20 Episode results for "diabetes"

Diabetes Health in The News Podcast: Children with Type 1 Diabetes Taper Adherence on Weekends and Holidays

Diabetes Health in The News Podcast

01:13 min | 2 years ago

Diabetes Health in The News Podcast: Children with Type 1 Diabetes Taper Adherence on Weekends and Holidays

"Hello I'm not Al Samra Diabetes. You're listening to diabetes health in the news today story. Children with type. One diabetes tapered adherents on weekends and Holidays. Summers here but has your child's daily medication fled with the April showers according to a study conducted by the women's and children's Hospital in North Adelaide Australia Children's adherence to their medication tends to taper off during the holidays and over the weekend. This can pose a number of difficulties for those who require daily doses to help manage chronic conditions like type one diabetes researchers found that. This lowered adherence was true regardless of gender age diabetes dose or Body Mass Index the takeaway. Badging diabetes isn't easy and it's important to ensure that your children take the necessary medication. Even their holidays. Consider working directly with your clinician to develop a strategy to keep them on track regardless of the season. These findings were published by physician briefing on June eighteen. Twenty nineteen from diabetes health. I'm not out Samri.

diabetes Samra Diabetes North Adelaide Australia Summers
Diabetes Health in The News Podcast: Text Messaging Can Help Those with Type 2 Diabetes Control Blood Sugar

Diabetes Health in The News Podcast

01:13 min | 4 years ago

Diabetes Health in The News Podcast: Text Messaging Can Help Those with Type 2 Diabetes Control Blood Sugar

"Oh Samri with Diabetes Health magazine. You're listening to diabetes health in the news. Today story text messaging can help those with type. Two Diabetes Control Blood Sugar and new study published in the online journal Diabetes. Care reports that intervention text messages can help those with type. Two diabetes improved their blood sugar levels. The study looked at Hispanic patients. Were classified as low income. Dr Addy Fortman and her team at the Scripts Whittier Diabetes Institute Track One Hundred Twenty six participants some received as many as three doty digital intervention. Text over the six months steady others received only the regular care. Those who receive the tax showed an improvement on their HBA. One C test P zero point zero three with no other statistically significant secondary. You facts patients gave the intervention text a high satisfaction rating. These findings were published in diabetes. Care on June ninth. Twenty seventeen from diabetes health. I'm not yell Samri.

Diabetes Diabetes Health Whittier Diabetes Institute Tr Dr Addy Fortman six months
These Foods That People Think Are Junk Are Actually Good For You

On Air with Ryan Seacrest: The Post Show

01:03 min | 2 months ago

These Foods That People Think Are Junk Are Actually Good For You

"Here's your morning. Hack the quote of the day. A lot of us are interested in this. There are three food specifically that we thought were not good for us. Turns out they are the more we learn about Our food our bodies some of these things. We've believed are bad proven wrong. The here are three food. A lot of people think are unhealthy. But they actually are not unhealthy okay. Popcorn on that list. O popcorn contains more antioxidants than some fruits and vegetables. It is the butter and the salt. That is not healthy. Well that's true peanut butter. it's healthy fat. Helps with appetite. Regulation contains vitamin e. b. six and potassium Saw just watch the sodium and the sugar counts and cheese. There's no evidence. She's causes weight gain or leads to cardiovascular problems or diabetes in fact the recent study suggests it may lower those risks. Tomorrow we'll flip it into foods youth our healthy but aren't.

diabetes
Diabetes Health Podcast News: US Dietary Guidelines Recommend a Low Carb Diet

Diabetes Health in The News Podcast

01:19 min | 2 years ago

Diabetes Health Podcast News: US Dietary Guidelines Recommend a Low Carb Diet

"Hello I'm not Al Samra with diabetes South you're listening to diabetes. How in the news today story? Us Dietary guidelines recommend a low carb diet. Are you just a bit too sweet? According to the American Diabetes Association Diet that's low in carbohydrates is best for most people with diabetes. They're twenty nineteen standards of medical care and diabetes. Explains that eating. Fewer carbs often result in lower blood glucose focusing your diet around nutrient dense foods the ADA has been developing diabetes care standards for more than two decades and many doctors find their input critical to best help their patients. They recommend placing an emphasis on vegetables and getting some exercise as often as possible as a great way to manage your diabetes with that said always consult with your doctor about any dietary changes. I also like to remind you. We've just launched her diabetes health podcast on itunes Google. Play in spotify if you'd like to receive the latest recording sign up to the podcast newsletter. And you'll be alerted every time we upload a new recording he can now follow us on twitter facebook and instagram from diabetes. Half I'M NOT SAMRI.

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Diabetes Health in the News Podcast: Fast Food Linked to Industrial Chemical Consumption

Diabetes Health in The News Podcast

01:34 min | 4 years ago

Diabetes Health in the News Podcast: Fast Food Linked to Industrial Chemical Consumption

"Hello I'm not out Sami with diabetes. How you're listening to diabetes. Hell in the news today. Story preclinical signs of diabetic retinopathy. Your eyes might be the window to your souls. But what did they say about your diabetes? According to recent research your eyes say quite a bit about your health and the extent to which diabetes is impacting your vision. Researchers BELIEVE DIABETIC. Patients might be more susceptible to early. Capillary dropout then patients without that means that even before you're diagnosed with diabetic retinopathy. You might experience significant difficulty with contrast sensitivity and visual acuity. You may find it harder to do things like drive at dusk or read in dim lights before being officially diagnosed with retinopathy visual impairment might be considered an early manifestation of neo vascular damage with diabetes patients. More research in this area is forthcoming. If you'd like to follow our weekly podcast. He can sign up to receive the Diabetes Health weekly newsletter. Or sign up with your itunes Google. Play or spotify count. You can also follow us on twitter facebook and instagram from these health. I'm not yell Samri.

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How Can COVID-19 Cause Diabetes? | Diabetes From COVID-19 Can Be Deadly...

Acupuncture is my Life

04:05 min | 6 months ago

How Can COVID-19 Cause Diabetes? | Diabetes From COVID-19 Can Be Deadly...

"Hello everyone and welcome back to my show. I'm dr lot from acupunctures my life. I have an interesting topic of discussion for this episode and that ten kobe. Nineteen caused diabetes. Now i've been in discussion with some of my medical colleagues on his topic over the past few days and quite surprised as to what was discussed as well as information come across as a result of recent studies. You see there are international groups of diabetes. Experts who believe there are individuals who may have developed diabetes but first time as a result of having been infected with this virus. There's research that suggests that this virus can cause sudden onset of insulin dependent diabetes. Now as i've stated in past episodes this virus gains access and can wreak havoc on various internal organs via ace two receptors. Now here's the potential connection. There were key metabolic tissues in the body which contain as to receptors in this case the beta cells in the pancreas in which the virus can attach to trigger changes in glucose metabolism. You seem beta. Cells of the pancreas are responsible for the production and secretion of insulin is a hormone responsible for regulating blood sugar now. Nothing is set in stone at this point because researchers are attempting to determine if the cases of infected individuals who would become diabetic as a result was due to the patient haven't become hypoglycemic as a result of let's say the stress response associated with infection or damage in which the pancreas sustained as a result of infection leading to insulin deficiency. Now there's been chatter among some of my colleagues estimate if this can be even seen as a new form of diabetes but i will reiterate it's just chat now when it comes to chinese medicine. Diabetes is termed xiao now as a state license board certified doctor vacuum puncture. I will say if you're feeling a bit concerned and are experiencing. Let's say irritability frequent drinking in dry mouth and tongue and chinese medicine those symptoms of upper shell whereas i could potentially focus on moistening the loans and claiming heat from the stomach as a treatment protocol. Now a few define yourself experiencing symptoms such as a propensity to hunger and dry stores. Some of the symptoms of middle show i would potentially focus on clearing heat from the stomach and nourishing the kidney says treatment protocol. Now if you find yourself experiencing turbine cloudy of sweet smelling urine or presenting with great a urine output then fluid intake as well as let's say an intolerance for coal co. limbs this can be a sign of low shower whereas i could potentially focus on replenishing. Say the kidney and tone of buying the lungs if you find yourself experiencing any of these symptoms contact an acupuncturist or myself if you don't have as well as a primary care physician if you'd like to be tested to see diabetic now. Don't forget to subscribe to this channel as well as download the acupunctures my life at from the google. Play store to learn more about acupuncture herbs and even in psalms and until next time acupunctures. My life what you.

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Diabetes Health Podcast Interview: Nick Jonas Beyond Type 1

Diabetes Health in The News Podcast

15:08 min | 2 years ago

Diabetes Health Podcast Interview: Nick Jonas Beyond Type 1

"Hello I'm not al. Samra Diabetes Health. Managing Diabetes is no easy task when a spiritual holiday comes along. That requires fasting. You need to ensure that your health is not compromised. Join me today as I speak to Dr Luma Khalib. Who HELPS US UNDERSTAND? Who should or should not fast during. Ramadan? And what to consider before you decide to serve the spiritual holiday that may affect your health first and foremost speak to your healthcare professional to ensure you can fast safely for instance if you take insulin during meals you need to ask your healthcare professional insulin. If any you should take when fasting what about when you break your face after dusk. Let your healthcare professional know what types of foods? You're planning to eat. This will help them. How many units of Rapid Acting Insulin? You may need to cover your meal. Doctor can leaves down to Earth. Answers is sure to eliminate all listen to her sage advice. Welcome to my show. Dr Gallon idea. Yes so Romo. Von is coming up for Muslims and I thought this would be a great opportunity for us to learn more about it. What what is rumbled on the five pillars of the staff? And it's a. It's a religious month and two lunar month that usually moves in over the year but basically more observant. Muslims are required to a fast from sunrise to sunset For a whole month For EVERY PERSON. Who's observant Muslim? They're supposed to fat but there are few exemptions that for for some people not to Do not have that model. What's the purpose of fasting to fast that there is the spiritual part and there's the health barred so the spiritual part that background? No from of mine is for Muslim to not to eat. Not to enjoy an indulgence live like food and drink so they can be closer to the poor people they can appreciate all these Little blessings that they have and make them more closer to their creator. So that's the the spurs fall apart from von from the health on as me being a physician I always try to twist it and try to understand what's the health benefit of things. There is a lot of data coming out now Showing that intermittent fasting actually can help to bolic profile of human not consuming food. Twenty four seven around the clock sometimes can almost in in a simple word reset the clock and make your body more in tune with the food. That's coming in and we act in different weight with the insulin. Getting screening. Crank to deal with food. And how is intermittent fasting defined? Is it that you fast for eight hours ten hours with you? All go fast. Intermittent fasting. You'll see a lot of data out even from the UK mainly in the United Kingdom more than in the United States are getting interested in that intermittent shots and some will do it for twelve hours. Then we'll do it for longer hours but for listening fast for for the religious purposes. It's from sunrise to sunset and that can't be variable from the season one from about falls into certain foods that they should once they break their faster. They're certain traditional foods for people. A lot of people here especially not statehood. People are not familiar with Muslim. People are not familiar with the fat. I mean most of the Christian fast they would exempt theirselves not eating one kind of food for the Muslim. It will be the whole food. You cannot eat anything or drink anything for a whole that day. That day of the fasting so it is different. Especially when you you see people talk to them or see all around physician who doesn't know about what remind as it just makes it bit hard for them to grasp the whole this whole concept so that's important for the Non Muslim people to understand what this whole fast is about. An Is there a traditional. Neil that you start with when you break your fast in the evening typically as a as a after breaking your fat. That's where a lot of the problems can happen especially in people who do have certain health problems like diabetic and all that typically traditionally if people break their fast with dates and some yogurt and then they do their their prayer and then they start their meal. that's where real real problem darts. Because we're human being. We beaten like this person has been fasting for hours. They starving they overindulge and overeat eat. And that's when we really can not get the full benefit of them and is that it for some people is that because their blood sugars low or for example people that take insulin. How does that work for them? Too fast they say they. You know they're taking insulin long acting Basil Insulin. And they're supposed to take insulin when the E so with fasting. Do They not take insulin. Because they're not eating and they only take the you know the the fast acting the rapid acting again so people with diabetes and Ramon have a very special challenge for both at risk of having glocer during the evening hours but then having very high sugars after the if dr which is the big meal in the evening so it makes it even more challenging both ways for diabetics most the majority of diabetic who are on oral agents. He just pills. The majority of them can't fast reasonably safely and they don't need to adjust their medication that much especially when they don't have high risk of having of earth are they had high-pricing before now the people who are on. Insulin is a bit of a different challenge. Because insulin like I in in a healthy individual who does not have diabetes when they fast. And that's what the study in England and all that when they fast. They've seen their insulin. Level goes really low almost undetectable levels so prevent them from having hypoglycaemia and they think. That's what may we set the insulin resistant type thing. That can happen in obese and diabetic people who take like the insulin long acting insulin or the fast acting insulin insulin. Staying in their system. They're eating or not and then can lead to be your hypoglycaemia the majority of people who elect to fast While there is still on insulin they most of them they will need to change the timing and the dose of their insulin. So sort of the fast acting insulin. You're not gonNA take any fast acting when you're not eating but even the Basil Insulin. The Long Acting. Insulin probably need to move the timing audit from if you take it in the morning you really want to move it to take it in the where the evening around the evening meal. And most of guidelines recommend to cut back does by ten fifteen to twenty percent to prevent these low sugar during the fasting hours. And what if you're on an insulin pump? Would you do the same thing? So you would adjust your basil bullish recog- a although I was reviewing some guidelines are on the safety of fasting during Ramadan. I'm not a clergy percents. So it's really hard to tell you can't believe take responsibility and saying you can fast and you cannot fast so this is a very hard decision for a personal decision to make once you get there. But in general there are few high risk markers really make people have to stop and think twice before they want to make that decision and proceed with the fast thing. And You you're well-controlled on pomp and you can feel the hypoglycemia. Continuous Glucose Monitor Daring. And he can tell when you're hypoglycemic. Then that's fine but if you don't or you have the hypoglycemia unawareness need you. Can crash down without even having warning symptoms. These are one of the categories that being placed in high risk people that really have to be very careful Before deciding fast really and free type twos as you were saying it's It's a little easier because their body does produce insulin and they're not taking insulin which could create a hike gratton episode for two diabetic. Some of them are still on insulin. But you said a very correct statement for diabetic their bodies to produce insulin and theoretically when they stop eating their own insulin. Production will start to come down and that prevent them from having significant severe. Low Sugar Action But people who are type two are still taking some basil and so on. They definitely can talk. I doubt dozes at that for just to go back on the pump s setting They really have to cut down on their Basal Insulin. Even they may change their car issues. That will be very personalized. Very specific tailored program and change to each person would have to have different recommendation. Do you do you feel overall that Muslims at have diabetes understand the risks associated with fasting or not are they defeated on that or I wouldn't say well educated. I don't think anybody really have paid much attention on. Not just for for patient even for physicians. I've been trained here in the United States and I don't recall really getting specific education forum on what to do when I have a patient come through to the clinic But in general Muslim people have good experience with that thing because probably facet. Before they became diabetic they fasted all along with the medication changes. So they have experienced but I don't I don't think they have really good education and that's why we're really trying to increase the awareness for physicians and for the community and community to be more aware of what's going on and what are the risk factors. And what are the things that they need to look for? Which medication that needs to be adjusted than others? This is for the patient the Healthcare Professional. I would say both I mean here and where where what I practice. We twee trying to reach out to the community and we've been giving lectures at the community center and in the same time trying to raise awareness for physicians to to know what Rama Ban and what to look for. There are a lot of really good resources links. Like the American Diabetes Association. International degration of diabetes have done amazing work to help guide physicians to help their patients. And how can people observe Ramadan in way? Witter some tips that they would could help them in terms of maintaining better blood sugars really a diabetic for all of Austral. All people her fat thing. The main thing is to keep well hydrated especially where among comes in in a long summer or like bring Month at dehydration is a main thing so keeping hydrated knock with sugary drinks. Not with sodas as you know for diabetics that will be a big obstacle but Hydration low sugar or no calorie fluids and to eat balanced diet to do multiple meals rather than just one big meal and skip the Asahara. Which is the early morning meal? 'cause that will make a higher burden on their body to to keep topping certain people that are exempt from fasting with your practicing Muslim. Would there be one caveat or some caveats where it's okay for you not to observe Ramadan shontae. In general religion really look for for Like make things simplified rather than complicated so it's into Peron in the second verse is There is a specific Sculpture there is if you are sick traveling then you can. You don't have to fast but you have to make it up and other days which is easy to do for an acute illness. But if it's a chronic illness like diabetes is. It's not going to go away. So the diabetic person have a couple of option. Either try not to fast when the days are long and try to make it up and other days and that's possible because they're exempt the other option is if they think it's face to fact and what does the best ways to work with their healthcare provider to make it safe for them to fast So that's would be an option and the third option if their healthcare provider themselves or their clergyman. I'll think that they are very high. Risk too fast than they are exempt. Are there any other tips that you would like to give people with diabetes or healthcare professionals? I would say knowledge best. Thank you will not know things you will I mean for even for my students For any diagnoses. If you don't know what you're looking for you want find it so knowing what your risk? Now at one of the symptoms of sugar was the high sugar. What could go wrong so read? Listen to programs like the one that you're doing now Would be really the best thing that you can help yourself help your family and make sure that you have a blessed month and healthy month right will thank you so much for joining us today talk. I'm not yet. It's been a pleasure to be part of your team for those of you. Observe Ramadan I wish you the best health from diabetes health. I'm not out Samri.

Diabetes Basil Insulin Samra Diabetes Health United States Dr Luma Khalib American Diabetes Association Dr Gallon United Kingdom Romo spurs Healthcare Professional Neil England Asahara gratton Ramon Witter Austral twenty percent twelve hours
Diabetes During Pregnancy has Long Term Implications

Healthcare Triage Podcast

29:06 min | 1 year ago

Diabetes During Pregnancy has Long Term Implications

"Welcome back to the Healthcare Trieste. podcast today my guest is Dr David. Ha's he is the Muncie professor and Vice Chair for research in the Department of of Obstetrics Gynecology at Indiana University School of Medicine. This episode of the Healthcare Trash podcast is sponsored by Indiana University. School of Medicine whose mission is to advance ads health in the state of Indiana beyond by promoting innovation and excellence in education research and patient care. We're GONNA be talking about justice diabetes. Today how was it. Different from other diabetes. Why's it important and what we might do about it? David welcome thank you very much. I'm glad to be here so let's talk a bit. We'd like to talk when we introduce someone on the PODCASTS. Komo sort of how they got to this position. How did you decide? Ob Gyn was for you. And and how did you get into this line of work. Sure so it was actually one of the things. I didn't didn't WanNa do going into medical school. I told my wife I didn't WanNa do pediatrics. Or Obgyn you made the wrong choice and you know I got to the end of my third year. It was my last rotation Sean and I realized that it had the three things I really loved. I loved to do surgery. You got to do a little bit of primary care and there's nothing in the world like catching babies. But how did you get interested in additional diabetes. So I got interested diabetes because we just see a lot of women who have it and it's something that leads to a lifelong as long health consequence in terms of just Asia. Diabetes can be the first sign that a woman has difficulty with their glucose metabolism and how they process sugar and then it can go away for a while but then they have a high risk for it to come back later in life. Diabetes is a major public health crisis with they'll be city that's prevalent in the United States and the sedentary lifestyles and so if we can do something about it while a woman is pregnant and they're engaged in the health system system then potentially we could have public health impact later on down the road so I guess we should backup for second province over. What exactly ease station diabetes? And how is that different from Diabetes in general or other diabetes distasteful diabetes is what develops during pregnancy. So that's the definition of justice diabetes whereas type one or type two diabetes develops in childhood or adulthood and they're all related in the fact that the people have difficulty D. N. processing and utilizing the Sugar and the glucose better in the blood stream. And that's what sells need to do all of the activities that happen inside the body and the processes processes and so what happens during pregnancy though is that there are changes in a woman's body in the development As the baby is progressing using and the placenta is getting bigger that can make it harder for her to process the glucose and so they can become insulin resistant so the normal insulin that their body produces uses which helps drive glucose sugar into the cells so that they can be active and do the processes that they need to do. That isn't handled very well. Well and the baby and the mom become resistant to it when in pregnancy does this happen typically happens the later you get in pregnancy. So it's mostly a disease in the third trimester astor but there are signs that it can happen earlier in pregnancy and just develops us on a continuous base. That is it show up. I mean do to women notice that there's something nothing wrong or is it something we try to screen for pickup and a lab test while we do universal screening now in prayer for everybody in pregnancy because the lowest I risk group was so small that they found that from a public health perspective. It was much better to screen everybody so that we would pick them up but typically. There's not a lot of symptoms that go along with just a diabetes as the blood sugars would tend to rise throughout pregnancy. You could get things like a lot of urination so women would have to go to the bathroom a lot. They could get a little bit more swelling but generally those are things that happen sometimes during pregnancy pregnancy even when there is no station diabetes so it is something that it's difficult to pick up and a lot of people are surprised when they have it because they could be totally otherwise otherwise healthy and not have any symptoms of it. So why does this occur during pregnancy so this occurs during pregnancy mostly because because of physiologic changes in woman's body as the pregnancy develops a lot of people point to the Placenta and the development of the placenta it produces a substance called human placenta lack. degen which is abbreviated. HP L.. If if people hear of it that way but it can interfere with a woman's ability ready to utilize the insulin. That's normally in her body and does it usually just go away once. They've had a baby usually once the placentas gone than the the Human Placenta lactogen is gone as well and so most women even if they have relatively severe station diabetes where they're needing medication. Therapy weather weather. It's insulin or Metformin or other things. Even if they have severe station diabetes a lot of them the day or two postpartum their blood glucose returns to normal normal values. How many women does this affect? And how many women actually need intervention with medications like you mentioned sure so about seven percent of women will have some form of diabetes during in pregnancy so about one in every fourteen women And most of those are stationed diabetes to they only medication or what not all of them. The majority of women actually can be treated just with diet modification and with more physical activity can. That's sort of the first line treatments and so we'll check women. Sugars will have them. Actually they do. Finger Stick Glucose checks for fasting in the morning and then two hours or one hour after every meal that they have and then we watch and see how abnormal they are. If they're too high then we can modify their activity in their diet or if they need medication because those Behavioral changes aren't enough so given that it seems to comes in late in pregnancy and it can go away a day or two after the percent is gone. Why is it such the big issue? We feel like pregnancy. oftentimes is a woman's I stress test. It's a big strain on the normal physiologic processes assesses and the ability of a person to compensate for those things and so what we find is the things that happened in pregnancy predisposes people to conditions later in in life. And whether it's this is the start of it or this is just the place we pick up these bodily changes is still open to some debate but we know for instance since with high blood pressure. That women who have high blood pressure problems in pregnancy have a much higher risk of developing high blood pressure later in life even if it goes away after pregnancy and also cardiovascular disease in other respects diabetes is the same way women who have station diabetes. have up to a seventy percent. Lifetime risk of developing type two diabetes later in life. Seventy percent so seventy percents okay. So that would seem to be like this is a major risk factor for for developing diabetes. It's the number one. Risk factor for developing type two diabetes. Okay and I WANNA I WANNA go deeper into that but before I do the pediatrician to me has to ask. It is their impact on. The baby is an impact on the child. There is depending on how well the blood sugars are. Control during pregnancy can impact the immediate health of the baby. Pretty pretty quickly because even though mom isn't utilizing her insulin very well. The baby's just fine with its insulin. And so if her blood sugar is high that that goes straight through the placenta to the baby babies. Insulin is fine but it has to put out a lot of insulin to keep up with all of that sugar. Coming in and so- oh insulin also has insulin like growth factor so babies tend to get bigger in MOMS who have uncontrolled diabetes and that can make the birth process harder higher risks of things like having to be borne by sincerity and delivery but also after the birth happens and the umbilical cord is cut. That sugar pipeline has gone John. And the baby's insulin though is really high so babies can have low blood. Sugars sort of counterintuitive. The infants initially have low blood. Sugar so they can have issues as with recovering from that and eating extra feedings and IV fluids and long term. We know that babies of MOMS who had diabetes have a higher risk of diabetes and metabolic problems as well so is that. Do we know that. That's causal that that's the something along something that they were exposed to in euros. What's causing net versus You know could it be the whatever predisposed mom to diabetes to begin with would make the baby more lucrative diabetes. I mean that's still an open area of research I know there's associations associations but I don't know if there's actually a causal link that's been found yet because remember correctly to is there. Is there a link of obesity. Well there is. Yeah that's always fascinating because of course you know whatever sorta terminate life or even genetic factors which predispose MOMS to be obese. Andrew Have Diabetes WanNa but you also wonder if there could be something in development in in utero. Are People doing research in that area. They are so there's a lot of people who are looking at whether there's EPA genetic or other changes that happened from generation nation to generation that just have an additive effect on these health consequences so given that you're concerned there for a baby's glucose level after they're born Lee. How long long does that hypoglycemia risk exist? Is it just a couple of days or Do you need to be worried for longer. No it's usually pretty much within the first day. Okay you worry about it. And that's why we're we spend a lot of time on labor and delivery optimizing MOM's blood sugar share so they get their fingers poked a lot more frequently if their blood sugars. Here's our abnormal. Because we really want them to. Have you know pretty steady blood sugar during the labor process so that the baby gets exposed to the right concentration. What's interesting you treating mom with insulin and right up until delivery sometimes if their blood sugars are too high we treat him with insulin all right? Let's get back to mom so first of all. We were talking about the fact that this seems seems to be a major risk factor for developing diabetes. Later in life. I'm assuming that's type. Two diabetes or diabetes. It's type two diabetes. Now we've identified a major risk factor in mom Rather that she's GonNa get diabetes. Do we do anything about that. The goal is to prevent it. I mean that would be the ideal and so. That's one of the things that we're doing with some of our research in the precision health initiative diabetes project is. We're really trying to find out. How do we predict women who are going to get station diabetes? Because then then what we can do is try to figure out the right mechanisms and pathways that we can try to treat to try to avert them getting just diabetes in the first place. Because if they don't get the station diabetes then the thought would be that they have lowered that major risk factor. So that's one of the things that we're trying to look at because if we can prevent it that will hopefully have better downstream effects. You're trying to prevent diabetes preventing type two. We're preventing at sort of both arms. So what we're doing with the with. The diabetes project is in two phases. One phase is trying to better predict and prevent justice diabetes and then face twos group is really working on in women who get station diabetes. How can we better prevent them? From from developing type two diabetes or trying to attack it actually on both ends of the station diabetes. And what can we do to prevent diabetes. Well right now. We feel like women who are in low risk are people who are at ideal body weight who are active who have healthy diets but that sort of is a small. Small percentage of people that get just diabetes. And so what we don't know right now is how we can prevent it. So that's what we're doing active research and trying into figure out from a genetic standpoint from a behavioral standpoint dietary are there certain protein biomarkers that are strongly associated associated with the development of station diabetes. That we could potentially see as predictive targets. So you're talking about looking for ways to prevent it with medication potentially okay because usually when we talk about preventing type two diabetes a lot of Diet and exercise which always you know the population base guy me as always like like. That's good advice for everyone. Not just people who are at risk for for just diabetes. But you're going beyond that you're actually thinking we might be able to find specific targets that we could it actually develop medications for the might specifically prevent generational diabetes correct. Would those same drugs used to treat regular I mean raillard up with those same drugs B.'s. The treat other type two who diabetes or do you think they'll be specific to just ational. I think they could be used. It depends on the pathways that we identify if they are similar to those is that we identify in women who have type two diabetes or even type one diabetes than those could be some that we would investigate in that area too so we think that women get just asional diabetes. And you were saying that. It's for the first stress test then. My mind immediately went to. We've just unmask. Ask the risk that now. We've identified the women who are at high risk for diabetes in general and we should therefore try to prevent type two diabetes. But if we're specifically trying to prevent diabetes medication is it that you think the actual development of justice diabetes somehow changes a woman in such a way that she's then at high risk ask for type two diabetes. That's a great question. And that's actually an area of debate that we've had with experts in the field and there are some who believe that. Just women have diabetes really. It's a spectrum disease and they've already been on this path and it just happens to be that this is the snapshot we've taken to identify. Identify it because a lot of people don't get a lot of routine healthcare right until they become pregnant and then they engage in the health system. There are those who though feel the other way that this is sort of that stress test and that they didn't have problems with their glucose before this is really the thing that's tipping them over the edge and starting cascade so there's discussion on both ends if it's a total spectrum and that this is just a snapshot of diagnosis is that we've come to. That is something. We can't stop just in pregnancy but we can try to maybe divert the course a little bit to improve their health. long-term long-term fascinating. Is this more common than it used to be. It's definitely more common than it used to be is that we're better picking it up or is that really it's comedies. It's really that it's more common. You know we've you've been doing. Universal screening for a long time but as the population in the United States has risen in the rates of obesity and sedentary lifestyle. That really has driven up. The rates is just diabetes. Like a marker for the broader problem that we have do you think or is it a specific entity that we need to get a handle on And doing so would actually reduce risk overall. I think it probably could be both okay to be honest with you. I think that it definitely is a byproduct of some of the behavioral things that we're doing as a society and some of the the lack of activity that that a lot of people are doing but I think in general I think we do have a potential here to impact health long term for people and if if this is the tool tool that we can utilize for women's health. At least that if you get if you have this condition developed while you're pregnant this is really the risk factor and maybe this is. What actually gets them to do something about it? Because you're right. Everybody talks about Diet exercise and at the end of the day. I think that we've become a little bit death to that as a society because everybody keeps Syrup Diet and exercise right and so if this is what gets them off of the couch and gets them into some kind of a program. That's the goal if it can impact public health. Yep General so do you. Is this the kind of thing that I think we're looking at are you. There is evidence that says we can use this as a moment. I think we're more looking at that. I think we're trying to capitalize relies on it as a moment rhino from Diabetes Prevention Program that we can reduce the rate of diabetes. If you engage in one of his healthy lifestyle style programs so what we're trying to do in our second phase really is take women who had just as diabetes. So we've gotten this snapshot we know that these women are at super super high risk and engage them better in programs figure out what works with their lifestyle do more of an individualized personalized is precision. Kind of way to get them engaged in a program whether it's with their family whether it's at a Ymca through weightwatchers programs of virtual online thing but try to figure out what is the best way to engage people in these healthy lifestyles that can be sustainable. Are there disparities with this or is it affect all women about the same or certain races or socioeconomic classes more likely to be associated with diabetes. The highest risk groups are women who are older when they're when they're pregnant and also there are racial and ethnic distribution so we tend to see a large risk of this in Hispanic women. Asian women women and one of the really sort of striking things about just as diabetes transitioned type. Two diabetes is. It's particularly really hard on Hispanic women in that. Fifty percent of the Hispanic women will develop this within five years of their pregnant diabetes. Build about tie to diabetes eighties fifty percent women who have just developed. Ib Five years in five. That's horrifying it's horrifying. Which is why this is such an important thing that that people don't talk about? I'm like I can't believe I did not know that and I can't believe that that's not you know front page news. That's horrifying we've talked about before we've seen a lot the news in fact that maternal mortality is a real problem. Right now. Is this diabetes part of the reason for that or is it true chewing unrelated. I wouldn't necessarily it's unrelated but I don't think that it's a major driver. Okay now we do know that. Women who have just ational diabetes have a higher rate of pre ECLAMPSIA and high blood pressure and pregnancy. And that that is a driver of maternal mortality. And so it's sort of quasi related it's sort of on that pathway because we know that people blue have one complication of pregnancy. Tend to develop more. So I'm going to get back to the horrifying statistic as I can't get that in my mind so I mean any group that has is a fifty percent chance of a bad outcome would seem to be right for an intervention. I mean I just can't believe that you know that's not a public health crisis. The people are not saying like we need an intervention. I've if I said you have a fifty percent chance of developing heart disease in the next few years we would have a drug in. Everyone would be on it yesterday. knowing that his is there a real move to try to figure out. How do we prevent this or at least get all of those people into a diabetes prevention program or something like it? There are a lot. AWW Health System based and community based program would seem. Just how an insurance stamp. When you're over weight those costs? Yeah like it'd be a massive. I mean we. We discussed before to help. Prevention rarely saves money. But if I knew that there was a fifty percent chance of a bad outcome and a certain population that will cost me a fair amount of money in the short term. It would seem like that would be where I'd want to invest right now. Well I think the one of the problems is we don't have a drug right. We don't have the the magic pill that's going to prevent diabetes right. Maybe we can find one maybe in all this research that we're doing we can find one that's part of the grand challenges L. Inches to prevent a chronic disease. We can do that but I think that there are a lot of programs that people are trying to engage in insurance companies will help Pay For some gym memberships and things where you can make lifestyle modifications have but I think it gets back to then people disengaged from the health system system until they get older and they just don't the momentum is really hard to maintain even when you tell people flat out there's a fifty eighty percent chance in five years you'll have diabetes. Yeah yeah that's amazing. I mean because again it's like I think we we. We scare people with numbers a lot. But that number is truly scary. It needs no fudging That's an absolute risk like that's just that's just amazing. So what are you most optimistic about like. Where do you think the Best Bang for the buck is or what do you think is GonNa make a big difference in the future in the future if we can prevent the women from getting stationed Jason Diabetes in the first place? I'm very excited about a lot of the collaborative work that we're doing with some investigators down at Iu Bloomington and in computer science and a lot out of interdisciplinary people. That are coming at this from a lot of different ways. Whether it's we put a fitbit or activity tracker on everybody and that helps motivate them during the early part of pregnancy or trying to do some interesting work with how do we look at nutrition content and can you take pictures of your food and figure out what your nutrition is. We're looking at but proteins in the blood that could be used as biomarkers. We've got genetics so I think it really gets me excited that we're trying to approach this from multiple aspects and then really smart computer. Scientists are going to try to throw this all together. And and come up with some really good predictive models and looking at pathways and proteins we could potentially use as early predictors. So that in the first trimester her during some of the early screening tests you know when they get blood tests to see if they're anemic or if there's any increase risks for baby they could get a test that would say this is your risk of diabetes and we need to do these things to help lower that rhys not to be a naysayer but since we just finished a few minutes ago talking about the fact that when I tell people where they have a fifty percent chance risk of developing diabetes in the next few years. That doesn't seem to be a motivator enough to prevent them. I'm an eternal optimist missile. That's great I'm just like but I'm thinking maybe we do need a drug. I mean maybe it is that You Know I. I love the idea of trying to pack the small angles. I believe me But I I just I am struck by this conversation about how difficult it is to try to get people to change their behavior even when their risk is truly known But but a drug is sometimes easier for people to reprehensible especially if you're only taking during pregnancy right well one of the things that I think is interesting about this. Grand challenges is it's not only has disease state teams. But it's got a lot of extra research pillars and a lot of them have to do with drug discovery and they have to do with different core laboratory facilities that can help find these pathways and discover these drugs. So that's why with a lot of these large pregnancy cohorts sports that were recruiting. We're recruiting five hundred more women here in Indiana to look at these things and collecting a lot of specimens and we can find these proteins scenes or these pathways that we could attack with draft and as part of this large endeavour of the precision health initiative is. We'll have partners. I who can think of these problems really carefully and say you know what this is potentially drug -able and maybe we could develop a small molecule that we would obviously have to then test to make sure it's safe in pregnancy because that's a big hurdle to get through because you not only have one patient the woman you've got the baby developed to and so. I think there are potentials to do that. And yes it's so much easier. And if I could tell every woman who had station diabetes to just take take an oral medicine right. It may not be as effective as lifestyle. What you're right? I'm not trying to talk people out of lifestyle change. I mean there's nothing more we could do probably for for public health in general than to get people to improve their lifestyle. I mean it's just that's been shown again and again that you you know. I remember writing a column years ago. There was a you know if you just make the simple lifestyle changes of if you you know. Th thirty minutes of moderate activity five days. A week stopped smoking thing. Don't drink too much and eat reasonably well. And that's like fifty percent of all chronic disease like right. There would be more than do you know any drug that we could take. But we've known that for so long and we just have so much trouble doing it And I'm certainly not advocating that. We find a drug but given there's a reasonably short window to try to change people's lives and we've got evidence in our face. This is so hard to get people to change their behavior. I agree we've gotTA WE'VE GOTTA try every avenue would every avenue which is why you know certainly sounds like you're doing that But it's such a hard problem to lick it is you know. Sometimes I I think I would say like well. We should raise awareness awareness and we should we should have you know. Make sure that women get too but it sounds like we do universal screening. It sounds like everyone is going to get checked for station diabetes if they're pregnant and they're getting healthcare correct having said that it's probably a good idea for everyone to engage in improved lifestyle. I mean all the things that I mentioned that make people healthier in general also make for healthier pregnancies and and babies it sounds like as well absolutely optimizing health before you get pregnant really important and we have a real struggle with getting people blend for preconception care where we can talk to people about. Oh you know what your sugar's high now. We know that that's going to increase your risk of problems in pregnancy or your blood. Blood pressure is high. Now let's work on that before you get pregnant or you're you're obesity is GonNa put you at a high risk during your pregnancy and and even afterwards you know just because you're done having babies doesn't mean you don't need to have healthcare and particularly for women with just diabetes. You're supposed to see a primary care doc and get your blood. Sugar checked every one to three year. You know you're so right and that's an excellent point. I think we we made a video not long ago about a lot of the warnings about alcohol. Use and pregnancy. Don't resonate well with women because they're brought up when women get pregnant as opposed to making healthy lifestyle choices even with alcohol important before pregnancy after pregnancy. It's part of women's health in general and that we shouldn't make it necessarily pregnancy thing. I think you're right. The healthy lifestyle and making good choices is a women's health issue It's not just a pregnancy issue And probably focusing on that would result in a lot more health for women in general even during pregnancy. I think another thing to focus on his walls. How's that pregnancy is not just a women's issue other other people are involved in pregnancy? And so are we should. We involve more than than just D- TO BE MOM. I think we have to. I think family health is really important and I think that maybe one of the reasons why we failed in the past with some interventions is that we haven't focused focused on the entire family unit. It's one of the pieces that we have with our face to prevention of type. Two diabetes is some of the programs that we're engaging in our family based I where women can come with their partners with their kids and do it as a family because if you can get the family into a healthy lifestyle the hope is that it would be sustainable. Because everybody's going to try to fall off the wagon a little bit and they're going to be days when it's like I just don't want to go for that run it's cold outside but if your kid then and says but were supposed to go for a run today or were supposed to go for a walk in the park or the partner can say you know you keep feeding off of each other things. Things tend to work better. When you've got partners going through this stuff with you all right? Well this has been fascinating David. Thank you for joining us here as these studies. Gather more data and we have more to talk about. We hope to have you back absolutely love to be back again. Thanks to Indiana University School of Medicine. Who's sponsoring this podcast? And whose mission is to advance health in the state of Indiana beyond by promoting innovation and excellence in education research Chen patient care. And if you'd like to support the show you can go to patriotdepot dot com slash healthcare. Triage we'd especially like to thank our research associate. Joseph and of course our surgeon Admiral Sam and all of you too can help make the show bigger and better

