#47 - Rapid Fire Friday: Fasted workouts, food pairings, and medication exit strategies

It’s the final Friday of March, which means it’s time for another lightening round of Rapid-Fire Friday, answering YOUR questions about diabetes remission! As a bonus this week, Brian insults Cory’s age by implying his bladder strength is not what it once was. Cory quickly gets things back on the rails, and the two of them tackle these three listener questions:

-Does food pairing to control blood sugar spikes work in the long run to put diabetes remission if there is no net decrease in energy intake? Aka: Can I keep eating donuts as long as I eat it AFTER some protein to reduce my blood sugar spikes?

-Are fasted workouts a good idea for people with Type 2 diabetes?

-Why have I never heard of a medication exit strategy?

Got a question for Rapid Fire Friday? Sent it to brianandcory@diabetesremissionpartners.com

Mentioned in the episode: Refer the podcast to three people and get a free gift from us! Just have the new listener send us a DM or a email!

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Brian & Cory
 Diabetes Remission Partners

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Transcript

Why Remission Is Possible

SPEAKER_01 0:02

If you have type 2 diabetes and you're tired of being told it's chronic and something you'll just have to manage forever, if your ANC is control but your medication list keeps growing or stays the same, and you know deep down you're capable of more than this, you're in the right place. This is the Diabetes Remission Roadmap Podcast, where Brian Bitcher and Corey Jenks, two pharmacists who spent over two decades inside healthcare. And we started this show because we got tired of watching capable people stuck getting managed instead of rebuilt. Here's what most people aren't told. Type 2 diabetes isn't just a blood sugar problem, it's a muscle and energy storage problem. When your body loses strength and metabolic flexibility, blood sugar rises. And you can rebuild that. On this show, we break the scripts and say more meds are inevitable, you're destined to just manage, remission is impossible, and instead we teach you how to build muscle, eat in a way that keeps you full, and regain control of your health again. No extremes, no shame, just practical strategy to help you move toward remission and lead your health again. Let's get to work. I'm ready to roll, man.

SPEAKER_00 1:22

I just went my pants a little bit because you aggressively came at me on the video here on Zoom and I got scared and wet my pants just a little bit. But we're gonna go through it. We don't make sure it's not early. No time of change underwear. Here we go. All right.

SPEAKER_01 1:35

Are you sure though, Juan? Are you sure it's not because you're almost 40 and you're losing control of your just kidding?

Fasted Workouts And Fuel Switching

SPEAKER_00 1:41

Go for it. Thank you for that insult of my age. Yeah. As we record this, my wife is a matter of five days away from turning 40. And I uh my birthday is in December, as we record this in March of 2026. So I still have still have some time with the three at the beginning. And Ryan is a young young guy, he's three years younger than me. So uh yes, he's just delaying, folks. He was he was delaying, but he actually did 13 more push-ups while I was explaining my poor old man bladder. So here we go. First question for you, Brian. What are your thoughts on fasted workouts? I'm interested in trying fasting, but I also like morning workouts. I sometimes work out fasted, but sometimes I'll eat a banana before I work out. Are there any negative quant consequences to blood sugar or recovery with a fasted workout?

SPEAKER_01 2:30

Wow, I love this layered question. I think we gotta just slice it up. So I'll start off by saying that I started doing fasted workouts years ago when I got into intermittent fasting, and they slowly became some of my best workouts because in a fasted state you get a gradual increase in adrenaline hormones like norepinephrine, epinephrine, so you get just like a better pump. Your body's not focusing on digestion, so you can you don't have this diversion of blood flow to your intestines, and now you can get like just more blood flow to your your muscles. Um all that to be said, you have to be able to access your energy efficiently to perform well. So I think they're a great way to really start to train your body to be more metabolically flexible, so it's gonna take time. So if you have type 2 diabetes, not very metabolically flexible, which is why then you rely on, you might rely more on like short short forms of energy consuming it before just to get through the workout. However, if you tell yourself I can train my body to be more flexible by not eating something and to tap more into my muscle stores of glucose, aka glycogen, and then therefore later on, like start to empty those stores of glucose and glycogen in your muscle, and then start to access more body fat. And so you become more metabolically flexible. Long term, long story short, you become better able to go periods of time without food. Now, that being said, certain medications you have to be careful about, like sulfine.

