Episode 2017 - On this Saturday show, Terri Barnhardt joins Vinnie and the two talk Colorado snow, Terri's journey, diabetes development, turning life around with NSNG, and more. Https://www.vinnietortorich.com/2022/01/turning-life-around-nsng-episode-2017 PLEASE SUPPORT OUR SPONSORS TERRI'S JOURNEY Terri is based out of Colorado. She's waiting for more snow. She was always reasonably heavy. At around age 21, she worked in Grand Canyon, and still gained 60 lbs in 9 months. At the time, her doctor just told her to cut down on the peanut butter. This weight gain occured while she was active each day. The diet was made up of lots of Mexican food (rice and beans), lots of margaritas, heavy carbs. She continued gaining weight, and developed diabetes, was on statins, and the like. When she was type 2, around 2012, her A1C was 13.3. Then, she ballooned up from there. TURNING LIFE AROUND In about 2016, she was diagnosed with two separate types of cancer that were unrelated within two months. She had kidney cancer and bone cancer in her opposite leg. Her kidney surgery happened first, and then she underwent leg surgery. At that point, she heard cancer would kill her or at least take her leg. She had metal parts. Terri then found a doctor who told her she needed to lose 100 lbs or he would put her on full time oxygen. Weight Watchers didn't work. Then, she found NSNG®. She went all in, and it changed her life. It took Terri a few weeks to figure out where her good intentions were being stolen. She got off all of her insulin within six weeks. She had other incredible developments, along with her weight loss, too. Terri feels this way of living saved her life. PURCHASE BEYOND IMPOSSIBLE The documentary launched this week on January 11! Order it TODAY! This is Vinnie's third documentary in just over three years. Get it now on Apple TV (iTunes) and/or Amazon Video! Link to the film on Apple TV (iTunes): Share this link with friends, too! Link to the film on Amazon Video: It's also now available on Amazon (USA only for now)! Visit my new Documentaries HQ to find my films everywhere: REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! FAT: A DOCUMENTARY 2 (2021) Visit my new Documentaries HQ to find my films everywhere: Please share my fact-based, health-focused documentary series with your friends and family. The more views, the better it ranks, so please watch it again with a new friend! REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! FAT: A DOCUMENTARY (2019) Visit my new Documentaries HQ to find my films everywhere: Please share my fact-based, health-focused documentary series with your friends and family. The more views, the better it ranks, so please watch it again with a new friend! REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter!
**This episode is brought to you by MuteSix, and Yotpo** “The most powerful thing you can do is maintain a healthy diet” that's what Laurence recommends. In part 1, we have Laurence Girard, Founder & CEO of Fruit Street, a developer of digital diabetes prevention and weight loss programs. During a college internship at a healthcare facility, Laurence had an intense experience with an overweight diabetic patient who passed away. This experience led him to Fruit Street. Fruit Street's program is designed to help people with pre-diabetes avoid developing type two diabetes. According to Laurence, approximately 88 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 84% don't know they have it. That's why he advises taking their risk quiz and then a blood test along with a hemoglobin A1C test. There's a need to raise awareness amongst the public and physicians. He discusses: * Gratefulness * Overview of the company * How to identify pre-diabetes * Challenges around pre-diabetes * His motivation behind the brand * Impact of diet & lifestyle * Dean Ornish's books * What's different about Fruit Street * Being CDC endorsed Join Ramon Vela and Laurence Girard as they break down the inside story on The Story of a Brand. For more on Fruit Street, visit: https://fruitstreet.com/ Subscribe and Listen to the podcast on all major apps. Simply search for “The Story of a Brand.” Click here to listen on Apple Podcast or Spotify. * OUR SHOW IS MADE POSSIBLE WITH THE SUPPORT OF MUTESIX. MuteSix is the leading agency in performance marketing. They have been in this space for nearly eight years, growing and scaling the world's most recognizable e-commerce brands with breakthrough creative, targeted media buying, and data-driven results in every step of the funnel. They're currently offering listeners a FREE omnichannel marketing audit. Their team of auditors will perform a deep dive analysis into your current marketing efforts and identify which strategies might be budget wasters and which strategies will improve performance. The audit covers all digital marketing channels, including Facebook, Google, Email, Amazon, Snapchat, TikTok, Pinterest, Influencer, Programmatic, and Website CRO. For your free digital marketing consultation, visit: https://mutesix.com/storyofabrand * This podcast is supported by Yotpo, the leading eCommerce marketing platform for brands looking to drive customer loyalty. As I'm sure many of you know, customer retention is the new acquisition. With Yotpo, brands can provide value through a strategic loyalty program — and ensure shoppers come back time and again. Want to know more? Visit https://yotpo.com/storyofabrand And turn your one-time shoppers into lifelong brand lovers.
In the News... top stories this week: A second glucose-regulating molecule discovered, CGM use closer to diagnosis helps T1D kids, Lilly discontinues "Journey Awards," study on Dexcom use in hospitals, and why does this concept car share a diabetes tech name? -- Join us LIVE every Wednesday at 4:30pm EST Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Episode Transcription: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. All sources linked up on our Facebook Page and at Diabetes-Connections dot com when this airs as a podcast. XX In the News is brought to you by The World's Worst Diabetes Mom, Real life stories of raising a child with diabetes. Winner of the American Book Fest Prize for best new non-fiction. Available in paperback, on Kindle or as an audio book – all at Amazon.com. XX Our top story.. You know insulin helps regulate blood glucose. Now scientists have discovered a second molecule in the body that seems to do the same thing. It's produced by fat tissue but uses a different molecular pathway.. so it's hopeful this could get around insulin resistance. These scientists say the hormone, called F-G-F-1 suppresses breakdown of fat cells into free fatty acids and regulates the production of glucose in the liver. Because it does this in a different way from insulin, they're calling it a second loop. Very early here but very intriguing. XX New study out of Stanford says setting children and teens up with a CGM shortly after a T1D diagnosis.. results in a lower A1C a year later. They looked at kids diagnosed in 2018 to 2020… and compared that group to other children diagnosed four years earlier. In that first group, about 90-percent started CGM in the first month.. in second group it was under 2-percent that started that early. At diagnosis, the children in the newer cohort had higher A1c s. At 6 months and 12 months after diagnosis, the patients in the new cohort had significantly lower A1Cs than the other kids. These researchers say the news is more evidence to get insurers to cover the devices. https://healthier.stanfordchildrens.org/en/kids-early-use-of-diabetes-technology/ XX A new risk factor for type 2 mostly affects women, and it's in about 10-percent of the population. A new study says about one in 10 adults has a lump in their adrenal glands that, though otherwise harmless, increases production of certain hormones that increase the risk for Type 2 and high blood pressure. About 70% of those with them were women, most of whom were 50 years old or older. It's called mild autonomous cortisol secretion and these researchers say we should start screening for it. https://www.upi.com/Health_News/2022/01/03/adrenal-tumor-diabetes-blood-pressure-study/2471641237308/XX XX After almost 50 years of honoring people with diabetes with anniversary medals, Lilly Diabetes is phasing out the Journey Awards. Awards were given to patients for 10, 25, 50 and 75 years. A Lilly spokesperson confirmed the news to me today.. saying “We periodically need to re-assess and prioritize programs as the environment and our business shifts. We believe our decision will allow us to focus on programs that we hope bring the most value to people living with diabetes.” They encourage people to check out the Joslin Medalist program and I'll link that up. Joslin.org/research/our-research/medalist-program-study XX Movement on a couple of court cases involving insulin makers. Sanofi lost its appeals court bid to revive patents on Lantus. You'll recall that last year, Viatris got approval for Semglee, it's long-acting insulin, which is basically the same thing and is approved for the same indications as Lantus. Sanofi is facing an antitrust lawsuit accusing it of obtaining some 20 patents in an effort to delay competition. Viatris has been knocking out the patents in court. https://www.bloomberg.com/news/articles/2021-12-29/sanofi-loses-bid-to-revive-lantus-solostar-insulin-pen-patents XX A federal judge has pared down a class action lawsuit accusing the biggest insulin makers of racketeering. Novo Nordisk, Sanofi and Eli Lilly are accused of scheming together to inflate prices. However, the US District Judge ruled that claims under the racketeering laws of several states (except for Arizona's) must be dismissed… because the laws do not allow claims by plaintiffs who bought the drugs through intermediaries, such as insurance companies, rather than from the drugmakers directly. The same judge did allow these RICO claims to proceed earlier this year in a separate class action against the companies brought by direct purchasers. https://www.reuters.com/legal/litigation/sanofi-lilly-escape-state-racketeering-charges-insulin-price-battle-2021-12-17/ XX New look at CGM accuracy in hospitals, mostly for people with type 2. This study looked at the Dexcom G6 and didn't measure how it influenced care, just whether the readings were accurate compared to finger sticks. As you'd imagine, the readings were less accurate at the extreme highs and lows, but the researchers concluded CGM technology is a reliable tool for hospital use. The FDA allowed expanded Dexcom use in hospitals less than two years ago, so this is still very new. https://pubmed.ncbi.nlm.nih.gov/34099515/ XX Dexcom partners with another new company.. this one is called SNAQ. Snaq is a diabetes app that is designed to track both your diet and your blood glucose… and can give you nutritional info of your food just by taking a photo with your smart phone. Good write up & review on that from Diabetes Daily which I'll link up. Apparently, it works pretty well! The partnership means all US based SNAQ users can automatically view Dexcom CGM Data together with their meals inside the Snaq App https://www.diabetesdaily.com/blog/we-tried-the-snaq-diabetes-app-695058/ XX Hat tip to our friend Nerdabetic who spotted this ridiculous story. LG Electronics introduced a new in-vehicle infotainment concept tailored to autonomous vehicles. It's designed to blur the distinction between home and car .. This is a car cabin that can turn into a space where passengers work, watch TV, exercise or experience camping virtually. The name? LG Omnipod It was presented at the Consumer Electronics Show this week. No comment yet from Insulet, the makers of the Omnipod with which most of us are already familiar. http://www.koreaherald.com/view.php?ud=20220103000636 XX Before I let you go, a reminder that the podcast this week is all about diabetes in media, a really deep dive into how representation on screen influences those watching. Listen wherever you get your podcasts or if you're listening to this as on a podcast app, just go back an episode. Next week's episode will be a little bit delayed.. released either very late Tuesday evening or early Wednesday morning. I'm set to talk to the CEO of Dexcom on Tuesday and I want to get that to you as soon as I can.. rather than hold it. So thanks for your patience on that. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
In this episode: Tyler Kimura and Marcus Inamine, founders of Always Best Care Oahu, shared that they are hiring caregivers with the aloha spirit to assist seniors in the north shores and all areas on Oahu. They are looking for reliable, compassionate and caring professionals. Offering caregiver referral fees and bonuses for new clients. On-call, part-time and full-time employee positions available.Evan's news segment touched upon Senator Klobuchar's latest virtual roundtable with northwest Minnesota caregivers who assist those living with Alzheimer's disease. Senator Klobuchar and Senator Collins have been integral in bringing forward the Alzheimer's Caregiver Support Act to expand training and support services for families and caregivers of patients with Alzheimer's disease and related dementias.Savy shared that Gimme a Break is continuing a 10 part series in their weekly support sessions around the theme of PAUSE. Last night the discussion was about the “U” in PAUSE for unappreciation and that certainly all caregivers have felt unappreciated. Savy welcomes all caregivers to these free, life-changing support sessions.Special Offer:Always Best Care Oahu - $200 signing bonus for all new caregivers paid after the first 40 hours of work.Recommended Resources:Always Best Care Oahu - Provides families with non-medical in-home care on Oahu, Hawaii and surrounding areas. Call for a care consultation at (808) 207-8558.Caregiver Health Club - The leading wellness program for caregivers with pre and type-2 diabetes. Get your sugar under control, lower your A1C levels, reduce medications, lose weight, and feel great again.Gimme A Break - Non-profit for caregivers aiming to bring back joy to caregiving, free weekly support sessions offering caregivers a chance to relax, renew, resource and revive. Register or register a caregiver for a break.Givers Guides Magazine - The complete caregiver resource guide. Get your first issue today, as 100% of all profits are donated to support Gimme A Break.Hosts:Evan Kharrazi - founder of Caregiver Health Club and certified Type 2 Diabetes Health CoachSavy Makalena - founder of Gimme a Break and Givers GuidesConnect with the Caring Caregiver Show:Facebook Page: Caring Caregiver Show with Evan & SavyInstagram: caringcaregivershowWebsite: www.caringcaregivershow.comFacebook Group: Click Here to Join
Liz and Sarah reveal their team motto for the new year — What Would Dolly Do 2022! Their goal is to harness Dolly Parton's spirit of strength, fun, and goodness. They also plan to wear more eye shadow. In Take A Hike, they each make a commitment to make one change for their mental health and one change for their physical health in 2022. Sarah is going to cut down on scrolling and increase how much she's hiking each week. Liz is going to read more novels and lower her A1c. They've also got 2021 Hits & Bombs. Hits go to the vaccine, Season Two of Fantasy Island, and making the best of a bad pandemic. Bombs go to the Covid variants, failing at Christmas, and holding on to the Covid 19 pounds. Finally, this week's Hollywood Hack comes from Liz's niece Eliza: When evaluating a new job opportunity, ask yourself if it meets at least one of these criteria — is it fun, meaningful, or does it offer a steep learning curve. Get in touch on Twitter: @sarahmfain & @elizabethcraft Get in touch on Instagram: @Sfain & @LizCraft Visit our website: https://happierinhollywood.com Join our Facebook group: https://www.facebook.com/HappierinHollywood/ Happier in Hollywood is part of ‘The Onward Project,' a family of podcasts brought together by Gretchen Rubin—all about how to make your life better. Check out the other Onward Project podcasts—Happier with Gretchen Rubin, Side Hustle School, Do The Thing, and Everything Happens with Kate Bowler . If you liked this episode, please subscribe, leave a review, and tell your friends! LINKS: Charlie Podrebarac: https://www.gocomics.com/cowtown Dolly Parton: https://dollyparton.com/ Learn more about your ad choices. Visit podcastchoices.com/adchoices
We are replaying one of our most popular episodes for you this week! Amy and Brian break down the science behind pre-diabetes and how strength training is the most efficient and effective way to escape the negative feedback loop of insulin resistance, systemic inflammation, and weight gain. If you or someone you know has been diagnosed as pre-diabetic, this information could change your life. Approximately 1 in 3 Americans are pre-diabetic, which increases their risk of developing Type 2 Diabetes, heart disease, and stroke, and most people don't even realize they are at risk. Pre-diabetes also increases the risk of developing Alzheimer's disease, problems with vision, and amputation later on in life. There are two leading factors to pre-diabetes: exercise and nutrition. As we lose muscle as we age, we develop insulin resistance which exacerbates the problem. High blood sugar levels over time lead to the wearing out of the body's ability to even produce insulin. The good news is that pre-diabetes is a very modifiable condition that can be positively affected by exercise and proper nutrition. When we condition our muscles, we improve insulin sensitivity. Fast twitch muscle fibers store sugar in the form of glycogen, which removes it from the bloodstream. When muscles resist the effect of insulin, the insulin remains in the bloodstream at elevated levels and leads to systemic inflammation. Systemic inflammation is the root cause of all the health issues mentioned. Unlike acute inflammation, you don't feel systemic inflammation except for the symptoms of the diseases and the effects of aging. The most important lifestyle recommendations are to start eating a whole food diet, eliminate high carbohydrates and refined sugars, and then begin strength training. A1C is the measurement of how saturated your red blood cells have become over a 90 day period. Whole food and whole effort strength training are how to keep that number in the safe range. Only strength training can target the fast twitch muscle fibers which are directly related to A1C levels in your body. People can experience tremendous improvements in their A1C levels over a short period of time just by implementing a strength training program in their life. If your doctor has diagnosed you as pre-diabetic, they are going to recommend exercise, and whole effort strength training is your best bet. Research shows that losing the first 5% of your body weight confers the majority of the health benefits, which is good because that means it's easier to see results in a short period of time. Diabetes predisposes you to weight gain, but the reverse is also true. Elevated insulin levels, weight gain, and insulin resistance act on each other, which leads to a dangerous feedback loop. The best way to break the cycle is smart and brief strength training sessions. Link: exercisecoach.com This podcast and blog are provided to you for entertainment and informational purposes only. By accessing either, you agree that neither constitute medical advice nor should they be substituted for professional medical advice or care. Use of this podcast or blog to treat any medical condition is strictly prohibited. Consult your physician for any medical condition you may be having. In no event will any podcast or blog hosts, guests, or contributors, Exercise Coach USA, LLC, Gymbot LLC, any subsidiaries or affiliates of same, or any of their respective directors, officers, employees, or agents, be responsible for any injury, loss, or damage to you or others due to any podcast or blog content.
Peloton instructor Robin Arzon was diagnosed with type 1 as an adult, when she was already an endurance athlete and marathon runner. After her diagnosis, she was determined to keep those incredible fitness feats coming. Arzon is now Peloton's VP of fitness programming, an ultramarathoner, a best-selling author, a new mom, and more. If you're looking for some new year fitness inspiration, she's got you covered. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about Robin Arzon More about Gvoke HypoPen Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription Below: Stacey Simms 0:05 This is Diabetes Connections with Stacey Simms. This week, peloton, instructor Robin Arzon was diagnosed with type one as an adult when she was already an endurance athlete and marathon runner. after her diagnosis, she was determined to keep those incredible fitness feats coming. Robin Arzon 0:24 I really have had to treat myself kind of like an experiment like get curious and just see and trust that even on the days that aren't my best, I'm trying my best and my best is good enough Stacey Simms 0:35 Arzon is peloton's vice president of fitness programming an ultra marathoner, a best selling author, a mom, and more. If you're looking for some new year's fitness inspiration, she's got you covered. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. I'm always so glad to have you here, you know, we aim to educate and inspire about diabetes with a focus on people who use insulin. this time of year I always seem to have a fitness interview, right? That makes sense. It's the new year we're making resolutions. We're getting motivated. So you know, take a look back in years past I talked to Chris Rudan from the Titan games. I talked to Eric Tozer, who did seven marathons on seven continents in seven days, you know, stuff like that. But you don't have to have these incredible achievements, these these incredible goals. You know, this to be fit to stay healthy. I mean, I'm certainly never doing an ultra marathon. It's not one of my goals, especially as I get older, I want to stay moving. That's really important to me. So well, somebody like this week's guest Robin Arzon isn't I'm sorry, Robin isn't going to motivate me to ever run a marathon. She is going to inspire me to try a little more to do some different things. And I hope she inspires you in the same way as well. Whatever your fitness goals are for 2022 I have a story that I want to share about something that happened recently with me and Benny, it isn't really about new year's resolution. So I'm going to keep it till the end of the interview. I'll come back and tell you he challenged me to do some things kind of an empathy exercise about type one, I failed miserably. That's the spoiler. So we'll get to that in a little bit. This week's interview is one of my shortest ever I had very limited time with Robin. So I decided to not ask her about her diagnosis story. I skipped a couple of questions that I would usually ask, but in case you're not familiar with her, I wanted you to learn more. So here is a quick explainer that she gave beyond type one a few years ago, and we're playing this with their permission. Robin Arzon 2:32 I am a reformed lawyer turned ultra-marathoner. I'm head instructor at peloton cycle as well as vice president of fitness programming. I'm on the Leadership Council beyond type one. I was an endurance athlete Well, before I was diagnosed with type one diabetes, I was diagnosed in February of 2014. So only a few years ago, as an adult, I was in my 30s when I was diagnosed. And it's been an interesting little dance I'm doing with my pancreas these days. I had just returned from a trip to India. I was in India for about three to four weeks with my mom and my sister. And when I came home back to New York City, I thought I had jetlag or something like my body just felt really sluggish. And I had extreme thirst. That was the number of extreme thirst and frequent urination. And that was the number one thing that really was strange, because I know it wasn't dehydrated. And as an athlete, I kind of could tell immediately that something was off with my body. I had an awareness of type 1 diabetes, but certainly not on any kind of medical or even practical level. And I definitely didn't know how to how to live with it. That was actually my very first question after I was diagnosed was how am I gonna run 100 mile races? And that was a question pretty unfamiliar for my endocrinologist and so then I want an immediate search for all the technology that would allow me to train uninterrupted. I actually had a half marathon two weeks after my diagnosis and I and I ran it. And I think I was on a pump within a week that I had a Dexcom within 14 days. Stacey Simms 4:27 Robin was diagnosed in 2012. She's now peloton vice president of fitness programming. She and her husband had a baby in 2021 and January just a couple of days from this episode going live. She is publishing a children's book and you will hear her talk about that. There is a video of this interview over on the Diabetes Connections YouTube channel if you want to watch I will link that up in the shownotes. Full disclosure. The reason I had limited time for this interview is because Robin is on a media tour courtesy of Gvoke Hypopen so you will hear a lot about that in this interview ended agreed To do this, I also agreed to post information about Gvoke in the show notes which I have done. If you've listened for a long time, you're probably tired of hearing these disclosures. But if you're new, it's very important to me that I'm open and honest about what you hear on the show. And I really thought the tradeoff of hearing about Robin's experiences and advice was worth it. Robin, thank you so much for joining me and spending some time with me and my listener. So how are you doing today? Robin Arzon 5:29 I'm great. So nice to speak with you. Stacey. Stacey Simms 5:31 I know that you have a little bit that you want to talk about with Gvoke. They are a sponsor of my podcast as well. Let's just dive in and talk about that because being prepared is just part of the reality when you live with diabetes, right Robin Arzon 5:42 100% I mean, in the landscape of things that are uncontrollable of living with diabetes and diabetes management, we have to control what we can control and Gvoke Hypopen is the first auto injector of medicine if we have a severe low blood sugar event, and the looming prospect of that can be scary. And as an ultra marathoner as someone who lives as an athlete lives with movement, you know, and I know your listeners are very, very well versed in the diabetes landscape, and probably can relate to that to a certain extent. I needed to take agency back, which is why I partnered with Gvoke Hypopen because recently, for example, when I ran the New York City Marathon, I had the Gvoke Hypopen in my race kit. Thankfully, I didn't need to use it. But it does give me peace of mind out there on the racecourse, you know, knowing that I have this medicine accessible to me, if I have a severe low, Stacey Simms 6:31 I'm going to knock wood everywhere I can find some because yeah, I've had to use Gvoke or any kind of emergency glucagon in the 15 years since my son was diagnosed, have you ever had to use anything? Robin Arzon 6:41 Thankfully, no, thankfully, I have not had to use it. And I'm very grateful for that. And I'm also grateful that I sought out the right care for myself. And I advocated for myself with my doctor. And I recommend folks do the same and of course, do their own, you know, investigation of safety and risks and allergies and all the things associated with with any medical prescription. But we have to advocate for ourselves and figure out what works for our lifestyles. Stacey Simms 7:04 Alright, so you were diagnosed with type one as an adult, you were already an incredible athlete. And I think I heard you say somewhere that you ran a half marathon a week or two after your diagnosis. Robin Arzon 7:14 Yes. So I had a half marathon, I think a week later. And then I had a 50 mile ultra marathon few weeks after that. So it was a blurry and really daunting time. And I had to figure out quickly, this new life, this new thing, I believe superheroes are real. And I know that folks living with diabetes, diabetes warriors are superheroes. And in my superhero toolkit, It now includes insulin, it includes glucose taps. It includes the you know, the Gvoke Hypopen and it's I developed a mantra actually, during that time that forward is a pace. There are some days when the next step is the only step that you can focus on and that's okay. But I figured it out because it was meaningful to me the first question I asked, when my endocrinologist said, you're going to be living with insulin, your pancreas doesn't produce enough or any, I thought, Oh, okay. And I said out loud, how am I going to cross the ultra marathon finish line I have in a few weeks. And we figured it out. And I made mistakes, and I figured it out. And I educated myself. And I want folks to feel that same empowerment of like, gosh, we're gonna figure it out. We're going to be ready. We're going to be warriors, and we're going to continue to be epic. Stacey Simms 8:24 One of the biggest questions I got when I told my Facebook group for the podcast that we were talking was, again, knowing everybody is different. But you know, just what do you do to avoid lows? Because exercise? I mean, let's face it, some people with diabetes do not exercise because they are afraid of low blood sugar. How did you get past that? How do you avoid crazy highs, crazy lows, when Robin Arzon 8:44 you're exercising, it is a lot of trial and error. And just like anything else, it's observing, just like observing how your body reacts to a certain food, you have to observe how your body reacts to a certain type of movement. For example, lifting weights, for me might make my blood sugar go up. Whereas of course, cardiovascular or aerobic things like the bike with running will make it go down. So I really encourage folks to get curious, start small, right? Well, you don't have to go out and run an ultra marathon. But maybe you know, you start with the 10 minute walk around the block and see what happens. And then you bring you know the glucose tabs or the apple juice with you, I always have some type of rescue carbs, right. And this is really where the Gvoke Hypopen can come in as well. Because you know, you've got that in a severe and you know, in the situation where we're really putting ourselves in a low blood sugar, severe low blood sugar circumstance, we have medicine that is on the spot that is going to react on the spot that gives me a lot of peace of mind. So it's that two pronged approach of daily diabetes management. And then you know, having this in a circumstance where things get a little bit more severe, or a lot more severe. Stacey Simms 9:48 Yeah, we have quite a few people who said I take her class I see her all the time. Have you ever had a low blood sugar during instruction like when you're doing a class? Robin Arzon 9:57 Thankfully, yes, I've gone low but It's all been manageable, drink some juice, keep it moving. I've never had to stop a workout, thank goodness. And that's literally 1000s of hours of practice of knowing my body and knowing the exact timing of like, okay, I'm going to drink a quarter of my smoothie. Eight minutes before this class, I really have had to treat myself kind of like an experiment, like, get curious and just see and trust that even on the days that aren't my best, I'm trying my best and my best is good enough. That is also encouraging. So So I encourage folks to give themselves that same grace, but also that same dose of bravery. You mentioned that there are folks of your listeners who are so scared that they're not moving, but they're not working out. And that really saddens me, because they're limiting their own potential. And why you're letting diabetes when when you do that. Stacey Simms 10:46 I don't know if you're familiar with Don Muchow, who ran or walked from Disney Land to Disney World that she I did I Robin Arzon 10:53 read about this. He was told Stacey Simms 10:55 when he was diagnosed a long time ago, right. I think it was the late 70s. He was told do not exercise because it was too dangerous. That was a real thing that people were told not all that long ago. And he had to wake up one day and say no, no, you know, so I give you so I mean, sounds silly to say, but I give you so much credit for getting your diagnosis and saying no, no, I'm, I'm getting right back into it. And I've had the privilege of talking to a lot of people in the public eye like yourself who have treated lows while they're on camera. musicians who sneak a sip of orange juice or racecar drivers to kind of have it in their car. Can I ask you do you keep something sneaky? Is your water bottle is the other two maybe that people should look for? Robin Arzon 11:32 One is water and one is juice. I always have some form of juice on me onset always, always, always. And yeah, no shame in that. If I need it. Take a sip, keep it and keep it moving. Thankfully, you know, Stacey Simms 11:44 yeah, I think it's lovely to find out those little things because it makes our kids and a lot of adults feel better to know they're not alone. I mean, that's half of this. Did you find a community when you were diagnosed with type one because it can be very isolating? Robin Arzon 11:57 You know, I was, as I mentioned, I was running ultra marathons at the time and there is an amazing ultra marathoner, Steven Anglin, very accomplished he does hundreds and hundreds of miles at a time really epic guy. He was the first person I went to outside of my medical team. And I was like, What the heck, what do I do and you know, he kind of talked me down. And you know, I hope to be able to pay that forward, especially as being part of this be ready campaign, I want to be a visible example of the fact that we can continue moving, we can continue being heroic in big and small ways in our very own lives. Um, you know, as a new mom, I read fairy tales to my baby girl every night and I want to live a fairy tale that is is is even stronger than things that she's going to read in books, and then pass the baton to hertz to one day live just as gravely, but it does require us to be prepared. And that is literally why I wanted to partner with the Gvoke Hypopen team. Because the reality is, the more prepared we are, the more peace of mind we're going to have. You can't control everything. And with any prescription medication, you have to speak to your medical provider to make sure that this is the appropriate avenue for you. But it does provide me peace of mind in the event that a severe blood sugar is looming. Stacey Simms 13:05 You're coming to 8 years with type one, have you experienced burnout at all yet? You know, it's I think, Robin Arzon 13:12 yes, I mean, there are certainly days where just like really more of this tightrope walk. So it's definitely exhausting. And we make to think like a pancreas requires a lot of mental energy. But I'll tell you something, I've discovered more than burnout, that every single day we have the choice to turn why me and to try me. And the self pity is poison. I think that self pity is poisonous and much more harmful than burnout. For me, I choose to constantly flip the script, constantly turn pain into power, I have no other way. And it's both being someone that lives with type diabetes, and also being an athlete, and also being a mom, and also being an executive and also being an author and also being an entrepreneur. And it's like, let's go. Stacey Simms 13:56 I know we're gonna run a time. Two more questions, if I could, you mentioned your daughter things beep with diabetes. How was she doing with that? I mean, she's so tiny. But does she know what? Robin Arzon 14:05 Oh, my goodness, you know, I mean, we're just learning and she's very curious about the gadgets and the beach and the stuff and I will explain to her, you know, in age appropriate ways of like, this is mommy's medicine, and this is what Bobby needs to do. And now I explained to her what a pancreas is, and you know, things that I definitely didn't learn at her age. But you know, I want her to know, I want her to be informed too. And I want her in order for her to be proud of me. She needs to be informed as to what I go through. And I want her to see me dealing with challenges and rising above it. The Diabetes community is incredibly supportive, and whether you know, the Gvoke Hypopen can be used for folks, age 2 and up. So that's a wide swath of our community and Gvoke.com is a great place for more information. That's where the total story is, including any side effects information and safety language. Stacey Simms 14:51 And then the last question is just what are you looking forward to in 2022? You've already accomplished so much you listed all those things that keep you so busy. Robin Arzon 14:58 I'm very excited. about the launch of my children's book, it's my first children's book strong mama. It is a love letter to my baby girl. And it really puts the focus on a caregivers self care. So let's remember that we have to prioritize our self care. It's not selfish, whether your parents or not take the time for yourself. Because yes, that burnout is real. And we have to go inward sometimes in order to give Stacey Simms 15:21 outwardly but like hope when it comes out, you'll come back on and share. Robin Arzon 15:24 Oh, that would be great. That would be great. Nice. Nice to see you today, Stacy. Stacey Simms 15:28 Oh, my gosh, thank you so much, Robin, I appreciate your time. Have a great one. You're listening to Diabetes Connections with Stacey Simms. More information about Robin a full transcript and the links to Gvoke and to the video are all at the homepage at diabetes connections.com. I am going to follow up with her hopefully, she'll come back on in a couple of weeks to talk about her children's book and answer more of your questions. I mentioned at the beginning of the show that Benny asked me to try something new. So let me just set kind of set the table about what's been going on here, especially if you're new to the show. So Benny was diagnosed in 2006. Right before he turned two, he is 17. Now, and so he's had diabetes for really just over 15 years. For the last two years, I've really tried to slide into doing less and less and less to the point where in October of 2020, I turned off all of my Dexcom alarms except for urgent, low. And after a big trip he took the summer he went to Israel for a month with a non diabetes camp after he did well with that. I said to him, Well, what do I do now? Right? What do you want from me? How can I help you? Am I here just for customer service? Right? When you want me you contact me, not the other way around? And he said that that's what he really wanted to do. Have I been 100% successful at that, of course not doing nag him here and there to bolus or if I see something wonky? Of course, is he doing? Well? Yeah, he's doing really well, except I'll be honest with you. He's not as diligent. He's not as on top of it. And he wouldn't mind me saying this, as he was when I was diligent and on top of you know, and as you're listening, if you're laughing, if you're an adult with type one, or if you're a parent of an older child, or young adult with type one, you have gone through this, I've gotten a lot of reassurances from my friends, the diabetes community that as long as he's not doing anything dangerous, and he certainly is far from that he's doing great that the way I would do it is not gonna happen anymore. It's up to him now, which is really, really, really hard. So here's what the challenge came in. About a month ago, I pointed out to him that, you know, he was missing some boluses. And he wasn't paying attention to things as well, you know, we had like a, it was a moment where I said, can I talk to you about this? And he agreed, and we had a really good conversation like we do every once in a while. And he said, You know what, Mom, I'd like you to try to remember every time you eat to do something, and I said, Yeah, but after 15 years, like how can you not know how can you not do this? Right? I mean, every parent has said that or thought that right? So he said to me, okay, every time you eat anything, I want you to text me. I said, Sure. No problem. I always have my phone with me. That's gonna be easy. And you know, he rolled his eyes. And he said, we'll say, so the first day, I text him every time I eat three meals, you know, a billion snacks, whatever I'm eating, I text him every time. The next day. I text him. I'm not even really thinking. I text him at dinner. He was at work. He texts back “Is this the first time you've eaten today?” with assorted emojis. And I went, Oh, my God. I did not text him for breakfast. I did not text him for lunch. I hadn't even thought about it. I completely forgot about our bet. And I said, Okay, not fair. That was just day two. It wasn't that I forgot to quote bolus while I was eating. I just forgot that we had agreed to do that. He said, Okay, I'll give you another couple of days. Well, the next day, I remembered breakfast, I forgot lunch. So he wanted me to keep it up for two weeks, which was our original agreement, I felt that he had proved his point after a day and a half, really. But I kept it going. And I did better. But I really failed at it. Was that a lesson with universal implications? Probably not. I bet you'd be a lot better at it than I was. I don't know why I couldn't remember. I don't know what I was thinking. But between the two of us, it was a fantastic lesson. And it was such a great way for me to see how even after all this time, you know how difficult this is how tough it is to be perfect. And you know, as you listen, maybe your lesson is, well, that means that you need to set more reminders. And be on him more. I mean, everybody, I guess would take this a different way. The lesson to me was: have a little bit more empathy, and have a lot more respect for the way he is doing it. Well, I mean, we're not talking about a kid who's ignoring his diabetes, and you don't like I don't talk about numbers, but we're talking about an A1C that's, you know, maybe a couple of tenths, maybe a half a point higher than it was last time. And we're already seeing numbers that I never thought we'd see when he was in the teenage years. If you'd asked me, you know, years ago, thank you control IQ. Thank you for a kid who is responsible. So that's a long way of telling this story that I really got a lot out of so as you listen, if you're a parent, talk to your kid, maybe this is something you can do if you're an adult nodding your head saying yes, Stacy, we could have told you that's what would happen. You know, thank you for your patience. But I got a year and a half before Benny goes off to college. That's it. He is beginning his second semester of junior year. And I think most of these lessons, frankly, are for me. So boy, I hope I'm learning. All right, we do you have a newscast this week, that is Wednesday, live at 430, on Facebook, and YouTube, and then live on Instagram at 4:45 different times, until these services decide to play nicely together. And I can do them all at once. But right now, Instagram will not let you that's why there are different times for that, but we turn it into an audio podcast that you can listen to on Fridays. And then going forward, we're back to our regular schedule with the long format interview shows every Tuesday. I am hoping that we're gonna have a lot of technology to talk about this year. We do have some great episodes coming up with the folks at Tandem. We've got an update from Dexcom, as well as some interviews with newly approved products and products overseas that are going to be submitted for approval in the US this year. So a lot to work on a lot to come. I'm really excited about 2022 Not just for the show, but for what I really hope the community starts seeing when this logjam of COVID approvals or COVID, delays at the FDA starts loosening up and walking through so fingers crossed for that. Thank you as always to my editor John Bukenas at audio editing solutions. Thanks so much for listening. I'm Stacey Simms. I'll see you back here in a couple of days until then be kind to yourself. Benny 21:29 Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged
New year, new you! What are your goals for 2022? You might be thinking about what you want to change in the coming months. But when it comes to achieving success, often times forgetting how you can make small but intentional shifts is key. If you're not sure where to start in order to reach your goals in the new year then this video will help get you started with five simple tips that will lead towards a successful 2022! Get updates our latest episodes by texting PODCAST to 718-504-2192 Become a supporter of this podcast: http://paypal.me/makeitfunnyc Need some support and accountability with your goals? I have a great resource/accountability app for you. A goal coach in your back pocket. It will change your life! FREE 21 day challenge Text GOALS to 718-504-2192 or http://bit.ly/goalsmif Follow Us: Instagram: https://www.instagram.com/bernadettethenryshow/ LinkedIn: https://www.linkedin.com/in/bernadette-henry-977b7621/ Twitter: https://twitter.com/Bernadettethsho Facebook: https://www.facebook.com/bernadettethenry Website: http://www.makeitfunnyc.com Tiktok: https://www.tiktok.com/@bernadettethenryshow? Youtube: https://www.youtube.com/channel/UC4o2OX34kD3825qJHqi4yTg AFFILIATE PROGRAMS: This post contains affiliate links, and I will be compensated if you make a purchase after clicking on my links Instacart: Get your groceries and essentials delivered in as fast as 1 hour with Instacart. Free delivery on your first order of $10+ or more. Terms apply. https://instacart.oloiyb.net/jWmZge Get leads for your business daily: http://jump2live.mlsplive.org/ Support the show (http://paypal.me/makeitfunnyc) Don't wait to the New Year to start your wellness/fitness/weightloss/lower your blood preassure & A1C goals, GET STARTED TODAY!