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Diabetes Health Type 1 : Catching Up with IndyCar Racer Charlie Kimball

Diabetes Health in The News Podcast

25:16 min | 1 year ago

Diabetes Health Type 1 : Catching Up with IndyCar Racer Charlie Kimball

"Hello I'M NOT AL SAMRI WELCOME TO MY show. Today I'm speaking with Charlie Kimball indycar race driver with type one diabetes. It's been nine years since we spoke last. I'm happy to see that you're still doing what you love back. In two thousand eleven had been diagnosed with diabetes for four years. I came from noma watched you race. Check your blood sugar with a GM on your dashboard for the people who don't know much about the Indycar race where drivers start in their racing career. And what's the ultimate goal which trophies a driver reaching for me and for a lot of drivers within INDYCAR We start in go car OUTTA. We started racing As young as five six seven years old I started go hurts at the age by then and just like in a lot of other sports Baseball comes to mind. There's a ladder series started in little league and work your way up through high school and college. Minor Leagues of towards the Major League. racing is very similar. There is a a ladder series. That as you climb that ladder two cars that you're racing get faster the crowds get bigger about that sort. Sorta thing and and within within Racing Day Bacar here in North America. The alternate goal is being the car. Siri and the Indianapolis five hundred. The indy five hundred is the single largest one day attended sporting event in the world there are typically three hundred plus thousand people there every single year on Memorial Day Sunday so as you talk about the trophy that an indycar driver is striving and reaching poor I if been recognized as one of the greatest sports trophies in all the world I Borg Warner and one of the special things about Borgwarner is even when you win the indy. Five hundred. You don't get to keep the Borgwarner because it's one of the kind. It is about six feet. Tall made completely solid sterling silver. And when you win. They engrave Or they relief of your face on the trophy along with your year. I and average speed to win right. Let's exciting and and then does the person me. Yeah and if the person said that the following year so who who holds the trophy Curiosity the driver doesn't but the honor is getting engraved. Is that correct correct? And the driver receive what's called a a baby board So a miniature replica. It's I think about six or eight inches tall To go on your trophy case in your trophy case on your show and the trophy itself almost has some of the same mystique bit more Stanley Lord Stanley Cup does for the NHL in the INDYCAR series. Hold jet There are a couple of people that travel with it exclusively. They carry it Molded around with white Lycra feiger gloves To get it where it needs to go and in fact a few years ago was the first year that it had first time in the over one hundred year history. The Indianapolis five hundred had ever gone to Japan Tacoma Sato a driver of Japanese heritage. won the race. I think I wanNA say twenty seventeen. And as part of his victory tour over the summer he flew with the Board Warner and a couple of representatives from being the Annapolis Motor speedway in the hall of Fame Museum to Japan and to Honda headquarters one with on power To show off the Board Warner in Japan. That's very exciting. For sure. So you must be in terms of diabetes. You must be really delighted. With all the medical device advancements with Bluetooth connectivity tell US Higher Diabetes Management has changed since then when you when I saw you. Last you've had diabetes for four years so you had a certain way of managing your diabetes in the last nine years so much in terms of medical devices and medications of evolved. So which. How have you changed with that? I think that's part of being being a competitor and being a person with type one is continuing to evolve my treatment protocols by management and I think as a driver continue to evolve on the race track but with my health I'm currently using Both TRICIA and and You know when we met in twenty eleven. I'm trying to remember but I was probably on Leather Mare and Nova logged at the time. I believe sound so as okay. So that makes sense that as The science has evolved of flooding meditation. Then my treatment has evolved as well. I worked very closely with by healthcare. I'm a huge proponent. That diabetes is a team. Sport breaks a full team to successfully manage diabetes when it comes down to medical professionals for sure by chronology Dr Peters Diabetes Educator Donna. Working with the nutritionist. My exercise physiologist integrated that. But it's also my team at home. It's it's my wife. My parents my sister. My friends that I'm having a hard day on burned out. They're the ones that support me healthy and encourage me Even people the diabetes community are the people that understand what I what I go through every day and sometimes reaching out to ban and just talking through challenges they faced or how things have gone really well for the last couple of weeks Is I think that's an important part of vantage get talked about Managing Diabetes exported working within that team to continue to ask questions about what infringer available. What injection method allergies are out there? how how things worked for me? It find having problems if I have an issue with by JAB activity. Is someone else they that overcome that. I think that that dialogue is really important to keep getting better lie. I think families are really important component. My former husband is a type. One of forty four years and doesn't have any diabetes complications. And we're really good friends and I was meeting recently. Were talking about blood. Sugars new said. Don't you remember you know? We got married in her late twenties. I don't remember every time my blood sugar was high said. Don't worry it's GonNa come down and it really made a difference and I said I really said that he's like yeah and it helped so I really. It's interesting because even for me I you know having these conversations you forget that how important your family is. Because it's easy are they're that first line of support and and sometime. I definitely kill badly. That has to get the deal with my Mood swing by blood. Sugar Swing sometime and the Beeping of my my desk com g six bedside table in the middle of the night those sorts of things. I feel badly that when she's trying to sleep and especially at the moment she's pregnant and where Trying to make sure she gets arrest. And sometimes especially if I'm hovering around and alarm blood sugar and I've a glowing above the flow it It doesn't always wake me up because I I hear it. I understand by punchers. Okay right around that alarm number. I'm fine but it definitely wakes her up. I feel badly about. I think you know as you were saying. Family's really important but also diabetes is a family disease you know. Everyone learned to participate. I know for me when I got involved with my former husband. I was really impressed. The way he manages diabetes. He really was proactive. He wasn't embarrassed about it. And the way he modeled. It was the way I expected everyone to being than later when I start working in the industry I realized that not. Everyone's like that so modeling that in having the support and having your family support you know rather than publicly shaming you for example some people write me and say hey you know i. I dated someone and they tested their blood sugar at the table. Unite isn't that improper knows like I said No. It's not so so I think that's I think to me that's one of the great things about having worked with the race with influence program for the last twelve years is being able to green diabetes into the light a little bit too to kind of remove some of those stigmas that people talk about And I can't remember who it was. It was another notice patient lassiter and he was talking about. How is his grandmother had diabetes and and they didn't talk about it they said. Oh she she's got the sugar just kind of it was. It was just kind of a nord or almost minimized and now the conversation around diabetes has changed part of it is the growth of the the community wants. Take Two's And access all right access and communication. I think social media podcast boggs. Online interaction has really allowed the conversation within the diabetes community to to remove that stick by to to make it more of a interactive dialogue with all of the stakeholders within the the disease state from. You know medication. Companies to healthcare professionals to patients to advocates to passengers. There's there's there's this great continuing to grow as low energy of bow the conversation and and the future And then something that you know being involved with no one can being part grace within flip program. I think my rookie year in Indycar in twenty eleven in fact couple years before that has been a lot of fun to be part of and does the new team that you're racing with is something that they're learning about also taken it upon themselves. They know the difference between type one type two or do you feel a responsibility to them with that. Like oh it's funny. You say a responsibility to educate I think I see it as an opportunity to you educate The new team for me. It's really exciting on a professional level to raise for somebody like Aj four Aj for history with indycar racing thing within the Indianapolis Motor speedway general as a driver. He's one all over the world. Some of US psychotic races out there and touch was the first four time winner of the Indianapolis five hundred. That's pretty rarified. Air and he has his face on the Warner Trophy. Times fighting it out with five hundred in five different decades and you talk about that and how challenging it is to just make indy five hundred not only did he make it in five different decades. But then he went on to win it four times so his history as a driver. Is it Tommy? The whole team and a culture of the team the being able to to learn from him and and work with their team at at in the card every car race. This year is pretty exciting. I think it's it's early days within by awareness and education campaign within the the race team but there are a couple of team members mechanics team managers. But I've worked with at previous rates. So they're pretty aware and they're really excited to to continue to learn and and learn about the race with programming. Will THAT BE TRUMP? Let let me ask you with the decks COM G. Sex You have the ability of having other people know what your blood sugars are. When you're driving is at something you share with your wife. You're racing and your coach and who were how do you. How do you handle that? Who gets to sit your doctor who gets to see where your blood sugars are. When you're racing well I'm actually going to answer what I thought in the race car. I I share my on g six readings with my wife And I think Dr Peters is off by share list as well I think she she follows pretty much all patient. I don't quite know how her APP or salt handled that But she's an amazing person by data so when I'm traveling and speaking or on the road and Chapel at home with our daughter her being able to check on my blood. Sugar is I think it gives her a lot of confidence and and that added safety right. There's under persons keeping an eye out and a lot of time especially when I'm in a hotel by myself and I'll get a low blood sugar alert or what Just about the time that I am drinking bottle of orange juice or having a chocolate fill. I'll get a text or a phone call. Hey you're getting sugar. You good question mark. It's a way not not only that it gives her confidence but I also got someone keeping eye obvious well and and it doesn't happen very often I to have it and not need it rather than needed habit. But he absolutely But but in the race card. It's a little different Because I'm a big advocate texting and driving or having your phone while driving idea Having your phone and driving it over two hundred twenty hour is it even worse idea. I actually use the desktop G. Six receiver So I don't use my phone as a blood glucose out. I use the receiver itself and we worked wished some electronics engineers with the car And were able to integrate to originally badge. Twenty eleven by x Com was now night on my steering wheel through the Tech Science. The VELCRO was now that that's right so that receivers now integrated with the because to not only. Does the race card charged my receiver for me but unable to see my blood glucose right all by steering wheel right on by electric dash so in front of me. I have speed. I oil pressure blood. Sugar Water temperature car and my body data right thirty. Gather and you. You mentioned who I share that with and beneath thing donald the data being in the CAR SISTA is extent via Telemetry Radio. Back to the timing standard pit lane with all the engineers so the engineers and mechanics but are watching the computer screen making sure that the cars running right and keep an eye on it and make sure the by bodies running right as well and if my wife's there she cheat and keep an eye on If you know by personal managers there they keep an eye on it. Whoever sort of has an extra set of eyes And that's part of where that education within within the race team comes in because they need to know what numbers are outside normal parameters and back. Then you used to use to have two bottles in the car. One was A glucose liquid one was water. So do you still do that or mused? I do get inside. I think back in twenty eleven the valve we used was kind of big clunky and it was mounted on the side of the car. We had basically you know to drink bags. One with water and one with a glucose rich fluid is you said when you use orange juice with extra sugar in it so it's pretty dense as far as carbohydrate to volume so. I don't have to drink a whole lot of volume to get the impact into my blood glucose But since then my dad who mechanical engineer and designed race cars designed a valve for me And we got treaty printed and plastic at Bell. Now right on my seatbelt and from the seat belt that host that runs into my helmet is pretty close to four or six fluid ounces to it gives me kind of a rough measure of how many carbs drinking based on when I switched the vowel from water which is what I normally drink to that glucose fluid which I've never never actually needed in a car to keep going because my diabetes. How do you prepare? In terms of like woody eat before arrays or do not eat much because of the speed that you're going and could make you feel nauseous What's what's that like. I don't think I could not eat before a race. The more of the challenges with driving indycar is. We don't have power steering We don't have power brakes and a five hundred mile race to be three three and a half hours long but just like the mechanics. Prepare the race car and fuelled the race car. I need to make sure that I'm doing by body as well My creates nail typically. It's not particularly exciting and by the end of the season Particularly tasty but Most by meals during race weekend hour plane grilled chicken breasts Plain White Pasta with a little olive oil on it Salad and some fruit. And it's all weighed and measured out And I'm not sure I can't without remembering digging through some of the research to make sure I could nail down. How many calories are in that meal? But I know that it's it's about forty I wanNA save forty to seventy grand of carbohydrate And I will take in fun for that with the idea that I take a little less than I would if I wasn't in the race card. Is that the night law quarrel day meal typically On on the day itself okay So so if the races at two o'clock in the afternoon usually eat lunch at eleven eleven thirty when I need those carbs that that lunchtime meal pre rate take some fun and and I'll reduce it by Dow twenty twenty five percent. I'll kind of undershoot so to speak on. My employer does because I'm aiming for my blood sugar to be a little higher than I would on it all day. If if I was a day but I was in the office or traveling. I aim to be a great a patient with diabetes. My blood sugar is ninety. Two one twenty five all the time and if he asked me I will tell you that almost with a straight face but in the in the race car I WANNA have a safety If my blood sugar is too high then I lose concentration and focus I noticed some vision issues when when my pleasure is north of two twenty to forty If the reaction times and I don't want to be too low either. One of the unique challenges of day beatty's is you're not aiming to stay above a certain number or stay under a certain number you have to stay in the middle of the road And so between my exercise physiologist Dr Peters Experience. You've taken all of that. Pgn data from the race car. And put it into a regression analysis with Competitiveness on the track the type of race track to g loads weather pitstop time And looked at finishing position starting position average lifetime time and distilled it all down and for me my performance wise my ideal blood sugar is really one fifty to one seventy five milligrams per deciliter. Bor And I know that kind of getting into the weeds a little bit about what my blood sugar is. And how advantage it race car But I think it's a good example that you could figure out how to make. Work Make Diabetes Management Work based on whatever it is. You're doing it like if that's driving a race car or something all right well. It's very impressive Charlie what you do and The way you manage it and you really have a very nice disposition in terms of your diabetes and Sharing your thoughts and being inspirational to other people. I appreciate it. It's it's very fulfilling. I never thought that I would have the opportunity Because of what I did in life is I sitting down at work and wearing a helmet to to my office that I would get the opportunity to meet so many people and hopefully inspire at least one person through what I do at work and frankly I think it's made me a better athlete because of my diabetes rather than despite because I listened to by body more than I ever have and I have a bad day at the office being out there and competing is is a victory for so many people within the Diabetes Community. True very true not letting it stock you not letting it define you in doing what you really love. Well thank you. Thank you for joining us. I wish you a successful twenty twenty racing season. Thank you very much looking forward to being in the number four car all year long The first race middle of March. Down the PEOP- boarder building up to our Crown Jewel event. The one hundred fourth running of the Indianapolis Five Hundred Memorial Day Sunday on NBC this year at the Indianapolis Motor speedway. When we're going to follow you see how you doing in real. Don't forget you can follow me on twitter at race within great. We will definitely do that. Thanks for having these.

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Diabetes Health in The News: Insulin Companies That Now Offer Discounts for Their Medications

Diabetes Health in The News Podcast

02:52 min | 1 year ago

Diabetes Health in The News: Insulin Companies That Now Offer Discounts for Their Medications

"Hello I'm not Alexandra. Samri with diabetes held. You're listening to diabetes health in the news today story. Insulin companies. That now offer discounts for their medications. If you've been wanted the voices demanding change because having to choose between household expenses medical supplies and insulin has infuriated you. Then you'll be excited to know your voice has been heard easing the high cost of your insulin medication as of yesterday all the insulin pharmaceutical companies offer discounted insulin for your convenience. I've briefly describe the cost and provided you with the links and phone number so you may read the qualifying criteria to receive your insulin at a lower rate. These discounted medications are limited to us. Residents only a frazier offers several discounts for their inhaled. Insulin that range from one hundred fifty to two hundred fifty dollars a month. The program is implemented by Eagle Pharmacy. You must contact the pharmacy directly to complete their qualifying form. The offer is limited to three packs of four. Eight or twelve. Units of a frazier cartridges. A month the offer expires on December. Thirty first twenty. Nineteen to call Eagle Pharmacy. Dial one eight five five seven four. A two six six three ally lily offers up to a forty percent discount. On Their Insulin's the program is implemented by blink health offers expire on December. Thirty first twenty. Nineteen you can call blink health at one eight three three seven nine four one two nine three Sanofi Advantis offers insulin for ninety nine dollars a month through their value program for twelve months. The offer is limited to three vials of Insulin. Or two packs of insulin cartridge pens. You can call Sanofi at one eight three three eight one. Three zero one nine Zero Novo. Nordisk will start offering a generic version of their noval. Lock for ninety nine dollars a month. The offer is limited to three vials of insulin or two packs of insulin. Cartridge pens offer starts on January. Second Twenty twenty call. No vote at one six. Oh nine nine. Eight seven fifty eight hundred. I hope you find this helpful. If you're signed up on the Diabetes Health. Facebook feed made sure to like this article and pass it along to friends and family wishing you the best in health from diabetes. How I'm not out Samri.

Diabetes Health Eagle Pharmacy diabetes Twenty twenty Sanofi Advantis frazier Alexandra Facebook Nordisk lily ninety nine dollars two hundred fifty dollars forty percent twelve months
Carole Marks with Matt Petersen (Managing Type 2 Diabetes For Dummies)

A Touch of Grey

52:51 min | 1 year ago

Carole Marks with Matt Petersen (Managing Type 2 Diabetes For Dummies)

