Here's What You Need to Know About Diabetes
In today’s episode, in honor of World Diabetes Day, we’re diving deep into diabetes. Did you know that one in two people in the United States have either prediabetes or diabetes? This means that even if you don’t have diabetes, someone you love probably does. Today, we break down what diabetes is, the differences between type 1 and type 2, whether prediabetes and diabetes are reversible, and most importantly, why having diabetes should never be a source of shame. We’re joined by the two lovely ladies from the Diabetes Digital Podcast, and if you have more questions, you can find additional information on their website.
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Juna Hello, everyone. Happy November. And also happy early World Diabetes Day.
Eddie Yes. You know, World Diabetes Day is November 14th.
Juna Woo woo! And today is November 11th.
Eddie And diabetes is actually a topic strangely, we have never covered explicitly on the podcast.
Juna Crazy, right? Because we get questions about it all the time and it's a topic that hits really close to home for me because my mom has Type two diabetes and I have watched the effects of it on her over the past decade. And honestly, a lot of the time I just feel like I don't really understand what diabetes is or like how it works or what I should be doing to best support her. So I'm really glad that we are finally having this episode.
Eddie Also, you and I will share this one hits really close to home for me because my blood sugars have been sneaking up and I'm really looking for what I can do. In addition to all the things I thought I was doing so well. So in our bonus episode, we'll get kind of deep into what I'm trying to do for myself. And of course, I take care of oodles of patients who have diabetes and have many of the dreaded complications of the disease.
Juna I love the word that was fine.
Eddie I have oodles. That's the way we quantify patients. Yeah.
Juna Yeah. So today is also a really special episode because it's not just Eddie, me and an expert. It's actually going to be us collaborating with two fellow podcasters, the two ladies from the Diabetes Digital podcast, and it was so fun chatting with them.
Eddie And I have to say that we sort of screened each other. I mean, us too. And them, Yeah. And when we decided that we were going to talk about evidence based recommendations and everyone smiled, yeah, we're going to stay away from the like the snake oil, what they call it, the potions, the potions. We decided to stay away from the potions and talk about the evidence. We thought, These are our people. Let's start the conversation.
Juna And also, I don't know about you, but I feel like when they're other podcasters, I just feel like it's easier to talk to them sometimes because a lot of time with researchers like they're kind of in lab all day. And so a lot of the time, no offense to researchers, sorry, but a lot of time, like when people talk to you about their research, are like other researchers. And so sometimes I feel like we're doing a lot of the translating between the researcher and the person listening. But with other podcasters, they're used to doing that all the time.
Eddie You're talking about sort of our off the air media advice to the speakers that we have about get to the point where it's simple.
Juna Don't use crazy jargon. None of us know what it means. But yes, so they are really awesome. I know you guys are going to love the episode. So on today's podcast, we are covering everything you need to know about diabetes type one, Type two pre-diabetes, lifestyle interventions and medications. It's a deep dive into diabetes. And even if you yourself don't have diabetes, 50% of the population has either diabetes or pre-diabetes. So I know there is someone in your life who has prediabetes, diabetes, or has one of them and does not know it yet. So I hope that everyone can get a lot out of this episode. I'm Juniata.
Eddie And I'm Dr. Edie Phillips, associate professor at Harvard Medical School.
Juna And you're listening to Food. We Need to Talk. The only health podcast that is super sweet but never raises your blood sugar. First, you want to start out by shouting out one of our favorite reviews of the week. Eddie There is so many to choose from this time. Guys, thank you so much. I had like a hard time choosing the time. But don't worry, we will get to read all of them. I just had to choose between four today.
Eddie And I think we're getting close to 2000.
Juna We're so close.
Eddie Written reviews. Well, everybody can celebrate that. That 12th. This one comes from e r h 1227. I'm assuming that they have a December birthday.
Juna Yeah. Yeah, it's probably.
Eddie But who knows? I love this podcast and tell all my friends to listen to it. Woo Yoona and Eddy make health and fitness topics so fun and interesting. They break down the content to make it easy to understand. And of course there are a lot of laughs along the way. I really appreciate how open they are about their own journeys with health and fitness. The guests are top notch. The messages are always positive and never shaming. Give it a try. You won't regret it.
Juna Isn't that awesome?
Eddie My gosh.
Juna Yes. All our top points. Just like all our goals for the podcast. So thank you so much.
Eddie So thank you. RH Happy birthday when December 27th comes around.
