Episode Transcript
[00:00:00] You are listening to episode number 262 of Better Blood Sugars with Delane, Md. Welcome to Better Blood Sugars with Delaine, 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.
[00:00:29] Hey there, and welcome to the podcast. I am so glad you're here. This is a late night recording and I'm in my new office and the sound isn't great. There's just a lot of imperfections happening here. But I'm really excited to share this information with you and I feel like a late night dj right now. So we are going to talk about stress today and the impact that it has on human physiology. And again, I'm really glad that you are choosing to spend some time learning about your health. The information I've learned about this particularly has been just fascinating and incredibly interesting. I'm really excited to share this, even late at night and in my dj ways, I want to talk about stress and its impact on human physiology, how it plays a role in insulin resistance. We all know that we need to eat different to improve our blood sugars, and that's totally true. Like, that's, I mean, like, there's no amount of, you know, meditation and yoga that you're going to do or breath work that you're going to do or thought work that you're going to do, that's going to make a diet of Twinkies. Okay, like, that's probably not going to work out. So we know that we need to eat differently, and that's important. And certainly over the last few months, we've talked about exercise and muscle mass and how it helps improve our insulin resistance and hence our diabetes. So our blood sugars, those two strategies are going to have a huge effect on our insulin resistance, our blood sugars and our diabetes. However, stress can also be a huge player as well as. And we're going to discuss it and we're going to dive into it.
[00:02:02] In the past, I've spent a lot of time talking about how stress activates cortisol and epinephrine and norepinephrine and how those impact the liver to drive up our blood sugars, and that's true.
[00:02:16] But as I was researching this, there are a lot of other ways that stress actually leads to insulin resistance and our diabetes and high blood sugars. I am going to spend a lot of time on the science here because I feel like most of us think that, you know, stress is, in our mind, it's not really real. Yeah, there's this cortisol thing, and maybe there's a sereniferian thing and blah, blah, blah, blah. But, you know, that's not the main source of it. It's not the issue, really. What I need to do is buckle down, you know, and which creates stress. Right. Like this whole idea, I need to be more strict. I need to buckle down. I need to be more disciplined. All of that just creates stress. And that's what we think we need to do to fix our blood sugars. And the reality of it is, is that stress, it causes our insulin resistance in many, many different ways. And we're going to talk about that.
[00:03:08] Literature definitely shows that stress causes our insulin resistance and our diabetes. And our insulin resistance and our diabetes also causes stress. So, you know, there's been multiple studies out there that talk about lifestyle modification and meds can both lead to stress in the human body, which worsens our insulin resistance. So we like learning how we can really do the best that we can. Some skills for us to really manage our stress, I think, can't be overstated enough. And in general, life is too short to be stressed out all the time. If we can find ways to nothing be stressed out all the time, that seems like a win win situation.
[00:03:48] So I'm going to talk about a number of studies, and then I'm going to talk about six mechanisms. Um, and there's going to be studies that I mentioned in that also. Um, I'm not quoting the studies. If you are interested in the studies, if you want to go look these suckers up, you send me an email, delanemd.com, and I will link. I will send you all of that literature and you can read through them. However, I'm going to just state dates of studies, partly because this has been known for a very long time, this issue and the connection between stress and our insulin resistance has been known for a very long time. And I think that that's something that probably, we need to importantly point out first, I do want to talk about mental health in general and insulin resistance and diabetes. Multiple studies have shown or revealed that diabetics have far more anxiety, depression, anger, and stress related behavioral disorders than non diabetics. Why is this happening? There's been multiple things proposed as to what the origin or the source of this is. Is it poor coping skills leading to overeating or stress eating?
[00:04:54] Possibly. I think that there is a component of that, and I think most people, at least most women that I work with, and they mention, they talk about this, or is it also food choices during stress eating? Nobody's stress eating celery. The choices that we make when we quote unquote stress eat are not fabulous choices. It's food that makes us sick. It's food that's not natural. It's processed. It's high salt, high sugar, high fat. There is this connection between diabetes and mental health, and then there's the management of the mental health issues, which can be leading to the diabetes also. And this gets real circular. Learning any strategies that we can to manage our stress a little bit better, I can't imagine would be anything other than helpful. So the mechanisms that I found in the literature, again, you know, the effect of cortisol and epinephrine and norepinephrine are very clear. Like, that's well known and pretty well understood, I think, by most folks, you know, we have a stress response. Our body releases cortisol. Cortisol causes our blood sugars to go up, our body releases epinephrine and norepinephrine, also causing our blood sugars to go up to fuel ourselves.
