Introduction --- the data are unambiguous. Exercise not only delays actual death, but also prevents both cognitive and physical decline better than any other intervention. It is the single most potent tool we have in the Health Span Enhancing Toolkit, and that includes nutrition, sleep, and medication. Hi, and welcome to the Solving Type 2 Diabetes podcast. I'm Tom. And I'll be your host as I share what I'm doing in my daily life to solve my type two diabetes. Listen in, as I share the food, movement, and tools that I'm using each day. This podcast is intended for entertainment purposes only. For a full transcript or to follow the Solving Type 2 Diabetes podcast on social media. Please head over to SolvingType2Diabetes.com for all those links and more now onto the show. My Week in Review --- I hope you have had a very good week. I've had a fun week. I was home for seven days after our cruise, so of course I got a lot of time in on my favorite rail trail, the Lebanon Valley Rail Trail, which is near my house, and I get on that trail up in Colebrook. Pennsylvania, if you wanna look at a map, C o l e B R O O K, Colebrook Pennsylvania is where I get on the trail normally, and I walk down towards Mount Gretna. Very scenic. And I enjoy that a lot. And that gives me, depending on how far I want to go, I make a loop and it gives me usually three to four miles. And I did that a few times. This. Then on Thursday, we took a drive up here to Maine where we currently are. We're currently in York, Maine visiting, good opportunity to get up here during the winter. We actually got a snowstorm yesterday. We got about six inches of snow and really that's the first snow I've experienced this winter, hood home in Pennsylvania. we've had no measurable snow while I've been home. And of course when I was in the Caribbean, we had no snow, but up here we got some snow. So yesterday, the kids were able to go out and make a snowman, which was fun. And I took a, a nice long walk yesterday in the snow. Not too bad. They plow the roads up here really, really well, unlike when I was out in Arkansas and I'd gotten out there after they had a snow. and, they really didn't plow anything but up here. even like this is a back road, off of a back road, and it was plowed, I'm gonna say. three, maybe four times yesterday during this, snowstorm, it had snowed starting, I don't know. They said it started around one o'clock in the morning and then it stopped snowing by about four o'clock in the afternoon. So, it lasted about 15 hours. We got about six inches of snow and the road was really clear during the entire event. And now I'm looking outside and the road actually looks dry. It's a nice sunny day today, about 40. I'll get out for a walk here shortly after recording this. So for my eating this past week, I had some stuff out of the freezer. We really didn't need to make anything. I had, some of that great Mississippi pot roast. I had some vegetable beef soup. I had some of my yummy, yummy crack chicken, and I've given them recipes for all of those on the last few episodes. So if you look back, you'll see recipes for all of my favorite. and I did supplement with, I'd say I averaged probably one of my cheap Walmart, equate brand protein shakes. I like the chocolate flavor myself, and I did have one of those every day to supplement my protein. My Numbers --- So let's look at my numbers for my rings. I did close my Apple fitness rings six of the seven days. I didn't bother worrying about it the day we drove up here to. that takes a big chunk out of the day and we were visiting and I really didn't bother with it that day, but six outta seven days is perfectly fine for my workouts. I did get in great walks, both in Pennsylvania on the Lebanon Valley Rail Trail, as well as right in my own neighborhood, right around my house and here in Maine. I've gotten in good walks each day as. , my seven day glucose reading, using my continuous glucose monitor. My seven day 24 hour average has been 95, which is well down into the optimal. Blood sugar range, that equates, to an A1C of about 4.9, and I love an A1C of about 4.9. I no longer am seeing the higher pre-diabetes or type two diabetes readings, which is super duper. I, I really like that. Happy about that. My body fat percentage right now is sitting at 22.9%, and you may remember that I have a. Of getting it to no higher than 17%. So, 6% of my weight I still need to drop down, which right now, 6% of my weight. Is about 11 pounds. So it looks like I still have about 11 pounds of excess body fat, which I am slowly chipping away at. And to me that's the way to do it. weight loss with only 11 pounds of excess body fat right now. Weight loss is not my number one concern. It's certainly something I'm working towards. But keeping my A1C levels, in the optimal range are my number one goal right now. my macros for the week. I've been helping myself out a lot. I've been getting my macros where I want them. I have averaged 72 grams of carbs each day, and right now I'm trying to keep