Participants: Timothy Howe and Sheryl McWilliams
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. |
Revised 2014-12-17