Wonderfully Made

Diabetes

Three Angels Broadcasting Network

Program transcript

Participants: Timothy Howe and Sheryl McWilliams

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Series Code: WM

Program Code: WM000389


00:01 The following program presents principles
00:03 designed to promote good health and is not
00:04 intended to take the place of
00:06 personalized professional care.
00:08 The opinions and ideas expressed are those
00:10 of the speaker. Viewers are encouraged to
00:13 draw their own conclusions
00:14 about the information presented.
00:36 Hi and welcome to Wonderfully Made.
00:38 My name is Sheryl McWilliams and
00:39 I would like to introduce you to Dr. Timothy
00:41 Howe, who is our guest on the show today.
00:44 Welcome Dr. Howe. Thank you Sheryl.
00:45 It's a pleasure to be with you to speak about health.
00:48 We certainly are Wonderfully Made.
00:51 We are, I understand you are an internal medicine
00:54 specialist, a medical doctor and we are gonna
00:56 be talking about a topic today that is very near
00:59 and dear to my heart and that is diabetes.
01:02 I have numerous individuals in my family
01:04 who are diabetic and I need to learn as much
01:08 about this as it possibly can.
01:10 You know diabetes is really a wonderful
01:13 disease to have if you have to have a disease.
01:16 As William Osler once said the best way to live
01:19 a long time is to get a chronic disease and take
01:22 care of yourself and that's diabetes.
01:25 There is hope for diabetics.
01:27 Well good. Tell us about that hope.
01:28 Tell me, help me understand what diabetes really is.
01:32 Diabetes is a condition where you have too
01:34 much sugar in the blood. We need sugar in our
01:38 blood without it we die, but if you get too much
01:42 sugar in the blood you have
01:44 problems, lots of problems.
01:46 What makes the blood sugar go up?
01:49 There are two types of diabetes,
01:51 type I and type II. And the blood sugar
01:54 goes up for different reasons in each
01:57 type of diabetes. First of all, I have to
02:00 introduce another concept with diabetes.
02:03 There is another word and that word is insulin.
02:06 Because to understand diabetes, you have to
02:09 understand insulin. Insulin is like a key
02:14 in the door, insulin opens the door and allow
02:19 sugar to go from the blood stream into the cell.
02:24 Without insulin, you can't get sugar out of
02:28 the blood and into the cell. So you eat,
02:32 the food goes down and is digested, enters
02:35 the blood stream and then you got problems
02:38 because if you have no insulin you can't get
02:41 the sugar out of the blood stream and you die
02:44 of starvation because you don't get that sugar
02:47 in where you wanted. That's type I diabetes,
02:51 we used to say that's childhood onset diabetes,
02:54 but we don't call it childhood onset diabetes
02:57 anymore, we call it type I. Type II is a different
03:02 disease and yet it's really the same.
03:05 The difference is you have plenty of insulin
03:08 in fact in early type I diabetes or type II
03:13 diabetes, you have more insulin then normal
03:18 and you say well how can this be type I no insulin
03:21 and your sugar goes up. Type II more than normal
03:25 and your sugar still goes up.
03:26 Well, in type II diabetes the problem is you have
03:30 got the key but it doesn't fit in the lock.
03:34 It fits in but you have to turn in, turn in, turn in
03:37 and we call it insulin resistance, but it just
03:41 doesn't work and so you eat and the sugar is,
03:46 the food is digested and then the sugar is
03:49 absorbed into the blood stream but there is a
03:52 delay in getting it out of the blood stream
03:55 and as a result of that delay the sugar builds up
03:58 in the blood stream very similarly to type I
04:03 and you get all the same problems that you do
04:06 in type I and type II equally even though there
04:09 mechanisms are slightly different.
04:11 So, when you eat the food that you eat turns into
04:13 sugar and then insulin helps
04:16 this food to get into the blood cell.
04:18 That's correct, of course, the foods that we eat
04:22 are all different in how they are absorbed.
