Reversing Prediabetes- A Conversation with Dr. Jonar

Diabetes can hide in plain sight, especially when the usual red flags do not show up on the scale. We talk with Dr. Jonar de Guzman, a dual board-certified internal medicine and lifestyle medicine physician and the founder of For Truth Health, about why prediabetes and type 2 diabetes hit Asian and Pacific Islander communities so hard, even at lower BMI levels. 

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During the interview, Dr. Jonar explains visceral fat, missed screening, and the cultural patterns that can make diabetes feel “normal” or inevitable in families.

We also get specific about what diabetes reversal actually means: improving insulin resistance so your cells respond to insulin again, which can lead to remission of diabetes for many people. 

Dr. de Guzman breaks down silent warning signs, what to do in the first 48 to 96 hours after a diagnosis, and the biggest levers to pull right away with lifestyle medicine: nutrition and movement. We dig into processed foods, inflammatory fats, and why fiber matters so much for blood sugar, gut health, and even your body’s natural GLP-1 production.

Then we go where standard care often stops: real life and real feelings. If rice, noodles, bread, and shared meals are part of your identity, “just cut carbs” is not only unhelpful, it can feel like losing your culture. We share practical tactics like preloading before parties, bringing healthier alternatives, sequence eating, portion awareness, and post-meal walks. We also cover stress, grief, cortisol, and simple tools such as mindfulness meditation and qigong that can help steady blood sugar over time.

If this conversation helps you, subscribe, share it with someone who needs it, and leave us a review. 

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Transcript

Welcome And Guest Introduction

SPEAKER_02 0:53

Hello and welcome to the Art of Healing podcast or a video, depending on where you're catching us. I am so excited to introduce you to our guest, Dr. Jonard de Guzman. Dr. Jonar is a dual board certified physician in internal medicine and lifestyle medicine, and Dr. Jonar is also a certified healthcore coach. He's also trained as a mindfulness meditation teacher, and he now works full-time as the founder and CEO of For Truth Health. He graduated from NYU and Georgetown University School of Medicine, and his path started after he reversed his own pre-diabetes. Dr. Jonar works with all people, but he is passionate about helping Asian and Pacific Islander communities who deal with prediabetes and diabetes and often go ignored and neglected for a number of reasons that we'll get to discuss during this episode. So during this episode, Dr. Joan R and Joan R and I will be discussing prediabetes, diabetes, specifically how these two diseases impact Pacific Islander and Asian communities, some of the challenges specifically for these communities, and then he drops a lot of knowledge on us about managing pre-diabetes, diabetes, what to do right away if you've just been diagnosed, and some of his powerful knowledge on living with these diseases, what it means to reverse them. So we'll be in two different formats. If you're listening in the podcast, in your show notes or your app, you'll be able to find the links to connect with Dr. Jonar and his community, or if you want to work with him one-on-one. Otherwise, if you're listening to the webinar, make sure you see a chat box along the side, which should have the resources to connect. As you're listening, if you're finding this episode to be helpful, please leave us a review. We love reviews. It helps us spread the word about the Art of Healing podcast. Some of your podcast listening apps allow you to send a message. So take advantage of that. If you have input, advice, insight, uh, feedback, send us a message. Let us know. We would love to hear more from you. All right, let's get into the episode and make sure you listen all the way to the end. Don't forget also, my newsletter is the best way if you want to hear more episodes or hear about more of my offerings beyond the podcast. All right, let's get into it. Joe and R, thank you so much for joining us. How are you today?

SPEAKER_01 3:49

I'm good. Thank you for having me, Charlice. Like, I listened to your podcast, some of the most recent episodes, too. So I love the information you're putting out for folks. Like it's very informative, and specifically for you know, women in like paramenopausal um situation, like that is so key nowadays because I mean, I know I'm preaching in the choir, but that was not talked nearly as much about 10, 20 years ago. I love that there's more people, more awareness around this. So thank you for what you do.

His Story And Why This Mission

SPEAKER_02 4:24

Thank you. So before we launch into our first question, I will tell you that in one practice setting I worked in, I had roughly 25% Asian South Pacific Islander. It was a location I was in where it was 20 to 25 percent of my population, that was them. And everything that we'll be discussing today, I remember thinking, is anyone talking about what's happening with these people and they're diabetic and they have these below normal BMIs and they have what I think is a healthy lifestyle, but it seems that they've come to America and the diabetes is just rampant. So yeah, that's once I once I was introduced to your work, I thought, oh my goodness, prayers answered. So my first question is your story is so personal. You reversed your own prediabetes and you lost your father to a preventable chronic disease. What brought you to this mission of helping Asians and Pacific Islanders reverse type 2 diabetes naturally?

