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Understanding Diabetes · Bryan Health Podcasts

• 0:03
  Melanie Cole, MS (Host): Welcome to Bryan Health Podcast.
• 0:05
  I'm Melanie Cole.
• 0:06
  And today, we're exploring type 1 and type 2 diabetes.
• 0:10
  Joining me is Shelli Calhoun.
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  She's a registered nurse and a diabetes educator at Prairie Center Medical Clinic,
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  Grand Island Regional Medical Center.
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  Shelli, thank you so much for joining us today.
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  I'd like you to start by telling us what diabetes is.
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  We hear about it so much now.
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  Shelli Calhoun, RN: Thank you for having me, Melanie.
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  Well, diabetes, it's a condition where your cells can't use the glucose that's
• 0:35
  swimming around in your blood, and it can cause high amounts of glucose or
• 0:40
  sugar in the bloodstream, and the cells aren't getting the energy that they need.
• 0:46
  Melanie Cole, MS: So, it's a disease where the body is not able
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  to make or process what we need.
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  Now, this is insulin that we're talking about.
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  Can you explain to the listeners a little bit about insulin, what it is?
• 0:59
  Shelli Calhoun, RN: Well, insulin is a hormone.
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  So, it's a messenger.
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  And in this case, it's kind of like a key to unlock the cell so that the
• 1:11
  cell opens up for the glucose and that provides the energy for the cell.
• 1:19
  Melanie Cole, MS: So Shelli, we hear type 1 and type 2.
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  Tell us what the difference is between type 1 and type 2.
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  Why do they have different names?
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  What's different about them?
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  Shelli Calhoun, RN: Type 1 is where your autoimmune system kicks in and sees the
• 1:36
  beta cells on your pancreas as a threat, and it attacks and kills the beta cells.
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  The beta cells are what produces the insulin.
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  So once that happens, your body is no longer producing the insulin, so the cells
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  aren't going to open up and allow the glucose to come in to be used for energy.
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  So type 1 diabetics, they're insulin dependent.
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  They require outside sources of insulin in order for the cells
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  to open up for the glucose.
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  Type 2 diabetes is where the body doesn't use the insulin that's being produced.
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  The cells aren't opening up unless you have more and more insulin.
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  And eventually, your beta cells, they try to make extra insulin.
• 2:26
  But unfortunately, eventually, they kind of peter out and blood sugar goes up.
• 2:33
  Melanie Cole, MS: Well, thank you for that.
• 2:34
  So, that was an excellent explanation you just gave us.
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  And speak a little bit about causes.
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  Do we know is there a genetic component to diabetes?
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  Shelli Calhoun, RN: So, genetics does play a big factor,
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  especially in type 2 diabetes.
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  They're not really sure with type 1.
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  I know autoimmune diseases can play a factor, and genetics
• 3:00
  can play a factor in that.
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  So if your family has a history of autoimmune diseases, you can
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  be at risk for type 1 because it is an autoimmune disease.
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  Type 2, it's genetics.
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  If you're overweight.
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  It could be in age, it can even be prevalent with your ethnicity or
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  races, ethnic groups such as African Americans, Hispanic Americans, Native
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  Americans, and even some Asian Americans.
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  And then, there's also a lifestyle factor, whether you're
• 3:34
  sedentary and even a poor diet.
• 3:38
  Melanie Cole, MS: So, now tell us about symptoms.
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  How does somebody know?
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  I mean, we're getting our A1c checked at our blood work.
• 3:45
  But other than that, how does someone know?
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  Is there some symptoms, red flags you'd like to point to?
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  Shelli Calhoun, RN: Yeah.
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  So, a lot of type 2 diabetics we're noticing complaint of blurred vision.
• 3:59
  They may have just been to the eye doctor, they got a new prescription,
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  they're wearing their glasses.
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  And all of a sudden, they're starting to have blurred vision.
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  That could be a red flag.
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  Going to the bathroom more than usual, urinating more often.
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  Feeling extremely thirsty or hungry can be a sign and symptom.
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  Cuts or bruises that aren't healing or take an extra long time to heal.
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  If you're feeling extra tired and sleepy, and tingling pain or numbness
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  in either both hands and/or both feet
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  . Melanie Cole, MS: Thank you for telling us about those.
