Latest / Clearly Hormonal / Ep 12: Managing Prediabetes in Menopause

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Ep 12: Managing Prediabetes in Menopause · Clearly Hormonal

• 0:01
  Dr. Komal Patil-Sisodia: Welcome to the Reset Recharge podcast with your host, Dr.
• 0:05
  Dr. Komal Patil-Sisodia: Komal Patil Sisodia, a board certified endocrinologist, internist, and obesity medicine specialist.
• 0:11
  Dr. Komal Patil-Sisodia: This podcast is focused on empowering women's health and aims to help you reset your understanding of your metabolic health And recharge the conversations you are having with your health care providers.
• 0:22
  Dr. Komal Patil-Sisodia: While I am a physician, this podcast is purely for educational purposes.
• 0:26
  Dr. Komal Patil-Sisodia: No individualized medical advice is being given on this podcast.
• 0:30
  Dr. Komal Patil-Sisodia: If you do find information that is helpful, please discuss it with your health care provider at your next visit.
• 0:40
  Dr. Komal Patil-Sisodia: Hi, everyone.
• 0:41
  Dr. Komal Patil-Sisodia: Welcome back to your reset.
• 0:42
  Dr. Komal Patil-Sisodia: Recharge the.
• 0:43
  Dr. Komal Patil-Sisodia: The endocrine series today, we are going to talk about pre-diabetes.
• 0:47
  Dr. Komal Patil-Sisodia: In my last video, we talked about insulin resistance and insulin resistance.
• 0:51
  Dr. Komal Patil-Sisodia: Distance is really the point at which the body starts getting stressed out and insulin.
• 0:55
  Dr. Komal Patil-Sisodia: Sullen levels are rising because your body is not able.
• 0:59
  Dr. Komal Patil-Sisodia: To process carbohydrates at the same degree, it was with a lesser amount of.
• 1:03
  Dr. Komal Patil-Sisodia: Insulin.
• 1:03
  Dr. Komal Patil-Sisodia: So.
• 1:05
  Dr. Komal Patil-Sisodia: As insulin increases our beta cells continue.
• 1:07
  Dr. Komal Patil-Sisodia: You to get stressed out and eventually they will reach a tipping point.
• 1:11
  Dr. Komal Patil-Sisodia: Where there is not enough insulin to cover the carbs.
• 1:15
  Dr. Komal Patil-Sisodia: That you're consuming and the blood sugars start to rise.
• 1:19
  Dr. Komal Patil-Sisodia: And this is really.
• 1:20
  Dr. Komal Patil-Sisodia: What we call pre-diabetes that rise in blood sugar is happening even.
• 1:24
  Dr. Komal Patil-Sisodia: Before that, but it's still rising within the normal range in pre-diabetes.
• 1:28
  Dr. Komal Patil-Sisodia: The blood sugars tip over into what's called the prediabetes range.
• 1:32
  Dr. Komal Patil-Sisodia: And currently that is established by the American diabetes association.
• 1:36
  Dr. Komal Patil-Sisodia: Association for a blood sugar of a hundred to 125 or by the world.
• 1:40
  Dr. Komal Patil-Sisodia: Health initiative or sorry, world health organization.
• 1:44
  Dr. Komal Patil-Sisodia: To be.
• 1:44
  Dr. Komal Patil-Sisodia: Between one 10 and 1 25.
• 1:46
  Dr. Komal Patil-Sisodia: And I think that there are some.
• 1:48
  Dr. Komal Patil-Sisodia: Differences, depending on what your ethnic background is and things like that, that.
• 1:52
  Dr. Komal Patil-Sisodia: It can make a difference for which marker you should use.
• 1:56
  Dr. Komal Patil-Sisodia: The other thing.
• 1:56
  Dr. Komal Patil-Sisodia: Thing that we look at is when the hemoglobin A1C, which is a measure.
• 2:01
  Dr. Komal Patil-Sisodia: Uh, of how your blood sugars are doing over the last three.
• 2:04
  Dr. Komal Patil-Sisodia: Three months starts increasing into the range of prediabetes hemoglobin A1C.
• 2:09
  Dr. Komal Patil-Sisodia: Kind of an interesting test because what it does is it.
• 2:13
  Dr. Komal Patil-Sisodia: Looks at the number of red blood cells that have sugar that are stuck to.
• 2:16
  Dr. Komal Patil-Sisodia: Um, or the percentage rather, and as your blood sugars start rising in your blood.
