Episode Transcript
[00:00:00] You are listening to episode number 266 of Better Blood Sugars with Delane, Md. 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.
[00:00:29] Hey there, and welcome to the podcast. I'm so glad you're here with me today. I'm glad you've taken some time for you, and I feel honored that you're sharing it with me at this moment today. So happy Labor Day. This is Labor Day weekend, 2024. It's Saturday. It's chill. I'm actually in overalls right now. It's that chill of an experience, and I hope you're having a chill experience. Also today we are going to talk about sleep. I have been under the weather, so there's probably you're going to maybe appreciate a little nasally congestion with me. I apologize. I also realized that I got up and set for the podcast and failed to grab me a glass of water. So we're going to see how this goes, but we're going to talk about sleep today and how it impacts our diabetes and our blood sugars and our insulin resistance. I think the information behind sleep is incredibly compelling. A lot of what we think about sleep are based on misunderstandings about what sleep should be. We are going to clarify that. We're going to discuss how to enhance sleep. We're going to discuss what works and what doesn't work. A lot of this information is based off of information by the science two scientists. Matt Walker is one of them, and then Sage and Panda is another one. They both have books. Matt Walker's book is why we sleep. Sage and Panda has a book called the Circadian Code. They've distilled their research into books, which is really amazing. So I highly recommend it. But they're, these are two amazing scientists. They're highly renowned. Their books are well researched. I highly recommend you check it out. But a lot of the information I'm going to share with you today are based on information that came from that book and some others.
[00:02:14] So let's dive right in. I feel like there's a lot to cover here, and I don't want to dilly dally. So let's dive right in. I did look at a 2022 method analysis about sleep and poor sleep and insulin resistance. So this specific study looked at research articles and distilled down to ten major studies that showed a clear association between the development of insulin resistance and human beings who sleep less than 7 hours at night. What they looked at was there seems to be a role of inflammatory markers and some other biomarkers. And then again, a misalignment of the circadian rhythm are what seemed to be at play. And that is where I think doctor Sachin pandas book is really helpful. The circadian code. Another study I looked at from 2023, it looked, it was a small study. I'm not in love with the fact that there was a small number of women in there, but it looked specifically at women aged 20 to 75 years of age. And it showed that a very, a very clear correlation between mild sleep deprivation and the development of insulin resistance and how that was independent of adiposity. So what it showed was that 6 hours, on average, 6 hours and twelve minutes of sleep. So that's just slightly less than the 7 hours that are recommended. But 6 hours and twelve minutes of sleep over six weeks led to impaired insulin sensitivity, which is just insulin resistance, and it was independent of adiposity. So even normal weighted women were seeing this effect regardless of weight. There seems to be the development of insulin resistance with sleep deprivation.
[00:04:00] Again, the study wasn't huge, so it shouldn't really be overstated. But these are consistent findings. These are the findings that if you look across the literature, you're going to see these findings consistently.
[00:04:11] In general, you will find that if you have too little sleep, you're going to develop insulin resistance. Despite no changes in your food, you're going to develop insulin resistance.
[00:04:23] You need probably 7 hours of sleep. That's really the goal. Seven to 9 hours of sleep is what I always tell women. So really 7 hours is the low end of that. There is evidence that too much sleep will also lead to problems. But how much? What is too much sleep? That's unclear and it's far less of an issue for most of us. Most of us are struggling with getting enough sleep. So I don't think diving into that is too important at this point, at least my understanding of the literature out there is anything less than 7 hours of sleep consistently is not enough and will lead to insulin resistance regardless of what you're eating. So that's really important to see sleep cycles. I also want to talk about what our sleep cycles. Our sleep occurs in cycles, so we have sleep, we have a sleep spell, and that sleep spell has five different cycles associated with it, usually four to five. So these cycles, these four to five different cycles, within 7 hours of sleep that we're getting, they move between light sleep or even being awake, and deep sleep. Okay? And then there are multiple stages between super deep sleep and light sleep or weakness.