In this episode from the series “Key Decisions in HIV Care,” Jonathan Appelbaum, MD, FACP, AAHIVS, and Jens D. Lundgren, MD, DMSc, discuss important considerations for ART use in older PWH, including:DHHS, EACS, IAS, and WHO recommendations for first-line ARTVirologic outcomes for older PWH in clinical trials and results from the HealthHIV Second Annual National SurveyPolypharmacy and its potential consequences, including common non-ARV medications prescribed in the VACS cohort, drug–drug interactions with common concomitant medications, common comorbidities in older PWH, and drug–disease state interactions including renal and hepatic impairmentCardiovascular risk considerations including data from the D:A:D study and RESPOND cohort and lipid changes in the TANGO study of switching to DTG/3TC from TAF-based ARTPresenters:Jonathan Appelbaum, MD, FACP, AAHIVSLaurie L. Dozier Jr, MD, Education DirectorProfessor of Internal Medicine Chair, Department of Clinical SciencesFlorida State University College of MedicineTallahassee, Florida Jens D. Lundgren, MD, DMScProfessorRigshospital, University of CopenhagenCopenhagen, DenmarkDirectorCentre of Excellence for Health, Immunity and Infection (CHIP)Rigshospital, University of CopenhagenCopenhagen, Denmark Content based on an online CME program supported by educational grants from Gilead Sciences, Inc.; Janssen Therapeutics, Division of Janssen Products, LP; and ViiV Healthcare.Follow along with the slides at:https://bit.ly/3miT6qHSee the entire program at: https://bit.ly/2TXTYWx
What is the best diet for bad cholesterol? The answer from today's guest might surprise you. Amanda Grow and her family lost weight on DIRTY, LAZY, KETO while improving their lab work. Find out how the keto diet helped not just improve cholesterol levels but A1C levels too! In today's interview, Amanda shares how her own weight loss journey positively affected the health of her husband and teenage son. Just wait until you hear the details. Amazing! Watch on Youtube or listen on Apple Podcasts. Enjoy the show. Welcome to Season 4 of the DIRTY, LAZY, KETO Podcast by Stephanie Laska - a Weight Loss Journey! Prepare for a season of inspirational podcasts and interviews. Meet ketogenic diet weight loss success stories. From type 2 diabetes reversal success stories to keto diet and weight loss surgery discussions, you'll find yourself captivated. The dirty keto weight loss results are impressive! Come along on this podcast weight loss journey with me. I'm here to support you on your ketogenic weight loss journey. Let's get you started! It's my passion to help as many people as possible lose weight just like I did and achieve keto weight loss results - on an easier, more "doable" form of the ketogenic diet. It turns out you don't have to be strict on a keto diet to be successful. Would you like a copy of my free starter keto grocery list? Sign up here on the DIRTY, LAZY, KETO website and I'll send it to you automatically. It's free! I lost 140 pounds and created DIRTY, LAZY, KETO. Ketogenic Diet Resources: I have many resources to help you achieve keto weight loss results. My books have had more than 10,000 positive reviews on Amazon. Readers agree - DIRTY, LAZY, KETO works! DIRTY, LAZY, KETO Get Started Losing Weight While Breaking the Rules by Stephanie Laska (St. Martin's, 2020) The DIRTY, LAZY, KETO 5-Ingredient Cookbook: 100 Easy-Peasy Recipes Low in Carbs, Big on Flavor by Stephanie & William Laska (Simon & Schuster, 2021) The DIRTY, LAZY, KETO No Time to Cook Cookbook: 100 Easy Recipes Ready in Under 30 Minutes by Stephanie & William Laska (Simon & Schuster, 2021) The DIRTY, LAZY, KETO Dirt Cheap Cookbook: 100 Easy Recipes to Save Money & Time by Stephanie & William Laska (Simon & Schuster, 2020) The DIRTY, LAZY, KETO Cookbook: Bend the Rules to Lose the Weight by Stephanie & William Laska (Simon & Schuster, 2020) DIRTY, LAZY, KETO Fast Food Guide: 10 Carbs or Less by William & Stephanie Laska (2018) You're not alone in this keto weight loss journey. Let me help you get started with a more gentle, flexible, and FUN way to keto! I'm here to support you. I'm here to help. Let's do this together. Stephanie Laska USA Today Bestselling Author and Creator of DIRTY, LAZY, KETO Related Keto Resources: Start Keto: A Beginner's Guide to the DIRTY, LAZY, KETO diet plan Keto Weight Loss Results: Playlist of DIRTY, LAZY, KETO Videos on Youtube
Exercise is arguably one of the fastest ways to decrease blood sugar and insulin as well as prime the body to burn more fat. We review a recent paper that discusses the history and new research about exercise as a glucose and insulin lowering tool. Take control of your Metabolic Health w/ BioCoach's new at-home A1C test: https://bit.ly/3DSMIwk Use code HIH10 to save! Link to video, images and research: https://bit.ly/3GzUahA Time Stamps: 0:00 Intro 0:05 Insulin resistance is the root cause of many of today's premature deaths and chronic disease expression. 0:32 Moving/exercising, especially in the post meal window, makes changes that decrease glucose levels and make your skeletal muscle more sensitive to the effects of insulin. This leads to reduced insulin output by your pancreas. 1:40 Insulin is involved in post meal processing and anabolic reaction. It helps build. It helps replenish depleted glycogen. It helps, in the post exercise window, to increase amino acid biosynthesis. 1:58 Exercise is favorable, but it is catabolic, meaning that it tears down. 2:23 Post meal glycemic levels flatten with exercise. Diabetics tend to use less insulin on days when they exercise and blood sugar levels decrease more quickly. 4:48 During exercise your muscles become a glucose sponge; muscle glucose uptake increases in an intensity and duration dependent manner. Glucose is needed to make ATP in your muscles. 5:40 Exercise increases the expression and sensitivity of GLUT4 transporter. GLUT4 can be desensitized by persistent elevation of glucose levels. 9:35 Insulin is a potent inhibitor of adipose tissue lipolysis, the ability of your fat cells to release stored lipids. 10:10 Pre-workout or intra-workout carbohydrates may slow down your fat lipolysis, or fat burning. If fat loss is your goal, you may want to consider exercising in a fasted state. 11:30 When you exercise, your adrenal glands release adrenaline and noradrenaline. These enhance the liberation of stored fat from your fat cells to use for cellular energy when you exercise. 11:50 Fasting and exercise both elevate adrenals. Prolonged fasting and overexercising can be hard on your adrenals. 12:40 High insulin reduces the normally a progressive rise in free fatty acid oxidation during exercise. 13:15 One Legged Study: The exercised leg increased its muscle glycogen stores to levels twice that of the sedentary leg. Exercise increases the ability of your moving muscles to store glycogen. 13:50 When you move your muscles, you are depleting glycogen with the muscle. Exercise helps your muscles become more insulin sensitive by depleting glycogen within the muscle, causing muscles to be more insulin sensitive in the post exercise window. A glycogen-depleting workout is a good way to kickoff your fast. 15:25 After dinner starts your overnight fast. Perhaps you could take a brisk walk or lift weights before dinner to blunt the post meal glycemic index level. 15:50 Doing your post meal exercise when your post meal blood glucose level peaks, has the best ability to reduce glucose levels. This peak is most often 45 to 60 minutes after a meal. 16:23 Eat early. Sleep early. Eat your carbs commensurate with your physical activity level. Go for a walk after your meal. 17:15 Insulin sensitivity can be boosted for up to 48 hours after a single exercise session. Exercise increases the transport of glucose from the bloodstream into muscles by a factor of 34. 18:45 Eccentric exercise, slow descent, muscle damaging effects can cause a transient reduction in insulin sensitivity. Moderation is key. 19:40 You are most insulin sensitive in the morning. You become more insulin resistant as the day progresses. Exercise when you can. Afternoon resistance training can blunt your dinner glycemic index. 20:45 Sprinkle exercise throughout the day. Researchers call them exercise snacks. These snacks can be as simple as going for walks. 21:45 Big surges glycemic variability/glycemic levels are a big problem.
Are you trying to manage diabetes with your diet? What if I told you that you could ditch dieting and lower your blood sugar at the same time? That sounds crazy, right? You are probably thinking "yeah - I could do that but my numbers would be crazy and my medical team would NOT be happy with me!.” Well, what if I told you that you could eat what you want when you want…including sugar... WHILE reducing your A1C and enjoying the freedom to enjoy your life again! On the show today, I'm talking with a fellow intuitive eating dietitian, Amanda Ciprich about how to manage your diabetes intuitively! Amanda Ciprich is a registered dietitian who was diagnosed with type 1 diabetes almost 10 years ago. During the early stages of her diagnosis, she felt herself going down a path of restriction and obsession, which left her feeling weighed down and consumed by her diabetes diagnosis. She craved the freedom to enjoy her life without diabetes getting in the way and knew there had to be a way to find her love for food once again. Amanda ultimately decided to pursue a career as a registered dietitian to teach other people living with diabetes and their families how to manage their blood sugars without giving up the foods they love. Amanda's approach gives you tools that incorporate prioritizing yourself mentally, emotionally, and physically so you can navigate any scenario that life with diabetes throws at you. Listen in to learn more : Does weight play a role in diabetes management? [9:04] How praise and “good” lab values affected Amanda's quality of life [27:19] What factors affect blood sugar other than food? [41:10] Plus lots more tips and ideas to help you manage your diabetes, eat what you want when you want, and enjoy life again! Ways to connect with Amanda Instagram: @t1d.nutritionist Website: t1dnutritionist.com Resources Don't forget to check out my newest course, Overcoming Your Body Image Barriers to Binge Freedom - behindthebinge.com/bodyimage Behind the Binge Academy - https://makainutrition.com/behindthebingeacademy/
A new study finds longer daily fasts were demonstrated to produce more favorable improvements in biomarkers that are associated with metabolic and cardiovascular health as well as inflammation. Let's break it down... Support your fasting lifestyle with Berberine HCl & Alpha Lipoic Acid by by MYOXCIENCE Nutrition: https://bit.ly/berberine-biotin-ala-stack Use code Podcast to save Save 40% off this at-home A1C test by Biocoach: http://bit.ly/BOGO-A1C-test Use code HIH10 Links to notes: https://bit.ly/30WjpeE REF: Moro, T., Tinsley, G., Pacelli, et al. (2021). Twelve Months of Time-restricted Eating and Resistance Training Improves Inflammatory Markers and Cardiometabolic Risk Factors. Medicine and science in sports and exercise, 53(12), 2577–2585. Time Stamps 0:00 Intro 0:18 New Study 0:08 Testing 16 Hour VS 12 Hour Feeding Windows 0:27 Markers of Inflammation decreased 1:17 Only four hour difference in feeding window 2:22 Study Title: 3:43 Testing your metabolic health 4:42 Berberine & metabolic health 5:50 Feeding Window comparisons 6:43 How Calories were distributed 7:36 Whey protein post workout 7:50 TRF group ate less calories by accident 8:33 Strength and muscle loss between two groups 11:08 Testosterone did decrease 11:53 Insulin, Leptin and Adiponectin 12:44 HDL, Triglycerides and glucose 13:52 Chronic Inflammation 15:11 Trade offs to consider
Today, I am lucky to have here with me, a specialist in Weight Management and Bariatric Surgery for adults and adolescents, Dr. Robert Cywes. He has been doing bariatric surgery for 18 years, performing over 8,000 surgeries. This is an episode that originally aired on March 2020, and it was so good we decided to re-release it here today. Dr. Cywes' medical training began in Cape Town, South Africa, where he received his medical degree from The University of Cape Town. In 1989, Dr. Cywes moved to North America and completed a year-long residency in Pediatric Surgery at Ohio State University's Columbus Children's Hospital. After completing his pediatric surgery fellowship at the University of Michigan's C.S. Mott Children's Hospital, Dr. Cywes was appointed as an Assistant Professor of Pediatric and Fetal Surgery at Vanderbilt University in Nashville, Tennessee where he did hepatic stem cell research. During this time, Dr. Cywes became increasingly interested in adolescent obesity and the impact of the liver and metabolic syndrome on young patients. Dr. Cywes' research led to a comprehensive understanding of the toxicity of chronic excessive carbohydrate consumption as the primary cause of obesity and so-called obesity-related co-morbidities, and he became interested in developing a clinical program to treat obese patients using this knowledge. Dr. Cywes relocated to Jacksonville, Florida where he joined the Department of Pediatric Surgery at the Nemours Children's Clinic and Wolfson Children's Hospital. This led to a national meeting in Jacksonville where guidelines for adolescent obesity surgery were established. Dr. Cywes established JSAPA to continue his work in both adolescent and adult obesity treatment and surgery, and in 2013 opened a practice in Palm Beach County, Florida. He now works with a highly experienced team of professionals from a variety of medical sub-specialties to better care for obese patients. He has developed the practice into an internationally recognized Center of Excellence for obesity surgery. The practice uses a cognitive behavioral therapy approach that addresses carbohydrate addiction, along with bariatric surgery, to help patients manage their obesity long term. In this episode, Dr. Cywes opens the show discussing the correlation between carbohydrates and toxic drugs. Our bodies do not need to run on sugar; our bodies prefer a keto lifestyle. Also, Dr. Cywes explains effective methods of treating diabetes and what's wrong with conventional treatments. Stay tuned, as Dr. Cywes discusses dopamine fasting, serotonin loading, and how our feedback controls for survival work. BiOptimizers Special November Deal: www.magnesiumbreakthrough.com/ketokamp and use code ketokamp to get your discount and free gifts today!
Recently, Kim sent in a question to Ask The Egg Whisperer. She is 44 and has type 2 diabetes. She wants to know if she should continue trying to get pregnant with her own eggs, or consider other options. Here's what she had to say, "I have had 2 normal pregnancies in the past, with the last one 10 years ago. I have a boy and a girl; my husband and I have tried to conceive for the past 4 years naturally without success. We went to a fertility clinic and have done all test possible everything came back good besides that I was diagnosed with type 2 diabetes with 11.4 A1C and reduced it to 7 in 3 months, my AMH level was 0.25. We have done an IUI cycle last month, and it was unsuccessful, and we are trying IUI for the second time with clomid and obedril shot as the last time. Are we doing the right thing or are we wasting time? I would really like to avoid IVF if possible, plus I would like to use my own eggs if possible. Thank you!" You can tune in for more information about the chances of pregnancy and egg viability at age 44, along my suggestions on what to consider when trying to conceive. You can also hear the answers to other listener submitted questions. Submit your question at AskTheEggWhisperer.com Follow on Apple Podcasts Follow on Spotify Subscribe to my YouTube channel for more fertility tips! Join Egg Whisperer School Checkout the podcast Subscribe to the newsletter to get updates Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.
: Episode 1977 - On this Saturday show, Damian Welch Abernathy joins Vinnie to discuss going from soft and succulent to lean and mean, beating disease with diet, incorporating exercise, and more. https://vinnietortorich.com/2021/11/beating-disease-with-diet-episode-1977 PLEASE SUPPORT OUR SPONSORS DAMIAN'S STORY He has a broadcaster's voice. Damian spent only a brief time on the radio. Check out his podcast: https://phoneboy.com/ps Over the last few years, he's really established his podcasting set-up. He also does webinars pretty consistently. Starting at age 10, he began to put on weight. He was a skinny kid, then the guidelines changed and he became heavy. In 2004, he probably weighed 285 lbs and found the Atkins story. He got down to 215 but wanted to get down to 180. He had a second child then fell off the wagon and gained a lot of the weight back. BEATING DISEASE WITH DIET Eventually, in 2014, Damian was diagnosed with hypertension, Type 2 diabetes, and more. He was told to eat a lot of carbs each day and he knew that wouldn't work for him. It was important to him that he get his A1C down. In 2017, he discovered Jason Fung and The Obesity Code. This lead him to keto -- but pure keto, not commercialized keto. By 2019, he had lost 100 lbs. Then, he began running at 230 lbs. This supplemented the eating well. FAT DOC 2 IS AVAILABLE ON iTUNES and AMAZON Please also share it with family and friends! Buy it and watch it now on iTunes to get it to the top of the charts. We need it to get big for people to see it. Here's the (BLUERAY, DVD, PRIME) (MAY NOT BE AVAILABLE YET ACROSS THE POND). And the And the https://amzn.to/3rxHuB9 PLEASE DON'T FORGET TO REVIEW the film AFTER YOU WATCH! FAT DOC 1 IS ALSO OUT Go watch it now! We need people to buy and review for it to stay at the top of iTunes pages. Available for both rental and purchase. You can also buy hardcopy or watch online at Amazon. YOU CAN NOW STREAM FOR FREE ON AMAZON PRIME IF YOU HAVE IT!