Juna Why that not be there? They to they weren't born in the year. 1227 Eddie Okay. You're just making assumptions here. It's possible that remember, guys leaving your view really helps us out and helps other people find the partner. It makes us feel good. And I don't know, it helps us get us closer to 2000 reviews. So I say it's a win win, win, win win situation.
Eddie And besides reviewing, if you're listening to the podcast and you sort of say to yourself, my God, they're coming so fast, you wanna talk so fast? And that is not so. And that is not far behind there. And I'm learning so much, but there's so much to take in. And by the way, I'm also driving and.
Juna Doing laundry and I'm at the gym and I think you guys are.
Eddie All all at once. What do I do? Here's what you do. You get on our list and we send you a newsletter with all of the main points that you just heard. Yes, there's no spam. It's free. And hopefully it's as fun as we are in real life. So go to food. We need to talk.com/email and sign up right now.
Juna And now to the episode. Welcome to today's episode. Today I am so excited that we are going to have another podcast collab which we haven't had in a while with the two ladies from the Diabetes Digital podcast, Jessica Jones and Wendy Lopez. Do you guys want to briefly introduce yourselves and just tell us about who you are and what you do?
Jessica Sure . So I'm Jessica. You can call me Jessica. Jess. I am a registered dietitian, certified diabetes educator. They have changed the name to certified diabetes care and education specialist. I prefer the old name. And as you mentioned, the co-founder of Diabetes Digital, which is a one on one virtual nutrition counseling platform for people who have diabetes, prediabetes, PCOS, metabolic syndrome. I have been a dietician for over a decade and working in nutrition since 2009. And I've done so much work with people who have diabetes and also pre diabetes and have just seen how firsthand you can help to prevent diabetes, manage diabetes with small changes. And our values are very much culturally inclusive care, weight inclusive care, evidence based care, because there's a lot of misinformation online and helping helping people have a positive relationship with food in addition to like supporting their health goals.
Juna I love that. That's what this podcast is all about.
Wendy Wendy Hello. I'm Wendy and pretty much everything Jess said. I'm also a dietitian, a diabetes educator. Over ten years of experience in the field, Jess and I met in New York. That's where I'm from. And we were actually working at Farmer's Markets with the Department of Health. And that was, God, I feel like close to 15 years ago at this point. Yeah. And we've been working together ever since. We didn't think that it was going to go into all of the things that it has to this day, being diabetes educators. It's just such a perfect fit. Yeah, I'm really excited to talk about diabetes today. That's so.
Eddie Cool. Can you actually, for the sake of the audience, define diabetes and just kind of start us off where we need to start? What is it and can you catch it from your neighbor or. Okay, it doesn't really work like that. We know, but.
Jessica That's a great question. And one thing I will say is, like a large percentage of the population does deal with diabetes or pre-diabetes about 50%. So it is something many people deal with. So in terms of diabetes, it's a condition where your body essentially struggles to process glucose. And for people who have probably heard about glucose but aren't sure what it is, it's a form of sugar that comes from the food that we eat, particularly carbohydrates. So there's a hormone in our body. It's called insulin. And what insulin does is it helps glucose, which is a form of fuel go from your bloodstream into your cells. So we can use it for energy, right? So insulin kind of opens the door so that the fuel can get into your cells. But with diet. Betis There's a couple of things that are happening. So either there's not enough insulin being produced or your body doesn't use it as effectively as it should and it becomes insulin resistant. And this leads to high blood sugar levels. So that's why we often refer to people with diabetes as having high blood sugar, elevated blood sugar. And over time, this can cause damage to various parts of the body. And I think some people don't they're not aware of the connection. Right. Like we all have family members who have diabetes or even we know of people where they've had amputations or things. And that's because of the high blood sugar levels kind of causing damage to different parts of the body, like the heart, the eyes, the kidneys, the nerves. And that's why it's it's really important, you know, it's accessible to people to do lifestyle changes, to try to do those things, to help to get their blood sugar levels at target to prevent some of these complications.
Eddie And just jump right in. Type one versus type two. You mentioned not having enough insulin versus being resistant to it, but just sort that out for us.
