How to Track Blood Sugar, Sleep, Stress & Progress - What Your Doctor Isn't Measuring | Dr. Prasanthi | Part 2

This episode isn't about motivation or willpower. It's about what your body is actually doing - and how to track it before a diagnosis forces the conversation.

In Part 2 of this conversation, Dr. Prasanthi - internal medicine physician and diabetes specialist - breaks down the specific markers, tools, and lifestyle decisions that determine metabolic health outcomes. Not in theory. In practice.

This was not a lifestyle conversation. It was a systems conversation.

We cover:

→ Which blood markers to request at your annual physical - and which most doctors don't order by default (CRP, C peptide, fasting insulin)

→ Why over-the-counter CGMs have changed what's possible for non-diabetics tracking glucose

→ How insulin resistance connects to Alzheimer's disease - and why that raises the stakes for anyone with a family history

→ Why BMI is being replaced by visceral fat and waist-to-height ratio as the real metabolic markers

→ The surprising lifestyle factor Dr. Prasanthi ranks above diet and exercise: social connection

→ What "diabetes distress" actually means - and why it's distinct from clinical depression

→ How mindful eating changes your digestion, not just your portions

→ Why skipping breakfast may be one of the single worst choices for insulin sensitivity

→ Fasting: what the data shows, what it doesn't, and when medical supervision is non-negotiable

If you're an operator, founder, or parent managing energy, mood, and long-term risk - this conversation gives you the right questions before things go wrong.

This isn't a highlight reel. It's a practical breakdown of how metabolic health actually works - under real constraints, not in hindsight.

Chief Milestones is a video podcast featuring honest conversations with founders, parents, and investors about building real businesses, staying healthy, and raising families.

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Transcript

Stress Hormones And Hunger Signals

Dr. Prasanthi 0:00

Stress can trigger a chain of reactions and changes in multiple hormones, including your insulin, cortisol. It can lead to excessive hunger, anxiety, it can lead to mood problems, and people do develop like more again, you know, depression. If you have like good social interaction and social connections, I think all the other things can fall into place, meaning, like you are because somebody else is eating healthy, okay, you are more obligated to eat healthy, right? You could be walking to your friend's house even though it's difficult because you want to. Yeah.

Tracking Health Without Obsessing

Reshma Vadlamudi 0:38

And approaching from those six pillars, how can someone track those?

Dr. Prasanthi 0:44

If you have to track everything, yeah, it may be difficult and it could be challenging and sometimes stressful. If you say, okay, I am willing to do it, yes, you do have um wearable devices, right? Now you have your watch.

Reshma Vadlamudi 0:58

Uh okay, Apple watch. Yeah, Apple Watch.

Dr. Prasanthi 1:01

You can track your sleep, right?

Reshma Vadlamudi 1:02

Okay.

Dr. Prasanthi 1:03

Um, and there are continuous glucose monitors if you want to track your blood sugar. Uh now there are over-the-counter glucose monitors available, which are helpful to track the blood sugars if someone wants it. It's over-the-counter, uh, not necessarily DEXCOM and Libre, but they all they both of them they came up with over-the-counter ones. If someone wants to track their blood sugar. Yes. Yes, you can track the blood sugars, but how useful is it is the next question. Or you can do your finger prick also. So you can check your sugar in the morning and you can check it two hours after the meals to see how high it is going up to.

Reshma Vadlamudi 1:40

Okay.

Dr. Prasanthi 1:40

That's the simplistic way of doing it. And if you are really good, really good. And you can also check um different things on the blood. You can get your insulin levels, you can get your inflammatory markers, which is the CRP, you can get your C peptide levels. All these things can be checked at your, you know, whenever you do the lab testing or your physical.

Reshma Vadlamudi 2:02

So when someone goes for their yearly physicals, they can actually ask their doctor if they could check for all these inflammatory markers.

Dr. Prasanthi 2:10

Yes, you can you can ask them. Okay. Uh, does the insurance cover all of them? I'm not sure completely. Yes. But yes, you can you can get it. Most of them, they may be doing A1C, but they may or may not be doing the C peptide insulin. CRP, sometimes they do it, but most of the time they may or may not be doing it.

Reshma Vadlamudi 2:29

Okay.

