Participants: Agatha Thrash, Don Miller, Wynn Horsely
Series Code: HYTH
Program Code: HYTH000175
00:01 Hello! I'm Agatha Thrash, a staff physician at
00:04 Uchee Pines Institute, a place where we see a lot
00:08 of people with diabetes.
00:10 In fact I think probably my favorite disease to treat
00:14 is diabetes.
00:16 It's very common, it also has a lot of ramifications and
00:21 interlacing with other types of diseases,
00:23 and another thing is that it responds so well to the
00:27 very simplest of treatment.
00:29 We hope you will join us for this discussion on diabetes
00:33 and related issues.
00:55 Welcome to:
00:57 with Dr. Agatha Thrash of Uchee Pines Institute,
01:00 and now here is your host, Dr. Thrash.
01:03 Having had diabetes in my family it's always been
01:08 a disease that interests me.
01:10 But as I have practiced medicine,
01:13 the longer I have been in medicine, the more I realize
01:16 that this disease is very wide spread.
01:21 A lot of times people don't know that they have it,
01:24 in fact we have people who have had a large number of years
01:30 of experience with diabetes before it was ever made
01:33 by the laboratory.
01:34 So we have things that we can say that the laboratory says
01:39 they have diabetes so we will look back in the patient's
01:42 chart and see yes, you've had diabetes for many many years.
01:47 The major way of making the diagnosis of diabetes is by
01:52 the laboratory tests.
01:53 We can get a good idea about the person's metabolism of
02:00 sugar and the whole metabolic process that has to do with
02:06 dealing with sugar, salt, fats, proteins, and all of these
02:14 are involved in the diabetic syndrome.
02:17 We can get a lot of idea about this by the patient's history,
02:20 but to actually make the diagnosis, we need to have
02:25 laboratory testing, so I would like to show you
02:28 what we see with the laboratory.
02:30 Here you see a graph that shows the time on the bottom,
02:36 and the level of the blood sugar along the left side.
02:41 Notice that the blood sugar starts at 70 in this person,
02:46 and at one hour it is up to about 130, then at
02:53 one and a half hours it has come down a little bit,
02:55 then at two hours it's just slightly below where it started,
03:00 maybe 69, just a little below where it started,
03:05 now that's normal, or essentially normal.
03:09 There are a little variations on this, but essentially
03:11 that's normal.
03:12 Now lets see what a mild diabetic would be,
03:16 it starts at about 90- 95, maybe 100, then goes up
03:22 rather sharply and higher than it does in the normal
03:25 and does not come back down to normal in two hours.
03:29 Now lets take a person who is a severe diabetic,
03:32 it starts at a higher level, it can start at 110, 140,
03:37 it can even be at 200, and then as you can see it is
03:41 almost going off the graph over there at 250,
03:44 it can go even higher than that, 3, 4, 500.
03:49 At two hours it isn't anywhere near back down to normal,
03:54 it isn't even turning downward.
03:56 Sometimes people will keep this kind of curve
03:59 much of their lives, the higher the blood sugar is,
04:04 the greater the likelihood the person is to be producing
04:08 too much insulin, and we will talk with you about
04:11 what too much insulin does for you.
04:13 Before that I would like to show you one of those things
04:16 that we use to treat diabetics with and that is diet.
04:20 In the diet we promote a purely vegetarian diet,
04:24 and one might think, would I be able to do a vegetarian
04:29 diet and I have heard that it takes spending hours every day
04:33 in the kitchen to produce a vegetarian diet
04:37 and I will tell you to both of those, yes you can do
04:39 a vegetarian diet, and no it does not take many many hours
04:47 I have asked Lidia Seda who is an excellent cook to show...
04:52 Oh, this looks so good and it smells so good Lidia.
04:56 This is Lidia Seda who is one of my colleagues at Uchee Pines,
05:01 umm! What is the name of this roast, it smells so good?
05:05 - Cashew Nut Loaf - Cashew Nut Loaf
05:08 What are the major ingredients?
05:10 Rice, cashews, it has different types of seasonings.
05:15 - I think I can smell a little sage is it?
05:18 - Sage, it has Thyme, a little Oregano, and it's real simple,
05:23 you just get all the ingredients together,
05:24 place it in a loaf pan, I decided to use a round loaf pan
05:29 instead of a square one, and place it in the oven and bake it
05:32 for about 30- 40 minutes.
05:34 - My, that's pretty and it has a little bit of a meat like
05:42 texture, not that I require that not having eaten meat
05:45 in 35 years, nearly 40, so I don't think it would
05:51 appeal to me, but for people who appreciate meat
05:55 it would certainly look somewhat like it.
