Episode Transcript
[00:00:00] You are listening to episode number 250 of Better Blood Sugars with Delaine, Md. Welcome to Better Blood Sugars with Delanemd, 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. Hey there. Welcome to the podcast. I'm glad you're here. I'm glad you're taking a minute for yourself and for your health today. And I'm glad you're choosing to spend that time with me. So it's Mother's Day. It's Sunday, Mother's Day. I usually try to get podcasts recorded before the weekend, but it doesn't always happen. And this is one of those weeks where it didn't happen. And so I'm recording on Mother's Day. I've had a lovely day with my babies. I've got to spend the day with my twins and my family and my mom and my grandmother and my sister in law and everybody. And it's been just a wonderful, blessed day. I'm feeling very, very full in my heart right now. So, um, my eldest boy is overseas, and he texted me mid evening on Saturday to wish me happy Mother's Day because it was already Sunday where he was. So, um, just all the important people in my life has, have been in my life, and I've heard from them today, and it's just been a great day. And so I, for all the mothers out there, happy Mother's Day, and I hope you've had a blessed day as well. So today we are going to talk about diabetes and dyslipidemia or high cholesterol. I am not in love with this topic. And there's a lot of, just because there's a lot of mixed information out there regarding cholesterol. What's high? What to do about it? Is saturated fat good? Is it bad? What do we do? How do we stop? You know, how do we change this? There's just a ton of discussion about what causes it. Is it the food? Is it our genes? What do we do? Is the med right? Do we take the meds? Do we, do we change, you know, our diet? Do we cut out red meat? Do we eat more fish? Do we add more fiber? Do we add exercise? You know, what do we do? So I don't love the discussion about cholesterol, because there are, there just is a lot of mixed information, and it's just very nuanced and not very clear cut. You know, I'm going to wind this down. I'm going to whittle this down to a clear cut information that you've already heard from me no less than 3 million times. So don't expect that there's going to be any, um, you know, huge, ground shattering or earth shattering advice I'm going to give you at the end of this, because it's going to be stuff that you've heard. There is going to maybe be some new information you haven't heard or didn't know about cholesterol or statin therapy. But understand that the information, like what I say and like, what is my $0.10 on what we need to do to manage our cholesterol is not going to be anything you haven't heard from me before. So I want to be very clear on this podcast episode, this particular episode, I'm not giving you medical advice.
[00:03:01] I don't really do a really great job of pointing this out. In all of my podcast episodes, I give a general disclaimer that you need to contact your doctor, and I still, I'm going to follow that. But I want to be very clear that I'm not giving medical advice on this podcast.
[00:03:19] I think part of the reason I don't get real stringent on that and most of the podcast is because most of what I'm talking about is feelings and planning and being strong and keeping our words to ourselves and learning to love ourselves unconditionally. And all of these things that I talk about that I really do think is important.
[00:03:36] I don't think they need a legal disclaimer. However, this topic is a little different.
[00:03:41] Again, there's mixed information out there, so you can find information to say a lot of different things. And I just want to state quickly clear at the beginning of this episode that I'm not giving you medical advice. I'm not telling you to stop taking your statin if you're on a statin med for your cholesterol or any other medications. I am not telling you to not listen to your doctor. If your doctor is telling you to eat Doritos and Oreos all day long, that's a different conversation. Yes, you need a different doctor, but I don't. I seriously doubt that anybody's physician is telling them, or anybody's medical provider in general is telling them to eat Oreos and Doritos. They've given you a med because it's a standard of, uh, care in America or in your country or wherever you're at, it's a standard of care, and there is evidence out there to state there's a benefit. Today, I'm going to discuss some information regarding statin therapy. So these are statins. It's classmed. It's things like Lipitor or crestor, simvastatin, atorvastatin, rosuvastatin, all the statins, they're statin therapies. But I'm going to discuss some information. But I'm not telling you to stop this med or that these meds are bad, per se.