SPEAKER_01 5:30

Yeah, so that's a great question. You know, my origin story, I didn't even want to go into medicine or science to begin with, if you can believe that. And, you know, we're in the month of March, and March is actually Colorectal Cancer Awareness Month. And so for him, seeing what he went through and also that he ignored a lot of symptoms for many, many years, um, his struggle with his health and then his eventual decline and passing really inspired me to go into medicine. And so, as I went through, you know, you mentioned that I ended up having prediabetes and I was 40 plus pounds overweight. You and probably other folks who are healthcare professionals know how grueling medical training can be. And I wasn't taking care of my health. And I realized like, how can I give medical advice, sound medical advice, when I'm not even doing that for myself. And so I did a lot of research into healthy living, specifically nutrition, but other aspects of health because nutrition is so important, it's necessary, but it's not sufficient. You know, I think one thing that speaks to you and and your audience is there's this whole aspect of stress, emotional, mental health that is better addressed nowadays, but still far neglected for most folks because we weren't taught the skills to do so. And so, you know, through that whole process, I was able to lose the excess weight, keep it off. And that was 10, that was 2016, right? Keep it off, reverse my prediabetes, and now help Asians do the same. And the reason I target Asi specifically is because, you know, you mentioned earlier on, we actually represent here in the United States, we represent a smaller portion of the overall population. But when it comes to chronic disease and specifically diabetes, high blood pressure, high cholesterol, heart disease, we are far overrepresented compared to the general population. So you have to ask yourself, why is that? Part of it is our genetics. Part of it is we are more susceptible specifically to putting on this type of fat called visceral fat. So if you can think about this just generally, we put we we keep fat, we store fat in two different ways. One is subcutaneous fat. That's often the fat that like we typically can see from the outside, but visceral fat wraps around the organs. And this type of fat is especially toxic for creating inflammation that then leads to stuff like insulin resistance. And so at the same time, too, you you know, you mentioned it as well. You saw patients in your clinic who might fly under the radar because the scale, the body mass index, which is the scale to test for you know how overweight you you might be, any one person here in the United States is those scales were built for Caucasian body types, which doesn't apply to us agents. And so, yeah, they don't get screened nearly as much. And then what ends up happening, they get diagnosed way later when they have full-blown diabetes, when it could have been caught earlier on. And so, kind of to tie back my story with my dad, like a lot of these chronic diseases, they're preventable. And I took it upon myself to try to focus on this specific group because one, I am Asian, and then two, the the sort of like traditional healthcare approach for us Asians when it comes to diabetes, we are severely lacking in diagnosing and treating and even reversing. So that that was my main mission.

SPEAKER_02 9:51

And again, I cannot emphasize enough to the listeners that as far as a population, I felt it was just frankly ignored. And I wasn't aware of the problem until it was one specific practice setting I moved into. And as you can imagine, you know, with our our medical training, we work off of, you know, evidence-based algorithms, we know what risk factors to look for. And I felt completely unprepared to work with these Asian individuals that were diabetic and BMIs were below the BMIs were lower than what I was trained to look for, and how to care for these people. So I had to catch up really quickly that wait a minute, this is something different. And you were sharing with us it's the the visceral fat part. It's that's so what I would see in this practice is I I and I oh my I just as I'm talking to you, I could think of hundreds of patients. Um, in my the you know, this what I think of is a Vietnamese woman about 62 years old, her weight's 125. She's you know, maybe 5'152, and her A1C is eight. And I'm scratching my head thinking, okay, well, I guess we've got to treat her diabetes, but why? Why is this, you know, from everything I'm trained on, why is this happening to her?

SPEAKER_01 11:08

So yeah, we're not trained to look for it in our traditional medical training. I think there is slow movement to like bring more awareness to these issues, but we're again, we're we're I think we're behind when it comes to diagnosing catching this early and also reversing the insulin resistance, which is very possible when it comes to type 2 diabetes and pre-diabetes.

SPEAKER_02 11:37

That is my next question. So when people hear the phrase reversing diabetes, what is it that you want them to understand medically and practically? And can you define for us what it means to reverse diabetes, define remission, or meaningful improvement? Um, it's that's uh very important because with this population, sometimes I'd bring that up. And I honestly just I didn't have the language to describe to them why I'm saying you don't have to be diabetic.

