Dr. Jedha, Host

Good day there, Dr Jedha right here, and thanks for becoming a member of me for episode 47.

At present we’ve acquired a Q&A session and properly be recapping a few issues round morning blood sugar ranges, trying nearer at whether or not together with snacks helps hold blood sugar ranges regular, chatting about making eating regimen and vitamin modifications, exploring what to do to achieve weight, and protecting whether or not full fats or low fats dairy merchandise are a more sensible choice. 

Alright, let’s dive proper in with a query from Marie. 

02:44

Marie requested:

“Why is my blood sugar excessive within the morning?”

Properly Marie, I’m not going to reply that query right here as we defined excessive morning ranges in episode 38, together with offering efficient methods to assist decrease morning ranges. I’d extremely advocate listening to episode 38, it’s been a very talked-about episode as a result of excessive fasting numbers are a typical drawback amongst folks with prediabetes and kind 2 diabetes. 

03:21

In relation to that podcast, Paul requested: 

“Is it protected to take ALL the dietary supplements above daily?”

Simply to place that into context, there have been quite a lot of confirmed methods shared in episode 38 to assist decrease morning ranges, and amongst these methods we lined some pure therapeutics, six or so dietary supplements scientifically-proven to decrease fasting ranges. So, Paul requested whether or not it will be protected to take all of the dietary supplements daily.

Whereas it may very well be protected, as I responded to Paul, it’s not a superb technique to easily go and take each complement unexpectedly. It’s higher to start with one to look at the impact, then add extra assist if needed. 

For instance, Berberine has been proven to supply the simplest discount for fasting glucose. When folks with kind 2 diabetes got 500 mg of berberine per day, 3 occasions per day, for 13 weeks, fasting blood glucose was decreased by 68 mg/dL or 3.78 mmol/l. 68 mg/dL is sort of a big discount, so if you happen to have been contemplating the complement choices, it’s possible you’ll begin with Berberine after which consider from there. Now we have all the information on fasting ranges and these therapeutic dietary supplements on our web site with episode 38. 

And at the start, earlier than taking a look at dietary supplements, be sure you’ve addressed your vitamin plan and have your every day numbers monitoring within the regular wholesome vary as a result of these issues can have a big effect on morning ranges too. All the time be sure to begin with the basics earlier than looking for. Hearken to episode 11 for information on regular blood sugar ranges. 

05:22

The subsequent query we’re going to cowl in the present day is from Tom. 

Tom requested: 

“Ought to I eat 3 regular meals and let my blood sugar fluctuate, or eat snacks between meals to maintain my blood sugar regular? I’ve heard each really useful. What does the science say?”

Tom, thanks for this nice query. Let’s unpack this a bit.

First off, it’s necessary to know that it’s regular for blood sugar to fluctuate all through the day. That’s going to occur to us whether or not we have now diabetes or not. After we eat, our blood sugar naturally rises as our physique digests the food, after which it steadily comes again down as insulin helps transfer glucose from our bloodstream into our cells. This fluctuation, the rise and fall, is a standard a part of how our physique regulates blood sugar. With pre and T2diabetes, the bottom line is managing these fluctuations so that they keep inside a wholesome vary. We talked about wholesome blood sugar ranges in episode 11. 

Additionally, even when we’re not consuming, or in between meals, our blood sugar can nonetheless fluctuate, and that’s utterly regular too. Give it some thought: our blood sugar isn’t simply going to take a seat at 80 mg/dl all day, for instance. The physique is continually regulating blood sugar to ensure it has the vitality it must perform, whether or not we’re lively, resting, and even sleeping, so fluctuations are regular.

Okay, the concept consuming snacks between meals will hold your blood sugar regular just isn’t completely correct. As we’ve simply established, your blood sugar goes to rise in response to consuming meals, so continuously consuming all through the day can result in extra frequent blood sugar spikes and fluctuations, result in increased circulating insulin ranges within the physique and stop your physique from utilizing insulin effectively.

So, in relation to your query Tom about whether or not to eat 3 meals or embody snacks, what the science reveals us is that sticking to 3 meals a day, with out snacks, can really be a greater solution to hold blood sugar ranges extra secure over time. 

Why would this be? As a result of it permits your physique time to course of the glucose out of your meal, and it encourages a interval of fasting between meals, which may enhance insulin sensitivity. 

