Latest / The Healthy Diabetic / #161: The Hidden Complexities of Diabetes - Dr. Cyrus Kellerimer

Transcript

#161: The Hidden Complexities of Diabetes - Dr. Cyrus Kellerimer · The Healthy Diabetic

• 0:17
  Speaker 2: What's up everyone.
• 0:18
  Speaker 2: Welcome back to the Healthy Diabetic Podcast.
• 0:21
  Speaker 2: I'm your host, as always, coach Ken Kanis.
• 0:23
  Speaker 2: Before we get started, please remember that nothing that you hear on this podcast should be considered medical advice or otherwise.
• 0:28
  Speaker 2: Please always consult your medical team before making any changes to your diabetes management Awesome.
• 0:35
  Speaker 2: One more thing I want to remind you guys of if you guys enjoy this episode, please make sure you share it with a friend.
• 0:42
  Speaker 2: I know every single one of you that are listening to this episode has at least one diabetic friend or one diabetic family that you know that could really get value out of these episodes.
• 0:53
  Speaker 2: So please make sure that you're sharing this with your friend, family members, whatever.
• 1:00
  Speaker 2: Okay, let's get into today's episode.
• 1:02
  Speaker 2: So I'm so stoked about this episode I got Cyrus on today.
• 1:07
  Speaker 2: Cyrus is one of my fitness clients at the gym and he is actually a doc at the Ohio State University and works with a lot of type 2 diabetics, works with a lot of people that are having surgeries and having a lot of stuff going on in their life, so I really thought it was going to be a really good opportunity for me to bring Cyrus in and talk about, from the medical side, how does it actually work in terms of when you are going to the hospital, like what types of things he's seeing.
• 1:39
  Speaker 2: What this is going to be is it's going to be a very educational episode on the medical system and how the medical system rolls.
• 1:47
  Speaker 2: Me and Cyrus both have a really good understanding, a really good thought process about the medical system in terms of our values and our viewpoints about what's going on, the goods and the bads, so I'm really excited for you guys to listen to this episode.
• 2:03
  Speaker 2: So, without further ado, let's get with my man, cyrus.
• 2:09
  Speaker 2: All right, cyrus, thank you so much for coming in.
• 2:13
  Speaker 2: We finally got this scheduled.
• 2:15
  Speaker 2: I'm super pumped about this one.
• 2:17
  Speaker 2: This is going to be like a different episode than I usually do, because you're not type one, you're not diabetic, but you're from the medical field.
• 2:27
  Speaker 2: You're from the medical system.
• 2:28
  Speaker 2: We've had a lot of really cool conversations in our training sessions, so this would be a really cool perspective of getting you in and talking from the medical side of everything, because I talk a lot of stuff about the medical.
• 2:45
  Speaker 2: There's good and bads about everything and I thought this was going to be a really good episode, especially for my type two diabetics, to hear your perspective on this side of things, so I'm going to take it.
• 2:57
  Speaker 2: How have you taken it away?
• 2:59
  Speaker 1: All right.
• 2:59
  Speaker 1: Well, just to introduce myself, my name is Cyrus Kalamir, an anesthesiologist and an ICU doctor over at Ohio State.
• 3:05
  Speaker 1: I'd like to shout out for Ross there.
• 3:08
  Speaker 1: That's the cardiovascular ICU where I spend most of my time.
• 3:12
  Speaker 1: I grew up in Ohio, about two years out of my training, at three years now and yeah, I've been getting my butt kicked here by Ken for about eight months and we've had some good conversations Definitely every single day.
• 3:28
  Speaker 1: I feel like I keep you an extra half an hour just because we're kind of talking about things in the medical field and your perspective, my perspective, everything else.
• 3:36
  Speaker 2: Yeah, cool man.
• 3:37
  Speaker 2: So I think to jump off to start this conversation, I want to give the listeners, the viewers, some perspective on what you're actually doing and what you're actually seeing in the hospital in regards to because you're seeing all different types of people, but you do see a lot of type twos or people that are in some bad shape and bad shape, and in no way do I want this episode to come across to the diabetic community or diabetic population that as a fear tactic, but I think it's important to kind of show the other side of diabetes.
• 4:18
  Speaker 2: So I'd love to have you talk about that perspective.
• 4:22
  Speaker 1: So mainly, I'd say most of my experience with managing insulin resistance or diabetics is in the ICU side, especially in the cardiovascular ICU.
• 4:34
  Speaker 1: We all know that having diabetes can increase your risk of having heart problems, but I really think that a lot of people and you know this as well and you've brought it up on another podcast and when we're talking the problem with diabetes is you can't see the problem.
• 4:50
  Speaker 1: You can't visualize the injury that's occurring to your body if it's your blood sugar is out of whack or if it's poorly controlled or anything else.
• 4:58
  Speaker 1: And frequently we won't see patients until the first time when they've had foot pain and they haven't known what's going on for a little while.
• 5:07
  Speaker 1: And then they come in and they have no blood flow to their foot and it's an absolute tragedy when these kind of situations occur, because there's times when this kind of been intervened upon or they could have been better educated.
• 5:22
  Speaker 1: There's all these points and steps where a better care or just better awareness of what's going on could have made a big clinical impact.
• 5:31
  Speaker 1: But we know that having your blood sugar poorly controlled definitely increases your chance of having coronary artery disease, having issues with blood flow to your legs, and people know that for the most part they know about the nerve problems but they don't realize that it can lead to problems with your stomach, even working Over time.
• 5:56
  Speaker 1: They don't realize that it can increase your risk of infection.
• 6:00
  Speaker 1: Just in general, it's the biggest cause of the need for dialysis in this country, biggest cause of vision loss.
• 6:12
  Speaker 1: It's really underappreciated and something that always sticks with me.
• 6:16
  Speaker 1: I haven't been like an attending doctor for very long, but I remember in medical school I had an infectious disease doctor come in and he was talking about HIV.
• 6:26
  Speaker 1: Is this big, scary thing?
• 6:27
  Speaker 1: And I think I might have mentioned this to you one time, but it really stuck with me when he was talking about the treatments for HIV and how good it's gotten and one of the things he brought up was I would much rather have HIV than diabetes and I remember everybody in the class, all of us learning doctors.
• 6:44
  Speaker 1: That really stuck with us and to this day we'll be talking about school when somebody will bring that up.
• 6:50
  Speaker 1: But it's absolutely true, it's not just your blood sugar, it's everything else that comes with it 100%, 100%.
• 7:00
  Speaker 2: What do you think coming from like the medical thought process or the medical side of this.
• 7:05
  Speaker 2: What do you feel like is the biggest hurdle that we need to really overcome?
• 7:12
  Speaker 1: Oh, God, I mean my wife said it best, right, I was leaving.
• 7:17
  Speaker 1: We were talking about I was doing this today and this has been said before, but it really stuck with me coming here to do this podcast, because the American healthcare system is not really about healthcare, it's sick care.
• 7:29
  Speaker 1: We wait until the problems develop, until we're really aggressive about dealing with the issue.
• 7:35
  Speaker 1: Yeah, and we've become really good about aggressively dealing with the issue, we can do incredible things.
