エピソード

  • Episode 19 - The Remission Mindset

    Episode 19 - The Remission Mindset
    2025/08/11
    The Remission Mindset: 5 Truths to Move From Managing Diabetes to RemissionThis no-fluff episode gives you the remission mindset you need to go from coping to conquering. We share five truths that help you stop the slide, take charge, and put type 2 diabetes into remission. It’s bold. It may feel uncomfortable. It could change your life.What You’ll LearnWhy the remission mindset beats “management”The 5 truths that make remission possible and sustainableHow to stop fueling the disease so it withersHow common diabetes and prediabetes are (it’s half of US adults)What late-stage diabetes really looks like (so you don’t go there)The hidden costs (money, mood, time, family, freedom)The key checks that protect your eyes, feet, kidneys, and heartWhy you need help and how to get itA simple 5-year plan to guide your next stepsQuick Stats We Discuss1 in 2 US adults has diabetes or prediabetes (many don’t know it).Type 2 diabetes raises heart attack and stroke risk 4–5 times.Diabetes is the #1 cause of non-accidental amputations.Nearly 1 in 5 teens (12–18) and 1 in 4 young adults (19–34) have prediabetes.Annual US diabetes cost: $413 billion.People with diabetes pay about $4,800 more out-of-pocket each year (not counting ER or hospital stays).The 5 Truths of the Remission MindsetYou are responsible for your healthYour doctor cares, but you are with you all day. Most primary care visits are short. Generic advice won’t cut it. You must lead. This is not about blame. It is about power. When you lead, you win.How to act:Treat your health like your top job.Know your numbers. Track them.Learn fast. Apply faster.Managing diabetes is a losing strategy“Management” means living with the disease. Remission means moving away from it. You don’t want an “okay” level of harm. You want the harm gone. Patch the hole in the boat, don’t just bail water.How to act:Stop fueling the disease. Cut the inputs that drive high blood sugar.Make food, sleep, movement, and stress habits work for you.Aim for progress every week. Momentum matters.Diabetes is that badWe say this with love. The risks are real: blindness, kidney failure, amputations, stroke, heart disease, and more. Most people say, “No one told me.” We are telling you now—so you can act now.How to act:Take this seriously before a crisis hits.Do the checks that prevent the worst (see “Protective Checks” below).Build your “why”: family, freedom, years of good life.Diabetes is expensiveNot only money, but time, energy, and joy. Missed trips. Skipped parties. Worry at every meal. Complex med regimens. ER visits for highs and lows. It adds up.How to act:Spend now on prevention and skills, not later on crisis care.Simplify your regimen by changing your habits.Ask, “Is this choice worth a year of my life?”You need helpThis is hard to do alone. Not because you’re weak, but because life, food, stress, and systems are stacked against you. The right team and plan make the road shorter, safer, and faster.How to act:Get expert coaching focused on remission (not just “management”).Use a clear plan, simple rules, and steady support.Keep going when it gets tough. You are worth it.important note: Type 2 vs Type 1This episode speaks about type 2 diabetes remission. Type 1 is an autoimmune condition and is different. We love our type 1 community. This show’s remission content is for type 2.Protective Checks That Save Vision, Feet, Kidneys, and HeartAnnual dilated eye exam: Prevent up to 90% of diabetes-related blindness with early treatment.Regular foot exams and education: Prevent up to 85% of amputations.Blood pressure control: Cut kidney decline by about one-third.Cholesterol improvement: Reduce heart risks by 20–50%.Smart insulin use: If you are on insulin, learn how food, timing, and doses work together to avoid dangerous lows.Note on lows and highs: Many ER visits happen when insulin does not match food. Complex regimens make this more likely. A simpler path, with better habits, reduces that risk.How to Starve the Disease and Feed Your HealthFood: Choose foods that do not spike blood sugar. Eat enough protein. Favor fiber. Cut ultra-processed foods.Sleep: Keep a steady sleep schedule. Poor sleep drives insulin resistance.Movement: Move daily. Walk after meals. Build strength.Stress: Lower stress where you can. Use simple resets: breath work, short walks, sunlight, journaling.Environment: Make the healthy choice the easy choice at home and work.Remember: When you stop fueling the disease, it starts to wither.Your Action Step This WeekDo the 5-year plan exercise:If you could not fail, where do you want your health to be in 5 years?Are yesterday’s habits taking you there? Be honest.If yes, keep going and level up.If no or not sure, get help and get a plan.Take one step today:Book your dilated eye exam if you haven’t this year.Schedule a foot check.Plan your next 3 dinners with protein, fiber, and fewer carbs.Walk 10–15 minutes ...
