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The Metabolic Classroom with Dr. Ben Bikman
Nicotine and Insulin Resistance: What You Should Understand About the Connection
During Dr. Ben Bikman’s latest episode of The Metabolic Classroom lectures, Ben explores the metabolic effects of nicotine, emphasizing its influence beyond its addictive properties and its association with lung health and its connection to insulin resistance.
Nicotine, a naturally occurring alkaloid found primarily in tobacco plants, is widely consumed through various products such as cigarettes, cigars, chewing tobacco, e-cigarettes, and nicotine replacement therapies like gums and patches. While most discussions on nicotine focus on its addictive qualities and respiratory impact, Ben highlights its significant effects on metabolism, including interactions with fat cells, insulin, and the nervous system.
Nicotine primarily stimulates the sympathetic nervous system by increasing the release of catecholamines like epinephrine and norepinephrine. These stress hormones activate the “fight or flight” response, resulting in elevated heart rate, blood pressure, and metabolic rate.
Nicotine’s ability to increase lipolysis, the breakdown of stored fat into free fatty acids, often leads to temporary weight loss. However, its chronic use disrupts fat metabolism by impairing mitochondrial fat oxidation, leading to fat cell hypertrophy (enlargement). This enlargement, particularly in visceral fat, contributes to insulin resistance, fatty liver disease, and systemic inflammation.
Ben also examines nicotine’s role in insulin resistance through its activation of specific cellular pathways. Nicotine increases ceramide production, which disrupts insulin signaling by deactivating key proteins essential for glucose uptake. Additionally, nicotine activates receptors like RAGE (Receptor for Advanced Glycation End Products) and TLR4 (Toll-like Receptor 4), which further drive ceramide production and inflammation. This creates a self-perpetuating cycle that exacerbates metabolic dysfunction and promotes chronic insulin resistance.
The classroom lecture highlights the paradoxical nature of nicotine’s metabolic effects. While it temporarily enhances fat metabolism and weight loss, chronic exposure reverses these effects, promoting fat storage, inflammation, and severe insulin resistance. Ben emphasizes the metabolic risks associated with nicotine, especially in the context of rising vaping trends among younger populations. He concludes by urging greater awareness of nicotine’s systemic effects, particularly its hidden role in metabolic health.
visit: https://www.insuliniq.com
Ben’s favorite yerba maté and fiber supplement: https://ufeelgreat.com/usa/en/c/InsulinIQ
Ben’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10)
Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15)
Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20)
Show Notes/References:
Due to character length constraints, references are not posted here. However, for a complete list, we respond quickly. Please email: support@insuliniq.com with your request, and be sure to mention which Metabolic Classroom episode you are referring to, which in this case is “Episode 79 - Nicotine and Insulin Resistance”.
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83. The Unexpected Link Between Salt Regulating Hormones and Metabolic Health
35:20||Ep. 83We sincerely apologize! During the livestream recording, we experienced some technical difficulties between 07:15 to 08:50. Thanks for your patience and understanding.Learn more about becoming an Insider on our website: https://www.benbikman.comDuring The Metabolic Classroom lecture this week, Dr. Bikman dives into the intricate relationship between salt- and water-regulating hormones and metabolic health.Starting with a discussion of the renin-angiotensin-aldosterone system (RAAS), he explains how hormones like angiotensin II, aldosterone, and antidiuretic hormone (ADH) are not only critical for regulating blood pressure but also significantly impact insulin sensitivity and fat cell dynamics. Angiotensin II promotes insulin resistance by increasing ceramide production, which blocks insulin signaling, while also enlarging fat cells and inhibiting their breakdown. Similarly, aldosterone exacerbates insulin resistance by enhancing ceramide levels and promotes both the growth and multiplication of fat cells. ADH complements these effects, particularly by inhibiting fat breakdown through its action on specific receptors.Ben emphasizes the counterintuitive finding that salt