SPEAKER_01 12:08

Yeah, no, that was a great question. So, you know, there there is a lot of debate around labeling these things, reversing diabetes versus it being put in remission. And the issue at stake is insulin resistance. Okay, so what ends up happening with insulin resistance is you've got this hormone insulin that you can think of like a key that unlocks the door to cells for sugar in the blood to go into the cells. So, what ends up happening for otherwise healthy adults, when you eat a meal, insulin is released from the pancreas, it then unlocks the door to cells, and the sugar that gets in the blood from the gut goes into the cells. That's normally how the process should work. People who are insulin resistant, they that insulin key no longer functions properly. There is this disrupting of the signaling that allows insulin to work properly. And so those doors don't open. So what ends up happening? Sugar stays in the blood and can't get in the cells. So that in a nutshell is what insulin resistance is. Now, to reverse that process, whether you call it reversing or put it in remission, really it kind of doesn't matter because it's possible. You know, like I want to get over the fact that like there is these um semantics around this. What we're trying to do is get your cells to recognize insulin again. And if this was not possible, there's no way I'd be able to stand here today with you and say that it is in my own body, in my own health, and the many, many others that I've helped, patients and current clients. So what ends up happening is you can reverse that process so that your cells can recognize insulin and insulin the key can work properly again. And there is actually so, like, in terms of the medical world recognizing this, this is a recent change. Like last year, I think it was like mid to late last year. There are these diagnoses codes for specific conditions, and one of them was recently recognized as putting diabetes in remission. It's specifically diabetes in remission. So it's recognized is possible, but how you can do it, that's up to you.

SPEAKER_02 14:47

You focused specifically on Asians and Pacific Islanders, which again, I absolutely love because I felt in practice that this is a population that was being completely, I'm gonna say abandoned, not even ignored, was being abandoned. What makes diabetes risk different in these communities? And why do so many people underestimate their risk?

SPEAKER_01 15:13

Yeah, you're saying from the Asian population from their own perspective, why do they underestimate it? Oh man, I mean, I think that that there is multiple reasons behind that. I think part of it, there is like this, um, especially for the older generation Asians, there's this sort of if I don't think about it, if I if I can just avoid it, I you know, it's out of my mind. So like it doesn't exist. There's that sort of thing. So it's it's almost in a way, kind of like a denial. But then you have the other aspect of, for example, I'm Filipino, there's a lot of Filipinos who have diabetes and some of the other chronic conditions. It's so pervasive that people just accept it as normal. This is gonna be a normal part of life, and so there's like this complacency aspect to it too. And I think those in conjunction is why people are kind of like lackadaisical about even entertaining the idea of this being a problem.

SPEAKER_02 16:28

Thank you so much for that explanation. You explained something to me when I'm when I'm dealing with these, when I'm caring for these patients, that I'm attempt to take into account cultural differences. And the only way I know to cope with that is to, you know, have empathy, listen well, look for physical cues, and then just take into account it's a whole wave of that that I'm just not understanding. You know, I would notice when I had Asians and Pacific Islanders and I diagnosed them with a chronic disease, I perceived that they didn't, they didn't get very upset. So I wouldn't I wouldn't understand if this was, you know, culturally this is gonna be how you cope. And I guess what you're saying is there maybe there was probably an acceptance that like they they were already expecting bad news. So they yeah, you know, so I would I would attempt to just try to listen, like, you know, waiting for the other shoe to drop, and I would never feel it would now. Of course, you know, they're very open to learning and open to, you know, wanting to do the right thing, but I I would always question that. Um I don't want to say lack of response, but it's it seemed to be as if they knew bad news was coming. And so you're saying it's because it's so pervasive. For many of these poor individuals, they're saying, Oh, this was coming for me, I already knew.

SPEAKER_01 17:54

Yeah. Yeah. Definitely. I I think that for a lot of folks, you know, maybe it is just this sort of resigning themselves to the fact that they're gonna have this too, because they've seen it happen in their family. Their mom, their dad, their grandparents, their their, you know, uncles, aunts, even siblings, cousins, like it is it, it is so common that I think people just accept that this is somehow gonna be a part of life at some point in time. And when you get it, you see your parents and all the older folk get it and struggle with it. So you just resign yourself that that's gonna happen to you too.

unknown 18:38

Okay.

SPEAKER_01 18:38

So I think there's there's part of that that plays in into their response, I would say.