    続きを読む 一部表示
    1 時間 8 分
  • Episode 18 - Ultra-Processed Foods

    Episode 18 - Ultra-Processed Foods
    2025/08/04
    Ultra Processed Foods: Clarity Over Confusion This episode is all about ultra processed foods—what they are, why they matter for cravings, insulin resistance, and blood sugar, and how to spot them fast. No shame. Just clarity. If you’ve ever felt “the more I try, the worse it gets,” you are not broken. You are surrounded by food designed to overpower your biology. Let’s get you back in the driver’s seat.Quick SummaryWe explain the NOVA system (Groups 1–4) so you can name what you’re eating.We show how ultra processed foods change hunger and fullness.We cover why some foods make you eat more without meaning to (+508 calories/day in a study).We walk through high fructose corn syrup, seed oils, tallow fries, and processed meat with plain language.We end with simple swaps and a “workable” way to start.The NOVA System, Made SimpleGroup 1: Unprocessed or minimally processed food.Examples: fresh or frozen fruits and veggies, plain meat or fish, eggs, dried beans, lentils, whole grains, milk, plain yogurt.Group 2: Processed culinary ingredients.Examples: olive oil, butter, sugar, salt, vinegar.Group 3: Processed foods (Group 1 + Group 2, using simple methods).Examples: simple bread (flour, yeast, salt), cheese, pickles, canned beans, canned fish, jarred tomato sauce.Group 4: Ultra processed foods (industrially made with additives you don’t cook with at home).Common flags: artificial colors and flavors, preservatives, emulsifiers, gums, isolated starches/proteins, sugar substitutes (like sucralose or acesulfame potassium), high fructose corn syrup, hydrogenated or inter-esterified oils.Examples: flavored yogurts, protein bars with long labels, soda and energy drinks, many breakfast cereals, frozen pizzas and meals.Working tip:Short ingredient list (5–6 items you know)? More likely Group 1–3.Long list with words ending in “-ose,” “-ate,” or “-ide,” plus artificial sweeteners or gums? Likely Group 4.Why Ultra Processed Foods Matter (Especially With Diabetes)They can hijack metabolism, increase visceral fat, and raise inflammation.They are engineered to be super tasty and easy to overeat.In a controlled study, people eating ultra processed foods ate about 508 more calories per day on average when allowed to eat as much as they wanted.In 2 weeks, that group gained about 2 pounds.A 2023 BMJ paper: for every 10% increase in ultra processed foods in the diet, type 2 diabetes risk rose by 15%.Sugar can hit the brain’s dopamine system in ways that drive cravings. It’s not “you”—it’s design.“Out of a Package” vs. Ultra ProcessedNot all packaged food is bad. Canned beans, canned fish, simple bread, and jarred tomato sauce can be Group 3. The issue is the level of industrial processing and the additives used.High Fructose Corn Syrup (HFCS) vs. Sugar: What We SaidHistory: Farm policy and corn subsidies made HFCS cheap and common. Tariffs made cane/beet sugar pricier. HFCS is stable in acidic drinks and easy to ship as a liquid.How HFCS is made: corn starch → enzymes → glucose → more enzymes → part of it becomes fructose (HFCS-42 or HFCS-55).Table sugar (from cane) is crushed, boiled, and crystallized. Fewer steps. No enzymatic reshaping.Americans still consume around 40 pounds of HFCS per person per year (down from ~60 pounds in the early 2000s).Marketing tried to rebrand HFCS as “corn sugar.” FDA said no.If you want the “old school” soda once in a while, Mexican Coke uses sugar, not HFCS. Still soda—just different sweetener.Oils: Seed Oils, Trans Fats, and Tallow FriesHydrogenated oils (trans fats) were pushed in when saturated fat got blamed for heart disease. That didn’t end well.Inter-esterified oils were later used to replace trans fats in many ultra processed foods.Beef tallow has a higher smoke point than many seed oils. That doesn’t make a basket of fries a health food.Beware “one villain” marketing (like “100% beef tallow = 100% better fries”). A fried meal with white buns, processed meat, and soda is still not a health meal.Processed Meat, Safety Scares, and What ChangedMad cow disease (BSE) taught us about prions—misfolded proteins that are very hard to destroy.Risk rose when mechanical separation pulled spinal/brain tissue into meat products.Reforms followed: bans on feeding cattle-to-cattle (1997), removal of high-risk tissues in older cattle, tighter rules on separation and inspections.Bottom line: the system was built for speed and profit, then patched after problems. It’s better, but still opaque. The burden of choice lands on you.How To Spot Ultra Processed Foods FastIngredient list longer than 5–6 items.Additives you wouldn’t cook with at home.Sweeteners: sucralose, acesulfame potassium, erythritol.Isolates: soy protein isolate, modified food starch.Colors: Red 40, Blue 1 (note: “natural flavors” doesn’t mean much).“Enriched” refined flour often points to Group 4 versions.Suffix clues: “-ose,” “-ate...