that, at 80 or below. So 72 grams of carbs I've averaged over the last seven days, and I've averaged 117 grams of protein. So I'm right there at my goal of 120 grams per day of protein. I'd like to hit that as my target, so 117, that's extremely close to 120, so I'm happy with that. Mounjaro Update --- My Mounjaro update for this week is, pretty much the same as it has been. I have now taken my fourth dose at 7.5 milligrams, so this week I did finish that box and I've been, using Mounjaro now for 11 full weeks. I'm in the middle of my 12th week right now, and as you've just heard, I'm having. A1C control. I have, no issues there whatsoever. And as a side effect, for the 11 weeks I've been using Mounjaro, I have lost 18 pounds. Now that cannot continue forever. that is averaging less than two pounds a week. it is a. just maybe 1.6 pounds per week, which I think for me, is healthy. It's certainly less than 1% of weight loss per week, and that's okay. I can't continue that forever though. I will eventually have to, eat more than I am eating now, but most likely not much more. So we'll see what happens when I come. Now I am having a Mounjaro issue and not with the medicine itself, but with getting the medicine. As the medication is covered by my health insurance and, my doctor does prescribe it for me now, but she called in a prescription refill, 10 days ago. and so far, and I have checked in with my pharmacy several times. In fact, I've checked different pharmacies as well, and everybody right now in my area seems to be out of stock. So it has been back ordered for 10 days. Now I'm supposed to take my next dose in five days, so I don't know what I do if it doesn't come. It's a little bit more time sensitive even than that because in six days I get back on a cruise ship for almost two weeks. So if I don't have it in my hand in six days, I will be out of it. Let's see, at that point for about three weeks. So we'll have to see what happens with that. That might be, interesting. Stay tuned for that. This time next week, we'll know whether or not I got it, but yeah, I'm supposed to take my next dose in five days, so hopefully it comes in off a back order by then. Challenge &Win --- My challenge and win for the week. Well, I've talked about this now for a few weeks and that is varying my movement, but I've come to the mental point right now where I'm just gonna own what I'm doing. I am walking and I do know that I would definitely would benefit from strength training. , especially now that I'm, approaching 60, I definitely could benefit from maintaining muscle mass, but you know what? I'm not gonna worry about it. I'm not gonna fret over it a few times this past week. I, I, oh, I'm gonna do it. I'm gonna do it, and then I don't want to do it. And then, by the time I ended up going out for my walk instead, it was later than the day that I wanted it to be. . I'm just gonna put that in the back burner a little bit. While I know I would benefit right now doing the movement that I enjoy, that I look forward to, which is my outside walking. I'm just gonna let that come and the strength training will come back. I'm sure. But I'm not gonna push myself into it or force myself into it. Now, if I were sitting in the couch, yes, that would be unacceptable, but I am getting, in most days, at least a one hour walk at brisk walk. So I'm gonna, I'm not gonna call that a win for now. Take a little bit of pressure off myself and I'll get back to that. Hopefully here. . News --- All right, let's take a look at the news for the week. I do have four articles that I think are very interesting. Two of them are focused on exercise because that is the topic for the week. If you remember the topic we're gonna talk about here soon is, is exercise required in solving type two diabetes? For me, that's our topic coming up, but for right now, let's take a look at the news. The first article related to exercise is entitle. the surprising way Walking delivers a high intensity workout. Now, walking can take many different forms and they point out here in this article that if you're walking sort of strolling on a flat level surface, you really are not getting intense exercise. But by changing up just a few things, you can definitely. Push that walking up into the moderate or even intense level, depending on how you're doing it. Now, they say some of the obvious ways are to incorporate hills. You've heard of high intensity interval training while briskly walking up a hill. And then walking down and then briskly walking up a hill. Maybe you have rolling hills. Maybe it's the same hill. Maybe it's even climbing sets of stairs. you can actually get your heart rate up fairly high by varying the terrain that you're walking on if you're walking outside. Now, if you're walking inside on a treadmill, the obvious way to do that is with your. . In fact, I find that I'm able to walk, two and a half, three miles an hour on a treadmill, and that I can actually get my heart rate up into the one 30 s, maybe even close to one 40, simply