Do You Know with Dr. Dwain Woode
Dr. Dwain Woode invites you on a journey to transform your life, health, and mindset on this dynamic podcast. As a medical doctor, he understands diseases of the body and mind. As a life and wellness coach, he knows how to help you achieve your goals. He provides the education, empowerment, and encouragement needed for you to take charge of your well-being and realize the life you have always dreamed of living. Do You Know is a groundbreaking podcast that combines an engaging style with scientifically backed strategies to add to daily life. Get insight into proven methods to improve your health and gain control over your life, allowing you to reach your true potential. Whatever stage of wellness you're currently in, this podcast has something for you! Take the steps necessary for success today by listening in, where each episode promises to break down complex topics in a straightforward way that is easy to understand and even easier to apply to everyday life. Go from simply knowing what you must do to getting it done with Dr. Dwain Woode's transformative podcast!
Do You Know with Dr. Dwain Woode
Should I Start These Diabetes Medications?
Embark on an illuminating journey through the tangled web of diabetes with me, Dr. Dwain Woode, as your seasoned endocrinology navigator. Our discussion promises to give you a deeper understanding of how insulin functions as the maestro of your metabolism, orchestrating the energy conversion of every morsel we consume. We're not just talking about diabetes; we're exploring its reverberations across numerous health conditions, emphasizing the critical need for preemptive action and smarter lifestyle choices. Prepare to be enlightened on the staggering prediabetes statistics and the beacon of hope that certain medications can be, possibly leading to a life less dependent on medical intervention.
As your confidant, I pull back the curtain on my metabolic dance with insulin and glucose following an intense 72-hour fast. Witness firsthand how our dietary decisions affect our health, and arm yourself with actionable strategies to manage blood sugar levels. We'll navigate the delicate balance between insulin and glucagon and how medication can harmonize or disrupt this intricate duet. Let's journey together towards a horizon where insulin sensitivity is improved and the reliance on medication is minimized, paving the way for a healthier, more vibrant life.
Concluding our expedition, we'll dissect the complexities of diabetes medications, both their life-altering benefits and the potential side effects. From the latest on GLP-1 receptor agonists to the kidney-protective qualities of SGLT2 inhibitors, I'll guide you through these pharmaceutical landscapes. You'll even get a glimpse into my own diabetes management playbook, integrating fasting and cutting-edge technology. The episode crescendos with an empowering call to action: partner with your healthcare providers, dust off your willpower for fasting challenges, and become an agent of health awareness in your own community. Join us, and let's not just manage diabetes but chase the dream of remission together.
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If you've been following the news in any respect, you know that diabetes is a huge problem. You know that we have pandemic-sized issues with diabetes. Diabetes is a leading cause of heart disease. It's a leading cause of blindness and amputations and renal dialysis. It is a major cause and a major source of morbidity and mortality and it is a major source of cost. How do we put diabetes and remission? How do we reverse diabetes? How do we get off of some of this medication? Tonight we're going to talk about some medications that you may want to talk to your doctor about. Starting. That's right. Y'all We've been talking about getting off medication. We've been talking about getting rid of things, we've been talking about reducing, but maybe there are some medications that we can use to help us bridge the gap as we move in that direction, and that's what we're going to be talking about tonight.
Speaker 1:If you're new to me, I'm Dr Dwayne Wood, that's Wood with an E the E stands for endocrinology. Here on the channel, I educate, I empower and I encourage you to take charge of your health, your life, avoid complications and go to the next level. We're creating the life we've always wanted and in this year 2024, our new theme is New Year. New Year, we are specifically talking about adults with type two diabetes, but, as I've said since I started, the things that we talk about for diabetics are the same things that we want to promote for all the other people that suffer with other illnesses and other conditions. We're talking about high blood pressure, high cholesterol, polycystic ovarian syndrome, coronary artery disease, non-alcoholic fatty liver disease. We're talking about metabolic syndrome. All of those can improve with the things that we're going to talk about and the things that we are teaching. So make sure you tune in as we get down this road. Well, why don't we hop over? Why don't we go ahead and let's do a little background work? Because we got to get there. We got to get there y'all.
Speaker 1:Diabetes 430 to 460 million people around the world who are suffering with diabetes. You know the numbers. We're talking about half a billion, almost half a billion, and they're telling me that as the diabetes levels have gone up, we see a corresponding increase in obesity right, that's weight. So very allied with diabetes is this idea of insulin resistance and increasing weight. In the United States, there are 88 million people a little over 88 million actually who are pre-diabetic. These are people that are heading in the direction of diabetes and we've not been able to curtail, we've not been able to stop it. It just keeps getting bigger and bigger and bigger and bigger. And perhaps one of the reasons that it's getting bigger is because we're having the wrong conversation, maybe we're having the incorrect idea of how things work, and so we're going to spend a little time doing some background and we're going to come talk about these medications here in a minute.
Speaker 1:So when we think about diabetes, when we think about food, the idea that we have is that we eat food, it gets digested and it goes to create energy. So everybody says, hey, I'm feeling weak, I must be hungry, or I didn't eat today. Or somebody feels faint and we say, oh, did you eat? That's the first question we had. Did you eat anything today? You know how we do, right. And so we have this idea that food digestion goes to energy. And, in fact, even when we talk about the different types of food right, proteins, fats, carbs we get them digested and we say, hey, this is what my food is going to do, is going to provide energy for me, and that is really a surface understanding of how things work. In fact, when we talk about food.