04:26 If you took a soda that had fructose and sucrose
04:31 or corn syrup that's a usual sweetener plus you
04:35 say you took sugar and it was in water, add some
04:38 coloring in it, we call it soda a little
04:41 fizz and you drank it down, like that okay,
04:45 that sugar is gonna hit your blood stream very,
04:47 very rapidly, where is if you had a potato and
04:53 you baked it and you ate it with the skin on
04:56 the sugar still going to enter into your blood
04:59 stream quite rapidly but not as rapidly as
05:03 if you had a soda. If you took that potato and
05:06 you mixed it with some broccoli and some whole
05:08 wheat bread and a few other things then the
05:11 sugar absorption into the blood is going
05:13 to be even slower and it allows the insulin
05:17 more time down stream to get the sugar out of the
05:20 blood and into the cell where it belongs.
05:23 You have mentioned insulin, so what exactly
05:26 is that, where does it come from?
05:28 Insulin comes from the pancreas, it's made in
05:33 the islet cells of the pancreas and it is made in
05:37 response to sugar in the blood.
05:41 The body senses the blood sugar level
05:45 and it makes insulin accordingly.
05:47 Okay interesting, you mentioned that if we
05:50 eat certain kinds of foods that it will slow down
05:54 the rate at which sugar enters the blood tell me
05:56 what it is about those foods, the broccoli and
05:59 the potato with the skin on that helps that process?
06:03 If you think of our foods as I mentioned if
06:06 you eat just pure sugar that sugar is absorbed
06:11 in your mouth, it's absorbed in your
06:13 stomach, it's absorbed in the small intestine
06:16 and it enters very quickly.
06:18 If you are a type I diabetic and you have
06:21 a very low blood sugar and you get very
06:24 lethargic and or having an insulin reaction,
06:28 you can put just sugar in the mouth and it will
06:32 bring them out of the slow blood sugar and it's
06:35 absorbed very rapidly, but if you eat broccoli
06:39 or if you took broccoli and put it in your mouth
06:41 it would take a very long time for them to get the
06:44 sugar out of it because you have to break the
06:46 broccoli down, you have to break down the fiber,
06:50 you have to separate it, you have to break down
06:52 the carbohydrate from complex carbohydrate
06:56 which is really it's sugar hooked together,
06:59 you have one sugar molecule and then
07:00 another and another and another in a
07:02 long chain that's called the starch and your body
07:06 has to break those off one at a time, it requires
07:09 a lot of work and then gradually it feeds that
07:12 sugar into your system and helps
07:15 keep the blood sugar normal.
07:17 So, whatever you are saying is we should
07:19 eat a lot of fiber because fiber
07:21 helps to keep our blood sugar down?
07:25 Fiber helps slow the absorption of sugar
07:29 from our foods into our bodies, yes.
07:32 Okay interesting. Most of the people in my
07:34 family who have they all have type II diabetes,
07:37 most of them are overweight.
07:39 What role does weight have in this process?
07:43 Well it's interesting, let me tell you a story, okay.
07:48 Let's pretend that you and your husband are on
07:52 a vacation and you decide this vacation we really
07:57 wanna live it up. We are gonna go to a
07:59 really fine hotel and so you go to a city
08:03 and you think well I wonder which hotel
08:06 will be the best hotel and you say well I think
08:09 probably a busy one will be the best hotel.
08:12 So, you go to the hotel and you look in there
08:16 people just going in and going in and you say
08:19 this must be a really good one.
08:21 So, you get out of your car and you enter in the
08:24 lobby and it's very busy. There are people
08:27 everywhere and as soon as you come in
08:29 you start looking around for one of the bellhops
08:31 to take your luggage and to go with you
08:34 and you check in and it's so busy, it take so
08:38 while to find a bellhop but then he gets hold
08:41 of you and takes your arm and takes your luggage
08:44 and the way you go you through the lobby,
08:46 it's a beautiful lobby, you can tell well this is
08:49 wonderful hotel, although it's very busy
08:52 and you go through the door and into the hallway
08:55 and in the hallway it's just jammed there,
08:58 bellhops everywhere and they are holding
09:00 on to peoples arms and you go down and
09:03 he say let me see how your room is, oh yes
09:05 here it is, and so you knock on the door and
09:10 he knocks there and he say why you are knocking
09:12 and he said well, I just want to make sure that
09:15 no one is in the room. You say, well isn't this
09:17 our room and he say but we have to make sure
09:19 in this hotel, we are very busy.
