MedLink Health Connections Podcast

Understanding Diabetes: The Basics and Beyond with Jennifer Wright, MS, RD, LD, CDCES

• MedLink Georgia • Season 1 • Episode 21

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Diabetes can feel overwhelming until the pieces click. In this episode, Registered Dietitian Jennifer Wright joins us to break down what diabetes is, how blood sugar and insulin work, and what those numbers like A1C and fasting glucose really mean.

We cover early warning signs, simple lifestyle changes that make a big impact, and how stress, sleep, and even caffeine can affect your blood sugar. Jennifer also shares practical tips for building sustainable habits—like tapering soda, walking after meals, and making balanced food choices that last.

Plus, learn how MedLink Georgia’s Diabetes Self-Management Education and Support program can help you take control with personalized guidance.

No crash diets. No gimmicks. Just real tools to help you live healthier every day.

SPEAKER_01:

Welcome back to the MedLink Health Connections Podcast. I'm your host, Tangela, and today we're diving into an important topic, diabetes. Whether you're living with it, know someone who is, or just want to learn how to lower your risk, this episode is packed with helpful info. Joining me is Jennifer Wright, a registered dietitian here at MedLink, Georgia. She's been with us since 2020 and works with patients of all ages, helping them manage diabetes, weight, and overall nutrition. Jennifer, thanks for joining me. Let's start with the basics. What exactly is diabetes and how does it impact the body?

SPEAKER_00:

Great question. So diabetes is a condition where we have blood sugar levels higher than we want them to be. And if you've ever been to the doctors before and they've talked about your blood sugar level or blood glucose level, those are the same thing. You might have even gotten a blood test called an A1C check. That's a long-term look at our blood sugar levels. And they can all kind of help indicate whether our blood sugars are within a range that's appropriate for our health. And I mean, we might kind of you might get to this later, but uh diabetes, if it's left uncontrolled, if you're left with blood sugar levels that are just too high for too long, sometimes it can affect our vision, it can affect our kidney health, it can affect our nerve endings. Um so if it's something where you do have diabetes, we want to get those numbers uh down to an appropriate level as as fast as we can for sure. Of course.

SPEAKER_01:

There are two different types of diabetes. Um, can you explain the difference between type 1 and type 2?

SPEAKER_00:

Sure, sure. Good question. Um, so type one is an autoimmune disease. Um, out of everybody that has diabetes, probably only 10% of them have type 1. So it's much, much more uncommon to have type 1 diabetes. Um, because it's an autoimmune disease, that means that the body is kind of attacking your own organ cells. Specifically, the organ we're talking about with diabetes is your pancreas. Um pancreate, your pancreas is what produces insulin, and insulin is a vital hormone for lowering your blood sugar levels. Um, so with type 1 diabetes, the body produces zero insulin. And so that means that people with type 1 diabetes have to rely on taking insulin in the form of injections for all of their meals and usually a dose at nighttime to help them be able to digest those blood sugars. Um, without it, it would not be a pretty sight. Whereas uh type 2 diabetes, which is the much more common form, 90% of the people with diabetes have type 2, um uh can be more of a kind of like a family history of type 2 diabetes can put us more at risk. Usually it's seen a little bit later in life, but it can definitely be seen earlier, as early as kind of the teenage years as well that we're seeing nowadays. Um, and that's more so an impact of just our body not being able to use its own insulin effectively. You're still producing insulin with type 2 diabetes, um, but we think of insulin as like a key to help unlock some doors inside the cells of our body. And with type 2 diabetes, you have keys, but maybe they're not fitting in the locks, they could be damaged, and so essentially the body then still has trouble digesting those uh blood sugars and lowering them. Uh, but there's lots of different types of medication options for type 2 diabetes. It's not just insulin, there's oral medications that help to make the body more effective at using its own insulin. More so it's also, you know, controlled through diet and like lifestyle changes for type 2 diabetes as well.

SPEAKER_01:

Okay. So, what are some early signs or symptoms that people should probably pay attention to for either one of these?