restriction, often prescribed to manage hypertension, can worsen insulin resistance, particularly in individuals with metabolic vulnerabilities. Studies highlight that reducing salt intake leads to increased fasting insulin levels, impaired glucose metabolism, and unfavorable lipid changes, such as reduced HDL cholesterol. Additionally, he warns that dehydration, much like salt restriction, activates these same hormonal pathways, compounding their metabolic effects.Dr. Bikman concludes with a reminder that interventions aimed at improving blood pressure should consider their broader metabolic implications, particularly for individuals predisposed to insulin resistance.Show Notes/References:For complete show notes and references referred to in this episode, we invite you to become a Ben Bikman Insider subscriber. As a subscriber, you’ll enjoy real-time, livestream Metabolic Classroom access which includes live Q&A with Ben, ad-free Metabolic Classroom Podcast episodes, show notes and references, Ben’s Research Reviews Podcast, and a searchable archive that includes all Metabolic Classroom episodes and Research Reviews. Learn more about becoming an Insider on our website: https://www.benbikman.comTimestamps: (approximate)(01:13) Overview of Salt- and Water-Regulating Hormones(02:22) How Angiotensin II Influences Blood Pressure and Insulin Resistance(06:37) The Metabolic Effects of Angiotensin II on Fat Cells(11:22) Aldosterone’s Role in Insulin Resistance and Fat Cell Growth(15:57) Metabolic Impacts of Antidiuretic Hormone (ADH)(29:02) The Counterintuitive Effects of Salt Restriction on Metabolic Health(33:13) The Role of Dehydration in Activating Metabolic Hormones(34:51) Conclusion: How Blood Pressure Hormones Influence Metabolic Health#MetabolicHealth #InsulinResistance #Hypertension #SaltAndHealth #BloodPressure #HormonesAndHealth #DrBenBikman #MetabolicSyndrome #LowCarbLife #Type2Diabetes #KetoLife #HealthyLifestyle #NutritionScience #MetabolismMatters #HealthEducation #FatCellBiology #InsulinSensitivity #SaltIntake #Dehydration #HealthTips82. Hypertension Medications and Metabolic Health
39:52||Ep. 82Learn more about becoming an Insider on our website: https://www.benbikman.comThis week in The Metabolic Classroom lecture, Ben focuses on the relationship between hypertension medications and metabolic health, providing a critical examination of their mechanisms and metabolic implications.He begins by highlighting the role of insulin resistance as a common root cause of both hypertension and metabolic disorders. Ben explains that while hypertension medications such as diuretics, beta blockers, ACE inhibitors, ARBs, and calcium channel blockers are often prescribed, they each have unique effects on insulin sensitivity and glucose metabolism, which can either mitigate or exacerbate metabolic dysfunction. Notably, some classes of these medications, like ARBs, may improve insulin sensitivity, while others, like beta blockers and diuretics, can impair it, leading to heightened risks for type 2 diabetes.Ben underscores the importance of addressing the root causes of hypertension—namely, insulin resistance—through lifestyle interventions like low-carbohydrate diets and fasting, which improve both blood pressure and metabolic health. He emphasizes the need for personalized treatment plans that consider the metabolic side effects of medications, advocating for strategies that tackle insulin resistance as a primary approach to improving overall health.Show Notes/References:For complete show notes and references referred to in this episode, we invite you to become a Ben Bikman “Insider” subscriber. As a subscriber, you’ll enjoy real-time, livestream Metabolic Classroom access which includes live Q&A with Ben, ad-free Metabolic Classroom Podcast episodes, show notes and references, Ben’s Research Reviews Podcast, and a searchable archive that includes all Metabolic Classroom episodes and Research Reviews. Learn more about becoming an Insider on our website: https://www.benbikman.comBen’s favorite yerba maté and fiber supplement: https://ufeelgreat.com/usa/en/c/InsulinIQBen’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10)Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15)Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20)Ben’s favorite health check-up for women: https://choosejoi.co/drben15 (discount: DRBEN15)Ben’s favorite health check-up for men: https://blokes.co/drben15 (discount: DRBEN15)Ben’s favorite exogenous ketone: https://www.americanketone.com (discount: Ben10)Other products Ben likes: https://www.amazon.com/shop/benbikmanphd#MetabolicHealth #Hypertension #BloodPressure #DrBenBikman #InsulinResistance #MetabolicScience #FatCellBiology #Diuretics #BetaBlockers #ACEInhibitors #CalciumChannelBlockers #BloodPressureMedications #HealthTips #DASHDiet #InsulinSensitivity #FatCells #KetogenicDiet #LowCarbLiving #HealthyLifestyle #HeartHealth81. Thyroid Health and Low-Carb Diets: What Lower T3 Really Means
