#56 - Reading The Hidden Scoreboard Of Type 2 Diabetes (When Blood Sugar Numbers Lie)

**We're hosting a free, live webinar on Wednesday May 20th at 7PM ET called the Diabetes Remission Roadmap. 

This is for people with type 2 diabetes who want to know how to actually lower their blood sugar naturally and start building a real plan to reduce or get off their medications safely: without starving themselves, without cutting carbs down to zero, and without spending their entire life in a gym.

It's free. It's live. And it's an hour that could genuinely change how you see your situation.

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Your blood sugar numbers can look “fine” while the real problem of insulin resistance gets worse.  In this episode, we challenge the idea that a “good” A1C means you are safe, and  explain how type 2 diabetes can build for years before blood sugar finally spikes. Having some fun at the expense of Brian’s favorite baseball team, we show how to read the under the hood signs of insulin resistance and take practical steps toward remission without extreme diets.

Listen to learn:

• How A1C works and why it can miss early metabolic trouble

• The long compensation phase: hyperinsulinemia, insulin resistance, and storage capacity running out

• Under the hood lab markers that show you may be in for a blood sugar shock

• Non-lab clues your disease is getting worse

• Why numbers can jump fast after years of quiet strain

• How to measure progress beyond the scale 

If you have ever been surprised by an unexpected jump in your blood sugar, or want to avoid one, this episode will explain why, and what to do about it. 

Ready to take control of your health and stop settling for “managed” diabetes?
  Grab your earbuds and listen in.

Brian & Cory
 Diabetes Remission Partners

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👉 https://medfreehealthya1c.com/

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Daily education, encouragement, and straight talk about meds, muscle, and metabolic health:
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Transcript

Free Live Workshop Invite

SPEAKER_00 0:00

Hey, real quick before we get going, I want to make sure you know about something we have coming up. On May 20th at 7 p.m. Eastern, that's a Wednesday, we're hosting a free live workshop called the Diabetes Remission Roadmap. And I want to tell you exactly what it is because the title says a lot. This is for people with type 2 diabetes who want to know how to actually lower their blood sugar naturally and start building a real plan to reduce or get off their medication safely without starving themselves, without cutting carbs down to zero, and without spending their entire life in a gym. And honestly, even if your doctor has told you that you're controlled, that phrase always gets me, this is still for you. Because controlled on medication is not the same as healthy. It's not the same as free. We're going to cover what's actually driving your blood sugar, what a real medication exit plan looks like, and how to start moving in that direction without overhauling your entire life overnight. It's free, it's live, and it's an hour that could genuinely change how you see your situation. The link to register is in the show notes. We'd love to have you there. Now let's get into the episode.

The Show’s Core Message

SPEAKER_01 1:11

If you have tattoo diabetes and you're tired of being told it's chronic and something you'll just have to manage forever, if your ANC is controlled but your medication list keeps growing or stays the same, and you know deep down you're capable of more than that, you're in the right place. This is the Diabetes Remission Roadmap Podcast where Brian Butcher 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 isn't possible, 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 strategies to help you move toward remission and lead your health again. Let's get to work.

Baseball Numbers And False Confidence

SPEAKER_00 2:08

Welcome to another edition of the Diabetes Remission Roadmap Podcast. And Brian, I got a question for you. Are your numbers lying to you when it comes to your blood sugar? Like they were lying to you about the Cincinnati Reds.

SPEAKER_01 2:21

Yeah, I'm not wearing a Reds hat. It's okay.

SPEAKER_00 2:24

So welcome back, folks. Uh, for those of you who are watching on our YouTube channel, I'm wearing a Chicago Cubs hat because as we record this, the Cubs have just swept the Cincinnati Reds, who just happen to be Brian's favorite team. And as we all know, putting our happiness into a thing that have we have zero control over is such a good idea. Just kidding. However, my kids have been very happy with the way the Cubs have beaten the Reds around. And there's actually a lesson underneath the hood here about numbers. Uh, because, and I'm gonna make this work, Brian. You hang in there. Because going into the series on Monday, the Cincinnati Reds were in first place in the National League Central Division. And Brian was like, the National League, the first place Reds, this is great. And I like to look at some other different numbers. Like there's a record, and that's the outcome. Um, and underneath the hood, though, the Reds' run differential was negative, which means the teams are scoring more runs than the Reds were. And they had this thing called the Pythagorean record expected record based on how they're playing, what their players are doing. And it was much below what their actual record was, which tells me that they were getting lucky in some games, which you'd rather have a win. But although the record was good, the underlying metrics said that this was not going in a good direction. And after four days of getting slapped around by the Chicago Cubs, who are now in first place, whose underlying metrics said that they were gonna be better than what they were doing. I it made me realize something about the numbers we use to follow

Why A1C Is Not Enough

SPEAKER_00 3:42

diabetes. Brian, uh, wipe away your tears. Uh, we we'd all love to have you have a chance to do that.