[00:06:05] But what else is happening that's not as clear or hasn't been made up as clear, at least to me. This is news to me, and hopefully news to you, is that not only are we increasing the blood sugar, but on a cellular level, we're also increasing insulin resistance because of the stress. The effect of stress, the physiology and the biology of stress on our body is leading to insulin resistance. One mechanism, number one, is that stress has a negative toxic effect on beta cell function. So beta. Beta cells are the cells that live in the pancreas that make insulin. In type one diabetics, this is the cell that your body eats up. It basically has an autoimmune attack on those cells.
[00:06:52] So emotional stress has been shown to lead to death of these cells. It was thought to occur through the activation of the immune response. So there is that still that autoimmune response. These findings were described in 2000, 320 14 and 2014 2019. So there's pretty clear evidence that stress actually causes beta cells to die in our pancreas. If you're working them over time, if you are super insulin resistance or resistant, or if you have any evidence of any type one diabetes in your life, not managing your stress is going to make that situation so much worse, beta cell function is. Mechanism number one. Mechanism number two is that high cholesterol. So, dyslipidemia is known to have an interplay with insulin resistance, meaning that people who are insulin resistant tend to have high cholesterol. And high cholesterol also tends to cause insulin resistance. Okay? And this is caused. This happens by intracellular, but basically, it blocks the function inside the cell. So, if you remember, I've talked about this a lot, how insulin is present. You know, blood sugar floats around in our bloodstream after we eat. And our pancreas senses that it has little sensor cells, and it's like, oh, there's blood sugar here. We probably need some insulin out there. And the pancreas, the beta cells, kick out some insulin, and those insulin molecules go to the cell. And at the cell membrane, at the surface of the cell, they bind.
[00:08:25] And when they bind, that triggers a different port, not right there where the insulin is bound, but somewhere else on the cell membrane, a different port opens up and allows glucose to come in. And this cholesterol issue, this high cholesterol issue actually causes the that messaging that goes from when insulin binds at the cell membrane to that port opening up somewhere else on the cell membrane, it blocks that message. So that message never gets through. So we can't bring glucose inside and effectively, again, our cells aren't functioning normal in the presence of insulin, so our cells are insulin resistant. Okay.
[00:09:08] Stress, especially prolonged stress, negatively impacts lipid metabolism or cholesterol metabolism, in a way that leads to more of this blocking of that messaging system of our insulin on the inside of the cell, this abnormal metabolism of cholesterol then leads to insulin resistance. So that is the second mechanism of how stress impacts this stress, especially when it's prolonged, causes this negative metabolism of our cholesterol, which leads to that intracellular insulin resistance.
[00:09:47] The third mechanism is inflammation and immune responses. So, in the same way that the cholesterol or the lipids can block that internal signal of the insulin and cause that insulin resistance, and inflammation also does this. Inflammatory chemicals, or mediators, are activated in stress responses, and then high blood sugars are also a stress, a physiologic stress on our body. So it leads to even more activation of this inflammatory marker and these mediators and further insulin resistance. This really leads to a cycle of insulin resistance.
[00:10:26] So, inflammation is the third mechanism that I found in the literature that leads to further insulin resistance.
[00:10:33] Autonomic nervous system. The autonomic nervous system is the part of our nervous system that is unconsciously controlled, right? Like, there's a conscious nervous system. The nervous system that tells our hands to go and reach for a glass of water and drink our glass of water. That is a nervous system response that is controlled consciously. The autonomic nervous system, it's the unconscious control of things. So it's what controls our heart rate. It's what controls our heart contractility, how hard it contracts. It's what controls our kidneys and how much are they filtering our blood. The autonomic nervous system controls all of these different things that we don't think about, we don't have conscious control over.