Wendy Yeah, that's something that a lot of people get confused about. There are different types of diabetes. The main ones are type one and type two. So type one is an autoimmune condition. It happens when the body's immune system attacks and destroys the beta cells, which are the cells that produce insulin in the pancreas. So for people that have type one, they do have to take external insulin, they have to take medication in order to survive. And whether it's through injections or whether they do it through a pump, they are going to need that external insulin. Usually it develops earlier in life, like in childhood or adolescence, but it can happen at any age. Or it's also latter, which is when the onset is a little later and it has characteristics of both type one and type two. And then there's type two, which develops when your body might still be making insulin, but it's not using it properly. This is called insulin resistance. And so the pancreas might be trying to make more insulin to keep up, but eventually it's either not making enough, it's not using it properly, and that's when glucose levels start to rise. So with type two, you may or may not need medication. For many people, they if they do need medication, they might start off on like an oral medication versus like an injectable, for example. Type two is a lot more common. And it's the type of diabetes that is most often associated with lifestyle factors or things like genetics age. And it is like when we think about prediabetes. Prediabetes is a precursor to type two diabetes and there is a lot that you can do to prevent it or keep it well managed.
Juna Okay, great. I just wanted to ask you too, so I feel like some of the language that we've received on the podcast with type one versus type two diabetes has been a little bit judgmental or accusatory of people that have type two diabetes. And that always upsets me because I feel like it's never anybody's fault for having something that I've kind of like gotten comments here and there when we talked about diabetes that people have been like, you shouldn't talk about in the same way. Like they're completely different, like people type one diabetes into anything they like deserve diabetes or whatever. Can you talk about like why neither one of these two types of diabetes is a person's fault?
Jessica My gosh. Yes. Thank you for bringing that up. I first I didn't know that until I worked in one of the first outpatient clinics that I worked in like maybe ten plus years ago. And I remember, like talking to a dietician and she was saying, like, there is this perception that, yeah, like people with type two, it's like they're for people with type one, kind of I don't want to say this is everybody, but like from her experience, sometimes they might, like you said, look down at people with type two. And I just want to point out that whether it's type one and type two, they both have a big genetic factor, right? Like, for example, my family, my grandmother had diabetes type two. My dad has pre-diabetes. I've had pre-diabetes. It's just a very strong genetic factor there. Also, I want to talk a little bit about social determinants of health, too, because people of color are more at risk for diabetes and type two diabetes. And a lot of that is these different factors that are non-health related that have to do with like our environment, our access to health care. Racism is another thing, like just chronic stress. And so that's another factor. And that's not something that people are, you know, kind of asking for, bringing on themselves. They just our approach is very much like compassionate, whether you have type one or type two, We want to hear your story. We want to learn more about, like your diagnosis. How was that for you? Reduce that shame because this is not helpful.
Eddie Can I just share this remarkably poignant example of what you just brought up about the stigma with diabetes? For a couple of years I worked at the Joslin Diabetes Center, which is over 100 years old. It's right in the middle of the Longwood Medical area. It's like the medical Mecca for all of Boston. And to some degree, we think the world and the amount of money that people give turns into the height of the buildings. So the Joslin Diabetes Center is, from my memory, about seven stories tall, which is not so bad. And I remember I have a beautiful office overlooking Longwood Avenue there across the street is this monumental large building for the Dana-Farber Cancer Institute. Because most cancers are not your fault. People perceive so therefore you're innocent. And it's just by the grace of God, I'm going to give you my money. And the biggest building is the children's hospital. Because kids are always innocent. And if you really want to raise money easily, ask for money for kids with cancer. And it just struck me. And I remember talking to the people who were in charge of the fundraising and they said it's a challenge. It's they face it every day. And what's interesting is that they lean into the type one when they're when they're raising money, because that is more, as you guys are talking about, much more a genetic thing and it's autoimmune and boom, it hits you when you're a kid and you're innocent and you haven't had a chance to. So I just wanted to tell you that it just you can look on a Google map and see, yeah, you know, what's that short little building over there in the middle of this area? That's the diabetes center.
Jessica Meanwhile, it's like 50% of people have either diabetes or pre-diabetes. So it's like you see here that there's less of the research happening, but yet it's like so much more of the population. Yeah, that's a really well.
Juna I was going to say. The reason I even thought of this or like was aware of this issue is because my mom has diabetes and she got it maybe ten ish years ago. And I remember my mom has never really been overweight. And like we eat, I'd say relatively healthy because we're all being in. So we kind of a mediterranean diet. But when she got diagnosed, it was when basically she was working two jobs and like she would leave the house at 5 a.m. and get home at like 11 p.m. and then like, you know, have to take care of the kids. But I was just not sleeping enough. Very, very stressed out.
