This episode is brought to you by smart food, the sweet, salty snack. You need this holiday season, air popped, popcorn, tossed in delicious white, cheddar cheese or mix with sweet, caramel and cheddar. It's the perfect snack for your smart holiday party shop. Now at snacks, dot com, you should nearly ninety five million people are pre diabetic out of that Andy, five million, nearly half, don't even know it. I will kill you do today to prevent that risk later on in life. Welcome to fill in the blanks very excited about my guest today, because by good friend doktor John White is joining me. You ve heard me talk about

to doktor. Why, before he's the chief medical officer, where we indeed earlier this year, doktor White published a book entitled take control of your diabetes risk. Now that's interesting time and that's what we're going to have in our conversation day is not saying. Take control your diabetes is actually saying take control, Your diabetes risk that's important, because there are things you can do and we're gonna talk about that today and you may think well, what this is particularly relevant to me ill, you need, is that what we have to say for a couple of reasons, because its role do a lot more people than think it is, and what we're talking about, is relevant to managing over all health as well as diabetes, and there are some real, powerful tools in here for managing Your overall health now he's gonna

here are some really straightforward information and really equip all of you with strategies to help on a journey to better health, including knowing the causes of the different types of babies, learning the role food exercise and sleet play. understanding, the relationship between diabetes, heart disease and cancer. But again this also is important information for me managing your health. Overall. There is a tremendous mind body connection it we're gonna talk about, and all of this has been finch awaited by the pandemic. As we emerged from that, we need to do it and do it right, so he's here today to empower you with strategies for a better health journey, so doktor white. Thank you

be it here thanks for having made after fell it's good to see you again, we always have provocative conversations which I enjoy. We do and that we have said we should more people here for an hour. I have conversations of wish that we had a microphone fly on the wall in some of our conversations because they get pretty candid sometimes, which has really been thought, provoking to me an influence. Some show top we ve done even since you- and I talked in d c not long ago, absolutely it's been really great. Before we get into the specifics of diabetes in particular, the truth of the matter is this has to do with managing overall health and if your manager, overall health, your

encouraging your diabetes risk would that be affair statement. Absolutely you reference the pandemic in and what the pandemic has taught us at the end of the day, all we have is our health, and what can you do to control your own? factors for disease in a we spend so much time. You know just focus on job. Jobs and family, and then it's not until we actually get a disease till we get cancer till we get here. disease till someone tells us away, you ve got diabetes and people are like well How did that happen, and in that's wide so important to talk about? What can you do today to prevent that risk later on in life? Do the reason I say I want to talk about managing your overall health first and then we'll funnel it down specifically to your diabetes. Risk is because, as were coming out of this pandemic- and I hope were coming out of this-

pandemic. I had redfield on the other day well- has a cdc he's predicting that We're gonna see some real spikes as whether gets cold different mutations. no- and we can talk about that in a minute, but the truth is as we're coming. The pandemic, as a population were probably in. Not so good a shape, as we were before, because a lot of people were sedentary check more so the pandemic than they were before. We think maybe it had been different cause people had more time to exercise, get out and walk do things, but maybe we're not in his good shape as we were going in. So we ve got some ground to make up. Perhaps in I'm part of that group, doktor fail,

on on calls all day in doing a lot of interviews and out, I am wearing a fit fitbit cause. I'm gonna during the pandemic, so is gaining wait and I put it on and that these are the first week I was averaging, I'm not joking, like two thousand three key factor and steps about. There's gotta be wrong, it says, don't wear it on your dominant and I was sorry switch debt at it was still. I. five hundred, and I thought you know it I'll be right. I don't move too far from my office still living room upstairs, but I had to make that conscious effort. did to rethink and really refill as on what I'm doing you know this disease is by and large are caused by lifestyle, which is your point that the factors that we're in a talk about here apply

in other diseases. There are some nuances and some exceptions, but genetics doesn't cause most conditions that we get it. It's pretty small most is caused by our daily choices: overtime, overtime, absolute, which is right. So if somebody has a bad day eating things that aren't good for them. That's not going to be outcome, determinedly for their health if they smoke one cigarette, which I've never done- and I am now have I plan but making a bad choice on food or drink or

whatever on one day or splurging on a vacation is not going to be outcome determinative for their life. We're talking about patterns across time, because that sets a lot of things in your body and it takes a long time now. I grew up with three sisters and they used to say they eat one cheeseburger. It goes straight to the hips and take six months to get rid of, and I don't think it's that bad, but I think my sisters by the way, that's probably why we get along yeah. We were