09:21 So he knocks on the door and he starts to open it
09:24 and he can't get it open and he said sometimes
09:27 I really have to push hard on these doors,
09:29 so he puts his shoulder there and he gives a
09:31 mighty push and lone behold there is someone
09:34 behind the door, trying to hold it shut and the
09:38 person in the room says look you have already
09:41 interrupted my sleep twice tonight,
09:43 we only have two beds, yes they are double beds
09:45 but we already have four people and we are
09:47 not gonna have anymore. I just won't have it, okay.
09:52 And you say my, this is a strange hotel.
09:56 You know, that's really what
09:57 the problem is in type II diabetes.
10:01 You coming in are sugar.
10:04 The hallway is your blood vessel.
10:07 The room is the cell and in type-II diabetes
10:11 the problem is not with insulin.
10:14 He is doing his job the best he can.
10:16 The problem is with the management,
10:19 they have double booked every room,
10:22 and you go down to the cell and pour insulin,
10:24 he's got your stuff and he is trying his best to
10:27 get the door open and shut it back but there is
10:30 already too much sugar in that cell or too much fat
10:33 or too much calories in the cell and so he is
10:36 having a hard time opening the door and
10:40 there is the bottom line problem
10:41 with type-II diabetes. We often portray it as
10:45 insulin resistance. Well, it is true that
10:49 insulin, the Bellhop, who took you down the
10:52 hall to the room has a hard time getting the
10:56 door open, but it's not because he's not trying
10:59 to do his job, it's because down in the
11:04 lobby they've double booked everything,
11:07 that is they have eaten too much for too long
11:11 and you can, you can reverse type-II diabetes
11:14 if you get it early enough with careful diet,
11:19 restricting the amount of a gassed sugar calories
11:25 that you take, also restricting the times
11:29 when you take it, those poor bellhops you know
11:32 there is check in and a check out time at most
11:34 hotels, well at this hotel that you went to they
11:37 are accepting people around the clock instead
11:40 of having regular times for guest to
11:42 check in and check out. Like eating we should eat
11:45 regularly and we should eat the right amount so
11:49 that we can fill the rooms. Now let's take this
11:51 illustration a little longer, little further,
11:54 you know what the problem is with the
11:55 diabetes really? The problem is the sugar
12:00 in the blood, where it builds up, it is really
12:04 hard on the blood vessels, you know let's go
12:09 go back to the illustration. There you are with the
12:11 Bellhop and you're starting down the
12:14 hallway, and as you enter that hallway
12:19 there is sugar everywhere, and bellhops everywhere,
12:23 what's the hallway gonna look like?
12:25 It's gonna be crowded. It's gonna to be crowded.
12:28 It's gonna to be a mess and furthermore,
12:30 you know what insulin doesn't just
12:32 put sugar into cells. Insulin does a lot of
12:36 other things just like a Bellhop would.
12:38 Insulin says to the management, look we've
12:42 got so many people in this hotel, we need to
12:46 build some more rooms, insulin is a growth factor
12:50 and it signals back to management,
12:52 hey we need to build some more rooms.
12:55 We need to increase this, so the Bellhop takes
12:59 sugar down to the cell but he also says alright
13:02 let's start construction, so not only are you in
13:04 that hallway with all your sugar friends,
13:07 and not so good friends in this case,
13:10 you're having wheelbarrows going
13:12 down the hallway full of cholesterol,
13:14 because cholesterol is a basic building
13:16 block of all cell walls, all hotel rooms okay.
13:21 So let's going down there, and you've got
13:23 that whole hallway jammed up and pretty
13:25 soon the cockpits warren and sugar
13:28 it doesn't always get into the cell where it belongs,
13:31 it gets changed and folded into closets and
13:34 everywhere else and we got a mess and what we
13:37 really need to do to this poor hotel is we need to
13:42 stop, just stop for a minute, stop accepting
13:45 guests for a while and allow repair to take place.
13:50 Often times if we just take people and we say to
13:53 them alright cut back on the amount of food you're
13:55 eating or try two meals a day at regular times,
14:00 so if it's your time to clean up in between
14:03 that will take care of the problem.