Eddie So it's your fault?
Juna Exactly. And so then when, like, I feel like when people would find out my mom has diabetes or even like our family members would be like, my God, but you're not fat. You know, that's kind of something. I kind of heard like something that was implied. And so that's when I was like, okay, it's not just people who are overweight that get diabetes are like just people that unhealthy. Like there's so many other factors that go into a diagnosis. Speaking of diagnosis, how do people typically get their diagnosis? Like, do you have symptoms you experience, or is it always a blood test like an H1C test or something in your doctor brings it up?
Jessica Yeah, that's a great question. So it really can go either way. There are some people who notice those classic symptoms. Some of the classic symptoms are being thirsty all the time, needing to go to the bathroom a lot, going pee frequently, feeling really tired, sometimes unexpected weight loss, experiencing blurry vision. These are all signs that your blood sugar levels might be high. But in a lot of people, and this is particularly in people with type two, there might not be any symptoms at all. In those cases, diabetes typically gets diagnosed during routine blood work. Hopefully doctors are checking for this and the doctor might notice a couple of things. So one of the tests that they look for is the fasting glucose. So that's your blood glucose when you haven't eaten overnight and then you check it in the morning. And having that elevated is one indicator that you might be in the diabetes or pre-diabetes range. And usually that's over 100. And then there's hemoglobin A1. See what you mentioned? That's your average glucose over a three month period of time. Typically, people use A1C as a diagnostic tool to diagnose diabetes. And when your A1 see a 6.5 or higher, that is in the diabetes category. So there are so many people who have no idea that they have diabetes or pre-diabetes. They think everything's fine, they haven't changed anything. And so it is really important to know, especially your A1 C and get that checked at least once a year.
Juna And then can you guys go through what is pre-diabetes for you guys? Toss that around a couple of times.
Wendy Yes, absolutely. So prediabetes is the precursor to type two diabetes. It means that your blood sugar levels are higher than normal, but not high enough to be diagnosed as type two diabetes. And we use the A1. See also the fast. And Google said those are some medical tests that you can get with your primary care provider to, you know, just like check those levels. And I recommend doing it. If you have a family history of diabetes at least once a year, because sometimes doctors make assumptions, like you said, like they might think, well, you don't fit what someone with pre-diabetes is supposed to look like, especially for thinner people. Like they just kind of overlook a lot of things and they you don't get the testing and it's like every few years. And then next thing you know, by the time that you do get the test, you're like diagnosed with type two diabetes. So it is good to get those tests every year, especially if you have like a genetic predisposition. And I think of it as like a warning sign from your body saying like, we're having some difficulty processing glucose. It's a great opportunity to turn things around. There's a lot of things that you can do to reverse pre-diabetes, which I know that we're going to be talking about. It's not as simple and straightforward as like, yeah, you're drinking too much soda, so you're going to get pre-diabetes or diabetes. People like to simplify it, but like, it's not as simple as like, I eat too much carbohydrates or too much sugar because there are people that are just bingeing on sugar and they will never get help with diabetes or diabetes. So there is a strong genetic component.
Jessica So I'm thinking of Lisa Barlow. Does anybody watch Real Housewives of Salt?
Juna Yes. Yes.
Jessica You know, she's always like every day stopping up, which is like, Go girl, like all foods that she's like stopping operated Kit Kat. She's like, Yeah.
Juna Yeah, yeah.
Jessica Keep them in her prayers. And I don't think it affects her, but it doesn't seem like it isn't mentioned. So she's one of the people who can. Yeah, she can eat a bunch of sugar and it doesn't have those.
Eddie Don't go anywhere. We'll be right back with Jessica and Wendy from the Diabetes Digital Podcast. Also, if you know someone who needs to hear this episode, please take a moment to share it with them.
Juna If 50% of the population has diabetes or pre-diabetes, guys, I know anyone or someone you can share with half the people you know.
Eddie And we're back with Jessica Jones and Wendy Lopez from the Diabetes Digital podcast. What if we talked about lifestyle choices that would reduce your chance of getting diabetes? What would be the choices? Because the Kit Kats would not be on my prescription for a patient generally.