"Ladies and Gentlemen Children of all ages gathered around the radio it's time now for another installment of the touch of grey that talk show for grown ups. My name is Michael Harrison. It's my privilege to serve as anchor the program it's an ensemble show with lots of good people involved and it's host and founder. Is Carol Marks? Carol Mark Says One of America's leading experts on upper demographic issues and she is indeed a champion and the battle against ageism. But let's take it off right now with Carol Marks in conversation with Matt Peterson the Director of Information Resources at the American Diabetes Association. He'll be talking about new book that has been written by the American Diabetes Association titled Managing Type Two diabetes for dummies. Now pay to gave us the most common form one. Eleven American sever firm. It isn't a period of diabetes is employed problem with your body. Because it's your blood glucose right higher-than-normal what since things that cause your body not to use insulin properly that's a good question And it's It's complicated the easy part that leads to all the hard parts about taking care of diabetes is that the blood glucose levels are too high and even in type two diabetes The it's a little bit different from one person to another for some people. Their pancreas is producing lots of insulin When they're first diagnosed but their bodies just their cells of their bodies are not responding to the insulin. So the blood glucose goes up. Because it's insulin's job to help get the glucose out of the bloodstream and into the cells and then for other people The the packers actually not working too. Well it's which is an extreme. What type one diabetes is when the the the the pancreas to start stops producing insulin altogether. But what all kinds of diabetes have in common are those high blood glucose levels and the damage that can do is basically the same for everyone with idiots and the things you need to do to manage diabetes. Well are also Have a lot in common with. Everyone was Diabetes now don't some people did have type. Two diabetes have such mild symptoms that thing often go unnoticed an excellent point In fact most people with type two diabetes go on diagnosed for a while. It may have gotten better but we used to Estimate that it was five to seven years after diabetes was actually present before it was diagnosed. I think we're doing a little better but it's still very common because just as you say The the symptoms are pretty subtle and they go on noticed The the the really the main symptoms of having type two diabetes and not being diagnosed are somewhat more frequent urination Will be greater thirst Feeling tired well. These are all things that they're they're not easy to detect a lot of us. Think so on just getting older so it's just normal so it is very easy to miss and I was surprised that certain groups of a higher risk of type two diabetes and others. In fact you know. I was very surprised that it was more. Common African Americans What are some other groups series comedy? Yeah the three main groups. The United States that are at significantly higher risk than others are Hispanic Latinos African Americans and particularly Native American Alaskan Natives Hawaiian Natives Those those groups will have As much as or even twice as high rate of type two diabetes as Whites and Asian Americans now if someone just in diagnosed with type two diabetes. Can you tell us about this? Free twelve month program. American Diabetic Association offers WHAT RESOURCES TO PROVIDE Yes glad you asked We have a living with type two program which is Very carefully designed to provide people information who are newly diagnosed with type two diabetes. With the information they need overtime and really prioritizing. What is the first thing you need to know? And letting that Sink in for a few weeks under two. And then now please consider this so we kinda take people through a time line instead of hitting somebody with everything all at once. Where it's easy to get lost overwhelmed. we've worked with doctors and And diabetes educators to think through. What's a reasonable taste? Which people can Should should learn about what diabetes is and what they can do about it. That's a free program. It's all digital so people receive Periodic UPDATES And an e newsletter. With other information they might find and of course. That's that's free own website and I'll ask him again later. Sure That can be found on our main website along with a lot of other information diabetes dot. Org and so who goes to the DIABETES DOT? Org should easily find a link to living with type two and be able to sign up for that program. Now you also brought up something The Guy Association did That I really never thought about. And and that is that you were diagnosed with diabetes to to begin to assemble a team of health professionals. Because you need to realize it. Takes a medical village to manage type two diabetes We can only mention a few of them but I was surprised. Some of them. What are few people might think about? Yeah that's a great question. the U. Person's diabetes is always gonNA start with their doctor. Of course that's how they're going to get diagnosed for most people and this is just fine. It's a primary care doctor of some kind or possibly a nurse Practitioner Most people in primary care or fully capable of helping most people diabetes manage their diabetes. Well but the management of diabetes is really In the long run almost entirely up to the person who has it? And that's why Having a team to to work with to take care of certain issues is a good idea. Because you're going to be doing it mostly on your own and you need a few experts to help you with specific things. First and foremost we recommend that everyone. Newly diagnosed with diabetes. See a professional called a certified diabetes educator That's usually a nurse it can be a Dietitian or can be a physician Or or other professional. But it's someone who's been trained in diabetes education and how to Work with individual patients on just with that patient needs. It's it's it's been proven to the tremendous help and getting people off on the right start when their newly diagnosed so the the besides the the central team member besides the person themselves Of the doctor. That certified diabetes educator recommend everybody with ABC one. That doesn't always happen. But it's something that's reimbursed by insurance it's covered by Medicare and Medicaid. So people really should take advantage of seeing. He's certified diabetes Educator Right then the other the other people that we recommend people see reflect the complex nature of diabetes and how it varies from person to person diabetes can cause damage to The small blood vessels and nerves feet which can lead to Source that don't heal can lead to Ulcers and ultimately to amputation if not treated so some people diabetes need to see a podiatrist And similarly diabetes can cause damage to The is Particularly the small blood vessels in the eye that can lead to what's called diabetic. Retinopathy that if untreated can lead to blindness. Fortunately we have some great treatments now for diabetic retinopathy in the rate of blindness and and people diabetes was much slower than it was before. That's something that a person's diabetes is going to be to work with an ophthalmologist on was even surprised. That you talk about. The book talks about the fact that a pharmacist can help you because he can go over. All your prescriptions. Yeah that's right. diabetes usually have at least one if not several medications for their diving's alone but because diabetes is often accompanied by high blood pressure and by problems with cholesterol People Diabetes are awesome taking ray of medications and a pharmacist. Is that front line person. Who CAN Say Hey you know If you're taking this you need to be thinking about how it's GonNa Affect that. This is the right time of day to take that medication With a few medications sure your listeners. Know the They can interact different foods so the pharmacist can provide that hands on guidance on the best way to use the medication but the doctor has prescribed. Matt Peterson the Director of information resources. At the American Diabetes Association in Conversation with the host of our program. Carol Marks Talking about the book managing type two diabetes for dummies. We'll have more of this conversation between Carol. Marks and Matt Peterson when a touch of grey talk show. Grownups continues in a moment bill. Mm-hmm our convinces an eighty seven year. Old Korean War at his service to America embarked upon a sixty eight year career in radio and his new book. The tall skinny Jewish kid with eyeglasses from bridgeport recalls the fascinating characters. He met as a child of immigrants a soldier and a radio broadcaster. These include showbiz celebrities. Sports Stars politicians international spies and even a few mobsters Al Cross paths with hundreds of fascinating figures. Kate Smith to Bob Dylan to Benjamin Netanyahu historians set against the backdrop of nine decades of American history wars protests rapidly evolving pop culture and social norms. That tall skinny Jewish kid with glasses from bridgeport. Get your copy now. In paperback kindle on Amazon Dot Com published. By talkers talks. We live in what is often described as toxic stew. There's water and air pollution villas as unhealthy food additives and processing. We eat breathe and immersed in all kinds of scary chemicals that are foreign to our delegate biological systems. They're not to mention the constant pressure and stress phase in daily life and little time exercise work work work emails and to answer Greasy High Caloric fast food on the run. Run run and constant mental bombard. Mentally ill nobody will your crummy spam and just thinking scams are so many of us have bone and joint problems with weight and blood sugar issues. It's no wonder we often feel fatigued. And Right now. Easy okay listen. Here's a possible solution to counter terrible imbalance. Be Sure to visit this website. Here's the address of all they're gonNA say at once in this message. Www DOT radio minerals dot com? Bernadette Duncan spent twenty six years as a radio talk show producer in her new book. Yuppie days behind the scenes with losers schnauzers boozers and losers. She shares her adventures in the trenches of big time. Talk Radio during the changing backdrop of America's pre and post nine eleven realities. This exciting story includes for debts impressions of Corky Celebrity Talk. Show hosts who she served during her career. Larry King Sally Jesse Raphael Gil Gross. Tom Snyder Lou Dobbs Charles. Osgood and more. It's full of anecdotes about hundreds of high profile guests from media. Show business and politics also quirky ego driven and neurotic. Yuppie Days Behind the scenes with Newshour Schmoozer is boozers and losers and analytical look at the media journalism and the complex nature of Ego. Get it now at Amazon. Dot Com pope continuing now with a touch of grey the talk. Show for grown GROWNUPS. I Michael Harrison in the anchor chair. Let's continue now with conversation between the host of our show. Carol Marks and Matt Peterson Director of Information. Resources of the American diabetes every day with type two diabetes is to check. Your Blood Glucose levels have the features and technology and blood glucose me improved. And what are the six tradeoff That's another great question Meters have improved dramatically and steadily over the last twenty years. So if you People are familiar with a meters of even ten years ago. And they now go see what's available. They'll find that the the small Lancet that little needle like device that allows you to drive drop of blood. They're very fine and very thin and and generally very close to painless to get that little drop of blood and and the meters that are available require and generally much smaller drop pleasant. They used to the meters faster They're they're more portable and meters vary a lot with features. That can matter a lot from one person to another. Some of them have screens that you know. Really Big wetering for people with With less than great vision some of them will even talk for people who are vision impair So there's a meters that much more flexible much faster. They store data for a long time. So using a meter is is a lot easier than it used to be and I thought the sections in in the book. There's vast differences in each of women and men with diabetes was very helpful and I was surprised to earn. It was the difference between Women that had diabetes and attacking strokes and then there are some differences Both men and women I tend to think of what's similar to because the rate of diabetes in men and women is similar and And the complications are similar but women tend to have Heart problems that are more likely to go on go undiagnosed and so we The people themselves and their doctors need to be on the lookout for things that maybe more apparent than a man Of of of heart disease. That is going undetected and women at a higher rate than it is in Asia. Important point I think how should this book is put out by the American Diabetes Association? Weren't this way to read it and use it. Well I it It is very user. Friendly book I don't know if you're thinking electronically or print forum. I'm a I'm a print print forum Kinda guy myself but I think it's It's a little. It's like a more robust version of our living with type two program which people can get for free online this Keeps it at your fingertips. it's somewhat more detailed information like we've been talking about the different kinds of health professionals that you may want to see over time when you have diabetes. So I think It's a great book Modestly priced for people to have handy because The an important aspect of diabetes is that it is a progressive disease. But it tends to whatever's going wrong with your Insulin not working well for you. It tends to progress so that you may start out really being able to manage your diabetes. Well on one oral medication that you take but that may require a second one at some point and for many people type two diabetes. It's GONNA require that. The person use insulin in order to manage their diabetes. Well that is not failure. That is not someone not doing things right. That's just the nature of diabetes it progresses. And so what you have to do to manage. It changes over time. And that's where having a book like Managing type two diabetes for dummies can be a good reference. If you notice something new or if you're having if you've been doing some kind of exercise but it's not working for you it's it's painful and you WanNa do something else The book can help give you suggestions about ways to New Ways to help your vantage diabetes as your diabetes changes over time and of Finding Matt Pearson. It's been a pleasure to have you on such great talking about managing type two diabetes for rebel me. And can you just give listers Any websites that the American Diabetes Association has and Haven't you develop one that has professional resources are and what about your phone number The phone number that anyone can reach again for information that's free most hours of the day is one eight hundred diabetes. And I shouldn't have memorized wh what. Those numbers are diabetes Smells but it's one eight hundred diabetes And we have a call center with well trained staff who have information available to tell people and they also have Print materials that they can send out to people so someone has a specific question and they worried about kidney disease or Or I disease. We have materials we can send people for free on that and then all of our online resources can be found at excuse me died. He's dot org where we have links to that living with type two diabetes program. With course a bunch of information on the site itself about healthy eating one of the that is the most frequent thing that people want to know when they have diabetes. Type one diabetes diabetes. Maybe they have a weight problem. Maybe they don't but everyone wants to know what are the healthiest food. They can eat when they have diabetes. There's a wealth of information. There we've just launched which is easy to find on diva's dot org something called diabetes food hub and it brings together a the thousands of recipes and suggestions and people can search for their preferred foods and then find a healthy recipe that include those Those foods so I think people would be very impressed. Look what's Freely available online and of course the book managing it for a type two diabetes for dummies can be found there in our ADA store. That's Matt Peterson. The director of information resources with the American Diabetes Association interviewed by the host of our program. Carol marks the book is titled Managing Type Two diabetes for dummies written by the American Diabetes Association. Coming up next Carol Marks and conversation with Dr Andrew Addison. Nationally recognized pediatrician with expertise area. Talking about rain period. Next next performance continues only Didn't REMATCH. Introit Hi this is Michael Harrison. I hope you're enjoying this installment of a touch of grey the talk show for grown ups and finding it to be a meaningful listening experience. This wonderful little weekend program has been on the radio across America in one form or another for more than twenty years. Its mission is to provide mature Americans with information and content about aging to help them cope with the non-stop challenges of life during these hectic modern times. We're talking about health finances relationships and plain old fun whether it's learning about the latest technology and social norms or finally remembering yesterday's arts and entertainment a touch of grey. The talk show for grownups is dedicated to serving that gigantic segment of the population so sadly ignored by most of today's popular media founded and hosted by a truly great lady. Carol marks one of America's leading experts on upper demographic issues and a champion in the ongoing battle against ageism. This program is geared to what has commonly been referred to as the sandwich generation baby boomers who are coping with such challenges as still supporting their adult children while caring for their elderly parents. It's my honor and privilege to be associated with Carol marks and be a part of her mission to support defend inspire. Today's generation of what she lovingly calls seasoned citizens a touch of grey the talk show for grownups online at www dot a touch of grey dot com. We spell gray with an e and right here on this great radio station every weekend. Thank you so much for listening this Brad Shepherd whenever you think of social security do you think of survivors benefits to UC? Social Security is more than retirement. Social Security makes making your monthly payments to the families of workers who died to more than seven million people get survivors benefits from social security including almost two million children benefits the pay for food and clothing medical care and school benefits. You can count on when you're planning your financial future for more information. Go to the essay website at www dot sa dot gov Michael Harrison. Here those of you who follow talk radio her interest in what goes on behind the scenes might also know me as the publisher of Talkers magazine. The trade publication that serves the talk media industry. We cover the talk show business as it exists on radio television and the Internet. I often have the opportunity to speak about these media as a guest on radio and TV. Talk shows or comment on industry developments newspapers magazines for the past three years. I've also hosted a weekly podcast that features interviews with fascinating people from a variety of fields and walks of life. It's designed to be enjoyed by media. Freaks pop culture aficionados political junkies and the philosophically curious recent guests include such interesting folks is former U. S. Senator Joe Lieberman Richard Nixon's grandson. Christopher Nixon Cox Alex Jones Freddie Boom Boom Cannon Deepak show for Doctor Allen Stern the principal investigator of NASA's New Horizons Pluto Mission Radio. Broadcasters Sean Hannity Mike Francesa and Joe Piscopo and legendary. Wwe Ring Announcer Lilian Garcia. How's that for variety each week? I interview outstanding personalities from the World of radio or any number of it's related fields and the arts science entertainment politics or academia. It's available to download and you can subscribe to it absolutely no charge whatsoever at apple podcasts or at the website and h interview dot com the Michael Harrison interview just a click away on your computer or mobile device visit Apple podcasts or M H interview dot Com. Make the Michael Harrison Interview. A weekly podcast listening. Experience back. Pain doesn't take vacations. It'd never celebrate holidays. It's on the job. Twenty four seven to keep your life exactly where it is in limbo but it doesn't have to be that way. Because Laser Spine Institute can help you take back your life from chronic neck and back pain with less than one inch incision our minimally invasive procedures have provided relate to over sixteen thousand patients with a ninety seven percent patient satisfaction rate. So get ready to stand tall and live the life. You've imagined for yourself without pain. Are you or a loved one suffering from a bulging disc herniated disc spinal stenosis pinched nerve degenerative Disk Disease Hours? Fine Care Consultants now for a no cost. Mri Review and to learn more. It's time to save goodbye to chronic neck and back pain. What did you to lose? Laser Spine Institute the leader in minimally invasive spine surgery. Call eight five five seven three. Oh back eight five five seven three Oh back. Eight five five seven three Oh back. That's eight five five seven three O B. A. C. K. We live in what is often described as a toxic stew. There's water and air pollution as well as unhealthy food additives and processing. We eat breathe and immersed in all kinds of scary chemicals that are foreign to our delegate biological systems. They're really not to mention the constant pressure stress. We face in daily life and little time for exercise work work work emails and texts dancer Greasy High Caloric fast food on the run run run and constant mental bombardment. Leave me alone already. Where your spam stinking scams no wonder so? Many of us have bone and joint problems as well as weight and blood sugar issues. It's no wonder we often feel fatigued and down right now Z. Okay listen here's a possible solution to counter act this terrible imbalance. Be Sure to visit this website. Here's the address of all. They're going to say at once in this message. Www DOT radio minerals dot com? This Brad Shepherd whenever you think of social security do you think survivors benefits? Do you see social security is more than retirement? Social Security makes regular monthly payments to the families of workers who died to more than seven million people get survivors benefits from social security including almost two million children benefits the pay for food and clothing medical care and school benefits. You can count on when you're planning your financial future for more information go to the SSI website at www dot sa dot gov continuing now with a touch of grey. Talk Show for grownups. Here again is the host and founder of our program. Carol Marks in conversation with David Anderson President and CEO of Bar Bar a a company that produces automatic livestock. Drinkers does your fascination. With science beginning early age because your father was at the radical physicist and what famous Research Center in Massachusetts Did you get exposed to jury or some vacations when you're young and you went through a a kind of his trying it's in your size institute From seven to sixteen so tell us a little bit about that You know I My background is is really been a lot of international traveling and and that's kind of what got me into the interest in viruses that animals can get you know in this corona virus. Sometimes we We focused all of our attention upon our own preventative measures. That we take human beings and the poor animals kinda get left behind and and And they viruses that they that they look. They can affect them and so many international travel. I've I've been able to turn to extend the viruses and one of the big viruses for animals is Deacon virus and also West West Nile virus. These are viruses that are not airborne viruses the chroma viruses an airborne virus and people can catch it when people sneeze those infectious materials into the air. And then other people read that. And that's how they get a- with animals These viruses that affect more transmitted primarily true mosquitoes. And so a mosquito in can be infected or it can carry blood From some other Piece of war meet that. They inspect lead from that has had it. And so they have the blood disinfected and then they stick and horse or a cow or and and they can get infected by by the blood that they they carry. Cantu to right horses from pigs so it's of y y variety when What what symptoms. Show up in in these animals What kind of Simpson's sister they exhibit They can be very far too They can Actually it can hurt their balance They can fall down because they don't have the correct equilibrium. This is hurt Thinking affect their eating and their water intake and food intake so it can be very deadly for horse and so there's several measures that we can take to help animals and the main main thing that can we can do to keep standing water at bay standing. Water is a breeding ground from -squitoes where they lay their eggs and Primarily it's the female mosquito that sex blood for manuals. Curious can back. You're getting standing water and that absolutely yeah. So standing water is just a. It's just like a magnet for all really negative informed full bacteria and you've seen Algae growing on standing water. You know this is. This is all kind of bacteria driven organism and When the Animal Street from anything that's dot algae own it tastes bad and has a terrible taste for them. They'll drink it just minimal to reduce their thirst but then they become dehydrated because they're not drinking enough snow. Lana live Tammy shares. Yeah we have be careful how we water. I mean. I've traveled throughout Europe and across the United States. It's not uncommon to see back up in persons field or pasture put water to water their animals and that'll bathtub and probably a lot of your listeners. Will be familiar with the bathtub with water out. Deal is really expecting place for bacteria and it can be used if it's cleanse cleans and after dump that water out regularly the new water in which wastewater and but if they keep it clean. It's fine most people I found. Don't keep it clean and you'll drive by those. Oh bathtubs tanks. And there's there's stunned growing on the top of those states and it's really not a good situation for our animals who are very susceptible to the bacteria that standing water causes the wave in West Nile virus and the virus Haven't human beings also gotten that was particularly viruses? They have and if they're bitten by SPEEDO? They have to be treated there. There are some vaccines for West Nile virus animals and people and they have to be treated and and there's some Studies show that that women that are pregnant are very susceptible to these diseases. Once they get them and it can and Have negative consequences Their new the babysitter forming within the singers of staggered standing water. And what we can do because he can affect our home and our yard. You have a website. W. Dot four stringer dot com and you have some suggestions for dealing with stagnant water. Can you tell our listeners about a few of them yes? Our goal is to treat Water systems that are safe for animals and avoid standing water and not only standing water but electricity. You know we've had. We had some electrocutions here in our area. Not Too long ago where The owner which owned Writing Facility for handicapped children had about nine horses and she went out one morning and every horse was dead and had been electrocuted by short in for automatic electric wiring system. And the only reason she didn't wasn't lying dead with those forces because percents strange reasons. He had the impression to put on some rubber gloves before she went out. And rubber gloves saved her life informed installations so that she wasn't shocked killed. So that's that's that's what we want to do is is make drinking water as safe as we can for animals. We just don't like standing water and the consequences of standing water more of the consequences of electricity. And that's really our our emphasis with our company is to create a safe way for animals to drink. And we've been trying to do this for twenty years and help animals and promote grazie greater safety for the animals on one thing of like. I know I never really think about too much. But you know emptying my bird baths and keeping the water clean. I mean because it's awful lot of bacteria and things can get in water and I don't suppose that's good for the birds. No no it. Is you know bird baths or or you know if you clean cleaning that regularly and I'm sure you do but they're probably some people just don't have the time or just forget about it and then especially in the summer when the sun beats down on that water. That's when the house he starts to form and create it causes Collector for bacteria in the Speedo some other other tests and as well as Drinking fountains for rodents. Now you also say that when it comes to the farm animals and and you know you talk about horses piece of maple several horses that they use for personal riding and and some other animals that you sh- you should avoid sharing a at. What did you mean by sharing equipment? they can harm farm animals. Well if you had one animal that's infected you. You need to isolate that animal. And and then in secretaries in water than in secretary is so that It's just like are the social distancing that we're experiencing right now is that animals need to have that social distancing or you know if one of the stick there's needs to be isolated sharing equipment of the same and getting all the yes six animals using the same equipment it can be hazardous to all the other animals is. The effective is drinking the same people equipment. That's mainly there now at your animal advocate an entrepreneur you're president of CEO Varvara a horse and livestock drinkers so How does the Barb are a Horse Lice. Talk drinker work to eliminate problems that farm animals to have because it is quite amazing. This how does it work? Well the the whole concept is is the the R units do not have standing water and so what that means is when the animal walks up to any of our units. There's no water in the bowl drinking at all it's anti and it requires them to push on a paddle just like Human Water Fountain. Turn a little off to bring water up the end wall pass to push on paddle in the water comes up instantly and they're drinking instantly and when they're done drinking their habit is to pull their head so when they pull their head they turn the water off so they turn the water on it during the off when they're drinking remaining water in that bowl dreams back down into the ground. Leaving people seem so. How long do you take battle that and get a patent for? Will it's just We started this many many years ago. That twenty five years ago and it took it took about a year research to figure out the concept and how we were going to make it work and A fellow by the name. The frank fraudulent is now passed away Came up with the concept. He was just a cowboy that had many experiences animals and had some horses that were being electrocuted. And he told himself. That's the end of that. And so he went back of. He's barn and went to work and so it took about a year. Research can get things going and then took two or three years after that to refine the product and make it so it was really workable and manufacturable. Kind of amazing does because you're Horse Life Doctrine Curry Megyn here this. There's no water left which they usually would be For to freezing and winter or you hot summer and it's not there to grow out Cayenne mosquito eggs so It's a great Protection really and You standing water can 'cause a lot of harm for a lot of people both An farm animals. So I WANNA thank you for being on the show and Kane telling our listeners about some ways it can be used to get rid of stagnant water and reduce the risk of people. Pets arrived stock getting ill for various viruses and and that Syria and finding can you give us the name of your website where you can find out more about the automatic waters. You advantage that run without electricity and allow farm Ams really have no electricity passing through their water in the manager season and always have fresh clean water to drink and that something all of us could have certainly are wild. Animals are far. Ma'am south. Thank you and what your website. Oh thank you carol. The website is. Www DOT horse winker. That's David Anderson. The president and CEO of Bar Bar a company that produces automatic livestock drinkers. The conversation was conducted by the host and founder of our program. Carol marks coming up next another installment of MEG with Meg McDonald. When it touchy gray. The talk show. Grownups continues in just a moment. We live in what is often described as toxic stew. There's water and air pollution as well as unhealthy food additives and processing. We eat breathe and reversed and all kinds of scary chemicals that foreign to our delegate biological systems. They're really not to mention the constant pressure and stress. We face in daily life and little time for exercise work work work emails and texts to answer greasy high caloric fast food on the run. Run run and constant bombard mentally alone. Nobody was your spam and just stinking scams the winter so many of us have bone and joint problems as well as weight and blood sugar issues. It's no wonder we often feel fatigued and down right now Z. Okay listen here's a possible solution to counter act this terrible imbalance. Be Sure to visit this website. Here's the address of all they're gonNA say at once in this message. Www DOT radio minerals dot com and Dunkin spent twenty six years as a radio talk show producer in her new book. Yuppie days behind the scenes with losers Schmoozer boozers and losers. She shares her adventures in the trenches of big time. Talk Radio during the changing backdrop of America's pre and post nine eleven realities. This exciting story includes Bernadette suppressions of the Quirky celebrity talk show hosts Sushi served during her career. Larry King Sally Jesse Raphael Gil Gross. Tom Snyder Lou Dobbs Charles. Osgood and more. It's full of anecdotes about hundreds of high profile guests from media. Show business and politics. Also Quirky Ego driven and neurotic Yuppie days behind the scenes with losers Schnauzers boozers losers and analytical. Look at the media. Journalism and complex nature of Ego get it now. Amazon dot com back. Pain doesn't take vacations hid never celebrate holidays. It's job twenty four seven to keep your life exactly where it is in limbo but it doesn't have to be that way because laser spine institute can help you take back here. Live from chronic neck and back paying with less than one inch incision our minimally invasive procedures have provided relief over sixty thousand patients with a ninety seven percent patient satisfaction rate. So get ready to stand tall and live the life you imagine for yourself without pain. Are you or a loved one suffering from a bulging disc herniated disc spinal stenosis pinched nerve or degenerative disk disease? Call hours fine care consultants now for a no cost. Mri Review and to learn more. It signed US say goodbye. Chronic neck and back pain. What have you got to lose lasers institute the leader in minimally invasive spine surgery call eight five five seven three? Oh back eight five five seven three Oh back. Eight five five seven three Oh back. That's eight five five seven three O b. a. c. k. Jane and saying own continuing now with a touch of grey the talk show of grownups on Michael Harrison and the anchor chairs will come to the final segment of our our and in the background. You hear one of the Great Classic Rock Songs from the Early Seventies David Bowie. One of its first really big. Hits changes lookout rock and rollers. Someday you'RE GONNA get older speaking of changes speaking of getting older Meg McDonald. Who Does the Popular Feature Meg here on? A touch of grey and talkers live dot com. She's here to talk about changes that come with putting on an extra minute at a time so the other afternoon. I'm walking in my Studio City Neighborhood Ventura Boulevard and everyone else walking is passing me by and I thought Where's everyone going in such a hurry? Then I realized it's not so much. They're moving fast. I'm moving slow so I started paying attention to my face and guesstimate my speed was somewhere between saunter and Mosey. Well this is different. I used to be a double time stepper. Now I'm a slow Lane Walker. When did this happen? Interesting thing about changes that come with maturing you either don't notice them at first because through so gradual or they just appear like that. Crick crack in your back. That wasn't there yesterday. And while we can't deny some changes we can work around and share with you one. I do myself when I look in the mirror. I take my glasses off and I can honestly say that looking back at me. Who will honey without my glasses? You're holding up okay. But sometimes there's no denial no work around and no getting past the reality. That time has passed. I got one of those reality checks in the mail last week and not the kind you can cash. My New Auto Club card arrived and my membership is so old. It could have grandchildren. What is it about time it? Either drags on or Zooms by remembering school watching the clock on the wall and wishing it would go faster now we look back on those days and say where did the years go. We all become members of the aging club. We just join at different times. And while we do our best to keep our youthful looks and physical stamina as the great philosopher George Harrison said. All things must pass so with. Time is unstoppable and changes in Evansville. Let'S NOT BE MON getting older. Let's be okay with it. Let's lean into it. Growing older has its privileges. And we get things we didn't use to get. Say It with me senior discount and while there's no getting around that time has passed and we may look a little different on the outside inside where still us. Well that certainly is a reassuring. Thought thank you. Meg McDonald and another installment of Meg. If you want to binge listen to meg can do so at. Www DOT talkers. Live Dot Com. That does it for this broadcast and I WANNA thank. Carol marks are host and founder when a thanked. Wayne do the junior producer on the front line. All our affiliates across the country and certainly you our listeners. Have all of us on Michael Harrison in the Anchor Chair inviting you to join us again here next weekend on this great talk radio station for another installment of a touch of grey the talk? Show for Broncos

diabetes American Diabetes Association Carol Marks Michael Harrison America Carol founder Matt Peterson Meg McDonald Laser Spine Institute Anchor Chair producer United States Amazon
Perfect Health: Kapha Dosha

Daily Breath with Deepak Chopra

02:24 min | 1 year ago

Perfect Health: Kapha Dosha

"Welcome back today. We move forward with an understanding of what caused imbalance in the coffee. The GAFA is notably as follows heavy obesity heavy digestion oppressive depression Kafka's drawn to sweet leading to weight gain or diabetes if too much sweetness is added to the body steady self contained bodily prostheses. Do not swing into extreme soft. The skin skin is soft. The hair is soft. Even the manners are soft. Undermining approach to situations Gotha people ebola slow with slow fluid movements along with slow speech and deliberate thinking what other patches Babia that the throws Out of balance. Do you see any of the following budgets in your life. A tendency towards diabetes or in fact having diabetes allergies or obesity. Perhaps you've gained weight and feel depressed about your diet. Contains large amounts of Sugar Salton. Heavy foods you've been under stress and react to it by withdrawing feeling insecure your or unwanted. You place excessive emphasis on possessing storing or saving things. You're dependent overprotective or overprotective in relationships. You sleep late many days in a row. You'll find that. Cold weather is aggravating Graduating the first step toward healing is to identify underlying causes of imbalance. Coffer it join me tomorrow as we conclude we with Friday meditation.

diabetes Kafka
DIY 'loopers' take diabetes into their own hands

The Science Show

17:54 min | 2 years ago

DIY 'loopers' take diabetes into their own hands

"When I was twelve years old and in hospital, just after I was diagnosed I was given a book as sort of had a manager on diabetes book, and it had a diagram a closed sick diagram of an artificial pancreas closed system, and I absolutely loved it. I really didn't enjoy diabetes. And so, I tend to that page all the time a really believed that that was coming. That's Marianne patent. She's from Brisbane, and she has type one diabetes, and this is the story of how she built her own oughta fischel pancreas. I'm James Berlin. This is the sign show and today, we're exploring the idea of people taking tech into their own hands. But first, let's go back to Marianne. She was diagnosed with type one diabetes almost forty years ago in the nine hundred ninety s it was very tricky to manage back, then we had a test tube. We had to do it away a p into it, and we used clinic tests, tablets to give us some vague sense of what our blood sugars done in the preceding hours, type one diabetes means you don't produce insulin or not enough insulin's, a hormone made in the pancreas, and it helps the body move glucose in the foods. We ate from out blood to as cells, where it's turned into energy for people with type one diabetes, the level of sugar in their blood can get out of control. Your try. To manage your blood sugar levels so that you don't dip into hyperglycemia, which can cause you to have pretty much like a panic attack that could happen without warning really. It's sort of like walking tight rope every day. So you're trying to keep your levels above that. But I need just above that, you don't want them to be high if the levels are high then you get worried about longtime diabetes complications, and maybe you've experienced some of those, it's, it's quite a mentally address tough to keep your blood sugars in that really healthy range and the long term, just so you always feel like there's this sort of Democles hanging over your head. And with regards to your future, and developing blindness kidney failure, or something like that. The tech that Marianne was using back, then left a lot to guesswork. So we actually had no way to detect topic. Let's mea apart from, you know, whether we were shaking sweating feeling confused. It was really stabbing in the dock back then from germs, literally, I mean we get used to it where real stoic says, diabetic sway just poke and prod and precare cells all the time. And don't think about it, but certainly as young teenager, the first time I had to use a bloodletting device. It was pretty awful equipment. The blood grind, it was quite savage. Those no white to chew not to be a bit gentler. It really did get the blood out, these gruesome tests helped Marianne to see if her blood sugars were in the right spot. And the majority of people with type one diabetes manage, in a similar way today test strips and a glue commented to check blood sugars and injections of insulin. Sometimes three or four each day to keep them in the Goldilocks zone. The have been some innovation since then though, some people have into. Pumps, which inject a steady supply insulin day and not the pump just gave me a little bit more freedom. You know, it was still pretty blunt tool in retrospect, but it did help to get rid of some of the rigidity of the diabetes. Then there are also continuous glucose monitors as the name suggests these provide a real time readout of a person's blood sugar levels. They're also known as CGM and it's these pieces of technology that opened the door to the holy grail Marianne had read about as a child in the hospital. The artificial pancreas, it was really only at the end of two thousand seventeen I discovered the we are not waiting movement. And that's a really, really clever. People had just reverse engineered insulin pump protocols and sit up these February's algorithms to manage diabetes in a really high fidelity treatment Conaway of it's just totally changed for me the whole nitric diabetes itself. The movement Marianne mentioned just now started under the Twitter hashtag, we are not waiting it since out into social media groups in person made up and increasingly diabetes and med tech conferences around the world. It brings together people who built a building a do it yourself. Pancreas one person who got involved in the movement early on is Jim medicine. It was always like in fifteen years like you all have to worry about this, like software. Sorted it out. And they were saying that for thirty years, and nothing Ed com. Jim was diagnosed with type one diabetes when he was ten years old after meeting with some of the founders and develop as early closed loop systems. He decided to build one for himself. I don't think my life sobbed me for a while. I definitely wasn't coming to bed I was working till midnight, and she didn't understand. I just kept ordering stuff off of Amazon frustrated by the white for commercial solution. Jim joined the growing group of people. -veloping their own automated pancreases and taking control of their diabetes. But how exactly does a DIY pancreas work? I visited Jim at his home in Sydney. So he could show me the first thing that happens is I built an installed myself an app onto my iphone and that app talks to both the insulin pump and the CGM which I wear us. It decks com. CGM the pumps attached to Jim's body, and the CGM is checking his blood sugars, but those devices are usually completely separate. They don't talk to each other. At least not unless you do a bit of tinkering. What happens is every five minutes, the decks com app on the phone reads in my blood glucose levels, those just come in. So we constantly know where I'm at, at the same time using this conversion device called Riley link. It can do the translation between iphone talk and. Pump talk. The Riley link is a small circuit board cased in plastic. It's about the size of a matchbooks. It will also query the pump and get content information about any activity going on with your insulin. And then it can also send commands to make changes in your insulin levels inside the iphone app. I have settings that would say if I'm going up at this rate, these are the right ratios to help bring me down. So Jim GM is measuring his blood sugars and talking to his iphone, which is then adjusting his insulin on the fly by combining all of these things together. He's essentially built his very earned bespoke pancreas, and it can see all of this. Pancreas, Dada coming in on his smartphone. In real time. It's pretty amazing to watch. I just couldn't stop watching it. It was really good. I started takes go. My diabetes. Pals telling them ev- at least great Brian that was controlling my diabetes. Finally, in mid twenty Marianne decided to build her own artificial pancreas to, because they systems are often cold closed loop systems, people who have them sometimes call themselves lupus, she read about how to do it online. It was a learning curve, and they were a couple of times when I had a high pie but had all the usual alarms that had made to that the first few weeks were about trying to find chain my settings. And she did start to see improvements. In the way, who diabetes was being managed, even in the first few weeks automatically automatically fabulous change in hba one St. so hitch onc- since fell black heated him a globe in basically a measure of. How much sugar Kubwa hydrate this attached to the hemoglobin molecule. This is the molecule that carries oxygen around the bunny, Dr T, and Ming-hung is an endocrinologist, who works with people who have talked one, diabetes, hate onc- sounds complicated. But it's really just an indicator of the amount of sugar in your blood, or the time if you'll blood sugar levels are high for the live span off that molecule, which is about three months, the measurement, you're going to get is a high number in medical circles. A lot of the long-term trials of complications outcomes have been based on a one, c over last year's there's interest in knowing what the numbers are Marianne, Jim both saw the hba one, c head south after they started looping, get dropped from eight point five or something down to six point IOT. And now, sort of in the lice sixes. I mean that's teiken may add of the risk of diabetes complications. Group into the probably never have to worry about complications group, which is brilliant. That's very stock difference. So my hemoglobin A, one, c was an eight point zero before I started I it's actually quite amazing how quickly those things can change. I think I was in the high five within a couple of months, and then essentially, I am at a steady state now of between five point zero and five point two maybe five point three four. My eighty one sees pretty much consistently. But hey ch- BA onc- isn't always a reliable measure of good health, someone who's blood sugars yoyo, lots of highs. Lots of lows could still average out to what seems like a good number. What's also important is how long you spend in range in other words in that Goldilocks zone. What I found is now that I've been looping the edge cases are so few and far between. I'm pretty much very concise. Distant. We know that knowing what someone's time in range is another important parameter, because it's perhaps, more. Reflective of what's actually going on from day to day basis? Dr Tianming whom has conducted a survey of a stray Lian lupus. It was interesting to see the impact having better quality sleep was a standout feature there. And I can understand the significance of that report, if you use an insulin pump, and you have let your lowest that are not stable, you can get alarms going off in the middle of night. And so you're this have disturbed sleep and not only you, but your partner and your whole family households for. And so just by being able to sleep better makes a difference. This is early research with a very small sample size nineteen respondents reporting in results. But all of them listed improvements in their blood sugar levels and their time in the. Cody look soon doctor who says they also wanted to take things into their own hands people were doing this because they wanted to take control off the diabetes unknown Thames using new technology. And so these people who are quite motivated, also to some extent, happy to explore and to take a risk to manage your diabetes using this method. Were you ever concerned about tracking devices in raise that the manufacturer, perhaps, unintended not really? I know some people are I it sort of depends. I think with the pump the reason why we can communicate with the puppies. The early versions of the Medtronic pump were intended to have that communication. So really the only part that was a little bit hacky was how we received that communication. But that's real information going back and forth between the pump and the looping system. We weren't tweaking at all with any of the readings from the GM. So that was really on label in terms of how the manufacturer had had produced that. So I wasn't really too worried about the technology is certainly the first question I always get asked the pumps and monitors. Loop is a typically approved by the TGI industraliazed, but they haven't been explicitly approved. For the purposes of a closed loop system, and neither have the paces of open source software used to run the system. This doesn't concern Marianne there. There are lots of safety settings. There is safety settings dialed into my pumps. So there's really only so far. The algorithm can influence things. I feel it's good to reassure people. But this system has been set up extremely thoughtfully to ensure safety. In the US the food, and Drug administration has fast tracked the approval of commercial close loop systems. But last month it also released a warning about DIY systems after a report of a patient needing medical assistance. The person say GM sent incorrect values to their looping system, giving them doses of insulin that were too high and causing their blood sugars to crash, diabetes, Australia. The country's peak diabetes advocacy pony doesn't endorse the systems. It says people who choose to go DIY do so at their own risk. But it also says people can't be stopped from pursuing their own solutions. Especially when commercial options have lagged behind that's the position, Dr Tianming whom takes to personally my belief is that people will do what they want to do, and as a physician one has to decide whether you're going to support them and I think it's important. This people because diabetes is not just only about the blood sugar levels is a lot more to it than that. And so if you don't support this people, we wear, you're going to go to one needs to draw a line somewhere about what can want advice in Tim sof people using systems that they've built themselves. I mean, he's very clear that they build systems knowing that it is at your own risk. I think a lot of people go in with the is open. I think a lot of people get benefit from it, and it's just that the moment I don't think it's something we can openly recommend, which is a different level altogether of care at last count, about one hundred people in ustralia report using closed loop systems. It's a tiny fraction of the turtle type one diabetes population, but interest in DIY is growing and commercial clerk sleep systems are coming down the line to the first of these the Medtronic six seventy g became. Available in Australia earlier this year. Dr whom says we need a clear picture of the health outcomes lupus, get than to be more research in this area in professional circles. Research goes a long way, the problem is finding money to do research. I think the, the DIY population would be keen to participate given the opportunity Marianne patent agrees. More research is needed, but also with different funding. Modal looping is expensive. It's restricted to those who can buy the required pots have the technical ability to set it up. And then there's the ongoing costs of continuous glucose monitoring. It's extremely expensive in a strategy of full, I think Eighty-eight percent of people with type one diabetes at alz. And they aren't eligible for any Rabai all subsidy on the through the national diabetes supplies game old for a private health. Sheri- on nitrate people at the moment that wanna leap, I spiked to a friend yesterday that really wants to start. She's had diabetes since nineteen seventies. But she just said, Luke Bryan aren't kennel to food the CGI my count. I just can't do it. But for those who can leaping provides a new sense of control by condition that stays with them for live people that don't have diabetes when they're trying to figure out what we're doing here. What they don't realize is diabetes is this thing that's always there. It's never gonna go away, you could be on the toilet. You could be an important meeting. You could be chasing your daughter around all of the things and stresses that you have in your life. Diabetes is always there, and you're always having to make adjustments for that, and everything that you do, and it's all guesswork, people think, oh, maybe what you're doing this dangerous diabetes is dangerous like it really is. You have to learn in adapting and make lots and lots of guesses, literally hundreds of them every day. And so what I think is great about this automated. Pancreas. System is I can program in the things that I know for me, including how much I'm going to drop if I'm exercising or how to adjust it if I know I'm going into a big stressful meeting or something like that at work. It knows all of those things over time like it can just with the president of button. It can make those changes for me. The reality is, is. I'm not always there for every single decision. One hundred times a day. I'm not there. I might have to wait. Twenty minutes to do something that would be optimal to do now. And so it's actually much safer. It's not much more dangerous than just having diabetes.

diabetes diabetes Marianne Jim diabetes Dr Tianming Brisbane GM hyperglycemia Australia James Berlin Jim medicine Jim GM Riley Medtronic
Show 1173: How Is Diabetes Diagnosed and Treated?

People's Pharmacy

54:19 min | 2 years ago

Show 1173: How Is Diabetes Diagnosed and Treated?