[00:04:45] I'm definitely going to tell you to cut the Oreos and the Doritos, though, if your doctor hasn't already told you that, I'm going to definitely tell you this. So, um, I always, you know, think if you cut the Oreos and the Doritos, you may not need the statin therapy, you may not need the meds. But I don't want anybody thinking they need to stop their statin based on what I've said in this podcast episode or that the, that I'm saying that, you know, the statins are horrible and stop them. That's not what I'm saying. I'm just going to offer some information on it. So this discussion about dyslipidemia, which is the term I use, it goes back to this family medicine or this primary care value pack that I talked about last week. Last week, I talked about hypertension and insulin resistance. Excuse me? I talked about hypertension and insulin resistance last week, and I kind of brought this concept of the primary care value pack. This is what we called it in residency because these were the three things. Kind of like a value pack is a soda and a sandwich and, like, fries. That's like, that's a value pack. At most fast food restaurants, the family medicine or the primary care value pack is the things that run together, diabetes, hypertension, and dyslipidemia. And of course, they all run together because they're all caused by the same thing. They're caused by too much insulin in your system. I use the term dyslipidemia. You may have been told it's high cholesterol. You may have been told it's high blood cholesterol. Cholesterol or high blood lipids or hypercholesterolemia. There's all these different terms that all kind of mean the same thing. I use dyslipidemia instead of those, um, those terms that mean high cholesterol, although dyslipidemia is high cholesterol. But sometimes it's that you have low hdl, so it's not a high cholesterol. You have low good cholesterol, quote, unquote good cholesterol. Or even the triglycerides. You can have hypertriglyceridemia, right? Like, or you can have higher, you know, triglycerides in a normal ldl. So I just use this term dyslipidemia. It's just diseased. It's just abnormal, out of, uh, normal range cholesterol panel. So that's what I call it, dyslipidemia. But you'll hear a bunch of different names discussed by other medical providers and by your physician.
[00:06:56] I'm going to talk today about what the connection between diabetes and dyslipidemia is. Remember, dyslipidemia is what we are looking for. This cholesterol business is what we're looking for when we check a fasting cholesterol level on your labs, okay? And you have to be fasting. This is the real big thing that we need you fasting for. We don't need you fasting for your complete blood cell count or your chemistry panel to look at your electrolytes or your liver or your a one c even. What we need you fasting for is this cholesterol panel, this fasting, uh, cholesterol levels. So we're going to talk today about the connection between insulin resistance and, um, cholesterol with many things. And again, kind of why I use dyslipidemia versus high or low or abnormal. I use this term because, as with many labs that we check in the medical field, there are quote unquote normal ranges. But you can still not have normal biology, even though your numbers are reading in the normal range. Outside of the normal range really just represents disease. Like, you're so far out of the normal that now you have a disease, you can have abnormal biology and not be manifesting as a disease yet. And a great example of this is when we have high or high insulin levels and our blood sugar hasn't gone up yet because our body's been able to keep on top of it, or our cholesterol hasn't gone bad, or our liver enzymes haven't gone abnormal, or our, you know, ovaries are still working fine and there isn't any evidence of polycystic ovarian syndrome. You can have high insulin, although I would offer that. I don't think high insulin is healthy, but you can have a high insulin level and not have a disease state. And you can have cholesterol that's normal, like, in the normal range, but it's still not functioning normally. It's just not your. You're just not in the disease category yet. So I want to be clear about that.
[00:08:55] Um, someday we'll have a. I'll do a podcast where I discuss kind of this normal range labs and what it means to be in the normal range, but not have normal biology. But that's a discussion for another day that'll probably take quite some time. So. So let's talk about how diabetes and dyslipidemia are connected. Insulin resistance is the root cause of type two diabetes, and insulin resistance, its effect, its impact on the liver means that the liver does not process your cholesterol correctly, and this leads to higher ldl levels. So LDL is one form of. It's a low density lipoprotein, ldl, low density lipoprotein. Um, and then you have hdl, high density lipoprotein. You have VLDl, very low density lipoprotein. You have all these different types of cholesterol, but basically, when your liver is under the effect of insulin resistance, it just means that you're not processing cholesterol correctly, and you have higher levels of the LDL, higher levels of triglyceride, and lower levels of hdl. Okay. Ldl is thought to be the quote, unquote, bad cholesterol, and HDL is thought to be the good cholesterol. And all of these are very general terms. There's a lot of nuance within these terms. So I don't know that you can just say, hdls are great, and you want all of them. You want it to be high, or ldls are always bad, and you always want it to be low. It is not that simple. So the ldls and the triglycerides are higher in an insulin resistant human being than they would be in a non insulin resistant human being. So the triglycerides, the h or the LDL, is what happens when our body eats fat, when we get dietary fat, and it's just how our liver processes that dietary fat, and it turns it into this ldl. And what happens is there's not as much reabsorbed by the body, so we're making more of the LDL. So there's not as much of that fat reabsorbed and used because of the effects of insulin, that now we're making more of these LDL. So your ldl goes up in addition, your triglyceride level goes up. So triglycerides are actually the part of the blood fat. So the fat that's in your blood, the cholesterol that's in your blood, triglycerides represent the fat that's in your blood, that's made from your body processing carbohydrates, okay? Not the fat of butter. Like I always say, you know, the lDL looks at the burger and the hamburger you made, you ate, right? The hamburger that you ate, it looks at the beef, the LDL looks at the beef that you made. But the triglycerides, look at the burger bun that you ate, okay? Triglycerides are a representation of the carbohydrates that you have eaten.