[00:11:21] So the connection between the autonomic nervous system and insulin resistance is pretty complicated, and it's not fully understood. However, what we do know is this part of our nervous system plays a huge role in energy metabolism and availability. And what's cellular energy? Glucose. It's also fatty acids. So there's. That is part of our energy and part of what is managed. But primarily, when we talk about energy metabolism and energy availability, we're talking about glucose. So this autonomic nervous system is divided into two arms. The sympathetic nervous system, which is our fight or flight system, or our stress system, and then the parasympathetic nervous system, which is the rest and relaxation part of the system. In 1988, in 2001, in 2012, in 2013 and 2014, it has been shown repeatedly that the level of activity between these two parts of the nervous system play a huge role in affecting our insulin resistance. So when the parasympathetic division or the parasympathetic arm of this part of our nervous system is engaged or activated, what we know is there is improvement in insulin resistance or there's an increase in insulin sensitivity. Insulin resistance is diabetes. Insulin sensitivity is the opposite of insulin resistance. So it's like anti diabetes. Parasympathetic nervous system seems to improve our insulin sensitivity. It's furthermore been shown the stimulation of the sympathetic nervous system. That's our fight or flight system. One of the things that they watched and measured was our heart rate variability. They measured heart rate variability to see how engaged is your sympathetic nervous system. Heart rate variability is a vital sign, essentially, that can be calculated. It's complicated how they calculate it. They can do it with an EKG, but there are calculators. And then a lot of our, like, fitbits or garmins or even apple watches will calculate this for you. Is it the perfect calculation? No, but it's pretty nice, crude of calculation.
[00:13:36] And when we have high heart rate variability, that's good. That's associated with better health and when we have low heart rate variability, that's not good. Okay. And what this heart rate variability is thought to measure is the balance between the parasympathetic and the sympathetic nervous system. And what we know is that people, or what we've seen is that people who have a low heart rate variability, which is then again, like, too much sympathetic activation of that nervous system, they have higher fasting insulin levels, not fasting blood sugars, fasting insulin levels, and that is indicative of insulin resistance.
[00:14:24] So we know. I mean, like, it's been pretty clearly, at least associated. Is it causative? Gosh, I don't know. No, that evidence isn't out there yet. But definitely there is an association between people who have too much of their sympathetic nervous system, that fight or flight system, that stress system activated, that they tend to be more insulin resistant. And the con. The converse has also been proven. People who have more parasympathetic activation happening, they tend to be more insulin sensitive.
[00:14:57] So that autonomic nervous system and its interplay with insulin resistance and insulin sensitivity is the fourth mechanism that I found when I was looking into this more deeply. The fifth mechanism that I found that has a play. It plays a role in our insulin resistance is what's called the renin angiotensin system. Okay, so, this is a part of our biology that manages what I knew it was, was manages our fluid intake, and it manages our blood pressure. And it kind of makes sense that stress would cause an activation of that, because you need changes in your blood pressure and possibly changes in your fluid retention. You might be sweating because you're stressed or you're running or whatever. I mean, there's all sorts of things. This makes sense in my brain. What I didn't realize is that multiple studies have shown that activation of that renin angiotensin system leads to insulin resistance, and it does this by blocking that intracellular signaling, again, so that inside the cell, the insulin binds. It's supposed to send a message to another port on the membrane, telling that port to open up and bring glucose in. But there's a blockage of that messaging that happens inside.
[00:16:19] What we've also seen is blocking that renin angiotensin system has been shown to improve insulin sensitivity in animal models. So there is clearly some interplay between insulin resistance and that renin angiotensin system. And then lastly, the 6th mechanism that I came across. So, stress is known to stimulate, of course, cortisol production, which we know, and we know that cortisol production will increase blood sugar however, what it also does is it decreases sex hormones like estrogen and progesterone and testosterone. And this is known to impact insulin function in a way that allows blood sugars to climb higher and leads to more insulin resistance. Like there's poor blood sugar management when we don't have appropriate levels of our sex hormones in our system.
