Participants: Lee Wellard & Dr. Scott Grivas
Series Code: WM
Program Code: WM000421
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00:01 The following program presents principles
00:03 designed to promote good health 00:04 and is not intended to take the place 00:06 of personalized professional care. 00:08 The opinions and ideas expressed 00:10 are those of the speaker. 00:11 Viewers are encouraged to draw their own 00:13 conclusions about the information presented. 00:36 Welcome to Wonderfully Made, 00:38 your host for today is Lee Wellard, 00:40 a lifestyle educator from Wildwood Lifestyle Center. 00:44 And today we have on the set Dr. Scott Grivas, 00:48 thank you for joining us today. Thank you. 00:50 We are going to be looking at a very 00:52 important topic today, one that is, 00:54 one of the most fastest growing debilitating 00:57 conditions in our world today, 00:59 we are going to looking at diabetes, 01:00 but in the contest of the good news of diabetes. 01:04 Dr. Grivas let's just start the program 01:07 by finding out how prevalent is diabetes, 01:10 is it something that's on the decrease? 01:13 What is it today? 01:15 I wish I could say that it is Lee, 01:17 but unfortunately no, diabetes is increasing 01:21 almost daily. I think the last estimate that 01:24 I read was probably close to 24 million Americans 01:29 are afflicted with this disease. 01:31 And also it is occurring in younger ages now, 01:36 even in children. Now tell us what are some 01:39 of the signs and symptoms of diabetes? 01:44 It can vary some actually have very little 01:49 in the way of presenting symptoms. 01:52 But, others may represent excessive thirst, 01:58 increased urination, sometimes weight 02:02 loss actually. Because of an ability 02:06 to metabolize carbohydrates, fatigue, 02:12 just general debility and weakness. 02:14 Now, there are millions of Americans 02:16 I believe that have diabetes but not even 02:19 aware that they have this problem. 02:22 How can these people identify that 02:26 they do have a problem, or do they often just wait 02:28 too long before they do something about it? 02:31 You know if you're not feeling bad you don't 02:34 usually go for checkups that's the tendency. 02:38 But, yes by simply going to your physician 02:42 or to a health clinic and having your 02:45 blood sugar checked. You can pretty much 02:48 tell whether or not you have 02:50 problems with glucose metabolism. 02:52 Right, lets just talk about glucose for a minute, 02:55 what is considered a diabetic range 02:58 when we're talking of blood sugar levels? 03:00 For fasting levels of blood glucose over 125 03:06 would be considered in the diabetic range. 03:09 Pre-diabetes probably some where 03:11 between a 100 and 125 in a fasting state 03:15 Now, when we're talking about pre-diabetes 03:17 we are talking about not full blown, 03:19 we're not there yet but we're actually on our way, 03:22 exactly. So, that can be just as dangerous 03:27 so to speak then someone who maybe 03:30 is on the low side of diabetic but they, 03:34 they're not even aware that 03:35 they have that problem. It shows you, 03:37 you're on the wrong path, and you need 03:40 to make some lifestyle changes. 03:42 Right and as sugar levels change from time to time, 03:45 so we may have a high blood sugar level at 03:51 one point but then it may not necessitate 03:54 that in fact we have diabetes but at the same 03:57 time it could mean that you know we are well 04:00 on the way to developing a lot of the complications 04:03 that diabetics have, sure. Now let's talk 04:06 about some of the complications. 04:09 What are the most serious complications 04:11 that diabetics face today? 04:14 Well, there are two class of complications 04:16 for the diabetic, we call them macrovascular 04:22 and microvascular because most of the 04:24 damage occurs in the vessels, 04:27 the large vessel complications, 04:31 we lump together as heart attacks, strokes, 04:36 peripheral vascular disease involving 04:39 the extremities that often end in 04:42 gangrenous limbs, amputations etcetera. 04:46 The microvascular complications would be 04:51 problems with the eyes. We call it retinopathy, 04:56 an involvement of the small vessels of the eye. 04:59 The small vessels that go into the kidney 05:02 that result in the term is nephropathy 05:06 or kidney insufficiency. And this leads to a very, 05:11 very high incidence of end stage renal failure 05:15 and dialysis complications. The other would be 05:19 neuropathy, the small vessels that 05:22 carry blood to the nerves. 05:25 They're impaired and so you start to get ischemic 05:28 or a lack of blood changes to those nerves 05:32 and they begin to malfunction, 05:36 results in pain, discomfiture in the 05:39 legs and feet. A feeling of burnings, 05:42 sometimes numbness, just discomfort. 