SPEAKER_01 3:46

I'm not crying. I've detached from outcomes from sports and society a long time ago.

SPEAKER_00 3:50

Right. Okay. Yeah, right. So what we're gonna talk about here is how sometimes, even though the the outside air quote record looks good, the underlying system is struggling. Because honestly, we see this all the time in diabetes and metabolic health. So one metric that I think sort of providers hang their head on, clients, patients, whatever you want to say it, hang their head on, is the hemoglobin A1C, which is a three-month rolling blood sugar average based on the amount of sugar that has stuck to your red blood cells. Brian, you made a face.

SPEAKER_01 4:18

No, I was just gonna say, let me take a guess.

SPEAKER_00 4:20

You already named it. I already said it. We don't have time to guess, Brian. We got to get right to this. So we're not, but here's the thing we're we're not anti-A1C, and it can be valuable and it matters, but it's one metric and not the entire scoreboard. Because I can't tell you the number of times in my pharmacy career where someone would come to me and their A1C would not be in the diabetes range. Maybe they're creeping up to pre-diabetes and they were a little cocky. They said, Hey, Corey, I I hear you, you have some stuff for me to do, but I my numbers are good. What do I have to worry about? And Brian, what do you say to that? Because these people three months later would come in with an A1C of like 13, looking shocked, dismayed, and confused about what happened to their air quote good blood sugar. Their blood sugar went the way of the Cincinnati Reds.

SPEAKER_01 5:05

I was gonna say, it sounds like what the Reds probably feel right now is they probably feel shocked and confused and uh yeah, like a dumpster fire is what they feel like. So yeah.

SPEAKER_00 5:14

So, because here's the deal the A1C does measure what your actual blood sugar is, but before you see high blood sugar numbers, years before that, you are developing, if you're on the road to diabetes, developing insulin resistance, right? We're at a place where there's a toxic amount of energy coming into the body. So the pancreas is having to secrete more and more insulin to keep your blood sugar at a at a normal level. Uh, maybe as you get older, or if you're at a job or you're sedentary, you're losing muscle mass. So that capacity for your body to hold on to sugar is and store it appropriately as glycogen is diminishing. And so your body is essentially ramping up and working overtime, getting into this place of hyperinsulinemia, where eventually you're getting to a place of insulin resistance, and you might be developing like liver fat before you see it. And there's a number of metrics we're going to go through that maybe looking under the hood tell you that the A1C isn't giving you the full kind of picture of danger you're in.

SPEAKER_01 6:09

Yeah, I'd love to hear it because you got my attention. And yeah, this sounds like a lot like the analogy we use where you're looking at storage tanks. So the storage tanks are essentially filling up at this time, but they're not overflowing yet. But you can start to see the precursors to what's going to happen, right?

SPEAKER_00 6:26

Yeah, the storage tank analogy doesn't work perfectly with what we're talking about, but it's like it's like a machine is working overtime to keep the keep to keep them to keep them filled up. And so what do you need

Under The Hood Warning Signs

SPEAKER_00 6:36

to be looking at? So the one of the the sort of tricks that I would use looking at uh possible signs of going down the road of diabetes is your is uh some of your cholesterol markers. So what I look at are high triglycerides and low HDL. Now the triglycerides aren't always high in certain populations like African Americans. We might not see as much of a bump of triglycerides. But if you get your cholesterol panel back and your your doctor says your LDL is great, but your triglycerides are high and your HDL is low, that's a couple of signs that you're on the path to metabolic problems.

SPEAKER_01 7:07

Okay. Good to know. Okay. I'm just gonna let you go because you're running the show.