05:58 - I tried this about a week ago and it's quite tasty.
06:02 - Was it? Do you have a recipe for that?
06:04 Yes, yes we do, and you can actually find his recipe
06:08 in the book, Eat For Strength, this is one of the places
06:13 you can find this recipe, Cashew Nut Loaf.
06:17 - I've seen that book before. - I'm sure you have Dr. Agatha!
06:19 - Well, I certainly hope I get to eat with you when you eat
06:26 this roast. - I'm sure you will!
06:30 The other thing I wanted to share since we are talking
06:32 about diabetes, and how individual who are diabetic
06:36 can be helped with this situation, one important thing
06:39 is Stevia.
06:41 Stevia has been used in the Orient for many many years
06:45 for diabetics in place of using a sweetener,
06:50 it has no calories and they are actually finding that insulin
06:54 can actually help the pancreas increase it's insulin capacity
06:59 because it works on the Beta Cells of the pancreas so
07:02 it's no calorie, and also it can help stimulate the pancreas
07:05 to produce more insulin.
07:07 There are many many different types of cookbooks out on the
07:10 market that have recipes with Stevia that you can find
07:15 in any heath food store that they can use.
07:18 - Well Stevia is from a plant and it's a natural product,
07:22 it has a delightful flavor if you don't use to much,
07:26 which is the same way with honey, if you don't use to much,
07:29 and it tastes good in a recipe so we are accustomed to not
07:33 using too much, so I like the fact that Stevia
07:38 can be used in sweet dishes.
07:41 - Now what about the cashews, I know they are very high
07:45 in fat, does that bother a diabetic?
07:48 - Overall, no it will not bother a diabetic, the one nice thing
07:52 about vegetarian meals is that they are high in fiber
07:56 and diabetic will do well if they have meals that are
07:59 high in fiber.
08:00 Fiber acts like a time release capsule allowing that the
08:04 carbohydrates that will be converted into sugars
08:07 so that their blood can convert that into energy,
08:10 it releases it slowly, at a steady pace and not at
08:14 a rapid pace.
08:16 - Ok, so the body because of the fiber in the food, like in this
08:22 nut roast, the fiber in the food makes it so that the body is
08:28 more slow in digesting the food, meaning that the
08:33 sugar level is going to rise more slowly.
08:36 - Exactly!
08:37 - And that does not put the burden on the pancreas
08:39 that it would if it rose very high as we saw on the graph.
08:43 - Exactly, and that's one nice thing about a vegetarian diet
08:46 besides the fact that it's simple just with a little
08:49 preparation and it's very tasty.
08:51 - How long did you spend making this dish?
08:54 - This dish actually within 40 minutes I had all the
08:57 ingredients, which in 40 minutes, actually about
09:02 30 minutes I had everything done, it was just a matter of
09:04 putting everything together, put it in the oven,
09:06 and then I went about my business doing what I needed
09:08 to do and then I had my cashew nut loaf.
09:10 - I want to ask you what you would think about making
09:15 three of these at one time, it might increase your cook time
09:19 maybe 5- 10 minutes, to make three of these at one time and
09:22 put two of them in the freezer.
09:24 - It freezes well, - uh huh,
09:26 - it really does! - Ok, so you can eat it
09:28 two weeks later. - Exactly!
09:30 - So if you want to plan ahead of time for your guests
09:32 or get this ahead of time for Sabbath, you just take it out
09:37 of the freezer and let it thaw when you go to church.. Exactly!
09:41 and when you come back it is ready to pop into the oven
09:44 and heat for 30- 40 minutes and it is ready for you to eat,
09:49 that sounds good.
09:51 I think every diabetic should understand about the
09:54 vegetarian diet so that when you are able to produce this
10:00 for yourself, you can see that there are advantages
10:03 to your blood sugar after the body becomes accustomed
10:06 to it you will do much better.
10:08 Now I have asked Dr. Wynn Hoarsly
10:10 who is one of our staff physicians at
10:12 Uchee Pines who deals with diabetes a lot to join me
10:15 in this...
10:16 Thank you for coming Dr. Wynn Horsley and together
10:21 we are going to tell you a few things about diabetes.
10:24 Dr. Horsley has had quite a lot of experience with diabetes
10:28 of course since we treat so many diabetics at Uchee Pines
10:31 and I would like to know something about how you
10:34 approach this whole problem, how you think about it,
10:36 how you explain it to the patient and that kind of thing.