"I'm Joe Graydon Terry Graydon welcome to this podcast of the People's pharmacy you can find previous podcasts and more information on a range of health topics at People's pharmacy dot com type. Two Diabetes is one of the fastest growing epidemics around the world. What's the best way to diagnose this condition? This is the people's pharmacy with Terry and Joe Graydon and there are important differences between type of one and type two diabetes. What are they and how do they impact treatment? Traditionally many diabetes experts believe believe that aggressive blood sugar management would reap rewards in better health researchers have tested that strategy. How well did it work? The price of insulin has been skyrocketing as a result. Some people have been rationing earning their doses. How does that impact their health coming up on the People's pharmacy learn how diabetes diagnosis and treatment is changing welcome to the People's People's pharmacy? I'm Terry Graydon. I'm Joe Graydon today. The topic is diabetes according to the C._D._C. More than thirty million Americans have this metabolic disorder. That's roughly one person in ten type. Two Diabetes Diabetes says become an epidemic not just in the United States but around the world to learn more about how diabetes is diagnosed and treated we turn to Dr Kasha Lipscomb. She's an assistant professor of medicine and an endocrinologist endocrinologist at Yale School of Medicine Doctor Lipsky is also a clinical investigator at the Yale Newhaven Hospital Center for outcomes research evaluation abbreviated core welcome to the People's pharmacy Dr Tactic Kasha Lipsky. Thanks for having me Dr Lifts Insulin has been available to treat diabetes since nineteen twenty two and there have been recent investigative reports that note the price of insulin has skyrocketed in recent years. We're going to discuss that in a few minutes because I know you have some opinions about that but I can. You please give us an overview on diabetes basics and the difference between type one mm-hmm and type two diabetes. Absolutely diabetes is a chronic condition that's defined by elevated blood sugars and the bloodstream <hes> so we define diabetes it just based on that that somebody has an elevated blood sugar either at that moment or we also measure something called Hemoglobin a one C which gives us a measure of blood sugars over the last two to three months on average. There are two different types of diabetes than the two major types of diabetes are type one and type two type. One diabetes happened when the Pinkus Stop secreting any insulin and typically typically type one diabetes diagnosed early in life but it can actually occur anytime during somebody's lifetime it is an auto immune disease which means that the body itself is producing immune cells that attack the pancreas pancreases and that results in insulin deficiency or not enough insulin in the body <hes> because there's not enough insulin blood sugars are very high and in order to treat type one diabetes people absolutely need insulin to survive type. Two diabetes is the more common type of diabetes in our country and that is typically diagnosed later in life although if had actually an epidemic of type two diabetes now in in younger patients as well and that type two diabetes is associated with increased body weight and happens because the insulin and the body is so the body's not responding to insulin properly something called insulin resistance there is actually insulin around but the body's not recognizing insulin properly and the end result is that blood sugar levels go hi the treatment for type two diabetes varies so some of it may start with changes in lifestyle such as <hes> diet that's low and carbohydrates and sweets <hes> with with some weight loss that can really help control the blood sugars exercise size and then a variety of medications that may sensitize the body to the insulin. That's already around some people would type two diabetes also require insulin particularly later in the course of their diabetes to control the blood sugars ducker lifts. I've heard this described as sort of a real paradox where you've got all of this fuel this glucose sugar a floating around in the bloodstream but you're sort of starving to death because you can't get that fuel into the cells where it needs to be and so that's what happens when the insulin is not available to do the job of transporting that glucose someone wants described it a little bit as if you were in a lifeboat in the middle of the ocean surrounded by water but not a drop to drink because as you can't drink the saltwater. Is that a fair analogy. I think that's a very good description Joe. That's exactly right <hes> the insulin unlocks this ability of the sugar to get into cells so that we can produce energy so you're exactly right without either insulin around or proper response to insulin the body is unable to use that fuel as energy and that that can produce devastating devastating consequences for people particularly those have no insulin around <hes> people can die without it duck lipsky. How'd you diagnose diabetes? Diabetes is diagnosed <hes> based on a blood test that shows either increased <hes> level of Plasma Blood Glucose or sugar in the blood and that's typically done in the fasting state so we have different criteria for diabetes media. If if you get a fasting blood sugar you're you haven't eaten <hes> at least for at least eight hours before that and you get a blood sugar that hundred twenty six milligrams per deciliter Amore and that's confirmed firm on a subsequent test that is diagnostic for diabetes. You can also diagnose diabetes with something that I mentioned before Haemoglobin Onc- which is the an indicator of average blood sugars over the last two to three three months and hemoglobin when C._F.. Six point five percent or more is is diagnostic of diabetes and then there's one other test that's done that to our oral glucose tolerance test where somebody ingests glucose and we measure to see what their blood sugar is and a blood sugar growth of two hundred or more two hours after glucose or or sugar load as is also diagnostic diabetes Dr Lipsky. There's been a bit of the controversy in the last several weeks about this diagnostic approach to you know determining whether somebody actually has diabetes or not and that's the what you referred to as the hemoglobin a one C versus the oral glucose tolerance tests that we've actually heard from a lot of our readers saying hey you know I I was normal on hemoglobin a one C but then it turned out that I actually had diabetes in the oral glucose tolerance test revealed that so convenience versus accuracy what do you you think while you're right Joe that the hemoglobin and went see test is very easy to do. You don't need to be fasting. You can do it anytime of the day you get your blood test and you're done the oral glucose tolerance test is is used less often because has it requires the glucose load and then you have to have a blood glucose level checked two hours later so it's it's not as convenient but as you noted there are some circumstances under which the hemoglobin ONC- <hes> test may not pick up on diabetes <hes> including their differences in a one sees by race by certain chronic conditions and in people with variety of <hes> red blood cells survival times so there there are some circumstances Francis under which it may not be as accurate Dr Lifts CA patients care about different things than hunters to and that's not to say that there isn't a shared concern but what what people really want from their diabetes management program is I think first of all quality of life and longevity they don't WanNA heart attack. They don't WanNA stroke they want to avoid kidney disease and visual problems and neuropathy nerve pain and we could good down a long list of things that people really are trying to avoid when it comes to whether it's type one type two diabetes but the food and Drug Administration often often approves medications based on their ability to lower blood sugar not necessarily to provide the outcomes that patients are looking for so. Can you help us better understand the difference between what will call all the surrogate endpoint of blood glucose versus really important clinical outcomes like heart attacks strokes neuropathy etc Joe. That's really critical. I think it for us to understand how drugs affect what matters to people I a you. Put it very very nicely what you asked. That's exactly right so the the F._D._A.. Right now approves drugs for diabetes based on how they lowered blood sugar. Although they've changed their guidance over time and now they require that the drugs be at least cardiovascular the safe which seems a little bit backwards if you if you ask me that you know one of the biggest risks risks from diabetes heart disease but the drugs just just need to not increase the risk of heart disease they don't need to actually lower it but they're not required to show that these drugs that we used to lower blood sugars actually reduce the risk risk of blindness. I'm mutations and kidney problems and overtime. I think we've learned that different drugs have different effect on these outcomes even though they may lower blood sugars just the same so for example <hes> there are drugs that have been implicated in increasing the risk of heart disease like Rosie glittered zone Rosie glitters own lowers blood sugars at does a lot of things that you would think would be helpful for the cardiovascular system stem but yet it may actually increase the risk of heart disease but another medication. It's just more new and peg lift Lison also lowers blood sugars and in recent trials was shown known to actually reduce the risk of heart disease so I think what we're learning over time is that it's not just about lowering blood sugars. We have to really know how these drugs affect the things that mattered to patients such as having a heart attack and even though to drugs may lower blood sugars about the same they may have different impact on those and points such as the heart disease <hes> <hes> so. I think I'd I diabetes is actually undergoing a lot of change given these findings that we we realizing that the strategy that we use to lower blood sugar really matters. You're listening to Dr Caccia Phillips GotTa. She's an assistant professor of medicine and an endocrinologist at Yale School of Medicine Doctor Lips Gut is also a clinical investigator at Yale Newhaven Hospital Center for Outcomes Research and Evaluation Valuation Terry. I'm so glad that she emphasized the importance of outcomes that matter to patients versus those surrogate end points absolutely after the break will learn more about how doctors are rethinking thinking the goals for Hba One C. Can you get blood sugar too low. What happens then find out what hypoglycemia that low blood sugar? You're talking about feels like is there an advantage to continuous continuous glucose monitor a large scientific study aimed for very tight blood sugar control. I I wonder how well it did our older people with diabetes being over treated. We'll find out how to tell whether symptoms. As an older patients are due to low blood sugar or a T._i.. You're listening to the People's pharmacy with Joe and Terry Graydon. The People's pharmacy podcast is sponsored in part by Kaya -Biotics Kyi. A -biotics offers the first probiotics which are both certified organic and Hypo allergenic. All probiotics are produced in Germany under laboratory conditions with high quality ingredients and under strict regulatory oversight the three available formulas are created for very specific purposes such as strengthening the immune system fighting yeast infections and helping with weight loss to learn more about Kaya -biotics probiotics and the important topic of gut health. You can visit their website Kaya -biotics dot com. That's K. A. Y.. A. -BIOTICS DOT COM use the discount. What Code People for ten dollars off your first purchase welcome back to the People's pharmacy? See I'm Joe Grayton and I'm Terry Graydon if you would like to purchase a C._D.. Of this show you can call eight hundred seven three two two three three four. This is shown number one thousand one hundred seventy the three the number again eight hundred seven thirty to twenty three thirty four for you can visit our website people's Pharmacy Dot Com and place your order then you can also download the podcast from our website or wherever you get your podcasts casts. The People's pharmacy is brought to you in part by Verizon A- An analytical laboratory providing home health test for hormones gut health and the microbiome online at V. E. R. I. S. A. N.. A. Dot dot com today. Our topic is diabetes. Can you treat this condition too. Aggressively what are the most appropriate goals for blood sugar control were talking with Dr Cashew Lipscomb. She's an assistant professor sure of medicine and an endocrinologist at Yale School of Medicine Doctor Lips is also a clinical investigator at Yale Newhaven Hospital Center for outcomes research in Evaluation Dr Lips Go. We understand that over the years people who have been dealing with diabetes have been encouraged to try to get their H._p.. A one C number as low as they possibly can and there's some wreath thinking of of that goal that you have been involved in. Can you fill us in please sure thing Terry. You're correct that for many decades I think <hes> this point. We've we've heard that lower is better. Get it as low as you possibly can with H._p.. ONC- and truthfully you know if you're lowering your each one see because you have type two diabetes and you're eating healthy and you're exercising and you've lost weight and you're going down in down in down. There's really no no <hes> no harm to that that that's great. I think that the controversies really in people who require medications to do so and that's because the medications carry a certain risk of harm and the the more medications you require to lower your H._p.. One see the bigger the harm they're still controversy even among doctors about hollow. Oh these blood sugars should on average be or how low the H._p.. Once she should go again for many decades <hes> the guidelines said you know for most people H._p.. ONC- should be below sevenpercent but now even among guideline headline makers there are disagreements. The diabetes guidelines still say most people should go under seven but the American College of Physicians recently put out a guideline which said well for most people that number should be between seven the eight percent so less stringent correct less stringent according to the A._C._p.. Or the American American College of Physicians this reminds me a little bit of the the guidelines in the recommendations nations over the years for cholesterol or even for high blood pressure because there was a time you know fifty sixty years ago in doctors were a little more casual about both lipids as well as hypertension and then the last decade or too. It's like no no no. You can't get cholesterol too low. You know if it's if it's L._D._l.. Of thirty that's way better than seventy which is way better than a hundred with etc and did with high hi hi blood pressure people never get concerned or very rarely get concerned if blood pressure is like one ten over sixty unless of course here a little old lady and you start falling over when you stand up we'll that's where I was going next next. What happens when people are just too aggressive in getting their hemoglobin a one c down because some people think that's like a report card the lower the better and you're suggesting that so fast and that's right not so fast and that's because these again it's different in in people who don't require medications and so-called Diet Control Diabetes? I think that Diet and exercise are healthy ways if controlling blood sugars but once you require medications there are risks to them particularly with the use of insulin all people type one diabetes require insulin on about a third or thirty percent of people type two diabetes eventually they require an insulin to control their blood sugar in our country and those those medications insulin or insulin like medications can lower blood sugars too much and cause low blood sugar reactions. hypoglycemia and hypoglycemia can be quite dangerous eight first of all. It doesn't feel good to people so we know it's people report their health related quality of life is worse when they experienced hypoglycemia and <HES> can develop yeah go ahead what does it what does it feel like what well it feels like <hes> almost like a panic attack sometimes so you feel your heart is racing. You may feel sweaty. You Feel Hungry Week Doc <hes> like you're you're craving fuel in your body because you're you're the blood sugar and the blood is so low sometimes when the blood sugar goes to low though you may run out of fuel particularly to the brain I and you may pass out completely so you can go into a coma and you can die when when blood sugars run really really low so it's very it can be very dangerous and this can happen with both insulin as well as oral medicine awesome it can happen with insulin and I think I said insulin the like oral medicine so there's a group of medicines called Insulin Secreta dogs which include soften a urea drugs like lip aside glamorized Glib you ride and then <hes> kind of less used medicines called Glee nights so not with all of oral medications but certain ones yes Dr Lipscomb. I think everyone has seen the type of finger prick blood tests that people with diabetes use to determine what their blood sugar is right at that moment and <hes> people who use insulin in May test several times a day people with type. Two diabetes may only test <hes> a few times a week. Perhaps we have encountered a new technology that even people who don't have diabetes diabetes are starting to use that is continuous glucose monitoring system that does so through a patch that you slept on your arm. Is this something that will be helpful for people with Diabetes So yes continuous glucose monitoring can be very helpful to some people with diabetes particularly people who use insulin and require multiple as you said multiple finger sticks today so oh it's particularly helpful in people with type one diabetes or those people with type two diabetes who are more have more advanced disease where they require multiple injections today and particularly those people who are prone to low blood blood sugar reactions or hypoglycemia because we can pick up those with with these C._G._M.'s continuous glucose monitors now there were some trials they they they had an umbrella name called accord and I'm sure that you know what that stood for but we don't even younger and in this trial they basically were thinking aggressive aggressive control of blood sugar aggressive control of blood lipids like cholesterol aggressive aggressive control of high blood pressure and everybody thought well hey people with diabetes or the there the canaries in the coal mind if we can demonstrate that aggressive control of blood sugar for these folks folks is really working well and that will have implications. Perhaps for the wider community it kind of flamed out what happened. Yes I think it was a it was a huge surprise in disappointment because has early on the trials for diabetes did show did demonstrate that lowering blood sugars can reduce the risk of complications of diabetes like problems with vision amputations nerve nerve problems kidney problems and so there was <hes> there was enthusiasm for for lowering blood sugars and demonstrating that you know that that this may have beneficial effects that the try to you mentioned a cord <hes> there were two other trials around that time advance in V._D._T.. Where really designed to answer the question of whether lowering blood sugars even more than in prior trials can reduce the risk of heart disease and heart disease? The major issue for people with with diabetes diabetes really increases the risk of heart disease so <hes> the thought was that you know if you nor you bring the blood sugars close to normal. Maybe be weakened reduced that risk and unfortunately at least in these trials among the people this was among people with type two diabetes most of whom have had diabetes for awhile so there were not newly diagnosed. Neither one of these three trials reduce the risk of heart problems and accord one of the three trials was actually stopped early because of increased risk of death in the group of patients who were randomized to the more intensive blood sugar control and that was big surprise in a disappointment has that had an impact on how doctors think about <hes> treating diabetes over the last ten years so because I think it was about ten years ago that it was published accord was in no I think it was Oh yeah you're right. Two thousand eight correct has it had an impact. I think that the field has has shifted from you know pushing blood sugars again as as low as they can to now a more cautious approach although some of my work suggests that we still treating a lot of patients with advanced diabetes with many chronic conditions too tightly despite this evidence well in fact Dr Lips got in a recent New York Times article a new are expedite beatty's lighten up you are quoted it about your research saying it's important in shifting the thinking that lower is always better are older people with diabetes being over treated what we found is that treatment mint of diabetes both in terms of the low A. Onc- and also the types of medications used to achieve it really did not differ based on what we called the health status or how healthier stick you were which which is totally against what most of the guidelines recommend. which is you know you should treat based on these factors? If somebody's healthy without many chronic conditions you can treat them more aggressively particularly with these medications that carry less risk of hypoglycemia or low blood sugar reactions but if you have somebody who has end stage comb abilities who was very sick who has functional impairments well. You should be more careful in that person you should you should. You should really try to make sure that the treatment is safe again. We we found no evidence that that treatment differed am in these groups of people which suggests that one you know we have a lot of over treatment into that. We're not really individualizing care meaning that we're not tailoring <hes> the treatment based on on those factors how sick or healthy somebody is. It sounds as though that would be something you'd advocate. Yes absolutely I think it's really important that treatment is on a case is designed on a case by case basis and not just based on age or how many chronic conditions somebody has but also based on who that person is what do they want in terms of goals of care and how difficult it is to get them there right so there may be a person who is really <hes> not burdened by checking finger sticks often or taking multiple injections today <hes> an is happy to do that that doesn't doesn't lower their health related quality of life but there may be another person where that is really bringing them down and their quality of life is really affected by the treatment of diabetes in that person thinking about how to reduce that burden how to make the diabetes eighties as least disruptive in their life as possible isn't important. I think role for the clinician one of the symptoms of hypoglycemia that I worry about a lot especially in older people is dizziness us and the possibility that people may fall because a fall in an older person can lead to a hip fracture which can lead to all kinds of devastating consequences. What are the symptoms that you tell your patients to watch out for when it comes to to low blood sugar? This Simpson's May vary from person to person so I think it's it's really critical when a physician or clinician is starting treatment treatment with drugs that may put that person risk for hypoglycemia to describe this some patients may have the classic symptoms the heart racing sweating feeling weak perhaps dizzy hungry and it's easy to identify but others may have more <hes> subtle symptoms in fact one of the things that's really important. particularly in older person's is that they're they're mental. Status may change so I've had patients where they've had these episodes of sort of what people had called cognitive impairment. They were not really there. They seem to kind of drift off somewhere else. What turned out when we when we tested their blood sugars that their blood sugars were actually low so at those times and once we fix the blood sugars their their mental state really improved so some symptoms may be classic but there may be also more subtle symptoms? It sounds like that could actually be kind of hard to narrow down. Some people might think that this older person is having a T._A.. or a mini stroke correct sometimes it is hard to identify and I think particularly in people who are prone to hypoglycemia and those who use insulin it's important to monitor blood sugars either through finger sticks or you know people where we suspect well May- maybe there is something going on there that could be hypoglycemia to <hes> to potentially put on a continuous glucose monitoring device at least for some time to see whether whether there are low blood sugar reactions happening that we may not be otherwise picking up. It sounds a lot like the goldilocks phenomena you don't want it to be too high not too low not too hot not too cold. You're looking for that sweet spot right there in the middle exactly right the right balance and that right balance may be different for different people which is where you know a lot of guidelines now suggests that you really have to sit down with the patient on talk to set them about what's right for them. Dr Lips Go. We have a very good friend who has type one diabetes and he has a challenge because his blood sugars can go up to two fifty or three hundred and then they can drop down to forty or fifty and so it seems like he's on a roller coaster ride and that can be a very hard thing for the body. Yes your friend is not alone many any patients particularly those with type one diabetes or advanced type two diabetes when there isn't any insulin around have these experiences of a fluctuations in in blood sugars from really high really low or Brittle Diabetes Ace. We know that it first of all doesn't feel good to people right so these these swings in blood sugars can really affect how a person feels and functions and obviously the very low blood sugars can be a can can cause serious harm so that's difficult situation. You're listening to Dr Kasha Lip Ska. She's an assistant professor of medicine and an endocrinologist at the Yale School of Medicine Doctor. Lipsky is also a clinical investigator at Yale newhaven. You Haven Hospital Center for outcomes. Research and evaluation also called Core C. O. R. E.. I love the idea of this continuous glucose monitoring system because it really gives you a much finer her insight as to what's actually going on inside the body chew enough after the break will find out why insulin has gotten so expensive. What's the impact on patient health? Doctor Lips got testified about insulin prices cases before Congress. What did she tell them? Can people with diabetes live there healthiest life and how can people get their numbers in line with flexible guidelines. You're listening to the People's pharmacy with Joe and Terry Graydon. Yeah welcome back to the People's firm AC- Armijo Grayton Terry Graydon if you'd like to purchase a C._D.. Of today's show or any other people's pharmacy episodes you can call eight hundred seven thirty to twenty three thirty four today day. Show is number one thousand one hundred seventy three that number to call eight hundred seven three two two three four or go to people spicy dot com and you can find it online you can also download the free podcast from Apple Stitcher or from our web store. We invite you to consider writing a review. The People's pharmacy is brought to you in part by Kaya -biotics probiotic products made in Germany from certified organic organic ingredients K. A. Y.. A. -BIOTICS DOT COM. We're talking today about diabetes and how it's treated for people who have type one diabetes insulin is not optional. It's their lifeline line. The cost of insulin has been rising dramatically. How does this impact patient? Health or guest is Dr Kasha Lipscomb. She is an assistant professor of medicine and an endocrinologist. They Yale School of Medicine. Dr Lipsky is also a clinical investigator at Yale Newhaven Hospital Center for outcomes research and evaluation that your lips go. We've seen the price on a lot of different medications go up lately but the price of insulin is out of sight. This is an old drug. Main insulin has been around since nineteen twenty two. Why in the world is it becoming so expensive active the price of insulin's absolutely outrageous? I totally agree with you and the reasons for this are now under intense public scrutiny. I think that the people we'll have various opinions of why this happened but if you want to boil it down it can be quite simple in the United States just the re pharmaceutical companies have patent that allow them to manufacture insulin and that's ally Lily Jason Ofi in Nova Nordisk so we have three giants controlling our U._S. market for insulin and making much money as they can perhaps and making as much money as they can exactly this is stuff for profit industry and clearly we've seen the prices for competing products go up and up and up also in tandem together which suggests that this this market is not competitive. It's not the same as with some of the statin drugs or blood pressure medications that have been around whether it's a very strong generic competition that helps to bring prices down. We really haven't seen that with insulin with insulin. We have of these branded products that have just gone up an up and price. What's the impact on patient health? The impact of these high insulin prices is dramatic on people. I I became interested in this issue because patients began to tell me stories about you know the types of things they had to do in order to buy insulin or they were simply saying no Dr Scott Sorry. I can't go up on my insulin. Does I can just barely afford what I'm what I'm buying now so the the impact on a patient is is that patients can't you know many patients cannot afford insulin and many ration insulin. We have done a study in our yield diabetes Diabetes Center asking patients over the last year. How often have you used less insulin than prescribed specifically because of cost and we found that one in four patients reported rationing insulin? That's a huge proportion of people at diabetes. What are the consequences of rationing insulin? When people would type one diabetes use less insulin them prescribed or you don't use Insulin Day Condi- right so we've we've had very very sad and tragic consequences to this and people have died because they could not afford to buy their insulin so again as it was? We talked earlier. People type one diabetes need insulin to survive over the long term. If fusing less you still using enough to stay out of trouble out of diabetic cuter acidosis but not enough to control your blood sugars than you run into the complications of diabetes including blindness <hes> problems with your feet amputations promise with your kidneys going on dialysis and neuropathy so these are devastating consequences. What our other countries doing? I mean what is the solution into this problem because I have to assume that if you're in Norway or if you're in France or Canada or Australia that you know they these countries have type one people with type one diabetes. How how are they managing to control their prices? Prices of drugs are much lower elsewhere in the world compared with what the United States in in fact many patients go to Canada to get their insulin for that very reason and you know we have a system in our in our country where we really rely on market competition and our government states out of the way in many of the European countries and in Canada. There's a there's much stronger. Stronger government presence in regulating these prices and that can bring prices down as we see Dr Phillips Guy Understand that you testified before a House subcommittee easy on the topic of insulin not too long ago. Can you give us the essence of your testimony. Please <hes> sure I testified because I felt I couldn't do enough in clinic right so one when I see patients with with diabetes who can't afford their insulin. I get very frustrated because there's only so much that I can really do to help them. In the office and I felt it was important to to raise a voice and really tell our legislators about what's what's happening in our clinics in what impact this has on patients so the essence of my testimony was to say that this is a huge problem Lim again it affects potentially up to you know maybe more than one in four at least in our center one in four patients rationing insulin others make trade offs where they go they buy less of something else in order to afford their insulin and this this has these devastating consequences on people's health and I think it's I was calling on the legislators to interfere at this point point and to <hes> to regulate this market better because in order for us to protect the patients with with type one and type two diabetes who need insulin to survive into control their disease. I think we need a a better solution than what we have now. <hes> I think that the market is not working the way it is. I assume that your colleagues other diabetes experts of dealing with the same issues that you are equally frustrated because it has to be tragic as a physician to write a prescription for insulin for someone with type one diabetes and learned that they've had to ration it because they couldn't afford it. That's right a lot of people have a lot of physicians have expressed frustration Dr Lips go we heard an anecdote which was very disturbing. A young woman twenty eight years old you know as soon as a person turns twenty eight there too old to be covered under their parent's insurance any longer the affordable care act covers people until they're that age but twenty six twenty six so I believe so yeah I think you're right twenty six so so once a person gets into his or her late twenties they are pretty much on their own. They have to find their own insurance or go uninsured some of them do this. Young Woman said she started rationing her insulin once she had to leave her parents insurance plan and she said nobody cared. Nobody understood that without the next vial of insulin I wouldn't live you know to be able to do anything else us. I think it's unconscionable. What's going on with with insulin? I've heard stories this version of the story many times now <hes> I think that's right. I think our system leaves patients out. I think that the insulin prices are ridiculously high and these these <hes> pharmaceutical company assistance programs really do not have the <hes> the impact that the industry says they do because patients like the the patient you're talking about our common and you hear their stories and there is very little help for them in our system I think that's I think that's absolutely wrong and theoretically a twenty-six twenty-seven-year-old person who is able to control her diabetes. Appropriately has a a good long life expectancy but if not controlling her diabetes diabetes. She's in big trouble. She's in big trouble and she could. She could die right so Alex. Smith was in that exact. It's similar story right. He aged out of his mother's insurance couldn't afford the premium for prescription drug coverage was trying to raise money enough money for his insulin and couldn't and was was found dead with with empty cartridges Trajan for his insulin so this can have very tragic circumstances. There are other young people who you know intentionally <hes> have their blood sugars run highs it can be admitted to the hospital in provided with with free insulin upon discharge for two weeks afterwards Yikes. That's it's crazy yeah. It makes no sense it makes no sense and makes no sense. I'd like to switch gears for just a moment. Talk a little bit about type two diabetes if we might there is a diabetes epidemic in the world. You alluded to it the idea that <hes> younger people including children are now being diagnosed with type two diabetes. Do we have any understanding why what went wrong. We have some understanding of what aren't wrong. You know people people always say that there is a genetic contribution Russian to type two diabetes that there is there is often a family history of of type two diabetes people but if you look at the recent history of the increasing incidents of type two diabetes or genes haven't changed our genes have been the same for those few decades so what's really changed is the environment. It's really the environment that driving this this diabetes epidemic and it can track the obesity rates. The obesity rates go very much hand hand-in-hand with increasing diabetes incidents. I'm that's fueled by the way the way we each the way we work the way we spend our time. which is you know we eat more carbs over time <music>? I'm more more sweetened beverages over time and were much more sedentary than we used to be and that is definitely contributed to the diabetes epidemic. What do you recommend to your patients so they can live live as healthier life as possible despite having diabetes that seems like a simple question but it is so difficult to answer questions are hard to answer and even ought to carry through they are and you have? I do not have the same advice for everyone so I have to tell you that I tell patients that in terms of nutrition the advice that we not as doctors have given them over time has changed and still A._M.. Extremely skeptical about going on record saying things like eat eggs. Don't eat eggs eat carbs. Don't eat carbs. Everybody has to find a diet that fits them and because I see mostly you know my specialize in sort of older patients with diabetes. I find that it's difficult at that age to make huge changes in the Diet. I think people should enjoy their food. I think food that if you eat a variety of foods that are you know as these processes possible. That's likely to be good for you. You eat vegetables and fruits you eat lean meats and fish and you avoid a huge cartloads but that's as sort of specific as as I get to be honest what about activity now I recognize that with older adults that there's a huge huge range in terms of what people are able or interested in doing exactly so it depends again it depends on the person's <hes> ability to to be active <hes> for many older adults it may be safer to do water-based sports to aqua aerobics <hes> or swimming <hes> because some people are more prone to to false they may also need some assistance in and physical training in order ready to do this safely. I'm a huge you know I'm a I'm an athlete. I love sports but I recognize not not everyone does not everyone drives joy from being active so I tried to figure out what is it that the person really likes to do for some some people it's participating in you know walking with the group where it's a it's a social event and they really enjoy being with people and that's what really gets them out going in and walking and so I you know I tried to help them figure how how they can do that so that they can really enjoy that and for some people it's it's other things you know biking or joining a gym or tracking their steps but I think it it really depends on what what is it. That's going to make that person do it again. Dan and again consistently an enjoy it and ducker lips go when it comes to blood sugar readings Hemoglobin A. One see what's your recommendation. How do we get people to not obsess us about trying to get their numbers as low as possible and and get a pat on the back from their doctors so that it's actually more flexible what trying to get there? I think as a as clinicians <hes> I think that that this concept of individualizing care meaning that it's not the same report card for everyone and let's not focus so much on that one particular number but let's think about overall the person's quality quality of life how how they are feeling how they're functioning what's their burden of treatment what brings them joy in life and trying to really focus more on the whole person as opposed to just a number. I think that in the end that's going to be more helpful to helping people really live happy. Healthy lives that cash Lipsky. Thank you very much for talking with us on the People's pharmacy today. Thanks for having me. You've I've been listening to Dr Cossio Lipsky. She's an assistant professor of medicine and an endocrinologist at Yale School of Medicine Doctor. Lipsky is also a clinical investigator at Yale Newhaven Hospital Center for outcomes comes research and evaluation also known as core one of the things that we did not have a chance to talk to Dr Lips about was medications that can either raise blood sugar or actually cause diabetes or make it harder to treat that condition and one of the categories is statins. <hes> there was a study in the British Journal of Clinical Pharmacology not that long ago that suggested statins may increase increase the risk <hes> by about thirty eight percent and they said that you author said individuals using satins maybe at higher risk for hyperglycemia that's high blood sugar insulin resistance and eventually type two diabetes. He's Lynn single produced. Today's show Alydar ski engineered Dave Graydon Edits our interviews. The People's pharmacy is produced at the studios of North Carolina Public Radio W U._N._C. The People's Pharmacy Theme Music Doc is by B. J. Liederman the People's pharmacy is brought to you in part by Verizon an analytical laboratory providing home health us for hormones gut health and the microbiome online at V. E. R. I. S. A. N. A.. Hey Dot com if you'd like to buy a C._D.. Of today's show or any other people's pharmacy episode you can call eight hundred seven three two two three three four. Today's show is number one thousand one eight hundred seventy three that number again eight hundred seven thirty to twenty three thirty four or place the order online at People Spar Masih Dot Com when you visit our site you can share your thoughts on today's show have view successfully overcome type two diabetes with Diet and exercise what medications have worked best for you. Tell us your story Ed People's Pharmacy Dot Com you can sign up for our free online newsletter or subscribe to the free podcast. Did this show you need never miss another episode and moreover you can share with a friend when you sign up for the newsletter. You'll get our free guide to favourite home remedies in Durham North Carolina. I'm Joe Graydon and I'm Terry Graydon. Thank you for listening. Please join us again next week.

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548 - Six Myths about Type 2 Diabetes

The Nutrition Diva's Quick and Dirty Tips for Eating Well and Feeling Fabulous

09:38 min | 1 year ago

548 - Six Myths about Type 2 Diabetes

"Hello I'm Monica Reina. And you're listening to the nutrition. Diva podcast welcome. November is national diabetes awareness month. This is a time when health nutrition. Educators try to increase the public awareness and understanding of a disease that affects thirty million. Americans and threatens seventy million more so today. I'M GONNA try to clear up. Six popular misconceptions about type two diabetes which is by far the most common form of diabetes. It's also the most preventable support for this. podcast comes from Pete. and Jerry's varies organic eggs. Pete Jerry's has done one thing for generation produce eggs. You can be proud of their small family. Farmers across the country take pride in raising hens and providing certified organic free range eggs that meet the highest standards. They do it because it's the right way to farm and also because they want you to be able to believe in what you buy learn more at Pete and Jerry's dot com that's Pete and G. E. R. Y. S. DOT COM in type two diabetes. Either the body does not produce enough insulin or the cells. Start to ignore that insulin. And as as a result your blood sugar stays too high one in ten Americans has type two diabetes and a quarter of these don't even realize that they have have the disease and for every person with type two diabetes. There are two more who are considered pre diabetic. meaning that their blood sugar levels are in the high normal range range an old medical texts. You'll sometimes type. Two Diabetes referred to as adult onset diabetes because this condition usually usually developed in mid life unfortunately as rates of childhood. Obesity have gone up type. Two diabetes is now routinely diagnosed in kids and and the earlier. Someone develops diabetes. The more likely it is that they will eventually experience serious complications. Having type two diabetes increases your risk for heart disease his blindness nerve damage and kidney damage. especially if you're disease is poorly managed however people can live long and healthy lives with diabetes. Beatty's if they take proper care of themselves in some cases it's even possible to reverse the disease. So with that in my. Let's take a look at some of the most common myths and misunderstandings understandings about type. Two Diabetes Myth number. One all type. Two diabetics will need to take insulin or other anti diabetic drugs for life. This is not true. Many newly diagnosed diabetics will not have to take medication if they make appropriate lifestyle modifications such as managing edging their Diet exercising and losing weight if they need to even diabetics who are currently taking medications can sometimes reduce or even eliminate the need for these medications by losing weight and managing their diet better. Now you shouldn't discontinue medications without checking with your doctor of course but for type. Two diabetics headaches. This is a real possibility myth number. Two diabetics shouldn't eat fruit now. It's true fruit. Does contain sugar and carbohydrates hydrates which do affect your blood sugar levels and this leads many to assume that it's off limits for diabetics but fruit can be a very healthy part of your diet even even if you are diabetic. Fruit contains lots of valuable nutrients and it doesn't a milder effect on blood sugar than other types of sweets. A healthy diabetic meal plan might contain two or three servings of whole fruit every day. Myth number three diabetics only need to pay attention to carbohydrates not protein gene or fat will carbohydrate. Rich foods do have the most dramatic effect on blood. Sugar and these are foods like breads cereal. Pasta Rice `tatoes and of course desserts. So if you're diabetic you'll definitely need to watch these types of foods but you need to pay attention to the rest of your Diet Diet too because if you're eating too many calories even if they're not coming from carbohydrates that's GonNa make it hard for you to maintain your weight and that's it's GonNa make it much harder for you to manage the disease. So should diabetics go on a low carb diet. What can you eat. If you're taking medications for your diabetes of answers to these questions right after this brief break to thank our sponsors support for today's show comes from bare minerals creators of clean beauty. The bare minerals believes that. Make up and skin care. Should make your skin better. Not just better looking. That's why their best selling original foundation is made with only five ingredients. Ingredients all of them minerals. They're good for skin formulas with proven performance. That's clean without compromise. So upgrade to clean beauty products use the foundation finder at bare minerals dot com to find your perfect match and get twenty percents off with the Promo Code Diva Bare Minerals. The power of good would. This episode was also brought to you by hallmark cards. You know we always feel like we need a special occasion to give someone a card but you can give someone a card for any reason at all. I recently got a card in the mail from my sister. Who just wanted to tell me she was thinking about me and it meant so much it maybe everything. Why don't I do that more often. Why not share some love and appreciation with the people in your life with a hallmark card. You can send a hallmark card to let somebody know that you miss them or that you're Thinking about them it helps them feel like you're right there even if you're miles away and they can go back and read that card whenever they miss you. It's really simple but it's a powerful gesture that makes awesome such a difference. See what it can do to show someone how much care visit. HALLMICH DOT COM slash diva to shop cards for any occasion. And use the Promo Geico diva to get twenty percent off your card purchase. That's hallmark dot com slash diva and the Promo Code Diva for twenty percent. Off Your purchase myth number for diabetics have to eat a low carbohydrate diet. Actually diabetes can be successfully managed on a higher or lower carbohydrate diet in fact for decades the American Diabetes Association recommended that type two diabetics either low fat diet which tends to be higher and carbohydrates but many studies have now shown that low carbohydrate diets can be very effective in helping diabetics lose or maintain maintain their weight and improving insulin sensitivity. The key here is to find the approach that works for you and not just in terms of your health but also for your lifestyle and your food preferences if you're diabetic and you've had trouble losing weight or managing your blood sugar on a traditional moderate carbohydrate diet. It's possible that a lower carb approach would work better for you. This is just not a one-size-fits-all prescription myth number five. If I'm using insulin or antibiotic medication than I can eat what I want. Many people believe that. If they're taking medication to control their diabetes than they don't need to pay attention to their diet and this is such a dangerous misconception. Even if you are using anti diabetic medication your first line of defense against the complications of diabetes is still going to be eating right exercising and maintaining a healthy weight medications. If they're needed needed are always used in addition to not instead of these healthy lifestyle habits. If you're not managing your diet and your weight you're going to need need more medication to manage your blood sugar but if you do everything you can to live a healthy lifestyle then. Your medication is going to work better for you. You're going to need bless of it and you'll be healthier in the long run and finally myth number six people with prediabetes or a family history. St Of type two diabetes always eventually end up with full blown. Type two diabetes. Fortunately this is not true. If your doctor has told told you that your blood sugar levels are borderline or that you have prediabetes. Consider this a wakeup call. Get Serious about losing weight. Eating a healthy not diet and exercising. And you can vary likely. Avoid developing diabetes. Altogether in the transcript for today's show I've included links awesome related episodes on managing preventing and even reversing type two diabetes. And you'll find that quick and dirty tips dot com. I also so host of free facebook group to support people who are trying to lose weight in a sane and sustainable way. And that's something that can really help if you're dealing with diabetes. Just search for way way less life on facebook. Our show is written by me. Monica Reindel edited by Karen Hertzberg produced by Nathan Sems and our team at Macmillan audio also includes Michelle Margulis. Emily Miller Morgan rattener. And Kate hines under the direction of Kathy Doyle. Check out quick and dirty tips dot Com to learn more about our other podcasts tests including get fit guy and savvy psychologist and of course grammar girl. You'll find all of the quick and dirty tips. podcast wherever you listen and thanks for listening this week. I'll see you next week.

diabetes American Diabetes Association Pete Jerry Monica Reina facebook Obesity Pete. Beatty kidney damage. Emily Miller Morgan Kate hines Macmillan audio Kathy Doyle Monica Reindel Michelle Margulis G. E. R. Nathan Sems Karen Hertzberg twenty percent
Diabetes at Menopause

