[00:00:00] You are listening to episode number 243 of the Reversing diabetes with Delane, MD podcast. Welcome to reversing diabetes with Delane MD, where women who are confused and worried about their type two diabetes come to learn strategies to fix it. I'm your host, Dr. Delaine Vaughn. Ladies, if you know you are capable of doing badass things at work and for your family, but you're frustrated with why you can't seem to stop eating the chocolate cake, this podcast is for you. Let's talk. Hey there. Welcome to the podcast. Today we are doing a question and answer podcast where I have taken questions from various social media outlets, and I am answering them. They are questions to me directly. They are not questions to the universe or questions for somebody else to answer, but they were questions to my accounts. So that's what we're going to do today. But I want to take a moment to say thank you for joining me. Thank you for committing to your health today. Thank you for taking a few minutes and doing something for you. I think as women, we don't do that nearly enough, and I think that it's something that we need to celebrate and we need to do more. So thank you for joining me today, and thank you for taking a moment for your health. So these are questions, again, from my Instagram account, from my Facebook account, from the Delaney, MD Instagram account and my Facebook account, and then also the DelanemD reversing Diabetes Facebook group. If you're not a member of that, go find that group. And again, Delanemd reversing diabetes, you can search it on Facebook and you'll find it, and you can join that group. There's a lot of fun things that go on, on there right now. This week, we did a 30 day or 30 plant per week challenge. So we're coming to the end of that. But there were a number of us participating in that, trying to get 30 different plant varieties into our diet over this week.
[00:01:53] It's been a fun time. There's just a lot of fun people in that group and a lot of fun conversations. So if you're not a member, go become a member. It's also a place where you can ask these kinds of questions, and not only will you get an answer in the group, but you'll also maybe possibly hear me ramble on about it in the podcast. So I am going to answer a few of those questions today. Some of them are pretty straightforward. Some of them are more in depth. So one of the questions came from Nikki, and somebody else actually asked this question also, and I am not sure if it was on the Instagram feed or whether it was on the Facebook Delaney MD page or whether it was in the group on Facebook, but it was a question about protein. It was a question about, I am fasting, and I find it really hard to get all of the protein that I need in my diet on the days that I'm fasting. So, fasting, the act of narrowing the window that we eat, makes it challenging to also get the protein into our diet that we need. So there's a lot in this question, and a lot really goes into it, and so I want to simplify it first, we're talking about two things that we are looking to do, two goals that we are looking to accomplish, and they aren't always going to go hand in hand. All right? We want to add protein and we want to fast, okay? We want to add protein because we want to make sure there's enough macronutrient, there's enough building blocks to ensure muscle growth in our body. That's why we add protein. Okay. Some women also want to add protein, and I've promoted this add protein because you'll feel full faster. You'll feel satisfied quicker. So adding protein, we do it because we want to build muscle, and we do it because we want to feel full. So, in general, why do we want to add muscle? Muscle increases our insulin sensitivity. So type two diabetes is caused by insulin resistance. It is not because your blood sugars are too high. That's actually an outcome or a result of being insulin resistant. For most people who are type two diabetic, type two diabetes is caused because your cells are insulin resistant. The opposite of insulin resistance is insulin sensitivity. And muscle, the more muscle volume you have, the more insulin sensitive your cells are. Okay. Muscle cells are very insulin sensitive in general. If we add more of them, if we bulk them up, if we make them more active, there is going to be more insulin sensitivity. We want to add protein to our diet so that we have the building blocks to make more muscle. That was a big, long answer. Right? So, overall, this improves our insulin function, it improves our insulin resistance, and it means our blood sugars get lower.
[00:04:53] I want to offer to you, fasting is the opposite of this.
[00:04:58] Adding protein to build muscle is building up.
[00:05:02] Fasting is like breaking down. We are doing two opposing things, so it kind of makes sense that it's hard to do it. Okay. We also want to point out that adding protein, again, adding protein so we can make more muscle and become more insulin sensitive. That is one way to help improve our blood sugars and our diabetes in general. Adding protein also helps us feel satisfied. It increases the satiety that we experience or the satisfaction that we experience from a meal. I will offer to you that feeling satisfied is an art form. It's not a science. It's not exact. You're not going to be like, x number of grams of protein, right? X number of grams of food, x number of volume of food equals satisfaction.