[00:05:37] Some terms you're probably familiar with are things like REM, rapid eye movement.
[00:05:42] And that is actually closer to being awake than it is to being deeply into sleep. And that might surprise you. But then there are other terms like non REM or n REM, non rapid eye movement sleep. And that tends to be our deeper sleep. That's our restorative sleep. That's when reparation is happening. Repair, healing, that's when the important healing of our body occurs, is in that n REM sleep. Most of the time, we're not dreaming in that phase. Dream is more of what happens in REM sleep and that lighter sleep.
[00:06:15] So we cycle through five cycles of sleep that go between this light sleep, awakeness, REM sleep, and deep sleep.
[00:06:25] These cycles, each of these four to five cycles, last 90 to 110 minutes in duration. And I refer to these as sleep cycle 1234 and five. I'm very, very clever, and the literature refers to them sometimes in different ways. That's how I always, when I teach this to women, this is how I always teach it. Sleep cycles one and two, you spend most of your time, again, this is going to be a 90 sleep cycle one is going to be 90 to 110 minutes, and sleep cycle two is going to be 90 to 110 minutes. I'm sure there are some people have shorter cycles, but this is just on average, what we're looking at. You spend most of sleep cycle one and two in this deep nrem three. This used to be nrem one, two, three and four. And they kind of grouped nrem three and four together as deep sleep, nrem one and two as mid sleep. And then, of course, rem and dreaming and light sleep was in this, a different category. They've changed the terminology when I researched this for just for this podcast. And it seems that they've grouped NREM three and four, that very, very deep sleep, into just one category called n rem three. And again, this is your really deep restorative sleep. You do this, you spend most of sleep cycles one and two. So the early part of your sleep, most of that is spent in that nrem three, that deep sleep. And then you come out of it. You come out of that deep sleep, and most people will have an awakening after those first two cycles of sleep. So what that means for you is after about 3 hours of sleep, you wake up and it's normal. This awakening 3 hours into your sleep cycle or into your sleep period is normal. There's nothing wrong, you're normal, nothing's broken, no need to get upset, no need to get mad. That just keeps you awake longer.
[00:08:24] Once you wake, have your awakening, you drop back down into nrem, and you go through n rem one and two, and then you'll drop into, you know, this deep nrem three again, and sleep cycle three.
[00:08:37] But you come out of it and at the end, and this is true for cycles one, two and three and four and five. All of the sleep cycles do this. But you will spend a period of time in REM sleep. And REM sleep has to do with the deciphering of what has happened during your day. It puts down memories, it lays down memories. It starts to look at the argument that you had, or the worry that you have about your kid. It looks at all of those things REM does, and it helps you kind of make sense of it. And so REM sleep is part of all four or five sleep cycles.
[00:09:13] But you spend different amounts of time in REM versus in REM sleep, depending on which cycle you're in. So, you know, sleep cycles one, two and three, you spend less time in REM, and sleep cycles four and five, you're spending quite a bit more time in. Remember, during those cycles. There's also a unique kind of milieu environment of hormonal events occurring. And the important part to realize is what is happening later in your night of sleep. So you have seven or 8 hours of sleep. What's happening at hour five, six and seven, or sleep cycle four and five, is different than what's happening at hours one and two of sleep, or sleep cycle one and two.
[00:10:00] And you cannot get to what's happening in sleep cycles four and five. So those hours six and seven, you can't get there without going through those initial hours of sleep, those initial cycles of sleep. So if you are trying to work through something in life and you need that REM sleep, you can't get there until you've gone through the initial stages of sleep. And I think it's really important, this is why it's so important to give yourself adequate opportunity to sleep. And that really is at least 7 hours.
