Introduction --- but just a few nights of maybe getting only five hours of sleep, six hours of sleep can send your blood sugar up to pre-diabetes level, even if you normally have totally fine blood sugar. Hi, and welcome to the solving type two 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 two diabetes podcast on social media. Please head over to SolvingType2Diabetes.com for all those links and more now onto the show. Well, I hope you have had an absolutely fabulous week and, I'm gonna talk about my week here in just a little bit. But before I do, I'm gonna ask you a favor. I'm gonna ask you to please share this podcast with someone that you care about, someone who may have type two diabetes or be caring for Selman with type two diabetes. Just reach out, share the podcast and I certainly would appreciate it. My Week in Review --- So this week, we're currently up in Maine. we had a few days more at home and then, we traveled up here to Maine. It's about, I don't know, with stops. I'm gonna say it's about a seven hour drive. To get up here to York, Maine and we're visiting with family, our youngest and also youngest, grandkids and, having a fun time up here in Maine and for the days of travel, pretty full day of travel. I did take along some protein shakes, which were very helpful. I also had, a few cans of code red. mountain Dew Diet of course, and Mountain Dew Zero. And that was a little bit of a treat, and I really enjoyed those. So that made for a quick day of travel. Not too much traffic, not too bad. And, made it up here. And it's a little bit cooler up here, not too cool. in fact, today it got up into, The mid seventies, about 72, 73, and I was actually outside cutting grass, trying to help out a little bit. unfortunately the lawnmower was actually a push, not a self-propelled lawnmower, but a push lawnmower. So I certainly closed my rings today. My Numbers --- speaking of my numbers, I did close my rings five outta seven days this week, and that's become pretty standard for me lately. it's been, maybe it's been about a month or so since I've closed them all seven days, but had another good week, five outta seven days. My seven day glucose average, was one 14 up just a tad. That gave me a GMI of 6.0 when calculated over the 24 7 period of a week. My body fat percentage is held steady at 20.5% and so I have been eating a little bit more. You'll notice there my carbs were up just a little bit here. in fact, for my macros, my carbs average 68 grams of carbs each day, 142 grams of protein. So I have been trying to, slow that weight loss, taper that weight loss off a little bit. And, it's not difficult. the difference between losing just a little bit of weight or holding steady is typically just a few hundred calories a day, and that's easy to. Get in and, so I had no problem with that this week Mounjaro Update --- for my Mounjaro update. I'm still having really good A1C control, still at the 7.5 milligram dose, and I find that when I do eat carbs, Especially things like, bread or something. they have a bread store up here called when pigs fly and it's really good homemade, all sour dough based breads. And we get the, traditional, original sourdough bread. And, when I had some of that, had some, for toast this morning, as a matter of fact, and my blood sugar does go right up. say it was clocking long at about 100 or one 10, have some toast and it happily shoots right up to about 1 50, 1 60. But then, because I'm having this much better A1C control with the help of this Mounjaro, it's gone down, right back within an hour and a half. After spiking up, it spikes right back down and then just chugs along, around a hundred, 110 or whatever. And I saw that happen twice today. And, for breakfast, like I said, I had some sourdough, toast with my, breakfast. And then at lunchtime we were out at a little hamburger joint. And I had the bun, actually, I had most of the bun, not all of it. But once again, it, it went up and then a couple hours later came right back down, which is much different from before. earlier in my, experience with type two diabetes, it would go up, but then it would stay up. if I had, bread or something like that, like I had twice today, previously when I had that, it would go up and stay up for a day. literally it would not go down again, for quite some time because I was completely insensitive to the insulin, that my body was producing. But now I'm, I'm getting a little bit better with that. So that's good. My Challenge and Win --- And that goes into my challenge and win for the week. being up here now for four days so far, we'll be here for a couple more days in Maine. I've been eating a lot more high carb meals, than I'm used to either the dinners or high carb or the breakfasts or lunches or whatever, maybe sandwich based for the lunches, things like that. And, this is how a lot of normal folks eat. But I, I'm not used to it. So what I've been doing is, really keeping my portion sizes down. I find that by, just having a smaller portion of the