Dr. Prasanthi 2:29

Um, so that suggests okay, is there any inflammation going on? Where are we with regards to the insulin resistance? Uh, that is helpful. And sleep, I think we talked about it. Uh, even the stress, um, you can use your, you know, any of the wearable devices. Now, rings are available.

Reshma Vadlamudi 2:48

Yeah, the aura ring.

Dr. Prasanthi 2:49

Aura ring, and I think there is um ultrahuman. There are multiple rings. Okay. I think there are several devices now coming into the market with regards to management of stress and sleep.

Reshma Vadlamudi 3:00

Okay.

Dr. Prasanthi 3:01

Um, there are several improvements coming on.

Reshma Vadlamudi 3:05

Um, and I do work with some of the apps also, so uh, it's interesting to see how so those apps do they actually track all these in there, like all six pillars in there?

Dr. Prasanthi 3:17

You depending on what device you are wearing. So let's say you have a Google Fit.

Reshma Vadlamudi 3:22

Okay.

Dr. Prasanthi 3:22

And then you have um some other device, CGM. So all of them can be connected into one place, or like you know, Google, Google or Apple. Um both of them, they do have like connections, and then the apps, most of them they are trying to connect with uh any number of Bluetooth devices.

Reshma Vadlamudi 3:41

Okay.

Dr. Prasanthi 3:42

Uh also in our office or in general, there is like uh even Bluetooth blood pressure monitors, weighing scales that are available, which can track uh body composition and your um, you know, the fat content, all of those things.

Reshma Vadlamudi 3:57

Got it. Okay. And

Social Connection As A Health Tool

Reshma Vadlamudi 3:59

what about uh the social connections part of it? What would you say for someone like go out at least once every week, or uh how many times should someone because these days everyone is just looking at their screens, or they would prefer to not meet anyone um if there is a chance? You don't really have to go anywhere right now, like there is no need for you to go anywhere to get anything done. So it doesn't have to be like if there is a chance, everyone would avoid a face-to-face contact. So yes. So what would you say like for the social part of it? Because it is one of the pillars. And at least go spend one day with your friend, or what what would you recommend in that part?

Dr. Prasanthi 4:44

I want to say again social connections, does it have to be friend, does it have to be family? It depends, right? Whatever makes a positive impact on you, right? So if you're getting that positive connections at home, okay, great. If not, you can find your tribe, like who is somebody like-minded people.

Reshma Vadlamudi 5:02

Yes.

Dr. Prasanthi 5:02

So when you are with like-minded people, it's much more positive social connection. Yes, I think that is very, very important. Okay, even at home, if you do the things together, of course, that itself is interaction and social connection. You can cook a meal together, right?

Reshma Vadlamudi 5:18

Mm-hmm.

Dr. Prasanthi 5:19

And then eat together. Everybody can eat the same thing, and even the kids, if they are involved in the preparation, they may enjoy it because they made it, they may like it. Okay, and being involved really like encourages them to do more.

Reshma Vadlamudi 5:32

Yeah.

Dr. Prasanthi 5:32

And that's, I mean, starting at home. Yeah. And then again at schools, you can make your own friends and you can play with them. Of course, that's a social connection, right?

Reshma Vadlamudi 5:42

Yes.

Dr. Prasanthi 5:43

Um, same thing. You can go out with your friend for a walk. You can incorporate some of these lifestyle pillars like in connection or in conjunction with one another. Like you are walking to your friend's house, right? Or walking to your gym. And then you go with a friend, or like you make friends in the gym. That is still social connection. You spoke with somebody that day, yeah, maybe made a positive impact on you.

Reshma Vadlamudi 6:07

Yes.

Dr. Prasanthi 6:08

And that makes you feel good.

Reshma Vadlamudi 6:09

Yeah.

Dr. Prasanthi 6:10

And same thing, positive words, yeah, right. So I think the positivity is very, very important.

Reshma Vadlamudi 6:17

Okay.

Dr. Prasanthi 6:17

And how, where, when you make the connection, you can even make it social. So, I mean, like you found somebody on LinkedIn. Yes, it could be a you know, social connection, right?

Reshma Vadlamudi 6:27

Yes, yes.

Dr. Prasanthi 6:27

And you can call your old friend on the phone, even when you are at home.

Reshma Vadlamudi 6:32

Yes.