[00:10:31] So I wanted to clear to discuss what we call sleep architecture, or what's a normal sleep event, what's a norm, what happens when we sleep, at least as far as we know, because it is really important to see one. What happens later in sleep is very different than what happens in the beginning of sleep. And you can't get to what's going on later in sleep until you've gone through the first part. That's really important to see. The second thing is that later in your sleep, so hours five, six and seven, you're actually spending more time in REM and light sleep. So it seems like you're awake. There's a lot of times that we're like, I just can't get back to sleep. I just feel like I'm awake the whole time. And you are like it. That's because you're so close to being awake. You're so close to that line between light sleep and awake that it. Your brain will interpret it as you being awake. Now, many times if we put eegs. So if we put on, what is it? Electroencephalography eegs, we put the electrodes on your brain and we look at brainwaves. Many people would find that they are actually having sleep waves, even in that light phase. They just associate it. They label it as being awake because it feels more like being awake than those really deep sleep periods where you're unconscious and totally out of it. So I wanted to go through that because I do think it's important. Lots of times what I see with women is that they get very upset when they are not getting into the sleep that they think that they should be having. They. We all believe that we should be out, knocked out and unconscious for seven to 8 hours. And that's what sleep is. And of course, that's not really what sleep is. So I wanted to clearly identify, like discuss that structure.
[00:12:19] So other things that poor sleep will impact. Poor sleep not only will make you more insulin resistant, but poor sleep will also. There's clear evidence in the medical literature, if you look at it, that you will choose bad foods. Nobody's reaching for the carrots and the celery. When they've had a bad night's, night of sleep, they're reaching for chips and twizzlers. So we choose worse foods, and there's tons of evidence for that. And then there's also the studies that show that poor sleep is associated with everything from cancer to cardiovascular events. And what do I mean by cardiovascular events? I mean heart attacks. There is. We've looked at research, looking at daylight savings. So in the spring, when we spring forward and we lose an hour of sleep, there is evidence out there that there is an increased occurrence of myocardial infarctions, and that is reported in the literature. I did come across a study from 2023 from Mayo Clinic that said that maybe that's overstated, that it's not as bad as we maybe thought it was, but it's still there. It's very clearly there. There is an association between one single hour of sleep lost and an increase of myocardial infarctions, of heart attacks. So recognizing that that is going on. But also the World Health Organization lists poor sleep, or circadian disruption is what they call it. So poor sleep, they list anything that disrupts your circadian rhythm as a probable carcinogen. So poor sleep over time will probably cause cancer. That's what that means.
[00:13:58] We also know poor sleep will drive adiposity or fat accumulation. So if weight is something that's important to you, it could be as easy as like, sleeping more could be that one thing that pushes you over the edge to make your weight loss a little easier. So recognize it's going to be harder, certainly to lose weight because your body is going to drive the accumulation of fat, like how holding on to the fat if you're sleeping poorly.
[00:14:24] So I hope that I've inspired you to realize that sleep is really important. Like, we all need to sleep more if you are interested in being healthy. Sleep is a key, vital part of that, and I hope that I have emphasized that here.
[00:14:39] So how do you improve your sleep? So, first, ladies, I really want you to stop getting angry when you're not sleeping. When you have that hour or that, you know, wake up at 3 hours into your sleep, it's normal. Don't get angry about it. One, this is clearly, this anger part is clearly not helping anything out. So I want you to take a deep breath and recognize that laying in your bed and resting is still more rest than anything else you could be doing. If you can't be sleeping, this is the second best thing. Take a deep breath and rest. And I know that is not what sleep scientists like. Sleep doctors will tell you to do it for 20 minutes, get out of bed, go do something else, but take your mind off of it. Come back. I get that. I understand why they say that. I think that there are a couple other strategies to use in order to create better sleep for yourself. And the first is realizing that laying in bed is more restful than anything other than sleep that you could be doing. Okay. And then I want to encourage you to get some control over your thoughts. We as humans in America are raised to believe that thoughts are these serendipitous things that just fall from heaven into our brain and we have absolutely no control over them. And that is unfortunate because it's just not true. We do have control over which thoughts we ruminate on. We spend time with. We choose to continue to think. And so I want to encourage you to start practicing some strategies that will get you some control over your thoughts.
