[00:00:00] Welcome to episode number 246 of Better Blood Sugars with Delaine, Md.
[00:00:08] Welcome to Better Blood Sugars with Delane, MD, where you can learn strategies to lower your blood sugars and improve your overall health. I'm your host, Doctor Delane Vaughn. Ladies, if you know you're capable of doing badass things at work and for your family, but you're confused and frustrated with why you can't seem to stop eating the chocolate cake, this podcast is for you. Let's talk.
[00:00:30] Hello there, and welcome to the podcast.
[00:00:34] I'm your host, Doctor Delane Vaughn.
[00:00:37] I am going to talk to you today about the different types of diabetes. However, I recorded this once already today and realized when I went to edit it and to post it that my mic had not been on, which made this sound awful. So if you follow on YouTube, if you don't know, I always broadcast these live on YouTube. You can always get the podcast as soon as possible. If you subscribe to my YouTube channel at Delanemd, of course they will flag you whenever I go live, and that's great and grand. However, there's now a podcast up there that I need to pull down because the sound was awful. So we are re recording this. Okay, so I want to welcome you to the podcast. I want to thank you for prioritizing your help today. If you're a returning listener, thank you for coming back. Thank you for your support throughout the years that I've done this podcast. And if you've done your, you know, if you've done a rating and review of this podcast on your podcast player, thank you so much for that. That helps the podcast get out to new people. If you're new to the podcast, thanks for checking me out. I hope you find some help here. I hope you find what you're looking for here. If you enjoy the podcast, I ask that you please rate and review it so that others can get access to this podcast. If you have any questions, never hesitate to send me an email. You can always email
[email protected]. Dot I'm happy to answer anything. I'm happy to hear suggestions. A listener suggestion is actually what led to this podcast today. A listener recommended, and I felt silly once I realized that I hadn't already done this, but they recommended a podcast explaining the different types of diabetes. I appreciate you guys so much, and I appreciate that recommendation. So that's what we're going to talk about today. This is a long podcast. The first time that I recorded it, it was about an hour. So prep yourself. I don't feel like my podcasts are usually that long, but today, I think that to give a really an all inclusive review of the different types of diabetes and kind of what that means, I think that it's important to do that. So we are going to dive into that.
[00:02:48] So, the vast majority of diabetes is type two diabetes, but there is five to 10% of diabetics in America. At least these are statistics. According to the American Diabetes association. Um, five to 10% of diabetics in America are type one diabetic, leaving again, the overwhelming majority at type two. Okay, if your brain's asking what the difference is, we're going to talk about that today. Before we dive into what the types of diabetes are, we need to probably have a full understanding of insulin function.
[00:03:20] Insulin functions in order to bring glucose inside of a cell, and the cell can burn it off as energy or utilize it as energy.
[00:03:31] When there's a malfunction of insulin, diabetes occurs.
[00:03:36] Now, that malfunction can be a variety of different things. It can be a change in the production of insulin, it can be insulin destruction, it can be malfunction of the way the insulin enters the cell, and then it can be malfunction of what the insulin does or what the cell does on the inside. Once the insulin has kind of given its message to the cell, all of these things lead to high blood sugars. There are other types of cellular energy other than sugar, but the primary energy that the cell likes to use is glucose. And so if it's not available, it allows the glucose to build up. Right. If we don't get it inside the cell to burn as energy, then the glucose on the outside of the cell builds up outside of the cell, and that's diabetes. So, at the heart of all diabetes is this insulin function component. So today, we're going to talk about type one diabetes, we're going to talk about type two diabetes, we are going to talk about gestational diabetes, we are going to talk about type one diabetes with insulin resistance. We're going to talk about Lada, or latent autoimmune deficiency, or autoimmune diabetes in the adult, or sometimes it's called 1.5 diabetes. 1.5. We're going to talk about ModI, that's maturity onset diabetes in youth. We are going to talk about type three diabetes, we're going to talk about post pancreatitis diabetes, and then we're going to mention some syndromic diabetes, but we're not going to talk very much about that, just that it's out there, and that can happen.