[00:05:55] Satisfaction is a moving target that's based on a lot of things. It's based on things in our brain. It's based on the quality of our food. It's based on biochemistry that's occurring in our body, on our metabolic biochemistry that's occurring in our body. Satiety is a moving target, and it's an art form. So when we're using protein to treat or to create satisfaction in a meal or in our diet, recognize that can change from moment to moment, that can change from day to day, and the understanding that we're going to have to be pliable enough, we're going to have to give enough wiggle room, we're going to have to be gracious enough with our experience to allow for that change, allow that to be different from day to day. So that is not an exact science.
[00:06:48] Learning how to navigate how satisfied we are with a meal is not exact. We're going to have to give some grace and some space and some forgiveness in what works for us on Monday versus what works for us on Wednesday, Thursday, or Friday. Okay, so adding protein does some things, right? Helps us build muscle, helps us create satisfaction in our meals.
[00:07:12] Fasting is something entirely different.
[00:07:16] Okay. Fasting is when we are not consuming so that we can lower our insulin levels.
[00:07:25] And that lowering of the insulin level helps our cells become insulin sensitive again. It decreases our insulin resistance. Okay. Yes, we are trying to decrease insulin resistance, but we are going about it in two very different ways, almost like riding the brake and the gas pedal at the same time. We can't expect to get huge gains when we're focused on both of them. So my point is that sometimes you have to decide what you're focusing on. What are you going to do? If your focus is building muscle in order to create insulin sensitivity, then you may have to give a little bit on that fasting end. If your focus is fasting in order to create or to resolve or improve or heal insulin resistance, then you may have to give a little bit on how much protein you consume. They are both important, and we may want to do both but we can't probably do them together. Okay, so my recommendations, like, what do I do? How do I manage this in a day to day moment? I do a long fast most days, so I fast anywhere from 18 to 22 hours most days of the week. Sometimes maybe it's a 16 hours fast a few times a year, like probably less than ten times a year. I'm doing like a twelve hour fast only. And that's usually in the holiday season. And food is just different for me during that season so that I enjoy my birthday and my kids birthday, and I enjoy the holiday.
[00:08:59] But for the most part, I live in a space where I fast 18 to 22 hours a day. And what that means for me is when it's time to eat, the volume I put in my stomach has to be pretty intentional. So I eat my protein first, not because I want to be full, not because I want to feel satisfied, but because it's the most important part of my meal to make sure that my muscles are getting everything that they need, because I do some pretty aggressive workouts, and I want to make sure that my muscles have everything they need to grow and to repair and to be as much as they can be at age 49. Okay, so I make sure that I'm consuming my protein first. And why I do that is because if I take the fruit that I want as a snack or as a treat or that special thing or that pizzazz in my diet, if I take the fruit first, suddenly there's not enough volume to get all the protein that I need to get into my meal, like get it into my belly, there's no space because I put an apple in there. I put the fruit in there, or I put maybe chocolate or whatever. So that's the first thing I call this stomach real estate. Make sure you're taking up the room in your stomach with nutrients that matter, not the treat things that we want. If you're full from the nutrients that you need, the protein that you're looking for, that's great. You don't have to fight hunger anymore, right? But you may find that you're full from that, and there is no room for the thing that you want as a treat. Recognize that you just want the treat.
[00:10:39] And if you're feeling like, bent out of shape because you want the treat and you've eaten the protein and there's not room, it's a different issue. We need to look at some desire issues. That's what needs to happen there. But I get what women are saying, and they're like, oh, my gosh. It's hard to do the fast and to get all that protein in my body, and it is. We have to be very intentional about the things that we eat, so that's how I encourage women to manage it. Make sure you're eating your protein first so that you can keep your muscles as big as you need them. They can heal if you're doing exercise or if you're doing weight work. That's part of growing a muscle bigger. Is there is this phase where there is this strain to the muscle? That strain needs to be healed, and we can't heal it without the protein. So, yes, you want to make sure that happens so you can get your muscles as big as you can get them, so that there can be insulin sensitive tissues in your body and pull your blood sugars down. Great. That's grand. But we can't waste time with foods that are not part of that. Right. We can't waste space with foods that aren't a part of that. Okay. So you kind of have to work on that part, and a lot of times, we want the treat that we want, and sometimes we have to change that mentality. So that's my recommendation for how to get protein into your diet. Another question that I had was, I was shocked at how long it took to reverse my insulin resistance. And this is from Marie. And this, I think, what is under this know, how long does it take to reverse insulin resistance? And my answer to you is, it takes as long as it takes. That's really what it comes down to.