by jacking up the incline. Now you can just keep it up high, six, eight, 10% incline, or you can vary it. Maybe you do three minutes at 10% incline and then. Two minutes flat or two minutes at a 3% incline. You can vary that, make it into intervals to where you're really getting outta breath on the high incline and then you back off just a little bit for a couple of minutes and then you go, I intense again. So because they're saying this high intensity interval training is really, really beneficial for you, another way you can do that is speed. You can do speed walking, you can do just very brisk walk . Some people, put on a weight vest. Other people you see carrying dumbbells around in their hands. I don't know about that. I think that would throw off my balance or my, my cadence or my stride a little bit. Wearing a weight vest, is one way to do it. Obviously, if you don't have a white vest, if you have. overnight camping backpack. You can maybe put that on, give yourself some more weight and make your walking a little bit more difficult. be careful though, you don't wanna injure yourself or you don't wanna, put yourself out of balance or out of whack by having something on your back. So, experiment with that carefully. And then just moving faster, things like that. You can definitely get your heart rate up, with just walking. And I find that, hiking while that's a form of walking, if you're up in the mountains or the hills and you're hiking, You can definitely get in a, pretty moderately intense, workout, which is a way to get more, out of your walking. So, good article. This next article doesn't have to do with exercise. It actually has to do with nutrition. The title is, , this vitamin can improve blood sugar, especially if you have type two diabetes. So what they're saying here is that this vitamin, vitamin D specifically vitamin D three, and that has a long molecular name that I'm not gonna try and pronounce, but we'll just call it vitamin D three has a very important. In stimulating pancreatic beta cells. Now pancreatic beta cells are where insulin itself is produced and stored, and it stimulates, this vitamin D three stimulates those cells to secrete that insulin. it plays a direct and important role in getting out insulin into your body when you need it. they say that it's almost impossible with our modern lifestyle to get enough vitamin D three from sun or even from food. And for most people, they find here that of the people who have type two diabetes, over 50% of those people are deficient in their vitamin D levels. So you know, if half the people aren't getting enough through just normal lifestyle, they recommend for those people. Supplementing. Now, this is definitely something you wanna talk to your doctor about before you just try this on your own. But they say that, for most folks, it helps to supplement 5,000 international units, 5,000 IU of Vitamin D three, and they specifically say, don't bother with a D two. Evidently that's different. It doesn't work the same way, but you want vitamin D. If your doctor suggests that you get a supplement and you can get a vitamin D blood test, it's normally part of a routine, blood panel that might be ordered by your doctor. And they say that Vitamin D three usually comes in a pill that contains some fat, because fat is what makes vitamin D bioavailable. So when you ingest it, you need it to be available to your body systems to use, and that's, that's done in. So it usually comes in some sort of little oil. It's almost like a yellowish clear capsule. So that's a good thing to think about is, maybe you wanna talk to your doctor and check if you have enough, vitamin D cuz especially if, if you are diagnosed with type two diabetes, that can dramatically, impact your ability to secrete insulin from your pancrea. All right. This third article is Back on Strength and Fitness, and it says the impact, strength and fitness have on your lifespan. Well, obviously we all want a good lifespan. We want to be healthy during that lifespan, but they say here that, exercise and overall fitness is the key number one. Thing that you can have to help your overall, mortality. In other words, your overall ability to stay alive, which, I think is a pretty key thing for us. And they're saying that, generally speaking, three sessions a week is, is typical. especially, if you're in your older age, you don't need to be doing strength training every day. I should do some though. But they recommend here three sessions, maybe 45 minutes to an hour of total body strength training and things that you can test, they say that will show your overall fitness are, grip strength, your ability with pulling motions. Hip hinging. They list different things here that you can check to, to judge, your overall strength and fitness. And, evidently this is, it's a non-tested notion that strength and fitness, , so not just, your ability to jog, but your ability to do work, to move weight, either lift it up off the ground. Put it up over your head. those types of things. Moving