[00:17:16] So that was a lot of mechanisms that were not very clear to me, at least. I always, again, knew that, yes, we have the sympathetic system. It activates. We have cortisol, we have norepinephrine, we have epinephrine. They go to the liver. They tell the liver to spit out some glucose and that glucose feeds our muscles. That seemed to make straightforward sense. There's a lot of other things happening here that just increases insulin resistance. Not only are we increasing blood sugar in the system, but we're also increasing insulin resistance, meaning that our cells won't pull that blood sugar up. But here's the interesting thing about why it makes sense so teleologically. It makes sense that we want more fuel for our cells and our bloodstream if we're having a stress response. These stress responses were really meant to save our lives. Either it was always meant to prolong our immediate life, whether that be fighting or flighting or running. Right. Fleeing from a situation. There was going to need to be fuel to your body, to your muscles, to your tissue. So it makes sense that when we're stressed, we want to increase the fuel availability. And if you further think about this even further, we want more fuel. That means more glucose, more fats available in the cells.
[00:18:39] We want our bodies to utilize that energy. We need to have energy available so that we can save our bodies and run. But here's the interesting thing. So the insulin resistant cells would be liver, kidney cells, maybe skin cells. But here's what's not insulin resistant is the muscles. The muscle cells. Remember, when muscles contract, they start to bring in glucose in a way that is irrelevant of insulin resistance. Muscle cells can be insulin resistant, but when they start to contract, they start to pull glucose in in a way that does not rely on insulin. Okay, so we're increasing glucose as availability to our muscles and decreasing its use by other cells. It's really makes tons of sense why our body does this. What doesn't make sense is why we stress out about things that aren't actually going to kill us. That's probably where the bigger change needs to be made.
[00:19:43] Under stress, our human bodies are going to look for ways to increase our blood sugars. And it's found really clever ways to do this, and that's great. Our job is to then decide what we need to stress about. Biological stress is really meant to keep you from a life threatening experience. That's really what it is. Stress 10,000 years ago was a life threatening experience. It was not a bill. It was not an argument. It was not an annoying co worker. It was none of those things. It was okay to accept the risk of these, you know, long term negative impact, right? Like, there's a lot of negative costs that come with these stress responses, but in the immediate moment, you're saving your life. So whatever the long term cost was seemed like a decent payoff. And because we weren't under prolonged stress 10,000 years ago, we ran from saber tooth. The saber tooth caught something to eat, and then it wasn't chasing us anymore. The stress was limited, and it was short lived. And so our bodies responded well, and we were willing to take the, you know, the fee, the cost that we paid by having kind of this negative impact, and then we would, you know, remove the stressor. The stressor would be gone, and we'd go back to normal biology. Okay? But there were definitely a lot of negative costs. Long term costs of being stressed will lead to disease in our body, right? So if we think about the increase in the vital signs that happen when we're stressed, right, if there's a stressor, our heart rate goes up, our blood pressure goes up, our heart contractility goes up, our kidney function starts to change.
[00:21:27] And what we realize is that long term, if our heart rate is up, if our blood pressure is up, of our contractility of our heart is increased. Long term, what that leads to is heart failure. Like, the human heart's not meant to be under that biology for a long period of time, okay. These physiologic adaptations were meant to be short lived, and when they are prolonged, they really lead to disease, as does insulin resistance. That cause that happens with this long term stress response also, and that insulin resistance, of course, leads to diabetes. That I do really believe, the more that I learn about insulin resistance, that insulin resistance is of its own, a disease state. There are negative consequences that happen in the human being from insulin resistance alone. One of them is higher blood sugars. That has its own set of consequences. So the human body can tolerate these negative effects for a brief period of time. And again, they serve our immediate survival, but only for a brief period of time. When they're prolonged, they start to break down our body and cause disease and make us sick.
[00:22:40] Most of us do not really have regular, consistent, life threatening events. Most of us, thank God, we don't usually have this. Some humans do. And that is unfortunate, deeply unfortunate. But most humans do not have life threatening events happening prolonged all the time.