[00:12:21] I do think that some women, when they've had insulin resistance longer, that sometimes the process can take longer to reverse. I talk about this concept of collecting better biology, collecting more seconds, more minutes, more hours, more days, more weeks, more months, more years of better biology. Of your biology functioning normally versus functioning from a state of pathology or disease. So the longer you've functioned from a state of disease may mean that it takes longer for you to collect more time and better biology than it does for somebody who's not functioned on that time frame, functioned in disease for that time. Okay, there's no clear way of determining this.
[00:13:14] The answer to how long does it take? Is it takes as long as it takes.
[00:13:18] We're improving insulin sensitivity. And this definitely can feed off of each other. But it falls into two categories. Like, there are two categories that we do to improve our insulin sensitivity. One, we decrease the things that are causing insulin resistance. And the second category is, we increase doing the things that improve insulin sensitivity. Right. We ride the rake in the gas. Right? How much are we doing of each in order to improve our health? So, insulin resistance is caused by a number of things. But the things that come to my mind when I initially think of this is the food that we eat causes insulin resistance. Period. End of sentence. Stressors cause insulin resistance via cortisol.
[00:14:05] Inflammation causes insulin resistance via cortisol. Circadian disruption causes insulin resistance via not being able to heal. Okay, so insulin resistance is caused by things, and then insulin sensitivity is caused by things. So there are things that we, as human beings do that create insulin sensitivity that are, regardless of our insulin resistance, exercise, which we just talked about, the building of muscle exercise improves insulin sensitivity. Both muscle building and cardiovascular exercise improves insulin sensitivity.
[00:14:46] Irrelevant of our insulin resistance or the food that we eat or stressors, exercise alone. If all of those other things, those things that cause insulin resistance are happening, exercise alone will improve insulin sensitivity and thereby normalize, help normalize our blood sugars. Decreasing the cells, the time that cells are exposed to insulin, that is going to, over time, improve insulin sensitivity. And what that means is twofold, right? Fasting will decrease the time, and not eating heavily processed foods will decrease the concentration of insulin that we're exposed to. Those two things, decreasing the concentration of insulin we're exposed to and decreasing the time that we're exposed to insulin. Both of these are going to improve the way your cells function in the presence of insulin.
[00:15:41] There are likely a number of other things that will also improve insulin sensitivity. Okay? But those are the two main things that come to my brain. Decreasing cellular exposure and increasing exercise are going to improve insulin sensitivity on a cellular level. Okay? And then again, insulin resistance. How do we decrease insulin resistance? We watch the foods we eat, we decrease stressors, we decrease inflammation, and we monitor and protect our circadian rhythm. So, a lot of times, we're impatient to get there. And I find that this is really the question, like, how long is it going to take? Is really, like, when can I be pissed that it hasn't happened for me yet? This keeps us stuck.
[00:16:30] I tell my clients all the time that we're looking at the numbers that when. I guess when we are only looking at the numbers that we want to improve and we're not seeing the improvement that we expect, we get frustrated, right? Frustration is reality minus expectation. Like, that leads to frustration. That's what happens there. That's how we become frustrated, is when our expectations are not meeting the reality we're experiencing. We feel frustrated. When we feel frustrated, we have the temptation or the thought that effort I'm not doing it anymore. This is hard work. I'm having to do things different. I'm not doing the things that my brain wants to do, and I'm not seeing the damn results. I want so effort. So what I want to remind you of, this is the thing that I tell my clients almost every week. It seems I go through this not because then it's not a pain in the butt. It's actually really meaningful for me to spend time with this belief. So I don't mind going over it as many times as we need to. But what I want you to remember is your health is not your numbers.