• 7:40
  Speaker 1: You know, like the patients that we take care of you know my job and my role like it's absolutely incredible what we can try to fix and try to turn around, but still just the money, the resources involved, what you go through as a patient and just the chance of a good life.
• 8:00
  Speaker 1: You know, if you come in and you've had this problem that hasn't been dealt with in 20 years, you know that's 20 years of damage that you're trying to correct and it's impossible.
• 8:09
  Speaker 1: Yeah.
• 8:10
  Speaker 2: But I think that what you just said right now is one of the looming things for me with whether it's that type one or type two, and it is that thought process of like the longer you let this go, the longer you don't be educated and learn more about the disease and how it can alter how you can ultimately work with the disease and live with it.
• 8:33
  Speaker 2: The longer that you don't do that, the impact that that has on your overall health.
• 8:41
  Speaker 2: We just don't understand, like as a normal person, like someone outside of the medical field, someone that's not educated about the biochemistry and what it does to your stomach, what it does to your digestive system, what it does to your body in general, like it's crazy the damage that we're doing with uncontrolled, fluctuating blood sugars.
• 9:02
  Speaker 1: No, 100% and you know I think it's exacerbated and, like I said, I'm impatient.
• 9:09
  Speaker 1: I work in the hospital all the time.
• 9:10
  Speaker 1: I do anesthesia and ICU.
• 9:12
  Speaker 1: I'm probably the least qualified doctor to talk about diabetes that you've had on here, but in dealing, talking about the sequela and the complications that arise is something that I deal with all the time.
• 9:22
  Speaker 1: You know, looking at it from my perspective, if you come and you're admitted to the hospital, we're just trying to prevent you from getting hypoglycemic.
• 9:31
  Speaker 1: We're usually shooting for a blood sugar of 180.
• 9:33
  Speaker 1: We've talked about this.
• 9:34
  Speaker 1: You think that's crazy.
• 9:35
  Speaker 2: I do You're thinking crazy, man yeah.
• 9:38
  Speaker 1: I do, but I get it.
• 9:39
  Speaker 1: I get it, yeah, and, like you know, we're just trying to fix whatever problem the patient has, yeah, and get them to the next step.
• 9:46
  Speaker 1: So we're not addressing, you know, the lifestyle factors, everything else.
• 9:50
  Speaker 1: Maybe we'll put you on a diabetic diet.
• 9:52
  Speaker 1: Probably not, because we have data that says there's no point in even doing that, because then if they're eating a diabetic diet and then they go home and they eat whatever they want, whatever insulin, you start them on whether an inpatient is going to be ineffective.
• 10:03
  Speaker 1: So usually we'll have these people eat whatever they'll be eating at home.
• 10:07
  Speaker 1: They come in with whatever it is.
• 10:10
  Speaker 1: They get that fixed up, they get sent out with plans to follow up as an outpatient.
• 10:16
  Speaker 1: But also the problem with the outpatient side as well is you know I have friends that are family doctors, you know internal medicine doctors, apps, nps, whatever you are that work in that outpatient setting and it is hard at this point in America it's never been harder to be an outpatient provider.
• 10:36
  Speaker 1: You know there's just not enough of them.
• 10:39
  Speaker 1: Their schedules are packed through the roof.
• 10:42
  Speaker 1: You know you have 20 minutes to see somebody understand them, try to help them and, you know, provide some meaningful care before you're kicked out and you've got to see the next one, yeah, next patient.
• 10:52
  Speaker 1: So I feel for them.
• 10:56
  Speaker 1: But I do think that there is a level of people come in with a problem.
• 11:02
  Speaker 1: You know I don't think that I can help them with the problem, with the causes of that problem, whether it's lifestyle modification, talking to them about diet, you know, is your issues with insulin resistance related to inflammation from your diet or stress or whatever other factors.
• 11:19
  Speaker 1: You know we don't have time, they don't have time for that.
• 11:21
  Speaker 1: Yeah, so really, it just comes down to prescribing a medication, following up with that and it's, it works.
• 11:30
  Speaker 1: You know it can improve your A1C.
• 11:34
  Speaker 1: It can, you know, improve your fasting glucose levels, but you're really not dealing with why this happened.
• 11:40
  Speaker 2: Yeah, and I think we've had multiple conversations about this, right, multiple, multiple conversations about this, and it's just, it's it's crazy to me to think about that aspect of it.
• 11:51
  Speaker 2: It's like, you know, we go back to what you said at the beginning of this is not a preventative thing.
• 11:57
  Speaker 2: It's like, hey, we're dealing with a situation that's arising right now and it's it's really sad that that's where we've come to and the technology and what is available to us.
• 12:10
  Speaker 2: We could 100% change it, 100%, 100% could change it.
• 12:15
  Speaker 2: But do we want to?
• 12:18
  Speaker 1: And and you know it's hard because we are, you know there's never been less primary care providers for the population than there is right now.
• 12:27
  Speaker 1: We have a system still based around the more that you do to a patient, you will get money for the more that you do, which I'm not, you know.
• 12:36
  Speaker 1: I think that the number of people that are corrupting that or using that inappropriately or low, but if that's the goal, then there's not going to be a focus on prevention, there's not going to be a focus on lifestyle modification or, you know, addressing these factors.
• 12:51
  Speaker 1: It's, you know, it's going to be wait and see until a problem develops and then hopefully, we'll be able to deal with it.
• 12:55
  Speaker 2: Yeah, and a lot of times I mean, from the stories that you tell me, my gosh, like the stories that you tell me of like not being able to like really deal with it, you're just like kind of putting the band-aids on.
• 13:07
  Speaker 2: Oh 100 walking away.
• 13:09
  Speaker 1: I mean you see that person that's on 100 of Lantus, you know BID, I can't.
• 13:13
  Speaker 1: That's so crazy.
• 13:14
  Speaker 1: And you know they came in for whatever their problem is.
• 13:18
  Speaker 1: But then they you know they have an increased risk of getting a kidney injury and maybe going on dialysis, increased risk of sepsis Just a poor outcome for any admission.
• 13:29
  Speaker 1: And by the time they're at that point the damage is so far done that it really does just become like kicking the can down the line and just dealing with any problems as they arise.
• 13:40
  Speaker 2: For the rest of that individual's life.
• 13:42
  Speaker 2: Yeah yeah, becoming a chronic, that's a person that's becoming a chronic hospital visitor.
• 13:50
  Speaker 1: And it's you know, it's tragic and it's all too common.
• 13:54
  Speaker 2: Yeah, it's just a whole lot of pain all the time.
• 13:59
  Speaker 2: You told me a story one time I just I thought this, this just blew my mind about how much insulin these individuals are on when they come and see you.
• 14:08
  Speaker 2: And I think that it's it's an important piece to bring up because I had it took me back and I had to sit with it for a second when you first told me this, because it's not just insulin like I'm taking now, my insulin pump.
• 14:23
  Speaker 2: It's in the IV, the best time, the best place to put it.
• 14:28
  Speaker 2: It's the most active, it's the most media onset, the most you know you're going to get it right now and there's no breaking it down.
