Transcription:
Thrive with Diabetes: Tips for Managing Diabetes and Overall Wellness

Intro: Riverside Healthcare puts the health and wellness information you need well within reach.

Gabby Cinnamon: Receiving a diabetes diagnosis can be overwhelming and sometimes scary. However, with the right medications and lifestyle changes, you can thrive with diabetes. Joining us today to share tips about managing diabetes is Julie Allen, a certified diabetes care and education specialist at the Riverside Diabetes Wellness Center.

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Gabby Cinnamon: Thanks so much for coming on the podcast today, Julie.

Julie Allen: Thank you for having me. It's a pleasure to be here.

Gabby Cinnamon: Can you tell us about yourself? This is your first podcast with us?

Julie Allen: Yes. Actually, I have been a registered dietician for-- I'm in my 30th year now.

Gabby Cinnamon: Oh, wow.

Julie Allen: And 22 of those 30 years has been in diabetes, both in research as well as teaching and management.

Gabby Cinnamon: You have a lot of experience, so I'm excited to talk with you today. What is diabetes?

Julie Allen: Diabetes is actually your body's inability to turn food into energy. And the way that diabetes is recognized is through blood work and elevated glucose or blood sugar levels. When I was preparing for this podcast, I was just reading through different statistics and things. And there are a lot of people who have diabetes but are undiagnosed.

Gabby Cinnamon: That is correct. What are some early warning signs of diabetes or signs that people should look out for?

Julie Allen: Yes, there are some symptoms that you might experience when your glucose or blood sugar level is elevated. Some of the symptoms could include fatigue, excessive thirst, excessive urination, possibly some blurred visions. So, symptoms definitely are your clue to get yourself checked out.

Gabby Cinnamon: What treatments are available for those with a diabetes diagnosis?

Julie Allen: So nowadays, in the year 2023, we have a multitude of different medications that we can use. Oral medications; of course, insulin; different medications now that are injectables but are not insulin; and of course, healthy lifestyle habits can be a really good way to start treating diabetes.

Gabby Cinnamon: It seems like in healthcare in general, a lot of different conditions are connected or, you know, different conditions can develop from other conditions. What are some of the side effects of having diabetes there or different things that maybe people don't think about that can happen when you have diabetes?

Julie Allen: Definitely. So, we look at complications that can result of diabetes being uncontrolled for too long. Things like poor vision or potentially blindness; poor kidney function, which can lead to dialysis; a condition called neuropathy, which is nerve damage, which can lead to loss of limbs. So, potentially every organ and system in your body can become affected from diabetes if it's not under control.

Gabby Cinnamon: Yeah, definitely some scary side effects. And to make sure, you know, you keep an eye on things even after you've been diagnosed because things change. You know, medications might need to be adjusted, other lifestyle changes too.

Julie Allen: Most definitely.

Gabby Cinnamon: You mentioned this, there are other ways to help manage diabetes beyond medication. Can you talk about some of the lifestyle changes that can help when it comes to nutrition, all those kinds of things?

Julie Allen: Definitely food management, you know, making healthy food choices, fresh fruits, fresh vegetables, whole grains, your beans. You know, those should be the foundation and the basis of your diet, diabetic or not. And these days with the accessibility of fast food and maybe food that's not so healthy, I think people are eating that more often than we used to. And then, we have to couple good nutrition with a healthy exercise too, trying to get that 150 minutes of exercise per week that is recommended for all of us.

Gabby Cinnamon: Yeah. So, a lot of it, it sounds like, has to do with preventative, eating and exercising, if you can prevent obviously a condition you want to when it's in your control.

Julie Allen: That is correct. Type 2 diabetes in my estimation is about 90% preventable. But it takes some work.

Gabby Cinnamon: Yeah. Oh yeah, for sure. So, I think one of the other things too, you know, having loved ones who've been diagnosed with diabetes, so you don't have to avoid, let's say, sugar or carbs altogether.

Julie Allen: Correct. And I think that's the biggest myth that's been out there for a while with everybody wanting to go on low carb diet or what now is known as the keto diet. It's not recommended by the specialists because we need carbohydrates for energy. Carbohydrates are what provides our body with energy. So, we definitely need to eat them, but in balanced amounts, not overdoing it and picking healthy choices of those carbohydrate foods.

Gabby Cinnamon: Right. Everything in moderation.

Julie Allen: That is correct.

Gabby Cinnamon: So, let's say someone has been diagnosed with diabetes and maybe they're on medication. They have made some lifestyle changes, but kind of like we talked about, maybe something in their condition has changed or they've been diagnosed with another condition. Are there any signs they should look out for? You kind of touched on these a little bit, but something might not be right or they need medications adjusted or need to make some other changes.

Julie Allen: Yes. What we want everyone to keep in mind is that diabetes does tend to be a progressive disease. And that just means that as time goes by, it has the capability of getting worse. And that may be of no fault to the person with diabetes. Our motto is if you're doing pretty much what you're told to do as far as eating healthy, trying to remain active, you're taking your medicine, you are checking your blood sugar, and then all of a sudden your blood sugars start to go up again. It might be time to change that treatment regimen, maybe alter the medications, change dosages, but by all means, maintaining those healthy habits all along.

Gabby Cinnamon: This wasn't on my original list of questions. But once you have diabetes, can it go away?