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I'm slash advertise, that's linked and outcome, slash advertise terms and conditions apply. The truth is we picked up some patterns during the pandemic of being more sedentary may be eating differently, not dealing with stress as well, maybe not being is active in catharsis for our motions and all, and so I think we ve come out compromised mentally emotionally. Physically, so I think we need to make a conscious effort at this point, not just to say, ok I'll get back to my normal self now, and everything will be back to normal I think we need to make a conscious effort to reset everything and not discuss, let it drift back up to where it was, but instead make a conscious effort. Intentional exercise, intentional diet choices, intentional behaviors that will get

back more quickly and more directly to where we need to be, and if people will do that, I think they can close the gap. A lot quicker, no doubt about it. We're going to see the consequences of the last two to three years, five years from now ten years from now twenty years from now, if we don't make those changes- and we also have to put in many people- didn't go to the doctor during that time, as you and I have talked about, mental health is going to have a huge impact in terms of our physical health as So if we don't do what you just talked about be intentional in terms of our lifestyle and hold ourselves accountable too, we need to do a little bit of that. Sometimes we you know that that bad day turns in two of a bad. We bad month a bad year and then you're waiting until much later in life till you say: oh I'll start exercising when retire. I've actually heard that from people are good enough sleep. When I die people often say that you know flip. Only that's not gonna help you solve we're

unintentional, now many many more problems in society. Five, ten twenty years are now well the truth is we picked up some new, habits during the pandemic. Like you said you don't walk is far from your living room to your office before you were walking around going to meetings goin on the hill, going here going different places for long I'm you didn't do that. We picked up new habits. Zoom Zoom wasn't even in my vocabulary all this I start him. People say zoom zooms, whom I thought. What are we really racing around? What are you talking about, then? I find out note these meetings, that everybody's havin so and they're. All video you ever did video conference with nobody did that before. Well, I guess some people did, but I didn't sing. You know you got eight hours, zoom meetings, today in your in a chair, so we picked up some habits and I just want to say to people you don't break habits,

you replace one set of behaviors with a new the set of incompatible behaviors. I say incompatible because it so much easier. to take on new behaviors if their incompatible with one's you're trying to replace you can't sit and run at the same time. So you need to adopt a new set of behaviors that are incompatible with what your wanting to get rid of, but you don't break habits if you simply stop doing a set of behaviors and don't put something else in his place, you will default back to that behaviour. Same thing. I talk about ah to patients in in the book.

When we talk about food is as important what you include as well as what you exclude and- and that goes to your point in terms of replacing and and that's how you have to to think about it in psychology. We talk about the dead man. Rule don't give people something a dead. Man could do. If you say don't do this, will a dead man can don't do something you have to give them something active to do So I don't want to tell people just don't sit around. Instead, you To put it in the active voice and say: do get up get outside do walk five thousand steps a day. Do walk. Eight thousand steps today do start drink. in this amount of water do start replacing these foods with these foods have a to do list, I think, it is also important that people realise that some day

not a day of the week, I love that look My calendar there, sunday, monday, tuesday, wednesday, thursday, friday saturday. There is not some day anywhere on the counter. Shall we say: well, you know some day I'm going to get this done now. That's the difference between a dream and a goal is a timeline count ability we ve talked about that. Our new year's resolution electronically is so critical. If you hold yourself accountable and say by friday, I'm gonna get a new pair of walking shoes or I'm gonna find my walking shoes, I'm gonna get whatever I need gathered up. And saturday morning, I'm going to the track or I'm going to the gm or I'm going to the mall or somewhere that I can get in some steps that I can

right. I swear tat. I can do this sad ago and hold yourself accountable to that goal in time on. It has to be something that measurable, Well, that's not intentional behavior that you're talking about and then you're having that plan that that's what happens. People have these lofty goals, I'm going to lose twenty pounds by summer. and then you think what are you gonna to do that and then what gonna do on a weekly basis. What you gonna do on a daily basis, what what are those short term goals and short term calls can mean tomorrow? What what are you They do tomorrow, debt to get you to where you were be where you aspire to be people don't realize that small changes accumulate too big results across time. You talk about it take control of your diabetes risk that its patterns that matter and if people can make