    続きを読む 一部表示
    1 時間 7 分
  • Episode 17: Nutrient Density of Foods

    Episode 17: Nutrient Density of Foods
    2025/07/28
    Nutrient Density: The Simple Way To Eat Better And Steady Your Blood SugarLearn what Nutrient Density is, why it matters for blood sugar and type 2 diabetes, and easy ways to add more Nutrient Density to every meal. Simple tips, real talk, and doable swaps from Richie and Amber.Slug: nutrient-density-diabetes-podcast—Episode SummaryRichie: Ever think, “I’m eating less… so why don’t I feel better?”This episode is for you.Amber: Today we talk about Nutrient Density. What it means. Why it helps your health and your blood sugar. And how to make it work in real life.In this show, we explain:What Nutrient Density means in plain wordsWhy “empty calories” leave you tired and still hungryHow to build meals that keep you full and steadyThe most common nutrient gaps we seeEasy swaps you can make this week—What Is Nutrient Density?Amber: Nutrient Density means how many good things you get in a food for the calories it has.Those good things include:Vitamins and mineralsFiberProteinPlant nutrients (the colorful stuff in plants)Nutrient-dense foods give you a lot of nutrition with fewer calories. They are often:Rich in vitamins and mineralsHigh in fiber and/or proteinLower in added sugar and refined grainsLess processed—Empty Calories vs. Nutrient DensitySome foods give you calories but not much else. That’s what we mean by “empty calories.”Examples:SodaChipsPastriesSugar-loaded coffees and teasAmber: These spike blood sugar, then crash it. They can leave you hungry again fast.Richie: The stat that shocked me—about 40% of the average American’s calories come from added sugar and fat. That’s a lot of energy with not much nutrition.—Why Nutrient Density Matters For Blood SugarYou feel full longer (thanks to fiber and protein).You get a steadier blood sugar curve.You stop chasing energy with caffeine and sugar.You help your body use insulin better over time.Richie: Is there a difference between being hungry for calories and being hungry for nutrients?Amber: Yes. You can eat a lot of calories and still be undernourished. Your body keeps asking for more.—The Donut vs. Beans PictureA donut and a cup of beans can have similar calories.But beans bring fiber, protein, minerals, and slow, steady energy.Donuts bring sugar and fat, and hunger comes back fast.Richie: Two donuts? Easy. Two cups of beans? That takes time. And I’d be full.—If You Eat Less, You Need More Nutrient DensityIf you eat fewer calories (small appetite, GLP-1 meds, or after surgery), your body still needs the same vitamins, minerals, fiber, and protein. So every bite needs to count.Signs you may be missing key nutrients:Low energy, poor sleepHair thinningStrong cravings“I ate, but I’m still hungry”—Common Nutrient Gaps We See (and how to fill them)MagnesiumWhy it matters: Helps blood sugar, blood pressure, nerves, and sleep.Low may look like: Cramps, restless legs, poor sleep, “wired but tired,” cravings.Foods: Beans, seeds, leafy greens, whole grains, dark chocolate.PotassiumWhy it matters: Helps blood pressure, heart, kidneys, and hydration inside your cells.Low may look like: High blood pressure, muscle weakness, fatigue, heart flutters.Foods: Bananas, apricots, sweet potatoes, beans, leafy greens.Vitamin DWhy it matters: Bones, immune health, mood, insulin sensitivity.Low may look like: Brain fog, joint pain, frequent illness, low mood in winter.Where from: Sunlight, fortified foods (like milk), and often a supplement.Note: Many people benefit from a modest daily dose. Vitamin D is fat‑soluble, so don’t megadose without guidance. Choose a third‑party tested brand.IronWhy it matters: Oxygen in the blood, energy, focus, temperature control.Low may look like: Pale skin, tiredness, cold hands/feet, dizziness, hair loss.Foods: Beans, lentils, tofu, tempeh, leafy greens. Pair with vitamin C for better absorption.Vitamin B12Why it matters: Nerves, DNA, red blood cells, mood and focus.Low may look like: Numbness/tingling, brain fog, fatigue, mouth sores, glossy red tongue.Who’s at risk: Vegans, adults 50+, people on PPIs, and some long‑term metformin users.Tip: A B12 supplement can help if you’re at risk.FiberWhy it matters: Blood sugar control, gut health, cholesterol, fullness.Foods: Beans/legumes, whole grains, fruits, veggies, nuts, seeds.Note: Avocados are a great fiber food.—Same Calories. Different Results. (A simple look)Two days at about 1,600 calories:Day A (lower Nutrient Density):Granola barFrozen “diet” entrée100-cal popcornGrilled chicken + white rice + broccoliSugar-free puddingDay B (higher Nutrient Density):Steel-cut oats + flax + berries + almond butterLentil soup + quinoa-kale salad + roasted veggies (fresh‑frozen is great)Greek yogurt + chia + walnutsTofu stir-fry + mixed veggies + brown riceApple + natural peanut butter or almondsWhat changes with Day B?More fiberMore proteinLess sodiumMore vitamins, minerals, and plant nutrientsResult: You feel fuller. Your energy is ...