[00:17:37] Your fasting blood sugar is not your health. Okay? Your weight is not your health. Your a one C is not your health. That is not what health is. Your insulin level is not your health. The actions that you do is what is healthy, not your numbers. Okay? Your health is not defined by any of the numbers. It's defined by the healthy activities you do. If you're putting food into your body that matches your biology, it's healthy no matter what your numbers say. If you're exercising regularly, it's healthy no matter what your numbers say. If you're sleeping the way a human being's biology requires that a human being sleeps, it's healthy no matter what your numbers say. If you're managing stress, it's healthy no matter what your numbers say. Okay? It's so important for you to hear that. And if you're going, but wait, Delane, that is not the way it goes. If my a one c is nine, I don't care if I slept 9 hours yesterday. Like, it's not healthy. What I want to offer to you is there are many people who smoke cigarettes by the carton, by the pack, and they have normal a one c's, and they are not healthy.
[00:18:55] You are not healthy because of a number. You are healthy because the actions that you do, the longer you do healthy actions, the more likely it is. Your numbers are going to fall into the normal range, into where you want to see them, into the expected range that you're hoping for.
[00:19:11] Do the healthy thing. When your brain's like, oh, but wait, this isn't working. Why is it taking so long? How much longer do I have to do this? The numbers are not health. The actions that you do, that is what healthy is. Your numbers will follow suit in due time. And that's kind of the answer, like, as long as it takes. Okay. I would get curious to anybody who's like, how long do I have to do this, there is likely a thought in your brain that sounds like once my numbers normalize, I can go back or I can start to loosen the reins. I can do things a little bit different.
[00:19:48] That is maybe something that needs to be addressed. That's something that we frequently address in coaching to see what that means for you. Okay, so get curious if that's ratling around in your brain. If you ever are asking the question, how long does this take? Another question I got from spire radio was metformin damages kidneys. And if this happens, why are the doctors prescribing it? So I hear two questions in this I'm going to answer definitely one, and maybe we'll answer the other one. Metformin does not actually inherently damage the kidneys. Metformin is not damaging the kidneys.
[00:20:24] Metformin is cleared by the kidneys. Our kidneys in our body clear metformin into our urine. We pee it out. If your kidneys are damaged from something else, the metformin isn't getting cleared appropriately, which allows it to build up and can lead to things like lactic acidosis, which is a side effect of metformin or an adverse outcome of metformin. So what damages your kidneys? Well, things like hyperinsulinemia damages your kidneys. Diabetes damages your kidneys. Hypertension damages your kidneys. It's not so much that the metformin is damaging your kidneys, it's that these diseases, when we're not fixing them, when we're trying to throw meds on a bad behavior and thinking we're going to create health with it, when we're not fixing the disease state and we continue to take the metformin, suddenly our kidneys aren't functioning as well and the metformin can't clear out and it builds up in our system and we get sick that way, it's not necessarily the metformin that's causing the damage, it's typically your metabolic disease causing the damage. The second question that I hear here is, why would a doctor prescribe something that could have a negative outcome? Because the doctors likely believe that if that negative outcome occurs, that we have a different med for that. Because that's what the western medical system is based on, is finding your symptoms the disease that has caused it, and which med goes with that disease. That's just the way the system is set up. So it's not that your doctors are inherently bad. I always tell my clients I've yet to meet that really malicious doctor. I've heard stories, I know that they exist. But I don't personally know any malicious doctors. I know some doctors that have some pretty crappy bedside manners, but they're not interested in harming or hurting their patients. Most of the doctors that I know are really interested in healing their patients as best they can. The problem is, the strategies they're taught to heal their patient don't actually heal or create health. For the most part, some do. But for the most part, in this setting of chronic disease, that's not happening. We just learn to medicate disease and to keep people chronically ill. So your doctors aren't bad, they're not trying to harm you with the metformin. They believe in better living through chemistry versus changing lifestyles in order to create health. Okay? Doing the healthy thing versus fixing the numbers. That's really what's going on there. So that was the answer I have to that question.
[00:22:50] Can water flush out insulin and improve blood sugars? And this comes from graphic giggles on Instagram.