• 2:21
  Dr. Komal Patil-Sisodia: Because you tread blood cell in your body lives on average about.
• 2:24
  Dr. Komal Patil-Sisodia: Three months.
• 2:26
  Dr. Komal Patil-Sisodia: It turns over every three months.
• 2:27
  Dr. Komal Patil-Sisodia: And if that percentage is rising, Rising for how many of these red blood cells have sugar molecule?
• 2:33
  Dr. Komal Patil-Sisodia: Or glycation products stuck to them that A1C starts rising.
• 2:37
  Dr. Komal Patil-Sisodia: So there can be two indications that we look for on blood tests.
• 2:40
  Dr. Komal Patil-Sisodia: A hemoglobin.
• 2:41
  Dr. Komal Patil-Sisodia: UNC F PI 5.7% to 6.4% is considered.
• 2:45
  Dr. Komal Patil-Sisodia: The pre-diabetes range.
• 2:47
  Dr. Komal Patil-Sisodia: Again, prediabetes and I cannot.
• 2:48
  Dr. Komal Patil-Sisodia: I cannot stress this enough is the point at which your beta cells in your pancreas.
• 2:52
  Dr. Komal Patil-Sisodia: Pancreas.
• 2:53
  Dr. Komal Patil-Sisodia: Are getting stressed out and starting to fail.
• 2:56
  Dr. Komal Patil-Sisodia: They cannot.
• 2:56
  Dr. Komal Patil-Sisodia: Cannot keep the blood sugars and what we determined as a normal range, but that range.
• 3:01
  Dr. Komal Patil-Sisodia: I wasn't quite into the diabetes range and I want to rehash a few.
• 3:05
  Dr. Komal Patil-Sisodia: Things from the last episode, your pancreas is a factory assembly.
• 3:09
  Dr. Komal Patil-Sisodia: The line under normal conditions, meaning you're at a normal body weight.
• 3:13
  Dr. Komal Patil-Sisodia: Eating a normal amount of carbs your pancreas can create and package insulin.
• 3:17
  Dr. Komal Patil-Sisodia: To be using or storing the carbs that you're eating.
• 3:21
  Dr. Komal Patil-Sisodia: So what actually stresses this assembly line and we.
• 3:25
  Dr. Komal Patil-Sisodia: We focused a little bit more on beta cells, but on this episode, I want to focus.
• 3:29
  Dr. Komal Patil-Sisodia: On, what is it that we're doing that is stressing out the assembly.
• 3:33
  Dr. Komal Patil-Sisodia: Somebody line.
• 3:33
  Dr. Komal Patil-Sisodia: And sometimes it's things that we're doing, meaning our environment.
• 3:36
  Dr. Komal Patil-Sisodia: And sometimes.
• 3:37
  Dr. Komal Patil-Sisodia: It's what's happening within us, depending on how our bodies are changing and aging.
• 3:41
  Dr. Komal Patil-Sisodia: So the first and foremost, and I think we're all guilty of this in American.
• 3:45
  Dr. Komal Patil-Sisodia: Society is eating too many carbs.
• 3:48
  Dr. Komal Patil-Sisodia: Carbs are readily.
• 3:49
  Dr. Komal Patil-Sisodia: Available everywhere.
• 3:51
  Dr. Komal Patil-Sisodia: You can, don't really have to look.
• 3:53
  Dr. Komal Patil-Sisodia: That.
• 3:53
  Dr. Komal Patil-Sisodia: Far to find curves and interesting fun fact.
• 3:56
  Dr. Komal Patil-Sisodia: Carps light up.
• 3:57
  Dr. Komal Patil-Sisodia: At the same reward pathways in your brain that crack cocaine does.
• 4:01
  Dr. Komal Patil-Sisodia: Right.
• 4:01
  Dr. Komal Patil-Sisodia: And crack cocaine is illegal, but sugar is available everywhere.
• 4:05
  Dr. Komal Patil-Sisodia: Right?
• 4:05
  Dr. Komal Patil-Sisodia: So.
• 4:05
  Dr. Komal Patil-Sisodia: So we have this unfettered access to something that is lighting up these reward.
• 4:09
  Dr. Komal Patil-Sisodia: Pathways on our brains.
• 4:10
  Dr. Komal Patil-Sisodia: So it becomes very, very easy for us to.