Silent Signs Of Prediabetes

SPEAKER_02 18:42

Okay, thank you. And although this is a podcast listeners, I have to tell you, to me, it feels like a uh a CME because these are questions that I have had and I haven't had anyone to ask. So thank you so much from the bottom of my heart. So, my next question. So, for a lot of individuals, they are walking around with pre-diabetes or early type 2 diabetes, and they don't know that they have it. What are some of the silent warning signs you wish more people recognized earlier?

SPEAKER_01 19:10

Yeah, great question. So there's many, okay? One of them is sort of this just fatigue throughout the day, tiredness waking up. Some of it is like um, you know, if you eat your lunch, you have this like afternoon crash. And so there's like these energy fluctuations that you can feel where you weren't feeling that way before. And then all of a sudden, why is it that I'm having these crashes? Or just like especially like sometimes after eating, maybe an hour or two later, you're hungry again and you don't know why. A lot of this has to do with insulin resistance. Okay, your body doesn't know that you actually your cells aren't recognizing that you you have this food that got you know absorbed from the gut into the blood in the system because insulin is not working. And so they signal to you again, hey, we have no food, you need to eat more. So there are symptoms like that. Now there's more sort of um progressive symptoms where you're getting up at night to urinate a lot. You know, that might mean like your your kidneys work to like help filter the blood. So that that might be spilling out sugar into the urine to like as a kind of compensatory mechanism to get your your sugars down in your blood. So there's that. There's thirst. Like your body thinks, like, oh, you might be dehydrated because your your blood sugar is super high. So you're thirsty. Um, those are some of the main symptoms, but there's other varying ones, like even more progressive. Like, let's say you you don't know, but you have full-blown diabetes type 2 at this point, you could be getting tingling in your your fingers or your toes. And that's a sign of diabetes progression that it's already gotten to a point where your nerves are now affected. Something called diabetic neuropathy.

SPEAKER_02 21:23

Um, what would you say like um uh something that came up because we just had we had a summit a few weeks back. Um, um what would you comment on as far as like mood changes? Have is there anything you've noticed like with mood changes in someone that might be pre-diabetic or diabetic and doesn't know it?

SPEAKER_01 21:41

Yeah, they there are, you know, I would say if we're talking about the Asian population, you kind of have to divide it for like the older folks versus like the the younger folks, because the older folks, they've been taught a different way to handle mood, to handle emotions. And so they might be suppressing what they actually are feeling, which are these like strong emotions tied around like that the health issues that they've been experiencing that they haven't been able to put a name on. So even though they might say, Oh, I'm fine, no, they're actually not. They might feel um symptoms like depressed mood per perhaps, or like anxiety keeping them up at night because of the health problems that they're having and they don't know what's going on. So, yeah, you can see that as well.

SPEAKER_02 22:32

One of the most common internet search questions is kind of boiled down to what's the fastest way to reverse diabetes. So let's say that we've got a listener, or a listener has a family member or friend that just learned they're diabetic and they're afraid, they just got their results, and they are saying, I want to reverse this right now. What are the first changes that they could make in the next 48, 72, 96 hours that matter the most?

