Latest / The Healthy Diabetic / #393: Smart Insulin, Stem Cells & The Future of Type 1 Diabetes

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#393: Smart Insulin, Stem Cells & The Future of Type 1 Diabetes · The Healthy Diabetic

0:14
SPEAKER_02: Welcome back.
0:15
SPEAKER_02: This is episode number 393 of the Healthy Diabetic Podcast.
0:21
SPEAKER_02: I'm your host, Coach Ken Kenniss.
0:23
SPEAKER_02: As always, joining me today is my good partner and diabetic partner in crime, Graham Hubbard.
0:30
SPEAKER_02: If you don't know much about our story, we are two type ones with over 50 years of lived diabetes experience.
0:36
SPEAKER_02: And we hope to inspire you to think differently about your diabetes.
0:41
SPEAKER_02: As always, before we get started, please remember that nothing that you hear on this podcast should be considered medical advice or otherwise.
0:46
SPEAKER_02: Please always consult your medical team before making any changes to your diabetes management.
0:52
SPEAKER_02: Okay, let's get into it.
0:54
SPEAKER_02: Graham, another episode, another day, another great day to be a diabetic.
0:58
SPEAKER_02: What's up, man?
0:59
SPEAKER_02: How you doing?
1:00
SPEAKER_00: Are you watching any Halloween movies?
1:03
SPEAKER_01: The girls like to watch some Halloween movies.
1:05
SPEAKER_01: I'm not like watching a bunch of Halloween movies.
1:08
SPEAKER_02: They like the Halloween town movies.
1:11
SPEAKER_02: Yeah, they're they're really into like the zombie series now.
1:14
SPEAKER_00: Do you so do you put everybody to bed and give yourself a scare type of?
1:19
SPEAKER_02: No, I put everyone to bed and or actually I put myself to bed and then Kelly puts the girls to bed.
1:25
SPEAKER_02: That's that's really how it goes down.
1:27
SPEAKER_00: Okay.
1:27
SPEAKER_00: The analogy of what I'm like, do you enjoy having some time to yourself and watching a fright, a jump scare type movie, or no, not at all?
1:35
SPEAKER_02: Not at all.
1:36
SPEAKER_02: Not at all.
1:38
SPEAKER_02: Okay.
1:38
SPEAKER_02: I I did not like the old Jason or Hellraiser or Friday the 13th.
1:45
SPEAKER_02: Like I didn't I did not like all of those movies.
1:48
SPEAKER_00: That's the big one out that I heard right now.
1:50
SPEAKER_00: It's I think it's called Crystal Lake, which is the camp where Jason is from, Camp Crystal Lake.
1:57
SPEAKER_00: But it's the uh it goes back to like Jason's mom.
2:00
SPEAKER_00: So like Jason's mom plays into the Jason story.
2:04
SPEAKER_00: This goes back to like Jason's mom to where she became like the origins of Jason's mom, like when Jason was a kid.
2:12
SPEAKER_00: I think it's it's called Crystal Lake.
2:13
SPEAKER_00: I think it's on like it's on on the apps, but that's what everybody's talking about.
2:17
SPEAKER_00: But uh so nothing goes across your head like it's October.
2:21
SPEAKER_00: I should watch something scary.
2:22
SPEAKER_01: Not watching something scary because I don't really like scary movies.
2:26
SPEAKER_00: What about like a classic fun, like a Ghostbusters?
2:30
SPEAKER_02: Oh yeah, I'll watch Ghostbusters.
2:32
SPEAKER_02: Like I said, the girls, we like that Halloween town, those Halloween town movies.
2:36
SPEAKER_02: I don't know if I know Halloween Town.
2:38
SPEAKER_02: They're old school, man.
2:39
SPEAKER_02: They're like 80s, maybe early 90s.
2:43
SPEAKER_02: I think I could be totally wrong about that.
2:45
SPEAKER_02: Well, they're older.
2:46
SPEAKER_02: They're older.
2:46
SPEAKER_02: They're older, yeah.
2:47
SPEAKER_02: Okay.
2:48
SPEAKER_02: We do uh movies.
2:50
SPEAKER_00: We do uh they're they're cute.
2:51
SPEAKER_00: Hotel Transylvania, that's a good one.
2:54
SPEAKER_00: I like Jack Skellington, the nightmare.
2:56
SPEAKER_00: So is night is Nightmare before last question.
2:59
SPEAKER_00: Is Nightmare before Christmas?
3:01
SPEAKER_00: Halloween.
3:02
SPEAKER_00: A Halloween movie or a Christmas movie though?
3:05
SPEAKER_02: I think it's a Christmas movie, technically, but it could be a Halloween movie, too.
3:09
SPEAKER_00: My argument is always you're not in the mood to put that on on Christmas.
3:13
SPEAKER_00: You're in the mood to put that on during Halloween.
3:16
SPEAKER_02: Yeah.
3:17
SPEAKER_00: Because it's more boring and dark and spooky.
3:20
SPEAKER_02: That's why it could be both.
3:22
SPEAKER_00: Hey, on the topic of movies, did you ever see the movie Purple Hearts?
3:27
SPEAKER_00: I sure did.
3:28
SPEAKER_00: Okay.
3:29
SPEAKER_00: Great movie.
3:30
SPEAKER_00: Give me a quick uh synopsis about it.
3:32
SPEAKER_00: Like my Did you watch it?
3:34
SPEAKER_00: I I didn't I don't even know that I knew about it.
3:37
SPEAKER_02: Oh, it came out years ago.
3:39
SPEAKER_00: It's 2022.
3:40
SPEAKER_00: 2022 with Purple Hearts.
3:42
SPEAKER_02: Yeah, so three years, four years ago.
3:43
SPEAKER_02: Yeah, it's a really good movie.
3:45
SPEAKER_02: You remember the scoring?
3:47
SPEAKER_02: A type 1 diabetic.
3:50
SPEAKER_02: She's uh I think she was a server or something like that, or something like that, but she lost her health insurance and wasn't able to pay for her insulin.
4:00
SPEAKER_00: She She was a singer.
4:02
SPEAKER_02: Go ahead.
4:02
SPEAKER_02: Oh, yeah, okay.
4:03
SPEAKER_02: That's right.
4:03
SPEAKER_02: Yes.
4:04
SPEAKER_02: My apologies.
4:04
SPEAKER_02: Yes, she's a singer.
4:07
SPEAKER_02: And uh so she didn't have health insurance.
4:10
SPEAKER_02: I think she got booted off of her parents' health insurance or something like that, or she didn't have health insurance, so she was rationing her insulin and couldn't pay for new insulin, couldn't get a CGM, couldn't get any of this, any of the things.
4:24
SPEAKER_02: So then she met this uh guy who was going into the military, was getting ready to go to boot camp, go into the Marines.
4:34
SPEAKER_01: Mm-hmm.
4:35
SPEAKER_02: And he owed people money, I believe, and they came up with this idea that they could marry and she could because they're married, they got he got like a certain amount of money because they were married to pay for to help pay for her living expenses and all that type of stuff, why he's overseas and why he's in like in the Marines.
5:03
SPEAKER_02: And so it was like this big controversy thing, but then she was able to get on medical insurance or get actual insurance, so she got on an insulin pump and a CGM, learning about how to use it, you know, it the rest is like, you know, it's just like a it was a c it was a really cool movie.
5:24
SPEAKER_02: However, there was there was definitely things in that movie that were like, yeah, that's not real, or that wouldn't that wouldn't happen.
5:30
SPEAKER_02: Like she had a she had a severe low blood sugar episode in the movie, and she got like juice or something like that, and then like came right out of it, which that wouldn't it would take a little bit to come out of it.
