Boosting Your Happiness Quotient: A Roadmap!

100:00:00,480 --> 00:00:02,404Speaker 1: Welcome to the Healthy, Wealthy and Wise 200:00:02,524 --> 00:00:08,064podcast with Dr William Chokta, MDJD. Our mission is to empower 300:00:08,125 --> 00:00:11,897you with the knowledge and the tools you need to thrive in all 400:00:12,099 --> 00:00:16,184aspects of your lives. Join us now as we discuss everything 500:00:16,285 --> 00:00:19,842from nutrition and exercise to money management and personal 600:00:19,862 --> 00:00:24,733growth. Dr Chokta will provide insightful advice on how to 700:00:24,774 --> 00:00:28,064improve your physical and financial health, as well as 800:00:28,103 --> 00:00:31,460your emotional and mental well-being. Whether you're 900:00:31,481 --> 00:00:35,930looking to boost your energy levels, unlock financial freedom1000:00:35,930 --> 00:00:40,228or cultivate a more positive mindset, we've got you covered. 1100:00:41,799 --> 00:00:45,901Get ready to become the best version of yourself? So let's 1200:00:45,941 --> 00:00:51,901get started. Here's Dr William Chokta, MDJD. Good morning. 1300:00:53,304 --> 00:00:55,969Speaker 2: Welcome to the Healthy, wealthy and Wise 1400:00:56,411 --> 00:01:01,609podcast. I'm Dr William Chokta and I will be your facilitator 1500:01:01,630 --> 00:01:05,346today. Today, we're going to talk about destroying myths 1600:01:05,787 --> 00:01:12,662about diabetes. Destroying mythsabout diabetes. I believe 1700:01:12,742 --> 00:01:17,248knowledge is power. I believe life is about service to others.1800:01:17,248 --> 00:01:23,081I believe leaders can change the world, as we routinely do. 1900:01:23,201 --> 00:01:28,831we will underlie the discussion today in the area of medicine 2000:01:29,332 --> 00:01:32,620and law. Well, let's take a lookat our outline, and the purpose2100:01:32,620 --> 00:01:34,808of the outline is to let you know what we're going to talk 2200:01:34,868 --> 00:01:38,346about, but more importantly or as importantly, it's to let you 2300:01:38,367 --> 00:01:42,046know when we're just about done.I realize that you're all very,2400:01:42,046 --> 00:01:45,301very busy people and we're absolutely delighted to have you2500:01:45,301 --> 00:01:49,381with us on this particular podcast, but today we're going 2600:01:49,400 --> 00:01:54,471to talk about diabetes, and particularly type 2 diabetes. 2700:01:55,439 --> 00:01:58,087We're going to talk about the relationship between diabetes 2800:01:58,147 --> 00:02:04,007and obesity. We'll further then discuss the body mass index, 2900:02:04,087 --> 00:02:07,033which is used to evaluate obesity as it relates to 3000:02:07,072 --> 00:02:10,145diabetes, but we're going to specifically talk about 3100:02:10,286 --> 00:02:16,924individual myths about diabetes,diabetes remission and then 3200:02:17,024 --> 00:02:20,872some of the medication that's new, relatively new and use to 3300:02:20,932 --> 00:02:26,969treat patients with diabetes. Well, what is the definition of 3400:02:27,009 --> 00:02:30,207diabetes? And again, we're talking about diabetes type 2. 3500:02:31,381 --> 00:02:36,150Type 2 is called adult onset diabetes and basically it is 3600:02:36,210 --> 00:02:41,123defined as a chronic disease that occurs because the body is 3700:02:41,304 --> 00:02:46,980unable to use blood sugar, ie glucose, properly. Let me say 3800:02:47,020 --> 00:02:51,705that again, diabetes is a chronic disease that occurs 3900:02:51,806 --> 00:02:57,804because the body is unable to use blood sugar, ie glucose, 4000:02:57,924 --> 00:03:02,931properly. The exact cause of this malfunction is unknown, but4100:03:02,931 --> 00:03:08,039genetic and environmental factors play a major part. Risk 4200:03:08,060 --> 00:03:14,031factors associated with diabetesinclude obesity and high levels4300:03:14,031 --> 00:03:19,286of cholesterol. Well, how does the mechanism of diabetes work 4400:03:19,526 --> 00:03:25,205in terms of creating difficulty for patients? Well, primarily, 4500:03:25,245 --> 00:03:29,818the pancreas is an organ in the body that sits right adjacent to4600:03:29,818 --> 00:03:35,568the stomach, in the mid part ofthe upper abdomen, and it 4700:03:35,608 --> 00:03:44,421basically digests or secretes insulin into the bloodstream 4800:03:44,923 --> 00:03:49,039whenever blood sugar is located in the bloodstream, and the 4900:03:49,060 --> 00:03:53,930purpose of this insulin is to take these molecules of glucose,5000:03:53,930 --> 00:03:59,227ie sugar, and to modify them ina way that they could be used 5100:03:59,367 --> 00:04:04,003efficiently by the muscle. So you need the insulin for the 5200:04:04,044 --> 00:04:09,216blood sugar to be used efficiently by the muscle, and 5300:04:09,256 --> 00:04:15,245what happens is that, if you arediabetic, you do not have 5400:04:16,346 --> 00:04:20,740either sufficient insulin or your insulin, more importantly, 5500:04:21,120 --> 00:04:27,218is not as effective in providingits physiological purpose in 5600:04:27,257 --> 00:04:32,406terms of helping blood sugar or glucose to go into the cells of 5700:04:32,507 --> 00:04:38,425muscles and other organs. Well, what are the causes of diabetes?5800:04:38,425 --> 00:04:42,935And this is a huge issue that has changed over time, and one 5900:04:42,954 --> 00:04:45,644of the things to keep in mind isthat health care is always 6000:04:45,704 --> 00:04:51,255growing, it is always changing, it is always advancing. It used 6100:04:51,295 --> 00:04:57,906to be felt that diabetes was primarily almost exclusively 6200:04:58,026 --> 00:05:03,259caused, according to some, by obesity. We now know that that's6300:05:03,259 --> 00:05:07,862no longer true. Yes, obesity isa contributing factor to some 6400:05:07,923 --> 00:05:11,259who have diabetes, but what we've learned is there are other6500:05:11,259 --> 00:05:16,677contributing factors, like stress, like an unhealthy diet 6600:05:17,218 --> 00:05:22,680and, most importantly, genes or your genetic makeup. What does 6700:05:22,701 --> 00:05:26,882that mean? That means what you have inherited from your parents6800:05:26,882 --> 00:05:30,636and grandparents or great-grandparents over the 6900:05:30,716 --> 00:05:35,264years can many times dictate whether you will or will not 7000:05:35,386 --> 00:05:40,322become diabetic. And this is independent of diet and exercise7100:05:40,322 --> 00:05:44,177, independent of what you may ormay not do, and it's important 7200:05:44,478 --> 00:05:48,180to keep that in mind And we'll expand on this idea later as we 7300:05:48,240 --> 00:05:52,298go through this discussion. It'simportant to keep in mind that 7400:05:52,338 --> 00:05:55,675when we look at something like diabetes, which affects every 7500:05:55,735 --> 00:06:00,589single ethnic group in our country, that there are 7600:06:00,649 --> 00:06:04,315differences in how it affects the different ethnic groups. So 7700:06:04,716 --> 00:06:10,449if one were to look at this as National Institute of Health 7800:06:10,550 --> 00:06:17,165Information if one were to look at the effects or the prevalence7900:06:17,165 --> 00:06:20,237, if you will, of diabetes in different ethnic groups. Let's 8000:06:20,278 --> 00:06:24,230take five different ethnic groups of individuals in the 8100:06:24,312 --> 00:06:28,139United States of America. The group that has the lowest 8200:06:28,860 --> 00:06:33,329incidence of prevalence of diabetes is white. Non-hispanic 8300:06:34,235 --> 00:06:37,747or Caucasians do not have the lowest incidence of diabetes and8400:06:37,747 --> 00:06:42,735that's usually around about seven or eight percent. The next8500:06:42,735 --> 00:06:50,447highest, above them, is Asian Americans and their incidence is8600:06:50,447 --> 00:06:58,423about nine percent. The next group is Hispanic and their 8700:06:58,583 --> 00:07:05,197incidence is approximately 12 percent. The next highest group 8800:07:05,579 --> 00:07:10,767is African Americans and their incidence is about 13 percent, 8900:07:11,795 --> 00:07:16,524and the highest ethnic group in our country with diabetes is 9000:07:16,684 --> 00:07:21,956American Indians, slash Alaska Native. So American Indians have9100:07:21,956 --> 00:07:26,086the single highest percentage of diabetes as an ethnic group, 9200:07:26,735 --> 00:07:30,266and Caucasians or white non-Hispanic have the lowest 9300:07:31,228 --> 00:07:35,197percentage of diabetes in this country. And so what that says 9400:07:35,298 --> 00:07:39,298is basically all groups get it. But the reason why it's 9500:07:39,377 --> 00:07:41,805important to understand the prevalence and incidence in the 9600:07:41,845 --> 00:07:45,482different racial groups is that when we make sweeping 9700:07:46,324 --> 00:07:50,059proclamations about diabetes in terms of cause and in terms of 9800:07:50,521 --> 00:07:54,853treatment, we have to understandthat there is a difference in 9900:07:54,875 --> 00:07:59,228how it appears in these different ethnic groups and also10000:07:59,228 --> 00:08:03,120how it can best be treated in these individual ethnic groups 10100:08:03,595 --> 00:08:08,571And, most importantly, it is notappropriate to take the largest10200:08:08,571 --> 00:08:12,279ethnic group, which is the white non-Hispanic, and do 10300:08:12,339 --> 00:08:16,447studies that only include individuals in that ethnic group10400:08:16,447 --> 00:08:20,062and then try to make broad statements about diabetes 10500:08:20,141 --> 00:08:25,759treatment, cause and effect of those other four ethnic groups 10600:08:27,442 --> 00:08:30,995in terms of what's best quality in their care. So what I'm 10700:08:31,036 --> 00:08:35,630saying is that you have to look at these groups individually and10800:08:35,630 --> 00:08:38,561you have to include all individuals in these particular 10900:08:38,600 --> 00:08:42,517groups in your study and your data to be able to predict 11000:08:42,839 --> 00:08:46,993accurately what's most effectivein their management and 11100:08:47,052 --> 00:08:50,604treatment. One of the big areas of controversy that has been 11200:08:50,644 --> 00:08:56,440around for a long time is is diabetes is inherited or is and 11300:08:56,480 --> 00:09:02,052caused by behavior, particularlybehavior in terms of overeating11400:09:02,052 --> 00:09:08,912? The reality is we know that a significant part of diabetes, or11500:09:08,912 --> 00:09:12,058a significant percentage of individuals who have diabetes, 11600:09:12,519 --> 00:09:17,336have it purely from genetics, purely from their genes. We even11700:09:17,336 --> 00:09:22,559know some of the genes that cause it. Capn10 is one of the 11800:09:22,580 --> 00:09:30,096genes that's been confirmed to cause type 2 diabetes. Tcf-l 11900:09:30,618 --> 00:09:37,307TCF-7L2 is a protein coding genethat has the strongest link to 12000:09:37,347 --> 00:09:42,317type 2 diabetes across all racial groups. So my point is 12100:09:43,058 --> 00:09:48,631the genes, or your genetic makeup, is a major cause, and 12200:09:48,692 --> 00:09:52,576many times the only cause, of diabetes in some patients, and 12300:09:52,596 --> 00:09:56,519we'll expand about this a bit more. So this changes the 12400:09:56,558 --> 00:10:00,168paradigm, if you will, of a lot of individuals that say no, no, 12500:10:00,315 --> 00:10:03,697no, no, no, don't blame this on your genes, you just need to 12600:10:03,738 --> 00:10:08,303have better habits, you just need to improve your behavior. 12700:10:09,014 --> 00:10:12,144Well, the reality is that some people do have it just because 12800:10:12,183 --> 00:10:14,039of their genes. They have nothing to do with their 12900:10:14,059 --> 00:10:17,076behavior, they have it because of their genes And that's a 13000:10:17,136 --> 00:10:20,720scientific fact. And remember, health care grows in terms of 13100:10:20,840 --> 00:10:24,677knowledge and scope and intelligence, and this is one of13200:10:24,677 --> 00:10:28,525the things that we have learnedover time over the last 50 13300:10:28,586 --> 00:10:33,515years that we did not know 50 years ago. In accordance with 13400:10:33,556 --> 00:10:40,607that, we physicians 50 years ago, many