and others). Fat is essential for our bodies. There are safe sources, such as fat from ruminant animals (goats, sheep, cattle, camels, etc., naturally pasture-fed), including butter and cheeses from these animals. Therefore, we should avoid processed cheeses, as this processing includes vegetable seed fats and other harmful ingredients. Furthermore, these milks undergo pasteurization, which eliminates all the healthy microorganisms present in the milk. Noble cheeses like Parmesan and colonial (clandestine) do not contain vegetable seed fats and are not pasteurized, and in this case, both are also healthy when these animals are fed only on pasture. Farmed chicken, pork, fish, and crustaceans have become a terrible food source precisely because they are fed a diet containing an average of 40% soybean meal, a grain that, in addition to being carcinogenic, affects our consciousness (mind). One of its effects is that it prevents the satiety signal from being processed correctly, leading to an unstoppable craving for food. Furthermore, it carries linoleic acid (which causes weight gain and is carcinogenic) from the feed into the meat of these animals, making it unfit for human consumption. However, pork raised on a corn-based diet, wild boar, free-range chickens raised without feed, and wild fish and crustaceans are excellent foods.
Stay away from all processed and ultra-processed foods available in the supermarket; they are all carcinogenic in some way because they contain a wide variety of additives that are harmful to health, as well as because their formulas contain oils (fats) from vegetable seeds or derivatives of these fats. An example is chocolate bars, even those with 70% cocoa. Buy cocoa powder (100% cocoa) and make your own recipe.
Develop this reasoning:
The insertion of these hot-processed (refined) oils and fats into a whole chain of industrialized foods that we find on supermarket shelves increases shelf life and makes these processed and ultra-processed foods highly harmful to our health. It is one of the major hidden causes of various types of cancer, chronic obesity, and an infinite range of diseases whose true origin is unknown to medical science, unknown because this science is controlled by the food industry and pharmaceutical laboratories. When we look for evidence to support this information in scientific publications from world-renowned universities and journals, we will find several publications that say exactly the opposite of what has been reported here. This is because the large food and pharmaceutical industries, not forgetting the chemical industry, remunerate key scientists in research institutions by coercively guiding (commanding) their peers through their criticisms, guidance, and management of the financial flow destined for science in their respective universities. All this is to benefit these industries whose sole objective is ever-increasing profit, and therefore, these already bad foods become even worse with each passing day, to the detriment of your health and life expectancy.
Summary
Do yourself and your family a favor and embark on a journey to eliminate all seed oils (vegetable oils) from your diet today and, consequently, also processed products to ward off virtually all chronic degenerative diseases and cancers. This means avoiding all seed oils and even fruit oils like olive oil and avocado oil, as they are often adulterated with cheap seed oils and are not obtained from raw materials.
Cold-pressed. Cook with butter or fat from ruminant animals and cold-pressed vegetable oil, and avoid all processed and ultra-processed foods that are loaded with vegetable seed oils. Also avoid eating at restaurants, as almost all of them abundantly use vegetable seed oils for cooking and put them in their sauces and seasonings. Finally, avoid farmed chicken, pork, and fish and shellfish, as they are diseased, and keep pasture-raised cattle, lamb, goats, and wild fish and shellfish, as well as free-range poultry and pigs fed naturally, as your main sources of animal protein. This all explains why people before the 1940s were thin, and today a high percentage of the Western population is obese, unhealthy, and a captive customer of laboratories.
Good information except there is no need for any animal products. Whole foods from healthy soils can provide all the necessary ingredients for personal, spiritual and environmental health. KISS the earth and keep it simple!
Thank you for such a detailed explanation. I was told after last Oct blood work I was insulin resistant? It didn’t make sense at the time- normal A1c & weight, lots of exercise, no sodas and little carbs, sugars or fruits, gluten free and organic eating-mostly vegetables and home grown grass fed beef and eggs (chickens pasture and GMO corn/soy free feed). So why? I’ve been dealing with autoimmune most of my life and prob overload of vaccines at childhood. My new NP and a friend ND both suggested Berberine- which you list. Also added CQ10 and Bio-Cardiozyme…Game changer in a matter of months. Would you suggest HOMAR-IR next labs? My triglycerides were 36 and HDL 78. This really can be confusing- thank you for making it clearer.