[00:05:07] So, type one diabetes is an autoimmune disease. It's autoimmune diabetes. And what they think is there's an autoimmune attack on the cells inside the pancreas. The pancreas is the organ that makes insulin. The cells inside the pancreas that makes insulin are called the beta cells. And type one diabetes is thought to be an autoimmune attack on those type or those beta type cells. Okay? This is a malfunction of insulin production. Okay? The lack of this insulin leads to a variety of issues, including high blood sugars, when that. When the high blood sugars get really severe. And usually the presenting condition that type ones come to the medical community with is this condition called diabetic ketoacidosis. So, this is a combination of very high blood sugars with very low insulin and acidotic changes to our blood chemistry. Okay? So, like acid and base that you would think of in chemicals, our blood has a neutral ph. Essentially, it's. It's right around seven, and it's actually 7.2. But those are getting in the weeds. But when we are in DKA, we actually shift over into a acidotic from that neutral, uh, chemistry of our blood. And, of course, that makes us quite sick. People get very sick with that. You don't stay in that condition for long. Most people present to the emergency department very, very quickly, and they get treated. They get diagnosed with diabetes, and they start getting treatment over time. High blood sugars certainly lead to conditions and consequences and complications that we know of to be the outcomes of type, of any kind of diabetes. So that's eye damage, kidney damage, nerve damage, cardiovascular disease, those sorts of things.
[00:06:57] So the cause of type one diabetes of this autoimmune effect is unclear. It's thought to be a combination of genetics and environmental factors, but it's usually diagnosed in childhood, and again, usually the human being that has this is pretty ill, and it's very clear that they're ill. Okay. Diagnosis is made from a variety of testing, including they'll, of course, test an a one c. A lot of times, they'll get what's called a c peptide level. They'll get insulin auto antibodies. So this is like a gad 65 antibody or an ia two antibody or an ia two beta antibody, or sometimes they do a zinc transporter, type eight. It's like transporter eight antibody. All of these antibodies develop, and these are all developing to markers on cells that are part of the process of making insulin. These antibodies develop months to years prior to the development of these symptoms. It's unclear what triggers these antibodies. There is certainly evidence that injectable insulin. So the use of injectable insulin can lead to the development of these antibodies. In fact, if a patient has been on insulin, you cannot reliably trust the antibody testing to give you a diagnosis of autoimmune diabetes. The insulin can trigger the development of those insulin antibodies, those autoimmune biomarkers in your bloodstream.
[00:08:27] So these antibodies, however, are responsible, or thought to be responsible for 70% to 90% of our type one diabetics. However, the other ten to 30% of these type one diabetics with this low insulin level and destruction of these beta cells, there's no antibody ever determined, and these are called idiopathic type one diabetics.
[00:08:52] There's still a lot that's not quite known about this. The treatment that we usually use, at least in western medicine, to treat type one diabetes, or any autoimmune diabetes, is insulin therapy. Your oral medications are not going to be helpful, so the meds you take by mouth are not going to be helpful in this treatment.
[00:09:10] And there are currently multiple different things under investigation. So there are some immunologics, meaning meds that we will use to attack the autoimmune component, like the antibodies that are attacking the beta cells and the insulin. There are meds that we can give to attack those components, to deactivate them, so that they leave our insulin alone and our beta cells alone, and we can continue to have normal insulin production by our pancreas. So there are some meds coming down the line in that arena, and then there's also some, lots of research around pancreate, like a pancreas transplantation. So there are some things coming down, but right now, the standard of care really revolves around insulin therapy. We give two types of insulin. Usually we give a short acting, or what's called a meal time insulin, or we give long acting insulin, which is usually a single dose that's meant to last in your system for 24 hours. So that is type one diabetes. Again, this is an autoimmune, um, response to the cells in our body that produce insulin. So we don't have enough insulin, and that means we can't manage our glucose, bring it inside, and burn it off as fuel. Again, this is an insulin production issue. Type two diabetes. This is the overwhelming majority of diabetes in America. This is the type of diabetes that I'm always talking about when we talk, when you hear these podcast episodes, I am almost always referring to type two diabetes. And if I'm not referring to type two diabetes, I'll let you know. But almost always, I am referring to type two diabetes, and this is because 90% of cases of diabetes in this country are type two diabetes. More importantly than that, almost all type two diabetes is a result of the food we are eating. And this is the best news ever, because if it's a result of the food that you're eating, you can fix that. If it's entirely a result of your genetic makeup, you can't change your genes, but you can certainly change the food that you're eating. This is the biggest gift ever. Okay. Type two diabetes is a problem in insulin function, unlike type one diabetes, which was a problem with insulin production. Okay. In type two diabetes, the insulin is made, but your cells do not respond to the insulin. Okay? This might be due to overexposure to insulin. Like, you're exposed to so much of it, you just get overwhelmed, and there's no more of it. I'm not going to respond at all. It's also possibly due to the cell. When it does bind to the insulin, the effect that's supposed to happen inside of the cell just doesn't happen. Okay. So there are a couple ways that this insulin resistance can occur, both of those depending on. You know, I think there's mixed evidence out there, and I think the truth is probably that different humans have different mechanisms of insulin resistance. But what we do know is processed foods, foods that are unnatural to human beings, I always say they aren't found in nature anywhere. Like, a human isn't going to come into contact to these foods anywhere. Pop tarts are a great example. Chocolate cakes, a great example. Hot pockets are a great example. These are foods that human beings would never come into contact with in nature. These are the foods that are usually responsible for both mechanisms of insulin resistance. Okay?