standard fair. And then maybe supplementing with some protein. I brought some protein shakes with me. I'm over, able to overcome not eating what I normally eat with really not too much problem. So I'm gonna call that a win for the week, because you know I am eating with the other folks and not eating separately or eating differently. I'm just getting a smaller portion, like for dinner tonight, they had a pasta dish, which is really good, but I just loaded up on the salad, had just a little bit of the pasta. And then maybe on later on tonight, I'll have a protein shake. News --- If you look at the news that I'm bringing you this week, we have four news articles, which is pretty standard for us here. The first news article is called, this is the number one thing you can do to bring down your A1C levels naturally. So I'm all for that. I'm all for, trying to do what you can. And it says here in this article, the key is to develop a healthy eating routine. So your blood sugar is primarily controlled. By what you eat. Now, later on, we are gonna be talking about the six S's of sugar spikes. That's our topic for today, but right now in this article, it's talking about limiting your added sugars, and don't be afraid of dietary fats or animal proteins. It says those are good. Also, it's recommending, and this is standard for us, get plenty of movement and maintain a healthy weight. So it's saying these things which we, I think at this point are pretty familiar with hearing Limit your added sugars. Don't be afraid of fats or animal proteins. Get movement, maintain a healthy weight. Those are what it's recommending, and I think those are things we talk about here a lot. The second news article says, higher blood sugar linked to faster loss of brain power in stroke survivors. So this is, this is interesting. Once again, it's showing that high blood sugar has, multiple negative effects on your body. So it is a study on folks who had a stroke and survived. But what they found is that, When they monitored the stroke victim's blood sugar, and this is long term, this is a 12 month study, and what they're finding is that the cognitive decline happened much more rapidly. The, the cognitive, the mental abilities, the onset of dementia, those type of things, and stroke victims were much greater, much higher rate of decline, for those folks who had high. blood sugar and they were highest for those that were officially diagnosed with type two, diabetes. So here again, is something else that having high blood sugar can set you up for, negative outcomes, in, in many different types of, health issues. And this is specifically looking at stroke survivors. And their loss of brain power and it's tightly correlated with their blood sugar levels. So I found that interesting. And it does link to the whole, study, if you wanna read more in depth about that. This article here next is from the uk. It says, type two diabetes is becoming a public health disaster. So we all know that, type two diabetes can lead to many negative outcomes. And what they're saying here is that because of the dramatic rise in type two diabetes that they're finding the. Folks are getting much higher rates of, now this is for uncontrolled type two diabetes, but they're getting much higher rates of heart disease, cancers, and other associated chronic diseases, and therefore it's driving their healthcare costs up dramatically. they're tying this to, the side effects and the comorbidities of obesity, which, as often comes with type two diabetes and not always, but it often does. So this is an interesting article. Again, it's unfortunately becoming more and more common to hear these types of things. but they're saying that, economically and, long-term health outcomes are all dramatically impacted by the significant rise of type two diabetes. Finally, this last article here is called How to Approach a Pre-Diabetes Diagnosis Now, Not always, but often someone is first diagnosed with pre-diabetes, maybe several years before a formal, diagnosis of type two diabetes. So they're recommending that folks really at age 35, maybe it should be earlier, but at least at age 35, they're wrecking folks, get routinely screened, for blood sugar levels. And this article here says that you should know your, information and if you are trending towards that pre-diabetes level. That you should take the steps, and again, they're talking about the same steps, but you should take the steps as if you already had a diagnosis of type two diabetes and what are they talking about? Again, it's the same thing. Limiting or almost eliminating, added sugar, watching out for the highly processed foods, the highly palatable foods. they're recommending eat Whole Foods. They're recommending, again here, movement, exercise, and working to achieve and maintain a healthy weight. Now those are the exact same things that they tell someone with Type two diabetes to do. So I guess what they're saying here is, Even if you only have a diagnosis of pre-diabetes, if you don't