Jessica Yeah. So a couple things. One, I will say absolutely there are things people can do to help, and there's research to suggest that even the smallest changes can have a really big impact. Those studies suggest that physical activity, that's one of those things. Trying to get 150 minutes per week is going to be excellent for helping to manage your blood glucose levels. And people often think like when he said it's all about like diet or cutting things out. But even if you walk after, you know, your biggest meal per day for 15 minutes, like that can have a good impact on your blood glucose. Things like squats, because that is a bigger muscle group when you're squatting. If you're able to like do some squats throughout the day and you know, if you're someone who sets a lot for work like I do, like maybe get up every couple of hours and do five squats, and that can have a big impact as well. And then in addition to doing that cardiovascular work like walking. The guidelines also recommend doing strength training because that's also going to help increase your muscle mass. And muscles tend to be more receptive to insulin. So that's going to help with some of that insulin resistance as well. So those are two things, like doing strength a couple days a week. Strength training can be weightlifting, it can be Paladins, it can be yard work, like pulling those weeds. That's like a high strength workout. You can have some kettlebells at your house. Like there's so many different options, but just trying to do it consistently. And then in terms of eating, because we are dietitians and that's what we focus on, I think first and foremost and it's something that's overlooked, but it's very important is consistency in eating time. What we see as a typical eating pattern for people with prediabetes is like, maybe they'll have coffee in the morning or nothing. They're not hungry. Then they'll have like no carbs at launch, like a salad. And then they might have like a kind of more carb rich snack, like a sweetened yogurt. And then for dinner it starts to they get hungry, right? Because they haven't really eaten much. So, you know, they might have heavier foods and then they might even have like a lot of heavier desserts later. The issue with this is that it kind of puts your blood glucose on a roller coaster, and that's not what we want. It's not ideal. So what I recommend is that people eat more, especially earlier in the day, and try to get at least three food groups with their meals. So trying to have, yes, carbohydrates. We need carbohydrates having protein. We also need protein and having a non-starchy vegetable as well on the plate. And ideally, if you can make half of the plate non-starchy vegetables even better. Having that consistently breakfast, lunch, dinner, plus snacks if you need them, that's going to help your blood glucose be more stable throughout the day. You're going to get less hangry and you're going to be less likely to kind of be craving those higher sugar, more dense carb foods later because you're more satiated. And then I just want to make a point about the Kit Kat, too, because as I mentioned, we are all foods fit dietitians. And I personally love dessert. And I do feel that there is a place for having dessert if that's something that's really important to someone because there are things you can do like having that dessert after your meal, right? Because you have the meal that's going to help keep the blood glucose a little more steady. Or maybe you go on, you know, five, ten minute walk to help bring the blood glucose down. So there are tools and we can you know, it's all about portion sizes, of course, but we still can enjoy the foods that we love.
Juna I have many questions about the food, but before you go to that, I just want to ask about reversing pre-diabetes. So can you reverse pre-diabetes and can you reverse diabetes? Because when my mom got her pre-diabetes diagnosis, I remember that very much. Her mindset was like, okay, well, it's too late. Like, basically I have diabetes. Like, it's basically just like a pre diagnosis for diabetes. She didn't think of it as something that was like a warning sign that like, you can reverse. So what is the mindset that you, like suggest people have around pre-diabetes? And if it's reversible, how and then if one of other you wants to take that, is diabetes reversible.
Wendy Or yeah, pre-diabetes is reversible or you can manage it very well. Same with diabetes. And studies show that doing things consistently like, you know, improving your nutrition and being active, but also it's really important talk about stress and sleep because that can have a really big impact on your blood sugars as well. So thinking about like stress management techniques and things that you can do to improve your sleep quality, because all of that can increase like cortisol levels and it could influence your A1. See as well. The earlier that you know that you have prediabetes, the more opportunity you have to reverse it because these are progressive conditions. So if you don't know that you have pre-diabetes, then years and years of going by and you're not doing any type of intervention to get that one sit down, it progresses. And by the time that it's diagnosed as type two diabetes, it just becomes a lot harder because the progression happens a lot quicker, which I guess if just if you want to talk about diabetes being reversible because that is, I think, a controversial topic in the medical community. Some people agree, some people disagree on like what the current status of that is.
