WEBVTT - How Diabetes Works 0:00:00.240 --> 0:00:02.960 Hey, everyone, We're coming to Salt Lake City, Utah, and Phoenix, 0:00:03.000 --> 0:00:06.840 Arizona this fall. Yeah, October, we're gonna be at Salt 0:00:06.920 --> 0:00:09.959 Lake Cities Grand Theater and then the next night October 0:00:10.600 --> 0:00:14.160 will be in Phoenix. And we added a second show 0:00:14.240 --> 0:00:17.200 to our Melbourne show, right, that's right, a second earlier 0:00:17.200 --> 0:00:19.840 show in Melbourne. So you can get all the information 0:00:19.880 --> 0:00:22.200 for all of these shows at s y s K 0:00:22.400 --> 0:00:27.319 live dot com. Welcome to Stuff you Should Know from 0:00:27.360 --> 0:00:38.280 how Stuff Works dot com. Hey, and welcome to the podcast. 0:00:38.400 --> 0:00:41.680 I'm Josh Clark, There's Charles w Chuck Brie, there's Jerry 0:00:41.720 --> 0:00:45.160 over there, and here we are doing maybe what's gonna 0:00:45.200 --> 0:00:47.400 be the best episode of Stuff you Should Know We've 0:00:47.400 --> 0:00:52.479 ever released? Jerry's back. Yeah, welcome back Jerry from hospice. 0:00:52.520 --> 0:00:56.640 You said she just through her her can of carbonated 0:00:56.640 --> 0:01:01.040 water down and belched. Is gonna name check it, But 0:01:01.320 --> 0:01:03.640 I'm glad you didn't. Man, we do enough buzz marketing 0:01:03.640 --> 0:01:07.480 as it is. Seriously, we can never do enough of that. 0:01:07.800 --> 0:01:13.440 I agree. Um, So, how are you feeling? Okay? Yeah? 0:01:13.480 --> 0:01:16.000 I feel like this article has ticked me off, though 0:01:16.160 --> 0:01:20.280 it is it's not that that Freud and Rick who 0:01:20.600 --> 0:01:24.720 is that? Yeah, the only PhD how Stuff Works. Ever, 0:01:25.480 --> 0:01:28.280 it's it wasn't he didn't do anything wrong. Like the 0:01:28.360 --> 0:01:31.559 logic behind the copy layout is what does it? It 0:01:31.600 --> 0:01:34.479 is almost like designed to keep from sticking in your 0:01:34.520 --> 0:01:37.039 mind to information you're reading. It's like, it's like if 0:01:37.080 --> 0:01:40.039 a person who in a grocery store put the milk 0:01:40.280 --> 0:01:43.840 together with like the canned spinach in an aisle and 0:01:43.959 --> 0:01:47.039 expected people to be able to find it. All right, 0:01:47.040 --> 0:01:49.480 all right, it's got worse than that. The cheese puffs 0:01:50.800 --> 0:01:55.400 and the game, the cheese puffs and the cash shots. 0:01:57.480 --> 0:02:02.080 Actually the little I can do this. Maybe by the 0:02:02.160 --> 0:02:04.080 end of the episode, I'll have it. But the point is, 0:02:04.720 --> 0:02:09.200 how about the oatmeal with a pickled herring? Okay, it's 0:02:09.240 --> 0:02:11.519 funny that you, like, we're picking things are still in 0:02:11.560 --> 0:02:16.120 the same unit. My imagination died at age ten. I 0:02:16.200 --> 0:02:20.240 just thought I turned into a robot about that. I 0:02:20.280 --> 0:02:22.480 thought it was a pretty dry article though, that was 0:02:22.560 --> 0:02:26.720 like none of the character of How Stuff Works articles 0:02:26.720 --> 0:02:30.120 that it read like a medical journal from the nineteen fifties, 0:02:30.360 --> 0:02:33.000 a diabetes how to article. Yeah, I was like, boy, 0:02:33.440 --> 0:02:35.640 how are we gonna make this fun? Well, that's our job. 0:02:35.840 --> 0:02:39.040 I know. So let's get started making this fun. Huh. Yeah, 0:02:39.040 --> 0:02:45.440 how about some stats, yeah, because these are pretty outdated. Uh, 0:02:45.800 --> 0:02:49.120 it's gotten way worse since this article. It has, and 0:02:49.400 --> 0:02:51.400 we're talking about in the United States, but in the 0:02:51.480 --> 0:02:55.800 last twenty years, type two diabetes has tripled. Eight four 0:02:55.840 --> 0:03:01.280 million Americans now have pre diabetes and don't know. Yeah, 0:03:01.639 --> 0:03:04.760 that's startling. Yeah, we'll we'll get into pre diabetes in 0:03:04.800 --> 0:03:08.600 a minute. And about thirty million people currently have diabetes 0:03:08.639 --> 0:03:13.160 in America type two or total I think total at 0:03:13.160 --> 0:03:18.239 a total cost of um, including lost wages, about three 0:03:18.280 --> 0:03:21.880 hundred and twenty seven billion dollars a year a year. Yeah, 0:03:22.200 --> 0:03:25.320 in the United States alone. I saw worldwide something like 0:03:25.400 --> 0:03:29.520 four hundred million people have diabetes and America makes up 0:03:29.520 --> 0:03:34.200 how many of those? Uh? Yeah, okay, which is surprising 0:03:34.240 --> 0:03:35.680 because it didn't used to be that way. It used 0:03:35.680 --> 0:03:39.560 to be like a wealthy Western disease, and all of 0:03:39.600 --> 0:03:43.680 a sudden it's starting to spread throughout the world, which 0:03:43.760 --> 0:03:46.080 is really kind of shocking and jarring. Like this is 0:03:46.120 --> 0:03:49.920 a huge increase in this disease. It's become a really 0:03:50.120 --> 0:03:53.840 big problem for not just like healthcare networks, but you know, 0:03:54.000 --> 0:03:57.000 the people with diabetes too. They're dying from it something 0:03:57.040 --> 0:03:59.720 like a million and a half deaths a year in 0:03:59.760 --> 0:04:02.200 the world. Yeah, it's it's a seventh leading cause of 0:04:02.240 --> 0:04:04.640 death in the the United States right now. And it's here's 0:04:04.680 --> 0:04:09.080 the thing. It's the type two diabetes is, from what 0:04:09.120 --> 0:04:14.280 we understand, utterly preventable. It looks like it is utterly 0:04:14.320 --> 0:04:17.279 preventable from what from what I've seen. Not one single 0:04:17.360 --> 0:04:20.200 person who has type two diabetes has to have it 0:04:20.240 --> 0:04:24.000 like they were genetically destined to have it, although there 0:04:24.120 --> 0:04:27.640 is some other evidence that we'll talk about that suggests otherwise. 0:04:27.680 --> 0:04:30.159 But I don't want to give anything up. Yeah, but 0:04:30.240 --> 0:04:32.359 I mean we can pretty much say now that it 0:04:32.480 --> 0:04:36.320 is let's just go ahead and say largely caused by 0:04:37.000 --> 0:04:40.400 being out of shape and being overweight and eating like 0:04:40.680 --> 0:04:45.320 terrible stuff all the time. Yeah. I love this article, Chuck, 0:04:45.839 --> 0:04:49.200 because it's one of those ones where it's like, oh, 0:04:49.279 --> 0:04:51.880 all of this makes total sense. Like I love the 0:04:51.920 --> 0:04:55.920 body just like I love Earth sciences. It's just we 0:04:55.960 --> 0:04:58.760 can kind of it forms a system that we can understand, 0:04:58.800 --> 0:05:01.800 and like when you understand this one part, you're like, oh, 0:05:01.800 --> 0:05:05.520 this other part that happens makes total sense. That's diabetes. Yeah, 0:05:05.560 --> 0:05:08.000 I hate the buddy in our sciences, I like um 0:05:08.200 --> 0:05:13.919 mysticism and cosmology and dreadlocks. Oh boy, why do we 0:05:13.920 --> 0:05:16.000 do that show on that? I was thinking of one 0:05:16.000 --> 0:05:18.960 the other day that we did Jackammers. No, it's even 0:05:19.000 --> 0:05:21.680 even worse than that. Oh I can't remember, but I 0:05:21.680 --> 0:05:25.919 was like, why did we even attend that one? Occasionally 0:05:25.920 --> 0:05:27.480 I'll look through the old list when we're picking out 0:05:27.480 --> 0:05:32.280 selects and I should go, what to myself? It's weird? 0:05:33.120 --> 0:05:37.880 All right? So we need to break down did mean 0:05:37.920 --> 0:05:41.640 that pun? A lot of breaking down in this in 0:05:41.760 --> 0:05:44.520 this show, you know what I mean? That was sort 0:05:44.520 --> 0:05:46.840 of a deep that was a foreshadowing punt, how it was. 0:05:47.360 --> 0:05:50.000 But we do need to break down the whole spiel 0:05:50.160 --> 0:05:54.520 with glucose and insulin, because the root of at all 0:05:54.680 --> 0:05:59.440 it's a disorder of glucose disorder. Yeah, it's a disorder 0:05:59.480 --> 0:06:02.000 of both will yeah, either be fair either high or 0:06:02.000 --> 0:06:07.920 low or none? Yeah. So okay, Well let's talk about 0:06:07.920 --> 0:06:11.080 glucose first, all right, Well, before we even talk about glucose, 0:06:12.200 --> 0:06:15.320 we need to