change these lifestyle factors, then almost certainly you will eventually move into a diagnosis of type two diabetes. So those are four quick articles. I think they're interesting. Now all these links to these articles are always gonna be in your show notes and you can find the show notes either directly in your podcast player. You probably see links right there for them. Sometimes you have to swipe right or swipe left inside your podcast player to see the show notes. Once in a while, they're just down below. If you scroll down below, but you can always for sure find them over on the website solving type two diabetes.com. You'll see all the show notes, all the links I include for every single episode. Six 'S's of Sugar Spikes --- Okay. Let's get to today's main topic. So today, and here's some alliteration for you. Today we're talking about the six. Ss of sugar spikes. So the titles of Rative, the items on the list draw alliterative. They all start with s. I thought that would be fun. Now, The guts of this, I did not come up with myself. As you know, I'm not a dietician. I'm not a nutritionist. I'm not a medical expert of any kind. So this topic I actually heard directly from the Healthy Steps Nutrition podcast. Now that's run by Nicole aco, and she is a registered dietician. She is the founder and owner of Healthy Steps Nutrition, CrossFit, gym, and also Healthy Steps Nutrition, nutritional Coaching. So she's a pro, she's an expert. She teaches other people how to do this stuff. So I was listening to her podcast and I came across these six s's of sugar spikes. Now the first one is sensitivity. Sensitivity to the insulin. That your body has if you are not sensitive. In other words, if the insulin does not have an immediate and effective, relationship in your body, you will get a blood sugar spike when someone else might not. I was talking about earlier how when I used to eat carbs, my blood sugar would go up. But then it would stay up and that's because I was not sensitive to the insulin. But as you become more sensitive, either through weight loss, through controlling what you're eating or I get medication support as well. When you become more sensitive, that can definitely. Lower your sugar spike. It can also make it last for a shorter period of time, which is what we want because we want our average blood sugar to not be high. You can get a blood sugar spike once in a while, but you don't want it to stay high. So the first way sensitivity, the second S of course, is for sugar itself. The second S is sugar, It's the sugar, it's the carbohydrate in your diet, the things you eat that cause the sugar spike. After all, that's the initial cause. So it's by ingesting sugar that you get the largest sugar spikes. Now when I say ingesting sugar, all carbohydrates that you eat, and it doesn't matter if it's a bean or it doesn't matter if it's table sugar, it gets converted to glucose in your body. Now if you eat something with high fiber, some fat, some protein, that's gonna be turned into glucose more slowly than if you just eat, for example, or drink a glass of orange juice or a Coke that's instantly turned into glucose. But if you eat maybe a bean or vegetables, that is more slowly turned into glucose, and quite frankly, there's less glucose in vegetables than there were. Would be, let's say, in a can of Coke. So the second S is sugar. The third S we're almost halfway through the third S is sleep. Not having sufficient sleep can also cause your blood sugar to spike. Nicole cited a study that said just three or four nights of not getting enough sleep. Let's say you're, I don't know, if you're in school, you're cramming for finals or if work there's a big project or you're just, not getting the sleep you need, you're working two jobs, whatever, but just a few nights of maybe getting only five hours of sleep, six hours of sleep can send your blood sugar up to pre-diabetes level, even if you normally have totally fine blood sugar. So the third S is sleep. The fourth S is stress. When you're under stressed, especially chronic prolonged stress, your hormone levels are out of whack. You're producing a whole lot of the hormone called cortisol. When you're producing that cortisol, your insulin production is down. Your insulin sensitivity is way down, and that's why stress can also cause your blood sugar. To spike because you're talking about your hormones here in your body and your hormones being out of regulation because of that stress. So that's the fourth s. The fifth S is steroids. Now certain medications, including steroids, can raise your blood sugar. So people don't maybe notice this, that they're on, steroids because they have some type of injury or they have some other reason to be getting these steroids and their blood sugar can be rising. So if they don't, check your blood sugar, they might not even be aware, especially if they're on the steroids for a longer period of time. That can raise your blood sugar. Now the final S is for slur. Now, I really had to think