even small changes to their eating habits. Sleeping habits, exercise habits. If people lose half a pound a week, think about people is a half a pound a week, and there are fifty two weeks in the year. That's twice The six pounds that's huge. It is- and I say it all the time to patients and you compound that, with as we get older, most people gain weight cause. Your basal metabolic rate can have that internal furnace slows down so you're automatically going to gain weight because you have less at output just by your activities of daily living. But you know DR phil, people are like, but I need to lose weight. You know, for it coming wedding for an activity, and then the only it for that and then often they regain the way. Nobody wants to think about that strategy that I tell people you know what I care less about where you are two weeks from now, as

close to where you are next year, where you are five years from now, where all of your friends are going to be twenty pounds heavier and you're, going to be ten pounds less, that success of study after study that people there go on diets. Gain more weight through the year, people, who don't go and eyes at all. It's absolutely true it it's the same four diet. Soda dad study after study has shown that people often gain weight on on diet, sword and there's. A lot of speculation is why that is part of it. Is? U overestimate the collar? is that you say from a soda. So that's why we joke you get the hamburger, the french fries and you say, died so click it clicks it all out.

It doesn't work that way on a banana split in a diet, coke or what, but it is about. You know having that plan and holding yourself accountable yeah. If we can just decide okay, we don't need to panic here and we don't need to jump tall buildings in a single bound. Absolutely right. We just need to recognize okay, we're coming out of the pandemic and because we've been more sedentary, because we ve gained some way, because, where two years older there's never a better time to manage our diabetes risk to manage our overall health. Then right now- and I can say we all need to panic. We this they do say. Ok, let me choose four or five things that I'm going to fold in to my lifestyle pattern for the rest of this,

here recognising that the rest of this year's gonna go by whether you're doing something about it or not. September's gonna pass october and november and December weather You're doing something about it or not, you might as well be doing something about it, we're talking about diabetes? You said some things in take control of your diabetes risk that just jumped off the page at me you said that nearly ninety five million people are pre diabetic and that thirty four million people have diabetes. That's one in ten So if you take the ninety five and the thirty four you're talking about a hundred and thirty million people, almost half of americans,

You know what even more startling doktor fell out of that thirty four million that have type two diabetes, twenty percent- don't even know it that ninety five million ninety six million people that are pre diabetes, nearly half, don't even know it. So here they are have disease type, two diabetes at signal, if again risk for developing it and they may not even know it that's even more concerned because that's going to get worse, let's switch forty million people with a disease that puts them at risk for heart disease. Cancer, amputation,

blindness that don't even know they are afflicted kidney disease and at major cause of end stage. Renal disease, diabetes is serious and and if people don't take control of their risk for it, the complications are going to come. I I find that many times with patients. They think it won't apply to them right, I'm not going to be the one that gets it. You know everyone that has high cholesterol, doesn't get you know heart attack. You know I won't be the one to get sti beatty's of I predict it is. You know what actually probably well, because most people develop some complication. Some people don't want to know, because this, like the sea word, they hope to go, get your turf call. It felt oh fear of finding out what they want the tat they would show up for the task. I found many patients do that groundwater says exactly what it is, but here's the thing you

Do you want to know this? Because this, when you can manage this, when you can get under control this, when you can reduce the risk of complications, because you can manage this disease, you know it's anxious about that actor fail as people don't want to know. because and rightfully so it can change their life right if life changing and what we're talking about is that early on you can. in some aspects of your life. So it's not a shock to you later. If you develop diabetes, anything I need you can. I need a changed. My life, that's why people don't want to know what it was seizing you earlier about yeah we do everything is boring and your sent it really isn't. It doesn't have to be at this point. Here's the thing if we say I you guys are gonna pound army till I do somethin an

he's right, we are so you might as well do give in there's no better time. Then right now and we are not asking people to join the marie- might port is saying: let's make four or five changes that people can live with and they're not going to have to feel like there being punished or deprived. That's the important thing don't get depressed, because we're not ask you to do things where you're gonna feel punished or deprived. Let's talk about four or five things that people can do that are not punishment. They're, not feeling like my life's over. I can't go to a party. I can't do this. I can't do that. One you mentioned is to start drinking

water instead of all the other things that you drink, which mostly would be sodas, which is probably ninety percent. I want now people drink besides water these free patina cap, neutrinos double odometer. Those things the calories on those things are astronomic: five, seven hundred twelve hundred calories, some of those ventis as extra large ones, alcohol, as well as a lot of calories, people don't think about it, but those property, let's just like going in getting a milkshake right. Absolutely that's why people, them tasty feller, but but then what happens off it? You feel tired later on and that's because your blood sugar shot up and then it came back

and now you're hungary again that that's the problem with all of these. They just promote weight gain when you take a big sugar shot like that, the net effect as it makes you hungry that's right, because your blood sugar goes up right away and then crashes down later and then your craving another sugar load and your hungry. That's what a lot of carbs do as well in terms of they dont promote what we call satiety, far listeners, that you feel full and an that's. What protein does? That's what some healthy fats do? They they make, you feel, that's why, when you eat a handful of nuts, you get pretty satisfied easily verses. That's why you can't stop with ones There's a lot of reasons why that is the sodium, but also, if you don't feel full with it. This