define what a simple sugar is, or 0:06:15.400 --> 0:06:18.840 a simple carbohydrate it can be called. These are carbs 0:06:18.880 --> 0:06:22.719 that are absorbed very quickly for energy. And they're called 0:06:22.760 --> 0:06:24.680 simple because they only have one or two units of 0:06:24.680 --> 0:06:29.039 sugar as opposed to like a complex carbohydrate. And glucose 0:06:29.120 --> 0:06:32.400 is a simple sugar, right, And since it's a simple sugar, 0:06:32.440 --> 0:06:34.080 I think that means it can be broken down from 0:06:34.160 --> 0:06:37.839 different types of complex sugars, So not just like sugar, 0:06:37.880 --> 0:06:40.479 but carbs like you said, right, yeah, And this is 0:06:40.520 --> 0:06:42.760 the sugar that gives all the cells in your body 0:06:42.920 --> 0:06:47.800 energy to do sell selly things. Enters the bloodstream through 0:06:47.839 --> 0:06:50.839 the intestine. All the cells are like, give me some sugar, baby, yeah. 0:06:51.160 --> 0:06:53.680 And this comes from the foot food food that you eat. 0:06:53.880 --> 0:06:56.960 It really does. Right. So you eat some food, particularly 0:06:57.000 --> 0:06:59.920 say a carbohydrate rich food, and your guts start to 0:07:00.040 --> 0:07:04.080 break it down and it breaks down ultimately to that glucose, 0:07:04.480 --> 0:07:07.200 the simplest form of sugar that the body can use 0:07:07.240 --> 0:07:11.360 for energy without being stripped down further, and it shoots 0:07:11.400 --> 0:07:14.320 out through the blood stream and it's just a free 0:07:14.360 --> 0:07:18.840 for all. Right. Cells, like you said, use this stuff, 0:07:19.120 --> 0:07:22.040 and some cells in particular use nothing but glucoset, some 0:07:22.160 --> 0:07:24.680 use glucost and like other stuff like a TP, which 0:07:24.680 --> 0:07:29.360 of those red blood cells. Brain cells quite importantly use 0:07:29.440 --> 0:07:34.119 nothing but glucose for energy, So glucose is extraordinarily important. Yeah, 0:07:34.160 --> 0:07:36.240 and what your body wants to do. We always talk 0:07:36.280 --> 0:07:40.000 about that homeostasis. There's another example that your body wants 0:07:40.040 --> 0:07:43.680 to keep a constant glucose supply for your cells. We 0:07:43.720 --> 0:07:47.640 don't want it to be super high or too low. Uh. 0:07:47.680 --> 0:07:50.400 And it does this in a pretty interesting way. Otherwise, 0:07:50.760 --> 0:07:52.800 when we like right after we eat, we'd be great. 0:07:53.240 --> 0:07:55.000 And then if we didn't eat for a while or 0:07:55.080 --> 0:07:59.320 went to sleep at night, potentially our organs shut if 0:07:59.320 --> 0:08:01.360 we slip along. And because again this is the stuff 0:08:01.400 --> 0:08:03.920 that fuels your cells. Your cells need fuel twenty four 0:08:03.920 --> 0:08:06.640 hours a day. It doesn't care whether you're sleeping or not. Right, 0:08:06.680 --> 0:08:08.960 that would solve everything. If your cells went to sleep, 0:08:09.360 --> 0:08:12.360 it would when you slept, they just stop yapping for once. No, 0:08:12.520 --> 0:08:16.440 they're always talk talk talk, which actually I guess it 0:08:16.520 --> 0:08:18.920 is good because again, if your cell stopped working, then 0:08:18.960 --> 0:08:24.200 you die. Right, Okay, So that's glucose energy That power 0:08:24.280 --> 0:08:27.600 sells some cells exclusively, and your body wants to keep 0:08:27.640 --> 0:08:30.320 an eye constant level. Yeah, and you get it through food, 0:08:30.400 --> 0:08:34.720 which could conceivably spike your glucose. So when you eat 0:08:34.880 --> 0:08:37.760 something and all of a sudden, you have a surplus 0:08:37.800 --> 0:08:42.880 of glucose rather than that even keel homeostasis glucose in 0:08:42.920 --> 0:08:46.560 your bloodstream. Uh. Your body has a way of dealing 0:08:46.600 --> 0:08:50.839 with this, and it's called insulin. And insulin is one 0:08:50.880 --> 0:08:54.439 of two chemicals that are made by the pancreatic islets. 