about this one. How could I make this into an S? How could I make this into a slur? for my sixth s, because it's alcohol. I'm talking about alcohol and its ability to raise your blood sugar, that people might think, wait a second. I've noticed if I have a couple of drinks, my blood sugar actually goes down. Yes, true. It goes down temporarily in the short term, but then what often happens, sometimes 8, 10, 12 hours later, is that your body senses the low blood sugar because your liver has been processing this alcohol and it postpones processing the sugar. The carbs that you've eaten. So it does not truly lower your blood sugar long term. It does short term, but then it rebounds and sometimes it rebounds much more than it needs to. It's trying to compensate. So drinking that alcohol and yeah, that's where I get the As for slur, but drinking that alcohol temporarily suppress your blood sugar, but then it rebounds right back up. So those are the six S's of sugar spikes, sensitivity, sugar, sleep, stress, steroids, and slur. So I hope that was helpful. Questions --- All right, let's look at your questions. So we got two questions this week. The first question here is from George. George writes, Good morning, and I hope you're doing well Recently. Out of curiosity, I started checking my sugars more than once a day. My fasting glucose in the morning, on average three 30 for work, 3:30 AM can be between 1 25 and one 30. So I started checking late to mid-morning, and I've been finding out that my glucose level is lower, averaging 80 to 1 0 5. With that, I've noticed that I am pricking my finger a lot to bring about some of the data. I would like to have one, learning to manage my diabetes, which brings me to my question. After writing to my insurance company, I've learned that the CMSs are covered in certain instances to include type two s. My question is simply, what was your justification for the cms? Thanks so much, George. hey George. Thanks a lot for writing in. so you have to get up at three 30 in the morning for work. I actually did that for a few years when I took a commuter bus into my job. And, the fact that I lived, an hour and a half away and, the commuter bus of course took a lot longer. But yeah, I used to have over a two hour commute each way when I rode the bus. yeah, I had to get up at three 30 in the morning, to start work at six. And, that was no fun. So you find that when you get up that early, your blood sugar is between 1 25 and one 30, but then several hours later it's down to 80 to 1 0 5. So let me address that first. hopefully you're getting a enough sleep. If you're not getting enough sleep, then that in itself can be raising your blood sugar. But most likely what you're seeing here is what's called the dawn effect. When your body realizes that it's waking up and your liver tries to prepare your body for waking up, it actually pushes sugar into your bloodstream, and that's called the dawn effect. And I notice myself every day, even before I've had any breakfast whatsoever, right around the time I normally wake up, my blood sugar starts to rise and it can rise from, let's say it was 90 or whatever before. during the time I'm waking up for that hour or so, it will go up to one 30, sometimes one 40, and then it starts creeping down, even creeping down as I'm having my breakfast. So that's what's called a dawn effect, and I think we talked about that, Dawn, d a w n I think we talked about that earlier. But then you ask about, using a C M S. Instead of having to stick your finger. Now, I'm not familiar with the term CMS when it comes to type two diabetes. In fact, I looked that up. I'm wondering if that's a typo. And you're talking about CGMs continuous glucose monitors. I'm not familiar with cms, but I'm gonna answer the question as if you had said cgm. And then your question would be, what was your justification for the cgm, the continuous glucose monitor? I really didn't have a justification. my insurance covers those if you have a type two diabetes diagnosis. So I simply asked my doctor to write the prescription. she wrote it and then I picked up my, monitors at the, drugstore, so I didn't really have to justify it. I hope that was helpful. if you have to justify it to your insurance company, I'm really not sure how to make a recommendation there on that, so hope that helps George. Sue wrote in. Sue wrote a question. She said, hi, Tom. I have been listening to your podcast over the past month or so. I was recently diagnosed as a type two diabetic and was 100% shocked. I consider myself a healthy person. I have exercised regularly all my life, mostly running. I have always been a more healthy eater and never considered myself overweight. When I was diagnosed, it was right after working out that I felt awful enough to go to the er, and the only thing they could tell me was to follow up with my primary care physician. They did ekg, chest x-ray, et cetera. They found out your A1C and blood sugar were high. And you were therefore diagnosed with type two