    続きを読む 一部表示
    58 分
  • Episode 16 - Fiber is the New Protein

    Episode 16 - Fiber is the New Protein
    2025/07/21
    Fiber Is the New Protein — The Diabetes Podcast Show NotesProtein gets all the hype, but Fiber is the real star for blood sugar, heart health, weight, and hunger. In this episode, we show you simple ways to add more Fiber to your day and why it works.The Big IdeaMost of us do not have a protein problem. We have a Fiber problem.95% of Americans get enough protein.95% of Americans do not get enough Fiber. Most people only get 10–15 grams a day.Aim for at least 25–35 grams a day. For blood sugar and heart health, 50 grams a day is even better. About 30 grams a day helps lower the risk of getting type 2 diabetes.Why Fiber Matters (and why we’re so excited about it)Richie: Protein bars, protein milk, protein cookies… it’s everywhere.Amber: But Fiber is the thing most people are missing. And it does a lot.Fiber helps your heartFiber forms a thick gel in your gut.That gel traps bile (which has cholesterol) so your body poops it out.Your liver then pulls LDL (“bad” cholesterol) from your blood to make more bile.Result: lower LDL, less inflammation, better blood pressure, lower risk of heart attack and stroke.Fiber steadies blood sugarIt slows how fast food leaves your stomach.You get a smoother rise in blood sugar, not big spikes and crashes.Fiber helps hunger and weightIt fills your stomach and tells your brain, “I’m full.”It turns on fullness hormones like GLP-1, PYY, and CCK (the same pathway many GLP-1 meds use).Your gut works a bit harder, so you burn a few more calories.Some calories get trapped in plant cell walls, so you absorb a little less.Cool nut study: people pooped out more fat from whole nuts than from nut butter or nut oil. Whole > butter > oil for fullness and Fiber.Fiber feeds your good gut bugsThey make short-chain fatty acids that help your gut, blood sugar, and brain.Your gut and brain “talk” through your vagus nerve and hormones. Fiber supports that healthy chat.Wait… so where did the Fiber go?Richie: Processed foods.Amber: Yep. Milling and refining strip away Fiber and many nutrients. Then companies “enrich” the flour to add some vitamins back. But the Fiber is still gone. Choose whole foods when you can.Protein: what’s “enough”?For most non-athlete adults, the RDA is 0.8 grams of protein per kilogram of body weight.Many older adults and women in perimenopause may need more.In the U.S., about 95% of people already meet protein needs. Fiber is the real gap.How Much Fiber Should You Eat?Most people today: 10–15 g/day (too low).Good minimum: 25 g/day for women, 35–38 g/day for men.Great for blood sugar and heart health: around 50 g/day.To lower type 2 diabetes risk: about 30 g/day.Amber’s personal stretch goal is 100 g/day, but that’s advanced and not needed for most. Start with 50 g if you have type 2 diabetes or want strong benefits.Richie: Fiber is like a low-cost, natural way to get some of the same effects as GLP-1 meds. Try Fiber first.Start Here: Simple, Safe, DoableAdd 1/2 cup of beans to your day. That’s it. Do it daily.Or track your Fiber for one day to see where you’re starting from.Increase slowly: add about 5 grams more Fiber per day each week.Drink more water as you add Fiber. The “gel” needs water to work well.Cook beans and lentils well to reduce gas. Your gut will adjust.Important note: This is education, not medical advice. Amber is a dietitian and diabetes educator, but not your personal clinician. Check with your care team if you have GI disease or special needs.Best Fiber Foods (easy wins)Think “beans, greens, grains, nuts, seeds, and fruit.”Beans, peas, lentils, legumesBlack beans, kidney beans, chickpeas, lentils, split peasHummus is good, but whole chickpeas have more FiberWhole grainsOats/steel-cut oats/groats, barley, bulgur, farro, quinoaPopcorn (air-popped, go easy on oils and butter)Nuts and seedsChia seeds (tiny spoon, big Fiber)Ground flaxseedPumpkin seedsAlmonds (whole nuts beat nut butters and oils for Fiber)FruitRaspberries, blackberries, prunesKiwi (golden kiwi is great; eat the skin for extra Fiber)VeggiesArtichokes, Brussels sprouts, broccoli, cauliflowerAvocadoHas a little Fiber; still a nice addTip: Whole foods beat powders. Fiber supplements can help, but food-based Fiber works better for most outcomes in studies.Label Hacks to Find Real FiberLook for “100% whole grain” or “100% whole wheat” as the first ingredient.Use the 5-to-1 rule:Total carbs ÷ FiberIf the number is under 5, that’s a higher-Fiber choice.Common QuestionsWill I get bloated? Maybe at first. That’s normal. Go slow, add water, cook beans well. Your gut will adapt.Do artificial sweeteners affect hunger? Some can. Amber tends to avoid them because they may confuse hunger/fullness cues for some people.Is 50 grams too much? Not if you build up to it. Many people feel great at 30–50 grams. Go at your pace.What To Do This WeekRichie: Keep it simple.Amber: Add a half cup of beans every day.Step 1: Track your Fiber for ...