weight, pulling weight, pushing weight, standing with extra weight, squatting down low while holding weight. Things that you want to do for life. I mean, think groceries, think grandkids, think putting away things up on a shelf. these are things that you wanna be able to do. And, it says here that the number. Indicator, the number one predictor of your longevity and how healthy and self-sufficient you're gonna be, later on in years is your, focus and attention on strength training and overall fitness. So if something very good to look at, and of course that ties in with our topic today. This last article, is entitled Type two diabetes. Why many people who are eligible aren't getting treatments such as ozempic. So this article focuses on the two main types of treatments that have. into, use within the past 10 years or so. The first one is the one they mentioned. It's, it's a GLP one, agonist, like ozempic, also like wago. Those two are the same medication, also like Mounjaro, which, which I'm taking. They're all GLP one agonists. The other medication they mentioned are the SGLT two inhibitor. those are the, medications like, FARA, like I take. So I do take both of these classes of drugs, the GLP one, agonist and the, SGLT two inhibitor. They're saying here in this article that 80% of adults with type two diabetes in the US are not getting treatments that they're eligible. Now they say there's a couple of main reasons that one is simply education. One is that they may be doctors who, let's say they've been treating type two diabetes, or more likely they're a general practitioner, there's a family physician. So, all the things they have to deal with and encounter, they might not be aware or fully informed on these new classes of drugs to treat type two diabetes because the SGLT two inhibitors have not been around for, more than 10, 15 years. The GLP one inhibitors, while they had some, 10, 15 years ago, the more powerful, stronger ones have only come out in the last few years. In fact, Mounjaro. Is out for now less than one year. So it's reasonable that some family practitioners, some general health providers maybe aren't fully aware of the benefits of all these drugs, but they are, better and better than some of the older, more go-to type medications like metformin. So they say that eight and 10 people could benefit. People with type two diabetes could benefit from this pair of drugs that only a small fraction are currently being prescribed compared to what could be prescribed. They're saying now that, less than 4% of people get the GLP one, medications like Ozempic or Mounjaro compared to who's eligible for it. So they, by eligible they mean they have a diagnosis of type two diabetes. And their health insurance would actually cover it, less than 4% and only 5% of the adults who are eligible for the SGLT two treatment were currently using it. Now, one thing they mentioned here is that all Medicare beneficiaries with type two diabetes are eligible for both of these medications yet. So few, are and they say in addition to the education of the provider and Education of the patient. The other thing that is an inhibitor is price, especially for the medications like Ozempic or Mounjaro, those can be over a thousand dollars a month if you get no health insurance coverage at all. But even if you have a copay of, a hundred bucks a month, that will, dissuade many people. from trying this medication simply because, the cost of a hundred bucks a month is, un undoable, unfortunately, and that's why maybe they get drugs like metformin, which are practically free, even without health insurance, but there is hope for the future. They say that as more and more people are being. and health insurance coverage is increasing for some of these newer medications that the rate of prescription is, going up. Both of these medications are now considered first line diabetes treatment, even though they rarely are used as a first line medication. So that's a good article to. It's, it's to me, a shame when you have something that is available is incredibly effective, yet many people are not using it, who would benefit from it? Is Exercise Needed in Solving Type 2 Diabetes? --- Okay. Let's look at our topic for the week Now, this won't be a long in-depth discussion. It's not necessarily a cut and dry topic. There's only a few ways really in my mind to look at it. So our, our question for today is, is exercise really required when I'm trying to solve my type two diabetes? Now, I am not a physician nor a sports physiologist. I cannot tell you if you should be exercising. So please don't take what I'm about to discuss as a prescription for you, because it certainly is not that, I'm not one to prescribe what you should or should not be doing. I'm just simply trying to tell you what I think about what my experience has been and then it maybe it gives you something to discuss with your, sports coach or your doctor. So I fully re. That exercise is quote unquote required for, healthy longevity, general health. The