Let’s Talk Diabetes
Content Courtesy of the Forever Young Podcast with Christiana Egi and Cherrie-Marie Chiu.
We welcome our readers to this special episode podcast "Let's Talk Diabetes" with our friend and mentor Angela Walker Sterling! This has been a long time coming and Angela was one of Christiana's inspirations to become a diabetes educator herself, after over 33 years of nursing. Angela and Christiana have over 70 years of nursing experience between themselves, and as partners in wellness, they have impacted a lot of lives through health management and weight management.
Angela is a clinical nurse specialist in diabetes, with a master's degree in Community Health and certification in Addictions and Mental Health. Her roles include the development of hospital policies and staff education programs related to diabetes management therapists. In 2005, Angela published cases on African Americans and obesity which fueled her passion to promote wellness, through education and lifestyle changes, particularly among high-risk populations. Angela currently works as a diabetes educator in an outpatient clinic interim and volunteers her time to support people living with diabetes in her community. Listen to the full podcast episode below to hear more from Angela:
While the word the actual word diabetes, and a lot of people do not realize this, is it actually means excess urination, or excessive fluid being passed out. On the surface, the term appears to have basically no link to sugars. But the reason behind the excess urination is actually the hidden connection to the term diabetes. The good news about diabetes is that you can not just survive but live well with the condition.
One of the reasons for diabetes to be manifested is damage to the pancreas. Pancreatic cells that make insulin actually start dying off, and they do not come back. We don't yet have the scientific information or knowledge on how to repair pancreatic cells. So whatever insulin your body was made prior to that damage is now less, but you can manage your lifestyle so that your body can still effectively use that amount of insulin. If you change your lifestyle, it's going to you're going to still go back to the disruption because now you still have less insulin to work with than you had before.
Vascular dementia is also connected to diabetes. Diabetes is one of those diseases that can cause you to have dementia because it leads to tiny strokes. If your blood vessels become narrower than clogged and the flow of blood is thickened, those tiny vessels that supply your brain could rupture. These damages eventually lead to brain damage, which is, vascular dementia. This is one of the most treatable types of dementia because if you manage your diabetes you won't get there.
In medicine, there are two types of conditions that lead to excess urination, or the term diabetes.
One is diabetes insipidus, which literally means water diabetes. This is caused by the problem with a hormone called vasopressin that helps your kidney balance the amount of fluid in your body. If the body cannot make enough of the hormone, most of the fluid gets flushed out instead of returning to the bloodstream. Hence the term diabetes by the insipidus along with the term diabetes means water diabetes or fluid diabetes.
The second is diabetes mellitus. We never really hear of the term Mellitus added to diabetes in layman's terms, but that is actually what it is. The word "Mellitus" literally means sweet water. So when we're talking about diabetes, we're literally talking about sweet water and that water is actually urine. Prior to blood tests in the late 1600s, people known as “water tasters” diagnose diabetes by tasting the urine of people suspected to have diabetes. Sounds gross. That's exactly the way it was, before we had blood tests and before we had lab work. So that was the only way to diagnose a person suspected with diabetes. These were professional water tasters, and if the urine tasted sweet, diabetes was diagnosed.
But generally speaking, when we speak of a person with diabetes, the reference is most often to diabetes mellitus, which means too much glucose or too much sugar is constantly moving through the bloodstream, leading to an excess of water passing through the kidneys. When someone refers to it in reference to sugars, they are correct, but the term diabetes actually means excess water, which is one of the symptoms of diabetes.
There are a number of reasons for diabetes mellitus to occur in a person. Number one, when the body is unable to make insulin, that type of diabetes is referred to as Type 1 formerly called juvenile diabetes. Then the second most prominent type is Type 2 diabetes, formally, we called it adult-onset diabetes. These terms were actually changed from adult-onset to juvenile diabetes because now we're realizing that diabetes spreads right across the lifespan. So we're finding adults with type one diabetes, not just children, and children with type two diabetes, not just adults.