physicians used to do 13500:10:40,769 --> 00:10:47,304everything. I can remember the general practitioners who used 13600:10:47,325 --> 00:10:51,639to deliver babies, and some would do some surgeries, and 13700:10:51,700 --> 00:10:55,056then time progressed and then there were surgeons who did the 13800:10:55,116 --> 00:10:57,845surgery and general practitioners didn't do surgery,13900:10:57,845 --> 00:11:02,423and then time progressed and there were OBGYN specialists who14000:11:02,423 --> 00:11:06,758delivered babies. The obstetricians and the general 14100:11:06,778 --> 00:11:10,457practitioners didn't deliver thebabies. And so my point is that14200:11:10,457 --> 00:11:16,234, over time, as health care continues to mature and grow and14300:11:16,234 --> 00:11:19,301become more intelligent and become more effective. 14400:11:21,326 --> 00:11:26,283Specialists develop, and so is the case in terms of obesity and14500:11:26,283 --> 00:11:31,178obesity that may be related to diabetes. Dr Fatima Stanford is 14600:11:31,559 --> 00:11:36,268a Harvard graduate and now Harvard professor in a specialty14700:11:36,268 --> 00:11:41,044called Obesity Medicine, which is a relatively new specialty. 14800:11:42,034 --> 00:11:44,923Most of us, as physicians, have treated patients who were obese,14900:11:44,923 --> 00:11:48,062and usually we gave the familiar mantra diet and 15000:11:48,123 --> 00:11:51,722exercise. Well, the reality is that doesn't work for everybody,15100:11:51,722 --> 00:11:56,918and that's just the honest truth, and so one of the things 15200:11:56,977 --> 00:12:02,027that's important is that we not beat up on patients 15300:12:02,106 --> 00:12:07,023metaphorically in terms of telling them well, you just need15400:12:07,023 --> 00:12:11,405to do better In situations where it does not matter what 15500:12:11,446 --> 00:12:14,659they do, particularly if they have a genetic reason for having15600:12:14,659 --> 00:12:18,773type 2 diabetes, but instead focus on the root cause for that15700:12:18,773 --> 00:12:22,783individual patient and treat them so they can live long and 15800:12:22,802 --> 00:12:27,625thrive. One of the issues that has also come up along the same 15900:12:27,725 --> 00:12:32,181lines is the body mass index hasbeen a index that's been around16000:12:32,181 --> 00:12:36,135for years, that we have used todetermine who is overweight and16100:12:36,135 --> 00:12:40,664who is underweight, or who is obese, who is not obese or 16200:12:40,705 --> 00:12:44,442morbidly obese, and the AmericanMedical Association just 16300:12:44,543 --> 00:12:49,182recently came out with a ruling,and recently in terms of June 16400:12:49,201 --> 00:12:54,461of 2023. And, in essence, what it says is that the American 16500:12:54,522 --> 00:12:57,397Medical Association has adopted a policy that encourages 16600:12:57,778 --> 00:13:02,892clinicians to reduce their focuson body mass index and health 16700:13:02,951 --> 00:13:07,020assessments, stating that the measurement is based on racially16800:13:07,020 --> 00:13:11,556exclusive data. That has causedharm. What does that mean? That16900:13:11,556 --> 00:13:15,509means that when this particularindex was devised and developed17000:13:15,509 --> 00:13:20,342, the individuals who were in the experimental group did not 17100:13:20,462 --> 00:13:25,274include racial minorities. Consequently, the outcome or the17200:13:25,274 --> 00:13:30,785results or the recommendations may not be most beneficial to 17300:13:30,826 --> 00:13:35,123those racial minorities, even though it may benefit a separate17400:13:35,123 --> 00:13:39,336racial majority. And so, to sayit another way, if you want to 17500:13:39,375 --> 00:13:43,845have something that benefits all370 plus million people in the 17600:13:43,924 --> 00:13:47,337United States of America, you'vegot to make sure that every 17700:13:47,418 --> 00:13:52,629particular ethnic group within that 370 million is represented 17800:13:52,815 --> 00:13:57,842in your study, so that you make sure that the needs and the 