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There is a society centre in your brain fin, hypochondriasis riot, by the way, the time you in just something and it gets in Do your stomach absorbed and into your blood into the society centre is anywhere from like eight to twelve minutes, that's right in and that's why you want to eat slower, cause you want, your stomach to stretch to send those hormones? Those signals to your brain that I'm full, so that's what's tricky about you know what we used to call dashboard dining eating your car eating super fast. Ah you know you don't get that signal that your full. So that means, if you're still eating when you feel full Everything you consumed in the last eight to twelve minutes. You didn't even want These are only the immediate return. You told me you were so full. I can't tell you, though, the by you over,

read by editorial better without likes that long for that lasted I to get around to you so that you had stopped before and gotten do same place you are now so eight slower, is a huge part of it, but If you eliminate all of those drinks with that many calories, that alone can make a substantial for dry. I've seen a time and time again with patience and heard it from the ride him give the storing the Boca, ah a woman, May I dont like water oscar hellish? What's what wrong with what I knew, what she meant. She wanted that you feelings. She wanted that ferdy Feelin actually convinced her to try sparkling water and then do regular water with lemon alive and she has lost a significant amount await just by beverages cause. It's really don't think that are when we were counting calories, which I'm not a big fan of. We forget that there are so many calories

in beverages and you can just drink and drink and drink and drink and consume so many beverages, because you're not getting that satiety that feeling full signal yeah. Well, let's talk about coffee and unsweetened ice to none of those register good news about coffee is that it consistently shown over time that it can help reduce the risk of diabetes, help reduce the risk of cancer and even heart disease. Now what I am talking about is regularly brood tk, if ye ah, not in other magazzino, is another ones typically round two to three cups, a day which are the old cups that our power parents might have had right man. I have not done this super large out. Tumblers that were were during gain an enemy.

and why is that many of these have powerful, Annie oxidants and is probably do from the coffee being an air accidents is actually a good word. So what happens? Particulars we get older. We have these things called free radicals and, as you know, from Washington dc that sounds. I could be a good thing: you're free of your radical, but but it's actually bad because they clause clots on in that causes, strokes and in heart disease, but any oxidants help wipe up these free radicals and therefore you reduce your risk of these other diseases. But it's really about.

two to three cups and it's. The studies have been done when you haven't been loading it with sugar and milk and and all the other things so two to three cups of coffee a day are pretty good and tea. Just a recent study about black tea, most of the tea has been green tape where they've shown it also has value as well, and those are always going to be better choices, a drink black ice tea. I see it and I don't put anything in it- is just straight water in black ice tea, no sweetener, it's no sugars, no artificial sweeteners, nothing! I I solid before you came in, I was I asked I was going to test it to make sure so that's okay! Absolutely I get to keep that you do alright fish a couple of times that's valuable in that it replaces something else: that's not going to be as calorie a fish, and but it also has some other values as well and we're not talking serpent

Sir? You add affairs, we're not tugging at is how beijing

turkey that he was serious fish sticks and like when I talk offers staggered were targeted. You know regular fish and he, DR phil. This time is my pet peeve. Twenty percent of americans eat fish once a week. Twenty percent- eighty percent- don't eat fish at all, really really they've done, study after study. Most people don't eat fish, and you know we're too bad. We can't polar listeners to say how many v in fish this week, it's going to be a very small number and and that's used to people, don't feel comfortable, sometimes cooking fish, although there's so many choices nowadays, but what's great about it, as you pointed out when you're you're replacing it with something else, is fewer calories, sir automatically gonna lose weight. You know most fish is two hundred and fifty to three hundred calories. You know based on it's size and that it has these powerful antioxidants and has vitamins. It has minerals, magnesium, potassium all the things that people want from a supplement pill right from that powder or pill or capsule. It's in whole foods

that's always going to be a better choice and people are fearful of cooking fish, and there are so many great recipes out there that that's what I really encourage people to consider it'll make a big change. Is there a fish to stay away from you know, I I get that a lot, and sometimes I felt like people ask that you know is another excuse like oh, I can't eat fish, there's too much mercury and they are there some tuna and in deep dwelling fish, It may have a higher mercury content, but in general it is u referenced early on it. managing different types of risks having fish twice a week, need to be concerned about too much mercury, yo yo.