5:44
SPEAKER_02: So or or maybe not.
5:46
SPEAKER_02: Maybe she said that it would like it would take 15, 20 minutes.
5:49
SPEAKER_02: Maybe they did get it.
5:49
SPEAKER_00: This is a Netflix movie.
5:50
SPEAKER_00: I remember seeing it.
5:51
SPEAKER_00: Cool.
5:52
SPEAKER_00: I'm gonna go back and it, you know what?
5:53
SPEAKER_00: This might have been up for best this might have been up for best picture too.
5:57
SPEAKER_02: It might have been, but the really cool thing is the singer wasn't actually type 1 diabetic, but her friend in the movie was type 1 diabetic.
6:04
SPEAKER_02: So the friend, the girl that played her friend in the movie actually is type 1 diabetic, and she was like telling the directors and working closely to try and working closely with the actress that was playing the main character that had diabetes to try to get everything right of what it actually does, how it acts how you actually live with diabetes.
6:26
SPEAKER_02: So it's it's a fantastic I did it, I did a whole episode on it.
6:29
SPEAKER_00: Really?
6:30
SPEAKER_02: Yeah.
6:31
unknown: Okay.
6:32
SPEAKER_02: Yeah, after I watched it when it came out in 22.
6:34
SPEAKER_02: Or maybe I watched it in 23.
6:36
SPEAKER_00: Let's have a you know what?
6:37
SPEAKER_00: Let's have a little bit of because it is October, it's October 21st.
6:40
SPEAKER_00: Let's have a look, let's have a little bit of fun, because I had something pop up here, and I'm gonna let me ask you about a couple, because there is one that doesn't come up on most people's list, but I'm gonna recommend it and I'll tell you why.
6:52
SPEAKER_00: And it's a true story.
6:54
SPEAKER_00: So I kind of brought this up as an ode to uh to Dolly Parton.
7:00
SPEAKER_00: And do you know do you know why?
7:02
SPEAKER_00: So Dolly Parton was in Steel Magnolias.
7:06
SPEAKER_00: Do you know what Steel Magnolias was?
7:09
SPEAKER_00: Yeah, so that's like the famous movie where Julia Roberts has diabetes and she passes away.
7:14
SPEAKER_00: So I was thinking about some diabetes movies and I and I looked them up.
7:20
SPEAKER_00: Really quickly, one that came up was Turning Red in 2022, which is an animated movie.
7:27
SPEAKER_00: So it says, though not explicitly mentioned in the dialogue, eagle-eyed viewers celebrated Pixar's inclusion of two minor characters wearing visible insulin pump infusion sets on their arms.
7:40
SPEAKER_00: It says because the film is set in 2002, the models are historically accurate for the era.
7:48
SPEAKER_00: Some that we I don't know that we ever talked about.
7:51
SPEAKER_00: I remember noting noting this though, Greenland with uh that was in 2020 with Gerard Butler.
8:00
SPEAKER_00: And he gets, I think that's the movie where he gets like a phone call and he's like, hey, if you show up to these grounds, you're gonna save you from like the end of the earth is coming, but only a few people are getting this phone call.
8:11
SPEAKER_00: I'm pretty sure I'm right.
8:13
SPEAKER_00: Hey, get here, and I think the kid has diabetes.
8:16
SPEAKER_00: Okay, so okay, then do you remember in Conair?
8:21
SPEAKER_00: Do you remember the diabetic in Conair?
8:23
SPEAKER_00: What do you remember about that?
8:24
SPEAKER_00: What do you remember about that?
8:26
SPEAKER_02: Just the fact that his buddy that he befriended when he was in prison was a diabetic.
8:34
SPEAKER_02: That's it.
8:34
SPEAKER_02: And they they had multiple scenes where he was taking a shot.
8:39
SPEAKER_02: And he had a low blood sugar in the scene in one of the scenes too.
8:42
SPEAKER_00: Wasn't wasn't the wasn't the climax to the original, like them going crazy was the guy fake, like he's like, hey man, my blood sugar's low, and he starts yelling and he's saying and he pretends that he's having a seizure and he's like, yo, get up here.
8:56
SPEAKER_00: Yeah.
8:57
SPEAKER_00: That's that's that's Connor, right?
8:59
SPEAKER_00: Yeah, yeah.
9:00
SPEAKER_02: So the yeah.
9:02
SPEAKER_00: So okay, so the one I was the one that I was thinking about, there's a movie called The Good Nurse.
9:08
SPEAKER_00: I think I've mentioned this before, and it's with Eddie Redmane, who was up for Academy Award, too.
9:15
SPEAKER_00: I don't know if he won an Academy Award.
9:17
SPEAKER_00: He was the guy that played Stephen Hawking.
9:20
SPEAKER_00: Remember the movie about Stephen Hawking where the guy acted it?
9:22
SPEAKER_00: That's Eddie Redmane.
9:24
SPEAKER_00: But he was in a movie where he was a nurse and it's a true story, and he would go up as a nurse, he would go up to people's IV bags and he would inject them with insulin, and it would eventually get to the person's heart and kill them.
9:42
SPEAKER_00: And as the hospitals, and this is a true story, again, I'm almost positive it's called the good nurse.
9:51
SPEAKER_00: But as the hospitals found out about it, they essentially would just kind of wipe him under the rug and move him to a different hospital, in a different hospital, in a different hospital.
10:00
SPEAKER_00: And in the end, I think he killed dozens of people this way.
10:04
SPEAKER_00: And I didn't know at the time that that is what insulin, but that is that that is exactly what insulin does to a regular person, that it stops, that it actually affects your heart.
10:14
SPEAKER_00: Were you aware of that?
10:15
SPEAKER_02: Well, it depends on what it's put with because it's that's not accurate whatsoever.
10:20
SPEAKER_02: Because think about all the bodybuilders that are taking a a stupid amount of insulin.
10:24
SPEAKER_00: Well, that's that's to regulate.
10:26
SPEAKER_02: It's not to regulate.
10:27
SPEAKER_02: They're not taking insulin to regulate blood sugar.
10:31
SPEAKER_02: They're taking insulin to to because they're on these high, high, high carbohydrate diets.
10:37
SPEAKER_02: They're they're taking insulin to they're saying support their pancreas so their pancreas doesn't have to work so hard.
10:44
SPEAKER_00: Yeah.
10:45
SPEAKER_00: I'm saying they're regulating because you they're regulating the other things that they're putting in their body with that insulin.
10:53
SPEAKER_00: Somebody who is just a patient sitting on a hospital bed that doesn't take even an aspirin who happens to end up in the hospital that has an IV drip, synthetic insulin, that's what it does.
11:04
SPEAKER_00: It causes cardiac arrest.
11:07
SPEAKER_02: Well, I don't know if it causes cardiac arrest, though.
11:09
SPEAKER_02: Cardiac arrest might be one of the one of the things that happens when your blood sugar goes low like that.
11:16
SPEAKER_00: Okay.
11:16
SPEAKER_00: Okay, keep going.
11:18
SPEAKER_02: You see what I'm saying?
11:19
SPEAKER_02: Because in that in that instance, okay, the the patient, their blood sugar is normal.
11:26
SPEAKER_02: So their blood sugar is probably between 80 and 110, whatever it might be, especially if they haven't eaten.
11:32
SPEAKER_02: So you it's just like us, if you put insulin into the synthetic insulin into the system, they've got an excess amount of insulin.
11:42
SPEAKER_02: Their system's gonna try to bring in more sugar from the liver, from the muscle, from the muscles.
11:49
SPEAKER_02: It's gonna it because that's how everything's regulated, right?