SPEAKER_00 4:12

Before we get into medicines, you say metabolically flexible and switching. So I want to just uh double-click on that for a moment because when Brian says metabolically flexible, it means that we are able to access all the forms of energy in our bodies. So there's glucose and there's fat. And I like to think of our bodies as a hybrid car. Uh, you can run on gasoline, you can run on electric. And if you are not metabolically flexible, it's like you can only run on one source of energy. Uh, but when you train your body and over time you are able to access both your glucose for short-term energy, but also fat stores, uh, it's like being a hybrid car, and you can access both both of them switching off more easily versus if you are off oftentimes with type 2 diabetes, you're kind of stuck in a sugar burning state where you burn sugar, you get hungry, you eat more sugar, you burn sugar. Uh, the goal is to get you to a place as you extend those intervals between eating. And we're not, this is not a fasting podcast. We're not telling you to go fast. This was a question about fasting and and what that might look like for a workout. But as you train your body to go longer intervals without eating, which is actually kind of how we're meant to be, uh, the the world where we eat so regularly and there's no breaks is abnormal. So being able to be flexible there is gonna let you access fat stores. And over the long run, as you build the muscle, work on satiety-based eating, and access those fat stores to burn energy, you're gonna burn the fat, lose weight, improve blood sugar, and also be able to go longer intervals without eating. So, Brian, we're pharmacists, though. You were getting back into medicines there. Please tell us about the safety issue here. Unless I've triggered something for you to talk about.

SPEAKER_01 5:42

Oh, they've triggered something else for me to talk about, but all right. I I think the question comes down to do I need to or is it a good thing? And the answer is no, you don't need to, because likely you have plenty of you you definitely, if you have type 2 diabetes, you have sufficient energy in your body to use for these workouts. Now, in the case of like high-intensity athletes or doing some sprints, like that kind of stuff, it is it is necessary in those cases, like they will benefit from some fast acting carbs to use quickly. But like when we're doing like strengthening, steady strengthening workouts, you do not your but your body will be able to do it without that banana before the workout. Yeah.

SPEAKER_00 6:23

Um and personally, I I also prefer to work out fasted. I actually, if I had food in my stomach, I feel garbage in any sort of activity I do. I actually ran a half marathon fasted. So maybe me too. And it did not go well. It went great, it went great for me. I went so fast my wife was not there at the finish line because she did not think I would finish that early. So actually, you could argue that it did not go well for me because I did not have anyone to greet me at the finish line.

SPEAKER_01 6:47

Well, but so let's go back to the medicine then, because if you are doing your workout after eating breakfast, well, if you're doing your workout and you already took medicine, and that medicine includes something that is gonna drop your blood sugar acutely.

SPEAKER_00 7:04

Something that affects a medicine that affects your insulin.

SPEAKER_01 7:07

So it affects your insulin level, yeah.

When Fasted Training Is Risky

SPEAKER_00 7:08

If you are literally taking a faster acting insulin or a medicine like a cephaniarrhea, so clipazide, glymeparite being two of the biggest examples. The glimpse the cefaniarrheas act by telling your pancreas to shoot out more insulin to lower sugar. So if you take one of those medicines and then exercise, which is going to pull sugar from your blood, uh, there's a chance that you could go low. Same deal for that fast-acting insulin. Now, we are not giving medical advice, and it really it all depends what your sugars are before you start all this. But if we're talking about a fasted workout, which was the question, if you take uh a medicine that will is either insulin or induces insulin, like zephonniarrhea, and you don't eat and then you work out, you're setting yourself up for low sugar. Quick pause for a second. If you're finding the podcast helpful and you want more practical ideas to help move your blood sugar in the right direction, come follow us on Instagram at Diabetes Remission Partners. We share quick tips, food and exercise insights, and blood sugar mistakes people don't even realize they're making. It's also where we can answer your questions directly in the DMs. So if you want more help between episodes, Instagram at Diabetes Remission Partners is the best place to find us. And when you follow us, make sure to say hi.

SPEAKER_01 8:29

All right, back to the show. Yeah. And then if you want to try working out without eating something beforehand, like I say, go ahead. Just understand that it might be a little bit harder because you're not giving your body that immediate source of energy right into your bloodstream to you. So you're gonna allow your muscles to train. Just ask your doctor, provider, about any medicine you're on and how it might impact and when you should skip said dose or delay the dose until it can be more safely taken.