Dr. Prasanthi 6:32

You can just pick up the phone once a week and go ahead and call them. The other thing is it's not just about the social connections. I

Finding Your Why For Change

Dr. Prasanthi 6:40

think again, you know, finding the purpose or value to what you are doing. I think that gives you a lot more happiness. So, how do you find your purpose and what are your values? Yes. And you connect them and you make your goals connected to those values. And what do you need to do to achieve that? Right? So, just as an example, a simple thing I want to say, which again I can see it on our classes and I hear it from our people that we teach all these classes. Uh, what is your why? We always ask, okay, why do you want to do it? So there is something, right?

Reshma Vadlamudi 7:15

Yes.

Dr. Prasanthi 7:16

Why do you want to live? Yes. Why do you wake up? Yes. And what do you want to do? Just as an example, I can ask you the same question. What do you care about in your life?

Reshma Vadlamudi 7:26

Yes. Yes. I think that will bring more perspective to people and make them stick to the things. Because anyone can start anything, it's not easy to perceive it. Right. So the only way someone can stick to it is if they know the why behind it. Because things are hard. It's not easy. If it's easy, everyone would do it. Yes. Yeah.

Dr. Prasanthi 7:48

I mean, it's so simple to say, eat right, yes, move well, right? And then sleep well.

Reshma Vadlamudi 7:54

Yes.

Dr. Prasanthi 7:55

Keep moving. It's very easy to say. Actually, these are simple things. They are not hard. You don't have to spend thousands of dollars, right? They are so simple.

Reshma Vadlamudi 8:03

The thing is, spending thousands of dollars is much easier these days than sticking to the basic, I would say the basic boring stuff that you have to do.

Dr. Prasanthi 8:13

Why is it boring? I had uh one person, I mean, uh, he did achieve diabetes remission, and then when I asked him, okay, what is important for you, right? So he wants to be able to play with the grandkids, live for them. So if you put together, okay, why am I doing this program? Because I want to be able to have fun with my grandkids. So, what does it take to have fun with the grandkids? If you are healthy, you can play with them or match them up, right? But if you are not healthy, how can you how can you even play with them? You may be in a nursing home, you may be in an assisted living where you cannot spend time with your own family properly. So then that makes you think through what do I need to do to get there? Yeah, then what does it take? Yes, then you can start and then build it, build upon it. Okay, do I need to eat healthy? And what sacrifices do I need to make?

Reshma Vadlamudi 9:05

Yes, that's that was exactly what I was about to say. I think it's also equally important to ask people like the why, and then combine it with the sacrifices. I think the reason people are not doing it is because of all the things that they have to give up. They have to give up donuts, they have to give up ice creams, they have to give up whatever they think uh it is. No.

Dr. Prasanthi 9:28

I don't think you have to give up everything, Reshma. Yeah, you can say, okay, I'm going to start slow. Okay. I'll do like five days right, and maybe on the weekend I may want to start with half of a donut instead of full donut. Or like eat the donut on that day. It's hard to change the habits, but can you start somewhere is the question. How slow, how fast? That's a totally different story.

Reshma Vadlamudi 9:51

Okay.

Dr. Prasanthi 9:51

But at least you started.

Reshma Vadlamudi 9:53

Yeah.

Dr. Prasanthi 9:53

And once you start making the change, slowly, I mean, your cravings do go away. The taste buds do change. I mean, there are a lot of things that happen in your body which you don't realize. The um, we didn't go over that, but the all those cravings and then the higher insulin, all of that, when it becomes normal, you may not feel the craving. Your taste buds may or may not like it. When you eat the sweet, it may feel like it's too sweet.

Reshma Vadlamudi 10:19

So, yes, can we talk about it? Because how can someone change that? How can someone change the taste buds approach? Like if there is a chance. Yeah.