• 14:37
  Speaker 1: There's no waiting 20 to 30 minutes for that thing to you know start working and they'll be on 15 units of like regular and human insulin an hour, an hour.
• 14:46
  Speaker 1: Yeah, insane, yeah.
• 14:48
  Speaker 1: And I mean and those are like specific circumstances, like you know transplant patients that just got a bunch of steroid you know, like prednisone and you know that's going to make your blood sugar all wonky and everything else.
• 14:59
  Speaker 1: But you know the transplant with diabetes on top of it.
• 15:03
  Speaker 1: You know you want to make sure that you have that diabetes under pretty good control before you.
• 15:08
  Speaker 1: You know, get this new organ because if you don't you're going into run into that issue.
• 15:14
  Speaker 1: You're going to be getting unbelievable amounts of insulin afterwards and you know your risk of all these bad things happening goes up.
• 15:22
  Speaker 2: Is this the?
• 15:22
  Speaker 2: And I wonder, too, is when we talk about general population, because, unfortunately, that's what we really have to think about when we talk about these types of things general population, not me or you.
• 15:34
  Speaker 2: That's really healthy, right?
• 15:35
  Speaker 2: We talk about general population.
• 15:38
  Speaker 2: I always think about, like the stats that come out and you see these crazy freaking stats with diabetes and like this crazy stats with insulin resistance, and this is, it's on the rise and it's one of those things that I think about in your situation, of these stats being created because of these types of individuals that are coming into the hospital, and it's insane to think about it that way.
• 16:03
  Speaker 1: You know and I want to stop you right there you mentioned like healthy people like us.
• 16:08
  Speaker 1: I mean you can be a diabetic and you're like, I've know how you take care of yourself.
• 16:14
  Speaker 1: I know you know that's the thing.
• 16:16
  Speaker 1: Like you have this chronic condition.
• 16:18
  Speaker 1: It's really well managed.
• 16:19
  Speaker 1: You know not to wipe the dust off your shoulder or anything like that.
• 16:23
  Speaker 1: There you go, good, yeah.
• 16:27
  Speaker 1: But you know, seriously, when I started training with you, you know I was drinking an energy drink at least a day.
• 16:33
  Speaker 1: Yeah, you know I wasn't grossly obese, but I was like, probably my BMI was like 32, 33 somewhere around there, and I didn't have much muscle mass.
• 16:44
  Speaker 1: And you know, I think that's something that's really underappreciated as well.
• 16:48
  Speaker 1: It's just how metabolically active muscle is.
• 16:51
  Speaker 1: Yeah, and you talk about the.
• 16:53
  Speaker 1: You know the goal of working out being weight loss and whatever else it is, but it's really, if you're not doing that, if you're not doing some resistance training or just aerobic exercise or whatever else, it is getting your heart rate up.
• 17:05
  Speaker 1: You're missing out.
• 17:07
  Speaker 1: Your body's not fully utilizing all of the its means at its disposal for getting your blood sugar under control, maintaining those healthy insulin levels.
• 17:18
  Speaker 1: Like we know that skeletal muscle activity improves the function of insulin.
• 17:22
  Speaker 1: You know, and I just you know, I think I said at the beginning, but I am really grateful for you and for helping me out the past eight months and not where I exactly want to be yet, but just getting stronger, getting healthier, and you really have been an inspiration.
• 17:39
  Speaker 1: Yeah, I can't even remember what the other part of your question was.
• 17:43
  Speaker 1: Sorry, I was just going to ask a side there.
• 17:45
  Speaker 2: No, that's good.
• 17:48
  Speaker 2: I can't remember what that question was now either.
• 17:51
  Speaker 2: Well, but I do think that going to your point with exercise and it's like this whole, and really going to your point of exercise and then kind of looking at all the things that we've been talking about in terms of preventative versus like Not being, you know, aggressively going after symptoms, instead of like looking at the whole entire picture, sure, and and that's one of the things that I think is so important to really understand and recognize, regardless of what type of diabetes you have and really regardless of what type of autoimmune disease you have or what type of anything that you might have going on in your life, sure, in terms of a health perspective, is we really need to do a better job, not just medical, but all of us in general looking at the overall health of that of the individual, of yourself, and the ones that are doing that, the ones that understand that on a deep level, might not be educated about it, but the ones that understand on a deep level are doing really really well.
• 18:47
  Speaker 2: Yeah, and I look at the people that I know in the diabetes community that are doing really really well because they understand that piece.
• 18:54
  Speaker 1: It's not, just, it's not just about the a1c.
• 18:57
  Speaker 2: It's not just about getting the glucose under control.
• 18:59
  Speaker 2: It's about the whole entire picture, the whole entire process of being not just a diabetic but a human being.
• 19:06
  Speaker 2: Getting enough sleep, making sure you're hydrated, you know, focusing on exercise, focusing on your relationship with food, your relationship with yourself and who you are like all of those things are Ultimately going to help your blood sugars, because it's just going to be, it's gonna work in in your body.
• 19:24
  Speaker 2: You start working in the right ways.
• 19:25
  Speaker 2: So I think it's important to bring everything back to that piece is the medical system and everything that you do and everything that you guys do.
• 19:35
  Speaker 2: We need it, we need it, we 100% need it.
• 19:39
  Speaker 2: But I think that the underlining issue right now in society is we are not looking at life as A proactive means to living the way we want to live.
• 19:51
  Speaker 2: We're looking at life in the way that our parents lived or the way that our friends live.
• 19:57
  Speaker 2: Right, I have tons of friends that are unhealthy, yeah, and tons of friends that are unhealthy really good friends from high school, really good friends from college and they look at me as like all your inspiration, like why, why am I inspiration?
• 20:11
  Speaker 2: Like it shouldn't be that way.
• 20:12
  Speaker 2: It's like, this is the way I want to live and I want to be healthy with especially with my diabetes, and I have chosen To live this way.
• 20:23
  Speaker 2: Not everyone has to live this way.
• 20:25
  Speaker 2: I know really good diabetics with really good a1cs that don't necessarily Serially live the lifestyle I live.
• 20:31
  Speaker 2: It's all really dependent on what you want out of life and what and what's gonna work for you.
• 20:37
  Speaker 1: I.
• 20:38
  Speaker 1: I think that's absolutely true and, just like you know, as a further aside from that, like when I came here you know I've been a OSU about two years now I joined a group of guys that do the same and women that do the same job as I do, and there's like 16 of us and, man, when I joined, the first thing that struck with me is like these guys are physically fit, mm-hmm.
• 20:59
  Speaker 1: I think I told you about that.
• 21:01
  Speaker 1: Yeah, and you know I have a lot of colleagues that do Iron man Triathlons and they, you know that, run marathons and I'm not there yet.
• 21:09
  Speaker 1: But I do think, going back to the medical community, like you know how being an inspiration or whatever else Met the medical community could do a lot better.
• 21:19
  Speaker 1: You know I talked about my own issues with you know, living and kind of an unhealthy life and making poor choices.
• 21:26
  Speaker 1: Like there's a lot of people with that same story nurses, doctors, yeah, yeah, whoever else and it's really hard to take care of other people if you're not taking care of yourself.