ability as we age to take care of ourselves and even improving mental attitude. I find for myself that when I get out and move, Whether it be a CrossFit workout or a nice long walk in the woods, my mental attitude is improved just as much as any, physiological, markers I might be measuring. So it's both a mental boost and a physical boost to do exercise. In fact, I'm gonna quote that article we just looked at, and I saw this when I was reading it, and it goes, the data are unambiguous. Exercise not only delays actual death, but also prevents both cognitive and physical decline better than any other intervention. It is the single most potent tool we have in the Health Span Enhancing Toolkit, and that includes nutrition, sleep, and medication. . So that was a quote out of that article we just looked at. it was the article entitled the Impact, strength and Fitness have on your Lifespan. So you'll find that quote in that article. What I find, and this is where I'm gonna throw in a, however, when I'm talking about controlling my blood, , the exercise that I do on any particular individual day is not the big lever for the short term blood sugar control. Like if I'm out briskly walking for an hour and a half, yes, I will see my blood sugar. Typically drop a little bit, towards the later parts of that workout, and even for a couple hours after the. , but I can control it in a much larger fashion by controlling what it is I eat. So I don't see the reason that I get out and walk today, or the reason I go to a CrossFit workout tomorrow. I don't see the reason being that day's blood sugar control, however, exercise, it does. , some of that glucose in the muscle into work. you, your muscle is burning some of that glucose that you have managed to store in there, and so when it gets replaced, it obviously gets that sugar from your bloodstream to replace what was in your muscle. as long as you're sensitive to the effects of insulin, then that will take some sugar out of your bloodstream and put it back into your muscle to replace what you've. now, I can see that on the meter, but this effect of insulin, that's a problem if you have type two diabetes, you're not as sensitive as other people without the diagnosis, so you're not getting that sugar back in those muscles as fast. But it still does help. building muscle. So now I'm talking about the long term, the long term effects of getting out there, hiking several times a week, or doing CrossFit a few times a week, or lifting, dumbbells, or that type of thing. That helps you build more muscle. and it's that act of building more muscle and therefore you gotta keep that muscle fed. And when you do work, you're able to do more work because you have more muscle and you're gonna burn more energy. It's that long term, 24 hours a day, seven days a week, ability to burn more sugar. That actually helps over the long term. Your exercise with controlling your type two. . So, is exercise required for today? No, but just like for today, if you go to the gym, you're not gonna see bigger muscles just from today, where exercise helps the control of your type two diabetes and where it's absolutely required for greater longevity, greater general health, greater ability to care for yourself is in the long term. So, to answer my own question, , is it required for today? No, but today can be part of a long term habit, a long term, sequence of exercises that will, generally speaking, build some more muscle, make you more active, and then in the long term you are burning more sugar each and every day. And that will definitely help with your type two diabetes. Questions --- Okay. It's time for your questions. You know what? I'm a little excited. Can you tell, can you hear it in my voice? I'm a little excited. I got four listener questions in this week. That's never happened before. I am really happy about that. I, I thank you all for writing in and if you also would like to share a question, there's two easy ways to do it. You simply send me an. , my email address is Tom@SolvingType2Diabetes.com. Send me an email. It's the easiest way. Another easy way is to go over to the website. SolvingType2Diabetes.com and then you click on feedback on the menu and you'll see a little form there and you just simply put in your question or your comment or your feedback and send that to me. And I will also get an email and, respond to you here, on the next podcast. And also if it's, appropriate and it's the type of question you asked, I can also send you some information, privately as well. So let me read the first question from Kathy. Kathy writes in. Hi Tom. It's so motivating to hear how well you are doing. Keep up the good work. It's really paying off. Question, are your numbers ever off The first day after inserting a new sensor, have you ever heard of or tried. Soaking the new sensor. I started using the Freestyle Libre three approximately six weeks ago and love it. However, during the first 24 hours after inserting the new sensor, my readings are unusually high. A finger