SPEAKER_00 8:59

You could also ask your local pharmacist who's who's in your local pharmacist care. Yeah, yeah. Really wait, great job of helping our profession, Brian. Uh they're too busy filming prescriptions. Oh, yeah, and primary care providers are just not busy at all. So um, all right. Yeah, so I think to summarize, if you'd like to try a faster workout, number one rule is always safety with us. If there's a medicine that can cause an issue, then you need to work with your provider andor pharmacist with that. But I think the the thing to be aware of is if you're used to eating before working out, you it might not be as good of a workout. But a faster workout is something that many people do. And uh if you end up feeling good doing it, great. But your your body will tell you how it goes. There was something about negative carbs we were gonna talk about. Can you even talk about that for a second? Well, I think that the idea of of working out and exercise is that we we are reducing the glucose in the blood. Um, and so if we are eating glucose right before that workout, we're not actually, you know, you're you're you're raising it before you work out. So you're not actually lowering it and forcing the body to pull maybe as much from those glycogen stores. But if you are not giving glucose to your body before you work out and and exercising, uh, it's like having negative carbs. Like you're you're you're pulling glucose out of the glycogen stores uh in your muscles and or liver?

SPEAKER_01 10:20

Yeah. Yeah. Thanks for clearing that up.

Food Pairing And Donuts Reality Check

SPEAKER_00 10:24

Cool. You ready for the next one, Brian? Yeah. This one's a 2C. Um so this question is Does food pairing to control blood sugar spikes work in the long run to put diabetes in remission if there's no decrease in calories? Uh otherwise put, can I keep eating donuts so long as it is after some protein and my blood sugar doesn't spike as high? And I think that's an extreme example, donuts, but yeah, I love donuts though. Yeah. Food pairing. Yeah, food pairing, blood sugar, and reversal, well, remission.

SPEAKER_01 10:56

Oh, this is a great question because I see videos frequently about like, how is this food going to impact my blood sugar? Let's see if we take this supplement to to impact the blood sugar spike, or let's let me show you, let me tell you the difference. I eat the exact same thing, but I just changed the order, but the blood sugar spike was different. And my question back to them is what is type 2 diabetes? It isn't energy toxicity problem, right, Corey. I'm not going to go into that. We we could talk about the model you created of calories in, calories out. Like, yes, that model doesn't work, it's broken because of all the other factors that plan.

SPEAKER_00 11:34

You're really coming off base here. Stay off, stay on target.

SPEAKER_01 11:36

Okay, stay on target. So energy toxicity, if you are not changing the total intake, food pairings don't change the total intake of calories of that meal. Now, actually, it might impact because what do blood sugar spikes do?

SPEAKER_00 11:50

Okay, so let's go back to food pairings, Brian. Let's let's let's lock it back. You look like you're struggling. I'm gonna throw you a little lifeline out there in the ocean, right? So, food pairings, what we're talking about is that when you have a we I call it naked carbs. So carbs that all on its own, without having any protein or fat, your blood sugar will spike more than if you have previously consumed some protein, fat, and fibrous vegetables, because it will blunt the sugar spike by delaying gastric emptying, the fiber in those vegetables will help reduce the amount that your sugar spikes. That's good, Brian, right? We're reducing the sugar spike, instant diabetes remission, right? No. Not so fast, my friend, as Lee Corsa would say. Okay. Because we are in with type 2 diabetes, we are in an energy toxicity. So if your plan is to eat one donut, but you have a piece of chicken chicken breast before that donut, and you eat all of the donut and all the chicken breast, you will not see as big of a blood sugar spike. However, the total energy you are consuming is unchanged. Is that correct, Brian? That's correct, Corey. Okay. So in that case, long like short term, you're not seeing the spike, but long term, your body's still getting that excess energy from that donut. However, does food pairing help with a sugar spike and remission if we listen to our satiety signals in our body? Because oftentimes with a correct food pairing, starting with the higher satiety foods, protein, fiber, will make us fuller. So we will not only blunt any carbohydrate-induced sugar spike after eating those foods, but we will eat less of those carb, carb, carb heavy, energy-dense foods because we are not as heavy, thus reducing the energy intake, thus improving your chances at remission. Did I get there? Yes. Yes.