• 21:38
  Speaker 1: Yeah, but you know there is, it is like a generational thing where you know I Can stay up for 24 hours and it's not gonna affect me.
• 21:47
  Speaker 1: You know it's.
• 21:48
  Speaker 1: It's like an ego thing a little bit.
• 21:50
  Speaker 1: It's a pride thing as well.
• 21:52
  Speaker 1: But just being able to see other people that are making good decisions, taking care of themselves, you know still working, you know hard, long hours, but taking rest on top of it and everything, and you know trying to do the best thing for themself, which ends up being the best thing for their patients, I it.
• 22:10
  Speaker 1: We need to really focus on that as a specialty.
• 22:12
  Speaker 2: Yeah, we do we absolutely do, and it's I.
• 22:15
  Speaker 2: We always make the joke in the fitness industry as, like, doctors are the worst patients.
• 22:19
  Speaker 1: No, no, I believe in them.
• 22:20
  Speaker 1: Doctors are the worst clients.
• 22:22
  Speaker 1: We're stubborn people, we like, we're stubborn we, we are used to getting what we want.
• 22:29
  Speaker 1: Yeah, a lot of us are.
• 22:30
  Speaker 1: Yeah, and, you know, when you're well educated, you think that you, you know, there's a little bit of.
• 22:39
  Speaker 1: Well, my opinion is really strong and if they can't convince me, you know, or it's gonna be really difficult to convince me and in the long term.
• 22:48
  Speaker 1: But you know, I, just as a refresher, I was looking up some Breakthroughs and diabetes, like before I came on there, and there were so many things that you know I'm an anesthesiologist primarily, like I don't deal with diabetes Intensively on a daily basis.
• 23:04
  Speaker 1: Yeah, you know, there's a, there's a long-acting insulin that's once weekly.
• 23:08
  Speaker 1: That they're that they're trialing.
• 23:10
  Speaker 1: Yeah, now, yeah.
• 23:11
  Speaker 1: There's an oral like version of his mpik that they're looking into too, and it's just.
• 23:16
  Speaker 1: There's all this data and it changes your opinion.
• 23:21
  Speaker 1: It really does, but there are a lot of people that are locked in and there's still.
• 23:23
  Speaker 1: You know, there's still diabetes.
• 23:25
  Speaker 1: It's type one or type two, and if you're type two, it's because you don't take care of yourself and you know you're just not always the case, which is not a, which is by far not only case.
• 23:34
  Speaker 1: I mean, you know type two diabetes is like 80% genetic and you know it's based off environmental factors, everything else, but like, there is still this classical mindset of, well, if you're over 20 and you become a diabetic is because that you don't take care of yourself.
• 23:51
  Speaker 1: You know, regardless of whether you might be a late onset, type one, which we know now probably is like 10% of these type twos that were poorly treated for years.
• 24:02
  Speaker 1: Yeah, but there's just so much more out there in terms of Management of diabetes, but also just there's so much more out there about the importance of taking care of yourself.
• 24:12
  Speaker 1: Yeah, I think that is the key right there, because that we have.
• 24:20
  Speaker 2: Because of the internet, because of social media, we have so much more access to me ever have In God in my lifetime To.
• 24:30
  Speaker 2: If you want to know, if you want to be educated, you can find it, you can 100% find.
• 24:33
  Speaker 2: It's not that hard, yeah.
• 24:34
  Speaker 2: So I think that is an important piece to understand too, because I hear a lot of people say, like, oh well, you know, I can't, I don't know where to look.
• 24:41
  Speaker 2: I'm like, what are you talking about where you don't know where to look?
• 24:43
  Speaker 2: Just go to social media, just Google it, for Christ's sake.
• 24:49
  Speaker 2: Like, just Google it and you'll find it.
• 24:50
  Speaker 2: You might have to do some digging, you know, within some of these search engines, but you can find it, you can 100% find it, you can find it.
• 25:02
  Speaker 1: I do think that.
• 25:03
  Speaker 1: I think it's good.
• 25:04
  Speaker 1: I think, for the right people, it encourages them to take ownership of their care, do their own research, form their best opinion, with the help of their doctor, hopefully, or whoever else.
• 25:17
  Speaker 1: There is so much misinformation out there, though, yeah, and you've got to be so careful.
• 25:22
  Speaker 1: Yes, yes, there is.
• 25:23
  Speaker 1: I mean, yes, there is, and I think there is something about loving yourself and taking care of yourself, and I do part of me worries about people that are promoting their lifestyle, sometimes where it might not seem the healthiest, and trying to make it seem acceptable, and I worry about that, but I do think that all that information in the right hands, and especially just if you take the time and do a little bit of research, it is more of a blessing than a curse.
• 25:56
  Speaker 1: Yeah, definitely 100%.
• 25:59
  Speaker 2: And I think even just the simple fact of knowing the little things is important.
• 26:07
  Speaker 2: Oh sure, don't eat fast food all the time.
• 26:09
  Speaker 2: Stop drinking pop, like.
• 26:11
  Speaker 2: Stop drinking energy drinks.
• 26:13
  Speaker 2: Stop doing a lot of these things that we know, we know is not good for us, but we still do it.
• 26:18
  Speaker 2: Still buy cigarettes, we still buy cigarettes, we still drink all the time and we still do all these things when we know that it causes problems down the road, but we don't care until it actually happens and then we make excuses for it.
• 26:31
  Speaker 2: That's the one thing that gets under my skin is okay, cool, you're going to do that 100%.
• 26:37
  Speaker 2: Go do it.
• 26:37
  Speaker 2: Who am I to tell someone they can't go drink, or they can't go eat cake, or they can't drink pop, or they can't go to McDonald's or they can't go to Starbucks every day?
• 26:46
  Speaker 2: I'm not the person who's going to tell that someone not to do that.
• 26:50
  Speaker 2: But don't come crying to me when you have issues down the road because of the lifestyle choices that you've chosen to live by.
• 27:01
  Speaker 2: Your values are not honed in on what you actually want.
• 27:08
  Speaker 1: I hope that that's getting better.
• 27:10
  Speaker 1: There's so much reason to be pessimistic.
• 27:15
  Speaker 1: There's 50 million type 2 diabetics in 1985.
• 27:19
  Speaker 1: There's about 500 million in the world today.
• 27:21
  Speaker 1: But only about half of those know that they have diabetes is what most people guess, and you know what the toll that will take on the healthcare system but, more importantly, these people's lives.
• 27:35
  Speaker 1: But you're right.
• 27:37
  Speaker 1: I mean, there's more information out there, there's more talking about diabetes.
• 27:42
  Speaker 1: It's not just blaming the patient anymore, especially for type 2.
• 27:45
  Speaker 1: There are better medications, better therapies and everything else, but it all starts down with just encouraging people to take care of themselves.
• 27:54
  Speaker 1: Yeah, 100%.
• 27:57
  Speaker 2: Do you feel from your perspective, do you feel like we're encouraging that enough?
• 28:03
  Speaker 2: From the medical side, you can treat this, you can prevent this, or whatever the situation might be, if you change up the things that you are doing outside of these four walls.
• 28:17
  Speaker 1: No, that is somewhere that we are, I think, lacking in a lot of ways, especially by the time you get admitted to the hospital.
