Transcription:
Managing Your Diabetes

Bill Klaproth (Host): If you’ve been diagnosed with diabetes you may have questions on how to best live with and manage diabetes, and what about prevention and how to live a healthier lifestyle. Let’s find out with Laurie Wallace, Diabetes Program Manager at Dignity Health. Laurie, thanks for your time. First off, can you explain to us, what is diabetes?

Laurie Wallace (Guest): Sure, diabetes is a condition where either the insulin that the body makes isn’t used very well or the body doesn’t make insulin at all, resulting in abnormal blood sugar.

Host: Okay, so what is insulin then?

Laurie: Insulin is a hormone that’s produced by the pancreas that is supposed to regulate sugar as it moves into ourselves.

Host: So who is at risk for this then?

Laurie: Certainly there is a genetic component for diabetes type 1 and type 2, but predominately I see people here in the Central Valley with diabetes who have gained a lot of weight recently or they have very little exercise, they have extra weight around their belly, and there is some higher predominance in people who are Asian or of Hispanic origin but anybody can get diabetes.

Host: Okay so anyone can get this. So is that mainly a result of poor lifestyle choices?

Laurie: Absolutely, lifestyle is a huge factor. There are people who are not overweight, but because they don’t exercise enough, their body doesn’t use the insulin they make and they end up with type 2 diabetes and some abnormal blood sugars and some complications related to that. For other people, they may eat all the right foods, they just eat too much of the foods, whatever healthy foods they eat – they eat too much of it and that results in some extra weight. Even a 10% weight gain from what is normal for that individual can make the body not use the insulin that it makes very well.

Host: Interesting. So you mentioned complications. What are the major complications of diabetes and what happens if left untreated and not managed well?

Laurie: So the primary complications of diabetes either have to do with the tiniest blood vessels in the body or the largest blood vessels in the body. So we’re talking about tiny ones in the brain, in the kidneys, in the eyes, in the nerve endings, in the places furthest away from the heart like the bottoms of the feet, or the major blood vessels like leading directly to the heart or through the middle part of the body. If you get damage to any of those blood vessels, then the blood doesn’t flow, and if you don’t have blood flowing to these important parts of the body, you’re not going to have very good body function, and so you end up with parts of the body that don’t work the way they’re supposed to.

Host: So the elevated sugar level does what to the arteries?

Laurie: It damages the inside of the blood vessels and eventually they cannot carry blood to those areas.

Host: So people may think well I’m just going to cut out sweets to lower my blood sugar level, but there’s more to it than that, isn’t there? And there’s a lot of myths and misconceptions about what raises blood sugar – can you talk to us about that?

Laurie: Well for the longest time, until we had a lot of processed food, for the longest time people just said, well I’m just not going to eat sugar and then my blood sugar’s going to be good all the time. But now with food processing, we can take something like a whole grain and turn it into a processed food, like a Cheeto or something, and there’s a lot of starch in processed food that can raise the blood sugar actually more than sugar ever did, so the most common myth is if I don’t eat sugar my blood sugar’s not going up, but you can have a bowl of white rice or a bowl of Top Ramen or half a sleeve of soda crackers, Saltines, and your blood sugar’s going to go up higher than if you would have actually eaten something made with sugar.

Host: Alright, so can you give us some tips then on how we should approach our diet?

Laurie: Absolutely. So we’re supposed to get nutrients from food. Most people eat because food tastes good, but we’re supposed to really get nutrients from food, and the way you get adequate nutrients from food is by having in just about every meal that you eat, half your plate being non-starchy vegetables, a little bit of whole grain starch and a little bit of lean protein. Ideally that’s the way we should all be eating whether you have diabetes or not, but if you eat that way, then the amount of sugar coming from your meal is going to be less.

Host: Alright, well that’s an easy way to remember it. Let me ask you this, when you watch TV, it seems like you see a lot of these diabetes commercials talking about A1c levels. Can you explain to us what an A1c level is and why it’s important to know that number?

Laurie: A1c is the standard nowadays by which most diabetes is diagnosed, it’s also the ruler, so to speak, that says how much risk do you have related to your blood sugar. So an A1c just refers to the way that they analyze the blood that they take out, usually of a vein, and they look and they see how much sugar is stuck to a red blood cell, that’s what an A1c test is, and if you have a lot of sugar stuck to your red blood cells, then you can assume that you have sugar sticking to a whole lot of stuff that’s been there longer than that red blood cell. Red blood cells don’t live very long, so if you have sugar sticking to your red blood cells, you can assume wow, there’s sugar sticking to the inside of my arteries and the inside of my retina and the inside of the blood vessels in my kidneys and all these other places. So A1c kind of gives you an idea of risk.

Host: So I’ve heard a lot of people don’t know they have diabetes until they go see the doctor and have a routine blood test. So are there no symptoms associated with this?

Laurie: Actually there are quite a few symptoms of abnormal blood sugars, but they are symptoms of so many other things and they’re so easy to justify for many other reasons. For example, one of the common symptoms of abnormal blood sugar is excessive urination. Well if you live in the central valley of California, it’s 106 degrees outside, you’re drinking tons of water or tons of something all day, of course you’re going to go to the bathroom more, so people overlook that. Excess thirst is the second one, and the same thing, people say oh my gosh, I’m thirsty all the time. Well if it’s 110 degrees outside, of course you’re thirsty all the time, it’s hot, you’re sweating. So we look past that.

Host: So a lot of times these symptoms are masked by environmental conditions.

Laurie: They are or we justify them as, oh well I guess that’s normal because I was sweating a lot or something.

Host: So can you give us your best tips for prevention of diabetes?

Laurie: So the first recommendation is if you’re overweight, get to a normal weight. Even 10 pounds of being overweight in a lot of people makes a difference between diabetes and not diabetes. Second thing is exercise every single day, 30 minutes or more every single day. It can be a different exercise every day. It can be golfing one day. It can be dancing one day. It can be swimming one day. It can be walking the dog, but people need to get up and move. That’s probably the most important one, and the third one is avoid processed, packaged, fast, convenience foods. Eat whole foods in their natural form and eat less if you have to lose weight.

Host: Eat more whole foods. I love it. So that’s a great road map Laurie. Number 1, get to a normal weight. Number 2, make sure you exercise, and number 3, avoid processed food. So if you could wrap this up for us then. Can you give us your best tip for managing diabetes?

Laurie: I always encourage people to test their blood sugar at home. Not everybody wants to, but if you get an A1c done, you’re always working 3 to 6 months in the past. You don’t get an immediate assurance of that your blood sugar’s good or bad or anything else, so I encourage people to test their blood sugar at different times during the day so they can see how they’re doing today and tomorrow and the next day, they don’t have to wait to go back to a lab.

Host: Well Laurie, thank you very much. This has been very informative and to learn more and to get hooked up with one of our providers, visit dignityhealth.org/Bakersfield/diabetes, and if you like what you’ve heard, please share it on your social channels and be sure to check out our full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health podcast. I’m Bill Klaproth, thanks for listening.