I need to be concerned about other issues. That's going to be the healthier choice, and sometimes DR phil. It's about making the healthier choice to start off with not always the best choice, but a better choice and fish is a better choice than red meat processed me. How about shellfish like shrimp crab lobster yeah, so they're still can be better choice there, not as as healthy as say a sea bass. Ah in general they're healthier than meat they, some of them, can have a higher sodium content than I'd like, but they're still going to be a better choice or seabass salmon and tuna a lot three excellent choice. Those are my favorites at three excellent one. I really like sea bass. So do I it's light. not fishy. It's really good that I, like I say it's not fish, because so many people say to me: they don't like this

well, if there's that you know what what do we expect fish to do, as you know, is I smell fish, but but I knew what they meant, but it's those white fish to the sea bass and some others that people haven't tried. You know a lot of times, people think Joseph salmon. That's not the only choice out there. It's it's a great choice, but even you know every now, and then people asked me what about tuna fish? You know: can tuna fish tuna fish in a pouch, still a better choice high in protein high in those healthy fats low in carbs? Nobody eats tuna fish for lunch anymore. Did you have tuna fish for lunch I'd, prefer separates except I never eat that anywhere. The lady lunch me, which is not a good choice, about a good choice. So if somebody change, what are you drinking. Put fish in a couple of times a week. Those would be to changes. That would be

Substantial lifestyle pattern changes right, substantial, ok, those would be big deals. Don't need to count calories, they could just do those two things. Those are lifestyle patterns. That would be significant and I bet they will come back and say these are tasty choices. I hear a time in and they say I never knew how tasty you know. Fish could be, or, as we talked about in, I told you I drank soda. If I went back to drinking regular soda nowadays, I would be like this feels he suits said gross toxic and we change our our attitude towards food We change our lives and exercise wise. If we can get people to exercise smart, they dont have to exercise like I said they have to be asked leads they don't have to go out and start wall climbing, but if they could do some fairly

high intensity interval training. If they could like power, walk even ten minutes a day. It would make a difference. You gotta start somewhere and the challenge with exercise or enough he's got tivydale. It is to play. It needs to be intentional. It needs to be structured. So often people say to me: oh doctor why'd, you know I'm active at war crime active at home that doesn't always cow. It's got to be intentional, that's right! So you got it, at that time that maybe you're gonna go for a walk with your spouse. But here You will do some power walking so not going chit chat. You know four thirty as I I have a lot of patience be like. I walked ten thousand steps a day. Why haven't I lost any weight, I'm like because you really haven't put any effort. You haven't made your heart rate go up a little higher you reference, high intensity interval training. It's not

everyone, but a lot of data shows that you got ten minutes all out. That's just as good as a sixty minute work out. It's about finding those activities. You enjoy it. I gave a talk recently. I mentioned his smithsonian. I showed a picture of exercise and swimming and the reason why put swimming is for some impatience. While we saved me, maybe I should try swimming doktor wipe out be like do you like swimming? but we like not really, but I heard I heard it's good for your joints and I'll be like swimming, takes a lot a work you gotta usually drives somewhere. You got to change, you got a shower, you gotta change and dry back. Do you have all that time will be like now? I would like to something that you want: choose pickle ball, a lot of people are into that right now. You know. I've talked about that. My kids have tried that so many options. But you need to have that intention or effort, and ideally you try not to live. more than two days go in between because- and you're really not doing it right here.