• 28:27
  Speaker 1: It's almost like, well, this is what you're dealing with, you'll get the information for it, they'll get you under control there, and then they just send you out in the wild and they're really, I would say the saddest thing is that for probably most doctors, when they hear that about encouragement or anything else, the first thing they'd probably think is well, that's not my job, I'm the kidney doctor or I'm the heart doctor or whatever else.
• 29:02
  Speaker 1: It is like anesthesiologist.
• 29:03
  Speaker 1: I think that, whether it's due to burnout, whether it's due to patient load and just taking care of so many people, whatever else it is, there's so many opportunities where that little bit of extra time, that little bit of extra encouragement and just seeking those additional resources, helping those patients find those things, would make a huge benefit, and we're just unfortunately missing in those areas.
• 29:30
  Speaker 1: Now, I don't think I've told you this one when I was in Pittsburgh, which is where I learned to be an ICU doctor, I still managed to get a lot of medical patients and I had a 19-year-old guy in DKA and he came in.
• 29:41
  Speaker 1: He was sick.
• 29:42
  Speaker 1: He needed to get a breathing tube.
• 29:43
  Speaker 1: Normal amount of acid in your body is like 7.4.
• 29:48
  Speaker 1: Once it starts to go below 7.2, funky things start to happen to your heart.
• 29:52
  Speaker 1: A lot of part of your body's function started to shut down.
• 29:55
  Speaker 1: His was like 6.95.
• 29:57
  Speaker 1: And he got a lot of IV fluid because all the sugar and he was peeing out all the time Everything's completely dehydrated, got like boatloads of insulin and he needed a breathing tube just for a little while and his brain kind of recovered as everything else stabilized.
• 30:14
  Speaker 1: He got the breathing tube out and he wanted to know why it happened and I did have the chance to sit with him and talk about it for like an hour and I don't know what happened to that guy.
• 30:25
  Speaker 1: But I wish I could do that with a lot of people and I wish other docs and other providers could take that time.
• 30:35
  Speaker 1: But I know how hard it is.
• 30:37
  Speaker 2: Yeah, I can only imagine, because even when I go see my endos I see their grind.
• 30:45
  Speaker 2: Even just in outpatient.
• 30:47
  Speaker 2: I see the grind, can't imagine inpatient.
• 30:50
  Speaker 2: You got 40-some beds on a floor, maybe more than that, and there's maybe four or five of you trying to deal with all that.
• 31:00
  Speaker 2: So it's like being able to be part of the education process.
• 31:04
  Speaker 2: I can understand why that's being overlooked because it's not part of the job.
• 31:08
  Speaker 2: But what I would argue with that is what is part of your job is to be a human being and you went into medicine to help people and to educate people.
• 31:21
  Speaker 2: So even if you're just saying like, oh, I really recommend you go see a dietician, I really recommend you go exercise here's some really good facilities or here's some really good coaches that I would recommend for you, having those recommendations in your back pocket I think is part of the job, because I would do the same thing.
• 31:42
  Speaker 2: When something's out of my school of practice, I refer it out and I've built that referral process.
• 31:49
  Speaker 2: I've built that referral, those people that I absolutely trust.
• 31:53
  Speaker 2: I think that for doctors is a big thing.
• 31:56
  Speaker 2: And even if it's just saying, okay, we've got personal trainers down that work for our facility.
• 32:02
  Speaker 2: I want you to go see them.
• 32:05
  Speaker 2: Oh yeah, sure you know what I mean.
• 32:06
  Speaker 2: Like it's just this revolving thing that we're not talking about the human being and we're talking about like let's put a band-aid on it.
• 32:17
  Speaker 1: And I have to say like there are all these other resources in the hospital there's dieticians, there's physical therapists, all those things but the problem is just like doctors, they're not the same and people like to think like the doctor and then everybody else.
• 32:32
  Speaker 1: Doctors are just like a small part of your care plan.
• 32:35
  Speaker 1: I'm probably only able to get some of these people out of the hospital because I have fantastic physical therapists that work with me.
• 32:41
  Speaker 1: I'm able to get breathing tubes out a lot quicker on people because I have respiratory therapists that are working with the patient trying to get them.
• 32:47
  Speaker 1: I'm really spoiled with the quality of people I work with daily.
• 32:50
  Speaker 1: That's not the same everywhere else and I don't know, man.
• 32:55
  Speaker 1: I think the biggest issue is that people, physicians, anybody that works in the hospital you talk to any of them and they're tired, they're burned out and I feel like it's almost there's like an empathy deficiency, I think, because people are afraid to feel, because the job gets a lot harder when you start to involve yourself and put yourself in those situations.
• 33:19
  Speaker 2: Have the empathy.
• 33:20
  Speaker 2: We've talked about that before.
• 33:21
  Speaker 2: But yeah, have the empathy come in.
• 33:25
  Speaker 2: It's easier to go tell that family that we've done everything we can and just being able to leave it at that then actually being emotional about it 100%.
• 33:37
  Speaker 2: I understand that for sure.
• 33:42
  Speaker 1: That's one of the things I think that I could definitely still improve in a lot of ways as a doctor, but I've always tried to remember this is a person.
• 33:50
  Speaker 1: This is what their own story.
• 33:51
  Speaker 1: Yeah, maybe they didn't take care of themselves for years and that's how they ended up here.
• 33:55
  Speaker 1: I don't know that and it doesn't really matter.
• 33:57
  Speaker 1: They're here now and if I can help them, I try to do that and it's funny.
• 34:03
  Speaker 1: You can work like a dog doing all these procedures and everything else on somebody and then you get a thank you from patient just because you like a written thank you, just because you stayed and watched a half of the OSU game with them or something like that.
• 34:20
  Speaker 1: You know what I mean.
• 34:20
  Speaker 1: You didn't care about like the eight hours I spent in your room trying to like get IVs and all these other things, and now you like the fact that I sat there and watched a half with you, but yeah, because they don't know the other side of it.
• 34:32
  Speaker 1: Yeah, they don't realize the other side of it.
• 34:35
  Speaker 1: We could definitely be better with just not forgetting that empathy aspect, and I'm hopeful that things will get better.
• 34:44
  Speaker 1: It's still the same system.
• 34:46
  Speaker 1: It's still the same kind of busted way of doing medicine that we've had for a long time here, but, like you said, there's more awareness, this upcoming younger generation that's going to be replacing older doctors, including myself, one day.
• 35:03
  Speaker 1: I do think that they get a lot of crap for not wanting to work as much, sometimes like complaining about the 24 hour call and those kind of things that we've talked about.
• 35:14
  Speaker 1: Yeah, and they put their probably right.
• 35:16
  Speaker 2: You need to, so we're going to put their foot in the sand.
• 35:20
  Speaker 1: Yeah, and somebody's got to put their foot in the sand and somebody has to step up and say this is unacceptable.
• 35:24
  Speaker 1: I don't care what tradition is, I don't care that.
• 35:28
  Speaker 1: This is the way it's been done.
• 35:29
  Speaker 1: Like you need to focus on your own health before you can help others, and in order to do that, you can't be working like a dog every single day and feel just like a.