11:52
SPEAKER_02: The system prevents you from having a hypoglycemic episode that's going to kill you if you don't have type 1 diabetes, because all of those organs and everything communicates together.
12:02
SPEAKER_01: So here, listen.
12:04
SPEAKER_02: So but pretty much hold on, hold on.
12:06
SPEAKER_02: So but what I'm what I'm saying is is if someone if someone is not type 1 diabetic and they're giving themselves synthetic insulin without over without giving themselves a blood sugar spike, 100% they're gonna have issues because they're gonna go into hypoglycemia.
12:23
SPEAKER_02: And hypoglycemia comes with tons of different types of symptoms.
12:27
SPEAKER_02: People pass out and you can have a heart attack.
12:29
SPEAKER_02: People pass out and like you don't wake up.
12:30
SPEAKER_02: People pass out, and like there's so many different things that can happen when you go into a hypoglycemic episode.
12:36
SPEAKER_00: Yeah, it says if a non-diabetic takes insulin, the hormone forces the body's existing blood sugar rapidly into muscle and fat cells without a diabetic baseline of high blood glucose to buffer this reaction.
12:50
SPEAKER_00: It triggers two severe physiological cascades that can culminate in cardiac arrest.
12:59
SPEAKER_00: Cardiac arrest is one of the byproducts.
13:01
SPEAKER_00: Because Jesus, those are hardware.
13:03
SPEAKER_00: Huh?
13:03
SPEAKER_00: Yeah.
13:04
SPEAKER_02: Cardiac arrest isn't because they took a bunch of insulin.
13:07
SPEAKER_02: Cardiac arrest is because they're having a hypoglycemic episode.
13:11
SPEAKER_00: Which is an overdose of insulin.
13:13
SPEAKER_00: An overdose of insulin causes potassium levels in the blood to plummet dangerously low.
13:19
SPEAKER_00: Or as you said, as blood sugar drops below critical levels, the individual will experience seizures, uh, lose consciousness, and slip into a deep coma.
13:27
SPEAKER_00: So yeah.
13:28
SPEAKER_02: Yeah.
13:28
SPEAKER_02: So I don't I again, I could be wrong, but I don't think the the hypoglycemic episode is causing a heart at cardiac event.
13:38
SPEAKER_02: I think the cardiac event is a byproduct of being their body being in that state.
13:44
SPEAKER_02: Just like they could have a seizure, just like they could pass out and go to a coma, right?
13:50
SPEAKER_02: So there's different things that can happen when you have a hypoglycemic episode, which is why our doctors try to keep us from having hypoglycemic episodes.
13:58
SPEAKER_00: Yeah.
14:00
SPEAKER_00: To put a ribbon on what we were saying, though, the final, final movie is Memento.
14:06
SPEAKER_00: You ever seen Memento?
14:07
SPEAKER_00: Do you remember?
14:08
SPEAKER_00: Do you remember about Memento and the ins and the insulin injections?
14:14
SPEAKER_01: Yeah.
14:15
SPEAKER_00: Okay.
14:15
SPEAKER_01: Mm-hmm.
14:16
SPEAKER_00: If you've never seen that movie, I don't want to give a spoiler, but it has to do with very carefully timed insulin injections that cause.
14:23
SPEAKER_02: Yeah, so that that was post-CGM, post-synthetic insulin that we or pre, not post, but pre-synthetic insulin that we have now, right?
14:34
SPEAKER_02: That was like timed insulin, probably, probably, what's it called now?
14:40
SPEAKER_02: Uh oh my god.
14:41
SPEAKER_02: Brain fart.
14:42
SPEAKER_02: Brain fart.
14:44
SPEAKER_02: Brain fart.
14:44
SPEAKER_02: What was the insulin that you used to be on?
14:46
SPEAKER_02: Like when you were first diagnosed?
14:47
SPEAKER_00: Regular MPH?
14:49
SPEAKER_02: Yes, thank you.
14:50
SPEAKER_02: MPH.
14:51
SPEAKER_02: Or in yeah, MPH, NPH.
14:53
SPEAKER_02: Okay.
14:53
SPEAKER_02: That that that's that from that movie, right?
14:56
SPEAKER_02: It wasn't the type of insulin, fast-feating insulin that I believe so.
15:02
SPEAKER_02: I believe so.
15:02
SPEAKER_02: But the really cool thing I loved about Memento is you can watch it in forward and in reverse.
15:08
SPEAKER_00: Christopher Nolan has videos of how he wrote that, and that's how he explains it out on the whiteboard, which is pretty cool.
15:15
SPEAKER_02: So I think it's cool when you watch it in reverse.
15:18
SPEAKER_00: But do you hear what I said?
15:20
SPEAKER_00: There's a video of Christopher Nolan on a whiteboard, and he writes out the story, and he does it like essentially in that like in like a C like not a circle, but like a C, and he explains how it Yeah.
15:33
SPEAKER_00: Hey, have we discussed G R I's glucose responsive insulins?
15:42
SPEAKER_02: We have not discussed this.
15:44
SPEAKER_00: For real.
15:45
SPEAKER_02: We've never discussed this.
15:46
SPEAKER_00: Do I gotta do I got a doozy for you, my friend?
15:51
SPEAKER_00: Essentially, I'll give you my quick analysis of it because I've been reading about this.
15:58
SPEAKER_00: The idea is insulin, a much a much not a not as regular, a not as regular dose of insulin, so call it a weekly dose of insulin that directly works with glucose coming into the body, into the bloodstream, where it's only reacting to fluctuations in your blood sugar levels.
16:28
SPEAKER_00: I'm trying to make it I'm trying to make it sound like fun and easy without like reading it, but um just give me your give me your perspective of what you think.
16:36
SPEAKER_00: It's exactly it's exactly that.
16:38
SPEAKER_00: It's essentially an insulin that would sit in your body and when you would eat, it would it would start doing it would start doing its thing.
16:47
SPEAKER_00: When it's sensed, when it as it is, it's glucose responsive insulin.
16:52
SPEAKER_02: It's it's a smart insulin.
16:54
SPEAKER_00: It's the smart insulin that they've been trying to for the past the one article titled them it bringing smart free wait bringing smart needle-free insulin to clinical studies.
17:10
SPEAKER_00: So again, this is literally pills.
17:16
SPEAKER_00: This idea is you would take pills and you're not even taking injections where it's gonna sit and do just that.
17:23
SPEAKER_00: It's gonna respond to high blood sugar levels, it's gonna respond to here again.
17:29
SPEAKER_00: I don't want to be reading off of this, but okay, so let's talk about this.
17:34
SPEAKER_02: So we got that we got the gist of it.
17:35
SPEAKER_02: Let's talk about it.
17:36
SPEAKER_00: Okay, okay, cool.
17:37
SPEAKER_00: Yeah, I don't wanna like be all ner I don't want to be all scientific about and go ahead.
17:41
SPEAKER_02: What what part of the diabetes population do you think that this particular medication would be good for?
17:50
SPEAKER_00: I I wonder if it's the future of insulin altogether.
17:52
SPEAKER_02: It's not the future of insulin.
17:54
SPEAKER_02: I don't think it is, but there's a specific population of diabetes that this is actually probably pretty good for.
18:01
SPEAKER_02: Who would it be?
18:02
SPEAKER_02: Okay.
18:03
SPEAKER_02: Who would it be?
18:04
SPEAKER_00: That's obvious.
18:05
SPEAKER_02: I guess it's obvious what you're saying, but Well, who would it be?
18:09
SPEAKER_02: If it's obvious, who would it be?
18:10
SPEAKER_02: A type 2.
18:11
SPEAKER_02: Correct.
18:12
SPEAKER_02: Correct.