Jessica Yeah, we actually did a whole podcast about this because this is a question we get asked a lot. And from our just gathering of the current guidelines and data, it's not possible to reverse diabetes. Let me just break it down a little further. So type one diabetes definitely can't be reversed because it is an autoimmune condition. So there's no way to reverse type one now. Type two also can't be reversed, but it can be put into what we call remission. That's generally the language that's used. And that means that people's blood sugar levels can return to normal range without needing medication. I have seen this a lot with patients and also with diabetes digital as well. Like patients go from their A1C being over the 6.5 to then under, you know, the quote, diabetes diagnosis range. But they technically still have diabetes. It's just well managed in remission but it's not necessarily cured and it still requires that ongoing management and those lifestyle adjustments, if that's what people choose to do to help maintain those blood sugar levels. Also, it's possible for some people, but it's not guaranteed for everybody. Right? Because again, we talked about all the factors, the genetic things. So you're not a failure if you don't get out of the diabetes like lab zone. It just means that, you know, you can still work towards getting your blood glucose at Target in whatever way is best between you and your doctor.
Eddie So give you just a little bit of the perspective from the world of lifestyle medicine, where the updated definition that we published 2014 2015 was was talking about not just diabetes, but lifestyle related illnesses that lifestyle medicine can help prevent great treat and even reverse, but never use the cure word. And I can tell you as a clinician, as you guys are, there is no greater satisfaction than someone who's followed some advice. Listen to these podcasts and comes in and want to ask about their their blood sugar. They go, I guess. I'm not sure if I have diabetes. I mean, I don't have to take those medicines anymore. And, you know, once I started lifting weights and and I changed my body composition and I did give up sugar sweetened beverages, they'll they'll call it soda. And I made these changes. I like you tell me whether I have it or not. And for health purposes, if your blood sugars are normalized, what you call it, probably irrelevant, right?
Jessica That's true.
Juna So how does someone like know? Okay, so for example, if someone is on medications, right. But they also want to implement lifestyle factors, how does someone go about knowing whether or not they can start to reduce their medications? Like what are the signs? Or is it that you go to the doctor, you're a once he's a certain level and they say you can lower the dosage or something. Like can you only do it with your agency levels being tested? Or I'm guessing you are not allowed to like actually manipulate your own medications by your own intuition because how would you know?
Wendy Yeah, exactly. It would be a conversation that you have with your doctor, with your endocrinologist. Like typically for people with diabetes, it's recommended that they do their doctor visits every three months. But it might be more frequent. Like if you're trying to experiment with a medication adjustment, we always recommend adjusting with your provider and not doing it yourself. Because I have come across so many patients where they just like they just adjust themselves. So they're like, well, you know, based on my readings and you just want to make sure that you're doing it under professional guidance so that you're not going too high or too low with your numbers. But yeah, I mean, if you're noticing that you're trending down, whether you have a glucometer or a CGM, you can have that conversation and you can either lower your dosage or completely come off the medication. But also, I just want to emphasize, like if you're not able to come off medication, it's not that you're a failure or that you're doing the wrong thing. Because for some people who have a very strong genetic component, it's very challenging. I mean, they could be eating all of the right things like perfectly balanced. I even know of people who go to the extreme and they just cut out carbohydrates over the long term and they're able to see is still. Really, really high. And they're like, what is that? Like, What am I not doing? Right? And we're looking at everything. And it's like, you know, sometimes that genetic component is really strong and it's not your fault. It's just that you might need the assistance of medication. You know, that's what it's there for. We don't want to, you know, like use Band-Aid solutions or like use medication when you actually don't need it. But for some people, it's a really helpful tool.
Juna That makes total sense.
Eddie If I could just share sort of a story that comes to mind, and it's a patient who is following all the advice we're talking about. The guy called me from the hospital where he had been admitted after collapsing from low blood pressure. He was in the gym. And how but the point was that as he got healthier, he needed less and less medicine.
Juna And it.
Eddie Took him collapsed in the gym. But he understood that. And he called and he goes like, This is great. I'm like, Really? He said, I don't I don't think I need that that that anti hypertensive anymore. And from what you guys are saying, people do monitor their own glucose and they will need less insulin and less oral medications and that's a really happy problem to have.
Jessica Yeah. Yeah. And cheaper. Yes. It's also these meds are I mean.
Eddie I should mention the cost of diabetes. I saw something in a slide. I was putting together over $350 billion a year cost to the U.S.. And that's out of, what, like over $4 trillion health care budget. But. And it keeps on going up.
Wendy It keeps going up. Yeah.
Jessica Because so many people have it and the complications you add.
Eddie But just to be clear, for you and his mom, whose diabetes was brought on by her children. Can she never have you know, she can never have a croissant again?