10:39 First of all I like approaching it just because of what you
10:44 said is exactly my experience, it's a rather major disease,
10:49 but you can get such excellent results in many cases.
10:54 - It is such a major disease that I describe it to patients
10:58 as a process of acceleration of the aging process.
11:03 - Yes, and of the worst killers of the aging process,
11:06 like arteriosclerosis, and heart attacks,
11:08 it accelerates that whole badness.
11:13 - Joint problems, kidney problems, eye problems,
11:17 and neuropathy, and all sorts of things are worse and start
11:23 getting complications.
11:25 - When I get into it with the patients we make a list
11:29 of the complications that diabetes gives,
11:31 who cares about a high blood sugar if it doesn't cause
11:34 any trouble. - That's right.
11:36 - One thing that I think is worth while early along is
11:42 to see just what is it that's going on at a cellular level,
11:46 so I would like to take a moment to look at the
11:50 board here. - Very good, I see you've got
11:53 a diagram there. - Yeah, this is my attempt
11:55 of sketching a cell. - Looks good!
11:58 - Here is the nucleus with all that library of information
12:03 and here is a blood vessel going by and you could take this
12:08 as even one of the tiny arterioles that finally
12:12 narrows down to a capillary where the red blood cells
12:15 are going through single file, it's so narrow.
12:18 Now of course this blood is carrying all the nutrients
12:23 to the cells, and the one that concerns us right now is the
12:25 glucose. - Uhhuh
12:26 - This glucose will come from the blood then and be out here
12:35 outside the cell, ready to go in.
12:37 Most people I believe that are not in health work
12:43 professionally, may not have done the studies about how
12:48 unique cells are.
12:49 They really are like a fortified castle, they don't let just
12:55 anything, even in the tissue right around here in the body
12:58 just automatically go in.
12:59 The environment is extremely different outside here,
13:02 here's the chemical symbols for salt, we all know that
13:06 blood tastes salty, inside the cell there is hardly
13:09 any of the sodium it makes for salt, instead you've got
13:12 potassium, I'm going to give you the chemical symbol K.
13:15 Now the cell membrane, the outside of the cell is
13:19 constantly keeping the sodium out and pumping in the potassium
13:24 well the glucose that is coming here is the fuel
13:31 of the body, the cells need it, but even glucose does not
13:35 have automatic entry into the cell.
13:36 The only way that glucose can get in is through a
13:42 special mechanism, and I like to compare it to a locked door
13:47 that even glucose can not go through this door
13:50 with this lock on it here, unless you have a key to
13:54 unlock it, and the key is insulin.
13:58 Insulin is the substance in our body that unlocks the cells
14:03 so that the glucose can pass inside, the insulin is produced
14:06 in the pancreas, one or our abdominal organs.
14:08 If you didn't have enough insulin then you can't get
14:16 that glucose getting into the cell like it should
14:18 so you get the glucose piling up outside, and the cell
14:24 is starving.
14:25 I've heard diabetes described as starvation in the midst
14:29 of plenty and I think that is a very apt description.
14:31 This very situation of not having enough insulin
14:39 is one kind of diabetes that now days they generally
14:43 refer to diabetes... by the was the full name is
14:46 diabetes mellitus, the sweet kind of diabetes where your
14:49 blood sugar is to high.
14:51 Diabetes mellitus we will abbreviate this way, Type I
14:55 now this is not the majority of diabetics,
14:58 they used to call this juvenile diabetes and I would say
15:02 10% maybe even less of diabetics are completely what we would
15:07 call type I, where there is insufficient insulin.
15:12 By the way, when we do lab testing routinely,
15:16 I think people certainly anyone who is diabetic knows
15:19 how you keep checking for glucose, but now with advances
15:24 in lab technology they can even check for insulin level.
15:27 It is a little more complicated and a lot more expensive.
15:30 - Oh yes! Absolutely! But a real interest here
15:33 because there really is what's the most common
15:37 kind of diabetes, the situation is not this one.
15:41 You do have the problem of glucose building up here
15:46 a person has high blood sugar so yes they are diabetic
15:48 and the cells aren't getting enough glucose in,
15:53 but when they check on the amount of insulin
15:56 you've got plenty, in fact it's often more
15:59 than the normal amount of insulin.
16:01 This would be the most common kind of diabetes that's
16:06 diabetes Mellitus II, what in the past has been called
16:11 adult onset diabetes.
16:13 - Why isn't it still called adult type?