A few years ago I was diagnosed as pre-diabetic. The only medical advice given was a printout on the Mediterranean diet. I'm not making this up.
On my own I chose to quit sugar, and flour as much as possible. In short order I lost 10 lbs. that never returned.
I also choose not to drive which forces more walking. In my late 50s I picked it up a notch with resistance band workouts, and a heckuva lot more sunshine. Tanning makes me feel better. A lot better, I discovered.
Not long ago my doctor ended a checkup visit with an almost aside: "Oh yeah, you're no longer pre-diabetic. Good news."
That, in a nutshell, encapsulates our sick care system.
Excellent summary of the common denominators of chronic disease, and the illustrations effectively make the points. Thank you Dr. Marik for your work and sharing.
This all makes a lot sense —especially how you frame insulin resistance as an adaptive response to overload. This is definitely what I have observed as well.
One question it raises for me is how the system is determining that it’s in a state of overload.
In other words, what governs the threshold where the body shifts into that protective response?
Could it possibly be not enough of usable magnesium? I think a correlation of people's magnesium levels needs to be looked into: one test group being people without insulin resistance, and the second test group being people with fairly high insulin resistance, and maybe even a third test group with people having outright type two diabetes. Which I have always maintained is not a disease, but a dietary insufficiency, or perhaps vitamin mineral insufficiency.
It seems like whatever is determining that threshold would have to sit upstream of the metabolic pathways themselves—something governing how the system is interpreting and responding to energy overall.
Still exploring it, but it’s been an interesting lens.
Worth researching the role of Taurine. An osmolyte which overcomes the cell danger response. It acts to "normalise" minerals within the cell and interstitial space. Then glucose is able to enter the cell again. It even allows glucose to enter the beta cells within the pancreas restoring insulin secretion. There is a lot of research on it's role in the treatment of rising blood sugar and pre-diabetes. I've not looked into the research on type 2 diabetes.
Thank you for another detailed explanation of a complicated problem involving the gradual progression of metabolic disease and insulin resistance. I traveled on the road of insulin resistance for many years, resulting in weight gain, hypothyroidism, and type 2 diabetes. Over three years, my symptoms have mostly resolved using many of Dr. Marik's suggestions. I take Armor Thyroid, eliminated all sugar and high-glycemic foods, seed oils, and began walking daily. The result is better health, normal weight, and managed blood sugar without medication.
Regarding historic trends in carbohydrate intake vs. type 2 diabetes, even Figure 2 of PMC8847553 -- a study purporting to claim that recommended carbohydrate intakes of 45% - 65% are "safe" -- reveals that all above-average risk of type 2 diabetes is found from studies with more than 45% carbohydrate, and that at 65% and above, risk clearly rises incrementally.
This is a vital point that remains chronically undervalued by the medical establishment.
We are dealing with a systemic 'storage + survival' trap. When hyperinsulinemia is the baseline, the body is forced to prioritize immediate survival over metabolic flexibility and long-term repair.
Crucially, this isn't just about 'diet'—it is a feedback loop where physical stress, emotional load, and circadian misalignment act as force multipliers for insulin resistance.
The medical-industrial complex prefers to treat these markers in isolation with lifelong prescriptions, rather than addressing the root environment.
Morning sunlight is one of the most potent, non-proprietary tools we have to break this cycle. It isn't just 'a tip'; it’s an essential biological input that anchors the rhythm of our entire hormonal cascade. By stabilizing the circadian clock, we improve insulin sensitivity and lower the cortisol load that fuels the survival state.
In a system that profits from our chronic dysfunction, simple, high-leverage interventions like this are a radical act of reclaiming one’s own physiology.
Singling out fructose here surprised me. I was already familiar with the bottom line, your “most important concept” of “chronic caloric excess”. And certainly fructose is a source of calories. But I remain unconvinced it’s particularly bad per calorie.
I would want some epidemiological evidence. I’m under the impression modern medicine looks too closely at things. If you’re just concluding it’s bad based upon some sort of reasoning derived from a knowledge of its biochemistry (being primarily metabolized in the liver and so forth) the most I would say is that it warrants suspicion. Would you advise against eating fruit? I’m inclined to think fruit is an important component of a healthy diet. There are other reasons to indict soda pop.