Speaker 1:Anytime we're eating, the food that we eat turns a switch. So the food that you put in your mouth, when it goes into the body, when it gets digested, a switch gets turned and the guy that controls the switch is a hormone called insulin, and insulin comes out from the pancreas. Insulin is the hormone that has been, has been, the culprit in diabetes, right? So everybody's heard of insulin resistance. You know, you've got cousins, brothers, sisters, coworkers, somebody you know who's probably on, probably on some insulin. But insulin has a very unique function in the body. Not only does it help to bring blood sugar down when we eat, not only does it help to regulate blood sugar, because that's why we give it, that's why we give people who are diabetic insulin but insulin also is the guy in the body that makes the determination of what happens to the food. Does it go for energy or does it go to storage? All right, does it go to energy, does it go to storage? And insulin makes the decision about that based on what's in the food.
Speaker 1:You could think of it kind of like oh yeah, so I traveled recently. I traveled recently and we got, you know, the precheck, the yeah, when you travel and some of you may have gotten a free precheck or clear or whatever it is they have now. And so you show up and if you have the if you don't have a precheck, you go to one line. And when I look over that line, that's that long line that comes down and wraps around and round and round and goes down the hall, around the corner, down the stairs, right. So that's the line, that's the line in the airport. But if you have the precheck, they take you into a different line and sometimes they take you along the track of the same line and you get up front. So the precheck allows you to go to one line. If you have it, you go to one line, if you don't have it, you go somewhere else. So that's what insulin does.
Speaker 1:When insulin looks at the food that you eat, it makes a determination of what happens to the food Either it's going storage or it's going somewhere else. And the thing that insulin is looking for is insulin is looking for glucose. Hmm, come on, come on, come on, let's say it, let's say it. So when glucose comes into the body, your insulin. When sugar comes into the body, sugar, you know people say, oh, maybe I'm eating some different types. So let's, let's go through them. So, glucose, lactose, which has two types of sugars in it, that gets broken down into glucose, right? Fructose all the different names of glucose and sugar that we've talked about. High fructose, corn syrup, molasses, brown sugar, molasses, brown sugar, refined sugar, right, all the the oses, right? Molotos, dextrose, all of those.
Speaker 1:When they come in the body, then they signal the body to produce insulin and when insulin comes out, insulin says, hey, that's stuff that we're seeing right now, I'm going to store it. That's insulin's job. When it sees sugar, it stores it. That's the signal. So anytime you're eating food that is high in carbs, then that signal says hey, this is going to storage, got it so far right, so let's go in storage. So let's hop back over here. So we're making that decision Are we going to storage or are we making energy from this stuff?
Speaker 1:And as we store it, then it gets put in different places. Now, the liver is only so big, it can only hold so much. So when it becomes stored in the liver, the liver gets full. Then the body has to take it and put it somewhere else, and the somewhere else is over the different places in your body. So it puts some of it in your muscles. It puts some of it in your fat cells, and I've commented before here on this show and I had a lady know for that said this to her and she's like no, dr Wood, that's not true.
Speaker 1:I said to her and I'm gonna say it to you do you know that right now you have the same amount of fat cells in your body that you were born with? And she said no, no, no, no, that's not true. There has to be more. And I said no, it's not more. What happened is we just put more stuff in it. Right, we put more stuff in the fat cells, we put stuff in the pancreas. Sometimes we put those glycerides, triglycerides, those fat cells. Yeah, they're floating around the blood, they get into the bloodstream and they go into the vessels. Now I want you to notice, as I'm describing where this is going. You can begin seeing the disease process that comes as a result of that, because if I go to the liver and I pack the liver, then I have fatty liver. If I go to the muscles and I pack the muscles, I've got muscle aches, muscle pains. If I put it in the fat cells right now, I have obesity, you see.
Speaker 1:So insulin is the guy that says, hey, I see it, let's go ahead and we're gonna put it into storage. Make sense, all right, now what happens in diabetes? And so the model that we've used with diabetes before is this lock and key model. We said, hey, blood sugar comes in, the insulin sees the blood sugar, and the insulin is what decides if it goes into the cell. And that, basically, is true, but we sometimes leave off the part about the storage. And because the insulin is unable to get blood sugar into the cell, then the body makes more and more and more and more, and that's our definition, that's our description of insulin resistance. But what if? What if? What if?
Speaker 1:Along with that idea, there's also this other idea, and I want you to hear me. Suppose we think of your cell kind of like a suitcase, right, and you're putting stuff in the suitcase, and the reason that we can't get more stuff in the suitcase is because the suitcase is already packed, so we keep trying to put stuff once again. I traveled recently right, we're not to California my son, my wife, my mother-in-law and I, and we were traveling, I packed my suitcase and somebody else in our house said to me hey, I got this stuff that can't fit in my suitcase. Can you put it in your suitcase? And so I went and opened up my suitcase and I think I got some stuff in there, but my suitcase was so packed I literally had to sit on it y'all to zip it back up. Now imagine if I tried to put more things in that suitcase. Now I want to put it in. The suitcase is designed for it to go in there, but I can't get any more in because the suitcase is already full. And so, in order for us to make a decision, what we did is we traveled, because we were traveling up to Nashville to catch the airplane up there. So we took an extra bag with us and we got up there and once we got to the parking lot, we stood in the parking lot with the car with the suitcase open, and then we made a decision about what we could take. So either we need to get more bags, so bigger cells, or we had to decide that, hey, we're not taking some of this stuff with us, right? Or we had to put this stuff in and maybe get an elephant to sit on the suitcase so that we can zip it up.