[00:16:14] Meditation is probably the most well studied, well validated, easy, cheap practice to do this. Start a meditation practice. I always describe and like teach that meditation is the bicep curl for your brain, right? If you're interested in building your bicep muscle in your arm, you're going to do bicep curls and you're going to do them a lot to build that muscle. Holding the dumbbell and not moving it is nothing. A bicep curl, it does not build your bicep muscle. Moving it is what builds your bicep muscle. And moving it multiple times is what builds your muscle. Moving it once isn't going to cut it. You have to move it over and over and over again if you intend to build that bicep muscle. Meditation is the same. Meditation builds the muscle of the brain.
[00:17:11] And it's not sitting in a zenith phase in a Zen state, hovering, you know, 18 inches off the ground or whatever. That is not meditation.
[00:17:21] That is not meditation. No more than holding the dumbbell is a bicep curl. It's not going to build the muscle. Meditation is refocusing your mind every time it floats off. What am I going to wear? Where do I have to be? What do the kids have tonight? What are we eating for dinner tonight? What did I do yesterday? There was something I needed to remember. That is what your mind will do on its own.
[00:17:46] Meditation is bringing it back to your focus. And usually we focus on the breath. When you meditate, I that's what I do. Some people focus on a third eye, some people focus on something else. Whatever the guided meditation that you're working through is having you focus on, you bring your mind from what am I going to wear today back to that focal point that you're focusing on. That's meditation in the same way that moving the bicep in a bicep curl motion is building your biceps, building the effect of having control over what your mind's doing. Using meditation to do that, that is the act of bringing your muscle back to what you're focusing on. I want you to seriously consider building that meditation practice so that when you're waking up in the middle of the night, you've practiced managing your thoughts, and that means that you're not ruminating on the dream you just had. You're not looking at the long list of things you've got to do for tomorrow. You're not thinking about how dirty the bathroom is. You're bringing your mind back to your breath, maybe your heartbeat and your body, and you're resting. That is the benefit of meditation as far as sleep goes. And I feel like it's one of the most important things that I see women need, that I see that women need in the work of normalizing their blood sugars and improving their sleep. There are other things that you can do to improve your sleep, but this is, meditation is probably the biggest lever I would encourage you to work on. So, according to doctor Matt Walker, again, the sleep scientist, he says, to enhance sleep, consistency is king. So you need to be going to bed at the same time every day and you need to be getting up at the same time every day. Now, could that vary within, you know, from Tuesday to, you know, Saturday? Absolutely. There could be some variations there, but it really shouldn't be more than about 60 minutes, 45 to 60 minutes variation. Consistency is king. If you are having a hard time sleeping, this is the thing you need to work on. Consistency is king. Going to bed at the same time every day, getting up at the same time every day. Other things you need to be in a cool environment. The human body has to drop its temperature, its core temperature by 1.5 degrees, like they say, 1.5 to three degrees. It has to drop in order for you to initiate sleep. So if you're in a room that's too hot, you're not going to be able to do that. So you want to be in a cool room, you need a dark room. Let's talk about light.
[00:20:18] You really need to be in a dark room. The room needs to be maintained dark, but also no light in the eyes for about 2 hours prior to sleep is what they recommend.