Mindful Eating And Screen Rules

Dr. Prasanthi 10:29

No, no, it takes time. Are we focusing? Even meditation, my any mindfulness, I mean, what is it about? It's about the focus, right? The same thing applies when it comes to food. Mindful eating. What is mindful eating? Putting all our senses together into what we are eating, and the brain gets the signal. Okay, your eyes are looking at it, your mouth is watering, right? And then when you are chewing, your taste buds can feel the taste, and then the signal goes to the brain, and then the enzymes, salivary enzymes, all of the process starts. So it's digested better. And then when you I mean when it goes through the stomach and everything, your brain when it gets the signal, it is much more satisfying. So you don't have to eat a whole lot. Even when you eat like small quantity, because you are eating mindfully, then it realizes, okay, yeah, I'm full. Let us stop. At least you are getting the signal, you are recognizing the signal. But if I'm watching TV and then, like, you know, I'm eating something, no, the senses are not going to connect with each other. And then I may be eating, I may not even know how much I ate, right? I don't even know what quantity.

Reshma Vadlamudi 11:35

Yes. And um, how hard is it to stop the kids these days from not watching the screens and eating? And how important do you think it is for the kids to make this habit of no screens while eating?

Dr. Prasanthi 11:50

Has to start with parents. Your family rule. It is very important. I mean, the screen time, if you look at like AAFP recommendations, is screen time is only two hours. Yes, unfortunately, you have iPads, you have phones and everything. We all deal with that, right? The screen time. At least I would say at the table, you can enforce. I mean, starting from childhood, no screen policy. So you can say everybody put your phones on screen survey. I try to do it. I don't want to say 100%, but 99% I am successful. Now my kids are grown. But I think that's one thing we spend time together is dinner time.

Reshma Vadlamudi 12:28

Okay. Yeah.

Dr. Prasanthi 12:29

So it's like, okay, you can talk about your day, you can Yes.

Reshma Vadlamudi 12:33

That's the time you guys connect.

Dr. Prasanthi 12:34

That's the time you connect. Yes. Yeah, now my kids they are grown and then they don't want to spend too much time. But at least they will come in for that dinner time for sure.

Reshma Vadlamudi 12:44

Yes, yes, that makes sense. Yeah, we we have uh once every week they get their screens. They don't even watch every day in our house. So we are very strict. That's very good, very good.

Dr. Prasanthi 12:55

It's very hard. Yeah.

Reshma Vadlamudi 12:56

Yeah, they don't know, like obviously my 11-month-old he doesn't know what a screen is. Uh, but the other two, even my six-year-old, she only gets it on Saturdays. Oh, very good. Yeah, very good.

Dr. Prasanthi 13:06

Yeah, so I mean, if they are I mean, already like into that since the beginning, yes, great.

Reshma Vadlamudi 13:12

Yeah, since yes, that that's why it is easy for us. I didn't know anything about screens. So they are my six-year-old, she's just finding out that kids can have iPads too. Yes. So that's why it's easy. It's not like we are not trying to break any habits, they don't have any habit of it. Right. So that that's why also it is easy for us. Yeah, yeah.

Dr. Prasanthi 13:32

And then when they go to school, they see each other, there is peer pressure, all sorts of things.

Reshma Vadlamudi 13:36

Yes, that's where she is starting to understand that kids can have iPads and that they can talk about like that to parents too. And you can work on iPads. Like she thinks she's working on the iPad, like playing a game is working on the iPad. So that's what she's learning at school. Yeah. So let's get into the other okay. Can blood

Blood Sugar Swings And Mood

Reshma Vadlamudi 13:57

sugar can blood sugar fluctuations impact mood swings, anxiety, and depression?

Dr. Prasanthi 14:02

Yeah, definitely. Um, of course. Uh as this is very true for people with diabetes. Uh, when they have like very high sugars or very low sugars, um, they become very irritable. Um, and like hypoglycemate can cause like a shaking, cremors, sweating, like a lot of reactions.

Reshma Vadlamudi 14:20

Okay.

Dr. Prasanthi 14:20

Um, and sometimes people become angry, irritable, and they shout. So uh we always say, okay, when somebody is not in a good mood, yes, make sure to check their blood sugars. They can be very lethargic, but the opposite can also happen.

Reshma Vadlamudi 14:35

Yeah, yeah. Okay. We hear a lot about the hangry effect. How does insulin regulation play into irritability and mood changes?

Dr. Prasanthi 14:44

Again, I think that applies the same way, meaning like people could have um reactive hypoglycemia, meaning their blood sugars went up very quickly and then they drop down, so people could feel that. Or if they again, you know, depending on the levels of the insulin, what they ate and everything, yes, there could be fluctuations in insulin plus other hormones also that can affect and cause mood changes.