Speaker 1:More insulin. So what's the plan? What's the plan? What's the idea? How about, instead of giving more insulin, we decrease the insulin's ability to make the decision to store stuff and to allow it to use the energy that we're putting in? What does that look like? What does that look like?
Speaker 1:One of the very first tools that we talked about was fasting. So we're going to bring the insulin level down. How do we bring the insulin level down? By not one-to-one putting stuff in that forces insulin to rise. Now you're looking at me and you're saying well, that makes sense. Right? That's the whole idea of watching your diet, low-carb diet, so on and so forth. Yes, that's true, but I want to take it a step further, because I want you to understand why that works, why that is important. Because you say, well, yeah, if I lower my blood sugar, I don't need insulin. Well, I'm not just talking about the insulin that we give from outside. We're not just talking about insulin, the medication. I'm talking about the insulin in your body. How do I lower the insulin in your body? We've already talked about some medications that we probably should try to get off. That was last week. If you haven't watched that, go ahead and watch that Right, because those are secretagogues. Those are things that force your body to make insulin. We talked about getting off of insulin itself.
Speaker 1:Let me put a point right here and just make sure that everybody knows we're talking about type 2 diabetics, type 1, they are insulin requiring. That is vital for their success, for their survival. We're not talking about type 2. We're talking about type 1. We're talking about type 2 diabetics and specifically here, we're talking about adults. Now there's a whole other conversation for children, because we're starting to see guys. I think my youngest type 2 patient when I and she's grown up now was 6 years old with type 2 diabetes. Yeah, so we're starting to see type 2 in younger and younger and younger folks. So it's not restricted now to the adult population. We're starting to see our kids there, and so there's this whole conversation that we should have and we're probably going to have on a different show about what that means, because everybody is saying, oh, it's genetic. Well, wait a minute, how quickly did genetics change? How quickly did our genetics change? Because if you go back 50 years, 60 years, 70 years from previously, we didn't have this problem and are we to believe that our genetics changed over the course of 70 years, that drastically. Anyway, that's a whole other conversation, right? Okay?
Speaker 1:So what we want to do is we want to lower the things that we put in that cause insulin to rise, because when we do that, the body is able to use the insulin that it's making more efficiently, and that is called decreasing insulin resistance. Let me go through that again. So if I'm putting stuff in the body that are low enough in the signal to the body that hey, you got to produce more insulin, right, because remember, higher sugar, higher glucose, more insulin comes out, more insulin comes out, more storage weight, and as the weight goes up, of course the whole idea of insulin resistance goes up, and so the blood sugar is rise and rise and rise. So if I put something in where the body doesn't have to produce as much insulin, then my body's response to the insulin that it makes is improved. That, by definition, is decreasing insulin resistance. So we talked about fasting as a way to do that. Okay, so let's move on. Let's move on.
Speaker 1:So the fed state, the fasting state. So glucose comes in, we digest it, insulin comes out and insulin is the thing that converts it to energy or stores it, depending on what we have Now. Here's a, here's a, and let me see, maybe let me pop back over and I want to go back to my, go back to my, my discussion from yesterday. Okay, my sister's going to kill me because she's going to say you're telling this people, I made your blood sugar go up. She didn't do it, I made the decision Right. So look at, right there. So so here I am Right. So this is Sunday, let's see. Let's go back to Friday. So Friday, so this is where I broke my fast. Right, it was a 72 hour fast. So right, here, about 645. Okay, and blood sugars, I mean, that's what? Okay, so, yeah, so about one.
Speaker 1:So we started out down here at 79, up, up, up, up, up, up, up, up, right, so we're going 80s, 90s, 120s, 130s, 100s. Now I want you to notice this is no medication, right, so the body is doing its thing. The body is doing its thing. Right, here we rose because my sister came, she cooked, I ate. We got up to 194, y'all, okay, and then we dropped back down and then, on the way to the airport, we decided we're going to stop off.
Speaker 1:If you didn't know, if you, if you didn't hear that story, go watch the show from last night, right, go, go. Go watch the show from last night and you'll see what happened. And look at that 246. So what do you think happened to insulin at that point? Right, insulin spiked up. So what I'm saying is, if we don't put things in that forces the body to make insulin, the body is well able to manage on its own Right. And then look at today, right, so this is today. Look at that. And I dare say to you that the result that you're seeing right here, these results for today, are a consequence, or I shouldn't say a consequence. They are the benefit of the fast that I did three days ago, right? So my body is still in that, in that adjusted phase, and we'll see what, what my, what my other numbers are here in just a little while. Okay, all right.