This is similar to how I regard all the disparaging stuff I read about seed oils. Like fruit, I regard nuts as an important part of a healthy diet. I have a hard time believing sunflower seeds are good for you and sunflower seed oil is terrible.
Excellent analysis of the problem. And the solution is also clear. Reduce/eliminate processed carbohydrates. Reduce/eliminate oils. Eliminate factory farmed animals. Enjoy your food. The answer to seed oil is NOT animal fat. Other than that, I agree with and appreciate you. Dean Ornish, MD and many others have shown that eliminating animal products and eating a plant based whole whole food diet eliminates heart disease. They agree with your analysis of the problem and have a proven solution for LONG TERM success.
Excellent article as always.
One additional test that has fallen into disuse, is better to detect insulin resistance before elevated fasting glucose evolves: the 2h oral glucose tolerance test (OGTT).
Is a lengthy test requiring adequate timing between blood draws, it takes at least 2-hr to complete and for those reasons is not as popular as it once was. If you have risks factors — strong family history and/or obesity — and so far the fasting glucose and HbA1c remain normal, this test is helpful in detecting the post-meal glucose elevation the others are not well suited to track.
Having said that, of you have risk factors you should be addressing your lifestyle with progressive dietary changes and increased physical activity, regardless of what your laboratory tests reveal, even if those are normal.
— Carlos
agree..
The OGTT is not necessarily a health-promoting experience for people who already have insulin resistance, however. And it can sometimes also be read as normal (by blood sugar measurement) even in the presence of abnormal symptoms—such as symptoms of reactive hypoglycemia, for instance.
Food, Agriculture, and the Relationship with Big Food
Due to decades of fraudulent research conducted to protect the food industry, we are currently facing an unprecedented wave of OBESITY and CORRUPTION in human history.
All vegetable oils should be obtained through cold extraction (cold-pressed), but there are exceptions in the industry because cold extraction (room temperature) yields 50% less than hot extraction (approximately 70 degrees Celsius, refined oil) with additives, known as Soxhlet extraction. All vegetable oils available in supermarkets, such as extra virgin olive oils, should state "cold-pressed" on the label. Therefore, we must ensure that olive oil and all other seed (vegetable) oils are cold-pressed, and this should be printed somewhere on the packaging. Coconut oils should also be obtained by cold pressing. Vegetable fats (seed oils) not obtained by cold pressing are fattening and harmful to health, some because they are poisonous (soybean), others because they are obtained through hot extraction (refined) with additives (e.g., canola, corn, sunflower, rice, peanut, and others). Fat is essential for our bodies. There are safe sources, such as fat from ruminant animals (goats, sheep, cattle, camels, etc., naturally pasture-fed), including butter and cheeses from these animals. Therefore, we should avoid processed cheeses, as this processing includes vegetable seed fats and other harmful ingredients. Furthermore, these milks undergo pasteurization, which eliminates all the healthy microorganisms present in the milk. Noble cheeses like Parmesan and colonial (clandestine) do not contain vegetable seed fats and are not pasteurized, and in this case, both are also healthy when these animals are fed only on pasture. Farmed chicken, pork, fish, and crustaceans have become a terrible food source precisely because they are fed a diet containing an average of 40% soybean meal, a grain that, in addition to being carcinogenic, affects our consciousness (mind). One of its effects is that it prevents the satiety signal from being processed correctly, leading to an unstoppable craving for food. Furthermore, it carries linoleic acid (which causes weight gain and is carcinogenic) from the feed into the meat of these animals, making it unfit for human consumption. However, pork raised on a corn-based diet, wild boar, free-range chickens raised without feed, and wild fish and crustaceans are excellent foods.
Stay away from all processed and ultra-processed foods available in the supermarket; they are all carcinogenic in some way because they contain a wide variety of additives that are harmful to health, as well as because their formulas contain oils (fats) from vegetable seeds or derivatives of these fats. An example is chocolate bars, even those with 70% cocoa. Buy cocoa powder (100% cocoa) and make your own recipe.