[00:22:58] I don't know of any evidence that says that water flushes insulin away. Water certainly can improve and increase your metabolic mean. If we're trying to burn off insulin, which sometimes I look at it that way, we're burning off the insulin. It's definitely a good idea, but I don't know that water flushes away insulin to improve blood sugars and insulin resistance. Another question from graphic giggles. Where do I find recipes without processed foods so that I can cook better and have better meals for me, so I don't have anywhere to look up recipes, I will google like, simple recipes. And I use the word simple in my google search because it usually will give me something with just a handful of ingredients. And I find that those are just healthier options. What I do with recipes and what I do when clients bring me recipes, and in fact, this is something that I'm going to do a webinar on, like bring me your recipes and let's pick through it. Let's put together something that works for you but gets you the meal experience you're looking for. So what I do is I start with a recipe, and then I just modify it with blood sugar friendly things. So I will offer to you a little disclaimer. I am a domestic disaster. I'm actually dangerous in a kitchen. I've caught a lot of kitchens on fire. So take any recommendation I make with a grain of salt, but I just make alterations to the recipes. So if it calls for pasta or if it calls for rices, or if it calls for breads, I pull that out and I do something different with it. So for pastas, I replace it typically with greens. What I like to do is to wilt or steam spinach in a pan with a little bit of garlic and onion and like olive oil, and I just warm it up and steam it. And then I put the pasta sauce over that. I like that. If you hate spinach, it's probably going to be not horribly appealing to you. I've also eaten pasta sauce when I'm really lazy as a stew. And so I just put it in a cup and I melt some mozzarella cheese over it and usually some parmesan cheese and a little bit of garlic. And I eat it just like that almost with a cap of that melted cheese in a bowl or a cup. And usually my pasta sauce is always chucked full of a lot of things, of a lot of healthy meats, of a lot of veggies and those sorts of things. So I either eat it as a bowl because I like the taste of that food, of the pasta component, of the sauce component, the tomato sauce and all of the herbs and stuff that go with that. I like the way that tastes. I don't really feel like I need the pasta and I don't do the pasta. But you can do greens. You can also do with pasta. You can do heart of palms, palm of hearts, heart of palm. It's noodles. You can find commercially available noodles. Some people feel like they have a tart taste to them. I've heard if you soak them in milk for 1015 minutes prior to using them, that that goes away. There are other veggie noodles, zucchini noodles, which I think are branded as zoodles or something. You can use those. I do highly recommend with the veggie noodles that you saute them in some olive oil before using them to get them a little more firm. If not, they can be soggy and I don't think they're very tasty. But I use those things in place of flour based noodles. Okay. If I have rices again, I either change it to beans, but more commonly I change it to greens, to some lettuce, whether it be arugula or arugula mix or a spinach mix or a lettuce mix or whatever it is. I just change it to some mix of greens instead of the rice. And I put whatever was going to go on the rice on top of those greens.
[00:26:52] I've used to thicken creamy sauces that we're trying to make. A lot of times a recipe will call for flour I don't use flour. Usually I will use cheeses to thicken it, or I will use heavy whipping cream to thicken those sauces.
[00:27:08] Lots of times, recipes will call for sugar because human beings love the sugar. We're crazy about sugar. Sugar. It's interesting, I've shared this on the podcast before, but I always think it's so telling about the way that sugar glucose affects our brain in infants for procedures like the neonatal infant right around being born infant. So these are things like circumcisions or IV starts if we need to do them. The thing that we give them to sedate them for the procedure is sugar water. We literally take binkies and we dip it into a cup of sugar water, and we let them suck on that because the sugar so powerfully impacts a brain that hasn't ever been exposed to sugar before. The powerful impact is the same as narcotics. We know this, and it helps sedate and soothe the baby for these procedures. That is the power of sugar, and that's why the human beings love the sugar. Okay, so all the recipes want to add a little sugar to make sure you're going to love the recipe and rate it highly on the Internet. So in place of sugar, I don't use sugar in any recipes. Okay. Sometimes I will crush berries. I did this just the other day. The recipe called for honey, and I use honey a lot, but I wanted to see what would happen. And we're doing this 30 plant challenge, and I was like, oh, let's try this. We'll add these berries. So I diced up some blueberries, and then I crushed them and I put them on the recipe that I was making, which was some goat cheese veggie saute or roasted veggie mix. It was really good, actually.
[00:28:56] So I'll use berries sometimes. I'll use them also, if I'm making something and it's needing to be blended, I'll use berries, definitely. I don't ever use sugar. I take sugar out.
[00:29:10] Dates and raisins are another thing that I do, but I don't do, like, date sugar. I actually use the whole date and chop it up and use that or blend it up. I will use honey and maple syrup. If I'm baking something for me, like if I'm baking a treat for me, I will use honey and maple syrup.