Reshma Vadlamudi 15:11

Okay, okay, got it. Some studies suggest a link between insulin resistance and mental health conditions like depression. What's your take on this?

Dr. Prasanthi 15:20

Uh definitely, yes. Okay. I think we kind of talked about how the inflammation plays a depression. Yeah, and then even depression is much, much significant in people with diabetes. Uh, yeah, they are much more likely to have depression. It's again multiple factors that plays a big role. They go through a lot to uh real people who are struggling with diabetes. We call it as diabetes distress. But for the type twos or even even type twos, I mean dealing with the disease is one thing, dealing with medications, they want to look like they are normal, but they have to deal with all the things that they have to deal with. So it's a lot on them, and of course, definitely it that can lead to depression, anxiety, mood changes.

Reshma Vadlamudi 16:06

Okay, so what what is diabetes distress?

Dr. Prasanthi 16:09

There is a questionnaire that you can go through. Okay. I mean, you can always give it to anybody to kind of understand okay, do they have diabetes distress or not?

Reshma Vadlamudi 16:17

Okay.

Dr. Prasanthi 16:18

But depression, uh, it's very common or much more common in people with diabetes versus without diabetes. Um and uh when we talk about uh diabetes distress, it's more on the type 1 side also because it's a lot for them. Yes. These people are diagnosed uh very early, very early. They have to deal with the insulin, they have to deal with the hypoglycemia, they have to deal with the monitors, blood sugar checking, even for people with type two, if they are dealing with you know constant checking, trying to control what they are eating, and it, you know, it's a yes, stressful situation for them.

Reshma Vadlamudi 16:55

How

Inflammation, Diabetes, And Chronic Risk

Reshma Vadlamudi 16:56

does insulin resistance uh contribute to inflammation and other chronic diseases?

Dr. Prasanthi 17:02

I think I want to say there are multiple, multiple diseases. It's not like one disease when we are talking about insulin resistance, right? We talked about um a depression part and uh other mood problems, but also there is like a higher chance or risk for Alzheimer's. I mean, there are there is so much of data coming in saying that, you know, once you have insulin resistance, it can trigger multiple things, right? Uh, where does it start and where does the inflammation and everything come into play, right? So once, I mean, you can say the inflammatory markers and everything, once you have it's a low-grade inflammation where it kind of starts as low grade inflammation. Maybe the markers will go up initially. And then slowly what they do is they get into like uh fat breakdown, creating more inflammation. So, and then like your um we call it macrophages, they all come in. It becomes a cycle of like you know, one triggering the other, and then the more and more inflammation it affects like again organ systems and which organ that all again depends uh like how much inflammation is there, and it's multi-organ system that's being affected. I mean, when we talk about Alzheimer's, okay, it's like you know, top protein and then insulin receptors in there. So you have insulin receptors everywhere, right? So the inflammation can affect anywhere and everywhere based on like how much insulin resistance you have. People with diabetes have a higher chance of developing Alzheimer's. I think it's double than normal population uh in people with diabetes. Again, it has to do with insulin receptors in your brain and um what they call is uh demyelination and then top proteins, which are responsible for Alzheimer's disease. They have noticed changes in people with diabetes.

Reshma Vadlamudi 18:54

Okay.

Dr. Prasanthi 18:55

So there is a higher chance or higher increased or higher chance or higher risk for developing Alzheimer's in people with diabetes.

Reshma Vadlamudi 19:03

Diabetes.

Dr. Prasanthi 19:04

And it's not only Alzheimer's, like we talked about, you know, you mentioned about heart disease, right? Yes, it's not just heart disease. But all these changes are happening everywhere, like your blood vessels, right? Small blood vessels, your nerve damage, blood vessel damage, so all those things lead to again eye damage, neuropathy. We call it retinopathy if it's eyes. I mean, people lose sensation in the feet that can lead to ulcers. So if your blood vessels are affected again, not only sensation, but people do have amputations, and I'm sure we all are aware of that. Same thing happens in the heart, it's small blood vessel disease that can happen. Not always big blood vessel where you have to put a stunt, but then people can have ischemic disease, even with the small blood vessel disease, kidney function. So, yes, this can be tracked, it takes like several years before you really can see that, okay, yeah, they have kidney disease, now they have Alzheimer's, they have something, but what is the root cause of all these problems? If I have to say real root cause, okay, you could prevent it, right? Just with lifestyle, as simple as that.