Videos for Today: 1. DR Peter C. Gøtzsche Comments – 3 mins 2. PARENTS IN NY TAKE TO THE STREETS TO WARN IGNORANT PARENTS INJECTING THEIR CHILDREN WITH PFIZER SHOT 3, DANIEL NAGASE – EFFECTS OF CV VX ON THE IMMUNE SYSTEM DEVELOPMENT IN CHILDREN 4.The Great Narrative: A call to action speaker Freeke Heijman (start 3 min mark) 5. COMMERCIAL PILOT CODY FLINT: “I DON'T KNOW IF I WILL EVER BE ABLE TO FLY A PLANE AGAIN.” 6. Study, Experts: Vaccinated Are Spreading COVID-19 start 23 seconds in 7. RFK CLIP Start 50 seconds in Everyone missed this one… vaccinated people are up to 9X more likely to be hospitalized than unvaccinated people Australian War Propaganda Keeps Getting Crazier Are we seeing some new form of Covid-19 Vaccine induced Acquired Immunodeficiency Syndrome? – Official Government data suggests the Fully Vaccinated are on the precipice of disaster as their Immune Systems are being decimated $285 Billion Tax Cut for the Rich Is Now 2nd Most Expensive Piece of Build Back Better Wall Street's Takeover of Nature Advances with Launch of New Asset Class Court Deals New Blow to ‘Fatally Flawed' Biden Vaccine Mandates, But What Does That Mean? Study: Sustainable eating is cheaper and healthier Oxford University, November 11, 2021 Oxford University research has today revealed that, in countries such as the US, the UK, Australia and across Western Europe, adopting a vegan, vegetarian, or flexitarian diet could slash your food bill by up to one-third. The study, which compared the cost of seven sustainable diets to the current typical diet in 150 countries, using food prices from the World Bank's International Comparison Program, was published in The Lancet Planetary Health. It found that in high-income countries: Vegan diets were the most affordable and reduced food costs by up to one third. Vegetarian diets were a close second. Flexitarian diets with low amounts of meat and dairy reduced costs by 14%. By contrast, pescatarian diets increased costs by up to 2%. “We think the fact that vegan, vegetarian and flexitarian diets can save you a lot of money is going to surprise people,” says Dr. Marco Springmann, researcher on the Oxford Martin Programme on the Future of Food. “When scientists like me advocate for healthy and environmentally-friendly eating, it's often said we're sitting in our ivory towers promoting something financially out of reach for most people. This study shows it's quite the opposite. These diets could be better for your bank balance as well as for your health and…the planet.” Miguel Barclay, author of the bestselling “One Pound Meals” series of cookbooks, says, “I definitely agree that cutting down your meat, or cutting it out completely, will save you money. I've written seven budget cookbooks and have costed up hundreds of recipes, and without doubt vegan and vegetarian meals consistently come in at a much lower price than recipes with meat.” The study focused on whole foods and did not include highly-processed meat replacements or eating at restaurants or takeaways. The study also found that in lower income countries, such as on the Indian subcontinent and in sub-Saharan Africa, eating a healthy and sustainable diet would be up to a quarter cheaper than a typical Western diet, but at least a third more expensive than current diets. To analyze what options could improve affordability and reduce diet costs, the study looked at several policy options. It found that making healthy and sustainable diets affordable everywhere is possible within the next 10 years when economic development, especially in lower income countries, is paired with reductions in food waste and a climate and health-friendly pricing of foods. “Affording to eat a healthy and sustainable diet is possible everywhere, but requires political will,” according to Dr. Springmann. “Current low-income diets tend to contain large amounts of starchy foods and not enough of the foods we know are healthy. And the western-style diets, often seen as aspirational, are not only unhealthy, but also vastly unsustainable and unaffordable in low-income countries. Any of the healthy and sustainable dietary patterns we looked at are a better option for health, the environment, and financially, but development support and progressive food policies are needed to make them both affordable and desirable everywhere.” The study, “The global and regional costs of healthy and sustainable dietary patterns: a modeling study,” is published in The Lancet Planetary Health on 10 November 2021. Country-level results are available here. Green One Pound Meals by Miguel Barclay is published on 30 December. It features planet-friendly recipes and includes tips and ideas for shopping smart and avoiding food waste. Meta-analysis concludes resveratrol beneficially modulates glycemic control in diabetics Zagazig University and Suez Canal University (Egypt), October 29 2021. Findings from a meta-analysis of clinical trials published on October 16, 2021 in Medicina Clinica (Barcelona) revealed an association between supplementing with resveratrol and improvements in glycemic control. “Type 2 diabetes mellitus (T2DM) is a progressive meta-inflammatory disorder, which induces micro and macrovascular complications,” Ibrahim A. Abdelhaleem and colleagues wrote. “Resveratrol is a nutraceutical known to have antioxidant and anti-inflammatory properties.” “This systematic review and meta-analysis is the first to consider resveratrol's efficacy on glycemic and cardiometabolic parameters in patients with T2DM.” Sixteen randomized trials that included a total of 871 diabetic men and women were selected for the meta-analysis. The trials compared resveratrol to a placebo with or without concurrent antidiabetic medications or other drug treatment. Resveratrol doses of 500 milligrams or more were associated with lower fasting blood glucose, fasting serum insulin, insulin resistance, total cholesterol, LDL cholesterol and diastolic blood pressure in comparison with a placebo. Resveratrol was associated with a greater reduction in hemoglobin A1c (a marker of long-term glucose control) compared to a placebo in trials of three months duration. When HDL cholesterol levels were analyzed, resveratrol was superior to a placebo in trials of less than two months duration. Resveratrol was also associated with a reduction in systolic blood pressure compared to measurements obtained in the placebo group. Furthermore, triglycerides were lower in association with resveratrol in trials that lasted six to twelve months. “We concluded that resveratrol appropriately improved insulin sensitivity by decreasing insulin resistance, fasting blood glucose, fasting serum insulin, and hemoglobin A1c,” the authors concluded. “In addition, it improved other cardiometabolic parameters, including triglycerides, total cholesterol, LDL cholesterol, and systolic and diastolic blood pressure. The most appropriate glycemic control effect was fulfilled when consumed for at least one month with doses of 500 mg or more.” Exercise linked to better mental health Kaiser Permanente Research, November 11, 2021 Kaiser Permanente research published on November 11 in Preventive Medicine showed people who exercised more during the initial lockdown period of the COVID-19 pandemic experienced less anxiety and depression than those who didn't exercise. It also showed that people who spent more time outdoors typically experienced lower levels of anxiety and depression than those who stayed inside. More than 20,000 people participated in the survey-based study from 6 regions served by Kaiser Permanente across the United States, which included Hawaii, Colorado, Georgia, and the mid-Atlantic states, as well as Southern and Northern California. “What these study findings tell us is that even during an active pandemic or other public health crisis, people should be encouraged to be physically active to help maintain their physical and mental health,” said the study's lead author Deborah Rohm Young, PhD, the director of the Division of Behavioral Research for the Kaiser Permanente Southern California Department of Research & Evaluation. “Parks and other nature areas should remain open during public health emergencies to encourage outdoor physical activity.” In March 2020, COVID-19 developed into a worldwide pandemic. With no known treatment, public health officials attempted to reduce its spread by limiting human interactions through stay-at-home policies. Businesses temporarily closed or changed their practices to prevent the spread of the virus, affecting the economy and many people's jobs. These stressful factors, along with fewer opportunities to socialize with friends and family, increased symptoms of depression and anxiety for many people. Since it is known that physical activity and time spent in nature are associated with improved mental health, researchers at Kaiser Permanente in Southern California sought to determine how exercise and time outdoors was associated with people's mental health during the height of the pandemic. In April 2020, researchers sent a series of COVID-19 surveys to more than 250,000 participants in the Kaiser Permanente Research Bank — a collection of lifestyle surveys, electronic health record data, and biospecimens, which Kaiser Permanente members volunteered. People who reported COVID-19 symptoms were not included in this analysis, resulting in 20,012 respondents. They each completed at least 4 surveys between April and July 2020. White women older than 50 accounted for a high proportion of the respondents. Most respondents said they were retired and generally adhered to the “safer-at-home” orders during the period of the survey. The study found that: Reports of anxiety and depression decreased over time Anxiety and depression scores were higher for females and younger people, and lower for Asian and Black people compared with white respondents Participants who reported no physical activity reported the highest depression and anxiety compared to people who had exercised Spending less time outdoors was associated with higher depression and anxiety scores People who had increased their time outdoors the most reported the highest anxiety scores, but the research could not explain the finding “What we learned from these findings is that during future emergencies it will be important to carefully weigh the decisions to close parks and outdoor areas against the negative impact those closures may have on people's mental health,” said Dr. Young. Bedtime linked with heart health University of Exeter (UK), November 9, 2021 Going to sleep between 10:00 and 11:00 pm is associated with a lower risk of developing heart disease compared to earlier or later bedtimes, according to a study published today in European Heart Journal—Digital Health, a journal of the European Society of Cardiology (ESC). “The body has a 24-hour internal clock, called circadian rhythm, that helps regulate physical and mental functioning,” said study author Dr. David Plans of the University of Exeter, UK. “While we cannot conclude causation from our study, the results suggest that early or late bedtimes may be more likely to disrupt the body clock, with adverse consequences for cardiovascular health.” While numerous analyses have investigated the link between sleep duration and cardiovascular disease, the relationship between sleep timing and heart disease is underexplored. This study examined the association between objectively measured, rather than self-reported, sleep onset in a large sample of adults. The study included 88,026 individuals in the UK Biobank recruited between 2006 and 2010. The average age was 61 years (range 43 to 79 years) and 58% were women. Data on sleep onset and waking up time were collected over seven days using a wrist-worn accelerometer. Participants completed demographic, lifestyle, health and physical assessments and questionnaires. They were then followed up for a new diagnosis of cardiovascular disease, which was defined as a heart attack, heart failure, chronic ischaemic heart disease, stroke, and transient ischaemic attack. During an average follow-up of 5.7 years, 3,172 participants (3.6%) developed cardiovascular disease. Incidence was highest in those with sleep times at midnight or later and lowest in those with sleep onset from 10:00 to 10:59 pm. The researchers analyzed the association between sleep onset and cardiovascular events after adjusting for age, sex, sleep duration, sleep irregularity (defined as varied times of going to sleep and waking up), self-reported chronotype (early bird or night owl), smoking status, body mass index, diabetes, blood pressure, blood cholesterol and socioeconomic status. Compared to sleep onset from 10:00 to 10:59 pm, there was a 25% higher risk of cardiovascular disease with a sleep onset at midnight or later, a 12% greater risk for 11:00 to 11:59 pm, and a 24% raised risk for falling asleep before 10:00 pm. In a further analysis by sex, the association with increased cardiovascular risk was stronger in women, with only sleep onset before 10:00 pm remaining significant for men. Dr. Plans said: “Our study indicates that the optimum time to go to sleep is at a specific point in the body's 24-hour cycle and deviations may be detrimental to health. The riskiest time was after midnight, potentially because it may reduce the likelihood of seeing morning light, which resets the body clock.” Dr. Plans noted that the reasons for the observed stronger association between sleep onset and cardiovascular disease in women is unclear. He said: “It may be that there is a sex difference in how the endocrine system responds to a disruption in circadian rhythm. Alternatively, the older age of study participants could be a confounding factor since women's cardiovascular risk increases post-menopause—meaning there may be no difference in the strength of the association between women and men.” He concluded: “While the findings do not show causality, sleep timing has emerged as a potential cardiac risk factor—independent of other risk factors and sleep characteristics. If our findings are confirmed in other studies, sleep timing and basic sleep hygiene could be a low-cost public health target for lowering risk of heart disease.” Garlic compounds may boost cardio health indirectly via gut microbiota National Taiwan University, November 6 2021 Allicin from garlic may prevent the metabolism of unabsorbed L-carnitine or choline into TMAO, a compound linked to an increased risk of cardiovascular diseases, says a new study from the National Taiwan University. TMAO – or trimethylamine N-oxide – has been known to be generated from dietary carnitine through metabolism of gut microbiota, and was recently reported to be an “important gut microbiota-dependent metabolite to cause cardiovascular diseases,” explained Taiwanese researchers in the Journal of Functional Foods . While antibiotics have been found to inhibit TMAO production, concerns over side effects and resistance have limited their use. This has led researchers to examine the potential of natural alternatives. New data indicated that carnitine-fed lab mice showed a “remarkable increase in plasma TMAO levels”, compared with lab mice fed a control (no carnitine). However, when allicin supplements were provided with the carnitine diet, TMAO levels were significantly reduced. “Surprisingly, the plasma TMAO levels in the mice of ‘carnitine diet + allicin' treatment group were as low as that of chow diet [control] group,” wrote the researchers. “This result indicated that the metabolic capacity of mice gut microbiota to produce TMAO was completely inhibited by allicin supplement even though provided with carnitine-rich environment in the gut. “It means the functional alteration of gut microbiota induced by carnitine diet can be prevented by addition of another substance with antimicrobial potential derived from food, such as allicin.” Garlic and heart health The study adds to the body of scientific literature supporting the potential heart health benefits of garlic and the compounds it contains. Consumer awareness of the health benefits of garlic, mostly in terms of cardiovascular and immune system health, has benefited the supplements industry, particularly since consumers seek the benefits of garlic without the odors that accompany the fresh bulb. The benefits have been linked to the compound allicin, which is not found in fresh garlic: It is only formed when garlic is crushed, which breaks down a compound called diallyl sulphide. Study details “This may offer an opportunity to take advantage of plants' delicately designed defense system against microorganisms, to protect ourselves by modulating gut microbiota to a healthier status,” wrote the researchers The Taiwanese researchers divided male C57BL/6(B6) mice into four groups: One group received only the control chow diet; the second group received the carnitine diet (carnitine added to drinking water at a level of 0.02%); the third group received the carnitine diet with supplemental allicin; and the final group received the control diet plus the allicin supplement for six weeks. Results showed that the second group (carnitine diet) had TMAO levels 4–22 times greater than those observed in the control group. However, these increases were attenuated in the carnitine + allicin group, said the researchers. “Our study suggests that antimicrobial phytochemicals such as allicin effectively neutralize the metabolic ability of TMAO production of gut microbiota induced by daily intake of L-carnitine,” wrote the researchers. “It may offer an opportunity for us to take advantage of plants' delicately designed defense system against microorganisms, to protect ourselves by modulating gut microbiota to a healthier status. “Our research also suggested that allicin and dietary fresh garlic containing allicin might be used as functional foods for the prevention of atherosclerosis,” they concluded. Drug used to prevent miscarriage increases risk of cancer in offspring University of Texas Health Science Center, November 9, 2021 Exposure in utero to a drug used to prevent miscarriage can lead to an increased risk of developing cancer, according to researchers at The University of Texas Health Science Center at Houston (UTHealth Houston). The study was published today in the American Journal of Obstetrics and Gynecology. The drug, 17α-hydroxyprogesterone caproate (17-OHPC), is a synthetic progestogen that was frequently used by women in the 1950s and 1960s, and is still prescribed to women today to help prevent preterm birth. Progesterone helps the womb grow during pregnancy and prevents a woman from having early contractions that may lead to miscarriage. “Children who were born to women who received the drug during pregnancy have double the rate of cancer across their lifetime compared to children born to women who did not take this drug,” said Caitlin C. Murphy, PhD, MPH, lead author on the study and associate professor in the Department of Health Promotion and Behavioral Sciences at UTHealth School of Public Health in Houston. “We have seen cancers like colorectal cancer, pancreatic cancer, thyroid cancer, and many others increasing in people born in and after the 1960s, and no one really knows why.” Researchers reviewed data from the Kaiser Foundation Health Plan on women who received prenatal care between June 1959 and June 1967, and the California Cancer Registry, which traced cancer in offspring through 2019. Out of more than 18,751 live births, researchers discovered 1,008 cancer diagnoses were made in offspring ages 0 to 58 years. Additionally, a total of 234 offspring were exposed to 17-OHPC during pregnancy. Offspring exposed in the womb had cancer detected in adulthood more than twice as often as offspring not exposed to the drug – 65% of cancers occurred in adults younger than 50. “Our findings suggest taking this drug during pregnancy can disrupt early development, which may increase risk of cancer decades later,” Murphy said “With this drug, we are seeing the effects of a synthetic hormone. Things that happened to us in the womb, or exposures in utero, are important risk factors for developing cancer many decades after we're born.” A new randomized trial shows there is no benefit of taking 17-OHPC, and that it does not reduce the risk of preterm birth, according to Murphy. The U.S. Food and Drug Administration proposed in October 2020 that this particular drug be withdrawn from the market.
Diabetes isn't a cookie-cutter plan, and it's time our medical team learned that. It's about so much more than your A1C.Grab Matt's free T1D Webclass here:https://diabetesinaction.com---------Welcome to the Pardon My Pancreas podcast!! This show is all about REAL life with type 1 diabetes, understanding fluctuations, and how to stabilize your blood sugar for good. Your host is Matt Vande Vegte is a certified personal trainer, nutritionist, and type 1 diabetic whose biggest goal in life is to help people with diabetes around the world live their lives fearlessly. Looking for an online health coaching program to help you live your best life? Go to https://www.ftfwarrior.com to learn more about his program for diabetics only that is focused on helping you reach your goals while living a happier and healthier life. Join the Tribe today!This podcast is sponsored by FTF Warrior - An online health and fitness coaching company for type 1 diabetics dedicated to helping them master their blood sugars through any activity, exercise, or meal!https://www.ftfwarrior.comFollow Matt here:Instagram: https://www.instagram.com/ftfwarrior/Facebook: https://www.facebook.com/ftfwarrior/Youtube: https://www.youtube.com/c/ftfwarrior------------------------------------------------------Disclaimer: While we share our experiences with diabetes, nothing we discuss should be taken as medical advice. Please consult your doctor or medical professional for your health and diabetes management.
Are you experiencing an elevated A1C despite your keto diet? Want to know the reasons beyond excessive carbohydrate consumption that your A1C could be elevated? Looking to lower your blood sugar using food as medicine? Tune in to learn what hemoglobin A1C measures, how to interpret fasting and postprandial blood glucose, and how A1C can be elevated based on a multitude of reasons from gum disease to stress and beyond. In this episode, we break down different ways of assessing blood sugar and how to troubleshoot an elevated A1C value. Even on a squeaky clean keto diet, factors such as gut health, sleep, and inflammation can drive your blood sugar out of whack. Learn how to recognize the cause of your elevated A1C and how to get it under control from the root cause using diet, lifestyle, and supplement strategy. Also in this episode: Episode 99: Ketosis as Medicine Episode 206: Diabetes Where We Went Wrong Episode 207: Diabetes a Functional Approach Episode 209: A Week of My Blood Sugar CGM Experiment Women's Wellness Workshop What is A1C? Assessment of Blood Sugar Beyond A1CCardioMetabolic Panel - measures glycomark, fasting insulin, leptin Advanced Metabolic Panel - measures A1C KetoMojo - ketone and glucose meter Oral Glucose Tolerance TestEpisode 196: Becki's Second Trimester Measuring Fasting & Post Prandial Blood Sugar What's Elevating My A1C?Gum Disease and Oral HealthX Clear Spray Beat the Bloat Cleanse Periowash Biocidin Pristine Protocol Joan Sefcik, DDS Gut Health and H. PyloriBroccoDetox Cellular Antiox Bio-C Plus GI Reset Dysbiosis Quiz SleepSanta Cruz Medicinals Deep Sleep Capsules & CBD Epsom Salts use code ALIMILLERRD Sleep Support Calm and Clear Episode 249: Sleep and the Benefits of Melatonin InflammationAnti-Inflammatory Bundle Inflammazyme MRT Test Anemia How Alcohol Affects A1c Dry Farm Wines StressNeuroHormone Panel Stress Manager Bundle Episode 149: Are You Running on Adrenaline Overweight and Obesity12 Week Ketosis Program Berberine Boost 10 Day Detox Free Detox Webinar Sponsors for this episode: This episode is sponsored by Santa Cruz Medicinals, makers of potent and affordable CBD with effective dosing. For more information check out www.scmedicinals.com and use code ALIMILLERRD for 15% off your order.
Check out this interesting data on A1C. DATA: https://bit.ly/3GJLje4 https://bit.ly/3q0FLpp More Videos on Benfotiamine: https://youtu.be/XmYrJ0s7QQU https://youtu.be/szY9ijBUDUs FREE COURSE ➜ ➜ https://courses.drberg.com/product/how-to-bulletproof-your-immune-system/ FREE MINI-COURSE ➜ ➜ Take Dr. Berg's Free Keto Mini-Course! ADD YOUR SUCCESS STORY HERE: https://bit.ly/3z9TviS Talk to a Dr. Berg Keto Consultant today and get the help you need on your journey (free consultation). Call 1-540-299-1557 with your questions about Keto, Intermittent Fasting, or the use of Dr. Berg products. Consultants are available Monday through Friday from 8 AM to 10 PM EST. Saturday & Sunday from 9 AM to 6 PM EST. USA Only. Dr. Eric Berg DC Bio: Dr. Berg, 51 years of age is a chiropractor who specializes in weight loss through nutritional & natural methods. His private practice is located in Alexandria, Virginia. His clients include senior officials in the U.S. government & the Justice Department, ambassadors, medical doctors, high-level executives of prominent corporations, scientists, engineers, professors, and other clients from all walks of life. He is the author of The 7 Principles of Fat Burning. Dr. Berg's Website: http://bit.ly/37AV0fk Dr. Berg's Recipe Ideas: http://bit.ly/37FF6QR Dr. Berg's Reviews: http://bit.ly/3hkIvbb Dr. Berg's Shop: http://bit.ly/3mJcLxg Dr. Berg's Bio: http://bit.ly/3as2cfE Dr. Berg's Health Coach Training: http://bit.ly/3as2p2q Facebook: https://www.facebook.com/drericberg Messenger: https://www.messenger.com/t/drericberg Instagram: https://www.instagram.com/drericberg/ YouTube: http://bit.ly/37DXt8C
Dr. Ryan Attar is an expert in managing Type 1 diabetes. Dr. Attar is a veteran of the US Army, and after serving overseas, Dr. Attar developed Type 1 diabetes, and was medically discharged from the Army after nearly 6 years of service. After the military, Dr. Attar decided to embark on a new career to aide those with diabetes and other health issues. He graduated in 2017 from the University of Bridgeport with a Doctorate in Naturopathic Medicine and a Master's in Human Nutrition. Dr. Attar has been LIVING and THRIVING with diabetes for 12 years, and helps his patients achieve better blood glucose, A1c and weight loss goals. He is very active in the TypeOneGrit online diabetes community, a group that was studied in 2018 in the journal Pediatrics. He has written several articles on the diabetes website Diabetes Daily. When not practicing medicine, Dr. Attar is an avid traveler, having been to 75 countries. Dr. Attar also enjoys fitness, weightlifting and is currently a blue belt in jiujitsu!Find Dr. Attar at-https://drattar.com/The Diabetes Solution documentary!
Do you get regular bloodwork run? Do you know the difference between clinically acceptable values vs. optimal? Have you ever wondered how genetics can impact your lab values for blood glucose or A1C? Then tune in! In this episode, your host William Grazione will have his recent lab values reviewed by Coach Gillis Pellegrin. The two will go over William's values mentioned along with testosterone, estrogen, liver enzymes, cholesterol, and more. Coach Gillis will lay down important information about supplementation that can be used to optimize your bloodwork when you are over or under in your numbers. This episode is information-packed with a lot of helpful insight that will give you tools to help you take control of your health. Grab and pen and paper, and let's get into it.
This week, the top diabetes stories and headlines in the news include: the popular Sugarmate app loses Dexcom connection, interesting study about internal clocks and type 2 diabetes, the FDA approves new "POGO" BG meter, T2D remission might be more common than thought, Type 1 college scholarships and lots more. -- Join us LIVE on Facebook and YouTube every Wednesday at 4:30pm EDT Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode transcription below: Click here for iPhone Click here for Android Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World's Worst Diabetes Mom, Real life stories of raising a child with diabetes. Available in paperback, on Kindle or as an audio book – all at Amazon.com -- Top story this week.. Big issue for a popular app – users of Sugarmate have been told as of this week – November 4th to be precise – customers in the US will lose connection. Those outside the US have seen issues since October. This is because of a change Dexcom made to its servers. Sugarmate says Dexcom is working with them to fix the issue – basically they're going to join the Dexcom Partner API – we've told you about that, it's how third party apps can talk with Dexcom.. In the meantime, Nightscout is probably the best alternative if you use Sugarmate. Quick note: Tandem acquired Sugarmate last year. And you'll recall that Dexcom does own a small piece of Tandem. So it looks like this will all probably work out.. but exactly how in the long run will be interesting to watch. -- https://help.sugarmate.io/en/articles/5678010-faqs-sugarmate-and-dexcom-connection?mkt_tok=MzQ4LVJYVi03MDUAAAGAgZ5w-m8YKeY90ybxznIKZ4b4XWStjdvSjf7vH3dNx8PMDzDa9sJP0En6odZtM-Z4UthLL9z7MNV86wnQ4R9o61-islyzvtyvg13By4FB5A&fbclid=IwAR39j2vxjr3JuUbcQdruIAttCSuRl5dD1jVbdNKrm1b5JQpuyYlQiwH1xXs XX A study of “dented” internal clocks seems to build evidence for a theory that people who work late or irregular hours are more at risk for diabetes. Researchers at the University of Pennsylvania created a timing mismatch by altering the function of a molecule within the brains of mice.. shortened their circadian rhythms from 24 to 21 hours. These mice gained more weight, had higher blood sugar, and fattier livers. This all corrected when the researchers changed their environment – sleep and meals – to match that shorter, 21 hour day. They say it might be a good idea for shift workers to try to do the same – eating meals and going to bed in a cycle that works better for them. https://www.pennmedicine.org/news/news-releases/2021/october/a-dented-internal-clock-provides-insight-into-shift-workers-weight-gain-and-diabetes XX New Blood glucose meter gets FDA approval. This is the POGO … with 10-test cartridge technology. The strips and lancers are loaded inside already, so you don't carry anything separate. You just put your finger down and press the button. They're calling this automatic blood glucose monitoring or ABGM. On the inside it's still a basic finger stick and blood collection. But you don't see any of that on the outside. Of course, there's a Bluetooth connected app for you and your healthcare team to use. The product is called POGO. the app is Patterns. https://finance.yahoo.com/news/pogo-automatic-one-step-blood-113000135.html XX New numbers out for diabetes around the world and the International Diabetes Federation says it's a pandemic of unprecedented magnitude. The IDF says more than 10-percent of adults worldwide live with diabetes.. by 2045 that number will be one in eight. The report also says that one in two people with diabetes across the world who need insulin cannot access or afford it. The theme of World Diabetes Day this November 14th is Access to Diabetes Care. https://www.prnewswire.com/news-releases/diabetes-is-a-pandemic-of-unprecedented-magnitude-now-affecting-one-in-10-adults-worldwide-reveals-the-international-diabetes-federation-301413238.html XX Good news for people with type 1.. when more intensive glucose management starts early, it greatly reduces the future risk of heart and kidney issues. This info comes from a look back at the DCCT and EDIC trials – which are 100% worth looking into if you aren't familiar with them. By the way, in these trials “intensive” glucose control was pegged at an A1C of 7 and the riskier group had an A1C of 9 or above. The earlier the A1C was brought down to 7, the less risk of complications. https://www.endocrinologyadvisor.com/home/topics/diabetes/type-1-diabetes/earlier-intensive-type-1-diabetes-treatment-reduces-long-term-cardiovascular-and-kidney-complications/ XX How common is type 2 remission? It's hard to say but a new study from Scotland suggests it's more common than we might think. These University of Edinburgh scientists say in Scotland, it's one in 20. They looked at everyone in the country over the age of 30 with type 2, based on A1C levels -that's about 160-thousand people. Then they said during the study year, 77-hundred people went into remission, which means their A1Cs dropped to 6.5 without medication. Those people were older, had lost weight since their diagnosis, had no history of glucose lowering therapy or bariatric surgery, and generally had healthier blood readings at the time of their diagnosis. https://www.sciencealert.com/reversing-type-2-diabetes-seems-to-be-more-common-than-scientists-realized XX College scholarship contest to tell you about. Senita (sen-EE-tuh) Athletics is partnering with Insulet to award four $5,000 scholarships to people with type 1 diabetes. In honor of National Diabetes Awareness Month, the athletic fashion wear maker is looking for 'Senita Scholars.” The co-founders have a younger brother with type 1 and their fitness gear is known for really good pockets. To be eligible, students across the U.S. must be either a graduating senior in high school or a current undergraduate and have type 1 diabetes. Applications close on Nov. 30. https://finance.yahoo.com/news/senita-athletics-partners-insulet-corporation-150000801.html XX Lots of events happening around the diabetes community for this awareness month. Friends for Life virtual starts next week as does Together T1D. I mention this because it's got a powerful lineup, with Olympian Charlotte Drury, Pietro Marsala, the first person with T1D to get a commercial pilot's license in the US and more… XX And finally, a big happy diaversary to a previous guest of the podcast – Yerachmiel Altman is marking 60 years with type 1 on November 8th. I'll link up my episode with him.. he worked on early insulin pumps and has worn every bit of tech you can think of.. Wishing you continued good health and thank you for sharing your experience and wisdom with us. -- quick reminder that the podcast this week is with Ken Rodenheiser – a diabetes educator who now works with Dexcom. He explains how he went from angry and lonely as a teen, to helping others start off on the right foot at diagnosis. It's a great story you can listen to wherever you get your podcasts or if you're listening to this as on a podcast app, just go back an episode. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