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  So, tell us about the diabetes education program.
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  How do patients receive your services?
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  What can they expect?
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  Tell us about your team
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  Shelli Calhoun, RN: So, they'll need a diabetes referral from their provider.
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  And then, really, diabetes education, I consider it a partnership.
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  I consider it something between me and the patient.
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  We focus a lot on some practical tools that they could use.
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  I offer support and I give them as much information as they can handle
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  so that they themselves can make good decisions about their health
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  and help them as best as I can to make the best choices for themselves.
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  Melanie Cole, MS: Tell us a little bit about what you do with them
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  because there are no one-size-fits-all rules and it is a lot of lifestyle.
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  I mean, obviously, there's medication involved, but there's a lot of lifestyle.
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  So, tell us how you help them manage it.
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  Shelli Calhoun, RN: Well, we go over, you know, how often are
• 5:39
  they checking their blood sugar?
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  Are they checking their blood sugars?
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  What are they eating?
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  How often are they exercising?
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  What are they doing for exercise?
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  Are they doing anything?
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  It could be something as simple as I joke around about taking tours of their house.
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  So, if they're not comfortable going outside of their home or, you know,
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  if they're just not able to, you know, something as simple as once they've
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  gone to the bathroom, just walking into each room of their house and taking
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  a walk around their house, simple as that, or it can be something where they
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  just go and take advantage of a free track where they can just walk laps.
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  Or whether they just go outside and they walk around their house, or they
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  go outside and they go for a small walk.
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  It could be almost anything, and it can be something where they go to
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  the gym three, four times a week.
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  There's a booklet they could use with a resistance band and there are exercises
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  they can do sitting down or standing up.
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  So, it's just based off of whatever that individual, that patient can
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  handle, what they feel that is realistic for them that they can do.
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  Melanie Cole, MS: And where does nutrition fit into that picture then?
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  As you're working with them about their lifestyle, their activity, their exercise,
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  all those things, where does nutrition and that sort of management fit into
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  this picture of how you're helping them?
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  Because they certainly do have to look at their diet, maybe weight loss.
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  There's a bunch of things involved.
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  Shelli Calhoun, RN: We go over carbohydrates and how they
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  can affect the blood sugar.
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  We also go over protein.
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  We discuss healthy fats versus not healthy fats, and eating
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  carbohydrates in moderation.
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  I tell them it's all up to them.
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  A lot of them come in thinking that they got this diabetes
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  from eating too much sugar.
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  So, we kind of go over that and we talk about carbohydrates versus just
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  sugar alone, and some ways that they can maybe eat healthy, get what they
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  need, the essential nutrients, and we just have conversations based on that.
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  And we play a lot.
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  I have fake food that I get out, and we go over how to kind of simply carb
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  count and make sure they get their protein and their healthy vegetables and
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  fruits and fiber and all the good stuff.
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  Melanie Cole, MS: And so, Shelli, what would you like them to understand
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  about this condition, about living with diabetes, that it's manageable
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  and that they can take control of this and you can help them do that.
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  Shelli Calhoun, RN: I just want people to understand that it's not
• 8:36
  always about eating too much sugar.
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  It's not necessarily always about making poor choices.
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  Baby steps are still steps moving forward.
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  So, it doesn't matter if it's something teeny-tiny small that
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  you feel is going to help you be successful, or if it's something really
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  big that you feel you can handle.
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  It doesn't matter what it is, just moving forward to help you
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  control your diabetes so you don't have the risk of comorbidities.
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  Melanie Cole, MS: Thank you so much, Shelli, for telling us about how you
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  are helping people living with diabetes.
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  Thank you so much again.
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  And I'd like to thank our Bryan Foundation partner, Eide Bailly.
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  To listen to more podcasts from our experts, please visit
• 9:24
  bryanhealth.org/podcasts.
• 9:25
  That concludes this episode of Bryan Health Podcast.
• 9:29
  Please always remember to subscribe, rate, and review Bryan Health Podcast on Apple
• 9:33
  Podcasts, Spotify, iHeart, and Pandora.
• 9:36
  Until next time, I'm Melanie Cole.