18:13
SPEAKER_02: It would be for a type 2 diabetic because this insulin, if this insulin is sitting in the bloodstream and it's like smart insulin, I'm using quotation marks, it's smart insulin, it detects if you have if you are going to rise, and then it springs into action.
18:30
SPEAKER_02: Basically, what your normal pancreas beta cells do, it's exactly what your normal beta cells and pancreas does.
18:38
SPEAKER_02: It communicates with T cells, it communicates with other organs, it communicates with other mechanisms or whatever throughout the body.
18:45
SPEAKER_02: And as soon as you eat something, as soon as you eat something, the enzymes in your mouth and in your tongue communicate to your brain, your brain tells your body and your pancreas, okay, we need insulin, we're having we're eating this much food, and then the whole process happens.
19:00
SPEAKER_02: This is kind of the same idea.
19:02
SPEAKER_02: Why I think that it's not the greatest idea for a type 1 diabetic is because so many other things are happening in the background besides you just eating food and a and you having a blood sugar spike, right?
19:16
SPEAKER_02: So is this smart insulin understanding food intake, or is this smart insulin understanding, okay, I see a blood sugar rise, so I'm going to kick into action?
19:29
SPEAKER_02: How much?
19:30
SPEAKER_02: And then how much is it actually giving?
19:32
SPEAKER_02: Because the the way I think about blood sugar and dosing for a rise or do dosing for you know food or whatever, dosing for correction, whatever it is, it's it's all based off of how much insulin that you're actually taking in units, right?
19:50
SPEAKER_02: So in that concept, right, and it I know it's probably different in this example, but is it like is this smart insulin or whatever we want to call it, it notices your blood sugar rises, and then it knows exactly how much of that insulin from that pill that it needs to give.
20:11
SPEAKER_02: How much insulin is that pill?
20:13
SPEAKER_02: Like, is is there a specific how long does it last?
20:16
SPEAKER_02: Like that's the that's the interesting questions about these things.
20:20
SPEAKER_02: Because right now, the way currently understand diabetes and managing diabetes with insulin, whether it's you're using, you know, NPH like we talked about earlier, where you regular insulin, whether you're using like the medium-speed insulin, fast-acting insulins, you know, slow-acting insulins, whatever you're using, there's a specific understanding that I need based off of my height, my weight, the formulas, I need this much insulin for whatever activity that's happening.
20:50
SPEAKER_02: Whether it's I'm playing a sport and I've got all this adrenaline going and now my blood sugar is spiking, so I need an extra unit, two units to help with that adrenaline spike, whatever it might be.
21:01
SPEAKER_02: Whether it's I'm eating 50 grams of carbs and my insulin to carb ratio is one to ten, so I need, you know, five grand or five units of insulin, right?
21:11
SPEAKER_02: So that that's where the interesting piece of, that's how I understand dosing and managing insulin.
21:17
SPEAKER_02: When you have a healthy pancreas, it doesn't matter because there's the communication is happening between all of the mechanisms, organs, whatever you want to call it, hormones that are involved in making that decision for the body.
21:30
SPEAKER_02: I'm like, you need 0.35 units right now for this food that you ate.
21:34
SPEAKER_02: You need 0.35 units because you're rising a little bit because of adrenaline.
21:38
SPEAKER_02: All that stuff happens in the back end when you have a healthy pancreas and you don't even think about it.
21:44
SPEAKER_02: But that's like the there's all this technically, there's all this math that's happening in the back in the background that your pancreas is is formulating and working through as it communicates to all the other hormones, as it communicates with insulin, as it Communicates with the brain, as it communicates with your muscle tissue, as it communicates with your liver.
22:05
SPEAKER_02: Do you pull sugar?
22:06
SPEAKER_02: Do you need to pull sugar because you're going low?
22:08
SPEAKER_02: And then do you need more like there's so many things that people don't really understand by not biomechanically, but biologically?
22:17
SPEAKER_02: There you go.
22:18
SPEAKER_02: Biologically.
22:20
SPEAKER_02: That's happening in the body when the body needs insulin.
22:25
SPEAKER_02: So that that's the interesting question I would have with this smart insulin and why I can understand it would be a really good medication potentially for type 2 diabetes, because I can take it and it would work almost like a GLP 1 right now would work, metformin would work, where it's just it's helping to reduce inflammation, it's helping to reduce insulin resistance.
22:46
SPEAKER_02: But this medication, basically, you've got just insulin that's helping a type 2 diabetic when their insulin, because they have high levels of insulin resistance, their insulin can work better.
22:56
SPEAKER_02: Or it's got support, whatever it is.
22:59
SPEAKER_02: So it's an interesting.
23:01
SPEAKER_02: I'd have to like go and read the article that you're actually talking about.
23:06
SPEAKER_00: Oh, it's not just articles.
23:08
SPEAKER_00: This actually goes way back.
23:09
SPEAKER_02: This tech this this Well, I know it's been it's they've been working on it for a long time, and I think it's very it's very interesting.
23:16
SPEAKER_02: I But I just as of right now, from what I understand of it, I don't know if it is something that would be utilized or could be utilized to the masses for type 1 diabetes.
23:30
SPEAKER_02: So I absolutely see how it could be utilized for type 2 diabetes.
23:34
SPEAKER_00: I don't necessarily disagree with anything you're saying.
23:36
SPEAKER_00: I think I think you got a little bit distracted by the idea of it being in a pill, but I don't know.
23:42
SPEAKER_02: It doesn't matter if it's a pill or if it's liquid.
23:43
SPEAKER_02: It doesn't matter.
23:45
SPEAKER_00: My argument is why are they calling it in if it's if it's more complex than just a pill formula, why are they calling it insulin?
23:52
SPEAKER_02: Because it is insulin.
23:54
SPEAKER_02: That's what it is.
23:55
SPEAKER_02: It's just in a it's just in a different chemical.
23:57
SPEAKER_00: Metformin is an insulin.
24:00
SPEAKER_02: Metformin is not an insulin, but what metformin can do is it could it could it one, it reduces inflammation, which we know that when you have a high amount of inflammation in the digestive system, in the muscle tissue, in the brain, wherever it is, once that happens, insulin resistance increases.
24:20
SPEAKER_02: So not only are you getting high levels of insulin resistance from the food that you're consuming because you're eating tons of ultra-processed foods in your sedentary, you don't exercise, you don't sleep, you don't, whatever it might be, right?
24:34
SPEAKER_02: Whatever's driving that insulin.
24:36
SPEAKER_02: So you're you're you're driving insulin resistance up in type 2 diabetes from the foods that you're consuming, your lifestyle, but then also stress levels, hormones, and what metformin and these GLP1s are doing is it's reducing that inflammatory response.
24:53
SPEAKER_02: So your body can uptake insulin easier.
24:57
SPEAKER_02: Now you definitely need to change your eating habits, and that would also help, because you're not throwing a bunch of sugar that needs to be broken down into the into the into the cells.
25:10
SPEAKER_02: You know, you you we've talked about that locking mechanism, and like if not enough sugar and and stuff is getting into the cell, then that locking mechanism won't let let blood sugar in and the communication.
25:21
SPEAKER_02: We've talked about all that before.
25:23
SPEAKER_02: But so when you think about something like this, it it's it is insulin.
25:30
SPEAKER_02: Just because it's not coming in a liquid form, it's still pretty, I'm sure, I'm I'm I'm pretty sure it is still insulin.
25:36
SPEAKER_02: It's just how much insulin.
25:38
SPEAKER_02: Because what they're doing is they're programming it not to break down, they're programming it to communicate with the hormone, with the other hormones to be able to dictate detect blood sugar spikes, which is which is super awesome.
25:51
SPEAKER_02: It's super cool to think about, right?