30:57||Season 2, Ep. 81This week in The Metabolic Classroom, Ben explores the effects of a ketogenic diet on thyroid function, addressing concerns that lower thyroid hormone levels observed during the diet may indicate dysfunction.Dr. Bikman begins by explaining the hypothalamic-pituitary-thyroid (HPT) axis, a regulatory system that controls thyroid hormone production. The thyroid gland produces two primary hormones, T3 (triiodothyronine) and T4 (thyroxine), with T3 being the active form that influences metabolic processes. He emphasizes the concept of negative feedback within the HPT axis, explaining that normal TSH levels generally indicate a well-functioning thyroid, even if T3 levels are lower.Ben also reviews a commonly cited study that observed decreased T3 levels in individuals following a ketogenic diet. Despite the drop in T3, TSH levels remained normal, suggesting that the thyroid gland was not damaged but rather adapting to reduced metabolic demand. He introduces two key explanations: improved thyroid hormone sensitivity and reduced glucose metabolism. Improved sensitivity means that lower levels of T3 are sufficient to maintain metabolic functions, while reduced glucose consumption on a ketogenic diet lessens the body’s need for thyroid hormone to regulate glucose uptake.The classroom lecture then delves into the concept of thyroid hormone resistance, a condition linked to metabolic disorders like obesity and type 2 diabetes. Dr. Bikman references studies showing that thyroid resistance is real and measurable, often associated with elevated TSH and thyroid hormones in individuals with metabolic syndrome. He speculates that a ketogenic diet may enhance thyroid sensitivity in these individuals, reducing the need for higher T3 levels.In conclusion, Dr. Bikman reassures those on a ketogenic diet that lower T3 levels do not necessarily indicate harm. If TSH levels are normal and no symptoms of hypothyroidism are present, the changes may reflect a healthy adaptation to the metabolic state induced by the diet.Show Notes/References:For complete show notes and references referred to in this episode, we invite you to become a Ben Bikman “Insider” subscriber. As a subscriber, you’ll enjoy real-time, livestream Metabolic Classroom access which includes live Q&A with Ben, ad-free Metabolic Classroom Podcast episodes, show notes and references, Ben’s Research Reviews Podcast sent to your inbox weekly, and a searchable archive that includes all Metabolic Classroom episodes and Research Reviews. You can learn more about becoming an Insider on our website: https://www.benbikman.comBen’s favorite yerba maté and fiber supplement: https://ufeelgreat.com/usa/en/c/InsulinIQBen’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10)Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15)Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20)Ben’s favorite health check-up for women: https://choosejoi.co/drben15 (discount: DRBEN15)Ben’s favorite exogenous ketone: https://www.americanketone.com (discount: Ben10)80. Hormone Replacement Therapy in Women: Metabolic Benefits and Misunderstood Risks
32:13||Season 2, Ep. 80In this week’s episode of The Metabolic Classroom, Dr. Bikman delivers a comprehensive lecture on hormone replacement therapy (HRT), focusing on its role in addressing metabolic health challenges faced by women during menopause.The loss of estradiol causes fat to redistribute from healthier storage areas, like the hips and thighs, to the abdominal region, where larger fat cells become more insulin-resistant and pro-inflammatory. This shift contributes to systemic inflammation and elevates the risk of cardiometabolic diseases. Ben explains how HRT, particularly with estradiol, can mitigate these effects by improving insulin sensitivity, reducing inflammation, and promoting healthier fat storage patterns.He also addresses historical concerns about HRT, including risks of blood clots and cancer. Dr. Bikman explains that oral estrogens may slightly increase clotting risks due to their first-pass metabolism in the liver, but transdermal delivery methods like patches and gels do not carry this same risk. Regarding cancer, he highlights how older studies, such as the Women’s Health