    続きを読む 一部表示
    42 分
  • Episode 15 - Charcot Foot - An Interview with Wayne Walker of The Trouble aFoot Podcast

    Episode 15 - Charcot Foot - An Interview with Wayne Walker of The Trouble aFoot Podcast
    2025/07/14
    Charcot Foot: Hope, Help, and Real Talk with Wayne Walker (Trouble aFoot Podcast)In this episode of the Diabetes Podcast, we talk with Wayne Walker, host of the Trouble aFoot podcast. We dig into Charcot Foot, what it is, who is at risk, what to watch for, and how to find help and hope. This show is for anyone with diabetes, and for loved ones who want to support them.Wayne blends lived experience with heart, humor, and straight talk. He shares the hard parts, the choices, and the path forward. You are not alone.SEO keywords: Charcot Foot, diabetic neuropathy, neuropathic arthropathy, foot ulcers, osteomyelitis, diabetes foot complicationsEpisode at a GlanceWhat Charcot Foot is (in simple words)Why it can happen without painWho is at higher riskEarly signs you should never ignoreReal stories that show how sneaky this isTreatment paths: bracing, surgery, amputationHow to talk to your doctorWhy there is hope and communityWhat Is Charcot Foot?Charcot Foot (medical name: neuropathic arthropathy) is a serious foot problem.The bones in the foot and ankle get weak and soft.The bones can shift and collapse. They can form a hard lump on the bottom of the foot. This is called a “rocker bottom.”Many people feel little or no pain because of nerve damage (neuropathy). That is why it is so risky.Wayne says it plain: the bones don’t just vanish—they move. They move down. That lump becomes the new “bottom” of the foot. People keep walking on it because they can’t feel it. Then sores and infections start. Infection in the bone (osteomyelitis) can spread fast and can be life-threatening if not treated.Why It Sneaks Up on PeopleNeuropathy means your nerves don’t send pain signals like they should.You can step on a nail and not feel it.You can twist your ankle and keep walking.Two true stories from the show:A man worked all day with a nail through his boot. He only found out when he saw blood inside the boot.Wayne once pulled the two metal prongs of a power cord out of his foot. He thought it was a leaf stuck there. He had almost no pain.When you don’t feel pain, you don’t pull back. You keep going. That’s when damage grows.Who Is at Higher Risk?Many people with Charcot Foot share three things:They have diabetes.They have severe neuropathy (loss of feeling in the feet).They have obesity, which adds more force to the bones.Other notes from the conversation:Some people without diabetes can get Charcot Foot if they have neuropathy from other causes.Younger, more active people with good blood flow can be at risk because the foot gets hot and inflamed, and they keep walking on it.Long hours on hard floors (like retail or factory work) and years of high-impact activity may add stress to the foot.How common is it? The numbers vary by study. Estimates discussed in the episode:About 1 to 4 in 1,000 people with diabetes may get Charcot Foot.Among people with neuropathy, some reports suggest it could be higher (numbers mentioned up to around 13%).If someone has diabetes, neuropathy, and obesity, the risk may rise further. Exact numbers differ. Ask your doctor about your risk.Early Signs to Act On NowCall your doctor right away, or go to urgent care/ER for fever and fast changes. Watch for:A foot that is warmer than the other footSwelling that starts suddenly, even after a small twistRednessA sudden change in foot shapeA new bump or “rocker bottom”A sore or ulcer on the bottom or side of the footA shoe that suddenly fits differentFever, chills, or feeling unwellTip: If you feel “off” and have diabetes or neuropathy, check your feet first.What To Do If You Suspect Charcot FootStop putting weight on that foot. Sit down. Use crutches, a scooter, or a wheelchair if you have them.Call your doctor or podiatrist now. If you have a fever or fast swelling, go to the ER.Say the words “I am worried about Charcot Foot.” Ask for an exam and imaging.Ask about “offloading” (keeping weight off the foot) to protect the bones.Early action can save your foot shape and help prevent infection.Treatment Paths We Talked AboutYour care team should explain all options. A good doctor will walk you through each one:Bracing/orthotics and offloadingCustom boots, casts, or braces to protect the bonesGoal: reduce pressure, prevent ulcers, and help the foot settleReconstructive surgeryWayne chose this pathAim: rebuild and stabilize the foot so it can bear weight more safelyAmputation (often below the knee)Some people choose this to remove the problem and pain riskIt is a personal choice; many do well with a prosthesisWayne’s surgeon told him: “I’ll give you a feasible foot, not a perfect foot.” You may not run or play high-impact sports. But you can walk your dog around the block. That hope matters.Foot Care and Everyday Tips From the ConversationWear good shoes that support your feet. Cheap, thin shoes can add stress.Check your feet every day. Look and feel for heat, redness, swelling, or sores.If you cannot see the ...
