Dr. Ben Bikman

And so you have to give them insulin therapy just to bring them to normal insulin.

In the type 2 diabetic, they're already high insulin and you're putting even higher.

Okay.

So that's the difference.

They're diseases of total opposites.

The only thing they have in common is that the glucose looks the same, in that it goes high.

Now, glucose is not benign, as much as I have an insulin-centric view.

Unapologetically, glucose is a problem.

through multiple mechanisms.

You mentioned the glycation.

That is a huge one.

Not only because of the change in the structure of that protein or that molecule itself, like skin, you can induce premature wrinkling by forcing glycation of the skin.

You can result in a compromised glycocalyx of the endothelium by all that glucose compromising with glycation.

So glycation itself is a way to

irreversibly alter a molecule and eliminate its utility.

And indeed at the same time, when you form an advanced glycation end product,

it becomes a substrate or a molecule that can ligand for RAGE, the receptor for advanced glycation end products.

And when RAGE gets activated, you have a lot of inflammation.

So the glycation goes beyond the altered structure of the molecule itself, leading into some chronic subclinical inflammation.

But there's another mechanism too, where when you elevate glucose substantially, you will have cells that are taking in that glucose