Hey guys, here's episode 5 of community Q&As! Why is my A1C is going up? When do you anticipate taking new clients?There are some influencers that say keto is bad long term. Your thoughts? Low carb caused hormonal imbalances?Chemical hormone replacement for menopause or natural herbs?Fruit and honey, yay or nay?Protein as the main energy source isn't accurate? Why is that?Fasting – best time for women with cycleCheese on carnivore, yes/no?Topical creams for face: Animal fats vs plant oils?Carnivore diet and the effect on the microbiome?Swallowing beef liver whole – ideal for digestion?Hives from allergies?Hair loss and prevention? Puffy/swelling face and body. Why? Dry mouth a thing? 7 months in Herbal treatments or supplements for SIBO?Thoughts on natural psychedelics?RESOURCES:People's Beef JerkyNwJ Carnivore BloodworkNwJ Symptom BurdenNwJ newsletterNwJ Stress EpisodeSIBO Study + YouTubeT3 and exercise study Honey and Fruit Q&ADairy Blog postThink Dirty and EWG's SkincareMicrobiome + CarnivoreGI MapLiver: Don't Eat Just Beef Histamine SupportOmega 3 TestingSole Water Recipe____CHECK OUT MY BOOK, Carnivore CureSIGN UP FOR MY WEEKLY NEWSLETTER_____ ADDITIONAL RESOURCESNutrition with Judy ArticlesNutrition with Judy ResourcesCutting Against the Grain Podcast_____ FIND ME
In today's podcast, you'll hear a very special interview from our 2019 online summit with Dr. Neal Barnard. In this episode, you'll hear him speak about the connection between the foods you eat and your risk of developing Alzheimer's disease. Dr. Barnard has written an authoritative book on the topic of cheese. So we asked him why it's so addicting and why cheese is so bad for your health. He gave us some insight into the connection between casein from cow's milk and type 1 diabetes Dr. Barnard and his team at PCRM conduct a lot of scientific research that's published in top journals. In this interview, we asked about his research findings and the underlying cause of insulin resistance based on his experience. And of course, we talked all about ketogenic diets, including the plant-based version of a ketogenic diet. There is a lot of gold in this interview so make sure to listen all the way to the end. Before we get started, I'm quite excited to announce our 2021 summit. So Cyrus and I have been running Mastering Diabetes summits since 2017. It's a highlight of our year getting to bring together the world's top experts in so many disciplines for one jam-packed event. Register for free today! https://bloodsugarrevolution.com/ Join The World's Top Health Experts At The 2021 Blood Sugar Revolution Summit Discover how to lower your fasting blood sugar and A1c, lose weight permanently, gain energy, clear brain fog, and stop yo-yo dieting by fixing one thing: INSULIN RESISTANCE. === Make sure to subscribe so you don't miss future episodes! Please leave us a review to ensure that the Mastering Diabetes message reaches as many people living with diabetes as possible. Connect with us on Instagram and Facebook
This week "In the News.." our top stories include: New features for Dexcom Follow, Vertex makes stem cell progress on a functional cure for type 1, funding comes through for a eye scan for glucose levels, a new aggregate diet/nutrition study measures T1D risk in babies, Medtronic snaps up a patch pump company and a lot more.. Join us LIVE every Wednesday at 4:30pm ET for the top diabetes headlines of the week. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription below: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – and new this week – Live on YouTube.. and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their breakfast line and all of their great products in your local grocery store, Target or Costco. XX Earlier today, Dexcom released some new features for its Follow app. It now includes a Homescreen Widget to an Apple device, a Quick Glance for Android users. You can submit a Technical Support Request or Request a Callback via Follow's Contact Menu. I assume that means you can request replacement sensors from within the app? And you can Access the Status page via Follow's Help Menu to check the status of any of the Dexcom systems. This is version 4.4 of Dexcom Follow and only applies to US users. XX Some news in the stem cell race – a few companies now looking at this as a practical cure for type 1. Vertex announced that the first patient in its islet cell replacement therapy is doing well – with a lower A1C and less insulin needs. The person is on immunosuppressive therapy and does still need to use insulin – although 90-percent less. This caught my eye - this person was diagnosed 40 years ago – this isn't a recent diagnosis. They also had incredible hypoglycemia, up to 5 episodes a day and pretty much have their life back now. One person does not make a cure but it's good to see these therapies moving forward. You may recall Vertex acquired Semma and joins ViaCyte which has an encapsulated stem cells – the hope for all long-term is that no immune suppressants would be needed. https://www.biospace.com/article/vertex-s-type-1-diabetes-therapy-shows-promise-in-early-stage-trial/ XX A new eye scan that could help diagnose diabetes is moving ahead. British-based startup Occuity has received investment funding for the Occuity Indigo, a non-contact, optical glucose meter.. The company says it's different from the failed Google contact lens… the Google version measured fluid.. but the Occuity looks within the eyeball. The company says quote - it is a transparent, stable environment whose glucose levels correlate with those of the blood. The Occuity Indigo sends a faint beam of light into the eyeball and measures the light that bounces back into the device. It can infer glucose levels in the eye based on the refraction of the returning light. https://www.uktech.news/featured/eye-scan-for-diabetes-berkshire-startup-is-developing-revolutionary-medical-technology-with-285m-funding-20211019 XX Medtronic's in talks to snap up what sounds like a pretty advanced patch pump from an Israeli company called Triple Jump. The Triple Jump system has a compact, fully portable, battery-operated miniature insulin pump and hand-held controller and includes all supporting accessories and sterile single-use disposables. The release here says it will be included in a future artificial pancreas system and that Medtronic plans to integrate Triple Jump's device to improve its pumping capabilities. https://en.globes.co.il/en/article-medtronic-in-talks-to-buy-israeli-co-triple-jump-for-300m-1001387534 XX No surprise but important info – using a flash glucose moniotor can improve A1Cs and reduce DKA cases. Big study in Scotland using the Libre – called a flash monitor because this version isn't continuous – you have to swipe to see your glucose. The technology has been free in Scotland since 2018 – so use in people with type 1 went from about 3 percent in 2017 to 46 percent in 2020. Improvement was seen across all ages, genders and socio-economic lines. Also.,regardless of prior or current pump use, completion of a diabetes education program, or early flash monitoring adoption. https://www.endocrinologynetwork.com/view/flash-glucose-monitoring-lowers-hba1c-rates-of-dka-in-patients-with-type-1-diabetes XX Controversial but more research into preventing type 1.. new studies showing that longer breastfeeding and later introduction to gluten may reduce the risk. This was a look at aggregate studies in Sweden.. which has the second highest incidence of type 1 in the world. (number one is Finland – I knew you were going to ask) For babies nursed for at least six to 12 months, the risk of developing type 1 went down 61 percent. Gluten at three to six months of age lowered the risk 64 percent. The studies also pointed to a protective effect of vitamin D supplementation during infancy. These researchers are careful to say that this isn't definitive but instead points to the need for more studies of babies' diet and vitamin intake and the risk of type 1. https://www.news-medical.net/news/20211018/Breastfeeding-and-later-introduction-to-gluten-may-have-a-protective-effect-against-type-1-diabetes.aspx XX Some early news about type 1 diabetes, pregnancy and the gut microbiome. This study shows pregnant women with type 1 had a decrease in "good" gut bacteria and an increase in 'bad' gut bacteria that promote intestinal inflammation and damage to the intestinal lining. These changes could contribute to the increased risk of pregnancy complications seen in women with type 1 This is very early on.. the next stage of the project was to identify markers that would determine which women with type 1 diabetes might benefit from safe interventions during pregnancy, including dietary changes. https://medicalxpress.com/news/2021-10-dietary-pregnancy-complications-women-diabetes.html XX More to come, including mental health help and a bit of a correction on my part. But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—we really like their breakfast line.. although Benny rarely eats the waffles or breakfast sandwiches for breakfast.. it's usually after school or late night. He ate like four waffles at ten o clock at night the other day. You can buy Real Good Foods online or find a store near you with their locator right on the website. I'll put a link in the FB comments and as always at d-c dot com. Back to the news… -- We talk a lot about mental health and diabetes and how there just aren't enough resources to help. I want to call your attention to a free virtual workshop by the Center for Diabetes and Mental Health. This is tomorrow as you watch me live – and if you're listening or watching after I'd still urge you to check out the resources. This is from Dr. Mark Heyman who I've had on the show and who has his own podcast. Dr. Heyman is a diabetes psychologist and Certified Diabetes Care and Education Specialist and he lives with type 1. https://cdmh.org/ https://www.reimaginet1d.com/c/reimagine-t1d?fbclid=IwAR1dsPn5wefVM3vnypUgRuBf8OA9qL-suMKlbdPZeASRXDyFuneTAYQ3igw XX Bit of a correction to last week's news.. I had speculated whether the Dexcom/Garmin partnership which uses the name Connect IQ had anything to do with Tandem's Control IQ. I heard from a lot of you – apparently Garmin's whole app system is just called Connect IQ.. and has been for years. But I did get that interview with Dexcom I mentioned.. so that will be our long-format interview episode coming up on Tuesday. That's a chat with the chief technology officer of dexcom The episode out right now is all about Halloween – it's an ask the d mom conversation with my wonderful friend moira mccarthy. We talk about everything from candy to getting your kids insulin pump under the costume to sugar free candy from well meaning neighbors That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
Metabolic Health should be a top priority for everyone, now there's a new easy at-home test kit to give you insights. Save on this at-home A1C test by Biocoach: https://bit.ly/at-home-A1C-test Use code HIH5 Time Stamps: 0:00 Intro 1:00 Hemoglobin A1C 101 1:49 Why you should care about your HbA1C 2:30 A1C Links with diseases 6:00 Hemoglobin A1C details 7:00 Testing your Hemoglobin A1C at home
Episode 69: Asymptomatic Bacteriuria. When do you screen for and treat asymptomatic bacteriuria? Find out what the IDSA recommends during this episode. PARTNER studies demonstrated that HIV transmission is minimal with condom-less sex if viral load is undetectable.Introduction: Urine. Urine is a straw-colored, pale yellow, or colorless liquid, which is by-product of metabolism. It is normally sterile when excreted under normal conditions, but it can also have bacteria even in the absence of infection. When you have bacteriuria with no symptoms, it is called asymptomatic bacteriuria or ASB. Today you will hear Dr Covenas, Dr Civelli and Dr Lundquist discussing when to screen and treat asymptomatic bacteriuria.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. [Music continues and fades…]_____________________________Asymptomatic bacteriuria (update by the IDSA)Written by Hector Arreaza, MD. Participation by Cecilia Covenas, MD; Valeri Civelli, MD; and Ariana Lundquist, MD.Case: 19-year-old female who came to clinic to review lab results with you. She is coming from another clinic and brings her results on paper. Routine labs were done 1 week ago. Her complete blood count is normal, TSH (thyroid stimulating hormone) is normal, hemoglobin A1C of 5.3, and a urine culture showing >100,000 CFU of E. coli. Patient denies dysuria, polyuria, or any urinary symptoms. She has a negative pregnancy test in clinic today. What are you going to do with this significant bacteriuria?This is an Asymptomatic Bacteriuria (ASB). The first question you may ask is “why did she get a urine culture in the first place?” The Infectious Disease Society of America (IDSA) published in its journal “Clinical Infectious Disease” an update in the management of ASB. It is a 28-page long document with answers to 14 questions regarding ASB screening and management in different patient populations.Recommended ASB screening and treatment: IDSA concluded that the only two groups of patients who benefit from screening and treatment of asymptomatic bacteriuria are: Pregnant women and patients who undergo traumatic urologic interventions that result in mucosal bleeding.Pregnant women: Recommend one urine culture at one of the initial visits early in pregnancy. There is insufficient evidence to recommend for or against repeat screening during the pregnancy for a woman with an initial negative screening culture or following treatment of an initial episode of ASB. Treatment: IDSA suggests 4–7 days of antimicrobial treatment rather than a shorter duration, the optimal duration of treatment will vary depending on the antimicrobial given; the shortest effective course should be used. Patients who will undergo endoscopic urologic procedures associated with mucosal trauma: Screening for ASB and treating prior to surgery is RECOMMENDED. The goal is to avoid serious post-operative complication of sepsis. IDSA suggests a urine culture prior to the procedure and targeted antimicrobial therapy prescribed rather than empiric therapy. If bacteriuria is detected, a short course (1 or 2 doses) rather than more prolonged antimicrobial therapy is recommended, and antibiotic should be initiated 30–60 minutes before the procedure.Against ASB screening and treatment: IDSA suggests no screening for or treating ASB in these patients:Pediatric patientsHealthy nonpregnant womenCommunity-dwelling persons who are functionally impairedOlder persons residing in long-term care facilitiesPatients with diabetesPatients who had a renal transplant over 1 month ago (insufficient evidence for less than 1 month ago)Patients with nonrenal solid organ transplantIndividuals with impaired voiding following spinal cord injury (consider atypical symptoms of UTI when deciding treatment vs nontreatment of bacteriuria in these patients)Short-term indwelling urethral catheter (30 days)Patients undergoing elective nonurologic surgeryPatients planning to undergo surgery for an artificial urine sphincter or penile prosthesis implantation (these patients should receive standard preop antibiotics before surgery)Patients living with implanted urologic devicesInsufficient evidence to recommend for or against ASB screening and treatment: Evidence is insufficient to recommend ASB screening and treatment in patients with high-risk neutropenia (absolute neutrophil count 7 days duration after chemotherapy). These patients should be treated with prophylactic antibiotics and start antibiotics promptly in there is fever. For low-risk neutropenic patients (neutrophils >100,
It's "In the News..." the only LIVE diabetes newscast! Top stories this week: Medtronic expands its insulin pump recall, Afrezza inhaled insulin pediatric studies to begin, new report says adults w/T1D are a "Forgotten population," new research into type 2 diabetes and statins and more! Join us each Wednesday at 4:30pm EDT live at https://www.facebook.com/diabetesconnections Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcript below: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their Entrée Bowls and all of their great products in your local grocery store, Target or Costco. XX Our top story this week.. Medtronic has expanded a recall of its MiniMed 600 series insulin pumps to include nearly half a million devices. This is an FDA Class One recall – the most serious type – because the pumps may deliver incorrect insulin doses. The recall was first announced in 2019 for just two models. Medtronic now says it will replace any MiniMed 600 series insulin pump that has a clear retainer ring with one that has the updated black retainer ring at no charge. That's even if there is no damaged and regardless of the warranty status of the pump. There's more to this – including directions on how to check if your pump may be affected and who to call. I'll put all of that here in the FB comments and in the show notes. https://www.usnews.com/news/health-news/articles/2021-10-05/medtronic-expands-recall-to-include-more-than-463-000-insulin-pumps XX Enrollment is under way for the first pediatric trials for Afrezza inhalable insulin. This will involve children ages 4 to 17 living with type 1 or type 2 diabetes. It's called the INHALE-1 phase three trial. They're going to look at changes in A1C after 26 weeks.. and then changes in fasting glucose after another 26 weeks. If you're interested, we've got the link for more info to this study and to learn about enrollment. Afrezza was approved for adults back in 2014. https://clinicaltrials.gov/ct2/show/NCT04974528. https://investors.mannkindcorp.com/news-releases/news-release-details/mannkind-announces-first-patient-enrolled-inhale-1-study XX Last week we told you about the Glucagon emergency kit recall from Lilly. Reuters is reporting that the kits were made in a factory previously cited for quality-control violations, including several involving the glucagon product. Lilly had received a report of a patient who experienced seizures even after being injected with the drug, a sign that glucagon was not potent enough to work. The company said the product failure might be related to its manufacturing process, without elaborating. A spokesperson declined to say whether Lilly has received other reports of adverse events related to the Glucagon kits. Separately, Lilly is facing a federal criminal investigation into alleged manufacturing irregularities involving another of its U.S. factories in New Jersey. Reuters is following both stories and of course, we will too. https://www.reuters.com/business/healthcare-pharmaceuticals/exclusive-eli-lillys-recalled-emergency-diabetes-drug-came-plant-cited-by-fda-2021-10-04/ XX Big new report on adults with type 1.. called a forgotten population in this write up. The consensus statement covers diagnosis, goals and targets, schedule of care, self-management education and lifestyle, glucose monitoring, insulin therapy, hypoglycemia, psychosocial care and much more. This is a joint statement from the American Diabetes Association and the European Association for the Study of Diabetes Their last consensus report on type 2 diabetes has been "highly influential," these researchers say.. so they recognize the need to develop a comparable report specifically addressing type 1 diabetes in adults. https://www.medscape.com/viewarticle/960158 XX Adults with Type 2 diabetes on statin therapy may see worsening diabetes symptoms. Important caution: the researchers are quick to say that association does not prove causation, no patient should just stop taking their statins based on this study. These are cholesterol lowering medications with brand names like Lipitor and Crestor.. Statin users had a 37% higher risk for diabetes progression, including extremely high blood sugar levels and elevated rates of disease complications. Nearly half of adults with Type 2 diabetes also have high cholesterol and many of them stop taking statins due to this kind of thing. But that may increase the risk for heart attack or stroke. So definitely talk to your doctor before making any changes. https://www.upi.com/Health_News/2021/10/04/statins-diabetes-progression-risk-study/7261633358483/ XX More to come, But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—the new Entrée bowls are great. They have a chicken burrito, a cauliflower mash and braised beef bowl.. the lemon chicken I've told you about and more! They keep adding to the menu line! You can buy online or find a store near you with their locator right on the website. I'll put a link in the FB comments and as always at d-c dot com. Back to the news… -- DreaMed Diabetes gets FDA approval to expand their platform to people with type 1 and type 2 diabetes. Called Advisor Pro, it's the first decision support system that has been cleared to assist healthcare providers in the management of diabetes patients who use insulin as well as CGMs and meters. We spoke to these folks on the podcast last year. They say Advisor Pro aims to solve the massive worldwide shortage of endocrinologists by empowering primary care clinicians, to be able to provide expert level endocrinological care to diabetes patients. The company's founder says the next step is to develop and extend the technology to cover all injectable or oral medications for diabetes. https://www.businesswire.com/news/home/20211006005640/en/ https://diabetes-connections.com/we-treat-the-data-lifting-the-burden-of-diabetes-with-dreamed/ -- Really interesting look at who's adopting newer diabetes technology. This is from an article over at Dia Tribe where they feature a research study showing that roughly 55% of people with diabetes had positive, open attitudes toward technology. However, another 20% had negative attitudes and did not trust technology, while the remaining 25% either did not want additional data, did not want to wear a device on their body or had a very high level of diabetes distress related to using devices. When they focused on people with type 2.. it turns out the uptake of technology was actually lowest among people aged 18 to 25. This group also had the highest levels of diabetes distress and the highest A1C levels, and many reported that they did not like having a device on their body as their main reason for refusing the devices. Others reported the frequency of alerts and alarms, feeling physically uncomfortable, and cost as reasons for rejecting devices. These researchers say providers need to find ways to avoid making patients feel guilty about their choice of technology as well as watching out for negative judgements for those who use devices but don't achieve near perfect glucose control. https://diatribe.org/new-tech-and-psychological-toll-diabetes-management Please join me wherever you get podcasts for our next episode - The episode out right now is all about the film Pay or Die an upcoming documentary about insulin access and affordability. – That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
Episode 68: Prevention - Aspirin, STIs, and Diabetes. Updates on aspirin use for preeclampsia prevention, updated STIs screening guidelines, and new age to start screening for diabetes. Introduction: COVID-19 Booster Shots. Every week there is a lot of information to cover about COVID-19. I'm sure you are aware of some of this information, but here you have it again for historical purposes. Pfizer and BioNtech announced on September 20, 2021, that their COVID-19 vaccine is protective in pediatric patients between 5 and 11 years of age. Let's remember that this vaccine is being used for patients older than 12, but so far none of the vaccines have been authorized for younger patients. A submission to FDA has been sent, but no approval has been given yet.Recently, we mentioned to you that a booster shot for the mRNA COVID-19 vaccines were likely to be authorized by the FDA around September 20. Indeed, an authorization for a booster was given on September 22, 2021. This authorization was given to the Pfizer/BioNtech vaccine only, and it can be given at least 6 months after the completion of the primary series.The patients who are authorized to receive the booster shot are: Patients who are 65 years of age and older; patients between 18 and 64 years of age at high risk of severe COVID-19; and individuals 18 through 64 years of age with frequent occupational exposure to COVID-19.The Moderna vaccine has not been authorized for a booster shot.Let's remember that both Pfizer and Moderna have been authorized for a third dose in patients who are immunocompromised. The third dose can be given 4 weeks after completing he initial 2 doses of these vaccines. Patient who may receive a third dose are those who are receiving active cancer treatment, recipients of an organ transplant, or have a moderate or severe immunodeficiency. Stay tuned for more updates in the future.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. Page BreakPrevention - Aspirin, STIs and DiabetesBy Hector Arreaza, MD, and Valerie Civelli, MDThe USPSTF has been very active lately. They have released several recommendations in the last few months. Aspirin and preeclampsia: On September 28, 2021, the USPSTF released their recommendation about the use of aspirin to prevent preeclampsia in pregnant persons at high risk. This recommendation is consistent with the previous recommendation given in 2014. New evidence has reinforced that aspirin is effective at reducing risk of perinatal mortality when used properly.The recommendation states: “The USPSTF recommends the use of low-dose aspirin (81 mg/day) as preventive medication after 12 weeks of gestation in persons who are at high risk for preeclampsia.” This is a grade B recommendation. A grade B recommendation means the net benefit of this preventive intervention is moderate to substantial.Who is at risk for preeclampsia? You can classify the risk as High, Moderate, and Low.High: Preeclampsia during previous pregnancies (especially if you had an adverse outcome), multifetal gestation, chronic hypertension, type 1 or 2 diabetes before pregnancy, kidney disease, autoimmune disease, or a combination of multiple moderate-risk factors. Recommend aspirin if a woman has 1 or more of those high-risk factors. Moderate: Nulliparity, obesity, history of preeclampsia in mother or sister, black persons, low income, age 35 years or older, personal history factors (e.g. low birth weight or small for gestational age, previous adverse pregnancy outcome, >10-year pregnancy interval, and in vitro conception. Recommend aspirin if patient has 2 or more of these moderate risk factors. You may recommend aspirin even to women with 1 of these risk factors. Low: Do not recommend aspirin to pregnant women who have low risk for preeclampsia. A patient is considered low risk if she had a previous uncomplicated term delivery and has none of the risk factors mentioned above.As a side note, given the current movement for diversity, equality and inclusion, the article also states that “black persons have higher rates of preeclampsia and are at increased risk for serious complications due to various societal and health inequities,” not due to biological propensities.When do you stop aspirin in pregnancy?The decision to continue aspirin in the presence of obstetric bleeding (or bleeding risk) should be considered on a case-by-case basis. You can decide to stop at 36 weeks or continue until delivery based on your clinical judgement or local protocol.Bottomline: Recommend low-dose aspirin to pregnant women who are at increased risk for preeclampsia after 12 weeks of gestation.Chlamydia and gonorrhea screening: On September 14, 2021, the USPSTF recommended screening women younger than 24 years old who are sexually active for BOTH chlamydia and gonorrhea infection. Also, screen all women 25 years and older who are at increased risk. Increased risk means: a previous or coexisting STI, history of incarceration, and any kind of sexual intercourse out of a mutually monogamous relationship (new partner, more than one partner, partner who has sex with other partners, partner with an STI, history of exchanging sex for money or drugs). The screening for GC/Chlamydia in women is a grade B recommendation. In this recommendation, the term “women” refers to persons born with female genitalia and does not apply to persons who identify as women but have male genitalia. This recommendation also includes pregnant persons and adolescents. The evidence is insufficient (Grade I) to assess the balance and benefits and harms of screening for chlamydia and gonorrhea in asymptomatic men. Remember, a grade I recommendation is not a recommendation for or against a preventive intervention. To make it easy to remember “I stands for I don't know, more research is needed”. Recommendations about the age to start screening or the frequency of screening is not given explicitly, but the population with the highest incidence is women between 15-24 years old. Use your clinical judgement to determine when to start and how often. Prediabetes and diabetes screening: On August 24, 2021, the USPSTF updated their recommendation for prediabetes and diabetes screening. The recommendations states: “The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity (BMI above 25). Clinicians should offer or refer patients with prediabetes to effective preventive interventions. This is a Grade B recommendation. The age to start screening is now 35 years old (instead of the previous recommended age of 40). This is an update from the recommendation given in 2015. We should consider screening at a younger age in:Persons from groups with high incidence and prevalence. These groups are American Indian/Alaska Native, Asian American, Black, Hispanic/Latino, or Native Hawaiian/Pacific Islander persons. Persons with family history of diabetes, history of gestational diabetes, or a history of polycystic ovarian syndrome.Screen Asian Americans with a BMI of 23 or greater after age 35.How to screen for prediabetes and diabetes? You have three options: Fasting glucose (normal below 100, prediabetes below 125, diabetes above 126)Hemoglobin A1C (normal Below 5.6, prediabetes below 6.4%, diabetes above 6.5%). Do not use point of care A1C for screening, use a venous sample instead.Oral glucose tolerance test in the morning (fasting); measure glucose 2 hours after ingesting 75 g of oral glucose (normal below 140, prediabetes below 200, diabetes above 200). The diagnosis of prediabetes or type 2 diabetes should be confirmed with repeat testing before starting intervention.Random glucose above 200 is highly suggestive of diabetes. The diagnosis of diabetes should be confirmed before starting interventions.Summary: Aspirin for preeclampsia prevention, screen for gonorrhea and chlamydia all women younger than 24, and screen for diabetes everyone older than 35 with overweight or obesity.______________________HIV Series Part II: HIV TransmissibilityBy Robert Dunn, MS3, Ross University School of Medicine.People infected with HIV are often thought to be contagious even by touch; though the reality is transmission is primarily transmitted via sexual contact, bodily fluids, from mother to baby during pregnancy, shared needles, or accidental needle sticks in the medical workplace. And when it comes to sex, it is common that a person is afraid to engage in any sexual contact with a HIV positive person, even though the patient may have their infection controlled with medicine.Per the CDC, the most common ways of contracting HIV are through sex without protection, shared needles, and perinatal transmission from mother to child.Sexual transmission:With anal sex, the receptive partner, or bottom, is at higher risk of contracting HIV because the rectal mucosa is thin, more prone to micro-abrasions and create an opportunity to contract HIV. The insertive partner, or top is also at risk of infection via the opening of the urethra, the foreskin of an uncircumcised penis, or any cuts, scratches or open sores on the penis. With vaginal sex, the woman can be infected via the mucus membranes that line the vagina and cervix. And the man can become infected from the vaginal fluid or blood that may carry HIV. Needlesticks:Sharing needles is high risk for contracting HIV. If one person has HIV and uses a needle, the blood of that person is carried on the needle and can inject the virus directly into anyone else who uses that needle. This can occur if people are sharing injected drugs, medications, or even in a needle stick accident that may occur when treating patients in the hospital with HIV. Vertical transmission:Perinatal transmission occurs when the mother infected with HIV passes the infection to her newborn. It is now recommended to test every pregnant woman for HIV and treat as needed. This can occur while the fetus is in the womb or upon delivery. It is recommended that the mother be placed on HIV medication immediately to reduce the risk of infecting the baby. These are ways how HIV is NOT transmitted: kissing on the cheeks, hugging, holding hands, sharing silverware, talking to someone, mosquitos, or sharing toilet.___________________________Now we conclude our episode number 68 “Prevention – Aspirin, STIs, and Diabetes.” Dr Arreaza and Dr Civelli explained the most recent updates by the USPSTF regarding use of aspirin to prevent preeclampsia, screening for gonorrhea and chlamydia in women, and screening for diabetes in patients older than 35. Robert continued with his HIV series and explained how HIV is mostly transmitted, a good reminder for all of us that the most common way of transmission continues to be sexual transmission. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Hasaney Sin, Valerie Civelli and Robert Dunn. Audio edition: Suraj Amrutia. See you next week! _____________________References:Erman, Michael, Pfizer/BioNTech say data show COVID-19 vaccine safe and protective in kids, Reuters, reuters.com, September 20, 2021. https://www.reuters.com/business/healthcare-pharmaceuticals/pfizerbiontech-say-data-show-covid-19-vaccine-safe-protective-kids-2021-09-20/, accessed on September 29, 2021. Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Preventive Medication, United States Preventive Services Taskforce, September 28, 2021, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication. Chlamydia and Gonorrhea: Screening, United States Preventive Services Taskforce, September 14, 2021, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/chlamydia-and-gonorrhea-screening. Prediabetes and Type 2 Diabetes: Screening, United States Preventive Services Taskforce, August 24, 2021, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes Ways HIV can be Transmitted. CDC, April 21, 2021. https://www.cdc.gov/hiv/basics/hiv-transmission/ways-people-get-hiv.html. Accessed on September 21, 2021.