14:05 Another thing that's helpful if you've ever
14:07 been to a hotel where there is a demanding
14:09 person, I want my room right now,
14:12 oh yes, get rid of those. You know you want
14:15 people to come in. They say no problem.
14:17 I've got time. That's like our high fiber foods,
14:21 no problem there is time. You drink a soda,
14:24 it's, I want to be in there right now and in they
14:27 go and poor bellhop has to work to get him to the
14:30 room right away and we got problems, and that's
14:33 really what happens with our body is we feed at
14:37 the wrong kind of food, quick sugar boom,
14:41 and then the insulin has to work really hard,
14:43 really fast to get into the cell or we overeat
14:47 even if good foods at a wrong times, you know
14:51 you might have heard of the stuff called grazing.
14:55 They say oh we need to graze.
14:57 We need to graze to lose weight,
14:59 and eat a little bit all the time.
15:00 Like the little sheep,
15:01 chewing all day long. That's right. It's really
15:03 good to do that if you are a cow.
15:05 If you got three stomachs, but you know what cows do?
15:10 They regurgitate and chew their cud and you
15:13 know, I don't know they gonna do that, you know
15:14 Sheryl if you eat all day long you are gonna
15:18 regurgitate too. You have that acid reflux
15:21 and acid reflux is epidemic for that same reason.
15:25 It's all from this problem eating too much,
15:28 eating demanding food, I want results right now
15:34 that's it quick sugar and it's also from eating at
15:39 irregular times instead of eating you know just
15:42 on time three meals a day or for type-II diabetics,
15:46 not type I, type II diabetics especially
15:50 if they are not already on medicine for it,
15:52 if they are on medicine, you gonna be careful.
15:54 But if you are not on medicine, or if they
15:56 have early type II diabetes two meals a day,
15:59 gives time for repair, gives pancreas time to
16:03 build up insulin for the next on-slot of the gas.
16:07 Interesting, so insulin is a growth
16:10 hormone and it doesn't necessarily
16:12 cause us to grow up, but rather out.
16:15 Oh, you know, insulin does when we are small,
16:18 it helps us grow up, but it causes a lot of problems
16:22 when we are big. You know, I say to my
16:24 male patients, I say you know you can tell
16:27 whether your insulin levels are too high or not.
16:29 All you have to do is look down and see if you can
16:33 see, oh there it is, see if you can see
16:35 your belt buckle. If you can't see your
16:38 belt buckle your insulin level is too high because
16:41 insulin puts that weight right around your middle.
16:44 Now with woman that's not always, you know,
16:47 helpful because they have other things between
16:49 their belt and their chin and we men do, they get
16:53 in the way, but the way women can do it is,
16:55 if they want, you want to have your hips bigger
16:59 than your waist and if your waist is bigger
17:01 than your hips you are in trouble.
17:03 You have got too high in insulin level.
17:05 Now some of that maybe genetic, but most of
17:08 it can be controlled by how
17:10 we eat and what we eat.
17:12 What role does physical activity play?
17:15 Physical activity is an interesting thing.
17:17 If you think of what we were really doing with
17:21 sugar, when you put it into the cell the only way
17:24 really to get it out is to burn it.
17:27 Now Unfortunately, when you go to the hotel they
17:29 don't burn you up to make room for the next guest,
17:32 but in your body when you put energy whether
17:35 it's fat or sugar into the cell, the only way to get
17:39 rid of it is to use it and so either you got to eat less
17:43 than you want to or you have got to
17:45 get out and exercise. It's interesting.
17:48 Insulin works better after exercise.
17:51 Best thing that you can do after you eat is to
17:54 have a little light exercise.
17:57 If you want to eat more fine burn more,
18:01 you can take that too far, I mean you can be
18:03 running 24 hours a day, and you know,
18:07 and push it too far, but most of us don't have
18:09 to worry about over exercise.
18:11 We need to exercise on average about 30-60
18:16 minutes everyday or at least six days a week
18:20 and if we do that our insulin works better why?
18:23 Because when it goes knocking on the cells
18:26 doors the cell says, yeah come right in and
18:29 bring that sugar, I want to burn it rather than
18:32 not here, I don't want anymore you forget
18:35 it and that's what happens in type II diabetes.
18:38 Insulin resistance is really a management problem.