0:08:55.640 --> 0:08:59.640 I s l et islets, right, I don't know, did 0:08:59.679 --> 0:09:03.280 you look it up. I think it's islets, like islands, 0:09:03.320 --> 0:09:05.920 like it means like tiny islands. That's probably it. And 0:09:05.920 --> 0:09:08.200 they're they're they're called tiny islands. That's what we're gonna 0:09:08.200 --> 0:09:10.160 call them from now on because I don't want to 0:09:10.160 --> 0:09:12.640 get it wrong for the rest of the episode. But 0:09:12.800 --> 0:09:16.760 they're they're called tiny islands because they're indeed little endocrine 0:09:16.760 --> 0:09:21.160 cells inside your pancreas, so they're they're embedded like a 0:09:21.240 --> 0:09:25.959 journalist with a troop detachment. Basically. Yeah, so you're pancreas 0:09:26.120 --> 0:09:30.199 in uh In in this case is producing to insulin 0:09:30.280 --> 0:09:35.680 and glcagon I'm sorry, glucagon. Glucagon glucagon or alpha cells 0:09:35.920 --> 0:09:39.320 produced by alpha cells and secreted by alpha cells. Insulin 0:09:39.520 --> 0:09:42.839 are the beta cells. All of its produced in the pancreas. 0:09:42.920 --> 0:09:46.319 Like you said, with those little islands. But so let's focus. 0:09:46.559 --> 0:09:50.079 And here's a better one than than a military um 0:09:50.320 --> 0:09:55.040 uh analogy a post office in an airport. It's like here, 0:09:55.040 --> 0:09:57.600 we're gonna serve you, our customers. We're just gonna go 0:09:57.679 --> 0:10:00.719 to you. Do they have those? Yes? Some do? Man. 0:10:00.840 --> 0:10:03.480 I think there's one of the Toronto Airport. Yeah, there is, 0:10:04.360 --> 0:10:08.800 y y z so um who thought that was gonna 0:10:08.880 --> 0:10:12.280 come up? Huh. So you've got these little cells that 0:10:12.320 --> 0:10:15.480 are specialized to create insulin, to release insulin from the 0:10:15.559 --> 0:10:18.600 liver um, you know, from the pancrease, I'm sorry. In 0:10:18.880 --> 0:10:22.839 response to glucost becoming abundant in your gut, as you're 0:10:22.840 --> 0:10:25.959 digesting it, your gut sends out signals saying, hey, I 0:10:26.080 --> 0:10:27.719 got a bunch of gluecoats here. You guys want to 0:10:27.760 --> 0:10:30.840 do something, and the beta cells say we're on it 0:10:30.880 --> 0:10:34.120 and start releasing insulin. So insulin enters the blood stream, 0:10:34.360 --> 0:10:37.720 and its whole jam is to take the glucoast that 0:10:37.880 --> 0:10:41.960 enters the blood stream and give it two cells and 0:10:42.000 --> 0:10:46.079 it doesn't just push it down the cells throats. Apparently 0:10:46.120 --> 0:10:48.040 the cells have some sort of say in whether they 0:10:48.040 --> 0:10:51.280 accept gluecoast or not. But the only The only person 0:10:51.360 --> 0:10:54.440 they're going to accept glucose from is insulin, So insulin 0:10:54.480 --> 0:10:57.760 will take this gluecoast too. Different types of cells and 0:10:57.800 --> 0:11:01.720 with different cells, Um, different things happened to it, right, Yeah, 0:11:01.880 --> 0:11:03.600 Like it depends on what part of your body. If 0:11:04.000 --> 0:11:06.640 you're the liver or muscle cells is going to store 0:11:06.640 --> 0:11:10.200 that glucose and something called glycogen. Yeah, it's like just 0:11:10.320 --> 0:11:13.880 chains of glucose, right. Yeah, it's gonna stimulate fat cells 0:11:13.920 --> 0:11:17.560 to form fats from fatty acids and glycerol. Uh. Then 0:11:17.600 --> 0:11:19.600 the liver and muscle cells is gonna make those make 0:11:19.640 --> 0:11:22.600 proteins from amino acids. Yeah. And these are like the 0:11:22.640 --> 0:11:26.160 three base proteins or based nutrients that you get from 0:11:26.200 --> 0:11:31.880 eating food, right, amino acids, fats, fatty acids, and glucose. Correct. 