[00:11:47] In fact, when I see that there's high triglycerides, I know to start looking for evidence of insulin resistance and diabetes, because if not already present, they are on their way in the next six to twelve months on the labs. Because I know if you've got high triglycerides, you're eating a ton of carbohydrates. Okay?
[00:12:07] So the primary connection here again is this effective insulin on the liver. The liver, it processes our dietary fat into cholesterol and excess dietary carbs into triglycerides. When we eat carbs and calories that we don't need in the moment, our body converts those into triglycerides and those get shuttled into our adipose tissue, our fat cells, and they store there. In general, over consuming calories and carbs will not just lead to the insulin resistance, right? Like it's the carbs that are causing the insulin resistance, but then it also leads to the total cholesterol being increased because your total triglycerides are increased and your ldl is increased. Okay, the insulin, this is just how the insulin resistance works inside of our liver. Overproduction of ldl and higher levels of triglycerides.
[00:13:04] The western medical system treats dyslipidemia, or this abnormal cholesterol business with statin therapy. It's just how it does it. Okay, so this is the connection, again, between the insulin resistance that's causing your diabetes and the cholesterol. I point this out to women when we're working together, because almost always they're on, or they're trying to get pushed on meds for their diabetes, and they're likely already on a med for their blood pressure, and they're frequently already on a cholesterol medication as well. And for me, I know these guys run together that if you can start to improve one, likely you're going to improve another and be able to come off of those meds also. Okay? And it's not because I'm a great magician. It's not because I, you know, am doing some rain dance medication, lowering rain dance. It's not that. It's that literally, you improve the root cause of your diagnosis, diabetes, and you're going to improve the root cause of your dyslipidemia and your hypertension. Okay, so the first statin, I want to talk a little bit about statin therapy. Um, the first statin that was introduced, it was introduced in 1987. It was lovastatin. Its brand name was like Mevicor, which I never have said in my life until today. I do know what lovastatin is. Um, but that was the first 135 plus years ago, I think 37 years ago, if you do the math right, statins, many statins have come on the market since then. And in the past 35 years, there have been some fabulous press, really. I mean, it's press, it's propaganda, maybe some fabulous information released on statin therapy. And I think that there is really, truly benefit to statin therapy in certain people. I'm not saying that statins have no role, they do. But there was a time where I, like I said this, it was just a general concept within medicine, the medical field, that we should put statins in the water. It's so beneficial to cardiovascular disease that everybody should be on one. We should put statins in the water. There was very much that approach in western medicine. The pendulum has, of course, started to swing back, and we're starting to practice a little more scrutiny regarding our statin therapy and how we prescribe it. We used to believe that the benefits of the statins on cardiovascular disease was primarily a result of lowering that cholesterol. These drugs, this statin therapy, lowers cholesterol. And that's what gives us cardiovascular effects or benefits. What we're now starting to see is that statin therapy is actually a really, really powerful anti inflammatory agent. And the majority of cardiovascular disease and vascular disease in general is an inflammatory process. And so we're starting to wonder if there's not more of an anti inflammatory effect that's giving us these cardiovascular benefits.
[00:15:53] After a while of using statin therapy, we started to realize that, like, we're lowering our cholesterol. I can remember driving people's cholesterol so low, and I feel really bad about that, because over the years, what we started to understand is the human being. Our bodies need cholesterol there are a lot of really important things that happen in our human body that is reliant entirely on cholesterol. So things like our hormones, our testosterone, our estrogen or progesterone, all of those, the base, the core, the foundation, the building block, the primary building block of these hormones is cholesterol. And if I drive your cholesterol so low that you don't have that building block, suddenly you're starting to have the side effects of low testosterone, low estrogen, low progesterone. Okay.