18:42 It's right here and right here, it's not down
18:44 in our pancreas. The poor old pancreas
18:47 in type II initially type II
18:49 A we call it makes plenty of insulin,
18:52 but after a while it gets tired and it says
18:56 oh, I'm making all these insulin molecules
19:01 and they keep calling for more and it gets
19:04 tired and it stops making enough insulin
19:08 and then often even in type II diabetes
19:11 you need to add insulin to keep the sugar normal.
19:15 Now as I tell my patients, I say you don't
19:17 have to do what I want you to.
19:20 If you want to stay fat, you want to eat the
19:22 wrong food that's fine, I've got enough pills
19:25 and enough insulin to keep your sugar
19:26 normal if you will just do it.
19:29 But that isn't the best way, the best way
19:33 is to give your pancreas a break poor thing so
19:36 overworked, working it day and night,
19:39 you know all the time. So, what would a
19:42 person like myself with a strong family
19:45 history of diabetes, what would I need to do in
19:48 order to avoid developing that particular disease?
19:51 Well unfortunately as you have said, diabetes
19:55 is genetic to some extent and I always
19:58 tell my patients. I say the most important
20:01 thing for you to do is choose your
20:02 parents carefully. That's number one. You know.
20:06 I will work on that, that's the point.
20:08 But you know its interesting I say that
20:11 but if you look back at the last 20 years in America,
20:16 the last 30 years, obesity rates have just been sky
20:20 rocketing, they just been going way up.
20:23 And right behind it its diabetes.
20:27 Now, you can't tell me that the genetics have
20:29 changed in this country markedly
20:31 in the last 30 years.
20:33 It doesn't happen that rapidly.
20:36 What's happening we all started gaining weight,
20:39 we are eating differently then we ever have,
20:41 we are eating more sugar, we are eating more
20:44 saturated fat and saturated fat also is hard on the
20:48 pancreas and makes it difficult for the islet
20:51 cells to make insulin, so a more saturated fat
20:55 were grazing all the time. We don't sit down and
20:58 have a meal like we should and we are not
21:01 following that good information that the Lord
21:03 gave us many years ago, two meals a day for
21:07 almost to everyone, not everyone but certainly
21:09 if you have a family history of diabetes
21:12 two meals a day, your body is best ready for
21:16 sugar, for calories in the morning don't skip
21:20 breakfast whatever you do if you have that
21:22 history of diabetes get up and eat your breakfast
21:26 and then a good meal in noon or at early afternoon
21:30 and then let give that whole body time to clean
21:33 the hotel and get things all set up because if you
21:36 don't, you gonna corrupt the arteries.
21:39 Now here is the problem with diabetes.
21:42 I can tell you all the big complications
21:45 and here they are. Diabetes is the number
21:47 one cause in this country today of amputations,
21:51 cutting off your legs. It's the number one
21:54 cause of blindness. It's the number one
21:57 cause of kidney failure. It's the, you have a
22:00 markedly increased risk for a heart attack
22:03 with diabetes and you have a markedly
22:06 increased risk of stroke. Those are all blood vessel
22:09 diseases; you think back to the poor old hotel with
22:13 the arteries, the hallways all jammed up.
22:17 You want to have nice clean arteries and the
22:20 best way to do that is to normalize your blood
22:23 sugar through proper eating.
22:26 Now if you not gonna do that I have got all
22:29 kinds of pills I can give you.
22:30 You won't feel well long but I have got
22:32 you know I, the drug companies are out
22:35 there making them faster then I keep up with them.
22:37 We've just had about three or four new ones
22:40 for type II diabetes this year.
22:42 And there are wonderful medicines if you can't
22:45 get the management to obey you.
22:47 You know, but talk to the management,
22:49 slow down that sugar absorption
22:50 you do really well. So, for an individual
22:54 who already has diabetes what I hear you are
22:57 saying is that it is possible to, through
23:01 lifestyle through what we choose to eat,
23:04 how you chose to move in terms of physical
23:06 activity to manage our blood sugar.
23:09 Let's take a look at type I diabetes first.
23:12 Type I diabetes, I can't make the
23:15 pancreas come back. Now there is some
23:17 evidence in type I. If you have it in your
23:19 family, and you don't want to pass it on to
23:22 your children, don't have them drink any
23:27 milk or milk products for the first two years
23:30 of life because its there is an autoimmune
23:32 process there. Is this cow's milk or
23:34 kind of milk? Cow's milk, cow's milk.