Having a plan in doing it once a week. That's ok! To start an starting somewhere is important. You don't have to go all out and be like I'm going to go. You know to the gym five days a week now start well that one day, if that's, what works for you, do ten minutes of power walking tomorrow, do five push ups a day to start, and I can't tell you how many patients I've had that couldn't do one push up or three months. Six months later there doing twenty five in the morning twenty five at night, and you know what they're proud about it new. Whenever feels bad about being physically active, No one ever says. Oh, I wish I didn't go to the gym. I wish I didn't go for one. What do they say? I feel great, because that releases, those powerful endorphins big out a fine and choose something that you like, like you said, if you ever see me running through neighborhood, you need to lasso the person behind me because I'm not job

I'm escaping whoever's behind chasing me, but you play tennis reduce. Every day and enjoy it- and I join that but jogging my niece, don't like oh, I know there is not for me but I'll, go out and kill myself on the tennis court and we stress tests and all they say, get your heart rate to like one, thirty, eight or one forty four twenty seconds four times during your work out now would be great. I wear the monitors and stuff and I'll get it to that level. For like forty five minutes during the words were out. So I know I m getting plenary is you show someone may enjoy and that is pleasurable and- and we can't look at being active, as you know, a chore, because then people aren't gonna want. do it, then that's at mindset and that's I'd accountability to something that is is reasonable

you can do and an fitted in here you know your time frame and year, lifestyle and there so many choices now days. So that would be a third thing. We talked about what they drink. Upset shooting fish in a couple of days, then doing that intentional extra eyes a couple of times and I'll suggest afore when this kind of off the wall, but I think it is really helpful for people to clean up their environment. If you go into people's kitchen and you take not all the contraband you go in there and get rid of all of the cookies the easily ingestible high sugar foods that people tend to snack on. on late at night or whatever, is not enough to just clean up the environment you have to,

put things in there that are positive alternative, because people get home. and when you get hungry, you're gonna want something to eat. But if you cut some vegetables up in there that you keep and why or salary carrots, whatever just something that if you would kill to get something that eat and you have some healthy alternatives in there. That will become the behaviors that replace the other habit. So if you go in and clean up your environment and replace it with positive alternatives, you can get in the car and drive to the convenience store and get a box of cookies or chips or whatever, but your mom. Less likely to do that. Then you argues, walk in your kitchen in graze, Israel, lazy, sunday, Elijah I'll, go one step, further doktor phil an hour. My people stop buying them ripe and unworkable

see that at home, sometimes chair and in people say while I bought it for my kids, I bought it for my spouse, but absolutely that's right. It's a family affair and that sometimes why people fail, because one partner is trying to be healthy and the other one is it, and that can create tensions in china, I'm just here. It is really a family affair. You'd be doing better tat, not just clean out that environment, but then be like. Oh hey, you don't need to go by it and have it there, because it did stare you're going to eat it. in that up and not replacing it? That would be a great environmental control ear now programming your environment to support your go, I think that's really important. I think if people would write down even for a few days what there actually consuming, they would be still and I asked patients to do that every now. Then I've done it too. And you have to eat. You ignore the first two days because people like you,

Try to do better because they wanna you know be get a good report card, but then We look at and you'd be like cause. I have had so many people be like I only eat salads I'll, be like you, don't only eat salads and then you realize that hey you're doing a night time nauseating you're having snacks, between. Ah every now and then I believe in these butter cookies stopped carry them, but people, then, when the sitting and look at it with me say- oh well- really was eating a latin I usually on the three scheduled meals, but it's it's the stuff in between and at night. This is what you can eat when you break off a piece of cookie that doesn't matter. Okay, that's right! If we get people mindful of diabetes. What are they likely to notice? That would be a tip off to them that a this really is something I might need to check on. What are the symptoms they're going to

noticed first, some of their early warning signs are that you're starting to urinate a lot. More often than you think in the average, for most people is about seven times a day, just in case there wondering because what's happened, is your high sugar load that staying in your bloodstream is pulling out water from yourselves. So you're your pain, a lot and then, in conjunction with that, you become thirsty a lot. I a patient about a month and a half ago that she came in her, Blood sugar was in the four hundred and she said to me she so thirsty. She almost you can't make this up wanted to drink out of the toilet, bowl she's so thirsty, that's because she's losing so much water she's becoming dehydrated because of the high sugar loads. When people tell me that they're thirsty a lot, I get a little

it concerned I'll? Tell you a bad sign that its progressed significantly is what we call the neurons I feel that lean the numbness once you experience that, usually your diagnosed with diabetes and that's hard to reverse. That medications aren't great, but that thirsty ah feeling they are having more often than urinating. Ah, you know the excess weight gain because what's happening is think about it you're using insulin to bring glucose into your cells, which is your energy in type two, when you have that resistance, you're, not getting that glucose into your cells that energy. So what do you do? You actually eat more? cause you're trying to get energy, because your insulin is still working somewhat, so you start to gain a lot of weight and in some of that, can be directly due to diabetes as well

causing diabetes. Those are some of the early warning signs. Let's talk about how important sleep is sleep is something over the last ten years. The weave learn the importance of an I'll be honest, storing residency and emma As you know, in in health care, it's always almost like a badge of honor right, a only need for hours, asleep five hours, sleep. Nobody feels good. After not getting a good night's sleep, whether it's you know our current a b or sick, ah spouse. Nobody feels good There is a reason why we don't let pilots fly planes when they're sleeping because we know that they're gonna make mistakes, and what do you think's happening internally to your body yourself, those are making mistakes, but sleep is always the thing that were always willing to get rid of first do at another time.