Speaker 1:So let's put things in, let's put the less things in. So that's the whole idea of the refined carbs and so forth. Okay, all right. So so let's get to what I want to talk about tonight. So, everybody got that so far. So put less things in, put less things in. The other thing that we can do is we can get rid of, we can decrease the blood sugar in another way. That's the whole idea of exercise. So we are trying to do things without the use of insulin.
Speaker 1:So first of all, we got rid of insulin itself. We discussed that last week. We got rid of the secretagogues those are the things that force our body to make insulin. Now we're putting less refined carbs in and actually the reason that I brought that slide up was a minute ago is the spike that you see in blood sugars is directly related to how intense the body sees the sugar. So the more refined the sugar that you eat, the bigger the spike in insulin. The more refined the sugar, the more refined the carbs, the bigger the spike that you will see. So that if we're not putting in those highly refined things in the body, then we get better insulin response and then the insulin because the blood sugars may not spike that high, we don't get as big a spike in our insulin level. If we don't get a big a spike in our insulin level, then the push to store is lower and some of that gets pushed over to energy. So we're decreasing our carbs, we're watching our diet and we're fasting. So those are ways that we're going to use to bring our glucose down. If we bring our glucose down, we bring our insulin down. If we bring our insulin down, we improve our insulin resistance and we improve the side effects of insulin. So that's the basis of the rest of the conversation that we're going to have as we move forward.
Speaker 1:So once again, just an example as blood sugars go down blood sugars that graph that you see on top as blood sugars go down, the insulin corresponds to that. Because insulin cannot y'all. Insulin cannot stay high if you have low blood sugar. This is the body's normal response. So I was talking to someone today in the office, a patient. She was saying hey, my blood sugars dropped and I felt kind of fuzzy headed, light headed. One of the reasons that happens is because we still have medication on board that's pushing our blood sugar down. If we didn't have medication on board when your blood sugar dropped, the body would essentially turn your insulin off and you would not feel that. But because the medication is still there, the medication is still driving the blood sugar down and because we're used to being higher in our blood sugar, we feel that a lot more. Okay, all right. So glucose level right. So here's another interesting side that's going to be a benefit for us later on.
Speaker 1:So as blood sugars go down, so does the insulin. But as insulin goes down, the counter hormone to insulin goes up. That's called glucagon. So insulin says, hey, store it. When insulin goes down, glucagon comes out and glucagon says, hey, now I've got to use that stuff, I've got to use the blood sugar. That's why. That's why, for those of you who take insulin, you get prescribed that glucagon pen, because the glucagon pen, when your blood sugar goes down, you give some glucagon and glucagon goes into the body and it finds sugar, it breaks down the glycogen that's stored in the liver and it pumps it into the blood, so that your blood sugars come up.
Speaker 1:And of course, we have all the toxicities, right. So the triglycerides that are formed when insulin is trying to store things. That's where all of those different things go, right. So lipotoxins, yes, the toxic levels of the lipids. The beta cell becomes dysfunctional because now we're putting fat there. And then other components. So the other parts of the body, the liver, right so fatty liver and so on, all right. So. And then, of course, all the disease processes, and we've talked at length about those. So what I want to do is I want to say hey, how do we decrease the sugar? And we've talked about several ways, but this brings us to the medication. This brings us to the medication.
Speaker 1:Now, as I've said and you've heard me talk about it here on the show that our goal is reversing diabetes. Now notice, I use the word reverse, right, because you usually hear me say remission, putting in diabetes and remission. The words are being used interchangeably, and the reason I like the remission version of that word better is because it gives the impression rightly so that your diabetes is controlled. You may not be, you're not on any medication. That's what remission means that you have good blood sugars, you're not on any medication and there's actually a timeline how long you have to be off of medication with good blood sugar for you to be considered to be in remission. The reason I like that idea is because when we talk about reversing diabetes, people get the or they think that, oh, my diabetes is gone and so now I can do whatever I want and the blood sugars are going to stay good. And that's not the case. But we're going to use those. You hear me use those words interchangeably, but I want you to understand if you hear me use the word remission, it's because I want people to understand that this is a lifestyle that they've got to adopt.
Speaker 1:Okay, all right, so, yes, so let's talk about the medication, right? So one of the ways, one of the ways of decreasing sugar in the body is with the use of some medications, and these are called SGLT2 inhibitors. Sglt2 inhibitors, and the SGLT2 inhibitor class is a class that the question is can we use some medication to help us bridge the gap as we move in the direction of remission, reversal, improve blood sugar control? And so the first group of medications I want to talk about are these medications that are called SGLT2 inhibitors. Sglt2 inhibitors, and these medications work by basically taking sugar and they put the sugar into the, they put the sugar into the urine.
Speaker 1:Okay, and let me pull that slide up here really quickly. So for type two diabetics, what happens is that, and let's see if you can see I hope you can see my pointer. It doesn't look like you can, but anyway, you see the big part to the left there, that this is basically a part of the kidney, and you don't have to look at all the wires and all the, all the arrows, but right there at the top, at the left side is where your blood goes into the kidney and then the kidney filters it out, and all the way at the other end, to the right side of that graph, down at the bottom, the blue line or the blue arrow is where your urine is coming out. Okay, that's where the urine is coming out. And so for people who are diabetic, for people who are diabetic, there is a defect in their kidney. There's a defect in their kidney, and so when, when the body filters the blood, one of the things that happens is that sugar comes out of the blood and it's being filtered through the kidney and the body. Because of this defect that's in the kidney, the body brings the sugar back into the blood. Now it's supposed to go out, it's supposed to go into the urine, but because of this defect, the body pulls it back in, and so you end up having higher blood sugars than you should. You got that so far. So, because of this defect, the sugar that should be not coming back into the body ends up coming back into the body and it doesn't get put into the urine. And this medication what it does is it stops that process or it fixes that process and it allows sugar that's in the body that now gets put into the urine to go into the urine, and it stays out there.