Initiative, overstated the connection between HRT and breast cancer, particularly when using estrogen-only therapies. Ben emphasizes the importance of evaluating the absolute risks, which are relatively small.Beyond its metabolic benefits, HRT also shows promise in protecting against conditions like Alzheimer's disease. Ben discusses studies suggesting that HRT, when started early in menopause, may improve cognitive outcomes, preserve brain volume, and reduce the risk of Alzheimer’s, particularly in women with the APOE4 gene. These findings suggest that timely HRT may support brain health alongside its other benefits.In conclusion, Ben underscores the substantial metabolic and overall health changes women face during menopause and the potential for HRT to improve quality of life, metabolic health, and long-term outcomes. He stresses the importance of individualized HRT plans tailored to each woman’s unique circumstances, allowing for a nuanced approach to mitigating menopause-related challenges.visit https://www.benbikman.comBen’s favorite yerba maté and fiber supplement: https://ufeelgreat.com/usa/en/c/InsulinIQBen’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10)Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15)Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20)Ben’s favorite health check-up for women: https://choosejoi.co/drben15 (discount: DRBEN15)Ben’s favorite health check-up for men: https://blokes.co/drben15 (discount: DRBEN15)Ben’s favorite exogenous ketone: https://www.americanketone.com (discount: Ben10)Show Notes/References:Due to character length constraints, references are not posted here. However, for a complete list, we respond quickly. Please email: support@benbikman.com with your request, and be sure to mention which Metabolic Classroom episode you are referring to, which in this case is “Episode 80 - Hormone Replacement Therapy in Women”.78. Oxalates and Metabolic Health: How and Why Antinutrients From Plants Can Be Harmful
35:01||Season 2, Ep. 78For The Metabolic Classroom lecture this week, Dr. Bikman explores the often-overlooked effects of oxalates on human health, with a focus on their impact on metabolic, kidney, cardiovascular, gut, and joint health.Oxalates are natural compounds found in various plants, including leafy greens like spinach and kale, as well as certain nuts, seeds, grains, and legumes. They serve as a defense mechanism for plants against herbivores, as their high concentrations can cause irritation and reduce nutrient absorption. While often thought of as harmless, oxalates can act as “antinutrients” by binding to essential minerals such as calcium, magnesium, and iron, limiting their bioavailability and potentially leading to deficiencies.Oxalates form crystals with calcium, creating a compound known as calcium oxalate. When these crystals accumulate in the body, they can contribute to kidney stones—a problem that affects many people. Ben explains that calcium oxalate crystals make up about 80% of all kidney stones, underscoring the connection between oxalate consumption and kidney health. Individuals prone to kidney stones, particularly those consuming high-oxalate diets or taking high doses of vitamin C (which the body can convert to oxalates), may face a heightened risk.To mitigate oxalate-related health risks, Dr. Bikman suggests practical strategies, including reducing high-oxalate foods, ensuring adequate calcium intake to bind oxalates in the gut, staying hydrated to aid in oxalate excretion, and consuming fermented foods or probiotic supplements to support a healthy gut microbiome. He also highlights the importance of a balanced approach to vitamin C supplementation, as excessive intake may increase oxalate production in the body.visit: https://www.insuliniq.comBen’s favorite yerba maté and fiber supplement: https://ufeelgreat.com/usa/en/c/InsulinIQBen’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10)Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15)Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20)Ben’s favorite health check-up for women: https://choosejoi.co/drben15 (discount: DRBEN15)Ben’s favorite health check-up for men: https://blokes.co/drben15 (discount: DRBEN15)Ben’s favorite exogenous ketone: https://www.americanketone.com (discount: Ben10)Due to character length constraints, references are not posted here. However, for a complete list, we respond quickly. Please email: support@insuliniq.com with your request, and be sure to mention which Metabolic Classroom episode you are referring to, which in this case is “Episode 78 - Oxalates & Metabolic Health”.#Oxalates #MetabolicHealth #KidneyStones #AntiNutrients #DrBenBikman #CalciumOxalate #GutHealth #Inflammation #JointPain #FermentedFoods #Microbiome #Probiotics #NutrientAbsorption #Metabolism #OxalatesInPlants77. Microplastics & Metabolic Health: The Surprising Connection with Dr. Ben Bikman