SPEAKER_00:

Yeah, so um some of them kind of overlap, uh, especially if you are at risk for type 2 diabetes, you have a family history of it, um, you know, we're maybe don't have the best diet, not being very physically active. Some of the symptoms that are very common are frequent urination, um, as well as excessive thirst. And not so much to the to the point where, like, you know, I think all of us have on a hot day been kind of thirsty. This is excessive thirst where you just can't seem to get enough hydration or going to the bathroom countless times throughout the night. Um, those would be two big signs that maybe we want to go to the doctor and get some stuff checked out. Um, with type one diabetes, those things are still true, the frequent urination and um the excessive thirst. Sometimes with type 1 diabetes, we also see some weight loss associated with the onset of diagnosis. Uh, so weight loss that's unaccounted for that could also be seen in type two. Um, so you know, something where you unexpectedly without trying or losing weight would be a sign that something's going on as well.

SPEAKER_01:

Okay. How would you say that these are kind of diagnosed? And can you help us understand what terms like A1C or fasting glucose mean in a plain language?

SPEAKER_00:

Great question. Uh, so yeah, so the way that we diagnose diabetes is with blood work most often. Um, so those two labs that you mentioned, either the A1C or the fasting blood glucose, are two of the most common. I'll start with the A1C. So the A1C, uh, like I said before, is a long-term look at your blood sugar levels. So your A1C looks back at your blood sugar levels for about the past three months. Um, the way I like to explain it to people is it's looking at how many sugars are attached to your red blood cells. So we have all a bunch of red blood cells, right? If you have a lot of sugars attached to your red blood cells, you're gonna have a high percentage of A on your A1C. So your A1C is in a percentage form. So it could be 5.0% all the way up to 14%, which would be very high. Um, but it's looking at the percentage of sugars on your red blood cells. Um, the reason it's every three months is because your red blood cells usually have a lifetime of 90 days or three months. So after 90 days, you would form new red blood cells, and essentially you could get a new A1C taken, and it might have a different amount of sugars attached to the red blood cells, leading to a different percentage. Even if you got your A1C checked the next month, you still have some red blood cells that have reached their 90-day limit, they have died off, no new ones have formed, and you you still have a different average. Um, so it's still a way that sometimes we check even on a monthly basis just to see if the average of your A1C is going down. Uh, usually if your A1C is above 6.5%, that's when we start looking at a diabetes diagnosis. Um similar to the fasting glucose or the fasting blood sugar, that is just like in the moment, what is my blood sugar? So it could be affected by what you had to eat that morning, which is why we like it to be fasting. So no food, no beverages other than water. Um, usually if your blood sugars are above 126 and they're measured in milligrams per deciliter, if they're above 126 on two separate occasions, that usually is associated with the diabetes diagnosis. We do two separate occasions because sometimes other things can affect our blood sugar levels, stress, pain, emotional stress. So if you just have one time where it's a kind of a fluke high fasting blood sugar, and then that never happens again, you don't necessarily just automatically get diagnosed with diabetes because you had it one time.

SPEAKER_01:

Okay.

SPEAKER_00:

Yeah. Um, so generally if you're over the age of 45, um races like Black, African American, or Hispanic are more at risk. Um, if you have a family history of type 2 diabetes, so especially like if you have immediate family members, if your parents have type 2 diabetes or siblings. Um, and then usually if our diet is poor or very high in like high highly processed foods, um, fast foods, sugary beverages, and then also if we're just not being very physically active or are all risk factors. Um if you know you're at risk, um, the best thing you can do is start making tiny changes to your diet. Um, if you're consuming sodas regularly, I I personally like to help people kind of wean off of them in a gradual manner because I'm not a big cold turkey person. Um, I don't think a lot of people do well with cold turkey, some people do, and that's great for them. But um, you know, if you're drinking three sodas every single day, try to go to two sodas every day, and then one soda every day, and then eventually one soda every other day, and so on and so forth until you've kind of decreased that. Um, and then again, physical activity, great. Even it doesn't have to be, you don't have to get a gym membership. Just a walk, just a 10-minute walk after you eat a meal can be extremely helpful to your blood sugar levels. Um, and and it can be separated if you work at a desk job, having five-minute breaks where you just take a walk around the office, you know, five times a day, that still counts, even if you're breaking it up into kind of little tiny, tiny exercise habits. Um, you could use that same philosophy for eating. If you don't eat all day and then you eat one giant meal at the end of the day, it's a lot harder for our bodies to process all of that food all at once. You're better off to have smaller, more frequent meals throughout the day to help your body be able to take the time to absorb a smaller meal easier than absorbing all of the, you know, sugars that might come from one super large meal.