SPEAKER_01 23:03

That's a great, great question. I would say that if that person who was just recently diagnosed is open and willing to make changes to their health, the the biggest levers you could pull would be your nutrition and your exercise movement. Those are the two biggest pillars. Now, you know, in my practice, my health coaching practice, I focus on four pillars, which is nutrition, exercise movement, the third one is stress management and mindset work. Last one is sleep. So I think for most folks, it would probably be easiest to pull those first two levers. And within those levers, in terms of nutrition, you know, a lot of times. So if we're talking about diabetes and prediabetes or any chronic disease, oftentimes it's related to our lifestyle. There is a genetic component for sure, but that's not the be all and all, right? As I tell a lot of folks, like you have to think of chronic disease like a gun. Genetics loads the gun, but your lifestyle pulls the trigger. Okay, so you have more power of your health than you realize. That being said, when it comes to nutrition, most of what has led you to that insulin resistance has to do with our modern food system. And so what I mean by that is our ancestors, you know, all of our ancestors, doesn't matter what ethnic background you come from. We here in our modern society are eating a lot of processed foods. Okay. We used to not. We used to eat foods from the farm, foods from the ground. And so one big key that you can do is just cut out, even if you cut out 50%, 70% of the processed foods you're eating, that can move the needle when it comes to improving your blood sugars. So, and in my opinion, it's more important to eliminate those foods that cause the inflammation that leads to insulin resistance. So, one thing I teach folks is like you have to think of insulin resistance like a fire. Okay. If it's a fire and it's caused by inflammation, which it's chronic inflammation specifically, that's also tied to some of the other chronic diseases that we've we've been like briefly mentioning. But you know, when it comes to insulin resistance, we have to remove the inflammatory foods that are causing the chronic inflammation that leads to the insulin resistance from the beginning. So that the fire can come out. So one of them is processed foods, the other one is unhealthy fats. Okay. And I'm talking specifically about the three main ones: cholesterol, saturated fat, and trans fat. Trans fat exists in a lot of processed foods, not as much anymore because of all the rules and regulations that happen over the past many years. But in terms of cholesterol and saturated fat, a lot of that is found in our animal products that we eat. So red meat, um, processed red meats, processed meats, dairy. So moving away from those foods, though those two things when it comes to nutrition, that's probably your biggest bang for your buck. Okay. Now, at the same time, too, for nutrition, you want to try to increase if the processed foods is what causes the inflammation, if the unhealthy fats is what causes the inflammation, vice versa, vice versa of that is true. So, like the things that would heal you are you know single ingredient whole plant foods, fruits and vegetables. And for fruits, like, yes, you want to minimize the sort of like sugar content and have like lower glycemic index sort of fruits um in the short term. So there's that part, but then also too with the fiber that's present in plant foods, veggies specifically, and I'm talking about green leafy vegetables. Fiber is key here. Fiber is the the money when it comes to reversing insulin resistance, but also, you know, going bringing back to like my dad having colon cancer, fiber is so um absent in many of our um daily food choices that we just are not eating enough fiber. And fiber helps with your gut health, it helps with with um, you know, we produce in our gut natural GLP1. So that's glucagon like peptide one, which you've heard about in mainstream media with stuff like Ozempic and Wagovie and Zeppound. We actually produce that in the gut. And so fiber helps to stimulate the production of that in our in our gut. So if you can get more fiber, that's also gonna help. Okay. Now that was nutrition, the other part is um movement, movement after meals specifically, that will help to bring your blood sugar down after eating. Like that's another big component because what you want to do is minimize and blunt your blood sugar spikes after meals because that's what's gonna help to reverse the insulin resistance around.

Culture Friendly Food Strategies

SPEAKER_02 28:37

So, Jonar, thank you so much for earning me a lot more listeners when you just told us how to get free GLP ones. I didn't want to interrupt you and you were saying that. And I thought that is gonna be very shareable. Yeah, a lot of my patients are saying, I can't afford my GLP one. I'll tell them, well, Dr. Jonar said that you can get it for free, and here's how to do it. We just gotta spice that up. So that that is very that is very powerful advice. Seriously, I thought, okay, well, that was that's great. They'll we all need we all need to hear that. So um, food, what we eat, meals, celebrations, gatherings, these are emotional, they're cultural, traditional, our family. We have so much tied into the meal, the preparation, the serving of it, the sharing of it. So, how do we help patients make blood sugar-friendly changes without asking them to turn away from the foods they take comfort in and that you know they might be serving their whole family at the next celebration? So, how how do we how can we tackle that? Is it possible? How do we do this?