Beyond BMI, Fasting, And First Steps

Reshma Vadlamudi 20:08

Got it. Can improving insulin sensitivity help with weight loss even if someone isn't diabetic?

Dr. Prasanthi 20:14

I can say yes, uh, but if you want to elaborate on that, I mean people who have like, you know, yes, higher body mass index, um, if they have insulin resistance and if they become insulin sensitive, yes, it does help with the metabol in general metabolic state, right? Your basal metabolic rate can be better, and then it may help with the weight loss.

Reshma Vadlamudi 20:36

Okay, yes. So, what is the ideal BMI you're looking for?

Dr. Prasanthi 20:41

I want to say we are going away from this BMI part of it because honestly, BMI has been used for several years, like to say, okay, obese and non-obese populations, but it's not a clear-cut demarcation. Um, even with BMI of 27 or even below, like even below 25, Asians they do develop diabetes very easily. Okay, and they can develop insulin resistance. Somebody may say, I am thin, right? I will not develop any diseases. That is not true. Uh, Asians have the tendency to develop insulin resistance very easily. And then between 20, I mean, like we say overweight is about 27, and then like you know, uh about 30, yeah, obese. But more than BMI nowadays, like people are looking at what is the visceral fat content, what is your waist hip ratio or like waist-to-height ratio. So these are becoming like more and more in use. Somebody could be very healthy and their BMI could be higher, right? You don't want to label them as like obese obese necessarily because they are doing everything right, maybe just their structure and whatever they it might be. But if they don't have like too much of visceral fat, yes, they are healthy, metabolically healthy. So there is no reason that they have to like, you know, be stuck on like okay, this much. Weight that much weight.

Reshma Vadlamudi 22:01

Yes.

Dr. Prasanthi 22:01

So I want people to think it, think of it in a different way. Yes, just because you are thin doesn't mean you don't get the disease. And just because you are obese doesn't mean you are not healthy necessarily. So instead of labeling people as obese and non-obese, I think we have to look at are they metabolically healthy or not?

Reshma Vadlamudi 22:19

Okay. So when you say the visceral body fat, are we talking about the fat that's around the abdomen?

Dr. Prasanthi 22:25

Yeah, or in the organs, you know.

Reshma Vadlamudi 22:27

Okay. So how would how would someone measure that?

Dr. Prasanthi 22:30

Is there body compositions are available now? Some of the weighing skills are also doing it. In our office, we do in-body, which is body composition, and then DEXA scans. Okay. They're also helpful to measure the body fat.

Reshma Vadlamudi 22:45

Okay. So and they are accurate. Okay. Okay. Okay. Got it. Um, is fasting an effective way to reset insulin sensitivity or does it come with any risks?

Dr. Prasanthi 22:55

I know if you're talking about intermittent fasting, there is data both ways, I have to say. Uh, but for the from the perspective of diabetes, I want to say it has not shown to be very, very helpful in like, you know, with regards to all the benefits, meaning, like, you know, yes, you could lose weight, definitely. But is it sustainable and can it lead to diabetes remission? We have not seen much of the data onto that part.

Reshma Vadlamudi 23:20

Okay.

Dr. Prasanthi 23:21

Uh, we do recommend again, you know, definitely not skipping the breakfast if you have to pick a meal. Uh, and it does help actually with the insulin resistance uh or insulin since they become they are more um insulin sensitive. Eating breakfast versus skipping breakfast.

Reshma Vadlamudi 23:38

Okay, okay, got it. And what's the simplest way to tell if insulin resistance is affecting someone's energy or mood?

Dr. Prasanthi 23:46

How the fluctuations can happen, right? If they have reactive hypoglycemia and we understand, okay, every time they eat a big high carb meal, something is happening. Yes, I would say focus on getting like the whole foods and uh you know, not giving them like nutritious food rather than just giving them like high carb or simple carbs or avoid the simple carbs.

Reshma Vadlamudi 24:08

Okay.

Dr. Prasanthi 24:08

And then is there anything to do right after eating? Okay, do five minutes of exercise, then that may be able to help.

Reshma Vadlamudi 24:14

Yeah.