diabetes and says here that Sue started Metformin and she says she feels better and realizes why some of her runs and workouts didn't make me feel better. So I was searching the internet to find solutions for a quote, skinny type two diabetic. This is what I found your podcast. I enjoy the format and sharing of your experience. I realize I don't know any type two diabetics. I only know type one diabetics. Since starting this whole ordeal, I have cut out bread, rice, pasta, potatoes, and sweets. Not surprising with the medication suppressing my appetite and cutting out the starchy foods, I have lost almost 15 pounds. Like most people, I was okay with the first 10 pounds, but now I've been drinking protein shakes daily to try and keep my weight normal. I am five foot two and 115 pounds. So I guess my question would be, do you have any suggestions, helpful tips or insight for me? Are there more Type two s like me? I haven't quite caught up on your current podcast, but I'll try to catch up so I can hear if you mention this topic. Sorry if you've, and I've just not heard it yet. I look forward to hearing from you. Thank you, Sue. Sue, thank you very much. And, it sounds like you are taking positive actions, which is great. sounds like you're reducing your carbohydrates, which is causing you to lose some weight and, assuming that's, fat that you're losing. I think that might, even help you some. Now as far as insights go and you ask about skinny type two diabetes. I have done some reading and I'm not a medical doctor, so confer with your doctor, but I have done some reading on my own for my own benefit, and I have found out that folks can have excess fat without being. Excessively overweight. Now, what that means is that the ratio between their muscle and their fat is what the issue is. So for those folks, even if they don't need to lose more fat, they could probably stand to gain more muscle. Now, you mentioned that you're a runner, and I'm blanking on this man's name. I should have, looked it up before. But there was a famous runner, just, I don't know, within the last 10 years or so, he used to run ultramarathons. And for the life of me, I cannot, he wrote a book called Water Logged. anyway, and he would run ultramarathons and he looked, and I'm gonna say quote unquote thin, but the problem is what little muscle he had was in his legs and he had no. Extra muscles anywhere. So he didn't have a lot of muscles. he was taking in a lot of, sugary drinks, taking in a lot of goos and gels and bananas, to fuel these long runs. But the problem is he was taking in way more than he needed, and while not dramatically overweight, He had a very low ratio of muscle to weight, and they're saying that actually is, just the same negative effect as if you had a normal amount of weight, a normal amount of muscle, but then excess fat. So instead of having normal muscle and excess fat, it's possible. That some folks with type two diabetes who are quote unquote thin, actually don't have way too much fat, but they don't have nearly enough muscle. So that's what I found in my reading. I'm not sure if that's what, affected you. I think sometimes we have a pancreas that once to cooperate and sometimes we don't. Sometimes we, don't eat. The things that are best for us, and it could be a combination there, but I'm glad you found out. I'm glad you found out the reason for your, poor workouts and not feeling great, and hopefully that you've nipped it in the bud and can turn it around and you say that you're feeling better. So I think that's really positive. So keep an eye on those blood sugars and, hope you have a long running career ahead of you. Now if you would like to write in like George and Sue did, it's easy to do. You can send me a quick email. My email address is Tom solving type two diabetes.com. Or you can head over to the website solving type two diabetes.com and click on feedback in the menu and just fill out that little page, send in your comments, send in your question, and I'd be very happy to, address it here on the podcast, even if you have a suggestion for a future topic. I'd love to hear that from you. Now I'm gonna ask you a favor again. I asked you in the beginning, but here it is. A half an hour later, you're still listening. I'm gonna ask you again, would you please this week, just take this and share it with one person you care about. If you did that this week, that would do me a tremendous favor and I would really appreciate it. What's Next? --- So what's next? Next episode. Now, we talked about blood sugar spikes, the six S's of blood sugar spikes. This week, next week, I want to talk about what I have found for me to be the five best carbohydrates to help me solve my type two diabetes. I still eat carbs. I eat 'em every single day. I wanna share with you what I found to be the best five carbohydrates when I'm trying to solve my type two diabetes. Thanks! --- Well, that wraps up another episode of the solving type two 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.