33:59||Season 2, Ep. 77During this week’s episode of The Metabolic Classroom, Dr. Bikman discusses the impact of microplastics on metabolic health, focusing on their effects on fat cells, insulin resistance, and blood vessel health.Microplastics—tiny plastic particles under five millimeters—are now ubiquitous in our environment, entering the body through food, water, air, and skin products. Their pervasiveness poses serious concerns due to their accumulation in human tissues and the release of harmful chemicals like BPA (bisphenol A) and phthalates, which disrupt normal hormone functions and lead to various health issues.Ben details how microplastics affect fat cell biology, particularly through BPA and phthalates, which mimic hormones like estrogen and testosterone, causing increased fat storage and even promoting fat cell growth and multiplication (hyperplasia and hypertrophy). This hormone disruption and fat cell expansion result in greater fat storage and elevated inflammation, contributing to insulin resistance, obesity, and chronic diseases like type 2 diabetes.Professor Bikman also explores how microplastics affect vascular health, citing studies that show microplastic particles in atherosclerotic plaques. These particles attract macrophages that attempt to remove the microplastics but instead form “foam cells,” which contribute to plaque formation and heighten the risk of cardiovascular disease.Ben concludes with recommendations to limit microplastic exposure, such as avoiding plastic containers for long-term water storage and choosing BPA-free, phthalate-free products, especially for food and beverages.visit: https://www.insuliniq.comBen’s favorite yerba maté and fiber supplement: https://ufeelgreat.com/usa/en/c/InsulinIQBen’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10)Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15)Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20)Ben’s favorite health check-up for women: https://choosejoi.co/drben15 (discount: DRBEN15)Ben’s favorite health check-up for men: https://blokes.co/drben15 (discount: DRBEN15)Ben’s favorite exogenous ketone: https://www.americanketone.com (discount: Ben10)Show Notes/References:Due to character length constraints, references are not posted here. However, for a complete list, we respond quickly. Please email: support@insuliniq.com with your request, and be sure to mention which Metabolic Classroom episode you are referring to, which in this case is “Episode 77 - Microplastics & Metabolic Health: The Surprising Connection”.#Microplastics #MetabolicHealth #FatCells #DrBenBikman #BPA #Phthalates #InsulinResistance #ChronicInflammation #EndocrineDisruptors #HeartHealth #Atherosclerosis #PlasticsInHealth #Metabolism #HormoneDisruption #EnvironmentalHealth #MetabolicHealth76. Using a Continuous Glucose Monitor (CGM) to Help You Improve Insulin Sensitivity
22:35||Season 2, Ep. 76This week’s episode of The Metabolic Classroom focuses on the potential of continuous glucose monitors (CGMs) as a valuable tool not only for individuals with diabetes but also for anyone interested in gaining deeper insights into their metabolic health.CGMs, which measure glucose levels continuously by detecting interstitial glucose, provide real-time feedback on how diet, exercise, stress, and sleep impact blood sugar, making them useful beyond their traditional application for managing diabetes.Dr. Bikman highlights studies that showcase the variability in individual glucose responses to the same foods, which can be attributed to factors like gut microbiome composition. Ben cites a prominent 2015 study from Israel that revealed individuals’ glucose reactions to identical foods varied widely, showing the personal nature of glycemic responses and the role of CGMs in helping people manage their blood glucose variability.Another study, from Stanford University, further illustrates how CGMs can reveal “hidden” glucose spikes, leading people to make more informed dietary and lifestyle decisions.Dr. Bikman touches on the idea that, beyond personal use, CGMs have clinical benefits as well. Studies from the Scripps Research Institute and the Framingham Heart Study show that CGMs can detect early signs of prediabetes and diabetes in individuals who may otherwise go undiagnosed, providing a