Juna Yeah, My mom loves Christmas present. Okay. And something that I struggled with. So you can tell me how I should better assist in this because I fully, like, acknowledged this was not the correct way to go about this. But I feel like because I knew my mom had diabetes, whenever I'd see her eat desserts or presents, I just get so upset and I feel like I was very judgmental because I was like, woman, like, why aren't you taking care of you? And it's not because I'm like mad that my mom doesn't have self-control. It's more that, like, I'm afraid of what's going to happen in the long term. You know what I mean? Like, I'm always thinking about like, yeah, what is going to happen later? Like, and I don't want her to deal with those things and I don't want to have to see those things. It's going to be so sad. And so I feel like there was years where I was like, I think she knew, like she could tell even if I didn't say something. It's just like the look on my face. I was like, you know, that I was disapproving. And now that I've gotten older, I'm like, okay. And that has never in the history of humanity has that ever made anyone eat better to be, like, judgmental about what they're eating. So I have like completely put it away as best I can, but like, how do you help somebody have better lifestyle choices without being judgmental or can you not do that? And then also like, yeah, is it still okay? Like how do you guys manage eating desserts and things that you like? Because obviously it's really not reasonable for anybody to spend their whole life not eating foods that they love. And most of us love refined carbohydrates.
Wendy Exactly. I mean, when people restrict they tend to overeat those foods that they're restricting. So it's all about finding a sweet spot, but finding a happy place when it comes to those foods that you love that maybe do have a bigger impact on your blood sugar. And you're right, like, you know, shaming people or judging people based on their food choices, it never works. I feel like if anything, people rebellious more, especially when it's like, yeah, you know, like I've had so many patients where they're just like, you know, they're like dragging their family member in to see us, to see a dietician. And, you know, it's like the motivation might not be there, but it's like it feels very forced. And it's hard when that person feels like, you know, they just have like all these fingers being pointed at them, like they're not actually feeling supported. So I know you ask like, what are some good ways to support people? And I think asking questions, questions that can elicit conversation about how they feel having diabetes, like how does it feel to have this diagnosis? What are some of your fears around having diabetes? And when it comes to nutrition, specifically working with a dietician for a lot of people who have health insurance, this is a service that is completely covered. So a lot of people don't have to come out of pocket for the most part. They don't really have to come out of pocket. So talking to a professional, because there's a lot of misinformation that we get, whether it's from family, friends, the Internet. A dietitian is trying to provide evidence based information when it comes to diabetes, nutrition, all types of nutrition. So just make sure that you're getting information from a reputable source because you don't have to cut out carbohydrates.
Juna Or.
Wendy There are carbs that we recommend eating less than others, but it doesn't necessarily mean that you have become. Completely eliminate it. Like usually that approach is just not sustainable for most people.
Juna What do you guys think are some of the biggest misconceptions about things that people aren't allowed to eat when they have diabetes, quote unquote? I feel like there's a lot of things that there's so much misinformation about what is a carbohydrate. And so I feel like when I talk to people, they're always like shocked that like, certain things are carbohydrates or other things aren't. And this thing is battery. This thing is not. Yeah, yeah. What are some of the misconceptions you guys feel like there is?
Jessica I mean, I think the biggest misconception is that you can't eat carbs when you are diagnosed with either diabetes or pre-diabetes. And I think this comes from a lot of different places. Like some patients will say that, you know, they go to their health care provider and that person tells them like, don't carbs. Other people like I've noticed I join some diabetes support groups just to see like what people were talking about with diabetes. A lot of the talk was like, how do I get rid of all the carbs in my diet? And I'm just like, no. So I think that is definitely prevalent. And I also think, as you said, like many people don't even realize which foods have carbs in them because so many foods have carbs. Right? Like, I think we think of carbs as being like cake and bread and cookies, but it's also found in.
Eddie Vegetables.
Jessica Quinoa and vegetables and.
Wendy And.
Jessica Sweet potatoes and beans. And all those foods have carbs as well. And so when you cut out carbs, you're like really cutting out those foods that have fiber, which, as I said, fiber helps to slow the release of glucose into your bloodstream. So you want fiber. And like fiber is pretty much found in foods that have carbs. I think that's one I think, as you said, like that, you can never eat dessert. That's also not true. Like I said, there's different methods that you can do, like have it after a meal and like things that may not have as big of an impact on your glucose but still are satisfying. So in particular, I love the Aso bars. There's like, Yeah, so in, in like. Yeah, they're like, I think they're like 80 calories and like seven grams of carbs or sugars around there. So it's like a pretty great amount for someone who is like kind of monitoring their blood sugar a little bit more.