That stated, snacking just isn’t all dangerous and it may possibly depend upon the place you’re at in your journey. For instance, throughout a dietary transition the place you is perhaps shifting away from carb-heavy meals to extra nutrient dense meals, it’s possible you’ll really feel you might want to snack. We regularly discover that may be the case and that folks might transfer away from snacking and towards core common meals, however they do that a bit later of their journey, as soon as their total dietary transition is changing into recurring and so they really feel snug. If that’s the case, it’s high quality to snack, however then it comes all the way down to the kinds of snack meals you select. 

In case you have been to snack often on high-carb or sugary meals, clearly that’s not going to be good as it may possibly trigger your blood sugar to rise and fall extra quickly, resulting in higher fluctuations total. This may create a roller-coaster impact that isn’t useful for blood sugar management. 

In case you really feel the necessity for a snack, it’s necessary to decide on one thing low carb and nutrient-dense—like nuts, some grilled hen or a boiled egg, for instance—which will help to keep away from these spikes and hold your blood sugar extra secure, as a result of proteins and fat have little affect on blood sugar ranges. 

In fact, there may be much more to this story on meal timing and meal frequency and we’re planning to cowl this stuff in additional element in a future episode. However for now, I hope that helps make clear that it’s regular for blood sugar to fluctuate and that snacking between meals just isn’t a confirmed technique to “hold blood sugar regular” so to talk.

General, a very powerful factor, whether or not together with snacks or not, is at all times ensuring your blood sugar ranges are staying inside the wholesome regular vary. We talked about wholesome blood sugar ranges in episode 11 so be sure you head again and take heed to that episode. 

10:42

Proper, subsequent up, Florence stated:

“I want to obtain and preserve the aim of conserving my HbA1c as little as I can. I’m 65 years previous and have been diabetic some 30 years in the past. I’ve been on a every day dose of Janumet 100/1000mg, since a month in the past the dose has doubled. How can I eat usually and revel in all my meals with out an excessive amount of effort. Please advise.”

Florence, it sounds such as you is perhaps saying that your medicine has not too long ago elevated in dosage and that you simply’re involved about that and wish to obtain a and preserve a decrease HbA1c. That is actually a superb aim to work towards, whatever the period of time you’ve been residing with diabetes. In case your physician has elevated your medicine, it’s seemingly the case that your HbA1c has gone up, so being extra proactive together with your eating regimen and vitamin might be key to getting your ranges again all the way down to the traditional vary and doubtlessly working together with your physician to cut back your medicines once more. 

Now, you talked about that you simply wish to eat usually and nonetheless get pleasure from all of your meals with out placing in an excessive amount of effort. That’s utterly comprehensible, however, it relies upon what you imply by “eat usually and revel in all of your meals.” In case your HbA1c ranges have gone up, then there’s a excessive likelihood that the traditional meals you’re having fun with are growing your HbA1c ranges, so the fact is you’re going to should make some changes to your consuming plan. You need to take a look at the kinds of meals you’re consuming and swap some issues for extra nutrient dense meals. You seemingly have to take a look at the quantity of carbohydrate meals you’re consuming at every meal and both trade these for extra greens or begin to decrease these meals by portion controlling – for instance, the potato, rice, pasta, bread and many others. I’d advocate listening to episode 6 on what to eat to deal with diabetes as we lined the most effective kinds of meals to eat and those to keep away from. 

And once you say with out an excessive amount of effort, typically the place to begin just isn’t by utterly altering each meal you eat. Simply take a look at the common meals and meals you’re consuming and make some switches. For instance, if you happen to’re consuming spaghetti bolognese with common wheat pasta, swap the pasta out for greens, zucchini noodles or soybean fettuccine. That’s nonetheless providing you with the flexibility to get pleasure from the identical meals however simply in a barely totally different method. You don’t should overhaul the whole lot in a single day. Begin with one or two changes that really feel 

Thanks once more in your query, Florence! 

13:44

Subsequent up is a query from Karima, who requested:

“You present good info however what do underweight folks do? Will your eating regimen assist?”

Karima, that’s an necessary query, and I’m glad you introduced it up. We acknowledge that not everybody must reduce weight and a few folks want to achieve weight and management their diabetes and obtain higher outcomes with blood sugar and A1c, for instance. We do deal with weight reduction a good bit, as nearly all of folks do wish to obtain some weight reduction, however you possibly can actually achieve weight, we have now different members in the identical scenario. We do have an in depth Weight Achieve Information inside our VIP Membership, so sure, the reply is our eating regimen will help. When you might want to achieve weight, you’ll nonetheless observe our common vitamin tips for blood sugar management after which our information helps you identify how you can deliver up your calorie consumption to the fitting stage to realize weight achieve. Then there’s a variety of sensible assets that can assist you obtain that purpose. For instance, we’ve additionally acquired lists of nutrient-dense calorie-rich meals and how you can embody these in your meal plan. Instance meal plans and how one can modify recipes and meal plans. We’ve additionally acquired a library of recipes to extra simply allow you to obtain weight achieve as properly.  Actually, if you happen to’re underweight, it’s essential to make sure you’re getting sufficient vitamins and energy whereas nonetheless managing blood sugar successfully. So if you happen to head to our web site, you will discover extra details about the Weight Achieve Program at Type2DiabetesTalk.com/programs.