[00:20:28] Melatonin production is a light dependent event, and what I mean by that is if there is light, it inhibits the production of melatonin. Melatonin is produced by cells that are inside the eye and they're actually on the bottom half of the eye. So when we're getting light from overhead, say the sun, like that's our natural experience, right? When we're getting light from overhead, that light is shining on those cells and inhibiting the release of melatonin into our brain. So at night, when it's time to go to bed, if you have all these overhead lights on shining on your eyes, you're inhibiting that melatonin production. And what melatonin does is it just tells your brain that it's time to shut down and go to bed. If you're not sending that message, it's hard to get sleepy. They say one to 2 hours. You're really going to have to around with it. I do try to keep things dark in my house. And if there is going to be light, it's coming from below my head. So a table lamp or my cell phone with its light on, you know, and I'm shining it on whatever I'm looking at with its flashlight on, I'm shining it on whatever I'm looking at. But I try to keep light below my head. So be reasonable with this. Stay safe. But that might mean like you have night lights plugged into your outlets that are again closer to the floor so that the floor can be lit and you're safe to walk. But you're not inhibiting this melatonin production in your brain.
[00:21:53] So if you need light, it should be from below. And you really should be trying to be cognizant of this for the 2 hours before you drop off to sleep or before you're planning on going to sleep. There are other things that people talk about. They talk about blue blocker glasses and the computer. The information on these are mixed. I think that the technology is getting better. But my understanding when I've looked at it in the past is it's not great. And what works and what doesn't work is inconsistent. So I would not rely on blue block or glasses. You really need to be doing. You need to, you know, work on the meditation component. You need to be consistent in your timing. You need to cool your room. You need to stay away from light. Those are probably the most important things that you can do. And then there are the other things that we need to avoid doing.
[00:22:47] Lots of times people will want to take drugs. That's the next thing that I'm going to talk about. The things that we're taking and how they impact our sleep. Lots of people want to go and get meds for drug or for sleep. And what I want you to know is that meds do nothing, make you fall asleep. They don't make you cycle through those five sleep cycles effectively. They make you unconscious. That's all they do.
[00:23:10] There are many drugs that we give for sleep and none of them actually make you. There are new ones coming out that look to mimic those sleep cycles. They're expensive. I don't even know what they are. I don't even know that they're on the market. But I've seen them in the literature discussed. But the ones that are on the market, the ambiens, the zolpidem, the, um, uh, trazadone, Benadryl, all of these drugs that we give to make people sleep, this is the Xanax, the Ativana, all of those, the benzodiazepines, all of them will make you unconscious, but they do not make you sleep. Which is exactly why, like, Michael Jackson unintentionally overdosed on propofol, right? Why did Michael Jackson unintentionally overdose on an anesthetic agent? Because anesthesia makes you unconscious. It does not make you sleep.
[00:24:00] And there is a difference between these two things. You never feel rested if you're just unconscious. You have to cycle through your sleep cycles before you're going to feel rested.
[00:24:10] It doesn't create rest, it just creates unconsciousness.
[00:24:14] So people will also talk about melatonin. You know, this is a hormone in your body. It's natural. Can we use this? Recognizing that the supplementation or the pills that we give the prescriptions or the supplements that you get from, you know, some manufacturer of melatonin is at a much higher dose than it will ever be produced by your body. Ok?
[00:24:34] So recognizing it's not the therapeutic dose. And I do question, like, is there an element of, you know, like resistance that's developing because we're giving such super therapeutic. It's not reported in the literature that there's melatonin resistance. What is reported in the literature is that melatonin drives insulin resistance, and that is pretty well described. There's also studies that melatonin has a negative impact on endocrine, specifically on gonadal function and size. So how large testicles are in rats and mice, how large ovaries are, how much hormones are being produced there?