SPEAKER_01 13:35

You got there. So it's a yes, no, yes. Yes, no, but yes. Yeah. Um something like that.

SPEAKER_00 13:41

Yeah. So I think here's here's what we're Thanks for helping me out. I know. You you have I know. I'm here for you, buddy. So the the we I we will always encourage you to pair foods smartly to avoid a spike in your glucose. And that means starting with the nutrient-dense, satiety, heavy, protein, fibrous foods, followed by your carbs. You will likely see if you're using a CGM or sticking checking finger sticks, a lower blood sugar spike. That being said, the goal by front loading with these nutrient-dense foods is to reduce our intake of those energy dense foods. Carbs, added fats, carbs and fats together. You know what I'm talking about, ice cream cookies, the kind of foods that, man, I'm kind of full, but I'll still eat that anyway. If we can reduce that total energy intake, not only will we be reducing the sugar spike with the pairing, but we will be long-term strategically improving our body's chances at remission by lowering total energy intake, by improving our satiety up front. Yes. I think we answered that question. I'm afraid we did. I don't want to talk any more about it before we we talk ourselves out of answering this question.

SPEAKER_01 14:52

Then move on.

SPEAKER_00 14:53

I'll say one thing.

SPEAKER_01 14:54

Let me say one thing because you stole this question from me, but thank you for doing that because I was apparently struggling. Uh, is in also because the the blood sugar spike can can impact your hunger. Not only would like the say in the opposite way, like eating filling food satire before make you eat less, but having a spike before can just like the crash can make you more hungry again and want to eat more food again later. So I think if anything, it's the opposite, like it can make you eat more food.

The Medication Exit Strategy Idea

SPEAKER_00 15:26

Yeah, you you actually bolstered the point there, Brian. I was a little worried that you would ruin it, but you actually did a good job. Because as you say, if you have a spike in glucose, your body responds by sending out more insulin to lower that blood sugar. What can happen sometimes is that if you your body will overcorrect, send out extra insulin, and it actually drop like you have a sugar drop, which makes you hungry, which makes you eat more. So um and yeah, great. We're moving on. No more, no more words on that before we before we talk ourselves out of it. So, last question today. A little less clinical for us. So, why have I never heard of the idea of a medication exit strategy?

SPEAKER_01 16:10

Because we coined it?

SPEAKER_00 16:11

I don't know.

SPEAKER_01 16:13

Copyright pending. Yeah. Because yeah, I think I kind of thought of this when making our masterclass, uh, a little soft plug for the masterclass, which you can get in the show notes, but it is in there if you want to see the visual. But I I don't know because it the term doesn't exist before we started saying it, maybe. Uh the idea exists.

SPEAKER_00 16:36

Like I think focus on the idea, Brian, not our our specific branding of medication exit strategy. Like the idea of why have I never heard of the idea of a medication exit strategy? Is is is basically how come my doctors never talk about stopping or reducing my diabetes medicines? Yeah, I think reframe the question like that so you get less caught up on our wording.

SPEAKER_01 16:57

What is a medication exit strategy? It is exactly what it sounds like. It's a strategy to like so medications are a bridge. You're you have type 2 diabetes and your blood sugar is high. Medications are okay. Like they need to come into play at some point to reduce the long-term the damage that can be done from high blood sugar. And so we but they they should be used as a bridge, as a tool, not as a long-term strategy for managing blood sugar, because you can get your A1C under control, it can look good by the numbers, but you're still dependent on medications. So I think the reason that it's not brought up more is because doctors don't have the really the time or the energy, nor potentially even the experience to talk people through strategically behavior change that is actually going to lead to remission, which is correcting the underlying issues of metabolic dysfunction that require medications in the first place. So I think before anyone starts diabetes medication, the standard of care should be hey, we're putting you on this medication, but let's look at some of the factors that are involved and why you need this. And then let's start to like, let's come up with a game plan to start gradually chipping it away at reducing your total energy intake, building muscle, steady strengthening your muscle, moving more, getting better sleep. And so, like, and as those things improve, aka like what we do with our clients, we instead but we're not the doctor, we can't directly take them off their medication, but we help them collaborate collaborative, collaborate. I can't, I was gonna say collaboratively, yeah, it's not a word. I can't say it. Uh maybe it is a word, I just can't say. Uh, we help them collaborate with their doctor to get them off.

