Transcription:

Prakash Chandran: Today, we're gonna be talking about managing your diabetes and joining us today is Jessica Locke. She's a nurse practitioner at Harrington Physician Services, Endocrinology Practice. This is Healthy Takeout. The podcast from Harrington Hospital. My name is Prakash Chandran. So first of all, Jessica, thank you so much for joining us. We really appreciate your time. Let's get started by learning a little bit more about the different types of diabetes. I've heard of type one and type two. Can you explain them?

Jessice Locke: Type one, diabetes really comes down to an autoimmune issue. So you have this autoimmune condition where these antibodies are attacking your pancreas. So it basically makes your pancreas not function as well as it once did. And it leads to a lack of insulin production and type two diabetes is more associated insulin resistance. So your pancreas is stilling insulin on its own. But your body just becomes resistant to its own insulin production. So your blood sugars are elevated in both cases, but in type one, it is because your body is not producing any insulin and in type two diabetes, it's insulin resistance.

Prakash Chandran: Okay, that makes sense. So, one thing that I've heard is that type one is usually hereditary and type two, usually affects those who might potentially lead an unhealthy lifestyle. Is that fair?

Jessice Locke: Yeah, it's more so type one diabetes can be seen in families, but it's more of the autoimmune component. Whereas the insulin resistance of type two diabetes often does come from obesity and generally unhealthy lifestyle choices.

Prakash Chandran: Okay. And then broadly, can you just talk about the likelihood of developing diabetes? Can you talk about the population of people this affects and how it affects them?

Jessice Locke: Sure. So I think more often than not, it does affect people that generally just make more unhealthy choices in their life. Lack of exercise, unhealthy eating. Those are kind of like the biggest things that will set you up to possibly develop diabetes in the future.

Prakash Chandran: Can you talk broadly about who's at risk for developing diabetes?

Jessice Locke: Yeah, so for type one diabetes it's really thought of as a childhood illness, but there is a possibility that you can develop it later in life because of the autoimmune component. Typically you see it in the younger population in kids. Usually people under the age of 13. But you can diagnose it later in life. And we've diagnosed people as old as 80 with type one diabetes, and they've never had diabetes in their whole life that they knew of.

So type one diabetes, there really isn't anything that you can do lifestyle wise to avoid getting that diagnosis. As far as type two diabetes, you know, generally we do see it. Older people typically, I would say over the age of 30, but again, we have diagnosed it in younger populations, just for people that lead an unhealthy lifestyle. And a lot of people that have suffered from obesity from a young age that really sets them up for type two diabetes much earlier in life than most people.

Prakash Chandran: So I want to talk about how diabetes is traditionally diagnosed and maybe some early signs or symptoms that someone might have it?

Jessice Locke: Sure. So a lot of times it's diagnosed because of a high blood sugar, which is often in type one and type two diabetes. In type one diabetes, often their first symptom would be DKA, which is diabetic keto acidosis. So a lot of times they will have like a fruity odor to their breasts. They'll be really thirsty. They'll end up urinating really frequently. They could be really hungry. They could be vomiting, they could just almost feel like they have the flu. You just really, really don't feel well. And a lot of times that's how type one diabetes is diagnosed because these kids have no idea that there's anything wrong.

And then all of a sudden they really don't feel well. And it's because their blood sugars are high. Type two diabetes, doesn't generally have the same sudden onset. It's more of a gradual onset. So people will still have some of the similar symptoms, but it's usually not the DKA presentation. So in type two diabetes, a lot of times they'll notice that they're a little bit thirstier, that they're hungrier, and they're urinating more frequently. Or they just feel really fatigued because of the high blood sugars. But again, it's more of a sudden presentation with type one diabetes versus type two.

Prakash Chandran: Okay. That makes a lot of sense. And for type two, you were kind of mentioning there's potentially a gradual onset. I've also heard the term prediabetes before. Is that predominantly a type two diabetes thing. Can you talk about what prediabetes is?