05:48 Now, let's get to the, the cause of the problem 05:50 we've seen diabetes dramatically increase 05:53 especially around the mid 1990s. 05:57 What do you believe is the cause 05:59 or the causes of this problem? 06:03 Well, you know we used to think that diabetes 06:05 was a sugar disease, right. 06:08 But, as our understating has increased 06:12 we understand that's really not the case, 06:14 the complication is rising blood sugar. 06:18 But, basically leads it's too many calories 06:22 too much fat in the diet especially animal fats. 06:26 And as people get larger and larger, 06:29 they develop more resistance to their 06:32 indigenous production of insulin, and so you can't 06:35 get glucose into the cell and so the cell then 06:40 it starts from its fuel source but the 06:44 blood sugar begins to raise in 06:47 the blood circulation and this is what is 06:52 very damaging, right to the vessels. 06:54 Now I understand that not all fats are 06:56 created equal, so when we talking about fats 06:58 what particular fats that we're really taking about? 07:01 Primarily the animal fats, cholesterol saturated 07:06 fats that we find that Americans are consuming 07:10 in such a large quantities today. 07:12 Right, right and what you believe has contributed 07:16 to us consuming more of these fats? 07:19 Well, we now have an increase in the fast foods 07:26 that are being offered to people 07:29 as a food substitute. And we've also gone step away 07:35 from ingesting our food in the most natural way, 07:39 we're processing, we are adding things to our 07:43 foods and so forth. So, it is not just as the Lord 07:46 originally gave us, right. We have a lot of 07:49 added sugars, a lot of added fats 07:52 and so forth animal fats. 07:53 It was interesting to me when I came across 07:56 some research about the island of Crete in Greece 07:59 that they have 40 percent of their calories 08:02 from fat and yet they have one of the lowest 08:05 incidence of heart disease in the world 08:06 simply because of the type of fat that they were 08:09 using was predominantly plant-based, yes such as 08:12 the olive and so this can be more of a protective 08:15 role rather than getting these other types 08:18 of denatured fats in more of a process form. 08:21 Sure, now let's talk for a minute about some 08:26 of the medications that people are on, 08:31 it's predominately insulin or metformin. 08:35 What are some of the complications that could 08:37 arise with people using these for long term? 08:42 Well, earlier on when we first began using 08:46 the oral glucose agents, we found studies 08:51 showing that there was actually an increase, 08:53 a raise in the cardiovascular 08:55 complications with diabetes. 08:57 And increased deaths, we are still though primarily 09:01 using agents that are like the Sulfonylurea drugs 09:07 that actually help to stimulate insulin release 09:14 and secretion by the pancreas. 09:16 We now have those that are called insulin 09:19 sensitizers that try to help with decreasing 09:23 the insulin resistance at a cellular level. 09:27 We do have new agents, 09:29 now we've got they what are they call 09:31 the incretins, which are to, they're given by 09:34 injection to help stimulate insulin secretion 09:39 via hormonal pathways in the digestive system. 09:42 Anyway we have insulin. 09:44 We've got other agents that help to retard 09:47 the breakdown of carbohydrates 09:50 in the GI tract, but with all of those agents 09:57 especially the drug agents. 09:59 Not so much the insulin, there is a raising 10:02 incidents of side-effects from changing in changes 10:07 in electrolyte, balance in the blood, nausea, 10:17 GI tract, disturbances like diarrhea with some 10:22 of these agents. Metformin a very common agent now, 10:27 one of the biggest problems there is the 10:30 incidence of what we call like lactic acidosis. 10:35 So, we have to be very careful that 10:37 these people are warned when they are on 10:39 this medication. If they get like a febrile illness, 10:43 if they become sick in anyway if they take 10:46 contrast media, that these patients have to be 10:49 taken off these mediations ahead 10:52 or during the time their illness that they don't 10:55 proceed into this very critical acidosis state 10:59 where people actually can lose their lives. 11:01 Right, and we know that diabetes is a very serious 11:05 disease because of the complications 11:07 and 80 percent of people who have diabetes 11:11 are dying from heart disease. 11:13 Why do we see such a high prevalence of 11:16 heart disease been associated with diabetes? 11:20 Well, with insulin resistance which 11:23 takes place in the diabetic you get a lot 11:26 of changes Lee, that takes place in the 11:30 actual a blood parameters. 11:32 There is raise in fibrinogen levels 11:35 which is a protein precursor to form 11:39 clots in the blood. We have a problem with 11:44 increase inflammatory changes in the walls 11:47 of the vessels with insulin resistance, 11:49 we can measure with this by such parameters 11:52 in the blood is CRP, C-reactive protein. 