Menopause Management

24:17 min | 6 months ago

Diabetes at Menopause

"Good day my students. Welcome your menopause. Your way in the state of menopause and the world day and welcome to the last podcast in the unit on heart attack. My goodness can you believe all the information you learned about heart attacks. Did you know there was so much to it. Did you know that it was even a part of menopause. As we've moved for the material podcast by podcast. Had you been shocked. Well if the other podcasts habits shocked you today's will we are gonna talk about diabetes at pulse. I know you're probably wondering why in the world i'd included in a unit on heart attack. When you see that's the thing there is so much overlap between diabetes and heart attack that it's enough to knock your socks. Aw actually it's enough to give you a heart attack so settle in and hear what i had to say you're going to realize there are so many connections between things you never ever connected before get every woman you know to listen to this. Podcast watched my videos by my book. If you haven't noticed type. Two diabetes is rampant and one of the reasons rampant because people don't get the education they need to avoid avoiding. I'm gonna make sense of it in a way you've probably never heard before and hopefully i'll make avoiding it or treating it easier for you. You know what. I'm going to start with the definition. Don't you i love definitions. You probably already know that. I love definitions. You probably already know. Also that there are two different types of diabetes. One diabetes is when your body doesn't make insulin you have insulin deficiency people left type. One diabetes get their diagnosis at a very young age. So another name for type. One diabetes juvenile diabetes because their juveniles when they discover that they have diabetes. Deficiency of insulin is incompatible with life so type one diabetic have to take insulin for the rest of their lives. we are not discussing type one diabetes. Today we're discussing type. Two diabetes type. Two diabetes is when your body makes insulin. But it's resistant to it in other words do produce insulin but your body has trouble using it properly. People who have type two diabetes their diagnosis at a later age. So another name for type. Two diabetes adult onset diabetes. And it used to be that only adults had type two diabetes. But now we even see it in children. And i'm going to tell you some of the reasons why they are the same reasons that more and more adults are developing type two diabetes. Now i like it. When the definition of one term requires you to know the definition of another. Because it's not fair. So since the definition of diabetes requires you to know the definition of insulin. I'll define it for us to. Insulin is a hormone. That your pancreas makes to aid in the digestion of your food. But insulin has one very particular and specialized job in the digestion process. It governs what your body does with sugar. So sugar is insolence. Only in concern. Insulin tells your body to either burn sugar as an energy source now or just store sugar as an energy source for later on and the medical word for sugars glucose you know when i was a kid growing up there was a candy called now and later and it's a lot later now than when i was a kid but it's still around and i think the name is really nifty now and later because now you're seeing that there's something to this now and later with regard to what your does with glucose so when you eat a meal. Some of the nutrients are glucose and glucose is present in many different foods. Not just in sugar itself. All carbohydrates contain some glucose all fruits and vegetables contain some glucose all grains contain some glucose. And of course. All suites contain some glucose in general the sweeter. The food the more glucose contains and your glucose is going to rise involved throughout the day depending on your last day and on what you last eight and on how well. Your body burn glucose neck. How or stores the glucose for later glucose is fuel for your body to us right now. It is supposed to be as quickly to give you energy. Now it is not supposed to be stored for later. Fat is stored for energy later. So the ironic thing about the now later candy. Is that the name implies. Something that you've probably never really considered your glucose will be lower before a meal in higher after a meal so your glucose metabolism is really really important. If your body does not metabolize glucose correctly a lot of other things are gonna go wacky. So the big issue is all about what your body does with glucose doesn't burn it for energy now or does historic for energy later and insulin is what determines which does Burn it for energy now or store for energy later. You know you can actually think of this phenomenon of using or storing glucose like you think of money you make money and you want to spend or some of it now and save or store some of it for later so to of money may have different purposes likewise your body is programmed to use different nutrients for different purposes. So you're supposed to use glucose now that's the money you're should spend for food and toiletries. It's what you used for. Immediate energy needs and you're supposed to store fat. That's the money you saved for later. It's an reserve so that you can utilize it in hard times. When you aren't getting enough glucose for your media needs it's just like if you're short on cash now and you dip into the money that stored a savings for later. So what would happen if you had money. Would you say doll of it for later. Had none spin rod. Now you would be able to pay for your current expenses. Well that's exactly what happens when your body uses insulin. Improperly so type two diabetes is a situation which your body produces insulin but it causes too much glucose to be stored for later and dada da. It stores it as fat so back. Right there is the big connection between diabetes and heart attacks. That's why i'm discussing. The topic of diabetes in the unit are heart attack. Because what's sugar is store. It as fat everything i've taught you about heart. Attacks comes into play it. It words type. Two diabetes put you at high risk for heart attack. Do you remember when i described menopause as an estrogen deficiency state. I explained that whenever your body is deficient in something. You have a long list of symptoms that telling you that. Something's missing diabetes because type one diabetes. You have no insulin it's a state of insulin deficiency but with type two diabetes. You do have insulin. Your body just doesn't know what to do with it. It's a state of insulin resistance. So use our baking analogy type. Two diabetes would be a situation where you put all your money into savings for later and there's not available to pay your current bills. Now you have money which just don't know how to use it properly so even though your body has insulin with type two diabetes. There are still symptoms with insulin resistance just as there are with insulin deficiency so what are the symptoms of type two diabetes. Well they include all of the following extreme hunger extreme thirst extreme fatigue. Dry mouth frequent urination headaches that gentle yeast infections dry itchy skin slow healing wounds and numbness or tingling in your hands or centers are quite attention getting but for some reason. Most people don't discover that they have type two diabetes based on symptoms alone. Most people discover that they have type two diabetes from a simple blood test. When you get your blood drawn for your yearly well woman exam or annual checkup. One of the blood tests glucose as with most things in medicine. There's a scale glucose values and there are different circumstances under which are glucose level is evaluated by the latte. So if you get your blood drawn when you're fasting like first thing in the morning before you've had anything to drink your glucose values should be less than one hundred twenty six milligrams per deciliter in the us or less than six point. One million miles per liter in europe and asia. This test would be called a fasting plasma lucas. But if you have any your glucose value should be less than two hundred milligrams per deciliter in the us. In less than seven point eight million miles per leader in europe and asia. And that's because your glucose will be higher after meal. This test is called a random plasma glucose and if your doctor wants more control over how the test is he may give you something. Called an oral glucose tolerance texts. This is where he has. You drink a specific sweetened beverage two hours before he draws your blood glucose test and this is called a two hour oral lukasz tolerance tests and the normal value for it is also less than two hundred milligrams per deciliter in the us or less than seven point. Eight million moles racia- now. There's one other blood tests you might get to diagnose type. Two diabetes is one of those crazy. Long nate's is called hemoglobin a. One c and it reflects glucose control over the last three months. This is the test. You'll get if you already have a diagnosis of type. Two diabetes because the idea is to keep your glucose role at all times and over the long term. The normal value for hemoglobin a. One c is less than six point. Five percent of the us your an asia. So you are a type two diabetic. If your values exceed eddie of these parameters fasting plasma glucose greater than or equal to one twenty six or greater than six point nine depending on where you live in the us or europe or asia random plasma glucose of greater than two hundred in the us or greater than seven point eight in europe and asia. A two hour oral glucose tolerance test rate of two hundred in the us or greater than seven point eight in europe or asia or hemoglobin a. One c value greater than or equal to six point. Five percent anywhere now because type. Two diabetes has become so so common there are now actually diagnostic criteria for something called pre diabetes. Prediabetes means you're on your way to diabetes land sister. It's supposed to be a wakeup call. It's supposed to make you say holy cow. I better do something about this. Now before i actually ended up in diabetes land. Unfortunately most people don't respond that way most just go on with their usual lifestyle habits that got them in trouble in the first place and they wait until they're completely diabetic and have no choice but to do something about it. We humans are very funny that way. We don't change our ways until forced to do so. So you've got pre-diabetes. Fasting plasma glucose is between one hundred and one hundred twenty five in the us or between five point six and six point nine in europe and asia. Or if you're random or two hour plasma Closest between one forty one ninety nine in the us or between seven point eight and eleven in your nation or if your hemoglobin a. one c. Is between five point seven. Six point. Four percent anywhere okay. So now it's time to tell you why diabetes is important at the time of menopause. A while back. I gave you a podcast on the similarities and conflicts between little pause thyroid disease. And then i told you that a pause itself causes your metabolism to slow way. Down metabolism is. How will your body utilizes food for energy and your thyroid hormones. Have a lot to do with it. But so does your insulin. So if you have type two diabetes. Your insulin is wacky and your insulin is wacky than your body does not know how to metabolize lucas. Instead of using it for energy it stores fat and win it stores too much of it. S fat your entire metabolic system goes out of wack. That is the very essence of type. Two diabetes saw at post menopause. You have three separate or model changes that mealy mess up your metabolism one. You lose your estrogen number two. You produce less thyroid hormone and number three. You either produce less or resistant to insulin. Every one of those things sets in motion all sorts of metabolic problems in your body and there's a whole lot of overlap in the symptoms. You notice at menopause you all the following weight gain due to increase storage of fat your abdomen slower metabolism due to decreased thyroid hormone and less efficient glucose metabolism due to insulin resistance. And it just so happens that the younger age at the time of postmenopausal the higher your risk of type two diabetes diabetes. Now every risks every disease has respecters risk factors of the things that put you at risk for developing the disease. And i've giving you a whole big long list of risk factors for a heart attack and one of those risk factors is diabetes. And if i give you a list of the respecters for diabetes itself you see that oh my goodness. A bunch of them are the same as the risk factors for heart attack. The ones that are the same for both diseases are high lousy. Ldl low healthy hdl. I try glass rides. Obesity that in abdomen high blood pressure sedentary lifestyle depression or a family history of type two diabetes. It's just shocking. This is really a big big deal. What you have here is to significant diseases but you have a lot of overlap in the factors that caused these two significant diseases in the first place. Plus you have a lot of overlap in the people who are likely to get them and you know what that needs. It needs that most of the things that you can do to prevent one also worked to prevent the other. it is so easy to prevent diabetes. The problem is that our society has developed ways of living which had high risk of both diabetes and heart attack. And up to you to do what you can end to do to avoid them. The biggest contributor of diabetes is all sugar. That's in everything these days. When you put too much sugar into your body your body just can't handle it. It overwhelms your insulin which is precisely what is lynn resistance announced to the next contributor is processed foods which strip nutrients right out and put preservatives in including sugar to that are sedentary lifestyles and your body stores glucose for later rather than burning it now goes right back to that count candy now and later and that leads to obesity fact being deposited your abdomen and all these things screw up your cholesterol values which leads to lip and build up in your heart arteries and the lipid buildup in your arteries put your blood pressure under higher pressure and that's the definition of high blood pressure. The blood pressure. Destroy your organs and eventually causes the heart attack. It is such a fish vicious cycle and it doesn't even have to be a stripped cycle. It's like any of those things can occur any order. You can draw a line from any one of them to just any of the others and it can look like a tangled web because that's really how it works if you're at risk for a heart attack you're also at risk for stroke. High blood pressure diabetes. It's a package deal physician. He or she will tell you that most of the patients who have one of them have all of them end. The sad thing is that this is becoming the norm. It's even happening to kids. These days people are getting fatter and fatter and with fat. You get diabetes. High blood pressure stroke and heart attack. That is why. I discussed all of these. In our unit or heart attack at everything presented in the unit for management options for heart attack applies to diabetes to. I'm beginning to sound like a broken record. The low fat high fiber low sugar diet regular exercise. Wake control no smoking. If you permit these diseases in the first place taking hr it will be much more beneficial than risky and it will also help to prevent developing diseases. But if you already have any of these diseases you're gonna find yourself in a catch twenty two. You might want to take each. Rtd prevent heart attack osteoporosis and alzheimer's but you can't because you already have high risk of heart attack. High risk for stroke hirishi for blood pressure and diabetes. The name of the game in menopause management is to use the options that have more benefit than risk. But you can't do that if you have all these diseases. And unfortunately most people with type two diabetes. Choose to take medication for the diabetes. Instead of getting rid of the diabetes by getting rid of their lifestyle. It's a product of our quick. Fix mentality so. I hope this podcast is a wakeup call for you. If you if you're headed toward diabetes land. I try to simplify the material. There's some excellent books on this one of which is called fat chance by robert looting and it's not exactly easy read but it's excellent in terms of how explain how explains how sugar does the same things to your body. That fat does to it. And that's why i talk about it in the heart attack. You didn't so. I tell you this business of understanding how these diseases are connected is so so so so powerful. It helps you so much in terms of making sure you understand not only the nuances of each disease. But how doing anything to help yourself from. What would what disease can help with all the other stu. It's absolutely shocking. How much bang your buck. If you know how to manage any one of these diseases and people who do change their diets and lifestyle they tell you it makes a difference in every aspect of lives and that should make you very happy and make you look very good match. Should be rewarding enough to make you want to keep it up. It's a shame that these chronic diseases are so common because it's so unnecessary and they're so preventable and it all boils down to you. You are the biggest part of the equation when it comes to these you have more power than anybody or anything and your goal is to use the power before you're in trouble with these diseases and that is why i teach the way i do that. Is why give you these lessons in a way. Where the analogies the if you watch my videos the props the models everything helps you understand things on a level that is an forgettable to use analogies. I like to use props. That are familiar to you. When i'm teaching you things that are unfamiliar to you. That makes it fun and it also makes it easy to understand and you understand it in a very relaxed way without feeling intimidated. You know medical stuff is kind of intimidating. So i try to take all that away. I hope you've enjoyed this unit on heart attack. If you need to go back and listen to some of these again please do or go to my website or go to the youtube channel. Menopause taylor and watched them on video and really solidify this education because this is critical this is this is the stuff on which people either make it or break it at my website you can schedule a consultation with me that will change your life forever for the better They are very popular. I stayed very busy very book. I love love love doing them. I am saving lives with for women all over the world and i knew them all on video platforms and i. I have my own video platform in the website. So wherever you are. I can do a consultation with you and it will be the most beneficial thing. You've ever done in terms of being proactive. Taking control of your health and making sure you know how to manage your menopause your way successfully and easily because no matter how you want to manage it. I'm biased. i cover everything. Diet lifestyle. vitamins minerals herbs botanical hormones. Non-mobile medications you see me doing these podcasts. Suspending i with all aspects of my education. So please go to the website. Please watch the videos. Subscribe to my channel and the more people you can get turned onto this education. The better off all women will be. My dream is for women women to get this education in their twenties and thirties. Because that would change the world in ways that we can't even imagine they would know what to expect. They would know how to address it. They would know all their options. So this is raw. Leave you today. I invite you to come back next week for another great podcast and thank you for listening. Thank you so much. See you next time bye.

diabetes heart attack asia europe diabetes adult onset diabetes insulin resistance us thirst extreme fatigue Long nate juvenile diabetes lucas abdomen high blood pressure se headaches High blood pressure diabetes
 Covid-19: how vulnerable are people with diabetes? podcast

The Guardian's Science Weekly

11:39 min | 1 year ago

Covid-19: how vulnerable are people with diabetes? podcast

"The The Guardian welcome to another episode of Science Weekly. We're continuing to take scientific questions about Corona virus outbreak and explore them in detail. We would love to keep hearing from you so please continue to send your questions fire foam. We've set up head over to the GUARDIAN DOT COM forward slash covert nineteen questions all in one word in today's episode. We'll be looking at something. Lots of you've been writing in about diabetes and whether patients with the condition are at high risk of developing severe symptoms of copied nineteen. We suspect there is altered or reduced effectiveness of the immune system in people with diabetes Mellitus. And this is more seen in people with Higher Blood Glucose levels or higher levels of diabetes. This is Depeche Patel. We're also beginning to think that actually abdominal fat which is increased in many patients with type. Two diabetes seems to be a potential for more access inflammation and that excess information is seen more commonly in people suffering from severe illness. Welcome to another episode of Science Weekly. I'm Sarah Bosley I'm Doug Depeche Patel. I'm a consultant in diabetes endocrinology. I'm also a honoree associate professor at UC l. So Depeche. You're currently working on the front line. I believe helping with the nineteen outbreak. Could you tell us a little bit? About how the last few weeks have been so confessed to my daytime specialty walking which is mainly outpatient based we've been assigned to ward work which is very different but I must say one of the most striking things about working on the front line on general medical wards is the fantastic junior doctors that we work with and we have to help us and their levels of dedication. I must say partly due to them. Morale is good and healthy and to seeing on a daily basis. Examples of team work putting together and focusing on our patients. You're a specialist in diabetes and more broadly and chronology very briefly. Could you tell us what is diabetes? So diabetes is a process of a reduction. In the body's ability to regulate blood glucose and this results in elevation of Blood Glucose detectable and if it is untreated for long periods of time this can lead to complications such as I disease kidney disease and lower amputation. They're boarded two categories of diabetes to type one and type two diabetes and Taiwan diabetes really correspondence to an insufficient amount of insulin. Produced by the body were as type two. Diabetes Is a process where that incident that's being produced is produced Sufficiently but incidents become less effective both processes lead to an elevation in blood glucose levels with your work on the ward. I'm assuming that you're doing. Also things are not just diabetes. Is that correct? That's right. We're seeing patients with general medical problems older patients who are suffering from curve in nineteen related issues so on average at any given week in adult inpatients Anywhere between fifteen percent to twenty five percent of patients having diabetes Militas At the moment although we don't have any official data within the hospital old UK. My feeling is we're seeing more patients than that due to the current cove nineteen Pat Democ other needs statistics in fact on that for the UK or globally as to the proportion of people with Kevin. Nineteen who do have diabetes one social the other way. We're still waiting for the official data from the UK. There are some data. That's come out of China and the prevalence of diabetes reportedly has been around ten percent. But I guess the also the important thing to notice. It appears that patients with diabetes seemed to be susceptible for developing more of a severe type of illness and it's reported that the risk of death is increased in patients with diabetes. Why do we think that people with diabetes might be more at risk so this is quite an interesting question that we will be asking ourselves? We know that people with Diabetes Amel vulnerable to sudden severe research infections. And I I guess that's one of the reasons why we offer old faced with diabetes an influenza vaccine every year. We suspect there is altered or reduced effectiveness of the immune system in people with type and this is more seen in people with high blood glucose levels or high levels of diabetes. We're also beginning to think that actually abdominal fat which is increased. Many patients with type two diabetes seems to be a potential for more accessible inflammation and that access information is seen more commonly in people suffering from severe illness. Yes I've noticed. In fact that the cases reported on from intensive care have shown up that there is a higher proportion of people with raised BMI. Exactly right and that's what we're seeing here would. Also I've seen some republic dates from New York showing also the rates of hospitalization being much higher in people who have obesity but also much higher than people who have more severe greats of peace ity. So we we now know that this is also a signal in terms of vulnerability to buy hospitalization animal survey disease and that might be linked directly to inflammation we know that people who have excess amounts of abdominal fat Already have a low level of inflammation more so than people with normal levels of donal front. Does this mean the borough saying hi case numbers for people with other metabolic disorders? That could lead to hypoglycemia. Usually these people have an underlying susceptibility to either diabetes or prediabetes on. It's the illness does unmasked that. But we're not seeing it really. In cases who do not have any predisposition to diabetes or prediabetes and some of our listeners including mark in Guilford have written in to ask whether there's a difference between what we're seeing in type one and type two patients. That's a really interesting question. I don't think we have any official data but we need to bear in mind that about ninety percent of all cases of diabetes in the UK. type two diabetes clearly. That's much more common form but also patients with type. Two diabetes are older and are more likely to have other commodities such as high tension or heart disease and we know that they are also seemed to be vulnerability factors in patients presenting with Kobe Tilmis it is also found that a lot of patients who have type one diabetes amish younger and maybe they also have a greater level of physiological reserve by the sole fact that they younger so I think we have any official on says but certainly local league in my hospital. We're seeing many more cases of type two diabetes rather than type. One Time Ts. Is there any chance? Toll that certain types of medication might be playing a role. I mean the medication. That people with diabetes might be taking. There has been some evolving discussion about a type of medication. Class called ACE inhibitors. It is salt. The Cova Nineteen virus enters the cell afire attaching itself to a receptor. That is cold. The H two receptor and we think that as two levels may be increased in patients with type two diabetes medications that patients use may also increase levels. Whoever I must stress this is still theoretical. And we just don't have the data to support this and something that's going to be subject to think significant investigation research in the coming months terrific number things. We don't know in fact on their about this. Absolutely I mean there are many many medical fields that are still learning a lot not just about the virus but how the virus also impacts on their special series of practice other listeners including Deborah have asked why diabetes is not currently on the list of most vulnerable conditions. Do you think this needs to be reconsidered? I think to Debra. That thing is a very good question I am. I guess slightly surprised that it's not on the list of foldable conditions. However we just simply don't have the data to support this in younger patients as Sedalia majority of patients with type. Two diabetes are one both older but also have other associated medical conditions that made them even more vulnerable to. We have data to support that. It's difficult to advise any advice. You'd give to those people with diabetes during these times things important not to worry excessively. It's difficult to I. Guess put in practice but it's important to check blood glucose levels regularly and best to do the things that we advise patients to do is to get plenty of sleep eat a well-balanced diet drink plenty of water. I would sign post the diabetes UK websites as a wealth of information for patients both covert nineteen related and general sick day rules the other very good portal of information for this including youtube videos for patients is the European Association for the Study of Diabetes. Ea SD thank you very much for giving us your time to bash and on behalf of all of us science weekly thank you so much for your clinical work. Thanks for asking me. Pleasure thanks to Depeche for joining me. This week diabetes. Uk are constantly updating their advice for patients. Sir If you want to find out more please. Head over to diabetes DOT ORG DOT UK. We'll also linked both organizations that depeche mentioned in the episodes description at the Guardian Dot Com. We would love to keep hearing from you so please continue to send your questions fire foam. We've set up head over to the GUARDIAN DOT COM forward slash Kovic. Nine thousand nine questions. Oman word from all of us here at science. Weekly stay safe. Stay inside and we'll see you soon. Put costs from the Guardian. The Guardian Dot Com put costs.

diabetes UK Science Weekly Depeche Patel Deborah official Doug Depeche Patel Oman consultant UC l associate professor ACE Sarah Bosley obesity Pat Democ
Ep. 8: Robby Barbaro - Having Diabetes Has Been a Gift