23:36 Its very interesting but that's number one if
23:40 you have type I in your family and you don't
23:42 wanted to go on, momma's milk only for
23:47 the first year and don't introduce cows milk for
23:50 at least two years or any you know yogurt
23:52 or cheese or anything else, just leave it out
23:56 and that will markedly reduce the risk of
23:58 developing type I, type II if you have it think
24:03 about the illustration. Give time for your
24:07 body to assimilate that food and don't eat
24:10 a calorie you are not planning on burning,
24:13 because you know if you pack on that
24:15 weight for tomorrow and the next day and
24:18 a next day think of insulin and what he
24:20 is doing and what he has to do to get that
24:23 sugar out of the blood and into the cell and the
24:26 cell in need it. And if you eat food that's
24:30 high in fiber, and you stay away from refine
24:34 carbohydrates and you have two meals a day
24:38 and you exercise regularly,
24:42 much of the time you can reverse diabetes
24:44 and I can tell you even its late, even if you've
24:48 had diabetes a long time you can reduce the
24:51 amount of medicine that you are taking
24:53 in every case you can. If you are on insulin
24:57 you can reduce the amount of insulin you are taking,
25:01 but you know the important thing to
25:03 remember is if you don't, you don't have
25:05 any another change, don't worry because if
25:08 you are willing to check your sugar regularly
25:11 and follow your sugar and keep it as
25:14 normal as possible. If you keep your
25:17 blood pressure normal and you keep your
25:23 cholesterol down, normal and even
25:26 below if you have diabetes, you can live
25:30 with diabetes for a very long time and live well.
25:33 Diabetes is not a death now, it isn't.
25:38 It is reversible, it is preventable,
25:40 but if you not gonna go that way it's still every
25:44 treatable and it should be treated and it should
25:48 be treated well, you know. So, we can live well
25:51 with diabetes by, you can, by eating well.
25:54 Yes, you mentioned eating foods that are
25:56 reach in fiber to help release the blood sugar,
26:01 the sugar into the blood more slowly.
26:03 You mentioned not grazing, not eating
26:06 lots of meals and there is fair bit of
26:08 controversy out there. There are those who
26:09 promote eating many small meals but what
26:11 I hear you saying is two meals, three meals at
26:14 the most, through physical activity
26:18 and through managing, making sure that our
26:21 blood sugar is within normal ranges and
26:23 our blood pressure and that's sort of thing,
26:26 what other words of wisdom would you
26:27 share for those who either want to control
26:30 their diabetes or who want to prevent diabetes.
26:33 Well, let's just go over the A, B, C's of
26:35 diabetes, and I really touched on.
26:37 The first one we say A1C, that's hemoglobin A1C.
26:42 That is the measure of how your sugar has
26:44 been on average for the last three months,
26:48 and every diabetic should know their
26:50 hemoglobin A1C. No question about it.
26:53 If you don't know it, call your doctor,
26:55 if he doesn't know it go in and say I want one.
26:59 Your hemoglobin A1C should be six and half
27:03 or less, why? Because for every one point,
27:08 it's over four your risk of having heart attack
27:11 goes up, and it goes up 20 percent.
27:15 So number one, you want you're A1C under
27:18 six and half. Number two you want your
27:20 blood pressure at 120/80 or less.
27:24 That's what you want it, 120/80 or less,
27:28 and number three you want your LDL
27:30 cholesterol, that LDL cholesterol,
27:34 you want that under 100, probably down
27:39 in the 80's. If you do those things
27:42 your diabetes is gonna be in good control
27:45 even if you don't want to do what I tell you
27:46 to do with diet and exercise.
27:48 So it's oblivious to me that we really are
27:51 fearfully and wonderfully made.
27:54 What I learned today was that if you have
27:57 diabetes or like me, in case of, you know
28:00 you want to prevent it that there are things
28:01 that we can do through what we chose to eat,
28:04 how you chose to live. Doctor Howe
28:05 I would like to thank you for
28:06 joining us today and thank you guests.


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Revised 2014-12-17