Referral Challenge And Closing Rally

SPEAKER_00 18:41

Does that help answer the question? It does. I think for me, I think you've never heard of it because it's so rare. I mean, standard of care, like 1% of people are able to reverse their type 2 diabetes. So why would a doctor provider spend time on an outcome that's so rare? They just they're they're so stretched. It's so rare. And as Brian said, they don't have the resources and time and honestly know-how to help with the behavior side of things. Like we we started this, uh, we kind of alluded to this idea or you know, the idea of energy toxicity. Well, energy toxicity is calories in, calories out, but what leads to calories and calories out is so much more than the doctor yelling at you that you're you need to exercise more and stop shoving food in your face. There's there's there's hormonal effects, there's behavioral, there's environmental things that we don't take into account in the guidelines and standard of care and that basically set set people up to fail. Uh, and that's why Brian and I are here, it's to help you win because we've seen all the failures, we've learned from it, and we know exactly what doesn't work, and we basically do the opposite and and get people there. So you've never heard of it because it's rare and the doctors don't see it enough to really believe in it. And if they don't believe in it themselves, they're not gonna believe in you. And let me tell you something, Brian, we believe we believe in our listeners, don't we? Oh, we absolutely do believe in our listeners. Right. So yeah, yeah. We believe in our listeners because we've seen them do great things. Yeah, we we've gotten many messages and emails from people who've just listened to us, listened to our advice, and have just dramatically improved their blood sugars, A1Cs, come off medicines, avoided medicines. Uh, we see it with our community of clients, uh coaching clients that are coming off medicines, losing weight, feeling more energetic, sleeping better, heartburn improving, mood improving. All of these things happen uh at the root. Type 2 diabetes is like the tip of the iceberg of a number of metabolic issues that affect our whole body. And so we think it's a tragedy, it's a tragedy and it's a it's an affront to the human beings that are in the standard of care that are stuck there not getting better. So that's why we're here doing this mission, which is why, Brian, we are offering a challenge to people. Um as we recorded this episode, Brian, uh, I just checked we have hit 5,000 downloads in the life of the podcast. So reason to celebrate. But we are not stopping there. Um, so what we want to do is offer a little incentive. So if you, amazing listener, refer the diabetes remission roadmap podcast to three people, we're gonna send you a little gift. So, how are we gonna track this? Well, we are we are pharmacists, we are not uh marketing experts, as you can probably tell. But if the if what we what we need to get is either a direct message or an email, all that information is in the show notes from the new listener who said they just sent us a note that says, so-and-so sent me, send us the uh they can pass along your information, we'll reach out to you. We get three referrals from you, listener, and we'll send you a fun little prize, a fun little gift, a fun little thank you for for sharing this. And if you don't want to play the game but still want to share it, that would be amazing. Um, we are we are seeing the numbers go up every week. We are seeing the impact in our inbox. And uh boy, it just lights a fire under us, doesn't it? Absolutely. So uh send us your referrals, send us your questions. Uh we'll get we'll hit you back with another few questions on our next month on our Rapid Fire Friday. Otherwise, share with a friend. rate, review, and uh go out and kick some butt. Brian, any last words?

SPEAKER_01 22:05

No. I like that. I like that any thank you for thinking of this fun challenge. Yeah. Two really good people to to spread the spread the good news.

SPEAKER_00 22:13

Listen, remission is fun. Getting off meds is fun. Winning is fun. And telling your doctor that you don't need them anymore is fun. So let's go all have some fun together. Thanks for another episode of the Diabetes Remission Rob podcast. We'll catch you next time.

Medical Disclaimer

SPEAKER_01 22:29

If this episode gave you clarity or hope, share it with one friend who's been stuck in the diabetes trap. That's how this mission grows one person, one family, one story at a time. And if you haven't yet, leaving a quick review helps more people find the show and realize they're not stuck with meds forever. It takes less than a minute and it means the world to us. Thanks for being here and thanks for being part of this movement toward freedom. Thanks for listening to the Diabetes Remission Roadmap. The ideas discussed here are for general informational purposes only and do not constitute medical or nutritional advice. We are pharmacists but we're not your personal healthcare providers. Always consult your own physician or qualified clinician before changing medications, exercise routines or nutrition plans. Results vary and what works for one person may not work for another