Where there is this imaginary sleep bank that will catch up on the weekend deposits and extra sleep and will benefit. Sleep really is critical to overall health. Now, what's good, is it seven hours six? What people need to try to turn him for most people, its seven to nine hours of sleep? Now there is a god at a variant where people only need four to five hours of sleep. That is extremely rare, and most people don't have it. They think they do, but they they don't. It's general seventy nine hours, but it's not just the quantity, doktor phil. It's also that quality right. You want that what we call restorative sleep. So if you are in feeling well, you got the flu you're, not feeling great. What's the first thing that you do you go to sleep because you instinctively know that's going to help your body

recharge. If you're not getting not sleep on a daily basis and its problems, and we all have trackers, you know rings, I'm calling the smart jewelry the watch is the groupings, the others. You can monitor your sleep and you can see how you do it and we need to make sleep a greater priority. I think if people would really pay attention to. seeing how much there actually getting on a regular basis that would have a profound impact on how they feel because of its erratic. then, if they're sleeping too much catch up on weekends, that can lead I'm groggy. Then during the week there Getting enough again, you talk so much about pattern and patterns across time I just think that were really not focusing enough on sleep. It just gives people

regeneration time that they need that repetitive time that they need what we don't put in importance on it and we need to change that. I loved your point about too much sleep. We forget about that. That's often a harbinger a sign of something serious going on, whether its depression or thyroid disease or other issues. I wish doctors would talk to people more about their sleep and how well they're sleeping in the car plenty of firstly, because we are having an issue and in her I resolve challenges with sleep for many people, partly due to the stress that they're under and and and that's not going to go away. If, as you point out, you're, not intentional about trying to solve it, it just doesn't get better. Most things, don't over time, but we tend to think somehow they will know. We prioritize and lay down. I know that a lot of people when they do get in the throes of

type, two diabetes. There are energy deficits and they start having emotional reactions to it there also a fair the judgment, I think when people get a diagnosis of type two diabetes, they do feel that people start judging them. Thinking there lazy that there the slugs that they don't take care themselves etc, etc. There is Certain amount of mental emotion, no baggage that comes with it as well. I think it's important for people to be intentional about that is well and recognise. Look this disease and I am taking up immediate steps to manage this. This is something that, if I'm acknowledged,

it and I'm doing the things that I need to to minimize this disease impact in my life. Then I can take pride in being an if manager at doing the things that I need to do because there's a stigma tied to type two diabetes, that's not tied to certain other disease If that's right and there's still a lot of misunderstanding about it, and I talk about and in the book you know this concept of diabetes, distress that you're referencing and there's also depression at which it goes both ways. If you're depressed you often may engage and unhealthy behaviors may not take medication, you don't go see the doctor and if you develop diabetes that change your life in many ways and closet distress. I really see turn that similar to heart disease. Soon patients have a heart attack. You that

in the first timeframe, early on is like okay they're going to clean out the pantry, as you just talked about they're going to you know, start to do a cardiac rehab and and really make those lifestyle changes. But then it's six months later, it's a year later when they get depressed about right thinking, I'm not seen as many changes anymore because right cause it's incremental over time were there. Hired about it or are they haven't thought through enough about this intentional changes?

I and and then they're starting to struggle with it, and then it's the people around them, who may not understand it and are confused and treat them differently, DR phil, and that's what bothers them as well. Will the adrenaline foods, when you first get into it, you're, okay, pumped up I'm going to do this within the adrenaline fades and then you're just left with the problem and the management. It is a slow turn, but that's why I say I really want people to recognize, particularly in health management in general. Disease management, in particular, diabetes management, specifically small changes add up to significant results across time. It's that pattern, a patient the other day who wasn't really making the changes that they had before you know came in there.