[00:25:14] I don't know that melatonin has such a great impact that we need to be using it when there are all of these kind of things that are kind of working against us, especially if we're looking to normalize our blood sugars. So, um, I don't know that I would recommend melatonin, and I don't think I would ever give melatonin to my children either, because of this endocrine impact. So, again, unless you're doing the things that we've talked about, consistency, cooling, darkness, avoiding the light, those sorts of things, I don't know that I would take the risk of the melatonin Benadryl. Again, we kind of talked about this. It makes you unconscious. It doesn't make you sleep. It blocks the way you rotate through your sleep cycle. So you won't go into rem with Benadryl, you won't go into rem with Ambien. You won't go into REM with the Xanax, you won't go into REM with alcohol. All of those drugs actually block the REm function, the REM cycle of sleep. So if you are getting in there, maybe you're so sleep deprived that your brain does override that block. That can happen, but that's not because you're well rested and living healthy. Right? Like, there's some other things that we need to work on. If you're so deprived of REM that your body will actually jump directly into REM before it does, these other deeper sleeps, which, again, those deep sleeps are really trying to restore and repair your body. So Benadryl makes you unconscious. It does. It blocks you going through sleep cycles. It, um, only lasts 4 hours. So now we're putting a med on that negatively impacts our sleep cycle. But the med doesn't even last that long, so we don't even know how long it's going to impact our sleep cycle. It's just, in general, not great for sleep. Ambien is the same. Same as Benadryl, same as propofol, will make you unconscious, but it blocks the sleep cycling. You can't do the reparations that need to happen in your body in various. In those various different sleep cycles. It's also associated benadryl, I'm sorry, ambien and benzodiazepines, like Ativan, they are associated with unintentional deaths. So some of these drugs are used in combinations with other drugs. Pain meds, you know, ambien and benzos and pain meds together, benzodiazepines. So xanax, Ativan, and pain meds like morphine, together, there is a high rate of unintentional deaths associated with those. And not even, like, I overdosed and stop breathing. Like, there's all cause mortality is associated with the combination of those meds, benzodiazepines. So these are drugs like Ativan.
[00:27:41] Lorazepam is the generic name. Xanax is a brand name that people will talk about. These are valium type meds, essentially, from way back in the day. They are valium, and they're derivatives of Valium.
[00:27:56] Again, they're addictive. They are controlled, so you're not going to be able to easily get a prescription for them. And they're associated, associated, clearly associated with unintentional deaths. Anesthesia. Right? Like, you're going for anesthesia, you are not sleeping during that. You're just unconscious. So those are other drugs that people are like, oh, I just need to do this anesthesia, and then I'm gonna get rested. That's not necessarily the case.
[00:28:21] Alcohol is another one that lots of people will rely on to induce sleep, and it's also something that, you know, lots of us indulge in. So recognizing that alcohol will block REM sleep, similar as Benadryl, it just does not let your brain go in the way it impacts the brain is does not let you go into REM sleep. You will get tired. The sleep is not the sleep that you need. It doesn't cycle you through. You will drift off. But you block those sleep cycles. You block. You get some of the deep sleep, but you block the rem sleep. The other problem with it is it stays in your system for about 20 hours. So if you're having a drink at 06:00 p.m. you're definitely. Even if you can fall asleep, you are impacting your brain and its ability to cycle through those sleep cycles for the next 20 hours. So, you know, I always joke that, like, I'm. I'm gonna have a drink. I'm gonna have it at, like, ten in the morning. And it's true. I really am. I'm not drinking late at night. Like, I'm not a raving alcoholic. I don't do it on work days, clearly. But if it's a Saturday and I want to have a beer and I'm mowing the yard or whatever, I'm going to do it early in the day because I want that out of my system because it clearly, I know it clearly impacts my sleep. When I look at my sleep, it clearly impacts it. So recognize alcohol will stay in your system for about 20 hours after you start it, being aware that it will block your ability to cycle through sleep, even if you can fall asleep.
[00:29:47] I don't ever drink alcohol close to bed. And I mean, like, if I do, it's like a half a glass of wine. And the reason that I do it is because it negatively impacts your sleep. So, lastly, let's talk about my most precious, my most precious of all sleep affecting meds. Caffeine. I love my coffee. I really love my coffee. So I don't want to get you know, nasty and ugly about caffeine, but clearly it will keep you up. Like, that's how it works. It actually works on the receptors of the chemical in your brain that has to rise up. Like, there's a chemical, it's called adenosine. It has to rise up to a certain level threshold so that you can initiate sleep. That's what makes you sleepy.