Develop this reasoning:
The insertion of these hot-processed (refined) oils and fats into a whole chain of industrialized foods that we find on supermarket shelves increases shelf life and makes these processed and ultra-processed foods highly harmful to our health. It is one of the major hidden causes of various types of cancer, chronic obesity, and an infinite range of diseases whose true origin is unknown to medical science, unknown because this science is controlled by the food industry and pharmaceutical laboratories. When we look for evidence to support this information in scientific publications from world-renowned universities and journals, we will find several publications that say exactly the opposite of what has been reported here. This is because the large food and pharmaceutical industries, not forgetting the chemical industry, remunerate key scientists in research institutions by coercively guiding (commanding) their peers through their criticisms, guidance, and management of the financial flow destined for science in their respective universities. All this is to benefit these industries whose sole objective is ever-increasing profit, and therefore, these already bad foods become even worse with each passing day, to the detriment of your health and life expectancy.
Summary
Do yourself and your family a favor and embark on a journey to eliminate all seed oils (vegetable oils) from your diet today and, consequently, also processed products to ward off virtually all chronic degenerative diseases and cancers. This means avoiding all seed oils and even fruit oils like olive oil and avocado oil, as they are often adulterated with cheap seed oils and are not obtained from raw materials.
Cold-pressed. Cook with butter or fat from ruminant animals and cold-pressed vegetable oil, and avoid all processed and ultra-processed foods that are loaded with vegetable seed oils. Also avoid eating at restaurants, as almost all of them abundantly use vegetable seed oils for cooking and put them in their sauces and seasonings. Finally, avoid farmed chicken, pork, and fish and shellfish, as they are diseased, and keep pasture-raised cattle, lamb, goats, and wild fish and shellfish, as well as free-range poultry and pigs fed naturally, as your main sources of animal protein. This all explains why people before the 1940s were thin, and today a high percentage of the Western population is obese, unhealthy, and a captive customer of laboratories.
DEC 2020
Thanks for you comments
Good information except there is no need for any animal products. Whole foods from healthy soils can provide all the necessary ingredients for personal, spiritual and environmental health. KISS the earth and keep it simple!
Thank you for such a detailed explanation. I was told after last Oct blood work I was insulin resistant? It didn’t make sense at the time- normal A1c & weight, lots of exercise, no sodas and little carbs, sugars or fruits, gluten free and organic eating-mostly vegetables and home grown grass fed beef and eggs (chickens pasture and GMO corn/soy free feed). So why? I’ve been dealing with autoimmune most of my life and prob overload of vaccines at childhood. My new NP and a friend ND both suggested Berberine- which you list. Also added CQ10 and Bio-Cardiozyme…Game changer in a matter of months. Would you suggest HOMAR-IR next labs? My triglycerides were 36 and HDL 78. This really can be confusing- thank you for making it clearer.
Yes, follow your HOMA-IN
That should be HOMA-IR
Yes, the Adrenal likely also plays a role. Certainly an early morning cortisol spike is responsible for a high glucose in the morning.
I’ve never seen so much useful info, thank you so much!
A few years ago I was diagnosed as pre-diabetic. The only medical advice given was a printout on the Mediterranean diet. I'm not making this up.
On my own I chose to quit sugar, and flour as much as possible. In short order I lost 10 lbs. that never returned.
I also choose not to drive which forces more walking. In my late 50s I picked it up a notch with resistance band workouts, and a heckuva lot more sunshine. Tanning makes me feel better. A lot better, I discovered.
Not long ago my doctor ended a checkup visit with an almost aside: "Oh yeah, you're no longer pre-diabetic. Good news."
That, in a nutshell, encapsulates our sick care system.
Excellent summary of the common denominators of chronic disease, and the illustrations effectively make the points. Thank you Dr. Marik for your work and sharing.
This all makes a lot sense —especially how you frame insulin resistance as an adaptive response to overload. This is definitely what I have observed as well.
One question it raises for me is how the system is determining that it’s in a state of overload.
In other words, what governs the threshold where the body shifts into that protective response?
Good question. Not sure.