stick confirmed that the CGM readings were not accurate and significantly higher than my monitor readings. Everything evened out the next day. I couldn't find anything on the Libra site to address the issue. But I heard that one way to ensure better accuracy for the first 24 hours is to soak the new sensor for several hours before activating it. This means that for several hours you'd be wearing two sensors, one fresh inactive one, and the soon to expire active one. Once the active one expires, you would take it off and activate the fresh one. The idea, I guess, is that your body has more time to adjust to the new sensor. Are you aware of such a. Well, thanks Kathy. Appreciate the question. Thanks for the kind words. And yeah, I have read, and in fact I have read it, I think it was on their website, on the Freestyle Lire website where it says that, accuracy for the first 24 hours, isn't that great? Now I've only experienced personally, and I have been wearing it for about 20 months. I've only experienced maybe the first three or four hours as being inaccurate. So if one expires and I get the last reading off of it, and then I immediately put a new one on. For that first couple hours maybe, and it's not even all the time, but maybe for the first couple hours I will get, it's usually a very, very high reading, like you say here, you get an unusual, usually high reading, and then after two, three hours, I simply, start getting normal readings again. So what I do personally is if that happens, let's say my blood sugar was sitting at about 85 or 90 or where. and then I put it in a new sensor and that one starts reading 240. Well, I know my blood sugar is not 240, even if it reads 130. My blood sugar just did not instantly by itself go from 90 to 130, especially if I haven't had anything to eat. So I usually wait two or three hours and I see, oh, it's back down in the 90 range again. And then I simply delete those first three hours worth of data. And in the, Nutri Senses app that I use, I can delete that data. Now. I'll stop using that app here as soon as my current CGM expires because I'm going to the new Libre three s like you use. And that would require me to use the Freestyle Libre three app. And I don't know honestly cuz I've never used that app yet, whether or not I can delete those first two or three hours with the data, but that's what I currently do. I've never had one be inaccurate for the first full 24 hours. So that hasn't happened to me. But, this idea of quote unquote soaking, in other words, putting one in on before you're ready to activate it, I honestly have no experience with that. So I, I cannot give you a recommendation, either way. But, let us know how that works. If you try that, I'd be very interested in hearing back from you as to how that. Our next question here comes from Stacy. Stacy says, hi Tom. I recently found your podcast and enjoy it very much. I have not had a chance to listen to every episode, but will eventually. I'm not sure if you've discussed in an episode I have not listened to yet, but how do you feel about intermittent fasting as a fellow cruise traveler? I appreciate you sharing your strategies for managing type two diabetes while cruising and away from home. Thanks again for sharing your experie. Stacy. Well, thank you Stacy. I appreciate your writing in and thank you for your kind words and your question here about intermittent fasting. How do I feel about intermittent fasting? Well, I don't feel one way or the other. I think that different ways of eating can have Differently, dramatic results on individuals depending on who you are, depending on your own physiology. Now, for those that are not familiar, intermittent fasting means intentionally doing without food for certain period of times. This could be. Just the eight hours you're asleep. This could be 12 hours. Let's say you only eat between 8:00 AM and 8:00 PM or maybe you only eat between 11:00 AM and 8:00 PM or maybe you only eat every other day. I mean, there's very many different types of intermittent fasting and honest, honestly, if you find certain ways of eating are helpful. That's great. I don't know that they helped me a lot. I would say six outta seven days. The only thing I have in the morning is coffee, and I do put heavy cream in my coffee, a couple tablespoons, which has no carbohydrates, and it's usually the carbohydrates. That people are trying to avoid a constant trickle. Some people feel, and of course there's been studies, there's been studies on everything. But some people feel that by limiting your carbohydrates intake to just a few hours a day gives your body a chance to, recover from eating basically. And that it gives your body a chance to, do some housekeeping. In your cells and you're not constantly, working your liver, trying to process incoming food that it, gives it a break. They think that maybe that's the way people ate, thousands and thousands of years ago. They weren't constantly snacking or grazing. I don't know. But if it's something that works for you, go for it. With my way of eating, I'm not intentionally intermittent fast. But I do tend to eat, food, quote unquote, from maybe noon until maybe 7:00 PM So yeah. Am I intermittent fasting? I go about. 