11:57 So, there is an inflammatory damage 12:01 done with increase in free-radicals 12:04 in the diabetic. This is all changing the 12:07 normal blood flow and blood supply. 12:10 You're building up now plaque in the walls 12:14 of the vessels, there is a raise in 12:16 cholesterol synthesis, a raise in LDL cholesterol 12:20 in the diabetic. A lowering of 12:22 HDL the good cholesterol and all of these things 12:26 are contributing to a impairment of blood 12:32 supply to the organs. And for the heart 12:36 or to the brain that results in the coronary 12:40 artery disease, the carotid artery disease 12:44 which leads to stroke and so forth. 12:46 Would you say that the biggest factor 12:50 of causing diabetes would be one's diet. 12:53 It is, yes probably one of the biggest, 12:56 now there are certainly we have to recognize 13:00 genetic vulnerabilities. Diabetes does have 13:05 certain clustering according to that 13:07 genetic background. But, given the wrong 13:12 lifestyle with that genetic pre-disposition 13:16 then that's where you get into trouble. 13:18 Right, so you're saying that genetics really 13:21 low again the lifestyle pulls the trigger, 13:24 and in your experience you've been a physician 13:27 for many years. You've had a lot of people 13:29 come through Wildwood and had treatment 13:32 as a diabetic, in fact I believe diabetes 13:34 is one of most common things that we're dealing 13:37 with on a day to day basis. How successful 13:40 have you seen people change especially 13:44 with the sugar level once they make these changes. 13:46 Yeah, some change quite quickly 13:50 and dramatically. I remember one individual 13:53 that came to us he was on over a 100 units 13:57 of insulin a day. And we worked with him, 14:02 changing the lifestyle parameters, the diet, 14:05 getting more exercise, weight reduction 14:08 and within a three week period Lee, 14:10 he was off of all insulin with normal blood sugars. 14:14 And I wish I could tell you that was end 14:16 of the story, but he went home 14:19 and he thought I'm doing so well, 14:22 I'll just go back and start having a little bit 14:25 of the other type of lifestyle and within 14:28 some months he was right back again 14:31 in our center again on the same amount of insulin. 14:35 But, the Lord is good and very patient with us 14:38 and again we worked with him 14:39 and the same thing happened. 14:41 He came off of his insulin. He had normal glucose 14:44 levels and he was very, very thankful, amen. 14:47 When he went home I'm hoping that 14:48 he continued to stay with the program, 14:51 praise the Lord. Others may not always have 14:54 that dramatic change and I would want to 14:59 encourage anyone who has diabetes 15:02 not to be disappointed. If at first, you're not 15:05 seeing those kinds of changes because 15:08 you know nature's way of healing are gradual, 15:13 right, these processes and even though 15:16 the Lord is orchestrating all of this. 15:18 We didn't get sick over night, right 15:21 and may not be that overnight we are seeing 15:23 everything just coming back to normal. 15:25 But, for those people who will persevere 15:28 with a good lifestyle change program, 15:31 it's not a question of if there is gonna be 15:34 improvement we know there will be, right. 15:36 It's just giving the Lord time to work 15:39 in these bodies. Right, and it seems the ones 15:41 that are, that are further off the path 15:44 they were on a terrible program that 15:45 seem to do better, as they make some 15:48 of those changes, I remember we were at 15:50 the Kansas city doing a program 15:53 and we had a gentlemen that came in, and I call 15:55 him a walking time bomb, you could hear 15:58 him come in, you could hear him labor, 15:59 every breath he took you could hear. 16:03 And he had so much medicine with him, 16:05 he used to carry around a bag of medicine, 16:07 you can make breakfast cereal out of all 16:09 these medicines. I mean he would take two hours 16:11 just to put his medications in the 16:14 right order, yeah. And I was afraid to tell 16:19 him of some lifestyle changes because 16:21 I felt well if he changes too rapidly he could 16:25 brought them out, and he could go into a coma. 16:28 And anyway we worked with this gentleman 16:31 and in just five days, he went from 202 units 16:37 of insulin that was a minimum he took, 16:39 202 to 225 plus 2000 mg of metformin. 16:44 He was off 200 units in just five days, 16:47 and it was astounding to me just chaining 16:50 his diet alone, he wasn't even 16:52 up to exercising yet. But, it was amazing to see 16:55 that and so for those who maybe on a good 17:00 program already you may not see as much 17:02 change but if you keep persisting God surely 17:05 will bless and I think that's a message 17:07 we want to get through. 