Earlier than we dive into our final query, let’s hear a testimonial from one in all our members.

16:10

The final query we’re going to deal with in the present day is one which got here up amongst just a few of our members not too long ago that I believed would make an important addition to this Q&A, one particular person stated:

“Simply questioning what is healthier for me, low fats or common entire fats meals merchandise? I used to be identified with pre-diabetes and discover {that a} complicated meals dilemma.”

One other particular person requested: “My complete ldl cholesterol and LDL are each elevated. My triglycerides are good. My HDL is excessive and my ratio is regular. Ought to I strive the common fats dairy or ought to I keep on with low fats?”

The talk between low-fat and whole-fat merchandise could be complicated, particularly once you’re attempting to handle pre or T2diabetes or elevated levels of cholesterol. Let’s break it down with some proof.

First off, it’s necessary to know that the entire low-fat versus full-fat debate has developed fairly a bit over time. For a very long time, low-fat meals have been promoted because the more healthy possibility, however latest analysis is displaying that this isn’t normally the case, particularly in relation to managing blood sugar and total metabolic well being.

A number of research have proven that full-fat dairy merchandise should not solely protected however may additionally supply some metabolic advantages. For instance, research have discovered that increased consumption of full-fat dairy was related to a decrease danger of growing kind 2 diabetes, in comparison with low-fat dairy. This means that the pure fat in whole-fat merchandise might have protecting results in relation to blood sugar management and insulin sensitivity. 

One thing to contemplate is that once you go for low-fat variations of meals, like dairy merchandise, what typically occurs is that these meals are stripped of their pure fat and generally have sugars or different fillers added to make up for the flavour and texture that fats supplies. For instance, Full fats Greek yogurt has round 6 grams of carbs, whereas low fats plain yogurt has 25g carbs for a similar measurement serve, relying which manufacturers after all, however that’s only one instance. By consuming low fats merchandise and considering they’re more healthy for you with out contemplating their total vitamin, can really result in increased blood sugar spikes, which isn’t ultimate if you happen to’re attempting to handle pre or T2diabetes. 

However, whole-fat meals, like full-fat yogurt or cheese, are usually extra satisfying and will help hold you feeling full for longer, which can forestall overeating. Additionally they are likely to have a decrease glycemic influence, which means they gained’t spike your blood sugar as a lot as low-fat, high-carb alternate options. Analysis helps this by displaying that diets increased in wholesome fat, together with these from dairy, are related to higher glycemic management and insulin sensitivity. 

Now, in relation to ldl cholesterol, we lined this subject on episode 42 and episode 44 and it’s important to know ldl cholesterol and get your head across the myths so you possibly can understand that fats and even saturated fats present in nutrient dense meals, just isn’t prone to be a difficulty for ldl cholesterol. In actual fact, research have checked out dairy consumption in folks with excessive cardiovascular danger and have discovered full-fat dairy to be protecting with no elevated danger. General, the analysis suggests full-fat dairy merchandise are impartial in relation to cardiovascular danger.

In case your complete ldl cholesterol and LDL ranges are elevated, however your HDL is excessive and triglycerides are in a wholesome vary, it’s a superb signal that your physique is processing fat properly. Entire-fat dairy merchandise, on this case, may actually be included as a part of your eating regimen, particularly in the event that they’re balanced with loads of greens, proteins, and different wholesome fat sources. Analysis has proven that increased dairy consumption might have a constructive impact on ldl cholesterol metabolism in folks with T2Dibaetes by modifying a biomarker concerned in bile acid synthesis that helps with ldl cholesterol clearance. General what the analysis reveals us is that full-fat dairy merchandise are essentially the most appropriate selection usually.

I believe it is going to in all probability be worthwhile for us to have a complete episode protecting dairy merchandise sooner or later however in the interim that ought to assist to resolve the complicated dilemma.

Properly, that brings us to the top of in the present day’s episode.

Take care till subsequent week, 

Dr. Jedha over and out.


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