Speaker 1:Now notice that this process does not use any insulin. We just talked about decreasing the problem with the insulin. So we just took some sugar out of the body, we put it in the urine. It's gone. So the amount of insulin that you've got to take from outside that is, insulin shots or the secretogogs that you have which are forcing the body to make insulin, or your bodies seeing the sugar that's high and deciding to make more insulin, decreases. And that's the point. That's the goal of what we're doing as we head to remission because we got to get rid of the sugar somehow.
Speaker 1:Now you're saying you say wait a minute, so we're going to get on medication to get in remission. And the answer is yes, because the idea in this model is not that we're on the medication and that's it Right. In the old model we say hey, your blood sugar is a high, this is going to be a chronic thing, this is going to be a forever thing. So you just take this medicine and you keep taking as much as you need to get those blood sugars down. Now what we're saying is hey, let's figure out how to get rid of some of the sugar so that we can deal with the defect, and the defect is an insulin issue. When we deal with the defect, we have all the benefits of decreased insulin Better insulin sensitivity Right. So now the insulin becomes sensitive, it works. Whatever your body makes works. We stop shuttling energy into those storage places liver, fat cells, pancreas Right. So all of those disease processes improve and we have the improvement that we have. That comes from the fasting that we're doing. So the goal decrease the sugar, get the insulin down.
Speaker 1:Now, ultimately, we're going to talk about okay, now, that if you're on this medication that we did, now we're off the insulin, now we're off the secretogogs now we're off the DPP4s and if you don't remember, go back and watch that show from last week we're off of those. We're doing the fasting, and here's another way to bring the blood sugars down. Okay, so that's one of them. All, right, so let's hop over and let's talk about another class of medication and this class of medication, like I said, you've heard, you've seen and this is what everybody's talking about that's helping people lose weight. Okay, Well, actually, before I do that, let me talk to you about what some of the names of these medications are, and these are.
Speaker 1:And there are two others that are not as prominent in the market. They actually were taken off the market. I think one of them is still on the market, but Jardians and Farsica, those are the names, those are the brand names. I'm not going to tell you the scientific name, because you probably have heard it, but everybody knows these, okay, so let's go ahead and say them. So Jardians and Farsica are the two that we were talking about, right?
Speaker 1:So these medications, all they do is they take sugar. I shouldn't say all they do when it comes to blood sugar. What they do is they take sugar, they put it in the urine. They correct a defect that's in the kidney of patients who have diabetes, where their body normally resorbs, brings sugar back into the body that should be put in the urine. So it basically fixes that and it gets rid of the sugar. If the sugar is lower, insulin goes down. That's the key. Now you hear me say that over and over. Sugar goes down, insulin goes down. That is the key. Okay, all right, and Teresa, thank you for hopping on.
Speaker 1:I see your question there, or your comment there. I'm going to go ahead and start, and we'll come back to that in just a little bit. Okay, does that make sense? So far for everybody? Yes, yes, yes, okay, if it makes sense, put yes in the comments and, as I'm talking, guys, go ahead and drop those in the comments, because we're going to come back, we're going to deal with some of those here in just a little bit, okay, all right, so let's then look at another group of medications.
Speaker 1:As I said, these are the ones that everybody's been talking about that are helping to lose weight, and I want you to look at this graph, look at all the different things that you see that these medications do.
Speaker 1:The ones, though, that I want you to kind of pay attention to are the ones you'll see up there at the top the brain, okay, and then you'll see the pancreas my mouse is not working, so I'm going to have to describe, okay and the skeletal muscle Okay, so they do a couple of things that are going to help us. Number one these medications are secretogogs. Okay, let me go ahead and say that they are secretogogs, and so they work similar to the DPP-4s that I just told you we need to get off, right. These are the ones that make the body produce insulin. However, the benefit that we get from them is that they also help to suppress the appetite. They suppress the appetite. They send the signal to the brain that we're full. They help the muscles to use insulin more effectively. Right, so several things.
Speaker 1:The benefits may outweigh the insulin that we're getting, because if we're decreasing our food intake, decreasing the things that we're putting in the sugar, right, those cravings are going down. If the cravings are going down, the blood sugars are going down. If the blood sugars are going down, the insulin level is going down. And, ultimately, our goal is going to be right. During the process of being on these medications, during the process of fasting, right, we're going to be learning some ways to manage our blood sugar, manage our food, manage our cravings, so that, when these medications go away, we can process that on our own.
Speaker 1:Okay, now notice what I'm saying. We're going to be on the bridges to where we need to go, so we're not saying, hey, you're going to be on this and this is it. We're saying how do we? Because we've got a strategy, y'all right, we've got a strategy on how we're going to do this, and the strategy includes hey, how do we get off of this medication and these medications? As I said, they are one of the ones that help with our weight, right? So everybody's all excited about that. So it's great, you know, you get that tummy, you get rid of that fat.