16:15 - Well, in fact I just heard an endocrinologist tell me
16:19 that a friend of his is treating a number of adolescents
16:23 who have type II diabetes, which seems...
16:26 - That would be 11, 12, 13 year old.
16:28 - People at that age, it's sad to see that happening but it is.
16:34 Another reason for not using the terms juvenile and
16:39 adult onset is that as a person goes on with
16:44 type II diabetes, producing extra insulin, it can exhaust
16:48 the pancreas and start turning into Type I.
16:53 Now those type I diabetics of course are older people
16:57 who have already gone through a whole length of time, "years"
17:00 of being type II, so these are not juveniles,
17:03 so again the term juvenile doesn't really fit.
17:06 It's worth mentioning here about this problem of insulin
17:13 resistance which characterizes Type II diabetes.
17:17 They have lots of insulin, lots of the key,
17:20 but it doesn't seem to be opening the lock,
17:22 so we could think of this as the lock being rusty,
17:25 and we are not able to make the key function.
17:28 - The cell won't let the insulin work.
17:31 - That's right, so in medical lingo the rusty lock is just
17:36 called insulin resistance.
17:38 Now the work that we do is largely with Type II diabetes,
17:49 and I think we need to make clear in our talk here,
17:52 that we are talking to people who have Type II.
17:57 If it is Type I, you really need further evaluation
18:02 and you will need something more than just the
18:04 diet recommendations.
18:06 - You need good professional help.
18:07 - Absolutely!
18:08 - Well I am always very interested in Type II diabetes,
18:13 because that is the one that is so responsive
18:16 to the things that we can do in the home.
18:19 Exercising, diet, regularity, drinking plenty of water,
18:25 all of those things.
18:26 - The most dramatic results of all that we see at
18:33 Uchee Pines are with even one added step, and I feel
18:38 a little unsure about whether to recommend this to people
18:41 at home, it's fasting. - Yes!
18:45 I like fasting for people and anybody can fast for a day.
18:50 - Oh yes, no problem for a day, and I really don't feel bad
18:54 about telling people to try even another day,
18:57 if they want to try two, but I wouldn't recommend
18:59 more than three days... - I should say anybody
19:02 can fast because a Type I diabetic should not fast.
19:06 - That's right. - And people with gout
19:08 should not fast.
19:09 - There's another important point that we need to make here,
19:11 and that is, even if he is a Type II diabetic
19:15 and he is taking medications, if he is going to fast,
19:19 he must stop those medications.
19:20 - Tell me what do you think about the non-insulin types
19:25 of drugs that will control the blood sugar?
19:29 How do you feel about those?
19:31 - Well in my residency, we used those and we had
19:36 various problems... Those drugs, none of them
19:40 is a chemical that is a part of our body mechanism,
19:45 my approach is do all you can without doing that.
19:53 If the diabetes is so bad that it really needs drug therapy
20:00 then the drug to go to is insulin, which is the one
20:03 that God made, and the one that works so dramatically.
20:06 - Yes and even though the insulin that we use may be from
20:10 an animal, or from another human, or something that
20:14 has been manufactured, it is still the very best one
20:18 that we can use for a person with diabetes.
20:21 I have a report here on caffeine and how it is linked to
20:25 poor pancreatic function.
20:27 With caffeine in anybody who is just having the
20:35 family background of an individual who is going to get
20:39 diabetes, they already have an appointment from their
20:42 family genetics.
20:44 Then if they take coffee, tea, or colas, or a lot of chocolate,
20:52 that increases the burden on the pancreas because
20:54 the pancreas does not work well in the presence
20:57 of caffeine and there are abnormalities in the blood sugar
21:01 that come about merely because of the caffeine.
21:04 This then can make it so that the individual is more likely
21:09 to develop diabetes, so we could say that taking
21:14 these caffeinated drinks increases the likelihood
21:18 of your getting diabetes.
21:20 What other things do you do when you instruct patients in
21:24 diabetes, and how do you treat it?
21:27 - I was wanting to say about that caffeine, about coffee,
21:29 there is a direct effect on the liver, where all this stored
21:33 glucose, in the form that is called glycogen is released
21:39 gradually between meals, well caffeine has a direct effect
21:44 to increase that process, especially when a person
21:49 takes it with his meals.
21:50 For instance a Continental Breakfast, where people take
21:53 something quite sweet which will shoot the blood sugar up,
21:55 and then they add in coffee, you are suddenly stimulating
21:59 that liver to put out a whole lot more sugar and you will
22:02 get an awfully high sugar level.