blood sugar is now back in em. You know abnormal range, as well what what's going on and she said may. You know how it is dark to white life gets in the way that was made was We let I knew what she met. Am I point to her was this? Is your priority right? It's now you have to change everything all at once, but what It is more important than your own house, but that's the mine, said doktor fill that sometimes we have to help people think through an inn, power them right that they can make these changes and they're going to feel good about it? It's not. You know something, I'm taking away we're actually giving them things, but which not acute. So if it was an earache they'd, be saying: okay,

hey. I got is about as it was at ankle. They couldn't walk on, but this is something that the insidious you know. It's not burning bright every single day, and so it's awful easy for days to turn into weeks and weeks turn in the months ahead, months turn into a more serious problem that they could have managed at if they had dealt with it at the time where they'll say I'll, just take a pill. We I'll take more insulin and then I can have that cake and psych. Okay. What? How did we get to this point and in again it goes back to empowering people with good information, helping them along the process and, let's be fairer. Doctors are always good about talking about prevention, managing symptoms and in we tend to focus on that broken ankle, that

no heart attack and in less so about how we got to managing chronic disease. So people know maybe they have some blood work there. Last blood work, maybe their doctors and discuss it with him. What is the normal range for forty two, fifty something bureau male female, what's a normal range for their glucose and there can be different tat. You are in and you can find them online allowed. Has we order? Something called hmm globally? One sees entire people, call it like casa late at him, a global. It's looking at your blood sugar really for about the past three months, because that's the last the rat red blood cell and they're. Looking at how well your blood cell is like oscillate, it

so normally we want to see a normal. You know a one see like five point: seven percent, it's a percentage and we give the definition of diabetes. Typically around six point. Five percent and in between would be considered, pre, diabetes and then a lot of times. We can do a faster blood sugar we could do on both of us. You know right now in really. We want to see it below a hundred to be normal. Above a hundred and twenty six is considered in the diabetes range and anything in between considered pre diabetes and these numbers have changed a little over time, just to be fair because we're trying to catch it earlier, on this something also called on our glucose tolerance test. I've only done it a few times in practice. We have to do the sugar word, and then you know you,

as your and then look at a buck like oscillated, hemoglobin and then the fasting plasma glucose is that the most andrew tests it in you could go in to day and get those tests done, and you can know by the end of the day whether you have diabetes, shortlived, its abnormal we're gonna repeat because sometimes people aren't truly fasting when you say they're fasting, if they're measuring that and and and that's important to point out, what's frustrating dr phil as I've had a lot of people, they don't come back to your point that they don't they don't wanna know, will realise the thing. Well, I think we've talked about this in a way that makes it understandable, and manageable. The book is take control of your diabetes risk its by John. Why empty, you confine lots of answers in this book. Interesting, it's not only telling you what to diseases is telling you what to do to me,

major risk and we try to give you some common sense thinking about it today hope really it's motivated you about it, and let me tell you we that we have talked about today concerning taking earlier: diabetes risk fits for man. During your overall health. If you have cancer for it, boy, you would add, avoid known carcinogens. Obviously, if it was heart, disease ever be specific things before your heart, but managing your health managing this he's process everything we ve talked about today, generalizers to managing as this process in general, right, absolutely dammit seeing stress, getting good sleep taking time to get intentional exercise

Is controlling your diet? All of those things are consistent to managing all of the chronic diseases cause. Most chronic disease is caused by lifestyle. Exactly and that's. If you can control your lifestyle, you can control your risk in most conditions, yeah. I know it's heard so much that it's probably lost it's meaning has become oh cliche, but early detection and early intervention is still powerful, powerful, powerful in determining the outcome of your disease process, don't be a denial if you dont know find out, The sooner you know the more options you have of controlling it and less damage is likely to do to you it's much easier to avoid the damage than it is to reverse it, wants it happened, so hopefully we can do it well. I hope you will come back and continue to talk about this.

Talk about cancer. Talk about heart disease, talk about all of these things, because I think it is a safe place for people to get really solid evidence based information about this in a course web cam day as the go to place. Thank you for all of this. Thanks for having these conversations at its in, for me, and people need. Well. You not talk about other things that are happening in society and stress, and I appreciate you sharing your platform in talking about mental. health, mental illness, middle challenges that we face, sing right now in this country and in this society you been great about talking about some of those things. We just had an up at peace in USA today, talking about this work from home situation, its had a great response and lots of pick up. If you haven't seen it find it on usa. Today, website to query the two of us on

working from home and it'll, be in there are no we'll keep talking about these issues to the all been great partners on get net information out as well. When I get so, I look forward to talk some more in a future doktor white. Thank you. So much always

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