[00:16:37] The cholesterol also is a primary building block of our cell walls. Our cell walls are made up of what's called a lipid bilayer. Bilayer being two, that means there's two layers of lipids, and lipids are cholesterols. If we're not giving our body enough of that building block, we're not able to turn over. And when we do turn over and have to rebuild a new cell, we don't have the building blocks to build that new cell to make that cell wall. Okay. Lastly, our nerves. And these are just three of the things that come off the top of my head that we're doing with cholesterol. I'm sure there's a lot of things that I don't even remember from medical school. The other main thing that cholesterol is really, really important for is our nerves are coated in this, what's called a myelin sheath, and it allows our nerves to transmit messages through them in a very rapid fashion. It makes our nerves work quickly. If you've ever wondered how your foot can step on a sharp tack and your body can remove that foot before, even though you were in the middle of a walk before, that tack has a chance to puncture and totally go inside of your foot. How that happens so quickly is because our nerves work so quickly, and they work quickly because they're coated in this fatty sheath called myelin. It is made from cholesterol. So there's a lot of really important things that our body is doing with cholesterol. And if we're just driving it low with the statin therapy, we are working against ourselves. We need cholesterol. Driving it as low as possible is just not going to be a great idea for us. So it's become evident that statin therapies have some effects other than just lowering our cholesterol, too. Okay. There are some other things that statin therapies are doing.
[00:18:30] Some of it good, some of it bad. Okay. So, again, this anti inflammatory effect is new. Like, that's new in the last, at least. Maybe somebody else knew about it, but I didn't know about it until about five years ago that statins have this powerful anti inflammation effect, and that that is probably what's leading to the cardiovascular benefits that we're seeing with statins.
[00:18:51] But then there are these other things that we're starting to see with statin therapy. We're starting to identify insulin resistance earlier. We're starting to know that insulin resistance is the cause of so many different diseases that now we're starting to look for insulin resistance, not the other diseases. Like, maybe it's not so important to measure your blood pressure at every meeting, every time you see your doctor, once a year, or whatever it is. Maybe it's more important to measure your insulin level. That may be more important, because we actually know that insulin resistance is the root cause of many different diseases. All sorts of different diseases, right? It's the root cause of diabetes, hypertension, polycystic ovarian syndrome, non alcoholic fatty liver disease, and many more. Okay, so what we're starting to realize is that there are studies out there showing that statin therapy actually worsens diabetes and insulin resistance. Apparently, there is some evidence out there that these statins actually cause changes in our pancreas to damage the cells that are producing insulin. So that makes our blood sugars higher, which worsens our insulin resistance. Okay. There's also, again, this effect of lowering our testosterone and our hormones, but primarily in testosterone, especially in this middle aged population that are getting diagnosed with diabetes, we have a lower sex drive, we have weight gain. And of course, your doctor's like, oh, you got to lose weight. That's going to make you healthier, which is not necessarily true, but we have weight gain, we have mood changes, we're depressed, we're fatigued, we have osteoporosis. There are all these things that are happening that we're starting to realize that maybe statin is causing some of these things. There are statin therapies are causing these things. So statins are probably not as great as we once thought there were. They were. There are still a population of people who clearly benefit from statin therapy. So if you've had a vascular event, a stroke, a heart attack, if you take a statin therapy after one of those events, that's called secondary prevention. Right? You've already had an event. We're trying to prevent a second event. Okay? So if you've already had one of those, statin therapy clearly shows a benefit in that population of people. If you've had a heart cath, or even, um, a ct calcium scan. Right. Which I have not done. That's something that kind of came into vogue after I did my training. And because I don't practice cardiac medicine, um, I'm not as familiar as when those get ordered. But we're starting to be able to identify atherosclerosis with less invasive mechanisms other than a heart cath. But if you've had something that has identified atherosclerosis in your vessels, you probably also should be on a statin, but we definitely should not be putting it in the water, which, again, that's something that I said probably ten years ago, definitely not, um, that beneficial, right? I mean, the anti inflammatory effect is really great and grand, but can you get that from just improving the way you eat? Because, remember, insulin in an insulin resistant human being is inflammatory. So do we need to actually, like, take an anti inflammatory? Do we need to fix our insulin resistant resistance so that we don't have so much inflammation pulsing through our body? Maybe. So what do we do?
[00:22:11] So here's the thing, my friend. Here is where you're going to be like, oh, wait, I've heard this story before. I'm going to give you the same advice I've given you over and over and over and over and over again.
[00:22:21] If it's your first time to the podcast and you've not listened to many of these episodes, this is going to start to sound very familiar. If you listen to a number of my episodes. Processed foods do not match your biology.