[00:30:28] Caffeine blocks the receptors that the adenosine will work on. That's awesome. If you want to stay awake, not so much if it's time for bed. So caffeine will last in your system for, again, about 20 hours after you drink it.
[00:30:45] So you need to start determining when you've had, like, when am I using caffeine? And it's probably impacting my sleep. Even if you can follow asleep, that adenosine is part of the normal sleep cycle, and we have to have it available to get into those normal sleep cycles.
[00:31:03] There are variations on each human being and how much caffeine and how they metabolize it and when they can drink it and when they can't. But, my friend, if you are having a hard time sleeping at night, please cut the caffeine for a while. Give yourself two weeks without the caffeine and see what happens. I feel like I have to do this a few times a year. Like, I just have to cut the caffeine out of my life because my sleep is so not right. I'm like, I just, mama got to get some sleep. So I cut the caffeine. It's a no brainer. Like, this is probably in my sleep or my system, and it's probably negatively impacting my sleep. If I'm having a hard time sleeping, cut the caffeine, do it for two weeks, see if it helps. And then I usually, it always helps me. Like, within four or five days, I'm getting the best sleep of my life, and then I start adding it back in. And usually. But I know, I know for me, I have to stop drinking caffeine if I want to go to bed at night. I have to stop drinking caffeine around 11:00 in the morning at least. And usually it's earlier, closer to 930 or ten. If you're having sleep problems before you're going to your doctor talking about Ambien or these new experimental drugs, or you're trying to get on Benadryl or you're having a nightcap before you're doing any of those things, cut the caffeine. Caffeine. Give yourself two weeks without the caffeine see if your sleep doesn't improve. If it does, it doesn't mean that you need to never have caffeine. It just means that maybe you need to have less of it or you need to have it earlier than you were. This takes some experimenting. Don't be afraid to do that. All right? I feel like that was a lot. I actually am impressed at how quickly I got through that. This is all I have for you this week. Don't hesitate to reach out to me. Delaney Lanemd if you have any questions, do understand there is more help at my website you can go to delanemd.com. you can find my 14 days to better blood Sugars guide there. You can also find information for upcoming webinars that are going to be held. All of that is on my website, delanemd.com dot before we end, I want to remind you if you are medicated for your diabetes, please be careful making the dietary changes that I recommend in this podcast. You have been medicated because of the way you've eaten in the past, and if you change the way you eat, you're going to need to change your meds. And if you don't do that, you can end up quite sick. So if you're going to make the dietary changes that I recommend, please call your primary carer, the provider who has given you these prescriptions for these meds. Let them know what you're going to do. Find out how you can share your blood sugar logs with them and how they intend to share with you any dietary changes they want or any medication changes that they want you to make to your medication regimen. This is going to keep you safe. This is going to keep you out of the ER. This is going to keep you out of the hospital. This is going to lead to living longer versus getting really sick on some of those meds that could lead to death. So I need you to call your provider and get a clear line of communication open with them as you're making the dietary changes.
[00:33:51] Again, if you're needing the 14 days to better Blood Sugars guide, you can find it at my website, delanemd.com. you can always send me any messages delanend.com lastly, I do have an ask if you're finding benefit from this podcast, please rate and review this podcast. Studies show that nine out of ten Americans are insulin resistant. That means they are on the path to type two diabetes if they are not already there. People need to hear about this. And the more times that people rate and review this podcast, the more times. The podcast player puts it out to people to listen to it. So please go and write and review this podcast, especially if you're getting benefits if you're seeing changes in your health with this. Lastly, I want to remind you to keep listening, keep avoiding the foods that make you sick, keep making choices for your health and your longevity and your vitality, and I will see you next week. Bye.