0:11:32.040 --> 0:11:34.840 And then your body makes use of those because insulin 0:11:34.880 --> 0:11:37.840 deliverism two cells around the body. Yeah, then it's gonna 0:11:37.880 --> 0:11:41.839 inhibit the liver and kidney cells from making glucose. Uh. 0:11:41.880 --> 0:11:45.240 And this is something called gluco neo genesis, which is 0:11:45.920 --> 0:11:50.679 confuse me just a little bit. Why, Yeah, because it 0:11:50.840 --> 0:11:53.920 just I don't know something about the metabolic pathway, Like 0:11:54.520 --> 0:11:56.600 I don't know I didn't fully grasp it. I think 0:11:56.600 --> 0:11:58.360 what it is is that maybe my answer is just 0:11:58.440 --> 0:12:00.360 I'm not smart enough to get I don't think that's 0:12:00.400 --> 0:12:06.000 it at all. If if anything, yeah, that's your problem. Um. 0:12:06.040 --> 0:12:08.079 If anything, it was the article Chuck not you. Well, 0:12:08.120 --> 0:12:10.599 now this article is pretty stinky, but also went to 0:12:10.679 --> 0:12:13.080 kids health sites like I always do. But it makes sense, 0:12:13.120 --> 0:12:16.000 and that like if you will die, if you don't 0:12:16.000 --> 0:12:19.719 have the source of of energy, you're gonna have some 0:12:19.840 --> 0:12:23.360 backup plan. And the backup plan is, well, we probably 0:12:23.400 --> 0:12:25.880 have some constituent parts that we can put together to 0:12:25.920 --> 0:12:28.400 make our own glue cose. So that's like Plan B 0:12:29.440 --> 0:12:34.040 is make your own glue cose. And that's Gluco Neo Genesis. Okay, 0:12:34.400 --> 0:12:37.480 that's what I think. I mean, that's my interpretation. And 0:12:37.480 --> 0:12:41.640 I play a doctor on TV. Dr Drake Remore. What's 0:12:41.679 --> 0:12:44.880 U from those Friends? You probably didn't watch Friends? Did you? 0:12:45.080 --> 0:12:49.319 I saw an episode or two. I love that. Were 0:12:49.320 --> 0:12:52.079 you into Friends? Oh yeah I still am? Yeah, I'll 0:12:52.080 --> 0:12:55.680 watch those reruns. Oh really? Yeah, it's funny. It's very 0:12:55.760 --> 0:13:00.120 dated show now. Oh man, the clothes, the hairs, the 0:13:00.120 --> 0:13:03.840 white people. Yeah, I mean everything about it that they 0:13:03.960 --> 0:13:06.200 hung out at a coffee shop when that was new, 0:13:07.240 --> 0:13:09.280 because if you cast that show today, it would look 0:13:09.280 --> 0:13:13.960 like a Bennetton Colors ad. And rightly so, probably so. Alright, 0:13:14.040 --> 0:13:16.439 So at the end of the day, though, insulin is 0:13:16.440 --> 0:13:19.160 gonna store nutrients right after you eat that meal, but 0:13:19.360 --> 0:13:22.720 by reducing these concentrations of glucose and like you said, 0:13:22.760 --> 0:13:26.839 the fatty acids and amino acids, those three main components, right, 0:13:27.080 --> 0:13:29.240 which is pretty interesting because you really only hear of 0:13:29.280 --> 0:13:31.840 insulin dealing with blood sugar, but it deals with the 0:13:31.880 --> 0:13:35.160 main three nutrients. I didn't know that before, did you. 0:13:36.080 --> 0:13:38.120 I don't think I did. It's a it's a pretty 0:13:38.120 --> 0:13:40.400 handy little hormone to have, and by the way, it's 0:13:40.400 --> 0:13:43.320 a protein hormone. Glucos gets all the headlines it does 0:13:43.440 --> 0:13:46.040 because it's the troublemaker. And we'll see what happens when 0:13:46.440 --> 0:13:49.679 insulin can't do its job. What you get his diabetes 0:13:49.720 --> 0:13:52.160 and the symptoms of diabetes. We'll talk about that later, 0:13:52.200 --> 0:13:55.560 but first let's talk about glucagon. I thought you said 0:13:55.559 --> 0:13:59.440 for a second, the Simpsons of diabetes. The symptoms, Yeah, 0:13:59.480 --> 0:14:03.439 I know the Simpsons. No, the who would have diabetes 0:14:03.480 --> 0:14:06.520 on the Simpsons? Oh? Probably Homer and Wigham, yeah, I 0:14:06.520 --> 0:14:11.640 guess and Barney yeah, and well that will become clear 0:14:11.800 --> 0:14:15.160 as we explain diabetes more. Right, But let's talk about 0:14:15.200 --> 0:14:18.360 glucagon real quick, because you've got insulin doing its thing, 0:14:18.559 --> 0:14:21.600 and it's pretty clear now what insulin does, but there's 0:14:21.640 --> 0:14:25.560 another hormone that does the exact opposite that comes from 0:14:25.560 --> 0:14:28.960 those pancreatic tiny islands too. Yeah, this I thought was 0:14:28.960 --> 0:14:31.400 pretty neat as far as that homeostasis, that the body 0:14:31.400 --> 0:14:35.240 has like two methods to deal with this, you know. Yep. 0:14:35.360 --> 0:14:38.560 So like you said, if you go without eating or 0:14:38.760 --> 0:14:43.000 you um sleep, if your cells don't get that glucose 0:14:43.080 --> 0:14:45.840 that they need, they starve and die. So while you're 0:14:45.880 --> 0:14:48.880 sleeping and not eating, your your cells are still powering. 