Eddie Those are potentially better because they have more fat in them or more protein.
Jessica I think they're, they're made with, Yeah, the Greek yogurt is the base.
Juna I want to try those. I keep seeing commercials for them.
Jessica Try them. Yeah. They're really good. I like happy. I like having those after dinner. And there's a lot of good flavors like chocolate chip and so many. So try those. So that's one thing. And then I think people underestimate the power of physical activity. So when I was wearing a continuous glucose monitor, which is a way to like continuously monitor your blood glucose, I would do different tests just to see what had an impact. And on the days where I was physically active, like let's say I had the exact same breakfast, my blood sugar level didn't go up as much, which is a good thing for somebody with, you know, I mentioned I had prediabetes or diabetes. So exercise is huge. However, it's recommended that you kind of spread it out throughout the week, I will say, because the benefits, especially of like aerobic exercise, the benefits are kind of only as good as when you're doing it. Train training is different because like those benefits live longer, sometimes up to like 72 hours. But I will say like try to not go more than two days without just doing some kind of aerobic exercise. And even with my patients, I feel like they mentioned nothing about their diet but at exercise, and that has a huge impact.
Juna Is there a reason why somebody would have a glucose spike as they're exercising? Because I know when I brought my mom to the gym a couple times, I feel like she's felt really discouraged because her sugar looks like it goes up while we're exercising and we don't know why, but I don't know if there's like something happened because of the exertion or something and I'll go down later. But like, what should your blood sugar be doing while you're exercising?
Jessica So yes, it is true that that can happen. And we have seen this with diabetes digital as well, with some of the patients where they will exercise and they'll have like a temporary glucose spike and they can be like distraught about it, like, my gosh, but don't have no fear. So, like, exercise is a stress on the body, right? Yeah. Yeah. It's okay for it to go up a little bit, but it's going to come back down and like that shouldn't be a reason why people don't exercise.
Juna Okay, cool. Thank you. To wrap up, if somebody has just got a diabetes diagnosis, what are you guys his message to them all?
Wendy I would say be gentle to yourself because there's a lot of shame and blame that we do to ourselves, especially when it comes to health conditions. We're like, my God, where did I go wrong? Was it the Thanksgiving meal? Like, now just be gentle. There's a lot that you can do. It's really important to tap into support. And so figuring out what does that look like? For you to have a supportive health care provider, a supportive dietician, supportive family and friends that you can lean on for guidance and for love. Because it is hard getting any diagnosis, you start thinking about like, what could I have done differently? But again, this is something that a lot of people have, and there are so many things that you can do to bring your numbers down. So yeah, that's what I would say. Try to lean into like all of the people that are supportive in your life, including your health care team.
Juna I love that. Guys, we are going to now record a bonus episode where we talk all about the things that you can do to balance your blood sugar. But before we do that, I just want to say thank you so much to the both of you for your compassion and the information that you've given us and just the way that you convey the information. I know so many people just feel so seen and so not shamed and not judged by the way you to talk about diabetes and podcast. So thank you so much for that. Thank you. Thank you so much to these two ladies from the Diabetes Digital podcast. You can find them wherever you get your podcasts. If you want to hear our bonus episode where we talked all about balancing blood sugar hacks.
Eddie Home.
Juna Cinnamon fiber, walking after meals, vinegar. Are they true or false? Are they helpful or not helpful? Find out in our bonus episode and we answered a bunch of your questions in our bonus episode. You can go to food. We need to talk.com/membership or you can click the link in our show notes. You can find me on Instagram at the official unit and Unit Jodha on YouTube and TikTok. You can find Eddie.
Eddie Still eating his coffee ice cream with the walnuts on top.
Juna You can tell my expressions. Like what? I don't know about this. I'm just kidding. I'm just kidding. Guys. Ice cream is good for the soul food. We Need to Talk is a production of PR X.
Eddie Rebecca Sydell is our producer and mix engineer.
Juna Food We Need to Talk is co-created by Kari Goldberg, George Hicks, Eddie Phillips and me.
Eddie For any personal health questions, please consult your personal health provider to find out more. Go to food. We need to talk Tor.com. Thanks for listening.