If you have a strong family history of diabetes, one of the things that Angela advises us is not to wait for signs. Do annual bloodwork and look out for symptoms. One of the early symptoms might be increased thirst. This is because you are pushing a lot of fluid out. Increased urination may be because the body is trying to excrete all that sugar. Because you're not excreting just sugar, you're excreting fluid as well. Another symptom can be excessive hunger. This is because that sugar is meant to go into your cells, the brain cells, the muscle cells, and it's not getting to where it needs to go. Excessive hunger is also a sign of blurred vision. That's when the damage starts occurring to the small blood vessels in the eyes. All of these are usually signs of Type 2 diabetes that have been misdiagnosed, or not diagnosed at all. And so why and which is why I say don't wait for signs. But if you do have these signs, certainly make sure you're checking with your family doctor and checking to get the bloodwork done.
One of the things that could increase your risk for diabetes will be a family history of diabetes that would increase your risk for type two diabetes. If you had gestational diabetes, when you were pregnant, or if you had a baby over four kilos (which is approximately nine pounds) puts you at risk. If you belong to a specific background, higher risks are found in Aboriginals, Hispanics, Asians, South Asians, or people of African descent. Angela and Christiana also spoke about metabolic syndrome. Metabolic syndrome is not a disease, but a cluster of symptoms that puts you at higher risk. That cluster of symptoms includes high blood pressure (if your blood pressure is over 130, over 80) or a larger waistline. So for women, ideally, to reduce your risk, the measurement of the waistline at the belly button should be less than 35 inches, and for men 40 inches or less. If you know you've got these challenges, it's really the time to take a look at correcting them.
So what can we do to prevent ourselves from developing diabetes?
One of the questions Angela's patients usually ask is "what am I going to eat?". When diagnosed with diabetes or high sugar levels, people sort of get into their minds that they cannot eat certain things. However, the first thing to remember is that there is really no diabetes diet. When the dietitians discuss diet with patients what they are discussing is portion controls and really just the quality of the foods that they're taking in. So some of the things that you can actually do to prevent or manage diabetes if you actually have it, is to choose foods that are high in fiber. Fibrous foods are really great because they're more filling. The fiber does have carbohydrates or starch, but it does not get digested, so the starch in it does not count.
Sleep is also important in keeping your body healthy. When we sleep our bodies secrete growth hormones, which build and repair muscles. Sleep is a time for the body to really rejuvenate itself. Our bodies usually need about six hours to repair and, and rebuild themselves. If we stay awake at a time that we shouldn't be sleeping, our bodies are forced to keep insulin levels higher. Basically what that is now doing is contributing to insulin resistance and inflammation. So it means that there's a lot of floating insulin in our bloodstream but our cells are not reacting to it. So we know that in terms of research, one night of sleep deprivation can actually trigger resistance the very next day. So when you're not feeling really right and feeling really crappy the next day, it's really because your body has not had the time to rebuild and rejuvenate itself.
One of the biggest things that can help prevent diabetes, is weight loss. Weight loss has a dramatic effect because it actually helps to reduce insulin resistance. Belly fat actually has a different type of fat than fat found on the hips, the legs, or the arms. It's a brown type of fat, and it produces its own hormone that actually causes insulin resistance. And so if we can lose not just pounds on the scale, but if we're looking at losing belly fat as well, that will make a dramatic difference.
We’ve talked a lot about diabetes, but is there a cure? In terms of taking insulin, you may know many that take medication and very few people who actually take insulin. Especially with pre-diabetes, you can certainly live without it for a very long time. However, one of the main misconceptions is that if you have diabetes, you will eventually end up on insulin (or even that if you start with medication, you must take it for the rest of your life). But the truth is that many people manage type 2 diabetes with just lifestyle alone. With proper management and a little bit of work and focus, taking insulin does definitely not have to be the answer.
Diagnosis of diabetes is not actually a death sentence, though it can be dangerous if you are not actively taking care of your body and overall health. There are so many things that diabetes can lead to in your body but also, it's really exciting that you have the power within you to change things, right? Ultimately, you can make it better. You have to be you have to work at it, but you can do something.
*The Forever Young podcast is created and produced by Christiana and Cherrie Marie Chiu. Produced and engineered by Elisse Hill. The podcast represents our opinions and those of our guests. The content should not be taken as medical advice. It is for informational purposes only. Please consult your health care professional for any medical questions. If you like our show, please tell your friends and leave a five-star review on Apple Podcasts. New episodes are available every other Wednesday. Have questions? Email us at ourforeveryoungpodcast@gmail.com