Plant Strong

58:55 min | 1 year ago

Ep. 8: Robby Barbaro - Having Diabetes Has Been a Gift

"Welcome to the plan strong. Podcast I'm Russell Wilson and I am super pumped richer here. It is my goal with this show to inspire you and also to provide you with actionable steps. You can take it home to not only eat more plants but to discover the best best you that you can be and the good news is I know. It's a new. Here's an unfortunate truth right now. Type two diabetes is a pandemic. They claims the lives of millions of people every year. But another truth is that it's preventable and reversible if you put the right lifestyle habits into play and contrary almost everything that you've heard all forms of this devastating disease can be mitigated and managed for the whole food plant based Diet during our recent heart of a hero campaign and Pittsburgh we tested every participant for cholesterol blood pressure weight and blood sugar. Before and after the event in fact one individual had a fasting pre glucose of three hundred eighteen at the start which was evidence of diabetes going completely untreated and unmanaged in just seven days. This person's post blood. Sugar came down to two fifteen following our seven day rescue challenge guidelines. It's still a long way to go but it's one example that demonstrates how the body quickly responds and West to heal when it's fueled the right way. My guest today is the super sharp super handsome Robbie Barbaro. He's the CO of mastering diabetes. A comprehensive program developed to help people both understand the science of insulin resistance and take control of their health through a healthy plant based Diet together with his partner Dr Cyrus Combat. They have just released their first book called mastering diabetes. It's an absolute beauty of a book. Highly recommended You can go to your local bookstore or Amazon to pick up a copy and I just got done reading it. And these guys have done an amazing job explaining exactly what is going on with every type of diabetes imaginable from type. One type two type one point. Five stations diabetes prediabetes. You name it. These guys are are all over it fair warning. There is a lot of information in this episode. So you may want to listen twice and take notes all right. Enjoy a welcome to the plant. Strong podcast season two as you know the theme This season is the heart of a hero. And so we're we're we're I'm interviewing people who really are changing the game in the in the plant based field and I can think of really no one better than the the young lad sitting across me right now. Robbie Barbaro Robbie. I think I've known you if I'm not mistaken I'm just until this out there. Like two thousand eleven or twelve. It's going to be somewhere around there absolutely. And that's because you used to work with With Brian Yes with Brian. Wendell WITH FORKS OVER KNIVES. You helped really kind of create that that empire. I'm going to call it an empire. We had a lot of fun. You got a lot of fun. And and then you kind of set sail on your own with mastering diabetes Cyrus Combat Cyrus. We we saw a need in and set out to fulfill it and that was. How long was that three hours to twenty seventeen is when we officially started mastering diabetes and I left forks over knives in the middle of Twenty Sixteen? And did you. Do you feel like you learned Just a ton with the work you did with Brian and marketing forks. Over knives to that you can then apply with mastering diabetes absolutely Working at seven is particularly with Brian. Wendell who's just a really special person. I always tell people. He is Fox overnight his brainchild and he's just brilliant guy his communication to sort of help execute the movie and everything beyond is really special so definitely getting the opportunity to work with him. Every single day we worked really hard Tirelessly to to get off the ground and to see it. Continue to succeed in the way that it has been really fun. Forks over knives has done so much for the movement so much for So many of the brands within the movement myself. I mean without forks over knives. I don't think you know engine to and myself would be on the map and it's really spectacular men. We're not do. Yeah that was. That was my. That was my big line. So I WANNA talk to you today about mastering diabetes the but specifically you and Cyrus just wrote a book yes. What's the name of it it's called? Mastering diabetes is subtitle. There's a subtitle. It's called the revolutionary method to reverse insulin resistance permanently in type one type one point five type two prediabetes and just ational diabetes. That's a that's a pretty a pretty strong statement right there. It's a strong statement and permanently is in Italic intentionally because we really mean it and when when you optimize your lifestyle when you follow the principles totten this book you maximize Your Insulin Sensitivity and insulin resistance is a thing of the past gay so you just said a mouthful there and I know for you because you're in this space you know it just seems like you know brushing your teeth or putting your seatbelt but I think for a lot of people out there. It's like I think we gotta break apart that sense and before we do I wanna I wanNA know a little bit more about Robbie. Okay so in this book Cyrus introduced. You're introduced and next to your name. It says the Seeker Right. So tell me why. Why is your nickname? The seeker and let's let's know a little bit about your journey and got you to where you are right now. Yeah so my journey particularly with diabetes. It started out with the idea. That I'M GONNA reverse type one diabetes. Okay so that's where the secret comes from. Let's take a step back all the way to the beginning okay. So what is where you so? Type one diabetes. Why don't we start there OK? Okay yeah so I was diagnosed with type one diabetes. I was just about to turn thirteen so I'm thirty one now. By the time people listening to this I would have lived with type one for twenty years. Okay now type. One is when your pancreas has been damaged. We don't know exactly how you don't know the cause. But the panthers has been damaged and it does not produce sufficient quantities of insulin anymore. And Insulin is a hormone that is responsible for taking. Blood Glucose or glucose from your bloodstream into your cells. That's insulin function okay. My pancakes is damaged. Doesn't produce insulin. Longer I need to inject insulin to manage my bug coast levels that is type one diabetes. So you're injecting insulin. That can then escort your sugar into your cells food. You Eat Yup and and I'm trying my best to repeat some of the stuff here so it sinks in please do please do. I like that okay. So now the other most common type of diabetes type two so type two. That is when a person's actually producing plenty of insulin. Most in the beginning they're producing too much. Okay I've excess insulin. But their bodies not using it properly. Bats type two diabetes. Also prediabetes is similar situation. So so when you say. Their body is not X. accepting it so it's rejecting it exactly right okay. Okay develop insulin resistance. Okay and we'll have to. We'll talk about that in a SEC. Okay Yep so then. I'm just going to go back to that title. The book also type one point five diabetes when the world's at so that is a slow onset version of type one. So there's still a little bit of insulin production a little bit. So pancreas isn't completely decimated exactly of the again. This is where we scientists don't really know. We don't know exactly what's going on. Why do the type one's just have their pancreas completely obliterated and Produce Basically Zero Insulin? And why do people with type one point? Five has such a slow onset of the condition where they're just kind of slowly progressively getting worse and worse over time. We don't fully understand it but it's real and there's a lot of people who are getting misdiagnosed. They people say their doctors will tell them how you're living with type two but really the living with type one point five. They don't have enough insulin production so we help people and and is there a certain like like in my experience it seems like type one usually happens under the age of ten usually? I don't know if that's true. So used to be like that. Used to be called juvenile diabetes and then type two adult diabetes and now over fifty percent of type. One diagnosis happens in people over the age of twenty. One say that one more time fifty percents diagnosed with type one. Our older than twenty one right now. That's that's crazy to me. It is okay so so that's type one point. Five is where your pancreas is producing a little bit but but not enough exactly at prediabetes. That's you're on your way to type two diabetes and so you have a little bit of the beginnings of insulin resistance exact okay so and then the last thing you say is occurs during pregnancy. So that only happens for females. And it's really again no situation of insulin resistance. That's the core thing this hormonal things going on yet but in some cases is the core problem once again okay So if I was to clump all these together in under one umbrella called diabetes what percent of Americans are currently living with type. One point five two prediabetes or station diabetes. So it's over one hundred and ten million and there's eighty million who are living with prediabetes. Don't know they're living with so. Should we add the one ten an eighty does that? No no one includes. That's okay okay. Okay 'cause I twenty six million with diagnosed diabetes. Okay so that's that's a good third of America. Yes so right so to me. You're mastering diabetes book and programs. You have a large audience we sure. Do we have a lot of people to help? Wow a lot of people to do. You want to explain more about your journey and the Secret. Explain that so now we understand what happens in twelve years old. I get diagnosed with type. One diabetes actually basically self diagnosed myself. I have two older brothers and the middle older brother had type one diabetes four years prior to my diagnosis. So I was complaining to my mom for two weeks came on. I think I have diabetes. Just like Stephen. She said No. No No. Don't be silly. You don't have diabetes. So then she goes away for the weekend with my dad looking at homes in Florida and we're living Minnesota at the time and my mom calls a check in. She says hey how you doing. I'm like mom I couldn't sleep last night. I was cramping she said. Okay go upstairs. Use Your brothers because meter and test yourself so tests myself and I'm over four hundred. You're supposed to be between eighty and one thirty so my bug because was sky high and my brother said then and there you have type one diabetes. Pack your bags. You're going to be in the hospital for a few nights so we went to the general doctor. They ran some tests. I'm not exactly what they tested. But this idea you're type one then I go to the hospital for a few nights. My parents flew home from Florida. And I remember my dad saying look. It's just an inconvenience. You can still do whatever you want in life. Don't worry about it. It's just an inconvenience and that impacted you. Yes have a huge impact on me and I really feel like the way my parents parents at me through this allowed me to not let it take over my life. It was just a thing you just handle it and everything is okay and right now thirty one. Would you say that having type one diabetes is one of the greatest thing that's happened to you in your life absolutely that? That's a huge blessing in disguise. And it's giving me so much purpose I get to help people. It's taught me a lot about my own body what I get to see every single day with this whole concept of insulin sensitivity to we're gonNA talk about It's really powerful now. I will say it's part of my journey being the seeker. I'm ready to get rid of it. I learned the lessons. I'm happy with it. I would like for nobody living with type one to have to live with it any longer and for people to not continue being diagnosed. I would love for that to happen now to your knowledge. Is there ever been a case of type one being reversed so there are some rare random situations that are not repeatable and a hard to explain so nothing in research? There's no evidence based studies showing. Hey if you do X Y and Z. This will likely lead to the reversal. Which basically means. We're trying to figure out how to get Beta cells to work again so type. One diabetes technically classified as an auto immune condition. So I have. Antibodies that are said to be attacking the Beta cells or insulin. One or the other so even if I was producing new Beta cells right now I have antibodies. That would then kill them right so we don't understand really exactly how to solve this. But that's that's the situation right so anyways as a seeker that is a mission. I went out and said I'm going to be the first one to solve this. Hey if Roger bannister could run down. Everybody believed that wasn't possible. The smartest people in the world smart scientists said that's not possible and he did it and then other people do it so somebody's got to set the trend. That's just human history. Yeah so we're we're gonNA figure this out. Somebody's figured out. I'll and I'll just give the example of you. Know Look what Dean Orange and my father were able to heart disease absolutely right and it was an. It's funny how people in the Profession. The cardiologists didn't think it was possible. And so it took basically two doctors outside the the fold to basically show that it was possible. I think it's perfect. It that maybe you and Cyrus are able to figure this thing out. Make it happen. God people that do that huge. Yeah so anyways. That's sets me on this path of doing anything and everything to optimize my health. So my body can create. Its own new Beta cells. That's the mindset mine says his bodies infinite wisdom. Does this amazing healing. You fathers reversing heart disease. It's the body that's actually doing. All the fixing repairing giving the right nutrition and lifestyle habits. So I'm like okay. Why can't we do this type one this? This shouldn't be that hard to just get some new cells working again and that set me on the path of just learning everything and anything I possibly could about getting my body to function at its highest level. Okay and so So what point on this journey as a seeker did you discover a whole foods plant based nutrition so in September of two thousand six? That's when I heard a podcast by a man named Doug Graham Yup talking about eating eighteen ten and vegetables. Okay so here this podcast. And he's talking about this book. He has coming out so I learned from the podcast starts to eat more fruits and vegetables and getting excited about it because prior to that I was doing a plant based Diet and not feeling well. I just need to stop you for. Yeah no one. You remember the. You're doing Kyodo Diet. So you were sixteen fifteen plus years ago right And relieve in podcast. Then there was this your raw Vegan radio with Steve Bruce Act. That was the show. I mean. That's that's pretty impressive. Yeah Wow I thought. Podcast started in two thousand ten. I think looking back on the show. I should've started a podcast. Okay before that you're doing Kito. Yeah so before that I was doing a plant based Kito Diet so I was eating lots of Greens lots of nuts and seeds lots of oil and I felt terrible okay. I was taking the least amount of insulin. I've ever taken my blogger coast was pretty solid but I felt terrible so went back to a natural path and trying to figure out what should I do? Do you have any options for me? She said maybe. Do Some curation therapy. Maybe it's heavy metals that are problem and I was considering it. This is going to be very expensive. It's going to drive from Gainesville University of Florida where I went to school to Tampa to get this done and in between that I heard this podcast with Doug Graham and he was saying if you eat well that actually nutrition can help you read your body heavy metals. And that was very intriguing. So He's got this book coming out in December of two thousand six between there. I started eating more fruits and vegetables and figure things out. I read the book straight through and Cyrus is one of the testimonials in the back of the book so I started googling his name. This was in two thousand in two thousand December. Two thousand six because when the book comes out. Okay we've been at this for a while. Both of us combined means Cyrus so he was in the the book and I was really. I was definitely inspired by that testimony when I go. Google his name. I see pictures of him involved with this organization called organic athlete. He's doing biking. The Dude looks. Rip On like this is cool. I'm GonNa do this so I signed up for coaching with Dr Graham. One on one coaching best decision I ever made and I learned how to start eating fruits and vegetables from the expert and figuring out how to manage my blood glucose along the way and when I started I literally just beneath for the first week. Rip Just Bananas. This is Christmas okay. My grandmother is in town visiting. I come down for Christmas dinner with a Pyramid of bananas on a plate. Five on the bottom and for them. Three legit peeled banana. I'm looking at a crate right there. You we're not messing around when it comes to bananas around here so and I started doing this and the fact that I'm eating all these carbohydrate rich foods put your told to avoid and seeing my insulin sensitivity. Sore was mind boggling. It was fun. It was exciting. But still mind boggling and I wanted to learn more and that's what I kept on doing and the at that time they were good good research. Navarre material out there like this does spend literature for a long time so okay a long time. How long is a long time that this stuff is years? Goes back to one thousand nine hundred twenty. Six doctors. Sansom was one of the first studies of patients being fed a high carbohydrate diet and seeing their insulin sensitivity improve all right. I'm impressed. So what was Gimme another study? Sometime between nineteen twenty four and nineteen fifty. He name another one okay. How about nineteen thirty five? Dr Rabinovich publishes a five year results of basic fifty patients eating a low carb diet carbohydrate diet and fifty patients eating a high carbohydrate diet and he sees that insulin sensitivity improved. I think it was. It was like sixty percent or something whereas in the low carbon was like one percent. Wow and then in nineteen fifty five hundred. Give me give me five more years. Okay we have. We have publishing a paper in the Lancet where he has eighty patients living with diabetes. All using between twenty and one hundred twenty minutes of insulin feeds them a low fat diet. Thirteen percent of calories coming from fat and every single one of them saw reduction in their insulin. Use Eighty percent stop using some completely in eighteen weeks eighteen weeks so that's a little over four months. Yeah four and a half months yeah. That's impressive so the science supports exactly what you're saying and it has for a long time. I've every level so here's nothing to the contrary. That's the interesting part. So there's some things when it comes to nutrition admittedly confusing if you go read the research on fish you see things on both sides and even the researchers right in papers. Oh we looked at this paper and that was said this in this paper said that like the mentally but when it comes to insulin sensitivity on a low fat diet there is not a single study to show that it doesn't work everybody who did it every time it truly applied right. Maximum of fifteen percent of calories come from fat showed a significant improvement insulin sensitivity across the board. Yeah that's huge. So let me ask you this in in one sense. What is your prescription to mastering diabetes? And Yeah what is it? In one sentence one sentence sue eat a low fat plant based whole food diet with a maximum of thirty grams of fat per day. Thirty grams of fat. And how what percentage is that fifteen percent Samak's so okay so it can repeat that to you please. So low fat. Meaning fifteen percent of your calories coming from fat or less plant based whole food diet and I think we want to dive a little bit into the Hofu plant based. Yes but what's interesting to me? Is that that what you just said there? That completely defies traditional medicine medicines wisdom regarding how to treat this because because their whole thing is a local low carbohydrate high fat right. It's the exact opposite so it's the exact opposite of Italy and so I mean it's almost like you're telling people listen. I know that you think that the world is flat there. Let's say they're they're thinking the world's flat it's actually round and they're like that no they can't be that way. I mean that's almost like the the the battle that you're having to fight. It's exactly what we're having to fight. And the confusion is understandable and legitimate diabetes is one of particular diseases where we are self diagnosing or self assessing meal by meal with our own instrument. You can't figure out did you. Heart disease get worse or better meal by meal. There's no test. But when a person living with diabetes eats a bunch of bananas and they test their self and their two hundred the two hundred and fifty they say. How can you tell me that the bananas are not the problem? They just made my bug assault. What are you talking about right? I get they're coming from but what they don't understand is the reason their body was not able to metabolize. The bananas is because of what they ate prior because their insulin resistant they have eaten a diet. High in fat particularly saturated fat that has resulted in the storage of fat in tissues. That are not designed to store fat and that resulted in insulin resistance. So they ate the Banana. Their body was not capable of using. Its own insulin. To Take the glucose in the banana are the stream into the cells insulin resistant. But it's not the bananas fault. No it's not it's fascinating. I think it's one of the reasons why you said in that. One study in four and a half months was at eighty percent or something like that. We're able to get off there going to get to you in better to want to go in one thousand nine hundred seventy nine. American journal Clinical Nutrition James W Anderson. He had twenty patients. Okay they were all using insulin and in just sixteen days. He got half of them off of their insulin in sixteen days eating high carbohydrate diets this diet was nine percent of calories come from fat as well over seventy percent of calories from carbohydrates it was a high fiber diet and in sixteen days half of them get off their insulin. The rest of them also decreased their insulin. And there's a lot of these studies. Yes they're small numbers of people in many studies. You know when you look at research but the consistency in small numbers is a very big deal from study to study to study. I mean in your work with Nasrin Diabetes. Because you've got a pretty sensational online program with literally thousands and thousands and thousands of members. Yes do you ever encounter somebody that is compliant and doing everything right and they're not getting results. I love this question so the answer is no. I have yet to see it. I personally see it with my own eyes. Now I've talked to some doctors and you know who've been in this field for a long time and they always like to say hey. Be careful rob. I have this example of that random example and one person was low in chromium or something so the doctor had to fix that. And that's all the problem but I personally have yet to see it. Particularly in people. Living with insulin-dependent diabetes whether that's type one type one point five or insulin-dependent type two. Some people have had type two diabetes for a long time and just a pancras as exhausted. And so they may need to inject and some for the rest of their life because their pancreas has been burnt out. Okay so in. People who are living with insulin-dependent diabetes all fascinating test subjects. We know exactly how much insulin we injected. We know exactly how much food we ate. We can measure our insensitivity immediately and so with people living with that every single time they will increase the total carbohydrate content and they will use less. Insulin repeatedly never seen. I would love for somebody listening to this. Podcast to a friend senator skeptic. Show me the person who can actually prove they truly did it right and they needed more insulin. Because it won't happen and to raise the ante there rip one of the things. I'm proud of is that I have documented every single thing. I eight for three hundred sixty five consecutive days. I have a picture of everything the winning my mouth every bug because reading every insulin injection for three hundred sixty five consecutive days. Now I've done that for many more total but there was a year. I said I'm going to do it every day so if anybody was like. Hey no I don't want to show you pictures. Well no excuses here CDU at post your pictures on Instagram and showing that it doesn't work because well what I love about that in in it. Sounds like your program is that you want people. That don't mind being accountable. Yes right and if you're willing to be accountable if you're willing to work the program it sounds like the program works. Yes as long as you're willing to be vulnerable number one thing if you come into our coaching program is all I ask. I one thing communicate with us Just having the willingness to write whatever's going on I don't care how bad you failed. How far are you out the way it doesn't matter? Yeah taking that step to communicate this happen. I'm struggling. Can you help me that you would? That person will succeed if a plant based diet is ideal for humans. And we've learned that dogs are. I'm divorce as well. Can we just share our delicious leftovers to our pets? Well the answer isn't quite dead simple and it's probably not the best idea. Dogs actually can't safely eat everything that we need specifically. Let's take a look at some green leafy for example Kale. It's a superfood for us. But according to Dr Ernie Ward. Who's the veterinary medical officer for Wilder Dog Food? It's not such a great idea for our dogs and the same goes for spinach and cabbage and some other green Levi's but luckily there are plant based foods and specifically proteins that are ideal for dogs and all of them are included in the wild earth. Dog Food formula that our dog jade love so much and that. I'm sure your dog will as well visit. Wyler'S DOT COM or Amazon and use the code plans drawn to save forty percent off your first order. So your book is broken down into four components. I don't WanNa talk about all them. We don't we don't have time right now but I want to dive into a little bit more. Specific number one is a fat plant. Based whole food nutrition that is the first component and you break foods up into green yellow and red foods. What are Green Foods? What are yellow foods? And what a red foods okay. The green light category. These are foods that you can eat when you're hungry until you're satisfied okay. I'm not telling people to just stuff themselves and overeat on these foods but you can basically eat them ad Lib Dem right so in ad limited means as much as you want so much as you want all right so and these are in a specific order. Okay aware well-thought intentional order number. One is fruits bananas. Pears mangoes apples offer. It's number two starchy vegetables. Potatoes Yams butternut squash number three. We got beans peas and lentils. Okay Yup Number. Four is intact whole grains those first four in the green light. Category Are All coury providing plant foods so we really want people to learn how to eat in a way that they can sustain so a lot of people living with diabetes. They're scared. The Blood Glucose numbers okay. They're scared in the beginning. What's going to happen and so we actually have two separate meal plans in the book for people who are very insulin resistant. How to sort of mitigate those spikes in the beginning okay there's ways to do that is certain strategies but the point is I don't WanNa see people start eating lots of salads lose weight see better readings but then be starving and not be able to maintain it eventually go and have a cheeseburger and then feel better because they finally got the calories they were looking for. Yeah so we really want to emphasize these calorie dense green light foods as the staple. Okay this is not a vegetable diet. So but so the green their calorie dense their whole plant based foods intact grains potatoes fruits vegetables. There are definitely vegetables so non starchy vegetables leafy Greens. Yep Herbs and spices and mushrooms. Right okay out. The green light caddock. Okay and would it be correct for me to say that all those foods that you just said are have a calorie density of six hundred calories per pound or less? It's close to that. We made the cut off seven hundred. Okay chickpeas are kind of like around there. And they're cool. We're cool with that. The chickpeas are happy that we left him and and really a lot of that. Research comes from Barbara Roles at Penn state so it becomes fuzzy line. Where are you going to really draw? Line CHEF? Aj Jaws at at six hundred really through our coaching program and through personal application. We can tweak it. We'll make adjustments right right. But the general guideline is right around there. Okay so those green foods love it. That's complete alignment with the engine. Seventy rescue program all right. What about the yellow okay? Yellow light foods. These are still very healthy. Still should be a part of your program but these are not foods you get to Adam you have to be conscious about. How much of them near consuming? Okay so either high in fat or they're a little bit more processed. Those are the two things that will put a food in the yellow light category. GimMe Gimme some example. So a higher fat plant based food would be avocado nuts and seeds. Coconut Meat Olives. These are very healthy foods. Their whole foods. They're plant-based they're just not low in fat and it's very easy to many nuts. It's very easy to Avocado. And that will impact insulin sensitivity and your ability to manage your blood glucose levels what about dried fruit category. It's not whole right. And it's easy too much calorie dense. He's just way too high. Even dates dates. We technically dates our whole food. But the calorie density is over a thousand calories per pound. And it's just easy too much most people who are GONNA pick up. This book are looking to lose weight and dates are not going to help you do that. Now there's other things in the category which little more processed those are things like Brown Rice Pasta or Zeki Brad. Okay again healthy foods. You can be very great part of healthy program even weight loss but it's just be aware be conscious of those foods they're hiring calorie density there little more processed. It's better to eat the original ingredient that that food was made out of Brown. Rice is better than Rice Pasta. Yeah but Gareth plus is still great and that's why the yellow category is defined as eat. It just don't go crazy. Right was was the last time you had a handful of nuts so I have tried to take Brazil nuts and buy a bunch and Putin in my freezer eat one day. I thought that's a good idea. Why not let with AC? I'm not worried about my selenium consumption. But I thought I'll try it. I can't do it either. Eat them all right. So I don't put in the WHO's no nuts in my house? So you just did you so you just don't do nuts because a you don't actually need them for any particular reason or even the selenium in one. Brazil you do not there for Dr Michael Gregor okay. So what about what about dried fruit you? Do you do like dates or anything like that days? Treat LOW BLOOD GLUCOSE READINGS. Okay and again. This is where we get into the. I'm glad you're asking these questions. Because he's really important and we love. This is really are passionate. Mastering IBM is coaching and the specifics for each individual to achieve their goals. I'm not worried to lose weight like I'm out of good wait. I'm very active me. Using dates. To treat. Low Blood Glucose. Readings is perfect for somebody. Who's in that position? And that's why I use it for. I don't sit down and eat a meal of dates. Okay let's move on a Red Red light foods. Read by foods are going to be all animal products. That's GONNA be beef chicken fish shellfish all of it okay then also going to put in there really processed foods obvious things like you know a Dunkin donut very just process stuff and that includes some of the new process Vegan items which again. We're supportive of their healthy. They're changing the game. They're bringing a lot of people into this. You're talking about like the impossible trying to reverse insulin resistance. If you want a reverse type two diabetes. Now it's not a good idea. It's not good it could be a good transition. I don't depending on where you're starting at but long-term we're going to put down the red light category which he wants you to either. Never eat or really really minimize. Well if you if you look at the nutritional of a beef burger or even impossible beyond burger you'll see that there are anywhere between fifty to seventy five percent of calories coming from fat right and and typically Five to ten of those grams of fat coming from saturated fat. Which big problem. Big problem if you're trying to reverse your diabetes. Okay so those owed once your dad hear that yeah so all oils all oils. Yep Yep okay so. Those are the green light yellow light. Red Light Foods now. I want to continue down this path because I I again we could. We could talk forever forever so but so a lot of people are concerned or want to know. How much food can I eat? And you guys have five kind of guidelines rules in your book. I'm going to name name them. And then if you could just talk a little bit about them please. So number one is you say. Don't count calories. Just eat until you're satisfied. I mean I love that because so many people these days right. They're measuring their measuring laying their food. They're counting their points. They're looking at portion control in. It's like a scientific experiment. Yeah so you say put that. Throw that out the window when you start eating whole foods that are loaded with fiber loaded with water content and loaded with nutrients the nutrient density of those green light. Foods are through the roof when you eat those foods and you are predominantly eating the green light category. Your body tells you and you've had enough Natural mechanism the natural feedback of. I'm good. I'm satisfied and you just go onto your day and when you're hungry you eat more without overthinking. Yeah so you have a you have a calorie density section in your book and you basically say Calorie density can be a lifestyle of abundance. It sure can right. I mean hopefully I mean you're you're telling me it doesn't have to be about deprivation to abundance. That's exciting. It's really exciting. Particularly in the world of diabetes health where people have been told. It's all about limiting. You can't have too many bananas because it's going to raise your because level you can't eat keen walk. It's going to raise your bug because you can't have too many beans. You know maybe a copper here there now this program. Yeah Yeah and and the key for the key I think for people to know about Carrie density and eating until you're like comfortably full is the magic of the bulk this in these foods. What comprises bulk okay. Balk is fiber plus water. And you get a whole foods whole food. Am I going to get that in a date? Yes you are going to be lower in water content. It's going to be quite high in fiber okay. But a little bit lower in the water content which is a big point and that a raisin raisin exactly rape. I'm good yes okay. You have some examples of calorie density so just because this this to me is I'm very proud of the way the illustrations of this so you say three tablespoons of peanut butter is the same as one large. Baked potato. That's right which I'm like cool and then you give. How many grams of water hammer grams of fiber are in each? And that to me is very telling and because you don't have the book in front of you you know. I don't WanNa put you on the spot like that but you say that there's one gram of water in three tablespoons of peanut butter and two point five grams of fiber versus the Baked Potato That has two hundred and twenty four grams of water and six point. Five grams of fiber. That illustrates the whole thing about bulk equals Africa vertically in water. People will see Sarah's not eating a meal and be like wow. That's a lot of food and I know it's deceptive. It's a lot of water right right eating our water. And it's the purest water you can possibly consume. That's a big conversation big debate. What's the best water to drink? Number one is get it from your food. Nature has purified water. Yeah yeah and I will say. In addition to those images of the side by side my favorite illustration in this book is the one that compares a full day of eating versus individual foods so a full day of eating a ton of food of Apple. Banana breakfast lunch and dinner. Huge plates has fifteen grams a total fat for the entire day. Which is the number one teaching point that when you eat whole foods you get fat. There's no like added fat there. Okay and so. Can I stop you project so I think it's important for people to know that this is? I mean we said in the very beginning. It's fifteen percent calories or lesser coming from fat. But it's not a no fat diet because all the fat you need is there in its inherent in the food. It's a hair in the food and we do have an insurance policy just to make sure everybody's covered of having ground. Chia seeds of flax seeds at breakfast. You automatically meet your essential fatty acid needs right then and there everything else. Get from whole foods is a bonus when you say essential fatty acid needs. What do you mean by that? So that's Alpha lipoic acid and they're like acid so your Omega threes and a mega sixes. Gotcha that's what you got. You know you gotTa have a very small amount required up and as an essential because what you buy does not produce them. You need to get them from food. Okay I want to move on to rule number two here. Yes pay attention to total fat consumption. Yes I feel like. We can actually just kind of but anything added to add to. It's very simple. You use. We teach people in the book that it's smart to use nutrition logging software in the beginning of your journey. We don't want like you said we don't want people counting things and putting all the time like that's ridiculous you don't have that for your life but in the short term you learn a lot when you put your food into interest logging software So I use crime meter. That's what we teach our members to us. It's a really simple easy to use software and so when you become aware of how much fat you're eating it's mind blowing right but you gotta you gotTa put it in the data to see right so you gotta play play the game not understand and also I would imagine too if if you've got diabetes and you WanNa know how many carbohydrates you're taking in. And how much insulin you need to be using. It's important to maybe be logging all that and so. I mean you probably still are absolutely so. The mastering diabetes method has four components. The first one is low. Fat plant-based Hofer Nutrition. Yep Number. Two is intermittent fasting. Yup Number Three is daily. Movement and number four is decision trees. So what you're talking about is what it takes to fill out a decision tree and that is absolutely required. It is absolutely essential part of this massive diabetes method. And you're right for people using insulin. What happens is they become very sensitive and they start taking too much the insulin. They're injecting working too well. Lots of logos readings and that's dangerous by filling out with decision trees. They can prevent that and understand. What adjustments to make based on objective data is all about empowering people with diabetes to take full control of their health. You don't need to rely on other people to tell you what to do. You collect the data. The data tells you what to do. Gotcha rule number three. Remember all whole food plant based Foods contain Barbara hydrates fat and protein. Yes so nobody needs to worry about protein right no need to worry about post. Don't worry about like overdosing on carbohydrates right. Now have you. Have you ever been hospitalized for overdosing on carbs? I have not so the other day you said you had seven hundred plus yes grams of carbs. I mean that's almost three thousand calories and most importantly is that I injected twenty six total units of insulin. Now a normal. What does that mean? Healthy human pancreas is gonNA use somewhere between twenty five and fifty okay. That's what a normal healthy human packers. Going secrete okay. You're you're you're somewhere around the fifty over the course of a day every other day. Yes so people who are living with type one diabetes. A great test subjects for this there will be people who follow a low carbohydrate diet. They will eat very low carbohydrate diet. They will eat thirty total grams of carbohydrate and inject thirty units of insulin thirty thirty. That's a one to one raise. Yes whereas yesterday I was over a thirty two one ratio for a twenty four hour period. So the magnitude difference that we are talking about here when it comes. Insensitivity is quite extraordinary. It's mind blowing because again if you're listening to this show you probably into plant based eating. Share it with somebody. Who's Nah okay? Share these numbers. Somebody who undertake wait a minute. That people don't believe Me Rep. I post stuff on instagram history. On Story People Reply. Back to me. They say that doesn't look like one hundred twenty six. Are you sure you're counting right? Yeah and I say yes. I'm using food scale and I put things into chronic meter because that's what I do living a person living with type one. I'm very aware of what I'm eating and people are just floored. Well I'm looking behind me right now and I'm looking at this wall of mangoes. Persimmons peaches I mean God what else. Oh papy I mean it is phenomenal and I mean this isn't for a family of eight right. This is for a family of one. Robbie and and Mr Barbera right. That's it and you're GonNa go through this in what period of time I would say about a week. We can have. Wow but again a lot of water. Yeah it's beautiful water yes okay. So that that's that's good so Rule number four treat fruit like it is your best friend and you are doing that. I absolutely am and again that runs. I mean how many I we had. We had a woman that was at one of our engine to medical emergencies just recently and she you know her doctorate. Put Her on a Paleo program. She hadn't had a piece of fruit in over a year and she was literally frightened of what a fruit would do to her. We've had people come to our coaching program. And their first step towards eating more fruit is just holding it. Thinking one of our clients. I think my love because we're not just holding the apple. People are very scared for again for good reason. I understand where they're coming from. They all absolutely had the experience of eating fruit and seeing the bug because sore. So it's really a lesson in. What is the core problem here? And so the reason we teach people to treat foot like it's your best friend is because of the nutrient density because of the water because of the fiber. This is actually going to address the root problem. Which IS INSULIN RESISTANCE? That's the connection across all of these forms of diabetes. That's where we are united in our coaching program in our community. And everybody would working with this a lot of the public and divide between type one community and type two and people type one get upset when people see them and be like. Oh you ate too much sugar. That's why you have type too much cake. You know like no no no. I didn't and if I hear somebody say that I'm like great. That's awesome glad you have an awareness that it's diet that is leading to people living with type two diabetes because that's true so I'm grateful for that awareness but we're bringing this all back to one simple thing. What do you got to do to maximize your insulin sensitivity to insulin? I inject work more efficiently. And what are we? GonNa do for people having a prediabetes and type two diabetes to make their Endogenous Insulin Insulin. Inside their own body Yup make bat work. Properly and fruit is your friend in that game of maximizing on yeah and just so we were hammering home for people. The the reason why they're insulin resistant. To begin with is because of all the fat that has been packed away in their cells. Right where we're really shouldn't be vastly right and by eating this way. A whole foods plant based low fat diet. Your body is now an. I'll just use this term. You tell me if you think it's fine metabolising away the excessive fat. That's in those cells exactly right and now without the excessive fat in their. Your cells are now sensitive. Yes not rejecting. But they're sensitive to the the insulin. That's going to escort the sugar in. It's exactly right okay. All right and then the last thing as far as you know when people won how much can I eat? Is Log your your food. You kind of already addressed this but You know I think it bears repeating. Yeah and especially because people don't understand how much fat they're eating. It's so hidden. People don't understand how much fast ruling that tablespoon of all oil eat the salad. I thought it was really healthy. I probably low in fat but that olive oil. Just screws it up well okay. But conversely I think it's important for people to know that they would be blown away when they're eating fruits and vegetables and grains and beans. How much fat. They're getting a very good point. That is an excellent point so if I look at the foods behind you Like mangoes do you have any idea. What percent fat mangoes? I don't off the top my head but if I had to guess it's going to be somewhere around five to seven percent. Okay I would. I would guess seven percent. And what about a banana again? I don't know for sure but I think the average I think is gonNA be between five eight percent for fruits and what about Rubella or one of your one of your favorite Greens actually have more fat than people would imagine. I think I think lettuce is in the twenty percent range double check. Yeah my understanding. Is that green leafy? You're dark green leafy yeah are typically somewhere between nine and eleven percent fat super locale toilet yet but but so. You're still enough there when you eating them in large volumes it matters right but so you're you're you're cronin meter you're putting it all in there and it lets you know over the course of the day. Exactly how many grams of fat that you're getting and typically how many you get so yesterday with you know eating over three thousand calories over seven hundred grams of carbohydrate eating no. Overtly fatty foods no nuts and seeds avocado. I had eighteen grams of total fat grams. So I'm GonNa just so. A gram of fat is about nine point five calories so I'm going around that up to ten. So that's one hundred eighty calories out of your mouth. Just call it three thousand zero so you do the math on that and ten. So that's actually that's somewhere around six seven percent. Yeah I'll give you. The exact number. Yesterday was six percent. Yep It was six percent and what about your protein? What percentage of your calories are coming from protein for me is actually a little bit lower? It's six percent six percent. Well you know what I mean like. According to all these nutritional authorities your protein consumption too should be between five to ten percent ten percent at the high end. Yeah so you know what? It works beautiful. You bring up a great point here. Which is the foods just automatically have what you need. Yeah we don't need to make this too complicated. Yeah well what's interesting about this experiment that I'm having with you right now is that I want you know I have never done what you're doing. Never log my food. I've never figured out. How many grams of protein carbohydrates fat I get and so I find it fascinating. Yeah and just knowing the way I eat verse how you eat. I know that I'm getting probably twice the amount of fat. I'm probably getting you know higher amount of protein in there because I'm eating a lot more beans and stuff like that but anyway log your food and to be clear. People following the mastering diabetes method. Can he just like you? This is not like just like rob your Cyrus right book right. It's very personalized and we are very passionate about that through our coaching program. Which is you have to love the food you eat if you don't love it if you don't take the time to explore new recipes and try new things and eat new foods and figure out what is really enjoyable to your palate. You're not going to stick to it. Yup and so we really encourage experimentation and trying to eat different foods you and I. We need to sink our teeth into a couple mangoes as soon as this is over. Okay absolutely like I'm just eyeballing these routes behind you the whole time and I'm like drooling inside well. Listen this book When can I pick up a copy? February eighteenth right well so that was. That was two days ago. Pick it up right now. Wow so it's available. And if I want to know more about mastering diabetes you know everything that you and Cyrus are doing work and I go. The best price to go is mastering diabetes. Dot Org and you will see everything you need. Their ticket started. Fantastic well a I want to have you back because I feel like all we really spoke about. Today was the first component of your book right. I'd love to actually come back and talk to you about intermittent fasting and the role that that plays in mastering diabetes led to talk to you about daily movement. And then maybe we can explore the decision tree again a little bit more so that Robbie I want to thank you for letting me come to your home like where I can see the beach. This is like heaven right here. If I was thirty one again I WOULD WANNA be right here doing what you're doing man. What a life You're doing amazing work. You have the heart of a hero. Thank you for the the difference that you're making in in making keep all over the world healthier. I really appreciate it. I just want to say thank you for everything you have done to sort of set the stage for people like Sarah and myself to come in and participate in this movement. You are a true true leader. Your an amazing example of a human being that just cares. this cares about people and amount of traveling and lecturing. You do look the sacrifices you've made for family time to get this message out is like not GonNa notice is really appreciate it. Thank you thank you. My plan strong rather piece engine to keep plan strong in my ten years of providing plant strong programming. We have always stressed the importance of knowing your numbers because you can't manage what you don't measure if you attend. One of our retreats biometric screening is included. So we can show you just how effective the lifestyle is even within a week to start. Healing your body from the inside out. I'm excited to share that. We have partnered with the nation's largest direct to consumer lab testing company to give affordable access to hundreds of tests and up to eighty five percent off retail one of visit plants drawn dot com slash Ludwig to see the tests that we recommend and those that are available to you. You'll have your choice of using her labcorp or quest diagnostics and you can get your numbers checked today again. Land strong DOT COM backslash. Blood Work Right. I hope that your is inspired as I am after that riveting conversation with Robbie we're GONNA share links to his website and the new book in the show notes if you're listening on your phone through any of the PODCAST platforms simply. Scroll down in the player to find links to all today's resources next week. What's going on? Well I'm headed to Cleveland and I'm going to jump in the kitchen for some culinary inspiration and general mayhem with my sister Jane and my mom and Kreil S Allston. Thank you for listening and subscribing to our show. I want you to know that we read each and every one of your reviews and we appreciate each and everyone. If you WANNA learn more about this season or today's guests and sponsors please visit plans drawn. Podcast DOT com the plan. Strong podcast team includes Scott Vadasz. Ill will record which amy mackey. Patrick Gavin Wade Clarkin and Kerry Barrett. I WanNa thank my parents Dr Kabul the Elson Junior and an Kreil Hustle Ston for creating a legacy that will be carried on for generations and being willing to go against the current and trudge upstream to the causation. We are all better for it.

diabetes Dr Cyrus Apple Robbie Barbaro Robbie Heart disease Brian Yes diabetes Russell Wilson Amazon Doug Graham Nasrin Diabetes Wendell Robbie Barbaro totten Fox panthers partner Stephen
How to reverse Diabetes with Robby Barbaro and Cyrus Khambatta