25:54
SPEAKER_02: And maybe that type of technology is going somewhere where I say, okay, as a type one, okay, why take 40 units of insulin with basal insulin and bolus insulin a day, right?
26:07
SPEAKER_02: Okay, well, I can take this pill, and this pill is basically gonna help with that 40 units.
26:13
SPEAKER_02: It's like a 40 unit pill as an example, right?
26:17
SPEAKER_02: Maybe that, maybe that could potentially happen.
26:20
SPEAKER_02: Where now we're not taking shots anymore.
26:22
SPEAKER_02: Now we're not having to be tied to an insulin pump anymore.
26:27
SPEAKER_02: Now we don't have to do the math anymore.
26:29
SPEAKER_02: Now we don't have to worry about pre-bulsing anymore.
26:32
SPEAKER_02: That so that there's all kinds of really cool stuff that that this potentially could be, but as what I know of the technology right now, which isn't a lot, what it sounds like is it would be more beneficial as of right now for type 2 diabetes and pre-diabetes.
26:52
SPEAKER_02: So it would help for with that uncontrolled blood sugar from someone's meal because they're so insulin resistant.
27:00
SPEAKER_02: Their body, their body simply can't produce or uptake as much insulin because of insulin resistance.
27:09
SPEAKER_02: They need double, triple the amount of insulin.
27:12
SPEAKER_00: So with everything on the table right now, what to you seems like the most promising technology of everything that's on the table?
27:21
SPEAKER_00: In in in 20, in 10, in let's say in 20 years from now, what's gonna be the story of diabetes?
27:28
SPEAKER_02: I think personally, and I don't know how I feel about it.
27:32
SPEAKER_02: Personally, I think it's stem cells.
27:34
SPEAKER_02: It's stem cells.
27:36
SPEAKER_02: I think that's probably the downside.
27:38
SPEAKER_00: That's probably the odds favorite, in my opinion.
27:41
SPEAKER_02: And whatever that means, I think that this Elodon trial is really, really interesting.
27:49
SPEAKER_02: Again, as we look at the drug teleprobar that they're using, it seems like, in the short term, it doesn't look like it has tons of tons of or any issues on the system.
28:02
SPEAKER_02: So being able to use a medication like that along with stem cells, it's a very interesting time.
28:11
SPEAKER_02: Now, obviously, a lot of things have to happen for that technology to be out for everybody.
28:19
SPEAKER_02: But I feel like in 20 some years, like that that's what we're gonna be talking about.
28:24
SPEAKER_02: Some type of stem cell infusion that we're getting that hopefully we don't have maybe you I don't know.
28:32
SPEAKER_02: It just it's just I d I have no idea.
28:34
SPEAKER_02: That's what I feel like is is the future is something like that, because that looks the most promising.
28:41
SPEAKER_02: Now, saying that this taking a pill and allowing your and you don't have to take shots, you don't have to pre-bulse, you don't have to wear a CGM, you don't have to do wear an insulin pump, that sounds really cool.
28:54
SPEAKER_02: That sounds like a a really cool thing.
28:57
SPEAKER_02: What type of side effects does that have?
28:59
SPEAKER_02: Does it have any side effects on any other organs or any other hormones, or is it going to make anything else in dysfunction?
29:07
SPEAKER_02: That's the only that's the only big question, right?
29:10
SPEAKER_02: But that's the big question for anything that we're we're trying to invent right now, even with the Celodon trial.
29:18
SPEAKER_02: Like we it's still it's still early.
29:20
SPEAKER_02: It's so early.
29:22
SPEAKER_02: It's so early.
29:23
SPEAKER_02: We're not even three, four, I think we're not even three or four years into these trials.
29:28
SPEAKER_02: It's gonna take years for people to for us to understand what's the long-term effects of being on teleproof bar, or what's the long-term effects of you know, getting stem cells, or you know, and the Eldon trial is not even getting stem cells, they're getting cadaver cells.
29:44
SPEAKER_00: So that was another thing I was gonna ask you.
29:46
SPEAKER_00: Do you think we're past people having a moral issue with stem cells?
29:51
SPEAKER_02: I don't think so.
29:52
SPEAKER_02: I think there's always gonna be people that have moral issues issues to everything.
29:57
SPEAKER_02: Just like politics, people there's e everybody has their own opinion and their own beliefs, which is fine.
30:04
SPEAKER_02: But the problem is, is when there's all this hate and there's all this like, oh, you you're the worst person in the world because you don't believe what I believe.
30:15
SPEAKER_02: That's not that's not gonna get us anywhere.
30:18
SPEAKER_02: We can think that as a species as much as we want.
30:22
SPEAKER_02: Oh, you you are a different race than me.
30:25
SPEAKER_02: I'm a b I'm better than you, so I'm gonna kill you.
30:27
SPEAKER_02: Or like what whatever it is.
30:29
SPEAKER_02: Like, it's just there's always going to be people that find fault in something.
30:38
SPEAKER_02: There's always gonna be that.
30:39
SPEAKER_02: And I'm not even saying that stem cells should be the answer.
30:43
SPEAKER_02: I'm not.
30:44
SPEAKER_02: I'm not saying that this this you know pill insulin is the it shouldn't be the answer.
30:50
SPEAKER_02: I'm not.
30:50
SPEAKER_02: I don't know what the answer is.
30:52
SPEAKER_02: But what I know for me personally, I'm not going to take something, whether it's a cure, whether it's a pill, whatever it is, without really looking at the research, really looking at what everything says, what are the possible side effects?
31:08
SPEAKER_02: Because if you don't do that and something happens to you later on, you can't be upset about it.
31:14
SPEAKER_02: You didn't ask the questions.
31:17
SPEAKER_02: So I don't know.
31:18
SPEAKER_02: That's just my personal opinion.
31:19
SPEAKER_02: There's always going to be people that are gonna be pissed off at whatever it is when it comes to innovation.
31:28
SPEAKER_02: And if we allowed those types of people that got pissed off about innovation to take a hold and stop diabetes innovation, we wouldn't have CGMs, we wouldn't have insulin pumps, we wouldn't have the synthetic, the synthetic insulins that we have, right?
31:44
SPEAKER_02: So I don't know.
31:46
SPEAKER_02: It's it's a hard pill to swallow because there's there's things about inventions that are created for not humanity, but to make money, and they don't care what it does to humanity and to the people.
32:03
SPEAKER_02: They really don't care.
32:05
SPEAKER_02: And then there's other inventions that come out that are like, holy my god, like a seed, like a like a continuous glucose monitor, like an insulin pump.
32:12
SPEAKER_02: It's like, oh my God, that was the incredible invention for diabetes.
32:17
SPEAKER_02: Moving from NPH to synthetic insulin that's faster.
32:22
SPEAKER_02: Moving from NPH to humolog and novolog and Lemjev and Fiast, that's incredible.
32:29
SPEAKER_02: And that's just gonna keep on happening.
32:31
SPEAKER_02: We're just gonna keep getting better and better and better and better.
32:34
SPEAKER_02: I rem I think about what you said some well on a previous episode before the insulin's pretty good right now.
32:41
SPEAKER_02: What's the incentive to make it better?
32:44
SPEAKER_02: I 100%.
32:45
SPEAKER_02: I don't know if there is.
32:47
SPEAKER_02: I really don't.
32:48
SPEAKER_02: It's good enough.
32:50
SPEAKER_02: They got enough type 1 diabetics on it.
32:52
SPEAKER_02: There's tons of different options.
32:55
SPEAKER_02: What what is what is the incentive for Eli Lilly or Nova Nordisk to make Novolog and Humologue faster?
33:05
SPEAKER_02: I don't know.