[00:12:33] There's a lot of associated. There's a lot of things that we think are associated with type two diabetes and insulin resistance. Obesity used to be the big hallmark of it, but we're really finding that doesn't hold true anymore. We're seeing, as we start to implement more sensitive and specific testing for insulin resistance and type two diabetes. We're finding it early and earlier, and we're finding it in all body types.
[00:12:56] An interesting statistic I came across, which I wasn't aware about until today or when I was doing the research for this, is that diabetes is actually more likely to develop in women.
[00:13:06] There's some thought that maybe this is due to the estrogen effect in women, but also due to the effect of pregnancy in women. So, you know, primarily the women that I help in my coaching or the people that I help in my coaching are women with diabetes. That was not intentional, according to this literature, but I was like, oh, that's really, really interesting. So, um, there is thought to be a bigger percentage of, um, diabetic women than there are of men, which I thought was really, really interesting. The cause is, again, you know, in medicine, we really like to tie a gene to the disease, so there is thought to be a genetic component. However, they've, like, found multiple different genes and multiple different versions of these genes that have been implicated in the development of insulin resistance. In type two diabetes, there is an association with certain ethnicities, like Pacific islanders, for example, have higher rates of type two diabetes. There is no question that lifestyle is a major player in insulin resistance and type two diabetes. There is discussion about epigenomics and epigenetics and methylation as a mechanism of inducing insulin resistance and type two diabetes. Interestingly, there are two specific bacterial strains in the gut microbiome that if they are present, they are associated with insulin resistance and type two diabetes. So there's a number of different things that they think are associated, possibly causative, we're not sure, with type two diabetes. When you get tested for type two diabetes, that's usually going to involve an a one c. I always get a fasting serum insulin level because I think that we see, I know that we see the serum insulin level go elevate, go high before we see the blood sugars go high. So we see evidence of insulin resistance with that serum insulin level before we see it with the a one c, and that's a fasting serum insulin level. Some doctors will also get a c peptide, and really what they're doing is they're trying to do a screening to see if this is a type one diabetes. For me, nine out of ten of the times it's going to be a type two diabetes. It doesn't. I mean, like, I don't need the c peptide to tell me that what I always recommend is making dietary and lifestyle modifications. And if you see changes in your blood sugar, that then you high five up top, and you realize that this is likely type two, and you're going to get far more bang for your buck with your health by changing the food that you eat and your lifestyle than you will with any medication. So that's what I always work with when I'm diagnosing type two diabetes. Treatment for type two diabetes almost always starts with oral meds. In fact, it should really start with, um, diet and lifestyle modification. If you look at the american diabetes association recommendations, diet and lifestyle modifications are the cornerstone of treatment for type two diabetes.
[00:15:58] But usually you're going to see a prescription of an oral anti diabetic medication. So these are going to be things like metformin.
[00:16:09] Oh, there's a number of different other ones. You're going to see the sulfony areas like glipizide and glimepiride, and there's a number of others out there that you'll see orally. And then there are some injectable ones also.