In the News.. this week: Lilly drops the price of some insulins, this T1D group most likely to be hospitalized if infected with COVID, insulin pumps reduce risk of retinopathy, Novo Nordisk pays investors to settle earnings claims, another through-the-skin glucose monitor and more! Join us Live on Facebook each Wednesday at 4:30pm EDT! Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription below Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their Entrée Bowls and all of their great products in your local grocery store, Target or Costco. XX Our top story – Lilly announces a big price change on some insulins. Starting this January, the cash price of Insulin Lispro goes down 40%. Lispro is identical to Humalog – the price on that one isn't changing. Lilly says one in three prescriptions for their mealtime insulin is for Insulin Lispro. I asked Lilly why now and what about Humalog? I'll put my Q&A in the show notes – you'll be able to read them at diabetes dash connections dot com and in the Facebook group.. their answers were vague – although one interesting point.. they claim these programs have lowered the monthly out of pocket cost of a prescription for Lilly insulin to 28 dollars.. a decrease of 27% over the past four years. The bottom line here is that you still have to do the work… your pharmacist can substitute lispro for humalog – or the other way around – however the prescription is written.. make sure you ask them to check which is cheaper either with your insurance, with a coupon or with the cash price. It's a lot of work, but with all of these options, you want to figure out what's best for you. https://beyondtype1.org/lower-list-price-lilly-insulin-lispro/ XX Adults over 40 with type 1 are 4 times more likely to be hospitalized with COVID 19 than younger people. New study in the Journal of Clinical Endocrinology & Metabolism. This study looked at thousands of people with type 1 from April 2020 to March of 2021 – so it's worth noting that the recent Delta wave isn't included here. Hospitalized here means inpatient or ICU not emergency room. This is where it gets really interesting – they adjusted for sex, A1C, race and ethnicity, insurance type and comorbidities – it was being over 40 that still increased the odds. That's not to say A1C didn't matter.. The likelihood for hospitalization was higher for all ages with a higher A1C. Also interesting.. there was no significant difference for adverse outcomes between the age groups. They grouped together DKA, severe hypoglycemia and death as the adverse outcomes here.. https://www.healio.com/news/endocrinology/20210928/older-adults-with-type-1-diabetes-more-likely-to-be-hospitalized-for-covid19-than-youths XX Using an insulin pump may decrease the risk of diabetic retinopathy in younger people with type 1. These researchers looked at almost 2000 patients under the age of 21 and found - after adjusting for race and ethnicity, insurance status, diabetes duration, and A1C - patients with pumps had a 57% decreased risk for retinopathy. The thinking here is that it's about less variability in blood glucose. However, there were disparities in access to pumps, with pump users more likely to be white and have private or commercial insurance. https://www.medscape.com/viewarticle/959758 XX Very early on but potentially big news out of China… this is the DREAM study a phase three clinical trial of a medication called dorzagliatin (DOOR-zuh-GLY-uh-tin)– this is for people with type 2. While it was a small study it has big results.. after a year, 65% of the 69 patients were in remission – that generally means A1Cs under 6.5 with no glucose lowering medication – although the exact definition of remission was not given here. These findings were presented at a recent BioMed Conference in China. https://www.biospace.com/article/hua-medicine-may-be-sending-type-2-diabetes-into-remission-/ XX XX Novo Nordisk shareholders say pants on fire to the insulin maker and get a $100 million dollar settlement. What happened here? Novo allegedly told investors not to worry about insulin pricing pressures from lawmakers and patient groups - that they'd still make plenty of money. But the investors disagreed – saying other insulin makers were warning their investors that profits could fall. This lawsuit has nothing to do with any benefit to patients – it was all about investors who were actually asking for 1.7 billion dollars. Novo agreed to the smaller deal saying they just wanted to avoid the burden of litigation, no admission of wrong doing. https://www.fiercepharma.com/pharma/novo-nordisk-agrees-to-100m-settlement-investors-who-claimed-company-misled-them-about-its XX This is from last week but want to make sure you've seen a voluntary glucagon recall. Lilly is recalling a specific lot from their red box emergency kit. It's lot D239382D so please check. The problem here is that someone reported the vial of glucagon was in liquid form instead of powder – which can mean the glucagon isn't going to work well in an emergency. If you got this lot – bring it back to the pharmacy or call Lilly. Info in the link and show notes. https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/eli-lilly-and-company-issues-voluntary-nationwide-recall-one-lot-glucagonr-emergency-kit-due-loss XX You might have seen the headline on this one: if you can't fit into the jeans you wore at age 21 you're at risk of developing type 2 diabetes. I dug a little deeper on this.. very small study. First. These people weren't even overweight. They did have type 2 and as part of the study managed to lose fat and the researchers said their diabetes was put into remission. They all followed a weight loss program of a low calorie liquid diet for two weeks – 800 calories a day! They did this three times until they lost 10 to 15 percent of their body fat. The researchers say this “demonstrate very clearly that diabetes is not caused by obesity but by being too heavy for your own body”. What does that mean?! What does it have to do with the headline about jeans at age 21? And what happens to these poor people who were slurping 800 calories a day and are now just back to their normal lives? I'm hoping I missed something big on this one.. https://www.theguardian.com/society/2021/sep/27/people-who-cant-fit-into-jeans-they-wore-aged-21-risk-developing-diabetes XX More to come, But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—the new Entrée bowls are great. They have a chicken burrito, a cauliflower mash and braised beef bowl.. the lemon chicken I've told you about and more! They keep adding to the menu line! You can buy online or find a store near you with their locator right on the website. I'll put a link in the FB comments and as always at d-c dot com. Back to the news… -- We've got another through the skin glucose monitor in the news. Know Labs debuted it's Know-U device which is very small, fits in your pocket and is powered by what they call Bio R-Fid technology. It emits radio waves to measure specific molecular signatures in the blood through the skin. They've also got UBand.. which is a bracelet that does the same thing. Do they work? According to a 2018 study 97% of the UBand's readings were within 15% of the values calculated by the Abbot Libre. But that wasn't a clinical trial – those are starting this year. https://www.fiercebiotech.com/medtech/know-labs-unveils-pocket-sized-glucose-monitor-swaps-fingersticks-for-radiofrequency -- And finally, maybe the most glamorous photo featuring an insulin pump.. model Lila Moss – daughter of supermodel Kate Moss – walked the Fendi Versace runway at Milan's fashion week with her Omnipod very visible. Lila Moss has type 1 and while they family has never really mentioned it, she's been photographed with her pod on before. Lots of write ups about this – great to see the representation -- Please join me wherever you get podcasts for our next episode - The episode out right now is with Marjorie's Fund – helping people survive diabetes in countries with few resources.. and next week we're featuring the folks behind the upcoming Pay or Die film about insulin access.. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
The podcast is back with a new name and a new, expanded focus! Harry will soon be publishing his new book The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer. Like his previous book MoneyBall Medicine, it's all about AI and the other big technologies that are transforming healthcare. But this time Harry takes the consumer's point of view, sharing tips, techniques, and insights we can all use to become smarter, more proactive participants in our own health. The show's first guest under this expanded mission is Dave deBronkart, better known as "E-Patient Dave" for his relentless efforts to persuade medical providers to cede control over health data and make patients into more equal partners in their own care. Dave explains how he got his nickname, why it's so important for patients to be more engaged in the healthcare system, and what kinds of technology changes at hospitals and physician practices can facilitate that engagement. Today we're bringing you the first half of Harry and Dave's wide-ranging conversation, and we'll be back on October 12 with Part 2.Dave deBronkart is the author of the highly rated Let Patients Help: A Patient Engagement Handbook and one of the world's leading advocates for patient engagement. After beating stage IV kidney cancer in 2007, he became a blogger, health policy advisor, and international keynote speaker, and today is the best-known spokesman for the patient engagement movement. He is the co-founder and chair emeritus of the Society for Participatory Medicine, and has been quoted in Time, U.S. News, USA Today, Wired, MIT Technology Review, and the HealthLeaders cover story “Patient of the Future.” His writings have been published in the British Medical Journal, the Patient Experience Journal, iHealthBeat, and the conference journal of the American Society for Clinical Oncology. Dave's 2011 TEDx talk went viral, and is one the most viewed TED Talks of all time with nearly 700,000 views.Please rate and review The Harry Glorikian Show on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to The Harry Glorikian Show podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3. Scroll down to find the subhead titled "Ratings & Reviews."4. Under one of the highlighted reviews, select "Write a Review."5. Next, select a star rating at the top — you have the option of choosing between one and five stars. 6. Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7. Once you've finished, select "Send" or "Save" in the top-right corner. 8. If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9. After selecting a nickname, tap OK. Your review may not be immediately visible.That's it! Thanks so much.Full TranscriptHarry Glorikian: Hello. I'm Harry Glorikian. Welcome to The Harry Glorikian Show.You heard me right! The podcast has a new name. And as you're about to learn, we have an exciting new focus. But we're coming to you in the same feed as our old show, MoneyBall Medicine. So if you were already subscribed to the show in your favorite podcast app, you don't have to do anything! Just keep listening as we publish new episodes. If you're not a regular listener, please take a second to hit the Subscribe or Follow button right now. And thank you.Okay. So. Why are we rebranding the show?Well, I've got some exciting news to share. Soon we'll be publishing my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer. It's all about how AI and big data are changing almost everything we know about our healthcare.Now, that might sound a bit like my last book, MoneyBall Medicine. But I wrote that book mainly to inform all the industry insiders who deliver healthcare. Like people who work at pharmaceutical companies, hospitals, health plans, insurance companies, and health-tech startups.With this new book, The Future You, I'm turning the lens around and I'm explaining the impact of the AI revolution on people who consume healthcare. Which, of course, means everyone. That impact is going to be significant, and it's going to change everything from the way you interact with your doctors, to the kind of medicines you take, to the ways you stay fit and healthy.We want you to be prepared for this new world. So we're expanding the focus of the podcast, too. To go along with the new name, we're bringing you interviews with a new lineup of fascinating people who are changing the way patients experience healthcare. And there's nobody better to start out with than today's guest, Dave deBronkart.Dave is best known by the moniker he earned back in the late 2000s: E-Patient Dave. We'll talk about what the E stands for. But all you need to know going in is that ever since 2007, when he survived his own fight with kidney cancer, Dave has been a relentless, tireless advocate for the idea that the U.S. medical system needs to open up so that patients can play a more central role in their own healthcare. He's pushed for changes that would give patients more access to their medical records. And he hasn't been afraid to call out the institutions that are doing a poor job at that. In fact, some folks inside the business of healthcare might even call Dave an irritant or a gadfly. But you know what? Sometimes the world needs people who aren't afraid to shake things up.And what's amazing is that in the years since Dave threw himself into this debate, the world of healthcare policy has started to catch up with him. The Affordable Care Act created big incentives for hospitals and physician practices to switch over to digital recordkeeping. In 2016 the Twenty-First Century Cures Act prohibited providers from blocking access to patients' electronic health information. And now there's a new interface standard called FHIR that promises to do for medical records what HTML and HTTP did for the World Wide Web, and make all our health data more shareable, from our hospital records to our genomics data to the fitness info on our smartphones.But there's a lot of work left to do. And Dave and I had such a deep and detailed conversation about his past work and how patients experience healthcare today that we're going to break up the interview into two parts. Today we'll play the first half of our interview. And in two weeks we'll be back with Part 2. Here we go.Harry Glorikian: Dave, welcome to the show.Dave deBronkart: Thank you so much. This is a fascinating subject, I love your angle on the whole subject of medicine.Harry Glorikian: Thank you. Thank you. So, Dave, I mean, you have been known widely as what's termed as E-patient Dave. And that's like a nickname you've been using in public discussions for, God, at least a decade, as far as I can remember. But a lot of our listeners haven't heard about that jargon word E-patient or know what E stands for. To me, it means somebody who is assertive or provocative when it comes to managing their own health, you know, with added element of being, say, tech savvy or knowing how to use the Internet, you know, mobile, wearable devices and other digital tools to monitor and organize and direct their own care—-all of which happens to describe the type of reader I had in mind when I wrote this new book that I have coming out called The Future You. So how would you describe what E- patient [means]?Dave deBronkart: You know, it's funny because when you see an E-patient or talk with them, they don't stick out as a particularly odd, nerdy, unusual sort of person. But the the term, we can get into its origins back in the 90s someday if you want to, the term has to do with somebody who is involved. What today is in medicine is called patient engagement. And it's funny because to a lot of people in health care, patient engagement means getting the patient to do what they tell us to. Right. Well, tvhere's somebody who's actually an activated, thinking patient, like, I'm engaged in the sense that I want to tell you what's important to me. Right. And I don't just want to do what I'm told. I want to educate myself. That's another version of the E. In general, it means empowered, engaged, equipped, enabled. And these days, as you point out, naturally, anybody who's empowered, engaged and enabled is going to be doing digital things, you know, which weren't possible 20 years ago when the term patient was invented.Harry Glorikian: Yeah, and it's interesting because I was thinking like the E could stand for so many things like, you know, electronic, empowered, engaged, equipped, enabled, right. All of the above. Right. And, you know, I mean, at some point, you know, I do want to talk about access, right, to all levels. But just out of curiosity, right, you've been doing this for a long time, and I'm sure that people have reached out to you. How many E-patients do you think are out there, or as a proportion of all patients at this point?Dave deBronkart: You know, that depends a lot on demographics and stage of life. The, not surprisingly, digital natives are more likely to be actively involved in things just because they're so digital. And these days, by federal policy, we have the ability to look at parts of our medical information online if we want to. As opposed to older people in general are more likely to say just what the doctors do, what they want to. It's funny, because my parents, my dad died a few years ago. My mother's 92. We're very different on this. My dad was "Let them do their work." And my mother is just all over knowing what's going on. And it's a good thing because twice in the last five years, important mistakes were found in her medical record, you know. So what we're at here, this is in addition to the scientific and technological and data oriented changes that the Internet has brought along. We're also in the early stages of what is clearly going to be a massive sociological revolution. And it has strong parallels. I first had this idea years ago in a blog post, but I was a hippie in the 60s and 70s, and I lived through the women's movement as it swept through Boston. And so I've seen lots of parallels. You go back 100 years. I think the you know, we recently hit the 100th anniversary of the 19th Amendment, giving women the right to vote. There were skeptics when the idea was proposed and those skeptics opinions and the things they said and wrote have splendid parallels with many physicians' beliefs about patients.Dave deBronkart: As one example I blogged some years ago, I can send you a link about a wonderful flyer published in 1912 by the National Association Opposed to Women's Suffrage. And it included such spectacular logic as for, I mean, their bullets, their talking points, why we should not give women the vote, the first was "Most women aren't asking for it." Which is precisely parallel to "Most patients aren't acting like Dave, right? So why should we accommodate, why should we adjust? Why should we provide for that? The second thing, and this is another part, is really a nastier part of the social revolution. The second talking point was "Most women eligible to vote are married and all they could do is duplicate or cancel their husband's vote." It's like, what are you thinking? The underlying is we've already got somebody who's voting. Why do we need to bring in somebody else who could only muddy the picture? And clearly all they could do is duplicate or cancel their husband's vote. Just says that the women or the patients, all right, all I could do is get in the way and not improve anything. I bring this up because it's a real mental error for people to say I don't know a lot of E-patients. So it must not be worth thinking about. Harry Glorikian: Yeah, I mean, so, just as a preview so of what we're going to talk about, what's your high-level argument for how we could make it easier for traditional patients to become E-patients?Dave deBronkart: Well, several dimensions on that. The most important thing, though, the most important thing is data and the apps. Harry Glorikian: Yes.Dave deBronkart: When people don't have access to their information, it's much harder for them to ask an intelligent question. It's like, hey, I just noticed this. Why didn't we do something? What's this about? Right. And now the flip side of it and of course, there's something I'm sure we'll be talking about is the so-called final rule that was just published in April of this year or just took effect of this year, that says over the course of the next year, all of our data in medical records systems has to be made available to us through APIs, which means there will be all these apps. And to anybody middle aged who thinks I don't really care that much, all you have to do is think about when it comes down to taking care of your kids or your parents when you want to know what's going on with them. Harry Glorikian: Would you think there would be more E-patients if the health care system gave them easier access to their data? What are some of the big roadblocks right now?Dave deBronkart: Well, one big roadblock is that even though this final federal rule has come out now, the American Medical Group Management Association is pushing back, saying, "Wait, wait, wait, this is a bad idea. We don't need patients getting in the way of what doctors are already doing." There will be foot dragging. There's no question about that. Part of that is craven commercial interests. There are and there have been numerous cases of hospital administrators explicitly saying -- there's one recording from the Connected Health conference a few years ago, Harlan Krumholtz, a cardiologist at Yale, quoted a hospital president who told him, "Why wouldn't I want to make it a little harder for people to take their business elsewhere?"Harry Glorikian: Well, if I remember correctly, I think it was the CEO of Epic who said, “Why would anybody want their data?”Dave deBronkart: Yes. Well, first of all, why I would want my data is none of her damn business. Well, and but that's what Joe Biden -- this was a conversation with Joe Biden. Now, Joe has a, what, the specific thing was, why would you want to see your data? It's 10,000 pages of which you would understand maybe 100. And what he said was, "None of your damn business. And I'll find people that help me understand the parts I want."Harry Glorikian: Yeah. And so but it's so interesting, right? Because I believe right now we're in a we're in a state of a push me, pull you. Right? So if you look at, when you said apps, I think Apple, Microsoft, Google, all these guys would love this data to be accessible because they can then apps can be available to make it more understandable or accessible to a patient population. I mean, I have sleep apps. I have, you know, I just got a CGM, which is under my shirt here, so that I can see how different foods affect me from, you know, and glucose, insulin level. And, you know, I'm wearing my Apple Watch, which tracks me. I mean, this is all interpretable because there are apps that are trying to at least explain what's happening to me physiologically or at least look at my data. And the other day I was talking to, I interviewed the CEO of a company called Seqster, which allows you to download your entire record. And it was interesting because there were some of the panels that I looked at that some of the numbers looked off for a long period of time, so I'm like, I need to talk to my doctor about those particular ones that are off. But they're still somewhat of a, you know, I'm in the business, you've almost learned the business. There's still an educational level that and in our arcane jargon that gets used that sort of, you know, everybody can't very easily cross that dimension.Dave deBronkart: Ah, so what? So what? Ok, this is, that's a beautiful observation because you're right, it's not easy for people to absorb. Not everybody, not off the bat. Look, and I don't claim that I'm a doctor. You know, I still go to doctors. I go to physical therapists and so on and so on. And that is no reason to keep us apart from the data. Some doctors and Judy Faulkner of Epic will say, you know, you'll scare yourself, you're better off not knowing. Well, ladies and gentlemen, welcome to the classic specimen called paternalism. "No, honey, you won't understand." Right now paternal -- this is important because this is a major change enabled by technology and data, right -- the paternal caring is incredibly important when the cared-for party cannot comprehend. And so the art of optimizing and this is where MoneyBall thinking comes in. The art of optimizing is to understand people's evolving capacity and support them in developing that capacity so that the net sum of all the people working on my health care has more competence because I do. Harry Glorikian: Right. And that's where I believe like. You know, hopefully my book The Future You will help people see that they're, and I can see technology apps evolving that are making it easier graphically, making it more digestible so someone can manage themselves more appropriately and optimally. But you mentioned your cancer. And I want to go and at least for the listeners, you know, go a little bit through your biography, your personal history, sort of helping set the stage of why we're having this conversation. So you started your professional work in, I think it was typesetting and then later software development, which is a far cry from E-patient Dave, right? But what what qualities or experiences, do you think, predisposed you to be an E-patient? Is it fair to say that you were already pretty tech savvy or but would you consider yourself unusually so?Dave deBronkart: Well, you know, the unusually so, I mean, I'm not sure there's a valid reason for that question to be relevant. There are in any field, there are pioneers, you know, the first people who do something. I mean, think about the movie Lorenzo's Oil, people back in the 1980s who greatly extended their child's life by being so super engaged and hunting and hunting through libraries and phone calls. That was before there was the Internet. I was online. So here are some examples of how I, and I mentioned that my daughter was gestating in 1983. I took a snapshot of her ultrasound and had it framed and sitting on my office desk at work, and people would say, what's that? Nobody knew that that was going to be a thing now and now commonplace thing. In 1999, I met my second wife online on Match.com. And when I first started mentioning this in speeches, people were like, "Whoa, you found your wife on the Internet?" Well, so here's the thing, 20 years later, it's like no big deal. But that's right. If you want to think about the future, you better be thinking about or at least you have every right to be thinking about what are the emerging possibilities. Harry Glorikian: So, tell us the story about your, you know, renal cancer diagnosis in 2007. I mean, you got better, thank God. And you know, what experience it taught you about the power of patients to become involved in their decision making about the course of treatment?Dave deBronkart: So I want to mention that I'm right in the middle of reading on audio, a book that I'd never heard of by a doctor who nearly died. It's titled In Shock. And I'm going to recommend it for the way she tells the story of being a patient, observing the near fatal process. And as a newly trained doctor. In my case, I went in for a routine physical. I had a shoulder X-ray and the doctor called me the next morning and said, "Your shoulder is going to be fine, but the X-ray showed that there's something in your lung that shouldn't be there." And to make a long story short, what we soon found out was that it was kidney cancer that had already spread. I had five tumors, kidney cancer tumors in both lungs. We soon learned that I had one growing in my skull, a bone metastasis. I had one in my right femur and my thigh bone, which broke in May. I now have a steel rod in my in my thigh. I was really sick. And the best available data, there wasn't much good data, but the best available data said that my median survival. Half the people like me would be dead in 24 weeks. 24 weeks!Harry Glorikian: Yeah.Dave deBronkart: And now a really pivotal moment was that as soon as the biopsy confirmed the disease, that it was kidney cancer, my physician, the famous doctor, Danny Sands, my PCP, because he knew me so well -- and this is why I hate any company that thinks doctors are interchangeable, OK? They they should all fry in hell. They're doing it wrong. They should have their license to do business removed -- because he knew me he said, "Dave, you're an online kind of guy. You might like to join this patient community." Now, think how important this is. This was January 2007, not 2021. Right. Today, many doctors still say stay off the Internet. Dr. Sands showed me where to find the good stuff.Harry Glorikian: Right. Yeah, that's important.Dave deBronkart: Well, right, exactly. So now and this turned out to be part of my surviving. Within two hours of posting my first message in that online community, I heard back. "Thanks for the, welcome to the club that nobody wants to join." Now, that might sound foolish, but I'd never known anybody who had kidney cancer. And here I am thinking I'm likely to die. But now I'm talking to people who got diagnosed 10 years ago and they're not dead. Right? Opening a mental space of hope is a huge factor in a person having the push to move forward. And they said there's no cure for this disease. That was not good news. But the but there's this one thing called high dose Interleukin 2. That usually doesn't work. So this was the patient community telling me usually doesn't work. But if you respond at all, about half the time, the response is complete and permanent. And you've got to find a hospital that does it because it's really difficult. And most hospitals won't even tell you it exists because it's difficult and the odds are bad. And here are four doctors in your area who do it, and here are their phone numbers. Now, ladies and gentlemen, I assert that from the point of view of the consumer, the person who has the need, this is valuable information. Harry, this is such a profound case for patient autonomy. We are all aware that physicians today are very overworked, they're under financial pressure from the evil insurance companies and their employers who get their money from the insurance companies. For a patient to be able to define their own priorities and bring additional information to the table should never be prohibited. At the same time, we have to realize that, you know, the doctors are under time pressure anyway. To make a long story short, they said this this treatment usually doesn't work. They also said when it does work, about four percent of the time, the side effects kill people.Harry Glorikian: So here's a question. Here's a question, though, Dave. So, you know, being in this world for my entire career, it's my first question is, you see something posted in a club, a space. How do you validate that this is real, right, that it's bona fide, that it's not just...I mean, as we've seen because of this whole vaccine, there's stuff online that makes my head want to explode because I know that it's not real just by looking at it. How do you as as a patient validate whether this is real, when it's not coming from a, you know, certified professional?Dave deBronkart: It's a perfect question for the whole concept of The Future You. The future you has more autonomy and more freedom to do things, has more information. You could say that's the good news. The bad news is you've got all this information now and there's no certain source of authority. So here you are, you're just like emancipation of a teenager into the adult life. You have to learn how to figure out who you trust. Yeah, the the good news is you've got some autonomy and some ability to act, some agency, as people say. The bad news is you get to live with the consequences as well. But don't just think "That's it, I'm going to go back and let the doctors make all the decisions, because they're perfect," because they're not, you know, medical errors happen. Diagnostic errors happen. The overall. The good news is that you are in a position to raise the overall level of quality of the conversations.Harry Glorikian: So, you know, talk about your journey after your cancer diagnosis from, say, average patient to E-patient to, now, you're a prominent open data advocate in health care.Dave deBronkart: Yes. So I just want to close the loop on what happened, because although I was diagnosed in January, the kidney came out in March, and my interleukin treatments started in April. And by July, six months after diagnosis, by July, the treatment had ended and I was all better. It's an immunotherapy. When immunotherapy works, it's incredible because follow up scans showed the remaining tumors all through my body shrinking for the next two years. And so I was like, go out and play! And I started blogging. I mean, I had really I had pictured my mother's face at my funeral. It's a, it's a grim thought. But that's how perhaps one of my strengths was that I was willing to look that situation in the eye, which let me then move forward. But in 2008, I just started blogging about health care and statistics and anything I felt like. And in 2009 something that -- I'm actually about to publish a free eBook about that, it's just it's a compilation of the 12 blog posts that led to the world exploding on me late in 2008 -- the financial structure of the U.S. health system meant that even though we're the most expensive system in the world, 50 percent more expensive than the second place country, if we could somehow fix that, because we're the most expensive and we don't have the best outcomes, so some money's being wasted there somewhere. All right. If we could somehow fix that, it would mean an immense amount of revenue for some companies somewhere was going to disappear.Dave deBronkart: Back then, it was $2.4 trillion, was the US health system. Now it's $4 trillion. And I realized if we could cut out the one third that excess, that would be $800 billion that would disappear. And that was, I think, three times as much as if Google went out of business, Apple went out of business and and Microsoft, something like that. So I thought if we want to improve how the system works, I'm happy if there are think tanks that are rethinking everything, but for you and me in this century, we got to get in control of our health. And that had to start with having access to our data. All right. And totally, unbeknownst to me, when the Obama administration came in in early 2009, this big bill was passed, the Recovery Act, that included $40 billion of incentives for hospitals to install medical computers. And one of the rules that came out of that was that we, the patients, had to be able to look at parts of our stuff. And little did I know I tried to use to try to look at my data. I tried to use the thing back then called Google Health. And what my hospital sent to Google was garbage. And I blogged about it, and to my huge surprise, The Boston Globe newspaper called and said they wanted to write about it, and it wasn't the local newspaper, it was the Washington health policy desk. And they put it on Page One. And my life spun out of control.Harry Glorikian: Yeah, no, I remember I remember Google Health and I remember you know, I always try to tell people, medicine was super late to the digitization party. Like if it wasn't for that the Reinvestment and Recovery Act putting that in place, there would still be file folders in everybody's office. So we're still at the baby stage of digitization and then the analytics that go with it. And all I see is the curve moving at a ridiculous rate based on artificial intelligence, machine learning being applied to this, and then the digitized information being able to come into one place. But you said something here that was interesting. You've mentioned this phenomenon of garbage in, garbage out. Right. Can you say more about one of the hospitals that treated you? I think it was Beth Israel. You mentioned Google Health. What went wrong there and what were the lessons you took away from that?Dave deBronkart: Well, there were, so what this revealed to me, much to my amazement, much to my amazement, because I assumed that these genius doctors just had the world's most amazing computers, right, and the computers that I imagined are the computers that we're just now beginning to move toward. Right. RI was wrong. But the other important thing that happened was, you know, the vast majority of our medical records are blocks of text, long paragraphs of text or were back then. Now, it was in a computer then, it wasn't notes on paper, but it was not the kind of thing you could analyze, any more than you could run a computer program to read a book and write a book report on it. And so but I didn't know that. I didn't know what Google Health might do. The next thing that happened was as a result, since Google Health was looking for what's called structured data -- now, a classic example of structured data is your blood pressure. It's fill in a form, the high number, the low number, what's your heart rate? What's your weight, you know? The key value pairs, as some people call them. Very little of my medical history existed in that kind of form. So for some insane reason, what they decided to send Google instead was my insurance billing history.Dave deBronkart: Now, insurance data is profoundly inappropriate as a model of reality for a number of reasons. One of one reason is that insurance form data buckets don't have to be very precise. So at one point I was tested for metastases to the brain to see if I had kidney cancer tumors growing in my brain. The answer came back No. All right. Well, there's only one billing code for it. Metastases to the brain. And that's a legitimate billing code for either one. But it got sent to Google Health as metastases to the brain, which I never had. All right. Another problem is something called up-coding, where insurance billing clerks are trained you can bill for something based on the keywords that the doctors and nurses put in the computer. So at one point during my treatment, I had a CAT scan of my lungs to look for tumors. And the radiologist noted, by the way, his aorta is slightly enlarged. The billing clerk didn't care that they were only checking for kidney cancer tumors. The billing clerk saw aorta, enlarged, aneurysm, and billed the insurance company for an aneurysm, which I never had. Corruption. Corruption. People ask, why are our health care costs so high? It's this system of keyword-driven billing. But then on top of that, I had things that I never had anything like it. There was, when this blew up in the newspaper, the hospital finally released all my insurance billing codes. It turns out they had billed the insurance company for volvulus of the intestine. That's a lethal kink of the intestine that will kill you in a couple of days if it's not treated. Never had anything of the sort. Billing fraud.Harry Glorikian: Interesting.Dave deBronkart: Anyway, because a random patient had just tried to use Google Health and I knew enough about data from my day job to be able to say, "Wait a minute, this makes no sense, why is all this happening?" And I couldn't get a straight answer. You know, it's a common experience. Sometimes you ask a company, "I've got a problem. This isn't right." And sometimes they just blow you off. Well, that's what my hospital did to me. I asked about these specific questions and they just blew me off. So then once it was on the front page of the newspaper, the hospital is like, "We will be working with the E-patient Dave and his doctor." And there's nothing like publicity, huh?[musical interlude]Harry Glorikian: Let's pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that's to make it easier for other listeners discover the show by leaving a rating and a review on Apple Podcasts.All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but you'll be doing us a huge favor.And one more thing. If you like the interviews we do here on the show I know you'll like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer.It's a friendly and accessible tour of all the ways today's information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.The book comes out soon, so keep an eye out for the next announcement.Thanks. And now back to our show.[musical interlude]Harry Glorikian: One of your slogans is "Gimme my damn data," meaning, you know, your patient records. And so can you summarize first, the state of the art prior to this digital transformation? Why was it historically the case that patients didn't have easy access to charts from their doctor's office or their visits? Why has the medical establishment traditionally been reluctant or maybe even unable to share this data?Dave deBronkart: Well, first, I want to explain the origin of that of that term. Because the speech in September of that year that launched the global speaking had that title. What happened was that summer of 2009, my world was spinning out of control as I tried to answer people's questions and get involved in the blogging that was going on and health policy arguments in Washington and so on. And so a real visionary in Toronto, a man named Gunther Eisenbach, who had quite a history in pioneering in this area, invited me to give the opening keynote speech for his annual conference in Toronto that fall. And several times during the summer, he asked me a question I'd never been asked. I came to learn that it was normal, but it was "For our brochure, we need to know what do you want to call the speech? What's the title of the speech?" And I remember very well sitting in my office at work one day saying into the telephone, "I don't know, just call it 'Give me my damn data, because you guys can't be trusted." And much to my amazement, It stuck.Dave deBronkart: I want to be clear. Under the 1996 health information law called hip hop, you are entitled to a copy of every single thing they have about you. All right, and a major reason for that. Back in the beginning was to detect mistakes. So it's interesting because HIPAA arose from health insurance portability. 1996 was when it first became mandatory that you had to be able to take your insurance business elsewhere and therefore your records. And that's the origin of the requirement that anybody who holds your health information as part of your insurance or anything else has to be really careful about not letting it leak out. And therefore and it has to be accurate. Therefore, you have a right to look at it and get any mistakes fixed. But. Foot dragging, foot dragging, foot dragging. I don't want to. As we discussed earlier, there are some doctors who simply wanted to keep you captive. But there are also, the data was also handwritten garbage at times, just scribbles that were never intended to be read by anyone other than the person who wrote the note in the first place. Harry Glorikian: Well, but, you know, I'm not trying to necessarily defend or anything, but but, you know, as you found at Beth Israel Deaconess, and I talk about this in The Future You as well, part of the problem is most of these things that people look at as large electronic health record systems were are still are in my mind designed as accounting and billing systems, not to help the doctors or the patients. And that's still a major problem. I mean, I think until we have, you know, a Satya Nadella taking over Microsoft where he, you know, went down and started rewriting the code for Microsoft Office, you're not going to get to management of patients for the betterment of their health as opposed to let me make sure that I bill for that last Tylenol.Dave deBronkart: Absolutely. Well, and where I think this will end up, and I don't know if it'll be five years or 10 or 20, but where this will end up is, the system as it exists now is not sustainable as a platform for patient-centered care. The early stage that we're seeing now, there is an incredibly important software interface that's been developed in the last five or six years still going on called FHIR, F-H-I-R. Which is part of that final rule, all that. So all of our data increasingly in the next couple of years has to be available through an API. All right. So, yeah, using FHIR. And I've done some early work on collecting my own data from the different doctors in the hospitals I've gone to. And what you get what you get when you bring those all in, having told each of them your history and what medications you're on and so on, is you get the digital equivalent of a fax of all of that from all of them. That's not coordinated, right. The medication list from one hospital might not match even the structure, much less the content of the medication list. And here's where it gets tricky, because anybody who's ever tried to have any mistake fixed at a hospital, like "I discontinued that medicine two years ago," never mind something like, "No, I never had that diagnosis," it's a tedious process, tons of paperwork, and you've got to keep track of that because they so often take a long time to get them fixed. And I having been through something similar in graphic arts when desktop publishing took over decades ago. I really wonder, are we will we ultimately end up with all the hospitals getting their act together? Not bloody likely. All right. Or are we more likely to end up with you and me and all of us out here eventually collecting all the data and the big thing the apps will do is organize it, make sense of it. And here's a juicy thing. It will be able to automatically send off corrections back to the hospital that had the wrong information. And so I really think this will be autonomy enabled by the future, you holding your own like you are the master copy of your medical reality.Harry Glorikian: Yeah, I always you know, I always tell like what I like having as a longitudinal view of myself so that I can sort of see something happening before it happens. Right. I don't want to go in once the car is making noise. I like just I'd like to have the warning light go off early before it goes wrong. But. So you mentioned this, but do you have any are there any favorite examples of patient friendly systems or institutions that are doing data access correctly?Dave deBronkart: I don't want to finger any particular one as doing a great job, because I haven't studied it. Ok. I know there are apps, the one that I personally use, which doesn't yet give me a useful it gives me a pile of fax pages, but it does pull together all the data, it's it's not even an app, it's called My Patient Link. And anybody can get it. It's free. And as long as the hospitals you're using have this FHIR software interface, which they're all required to, by the way, but some still don't. As long as they do this, My Patient Link will go and pull it all together. Now it's still up to you to do anything with it. So we're just at the dawn of the age that I actually envisioned back in 2008 when I decided to do the Google Health thing and the world blew up in my face.Harry Glorikian: Yeah. I mean, I have access to my chart. And, you know, that's useful because I can go look at stuff, but I have to admit, and again, this is presentation and sort of making it easy to digest, but Seqster sort of puts it in a graphical format that's easier for me to sort of absorb. The information is the same. It's just how it gets communicated to me, which is half the problem. But but, you know, playing devil's advocate, how useful is the data in the charts, really? I mean, sometimes we talk as if our data is some kind of treasure trove of accurate, actionable data. But you've helped show that a lot of it could be, I don't want to say useless, but there's errors in it which technically could make it worse than useless. But how do you think about that when you when you think about this?Dave deBronkart: Very good. First note. First of all, you're right. It will...a lot of the actual consumer patient value will, and any time I think about that again, I think a lot of young adults, I think of parents taking care of a sick kid, you know, or middle aged people taking care of elders who have many declining conditions. Right. There's a ton of data that you really don't care about. All right, it's sort of it's like if you use anything like Quicken or Mint, you probably don't scrutinize every detail that's in there and look for obscure patterns or so on. But you want to know what's going on. And here's the thing. Where the details matter is when trouble hits. And what I guarantee we will see some time, I don't know if it'll be five years, 10, or 20, but I guarantee what we will see someday is apps or features within apps that are tuned to a specific problem. If my blood pressure is something I'm.... Six years ago my doctor said, dude, you're prediabetic, your A1C is too high. Well, that all of a sudden brings my focus on a small set of numbers. And it makes it really important for me to not just be tracking the numbers in the computer, but integrate it with my fitness watch and my diet app.Harry Glorikian: Right. Dave deBronkart: Yeah, I lost 30 pounds in a year. And then at the age of 65, I ran a mile for the first time in my life because my behavior changed. My behavior had changed to my benefit, not because of the doctor micromanaging me, but because I was all of a sudden more engaged in getting off my ass and doing something that was important to me.Harry Glorikian: well, Dave, you need to write a diet book, because I could use I could stand to lose like 10 or 20 pounds.Dave deBronkart: Well, no, I'm not writing any diet books. That's a project for another day. Harry Glorikian: That's it for this week's episode. Dave and I had a lot more to talk about, and we'll bring you the second part of the conversation in the next episode, two weeks from now.You can find past episodes of The Harry Glorikian Show and MoneyBall Medicine at my website, glorikian.com. Don't forget to go to Apple Podcasts to leave a rating and review for the show. You can find me on Twitter at hglorikian. And we always love it when listeners post about the show there, or on other social media. Thanks for listening, stay healthy, and be sure to tune in two weeks from now for our next interview.