• 4:13
  Dr. Komal Patil-Sisodia: I eat more sugar than we're anticipating.
• 4:16
  Dr. Komal Patil-Sisodia: The other thing is, is that we have.
• 4:17
  Dr. Komal Patil-Sisodia: I live such busy lives.
• 4:19
  Dr. Komal Patil-Sisodia: Nowadays we are bogged down with technology and.
• 4:22
  Dr. Komal Patil-Sisodia: At work and running activities and trying to spend time with family.
• 4:26
  Dr. Komal Patil-Sisodia: And friends and sometimes grabbing a packaged meal is easier, but a lot of times these.
• 4:30
  Dr. Komal Patil-Sisodia: Packaged meals have a lot of refined sugars and starches in them.
• 4:34
  Dr. Komal Patil-Sisodia: The second.
• 4:34
  Dr. Komal Patil-Sisodia: Thing is that we are not moving our bodies.
• 4:38
  Dr. Komal Patil-Sisodia: Enough.
• 4:40
  Dr. Komal Patil-Sisodia: Number of times I find myself seeing patients virtually.
• 4:42
  Dr. Komal Patil-Sisodia: Really.
• 4:43
  Dr. Komal Patil-Sisodia: And counseling them about you know, Exercise and moving their bodies and trying to make sure that they're.
• 4:50
  Dr. Komal Patil-Sisodia: We're getting like.
• 4:51
  Dr. Komal Patil-Sisodia: Between 10 to 30 minutes of movement a day.
• 4:53
  Dr. Komal Patil-Sisodia: And then I look at my apple watch at the end of the day and go, Ooh, you didn't really move much yourself.
• 4:58
  Dr. Komal Patil-Sisodia: Herself today, lady.
• 4:59
  Dr. Komal Patil-Sisodia: So I think that, you know, it becomes something.
• 5:02
  Dr. Komal Patil-Sisodia: That is harder and harder because again, we're tied to technology, our jobs.
• 5:06
  Dr. Komal Patil-Sisodia: We're a little bit more sedentary than they used to be.
• 5:08
  Dr. Komal Patil-Sisodia: So a lot of times we're not moving our bodies.
• 5:10
  Dr. Komal Patil-Sisodia: He's enough and that can start stressing the assembly line as well.
• 5:15
  Dr. Komal Patil-Sisodia: Because when we are not exercising, it is easier for our.
• 5:18
  Dr. Komal Patil-Sisodia: Our muscles to start decreasing and what we call atrophying means.
• 5:22
  Dr. Komal Patil-Sisodia: Meaning our muscle mass goes down.
• 5:25
  Dr. Komal Patil-Sisodia: And then when we're not moving.
• 5:26
  Dr. Komal Patil-Sisodia: Moving.
• 5:27
  Dr. Komal Patil-Sisodia: We tend to gain weight, especially around our middle, and then we're not even considering.
• 5:31
  Dr. Komal Patil-Sisodia: Stress or lack of sleep or other things.
• 5:33
  Dr. Komal Patil-Sisodia: So our body composition can start.
• 5:35
  Dr. Komal Patil-Sisodia: Shifting and those changes in body composition.
• 5:38
  Dr. Komal Patil-Sisodia: Either because.
• 5:39
  Dr. Komal Patil-Sisodia: Because of what's happening in our environment around us or say something like peri-menopause.
• 5:43
  Dr. Komal Patil-Sisodia: Menopause.
• 5:44
  Dr. Komal Patil-Sisodia: Is really going to be what stresses the assembly line and tips.
• 5:47
  Dr. Komal Patil-Sisodia: That over into pre-diabetes.
• 5:50
  Dr. Komal Patil-Sisodia: So again, I love.
• 5:51
  Dr. Komal Patil-Sisodia: Love the show.
• 5:52
  Dr. Komal Patil-Sisodia: I love Lucy.
• 5:54
  Dr. Komal Patil-Sisodia: And I know I gave that as an example.
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  Dr. Komal Patil-Sisodia: For what our pancreas functions like.
• 5:58
  Dr. Komal Patil-Sisodia: Right.
• 5:58
  Dr. Komal Patil-Sisodia: So our pancreas again, factory.
• 5:59
  Dr. Komal Patil-Sisodia: The assembly line.
• 6:00
  Dr. Komal Patil-Sisodia: And if you've never seen the episode, I recommend at least.
• 6:04
  Dr. Komal Patil-Sisodia: You tubing.
