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📢 Dr. Bikman’s Community & Coaching Site, Insulin IQ: https://insuliniq.com and/or 📢 Become an Insider, Ben’s website: https://www.benbikman.com In this Metabolic Classroom lecture, Ben challenges the conventional insulin-centric model of type 1 diabetes by introducing the “bi-hormonal hypothesis” proposed by Dr. Roger Unger. While insulin deficiency is a defining feature of T1DM, Dr. Bikman emphasizes the overlooked role of glucagon in driving hyperglycemia, ketone production, and muscle wasting. In normal physiology, insulin from beta cells locally suppresses glucagon from alpha cells. But in type 1 diabetes, this local regulation is lost, allowing glucagon to run unchecked—even when blood glucose is high. Ben explains how injected insulin, although lifesaving, can’t mimic the precise intra-islet insulin levels needed to suppress glucagon secretion. This mismatch helps explain why blood sugar control can remain elusive despite appropriate insulin use. Excess glucagon ramps up liver glucose output and ketogenesis, creating a more complex hormonal storm than insulin alone can calm. The lecture also explores new therapeutic strategies—including glucagon receptor blockers and GLP-1 agonists—that may help suppress glucagon more effectively. Dr. Bikman urges a shift in perspective: instead of seeing diabetes as just a disease of insulin, it’s time to recognize its bi-hormonal nature and tailor treatment accordingly. Show Notes/References: For complete show notes and references, we invite you to become an Insider subscriber. You’ll enjoy real-time, livestream Metabolic Classroom access which includes live Q&A with Ben after the lecture, ad-free podcast episodes, show notes and references, online Office Hours access, Ben’s Research Review Podcast, and a searchable archive that includes all Metabolic Classroom episodes and Research Reviews. Learn more: https://www.benbikman.com Translation Notes: You can click the gear icon at the bottom of this video to auto-translate captions. For example, to translate into Polish, select Subtitles, choose Auto-Translate, then first choose English, then choose Auto-Translate again, then choose Polish.) In addition, our channel has first access to YouTube’s new, innovative “auto-dubbing” feature. The process currently supports translations from English into many languages, with more to come. Click on the gear icon, then choose “Audio track” to access. #Type1Diabetes, #T1DM, #InsulinResistance, #Glucagon, #RogerUnger, #DiabetesScience, #MetabolicHealth, #BloodSugar, #Ketones, #DiabetesEducation, #InsulinTherapy, #Endocrinology, #DiabeticKetoacidosis, #DiabetesTreatment, #DiabetesResearch, #MetabolicDisorders, #GlucoseControl, #BetaCells, #AlphaCells, #PancreaticHealth #keto #metabolicclassroom #benbikman #drbenbikman Timestamps (approximate): 00:01 – Rethinking the Insulin-Centric Model 01:04 – Dr. Roger Unger and the Bi-Hormonal Hypothesis 03:15 – Glucagon: The Forgotten Hormone 05:17 – Glucagon Physiology and Liver Function 08:23 – Pericrine Regulation in Pancreatic Islets 10:36 – What Goes Wrong in Type 1 Diabetes 12:45 – Glucagon Secretion Without Insulin 13:50 – Glucagon’s Role in Ketogenesis and Protein Breakdown 15:54 – The Limits of Injected Insulin 17:58 – Why Systemic Insulin Misses the Mark 19:10 – Explaining Glucose Variability and High Insulin Needs 21:34 – Clinical Implications of Hyperglucagonemia 23:32 – Muscle Wasting and Amino Acid Shuttling 24:29 – Blocking Glucagon: A Therapeutic Strategy 25:29 – Type 2 Diabetes and Glucagon Resistance 26:21 – Drug Therapies Targeting Glucagon 28:31 – GLP-1 Drugs as Glucagon Suppressors 29:37 – Final Thoughts: A Paradigm Shift in Diabetes Treatment Ben’s favorite yerba maté and fiber supplement: https://ufeelgreat.com/usa/en/c/1BA884 Ben’s favorite meal-replacement shake: https://gethlth.com (discount: BEN10) 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) Other products Ben likes: https://www.amazon.com/shop/benbikmanphd