[00:16:22] Um, and the vast majority of the cases you can quote, unquote manage, you can quote unquote normalize, you can quote unquote reverse. I don't care what word you want to use. This condition is entirely amenable to diet and lifestyle changes. So diet, exercise, and other lifestyle modifications will help you fix this process in your body, this abnormal functioning of insulin in your body. This is what this podcast is committed to. This is what my episodes are committed to. This is what I help women do. I don't feel like the healthcare society in America or the healthcare industry in America does a great job of telling you that you don't have to be on meds for the rest of your life, that this chronic condition can entirely be improved and typically done away with entirely if you just change your diet and lifestyle patterns. So, um, that's the nice thing about having type two. It's a good thing that 90% of diabetes in America is type two, because you can fix it.
[00:17:24] The next type of diabetes I want to talk about is gestational diabetes. This is a diabetes that occurs in pregnancy.
[00:17:30] It's not present prior to a pregnancy, but it develops during the pregnancy, and it might persist after the pregnancy. In fact, some studies show up to 70% of women who have type or have gestational diabetes will develop type two diabetes within six years after delivery.
[00:17:47] This is highly dependent on the treatment that's used during your gestational diabetes.
[00:17:53] If you start insulin therapy, you start injecting insulin during your pregnancy, you have a higher chance of developing type two diabetes later, and you will develop more quickly. I think this is due to that development of auto antibodies when we expose ourselves to injectable insulin.
[00:18:11] So, this type two diabetes, or this type of diabetes, is thought to be caused by hormones that are produced by the placenta. That's one theory, and then some other changes of our of women's physiology when we're pregnant.
[00:18:23] The diagnosis of this is done through what's called a glucose challenge test. And so basically, you drink a dose of glucose. It's called the.
[00:18:31] It's called glucola. It looks like a soda can. It's really disgusting. It does not taste as good. I don't know why we can't just drink Coca Cola or something, but it's called glucola. It tastes really gross. There's a 50, a 75 grams and a hundred gram dose, and then you can do a 1 hour, a two hour, or a three hour glucose tolerance test or glucose challenge test. And what that means is they will bring you into the lab, they will take your blood as a fasting blood sample, and then they'll give you this glucola. You'll drink it, and then an hour after you drink it, they'll dry your blood. 2 hours, they'll dry your blood, 3 hours, they'll dry your blood. And then the gynecologist or the obstetrician will look at those numbers and they have normal things that they expect to be within normal range. And if you hit so many abnormal readings, like, it's two out of four readings that have to be abnormal, then you get the diagnosis of gestational diabetes.
[00:19:25] So treatment is limited because we don't want to expose baby to toxic things, to toxic medications. So lifestyle is a huge benefit in gestational diabetes. Cutting your carbs, you know, cutting out processed carbs. I am not even saying cutting out carbs. Like, nobody got diabetic because of their carrot problem. Nobody got diabetic because of their corn problem. Nobody got diabetic because their apple and banana problem, that's not the issue. It's the pop tarts, it's the cake, it's the ice cream, it's the candies, it's the pizzas, it's the processed foods. Cutting those carbohydrates down and getting some exercise. But according to what your obstetrician says is okay, those are things that can significantly improve gestational diabetes. Keto is not recommended in pregnancy. So hear me, as far as gestational diabetes go, keto is not recommended. There have been some studies that show some negative outcomes with babies, so they don't recommend keto in pregnancy.
[00:20:20] There are also some oral meds that your ob may use, but they quickly. Obstetricians are quick to go to insulin just to avoid any harm to the baby. So again, remember, if you're using insulin that can lead to those auto antibodies developing and increase the risk of development of type two diabetes later in life.
[00:20:40] So the next type of diabetes I want to discuss is ladis. That's latent autoimmune diabetes in adults, and they like to call this diabetes 1.5.
[00:20:50] It's very similar to type one diabetes. There is, again, this autoimmune attack on the beta cells or insulin itself in your body, and it deactivates. Either it makes it to where your pancreas does not make insulin or it deactivates your insulin.
[00:21:06] There are some variations from this. It's not as straightforward as this is just type one diabetes setting into a human being later in life. There's some variations that involve insulin resistance. Okay. And that insulin resistance is not usually seen at the beginning of type one diabetes. Okay. So it's a little bit different. Testing for this is a little more complicated. Lots of docs want to look for this, especially when they find a thinner adult who has an elevated a one c. Since more doctors are looking for it, we are finding it more. However, the overwhelming implicating factor in type 1.5, or lot of diabetes is really lifestyle. Even if you have a genetic predisposition or an autoimmune component to it, changing the food that you eat, improving your lifestyle, doing the healthy things, is going to be the thing that improves your health, improves your long standing health health with this condition, given the negative of impact. So this is something that I always work with women on.