• 6:04
  Dr. Komal Patil-Sisodia: The clip.
• 6:06
  Dr. Komal Patil-Sisodia: At this episode where Lucy and Avalara.
• 6:08
  Dr. Komal Patil-Sisodia: And a chocolate factory and they are working this assembly line.
• 6:11
  Dr. Komal Patil-Sisodia: And when the assembly line.
• 6:12
  Dr. Komal Patil-Sisodia: And again is going the right speed.
• 6:14
  Dr. Komal Patil-Sisodia: They're able to take those chocolate.
• 6:16
  Dr. Komal Patil-Sisodia: Gluts, package them up in the box, make them look nice and send.
• 6:20
  Dr. Komal Patil-Sisodia: Send them to the end of the assembly line in pre-diabetes.
• 6:24
  Dr. Komal Patil-Sisodia: It's like the switch goes into hyperdrive.
• 6:27
  Dr. Komal Patil-Sisodia: And all of a sudden.
• 6:28
  Dr. Komal Patil-Sisodia: Sudden your body is having to churn out huge amounts of insulin just to keep.
• 6:32
  Dr. Komal Patil-Sisodia: Your blood sugars in the normal range.
• 6:34
  Dr. Komal Patil-Sisodia: So again, What happens in this.
• 6:36
  Dr. Komal Patil-Sisodia: Chocolate factory episode is when Lucy accidentally hits that on switch.
• 6:40
  Dr. Komal Patil-Sisodia: And it goes.
• 6:41
  Dr. Komal Patil-Sisodia: On like turbo speed.
• 6:43
  Dr. Komal Patil-Sisodia: She and Ethel can't keep up.
• 6:44
  Dr. Komal Patil-Sisodia: I mean, they're.
• 6:44
  Dr. Komal Patil-Sisodia: They're shoving chocolate down their shirt.
• 6:46
  Dr. Komal Patil-Sisodia: They're shoving it in their mouth.
• 6:47
  Dr. Komal Patil-Sisodia: Like nothing is really making.
• 6:48
  Dr. Komal Patil-Sisodia: Making it.
• 6:49
  Dr. Komal Patil-Sisodia: To the end of the assembly line in a pretty packaged manner.
• 6:53
  Dr. Komal Patil-Sisodia: That can actually be functional or something that you can use.
• 6:55
  Dr. Komal Patil-Sisodia: So think of your insulin in.
• 6:57
  Dr. Komal Patil-Sisodia: In that capacity when you are in pre-diabetes.
• 7:00
  Dr. Komal Patil-Sisodia: It's like that.
• 7:01
  Dr. Komal Patil-Sisodia: At assembly line is on hyperdrive and insulin resistance.
• 7:03
  Dr. Komal Patil-Sisodia: It's starting to speed up and your.
• 7:05
  Dr. Komal Patil-Sisodia: You're seeing it get a little bit more stress, but in prediabetes and.
• 7:09
  Dr. Komal Patil-Sisodia: Going into diabetes.
• 7:10
  Dr. Komal Patil-Sisodia: That's where it's in hyperdrive.
• 7:11
  Dr. Komal Patil-Sisodia: So how would.
• 7:13
  Dr. Komal Patil-Sisodia: We slow the assembly line down.
• 7:15
  Dr. Komal Patil-Sisodia: Well, a lot of it is kind of reversing.
• 7:18
  Dr. Komal Patil-Sisodia: What we're doing for our lifestyle.
• 7:20
  Dr. Komal Patil-Sisodia: Right?
• 7:21
  Dr. Komal Patil-Sisodia: So.
• 7:21
  Dr. Komal Patil-Sisodia: Really looking at the foods that you're eating and picking foods.
• 7:25
  Dr. Komal Patil-Sisodia: Ads that are lower in refined sugar or starchy.
• 7:29
  Dr. Komal Patil-Sisodia: Marches.
• 7:30
  Dr. Komal Patil-Sisodia: And by that, I mean, like anything that has white sugar, white flour.
• 7:34
  Dr. Komal Patil-Sisodia: It's not bad for you per se, but you have to look at.
• 7:38
  Dr. Komal Patil-Sisodia: The serving size of it and eat unappropriate amount.
• 7:41
  Dr. Komal Patil-Sisodia: We.
• 7:42
  Dr. Komal Patil-Sisodia: We have not really.