• 35:41
  Speaker 1: You know another item or number on the hospital's?
• 35:45
  Speaker 1: You know work list or whatever?
• 35:49
  Speaker 2: Yeah, yeah, I just I still think that conversations that we have about a doctor, a surgeon or someone being in that OR for 16, 24 hours, basically straight doing multiple operations, is just that's insane to me.
• 36:10
  Speaker 1: Yeah, I mean, you know, I definitely.
• 36:14
  Speaker 1: I remember, even when I was in like residency, like the training you do before you, you know, become an anesthesiologist or surgeon or whatever after med school.
• 36:23
  Speaker 1: I remember like once a week doing like a 24 hour call and still being told like, oh, you guys have it so much easier than we used to you know, it's like what are you talking about?
• 36:33
  Speaker 1: This is awful, yeah, 24 hours straight.
• 36:36
  Speaker 1: Yeah, thank you, mm, mm, mm.
• 36:38
  Speaker 1: Hmm, take it easy.
• 36:38
  Speaker 1: I'm optimistic, at least, that there's going to be a regime change.
• 36:47
  Speaker 1: As older doctors retire, people have more of a focus on the bigger picture in terms of what got the patient here, and also just a focus on yourself, because I firmly believe that you're not going to be doing your best work for other people if you're not looking out for yourself 100%.
• 37:09
  Speaker 2: I want to shift gears real quick to another conversation we've had before.
• 37:13
  Speaker 2: Sure and this really goes into the diabetes realm and even into the general population realm but CGMs in the hospital we've talked about this in length.
• 37:26
  Speaker 2: I've gotten really frustrated with it before You've expressed your frustrations with it.
• 37:32
  Speaker 2: Where do you think we are right now with the hospitals just saying, okay, we're sticking to CGM on this person because their blood sugar is elevated?
• 37:41
  Speaker 1: I think we're probably about 10 years out, okay, five to 10.
• 37:44
  Speaker 1: I'm sure there are facilities that already do that.
• 37:48
  Speaker 1: During COVID they were doing everything.
• 37:51
  Speaker 1: During COVID, cgms got really common because you didn't want to expose yourself multiple times, going in every hour and check blood sugar, whatever else it is.
• 37:59
  Speaker 2: Yeah.
• 38:00
  Speaker 1: So that was really in hospital for a lot of places.
• 38:03
  Speaker 1: That was their first exposure to using CGMs.
• 38:05
  Speaker 1: But I think that there's going to be time to argue for the utility of the device.
• 38:14
  Speaker 1: I think that a lot of nurses are comfortable with finger sticks and patient care attacks and everything else.
• 38:22
  Speaker 1: But eventually I think that it just comes down to money, just like everything else.
• 38:27
  Speaker 1: Eventually it'll get low enough that the hospital will finally say this looks like a good deal now and they'll go for it.
• 38:33
  Speaker 1: Yeah, but I do think it'll improve patient care, if anything.
• 38:38
  Speaker 1: I've seen your experience with your device and I've talked to other diabetics.
• 38:43
  Speaker 1: Overall they seem like they're getting better and better.
• 38:48
  Speaker 1: It seems like the way to go.
• 38:48
  Speaker 1: Nobody likes getting their finger stuck.
• 38:51
  Speaker 2: That was a game changer for me when I went on the G6, the desktop G6, it was a game changer Because I was on the G5 and every time you put a new one on every 10 days you had to finger stick yourself to calibrate it.
• 39:07
  Speaker 2: And that could be a multiple thing throughout the first 24 to 48 hours to actually get it calibrated.
• 39:13
  Speaker 2: And now on the G6 and even the G7, now you don't have to do that.
• 39:18
  Speaker 2: They say it's no more finger sticks.
• 39:20
  Speaker 2: It's not 100% true because sometimes if you have a bad site you might have to recalibrate it.
• 39:25
  Speaker 2: Even the site right now that I have on my tricep, I've had to calibrate it multiple times because it was off by 20, 30 milligrams per deciliter and it's even done that where I've gone low, because I'm looking at the CGM and it says I'm 80, but I'm really 45.
• 39:41
  Speaker 2: It's kind of terrifying.
• 39:43
  Speaker 2: Yeah, it is, but thank God that I know how to deal with it.
• 39:49
  Speaker 2: My body understands it, my body understands the body signals, my body understands the feelings, so I can easily deal with it.
• 39:56
  Speaker 2: Thank God I don't ever have issues where I pass out.
• 40:00
  Speaker 2: I can't imagine going through what I go through with hypoglycemic unawareness and hyperglycemic unawareness, having that and then you can't identify your body doesn't really have very good identification when you are really low.
• 40:14
  Speaker 2: Yeah, that would be really scary.
• 40:18
  Speaker 1: Yeah, and I think, as a caveat, you're focused on control and you know your body and everything else.
• 40:26
  Speaker 1: If you were my patient, I would trust you.
• 40:29
  Speaker 1: Yeah, I can't tell you how many times though I've talked to people, man, they've been like, oh, I can't go below 250.
• 40:36
  Speaker 1: I start to really feel it if I go below 200.
• 40:38
  Speaker 1: And it's like that's just because you've been so out of control for so long.
• 40:45
  Speaker 1: Your body doesn't really need to get past this and I, oh man, all the time, at least once a month, I'll hear that from a patient and it's just.
• 40:55
  Speaker 1: It really gives you an idea of just like what their perspective is in terms of their health, and it's not just even their perspective is hard to cut you off, Not even just their perspective.
• 41:05
  Speaker 2: But they're not being educated in there and the need for that individual to have support.
• 41:10
  Speaker 1: Yeah, yeah and it's.
• 41:12
  Speaker 1: But it's also in my mind when they're saying that it's almost like this is the way it is.
• 41:19
  Speaker 2: Yeah, you know, it's like a level of giving up.
• 41:21
  Speaker 1: Yeah, and I mean I've never dealt with the sequela of heaven diabetes I've.
• 41:29
  Speaker 1: You know I don't have to check my blood sugar regularly, I you know I don't have to stick myself for insulin, but just seeing what I've seen and like you said, this is not I'm not here to scare people or do anything else, it's just advocate for yourself, advocate for taking care of yourself and do like just getting your conditions under control.
• 41:50
  Speaker 1: Yeah, really yeah.
• 41:52
  Speaker 1: That's what it comes down to.
• 41:54
  Speaker 2: Yeah, it is a scary disease and I just like a lot of other things in my life, I feel like I'm in a bubble because I I coach people on this concept of understanding that you are who you choose to be around, you are what you, what environment you choose to be around.
• 42:19
  Speaker 2: That is going to help you with your success.
• 42:22
  Speaker 2: If you choose to be around really bad environments, then you're going to have a really bad result.
• 42:29
  Speaker 2: Sure, and it's the same thought process when I think about the places that I'm at in my life, because I choose to be around people that hold my same values.
• 42:40
  Speaker 2: I choose to be around people that hold those things of wanting to be as healthy as possible and they fight in claw and we just we fight in claw for those environments and those moments and those meals and, like those really good blood sugars, we fight in claw for that stuff.