[00:29:29] I never use as much as they say, and this is true for any baked goods I do for my kids, too. So I bake chocolate chip cookies for my kids on a regular basis. I make a batch of them, and I put them in the cookie jar, and they'll eat them throughout the week, and that's fine.
[00:29:47] I hope my kids don't listen, because I'm going to let you in on a secret. If you're going to use sugar that's in a recipe, cut it in half. Rarely does any recipe require all of the sweetener that the recipe calls for. Okay. I cut the recipe, the chocolate chip cookie recipe, in half, and I put half the sugar that it calls for. That being said, they don't always look correct. I think they puff up a little big because I don't use all the sugar, and I'm okay with that. They're a little puffier than typical cookies are, and I think it's because of the less sugar that I put in it. But I feel like it's healthier. And my kids love it. And I always tell them, these are cookies chucked full of love that I made. Full of love for you. So that's how I handle recipes, especially recipes with sugar in them. And I definitely look for these simple recipes. If you add simple to your search, you will find recipes that have just a few ingredients.
[00:30:44] Part of this also is because of my crude culinary skills. But I also think it does serve my biology, and I think it'll serve your biology, too. So I don't have a single place that I look for recipes. I google them. I google them with the word simple, and then I make adjustments as I see fit because there are certain foods that I don't add in my diet.
[00:31:06] Lastly, I want to address the recent study on intermittent fasting. I believe the American Heart association, it's their researchers that have put this information out.
[00:31:22] It was put out in March of 2024. So this is on intermittent fasting being linked to a 91% higher risk of cardiovascular death. Okay. Very dramatic. It was reported by news sources, multiple news sources. I got multiple people sending this to me going, oh, my gosh, what's going on? So, one, this study has not been released.
[00:31:50] What was put out? There was an abstract for a presentation that was going to occur at a conference. That was what was put out there, and news sources took it and reported on it.
[00:32:04] You cannot find the study at this point that was actually done. You can only find the abstracts and these clips that journalists have taken on. Okay? It's not been fully released. It has not been peer reviewed. It has not been published.
[00:32:23] This is not a fully released. This is not a scientifically critiqued finding. Okay. Part of me does feel like this is irresponsible journalism because they've thrown this out there. And many people are going to hear this and think that the benefits of fasting have been debunked, and that's just not true. Okay? So I just want to point that out. If you have that question, great. I've got an answer for you, so I hope that was helpful. If, you know, if you ever have questions, you can always email me.
[email protected] I'm happy to answer any question that you send me. And sometimes they'll end up in podcasts like this. Before we go, I do want to remind you that if you have been medicated for your type two diabetes, please be careful making the changes that I recommend in this podcast. You've been medicated for the way you have eaten in the past, and if you change the way you eat, you're going to need to change your medications. Also, you need to contact the provider who's prescribed these meds to you. Let them know what you intend to do with your dietary changes. Find out how they want you to share your new blood sugars with them. Find out how they intend to share with you their changes and recommendations that they want you to do differently with your meds. Okay? If not, you can end up very sick, the kind of sick that involves er visits, hospitalizations, and possibly even death. And you're not doing these changes because you want to die. So make sure you're safe. Call your doctor. Let them know what you're going to do.
[00:33:49] I want to let you know that you can sign up for my 14 days to better blood sugar guide. You can find that at www.delanemd.com.
[00:34:00] Better b as in boy. E t as in Tom. T as in Tom. Er. The word better. Like better blood sugars. There will also be webinars coming up in April. April 3 at 10:00 a.m. We are going to have a webinar where we're discussing the effects of, well, not the effects, but how do you grow the muscle of doing the hard thing, what that looks like? I've come across a number of different pieces of science and reports from investigators that talk about the benefits of doing the hard thing and how we can learn to do that, how we can hone that as a skill. So I'm going to be talking about that. Lots of people report that it's hard to do all of the things that we need to do to get better blood sugars. And if we can get better at doing the hard thing, that's going to all come easier. So that webinar will be April 3 at 10:00 a.m. And you can can sign up for that at delaneymd April 3. If you have any questions, holler at me. If you want any more information. You can always follow me on Instagram and Facebook at delanemd. And you can always get more help on my website, www.delanemd.com. All right, have a great week. I will be back next week. Bye.