SPEAKER_01 29:52

Yes, it's possible. Okay. I think the question you have to ask yourself first is what do you want? Do you want to just manage your diabetes or do you want to reverse your insulin resistance around? Because starting there will determine what you do, right? If you're all about just managing, yeah, that's fine. You can indulge, you can enjoy, you know, the foods that are at these parties. And this is honestly, this is like one of the biggest things I talk about with my clients that comes up on our one-on-one calls, on our group calls, because this is such a big thing. The thing is like parties, celebrations, whether it is like anniversaries or birthdays or going on vacation, even those things will never stop. So you got to figure out a plan around that. You know, you have to build it for your daily life, right? And so, yeah, you have to be realistic about it too. It's just about managing, you can go ahead and do that. Now, if you want to do it in a in a smarter way that honors your health goals of like potentially reversing this insulin resistance around, there are ways to do that in the meals themselves, but even before you step foot in that party. So, one one strategy I teach folks is preload, load up on the healthy foods, eat it at your house before you even go to the party. Because that way you can go and maybe have a taste or two and not feel like you have to fully engorge yourself with the foods that your family and your friends are eating. So that's one strategy. You know, the other strategy is bring a healthy alternative option that is of a similar nature to whatever cuisine you're talking about. So let's just give an example. I'm Filipino, right? So there's a lot of sort of healthier Filipino dishes you can turn into so that you can share it with them as well and kind of introduce this concept of, yeah, it doesn't have to be so unhealthy for us, and we can still enjoy those same flavors. So there is that part too. Now, like the actual like sitting down to eat, there's strategies around like something called sequence eating, where depending on what you're eating on that plate, the order in which you eat that food matters a whole lot when it comes to your blood sugar. So, what I mean by that is there was actually a study done, I think it was in 2017, and it looked in the study was published in the British Medical Journal of the Open Diabetes Um Clinic, something or other. But like it's it's like a subset of the BMJ. They looked at diabetics and they looked at folks who ate their carbs first in their meal. So there was carbs, there was protein, and then there was fiber plants. So the people that ate the carbs first versus people that ate the plants and then the protein and the carbs last. If you can guess which which group had a better blood sugar control after that meal, it was the ones that ate the carbs last. Why? Because of the fiber first. And this goes back to my discussion about the fiber, you know, how it can support gut health, it can help to, you know, release the natural GLP1. And so part of it is that for it, but also too, fiber in and itself helps to slow the uptake of the sugar from the gut into the blood. So it has kind of like a dual effect. So yeah, save the best for last. Eat the carbs last if you're gonna eat them. Portion control is another big thing. Like controlling your portion size matters a lot. Like, eat, for example, eating you know, half a banana versus eating four bananas. Totally different story if you eat four bananas, right? When it comes to your blood sugar. So the the portion size matters. And then after the meal, like if you guys are, you know, if it's warm outside, go out for a walk with folks. Say, hey, let's let's all go for a quick walk, make it a family affair, you know, and that will help to control your blood sugars.

Carb Myths And Better Choices

SPEAKER_02 34:23

That's wonderful advice. And it's so oh, that's great. We'll be sharing with the community how to connect with you because that's just a preview of what you offer, and that is incredible. I love that preload. I love that is wonderful advice. So thank you so much. That's wonderful. You partially answered my next question because I did want to ask you for the people that are confused about what they can eat. So, you know, they're they're learning their diabetics. So, you know, they'll ask, Well, can I have fruit? Am I allowed rice? What about the breakfast food like the cereals, the fancy coffee drinks? Oh gosh. You know, so what what are what are the biggest myths around you know making those corrections? What they should do, especially when they first get diagnosed. And you and I know the average um, you know, medical practice with that diagnosis of a you know, 10-minute visit, your diabetic, get out of here. So they're gonna walk out and be very confused. So, how do they handle this?

SPEAKER_01 35:21

Yeah, I mean, this is a big, big topic that like I would love to just talk about forever, but I think the one thing that you have to remember and is that there is this general misconception, I will call it, about the management of diabetes. And one thing that you will often encounter, whether it is in your clinic, whether it is like online, is when it comes to diabetes, people are afraid to eat carbs. You know, like people are told cut out the carbs, minimize your carbs. The thing is, carbs in and of itself, when you have diabetes, yes, you you do want to be cognizant of the carbs you're eating, but not all carbs are created equal. And what I mean by that is there's processed carbs and then there's there's whole food sourced carbs, they act very differently in the body. And so the other part of this is that carbs don't cause diabetes. If they did, all of us would get diabetes. The insulin resistance, whether you have prediabetes or diabetes, happens because of the inflammation from stuff like processed foods, from stuff like unhealthy fats. So, really, it is the carbs are a symptom of the insulin resistance, they don't cause the insulin resistance. So, what you have to be able to do is pick and choose the carbs that are actually going to be healthy for you, not the white rice in the short period of time that you're trying to reverse this around, right? Not like the white bread, not like the white pasta, like staying away from the processed carbs that are stripped of fiber. See, again, fiber's coming up, right? Like there is a common theme. Like, you want to stay away from those things because it's basically like you're injecting sugar into your bloodstream with those processed uh carbs. Not to mention, there is a whole like slew of additives that can cause further inflammation and metabolism disruption in your body. So carbs are given a bad rap, but I would say that that is not a complete picture of exactly what's going on. Okay. You know, a mango and a bag of cookies are not the same thing, you know, even if they both raise blood sugar. And so I just want to emphasize the point that whole food source carbs matter so much because they behave differently in your body as compared to processed carbs. Um, and again, it's not just what you eat, it's how you eat it, right? I talked about portion size, I talked about the sequence that you eat your foods. So bear those things in mind. You do not have to cut out carbs. Okay. That's actually one of the components of the pillars of like my program in my diabetes reset protocol is carbs do not have to be given up.