SPEAKER_00 7:14

All right. So another so another lab that is not often ordered but is useful is fasting insulin. So you if you have a high fasting insulin, that is a sign that your body is sending out lots and lots of insulin to keep the same blood sugar numbers. So you're getting close to a sort of cliff where you're gonna fall off. Yeah. All right. The other other like non-lab markers we want to look at are increasing waste size. So uh if you're if your waste size is increasing, this is a sign that your body's run out of places to store fat in a safe place, and it is putting it around your liver and your other visceral organs like your pancreas. So if anyone's ever heard of like fatty liver disease or the the nomenclature is changing all the time on what we officially call it, but we're gonna call it fat around your liver, which is your body does not want that. But if it's the last, it's the last place that it wants to store it because it is a dangerous place to have body fat. So if your waste is expanding, but your sugars are good, this is a sign that this is sort of a a yellow to red flag. Um, and then there's a couple of other sort of non-measurement things: fatigue, poor sleep, energy crashes, especially after you eat. This is a sign that your body is just like in overdrive mode for sending out insulin to lower sugar, and it's often overcompensating and making you hypoglycemic. So having sort of the symptoms of blood sugar swings, which can mean bad energy, it can mean feeling sort of hypoglycemic and shaky after eating. Um, and then uh this is um kind of one of the other things. If you're really dependent on caffeine and sugar uh for energy, uh it just means that your body is not appropriately using energy, and you need to be on the lookout for uh the eventual uh Cincinnati red sweep of blood sugar where you're where you're where you see an A1C jump and blood sugar drop. So that really what's what's happening here is that some people are quote winning ugly metabolically. Like they're winning the one-run games, they're coming from behind, they're finding ways to win games, which the standings matter, your blood sugar matters, it's just not sustainable. Like a team with no bullpen or offense, uh, and if you don't like baseball, you know, maybe you're learning a couple of things here. But if you have underlying issues within that team, eventually you're you're gonna it's gonna catch up to you, and your body will will eventually run out of the ability to compensate.

SPEAKER_01 9:27

Yeah, I'll say a team with no uh ability to hit with any runners in scoring position.

How A1C Jumps Overnight

SPEAKER_01 9:32

Uh Corey, so you mentioned people might be like at this either pre-diabetes, maybe like right and below that. So, how does it go from just like that lower A1C to all of a sudden now they're over 10?

SPEAKER_00 9:46

You essentially I I think what I mean, this is this is a speculative mechanistic way of looking at it, but essentially I feel like you I think your body just runs out of place to store that extra energy despite the extra insulin coming out. Like to use your your storage tank analogy, it does work. It does work, it comes back to it. It does work. Like it's you can you can push it's or or like over overstuffing a suitcase. You can stuff clothes into a suitcase until there's literally zero room for clothes in that suitcase, and then it's falling out of the suitcase. And so you can mask the problems, but if you don't fix the underlying issue, eventually things are overspilling, whether it's your sugar into your blood or the clothes out of clothes out of a suitcase.

SPEAKER_01 10:28

So is it time to discuss how do we fix this underlying issue? Or is there more to really well?

SPEAKER_00 10:33

I just want to to like really emphasize. I mean, this could this could be years. Like your body can literally compensate for years. It's super adaptive. Uh your pancreas can pump out a ton of insulin. You can have your hormones compensating, your stress hormones, you can try to mass your fatigue with caffeine. Uh, if you're snacking all the time to prevent your sugar crashes, like you're kind of putting band-aids on this gaping wound. But even though your blood sugar is looking normal, the body compensates basically until it can. Like your disease underlies, like it whispers before it screams. And so essentially, like you go to the doctor and the doctor has stipends with you, and they look at the general labs, usually that fasting insulin isn't part of it. They'll say, Oh, your A1C is good, you're you're functioning in your life, your your LDL is good, and your triglycerides are a little high and your HDL is a little low. Maybe get out and move a little bit more. But if if you're seeing high ratios of triglycerides to HTL, that that could be a sign that there's underlying issues. And you're exhausted, you're inflamed, you're maybe not moving as much as you want to. And underneath it all, you're probably under muscled and you're overfed but undernourished. You're getting all this energy coming in, but not the nutrition that your body needs. The protein, the fiber, the vitamins, the minerals, all even say healthy fats here, fiber, all the things your body needs to function well, you're getting calories, you're getting energy, you're getting carbs and fats and snacks and drinks and sugary stuff. But your body's not getting the nourishment it needs. And so it just gives out.

SPEAKER_01 11:56

So, yeah, that just all of a sudden gives out and you see these higher numbers. And then your your doctor, your primary team is like, oh no, we need to treat this. This is type 2 diabetes. Came out of nowhere.

SPEAKER_00 12:05

What happened? When this could have been a 10-year issue under the hood, uh, that you could have turned it around earlier. And it and the earlier that we can do this, the the more effective we can be at at interbeating. It's not to say that if you've had issues for 10 years, you can't do anything, of course not. But if you're driving a car, you don't wait till your engine's on fire to check under the hood. Like you got to be doing this, you gotta be doing this maintenance regularly. So we got to check trends or catch our trends early, see what our energy is like, see what our muscles, you know, our strength is like, how's our sleep? And and we got to improve our metabolic flexibility before diabetes progresses. So, Brian, let let us talk about how we fix this.