Dan Churchill's The Epic Table

1:37:29 hr | 5 months ago

How to reverse Diabetes with Robby Barbaro and Cyrus Khambatta

"Hello my friends of the epic title community and welcome to twenty twenty one a year. Such promise excitements. We turn that page and we shall not name your twenty twenty. Because i think we all learned something from it all avenue she. I'm excited. I know you. Allies toddler years. What we focus on a healthy more specifically may have set some goals as always. I'm here to help. facilitate talk. everything where it comes. To recipes fitness human physiology food applies to it. So please do not be afraid to reach out to the payment. I hear for on top of that. This wake of jump back in the kitchen with excitement. Delivering you guys. Those recipes. Keep talking about those tips those hacks and of course more expert podcast guests and let me say thank you to everyone listening in. We had such a phenomenal growth in twenty twenty that in twenty twenty one we have had people reach out to us with prolific expertise well known individuals and just a blessing tonight that this podcast has grown so much that people want to be honest Of all walks of life. Say thank you to everyone. Listen that could not be possible without you so yes. Speak side of the guests. We have in store be excited for the topics that we cover. And how you ask and continue to learn about your human performance on pumped and let's begin with our first episode of twenty twenty one on a topic. I think he's so important. I understand whether or not we succumb from the symptoms itself. Today we have in the short robby and cyrus of mastering diabetes and we are talking how to reverse diabetes. These gentlemen are as charismatic as they come. It makes sense that dr be juice them to me much. All four of us in a room gathered. Sir batu batu here to be some form of funding and tell you that mosh now. What i love about this episode if you have diabetes each gripe for you if you do not have diabetes is also right for you because we learn about what happens with insulin. How your work goes on. With the beta cells will beta cells off and ultimately. I think this is such an awesome opportunity for us to learn about something that can help. Prevent the onset of god babies whether or not we have on dosa helps us learn more about how we can make out food choices. What's good for us is fat actually bad for us or is it good for us Carbohydrates leading or not leading to diabetes. All these questions we talk about in today's episode and one that i think everyone is just going to walk. Why going a honey to ask more bit because of that. Don't worry i've more questions ask for these two gentlemen. This program is from helped. Thousands of people around the world have an amazing book. Mazarine diabetes that. I've read twice taking notes so plays if you feel compelled. Definitely get book. I talk about a lot and all that can be found in the shirts as well and of course. If you want to continue to support this podcast lever of you. Wherever you listen to your podcast on apple you can lock it. In review rod comment four five star. Whatever you wanted a and of course if you think someone in your network is going to benefit from today's episode definitely share with them on instagram. All share your existing network in general we love to share it and the boys do to. You can definitely follow the handles. So i'm excited to kick things off of this episode. I think it's an exactly in the wheelhouse of awesome community that you guys and please continue rate chat with any asks on these topics. We're going to cover a lot of carbohydrate and diabetic questions. This week. I saw welcome to their first episode of the epidemic podcast for twenty twenty one and rubbing siris boys. Let's get cooking robby Welcome to the epic table podcast. My friends it's great to be here banks and can't wait to get get in depth with some really cool conversation here today absolutely now. This is interesting. I've never had to other people on the podcast at once via technology. So i'm not gonna have a buzza site. I just trust you mitchell. Gentlemen to be added like ants. This person u2 The o'hara is say masters behind massine diabetes. It doesn't make as much of an impact. You are the geniuses behind mastering dawkins that as such a great book man. Such a great book man. Who is that. Who who who book names. Actually robbie was the one who came up with the with the business name. Mastering diabetes and book name. So i'm gonna give him full credit for that. Tassie that branding a win. It's right there. Takeover offer seo possibilities teamwork. Dan jack as subtitle shows like the key is that we're talking about addressing all forms of diabetes. That's why the were mastering is key because you don't necessarily reverse type one point five but you certainly can't master it and get it under control and avoid the complications. I love where you have credit segue when we already rubbing you know this. This is what i'm gonna do my listeners. I'm sure we'll have a good foundation of diabetes. Gentlemen let's let's lay. The let's go award is taught one was one point five. It's tough to prediabetes. Let's lay the foundation just so everyone stands where he's for those people who may not may think they do but about to mind mind-blowing let's go forward bom. Let's start the mind right now. Okay here we go. There's many different forms of diabetes. Type one one point. Five prediabetes type two diabetes and station diabetes and lo and behold. There's also now type three diabetes that has become pretty widely known in the past ten years so it can get really confusing but a simple way to think about here. Is that if you divide diabetes into two different groups group. One is called. Non insulin dependent diabetes guy and the other one is called insulin-dependent diabetes. That's one way of thinking about it. Another way of thinking about it is which is even simpler in my mind. Is you refer to it as either. Autoimmune diabetes or non autoimmune and that really makes the distinction very clear so the autoimmune versions of diabetes. There's only two type one and type one point five so type. One diabetes is what i have. It's what robby has. It's generally what affects young kids. You know you can either be born with type one diabetes or you can develop it at the age of two three five fifteen somewhere in. Adolescence is pretty common and according to the research type one diabetes generally affects people up until about the age of thirty. So it's an auto immune reaction which means that your body has been co worst or so your immune system has basically been tricked into believing that you're beta cells are actually dangerous to your health and we can go into detail about the sort of dietary and environmental causes of that maybe later in the podcast but for the time being suffice it to say your immune system is actually mounting the attack that's actually compromising your own beta cell status and as a result of that your immune system is destroying beta cells which then cripples your ability to manufacture and secrete insulin so people with type. One diabetes generally go from being quote normal and healthy to fully insulin-dependent within about twelve to eighteen months. Which is a pretty fast Reaction pretty sort of fast sequence of events that that goes from being healthy to completely insulin-dependent now type one point. Five is very similar to type one diabetes. But there's a couple of distinctions number one type. One point five diabetes people generally speaking over the age of thirty as a year older than the age of thirty which means it's adult onset. It is still an autoimmune reaction just type diabetes except it is a slow were progressing version of auto immunity and the reason for that is actually fascinating your immune system manufacturers proteins called. Antibodies and. antibodies have a specific responsibility to basically go and neutralize a foreign threat. So you know in the case of the corona virus or the flu Antibodies are what your immune system manufacturers in order to specifically neutralize a very particular protein sequence that comes from one of those two viruses in the case of type i diabetes and type worn your immune system manufacturers auto. Antibodies that are specific to the beta cells specific protein fragments on the outside of beta cells. And so in type one scenario you end up with usually multiple antibodies. Which makes it a fast of insulin. Pens and in type one point five diabetes you end up generally producing one antibody in only one antibody and again this is relatively generalized. Some people produced multiple but in general majority of people type point five produce only one and as a result of that. It's an adult onset. Slow progressing auto immune version of diabetes. You've you've fallen. Yes so by the sounds of festival really well presented. Thank you so much. sorry. I see a sign that onset off the age of thirty generally speaking is point a one point five and this instance on the one antibody is the is the root cause. That's exactly right. That's that's type. One point five like in a nutshell are okay. Continue on play. this is okay. So those are the autoimmune versions of diabetes. Now if we go into the non auto immune category. We're looking at prediabetes type. Two diabetes generational diabetes and type three diabetes. So let's walk through them. One by one prediabetes and type. Two diabetes are there linked to each other. They're basically like cousins. So before you develop prediabetes you develop another condition called insulin resistance. So insulin resistance. Is basically the root cause once insulin resistance progresses insulin resistance manifest itself i as prediabetes and prediabetes state. You end up with an elevated. Fasting blood glucose first thing in the morning you can end up with an elevated fasting insulin level and you can end up with High blood glucose sort of all throughout the day as well so that you can think of prediabetes as being a warning. Sign that type. Two diabetes is on the way. Because if you do not put the right lifestyle into play when you have prediabetes and you let insulin resistance. Continue to grow over the course of time. You will eventually develop type two diabetes so type. Two diabetes is basically prediabetes on steroids. It's it's what happens when you have become more and more insulin resistant to the point. Where now you're fasting glucose elevated even higher usually greater than one hundred twenty five milligrams per deciliter fasting. Insulin is certainly elevated as well. Your post meal blood glucose as elevated your post meal. Insulin is elevated and result of that. Now you're beta cell The population of cells in your packers are over. Secreting hyper secreting insulin. In pretty large quantities. So type two diabetes is really sort of classified as being a state of metabolic distress. But the beauty here is that you can actually go from type two diabetes and you can move back into prediabetes and you can go for prediabetes and back into insulin resistant. You can go from insulin resistant. Back into non diabetic. So it's like a two way reversible path and in about eighty percent of all cases eighty to ninety percent of all cases. You can move from type two diabetes all the way back down the spectrum. Two zero guy there are. There is a segment of the population. Ten to twenty percent of all people who will not be able to reverse type two diabetes and these people are the type of people who have been living with type two for sufficient period of time that the beta cell population in their pancreas has accrued a significant amount of damage and as a result of that. They just don't produce sufficient amounts of insulin anymore. So you can almost think about it as though they are similar to people with type one in that they have a compromised beta cell population. It's just that they're beta. Cells have been over working for a very long period of time and as a result of that. Some proportion of that betas population has now died. You make isn't making sense absolutely just Phillies nece asking for a friend seriously. Fearlessness what are they. Oh perfect okay. So beta cells are basically a small but extremely important population of cells. inside of your pancreas. That are the only cells in your body that are capable of manufacturing and secreting insulin. Now important because insulin is a required hormone for life now. Insulin is always talked about not always most of the time. Insulin is talked about as though it's a threat as it's a bad thing and that you'll see this all throughout the internet as you go Searching learn more about diabetes and insulin. People are constantly putting a finger. Insulin saying insulin's bad for you instance gonna make you fat going to raise your cholesterol level. Insulin is actually what causes insulin. Resistance in diabetes the whole game down insulin and unfortunately the fortunately that information is not true. Insulin's is a required metabolic. Hormones that is Is absolutely required for life. And it's actually not a dangerous hormone as most people want to believe or or think they believe the reason for that is because you dan your non diabetic. You manufacturer insulin. Guy your mom your dad your sister your dog monkeys raccoons cats all mammals secrete insulin because again insulin. A required hormone for life. It's just that the problem is not insulin. The problem is excess. Insulin production when you when your lifestyle creates a scenario whereby your pancreas has has to work in overdrive and secrete excess amounts of insulin the excess insulin or what's called hyperinsulinemia becomes extremely problematic for all tissues in your body for your nervous system for your liver for your kidneys for your muscles for your brain for your thyroid gland for your sexual organs. You name it. So the hyperinsulinemia state is actually is what causes metabolic distress but having a normal insulin level and secreting Physiologically normal amount of insulin is not only helpful but absolutely required so point. Being the beta cells are the only cells in your body that can manufacturing secrete insulin. So that's a good thing you want to preserve beta cell function as long as possible when beta cell health becomes manipulated either to overproduce insulin or when they become crippled end. They are now not producing a sufficient amount of insulin. Both of those scenarios can become problematic course of time boom absolutely does this is and this is really really good so i think it's great to identify you. Talked about the pancreas. The better cells their all their lousy insulin insulin resistance and where does that. Put us on the next part of the continuum. Okay cool so now. We have two different to other types of diabetes. That we haven't really touched on. We already did type one type. One by five prediabetes type two diabetes. Now just ational diabetes. This is what affects women. When they're pregnant. Usually women discover that they are living with jeff station diabetes at the end of their second trimester the beginning their third trimester because they go into their doctor and they take this test called a glucose. Tolerance test and the glucose tolerance test is is not a fun test to take at all. You doctor's office. They give you a solution which is water with seventy. Five grams of glucose dissolved inside of it. Which is a very. It's hard beverage to put down but what you do is they they. Test your blood glucose before a test your fasting insulin before you take that the take. That glucose beverage. You drink it. And then they monitor. Both your blood glucose insulin levels over the course of the next two hours. What they're trying to determine is in the presence of glucose challenge what happens to your blood glucose and what happens to insulin in your blood. If you drink this glucose containing solution otherwise known as a challenge and over the course of the subsequent two hours your bug because is elevated Depending on the country you're in depending on the organization that the hospital follows. It is all over the map as to like what is the quote unquote like you know. International definition of justice diabetes literally does not exist today but depending on which organization you follow if your bug because generally speaking goes above one hundred eighty at any point within that two hour window. You fail the test. And then you are diagnosed with diabetes in other words. What that means that. When you consume glucose and you are challenged with glucose your body is incapable of handling that glucose of metabolising glucose properly and as a result of. It accumulates inside of your blood thus jeopardizing the health of your baby right. So that's the that's what just diabetes is all about is is it's a state in which not only the moms glucose gets elevated but as a result of that the baby's health compromised and it can lead to a number of complications for the baby when the mom is delivering right. I'm just gonna. I'm just going to inject you quickly clarify for everyone. Essentially what's going on is if if you are a bob one hundred and eighty it just means as you said cyrus that your ability to metabolize glucose is inefficient as in effect. When you take on any form of energy. Through the form of glucose your body will break it down if it stays around in size elevated breakdown. Obviously it's not going where it should be. Because i mean that's issue is so why before you continue on y second trimester is that just because it's getting closer to the babies. I guess closer to that birth. Is that the reason. Why test then Yo that's actually a really good question. usually what ends up happening. Is that among a women. Become naturally insulin resistant. Over the course of their pregnancy is just a normal physiological process and Scientists believe that the reason why that happens is because it's the mother's body's way of directing nutrients to the baby. It's actually fascinating so in order to really understand. We have to go backwards just a little bit here. Insulin resistance is what happens when your muscles and your liver are are when their ability to absorb glucose from the blood goes down over the course of time so if you eat something that contains carbohydrates or you're provided with this glucose containing solution and there's glucose inside of your blood glucose should go into your liver it should go into your muscles and be quote unquote disposed of inside of both of those tissues easily in your body. That's what would happen. Because you're non diabetic feed you glucose containing solution or you eat carbohydrates from whole food and glucose from that should go directly into your liver in directly into your muscles and will also funny enough go into your brain and as a result of that your blue will stay nice and stable dam which is a good thing and that means. You're not diabetic. But in the situation where you develop insulin resistance insulin. Think of insulin resistance has basically being a wall a temporary wall that your liver constructs for itself and your muscle constructs for itself to prevent glucose from entering both of those tissues. Gay now the reason that your liver and the reason that your muscle would construct. That wall in the first place is because when you consume diet. That actually is high in fat especially saturated fat. Then the saturated fat actually causes a metabolic traffic jam inside of your liver and inside of your muscle then overloads both of those tissues with excess fatty acid deposits. Caso the whole name of the game when it comes to insulin resistance does not start with sugar it starts with fat. It starts with lipid. So if you overfeed on fat from your diet especially saturated fat your liver and your muscle ended up taking up. Excess quantities of it beyond their designed beyond their physiological design and as a result of that their next action is to say. Wait a minute. Hold on hold on hold on. Let me block more energy from coming into these tissues. I don't want more energy block it now. The simplest way to block energy from getting into a tissue is to not respond to insulin. When insulin comes around gay because insulin is the most powerful anabolic hormone in your body. Insulin's job one of thousands of jobs that insulin has but one of the strongest responsibilities that it has inside of your body is to go to your liver and say knock knock liver. There's glucose in the blood. Do you want to take it up. Knock knock muscle. There's glucose in the blood. Do you wanna take it up and your liver and muscle under normal. Circumstances would respond by saying. Yeah give that stuff to me. So in your body dan. You're not insulin resistant. You don't have diabetes. As soon as insulin comes around in your blood and says hey knock knock knock knock muscle. Do you want this glucose. Both your liver and muscles say yes. Give it to me now. And they open the doors. The doors inside of the cellular architecture that enables glucose to get inside both of those tissues. And that's a good thing because glucose escapes the blood and gets inside of the tissues where it belongs but in a person who's living with insulin resistance when the fatty acid deposits accumulated beyond their normal physiological design. Then both of those tissues have basically created an at a self defense mechanism to say. No no. no don't talk to insulin. Next time length comes around. You don't respond. Don't respond so then went. Insulin goes knock knock. I got some glucose to take up both of those tissues. Don't respond and by not responding to insulin or not responding to insulin. Well insulin gets trapped in your blood. Causing high insulin levels glucose gets trapped in your blood causing high blood glucose and this is classic insulin resistance when both glucose and insulin are present in excess of their normal physiological design in your blood simultaneously so going back to the description of a mom right. We asked we were talking about. Just stations diabetes. Why would a mom become insulin resistant. The first place. The answer is as the baby grows. Part of the normal physiological design is for the mother's body when she eats food to be able to take those nutrients not only use it to fuel her body but also to send them to the baby so that the baby gets a fresh supply of nutrients everytime the mommies and what better way to give your baby nutrients than by blocking glucose from getting inside of your liver and blocking glucose from getting inside of your muscle. if the mom's body basically blocks glucose from getting of both those who are not blocks but reduces the at which glucose gets inside of her own body than the glucose goes into the baby's body and as a result of that the baby gets a fresh supply of glucose and it helps the baby. You know metabolize glucose use for energy and grow over the course of the pregnancy making sense yemen. So the question is then what happens if so if it's just to clarify is it an occurrence where the able to still store it and provide for the baby but can still be having just diabetes. Or is it the case where they do not either within or providing off the baby nor but they're still elevated like what does that spectrum work okay so this is a question so so let me let me be real clear here A mother becomes naturally insulin resistant over the course of her pregnancy again. To sort of shut or direct glucose towards the baby get that sort of like the scientists. Believe that's the primary reason why mom would become insulin resistant now. That's sort of a normal physiological process. But in the case of generational diabetes. While we're talking about. Is that level of insulin resistance. But way more so if the mom is living an insulin resistant lifestyle. She has a high fat diet. she is sedentary. maybe she's overweight. maybe she has some other You know chronic metabolic conditions as well. A combination of those factors can make the mom more insulin resistant than she would otherwise normally be just from pregnancy so as a result of that now she is living with an excess quantity of insulin. Resistance incited for monte then elevates her blood glucose values k and by elevating her blood glucose values it puts her in a state of metabolic distress and increases her risk for chronic disease. But it also elevates the risk for complications during delivery and it increases the risk for that baby to develop diabetes. That baby is delivered. So the baby one diabetes would get or. Is it. actually insulin resistance in. Generally i would be insulin. Resistance causing metabolic dysfunction in prediabetes and type two diabetes down the road right. So what's interesting here is. I mean we've seen this before we we've seen over the course of time that there are now babies. I'm sorry there are young. Children who have type two diabetes. They're literally young children who are like eight years old. Who who have a body waited two hundred pounds right. They weigh forty pounds. More than me in the eight years old. And they're living with type two diabetes already. I mean this is. This is happening. All across the united states All across the world that happens as a result of poor nutrition from a young age. But it also it starts in the womb so if the mom is overweight if the mom has type two diabetes if the mom is insulin resistant she from day. One predisposed her child to the development of obesity. The development of insulin resistance the development of prediabetes of type two diabetes of cancer heart disease. You name it so that way when the baby is born into this world. The baby is already in advanced risk for chronic disease and then it can continue to grow as the baby continues to grow himself. This is firstly knowledge. Bombs bid super devastated. He'd that's something out of control of the baby that comes on the responsibility so passionate agree very sad. Damn one in five adolescents. Living with some form of diabetes. Right now one in five one is that's crazy it's devastating and it gets me real man. This is this is. The thing is i grew up in a world where las style and we'll have privileged because Grew up with a couple of brothers run around mom and dad were you know elise privy to certain things but even if i knew it new now i'm fortunate because i feel that my parents and their parents living different food choices to what we know now which we will get into. But i don't shy away from this phenomenal track. You buy on but just a couple of questions on that. So i see. We saw just to clarify those. They seen in following along. We have pregnant. Women have a natural state of insulin resistance however if certain last choices it can cause it to be to insulin. Resistance where it will lead to station diabetes Any jumping stars forever. You know say. Somebody's not correct question. How common is is just icing diabetes. that is a good question. I'm gonna pull up the statistics for you right now. Because i don't know about the top of my head But give me a few minutes. I'll pull it out for you right away. Bowie of like one in five. So is that across america. You say cross. The what was was the study. I read on. It was in america. that was definitely. Yeah and it was looking at different Ethnicities and unfortunately. It's the tino's in african americans Being impacted more so in. What's the con. Just assume i guess but like the suggestion is education right. You know if that is a really complex puzzle. That's going on there. But i think education is certainly part of it I think access to food. Certainly part of it And it's it's just it's really sad to say the whole. Yeah what's what's interesting is Australia despite being a very health conscious country and nine what we do we still have big big pulmoddai bays in the uk. Dasa's well So it's not just a a nationwide thing for america. It's a global problem and i think for me. It's like this is why i love what i do because you same what you gentlemen do. We have the ability to educate now. It's like how do we take this this platform and do the simple things right. Because it's to wa- so simple as not indict but how do you try that same portrait for some people who do not have any idea. I love that point. You made about saying the simple things that there are so many aspects of what's going on in our current food culture that is just against common sense the so much fighting about this and that but like there's more we agree on than we don't agree on in one of our friends. David katz started the true food initiative. And he's moving on that just like we gotta wake up. Yeah yeah exactly. We make sure we do that. A lot of my listeners. Already health conscious already. So you know it's it's Saw quite often when not speaking to the people who who have the of the abbey don't have the knowledge but i do have the power to influence how we doing that study. Sr she got in front of ya. I got from the united states. It's between six to nine percent of pregnant women develop station diabetes. So it's it's not like a an overwhelming number however sixty nine percent is you know. It's it's growing over the course of time. No question and you know. It's a significant it places. A significant toll on the us health Healthcare system but okay so like a question to is you probably. I don't know if you know the answer. This one but just diabetes. Isn't that common. I don't know much about it. And is that like so in terms of reporting may be sixty nine percent but how often is it reported. And how is it reported. And i'm i don't wanna question any studies national obviously as the methods and more the more we look at studies we more or look at the reality is one of those things where as it becomes more popula that will actually increase the fact. It's not that commonly nine. Yeah it's kind of like You know testing for covert. It's like all the number of people who got diagnosed with covid increased last month. And it's like well the number of people that got tested for covid actually increase in. That's why the more people with the actual diagnosis right. It's the same thing you know. When you're screening more women who are pregnant diabetes. Yes the number of women who get officially diagnosed. We'll go of questions asked okay. Well let's leave in asterix next to that one which is a rather than as a percentage of risk. Just avoid it are. Let's continue on. This is amazing. Size thank roby. Plays chime sars his crushing it right now did but yeah i can feel your energy jumping you call your your listeners legends. And all that we know you're legend like you gotta understand the man on the line here. Dr cyrus. Kamata is a true true legend. I we haven't gotten into siris is background is education is biochemistry just like knowledge. It's outrageous like. I do interviews. We talk on the high level. As of general things is also the you know the fun arguments and games with people who on like dig into the deep biochemistry. And i've seen cyrus show up to those and it's just it's just a lotta fun that we all have roles right and I know you both know that. Amount on this topic i just. I think it's so funny when you in this wave and we could definitely go into your backgrounds. I'm going to do that. Actually intro just so we can handle much more of the weeds. And i'm going to have you guys and more than once a week. We can chat all things about your family you outrage speaking of legends robbie sars who would continue robbie you take it over fire the question it will reno who answers yes way all right so we've done prediabetes we've done just station is. Is there a top three. Yes there is a type three okay. So tight three diabetes is otherwise known as dementia otherwise known as alzheimer's disease and the reason why they referring to his type three diabetes is because there is a significant body of research is now showing that that people who develop dementia and or alzheimer's over the course of time as they become older significant proportion of that population is living with insulin. Resistance and this is not necessarily just association. There's evidence to show that people who develop insulin resistance that insulin resistance itself has a dramatic detrimental effect on noor on neurons inside of your central system. A.k.a your brain so as you become Scientists generally think of insulin resistance as being a problem of you. What's called your peripheral tissues. Your liver your muscle. Basically everything from your neck down but over the course of the last ten or fifteen years. They've started to realize that. Insulin resistance also does affect the way that your brain functions and especially affects the way that your brain functions over the course of time and so Neurons inside of your brain can take a beating when your blood glucose value is elevated. And especially when you're insulin. Level is elevated over the course of time because both of those can affect the way that these neurons function and so when you're living with insulin resistance and or high blood because and or high insulin over the course of time The chances of you actually developing cognitive impairment or cognitive decline over the course of time goes up dramatically and so the two of the leaders in this world are isha in dean shares. I don't know if you've had them on your podcast but it's not. Let's get him on this. Mike that happen. oh gosh. They are unbelievably smart and they have actually helped me understand the connection between insulin resistance and dementia alzheimer's and is a very strong connection. And because of that that's why they are now classifying dimension alzheimer's as actually a form of diabetes of your brain. How my friends. I'm sure we know by now. How much i feel about. The world is sustainability particularly as it relates to food being a chef. I have a responsibility feel scenario in deathly impact on. That's why when. I make these decisions to be talking about this area. I want to be doing so with enough resources to make your own informed decisions the future of our families and our planet to die. I'm excited to talk to you about an ingredient. I have been very blessed to have worked with for some time and his wants. So kuhn only is very lane. High protein and super tasty easy to add little flavor to it's also walt court and the most abundant sustainable fish on the planet. I'm talking about wilde alaska. Pollock it is the most abundant sustainable fish on the planet as so incredible story behind. That alone is amazing. So yeah as i said. It's great icing. Very good for you as well knew looking off the planet site for you the planet. That's really good win so over the next few months seeing lots a recipes coming across my instagram using fishing. He goes to do so as well. That if you at the market or somewhere where the fisher has an option vein wild west apology just no you have the option to be consuming. Abundant sustainable fish on the planet. And looking up to you and the planet as well it's fascinating. I wish i just had like that. Mizuho precaution nike. Make that sandstone dramatic ravi day man. It's crazy i love it. I love it. I've actually heard them bo. Speak about this and it's just crazy to think it's not actually you know it's not crazy. It's it's believable. Because of how much our body is intertwined and how much everything can be affected with through because of a. i'm assuming it'd be the inflammation inflammatory. Response that occurs that causes chronic information which affects the messaging and the brian. And maybe the onset of the what the bit amyloid in the to a distant kind of untangle pro is that is that essentially an assumption that right you know. I don't actually know the specific mechanism. So so i'll tell you. This research is used to believe that dimension. Alzheimer's was called specifically by emily plaque. That accumulates in specific regions of your brain and so as a result of that they developed a whole collection of pharmaceutical drugs to try and come back the accumulation of that black and one hundred percent of all dimension. Alzheimer's drugs that have ever been created failed one hundred percent of them because the pharmaceutical drugs are ineffective in secondarily. it's not the accumulation of the beta amyloid plaque. That actually causes the dementia right. So one simple way to think about this is though nerves are just like other tissues in your body. Caso part of the reason that that diabetes can be such. A problem can be so detrimental over the course of time is because when your buco goes high every single tissue in your body is affected. Your vascular is affected. Your liver your kidneys. Your sexual organs here is the capillary blood vessels in your fingertips and toes Your nervous system your peripheral your central nervous system. Everything affected and so. That's why the list of complications of diabetes is tremendous gay. My professor in graduate school came up to me when he says pop quiz cyrus. How many people died from diabetes You know over the course of the last years. I was like i don't know two hundred fifty million. He goes no less like two hundred million. Less hundred million less fifty nine less five million less one hundred less because zero was like what i was. Zero people died from diabetes. He goes you diabetes. You dive the complications of diabetes. And i was like oh is you're talking about he. Goes you die of failure. You die of kidney failure. Liver failure of pancreatic failure. You die of limb amputations you die of. You know all the complications of other tissues that are exacerbated by living in a high glucose and high insulin environment for a long period of time. That's the reason why every tissue in your body is negatively affected in. Your brain is definitely You know part of that metabolic dysfunction and why we always hear his word diabetes bert. I think that's a thing. You just summed it up perfectly. Why we are trying to prevent and never have diabetes in the first place. Because that i. I am actually play on the going up. I didn't know diabetes in terms of the actually ever hear of anyone dying of diabetes at a title. Someone had to on this sounds bab obviously spot themselves with some insulin you know. And that's that's all. I thought it was like okay. Cool people just handle. They'd have they don't have the ability to do it themselves. And so like when. I was like my teams but to heat that makes so sense because it is a catalyst for a number different physiological problems that occur as a result of its issues. So oh wow okay get motion or let's go. Let's this is great now. The spectrum of diabetes and Is is anymore so at the time of this recording. I think those are the diabetes. Than i am i. It sounds like sars and the experts. So i'm just gonna. I'm just gonna claim that as the that's constitution right there now call about her missing some of the other ones which is not going to but there's there's type three see there's some other ones but in general of the ones are impacting. What significant numbers of people. We covered the phrase. Lovely thank you robby. Robby robby. i'd star. This is where i think you've now laid the foundation. Let's let's talk about it. I do wanna talk about that. 'cause you you know you highlighted that. Let's just do the brief common things that people may or may know about as risk factors associated with diabetes Both pray at both tight wanna talk to and then let's go into fat because this is a. This is a big like i guess. This area is pretty grey. To an extent i love you. Boys just jumping and smashing out of the pox. I let's quickly respect. Factors taught one and talk to okay. So risk factors type one The the way that you let's put it this way. The symptoms of developing type one diabetes Let's let's start with those because most people don't even know what those are kind of The first one is going to be excessive thirst. The second one is going to be unexplained weight loss. The third one is going to be frequent urination and end. The fourth one is Extremely low energy a so. If you are experiencing one or multiple of those symptoms what could be happening is that it's your brains way of saying. Hey there's a ton of glucose in the blood right now I'm trying to flush that glucose out of the blood by number one making you very thirsty so go drink water and then number two. Because you're taking on a lot of water. You end up just frequently urinating and flushing fluid out of your body so it's literally a mechanical way of trying to lower because value out of your blood by taking on a bunch of liquid and then putting it out and so in the process of doing that you also become electrolyte depleted. 'cause electrolytes flushing the toilet as well and so that can lead to a lot of cramping and You know extremely being very uncomfortable and so any combination of those symptoms is indicative that type one diabetes may be developing so just jumping before everyone just assumes that round three o'clock when they get really tied they have babies would like you to says clearly like dead that's a i guess a concoction of all those close on as opposed to just being tired right. Yeah i mean all of us get tired. You guitar guitar. You go for a workout. But if when. I'm saying you know a collection of those. If you're if you're chronically tired meaning from the time you wake up in the morning to the time you go to sleep at night you just can't seem to keep your eyes open and you are effectively. What is happening is that you are malnourished. that is one indicator another indicator is that when i say your frequently urinating i mean fifteen to twenty times a day thirty every thirty minutes clockwork just going going going going going and when i say that you're thirsty i mean this is the most insatiable thirst you've had another long time if ever right. I don't mean you're just drinking three liters of water instead of two. I mean you're drinking one to two gallons of water per day. No matter how much water you drink you are still thirsty. So this is like these are also yes. It is a big one too. Yeah yeah like how much what are we talking is it. Like an percentage relative to an individual do not That's a good question. I don't know if i can answer it as a percentage per individual. But i've seen as low as five pounds and as much as thirty to forty pounds and just for context here. We're talking about people. Type one diabetes people with type. One diabetes are generally not overweight or generally not very overweight in comparison to the general population. General tends to be More overweight so if you take someone you know on one hundred sixty pounds. And i met my ideal body weight. Someone like me could have losing ten to fifteen pounds. Which i don't have that much mass to lose and that right there would put you in the underway category And that's a strong indicator that there's you know some type of metabolic dysfunction yawn it chai this is This is powerful stuff gentleman this stuff. You moving voters all right. Let's continue on so you got symptoms that you wanna go onto symptoms of taught toured your continue with risk factors and associated taught one flag question. Let's do so. So what i'll do. I'll do risk factors associated with type one. And then robert you wanna take over on Know risk factors for type two. Okay go there again. Risk factors for type one include. This is fascinating not being breastfed for a sufficient period of time. The recommendation is to breastfeed your child for at least a year. The first year of life and Babies who are breastfed for less than a year especially babies who are transitioned to cow's milk formula within the first few months of life are they significantly increased risk for type one diabetes children who are breastfed for at least a year but then end up consuming. A significant amount of dairy products. Early in life are at a significantly increased risk for type one diabetes and there's another potential cause of diabetes that is only becoming more known in today's world and that is a bacteria known as m a p. m. a. p. stands for micro bacterium avium paratuberculosis. Oh don't worry it's not going to be on the quiz. what am i is is. It's a bacteria that starts at originates in the intestinal tract of cows. That are in You know large industrial farms and cows. That are in these. large industrial firms. Generally speaking over five hundred cows per farm if they develop the bacteria inside of their intestinal tract the cow develop a condition called yawns disease and yawns disease causes muscle wasting and the cow generally dies in a very short period of time so if a cow ends up with bacteria when the cow goes to the bathroom the fecal matter has the bacteria inside of it so if account You know it is. Fecal matter contains the bacteria the bacteria is still alive. Once it comes out of the cows body it gets onto the hoods and onto the for and the skin of other animals in the vicinity when those animals. Then go to slaughterhouse now the live maybe bacteria is actually on the outside of the cows bodies and as a result of that some of that m a p bacteria game to the gloves and the boots and the suits of the hasmah of the of the slaughterhouse workers no matter how much sort of like personal protection protective equipment. There were some of that. Bacteria actually gets back in to the meat. It gets packed in to the dairy products. And some of the Actually escapes pasteurization. Once it before it gets to the grocery store and so there are some studies that actually demonstrate that there is a live bacteria inside of products annual grocery store that you and i don't even know about now why is important. The reason why it's important is because in a few studies they've gone in. They've actually tested people. Type one diabetes to find out how many of them test positive for bacteria are the mvp dna inside of their immune system. Yes how many people guess. What percentage of people living with diabetes test positive for bacteria. I'm gonna. I'm gonna. I'm gonna say seventy percent just to be hard. Seventy percent of the answer is one hundred percent. Omar one hundred percent of people test type. One diabetes greenwich. This is not a study that contains thousands and thousands of people. But when you see a number like nat. It's indicative that there is a problem and that it's worth paying attention to it's worth more scientific investigation. We're talking about an overwhelming proportion of type one diabetes population that test positive for mvp. And that's one of the reasons why scientists are now thinking that could in fact be not just associated with but causation uil in initiating the auto immune reaction is mon blowing crazy. We'll the fact that it's not even ninety nine percent. It's one hundred percent. That's a crazy unbelievable. When i first not. I was like i just did. It floored me like whatever studies being done to associate the two That that you know other. That's been young. I guess pasta right now for the funding or anything you know so. I don't know of any studies that are like current studies that are being conducted carried out And honestly this line of research in my mind is one of the strongest lines of research. That i've seen in a long time. I mean granted. It's a small collection of papers but a lot of them that not only can bacteria potentially cause type one diabetes but it can also cause crohn's disease inside of humans as well so it starts as a thing called jones disease results in two autoimmune conditions inside of humans and I would like to read more about it over the course of time. No question jan. Like i said you said that i was thinking. What else is it. Actually being a catalyst for what else is doing to body. This bacteria is so i. I wish i knew the answer probably doing a lot. Yeah i shy from and would you say. I mean practice. Yes the practices of where we get dairy from. You'd think the ones you slipping from the high price series will ganic is. It's still eat still to come to seeming sale time. Will i keep. It was not your typical. It was like a beautiful raised cow versus being inside. A you know a factory. They both within the same of risk of having this issue to play with no definitely not definitely not so the only reason to mit exists in the first place is because there was an infected cow but she writes an account developed the or or Was infected by the bacteria inside and that generally happens inside a larger industrialized feedlots. Because it's easier for cows to not only developed that bacteria but then spread amongst other cows. Right what if you're talking about a non diseased cow whose grass-fed fed living on a pastor. The chances of that count having you know maybe bacteria live inside of their body is very very very small. But it's not necessarily zero yet. Now makes sense blum guy. So respect is i cannot believe the first one and definitely did not know about the second one. What have you got us man okay. I've got some very simple basic factors for you for type two diabetes. I don't think i'm gonna blow your mind with this house. Risk factor for type. Two diabetes is being overweight. It's simple and clear you carrying access pounds you letting that add up over the years. You're increasing your chance of developing type two diabetes if you're inactive you're increasing your chance of developing type two diabetes. There's also a link with your family history. But i think you could make an argument that has more to do with the family. The parents teaching their kids to eat. You know it's it's the fork. It's a dietary pass along more so than just genes itself but it's technical risk factor. You can also look at race and ethnicity which we talked about earlier but african americans. The tino's native americans and asian americans are all at a higher risk. Now your age impacts your risk for developing type two diabetes. If you're older than forty five chances increase again. i think that's lifestyle factors catching up with you. And cyrus mentioned this earlier but prediabetes diabetes both increase. Your chance of developing tattoo diabetes for out. I mean it's it's you know it's a lot but it's also i think the top two diabetes something that we've all been more familiar with given the law saw out of it and how much we haven't been more of control if you will over it so you know. It's still amazing tomato. I think that's that's the one that is more control. I think that's in my eyes in us intel. But that's one you would think would be reduced. I right oh absolutely. I mean in america have over. Eighty five million people living with prediabetes. That don't even know it okay. So it's ridiculous. Well now you guys have got this wonderful book with this brand company amazing empires going to be happening even further an hour. Talk about some of the studies that you guys talk about in your book in association with fat obviously saturated fat particularly casaus. You mentioned this now. Saturated fat or fat and generals had this biggest continuum of good bad. Good bad goodbye. Where are we at with guys. And where where should we be concerned as it relates to diabetes greg Very like one and saw that's going to open up about twenty questions. So i just got my notebook ready okay. So let's talk about what types of fat we are referring to the first by speakers in order to in order to have this conversation in order to like really talk about diabetes with precision. I think it's really important to make sure that the language that we use is very very specific and very clear. All too often in the world of diabetes unfortunately people throw around terms they throw around the word carbs and sugar and they they don't really define those words properly and as a result of that it leads to a lot of misinformation a lot of confusion and then you know people end up getting hurt over the course of time so i said earlier that the consumption of a diet containing excess dietary fat is indicative or causes insulin resistance and that is a true statement especially if that fat comes from saturated sources. So that's different than me. Saying fat causes diabetes right. Because that's the technically in an inaccurate statement so to get into more detail here. There's basically three types of fat that i think are worth paying attention to the first type of fat are called. Trans fatty acids so transfatty. Acids are was on his trans fats and they exist in In foods in the grocery store that are you know that orgin they occur naturally occurring foods and they also occur predominantly in Foods that contain partially hydrogenated vegetable oils. So the reason they exist in the partially hydrogenated vegetable oils is because this this process of hydrogen nation is what food manufacturers used to turn liquid fat into a solid fat at room temperature. It's just a chemical process that basically says hey liquid let me modify structure just a little bit so that you become a spreadable substance and then as a result of that it increases shelf life and it makes the product more appealing to customers so they can make more money it slowly what. It is so food. Manufacturers invented this process of hydrogen nation that takes liquids and turns them into solids and so margin is a perfect example of that. It's gone through hydrogen Process it contains partially hydrogenated vegetable oil and as a result of that anything any product hydrogenated vegetable oil goes into become suspect like cakes pies. Cookies biscuits breakfast sandwiches crackers microwave popcorn you name it. It's all over the place so if you just pick up a product in the grocery store and you look on the back and it says and like partially hydrogenated vegetable oil partially hydrogenated canola oil partially hydrogenated rapeseed oil. Any of those are suspect. Because that's where trans fats. The majority of trans fats in our diet occur so just just jumping in quickly vastly possibly versus fully. Is that even a thing. Not that we should like if it just says. Hydrogenated is a problem and my second thing is more of a noise module. Did you say this is more a question my listeners. Whoa colored actually is what you call her margarine. Actually i don't know right. No masty daddy's bad and just continuing on ours as you were talking about for marketing aspect benefits of prophets. They add coloring to it to replicate butter because it essentially was seen as easy widespread butter. That wasn't butter. And that's the reason why but versus margarine has. The situation is worse being similar and murdering more. Yeah easy to spread through these partially hydrogenated oils. It also seems very smart about a you gentleman the softeners go. I d. I'm going go read about that one. That's facet it's all right anyway. So my question back from hajj. Hundreds and hundreds is partially or fully zach is continuing now or is it just essentially the same thing that you know. That's actually a really good question. I'm not gonna say that. I actually answer that question. I took the reason why they're called. Parson androgen vegetable oils is because the oils have been hydrogenated enough to make them solid at room temperature. But the end product contains both hydrogenated as well as unh- hydrogenated oils and that's why they are fatty acids which is why one if one hundred percent of all fatty acid chains were then hydrogenated. Then they could technically call it a fully hydrogenated oil but i think the result in product has both hydrogenated an hydrogenated. And that's why they call it that. But i could be and that's one of my listeners. You can trust these two gentlemen because they on up to what they don't actually know but that means what they do know is what they do actually ni- anyway. You got continue on women. This is amazing. Okay so transfatty. Acids are a pain in the butt because they are with at a long list of cardiovascular conditions including congestive heart disease stroke atherosclerosis or hardening of blood vessels blood vessels as well as high cholesterol and high blood pressure so there are studies that show that people who consume more transfatty. Acids are at higher risk for all of these cardiovascular conditions and there are randomized control trials that showed that people who consume transfatty acids actually have higher ldl cholesterol. This is very well known so not only can raise your ldl cholesterol. It can also reduce your hdl cholesterol so it gives you more of the bad cholesterol and lowers the good cholesterol. And it can also accelerate the development of these athletico at therapeutic plaques inside of your blood vessels so all of that is terrible news for you because impairing the function of your cardiovascular system. Trust me is not something that you want to be doing over the course of time day. So when it comes to the second of fatty acids reluctant saturated fatty acids the saturated fatty acids are also naturally occurring fatty acids that are found all over the place. They found in both plant foods and in animal foods. But they're mainly found in animal foods like meat poultry fish shellfish dairy products of all shapes and sizes as well as eggs and they tend to also be found in vegetable or i should say plant products including vegetables. Coconut oil palm. Oil cocoa butter avocados coconuts nuts and seeds as so there definitely present on both sides of the spectrum. Now the reason why. Saturated fatty acids are the most problematic form of fatty acids. Especially when it comes to insulin. Resistance is because that's what the studies show if you look at animal studies says he's studies that are done in mice and rats that are what are called preclinical data that help scientists understand what could be happening inside of humans and you go and you try and find out. How do you create insulin. Resistance in laboratory animals every single not every single most of the papers demonstrate that the way to make animal. Insulin resistant is to feed them a diet. That contains a large amount of saturated fat. If you look at the work of gerald shulman from yale university. He's one of the most prolific authors. When it comes to insulin resistance. He's actually him. And his team have worked out the mechanism the exact mechanism whereby saturated fat in excess quantities. In your diet negatively affects the function of not only the insulin receptor but the downstream signaling molecules inside of cells in your liver and muscle that are directly connected to the insulin receptor and as a result of that saturated fatty addis at fatty acids in your diet impair. What's known as insulin signaling. So the more fatty acids in your diet within hours insulin signaling inside of your liver and insulin signaling side of your muscles goes down and that's a problem because we talked about earlier when insulin cannot communicate with these two tissues well than glucose ends up being trapped inside of your blood causing high blood glucose so are problematic now. I'm sure you know this. Dan more better than most people out there but in the blog is fear and in the you know in on instagram on facebook on youtube. There's this massive debate right now. About whether saturated fat is good or saturated fat is bad right and there's a whole collection of authors who say things like there is no human clinical data that demonstrates that saturated fat increases hdl or l. Cholesterol there is no human clinical data that demonstrates that That saturated fats saturated fat impairs cardiovascular health. You guys have seen this. Olive replace fatally. I'm going to be up. I can hear always news is going. I'm so confused because there's always like essentially everyone is a lot. There's a lot of stuff out there. Yeah so size. Help set the story straight okay. So so trust me. Sometimes i get justice confused as someone else i trust. I feel it all the time because these new studies come out and these new marketing campaigns. Come out that basically say you know. Saturated fat is not bad for you. Saturated fat is good for you. And that's leads these marketing campaigns. That say you know. Eat one aga- day for good health. Eat butter is back. You know red meat is not bad for you. And i'm looking at this stuff and i'm like is there truth to that or is that pure marketing. I don't understand right. And so there's entire books written about the fact that saturated fat is is good for you and it can be very very very confusing so we could. Do you know hours and hours and hours of podcasting about that but to save time Note this there are human clinical There's plenty of human. Clinical data the demonstrates that lipid overload or excess consumption of saturated fat increases insulin resistance thus setting the stage for prediabetes and type two diabetes and there's plenty of data to demonstrate that there's also plenty of data that demonstrates that when you consume excess fatty acids especially saturated fat. It increases your risk for a thorough sclerosis. It increases the formation of Arterial plaques it increases. Ldl cholesterol and triglycerides and can cause a significant impairment in overall cardiovascular function. but again. there's plenty of people out there that are going to call me a complete heretic for saying that. And if you wanna do that then that's fine you can do it. I know but this is dan. This is one of my favorite points chime in here. Just throw something down. We as people living with type one diabetes cyrus myself. The hundreds of taiwan's we've worked with. We end up being the most fascinating test subjects for insulin sensitivity. Because we are injecting insulin. All the time to manager douglas levels. We calculate how come we're consuming and we monitor. Our bug glucose values all day long. Many of us wearing continuous glucose monitors where we actually see our bubble Values every five minutes on a graph twenty four seven and for anybody out who's confused. Okay decided you're talking about you. See all this news release papers. Like i just don't know what to believe. The good news is if you're living in any form diabetes particularly type one or using insulin you can answer that question in your own body and know the truth beyond any shadow of doubt no matter what anybody tells you based on simply putting to the test and the numbers speak for themselves. The data speaks for itself when you start reducing your saturated fat intake replacing that with whole carbohydrates and see your fasting bug because drop your insulin. Sensitivity skyrocket wade started. Just fall off your blood pressure. Normalizes your chocolates theorized. Drive your question drops all of a sudden like you know what i have my answer. I'm ready to go. And that is like honestly. I was thinking that because you have to have that monitored all time. So it's not as if is if you're going every so often like you are an actual subject for yourself and so for me. You know bless them have had to do that. And so i actually don't know like i do now but i'm sure people don't know what a healthy tossing blood sugar level is not healthy Fasting glucose and insulin levels should bay you guys know it is and so for you to say every single day wake lee what is going on and you probably eating the foods respective. So what you're talking about that. That's a big deal. My question no mar on the caveat you know we both dr bay really well and we talked about plants. I've esi we talked about. How microbiomes never the same does and this is opposing question. That i don't know How much scan little worms but judy. How differing and dynamic gut microbiome are also susceptible to different levels of sensitivity when it comes through saturated fat or fat in particular that you know of so pretty that question essentially what i'm saying is just because some people can't handle it can other people handle it and not get as impeded of the effects and not encouraging any other way. But maybe i'm i'm trying to size the reason why that may be diversity in what people say in studies because people different yet. There's no question about it and one of the things that i want to be like super clear about is that One of the things. I've learned over the course of time. Is that there really is no one-size-fits-all prescription for all human beings. I wish there was. I honestly wished i was making so much more black and white but In the same way that you know human beings are different shapes different sizes different genetic backgrounds different metabolic rates different hair-color you name it different levels of athleticism different disease. Risks as a result of that there's a considerable amount of variation from person to person that is worth paying attention to no questions asked. But with that i will say that yes. There are a collection of saturated fat. Are sorry there's a collection of Lipid processing enzymes. Whether they're enzymes that are that that store. Fat inside of your adipose tissue enzymes that breakdown fat inside of your outpost issue enzymes that oxidizing fatty acids inside of your muscle and liver and beyond the your dan churchill's You know what's the word. I'm looking for like the way that your enzymatic nature exists inside of your body inside of those tissues is slightly different than it is for robbie. It's slightly different than it is for me right the action of these enzymes and what they're capable of handling and how much is based on your genetic makeup as well as your lifestyle so that being said yes. There's going to be individual variability between you and someone else but the most important thing to take out of this conversation. Is that a diet. That is high. In saturated fatty acids at a certain point becomes overwhelming for the majority of the population. Okay so i'm not talking about the two percent of human beings that are capable of eating extremely high saturated fat diets without any complications down the road. I'm talking about the ninety. Eight percent of people. Ninety percent of people to whom eating a diet containing a significant amount of saturated fat causes problems and again we have plenty of clinical data both from like randomized controlled trials as well as epidemiological data that demonstrates that consuming diets that contain significant of it. Just it literally just causes more metabolic dysfunction period story. Today's episode of the podcast is brought to you by athletic drains. And when we're talking about you before as we discuss here on the table this stuff becomes really hot topic and upon points now. It's really important that you have a wide rod. Even grades particularly on the plants fee to improve gotha maintaining in your points. In general now ethic grains have seventy five hall foodgrains soil. Strong really epic places around the world and why trust it using the threes energy. My biggest thing that focuses on your digest hell while having pre and pro botox along with ends on as you're learning through these podcasts general. It's not necessarily what you put in want. You all annual dot individually. He somporn understand. And by having the prebiotics support that martin and listening to digest. The enzymes eat becomes soup up. Crucial sort of course as always support things are generally believe in being in this world. It's important to be selected will not grains is something. I'd genuine stan boy. And his wife's name affiliate formation that can go to athletic grains dot com forward slash epic to pick up your first sitution pack. I said big fan every day after grants. Yeah it makes a lot of sense and just to clarify. I call them my My bowl team of army warriors. When you were looking for the right terminology for we work out a few times a day you know he make. Sure we keep healthy and active army warriors. Man just the puzzle involves carving out and then make sure you keep them tars i. Sometimes they get too much broccoli. You like oh cauliflower. That one coming anyway. Okay so this is all really cool. There's a particular study that. I did notice in the book known as the epic study. You guys remember the referencing neo. Do you wanna talk about this. 'cause it's a pretty big participation which supports what you're just saying sars. Yeah okay so the epoc study. I mean the episode is actually a collection of studies but the term epic refers to what's called the european prospective investigation into cancer and nutrition. And this is just like a collection of studies that was done within the past fifteen years or so since mid analysis essentially. Yeah it's it's a collection of studies that investigate various aspects of human physiology that that analyzes of very large data sets been collected over the course of twelve years or more Actually i think it's more than like sixteen years right so what researchers do as they say. Okay there's this massive database that's followed people over large period of time. Let's peer into that database and try and find out how does thing a correlate to thing. Be right how does saturated fat correlate with diabetes. How does Activity level correlate with obesity. How does smoking correlate with cancer right and so the what what epic researchers have done is basically analyze this data set over and over and over and over and over again from different angles to try and figure out. Well what do we know. What can we learn from people that were participants in this. Study right one of the reason. Why such an awesome studies. Because it's one of the largest collections of data that's ever been collected specific to investigate the connection between nutrition and chronic disease. In general right and they've studied over five hundred thousand participants over the course of twelve. Fifteen years. I don't remember the exact timeframe but it's it's between ten fifteen years ago so one of the things that they discovered was that meat especially processed meat like bacon. Cold cuts sausage. Hot dogs hamburgers. These are the types of foods that are highly processed that you find in the deli section in general they increase your risk for type two diabetes and they definitively determined that by studying this data set and eating a diet. Rich in fruits and vegetables actually reduces your diabetes risks. What a concept right. It's almost like it's of course that would be true. But again they have to Rigorous science and millions and millions of dollars towards it to really like show the data right now. What's interesting here. Is that when it comes to saturated fat they. The researchers found that. If you simply replace five percent of the saturated fat in your diet with fructose. Okay and this. Fructose comes from fructose containing foods. Either whether it's fruits or whether it could even be refined for us they don't specify simply reducing replacing five percent of saturated fat with fructose containing foods reduces your risk for diabetes by thirty percent even though the world of diabetes is constantly pointing a finger at fructose saying fructose causes diabetes. Fructose causes diabetes. They also demonstrated that replacing five percent of protein in your diet with again. Fructose containing foods reduces your diabetes risk by twenty eight percent. Okay so again what. They're trying to establish year is that saturated fat is more problematic than fructose. And that is a huge huge point in the world diabetes because people are constantly saying sugar causes diabetes glucose causes diabetes. Glucose is bad for you just as bad for you. Stay away from that and eat more. Fat rich foods eat akita. Genyk diet eat more saturated fat. There's no problem with that. But yet the data shows the opposite. Yes goes back to that wall. You talk about with respect to fast and it's buried entry so this is this. Is this the first. I really heard of this because obviously sugar has always been so prominent as the main course of issues when it comes insulin. So can you can go into the weeds a little bit on how that actually works at the cellular wise find more prominent even though the the data shows that. Why why's that just be more specific on that. Okay so the question is why is fat. More problematic for diabetes than fructose. Yes okay so if we look at the cellular mechanism Here's what actually we. We go into like a ridiculous detail in our book about this Who also did you want to leave geneva for the book. Let's put it this way. Let me try and describe the photo this in the book. Maybe and then you know if somebody else wants to you know if your listeners wanna get more information just go to the book you'll find. It guarantees your pick the book regardless because of the amount of knowledge. You guys have dropped and you're not going to remember sticking up to other repeat this episode of few times or they have to buy the book so that you can buy the book the going okay. Perfect so for those of you. Who have the book you can follow along on. Page seventy two and for those that. Don't have the boko vegas over i. Now i get so the way that this works is that fatty acids signal to Fatty acid receptors. A transport proteins. I should say that are in the cellular membrane in your liver and in your muscle so your liver contains billions of cells. Your muscle contains billions of cells and no cells are Glucose dependent they like glucose they feed off glucose they burn glucose for energy and both of those tissues can store because energy so glucose is a currency that both of those tissues know how to operate using okay. So under normal circumstances glucose comes to the door of the tissue glow comes to the the the cell membrane and Glucose accompanied again by insulin. Insulin attached to the insulin receptor and what i said earlier was that instant says. Hey knock knock there's glucose available and the cell says okay great. Let's bring it but in reality. What happens on a biological level. Is that the insulin. Attached to the insulin receptor and then inside of the cell. There's a change in the way. The insulin receptor actually There's a there's a. What's the word i'm looking for charter. See there's a confirmation. Change us what they refer to it as so basically just means a shake change so the inside of the insulin receptor on the inside of the cell. Basically confirmation changes which then initiates like a whole collection of domino's is a picture in your head. One of those. You seen this before like you knock one domino over and you can start a cascade of domino trains that all lead in different directions. So that's what happens. Insulin signaling is horrendously complex and it's not like insulin just tells one or two things to go do something inside of a cell. The insulin receptor is a master receptor inside of that cell which then initiates multiple biochemical pathways to initiate at the exact same time some of those biochemical pathways end up signaling directly to monaco andrea. Some of those biological pathways ended up going to the glycogen granules and telling the glycogen granules to start growing some of those pathways end up going directly into the nucleus to tell dna to start replicating at some of those one of those biological pathways. Ends up telling these these glutamate receptors. I'm sorry these these vesicles inside of the cell to move to the cell membrane to open up to allow glucose to get inside of them so think of there is being like thousands of little spaceships. Inside of the cells gather little like circular spaceships and as soon as the insulin signal is relayed to them these spaceships literally move to the top of the cell or to the to the right to the cell membrane and then they dock at the cell numbering and then the cell membrane opens up and allows glucose to get inside of those glucose transporters they then close up again literally physically pull glucose down into the inside of the cell and in the glucose ends up going to multiple locations in either goes to the monica andrea to get burned or it goes into the glycogen granules to get stored for later use. And so. that's what's supposed to happen under normal circumstances but again insulin had the first dock at its receptor. I'm sorry at its edits a receptor. In order to initiate the glucose transporter to get up to the surface to take the glucose it now. How does that factor problem well. When you're consuming a fat rich diet especially saturated fat what the saturated fat does is it negatively. It actually changes the operation of the inside of the sailor. Receptor of the of the insulin. Receptor guy so the insulin receptor recognizes insulin and again what the insulin receptor supposed to do is change shape so that it can start the insulin signaling process as soon as it changes shape it's supposed to knock its first domino. Its first domino's known as this thing called. Irs one that's the name of the protein itself irs one is Cannot communicate with the inside of the cellular receptor the insulin. The insulin receptor effectively. When fatty acids are present. And that's a huge problem. Because if the insulin receptor cannot tell. Irs one what to do than irs. One cannot tell hundreds of downstream players. What to do. And so the entire insulin. Signaling process is almost like inhibited from the get-go is this making sense. Yeah dude i'm sorry nights recognized Can you hear my pen interest. I can't now all right. So what ends up happening. Is that the the fatty acids negatively impaired the action of his. Irs one molecule on inside of the insulin receptor and as a result of that the galut four vesicles or the glue to vesicles depending on which tissue. You're in do not trans locate to the cell surface as well as they used to and. That's a huge problem. Because if they can't get to the surface they cannot allow glucose to enter the cell and so glucose is on the outside of the cell. Just hanging out and waiting waiting waiting waiting waiting and these gluten vesicles on the inside are not physically getting to the surface of the cell. And as a result of that glucose doesn't have a signal to come inside of the cell so that we stays in the blood so insulin docks at its receptor and glucose gets trapped in the blood and as you can tell by this. Both insulin and glucose basically still hanging out in the exercise environment. They're not going anywhere. Because the inside of the cell has become relatively dysfunctional. In addition to that this this The accumulation fat inside of the cell can then go. Negatively impair the function of mitochondria and actually impair the ability of maddock andrea to utilize glucose fuel. And they can actually start to produce more free radicals and as a result of that the free radical generation has gone up so now this the inside of the say their architecture has become slightly more unstable a little bit more inflamed. The glycogen granules does not increase in size because it cannot get glucose inside and so as a result of that now glucose effectively trapped outside the cell and fatty acids are the the molecule on the inside that has sort of created what i refer to as a metabolic traffic jam or created an ability for insulin. Signaling to basically get shutdown. That's a problem. Huge problem. And i just wanna make sure ever knows that this will be in the final paper send mark also at night. I feel like glucose myself back in the day. When i used to go out to the clubs and didn't get led into the baas you i'd go home and you're familiar mom and dad wanting a nas not to themselves not annoy them. So i'd be the one that stuck around and causing inflammation and issues at high sets great of the house my metaphor. That was that perfect. But we gotta we gotta work on his metaphor and get some more like bouncers totally Man good solid. Sarah sightsee huge. Should i mean. Here's the thing dan. It's like your average person. Who goes onto youtube or instagram. To try and understand. What do i eat for diabetes may or may not here this podcast right in may or may not understand insulin. At this level of i'm sorry Diabetes level of detail. They probably don't. And that's okay. Because i tend to be a super now. I love this stuff but what we are the whole purpose of what we do in the whole purpose of what you do is to try and make stuff relatable for for everyday people so that they know exactly what to eat and what to do so that they can make things like diabetes and insulin resistance disappear right exactly. That's the idea. So we this being said where soil of i would like to officially claim that you gentlemen are the longest single episode. Podcast add to the point that can be divided to this alone. So we're gonna go to is this. So i wanna talk about mazarine diabetes. What you guys do. And just as a teaser. We gonna do a little bit of a tease. And the fact that next we re talking about the action plan and more about food specifically. Because right now i feel that would be a least another whole episode at his. I would you gentleman. And i'm sorry to the audience if they wanted to dear arab it long. No let's do it. I apologize ten talk a lot. So i'll stewed way. I'm so please listen to my voice. Do i sound excited about life right now. I just crossed west talk about this book was done. We talked about new york times bestseller introduction. Figo is it's it's credit. Pathway yourselves obviously you've got the online support as well to about like what. What are you guys doing. What's next in credible. Because you got this foundation of knowledge. I think i her. She put it pretty simply. You look people like yourself in with my invitation. My respect women's the very high end stuff to make that super reliable. So that's what i love about. You know skimming through said skimming through what i've seen so fine. No the action plan will get towards the end of the book. You read a pathway able to truly understands and take away an action themselves. And i found that in a world where these this so many variants and as you said. Overtime diabetes is vote abbott. So as our knowledge yet don't think people caught up to both of those evolutions yet you making it super easy for us to elite. Have the opportunity to decide so how. How's your world's changed. And what can we expect more for other than another episode. The table guests robbie. How's your life changed since You know i will say it's it's changed in the sense that there are more testimonies coming in and that is just everything wrong thing man. It's just it never gets old. It really never gets old whether it's like an email or dm or somebody went through our coaching program and shares their success Assist it's why do it we do. So that's the best part. Yeah exactly and so on just one of the listeners who haven't been to the website yet monitoring diabetes. Don't all you've got everything from your coaching. You method you recipes. You know. I'm getting involved with that. I'm sure this is what he get testimonies as well so you said she tight quiz little co action that gentleman who did your back in fantastic quarterback. I'm assuming that helps identify using individual. Where you're out with your your insulin and potential debate that situation that exactly right so people go through a sixty second ninety second quarter where they just answered some questions about the types of foods that they are eating and the frequency with which they're eating them and then whether or not. They moved their body in approximately. How much and then based off of that. We put them into one a four buckets either low medium high or very high insulin resistance and then based off that we kinda give you an action plan. That says okay. You scored high. This is what it means to be high. And this is what you can do to try and reverse insulin resistance and become non. Insulin resistant altogether unreal. You know what it's so funny looking through all the different steps as well you can go through. We haven't talked about. I know we touched on animal. Fats versus plant based fats We didn't talk about fasting. We didn't talk about you. Know obviously daily movement i feel is a is something that we all in our industry just to encourage. Anyway mathur it. This is so much so much data on to go with those after mentioned food choices. And that's where. I'm excited to continue the conversation side. No doubt rummy size it has been an absolute pleasure having you on today. I've thoroughly enjoyed compensation. I broke down noted out in the same. Vicinity of compensation i didn't even think was possible Other than you guys knocked bay. And i can understand why dr banerjee saas is just make sense But gentlemen thank you on. Thomas afternoon And i look forward to next installment and of course getting listeners to share their favorite thoughts from today so gentlemen. Thank you once again. Dan you are the man. I it's been a pleasure getting to know you and i feel like rolling very typical expert here but I love the fact that you're trying to change the world using food because food is something that people have at. Everybody has to eat food the story and you know we do it multiple times a day and i love the fact that. You're you're promoting evidence right. You're not just saying this is my opinion. This is what i think you should do. Your all about evidence Love it and i can't wait to come to your restaurants an east and learn more so i just want to throw in there man. I appreciate you living by example because your physique. I'm seeing on this on your instagram page man. It's like you know. Thanks for showing up eun. Cyrus could have some fun of across their class. I'm i'm happy to join. But i'm not gonna put in the level of performance in santa monica seeming la. Yeah yeah man. I'll take you to the farmers market. Yeah that's my boy. What what a couple of fun times ahead. We have appreciate you youtube great talking with you.