SPEAKER_01:

Okay. I've heard of like prediabetes. So could you explain exactly what that is and how someone would know if they have it?

SPEAKER_00:

Yeah, so prediabetes is where your blood sugars are kind of elevated, but they're not so elevated where we would diagnose you with diabetes. Um, prediabetes can be determined also through an A1C. Uh, usually an A1C anywhere from 5.7 to 6.4% is considered in the prediabetic range. Um, and if you are pre-diabetic, the good news is that prediabetes is totally reversible. Um, so essentially the same thing, lifestyle changes are the biggest factor with prediabetes. Um, a lot of research shows that even just losing maybe 5 to 7% of your body weight can help get you out of that pre-diabetic range. So, food choices and then physical activity are again two ways at getting that A1C to come down. Um you know, with with type 2 diabetes, type 2 diabetes, if we get to that point, is not reversible. It's very treatable, it's very managed, um, and it can be very well managed for the long term, but we can't go back to not having diabetes once we have diabetes. Um, whereas prediabetes, we can we can get rid of that. Um, we would still want to make sure we're following the lifestyle changes we made to get rid of pre-diabetes so that we don't get it again.

SPEAKER_01:

Okay, what are some of those? You kind of talked briefly on like not not necessarily it being durable, I guess, but more so like preventable for type 2 diabetes. What are some of those like practical steps you might would say someone could take to hold off that diagnosis a little longer for like if you're pre-diabetic or you're just trying not to get type 2 diabetes? Um I guess both.

SPEAKER_00:

Okay, um, sure. So one would be I like if I'm looking specifically at someone's diet and they're trying to kind of prevent the onset of type 2 diabetes, we want to make sure we are increasing our intake of things like fruits and vegetables, decreasing our intake of highly processed food, like sugar-sweetened beverages and fast food options. Um, also trying to consume lean proteins, so like your chicken, fish, eggs, maybe turkey are good choices. Um, and then getting into like a regular exercise routine. The key with with any sort of lifestyle change is you you need it to be sustainable for the long term. You need it to be something that you can picture yourself doing for for the long term. I mean, that's that's how we're gonna prevent it for as as long as possible. Um, so if you go into kind of like a really drastic dietary change or like you're trying to go to the gym for an hour every single day and you've never been to the gym before, usually we're not super great at keeping up with those changes because they're so extreme and we're just we get real tired of them real easily. So it doesn't have to be all or nothing, just making tiny changes every day is gonna lead to a big change that can be more helpful because you're able to stick to doing it longer.

SPEAKER_01:

I feel like that's so much it's that's the complete opposite of I feel like what you hear on like social media and stuff, but I feel like that's so much more effective, if that makes sense.

SPEAKER_00:

Yeah, and I'll tell you a secret is that all of the things you see on social media about like try this crazy diet and do this and you'll lose X amount of pounds in two weeks. All diets were designed to fail. All of them are meant to not be sustainable. They want you to try it, they want you to fail it so that you'll move on to the next diet. You know, we there was a big boom of the keto diet, and and that's incredibly hard to stick to for the long term. So people might do it for a couple of weeks, a couple months. Eventually they're gonna stop doing it, but then they're on the lookout for the next big thing that's gonna promise them all these results. Um, and that's how the diet industry keeps going, is because they know that what when one fails, they're gonna have another one to kind of take its place that people are gonna be interested in trying. Um, it might it might honestly be the boring answer, but just healthy eating and exercise really is the key. Um, sometimes we want to believe in those, like a magic pill or a magic gummy, or if I just do this diet for three weeks, you know, all my problems will be solved. But I promise if there was a little magic solution like that, I'd be I'd be telling everybody about it. Um and it's just there, there there just isn't.

SPEAKER_01:

So let's kind of take a bit of a different uh turn here and let's talk a little bit about like stress. So could things like stress or the lack of sleep really affect your blood sugar levels?