0:14:48.920 --> 0:14:51.560 They still need that energy. So your body has a 0:14:51.600 --> 0:14:54.720 way to deal with this, and it is by producing 0:14:54.760 --> 0:14:59.360 glucag glucogen, right, Yes, And it's a little confusing because 0:14:59.360 --> 0:15:03.600 it's glucagon and glucogen. Oh yeah, I'm talking about both 0:15:03.600 --> 0:15:06.560 with the G. Glucagon is what I'm talking about. That's 0:15:06.560 --> 0:15:10.240 how your body deals with a lack of a flood 0:15:10.280 --> 0:15:14.120 of new glucost being introduced from food, that's right, And 0:15:14.480 --> 0:15:17.200 that comes from the alpha cells of the pancreatic islets, 0:15:17.280 --> 0:15:20.400 right yeah, and it it acts on those same cells, 0:15:20.480 --> 0:15:23.400 but it just has the opposite effect, which is pretty cool. 0:15:23.480 --> 0:15:26.400 Like in the end, it's gonna like when you're sleeping 0:15:26.400 --> 0:15:30.080 and when you're not eating, it's gonna mobilize glucose and 0:15:30.120 --> 0:15:31.920 where it's stored up your body and say, hey, we 0:15:31.960 --> 0:15:34.280 need this stuff now, right, So it goes to the 0:15:34.320 --> 0:15:37.840 liver cell and the muscles and the muscles and says, hey, 0:15:37.880 --> 0:15:42.720 you remember the the glucogen. Isn't that what the chain 0:15:42.720 --> 0:15:48.360 of it's called, Yes, glycogen. So the the glucagon goes 0:15:48.400 --> 0:15:52.280 to the liver cells and the muscle cells, right, and 0:15:52.360 --> 0:15:54.800 it says, hey, you remember the chain of glucose that 0:15:54.840 --> 0:15:57.760 you made the glycogen the other day, Well, we need it, 0:15:58.400 --> 0:16:00.440 and so break it up and spit it out to 0:16:00.480 --> 0:16:02.640 me and I'll just get it into the blood stream. 0:16:02.920 --> 0:16:05.920 And it does that to the liver and muscle cells. Um. 0:16:05.960 --> 0:16:09.840 It also tells the kidneys and liver It says, by 0:16:09.840 --> 0:16:11.760 the way, liver, while I'm here, why don't you kick 0:16:11.800 --> 0:16:16.440 off some gluco neo genesis to make some glucose. And 0:16:16.480 --> 0:16:18.720 so all of a sudden, the low blood sugar in 0:16:18.720 --> 0:16:21.920 your blood stream comes up to normal, and your cells 0:16:21.960 --> 0:16:26.440 all say hooray, we're saved, and insulin gets a lifted 0:16:26.520 --> 0:16:29.880 up on everybody's shoulders and all the cells carried around 0:16:29.920 --> 0:16:36.000 for triumphant fist shaking um parade. Yeah, and it's pretty 0:16:36.040 --> 0:16:38.440 great because this is all happening when you're sleeping. This 0:16:38.520 --> 0:16:42.720 is right. So all this, this is how your your 0:16:42.760 --> 0:16:45.840 body keeps homeostasis for your blood sugar in your blood stream, 0:16:46.160 --> 0:16:49.920 your cells powered, if you're healthy. If this goes wrong, 0:16:51.280 --> 0:16:54.760 well you'll find out all about that right after these messages. 0:17:15.520 --> 0:17:19.800 So I don't think we mentioned that there is an 0:17:19.840 --> 0:17:23.119 ideal level here, and that's about ninety milligrams per one 0:17:23.520 --> 0:17:29.760 milds of blood for your blood glucose concentration or five millimolar. Yeah, 0:17:29.880 --> 0:17:32.879 and they, uh, you know that you can get this tested. 0:17:32.920 --> 0:17:35.639 They have little strips where you can poke yourself in 0:17:35.680 --> 0:17:38.240 the finger and bleed on the strip. Yeah. So this 0:17:38.320 --> 0:17:42.159 is apparently the most complex thing I've since the breathalyzer. 0:17:43.040 --> 0:17:49.000 You glucose call tolerance test um with a I'm sorry, 0:17:49.040 --> 0:17:51.280 I guess that's not it. It's a gluck glucose meter. 