    続きを読む 一部表示
    40 分
  • Episode 14 - Clinical Inertia

    Episode 14 - Clinical Inertia
    2025/07/07
    Clinical Inertia and Type 2 Diabetes: Why Care Gets Stuck and How to Unstick ItIn this Diabetes Podcast episode, Richie and Amber break down Clinical Inertia in type 2 diabetes—why care stalls, why A1C goals get missed, and simple steps you can start today to protect your health and aim for remission.Keywords: Clinical Inertia, type 2 diabetes, A1C, remission, insulin resistance, beta cells, primary care, diabetes education, lifestyle changeEpisode summaryYou leave the doctor’s office scared. You hear “eat better, move more,” and “see you in three months.” No plan. No help. Then your A1C is higher, and you get another med. You feel stuck.In this episode, we name the problem: Clinical Inertia. It’s when treatment does not start or does not get stronger when the A1C says it should. It’s common. It is not your fault. It is not because doctors do not care. It is the system, short visits, too many problems to cover, and not enough time for real support.We explain why this happens, what it costs, and what actually works. We talk about the best window for remission. We give simple actions you can start today. You can take back control. You can change your story.What we coverWhat Clinical Inertia is, in plain wordsWhy short visits (about 16 minutes) lead to missed care stepsWhy so many people leave visits without a clear planHow delays hurt A1C goals and long-term healthWhy “more meds” without lifestyle change is not enoughThe best time window for type 2 diabetes remissionSimple daily steps that help right nowHow to own your health outside the clinicTimestamps00:00 — The scary first visit, and why people feel lost00:02 — How most people find out they have type 2 (a quick call, then Google chaos)00:04 — Short visits, many problems, and “triage” in primary care00:05 — Clinical Inertia defined00:09 — Where lifestyle help breaks down; insurance and “info dump” classes00:14 — Classes lower A1C a bit, but overload is real00:16 — 1 in 3 misunderstand the plan; 60% leave without clear “what to eat/do”00:18 — Clinical Inertia drives about 80% of missed A1C goals00:20 — Med stacking vs fixing insulin resistance; why lifestyle is powerful00:23 — Why higher A1C = higher risk (simple stats you should know)00:25 — How fast meds pile up for many people00:26 — The best window for remission is early (1–3 years post-diagnosis)00:27 — Your beta cells need urgent help; delays matter00:29 — When doctors say “I can’t help more,” and why that happens00:30 — The big system problem vs what you can do now00:31 — Own your health like your money: day-to-day is on you00:35 — Hope: remission is real; behavior change works00:35 — Simple steps to start today00:38 — When A1C is “flat, flat… then jumps,” that’s inertia00:38 — Free resources and fast-track help at EmpoweredDiabetes.com00:39 — Closing: You deserve a plan, a partner, and real changeClinical Inertia: what it is and why it happensSimple meaning: care does not start or does not ramp up when your A1C shows it should.Why it happens:Primary care doctors care for 1,800–2,000 patients.Visits are short (about 16 minutes).About six problems per visit. Diabetes competes with other urgent issues.Real life happens: floods, stress, pain. Doctors are human and try to help with what’s most urgent.Group classes are often “info dumps.” People leave overwhelmed.Insurance pays for very limited visits. Not much for ongoing support.What Clinical Inertia costsAbout 80% of people who miss their A1C goals do so because care was delayed, diluted, or dismissed.Many leave visits confused:1 in 3 misunderstand the plan after a standard visit.Over 60% leave without clear steps on what to eat or do.Risks rise as A1C rises (UKPDS 1% rule):For each 1% A1C above 7:21% higher risk of death due to diabetes14% higher risk of heart attack37% higher risk of small blood vessel damage (eyes, kidneys, nerves)An A1C of 9 can double the risk of kidney failure, blindness, and stroke over time.Why “more meds” alone is not the fixWhat often happens: metformin → add-ons (like DPP-4, SGLT2) → more meds → insulin.These can help, but many do not fix insulin resistance, the core problem.Without lifestyle change, meds pile up while the root issue stays.Data shows:Within 5 years, about 50% are on multiple meds.About one-third are on three or more.The best window for remissionRemission is most likely in the first 1–3 years after diagnosis.Every 6–12 month delay lowers the chance.Why? Your beta cells (the insulin-making cells) get tired and fewer over time.Early action protects these cells. That helps long-term control.What your doctor sees (and why they push meds)Doctors see the whole road: from first A1C rise to ulcers, eye damage, and amputations.They know many people cannot make big changes fast. So they push meds to protect you now.They are not the enemy. The system is hard. The time is short. The stakes are high.How to ...