[00:22:10] There's negative impacts with medications. They can be hard on your kidneys, they can be hard on your liver. They're expensive. You got to go to the doctor and get the prescription and get tested. You have to do all of these things. In addition to that, taking a medication to lower your blood sugar is not creating health.
[00:22:30] The food that you feed your body, the fuel that you fuel your cells with, the food that you are metabolizing in your body, that choice is the healthy choice. The food that you eat, the exercise you get, the sleep you get, the stress management, all of those things. Those are the healthy things that you do. Taking meds because you continue to eat oreos or pop tarts or whatever it might be, that is not healthy. I don't care what it does to your number, it's not healthy. To your blood sugar number. I don't care. It's not healthy. Okay?
[00:23:00] So for me, it always makes sense if you're not sure, you know, if you're worried you have this latent onset, type one. If you're worried you have one of the Modi, and I'll talk about the Modi types. If you're worried that you have one of these other diabetes, that's not just the straightforward type two, even though nine out of ten diabetics are going to be straightforward type two insulin resistant diabetics, if you're worried you have one of these other things, give yourself a fighting chance to see if being really committed and eating in alignment with your biology changes your health, changes your numbers. If you can eat in alignment with your biology and your blood sugars go down, then you have so much agency to live healthy. Not requiring meds, not requiring prescriptions, not paying money for it, not needing lab draws, not needing multiple doctors appointments. Give yourself the chance and the gift to figure that out. And I'm going to talk about what that looks like here in a minute. Treatment for this type of diabetes. This lot of diabetes starts with oral meds, but it's thought to progress pretty quickly to insulin requirements. Okay, so let's talk about type one diabetes with insulin resistance. And this is also true because a lot of this, um, latent autoimmune diabetes of the adult, or 1.5 diabetes. 1.5, type 1.5 diabetes, this form, these are all considered type ones and including Modi, which I'm going to talk about next. But it's Mody, the maturity onset diabetes in youth. All of these are considered type one, even though they're not really, like entirely no insulin.
[00:24:46] That's just how they're classified.
[00:24:48] But do recognize, in type one diabetes, we can stimulate insulin resistance. Essentially, this is becoming a more recognized complication of type one diabetes. There are studies out there looking to identify the causatives. I have a theory about this.
[00:25:07] When we treat type one diabetes with three injections of insulin and then a fourth long acting injection of insulin every day, we are creating both of the situations that lead to insulin resistance. Insulin resistance is usually caused by high concentrations of insulin over a prolonged period of time. When we give you an injected dose, that's a high concentration, and when we give you an injection that's supposed to last 24 hours, the long acting insulin that's over a prolonged period of time. So my theory on this is that we're actually causing this with our therapies. Okay. In addition to that, there is this mindset that you can eat what you want and just take more insulin. And in fact, this is taught a lot of times by diabetic educators because we don't want kids to feel like they can't have a birthday cake. Or a cupcake or eat the way their friends eat, or, you know, these young kids that are diagnosed with type one diabetes, we don't want them to feel left out, and I don't want anybody to feel left out either.
[00:26:08] But eating a bunch of food that isn't meant for our biology and just trying to pull your blood sugars down with higher doses of insulin just creates insulin resistance. It just makes people sicker. That's not the way that, like, we need to be doing it. So there's no testing. I mean, like, nobody tests for type one diabetes with insulin resistance. And recognize, even if you look for auto atomatis, we've been giving you insulin, so you probably have those. The treatment becomes this element, this component of chasing our tails, right? Like, the more insulin resistant somebody gets, the higher their blood sugars run. When we start seeing those blood sugars run high because of insulin resistance, what do we do? We give higher insulin dosing. Those higher insulin doses lead to more insulin resistance. Over time, you see the blood sugar start to go high again. All of a sudden, we need more insulin, and that just leads to more insulin resistance. It's just a cycle. We're chasing our tail.
[00:27:04] So I always remind, I remind my clients this. If you've listened to more than one episode of the podcast, you've probably heard me talk about this. This food, these foods that make us sick are just not foods that align with our biology. And there is no amount that's okay.