33:06
SPEAKER_02: I don't know if they have an incentive.
33:10
SPEAKER_00: I I think my prediction, if I kept it under 20 years, I think what's gonna happen is uh closed loops.
33:22
SPEAKER_00: I think the technology, the AI, the insulin is gonna get so good that it only makes sense to be on a closed loop while we iron out what what this stem cell means.
33:36
SPEAKER_00: I.e., does that mean that Ken and Graham are not gonna have diabetes anymore, or does that mean there's gonna be a vaccine or a treatment or this like a this is like a big topic that we talk about?
33:49
SPEAKER_00: Like, is a is the end of diabetes gonna be the future end of diabetes or the or the right now, right?
33:56
SPEAKER_00: So like I had a vision one time and I thought I I I saw diabetes plateauing on that closed loop, and I could see that happening in the in the next really soundly in 10 years, where if if it look if it's looking like I'm 50 and I'll probably have diabetes for the rest of my life, I'll I'll probably just be on a closed loop.
34:18
SPEAKER_02: So But what what is so here here's my question to you as the patient.
34:23
SPEAKER_02: Someone that doesn't like insulin pumps, someone that doesn't like CGMs, at least as right now in your life.
34:30
SPEAKER_02: Sure, sure.
34:31
SPEAKER_02: You don't like that stuff.
34:33
SPEAKER_02: Okay.
34:34
SPEAKER_02: If the technology is, because it already is, like we can, we can as a as a collective community of type 1 diabetes, we'll just we'll just bucket type 1 diabetes into this conversation.
34:47
SPEAKER_02: As a collective society, a collective community of type 1 diabetes, as of right now, closed loop is where the technology is going.
34:57
SPEAKER_02: Just like you said.
34:59
SPEAKER_02: Because we already have it.
35:00
SPEAKER_02: We already have closed loop systems.
35:02
SPEAKER_02: We already have smart insulin.
35:04
SPEAKER_02: We already have insulin companies creating insulin pumps that are gonna include glucagon as well.
35:11
SPEAKER_02: Right?
35:12
SPEAKER_02: So those things are already happening.
35:13
SPEAKER_02: So you are going to be able to have basically in a nutshell, and you already do, an external pancreas, where most of your decision-making process doesn't have to be there because it's making the decisions for you.
35:29
SPEAKER_02: Here's the problem with this, and we're seeing it, and we just talked about it last episode.
35:35
SPEAKER_02: In order, as of right now, in order for that to happen, in order for your pump to do all the amazing things that it's supposed to do, it has to have accurate data from a CGM.
35:47
SPEAKER_02: And that is not happening on a on a grand scale.
35:52
SPEAKER_02: There are so many, not just DEXCOM, but Abbott Libre 2, like there's there's these insulin companies aren't 100% accurate.
36:02
SPEAKER_02: So until the accuracy gets better, the the real thought about taking off taking your hands off of the system and just allowing it to do its job is not reality.
36:14
SPEAKER_00: I know.
36:15
SPEAKER_00: We said 10 to 20.
36:16
SPEAKER_00: That's why we said 10 to 20.
36:18
SPEAKER_02: Yeah, okay.
36:19
SPEAKER_02: And and I think it'll be er I don't think it'll be faster than 10 to 20.
36:24
SPEAKER_02: I do.
36:25
SPEAKER_02: Because they're already they're already creating or they're already in process of making these insulin pumps that have glucagon.
36:32
SPEAKER_02: So the idea of you going low isn't it soon it's not even gonna exist anymore.
36:39
SPEAKER_02: Sure.
36:40
SPEAKER_02: Which is cool, which is super cool.
36:42
SPEAKER_02: But again, it we run into the issue of the insulin pumps giving me glucagon because my CGM says I'm 40, but I'm actually 120.
36:53
SPEAKER_02: So now an hour later, I'm 200.
36:57
SPEAKER_02: Or vice versa, I'm going low, I'm actually 40, and my blood and my CGM says I'm 130.
37:04
SPEAKER_00: Yeah.
37:05
SPEAKER_02: And it doesn't, it doesn't give me glucagon.
37:08
SPEAKER_02: That's the issue.
37:10
SPEAKER_02: And that's a real that's a real issue that we're that we deal with every single day, even without the the the technology using glucagon.
37:18
SPEAKER_00: Totally.
37:19
SPEAKER_00: And and is with that as an example, but as you read into this, we're talking about the smart insulin or the stem cells.
37:28
SPEAKER_00: These scientists have broken down every little aspect of the human body to like the to the minutiae.
37:36
SPEAKER_00: They know how everything changes this, and how every molecule can do this, and how this can affect that, you know.
37:45
SPEAKER_00: I I think all that technology will come together and it will all it will all really, really, really, really, really understand each other very, very quickly.
37:56
SPEAKER_00: And it'll be like I'm trying to date, I guess I'm trying to date this.
38:00
SPEAKER_00: It was maybe 2008, 2009, when everybody had a flip phone and you came over to your buddy's house, and you're like, bro, are you on like a mini iPad and they're on their iPhone for the first time?
38:12
SPEAKER_00: And at some point it just didn't make sense to have your flip phone.
38:15
SPEAKER_00: It just and that's an analogy for me where I'm at right now.
38:18
SPEAKER_00: It's just at some point it just doesn't make sense.
38:21
SPEAKER_00: You gotta get you gotta get with why would I be why would I keep doing it all by hand when the techno when you know like when the technology will literally do it for me, you know?
38:33
SPEAKER_02: So well, but here's the thing, Graham, and maybe you don't understand this, the technology will already do it for you.
38:40
SPEAKER_02: Because the algorithms are very smart, especially the beta bionic insulin pump.
38:45
SPEAKER_02: It's designed so you don't have to make decisions.
38:48
SPEAKER_02: That's the way that they designed it.
38:50
SPEAKER_02: They designed it basically, you you the only dosing that you can give that thing is small, medium, or large.
38:57
SPEAKER_02: Literally, when you go in a dose for a for a meal, you tell it this is a a because it it tracks your baseline when you first get on it, how much how many grams you take every single day, how much insulin you're taking every single day, right?
39:10
SPEAKER_02: So you just tell it, okay, this is a small meal, a medium meal, a large meal, and done.
39:15
SPEAKER_02: That's it.
39:17
SPEAKER_02: I think you still have to pre-bolish a little bit because you're still using Novolog, Cumulog, Lemjev, Fias, you're still using those insulins, which they require you to pre-bolis because of the way they break down and get into the cell and start that whole activation process that we've always talked about.
39:36
SPEAKER_02: But we already have insulin pumps that take your hands off.
39:40
SPEAKER_02: We do.
39:42
SPEAKER_02: We don't have insulin pumps that take your hands off 100%, but we do have insulin pumps that take your hands off of it.
39:49
SPEAKER_02: I would even argue that the if if you are exercising consistently, sleeping well, hydrating yourself, getting good eating good quality foods, not getting a ridiculous, ridiculous high amount of carbohydrates in one sitting, and you're pre-bullishing and taking enough insulin, the algorithm of the omnipod can take your hands off for the most part.
40:10
SPEAKER_02: The algorithm of the tandem T Slim and the tandem Mobi can take your hand, can allow you to take your hands off.
40:16
SPEAKER_02: The problem is everyone is everyone's life is so crazy that there's other things outside of just the food aspect that raise your blood sugar or low your blood sugar.
40:27
SPEAKER_02: And right now the technology can't detect those things.
40:31
SPEAKER_02: And I don't know if the technology will ever be able to detect those shit those things unless you introduce something like the pill we were talking about that can detect things right inside the inside the body.
40:44
SPEAKER_02: And maybe they'll have an insulin pump out, or maybe they'll have some type of technology where the body can detect and communicate with other hormones and organs and stuff like that.