SPEAKER_00:

Yes, yes. There's so many, there's so many things that can affect your blood sugar levels, and that's what makes diabetes so complicated. Um, because even if you're someone with diabetes and you're really dedicated to checking your blood sugar and you're watching what you're eating, your blood sugars are gonna always change. Um and sometimes it's frustrating because I have patients that say, Well, I I did the same, I ate the same thing for dinner, but I woke up this morning and my blood sugars were so much higher and I didn't do anything different. And and it's maybe not the food, it's maybe they didn't sleep great. It's it's maybe because they had more of a stressful day. Um, you know, all that stuff can affect your blood sugars. Uh, caffeine can affect your blood sugars. Even if you have just straight black coffee, sometimes the caffeine can make your blood sugars go up. So everybody's a little different. So it's kind of learning about yourself and trying to figure out what foods and beverages kind of affect your blood sugars more often or what conditions like stress, you know, um where they notice and and they realize, oh, when I'm having a stressful day, you know, I know my blood sugars are going up more, you know, trying to find coping mechanisms to deal with stress. Again, like walking, great option, um, are all helpful tools to use. And it's it's a whole it's a whole process that includes all parts of our our life and our body. I mean, you know, your food choices, your exercise choices, how you manage stress are all important. And and one of the reasons we have like the diabetes program we do at Medlink is the like the what you mentioned, the DSMES. It stands for diabetes self-management education. You know, we we want our goal is to help people realize how to best manage their diabetes for them, you know, not for what works for somebody else, but what works for them as an individual, to give them the tools and the knowledge of of knowing things that affect their blood sugar and how to deal with it. Because, you know, they've got they're the ones dealing with it on an everyday basis basis. We're here to help. But they want that we I want I want to make sure they know on the weekend what to do if if they notice their blood sugar goes up to you know 200 and and what and figure out why it went up to that so that we can we can maybe help prevent that from happening as often. So it's all about the more knowledge, the more power. I really do believe that.

SPEAKER_01:

Yeah. Um, so you mentioned this program that we have here at Medlink, and just kind of on that lines and maybe more, if someone thinks that they might have diabetes or even pre-diabetes, what's some of the first steps that they should take?

SPEAKER_00:

So if you just yeah, if you're just worried about it, like if you just are worried that you have it, I would say the first step would be to visit your regular, have like appointment with your doctor um or your provider, and maybe do some blood work would be a first step. Um, if you're truly just kind of wanting to know where you stand in the process. And you can always, always come to see one of us as like a dietitian. You know, we're diabetes educators, but we we do all things related to nutrition. So even somebody that wants to come that's not pre-diabetic, that doesn't have diabetes, but they just want to make sure they don't get it later on in life, we help them as well, just to make sure that they're living a balanced lifestyle with their food choices and their beverage choices and their activity level.

SPEAKER_01:

Okay, and how would someone who does have diabetes kind of navigate and figure out how to get themselves into the DSMES program?

SPEAKER_00:

So, good question. Usually, I mean, technically, some insurances require referrals, most do not. You're always welcome to just call your local med link and ask for the nutrition department, and they will send you to our uh grand uh nutrition coordinator. Her name is Marleni. She's really great at scheduling people, making sure they get to the best location that's for them, because we go to a lot of different locations. Um if you wanted to go through your doctor, that's also fine. Sometimes having a referral just kind of make sure we close the loop with things. Uh, but honestly, since a lot of insurance companies don't require it, if a patient just comes to us themselves and says, hey, I really want to come in and just have an appointment, if for some reason we need a referral, we ask the provider for one if if we ever needed one. So there's there's no reason that they have to go to their doctor first just to come and see us. They can just call and get scheduled if they really wanted to.

SPEAKER_01:

Thank you for tuning in to the Medlink Health Connections podcast. We hope you found today's episode informative and inspiring. If you enjoyed the show, please subscribe, rate, and leave a review on your favorite podcast platform. Remember, the information shared in this podcast is for educational purposes only and should not replace professional medical advice. Always consult with your healthcare provider for any medical concerns. Stay connected with us on social media and visit our website at medlinkga.org for more resources and updates. Until next time, stay healthy and take care.