Shame And Identity Around Food

SPEAKER_02 38:43

So uh, do you have time for a few more questions? Yeah, I do. Oh, perfect, perfect. So uh something else that comes with this pre-diabetes or diabetic, you know, risk diagnosis, there's an emotional component that we don't really address a lot. And some people will go to the doctors or leave feeling guilty and feeling that they did this to themselves and even wanting to punish themselves and feeling some sadness or grief, maybe not sharing that with others. So, how how can can how can you help us address that feeling that comes with that, especially that early part, or um, maybe someone that's diabetic and it's gotten worse and they're having to progress in their medical therapy or progress to insulin? So, how can you help us address that feeling?

SPEAKER_01 39:36

So it's just that feeling of guilt that might come up, or even like shame that these things are happening to you when it comes to sharing those foods, your cultural foods. Is that what you're you're asking? Yeah. No, this is such a big thing. So I'm gonna give a quick story. Like, I started posting bread reviews online, like on social media recently, and they blew up. Like, I was expecting just like, you know, maybe a couple people to find it helpful. There was hundreds and thousands of people who showed up to this post commenting, sharing, tagging friends, and like the engagement was like nothing I've ever seen. It really dawned on me. People aren't just interested in carbs and their cultural foods. There is this emotional tie that they have in a way that goes beyond taste. You know, for Asians, for example, but this applies to any ethnic group. Like, carbs aren't just a food group and a calorie, they're they're our culture, they're part of us. You know, they're they're practically a religion. Like, if you think about it, for example, I'm Filipino when I sat down growing up, the thing in the middle of the table was rice. That was the centerpiece of the in for a lot of different ethnic cuisines, that is the centerpiece, you know, or like you know, for example, the special occasions, punsit, which is the signature noodle dish, that showed up at like every birthday, every celebration. In the mornings, it was pandasal, which is like this morning breakfast bread. So these foods aren't just you know, um foods in and of itself, they're like tied to core memories, to family, to belonging, and our identity. And so when you hear these things from like your your doctor or online, just cut the carbs to manage your blood sugar, it's really not that helpful. And that's it's like not even dietary suggestion. It feels like a slap in the face for so many folks. And so I want people to hear that that you don't have to fully opt out of your culture, your history, your family. You can still do those things in a way that honors your culture and honors your health. So you don't have to give up those things entirely. Okay, that's what I would say.

Stress Cortisol And Mind Body Tools

SPEAKER_02 42:05

And my last question, tapping into the because you're you're a physician and you've got a lot of training and a health coach, you're also a meditation instructor. So tell us about the role of stress, grief, mindset, how it plays a role in our blood sugars, and what happens in standard care that we're not addressing that. This is a very interesting background that you understand both sides of that. So, can you tell us uh, you know, how what's going on in the mind and in the spirit that could be driving this? And, you know, how do we come to how do we come to learn about that? Because for some people, that's a new concept for them. They hadn't really thought of, you know, is my mind, is my stress contributing to this diabetes?

SPEAKER_01 42:57

So yeah, great question. Thank you for asking this one, because this one is not given enough credit, I would say. So anecdotally, oftentimes the people that first come to me, there's some triggering event that happens in their life. Oftentimes it's like a traumatic event, like the passing of a loved one, a mom, a dad, you know, or a spouse, even. And so there's this cascade of sort of health issues that pop up after that. And now we're not even talking about insulin resistance anymore. We're talking about stuff like autoimmune disease. We're talking about things that that have actual real consequences to our health because of these sort of unprocessed emotions, strong emotions that we were never taught growing up how to effectively manage and handle.

SPEAKER_00 43:59

And you know, I think for a lot of folks out there they don't think about that.