Julie Allen: It can't be cured. We now use the term remission when it comes to type 2 diabetes, and think about the word remission. We use it a lot when we talk about cancer. It just means that it's inside of you, but it's basically dormant or sleeping. So, we have seen, you know, a few of our patients actually go into remission because they made definite changes in their lifestyle. They may have either decreased the dosage of insulin they needed, or I do have a select few patients who have been able to get off of insulin completely. And that is a capability or that is a possibility if a person's pancreas, that's the organ that makes insulin, if that is still functional, remission is a possibility.

Gabby Cinnamon: Oh, that's great. Because I think sometimes, kind of like you talked about, there are so many more treatment options available now. But I think several years ago, a diabetes diagnosis, a lot of times it seemed more somber back then than it does now, just because there are so many more options. But then even the fact, I think, knowing that there is that hope so to say that if you, you know, make some changes and really take an active role in your health, that kind of you can maybe go off those medications.

Julie Allen: Definitely. Diabetes is not the death sentence that we viewed it even 50 years ago when the medications weren't as numerous or as good as the medications we have now, our knowledge about food and the way food effects blood sugar is so much greater now. So, we at the Diabetes Wellness Center, we always want to give that hope to people that when they have it, it can be a manageable condition.

Gabby Cinnamon: That's a perfect segue into my next question. Can you talk about all that you guys do at the Diabetes Wellness Center and how that can help manage diabetes, maybe even for someone who's had diabetes for a long time? How can the Diabetes Wellness Center help them?

Julie Allen: I think we can provide a tremendous help to people who have been struggling and I like to see a wide variety of people come into our center, whether they were diagnosed last week or they've had diabetes for 35 years. We get both ends of those spectrum and everything in between. So, our program consists of a complete education series of visits with the registered nurse, visits with the registered dietician, all of whom are diabetes specialists. We teach them how to count carbohydrates and manage them. We teach them about the types of medications they might be on, and all the while encouraging them to stay active. So, I believe that when they come to see us, they actually learn a lot more than they think they would before they actually make that decision to come.

Gabby Cinnamon: Yeah, I think too kind of it's probably even harder to get there once you've had, I would assume, had the diagnosis for a long time. So like you said, there's still all these things to learn.

Julie Allen: Absolutely. And oftentimes, we hear when a person has completed or graduated from our program, boy, I wish I would've done this a long time ago. So, I think that means that we've done our job in terms of teaching.

Gabby Cinnamon: Yes. When we were talking before this, I appreciate how you were explaining, you know, you explain things in a simple way that makes sense because I'm a nonclinical person, but to the average patients who is the same that makes all the difference in helping them.

Julie Allen: Correct. And when we do their initial assessment, that would be their first visit that happens when they come to see us. We kind of ask questions about what is your best way of learning? We use a lot of different learning methods and matching the method to the patient. Chances are they're going to be successful. So, we try to use very simple concepts. Diabetes can get complicated, but we try not to express it that way.

Gabby Cinnamon: Yes. What are some common misconceptions people have about diabetes? You mentioned earlier one of the biggest myths being, you know, absolutely no sugar. Are there other misconceptions that you hear from patients or, you know, on the street?

Julie Allen: There really aren't any good or bad foods. There's good and bad dietary habits. So, the message that some people are hearing is "All carbs are bad," "I could never eat sugar again," "A diabetic can't eat sweets," all of which are proven to be false. And we teach them how to enjoy foods that they've always enjoyed, but you use the concept or the word moderation, that is really bottom line.

Gabby Cinnamon: Yeah. And that's I think a weight lifted off their shoulders as well, because, you know, when you're at a family gathering or whatever, you want to be able to enjoy a treat now and again.

Julie Allen: Yeah. And I don't want our patients to feel guilty about eating those favorite foods, and oftentimes they do.

Gabby Cinnamon: So, the person who maybe got diagnosed with diabetes a week ago and then comes to the Diabetes Wellness Center, what do you tell them maybe if they are, you know, worried about the diagnosis? How do you put their minds at ease?

Julie Allen: I think we at the Diabetes Wellness Center, we all have had enough experience to see that people can live a long, happy, healthy life despite the diagnosis of diabetes. So, easing their mind about medications they may be taking; easing their mind about, "Well, what if I right now can't exercise? I have pain, I have arthritis," finding ways for them to work around their barriers. That's key for us at our center, is identifying their barriers and providing potential solutions to working around or through those barriers.

Gabby Cinnamon: Yeah. Especially if a person, I would assume if you have diabetes and then you have barriers as well, that would be overwhelming at first.

Julie Allen: Absolutely. So, we try to ease their mind and encourage them to take small steps. Small steps can lead to big results in the long run. So, it's a process. It's not going to be instant gratification the way that we Americans and humans in general want. We want instant results. Diabetes does not work that way, nor does weight loss work that way. So, the concept of be patient, be persistent and good things will come.

Gabby Cinnamon: Yeah. That is a great place to end off on. Before we go, is there anything else you would like to add, Julie?

Julie Allen: I would say if whether you are recently diagnosed or have had diabetes for a long time, if you have never had diabetes education, we encourage you to talk with your primary doctor to get a referral for our services and join us for a lot of learning. And actually, we have a good time when we teach our classes, so come and join us.

Gabby Cinnamon: Yes. You guys seem like a very fun group of people.

Julie Allen: We are.

Gabby Cinnamon: That's awesome. Well, thank you so much, Julie, for coming on the podcast today.

Julie Allen: Thank you for having me. You're very welcome.

Gabby Cinnamon: We really appreciate it. And thank you listeners for tuning in to Well Within Reach, brought to you by Riverside Healthcare. Make sure to rate and leave a review on Apple, Spotify, or wherever you listen to our podcast.