We hear about our glucose and issues revolving around our metabolic health ad nauseam. But what exactly is insulin, glucose, and more importantly, how are these connected to our rate of aging and ability to get rid of belly fat. What ranges should you be aiming for when you receive back your annual reviews along with other checkups. These are a few things that I address in this episode, plus much more. In today's episode, you'll hear: What's insulin and its role What's insulin resistance and insulin sensitivity How the levels of your blood glucose are connected with weight gain, aging, skin health, and much more The connection between genetics and insulin resistance Why you should be careful with labeling your weight issues and various health ailments Why a fasting glucose test isn’t enough Why you need to include A1c and fasting insulin on your lab panels What’s the optimal range for a Fasting glucose test What’s the optimal range for a Hemoglobin A1c test What’s the optimal range for a Fasting Insulin test What is glycation and how does it relate to health and aging Simple interventions to improve your metabolic health and blood sugar Why you should consider supplementing with berberine And much more Connect with Julian: Connect with me on Twitter: https://twitter.com/thejulianhayes Connect with me on LinkedIn: https://www.linkedin.com/in/julianhayes Coaching — https://theartoffitnessandlife.com/application/
Today, I'm joined by Phil Southerland, founder and CEO of Supersapiens — a company using continuous glucose monitoring to help athletes manage their energy levels. In this episode, we discuss advancements in glucose monitoring. Phil explains why the company is focused on endurance athletes and high performance. And he shares his vision for using sports as a platform to change the health of the world. More from Phil Phil Southerland was born in Tallahassee, Florida, and was diagnosed with type 1 diabetes when he was only seven months old, the youngest case of diabetes on record in the world at that time. His parents were told that he would be dead or blind by 25. Fortunately, they were stubborn, and Phil had access to insulin, a knowledgeable medical team, and the latest in blood glucose monitoring tools. At six, he had the dream not to go blind and a drive to reach the A1C results needed. He discovered his love of the bike when he was 12. While attending the University of Georgia, he dreamed of combining his passion for cycling and his personal mission to raise awareness around diabetes. In 2005, Team Type 1 was founded, and by 2007 an all-diabetes cycling team not only won but set the world record in the 3,000-mile Race Across America. Under Phil's leadership, the dynamic squad rapidly grew from an amateur team to more than 100 athletes spanning the globe to inspire and unite people affected by diabetes and ranked in the top 25 professional cycling teams in the world in 2012. In late 2012, Phil and the team partnered with Novo Nordisk to create Team Novo Nordisk. The team is spearheaded by the world's first all-diabetes pro-cycling team and features a development team, elite team, and one female professional track star, Mandy Marquardt. Now in his late-thirties, Phil has dedicated his life to redefining what it means to live with diabetes and is driving a global movement to show the world how exercise can save the health of the world. "Exercise is the billion-dollar drug that rarely gets prescribed." Throughout his career, professional highlights include speaking at the United Nations on World Bicycle Day, leading a session at SXSW, and addressing audiences at ADA and AADE to speaking to one person at an event in Boise, Idaho. For Phil, the value isn't based on prestige as much as it is on impact. He is driven to make a difference in people's lives and approaches it one person at a time. To Phil, the bike has kept him alive for the past 25 years. While retired from professional racing, Phil regularly rides and still credits the bike for providing him with his continued health and sanity. Phil is a dedicated and proud father to three boys with wife, Dr. Biljana Southerland. In addition to the bike, Phil is a passionate skier and deep-water scuba diver. He calls Atlanta, Georgia home, and is a supporter of the High Museum. Phil is a former board member of Camp Kudzu, Hope Sports, and JDRF. He is a voracious reader and enjoys collecting rare wines and watches. Phil is the author of the book ‘Not Dead Yet', which chronicles his life from early diagnosis of diabetes to professional cyclist and his mission to change the face of diabetes on a global scale. Southerland currently serves as the CEO and co-founder of Team Novo Nordisk, the world's first all-diabetes professional cycling team, and the founder and president of the non-profit Team Type 1 Foundation. More from Fitt Insider Fitt Insider is a platform for entrepreneurs, executives, and investors redefining the business of fitness and wellness. From our newsletter and podcast to our industry-specific jobs board, we create content and resources to drive the industry forward. We also invest in early-stage health and fitness companies. For more, visit: https://insider.fitt.co/
Well, I did manage to get it down from 20 minutes to about 12 minutes. Essentially the same but with more about specific foods you can eat, more resources and just a touch less snark. Resources Mentioned: San Diego Union Tribune article about men ignoring their mental health issues. The Dana Foundation is a non-profit that provides information about the brain and brain health for kids and adults. Has a good explanation of Neurotransmitters. The Hormone Health Network is a website connected to The Endocrine Society, the world's largest organization of endocrinologists, representing more than 18,000 physicians and scientists. Endocrinologists look at the things that effect hormones and glands. Not only do they have a page about Serotonin, but they also have a page about the relationship between hormones and stress. They also have a little something about dark chocolate. 1 oz. a day will help mood, A1C levels, stress reduction and heart health. The National Health Service in the UK has a post on how to get Vitamin D for those living in the United Kingdom. It is different than what folks in the US need to consider. From Harvard Health: Serotonin The Natural Mood Booster. The have a series on the feel good hormones. If you need support contact the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or text “START” to 741-741. Disclaimer: Links to other sites are provided for information purposes only and do not constitute endorsements. Always seek the advice of a qualified health provider with questions you may have regarding a medical or mental health disorder. This blog and podcast is intended for informational and educational purposes only. Nothing in this program is intended to be a substitute for professional psychological, psychiatric or medical advice, diagnosis, or treatment.
Health diminishes with your BMI increasing. That is clear. In this episode we discuss health and happiness and we ask the question can you really be healthy at any weight? We all have metabolic markers; blood pressure, A1C, triglycerides, fasting glucose and waist circumference, if you're morbidly obese, you're going to fail that one. Even if you passed almost all of these metabolic markers, it's not okay for you to be overweight or obese or morbidly obese. With that said can you really be healthy at any weight? I don't think so... --------------------------------------------- Lose your first, next, or last 10 pounds with absolutely NO pills, powders, shakes, or exercise required. Click here to take the 10-pound takedown challenge! http://bit.ly/10lbtakedown Be sure to grab your copy of my book, The Code Red Revolution here. http://bit.ly/coderedbook Grab your very own Code Red water bottle today. The link is below! https://bit.ly/crwaterbottle Connect with Cristy: Facebook http://bit.ly/cristycoderedfb Instagram http://bit.ly/cristycoderedIG LinkedIn http://bit.ly/cristycoderedLI YouTube
Welcome to The High-Performing Coach Podcast which teaches Coaches, Authors and Speakers how to create an online high-fee coaching business from the heart, without websites or business cards. Tune in every week to coaching conversations that will give you strategies, tools and deep insights into how to create more freedom, impact and income in your business. Pauses and silences have been left in this conversation purposefully; within high-performing coaching sessions, the magic is often in the silence! This week Tina is with Lee Grigsby, coach and owner of LiveAllGood Coaching LLC. Lee began coaching when he needed to regain control of his A1C number (a predictor of diabetes) which had crept into the diabetic range. He trained for running and weight lifting. After some major setbacks - 2 leg procedures and severe Achilles tendinitis - he found his way back to fitness. Leading by example and being a positive influence in people's individual lives AND the world at large, has always been important and felt very natural to him. Having trained with HPC, his purpose has never been clearer! Along with the empowerment and coaching others to help them reclaim their personal power and step into the life they want! In this episode you will hear: How to take control of your health Understanding that the relationship and balance between physical, mental and emotional health How to package and price your coaching services Owning your value as a coach How to actively connect with people Understanding what's blocking you Are you ready to take your business to the next level? Go to https://hpcoach.co/call-pod to apply for a Breakthrough Discovery Call with our team. Just click the link and choose a time that is convenient for you and on that call you can share exactly what you've tried, what's working and not working and your revenue goals and vision for your business. During this call we will give you the 5 steps to creating clients and if you want to talk about how we can help you turn your passion for coaching into a business that creates more freedom, income and impact then we can talk about that too and if not, that's ok. Our intention is to give you massive value! Cheers to your success.
Are you at risk for pre-diabetes? Why your worry about belly fat goes far beyond your bathing suit. My Guest: Dr. Beverly Yates is a diabetes expert and author who has over 27-years experience of working with those who struggle with blood sugar issues related to type 2 diabetes and prediabetes, and feel like nothing works for them. She uses her systems engineering background as an MIT electrical engineer in combination with her naturopathic medicine skills to help people achieve and maintain blood sugar control. Truly an expert Dr. Yates is an internationally recognized speaker and expert in the field of diabetes and heart disease. She is a published author of Heart Health for Black Women: A Natural Approach to Healing and Preventing Heart Disease, and co-author of multiple books, including one with Jack Canfield, The Soul of Success, Vol. 2. By addressing the lifestyle factors that trigger blood sugar spikes, Dr. Yates creates breakthrough changes in the habits that cause blood sugar issues. This allows her clients to finally get off of the blood sugar rollercoaster, have more energy, and create the level of health that lets them live the life of their dreams. She is the creator of the Yates Protocol, a simple and effective lifestyle-based program, for people who have type 2 diabetes or prediabetes, to lower blood sugar levels, achieve healthy A1C and fasting blood sugar levels, and have more energy to live life the way they want to. Let's dive in! Questions We Answer in this Episode: Why women in their 50s are at particular risk of diabetes? Are there changes in our 50s that come with stress resilience? My female listeners are not strangers to tossing and turning, then experiencing cravings – all related to cortisol and blood sugar changes… Do menopause sleep changes that so many women experience (and men – in andropause) put us at risk of type 2 diabetes? Resistance training as a key exercise strategy in our 50s is necessary Tell me how you advocate for that… or more importantly where do you sit when faced with advising clients to exercise… cardio or strength? My listeners all potentially struggle with balance… or defining it… from the Dr herself what's the medical opinion, is it possible to find the balance in selfcare despite other demands in our lives? Connect: https://drbeverlyyates.com/better-sleep-better-blood-sugar/ Social media: Instagram: @drbeverlyyates Facebook: https://facebook.com/drbeverlyyates Youtube: https://www.youtube.com/c/DrBeverlyYates Coming up!! Type 2 diabetes coaching program
I was reading an article that said I should eat pineapple to increase my serotonin level. I also seen other articles about kiwis, avocados and other foods. In those articles you might find something about serotonin ability to calm you down. Or to help with anxiety. Or depression. This one got me a little twitchy. Because the article mentioned the pineapple should be inside of a sugar cake of delight. This is like a person pointing to the ice cubes inside an alcoholic drink. And trying to convince themselves they are hydrating with water. Which brings up the hackles in me about so-called superfoods. The special formulas. And buzzwords on parade. I think what ticked me off was the implication that the implication of a fruit inside of a sugar based cake becomes a healthy alternative. Posted is the short version because I wanted to say so much and it was coming in a twenty minutes. I have weed whacking to do so this is the short, simplified version for those who think six minutes is all they can take. In this episode, a look at what is serotonin and what it does to the mind and body. Resources Mentioned: The Dana Foundation is a non-profit that provides information about the brain and brain health for kids and adults. Has a good explanation of Neurotransmitters. The Hormone Health Network is a website connected to The Endocrine Society, the world's largest organization of endocrinologists, representing more than 18,000 physicians and scientists. There is a post on their website about What is Serotonin? that is written from their perspective. The also have a little something about dark chocolate. 1 oz. a day will help mood, A1C levels, stress reduction and heart health. From Harvard Health: Serotonin The Natural Mood Booster. The have a series on the feel good hormones. Very Well Mind has a write up about bananas and will they chill you out or not. If you need support contact the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or text “START” to 741-741. Disclaimer: Links to other sites are provided for information purposes only and do not constitute endorsements. Always seek the advice of a qualified health provider with questions you may have regarding a medical or mental health disorder. This blog and podcast is intended for informational and educational purposes only. Nothing in this program is intended to be a substitute for professional psychological, psychiatric or medical advice, diagnosis, or treatment.
It's In the News... the top diabetes stories of the past seven days! This week, what did lockdown mean for BG trends, Provention Bio keeps fighting for Teplizumab, the FTC shuts down diabetes schlockmeisters and if you're still using the Dexcom G5 - you need to hear this... Join Stacey live on Facebook each Wednesday at 4:30pm EDT to watch live. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription and links below Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their Entrée Bowls and all of their great products in your local grocery store, Target or Costco. XX Our top story.. What did COVID lockdown mean for blood sugar trends? A new study says when they had to stay at home, people with type 1 significantly improved while the opposite happened for those with type 2. You should know these studies all come from European countries with pretty strict lockdowns and they're an aggregate – a look at a bunch of previously conducted studies. With type 1, time in range improved significantly in 83% of the studies looked at here.. with type 2, almost half of the studies showed a clear decrease in blood sugar control, with higher A1Cs. So what happened? There's a lot of speculation but these researchers suggest less exercise and more snacking and more stress is to blame for the type 2 numbers.. although in my opinion the same could be said for all people with diabetes. They also suppose that the lockdown gave parents more time to look after kids with type 1 and gave young adults a more predictable routine. I hope another study is done on this in the US where, frankly – access to insulin & health care providers may have become more of an issue during the pandemic https://www.news-medical.net/news/20210913/COVID-19-lockdown-linked-to-improved-glycemic-control-in-type-1-diabetes.aspx XX Bit of an update - Provention Bio moving forward to answer the FDA's questions and hopefully resubmit. This is for Teplizumab the first drug shown to prevent type 1 diabetes for – so far- up to three years.. although the FDA turned it down in July. Provention says they continue to collect data and are moving to set up what's called a Formal Type A meeting to submit that new information. The company's CEO says they believe they're making significant progress to address the observations cited by the FDA and continue to work with urgency. https://finance.yahoo.com/news/provention-bio-provides-potential-timing-113000253.html?soc_src=social-sh&soc_trk=tw&tsrc=twtr XX Bunch of schlock-meisters got called out last week by the US FDA and FTC – that's the Federal Trade Commission. 10 companies got warning letters alleging they were selling illegal dietary supplements to cure or prevent diabetes. Regulators wrote the products cited in the warning letters are considered unapproved new drugs – they include things like turmeric, bitter melon, ginkgo biloba and more.. The report cites the increasing cost of insulin and other diabetes medications as a reason why people are turning to alternatives, even if they aren't proven.. Please.. be careful out there. https://www.naturalproductsinsider.com/supplements/regulators-target-diabetes-supplements-recent-warnings-about-claims Quick additional FTC note – they held a virtual open meeting today. Two people from the diabetes community spoke about rising insulin prices. If you'd like to learn more I'll link up the information. https://www.ftc.gov/news-events/press-releases/2021/09/ftc-announces-tentative-agenda-september-15-open-commission XX We don't talk a lot about shots – multiple daily injections – but here's some good news about the basics. New study shows rotating sites and using smaller needles really do help. You've likely heard of LY-po-hy-PER-tro-fee.. it's when lumps of fat or scar tissue form under your skin. These Belgian researchers did a six month study where they provided smaller pen needles and did a lot of education, including an online platform where they taught proper injection techniques, including not re-using needles. They reduced what they called unexplained high blood glucose significantly and glucose variability decreased as well. A1Cs stayed about the same. https://onlinelibrary.wiley.com/doi/10.1111/dme.14672 XX No surprise but still disappointing – insurance is what's dictating whether young children are more likely to use a CGM regularly. This was published in Diabetes Technology & Therapeutics. Those on public or government insurance often face more obstacles. This was a study of children ages 1-6 years, within two months of diagnosis. 82-percent used a CGM at least once during the study period.. but they divided everyone into 4 groups – always used CGM, stable use, inconsistent use or never used. Families with private insurance were more likely to be in the always group or the stable group than those with public insurance. And.. The “always” group had an A1C that was 1.3% lower than the “never” group https://www.healio.com/news/endocrinology/20210907/private-insurance-determines-cgm-use-by-young-children-with-type-1-diabetes XX More to come, including a Dexcom G5 update! But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—the new Entrée bowls are great. They have a chicken burrito, a cauliflower mash and braised beef bowl.. the lemon chicken I've told you about and more! They keep adding to the menu line! You can buy online or find a store near you with their locator right on the website. I'll put a link in the FB comments and as always at d-c dot com. Back to the news… Heads up if you're still – somehow – using the Dexcom G5. More than a year ago, Dexcom stopped selling the G5 and G4.. but – and thanks to the listeners who brought this to my attention – the G5 app is now sending out a notification.. On October 4th the Dexcom G5 app will no longer be available. As they've shared with us on the podcast many times, they've been transitioning everyone over to the G6 and will soon move on to the G7. No timeline on that btw I know you're going to ask. But as far as we know, it hasn't been submitted to the FDA and Dexcom has said it will go for European approval first. -- And finally don't forget to send me your Dear Dr. Banting audio! What would you say to the man credited with the discovery of insulin? All the details and how to send it to me is in the show notes. -- Please join me wherever you get podcasts for our next episode - The episode out right now is all about the new Walmart Insulin.. will it save you money? That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.
Dr. Lee Goldenberg of Greystone Chiropractic in Birmingham, AL interviews Dr. Curtis Fedorchuk of Cumming, GA- chiropractor, researcher, father, husband, hockey goalie. Dr. Curtis has spent the majority of his career conducting extensive chiropractic and clinical research.Neck study on blood flow: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458772/Neck study in canal diameter: https://pubmed.ncbi.nlm.nih.gov/33082920/Pediatric study on asymptomatic neck misalignment (spondylolisthesis): https://pubmed.ncbi.nlm.nih.gov/34276876/Blood sugar (A1C) study: https://www.longdom.org/open-access/improved-glycosylated-hemoglobin-hyperglycemia-and-quality-of-life-following-thoracic-hypokyphosis-vertebral-subluxation-correctio-2155-6156-1000807.pdfTelemere length: https://www.prlog.org/12651019-chiropractic-increases-telomere-length-new-research-just-released.htmlLung function study:https://www.vertebralsubluxationresearch.com/2017/09/04/improvements-in-lung-function-dysautonomia-and-grip-strength-in-a-patient-with-multiple-sclerosis-following-correction-of-vertebral-subluxation-using-chiropractic-biophysics-a-case-study-and-s/More studies by Dr Curtis: https://www.betterhealthbydesign.com/research-awards/
A high school swimmer with diabetes is told he can't compete at the state championships because of his CGM's medical tape. It's a story that's been all over social media and national news outlets. What really happened here? We talk to Ethan Orr and his mother, Amanda Terrell-Orr. They explain what happened that day, what they'd like to see change and what we can all do to protect our rights when it comes to diabetes. Also this week! Send us your "Dear Dr. Banting" audio! Details here This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcription below: Stacey Simms 0:00 Diabetes Connections is brought to you by Dario Health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar and by Dexcom help make knowledge your superpower with the Dexcom G6 continuous glucose monitoring system. This is Diabetes Connections with Stacey Simms. This week, you've likely seen the story of a high school swimmer with diabetes told he can't compete at the state championships because of the CGM, his medical team what really happened here, we talked to Ethan Orr and his mother. Amanda Terrell-Orr 0:41 The whole point of the rule is to prevent a swimmer from having a competitive advantage. You would not have to be someone who understood type 1 diabetes to look at what even had on his arm and know that of course that would not cause the competitive advantage. Of course, it was just medical tape covering up a medical device. Stacey Simms 1:00 Amanda Terrell Orr and 16 year old Ethan join me to explain in their own words, what happened that day, what they'd like to see change and what we can all do to protect our rights when it comes to diabetes. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. Always so glad to have you here. We aim to educate and inspire about diabetes with a focus on people who use insulin. I'm your host, Stacey Simms, my son, Benny was diagnosed with type one right before he turned two. That was almost 15 years ago. My husband lives with type two diabetes. I don't have diabetes, I have a background in broadcasting. And that is how you get the podcast. Before we jump in. I need your help. I am trying something for November. I want to hear your dear Dr. Banting stories and letters. I posted this on social media. If you're in the Facebook group Diabetes Connections of the group or you get my emails, you will be seeing this this week and for the next couple of weeks. Because all the month of September. I'm asking you to record some audio. It's very simple. Just do it on your phone. As part of the dear Dr. Banting exhibit. We talked to the folks at Banting house the museum where Dr. Frederick Banting had his eureka moment where he came up with the idea that led to the discovery of insulin with other people. But Banting house has an exhibit called dear Dr. Banting. And I go much more in depth on this. It's a Diabetes connections.com. It's on my social media. I'm asking you, what would you say if you could thank Dr. Banting for yourself for your child? Right, just thank him. So all the specifics are in the show notes. Basically just try to keep it to a minute. I'd like to play these back during the month of November. I'm really looking forward to what you have to say. Don't worry about making it perfect. Just try not to have too much background noise use your phone's voice memo app doesn't have to be anything fancy and send it to me Stacy at Diabetes connections.com I cannot wait to hear what you have to say. Alright if you haven't heard and boy this was all over social media last week and this week. Here's a quick synopsis of what has been reported. Amanda and Ethan will go much more in depth and and frankly set a few things straight that were reported a little bit inaccurately even has type 1 diabetes. He was diagnosed at age 10. He wears a Dexcom G6 he uses simpatch the brand of the tape is not important, but you should know that he wears the medical tape over the Dexcom as many people do, and that's pretty much what does that issue here. He also wears a Tandem t slim x two pump that he removes most of the time when he swims. Ethan swam all season for his high school in Colorado Springs. No issue he had the CGM on for every meet. But at the state championship, as you'll hear, it became an issue. And I'll let me tell that story. But you should know going in is that this is not a lawsuit. The family is not suing for damages or anything like that they filed a complaint with the United States Department of Justice, Civil Rights Division. This is not about money. And you may have also heard that the CHS at the Colorado high school activities Association, which is receiving the complaint here. They say that Ethan did not have a signed medical authorization to have something like this. Well, he has a signed 504 plan. So does that overrule? Or could that be looked at is in place of what they're talking about in terms of medical authorization to wear tape in the pool because it applies to his diabetes and his diabetes medical management plan, USA swim, that governing body does allow medical tape. So there's a lot going on here and I think it's more in depth. And then you've seen in certainly a lot of these media reports, as well done as they are, you know, these people don't speak diabetes, they don't cover diabetes on a regular basis. So it's really excited that Amanda and Ethan agreed to come on and share their story where we could really kind of drill down and figure out what happened here and more importantly to me learn what we can all do to prepare our kids for sports and to kind of learn what we can all do to stand up for ourselves when it comes to diabetes. Right. Okay, so quick housekeeping note, I'm nosy I like to talk to people so we set the table for a while here I talk about his diagnosis story how he adjusted to swimming you know all that kind of stuff. So if you're just here for the lawsuit stuff, we don't talk about the actual swim meet until about 12 minutes into the interview. So you could go ahead and skip ahead I'm not offended but just know that there's some getting to know you stuff that happens before we talk about the nitty gritty Alright, Diabetes Connections is brought to you by Gvoke Hypopen and when you have diabetes and use insulin, low blood sugar can happen when you don't expect it. That's what most of us carry fast acting sugar and in the case of very low blood sugar, why do we carry emergency glucagon there's a new option called Gvoke Hypopen the first auto injector to treat very low blood sugar Gvoke Hypopen is pre mixed and ready to go with no visible needle in usability studies. 99% of people were able to give Gvoke correctly find out more go to Diabetes connections.com and click on the Gvoke Logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma visit Gvoke glucagon comm slash risk. Amanda and Ethan, thank you so much. We did this on short notice I really appreciate you coming on and sharing your story. Amanda Terrell-Orr 6:27 You're welcome. Thank you for having us. Thank you. Stacey Simms 6:31 And Ethan, you got up pretty early to do this. I am East Coast, your West Coast. So I appreciate that very much. Ethan Orrr 6:35 It's all good. Stacey Simms 6:39 Let's back up a little bit before we jump into what happened here and the lawsuit and everything. Amanda, let me start with you. Tell me your diagnosis story. Amanda Terrell-Orr 6:48 Sure. So Ethan was 10 when he was diagnosed, and our diagnosis story, I think is fairly typical of other people we had noticed, Ethan's teachers had noticed that we had noticed that he was going to the bathroom way more than usual. So I took him to his pediatrician and expressed some concern about that didn't really know what might be happening. They did a test of his urine. And it didn't show any kinds of problems with sugar or ketones or anything like that. So we just sort of stopped at that point. And then you know, weeks go by, and this is still happening. We went on a small vacation and even drank all the bottled water that we had, and was still going to the bathroom all the time. And then the day before Easter that year even had been kind of wrestling with a friend. And he started to be short of breath. And he also felt like really like something was wrong. So the morning of Easter, we wake up and I look in his mouth, and I see white spots in his mouth. And I say to him, it's time we need to go to urgent care. So in the back of my mind this whole time has been some education that I saw on a friend's Facebook post about type 1 diabetes, her son has type one. And she always posts educational information. And so in the back of my mind, I was thinking, I wonder if the test whatever they did at the pediatrician was wrong. So we go to urgent care, they test them for strep throat, of course. And then I mentioned to the doctor that I'm concerned because of these other symptoms. The doctor, of course, has someone test his blood sugar. And luckily for him, it wasn't extremely high. He wasn't NDK. But urgent care at that time, send us directly to the hospital. So Ethan really stayed a day in the hospital. And the next morning, we were able to connect with the Barbara Davis center part of Children's Hospital in Colorado. It's an excellent place for treatment of kids with type one. So we were able to go there and immediately start connecting with resources and other families and of course, like, like everyone after diagnosis, drinking from the firehose to try to figure out how are we going to live in this new life? Stacey Simms 9:10 Even What do you remember that time? Ethan Orrr 9:12 I remember during the day before with all the symptoms that I would wake up in the middle of the night like to use the restroom. I didn't know what diabetes was immediately in the car. So mom was tearing up a little bit on our way to the hospital. And she when I asked asked, like, what is diabetes? She's like, well, you're gonna be getting quite a few shots today. Because like home, right? No, I like I thought she was kidding. At first cuz I've never heard of some like that. The beginning is I was just in shock a little bit. But then like, I slowly edged in or wet or things will be good. Nothing's gonna change too much. Stacey Simms 9:53 I don't want to fast forward too much as we're getting to, you know, the news story here, but you're 16 now, so Were those six years. Obviously you play sports, did things kind of go to a better place? Do you feel like you guys managed it pretty well? Ethan Orrr 10:08 Right? When I got diabetes, I was still competing, swimming wise, and I was trying to swim for the Colorado torpedoes in Manitou. At the time I, I had my CGM, but it didn't work in the water was a different type of CGM. So my phone couldn't connect in I was in a spot where I was close to my honeymoon period. And so we had a we are way too many troubles, trying to like dangerous troubles trying to be able to swim that year. So I ended up just pulling out, you know, we made a family decision is too dangerous, because I could feel my blood, like when I went low or high or anything like that isn't that low? This year, at the beginning of the season, we are a little bit of a problem. Not a little, there's a big problem at the beginning of the season, because my body wasn't ready and adjusted for stuff like that. So I had a lot of very, very bad lows during some practice for like about a month. And then it finally picked up and I was completely fine after that. And I was able to swim very well with the rest of it without blood sugar issues. Stacey Simms 11:16 Amanda, let me switch over to you. Tell me about that experience. Because I know with my son, every seat Well, first of all, he changes sports every couple of years, which is bananas, because we figure it out. And then he moves on. So what was swimming? Like? Yeah, you hear you, Amanda Terrell-Orr 11:29 I hear you. Yes, we have that experience as well. It sounds like our kids are similar that way Ethan likes to jump around sports. So he had been even been competitive swimming for not an insignificant amount of time, I would say when he was diagnosed, and it was just in that honeymoon period and learning everything. And being just terrified of every significant low. You know, at the beginning, those things seem really insurmountable. Because even had a couple of really scary lows, it was also kind of affecting his confidence to stay in swimming. So sadly, something that he really loves. What we said is we put it on pause. We didn't think it would be on pause this long. But it was really Ethan's choice. And so we were really happy this season, when he chose swimming again. And then he started swimming, and everything that we thought we knew about management of his diabetes changed in some ways. And in Ethan's case, he was he's very active, he's very fit. But his body was not used to the kinds of energy that need to be expended to swim in particular. So we tried all the things, all the tricks, all the tips that everybody gave us. And he was still having really significant lows, having to be assisted out of the pool sometimes. But to his credit, and one of the things I'm so proud of him for is that he swam right through that he had to sit out of practice a lot because of low blood sugars. But he still kept going every day. And he believed us when we said your team is going to help you and by team I meant his endocrinology team, and also athletes with type 1 diabetes. So we threw out questions out there into the social media world and got great advice from other people, athletes with type one. And we combine that with the guidance from our endocrinologist and Ethan's body also adjusted to the swimming. And so at the end of all of that he was at the end of the season, he was really doing pretty well in terms of being able to swim safely. So we were very proud of how he came through this season. You know, to be honest, as a person without type 1 diabetes, and an adult. I don't think I would have done that. It was very, very hard, but he stuck it through and was fortunate enough to be able to go to the state championships. Stacey Simms 14:01 He said