[00:27:21] It's like smoking a cigarette. One cigarette is not going to harm me. I'm not going to get lung cancer, and I'm not going to get COPD from a single cigarette. But I'm never going to believe smoking a cigarette is a healthy choice or it's okay. I know it's an unhealthy choice, and I'm taking a risk every time. If I were to smoke one, which I don't, we think about, I always remind women, like, think about the animals at the zoo. They don't ever take the lion's food when they're out of giraffes food and feed it to the giraffes, and they never take, like, the penguins food and feed it to the zebra because they're short on zebra food. That would make those animals ill. And we know that zoos put a lot of research, development, and resources into getting appropriate food for the animals.
[00:28:05] That's what we need. Also, if we don't feed our bodies appropriate foods, we will also get sick. Okay? And when I think about the things that are causing insulin resistance and, you know, leading to, you know, our blood sugars being high and all of these things, again, whether it's type one, type two, whether it's ladder or type 1.5, whether it's type one with insulin resistance. And this is true. We're going to talk about Modi types of diabetes here in a minute. But these processed foods, I don't care which of them you have, they just do not match your biology. They don't match any human beings biology.
[00:28:41] So this insulin resistance that develops in type one diabetes is primarily because we're still trying to eat processed foods that just doesn't match our biology, and it makes us sicker. So let's talk about Modi. Modi is the maturity onset diabetes and youth, and there are multiple types. There's like 12345. I think that I know. I think. I'm pretty sure there's six. I definitely know there's five. We're going to talk about type two and type three only.
[00:29:06] These are thought to be single gene mutations that are passed in a family. They're passed in an autosomal dominant fashion, which means you see them in consecutive generations. So grandparents, parents, children, you see them in all of those generations.
[00:29:20] So there are many types. The most common type is actually Modi type three, and it accounts for 50% to 70% of all of these Modi types of diabetes. Now, recognize Modi is classified under the type one, so you have type one, and type two are your main classifications. Five to 10% of diabetes are type one. Out of that five to 10%, that's type one. The 50% to 70% of Modi cases that are under that, because the Modi cases are a small fraction of those type ones, even, and 50% to 70% of those are this type three Modi. So it's really, really what I want to point my out point there is that it's a small fraction of diabetics that have Modi. Type three, it is a progressive diabetes that leads to complications associated with diabetes, like your eye problems, your nerve problems, your vascular, your cardiovascular stuff, your kidney problems. All of those consequences and complications of diabetes occur quicker with Modi. Type three.
[00:30:24] It is associated with significant glucose in the urine. Even when your blood sugars are normal, you will see glucose in the urine. Um, and it is, again, progressive. This is a bad player. This is one of those things that you don't want. Okay?
[00:30:40] The other type of Modi most common is type two modi, and it accounts for the remaining 30% to 50% of modi cases, again, there's a small fraction that's this one, and, you know, four, five, and six. But the majority of these maturity onset diabetes and youth cases are going to be type three, and then the second most common of these are going to be type two. So this is actually a benign case of diabetes, if you can believe that's even possible. I learned this. I think it's pretty cool. I didn't even think of this as a mechanism of seeing higher blood sugars until I researched this. But it's a benign case of diabetes. What happens is there are sensing. There are cells in the pancreas that sense your blood sugar level. And that makes sense because when the blood sugar goes up, the pancreas needs to make some insulin. So there are cells in the pancreas that say, oh, the blood sugar's up, let's make some insulin, and then it spits insulin out. And, of course, insulin's supposed to move the blood sugar out of the blood and inside the cell. The cell is supposed to burn it off. That's what's supposed to be happening, the level of sensing. So whether the sensing cells inside the pancreas are sensing at 120, at 130, at 140, at 150 is a set point in the pancreas. And some people just have a genetic variant where those sensing cells do not turn on until your blood sugars are closer to 140 or 150 versus 130. Okay. Or whatever it is, it may be up to 160, depending on the patient or on the human being. So what that means is your blood sugars run a little high. Like, chronically, your blood sugars will run a little high, but eventually your pancreas kicks into action and kicks out some insulin and brings the, you know, blood sugar inside and burns it off as fuel. So you don't ever run super high, and you don't ever run high for very long. So it turns out that this keeps us from getting the long term consequences. Blindness, kidney disease, neuropathy and nerve damage, cardiovascular disease. It keeps us from getting those long term consequences of diabetes. High blood sugars. I thought that was kind of cool. I never even considered that as a way that we could run high blood sugars. The body just never ceases to amaze me again. There are many genes associated with this, and there are genetic tests that they do to diagnose these Modi cases.