22:05 - Yes! Now diabetics have a lot of other problems,
22:08 they not only have high blood sugar, but sometimes they have
22:12 high blood cholesterol as well. Why is that Dr. Wynn?
22:16 - You know the whole process of arteriolosclerosis is really
22:22 accelerated in diabetes and I think with the overloaded
22:30 nutritional factors of blood which are sugar, you then can,
22:37 when there is excess there it will make
22:40 excess fats, and cholesterol is one of those.
22:42 In fact the other fat, the more common type of fat
22:45 that nutritionally is called triglycerides is often very high
22:48 in diabetics. - Umhum, yes triglycerides
22:51 are high, in fact triglycerides and sugar seem to go together
22:54 almost like twins, and gout is another part of that
23:00 whole metabolic mechanism.
23:04 Gout is a problem with the metabolism of the purines,
23:10 individuals who have gout will have a build up of uric acid,
23:14 which is the end product of purine metabolism and they then
23:18 began to get deposits of crystalline material in their
23:22 joints and this is also related to it, it's a double
23:26 first cousin to diabetes.
23:29 I know also that people who have diabetes have an elevated
23:34 homocysteine level, have you been involved in
23:39 treating people for homocysteine?
23:42 - I've done some watching of that, that's one of the new
23:46 factors that is very related to cholesterol.
23:48 - Yes, a good way to treat an elevated homocysteine
23:55 is by using vitamin B-12, and vitamin B-6,
24:00 and folic acid.
24:01 Now you will notice right away that folic acid is very
24:04 likely to be present is a vegetarian diet, so individuals
24:10 who are vegetarians, especially life long, they may not have
24:15 a lot of difficulty with the folic acid, but they may have
24:20 difficulty with the vitamin B-12 so they often will need
24:24 to have it administered to them in the form of a pill.
24:29 The sublingual pills are among the best of those that
24:34 can be used because they add the salivary factor and
24:38 that brings the homocysteine level down.
24:40 I think that people who have the kind of metabolic problem
24:45 that makes it so that they are going to have diabetes
24:50 should be aware that the homocysteine level can be
24:54 elevated and they should be checked for a high
24:58 homocysteine level because that can increase their
25:01 likelihood of getting a number of other diseases such as
25:04 Alzheimer's disease, and arteriolosclerosis, and cancer,
25:14 so that we find that elevated homocysteine in a number
25:18 of other chronic diseases.
25:19 What else would you like to tell us about diabetes?
25:22 - Well, I think you mentioned exercise.
25:25 - Yes! That's my favorite treatment, I think it's
25:29 the best one that we have.
25:31 - It's really a crucial part, you should not just deal with
25:35 diet, you really need to get the person exercising.
25:39 It has two advantages, first of all if you exercise
25:45 you are burning up the fuel, you are lowering that glucose
25:47 because you are using it.
25:48 But another major advantage is that exercise seems to have
25:54 a direct affect on the problem of the rusty lock,
25:57 it decreases insulin resistance so you are getting just what
26:01 you want. - Yes, with exercise and
26:05 the diabetic condition, of course they are burning up
26:10 sugar that will be removed from the blood.
26:15 Now sometimes we find that mothers before the birth
26:21 of a child will get a type of diabetes called
26:24 Gestational diabetes.
26:25 Gestational diabetes can have some extremely high blood sugar
26:30 levels and mothers who have this kind of diabetes are very
26:35 likely to give birth to a baby overweight.
26:39 The overweight baby may be 10 pounds or more and
26:45 these are post mature babies and they are at a disadvantage
26:49 in being born, and the mother who has Gestational diabetes
26:53 is also very likely to increase her risk of getting
26:58 adult onset type of diabetes, or Type II diabetes
27:02 in the future... What else do you have to tell us
27:06 about diabetes? Do you have some other
27:08 nice things, that is such a big subject.
27:10 - It really is, we've talked about fiber already,
27:13 I think that is a crucial element an you know that
27:16 really points us to what kind of diet one has to be in.
27:19 Animal products have no fiber in the nutritional sense
27:24 and all the plant products in the natural state have fiber
27:28 so a person needs to be on a vegetarian diet.
27:31 I want to mention one food that is especially helpful
27:34 for buffering that glucose from rushing in, and that is
27:37 beans, a wonderful food for diabetics.
27:40 - Yes! Beans also have a wide variety of other things
27:46 that are so protective, not only for diabetics but for
27:49 others as well.
27:50 Well I hope that this very brief discussion
27:53 of diabetes will be a great blessing to you as well.