[00:22:34] When you eat processed foods, foods that have been so corrupted from their natural form, you will inevitably get sick. And it's not because the food is bad, and it's for the love of all that's holy, my friend, it is not because your biology is broken. It is because that food simply does not match your biology. These foods are not nourishment to your body. They just simply cannot nourish your body. Instead, your body actually has to detoxify what you consumed and somehow either get it out of your system or store it in a place that's not going to make you sick as much as it can. Okay? This detoxification of these foods that don't match our biology, this detox process, makes us sick, okay? These foods make us sick with insulin resistance, primarily, and insulin resistance is the root cause. Again, diabetes, hypertension, dyslipidemia, polycystic ovarian syndrome, low testosterone dementia, non alcoholic fatty liver disease. The list goes on and on and on. Insulin resistance is the root cause. Of most of our chronic diseases, and it is caused by these foods that we eat. So this is the part that has to be fixed. Western medicine does not have a medication that fixes this. There is no med that your doctor can prescribe you that undoes the damage of eating these foods. All it does is mitigate the risk that you're going to have a bad outcome with. It lowers your cholesterol so that we're not depositing a bunch of cholesterol into your vessel walls and leading to heart disease or cardiovascular, cerebral vascular stroke disease. Right. Maybe giving you insulin so we can bring your blood sugars down. The, you know, western medicine, you know, the meds that we give you to lower your blood sugars are not making you healthy. They're just fixing an n number to hopefully lower your risk. Same thing with blood pressure, giving you a medicine to lower your blood pressure while you continue to eat food that your body has to somehow process even though your body can't use it.
[00:24:40] That medication to fix your blood pressure does not make you healthier. Okay? These meds just mitigate our risk, that's all. Okay, so I'm not telling you don't take your meds. Please do not hear that. I'm not telling you that you need to not take your meds. I'm not telling you what meds to take or what not to take. I'm trying to, one, help you see that your genes are something different than what you believe they are. Lots of people think that the genetic component is why they're sick.
[00:25:11] And maybe, maybe, maybe that there is some genetic component that means that you have really hard to control cholesterol instead of really hard to control blood pressure or really hard to control diabetes. Maybe that's true.
[00:25:27] But I'm trying to give you and encourage you to give yourself a fighting chance.
[00:25:33] Stop eating that processed food that makes you sick for 90 days and see what happens to your numbers, to your cholesterol, to your hypertension, to your diabetes, to your health. See what happens if at the end of the 90 days, you're no better off and you're like, no, this is definitely genetic. Awesome. That's grand. The Twinkies didn't go anywhere. You can still eat them, and there's still statin therapy if you want it, eat it up. I was wrong. But give yourself a fighting chance to prove me wrong.
[00:26:01] See what happens if you're needing help with this. This is what I help women do. Right? Like, this is what my program helps you do. I help you see that you can be healthy. If you're interested in this, set up a lab evaluation with me. This is 20 to 30 minutes. You and I hop on a Zoom call. You bring your most recent set of labs. You and I look at them, and we see where there's evidence of insulin resistance. You get some clarity on what, where your health is, on how healthy you are, how insulin resistant you are, what needs to be fixed, what improvements you're going to see. And if you're interested, I can tell you how my program can help you get there. Okay? There is a way to be healthy, and I can show you how that option is available to you if you're interested. If you just want to hop on a call and bring your labs and see, you know, where you're at, let's do that, too. So, again, you get clear, and you kind of know where there's room for improvement for you. So before we sign off, that's all I have for you today. Before we sign off, though, I definitely want to give you my disclaimer on meds. If you are medicated for your type two diabetes, you have been medicated because of the way you've eaten in the past. If you change the way you eat, you will need to change the medications that you're on. If you do not do this, you're going to end up very sick. The kind of sick that looks like hospitalization and possibly death, and that's not why you're making these changes. Okay? So get on the phone with your doctor. Get a very clear understanding of how your doctor wants you to share your blood sugar logs with them and how they intend to share with you any med changes that they want you to make, okay? This is how you're going to keep yourself safe when you're making these changes. All right? I also have a guide. If you're interested in it, you can go to delanemd.com better. B e t t e R. That is a 14 day menu. Um, breakfast, lunch, dinner for 14 days. At the end of it, you will see improved blood sugars. But again, it's very, very powerful. So be very careful. Change it like using this 14 day guide. You will. If you're on meds, you're going to need to change those meds, so be very careful with that.
[00:28:07] I do have an ask if you would rate this podcast. The more people that rate this podcast, the more ratings my podcast gets, the more reviews my podcast gets, the more the podcast players put it in front of other people. Okay? Nine out of ten Americans have been two different studies, one in 2019, and I think the other one was done in 2021, or at least published in 2021, showing that insulin resistance affects nine out of ten Americans. Most of the people you know have insulin resistance if they don't already have one of these other diseases that we know are related to insulin resistance. People need to hear this information. You do not need to be sick. You can learn how to eat in a way that matches your biology so that you are not sick with these chronic diseases tied to the medical system for the rest of your life. Okay, rate the podcast. Review the podcast so others can hear about this. So I want to encourage you to keep listening, keep avoiding foods that are making you sick, keep making the choices for your health and your vitality. And I will be back next week. Bye.