    続きを読む 一部表示
    39 分
  • "Anything Meds Can Do, You Can Do Better" Part 12 of 12 - Inflammation and Oxidative Stress

    "Anything Meds Can Do, You Can Do Better" Part 12 of 12 - Inflammation and Oxidative Stress
    2025/06/30
    Show Notes: Inflammation and Oxidative Stress — The Final Piece of the Diabetes PuzzleIn this episode, we close the Dirty Dozen series with the big one: Inflammation and oxidative stress. Inflammation isn’t just in the background. It speeds up every core defect in type 2 diabetes. The good news? You can cool this fire with simple, daily steps.Listen in as Richie and Amber break it down in plain language, tie it to the 12 core defects from Dr. Ralph DeFronzo’s work, and give you a clear plan.Episode SummaryInflammation: what it is, why it happens, and why chronic inflammation is a problemOxidative stress: how “cell rust” forms and how your body fights itHow Inflammation weaves through all 12 core defects in type 2 diabetesWhat labs and signs may point to chronic low-grade inflammationMeds that can help (and what they can’t do)A simple, real-life plan to lower Inflammation with food, movement, sleep, and stress careWhy 5–10% weight loss is powerful, and the role of adiponectinFoods and habits that raise adiponectin and lower InflammationQuick Guide (Timestamps)00:00 — Welcome + why Inflammation matters in type 2 diabetes02:00 — Acute vs. chronic inflammation (short-term vs. long-term)04:00 — Oxidative stress: what it is and why balance matters06:00 — Low-grade inflammation: common causes (obesity, sleep, stress)10:00 — How to spot risk: waist-to-hip, fatigue, central fat11:00 — How Inflammation hits each core defect (muscle, liver, fat, gut, brain, kidneys, pancreas, mitochondria)20:00 — Meds that help: metformin, GLP-1s, TZDs, SGLT2s, statins; NSAIDs caution24:00 — Food plan to calm Inflammation (plant-rich, fiber, omega-3s; avoid ultra-processed)32:00 — Movement lowers Inflammation even in small doses33:00 — Sleep and stress: why they’re non‑negotiable37:00 — Weight loss and adiponectin: why 5–10% matters41:00 — Your simple action plan + next stepsWhat Is Inflammation?Acute Inflammation: short-term and helpful (like a swollen thumb after a hit or an infection). Your body heals and the swelling goes down.Chronic Inflammation: long-term, low-grade. This is the problem. It can build for years and push insulin resistance and high blood sugars.Oxidative stress is like “cell rust.” Your body makes it every day (even just breathing), and your built-in defenses (antioxidants, enzymes, repair systems) keep it in check. When the balance breaks, damage builds.How Inflammation Touches All 12 DefectsInflammation and oxidative stress weave through every system:Muscle: fat buildup sparks inflammatory signals that block insulin.Liver: fat in the liver drives “new sugar” making at night → fasting highs.Fat tissue: overfilled fat cells leak inflammation and pull in macrophages (immune cells).Gut hormones (incretins): gut inflammation lowers GLP‑1 effect.Alpha cells: inflammation blunts glucose sensing → more glucagon → higher sugars.Beta cells: insulitis (inflamed islets) harms and lowers insulin-making cells.Brain: cytokines jam hunger/fullness signals (leptin, insulin) → more cravings.Kidneys: inflammation can raise SGLT2 activity → kidneys reabsorb more sugar.Amyloid toxicity: misfolded proteins + free fatty acids + ROS hurt islets.Microbiome: “leaky gut” lets toxins in → low-grade Inflammation.Mitochondria: stressed engines leak ROS → more oxidative stress.Net result: Inflammation fuels insulin resistance and beta cell loss across the board.How Do I Know If I Have Low-Grade Inflammation?Common signs: tired, more belly fat, poor sleep, high stress.Risk check: waist-to-hip ratio (ranges differ for men and women).Labs to ask your clinician about:C‑reactive protein (CRP): a general inflammation markerFasting insulin (not perfect, but can hint at early insulin issues)Note: Research tests like IL‑6 and TNF‑α exist but aren’t standard at big labs.Chronic Inflammation can start 10–15 years before diabetes is diagnosed.Meds That Can Help (But Don’t Replace Lifestyle)Metformin: can lower CRP and TNF‑α (inflammation markers).GLP‑1 receptor agonists: reduce systemic Inflammation, often via weight loss.TZDs (pioglitazone/Actos): act on fat tissue to lower inflammatory signals.SGLT2 inhibitors: may reduce oxidative stress and help mitochondria.Statins: not diabetes drugs, but can lower inflammation and protect vessels.NSAIDs (like ibuprofen): can ease pain, but they’re a short-term band-aid and can cause gut bleeds. Not a long-term fix for chronic Inflammation.Meds help. Lifestyle heals the source.Your Anti-Inflammation Action PlanBuild a plant-rich plateMake plants the star; meat the side.Aim for 5–9 servings of fruits and veggies daily.Eat more fiber: beans, peas, lentils; whole grains (try quinoa, farro, steel-cut oats).Go for color: greens, reds, oranges, purples = antioxidants.Add anti-Inflammation fatsOmega‑3s: flax, chia, walnuts, hemp seeds; fatty fish; algae oil (look for USP/NSF third‑party tested; 250–500 mg EPA+DHA/day ...