[00:23:01] We don't have near life, near death experience. Right. We're not constantly talking about life and death experiences. We're stressed about things that make us uncomfortable, usually. Or give us an unpleasant emotion or possibly create, like, increased workloads for us. But our lives do not usually end as a direct result of some of the things that we stress about. Okay. Modern stressors are bills which make us less able to pay for fun things, so it's less pleasant. Or maybe unable to pay for other bills, which is uncomfortable. Right. We have to make phone calls, and we have to, like, ask them to, you know, can I not pay this bill because I have to pay this other thing that came up unexpectedly. But death is not really, at least in our society, an acceptable consequence for not paying a bill. Arguments are similar. They make us have emotions, and they're not pleasant. And they're even uncomfortable. They're not fun, but they usually are not life threatening experiences.
[00:24:05] The stress response that our body has. And it knows no other way to respond to stressors.
[00:24:11] It was meant to respond to direct life threatening events, not discomforts or unpleasant trees. So how do we learn to manage or lessen our stress, given the role that the autonomic nervous system plays on stress? Learning how to control that, how to have some agency of control over our autonomic nervous system, specifically, our parasympathetic nervous system, is really, really important. Remember, there are these two parts of the autonomic nervous system. We just talked about it. You have the sympathetic, which is the fight or flight or stress response or part of the system. And then you have the parasympathetic, which is the rest, and digest or calm response of the system.
[00:24:55] The two sides of these nerve nervous system or this nervous system, it works in seesaw, when one is turned on, the other one has to be coming down. We call it turning up the tone or turning down the tone. Activating or deactivating if one is being activated. If the sympathetic system is being activated, the parasympathetic system has to be being deactivated. The converse is also true. If you are activating the parasympathetic system, you must be turning off the sympathetic system. Okay, so how do we activate the parasympathetic system. And, in turn, improve our insulin sensitivity?
[00:25:36] This is one of the most important ways to do it. I also want to point out when the sympathetic system, when that stressed fight or flight system is activated, you are not making decisions that are based on long term information. You're not making decisions based on pros and cons. And what's the best decision for me to make? You are making decisions in the moment. Is that decision going to kill me? Literally? Your brain, like, under the effect of the. Of, like, dopamine and norepinephrine and epinephrine, your brain starts to try to rapidly evaluate as many different options as are available to you to see which ones won't kill you. And then you just go for that. And then in that next step, you take one more step, and you're doing that same rapid evaluation. It's not like you're pro, you know, you're weighing pros and cons. You're just like, is something going to kill me right there? No. Okay. Step in that direction.
[00:26:36] So recognize when that sympathetic system is engaged, it's really hard to see clearly what best serves you, which is why we eat junk food when we're stressed, right? We're like, oh, I don't care if I die in 20 years for my diabetes right now, I feel horrible, and I feel like something, like my life or death thing is happening, and I need to feel better.
[00:26:58] Makes a lot of sense. We have to get that sympathetic system offline when we're making decisions, because it just makes really bad decisions. So the first step that you'll want to hone, like, the first skill we have to learn is how to become aware of our stress situation. Like, where am I in my stress response right now? Become aware of when you're becoming stressed, what happens in your body when you're stressed, how your body feels when you're stressed. Once you can start to identify my. For me, I always know, like, in 02:00 in the afternoon, I need to check where are my shoulders, because my shoulders are usually up on my ear lobes because the. But, you know, the heaviness of the day and the things I need to do are happening. And so I know what stress feels like, especially in the afternoon for me, is that feeling of my shoulders being up by my ears and then taking a deep breath and relaxing that. Okay. Once you can identify how stress feels in your body, you can start to name the experiences, like I just said, like, the afternoon that happens for me. Orlando, sometimes I just get anxious about things. I am a human being, and human beings get anxious sometimes. I am no different. It's a normal experience.