[00:33:09] The next type I am just going to touch on, there are syndromic diabetes cases. So there is a syndrome, meaning there's a collection of symptoms. Usually, you know, there's some. I mean, like, when I think of syndromes, they're going to be like cognitive symptoms. There's going to be deformity symptoms or abnormality, like physical abnormality symptoms. There may be changes in the heart, vasculature, whatever. There are syndromic syndromes, is what we call it, syndromic diabetes that are associated with diabetes. Two of them that I came across, Donahue syndrome, and then Rabson Mendenhall syndrome, are the two syndromic diabetes that I came across. I'm sure there are others, but again, this is just where there are higher blood sugars associated with other findings.
[00:33:59] There is type three diabetes. And I've talked about this on the podcast before. This is dementia.
[00:34:05] I'm not sure that we're really using this as a classification at this point, as much as we are really trying to make a point that dementia and Alzheimer's and insulin resistance are associated, they run together. Taking care of your metabolic health will help you keep cognitively sharp as we get older. The thought is that dementia and Alzheimer is. Alzheimer's is insulin resistance in the cells of the brain. Okay? So the brain cells are not able to pull fuel inside of them and work effectively. They get slow, and that's where we're starting dementia and Alzheimer's. Not a lot of research done here, especially related to causing and testing, but really, this is more to support that connection between dementia and diabetes treatment here. Again, the best treatment here is, of course, going to be lifestyle modifications similar to type two diabetes. And then lastly, another type of diabetes that I have seen clinically is what I call post pancreatitis diabetes. Pancreatitis is inflammation of your pancreas. Itis of anything. Tonsillitis, bronchitis, all of the itis are just inflammation of that organ. The pancreas is no different. It can get inflamed. And when it does, it can sometimes start to auto digest itself. So it produces, um, enzymes that not only does it produce insulin, but it produces enzymes that go into the gut and help you digest your food. Well, if it gets swollen and backed up, those enzymes start to digest the pancreas, and it basically obliterates the pancreas. The pancreas becomes non existent and certainly non functioning. And what that means is that it's not going to make you insulin anymore. Okay? So I have seen patients who have had pancreatitis were very sick with it and come out of the hospital with diabetes and requiring insulin. Where they started, they didn't require it before, and as far as they knew, they didn't even have diabetes before. So if you're prone to pancreatitis, there are a number of things that you can do, lifestyle wise and dietary wise. Um, they then people who have had pancreatitis have been given these instructions in the hospital. But the other thing to avoid is alcohol. Alcohol, there's, it's called alcoholic pancreatitis. It's just a type of pancreatitis. Um, if you have pancreatitis, avoid those things, because again, you can end up insulin dependent diabetic because you obliterate your pancreas from that inflammatory process. So that's another type of pancreas or diabetes. And I'm sure there are other types that I haven't mentioned here, but these are the types that I've come across. So I want to talk about the importance of lifestyle modifications, because again, that is the one thing I know. If you listen to this podcast, it's all I talk about. But do understand that you do not have to be sick and tied to the healthcare system in America for the rest of your life.
[00:37:04] These chronic conditions are caused by chronic decisions that we make in our life for the most part. Now, there are some chronic conditions that I'm sure are not, but that's not what we're talking about today. We're talking about the food that we eat leading to us being sick. Okay?
[00:37:19] The food that you eat will always be the most important thing you can do to improve your health. Period. End of sentence.
[00:37:27] The food that you eat, the food that you fuel every single cell in your body with, is always going to have the most impact on your health.
[00:37:35] I always think, like, health in, health out. Now, if you put shit in, you're going to shit out, right? Like, that's how that works. If you are eating processed foods, this is because you should assume that this is the cause of your diabetes. Until you prove otherwise, until you prove to yourself by cutting out the processed foods, the bed bread, the pasta, the baked goods, the sweetened drinks, including artificially sweetened drinks without any calories or out any carbs, you got to cut those to the health bars, the oatmeals, all of those things. Cut those out for twelve weeks faithfully. No, I am not talking about bananas and apples. No, I am not talking about carrots or the most starchy of vegetables. Maybe you can't eat a potato the size of your head every day. Okay, fine.