SPEAKER_01 12:41

Well, it sounds like we've discussed this many times, but we can re definitely reiterate it or rehash it for people who are maybe this is our first episode they've heard.

Build Muscle And Crowd Out Calories

SPEAKER_01 12:50

Steady strengthening, right? Let's get to that. Number one. The second one is nourishing your needs. So it's getting more uh protein and fiber so we can crowd out all the extra energy that is coming in. And yeah, this the strengthening will help get to the root of insulin resistance because it starts in your muscle.

SPEAKER_00 13:07

Right. So when you say steady strengthening, you'll go to your doctor, you'll see some pre-diabetes numbers, maybe you're at that, oh my gosh, we're hair's on fire, problem issue. And they'll say, you need to exercise more. And what do I do? You know, start moving, maybe you know, walk more, which we're never against walking. But when we talk about our body's capacity to handle energy, uh building muscle, and and Brian, we've we've talked about this in our live webinars. I recently was at a health fair here in Tucson, Arizona, talking to talking to people about what we do. And the one of the biggest surprises I hear is I've never heard someone talk about muscle before. Like, I can't tell you the number of people who came to me, kind of in that to like I'm in middle age now too, but middle age, like I don't know what happened. Like everyone in my like friend group, we all have the same labs. We all go to Zuma together, we're religiously like moving our bodies. And I said, that is great. But what's probably happening is you're under muscled. Like you're moving your body, but there's not as much muscle moving when you're doing it, so you're not sucking as much glucose out of your body. And so I think that's what maybe our perspective sets us apart from a lot of other pharmacists or even doctors or people in the diabetes world is we can get at this pre-diabetes problem. It's like making a trade in the in the offseason to get a better team. Like you may, maybe you won 85 games last year and went to the and stuck into the playoffs like the Reds did, but it wasn't because they were great, it's because everyone else was bad. And so you need to make your team better. So uh sorry, I had to make another dig up. Lots of jabs at the Reds, man. Oh man, I love it. Well, don't worry, next week. By the time this by the time this releases, the Cubs could have lost six in a row. So uh it's uh it's all very unlikely. Uh quick pause for a second.

Follow Us On Instagram

SPEAKER_00 14:42

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. All right, back to the show. What does your Pythagorean rhythm say? Yeah, Pythagoras says my crystal ball is cloudy. But I'm not it's not cloudy about what you can do to stop this this process that's going on under the hood in the body, building that muscle, nourishing needs. This essentially just means when you're eating food, you have nutritional food and energy food. Nutritional food being protein, fiber, vitamins, and minerals, energy food being carbs and fats. That's right. We are not team carb low carb, we are not team low fat, we are team kind of low carb and kind of low fat, uh, less overall, right? Yeah. And so this means more protein-centric foods, uh, lots of vegetables and some fruits to get your fiber. And this will crowd out a lot of the excess energy coming into the body. So when you create a better capacity to store it by strengthening your body, you put less toxic energy in, and yes, keep moving your body so you're utilizing that energy, you're going to be able to get at the root of this. And I can't tell you

A1C 13 To 6.5 Turnaround

SPEAKER_00 16:13

the number of people. Like, I specifically remember someone that when I was in clinical practice came to me, a woman in her early 70s, aymancy of like 13. And she's like, What is going on? I ride a bike for an hour a day, I swim for an hour a day. And we looked under the hood metaphorically, and she was actually a huge baseball fan. We talked a lot about uh going to different stadiums. So we're gonna make this all work together, Brian. But she wasn't doing any any, and I you can kind of like look at people's bodies and notice like they just don't have muscle.

SPEAKER_01 16:38

Yeah.

SPEAKER_00 16:38

So I said, you gotta start strengthening your body. And we talked through what their what their what their eating habits were, and they said, I'm eating healthy. Every morning I have or I have fresh squeezed juice, whole wheat toast, oatmeal, and there's like in isolation. I mean, juice is pretty sugary, but oatmeal is not, you're not here because you're eating too much oatmeal. And a whole wheat toast isn't the I don't think it's the health food it's made out to be, but it's not the devil it's made out to be on the low carb world. But there's no protein in there. You're getting all your fibers from grains, which is a higher energy source of fiber. So we talked about stop mainlining juice in the morning, sugar, basically, like juices when you're hypoglycemic and you're and your sugar's crashing. Otherwise, there's no medical necessity for juice. So we fixed a few of the things with the diet, got her moving, got it, got her building some muscle, and her A1C, I mean, she she did go on metformin. She refused insulin. I helped her avoid insulin, but she did go on metformin to appease her doctor, and her A1C went from like 13 to 6.5% in three months. And I can tell you, metformin in isolation doesn't do that. And the cool thing was the energy coming back, the like the the fatigue, the brain fog, like so many of these other underlying issues that happen that you can see under the hood that you're masking with caffeine and sugar and snacks, when you improve your body's ability to utilize energy and not be in an energy toxic state, you feel better subjectively.