• 7:44
  Dr. Komal Patil-Sisodia: Maintained our barometers.
• 7:46
  Dr. Komal Patil-Sisodia: For what a normal serving size is, especially in the United States.
• 7:50
  Dr. Komal Patil-Sisodia: Sometimes it's easier to overeat and think that we're eating the right.
• 7:54
  Dr. Komal Patil-Sisodia: Amount for a right serving size.
• 7:56
  Dr. Komal Patil-Sisodia: But when you actually start to get to looking at your food, Food.
• 7:59
  Dr. Komal Patil-Sisodia: You see that that can be something that is.
• 8:02
  Dr. Komal Patil-Sisodia: Is a little bit more difficult to do, but you know, focusing on what I call.
• 8:06
  Dr. Komal Patil-Sisodia: Call eating more carbs from nature.
• 8:08
  Dr. Komal Patil-Sisodia: So fruit.
• 8:09
  Dr. Komal Patil-Sisodia: Sweet potato.
• 8:10
  Dr. Komal Patil-Sisodia: Potatoes things like that think carbs that are coming from more natural sources.
• 8:14
  Dr. Komal Patil-Sisodia: Or complex carbohydrates that are made from whole grains and making sure that you're getting.
• 8:18
  Dr. Komal Patil-Sisodia: A reasonable amount of it, that food pyramid that we were showing when we were kids.
• 8:22
  Dr. Komal Patil-Sisodia: Kids again, aging myself on this episode.
• 8:26
  Dr. Komal Patil-Sisodia: At the bottom of it, it used.
• 8:27
  Dr. Komal Patil-Sisodia: Used to have six to 11.
• 8:29
  Dr. Komal Patil-Sisodia: Uh, servings of carbohydrates.
• 8:31
  Dr. Komal Patil-Sisodia: Or grains per day.
• 8:32
  Dr. Komal Patil-Sisodia: That is way too much.
• 8:34
  Dr. Komal Patil-Sisodia: And really.
• 8:36
  Dr. Komal Patil-Sisodia: I think what we find is that we have to work on.
• 8:39
  Dr. Komal Patil-Sisodia: Decreasing not and increasing the amount of fiber that we're getting.
• 8:42
  Dr. Komal Patil-Sisodia: So I'm not saying.
• 8:43
  Dr. Komal Patil-Sisodia: I give up carbs entirely.
• 8:44
  Dr. Komal Patil-Sisodia: I'm saying just be very mindful of what it is.
• 8:47
  Dr. Komal Patil-Sisodia: You're eating.
• 8:47
  Dr. Komal Patil-Sisodia: And putting in your body.
• 8:49
  Dr. Komal Patil-Sisodia: Second exercise.
• 8:50
  Dr. Komal Patil-Sisodia: Just moving.
• 8:51
  Dr. Komal Patil-Sisodia: Moving your body helps decrease the impact.
• 8:55
  Dr. Komal Patil-Sisodia: Of prediabetes and can sometimes help take you from pre-diabetes back into.
• 9:00
  Dr. Komal Patil-Sisodia: A normal blood sugar range.
• 9:02
  Dr. Komal Patil-Sisodia: Right.
• 9:02
  Dr. Komal Patil-Sisodia: So slowing down that factory.
• 9:03
  Dr. Komal Patil-Sisodia: The assembly line, getting it to where our pancreas is able to function more.
• 9:08
  Dr. Komal Patil-Sisodia: Normally is really going to be the key to.
• 9:11
  Dr. Komal Patil-Sisodia: To, to making sure that we're staying healthy.
• 9:14
  Dr. Komal Patil-Sisodia: So any type of exercise, their.
• 9:16
  Dr. Komal Patil-Sisodia: A study showing that just 11 minutes of exercise per day can make.
• 9:20
  Dr. Komal Patil-Sisodia: An impact, right?
• 9:21
  Dr. Komal Patil-Sisodia: If you look at the data around obesity medicine, you.
• 9:24
  Dr. Komal Patil-Sisodia: Can, uh, there are studies that show that exercising four 50.
• 9:28
  Dr. Komal Patil-Sisodia: 50, uh, sorry, 150 minutes a week.
• 9:31
  Dr. Komal Patil-Sisodia: I will keep.
• 9:32
  Dr. Komal Patil-Sisodia: You stable at the weight.
• 9:34
  Dr. Komal Patil-Sisodia: If you're actually trying to lose weight, you need more.