17 hours a day, typically without, especially without having any type of carbohydrate. But that's just, my lifestyle that's just working for me. So let us know how it goes. Let us know how you do, if you decide to try intermittent fasting, and we'd be very interested in hearing about that. So Joe sends in the question, Joe says, hello, Tom. I recently discovered your podcast. I'm going through the past episodes and I'm finding it informative and inspirational. I am pre-diabetic a1c, well 5.9, and have recently started using a glucose meter to track my blood sugar. As I make changes to my diet, I want to see if I can push my A1C lower. It has been at that level for at least 10 years. I have been an active cyclist for more than 20 years, so my weight and fitness are not an issue for me. So diet is the only knob I have left. I am very interested in using a CGM as I really want to dial in my on the bike nutrition. Up until now, I have followed the advice prevalent in the endurance community that you can pretty much eat as much sugar as you want while you're on the bike since it's needed to supply your working muscles. I'm concerned that I have been doing my self-harm. , I want to see what my blood sugar is doing for my longer rides two to four hours, sometimes longer. I'm considering either Nutri senses or vary. Have you looked at vary? Do you know how they compare to Nutri cents? I believe that vary is a bit cheaper and I don't think that I can get my insurance to pay for this. I'm a retired electrical engineer and enjoy data tracking and N equal one nutrition experiments that I can do. Thanks, Joe. Well, thank you, Joe. I appreciate the fact that you're finding the, the podcast helpful. I hope you continue listening. hey, share it with, some of your other, biking friends. and that's something maybe I could ask everyone to do actually. if you're getting something out of this podcast, if you're enjoying it, if you're still listening 40 minutes into this podcast, maybe share it with a friends, share it with someone who you think might benefit from it as well. So, Joe, back to your question. I don't know anything about the company. . evidently it's a company that also provides, continuous glucose monitors through telemedicine. if you're gonna go that route and assume they all use the same monitor, I would suggest going the cheapest way you can. Now you say here that you don't think your insurance will pay for this because you do not have a diagnosis of type two diabetes, and that probably is true. If you could still ask your doctor to write the prescription, I found that using coupon programs like GoodRx and other, prescription coupon programs that are out there. You can get, your doctor to write a prescription and still end up paying less out of pocket than if you went with one of these companies called Nutrien or Vary. it's not a big difference. Maybe for example, when I was stopping with Nutri Senses and switched to getting my CGMs through my doctor, I was currently paying about $199 a month with Nutri Senses, and I found that with GoodRx, even if I had no insurance covered. , which luckily I do, but even if I did not, I could get the CGMs cheaper through my local pharmacy using GoodRx. I think the cost was about $140 a month as compared to 199. Now I do get them through my own, doctor and my own health insurance now with a copay of $75 per month, that covers two sensors, so that's a way distance down from 1 99 that I was paying to nutrisse. So yeah, I would go for the cheapest way you can, and that might still be with a prescription in your doctor even if you don't get insurance coverage. Now you ask here about sugar intake while on a long distance bike ride Now. I, I, man, that's a tough one. This is definitely something that you want to do research into, talk to your doctor about. I personally, think that, I, I, I'm trying to remember the name of this Ultramarathoner. ok, so his name is Timothy Knoakes N O A K E S now this is a guy who ran Ultra marathon. And in his fifties he got diagnosed with type two diabetes. He was , noticing some issues with, tiredness and just was not feeling right, and he had full-blown type two diabetes. He was a super exerciser. He would run, his short run might have been six or eight miles and he was running ultramarathons several times a year and running marathons in between. So you're talking somebody who was running on the regular, well over 20 miles, sometimes over 30 miles. And he also was the, school of, Hey, it's sugar. Your muscles need sugar. Eat the sugar, you're gonna burn it. And if you look. Just calorie count of what you do burn on one of your long bike rides. It, I'm sure is much more than the sugar you're taking in, but it's something about that sugar, something about taking in that glucose and that's gonna cause you to pump