17:09 What is the danger of leaving things too long, 17:12 you know often we get people come into the 17:14 lifestyle center, they've already been have 17:17 warning after warning and they've just kept 17:19 pushing themselves and nature has given 17:23 away what are some of the dangers of leaving 17:26 things too late from a blood sugar perspective? 17:30 Well, the more damage that you accrue over 17:34 the years then the harder it is to 17:36 see that reversal. And for the diabetic like 17:40 let's take the type II diabetic, 17:43 their primary problem initially is insulin 17:46 resistance now they may have a little bit 17:48 of beta cell abnormality, that's the cells that 17:51 produce the insulin in the pancreas. 17:54 They may have a little dysfunction, 17:55 but the longer that this process of insulin 17:59 resistance goes on and the blood sugars 18:03 are remaining higher there is an element 18:06 of glucose toxicity that ends up in damaging 18:10 even the pancreas, right. So, that there is last 18:14 production of insulin, so now you've got two 18:17 major problems you see, not just insulin 18:19 resistance but now you've got lower 18:22 levels of insulin. And so we have to caution 18:28 people that the earlier you can intervene 18:31 in these abnormal metabolic processes. 18:36 The easier it is to see return to normal, 18:40 yes, the Lord can do anything right? Amen, 18:43 and He can reverse even those individuals 18:46 that are way far advanced, if that's well, 18:49 but we don't wanna attempt the Lord. 18:51 We want to try to do everything 18:53 we can as early as we can to prevent 18:56 further damage in the body. 18:58 And I believe the studies are showing 19:01 that the average person that is getting 19:05 diagnosed as a diabetic has already wiped out 19:09 a half of the beta cell function that make the 19:13 insulin to help control the blood sugar. 19:15 So, it pays to get it early, amen. 19:19 Let's talk a little bit about some of the 19:22 common misunderstandings of diabetes you know often 19:25 we hear about that, we shouldn't have fruit 19:28 in our diet, as a diabetic 19:30 could you maybe elaborate a little one that? 19:34 well the concern is in the diabetic 19:38 is the fat, we've talked about that, 19:41 but also the simple sugars, free sugars 19:44 we call them. That are not complex as the 19:48 Lord has made them with fiber 19:50 and other plant material. Fruits, yes, 19:54 a diabetic has to be careful with, 19:56 you can't eat too much, but fruits are so good. 20:00 They have so many antioxidants, 20:02 so many vitamins and the diabetic needs those. 20:05 So, we don't limit the use of fruits and say, 20:11 a diabetic should never have fruits. 20:13 We have to fat rate into their carbohydrate plan. 20:16 But, the main areas that we want the diabetic 20:19 to avoid are those simple sugars. 20:22 That are often added to processed foods 20:25 that are in the confectioneries, 20:28 the baked items, the pies you now the cakes, 20:31 the cookies those kinds of things. 20:34 But, complex carbohydrates that 20:37 is the sugars that are the complexed with the fiber 20:40 and other plant material. The diabetic needs 20:44 those and we encourage those. 20:45 And it's important to have that fiber in the fruit, 20:49 it help time release the sugar into the cell. 20:53 You know some diabetes like to use juicing, 20:57 is that any problem to the sugar levels? 21:00 Well, very definitely because when you juice 21:03 unless you have that fiber, if you're juicing 21:06 and you're removing all that fiber then you've 21:08 got a liquid medium with glucose that would 21:10 just go directly into the blood system, 21:14 the stream and raise your blood sugar 21:17 to higher levels after ingestion. 21:20 So, we don't encourage juices for the diabetic. 21:23 Right, now why would we often put even 21:27 diabetics on a two meal a day program. 21:30 You know some people will be quite concerned 21:32 about that, we often here about having 21:34 five or six meals a day, it's very common 21:37 knowledge that people need to be on this 21:41 program so they don't burn them out 21:43 and that's often the concern of the physician. 21:46 Can people last on a two meal a day program, 21:49 is that best for even the sugar 21:52 level of the diabetic? By all means two meals 21:55 are better then three especially for those 21:57 who are over their ideal weight. 22:00 What we have to make certain though is that 22:03 when we do that we are cutting back 22:06 on their medications. Whether it's the drugs 22:09 or the insulin or whatever we're giving, 22:12 and this is where it's very necessary for 22:15 a person who is making these changes 22:17 to be under some medical surveillance. 22:21 So, that we can adjust the medication appropriate 22:26 to their dietary intake, sometimes we almost 22:31 fall into this category of chasing the food intake 22:36 with the medicines by the insulin you see, right. 