I'm curious what worked. Looking back on all of that. Right back to Ethan answering my question, but first Diabetes Connections is brought to you by Dario Health and bottom line you need a plan of action with diabetes. We've been very lucky Benny's endo has helped us with that and he understands the plan has to change. As Benny gets older, you want that kind of support. So take your diabetes management to the next level with Dario health. Their published Studies demonstrate high impact results for active users like improved in range percentage within three months. reduction of A1C was in three months and a 58% decrease in occurrences of severe hypoglycemic events. Try Dario's diabetes success plan and make a difference in your diabetes management could have my dario.com forward slash diabetes dash connections for more proven results and for information about the plan. Now back to Ethan explaining how they got his blood sugar more stable during and after swimming. Ethan Orrr 15:03 So to be honest, the only reason it worked, I in my body got adjusted. At the beginning of it, I would have to take seven juices, maybe practice a, like during the entire thing, not not like a one point. But like throughout of like a one hour practice is really bad. But something that we did is I had gummies like little energy energy jam. Yeah, it's like the glucose gels. Yeah, we had glucose gels next to it. Because if you have too many fluids, with swimming, you can get nauseous, especially with it being juicing and eating granola bars before you, when something very hard tends not to work out very well to something that's like flexible with your stomach. So it's not like you're eating like a valley granola bar, and then you're going into pool and wanting to puke. Amanda Terrell-Orr 16:03 Yeah, even some of the things that you're maybe not remembering because they just became so routine for us is suspending his pump. like two hours before practice making sure he didn't have any insulin on board keyword also, toward the end there where we were waiting for his body to adjust, he would have the equivalent of a meal, about an hour before practice with no insulin to cover it. And he would still getting into the water, those first bit of time would still go very low in a short period of time. So then he would have to sit out like he was saying, you know, have a lot of juice. And then he would be nauseous and not able to swim as well. What the doctor kept telling us is, you know, hang in there, we're going to figure this out, your body's going to adjust. And sure enough that ended up happening. But those are the kinds of things that we had to try in the early part of the season. Stacey Simms 16:57 Sounds very familiar. My son's first wrestling practice freshman year of high school, he ate 85 uncovered carbs and still would not go above 70. Yeah, I was able. Amanda Terrell-Orr 17:09 Yeah, the other thing that was really challenging that we had never experienced before, but we know that other people have since we reached out is overnight. Well, after practice, Ethan would have lows that would last for hours, no matter how many carbs we would give him. So then we would have to get to the point where we were micro dosing glucagon with the advice of his doctor in his circumstance to try to bring his blood sugar back up. But there were nights where my husband and I were up for four hours at a time just trying to get his blood sugar into a safe range. And this year, is the first time in all of those years, he's had diabetes, that we had to ask for emergency medical assistance for a very severe low. So it was a really, really difficult time. But what we like to think about that, and you know, he's very resilient, he got through that time. And you know, the type one community was really helpful in helping us come up with ways that we could try to address these big problems that we're facing. Stacey Simms 18:14 So you brought up the state championships. Let's just jump into that now and talk about what happened and the basis of the lawsuit. And you know, what you hope to accomplish here, but start by telling me and Amanda, let me ask you what happened at the state championships. Amanda Terrell-Orr 18:29 So the summary version of that, that I would say is that even had several events that day, they were all relay events, which means that he was competing as part of a small team of other swimmers. He had swam to those events. And the last event of the day would have been his final relay event swim. He was standing at the side of the pool with another student next to a referee, and the referee asked Ethan about what was on his arm. And so Ethan explained, of course, that it was a continuous glucose monitor that it measured his blood sugar that it was for type 1 diabetes, and that he had the patch over it to keep it on during swimming, which every athlete knows that everybody's body's different, but you are more likely to need extra cover over your CGM when you're sweating or swimming or that kind of thing. So the referee asked Ethan, who his coach was and who he swam for, and minutes before the event was scheduled to begin the referee address the coach. The coach told the referee all the same information that Ethan told him And in addition, said Ethan has an active 504 plan that allows him to have his medical equipment. The referee insisted that Ethan was in violation of what is commonly called the tape rule, which is essentially the fact that a swimmer can't wear something extra on their body to aid their speed boy The four body compression because those things could give the swimmer a competitive advantage. The coach tries to explain again everything that was going on. And that not one time in the 70s even swam prior to the state championship. Did any other referee believe that that rule applies even. It's always obvious in some of the videos that various news stations have used. You can see it on Ethan's are messy swimming. So clearly referees who are paying close attention to the swimmer to see whether their stroke is off or they're, you know, doing anything else that would be a violation saw this on his arm and no one said anything. So the referee was told that information as well. The referee insisted that in order to compete under that tape rule, he would have needed a doctor's note to say that it was medically necessary. The whole point of the rule is to prevent a swimmer from having a competitive advantage, you would not have to be someone who understood type 1 diabetes to look at what even had on his arm. And know that of course, it would not cause a competitive advantage. Of course, it was just medical tape covering up a medical device, the Dexcom G6 says on it what it is. And I timed it, it takes about 15 seconds on Google to figure out what that is. So if the referee did not believe the information he was getting, and the whole purpose of the doctor's note is to say, you know if needed, and so it doesn't give a competitive advantage. All of that together means that the referee heard all that information. And he either didn't believe it. Or he continued to believe that either was potentially cheating by wearing a foreign device or substance to aid his speed buoyancy or body compression. So at that time, the referee said that Ethan was not going to be allowed to swim. One of the important things that has happened in the news that I know the governing body is having trouble with is the use of the term disqualification. In my mind when the kid doesn't get to swim, the semantics of that don't matter. But it wasn't the fact that even swam in the meets in that final event and was disqualified, he was not allowed to swim the final or that. And so what the coach tells us happens from that point is that the referee says Ethan will not be able to swim, you were required to have this note, he's in violation of the tape roll. And so the referees scramble, because again, he's addressed minutes before the event starts and substitute another swimmer for Ethan. But what the coach told us is that in the rules, when you're going to substitute a swimmer, you have to go to, you know, like the administrative table and make that substitution in a particular kind of way. And so he was not able to do that in that time period. And the coach indicated to us that the relay team was subsequently disqualified for not having a proper substitution. Now, we learned for the first time when chafta issued their statement, that they are saying that the team was disqualified for an early start. And, you know, from our perspective, although it's really upsetting to us that the whole team would have been potentially disqualified on this substitution issue. The fact is, the crux of this is that Ethan was not allowed to swim, because someone incorrectly interpreted what he had on his body is potentially cheating and violation of the taping raw. That is essentially what happened in Ethan's case. And that just started all of the research and that kind of thing that our family did before we decided to engage a lawyer got it. Stacey Simms 23:50 My question, I had a lot of questions. But one of my questions is, is it your belief, and I assume it is, since you're going to have with the lawsuit, that having a 504 plan, being covered by the American with Disabilities Act supersedes that tape rule. Amanda Terrell-Orr 24:05 There are several points to what we're saying. So the first thing we're saying is the rule doesn't apply to even circumstance. And although the high school associations have not chosen to be this clear, the USA Swimming rules are very clear that taping for medical devices is not a violation of this taping rule is really about kt tape or therapeutic tape that would be used to support somebody muscles or joints or ligaments or tendons in a way that would give them a competitive advantage. Anybody who knows anything about swimming knows that when something protrudes from your body like a CGM, that it actually causes the disadvantage because we're talking about milliseconds of time and surface drag can actually make him slower. Additionally, we know the rule didn't apply because no other referee instead Prior meet even mentioned it as being possibly implicated by that rule. So let's say he even mistakenly believes that the rule applies, there are a couple things about that he did have a 504. We do think that's important, because the 504 says that he's able to have his medical devices at all times, in all school activities. Secondly, and I believe this is standard across the country, but even had to have a sports physical before he participated in sports that said that he was safe to participate in those sports. So there are lots of reasons that we believe the rule didn't apply. Even if it did, Ethan should have been fine without a specific doctor's note to prove he had type 1 diabetes. And further, the referee under the rules had the discretion to allow even to swim if he did not find that to be excessive. And he says, and he chose not to let even swim. So for all of those reasons, I think the way I described it to someone is there was a tortured reading of that rule to exclude a kid was type 1 diabetes isn't Stacey Simms 26:13 how is your team reacted to all of this? Ethan Orrr 26:15 Whoa, I didn't find out until I was literally walking to the blocks. My team was a little bit upset, but because they didn't know what was going on. At first, my friend, I was with one of my teammates. While that was happening, and he's like, going on well, the coaches talk or not the coach, the referees talking to me. And so I was walking to start the event, like I was walking around the pool, and they were like, Ethan, why aren't you sorry? I was like, What? What do you mean? And they're like, you're not swimming coach just said, Go talk to coach right now. We're starting to bet right now. Aren't we? Just like, yeah, go talk to coach right now. And we're gonna talk to him. And he was like, yeah, we're looking. I'm looking at the rulebook right now. And we're all looking at the rulebook really quick, but you're not able to swim. Because the CGM on time. And so everyone was like, why? because they didn't know it was forward. And the teammates that I was with is like, was it that coach, or, or the rapper or whatever? I was like, yeah, know what? He was like, yeah. I don't know what to tell you. I was like, Oh, okay. We were all upset about it. I was really dumb. Did Stacey Simms 27:26 they support you? I mean, in these days in the time that has passed, tell me about that. Ethan Orrr 27:32 Oh, yeah, no, they've always, I'm friends with everyone on the swim team. Amanda Terrell-Orr 27:35 They're all super great. My coaches super great. The trainer for the cornado, the school that I stand for, is really great. My teammates are really supportive whenever I would have to get out, you know, they just, they'd make jokes, they'd be funny about it, like try and like lighten it up and whatever. They're really great. They're a really great team, they are really great team, I'm still going to swim for them this year, I'm still competing for I'm going to try and compete for state this year to this. I think the other thing, even in terms of the support even got, we we really can't say enough about this coach and the athletic trainer, it was a difficult season for them to of course, because of everything Ethan went through. So this happened, the state championship happened at the end of June, at the very beginning of July, the coach actually sent an email to chafa and laid out the situation of what occurred, asked if they would work with him, because he believed that what happened could potentially be a violation of even federal right. And I spoke with the coach kind of throughout that time. But at the end of July, I spoke with him more in depth and and I really wanted to know what kind of response he had received, he had received zero response to that email. So here we have a coach that's trying to act, you know, advocate for his student with diabetes and try to get something change. So this wouldn't happen again. And he received no response to that, Stacey Simms 29:04 you know, Amanda, a lot of people are going to be really excited that you've done this and want to see this change and are rooting for you. But a lot of people are also going to be wondering why a lawsuit. There's just so much that happens to you all. When you file a lawsuit, you're going to get a lot of negative attention, you're going to get pushback, we file the lawsuit and what are you seeking in the lawsuit? Amanda Terrell-Orr 29:26 So I'm glad that you raised that. That's one of the points that is confusing to people. We actually have not filed a lawsuit we filed a complaint with the Department of Justice alleging a civil rights violation. So that process is a different kind of process. That's not about monetary gain for anyone. That process is about the Department of Justice investigating whether or not there was a violation of even civil rights and if so, what kind of oversight is necessary over the governing body so that athletes with this abilities don't experience those kind of violation. So it's essentially a mechanism to enforce oversight and change, but not a mechanism whereby we would receive any funds whatsoever. Our lawyer is doing this pro bono. If we were to file a lawsuit, that would be a different circumstance. But it isn't our goal. To get money out of this situation, our goal has several parts to it, the main part of it is both the national and the state rules need to get with the times and make the kind of changes that USA Swimming has made. That makes it clear that taping of a medical device is not cheating. That is the primary thing that we need to see. I also truly believe that chafa in their rulemaking process needs to include the voice of athletes with disabilities, or people who have a lot of familiarity with those areas, I think that would help give voice to some of these areas where they clearly have not educated themselves. And I just think that voice is so important. So those are a couple of the main things that we're trying to get accomplished here. And, you know, in general, the governing body had the opportunity to say, we really care about this, we want to work with these folks to try to make change. We had one referee interpreted this way. This isn't what we believe as a system. But their statement, you can see, it's clear that they believe that discriminatory reading of that rule is the right reading of the rule. So we need some help from Department of Justice or other avenues to force the issue to get them to change. What kind of tape do you use? Do Stacey Simms 31:45 you mind? I mean, you can share a brand name or just you know, because there's so many different overlays for the Dexcom. I'm curious what it looks like Amanda Terrell-Orr 31:50 he was wearing the simpatch. Got it. And one of the things that I've been saying to people, if they're not swimmers, or athletes, they don't necessarily understand the difference between my kcca for therapeutic tape and Matt. But as you know, and as other people who use those overlay patches, now, that patch was specifically exclusively and obviously designed for that purpose. It has a perfect cut out just for made for the exact model of CGM that you have. And it's clearly obviously just holding that device on. So anyone who looks at the simpatch, or any other similar kind of patch, can easily understand what it's there to do. And not that and understand that it's not there to aid his speed, buoyancy or body compression, it can't do any of those things. And it's clear that it can't when you look at it, Stacey Simms 32:45 he said you've said you're gonna start swimming again, you want to make it to the states again, why is this got to be very disruptive to you? This can't be a fun thing to be going through. Tell me why you like swimming. Ethan Orrr 32:56 It's one of the hardest sports for you to be able to do. I really enjoy the individuality, but also how you work as a team. I mean, no matter what the points that you get for individually swimming, impact the entire team on in deciding if you win or lose the knee or event or competition, whatever, whatever composition, I really loved swimming, I've always loved swimming. But once I got diabetes, there's a we couldn't manage it properly without being safe. But nowadays I can. And I totally love to pursue it. I feel like it's great. It's great for the body. It's great. It's great in general, and just to get your mind off of whatever I mean, I think this is an amazing sport. And I'd love to pursue it. So even if we've had troubles, hopefully, we shouldn't have those same troubles. If the if we get the rule change that we need and want then I shouldn't have the problem, then I can swim and still compete. I don't hate chess or anything like that. I just want some real change. You know, before I let you go, Stacey Simms 33:57 Amanda, let me ask you what I saw this story on social media. I feel like it's been in every diabetes Facebook group. Obviously it was local television and got picked up by national media. What's the response been like for you? Amanda Terrell-Orr 34:08 What I want to focus on is the positive first because that is the overwhelming majority of response we've gotten. We've just received so much support. We've received support from jdrf. We've received some for support from Team Novo Nordisk we've received support we were contacted by Dexcom. So all of those are good, but also the heartfelt messages that we've received from other parents of athletes with type one have been moving and have really helped support us through a time where we're getting the kind of attention that we did not expect from this. We expected that we would file something that our lawyer would do a press release and a couple of local channels would be interested. And then we would just wait and see what happens. This has been way more of a response than we expected and the back much Already in that response has been positive and supportive. But as we know, in the public domain, there are always people who don't think about the consequences of what they say on real people. And they come after, you know, a 16 year old in their comments. And so early on, our lawyer told us don't read the comments. And that was really great advice. So now, we basically just engaged with people who have commented on, you know, like a diabetes, Facebook post, or some other kind of social, that's from folks who understand that better. And, you know, we've kind of asked those people who are supporting us, if they're reading the comments, they can address those issues, they can address people who are trolling us. And that would be really helpful to us, because we just can't be beat up that way. But I also think chaffles response was very disappointing to us. And it felt like they were minimizing denying and blaming. And they had the opportunity to look at this much differently in a way that was geared toward change that could allow student participation. And they chose not to do that. It felt like backlash to us that they chose to respond in that way. But by and large, boy, we really appreciate all the support we're getting, it's really the fuel that keeps us going. Because this is hard, it's really hard to be in the spotlight this way, and even made this choice themselves about whether we were going to do this after a lot of research. And so it's wonderful when people support him and say, Thank you, Ethan, for doing this, and lift him up around his struggle. That is just been wonderful. Stacey Simms 36:44 He's gonna let you have the last word here. When you hear your mom say all this stuff, like what's going through your head? Did you think it would get to this point where it's not nationwide? Ethan Orrr 36:53 Honestly, no, I was surprised that it got really big, really quick. I was not expecting that at all. So I'm really happy that that people are supporting it. Stacey Simms 37:06 Well, thank you so much for joining me, keep us posted. love to know how this moves forward and plays out. But thanks for explaining. And, you know, we wish you all the best. Thank you both. Amanda Terrell-Orr 37:16 Thank you so much for having us. You're listening to Diabetes Connections with Stacey Simms. Stacey Simms 37:30 More information at Diabetes connections.com. I'm gonna link up some of the stories about Ethan that some of you may have already seen most, we're gonna try to link up some follow up as the story progresses, because we're really just at the beginning here, you know, I'm going to follow through this complaint with the Department of Justice, see what the rule changes are like if they come through and see if other clubs and athletic associations follow suit, or do anything that is proactive. If you find something in your local community, let me know if there's a rule change because of this, or I gotta tell you, we've already talked to the coach about Benny's wrestling, and you know how he wears his equipment. I'm double checking, I just want to make sure that we're all good, because while he has been fine so far, and last year, we saw a ref wearing a T slim pump at a couple of the meats. I didn't go over. But Benny did go over after the meets and just say hello, when you just showed us pump and that kind of thing. But even if the ref has type one and wears a pump, you know, there still may be a misunderstanding of the rules. So I I'm definitely double checking all of that, to make sure that we're not gonna have any issues this year. It's complicated. I gotta tell you that my favorite part of the whole story is how Ethan's teammates have hung with him. Right. And they haven't made him feel different. They haven't made him feel like he's to blame for things. We've been so lucky with Benny that he's surrounded with people who support him as well. And if you heard the episode he was on a couple weeks ago. He says part of that is because he just doesn't want to be with people who don't support them. And we're really, really lucky that he feels that way. So Ethan is lucky as well. But Big thanks to Ethan and Amanda for coming on so quickly and sharing this story and making some time for me. All right, Diabetes Connections is brought to you by Dexcom. And we have been using the Dexcom system since he was nine years old. We started with Dexcom back in December of 2013. And the system just keeps getting better. The Dexcom G6 is FDA permitted for no finger sticks for calibration and diabetes treatment decisions you can share with up to 10 people from your smart device. The G6 has 10 day sensor wear and the applicator is so easy. I haven't done one insertion since we got it Ben he does them all himself. He's a busy kid and knowing he can just take a quick glance at his blood glucose numbers to make better treatment decisions is reassuring. Of course we still love the alerts and alarms so that we can set them how we want if your glucose alerts and readings from the G6 do not match symptoms or expectations. Use a blood glucose meter to make diabetes treatment decisions. To learn more, go to Diabetes connections.com and click on the Dexcom logo. If you are listening to this episode as it goes live on September 7, then I wish you a very happy new year. It is the Jewish holiday of Rosh Hashanah. And as you probably know, these podcast episodes are taped and scheduled in advance. So I am not working today I am celebrating the new year with friends and family. And I don't mind sharing that. We always go to our same friend's house. I don't have any family locally here in the Charlotte, North Carolina area. And our friends this year, were probably having like 20 to 30 people, they bought COVID tests for everybody those over the counter COVID test as I'm taping, I haven't taken it yet. When you're listening to this, I will have taken it. But I thought that was really interesting. We're all vaccinated this group we've gotten together before earlier in the summer, it was actually the first group of people that I got together with in Gosh, I want to say maybe late May, you know, we'd all been vaccinated, but he's really excited. Nobody knew Delta was coming. And so we know we're all reacting to this in different ways. I'm really, I guess the word is interested that this is going on. I wonder how many other people are doing this for small private gatherings. I'm excited to be celebrating and may it be a sweet and happy new here because my goodness, we definitely need it. So I'm gonna leave it there. Big thanks to my editor John Bukenas from audio editing solutions for really jumping in here. We put this together much more quickly than our usual episodes. So thanks so much as always, John, and thank you so much for listening. I'm Stacey Simms. I'll see you back here on Wednesday for in the news. That'll be Wednesday live on Facebook at 430 Eastern Time, and then we turn that into a podcast episode for Friday. Alright, until then, be kind to yourself. Benny 41:35 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrong avenged
Amy Hanus leads Full Plate Living, a foundation-funded FREE online nutrition resource for people who want doable small-steps that lead to big health outcomes. As the Program Director for the Ardmore Institute of Health foundation, Amy loves being able to share the power of fiber foods and how eating a plant predominant diet can transform our health. She helped develop Full Plate Living's lifestyle medicine nutrition approach, which shows you how to eat full plates of healthy, delicious food without feeling famished, frustrated or deprived. The best part of her job, she says, is celebrating when a member reaches a health goal, like seeing a number on the scale they haven't seen in decades or wowing their doctor with an improved A1C or lower cholesterol.In this conversation Amy shares brief history of the foundation, their mission and purpose and how the Full Plate Living program delivers on that mission. Amy talks about the main concepts of Full Plate Program - fiber-focus approach, getting a variety of fresh whole fruits and veggies, legumes, grains, feeling satisfied with the abundance of food, while also achieving your health goals. She share simple tips for turning any meal (like frozen lasagna) into a Full Plate Meal! Amy also answers common question about "too much carbs" and "not enough protein". Tune in to learn more!Join Full Plate Living for FREE and get access to the abundance or resources, recipes, tutorials, classes, live workshops and so much more:https://www.fullplateliving.org This podcast is brought to you by Emory Lifestyle Medicine & Wellness. To learn more about our work, please visithttps://bit.ly/EmoryLM
Today, I am blessed to have here with me Kristina Hess. Kristina is a premier health coach and licensed dietitian/nutritionist who works with clients to support them in making lifestyle changes that produce real and lasting results. Kristina has a master's degree in clinical nutrition and Integrative Health from MUIH - Maryland University for Integrative Health and several certifications in areas ranging from Mindful Eating, Heartmath,to Ericksonian Hypnosis to Sport Nutrition. Kristina received her health coach certification from the Institute for Integrative Nutrition. Kristina's integrative and functional approach is an arm within the Functional Medicine model of the IFM. Functional Medicine views us all as being different; genetically and biochemically unique. A functional approach is deeply science based and views everything that happens within us as a connected network or web of relationships. Kristina's private practice in Connecticut is called Thrive Results Coaching. In this episode, Kristina explains what health complications come from insulin resistance and the Standard American Diet. If you're a sugar burner, Kristina describes what you need to start doing right away in order to turn your health around. One of the first things you need to do is start testing critical health markers. Kristina reveals which health markers are essential and which brands she recommends to her clients. Tune in as we jump into epigenetics, mental health, and Kristina's upcoming Keto Symposium. Learn about The Keto Symposium: https://www.ketosymposium.com/ Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E S P ON S O R S PureForm Omega Plant Based Oils (Best Alternative to Fish Oil): http://www.purelifescience.com Use ben4 for $4.00 off. Upgraded Formulas Hair Mineral Deficiency Analysis & Supplements: http://www.upgradedformulas.com Use BEN10 at checkout for 10% off your order. Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. [01:15] Complications From Insulin Resistance and The Standard American Diet It can take 15 to 20 years to develop insulin resistance. Parents don't want to take food away from their kids like macaroni, pizza, and chicken nuggets. Kids will start metabolically flexible and can get away with eating anything. However, it won't last forever. If you still want to buy chips, then Kristina will suggest buying chips with cleaner ingredients. Instead of buying Ben & Jerry's ice cream, try a pint of Rebel ice cream. The most common contributing factors leading to insulin resistance are lifestyle issues like nutrition. If we ate real food, then we wouldn't develop insulin resistance in the first place. Processed food is speeding our way to insulin resistance. [06:10] Are You A Sugar Burner? Here's What You Need To Do Now There are three things we can do when we are trying to get well: Time Restriction: how often you're eating and when you are eating. It's critical to stop eating before bedtime. Caloric Restriction: if you're going to eat garbage, then eat less of it. Dietary Restriction: take something out of your diet that is not healthy for you. It will be a vast improvement from the Standard American Diet. If you want results, try all three of these steps. 76% of the world population does not have the genetic adaptation for LCT. You should consider cutting out dairy; cow dairy is inflammatory for most humans. If you have skin issues, headaches, and extra flatulence, then dairy could be the problem. [11:50] The Importance of Testing For Glucose Values and Ketones Values If you are extremely insulin resistant, there is hope if you're willing to put in the work. There are two different companies that Kristina recommends for her clients: Keto Mojo: https://keto-mojo.com/ Biosense: https://mybiosense.com/ Keto Mojo allows you to test ketones and blood sugar. Plus, they provide your GKI. People should test every single day, especially in the beginning. That way, you can learn which foods are taking you out of ketosis. Plus, by testing, you can learn how many carbohydrates that you can tolerate. Some people can stay in ketosis at 50 total carbs or 75 total carbs. Everyone has their own carb tolerance. [18:50] What Is Nutrigenomics? It Might Be The Future of How You Eat The Human Genome Project was a project that spanned many years. Human DNA was mapped out to correlate to different nutrients and hormones. APOE4 is an old gene, and it conferred a lot of health benefits. One of the benefits was fertility in cold weather. Plus, APOE4 correlates to neuronal health in the brain and also to cholesterol production. Unfortunately, today's diet doesn't correlate to that old gene. Our diet causes a lot of inflammation. If you have APOE4, you shouldn't drink at all because you are 23% more likely to develop Alzheimer's. If you want to test your genes, Kristina recommends the Nutrition Genome: https://nutritiongenome.com/. If you have done a 23andMe, then you can use that data as well. [26:10] The Role That Epigenetics Plays With Our Genes and Lifestyle How you live is what impacts your epigenetics. We are in control of our health. How much sleep do you get each night? How are you moving your body? Genetics is the blueprint. Genes are the potential, and they can give us a roadmap on how to live our lives. Epigenetics is the optimal lifestyle that will help you lead a healthier and longer life. There's a gene that correlates to ketones: PPARalpha. If you have this gene, eating extra fat will be challenging. [30:40] The Health Numbers You Absolutely Need To Know Ask for your A1C. That way, you know if you are headed for diabetes. C-reactive protein is a cardiac risk marker. You want it to be under a 1. Also, test for homocysteine, RBC magnesium, and B12. Lastly, get a full thyroid panel. [33:25] How Changing Your Lifestyle Can Impact Your Mental Health Sugar takes us on a roller coaster ride emotionally. There is a strong food-mood connection. Cold therapy can be a huge benefit for improving mood. People don't need antidepressants and antianxiety medicine if they have the proper tools. It takes 72 hours to get off sugar. Once that's over, you have all this freedom and clarity. Then, you'll have the energy to work out. Plus, you will sleep better. [40:15] All About The Keto Symposium and Why You Should Sign Up Today Learn about The Keto Symposium: https://www.ketosymposium.com/ Kristina loves to educate people; that's why she started the Keto Symposium. People are finally starting to understand the health benefits of a low-carb life. At the Keto Symposium, you can hear from all sorts of educators and experts. This year, the Keto Symposium is virtual. Next year, they are going to be in-person with a virtual option. Learn more about it on their Instagram page: https://www.instagram.com/ketosymposium AND MUCH MORE! Resources from this episode: Check out The Keto Nutritionist: https://theketonutritionist.com/ Learn more about Nutrition Genome: https://nutritiongenome.com/ Thrive Results Coaching: https://thriveresultscoaching.com/ The Keto Symposium: https://www.ketosymposium.com/ The Keto Symposium on Instagram: https://www.instagram.com/ketosymposium Follow Kristina Instagram: https://www.instagram.com/thrive19/ Facebook: https://www.facebook.com/Kristina-Hess-The-Keto-Nutritionist-103924274916070/ Watch How to lose weight on keto with licensed nutritionist Kristina Hess: https://www.youtube.com/watch?v=atE9Y8wQ2zE Listen to Kristina Hess MS, Uncommon Benefits of Ketones, The Worst Nighttime Habit, Mindful Eating, & Keto Community - KKP 104: https://podcasts.apple.com/ie/podcast/kristina-hess-ms-uncommon-benefits-ketones-worst-nighttime/id1470779784?i=1000465314376 Keto Mojo: https://keto-mojo.com/ Biosense: https://mybiosense.com/ Join theKeto Kamp Academy: https://ketokampacademy.com/7-day-trial-a WatchKeto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E S P ON S O R S PureForm Omega Plant Based Oils (Best Alternative to Fish Oil): http://www.purelifescience.com Use ben4 for $4.00 off. Upgraded Formulas Hair Mineral Deficiency Analysis & Supplements: http://www.upgradedformulas.com Use BEN10 at checkout for 10% off your order. Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. *Some Links Are Affiliates* // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸clubhouse | @thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.