Jessice Locke: Sure. So prediabetes is when your A1C is between 5.7 to 6.4. So that just means that you have an elevated blood sugar. You have generally elevated blood sugars, but they're not elevated enough to diagnosis type two diabetes. So with prediabetes, we do try to focus on diet and exercise before you actually make the progression to type two diabetes.

Prakash Chandran: Okay, understood. So today we're talking about managing your diabetes. Talk about how people with diabetes can get it under control and some common treatments for both types?

Jessice Locke: Sure. So for type one diabetes, the only treatment that is approved by the FDA is insulin. So it requires that you take an insulin that keeps your blood sugar stable throughout the day. And then you take a second insulin where. You would cover your meals and your blood sugars with this fast acting insulin. So that's type one diabetes. So insulin would be the only treatment because they don't produce their own insulin.

Whereas with type two diabetes, the most common initial treatment is Metformin. And the reason for that is give Metformin will help to increase your sensitivity to your own insulin, which again, with type two diabetes, the issue really is the insulin resistance and that Metfomin really does combat that very.

Prakash Chandran: Okay. I see. And then there's also behavioral or lifestyle modifications for type two. Is that correct?

Jessice Locke: Yes, absolutely. So we really do try to focus on diet and exercise. And the biggest thing with type two diabetes is just limiting your carbohydrates and sugar. Because those are the things that are going to raise your blood sugar most often. And exercise will really help to not only lower your blood sugars, but it can help to combat some of the insulin resistance as well.

Prakash Chandran: Okay. And I guess this is a related question. There's so many like diets that are out there now. You've heard about like fasting, you've heard about the ketogenic diet. There's so many different things for people that are managing their diabetes. Are these diets, something that they should look to or consider?

Jessice Locke: So we have had some patients that have been very, very successful with the keto diet. The only issue that I would say that I have with it is just that I don't really love the all or nothing diet. Like cutting out all of one thing, because I just don't find that it's sustainable. I do think you can have a lot of success with it, but I also think that it isn't sustainable for a long period of time. So usually what I would recommend for patients is just making sure that they're really limiting their carbohydrates and sugar, but realistically, I don't think it's something that you can necessarily cut out entirely and it may work for some people, but for the majority, I just don't think it's realistic.

Prakash Chandran: So just before we wrap up, there's a question that I always like to ask, and that is given all of your experience with patients that might be managing their diabetes, what is one thing that you now know to be true that you just wish more people knew?

Jessice Locke: I think I do. I think I would say that I wish people understood more about healthy choices and lifestyle modifications and the importance of exercise. Because I do feel like we see a lot of patients that. Really don't understand what even a carbohydrate is. And I think that was probably their biggest downfall because just a lack of understanding and maybe had, they had the understanding, they wouldn't have ended up where they were today. So I just wish there was more education and there was more I guess knowledge about diabetes and the things to avoid and just lifestyle modifications that people can implement before they actually get to the diagnosed with diabetes.

Prakash Chandran: Yeah, that makes so much sense. And then in terms of just people that are living with it, are there any resources that you can point to around ways that they might modify their diet or certain exercises that people can get started with that might be helpful?

Jessice Locke: I think, I always tell my patients to just keep it simple, because that is the easiest and the most sustainable thing that you can do. So I always say to just make sure that you're reading food labels, make sure that you're limiting your carbohydrates with all of your meals, and just making sure that you're really focusing on protein and vegetable intake throughout the day. I mean, realistically, our bodies need carbohydrates for energy, so it is important to make sure that you're getting a small amount throughout the day, but putting most of your focus on protein and vegetable intake will get you the

Prakash Chandran: Well, Jessica, I think that is the perfect place to end. Thank you so much for your time.

Jessice Locke: Awesome. Thank you so much for having me.

Prakash Chandran: That was Jessica Locke, a nurse practitioner at Harrington Physician Services, Endocrinology Practice. Thanks for checking out this episode of healthy takeout, you can head to Harringtonhospital.org to get connected with Jessica or another provider. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. My name's Prakash Chandran. Thanks again for listening, and we'll talk next time.