40:56
SPEAKER_02: Maybe we will get there.
40:57
SPEAKER_02: I don't know.
40:58
SPEAKER_02: But that's what it would take to be a true closed loop system.
41:02
SPEAKER_02: Because the hormones, especially for females, the hormonal displacement that happens as you get older, especially with the foods that we're eating now, the inactivity, the we don't get enough sleep, all the things we always talk about.
41:16
SPEAKER_02: With that on the rapid rise and showing no signs of that stuff decreasing or us getting healthier because we're making better choices, there's no way this technology is going to be able to recognize all of that.
41:32
SPEAKER_02: And for some people, it doesn't even matter, right?
41:34
SPEAKER_02: So I don't even know if I go play basketball, if there's a tons of adrenaline that's spiking my blood sugar.
41:40
SPEAKER_02: My blood sugar doesn't really spike.
41:43
SPEAKER_02: Right?
41:43
SPEAKER_02: So it's it but I can feel off, I do feel off when I'm super highly stressed.
41:50
SPEAKER_02: So the body, the body can't detect that stuff, or the insulin pumps can't detect that stuff.
41:56
SPEAKER_02: Our in synthetic insulin that we're taking doesn't detect that stuff.
42:00
SPEAKER_02: So that that's the really interesting piece to all this is how's that gonna all roll out?
42:05
SPEAKER_02: Because the hormones and how that part works in the body, along with the stress hormones, all that stuff is important when you think about diabetes management for type one, type two, pre-diabetes, gestational diabetes, whatever it might be.
42:24
SPEAKER_02: That stuff's important.
42:27
SPEAKER_02: Because just because I'm eating 50 grams as like as the example I used earlier, just because I'm eating 50 grams of carbohydrates, I would need five units for that.
42:37
SPEAKER_02: But I actually might need six because I'm super insulin resistant.
42:42
SPEAKER_02: Whatever else might be going on hormonally.
42:45
SPEAKER_02: I'm a female and I'm my you know, I need more insulin because I'm menstruating, whatever it might be.
42:52
SPEAKER_02: Can the can the system detect that?
42:54
SPEAKER_02: That you need more or need less?
42:57
SPEAKER_02: I maybe it can.
42:58
SPEAKER_02: I have no idea.
42:59
SPEAKER_02: Though those are the things I think about with all the technology, because for me, it is not as simple as this is as many grams as I'm eating, this is how much insulin I should take.
43:09
SPEAKER_02: There's so there's other things that go into that decision.
43:15
SPEAKER_00: Okay.
43:16
SPEAKER_00: Completely out of left field question.
43:20
SPEAKER_00: If you came to find out that let's just call let's just uh drinking a beer.
43:29
SPEAKER_00: Drinking a beer lowered your blood sugar.
43:32
SPEAKER_01: Sometimes it does.
43:34
SPEAKER_00: Okay, so hear me out, hear me out.
43:36
SPEAKER_00: But you go away for the weekend, you're with your buddies, you're having a bunch of beers, and you're like, man, I'm like, my blood sugar is like really, really, really good.
43:46
SPEAKER_00: And you're like, let me try to like let me try to like keep up with this and just this is just okay, this is just we're gonna be.
43:53
SPEAKER_00: It's hypothetical, I get it.
43:54
SPEAKER_01: It's hypothetical, I get it.
43:55
SPEAKER_00: Just from the hyposthetical, the fake of the argument a week goes by and you're just kind of.
44:00
SPEAKER_00: having a beer here and there every like and it's made your blood sugar perfect.
44:05
SPEAKER_00: How would you go about finding that out?
44:08
SPEAKER_01: By experimenting, by watching your CGM numbers, bought No.
44:13
SPEAKER_00: What would you do?
44:14
SPEAKER_00: What would you do from after that week passed?
44:17
SPEAKER_00: Would you look back and be like, all right, Ken, you have a decision to make.
44:20
SPEAKER_00: Are you gonna be drinking all the time for the sake of a good blood sugar?
44:25
SPEAKER_00: Or are you gonna No, fuck no, I'm not no.
44:29
SPEAKER_02: Because there's other things that you can do that's way better for your overall health that's going to be able to pull on that same exact lever.
44:39
unknown: Right?
44:40
SPEAKER_02: Because the lever that you're talking about is keeping your blood sugar in in an adequate space, right?
44:46
SPEAKER_02: So I'm 130, I'm 140, I go and have two or three beers with my boys and my blood sugar because alcohol, in this example, alcohol brings my blood sugar down, so now I'm that 110.
44:57
SPEAKER_02: Uh-huh.
44:58
SPEAKER_02: Right?
44:58
SPEAKER_02: If I'm going out with my boys, cool.
45:01
SPEAKER_02: Maybe I can use that tool.
45:02
SPEAKER_02: But I'm not going out with my boys every single night.
45:05
SPEAKER_02: So I'm not going to use the tool of drinking every single night to lower my blood sugar by 30 milligrams per deciliter when I can one just take a unit of insulin or I can just go for a quick walk.
45:17
SPEAKER_00: But if someone told you if you start every day with a shot of vodka, your blood sugar will be perfect for the rest of the day.
45:26
SPEAKER_00: Do you think you can manage that?
45:27
SPEAKER_02: How much how long do you think your liver is going to last if you take a shot of vodka?
45:30
SPEAKER_00: Well that's what I'm at and that's what I'm asking I guess to be like I'm I'm kind of like joking but that's what I'm asking at what point does the body like all jokes aside and I think this is true the Queen of England I I think she had a glass of champagne and a shot of vodka every single day.
45:50
SPEAKER_02: Like that was a part of her so here but here's the thing that you have to understand.
45:55
SPEAKER_02: It's just you you have to understand with those examples that those are one-offs.
45:59
SPEAKER_02: I understand I'm just trying to have fun just like the smoker just like the smoker that's 67 years old that have been smoking two packs of cigarettes every single day since they were 18 and never got can never got lung cancer.
46:13
SPEAKER_02: Yeah yeah right and the person that never smoked before in their life got lung cancer and died.
46:18
SPEAKER_02: Yeah they're one-offs whether it's a genetic thing whatever it might be it's not the general population for me that's what I work within that's where my brain goes is what what's going to work for 80% of the population because the other 20% I'm gonna high five them you're you're taking a shot of of whiskey every single day and you've never had an issue you've done it for 60 years like high five man that's awesome high five high five girlfriend that's awesome but for most other people they're gonna get liver disease by the time they're 60 years old.
46:54
SPEAKER_02: Yeah I that's that's my point with your whole with your with this hypothetical right so it's for me it is it's not about the task it's about is there a better option to get the same result and if a shot of whiskey or a shot of vodka or whatever it is a couple a couple a couple drinks of beer or a couple you know things of beer in a couple drinks of beer or whatever like lowered your blood sugar I I'm 100% going with the other option because for the most part I'm gonna feel better and I'm gonna live longer.
47:29
SPEAKER_00: Yeah I will kind of transition this into like kind of a serious comment on top like 20 years from now what as you were saying that I was like okay well drinking makes you happy and maybe happy lowers like but that's what I was thinking like I I I have always wondered I I have always wondered if there will be a collective humanitarian effort for what I just said that stress at the end of the day stress is what is killing it is what's killing everybody the stress from everything to buy your groceries the competition to have a job the to buy a house to have a kid to to all those things like I I do wonder you know I we've always said like they've always said what's the the number one killer is heart disease like heart disease there's a lot of stress there is a lot of stress related things that go into that as well so I I just I I do wonder and I were and I think about that insulin insulin might go a a a lot farther in a less stressful environment in a less you know right in a in a it 100% will because you in a peaceful people in a peaceful group of people go ahead.