Speaker 1:Now, the guy that's on the left, that abdomen that you see, that abdomen comes as a direct result of insulin resistance. Insulin resistance this is a good place. Let me, let me do this. I'm going to hop over, let me come back here so you can see me full screen, because I want to make this point. If, if you are, if you stand up and I'm going to stand up if you look down and you see your tummy, then you've got insulin resistance.
Speaker 1:People say how do I know if I'm insulin resistant? That's how you know, because the storage of energy, one of the places it goes, is right there, that omentum. And that's what that? That within inside the omentum, that's that fat pad that covers the abdomen. On the inside you can't see it. You can't, well, you can't see it from the inside, but you see it on the outside and if you look down and you can see your stomach, that is a sign of insulin resistance. So you don't have to wonder, you don't have to guess yes, it is.
Speaker 1:And insulin resistance, as we just talked about, is a. That's what everybody says. Diabetes is right, insulin resistance. But insulin resistance is more than just diabetes. That's why I say to those of you who are out there, if you don't have diabetes, don't tune this out, because this is for you as well, because how do you get rid of the omentum, the omentum, how do you get rid of that stuff right there? The exact same way as we're talking about the diabetics, the same way that we're going to put diabetes and remission is the same way that we get rid of that. And here, in a minute, I'm going to show you, I'm going to show you my weight, as we do with all of our numbers. We're going to see that here in just a second. Okay, all right.
Speaker 1:So so when we talk about, when we talk about diabetes, the goal, the goal, one of the primary goals, is how do we get the insulin down? And we get the insulin down by getting the sugar down. How do we get the sugar down? One, by fasting. Two, by getting rid of sugar, and how do we make it through the fast and how do we deal with those cravings? Maybe the GLPs are a way of doing that, okay, and those medications are ozympic and everybody's probably heard of ozympic. There is also biata, bi-durion victosa rebellisis is the only oral form of that of that class right now. And then manjaro has a GLP in it, but it also has another component, right? So it's a combination of things, All right. So that's the question, that's the explanation.
Speaker 1:We're going to come back and I'm going to tell you what my opinion. So this, I'm just giving you data right now. Right, I'm just giving you a radio. I'm going to tell you my opinion of those, what I think, right, when I answer the question should I start taking some of these medications? Should I start taking one of those medications? All right, so let's do this, let's hop over and let's take a look at some numbers, right? So we've already shown you what the DEXCOM has shown. I think, yeah, so that's my DEXCOM right now, what it's saying. My blood sugar is, and, of course, that's the Libre. So let me go ahead and let's pop over and I want to do the blood sugar here. All right, let's see what that shows.
Speaker 1:And I do people say, hey, when you're not doing the 72 hour fast. What do you do? Well, my normal plan is to do like a five to six hour eating window, so I don't eat anything. Once I stop eating at night, I don't eat anything until I eat in the office with my team or my wife. So I'm going maybe 14, 16 hours when I'm not fasting, but of course, as you know, my fast I do that and you see that I do that. That's been a 72 hour fast.
Speaker 1:Let's go ahead and put this blood on this meter and let's see what that shows. Right now, and for you, our goal has been for you to work your way up. Look at that 1.1. So that's actually pretty good, all right. So if you remember, when we talk about nutritional ketosis nutritional ketosis what we're talking about? Having ketones of 0.5 to 1.5. And when we talk about therapeutic ketosis, we're talking about having ketones higher than that. So now my blood sugar is 115 and my ketones are 1.1. And let's pull over now and go to our app, because the app is going to suck it in and then I get to show you the graph of what has been going on over the last couple of days with that. So let's go ahead and it should be pulling in here just a sec. If not, I'm going to hit the button to have it scan and it says yes, boom, got it, all right. So there we are, and let's take a look at our graph, because I want you to see here All right.
Speaker 1:So, right there. That was before I broke the fast, so that was Friday evening, and so look at that my ketones are high, my glucose is low. Now let me pause here, because if you've not been with us, you're like well, what does that mean and what does that have to do with our diabetes? Well, when your body doesn't have sugar, it switches to burn another source of energy, and the other source of energy is ketones, and you can measure the ketones in your body and you can tell when the body is actually using something other than sugar to burn energy, and that's what this is an indication of. And then you notice that when I stop fasting, so my blood sugar went up and then my ketones dropped. So down here, my ketones are like 0.6. 0.7. And, of course, 1.1., but my blood sugar is. What did we just say was 111. Okay, awesome, all right, so that's where those numbers are.
Speaker 1:Let's hop over and let me grab some of these questions, some of these comments. All right, let's see what it means. So Lashas and I'm assuming I predicted that correctly she said thank you, that's what's a welcome, I'm assuming. And then she says my insulin was at 8, 2 years ago and I got it down by lifestyle changes. Yes, definitely, definitely. I love that. Go ahead and, if you don't mind, just drop in the comments what it was that you did. What did you do? What did lifestyle changes explain a little bit more of that to us. Teresa says which one would you suggest that have very little side effects? Very good question.