out insulin, which is good. you want the insulin because you want to push that into your muscles so you can use it. I think that's causing a stress. Now, again, I am not a physician. I am not a nutritionist, but I think that sugar is causing a stress. On your body. Now, there are carbohydrate, formulations out there that you can take that are long chain carbohydrates that do not spike blood sugar like, glucose does. these goos or these other formulations that you can take as an endurance athlete and some of those long chain carbohydrate. Have almost no spike in your blood sugar yet fuel you, very well for your long events. So you might wanna research into some of those, but I'm of the camp. Where I believe that even for an endurance athlete, all this extra sugar, sugar, sugar, pumping it into your system, is causing stress on your system. But definitely something to talk to your doctor about. Definitely something to talk to may an endocrinologist about because yes, you would not expect someone who's an athlete such as yourself to now be pre. and it might be that sugar, that you pump in during some of these long workouts. So, Joe, let me know how it goes. I'm very interested in this, in how you're doing. And please write back, as you learn more about your own situation and maybe you can share that with us. So thanks very much for that. . All right, here we are. The last question. This is getting long. This last question's a short one. it's from Mike. Mike asks, if I'm not mistaken, you got your Mounjaro prescription from a telehealth provider. If so, why did you go that route? Was Mounjaro difficult for you to get from your regular prescriber even with a type two diabetes diagnosis? Is your insurance covering it or are you having to pay out of pocket? Well, thanks. easy question here to answer. Yes, I did get Barbara Mounjaro originally from a telehealth provider. it's called sequence. their website is join sequence. And, why did I go that route? Simply from convenience. I had just recently seen my doctor. when I, decided to try Mounjaro, I knew it would be easy to get from the telehealth provider because I did have a diagnosis of type two diabetes. it was never a question with my insurance. They covered it from the very beginning. They cover it, whether I get it from a telehealth provider cuz that's a physician, or I get it from my. normal, primary care provider. Either way, the insurance covers it just fine. So that was never a consideration. I did not ever have to pay out of pocket, and quite frankly, I cannot put out a thousand dollars a month if I would have to pay for it out of pocket. So that would be a non-starter for me. It wasn't difficult to get from my provider. it was just easier to get from this telehealth provider. And then simply when I went to my next appointment, I discussed it with my primary care physician, and now she has started writing, the prescription herself. it's not currently doing much good because they're out of stock, but, either way, regardless, it's the pharmacy who's out of stock, and it doesn't matter who wrote the prescription, I'd still be in that same bind. So thank you, Mike, for that email. I hope that helps. What's Next? --- Let's look at for next week, next week's episode. Now it ties in with Mike's question and it's gonna. Life after Mounjaro do I take Mounjaro now for the rest of my life? I take a blood pressure medication and even though while I'm taking that medication, my blood pressure is normal. I've gotten the right dose, and while before I had very high blood pressure. I mean, before this medication, I was getting readings of 1 6100, which is too high for. , but now I'm about 1 26 over 82. That's my average. That's my typical on any given day, and I check it about once a week. But when I stop taking that blood pressure medicine, just because my blood pressure is now normal while I'm taking it, I mean that doesn't make sense. So what about this Mounjaro? Will I take that forever? do I have 20, 25 years of life left? Who knows? But am I now getting a box of this Mounjaro every month for the rest of my life? What are my options? What are my alternatives if I don't want to take Mounjaro for the rest of my life? So that's gonna be our topic next week, and I will see you then. Thanks! --- Well, that wraps up another episode of the Solving Type 2 Diabetes podcast. I hope you found it valuable. Please follow and leave a five star review, as it helps other people find the podcast. By subscribing you ensure you won't miss the next episode. You can always get a full transcript of the episode at SolvingType2Diabetes.com there you also find the links to leave feedback and links to follow on social media. I'm very interested in hearing from you with comments and suggestions. Thanks very much for listening. Please remember that everything I share is just from my own personal experience and should not be taken as medical or health advice. Please consult your own medical professionals. This podcast is intended for entertainment purposes only.