• 42:59
  Speaker 2: So the people that are just not educated because I don't want to, I used to say, especially for type twos, I used to say the whole thought process, or agree with the whole thought process of you're just, you know someone that doesn't care, and it took someone that I really follow and listen to, and they're the really good diabetes coach who said that type two diabetics, people that are out of control, it's not because they don't care, it's because they're uneducated and they need support.
• 43:39
  Speaker 2: And that just totally hit home with me, because I think about all the individuals that you deal with.
• 43:44
  Speaker 2: You're not dealing with the people in my bubble.
• 43:46
  Speaker 2: You're dealing with the people that are outside my bubble and looking into my bubble and wanting to be there but not knowing how to get there.
• 43:53
  Speaker 2: Right, that's what this podcast for.
• 43:55
  Speaker 2: That's why people you know there's people like me that are coach people with diabetes and it's it's just an, it's a important piece to think about because it going back to what you keep saying of just really advocating for yourself.
• 44:12
  Speaker 2: Not enough people even understand that they have the ability to do that when they're in the hospital setting, that's true, right.
• 44:18
  Speaker 2: When they're in front of a doctor, a doctor's telling them one thing, but their BS meter is going off and telling them I don't know if this is really what I should be doing, but then they follow blindly.
• 44:28
  Speaker 2: That's what I tell people when they go to the endos.
• 44:32
  Speaker 2: There's just like anything.
• 44:33
  Speaker 2: There's really good personal trainers, there's really good strength coaches, there's really good coaches and there's really bad coaches, there's really good docs Mechanics, and and there's really bad docs Right and it's you have to advocate for yourself.
• 44:46
  Speaker 2: So I love that you brought that up.
• 44:48
  Speaker 1: Yeah, and you know you're talking about the people that you surround yourself with and you know this is not the topic.
• 44:55
  Speaker 1: But it's like smoking, yeah, you know.
• 44:57
  Speaker 1: And and it's like nowadays like there's people that you know are thinking about quitting or anything else and they, you know, they come in and maybe they're not smoking, they're getting their lung transplant or whatever else, and the entire room just smells like a hash tray.
• 45:10
  Speaker 1: You know, there's like three other family members in there and they're all still smoking.
• 45:14
  Speaker 2: Yeah.
• 45:15
  Speaker 1: What like just not seeing that correlation, or just like not recognizing that?
• 45:24
  Speaker 1: Oh, you know, my look what this did to my grandmother.
• 45:28
  Speaker 1: But you know, my mom smoked, my grandmother smoked, obviously, you know everybody smokes.
• 45:34
  Speaker 1: So I'm going to smoke now and it's the same way I think with, like you know, diabetes, like, oh, or any other kind of lifestyle adjustment.
• 45:45
  Speaker 1: It's like, oh well, you know, my dad had poorly controlled blood sugar.
• 45:49
  Speaker 1: It's just something I'm going to deal with, you know I hate that I can't.
• 45:53
  Speaker 2: that is one thing I cannot stand with, especially with diabetes, because I live with it.
• 45:57
  Speaker 2: But in our, in our existence as human beings oh, my dad dealt with high cholesterol, so I know I'm going to have high cholesterol when it that's not even like.
• 46:08
  Speaker 2: Yeah, you might be genetically dispositions to have elevated or your system, might you know, depending on what you eat, might you know, be affected by it in some way, but that doesn't mean you are going to do it, you are going to have it.
• 46:20
  Speaker 2: It's the same with type one, type two diabetes.
• 46:22
  Speaker 2: Just because it's in your family genes doesn't mean that you're going to suffer from type two diabetes.
• 46:29
  Speaker 2: It's 100% about what you're consuming and your relationship with the disease and with yourself and with food.
• 46:36
  Speaker 2: That's that's.
• 46:37
  Speaker 2: There's nothing else to say about that.
• 46:39
  Speaker 2: Like, it is 100% that.
• 46:41
  Speaker 2: What is?
• 46:42
  Speaker 2: What is your relationship with yourself, what is your relationship with food, and are you exercising and what type of lifestyle are you actually living?
• 46:50
  Speaker 2: Yeah, that that's it, there's.
• 46:53
  Speaker 2: There's nothing else besides that.
• 46:55
  Speaker 2: There are definitely extenuating circumstances, especially for weight loss, of people that are really have trouble losing weight, which is why I'm really glad we did that.
• 47:04
  Speaker 2: I did that episode on Osempic because I was even educated about that and there are 100% those those types of people that need pharmaceutical and need medical assistance to get to the result that they want.
• 47:18
  Speaker 2: But that's a very small percentage of the population very small.
• 47:24
  Speaker 1: Yeah, I mean, and you know talking about how classically, you know this is a little bit of a side, but just what you're saying reminds me of it.
• 47:32
  Speaker 1: You know there was type one and type two, and type one was before 20.
• 47:36
  Speaker 1: And you know it was because of autoimmune destruction of the eyelid cells, blah, blah, blah.
• 47:41
  Speaker 1: And type two it's usually after 30.
• 47:43
  Speaker 1: And they're usually obese and everything else.
• 47:45
  Speaker 1: Well, like I just, you know, I just was looking up in a book and they had like a cause of diabetes and they're the common cause of diabetes.
• 47:52
  Speaker 1: Yeah, there were 30, there are now like 30 different defined types of causes for insulin resistance or hyperglycemia.
• 48:01
  Speaker 1: You know diabetes, and you know I am worried because I don't think that we're doing enough in this country to.
• 48:10
  Speaker 1: You know, like we said, the lifestyle modification, encouraging healthy habits, prevention, medicine, those kind of things.
• 48:17
  Speaker 1: But I am a little encouraged by the fact that at least we're not just, you know, putting a generic label on these things and we're just saying, like you know, until you're, until you're not fat anymore, you're just going to deal with this.
• 48:30
  Speaker 1: Yeah, you know it's, it's it's like that's still out there, but at least making an effort.
• 48:36
  Speaker 2: Yes, and I do believe that, for all of the bad stuff, I do believe that medical society, people that have influence like myself and other people that have influence are trying to make the effort to educate the population, because I think there's two issues.
• 48:57
  Speaker 2: One issue is the education is finally starting to become more available to the public.
• 49:05
  Speaker 2: The other issue is the hidden stuff that's in our food.
• 49:11
  Speaker 2: The hidden stuff that we don't really understand and we might not have the expertise or understanding of how to figure out what all this stuff is that we're consuming and the whatever we want to say about who's actually running that process of putting things in our food that we shouldn't be eating, Just like all these serials now that are being banned in almost every single country in the world Skittles candies yeah, skittles has titanium dioxide in it, which is the main ingredient.
• 49:44
  Speaker 1: Sunscreen and every like 95% of countries on earth, skittles are banned.
• 49:50
  Speaker 1: Yeah, and you know, I just had a pack of them for Halloween.
• 49:53
  Speaker 2: Yeah, I did too.
• 49:55
  Speaker 1: I did too.
• 49:55
  Speaker 1: I mean, you look, you go outside this country and you know I had the advantage of recently, like going to France, for instance.
• 50:02
  Speaker 1: I think France is just a great example of they are really concerned about what's in their food, yeah, and like, our standards for what's organic here are like the baseline there, yep, yep.