Dr. Prasanthi 24:15

And then all the lifestyle factors do help also in general for the mood.

Reshma Vadlamudi 24:20

Okay. Okay, what lifestyle changes have the biggest impact on improving the insulin function? If you have to choose one or two.

Dr. Prasanthi 24:28

For me, I would say again, you know, the connections I most people don't emphasize that much, but I think the social connection is really very, very important. Yes, I could argue exercise and diet are very important. Those are the ones that are much, much focused on. But I look at it in a different perspective to say, okay, if you have like good social interaction and social connections, I think all the other things can fall into place. Meaning, like you are because somebody else is eating healthy, okay, you are more obligated to eat healthy, right? Depends on your connections, though. I don't want to say it could go the other way too, right?

Reshma Vadlamudi 25:03

Yes, yes.

Dr. Prasanthi 25:04

Because your friend is eating donut, yes, of course, you want to eat donut too.

Reshma Vadlamudi 25:08

Yes.

Dr. Prasanthi 25:09

But if you can make that good connection and then interaction, um, I think that can be very influential on how you are going to look at all the other things also. And you may be more amenable to go up and down the stairs, right? Because you want or like, you know, walk with your friend, or like even you know, because you want to look healthy and take care of your kids, you may do something more.

Reshma Vadlamudi 25:34

Yeah.

Dr. Prasanthi 25:34

So I think when you connect those connections very well or having that social interactions, I think it falls into place. You could be walking to your friend's house even though it's difficult, right?

Reshma Vadlamudi 25:44

Mm-hmm.

Dr. Prasanthi 25:45

Because you want to.

Reshma Vadlamudi 25:46

Yes.

Dr. Prasanthi 25:46

I mean, we used to do that in India. We used to walk here now again. You have a car that okay.

Reshma Vadlamudi 25:52

If someone wants to balance their insulin levels naturally, where should they start?

Dr. Prasanthi 25:57

Healthy eating and exercise.

Reshma Vadlamudi 25:59

Okay. Yeah. Okay. And your take on eating within a six to ten hour window can help reduce insulin levels and improve glucose control.

Dr. Prasanthi 26:09

Uh, it definitely can help with the glucose control. Okay. And insulin levels they do fluctuate throughout the day. Again, we talked about when you should not eat. Again, when you are talking about six to ten hours, okay, are we eating at night six to ten hours? Are we eating in the morning six to ten hours? Is important.

Reshma Vadlamudi 26:25

Yes, yes. So uh I would say like the same question. Yeah. Yes. Uh definitely because uh I think I wrote this particular one because for us the day ends at nine o'clock and everything is shut down after nine o'clock in our house. Like we are literally in the bed. So everything is from let's say why I wrote this six to ten hours is the ten hour. If I say ten hours, it's going to be maybe like early start in the day. So that's what I had in mind when I wrote it.

Dr. Prasanthi 26:55

Yeah, it doesn't have to be exactly six to ten hours. Yeah, it could be a little bit longer, but the earlier you finish eating and not snack too much at night, I think the better it is on the insulin resistance.

Reshma Vadlamudi 27:09

Okay.

Dr. Prasanthi 27:09

Or managing the diabetes.

Reshma Vadlamudi 27:12

Yeah, okay. Longer fast can help reset insulin sensitivity, but should be done under medical supervision, your take on it.

Dr. Prasanthi 27:20

I would agree on that. I mean, it can be done, people do water fasting, but soup supervision is very important. But also it's important to know what medications they are taking, how to manage their medications, right? If they're on insulin, of course, um they if they took the insulin and did the fasting, they're going to drop significantly. Not only insulin, there are other medications that can contribute to side effects or hypoglycemia. So we have to be aware of the fluctuations that can happen if somebody is going to fast. Um, but with proper instructions, yes, you can do maybe like a one-day fast, maybe once a month or something like you know.

Reshma Vadlamudi 27:57

Okay.

Dr. Prasanthi 27:58

You can do that, but you don't have to do, and I don't think there is real one way or the other, very good data to say you have to do the fasting or stop eating. Uh, the stopping eating is helpful because the amount of the calories you consume is less. So that way it helps partly with the weight and um how it helps in people with diabetes.

Reshma Vadlamudi 28:19

Okay, got it.