0:17:52.440 --> 0:17:56.439 You prick yourself and bleed onto that little strip of paper, 0:17:56.520 --> 0:18:00.359 like you were saying that the blood react with a 0:18:00.480 --> 0:18:03.679 chemical or with an enzyme I'm sorry. On the strip 0:18:04.640 --> 0:18:09.800 it's called glucose oxidase, and so that creates an entirely 0:18:09.880 --> 0:18:14.959 new compound, gluconate, which combines with another chemical, and that 0:18:15.000 --> 0:18:18.640 turns the strip blue. Right, And so you would think, okay, well, 0:18:18.680 --> 0:18:23.600 if it's blue, it's um it's it's I'm diabetic or 0:18:23.720 --> 0:18:25.879 I'm in trouble. If it's not blue, I'm fine. No, 0:18:26.680 --> 0:18:31.560 what the what the diabetes testing apparatus, I think that's 0:18:31.560 --> 0:18:35.159 what they're called. Does it analyzes the shade of blue 0:18:35.200 --> 0:18:40.240 that that turned? That's that's complicated. That's that's maybe the 0:18:40.280 --> 0:18:44.760 best blue. Really, sure, it's a good second. That's the 0:18:44.760 --> 0:18:48.520 only two blues, right, But I thought that'd be pretty 0:18:48.520 --> 0:18:50.120 cool if that's how I did do it. I I was like, oh, 0:18:50.160 --> 0:18:55.080 this is Robin's like, that's navy, this is cerulean, cerulian, 0:18:55.119 --> 0:18:57.399 you're in trouble. Well, that's not how they used to 0:18:57.440 --> 0:19:01.119 test it though. In fact, the full name for diabetes 0:19:01.200 --> 0:19:04.480 is diabetes, and militis M E L L I T 0:19:04.680 --> 0:19:07.800 U S, and that literally means sweet urine, because in 0:19:07.840 --> 0:19:13.200 ancient times the test involved the physician drinking your urine 0:19:13.240 --> 0:19:16.800 and going taste sweet. You're in trouble. You're in trouble. 0:19:16.920 --> 0:19:19.919 You're in trouble. So if you say that you have 0:19:20.119 --> 0:19:24.240 that sweet diabetes militis, you're saying you've got that sweet 0:19:24.280 --> 0:19:28.200 sweet urine. You know. I wrote a back in the 0:19:28.280 --> 0:19:32.080 day when I was writing spec scripts when I lived 0:19:32.080 --> 0:19:34.680 in l A. I wrote a seventies show script and 0:19:34.880 --> 0:19:37.280 uh it was a Halloween episode where Eric pete his 0:19:37.400 --> 0:19:40.480 pants at a haunted house and the title of the 0:19:40.520 --> 0:19:43.640 episode was urine for a Treat. Oh that's great, man. 0:19:43.960 --> 0:19:45.800 I thought that was enough. It was like, man, they're 0:19:45.800 --> 0:19:48.600 going to see that. That's it. You gotta publish those. 0:19:48.720 --> 0:19:51.480 I'm gonna be I should take that up, surely. I 0:19:51.480 --> 0:19:53.359 mean I don't have like a digital copy. I'd have 0:19:53.400 --> 0:19:57.600 to literally find the paper, take a how many pages 0:19:57.640 --> 0:20:00.720 do you think? I think it was like twenty four 0:20:00.760 --> 0:20:05.520 to thirty perfect, take a photo of each page. Why 0:20:05.560 --> 0:20:08.800 they didn't like it? Posted on Instagram a page day 0:20:08.840 --> 0:20:11.280 for a month. People will go crazy for it. They 0:20:11.320 --> 0:20:13.440 would love that. That's probably one of the better things 0:20:13.440 --> 0:20:15.879 I ever wrote. Oh, good out there like it was 0:20:15.920 --> 0:20:18.520 a legit sevenies show episode. I'll ever tell you about 0:20:18.560 --> 0:20:23.240 the Simpsons script I wrote not enough about. So remember 0:20:23.280 --> 0:20:25.639 the one where it turns out that Principal Skinners actually 0:20:25.720 --> 0:20:28.960 arm In Tanzarian. That's one of the great episodes. This 0:20:29.000 --> 0:20:31.440 one is if you If you remember, you know that's 0:20:31.480 --> 0:20:34.880 Matt Greening's most hated episode. I think he hated that episode, 0:20:35.280 --> 0:20:37.000 that one. I didn't know that at the time because 0:20:37.080 --> 0:20:39.399 I wrote this on spec to hoping that they'd notice 0:20:39.480 --> 0:20:42.680 it um although I never sent it in UM. But 0:20:42.880 --> 0:20:46.640 the at the end of that episode, they the judge 0:20:47.000 --> 0:20:49.879 says that it's you. They're You're never allowed to speak 0:20:49.880 --> 0:20:53.440 of this, punishable by death or something like that. So 0:20:53.800 --> 0:20:56.720 my episode starts with one of Armor tans Arian's