• 9:36
  Dr. Komal Patil-Sisodia: Exercise in that per week, in addition to.
• 9:39
  Dr. Komal Patil-Sisodia: In addition to modifying your.
• 9:40
  Dr. Komal Patil-Sisodia: Diet.
• 9:41
  Dr. Komal Patil-Sisodia: So when you are working on that and working on losing weight, Really the other thing you want to be paying attention to, again, is your body composition.
• 9:49
  Dr. Komal Patil-Sisodia: Position, we do not do enough strength, training exercises.
• 9:53
  Dr. Komal Patil-Sisodia: As a society.
• 9:55
  Dr. Komal Patil-Sisodia: There has been this huge focus.
• 9:57
  Dr. Komal Patil-Sisodia: On cardio, cardio, cardio, and cardio is great exercise for keeping your heart healthy.
• 10:01
  Dr. Komal Patil-Sisodia: But it does not necessarily help your muscle mass or holding onto.
• 10:05
  Dr. Komal Patil-Sisodia: To your muscle mass and your muscle mass is what determines your basal metabolic.
• 10:09
  Dr. Komal Patil-Sisodia: Abolish rate.
• 10:10
  Dr. Komal Patil-Sisodia: Meaning how many calories are you burning at rest?
• 10:12
  Dr. Komal Patil-Sisodia: So incorporating.
• 10:13
  Dr. Komal Patil-Sisodia: Rating strength training a few times a week.
• 10:15
  Dr. Komal Patil-Sisodia: There are studies that show you need.
• 10:17
  Dr. Komal Patil-Sisodia: As little as 30 minutes just to maintain your muscle mass or even potentially build.
• 10:21
  Dr. Komal Patil-Sisodia: Some muscle, if you've never strength trained before, um, for people who have.
• 10:25
  Dr. Komal Patil-Sisodia: Have worked out more frequently, they might need a little bit more.
• 10:30
  Dr. Komal Patil-Sisodia: You also need to eat more protein.
• 10:32
  Dr. Komal Patil-Sisodia: So again, that goes back to the diet thing.
• 10:34
  Dr. Komal Patil-Sisodia: While you were reducing the number, the number of refined carbs in your diet.
• 10:38
  Dr. Komal Patil-Sisodia: You need to be eating more protein in order to hold onto your muscle.
• 10:42
  Dr. Komal Patil-Sisodia: Mass.
• 10:42
  Dr. Komal Patil-Sisodia: And that is really what starts shifting your body composition.
• 10:46
  Dr. Komal Patil-Sisodia: To slow that assembly line down where you are.
• 10:50
  Dr. Komal Patil-Sisodia: Um, Where things are getting to a more normal range, right?
• 10:54
  Dr. Komal Patil-Sisodia: And.
• 10:54
  Dr. Komal Patil-Sisodia: And then we have.
• 10:56
  Dr. Komal Patil-Sisodia: Peri-menopause which shows.
• 10:59
  Dr. Komal Patil-Sisodia: And that decline in estrogen makes some of these body composition.
• 11:02
  Dr. Komal Patil-Sisodia: Position changes worse.
• 11:03
  Dr. Komal Patil-Sisodia: So we have to work a little bit harder in.
• 11:06
  Dr. Komal Patil-Sisodia: In order to maintain that.
• 11:09
  Dr. Komal Patil-Sisodia: So for any of my patients, Who are women over the age of 40?
• 11:13
  Dr. Komal Patil-Sisodia: I really stressed that.
• 11:15
  Dr. Komal Patil-Sisodia: Cutting back on refined carbs, increasing the amount of protein that.
• 11:19
  Dr. Komal Patil-Sisodia: You have in your diet strength training a few times a week, and then just.
• 11:23
  Dr. Komal Patil-Sisodia: Maintaining a general level of activity, whether that is walking for you, writing up.
• 11:27
  Dr. Komal Patil-Sisodia: An exercise bike.
• 11:29
  Dr. Komal Patil-Sisodia: Uh, going on a treadmill, whatever it is that gets.
• 11:31
  Dr. Komal Patil-Sisodia: Gets you that cardiovascular activity, in addition to the strength training, those are really going to be.
• 11:35
  Dr. Komal Patil-Sisodia: The things that help you hold onto your muscle mass and avoid that.
• 11:39
  Dr. Komal Patil-Sisodia: Midsection tire that we all dread.