valuable tool for early intervention.While there are critiques about CGMs, including concerns about potential overemphasis on glucose levels, costs, and possible psychological impacts, Dr. Bikman asserts that the advantages—such as improving insulin sensitivity, reducing glycemic variability, and empowering users to make healthier choices—outweigh these concerns.Ben concludes by encouraging those curious about their metabolic health to consider CGMs as a practical tool for self-monitoring, with potential for significant long-term health benefits.visit: https://www.insuliniq.comBen’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10)Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15)Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20)Ben’s favorite health check-up for women: https://choosejoi.co/drben15 (discount: DRBEN15)Ben’s favorite health check-up for men: https://blokes.co/drben15 (discount: DRBEN15)Ben’s favorite exogenous ketone: https://www.americanketone.com (discount: Ben10)Show Notes/References:Due to character length constraints, references are not posted here. However, for a complete list, we respond quickly. Please email: support@insuliniq.com with your request, and be sure to mention which Metabolic Classroom episode you are referring to, which in this case is “Episode 76 - Using a Continuous Glucose Monitor (CGM) to Help You Improve Insulin Sensitivity”.#InsulinResistance #CGM #MetabolicHealth #BloodSugar #DrBenBikman #ContinuousGlucoseMonitor #InsulinSensitivity #GlycemicVariability #Microbiome #Prediabetes #SelfMonitoring #HealthTech #DiabetesPrevention #MetabolicInsights #NutritionalScience #Hyperglycemia #Glycation #HealthOptimization75. Glucosamine and Metabolic Health: What You Need to Know with Dr. Ben Bikman
29:16||Season 2, Ep. 75In the recording of today’s livestream episode of The Metabolic Classroom, Dr. Ben Bikman explores glucosamine’s impact on both joint and metabolic health.Glucosamine, commonly used as a supplement to alleviate joint pain, especially in osteoarthritis, is an amino sugar that plays a role in cartilage formation. However, its effectiveness in improving joint health is debated, with some studies suggesting modest benefits, while others find it no better than a placebo.Dr. Bikman shifts the focus to glucosamine’s metabolic effects, explaining that due to its structural similarity to glucose, glucosamine can enter cells via glucose transporters, particularly GLUT1 and GLUT2. Once inside cells, glucosamine can contribute to the production of UDP-GlcNAc, a molecule that interferes with insulin signaling, potentially leading to insulin resistance and elevated blood glucose levels. This effect is particularly concerning for individuals with underlying insulin resistance or a family history of type 2 diabetes.Ben refers to several studies, with most finding that glucosamine supplementation can impair insulin sensitivity and raise blood glucose levels in people with metabolic issues, while having little to no effect in metabolically healthy individuals.Dr. Bikman concludes by advising that glucosamine may not be worth the risk for people with metabolic health concerns, while for those who are metabolically healthy, it is likely safe to use. However, he stresses the importance of monitoring blood glucose levels if taking glucosamine and suggests other strategies for improving joint health, such as improving insulin sensitivity and reducing uric acid levels.Ben’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10)Ben’s favorite electrolytes (and more): https://redmond.life (discount: BEN15)Ben’s favorite allulose source: https://rxsugar.com (discount: BEN20)Ben’s favorite health check-up for women: https://choosejoi.co/drben15 (discount: DRBEN15)Ben’s favorite health check-up for men: https://blokes.co/drben15 (discount: DRBEN15)Ben’s favorite exogenous ketone: https://www.americanketone.com (discount: Ben10)visit: https://www.insuliniq.comReferences:Due to character length constraints, references are not posted here. However, for a complete list, we respond quickly. Please email: support@insuliniq.com with your request, and be sure to mention which Metabolic Classroom episode you are referring to, which in this case is “Episode 75 - Glucosamine and Metabolic Health: What You Need to Know.”#Glucosamine #MetabolicHealth #InsulinResistance #BloodSugar #JointPain #Osteoarthritis #DrBenBikman #CartilageHealth #GlucoseTransporters #HexosaminePathway #InsulinSensitivity #Supplements #HealthEducation #MetabolismMatters #ChronicDiseases #DiabetesPrevention #Inflammation #JointHealth #Hyperglycemia