48:41
SPEAKER_02: Yeah because you have to think about what stress is also inhibiting biologically right stress inhibits and pushes insulin resistance it does a lot of other things 100% but it pushes insulin resistance because you're in fight or flight it pushes insulin resistance and what is one of the number one things that we have that's a problem in our world right now not just in the US but in our world type 2 diabetes pre-diabetes high blood sugar individuals that's that's the problem if we're if we can understand as a species that the fast food the ultraprocessed foods the high caloric foods like the bad shit that we're constantly consuming on a regular basis if we removed all that shit and like you're saying did things in our life to reduce our stress this world would be way different it would be way different because you're trying you're almost eliminating you're not eliminating insulin resistance but you you're dramatically reducing insulin resistance which is going to re dramatically reduce the amount of people that are struggling with type 2 diabetes prediabetes or people that are undiagnosed with type 1 or type 2 diabetes and prediabetes and just have chronic inflammation or have chronic blood sugar spikes that's the problem.
50:11
SPEAKER_02: When we think about all these people that are overweight that's the ultimate problem it's not it's not necessarily all the foods and inactivity and that's not the problem.
50:24
SPEAKER_02: That's the byproduct of what's happening biologically and I believe one of the things because there's tons of things that are happening but one of the things is insulin resistance.
50:34
SPEAKER_02: When you have a dramatic amount of insulin resistance you need more insulin to do the same job eating a Big Mac that requires a shitload of insulin and then you're throwing in the ultraprocessed protein that's fake shit and the fat that's fake shit and then you want to throw some fiber on there because you want to put some lettuce and some condiments and whatever else tomatoes whatever.
50:58
SPEAKER_02: So maybe you might be getting a little bit of fiber but you take something like a Big Mac and you're and you're constantly eating those foods your insulin resistance gets pushed really high and over time it takes longer for that to subside especially if you're sanitary you're not exercising you're not hydrating you have high stress in in your job in your life you're not getting enough sleep you're not actively doing the things that are going to reduce insulin sensitivity on the seesaw and increase insulin sensitivity on the other side the other really cool thing that I wish we knew how to do and maybe we're working on it I have no idea is being what if we could with maybe with like a blood sugar meter or whatever it is what if we could identify someone's insulin sensitivity and insulin resistance we can kind of identify insulin sensitivity with a C peptide test.
52:02
SPEAKER_02: We can see how active your insulin is but I don't know if we really have a test that can measure what your actual insulin resistance is.
52:14
SPEAKER_02: And if we even have a chart that says what's high, what's low, I don't even know think about that we're we're so we're so far into this world of these GLP ones, they can't even test if your GLP1 is active or not.
52:28
SPEAKER_02: They can't there's a test but it's a really hard test to do.
52:32
SPEAKER_02: And I don't think it's I don't know if I don't I'm pretty sure it's from talks I've had with physicians it's never really done if the if the test even is available to a lot of them.
52:42
SPEAKER_02: So in this world where we're seeing GLP1 be a massive problem and we're getting people putting people on these medications to help with not just blood sugar but other things, wouldn't it be cool to look at what your insulin resistance is too many got sticky blood sugars right now.
52:59
SPEAKER_02: Shoot I feel like I'm like throwing all this insulin on board and it's not working.
53:04
SPEAKER_02: Well let me just prick my finger and see what my insulin resistance is.
53:07
SPEAKER_02: Holy shit it's like up 200% what the hell no wonder I need more insulin right that would be cool.
53:16
SPEAKER_02: Just now we can do a blood sugar test for ketones instead of having to pee on a stick as we used to always have to do to check for ketones.
53:24
SPEAKER_02: I still have ketone sticks in my in my bathroom that I'll use sometimes if I need to if I need if I'm like oh shoot I've been high for a while man I'm really got sticky blood sugars I better check my ketones now we can just prick our finger and it'll tell us yep your ketones are high either take some insulin go drink some water or go to the hospital probably should go to the hospital.
53:48
SPEAKER_02: So I don't know I don't know where I was going with all that but it insulin resistance I feel like is the big issue in everyone's health and why people are having all kinds of issues it's one of the big issues that that is the it's all of the other things that happen the heart disease the autoimmune conditions the chronic illnesses whatever you want to call it that's all byproduct I feel like of insulin resistance and other things too but a lot of insulin resistance I'm done why do you get me on these tangents man what?
54:27
SPEAKER_02: Why do you get me on these tangents?
54:28
SPEAKER_00: Damn it went dude that went fast that went really really fast.
54:32
SPEAKER_02: It did go really really fast.
54:33
SPEAKER_00: That actually that's almost more less that was like a blackout for me.
54:37
SPEAKER_02: Yeah so all right well we're gonna get out of here everybody I hope all this was helpful for you we didn't give a lot of like advice today we just kind of talked about certain things so I hope this was impactful for you.
54:52
SPEAKER_02: If you're new to the show or if you've been here for a while and you enjoyed this episode if you listen to previous episodes and you enjoyed the episodes please refer a friend.
55:04
SPEAKER_02: Tell someone that you know that's your homework for today tell someone that you know that is affected by diabetes in some way about the podcast.
55:12
SPEAKER_02: Send them a link to the podcast.
55:14
SPEAKER_02: Just tell them tell them hey go listen to the Healthy Diabetic podcast we would we appreciate every single one of you every single one of you who continue to show up every single week and listen interact with the episodes leave reviews send messages it's it's it's very I guess I could say that's it's amazing and and I feel it from the bottom of my heart and all of you is why Graham and I keep meeting every single week twice a week why I make episodes all the time by myself why I'm doing all the editing and posting and posting to social media and doing all that by myself I'm I continue to do I continue to do it because of you.
56:04
SPEAKER_02: So I thank you from the bottom of my heart that you continue to come back and listen to these episodes.
56:09
SPEAKER_02: Thank you.
56:10
SPEAKER_02: If you feel like you need support right now okay there's the doors always open okay it one of the funnest things that I have been had the honor and privilege to do is be a coach from the fitness perspective from the nutrition perspective from now diabetes perspective it has been something that has brought so much joy to my life being able to find someone's challenges issues have great conversations around them and then guide them to a better solution than than where they're at and that's what coaching can do.
56:47
SPEAKER_02: It's not medical advice this is not me telling you how to manage your diabetes it's it's me coaching you and guiding you to a better solution for better results and better outcomes because that's what you deserve.
57:01
SPEAKER_02: And I know for me that's not what I got from my medical team when I first started so I've learned a lot over the years on how to manage this condition and I feel like I have a really really good grasp on not just how to manage diabetes but how to make diabetes work in your life both from the mental perspective the physical perspective the nutrition perspective the right building the right habits and the decisions so if you feel stuck right now don't hesitate.
57:36
SPEAKER_02: Let's just jump on a call and talk.
57:38
SPEAKER_02: That's it let's just talk and if coaching's the right thing for you great if it's not awesome we'll decide that together because the coaching isn't for everybody not everyone needs it but a lot of people do.
57:50
SPEAKER_02: So if you are someone that's stuck in in in this perpetual place where you're making decisions you feel overwhelmed you know feel alone you just the the decisions that you are making you're not trusting yourself I don't want you to be in that position because that's not a great position to be in and it's not going to last forever.
58:09
SPEAKER_02: It's not sustainable.
58:11
SPEAKER_02: So I can teach you how to make this really simplistic really freaking simplistic so yeah don't be afraid to reach out click on the button in the show notes that just says schedule free call because it's free we just get on a call and we chat.
58:27
SPEAKER_02: So thank you everybody for listening and I will see you guys next time