[00:28:18] But when we think it's abnormal, and then we're in this fight or flight response, and we're just looking for any way to try to appease that abnormal thing. The fact of the matter is, human beings are supposed to be anxious. It's what kept us running from saber tooths. Like, that's the thing that's supposed to happen. But the recognition of what it feels like and then the identifying of it. Once you can identify, this is how I feel when I'm stressed. I must be stressed about something. Oh, you know, the end of the month is coming. These bills are coming due. My kid's car, this really just happened to me last week. My kid's car has a replacement part, and it's going to be $1,000. That was unexpected. And I'm like, that stressed me out. My son was like, why are you so edgy? And I'm like, why are you so edgy? But in my head, I'm like, oh, I'm edgy because there was this unexpected bill that landed in my lap that I need to take care of. So knowing what it feels like in your body is going to allow you to acknowledge it and identify it. And that's the first step. And then start learning strategies for activating that parasympathetic nervous system. When we activate the parasympathetic nervous system, we have to turn down the sympathetic nervous system. Let me say that again a little differently. When we activate our calm system, we have to turn down our stressor system. They can't both be running at the same time. So what are some strategies for activating that calm, that parasympathetic system? One deep breathing is probably the most powerful way to activate your calming parasympathetic system. When your grandmother told you, baby girl, take a deep breath and calm down, she was not kidding. This is sage, old, wise pieces of information and encouragements that have come from elder people that have what before us, because this has long been known, even on an old wives tale level. Okay, what happens when you take a deep breath as your diaphragm flattens out? Your diaphragm has a hole in the middle of it, and your esophagus and your aorta run through that? On that esophagus and the aorta is the vagus nerve. The vagus nerve is a large, large nerve that runs through our body, and it does a lot of different things, and it runs a lot of different places. It is one of the largest parasympathetic nerves that run through our body. So when we stimulate the vagus nerve, it turns on our parasympathetic system or that calming system. When you take a deep breath, that diaphragm flattens out and physically rubs your vagus nerve, stimulating it. That's why a deep breath helps. So if nothing else, learning to take three belly breaths, you know the kind of breaths where your belly goes out, you really fill up and you can feel your chest and your belly really expand out. Take three of those. That is parasympathetic nervous system activation right there. Other things that can do this, meditation and yoga, both of those have a huge breathing component, which is why they do it. Exercise. Again, huge breathing component. Yes, there is a sympathetic tone that happens with exercise, but overall there is a calming effect. The net effect of exercise is a calming effect. Massage, mindfulness, I think that's huge and important, like just being aware what is happening to me, adequate sleep, gratitude practices, prayer time in nature, all of these things are known to activate that parasympathetic calming nervous system.
[00:31:57] Once you can do that, then you make a decision about what do you want to do about your stress long term. Okay, you have to start working on rewiring some of these thoughts. I feel like engaging these parasympathetic activators with the thought model that I've taught in previous episodes. I think that that is what really impacts stress long term. Again, you're not going to be able to evaluate your thoughts in a meaningful way if your stress response is turned on, because all you're doing is looking at what is happening right in front of you. You're not looking at long term benefits. And when you're stressed and angry, you feel entitled to being stressed and angry, because that turd did this and this and this, and he shouldn't have. And somebody, you know did me wrong. That's all stress response. And it's only focused on the immediate. It's not focused on what long term thing is happening, even when that immediate response is definitely not serving your long term benefits.
[00:33:03] If you want to know more about the thought model, I'm going to go through it briefly here. But you can check out episodes 105, 217 and 260 of this podcast. And I talk about the thought model and I explain it there. But the thought model is composed of five parts, and they're all related. So you have circumstances. That's part number one. Part number two is thoughts, feelings, actions, and results. So how they go together is there are circumstances that happen in the world, and our brain has thoughts about those circumstances. And those thoughts create our feelings. Stress is a feeling, and those feelings drive our actions, and those actions create our results. And those results give us evidence about what we thought in the first place. Place. Okay? When we believe. So this is a great example. When we believe, we are constantly arguing with our kids and we feel edgy, and it leads us to respond sharply to our children when they say something to us, and then that causes us to have another argument with our kids. All right?
[00:34:02] When we can activate the tools of mindfulness and awareness and we can pause and we can say, I constantly argue with my kids, is there even any benefit to me thinking that I constantly argue with my kids?