old 0:20:56.720 --> 0:20:59.760 friends coming to Springfield to start his life, anew Ida, 0:20:59.840 --> 0:21:02.800 and he sees Principal Skinner and says, hey, arm in 0:21:02.920 --> 0:21:05.280 Armor Tansarian, And all of a sudden the police surround 0:21:05.400 --> 0:21:09.040 him and he's taken away to jail and held UM 0:21:09.080 --> 0:21:12.000 and it gets out he escapes, I think, gets out, 0:21:12.119 --> 0:21:15.040 and then Clinton was president when I wrote this, Um, 0:21:15.080 --> 0:21:17.639 he gets out. Somehow it gets to like Clinton that 0:21:17.760 --> 0:21:21.199 this town is like holding people hostage basically unconstitutionally, and 0:21:21.200 --> 0:21:25.080 so Springfield gets invaded and yours was eighty pages long. 0:21:25.680 --> 0:21:29.879 Uh no, I think it was like appropriately Yeah, I 0:21:29.920 --> 0:21:33.679 think so. Actually, I imagine a different life where uh 0:21:33.800 --> 0:21:36.040 I wrote for the seventy show, that seventy show, when 0:21:36.040 --> 0:21:38.680 you wrote for the Simpsons and we like eight lunch 0:21:38.760 --> 0:21:41.280 together on the Fox slot. Can I that'd be pretty cool? 0:21:41.359 --> 0:21:44.399 You know? Can I tell you something though, I would 0:21:44.560 --> 0:21:49.800 I prefer this. Oh yeah, yes, I prefer what we do. 0:21:50.080 --> 0:21:53.679 As someone who's never written for The Simpsons, I prefer this. 0:21:53.800 --> 0:21:56.439 Hey man, I've been to the writer's room before. I 0:21:56.480 --> 0:21:58.800 know what it looks like to chain him to the desk. 0:21:58.840 --> 0:22:01.119 I like it. We get to we don't have to 0:22:01.119 --> 0:22:04.560 live in l A. Yeah, I like l A. I've 0:22:04.600 --> 0:22:06.119 noticed a lot of our friends from New York are 0:22:06.160 --> 0:22:07.879 starting to move to l A. Have you noticed that 0:22:08.320 --> 0:22:12.280 it's like a hemorrhaging? Al Right, should we get back 0:22:12.280 --> 0:22:15.040 to diabetes, we should probably just edit all that out. No, 0:22:15.119 --> 0:22:17.960 I think that's a nice tangent. Al Right, So in 0:22:18.000 --> 0:22:22.000 the case of diabetes, like we said, um it is, uh, well, 0:22:22.000 --> 0:22:23.959 we already said what it was, but there are three types, 0:22:24.440 --> 0:22:28.840 type one, type two, and gestational diabetes. Type one is 0:22:29.320 --> 0:22:32.480 by far the in the minority. It's um. It says 0:22:32.480 --> 0:22:34.719 here five to timber cent. But I saw like kind 0:22:34.760 --> 0:22:37.800 of a straight up five number for the number of 0:22:37.880 --> 0:22:41.720 diabetes cases overall. Okay, um, But they say five to 0:22:41.760 --> 0:22:45.439 tim percent in this article. Or it's called juvenile diabetes 0:22:45.560 --> 0:22:49.080 or insulin dependent diabetes. Uh. And this is caused by 0:22:49.119 --> 0:22:53.720 a lack of insulin, either not much insulin or sometimes 0:22:53.800 --> 0:22:56.080 no insulin at all in their blood. And this is 0:22:56.680 --> 0:23:00.240 this is clearly genetic, right, it says an also could 0:23:00.240 --> 0:23:04.399 be environmental, but yeah, they think it's possible, possible that 0:23:04.480 --> 0:23:07.560 it's caused by a virus. Exposure to a virus earlier 0:23:07.560 --> 0:23:11.560 in childhood. Interesting that sets off an autoimmune reaction, and 0:23:11.600 --> 0:23:14.600 so your immune system attacks your beta cells that produce 0:23:14.680 --> 0:23:19.480 insulin and just destroys them, and so you don't produce insulin. 0:23:20.000 --> 0:23:23.360 And it happens in your your younger years, maybe adolescence, 0:23:23.400 --> 0:23:26.440 which is why it's called juvenile diabetes. And you when 0:23:26.480 --> 0:23:30.760 you have type one or juvenile diabetes, you are you're 0:23:30.800 --> 0:23:33.040 dealing with it for life. And we'll talk about, you know, 0:23:33.119 --> 0:23:36.840 managing and treating diabetes. Um, but there's no cure for diabetes. 0:23:37.280 --> 0:23:40.119 But the idea that it's possible that this is the 0:23:40.160 --> 0:23:42.480 result of a virus has made some people call for 0:23:42.520 --> 0:23:47.280