SPEAKER_01 18:03

Yeah. Yeah, that sounds like an amazing story, and I'm really happy that you were able to help her avoid insulin and just drastically just change her metabolic health. Yeah. Write like a different story. Like she's just living a different life now than I'm sure she would have been.

SPEAKER_00 18:18

Right. So yeah, and it doesn't mean like if your A1C is good and it was higher and you lowered it, don't be like freak out. We don't want you to do that. Enjoy the wins. Brian enjoyed every Reds win on the road until this week when they was just snuffed out, right? But good teams pay attention to the underlying numbers before the losing streak starts. And health works the same way. So

Progress Beyond Weight And Fasting

SPEAKER_00 18:40

we don't need to obsess over perfection, we don't need to panic over a single number. We got to think systematically, look at trends, and build health before there's crises. And on your road to remission, there's also gonna be times where your where your labs and numbers are lying to you. Like when you're we have so many clients where their weight isn't budging, but their but their body composition is improving, the waist circumference is improving, but everyone cares about the number on the scale. Maybe their post-meal sugar is improving, but their fasting numbers aren't budging yet. But that's why we coach you through it. We've seen this hundreds of times, thousands of times. The underlying numbers say that you're on the path to remission and success, but in isolation, you're freaking out because all you know is your doctor just says A1C, fasting numbers, what's the scale? And so when your friends start seeing more definition in your body with muscle, when you start feeling more energy, when the heartburn gets better, when your pants fit looser even though the scale isn't budging, you're building muscle and and redistributing your body weight away from your dangerous visceral fat to muscle. Like it's gonna get there. And for some, it'll take months, for some, it'll take less time, but that's why we look at those underlying numbers.

SPEAKER_01 19:49

Yeah, yeah, for sure. That's definitely a good point. And I like the the whole analogy you brought here. I think it really clears up the whole picture, even though I'll I'm just gonna thank the Reds for taking the the brunt of the criticism and that I usually get. Not criticism, but the jokes that I usually get. And I also want to acknowledge you. You I heard throughout the like you you used the phrase crowd out, and I'm just gonna acknowledge you for that because it sounds like it's starting to stick. We're maybe getting to the point of like you're adopting some of these more health coachy uh uh phrases here. So good job, Corey.

SPEAKER_00 20:23

Well, thank you, Brian, for acknowledging that. And so when you're looking at your blood sugar, remember a good scoreboard is great, but real help is about building a system strong enough to keep winning long

Share This And Leave A Review

SPEAKER_00 20:34

term. So we want to hear from you. Share us, share some of your wins, send us an email, find us on Instagram, send us a DM. And if you're listening to this and know someone who's struggling, who's in that pre-diabetes range, who's saying they're fatigued, send this episode to them. Text it to them right now, put it in a group chat because we know we see people all around moving throughout this world that the underlying metrics say that they're due for a losing streak with their health. And we want to help. So and if you like baseball, let us know too. Who's your favorite team? Uh let us know. Send us an email. If you're a fellow Reds fan, I'm sorry for for uh beating your team up on this one. And if you are a Cardinals fan, you can just ignore us. I'm kidding.

SPEAKER_01 21:14

You know what? I'm actually glad because it produced this great episode. Now I'm grateful for the Reds on this losing streak here. It just produced such a great idea for this episode. So thank you.

SPEAKER_00 21:25

Boy, you're gonna love the episode after the Cubs win the World Series. It's gonna be the best diabetes metaphor ever. So we appreciate everyone listening. We we we get we read all the comments, we read all the emails, uh, we love hearing the story. Share the share the wins, share the scoreboard wins. We do, I mean, we do want to acknowledge sharing little wins, but we have that as as two pharmacists working with diabetes for years, we know how to read the scorebook. We know how to look at the analytics of blood sugar, and we can look under the hood and understand what's going on. So we hope this episode resonated with you. Share it with someone who did, if if it did, and uh until then, you know, this whole episode. Is about what we see at the end. Keep it simple and do what works.

SPEAKER_01 22:04

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.

Medical Disclaimer

SPEAKER_01 22:26

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.