SPEAKER_01 44:07

And when when I take uh uh just brief history, it all lines up. There was that one event, and then boom, boom, boom, right after that. Insulin resistance, some other health conditions. So physiologically, like what happens in the body is when you have like a stressful situation, or let's say you have chronic stress, like especially in this modern world, which is very much pervasive, there is a hormone called cortisol that's related to your emotional stress. And that's typically can be elevated with the emotional stress. So if you're not dealing with it properly, your emotional stress. Cortisol can remain elevated. And over time, what cortisol does it signals your body, your organs to release sugar stores. It's mainly the liver. But there's other specific mechanisms. I'm kind of watering it down, but just you know, for the the purposes of this example, your sugar in the blood goes up and it stays up. And so that puts you at increase for insulin resistance. And over time, yeah, it just gets it can get worse and worse. So addressing this component is so important because if you don't, there can be that block in getting past, let's say, a plateau or you hit a wall with improving your blood sugars. Look to see what stress sources you have in your life and what you can do practically for that. So it's not just a matter of recognizing it, right? Like we have to be able to have a daily practice to address these things. You have to think of stress management and this sort of ability to handle emotions in a healthier way, like a muscle in your mind. It's like a mental muscle. You have to practice that muscle because if you don't, the the issue will just start snowballing further and further. And so part of this is taking action. It can be something as simple as deep breathing exercises. But like, you know, you mentioned, like, I'm a mindfulness meditation instructor. You know, I got certified last year. I've been an avid meditator for like 22 years. And this actually happened right after my dad passed away. I realized like I was having a lot of grief. I was having a lot of strong emotions. And I realized, because my primary doctor was like, you should take Paxel, you should take this, this like anti-anxiety, anti-depressive medication. This is a long-term problem. I don't want that to be the long-term solution. And so I looked into different modalities and I came upon meditation. And that has helped carry me through many difficult periods in my life. And so for me, that works. But for you, it could be something different. It could be, for example, qigong. This is another practice that I teach my clients. This is energy movement. It has its roots in traditional Chinese medicine, but it is the skill of moving energy. And so it's similar to yoga, I would say, but in the sense that it's much more readily available to like your average person. Like you can have a kid or maybe even like an old adult uh practice this. And I'm sure if you've gone to any like park and you see a bunch of Asians gathered, especially if they're older, you see them doing Tai Chi. So qigong is a form of that, and actually Tai Chi is a martial art that kind of spun off of that. So there's that. Find something that resonates with you, you know, but you gotta do it. Even if it's five minutes a day, that's that's better than not doing it at all.

SPEAKER_02 47:50

So for those of us that are listening that have learned so much from this powerful time with you, you have uh you have an online community, you have group programs. Are you accepting patients or how do we how do we become part of this world, especially for the the Asian Pacific Islanders? Because I know that they're looking, they need you. So what's the next steps?

SPEAKER_01 48:14

Yes. So I people can reach out, I have a website, it's called for truthhealth.com. So you can you can find me on there. I have uh, you know, social media pages on Facebook, on Instagram, and on TikTok. And my my like username handle is reverse diabetes doc. So that's um, you know, hopefully you can provide that in the show notes, but that that's across all three platforms. Um I don't exclude non-Asians. I want to make that very clear, okay? I have a private one-on-one um wing of my health coaching. And so, yes, this is health coaching. I I don't practice anymore as a uh a doctor. I fo I focus mainly on health coaching folks. So I don't prescribe medications. This there's no supplements that I sell. This is all on lifestyle change. And so I welcome any non-Asian that is struggling with diabetes or some other chronic disease, reach out and we can have a conversation on how I can help.

SPEAKER_02 49:23

So, those of you that are listening in the podcast, you will see show notes on whatever app you're listening in. I know that we get busy, or if you're like me, I'm listening to my podcast while I'm walking my cats. Long story, but that's how it works. So if you go hit, look in the if you tap on that show, if you scroll down, I'll make sure you have every link to reach Dr. Jonar. If you're a little too busy and you miss that, the easiest way is to sign up for my newsletter, which will be at the very top of that, because I will email out Dr. Jonar's connections, his social media, how to learn about his communities and how to sign up to work with him one-on-one in his coaching program. So all of that will be easy. If you're watching on the webinar, you'll see on the side there'll be some notes that are coming up, and you'll see those come up there. So it'll be easy to click. So, Dr. Jonar, this has been such a blessing to have you on. Again, this is a topic that had been on my mind for years. And I'm just so happy that you gave a voice, you gave a description, you gave excellent medical education, CME level, medical education, CME level. So I I really appreciate this. And I know the listeners are taking so especially, and again, I know you don't exclude, but I know that there's a pocket of listeners who have not been heard. So I really appreciate you coming on and speaking direct directly to them. Thank you.

SPEAKER_01 50:48

For sure. Thank you so much for having me on my show, on your show. Like I really appreciate that. And I love what you're doing. Keep doing what you're doing. It's wonderful information and just insight and inspiration for others to, you know, go down the path of healthier living.

SPEAKER_02 51:04

Thank you so much.