This episode is sponsored by Let's Get Checked! Use my code YOGI30 to get 30% off your at home lab tests! Skip the hassle of the doctor & get to the root of what's going on from the convenience of your own home! Check your CRP - https://trylgc.com/carnivoreyogi Check your thyroid labs: https://trylgc.com/carnivorethyroid Test your A1C - https://trylgc.com/carnivoreyogiA1C - Micronutrients http://trylgc.com/CarnivoreMicronutrient - Vitamin D - http://trylgc.com/carnivorevitaminD - Cholesterol- http://trylgc.com/carnivoreyogicholesterol Vivica Menegaz is a certified whole-food nutritionist, blogger, published author and one of the leading voices advocating for a food-based approach to healing. Vivica was the first one to use the now popular expression “Keto Paleo” to describe her lifestyle and way of eating. She is the founder of the “The Healing Foods Method' – an 14 week online nutrition program where she works 1-on-1 with clients to turn their health around utilizing a therapeutic ketogenic diet for healing (keto paleo). Tracing back to her Italian origins, Vivica is a passionate cook whose love of healing food has been shared with millions through her blog, “The Nourished Caveman.” While living in Northern California, pursuing her self-sufficiency dreams and practice of nutrition, Vivica's life came to a turning point when she discovered she was pre-diabetic. The nourishing Paleo foods she had been advocating we evidently not the whole solution to modern health problems. Fueled by this discovery, Vivica dove into research and found the ketogenic diet. It was love at the first bite. Within the first couple of months, her blood glucose levels dropped, she shed excess weight, her brain fog cleared up and her energy levels skyrocketed. After a year of successful keto paleo lifestyle Vivica's own health journey took another turn as she was now diagnosed with Hashimoto's and Hypothyroidism. Again she had to rely on her studies and practical applications to resolve those challenges, and that is how she became the first holistic nutritionist to successfully utilize a ketogenic approach as the foundation to endocrine rebalancing. Vivica's therapeutic approach to food, lifestyle and supplementation, utilizes the healing power of foods and mindset, to address the incapacitating symptoms of many lifestyle-diseases that have plagued our modern lives. She has made it her mission to help others reclaim their health and quality of life. Vivica is also the author of 3 cookbooks: “The Ultimate Paleo Cookbook” 2015, together with 9 other bloggers, and “the big book of Fat Bombs” in 2016. Her latest book: “the Keto Paleo Kichen” was released in December 2017. Follow her on her website - https://thenourishedcaveman.com/about-vivica
It's "In the News..." the only LIVE diabetes newscast! Top stories this week: FDA hints on 2021 D-tech timeline, the Freestyle Libre 2 app is approved, interchangeable insulin to cost less, an "astonishing" type 2 teen study and a big fall-off in use of metformin in people with type 2. Join us on Facebook live every Wednesday at 4:30pm EDT This week I was on the road, at the Podcast Movement convention. Sorry about the setting! Back in the home studio next week. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode Transcription below: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. I'm on the road – again! This time I'm at podcast movement a big convention going on in Nashville.. so apologies if the audio and video are a little bit off but I think we're good enough. And As always, I'm going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more when you have the time. XX In the News is brought to you by Real Good Foods! Excited to have them back as a sponsor – we're big fans. Real Food You Feel Good About Eating. XX Our top story this week… a brief comment about diabetes devices at the FDA might give a hint to some timelines we're all watching. FDA Center for Devices and Radiological Health head Jeffrey Shuren says COVID-19 remains a source of uncertainty. "Goal is to be back to normal as we roll into 2022," Shuren said. "But there are a lot of variables that could impact that… don't know if we'll get hit with another tsunami of submissions for full marketing authorization for a lot of the COVID products. Getting back on track, everything is moving for the diabetes submissions." Products in front of the FDA expected by year's end: Medtronic's 780G and Zeus CGM, Insulet's Omnipod 5, Tandem's bolus by phone and it's expected that Dexcom's G7 will be submitted soon. https://seekingalpha.com/news/3715640-fda-devices-head-says-progress-being-made-on-diabetes-devices-backlog XX The FDA did clear one diabetes product this past week.. Abott's Freestyle Libre 2 iOS app. The Libre 2 hardware was approved last year.. this is the app for Apple phones.. it gives users optional real time high and low alarms – still have to scan to see the actual values. It updates every minute – only CGM that does – and it lets caregivers remotely monitor. Freestyle Libre 2 has a 14 day wear.. no exact date on when the App will be available or when it'll be available for android users. https://finance.yahoo.com/news/abbotts-freestyle-libre-2-ios-130000861.html XX Other side of the coin, Abbot will pay $160 million to resolve claims that two of its units submitted false claims to Medicare. The Justice Department said free glucose monitors were provided to get patients to order more testing supplies, and the companies routinely waived copayments. They were also accused of charging Medicare for ineligible patients and for more than 200 patients who were actually dead. https://www.reuters.com/business/healthcare-pharmaceuticals/us-says-abbott-units-pay-160-mln-resolve-alleged-false-medicare-claims-2021-08-02/ XX Back to the FDA.. for the first time, they're allowing a less expensive brand name insulin to be substituted for the original. Semglee – approved last year – is basically the same as Lantus but it's a lot less expensive. Semglee is now is the first-ever to earn the “interchangeable” designation Trusted Source, meaning it's fully approved to be substituted for Lantus at the pharmacy. No need to get permission from the doctor. This is the second copycat of Lantus; the first was Eli Lilly's Basaglar, launched in 2016. There is some new branding and labeling needed here, so expect a relaunch of Semglee by the end of this year. FYI the pens are a little different even if the insulin in them is the same. It's always a good idea to know what your doctor is prescribing and what your pharmacist is giving you.. even if it costs less. XX Big new studies focusing on children and teens with type 2 diabetes.. showing how different the disease can be in younger people. The studies, published July 29 in the New England Journal of Medicine, showed that within 15 years of a Type 2 diabetes diagnosis, 60% of participants had at least one diabetes-related complication, and nearly a third of participants had two or more. These Texas researchers call it astonishing and say it appears type 2 in youth is much more aggressive than in older people. These researchers say more treatment options are needed for younger people because lifestyle changes don't seem to be enough. The study also showed a lot of families don't have regular access to medication or health care providers. They say it was a diverse study representative of teens and kids in the US. https://medicalxpress.com/news/2021-08-young-adults-complications-diabetes.html XX More to come, including new about people with diabetes who stop taking a very commonly prescribed medication.. but first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods! We've been fans for a long time – Benny especially likes their ice cream. Real Good Foods makes delicious food you'll feel good about eating; high in protein, grain free and always made from real, nutrient dense ingredients. The labels are easy to read – because the ingredients aren't chemicals and fillers. Whether it's waffles or burrito bowls or stuffed chicken or the pizza that started it all.. I think you'll really love Real Good Foods. Learn more with the link in the FB comments or as always at d-c dot com. Back to the news… XX Interesting research using artificial intelligence to catch diabetes eye issues earlier – when they're easier to treat. Changes in the blood vessels in the retina cause diabetic retinopathy, the most common diabetic eye disease and a leading cause of blindness in US adults. There are several studies and institutes looking at the use of A-I here, but these folks at the Indiana University School of Optometry say they're using information that is often ignored for diagnosis and it's making a big difference. The National Institutes of Health's National Eye Institute funded the work. https://www.futurity.org/biomarkers-diabetic-retinopathy-blindness-vision-2604812/ XX Nearly half of adults prescribed metformin after a new diagnosis of type 2 have stopped taking it by 1 year. The fall off is most dramatic during the first 30 days. These researchers say it didn't matter how long the prescription was written for and most who discontinued still had A1C's high enough to still need glucose lowering medication. They say as physicians quote - A lot of times we're quick to prescribe metformin and forget about it...Physicians might write a script for 3 months and three refills and not see the patient again for a year...We may need to keep a closer eye on these folks and have more regular follow-up, and make sure they're getting early diabetes education." https://www.medscape.com/viewarticle/955893 XX That's In the News for this week.. if you like it, please share it! And quick note this is our 400th episode. I've been busy with some behind the scenes stuff and it caught up to me! A huge thank you to all of you.. incredible support from this community. Six years and 400 episodes is an accomplishment that I've only reached because of you. And join me wherever you get podcasts for our next episode -Tuesday – I'm talking to Eoin Costello the host of his own diabetes podcast – about staying active or starting getting more fit with type 1. This week's interview – the one that's out right now – is a look at the features of Omnipod 5 – the newest hybrid closed loop system in front of the FDA. Thanks and I'll see you soon
Learn how continuous glucose monitors can help you obtain metabolic flexibility. How using fasting glucose and A1C scores fall short. The concern with physiological insulin resistance seen in the keto population Ways to use CGM's to experiment and learn about how your diet is impacting your health and much more. Links mentioned in this episode! . Discounts mentioned on this show at https://burnitnutrition.com/podcast111/ . . Magnesium Breakthrough from BiOptimizers - 10% Off with code BURNIT10 at: https://bioptimizers.com/BURNIT . . Mitopure from TimeLine Nutrition - 10% Off with code BURNIT at: https://www.timelinenutrition.com/ . . Ned Full Spectrum CBD oil - 15% off your first order —WITH FREE SHIPPING: www.helloned.com/BURNIT and use code “BURNIT” . . Tonal Home Fitness System at www.TONAL.com promo code "BURNIT" for $100 OFF smart accessories . . PERFORM - A targeted essential amino acid blend for improved endurance and athletic performance - Get 30% discount when you use the code BURNIT at http://aminoco.com/burnit . . Podcast Shop Page for 5th Stage Keto Body Transformation & Vitamin C Powder at https://burnitnutrition.com/shop . Learn more about Kara Collier and NutriSense: Website: https://www.nutrisense.io/ Discount Code: BURNIT25 Facebook: https://www.facebook.com/nutrisenseio . Leave me a rating & review on Apple Podcasts: https://itunes.apple.com/us/podcast/burn-it-nutrition-podcast/id1195955730?mt=2 . Follow Joseph Navarro on Instagram under @BurnitNutrition . Follow Joseph Navarro on Facebook under @BurnitNutrition . Thank You for Listening!! Please share this episode! Be the one who helps spark a transformation in your family! Feedback to share? Send email to info@BurnitNutrition.com Subscribe! Don't miss another episode! Notice of Sponsorship Affiliate Disclosure with Ned, Amazon, Tonal, PERFORM, Timeline Nutrition, BiOptimizers, NutriSense . Please read the full medical disclaimer burnitnutrition.com/medical-disclaimer/
A2 Milk for Kids; Lean Mass Hyper Responder with Type 1 Diabetes; Fucoxantin and CLA for Fat Loss; Bile reflux, Gallbladder, Woe; Post-Diverticulitis Recovery Diet Make your health an act of rebellion. Join The Healthy Rebellion Please Subscribe and Review: Apple Podcasts | RSS Submit your questions for the podcast here News topic du jour: "Original antigenic sin”: A potential threat beyond the development of booster vaccination against novel SARS-CoV-2 variants "A phenomenon called “original antigenic sin” (OAS) was firstly proposed by Francis 6 in 1960. This phenomenon occurs in the second exposure of the immune system to a similar pathogen to which it has previously been exposed. In this situation, the immune system progresses to the memory response, generating cross-reactive antibodies that may not be effective against the new pathogen. 7 In addition, it has been speculated that overproduction of memory B cells could compromise the activation of naïve B cells capable of producing efficient and novel antibodies. 8 In this way, OAS can trigger immune evasion of the emerging variants in those who had been affected by or vaccinated against former versions of the pathogen. In the context of coronaviruses, cross-neutralization is a rare event, but cross-reactivity in antibody binding to spike protein is common in SARS-CoV-2 and SARS-CoV. 9 Furthermore, some degrees of cross-reactivity have also been demonstrated between seasonal coronaviruses and SARS-CoV-2. 10 Aydillo et al 11 reported a strong back-boosting of antibodies in SARS-CoV-2–infected patients previously infected with human β-coronaviruses. Interestingly, a negative correlation was observed between pre-exposure to human β-coronaviruses and induction of antibodies against SARS-CoV-2, mentioning the reduction of de novo humoral immune response and occurrence of OAS in patients with pre-existing immunity against related coronaviruses. 11 The impact of OAS in developing vaccines is of paramount interest. The hypothesis of antigenic distance was proposed to explain how the efficacy of vaccines could be influenced by the difference or relatedness of prior vaccinations. This hypothesis is substantially evident in the case of dengue fever-related vaccine research. Once an individual is immunized against a dengue virus variant, the booster shot for the second variant is unlikely to be successful because it triggers only the original neutralizing antibodies rather than effective antibodies for the new variant. 12" 1. A2 Milk for Kids [20:08] Nate says: Hi Robb, my wife is wondering if A2 would be better for our son than nut milks. I couldn't find anything on your site about A2 milk, but searching online have found that it lacks A1. We give our kid nut milks for calcium, but have been reading that nut milks are estrogenic, so are looking for other calcium sources. I read the paleo solution 12 years ago and know how you treated dairy in the book. My gut feeling is that A2 milk is from cows where A1 has been bread out, but it is still dairy and should be avoided. Any thoughts on A2 milk and if it is better than regular dairy? Thank you. -Nate Milk proteins and human health: A1/A2 milk hypothesis 2. Lean Mass Hyper Responder with Type 1 Diabetes [22:59] Alex says: Hi Robb, Thanks for your podcast with Bill Cromwell and specifically for the deep dive into LMHR. Actually I wish the dive was even deeper, hence the discussion and questions below :-) I am a 50 year old male. Have been following low carb (progressively from low carb to mostly keto to mostly red meat with occasional vegetables and berries) for the last 6 years. I developed Type 1 Diabetes when I was 33 after 13 years on SAD and 20 years on the Soviet Union diet (whatever that was). I am pretty active: kettlebells a couple of times a week, tennis a couple of times a week and soccer a couple of times a week. To play back on your frequently asked question: “How do you look, how do you feel, how do you perform?”: - I look great (5' 11'', 165 lbs), very lean, toned muscles - I feel great - I play soccer with a number of 20 year olds and I'm able to outlast many of them in terms of my energy and fitness. I didn't get into sports until my late 20s. What I'm describing is not different at all from other LMHRs who seem to be actually feeling and performing even better. Ok, fine — looking better too! So clearly LMHR is a phenotype, which on the surface seems to be selecting for great health and athletic performance at the expense of our ability to survive during ice age, since we can't store enough fat to save our lives! At the same time, we all have high LDL — a dubious metric that the Pharma industry is obsessed over because of the correlation it has with the health of a completely different phenotype. Is it even desirable for LMHRs to have a low LDL? Now, this doesn't mean that I don't take you, Bill Cromwell or Peter Attia seriously. I do and, hence, I'm concerned. So is there another evolutionary trade-off? Is the payoff for our excellent health and performance is that we will all die early from the heart disease? Assuming that high LDL is definitely bad for us, what sort of changes in lifestyle, nutrition or medication would you recommend? For me personally (keep in mind that I have T1D), my average HbA1c went from 6.7 to low 5.7 and my average LDL went from 149 to 361 after switching to low carb. Is it possible to achieve both low A1c and LDL? Thanks again for all your and Nicki's work! -Alex 3. Fucoxantin and CLA for Fat Loss? [32:02] Christina say: Hi Robb and Nikki! I've been a fan and have followed since 2011. Started my health journey with your book, Rob, Paleo Solutions! It changed my life forever! Now I'm a science nerd.. lol. Anyway, what are your thoughts on CLA supplements used for inhibiting fat storage and also for helping to rid the fat in the cells? It seems to be a craze with certain companies selling it with a ton of testimonials that this stuff really works. I'm very skeptical. Also, how about Fucoxanthin? Does it help with brown fat creation within the body? How beneficial are these 2 types of supplements when it comes to aiding your body in fat loss? Thanks so much for all you do… I would not be where I am TODAY, without you! Fucoxantin: a treasure from the sea 4. Bile reflux, Gallbladder, Woe [40:16] Phoenix says: Dear Robb and Nicki, I've been a listener and reader ever since holy cats days in college, 10 years ago. Three years ago I needed gallbladder surgery. I had very few side effects, as I eat pretty healthy. But, I was also struggling with alcohol and in a difficult relationship. Both got the boot around seven months ago, but due to personal stuff with the breakup, I was under a huge amount of stress. Suddenly, I had bile reflux. It's a frigging nightmare. I now take sucralfate and a bile binder but they are horrible to time well because I need a small snack when I wake up or else I'm queasy. Red meat and pork often set me off with heartburn. I used to eat tons of veggies but too many of those hurt my stomach now. I know I need more protein. It feels like one extra bite is the difference between puking at 3am and being ok. I'm 5'5" and an out-of-shape 150 lbs. I feel like a tick, with a chonky belly and skinny limbs. I just had bloodwork done and my white cell count and platelets are low (2.4 and 50). My cholesterol is on the higher side, but my glucose and A1C are normal. I don't know what to do. Plus, my emotional trigger for sobering up was my ex's drunken behavior. No more ex, and I'm trying to find healthy outlets for my ADD/depression-tending mind so I don't hit the bottle. Are there any recommendations you might have for physically rebuilding? Thank you, from a longtime fan, Phoenix 5. Post-Diverticulitis Recovery Diet [48:05] Sarah says: Hi Robb & Nicki, My husband ended up in hospital last June with what eventually turned out to be diverticulitis. This came completely out of the blue as he'd always had a pretty stellar gut beforehand. After he was discharged he did not have the recovery we expected and eventually ended up on a second round of antibiotics and a liquid diet again. The standard recommendation after diverticulitis is to gradually increase fibre content and a diet low in fibre is cited as the cause of it. This was definitely not the case for my husband as he was eating a lot of fibre before his hospital admission. After some dietary experiments, we have since realised that he can now only tolerate a very small amount of it or he ends up in pain. His current diet consists of white rice for carbs, traditional home-cooked dishes minus the vegetables (he's from South-East Asia), plus beef and fish. Unfortunately, he still hasn't managed to regain all of the weight and muscle that he lost. For some context, he's in his early 40s, about 5'10" and weighs about 143 lbs. He's very active, works out regularly and has a decent amount of muscle on his upper body. Do you have any recommendations on the most suitable diet for him to follow (he also can't tolerate dairy) and is there anything he should definitely avoid? He's tried some weight gain powders recently but they seem to cause him pain as does some forms of physical exercise and movement. Is there any way that he can fully recover from this? Many thanks, Sarah Sponsor: The Healthy Rebellion Radio is sponsored by our electrolyte company, LMNT. Proper hydration is more than just drinking water. You need electrolytes too! Check out The Healthy Rebellion Radio sponsor LMNT for grab-and-go electrolyte packets to keep you at your peak! They give you all the electrolytes want, none of the stuff you don't. Click here to get your LMNT electrolytes
It's "In the News..." the only LIVE diabetes newscast! Our top stories this week: Oral meds to prevent T1D move ahead, racial disparity in peds CGM use, what that Dexcom API news means, a new study with teens and Control IQ and a summer olympian talks about her recent T1D diagnosis. Join Stacey live on Facebook each Wednesday at 4:30pm EDT! Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone Click here for Android Episode transcript below: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more when you have the time. XX Our top story.. A new oral drug to prevent type 1 is moving along in trials. Right now it's called IMT-002 – and put very simply - it's meant to block a genetic trait that increases the risk for the disease and is seen in a majority of patients. It's a new way to think about treating type 1 – phase two studies could start next year. It's thought that this could help with other auto-immune diseases as well.. the next condition these researchers want to tackle is celiac. https://www.biospace.com/article/releases/im-therapeutics-reports-positive-results-in-safety-tolerability-and-mechanism-of-action-of-phase-1b-trial-of-lead-drug-imt-002-in-type-1-diabetes/ XX Could the global rise in diabetes have an environmental component? In an Advances in Pharmacology article, researchers say routine exposure to chemicals that disrupt our endocrine systems play a role in triggering diabetes. These researchers say "We often attribute patient's disease risk to individual choices, and we don't necessarily think about how systems and environments play into disease risk," They go on to say so-called lifestyle factors like exercise and diet fail to fully account for "the dramatic rise and spread" of diabetes. https://www.ehn.org/environmental-factors-of-diabetes-2653768475/how-endocrine-disruptors-contribute-to-diabetes XX A new study shows Black children less likely to start or continue with a CGM after a type 1 diabetes diagnosis. These researchers at Children's Hospital of Philadelphia or CHOP as it's commonly known, show that a racial-ethnic disparity in CGM use begins within the first of year after diagnosis. White children were more than two and a half times more likely to start CGM compared with Black children and twice as likely to start CGM compared with Hispanic children. There was a disparity even when broken down by types of insurance – commercial or government. These researchers say social determinants including structural racism, are likely playing a role in disparities in care and outcomes https://www.healio.com/news/endocrinology/20210719/black-children-less-likely-to-start-continue-cgm-after-type-1-diabetes-diagnosis XX Very large survey of women shows that half of those with type 1 or type 2 diabetes are not getting pre-pregnancy counseling. This study included more than 100-thousand women. Right now guidelines from many groups including the CDC and American Diabetes Association recommend providers offer women with diabetes health counseling before pregnancy to cut down on the increased maternal and infant risk associated with both conditions. These researchers hope to develop better tools for women & their doctors. https://publichealth.berkeley.edu/news-media/research-highlights/women-with-diabetes-and-hypertension-dont-receive-pre-pregnancy-counseling/ XX Big increase for time in range when kids use hybrid closed loop systems. We've heard about a lot of improvement, but in this study, the percentage of kids and teens with t1d spending at least 70% time in range… more than doubled after 3 months of using Tandem's Control IQ system. This was a study of about 200 kids, median age was 14, and it was a real world study – where the kids went about their lives, not in a clinical setting, and the researchers pulled the data electronically. Interestingly, sleep mode use increased through 6 months, while the exercise mode was used less over time. Kids with an A1C over 9 saw the most improvement. Those with an A1C under 7 didn't see much of a change. https://www.healio.com/news/endocrinology/20210714/more-youths-with-type-1-diabetes-meet-timeinrange-goal-with-hybrid-closedloop-system XX Dexcom gets FDA clearance for real time APIs.. what does that mean? Third party companies like Fitbit or Sugarmate which have long integrated Dexcom data have been doing so on a bit of a delay. Now they can do so in real time. API stands for Application Programming Interface, which is a software intermediary that allows two applications to talk to each other. Dexcom's Partner Web APIs will allow users to view all of their diabetes care data in one place to enable in-the-moment feedback and adjustments, the company said in the announcement. https://www.mobihealthnews.com/news/dexcom-gets-fda-nod-its-new-api-integration XX Cool new exhibit at Banting House – recent guests of the podcast and museum celebrating the birthplace of insulin. They're set to open up again this week – the first time since March 2020 – and there's a new computer generated exhibit. It does work outside.. In the square where Dr. Banting's statue stands. Giving visitors a virtual glimpse at the life and work of the man credited for the discovery of insulin. If you haven't visited – it's in Canada – or seen the museum, I highly recommend a spin around the website, we'll link it up. XX Summer Olympics are kicking off and by now you've probably heard that American trampoline gymnast Charlotte Drury was just recently diagnosed. She found out she had type 1 weeks before the 2021 Olympic qualifying trials, she revealed on Instagram last week. she and her coach pressed on and she basically got back into things within three weeks. She posted this photo of herself wearing the Dexcom. Drury is the first American woman to win a gold medal in trampoline at a World Cup That's Diabetes Connections – In the News. If you like it, share it. And feel free to send me your news tips. Stacey @ diabetes dash connections dot com. Please join me wherever you get podcasts for our next episode -Tuesday – I'll share my conversation with Gold Medal Olympian Gary Hall Jr – when he was diagnosed in 1999 he was told to give up swimming. He didn't and he talks about why.. and how he overcame what was conventional wisdom for athletes at the time. This week's show is the story of Jack Tierney, diagnosed in 1959 with type 1 he's 81 and he says he's never felt better. Thanks and I'll see you soon
Make your health an act of rebellion. Join The Healthy Rebellion Please Subscribe and Review: Apple Podcasts | RSS Submit your questions for the podcast here News topic du jour: https://www.q13fox.com/news/fallen-seattle-officer-was-a-real-life-wonder-woman? https://en.wikipedia.org/wiki/Cerefolin 1. Benefit to a Smaller IF Window? [19:19] Max says: Dearest Robb & Nicki, I've been making my way through the podcast archive and to my recollection have yet to come across the answer to this quandary. I've been practicing intermittent fasting for about 5 months now, sometimes ketogenic with minimal fat intake in the morning, sometimes full-on starvation mode. Generally I break my fast between 2-3 in the afternoon and get my last bite of the day in by 8:30 or so. I recall hearing John Berardi talk about his period of IF experimentation and mentioning that sometimes he would limit his food intake window to as little as two hours or one heaping, Spartan-esque meal. Do either of you have an opinion regarding the potential benefit or detriment of such a small eating window? When I've tried to limit myself to cramming in 90-95% of my unfasted calorie intake, which is 100% of my protein/carb intake, into a single meal or two small meals in just a couple of hours, I find myself really having to shovel it in. Either feeling too full to take in the amount of calories that I feel I need, especially if it's a particularly active day or week. Logic leads me to believe I shouldn't trade a smaller window of eating for packing my stomach so full of quality grub that I don't feel like moving afterwards. I may have just answered my own question. Thanks for all of the effort you guys put into sharing positive tips and information with the portion of us willing to listen. Cheers! -Max 2. Juicing - GERD - Electrolytes [26:18] Cynthia says: Hi Robb & Nikki. I love your podcast and the work you do. It is refreshing to listen to someone who really tries to give unbiased information. I have 2 questions (if only one is allowed please pick either one. Thank you :)) 1. Should LMNT be drunk with meals? My thinking is that it may counteract stomach acid and exacerbate GERD. I do have reflux, so I am trying to not make it worse. 2. Have you watched "Super Juice Me" (it is a 2014 documentary where 8 people with 22 combined diseases get remarkably better with 28 days of juicing)? According to many people in the paleo/carnivore community drinking that amount of carbs/sugar/fructose would make you sick, yet people got better, not worse. I am trying to bounce my ideas with someone smarter and more knowledgeable than me. So if some people get better with fruit and vegetable juices only, and other people get better with a carnivore diet, do you see a reason why combining both approaches would be detrimental? For example, having a fresh-pressed fruit juice (or even a couple of oranges) with my steak. Thank you. 3. Roasted Unmalted Barley [32:56] Irvin says: Hi Robb & the Wolf Team I like the sound of your statements, and arguments, please keep it going. I am experimenting with Paleo/Primal/Bulletproof experience whilst unemployed (n=1), and I am loving it; however, I have a question regarding my love of Guinness as a drink (I live in Europe). I am interested to know the effects of 'Roasting' on unmalted barley (Main ingredient for Guinness)? I have read that it chars the sugars, and is high on the 'Lovibond Scale',but what does this mean in 'laymans' terms as compared to barley for beer per se, is it better than normal beer for consumption? I know that the beer is my choice, as opposed to wine for the better Paleo affect, I am just trying to challenge the 'low beer' scenario with drinking Guinness, as it is not the same as the light coloured beers, and I can't find the solution so, I am basically asking you guys for help :-) Whilst I am taking the liberty, would or, does toasting bread change its properties as a starch, or sugar significantly for the body? Thanking you in advance ........Irvin........ 4. Digestion Issues [41:46] Tom says: Hi Robb, love the podcast and thoughtful answers, I've always had digestion issues with gas and diarrhea and spent around 10 years of my adult life eating SAD with a lot of fast food. My wife and I lost a lot following ketogains and I got into single digit BF levels. The digestion issues didn't go away and out of an experiment on myself I shifted to a very low fat (40-60g/day) high carb (200-400g depending on activity from rice, potatoes, oats, and sourdough bread) diet while keeping my protein up between 1.2 and 1.5g/lb bodyweight. I don't notice a ton of difference in training, A1C is 5.1, fasting glucose always 85-96 if this makes a difference (never diagnosed with diabetes to be clear). The biggest change is that my digestion issues have gone away, but I miss the ribeyes and bacon I used to have. Is there something I should look at to be able to digest fat more effectively, or just accept that it's what my body seems to prefer? I really like the low carb community, but I feel like an outsider with the high carb intake. Thanks 5. Give Up on the Chin-Up? [45:58] Nicolle says: Have you ever witness a female who could not do a chin-up make it her goal to get one and succeed? How long did it take her? How did she do it? For me, this is the holy grail of body weight exercises and the last one I have to master. I've been trying (with the help of resistance bands, negatives and my trainer) for over a year now and I just don't feel like i'm going to get there. What strategies do you use?I I'm 5'8", 135 lbs and I can do 20 push-ups so I started with that. Any advice would be appreciated. Thank you! Nicolle