diabetes Insulin resistance robby cyrus Sir batu batu Mazarine diabetes Dan jack Caso Autoimmune diabetes Alzheimer's robbie Phillies nece america insulin resistance insulin Tassie
Managing diabetes without weapons

RNZ: The Detail

21:47 min | 7 months ago

Managing diabetes without weapons

"Donovan and today on the retail we talking diabetes a courter of a million new zealanders diabetic. That's touch over. Five percent of the population and that number is increasing exponentially with mody pacific and south asian people. Most at risk it's one of the leading contributors to cardiovascular disease kidney failure and amputations and management of diabetes costs nearly two billion dollars a year. So why is new zealand's treatment plan so far behind the rest of the world and why a to effective medications facing barriers to being introduced here the co authors of an editorial in the new zealand medical journal published today a calling for the drug buying agency farm act to fund to drugs that could dramatically improve the lives of people with diabetes. It's affecting modern pacific populations much more. It is in the form of any epidemic and the truth is things that we can do. That will change it. Filemaker's is considering funding. These two new drugs and we saying that got to do it right. Gotta do it now. Here's dr brian beating medical director. The royal zealand college of general practitioners. Who's put his name to a news. Release calling out phonic for its lack of progress on medication for diabetes. The fundamental thing was diabetes. A male is the body loses its ability to control blood sugar levels. Lodge sugar or glucose is very very important for the way the body functions. It's essentially the patron of the body and like any any pitcher orange and we need to control. How much is in the body. Soft too much glucose guys into the body or too much sugar. We tend to flood the engine and caused damage. And so he fled the body and caused damage. Diabetes as fundamentally with the body loses the ability to control sugar levels and we get too much of it in the body now. This basically fundamentally two types type one diabetes Often with younger people and children. And that's what we call an autoimmune disorder and that is where the body tunes on itself and actually shuts down the pancreas. Now the pancreas is the thing that produces insulin. And insulin is the thing that controls blood sugar levels. So this autoimmune thing the pancreas seems to be shot stan. These no insulin. That's released into the body. The body can control sugar levels because it has now been and we cool that type. One diabetes the second type of diabetes type two. And that's essentially other time. The pancreas gets worn out. It's slowly starts to be not as effective at producing insulin. The body can't control the sugar levels as well as would and generally just gradually comes on. I've read number of years to appoint Really the body can't With suga anymore because the pancreas isn't working as well as was In that situation we normally use medication to try and boost the body's ability to control sugar and at cambridge. To a point where. We actioning use insulin as well to replace insulin in the body to control the sugar so really. It's the inability of the body to control sugar when we talk about diabetes innocent of issue scenes as we are here. Are we talking about both type. One and type two diabetes fear to sort of group those two together and talk about diabetes as as a whole or is it quite important to separate those out. I personally believe it's important to separate them out that someone living with type. One diabetes has a very very different ginny to someone living with type two diabetes. So we do have to make that distinction has separate in what they do and how they come about by coming out in different ways. They often have very different trajectory in terms unfold. One actually is a very blunt. Differences with type one diabetes dodig sizes important. That's very important with all diabetes with type one from the moment you had diagnosed you require ensure there is no option because the body is not producing insulin. The in for if you're a child who develops taiwan diabetes from the diet you develop. It becomes part of the rest of your life so that is very different with type. Two there is a softness very slow unfolding of the loss of sugar control and a number of strategies that can be put in place to try and mitigate detto change that inside the coast of the two conditions are very different. And i think we do have to separate them out in their minds. We can't live the two. We can't sort of a one condition. Now today. we're talking largely about type two diabetes. This is not because it's necessarily worse than type one at as an but at has more flexible treatment options with type. one diabetes. Yarn body is attacking the pancreas. The insulin manufacturing plant therefore you need and chilean full. Stop type to on the other hand. Involves your body not producing enough and chillan in. This can be mitigated even managed with more exercise to three glucose. Faster through paying attention to what you're eating which helps manage your glucose and so one thing is for sure. New zealand has a lot of people with diabetes. More than two hundred sixty thousand as of last year. Two hundred twenty thousand of whom have talked to and that is bad. News diabetes overtime. Kinkel is hot attacks or scheming hat. Disease can cause strikes Something co per for vascular disease that is with the circulation to in particular. The league's fate is blocked. And as a result that leads to amputation. causes a lodge cluster of the tie and related to the hat to the brain and the seeking big group of problems. That actually could is what we call micro-vascular that is a pig's. I'm eyesight can cause blindness. It affects the kidneys. Sought can shut down the kidneys over time and that is particularly important in new zealand because mallory and pacific patients literally twelve to fifteen times more likely to progress twinstar drain Heavy can these shutdown by diabetes more about vet and a few minutes in the food area to fix as the news the body. it can start to kill off. News to the fate into different parts of the body and that can lead to all sorts of problems. surreally diabetes encompasses and cancun's damage to to every part of the body. If you start to look at it and Is a major major contributor to heart disease rights new zealand to insight kidney failure zealand dialysis to amputate shouldn't of fate and legs and to blindness. Soy it is it is a really really major problem in the new zealand seating. It usually takes a while for people to accept that they have a A diagnosis a condition and chum often go on for months without fully really acknowledging the fact that they have diabetes. That is to call it. Took an associate dean at auckland. University's medical school and he has an interesting perspective on this. Because i have had diabetes type two diabetes for fifteen sixteen years now and i managed my so Injecting myself. So i'll have kind of bought from the fact that i use that i use to treat a lot of people diabetes. I'm living with what were the circumstances around you finding that out. We not feeling great and so you went to the doctor. Did you speak something. Well i guess being a medically trained. I was the aware of the fact that my mother and my father. And my mother's siblings all diabetes so in a sense i was programmed to have diabetes. It was just a question of time if you like. And as i got older put on more weight in the risk go higher and higher. But i didn't feel on well i wasn't sick just happened. One time i went to see a gp. Faw something else would just the usual story. And i got a blood test Came back and and confirmed that. I had thai blood. Sugar essentially diabetes and we tried with diets and didn't say a little and i moved onto tablets. And and then onwards. That's kind of how things happen. In fact it's very rare for people experiencing these symptoms so diabetes particularly type. Two diabetes usually found as a result of a blood test for something else. Having diabetes. means you're more likely to develop heart. Disease leads to hundreds of amputations each year. It costs the country nearly two billion dollars a year and treatment costs and the problem is getting worse over the past decade. The number of diabetes and new zealand has risen by forty percent from one hundred eighty eight thousand and twenty two two hundred sixty four thousand and twenty nine nine. Nearly forty percent of people with diabetes and new zealand are of molly pacifica or indian descent which biggs the question. Why well there are some people who still go on about the fact of their dynamically predisposed meaning. They have a genetic makeup that makes them at higher risk. Most people most doctors most business will now tell you that in fact the problem with diabetes relates to the environment in in which people live so in the food eat and reduce levels so excess is and that pretty much explains the bulk of it and As this is some people would still talk about a genetic link if there is one that's pretty weak and most of it has to do with the environment in which people live mainly because of the type of food. They eat high in sugar salts. Fats and and not enough exercise. People who are overweight or obese will have elevated risk of developing diabetes. So it's pretty much. And then a a as opposed a human body reaction to a toxic environment with the types of food that people are eating their these days. One thing that i found interesting about this is this is a phenomenon that we see around. The world among indigenous populations i. I'm curious your thoughts with that. Perhaps this is also a reflection of almost the residual effects of colonized health system. The idea of a lack of trust and the health system behaves and not seeking out medical treatment until problems become really big problems. That's an issue and we'll come to that in a minute but there was for a time and probably still is a theory. Somebody's theory it's called the thrifty genotype of this gentleman called. Neil what is is that polynesians in particular pacific. People from the islands are genetically programmed to live in environments where they go through prolonged periods of drought. Whether they're sailing or maroon on an island know something and then there's periods of plenty of food so in the since genetically bodies program to those kinds of environments the problem. now of course is Anytime you hungry you go to the fridge. Will you go to the local Takeaway place in this ongoing availability of food often not good quality food. And so you'll make up is not being able to adjust to your new environment. So that's been a theory obviously has a lot of Merit but difficult to prove and then to come to the point you just made and we talked a little bit about this earlier on often. People with diabetes Under treated like high blood people were high blood pressure. They'll they either not treated at all under treated and medical care or medical interactions between a patient and So doctor is a subject to so many things and one of those things is the level of trust in the doctor little trust in the nurse liberal trust in the system confidence in the treatment concerns about safety and generally pacific people. Don't get care that they need pretty much full for a whole lot of medical conditions including diabetes. So really these three to the treatment. Number one is locked style diet and exercise. I really really important in trying to control blood. Sugars and this is by Exercise teams to burn up sugar in the body so if we exercise on a daily basis we tuned to ben up sugar and bring out sugar levels down and if we control the amount of carbohydrate that we eight and suga the tyke and the body that teams to reduce the amount of sugar that has been put onto the body so those two things balancing those two things out really independent or the foundation of starting to treat. Diabetes dot is really really critical. The second treatment modality is medication now in new zealand. We've had basically two medications available to us that something mitt foreman which has made a cashless that patients go on strike off with. They stopped to get diabetes and something called salt from urea. Which which which. Actually stimulates the pancreas to to produce insulin about two years ago. We had another medication. Who voted clinton which came on board and at the moment there is a there is a third seat of medications. Something quotas Lt twos and gpl ones which the rest of the western world of head for the last five ten years new zealand has been very very slow in adopting them but family is very very close to releasing these medications in the new zealand system. Now these are really important medications because not only did they reduce shogo. They actually predict the kidneys from damage. And i predict the hot from damage with blood. Sugar salt Suga like focus on the heart and kidneys jalen context where narayan pacific instance at twelve forty times more likely to progress to rain. Failure a medication that protects the kidneys very very important zealand fell behind the olen. Tim's having access to the medication. We hope that that will be accessible on the next two to three months and night will change the landscape and confirms what we doing. So medication is very important. The food pat which which is incredibly important as well as the use of insulin and that is replacing the bodies insulin. Levelstrump insulin injections to bring down and control should illegals so dot makes us. Is the usa medication. And the use of insulin. I really the backbone of treating a type two diabetes type one diabetes. The there is A bit of consternation at the moment around pharmacy and in two types of treatment. I think impact low flow zain and do leg lutai. I've which have ridiculous names all we. These names come from brian. It's is outrageous comes over time. It is confusing. I don. I can tell me a bit about these these treatments and why there is a bit of consternation around then a case. Let's focus on the equity issue with diabetes new zealand. I believe that type. Two diabetes is one of the biggest medical equity issues. We have zealand. And that's because of the statistics like at marian pacific three to five times more likely to get type. Two diabetes a twelve to fifteen times more likely to progress twins dino files diaz seven times more likely to die from diabetes than europeans. So we'd have this of equity gap entombs of type two diabetes. Now as i mentioned they new medications are really really important because they protect the kidneys predict the hot now. What just see it as the we have this. Massive equity gap in terms of outcomes with talked to diabetes so these medications are very very important for new zealand. And i believe there are actually very important for addressing some of the equity issues. We have now the problem that has being with these medications emerged on the international scene about ten years ago now well established across wisdom world in terms of use and x dot patients living with diabetes however in museum because of the cost of these medications and one of the issues that actually rose was. We had two hundred. Twenty thousand patients will pay eighty living with diabetes and new zealand. it's potentially a huge cost to new zealand. System to fund. These medications. And i believe that that that was very slowed and understanding the problem with diabetes. Very slow to understand the equity or the iniquity intimidated outcomes new zealand and very slow to respond in terms of bringing these indications into the new zealand marketplace. A consequence of that as a treatment of diabetes really did full well below the standards. What was acceptable across the western world. We will lift with essentially mid foreman softener. And then sean which was was at is now considered a very old treatment paradigm intimidates national practice about phonics struggling to to reconcile the cost of the medication with how accessible it would be. Two hundred and twenty thousand yuan does living talk to diabetes has really lead to very prolonged the lion access to them. Which in many ways i think the diabetic provisional dominant community deals with general practitioners into chronologies cardiologist. Freedom physicians Do think is unacceptable. If you were given a day to enact some sort of achievable policies in this kind of area that would really make a difference to to diabetes. What would you do with individuals families and communities and really get him in the ten so to speak and get them to do more to prevent Weight gain to participate in activities to really change their diet. She work with where they get their food. So you you gotta do that. Then you gotta think about some legislative is like And physical mrs like texans offerings to discourage consumption of drinks high sugar. I would work with the doctors. And the nurses to support them to identify and to basically treat people with diabetes because many of them are missing out. at the moment i would Improve the availability of the drugs and some that we talked about and particularly working with You'd have to do A range of things. I i you know. It's not easy but you have to do these things and promoted and put some attention on what leads to diabetes. That's it for today. I'm emile donovan. The detail is brought to you by newsroom. Dot co dot in seed in my possible by our seed and you can get downloaded free to mobile device every weekday from podcast platform and of using april. Please leave us. A ratings are others can find us to jeremy ansell engineer. Today's episode which was produced by alexia russell. And thanks to dr brian. Busy and dr colin. The quintana mateo.

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