• 11:42
  Dr. Komal Patil-Sisodia: Uh, the next thing that you can do.
• 11:43
  Dr. Komal Patil-Sisodia: Do is talk to your primary care providers about, uh, You know, obesity, medications.
• 11:49
  Dr. Komal Patil-Sisodia: If you find that, you know, your, your.
• 11:51
  Dr. Komal Patil-Sisodia: BMI, which I don't love as a measure, but is really what's dictating.
• 11:56
  Dr. Komal Patil-Sisodia: Whether or not, we can have access to medications that help treat obesity.
• 11:59
  Dr. Komal Patil-Sisodia: If you're a BMI.
• 11:59
  Dr. Komal Patil-Sisodia: BMI is over 30.
• 12:01
  Dr. Komal Patil-Sisodia: You already qualify.
• 12:02
  Dr. Komal Patil-Sisodia: There are some insurance.
• 12:04
  Dr. Komal Patil-Sisodia: Insurance companies that are now recognizing that if you have a BMI of 27 or.
• 12:08
  Dr. Komal Patil-Sisodia: Are higher, but you're showing signs.
• 12:10
  Dr. Komal Patil-Sisodia: Of cardio-metabolic disease.
• 12:11
  Dr. Komal Patil-Sisodia: That can be something.
• 12:12
  Dr. Komal Patil-Sisodia: You can do.
• 12:13
  Dr. Komal Patil-Sisodia: And then if hormone replacement therapy is available.
• 12:16
  Dr. Komal Patil-Sisodia: To you talk to your doctors about that because for the pyramid.
• 12:20
  Dr. Komal Patil-Sisodia: Very menopausal woman.
• 12:21
  Dr. Komal Patil-Sisodia: There have been studies that have shown.
• 12:23
  Dr. Komal Patil-Sisodia: That hormone.
• 12:24
  Dr. Komal Patil-Sisodia: Replacement therapy decrease the progression of pre-diabetes.
• 12:28
  Dr. Komal Patil-Sisodia: Two diabetes by 30%.
• 12:30
  Dr. Komal Patil-Sisodia: That is huge as an endocrinologist.
• 12:33
  Dr. Komal Patil-Sisodia: That makes those types of treatment to women.
• 12:35
  Dr. Komal Patil-Sisodia: In addition to all.
• 12:36
  Dr. Komal Patil-Sisodia: All of the lifestyle changes other medications to help with metabolism.
• 12:41
  Dr. Komal Patil-Sisodia: Hormone replacement therapy.
• 12:42
  Dr. Komal Patil-Sisodia: If it's available to you is also.
• 12:44
  Dr. Komal Patil-Sisodia: A great thing to add onto it.
• 12:46
  Dr. Komal Patil-Sisodia: And for those of you who cannot you have in your arsenal.
• 12:49
  Dr. Komal Patil-Sisodia: There are actually.
• 12:49
  Dr. Komal Patil-Sisodia: Many other things you have in your arsenal, but for the purpose of this podcast episode, Those are the major ones.
• 12:54
  Dr. Komal Patil-Sisodia: So I just wanted to make sure that we covered all of.
• 12:57
  Dr. Komal Patil-Sisodia: Those things again, how can we slow down the assembly line once it's gone into.
• 13:01
  Dr. Komal Patil-Sisodia: Hyperdrive and pre-diabetes.
• 13:03
  Dr. Komal Patil-Sisodia: Diet exercise, focus.
• 13:05
  Dr. Komal Patil-Sisodia: Focusing on re configuring your body composition.
• 13:09
  Dr. Komal Patil-Sisodia: And potentially losing some weight and then talking to your primary care provider.
• 13:13
  Dr. Komal Patil-Sisodia: About medications to treat the underlying metabolic condition.
• 13:18
  Dr. Komal Patil-Sisodia: And or hormone replacement therapy.
• 13:20
  Dr. Komal Patil-Sisodia: All right.
• 13:20
  Dr. Komal Patil-Sisodia: That's all for this episode.
• 13:22
  Dr. Komal Patil-Sisodia: And I will.
• 13:22
  Dr. Komal Patil-Sisodia: We'll see you all for the next one on diabetes and menopause.
• 13:25
  Dr. Komal Patil-Sisodia: A tune-in.
• 13:26
  Dr. Komal Patil-Sisodia: In next week and I will see you there.
• 13:28
  Dr. Komal Patil-Sisodia: Bye.