    続きを読む 一部表示
    49 分
  • "Anything Meds Can Do, You Can Do Better" Part 11 of 12 - Mitochondrial Dysfunction

    "Anything Meds Can Do, You Can Do Better" Part 11 of 12 - Mitochondrial Dysfunction
    2025/06/23
    Mitochondrial Dysfunction: Why Your “Cell Power” Matters in Type 2 DiabetesWelcome back to the Diabetes Podcast show notes. In this episode, Richie and Amber break down mitochondrial dysfunction in simple terms. We explain what mitochondria do, what goes wrong in type 2 diabetes, which meds may help, and the daily steps that power your cells back up.If you’ve been doing “all the right things” but still feel tired, foggy, or stuck, this one is for you.Episode SummaryMitochondria are the “power plants” inside your cells. They turn food into usable energy called ATP.In type 2 diabetes, mitochondrial dysfunction makes it hard to turn fuel into energy at the right time.This leads to high blood sugar, fatigue, brain fog, and slow recovery.The good news: mitochondria are very responsive. Movement, food, sleep, and stress care can build new mitochondria and make them work better.Some medicines can also help.This is part of our 12-core-defects series on type 2 diabetes. Next week is the last one: inflammation.What Are Mitochondria?Think of mitochondria like tiny engines or refineries in each cell.Your body brings carbs (glucose) and fats to the refinery.Mitochondria “refine” that fuel into ATP, your body’s energy currency.When demand goes up (like after a meal or during a workout), healthy mitochondria match the demand.This fuel-switching skill is called metabolic flexibility.What Goes Wrong in Type 2 DiabetesIn mitochondrial dysfunction, the “refinery” gets stuck or slows down.Even after meals, cells keep burning fat instead of switching to glucose.That causes “traffic” inside muscle cells and leads to insulin resistance.Blood sugar stays high because glucose can’t get into the cells well.Your cells end up underpowered, even when fuel is available.Amber calls this “metabolic gridlock.”Fun (not so fun) fact: A study found people with obesity and type 2 diabetes had about 30% fewer mitochondria in muscle cells. The ones left were slow and less efficient.How This Feels Day to DayLow energy and afternoon crashesBrain fog and low moodHard time recovering after workoutsWeight gain or stalled weight lossFeeling “hangry”High blood sugar after carb-heavy mealsImportant: This is not a willpower problem. It’s a power problem.The Analogies That Make It ClickRefinery: You can’t use crude oil in a car. You need gas. Mitochondria turn food into usable “gas” (ATP).Battery/Charger: Mitochondria help “charge” your energy. If the charger is weak, everything feels harder.Gridlock: Fuel is everywhere, but it’s stuck in traffic. It can’t get where it needs to go on time.Medications That May Help Mitochondrial FunctionTalk to your clinician before starting or changing any medicine.Metformin (a biguanide)May make mitochondria more efficient over time by activating AMPK, a key energy signal.Common side effect: GI upset (start low, go slow up to 2000 mg/day).Pioglitazone/Actos (a TZD)Activates PPAR-γ, improves insulin sensitivity in fat and muscle, helps lipid handling, and supports mitochondria in muscle.Side effects: weight gain (often fluid and subcutaneous fat), fluid retention; CHF warning applies.GLP-1 receptor agonistsMay help indirectly by improving insulin function and lowering glucose and inflammation.Meds can help the “refinery” run better, but lifestyle is what builds more refineries.How to Power Up Your Mitochondria (Lifestyle Wins)You can build new mitochondria and make existing ones work better. Small steps add up fast.Movement (your most powerful lever)Take a 10–15 minute walk after meals (especially dinner).Helps move glucose into muscle even when insulin is not working well.Signals your body to build more mitochondria.Strength train 2–3 days per week.Builds muscle. More muscle = more “sockets” to plug in glucose and burn it.Sprinkle in short bouts of movement during the day.Climb stairs, quick bodyweight sets, or short walks.Optional: brief, safe higher-intensity intervals if your doctor says it’s okay.Tip: Movement tells your body, “We need more energy—build more power plants.”Nutrition (feed and protect your power plants)Focus on a fiber-rich, whole-food, plant-forward plate. These foods lower inflammation and protect mitochondria from “rust” (oxidative stress).Antioxidant- and polyphenol-rich foods:Colorful veggies and fruits, beans, herbs, spices, tea, coffee (unsweetened or lightly sweetened).Fiber-rich foods (also great for your gut bugs → more short-chain fatty acids → happier mitochondria):Beans, lentils, peas; oats and other whole grains; veggies; nuts and seeds.Magnesium foods (needed to make ATP):Beans, greens, seeds (pumpkin, sesame, chia), nuts, whole grains.B vitamins (help run energy steps):Whole grains, beans, leafy greens; B12 often needs fortified foods or supplements if plant-based.CoQ10 (supports the electron transport chain):Highest in organ meats and fatty fish; also in smaller amounts in spinach, broccoli, ...
    続きを読む 一部表示
    42 分