Speaker 1:And so let me give a little background for those people who don't know much about the GLP-1s. The GLP-1s work. One of the things they do is they slow food as it moves through the body, as it moves through the stomach. So some people feel that as queasiness, some people feel it as nausea. There are actually some people that actually can throw up from it, and that happens because the pancreas becomes inflamed for some people. The other thing that can happen is they throw up. So that's the big side effect, right? So the GI symptoms that people have Now for most of the medications, most of those GLPs, and I'm assuming that's the one you're talking about. Actually you didn't say, because let me talk about both then. So for the GLPs, the big side effect, of course, is the slowing of the food as it moves through your stomach. Because you feel fuller, people feel as queasiness. You adjust the dose if you need to. Some people come off of it.
Speaker 1:Now, one of the things that happened to me years ago was when these guys first came on the market, I tried taking them and I couldn't because they slowed my GI tract so much that I started getting constipation. So when they first came out, I couldn't take them. I tried, I'll tell you, multiple times. I tried and tried and tried. I went to my doctor and he said don't you want to try it? I said sure, and this is me as the endocrinologist y'all, but I couldn't take them. And so for years and years and years they didn't work for me.
Speaker 1:And then we talk about the SGLT2s, as the other group the Jardians and the Farsica, those because they're putting sugar in the urine, people who are prone to yeast infections can have a yeast infection. It has also to do with how big the blood sugars are, as we're dumping sugar. The higher your blood sugars are, the more possibility it is that you may have a urinary tract infection, and some people can have a severe urinary tract infection called Furnace gangrene. So that's one of the side effects there. All right, as then Teresa said, I heard that some cause thyroid or kidney issues, right. So the SGLT2s, the issues that you're hearing there, are the urinary tract infection and the severe infection in the general area. They actually have been now approved, many of them for kidney protection, right?
Speaker 1:So when they first came out, people saw, hey, wait a minute, we're putting sugar in the urine. Now, when I trained, when I was coming through medical school, it was bad to have sugar in the urine, right. If you found somebody who had sugar in their urine, they were called diabetic, right. But now, because of the mechanism of action, right, we actually use that fact. We didn't understand that back then. We used the fact that it put sugar in the urine to treat the blood sugars. The other thing about thyroid, so we're talking about now going back to fictosa and ozimpic and mungero and the rebalysis and the GLPs. So there have been cases of medullary thyroid cancer in rodents, right. So when they tested them, these rodents had medullary thyroid cancer and so someone who has a history in their family or have a personal history of medullary thyroid cancer, we don't put them on it. But we've never seen that in humans, right? But because the studies when they did them, they showed that it actually has to show up on the, on the marketing and on the box. So let's see. Teresa says yes, okay, so if you know somebody I think that was the answer yes, and oh, it does make sense. It makes sense, thank you, because I see Jeff says yes, makes sense as well.
Speaker 1:And receive, receive, I'm going to give you some music. Hey, take a real close look. Okay, I got to find my hand clap again. For some reason it went away. But anyway, receive, thanks for stopping by. I said which class of these medications do you recommend? I'm on ozimpic but have some side effects, okay, so receive, I'm going to hold that question for a minute because I'm going to come back and give you my thoughts in just a sec, right?
Speaker 1:And then Jeff says which does metformin fit in all of these meds? So metformin is not one of these medications, right, it is not one of the ones that we talked about in terms of getting off, right, stopping, right, we did that show last week, and it's not one of the ones that we're talking about getting on right now. Right, starting, it is one we have not discussed yet, and I've deliberately not discussed it yet. And well, actually there are a couple of other medications that we've not discussed yet about what we're going to do with them. I suppose I well, you've probably heard me say this in one of my other shows, anyway.
Speaker 1:So so metformin has been one of those medications that's been around forever and of the medications that, when they initially were studying diabetes in terms of complications and improvement and so forth, it was one of the medications that showed the slowing of the progression from pre diabetes to diabetes. It's also a medication that we've used to treat metabolic syndrome, obesity, and on and on and on. So, if I, if I, if I put my hey, my doctor hat on, I'm like this is actually a good medication for us to use, okay, because it does what we want it to do. I want to hasten to say, though, that, as we're talking about remission, we're not just talking about remission getting off of one medication or another medication or we're talking about getting off of all medication. So so, just like I'm saying to you, hey, consider these medications should we get on them and we should get off of those? Metformin is one of those that's in the between. So if people are on metformin right now and that's the only thing they're on, then our goal is to get them off the metformin. But if they're not on metformin and I need to treat their diabetes right now to get them better as we move towards progression, revision sorry, towards remission, then it is a tool that I use. So what I do in my office, what I try to do in my office, is if someone comes in and they are on insulin they're on a secretogoc my goal is to try to minimize those and get them on an SGLT2 and get them on a DPB4. That's what I do Now.
Speaker 1:Before everybody was talking about the weight loss that you get with ozympic and menjaro and all those, we were in the office when people's patients came in. We were putting them on a GLP because I knew if I got them on a GLP I didn't have to use as much insulin. I would put them on an SGLT2 because I knew if I got them on an SGLT2, we wouldn't need as much insulin. Do I think those are good medications? Yes, I think they are. I use them almost every day, I shouldn't say almost every day. I use them every day for my patients, I use them for myself.