[00:38:19] But I'm not talking about plant based starches and carbohydrates. I am talking about processed carbohydrates. And starches. Okay, when you have cut those processed foods out for twelve weeks and you've been faithful and 100% consistent, if you still have abnormal blood sugars, then you likely need to start looking into some of these genetic and autoimmune causes of diabetes. Okay? You need to look into testing, but give yourself the gift of that clear information.
[00:38:54] You can't know until you give yourself the opportunity to prove which way it goes and which way it doesn't. If you do it for twelve weeks and it doesn't change your numbers. Okay, great. Now you have some really clear information about that. But if you give yourself twelve weeks of being consistent with your choices and your blood sugars change, you've given yourself the gift of not having to be tied to medications for the rest of your life. Okay, even if you have a genetic or an autoimmune associated diabetes, you may find that you still can keep your numbers in check just by making these dietary changes. And you're going to create more health doing that than you ever will with a medication. Okay, remember, if I give you a medication to change your numbers and you keep eating pop tarts, that is not health.
[00:39:48] The medication certainly isn't health and the blood sugar number isn't healthy. The food that you feed your body, that's what healthy is. Period, end of sentence. Okay. These strategies of eating healthy, of eating in alignment how your body needs to be eating, are the same strategies that were used to keep type one diabetics alive before the development of injectable insulins. Okay, doctors McLeod and banting in the 1920s, 1922, developed injectable insulins before that was available to us. The way we kept our type one diabetics alive was we watched what they ate. We made sure that the foods that they were eating were not going to cause them to need tons of insulin because they didn't have it right.
[00:40:36] So, eating in a way that aligns with your biology is always the healthy answer. Always. No matter what your genetic or your autoimmune status is. Okay, do that for twelve weeks. See what results you get. If you need help with that, that's what I do. I help women with this. My program is twelve weeks. You get all the help you need in that twelve weeks, and we evaluate your numbers, we make adjustments, we figure out what you need to do, what you can do after the twelve weeks, if your numbers normalize, then you get to decide how frequently can you add something, a joy, eat something that maybe doesn't meet any biological need but you enjoy. We figure out how frequently you can have that back in. If you're needing help with that, call me. I can help. Send me an email. Delane at delanemd. I'm happy to answer anything or to set up a call so that we can talk about that. So before I sign off, I want to remind you if you are on medications for your type two diabetes, please get in contact with your provider before you start making these dietary changes. If you start making these dietary changes while you're medicated, you, you can end up quite sick. Like the kind of sick that involves being hospitalized and possibly even deaf. And that's not why you're wanting to make these changes. So make sure you call your provider. Ask them how they want you to share your blood sugar logs with them and how they intend to share with you medication changes that they want you to make. Okay? That's the way that you can do this and stay really safe. I also want to remind you, if you haven't already done so, there is a 14 days to blood better blood sugars workbook. You can find
[email protected] better. And again, that's 14 days to better blood sugars. There is a webinar coming up on April 18, 2024 at 10:00 a.m. Central time. And basically I'm going to be going over recipes. If you are interested in, if you have like a recipe that you love and you're like, I can't figure out how to convert this into something that won't make my blood sugars go crazy, I want you to bring those recipes to me and I'm happy to help you troubleshoot those. I have some that have been emailed. I intend to use those and I intend to go over some others that are really tasty that I like. Um, but yeah, you can, that's available to you. You can register for that and get the zoom link and
[email protected]. Forward slash recipe. And then lastly, there is a wonderful two hour training session coming up on April 24. It's a Wednesday at 10:00 a.m. Central time. And it is to help you develop a plan for lifelong eating that helps your, that keeps you, your healthy, your a one c down and your insulin in check and keeps you healthy. If you have found that you've used the 14 days to better blood sugars and you've seen amazing results, but you're not sure that you can eat that way, that same, those same meals for them that you've eaten in the last two weeks for the rest of your life, you want to do something different. That's what this planning training session is about. It's 2 hours. You get a journal. You will get a private web page where you have access to all the resources and some websites and a replay of this. It costs $59. You can find out more information about
[email protected]. Forward slash bbs P l A N S. So that's bbs, like better blood sugars. Plans, plans. And again, delanemd.com forward slash B B S P L A N S. All right, that's what I have for you this week. Keep listening. Keep avoiding the foods that make you sick. Keep making choices for your health, your vitality and your longevity. And I will talk with you next week. Bye.