Could it possibly be not enough of usable magnesium? I think a correlation of people's magnesium levels needs to be looked into: one test group being people without insulin resistance, and the second test group being people with fairly high insulin resistance, and maybe even a third test group with people having outright type two diabetes. Which I have always maintained is not a disease, but a dietary insufficiency, or perhaps vitamin mineral insufficiency.
That’s what I’ve been sitting with as well.
It seems like whatever is determining that threshold would have to sit upstream of the metabolic pathways themselves—something governing how the system is interpreting and responding to energy overall.
Still exploring it, but it’s been an interesting lens.
Could the adrenal gland play a role ?
Worth researching the role of Taurine. An osmolyte which overcomes the cell danger response. It acts to "normalise" minerals within the cell and interstitial space. Then glucose is able to enter the cell again. It even allows glucose to enter the beta cells within the pancreas restoring insulin secretion. There is a lot of research on it's role in the treatment of rising blood sugar and pre-diabetes. I've not looked into the research on type 2 diabetes.
Thank you for another detailed explanation of a complicated problem involving the gradual progression of metabolic disease and insulin resistance. I traveled on the road of insulin resistance for many years, resulting in weight gain, hypothyroidism, and type 2 diabetes. Over three years, my symptoms have mostly resolved using many of Dr. Marik's suggestions. I take Armor Thyroid, eliminated all sugar and high-glycemic foods, seed oils, and began walking daily. The result is better health, normal weight, and managed blood sugar without medication.
Important information here, Dr. Marik.
Regarding historic trends in carbohydrate intake vs. type 2 diabetes, even Figure 2 of PMC8847553 -- a study purporting to claim that recommended carbohydrate intakes of 45% - 65% are "safe" -- reveals that all above-average risk of type 2 diabetes is found from studies with more than 45% carbohydrate, and that at 65% and above, risk clearly rises incrementally.
What about insulin resistance issues for non-overweight people?
Such important information and very well presented, Dr Marik. Thank you very much!
This is a vital point that remains chronically undervalued by the medical establishment.
We are dealing with a systemic 'storage + survival' trap. When hyperinsulinemia is the baseline, the body is forced to prioritize immediate survival over metabolic flexibility and long-term repair.
Crucially, this isn't just about 'diet'—it is a feedback loop where physical stress, emotional load, and circadian misalignment act as force multipliers for insulin resistance.
The medical-industrial complex prefers to treat these markers in isolation with lifelong prescriptions, rather than addressing the root environment.
Morning sunlight is one of the most potent, non-proprietary tools we have to break this cycle. It isn't just 'a tip'; it’s an essential biological input that anchors the rhythm of our entire hormonal cascade. By stabilizing the circadian clock, we improve insulin sensitivity and lower the cortisol load that fuels the survival state.
In a system that profits from our chronic dysfunction, simple, high-leverage interventions like this are a radical act of reclaiming one’s own physiology.
Thanks. I agree.
Singling out fructose here surprised me. I was already familiar with the bottom line, your “most important concept” of “chronic caloric excess”. And certainly fructose is a source of calories. But I remain unconvinced it’s particularly bad per calorie.
I would want some epidemiological evidence. I’m under the impression modern medicine looks too closely at things. If you’re just concluding it’s bad based upon some sort of reasoning derived from a knowledge of its biochemistry (being primarily metabolized in the liver and so forth) the most I would say is that it warrants suspicion. Would you advise against eating fruit? I’m inclined to think fruit is an important component of a healthy diet. There are other reasons to indict soda pop.
This is similar to how I regard all the disparaging stuff I read about seed oils. Like fruit, I regard nuts as an important part of a healthy diet. I have a hard time believing sunflower seeds are good for you and sunflower seed oil is terrible.
Outstanding article. Thank you.
Excellent analysis of the problem. And the solution is also clear. Reduce/eliminate processed carbohydrates. Reduce/eliminate oils. Eliminate factory farmed animals. Enjoy your food. The answer to seed oil is NOT animal fat. Other than that, I agree with and appreciate you. Dean Ornish, MD and many others have shown that eliminating animal products and eating a plant based whole whole food diet eliminates heart disease. They agree with your analysis of the problem and have a proven solution for LONG TERM success.