22:39 But, if you will cut that back then you can also 22:42 then cut back on the amount of food consumed 22:46 and if it is primarily plant-based you've 22:49 gotten a lot more fiber it's lower in calories 22:52 and the diabetic then can lose weight better, 22:56 which is the primary problem you remember 22:59 the increased weight has contributed 23:01 to the insulin resistance. So, you're helping them 23:03 to lose weight as well as controlling 23:07 the blood sugar. I think it's important to also 23:10 keep in mind that if you do go low that don't 23:14 starve yourself either, if you need something 23:17 to pickup your sugar level temporally to get 23:19 you back on track, sure. Now someone that's 23:22 looking at this from home they maybe 23:24 wondering how do I get on this program 23:27 you know they may desire to get off some 23:30 of the medication as they make some of 23:31 these lifestyle changes, how do you as physician 23:35 know when it safe to transition people from 23:41 you know medication on to you know to reduce 23:44 that and to be able to have confidence 23:47 so they able to continue on a safe program. 23:52 Well, first of all Lee would suggest that 23:55 no diabetic that's on a treatment plan change 24:01 that plan without first consulting 24:03 with their physicians, amen. So, that the 24:05 physician knows exactly what this person is doing, 24:08 even in dietary changes. What I also though 24:13 might recommend is that for those who lets say 24:18 can't find that's support system in a home place, 24:24 that coming to a lifestyle center where physicians 24:28 who are well trained in lifestyle medicine 24:31 can address these patients and their needs 24:33 individually entailer a plan from the 24:36 nutritional aspect, exercise, you know all of 24:41 these lifestyle changes with a gradual reduction 24:45 in medications while we maybe also adding 24:49 some other natural agents that may 24:53 help with the blood sugar control. 24:55 So, when people come to lifestyle center 24:58 such as Wildwood we don't just immediately 25:00 cut them off, definitely, the medication but 25:03 we're trying to make lifestyle changes 25:05 while we're reducing some of these medication. 25:08 As we see improvement taking place in individual, 25:11 sure. Now let's talk for a moment for about 25:13 the spiritual motivation of a diabetic 25:18 and this would go for every condition. 25:21 Well, how important do you see the spiritual 25:24 component in making changes to one's lifestyle? 25:29 I see it as very key, because we can 25:33 educate people, we can tell them what 25:36 to do. But, the problem often is they 25:41 cannot find the strength to follow through, 25:44 right. And this is where only that relationship 25:47 with Christ can give them that divine power. 25:51 They may want to do well, they may 25:54 try to do well, but they often find themselves 25:58 falling back into those old patterns. 26:01 And so we tell our patients look we're not 26:04 interested in just trying harder. 26:07 But, we will encourage them to make this 26:10 lifestyle change a matter of prayer 26:13 and to discuss this with the Lord and ask him 26:16 for special grace to change these habits 26:19 because we can't really change ourselves, 26:21 only the Lord can do that. 26:23 Right, I think that's a very point to those 26:26 who are listening that our confidence really 26:29 has to be in a pie outside of ourselves 26:31 because we ourselves got us into a situation 26:35 where we don't have the strength, 26:37 we don't have the ability to change. 26:40 But as we lean on Him, as we trust in Him 26:43 then we see the motivation comes 26:46 to be able to make those changes. 26:48 Alright, maybe you could share a little bit 26:52 from your background you've seen many people 26:54 who've come they followed the program 26:57 and they've started to make some of these 26:59 changes and of course everyone comes different 27:04 you know with different problems, 27:05 different severity and the condition, 27:07 but what do you see is the difference between 27:10 those who are on a good program 27:13 and you know they've made some of these changes 27:16 but aren't doing as well, compared to those 27:19 who were really seem to go all the way, 27:21 what seems to be the main difference? 27:24 When people leave our center, they then go back 27:32 in to their home environment 27:33 Where things are not always as conducive 27:35 to making changes. Right. They will often encounter 27:41 let's say added stress from their work programs, 27:46 schedules are not as easy for them to follow 27:49 like with exercise routine and so fourth 27:52 and so just making sure that they're sticking 27:55 to the program when they go home, 27:58 this is what will make the difference. 28:00 This is Lee Wellard, Wildwood Lifestyle Center. 28:03 Thank you for joining us today, 28:04 I hope it's been a blessing to you, 28:05 please join us next time on Wonderfully Made. |
Revised 2014-12-17