[00:34:17] We can decide, is this the total truth? We can say, no, actually, this morning we had a very pleasant conversation, but we have to get that or that sympathetic stress system offline before we're going to be able to acknowledge that. And that comes from that mindfulness and that awareness and those deep breaths and that calming, actually. Is it true? Is this a total truth? And then we can decide, is it the total truth? Yes or no? We can decide, is there any benefit in believing it? Even if it does seem to be the total truth, is there any benefit in me believing that I fight with my loved ones all the time?
[00:34:50] Because you feel crappy with, that happens, right? Like, that's what creates that stress.
[00:34:56] If it's not the total truth and if there's no benefit in believing it, like, it's optional, you can find something else to believe. You can find some other thoughts to spend time with.
[00:35:08] Doing this thought work again, it requires us getting our sympathetic nervous system, that stress system offline and getting the parasympathetic system online. So I recommend doing those deep breaths and then looking at the things that you think and you believe.
[00:35:22] If you are stressed and you're thinking, I always argue with my kids, you're going to fall in. Like that's going to be the most familiar path is to have that thought. You're going to have to take some time and slow that down. Okay. The stress system only makes short term decisions that serve the immediate future. It does not make those long term decisions. And so you've got to get it out of the driver's seat, because what will happen is when you're feeling stressed, you're going to stay in that stress response until you get it out of the driver's seat. So what I mean by that is you are going to stay feeling stressed until you turn that sympathetic nervous system off. And the only way to do that is to take some deep breaths.
[00:36:11] The, you know, you can do yoga, you can do meditation, you can go for a walk outside. There's all sorts of things that you can do, but you need to get that parasympathetic nervous system online and start making some decisions from that over time. When you do this enough, you start to rely less on those deep breathing techniques. Although sometimes you do because it just feels good. But you start to see it. This happened again last week when I got this bill about my car, my kid's car, and my son and I were driving somewhere. He's like, you are just grumpy again. My response? You're grumpy, I'm fine. But I realized, I was like, oh yeah, I feel it. He's right. I am. I feel that stress everywhere in my body now. I could go through and do the thoughtwork about what I think about paying this bill for my car. I could do that.
[00:37:00] But what I did instead was just take some deep breaths, blow that stress away. I didn't need to do the thoughtwork because I know, oh, it seems reasonable that I'm stressed about that. I don't want to think something differently about it, but I don't need to feel stressed and I don't want to spend time being short to my son. So I take the deep breaths, I get to feel better. I have a better interaction with him. It can really be that simple. So if you have any questions about this, don't hesitate to reach out to me. You can always email me delanemd.com dot I want to give you a warning. If you are medicated for your type two diabetes, please be careful making the changes that I recommend in this podcast. In these episodes, I recommend changing your diet. But you've been medicated for the way you've eaten in the past, and so if you change the way you eat, you're going to need to change those medications. Also, you're going to need to contact your provider who prescribe those. You're going to need to find out how they want to see your blood sugar logs and how they intend to share medication changes with you. If you don't do this, you can get very sick, the kind of sick that looks like hospitalization and possibly even death. And that's not why you're making these changes. So make sure you set up that line of communication with your provider. I do have help for you. If you are not sure what to be eating, go to delanemd.com forward slash better and download the 14 days to better blood sugars it is a new and improved version. And actually in the next two weeks, I'm not sure whether it'll be next week or the week after. I'm going to be doing a podcast, going over that entire 14 day guide and explaining it and answering the questions as I have received them from folks when they email me about it. If you aren't sure what to eat and you're ready to get started on that, go to delanemd.com forward slash better. You can also follow me on Instagram. You can follow me on Facebook.
[00:38:47] As always, if you have any questions, you can always email me delanemd.com. lastly, I have an app if you are finding benefit from this podcast, if you would rate and review it on your podcast player. Nine out of ten americans have insulin resistance. If they are not already diabetic or pre diabetic, they are on the way. Nine out of ten of us more people need to hear about this. And the more people who rate and review this podcast, the more the podcast players present it to people and put it in front of people. Rate and review this so other people can hear that they do not need to live the rest of their life sick either. There. I will be back next week. Until then, keep listening. Keep avoiding foods that make you sick. Keep making the choice for your health, your vitality, your longevity, and your naturally healthy living. We'll talk soon. Bye.