• 50:14
  Speaker 1: And not that I'm saying that you have to, you know, spend 200 bucks on groceries every week or anything else like that.
• 50:21
  Speaker 1: I mean that seems like we're not that far off.
• 50:24
  Speaker 1: But I do think that just with a little bit of vigilance and like care and attention to what you're doing, you can make some really important modifications to your diet and avoid a lot of those things, and it's only going to help you out, yeah, yeah 100%, 100%.
• 50:45
  Speaker 2: Well, man, this was.
• 50:46
  Speaker 2: This has been awesome.
• 50:47
  Speaker 1: Is that really an hour?
• 50:48
  Speaker 2: Yeah, it's pretty much an hour.
• 50:49
  Speaker 2: Okay, yeah, yeah, we're at four o'clock right now, awesome.
• 50:52
  Speaker 2: So this has been great, man, I appreciate you, as always.
• 50:58
  Speaker 2: The constant conversations, constant education, from even my perspective, of learning of different things and different things that you're doing, different things that's going on.
• 51:07
  Speaker 2: The CGM conversation we had a couple months ago was like that was like a two or three week conversation we had on that thing.
• 51:17
  Speaker 1: No, I think we both like to talk and we both have strong opinions, so it kind of becomes a problem when we're trying to get a workout in too.
• 51:24
  Speaker 1: It does.
• 51:26
  Speaker 1: Now I, you know, you I got to say again, you know, I knew that there were healthy type 1 diabetics out there.
• 51:32
  Speaker 1: But with what I do in my field, some of the hard things that I see, it was really encouraging for me.
• 51:41
  Speaker 1: Not just like, yeah, you've helped me out from a, you know, looking after myself, a fitness point of view, encouraging me to improve my diet, those kind of things, but knowing that there are, like you know it doesn't have, you know it doesn't have to be what I've seen before with diabetes.
• 52:02
  Speaker 1: Yeah, and I think you're a shining example of that man and you deserve any success that you get.
• 52:07
  Speaker 2: Yeah, appreciate that, man, it's just it.
• 52:09
  Speaker 2: Sometimes it's sad, I mean saddens me when I have conversations with you about what you see every day and you see the.
• 52:15
  Speaker 2: I see the really good parts about diabetes, not just myself, but just again that environment and the bubble that I choose to associate myself with you.
• 52:26
  Speaker 2: Just you see the bad, yeah, you see the bad parts of what this disease could potentially do to someone and really are doing to people, and I think that that's that's one thing that always, or has at least really consistently made me want to be better even than what I am, because I know that I don't want to be that way, that way.
• 52:53
  Speaker 2: I know I don't want to go back to the emotional traumas that I had when I first started my diabetes journey.
• 52:59
  Speaker 2: Because of that I can only just crazy.
• 53:01
  Speaker 1: Imagine, especially that age, to get something like that.
• 53:04
  Speaker 2: Like yeah just out of college, like you know, you guys are whole life ahead of you and how this happens right, and in the constant thinking of like, why, why, why, why, why, why did this happen?
• 53:16
  Speaker 2: Well, we don't know why.
• 53:18
  Speaker 2: I think I know why, but I can't.
• 53:22
  Speaker 2: I can't say that for certain, sure, but I think that being able to have really good conversations with people like you that are also have different viewpoints than I have because we do we have different viewpoints in terms of medical, in terms of different things that are happening in the world, and I think those are very healthy and important conversations because they help us be educated and learn about something that we don't really know a lot about.
• 53:48
  Speaker 2: And that was one of the really good things I did when, when I was really trying to focus in and learn more about ozempic, because it was a big, hot topic and hot topic and you wanted to hate it and I really wanted to hate it.
• 54:02
  Speaker 1: I did, and I still hate it yeah.
• 54:04
  Speaker 2: But in a different way.
• 54:06
  Speaker 2: Right, and it's the same thing when I think about food.
• 54:09
  Speaker 2: I cannot stand.
• 54:11
  Speaker 2: I can't stand the things that are in our food.
• 54:17
  Speaker 2: It just it.
• 54:18
  Speaker 2: It sickens me to my core.
• 54:20
  Speaker 2: And it sickens to me to my core now, more than even six months ago, because I'm more educated on it.
• 54:27
  Speaker 2: Yeah, I understand now what I'm looking at when I look at something that has 50 things in the, in the ingredients, and I've developed a process of how I break that stuff down and, ultimately, how does it get from the shelf to my cart, to my mouth.
• 54:44
  Speaker 2: There's a whole process and I couldn't have done that if I wasn't curious, asking questions about different things, being curious and asking questions outside of my bubble, being curious and asking questions about from other people that don't necessarily hold my values, and being curious and asking questions from people that I don't necessarily 100% agree with.
• 55:07
  Speaker 2: Yeah, so I think that's an important piece when we think about researching different things that are happening to us in our life or different things that we're even very curious about.
• 55:17
  Speaker 1: Yeah, All right, speaking of that, like brominated vegetable oil or something like that, it's like one of the key ingredients in like Mountain Dew just declared not fit for, like human consumption.
• 55:29
  Speaker 1: Yeah, and like it's in everything.
• 55:32
  Speaker 1: It's in everything.
• 55:32
  Speaker 1: And also just like I think that people had the expectation that if it's available, it's OK.
• 55:41
  Speaker 2: It's got that green label on.
• 55:42
  Speaker 2: It's got some green label that has a leaf on it.
• 55:44
  Speaker 2: Man, it's good for you.
• 55:46
  Speaker 1: You got it like you're saying.
• 55:47
  Speaker 1: You got to be your own advocate, you got to do your own research and you know everybody benefits with just education.
• 55:54
  Speaker 1: So you know, work on educating yourself and use people like Ken to help you out too.
• 56:02
  Speaker 1: I think that's the most important thing, yeah 100% Well.
• 56:05
  Speaker 2: Thanks, man.
• 56:06
  Speaker 2: This has been great.
• 56:06
  Speaker 2: Thank you to everyone that's been watching or listening to this episode.
• 56:11
  Speaker 2: I was really excited to get Cyrus on because he just has a different perspective.
• 56:16
  Speaker 2: He has a different perspective.
• 56:17
  Speaker 2: He's not necessarily in our community, but he still works within the community, still works with a lot of people that are seeing really bad results from what's going on in their life.
• 56:28
  Speaker 2: And I really hope that, if you're type two, if you're, if you have a lot of if, even if you have type one, whatever it is, whatever you, whatever role that you hold within the diabetes community, I really hope that this episode really touched you and I really hope that you share it with someone else, because I think that a lot of the stuff that that Cyrus is talking about, the stuff that we talked about in this episode, are important pieces to kind of think about and and really take home for your, your overall health.
• 57:01
  Speaker 1: So thank you for being here.
• 57:02
  Speaker 1: No problem, take care of yourself it's never too late and utilize the resources that you got.
• 57:08
  Speaker 1: That's what it comes down to.
• 57:09
  Speaker 1: Yeah, 100% in.
• 57:12
  Speaker 2: Thanks, buddy.
• 57:12
  Speaker 2: All right, brother, thank you.