Speaker 1:We're going to come back and we're going to talk about that story and another show, but one of the things that I want to show you is, along with blood sugar, as you guys know, you've been watching me and you know that I've been also tracking my weight. This is where we are today. This has been our trend over the last month. Remember, I came on close to the beginning of the month and said, hey, look at this, I have gone below my weight, I've reached my goal. That was, I think, over here somewhere, 199. Right there, that was back on the 15th of January. I want you to notice something 15th, 16th, and so we went to 197. We went down to 197. We got down to 194 right here y'all and then 197, 200, 201, 198, 195, 197, 199, 198.
Speaker 1:Now let me make a statement here. Let me show you the month view. I want you to notice the graph. The graph is not linear. It doesn't just go in one direction. It goes up, it goes down. You need those fluctuations there.
Speaker 1:I want to point out to you because some of you are out there and you're frustrated in your weight journey. I want to point out to you that the daily fluctuations that you see is not where your concern should be. What you want to see is, when you look over the course of time, that the trend is what you want, because if I look on this right here, I'm like man. I was up 200, down 195. Look at me, I'm 198. Even if I look at this, I'm like man. Look at those fluctuations. I'm going up and down, and up and down. When I look over the course of time, y'all I want you to see that, right there, that was 240 pounds. That's March of last year. This is now 240, down to 198. Given that, if I look back further, I want you to see this guy. That was 260 pounds. That was January of 2022. I don't have recorded on this device, but at one point that number was up at 285 pounds. That must have been I don't know 2000, 10 to 15-ish.
Speaker 1:As we are on this journey it is a journey there are going to be stops and starts. Our goal is not necessarily that tomorrow we get where we're going, because we're not going to get where we're going. Let me say that to you. You're not getting where you're going tomorrow. It is a journey, but we want that journey to continue, heading us or taking us in the right direction. One of the things I love about this space and you've heard me say it before, I'll say it again I come on this show and I talk with you and I teach the things I do because you're part of my therapy group. I know, I know I'm part of who helps me to be who I need to be. As I talk about new year, new you, everybody thinks that they're by themselves. Everybody thinks, oh, it's just me. I'm telling you some of the things that I talk to you about. I struggle with all the time, but I want to be able to say that I'm moving forward in my journey and this year, y'all together in this group, yeah, yeah, we're heading. We're heading in the direction.
Speaker 1:Let me see, jeff said, for your thought of the day, my Freestyle Libre 3 provides so much information for me. Let's see, for your thought of the day, my Freestyle Libre 3. Where do you, jeff? I think I missed the first part of that. Oh, you want me to use that as a thought of the day? Okay, I like that. Thank you, awesome, awesome, all right.
Speaker 1:So, if you've not already done so, everybody, if you've not already done so and you're here, so maybe you have already done so, but if not, I would like to ask you for three things. Okay, I'd like to ask you for three things. What we've been doing is we've been talking about the fasting, talking about, okay, what do we do with the fasting? And if you're out there, whether you're diabetic or not, my challenge to you is to work your way up so that you can fast for 24 hours. So that's what we planned to do in January. That was the plan. Work our way up so we can fast for a 24-hour period. In the month of February, we're going to do another challenge, dealing with that 24 hours. Okay, so for right now, right, fasting 24 hours. Work your way up wherever you are.
Speaker 1:I want you to expand that so that you can be able to do that. And meaning that you're also talking to your healthcare provider. If you're on medication that you are having healthcare provider, help you adjust that. If you're one of my patients, one of my clients, one of the people who talks to me, that's what we do, right? So how do we back off of some of these medications? We've talked now about medications you should stop try to get off of. We've talked now about medications. You should probably talk about starting and you've heard the benefits of those. The fasting helps in that entire process.
Speaker 1:So, first of all, what I'm asking you to do is work your way up so you can fast for a 24-hour period. Number two I want you to commit to being on this journey with us. Being on this journey with me. That means showing up as we learn this stuff together. That you are here, that you share your information, that you share the successes that you've had, you share some of these disappointments that you've had. That you ask the questions Because, as you do that, the other people that are here listening, the people who are even going to be watching this on the replay they benefit because now they know it's not just them.
Speaker 1:Now they know somebody else out there is having the same issue.
Speaker 1:Somebody else out there is seeing the same thing.
Speaker 1:Somebody else out there is having success because maybe they're not seeing success.
Speaker 1:To show up in the community, engage in the community. And then the third thing that I'm asking you to do is to bring somebody with you. You can bring somebody with you on the show, send them a link, let them know what's going on, help them sign up, help them subscribe, tell your doctor, tell your pastor, tell your cousin, tell your mom and them about what we're doing here, because the 460 million people around the world that have diabetes, the millions of people that are struggling with prediabetes and obesity and metabolic syndrome and high blood pressure and high cholesterol and polycystic over in syndrome, and on and on and on, they all benefit from this information. So you can be the person who helps to spread that, to help improve their lives. Good night, we'll see you at the next show.
Speaker 1:This is Dr Dwayne Wood, that's Wood with an E. The E stands for endocrinology. Here on the channel, I educate, I empower and I encourage you to take charge of your health, take charge of your life, avoid complications and go to the next level, creating the life you always wanted. And for this year, y'all, new Year, new Year.
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