17900:13:57,984 --> 00:14:04,158individual specificities of the certain racial groups are 18000:14:04,238 --> 00:14:07,725represented, so that your outcomes can be beneficial to 18100:14:07,765 --> 00:14:11,082them also. So, in essence, the American Medical Association, 18200:14:11,123 --> 00:14:15,616which is the main body that setsup rules and regulations for 18300:14:15,697 --> 00:14:21,667repositions, recognizes the historical harm that the base 18400:14:22,528 --> 00:14:26,740metabolic body mass index has done and states that the metric 18500:14:26,780 --> 00:14:32,296has been used for racist exclusion And again meaning that18600:14:32,296 --> 00:14:39,408the data has been used in some instances to be more detrimental18700:14:39,408 --> 00:14:44,124to certain individuals in certain ethnic groups. That has 18800:14:44,163 --> 00:14:49,375been contraindicated. That has caused challenges and prevented 18900:14:49,416 --> 00:14:55,288those individuals from achievinghealthy, wealthy and wise 19000:14:56,552 --> 00:15:00,922existence, and so we want to correct. That is our point And 19100:15:00,942 --> 00:15:05,133this all boils down to the wholeissues. Is obesity and or 19200:15:05,192 --> 00:15:10,605diabetes caused by bad behavior or by other things? And the 19300:15:10,644 --> 00:15:13,956point we're making in the point I want to make, summarize at 19400:15:13,996 --> 00:15:17,905this point is this caused by a number of other things, And one 19500:15:17,946 --> 00:15:23,605of those other things is genetics is in your genes, and 19600:15:23,625 --> 00:15:28,375when it's in your genes, it doesnot matter what you do in terms19700:15:28,375 --> 00:15:35,066of causing you to get it or notget it. Okay, and because many 19800:15:35,125 --> 00:15:39,321times those of us in healthcare have mainly emphasized the 19900:15:39,360 --> 00:15:43,094behavior, part of it, saying things like well, you just have 20000:15:43,134 --> 00:15:46,201to be tough enough. Well, you just have to be stronger, you 20100:15:46,240 --> 00:15:49,717got to try harder When patients have been saying, dr, i've been 20200:15:49,857 --> 00:15:52,687dieting and I have been exercising, but I'm still 20300:15:52,746 --> 00:15:56,600gaining weight, and instead of believing them and coming up 20400:15:56,620 --> 00:16:00,115with different alternatives to manage them, we many times have 20500:16:00,254 --> 00:16:06,144sort of pushed those patients even more, to no positive 20600:16:06,184 --> 00:16:10,798benefit. And so now we have learned better And, as our past 20700:16:10,859 --> 00:16:13,208use to teachers, when you learn better, then you need to do 20800:16:13,249 --> 00:16:16,960better. So we in healthcare needto do better, because a lot of 20900:16:17,000 --> 00:16:21,015these patients are diabetic and or morbidly obese because of 21000:16:21,057 --> 00:16:26,149their genetic makeup, irrespective of their behavior. 21100:16:27,972 --> 00:16:30,599One of the other points that's important to keep in mind is 21200:16:31,179 --> 00:16:34,948that our country is becoming more and more and more diverse, 21300:16:35,774 --> 00:16:40,783meaning that these various ethnic groups are growing in 21400:16:40,884 --> 00:16:45,136numbers, and the fastest growingof the ethnic groups is 21500:16:45,197 --> 00:16:50,015probably Hispanic ethnic group, and so my point is that the it's21600:16:50,015 --> 00:16:53,369going to be more and more and more important that we include 21700:16:53,490 --> 00:16:56,437individuals in these various ethnic groups, along with a 21800:16:57,379 --> 00:17:02,148quite ethnic majority, to make sure that the data that we come 21900:17:02,268 --> 00:17:07,287up with to recommend treatment is truly representative and is 22000:17:07,406 --> 00:17:11,537beneficial to everybody, insteadof just a certain segments of 22100:17:11,557 --> 00:17:15,188the population. One of the otherthings that's been extremely 22200:17:15,268 --> 00:17:18,740helpful is the pharmaceutical industry has come out with 22300:17:18,800 --> 00:17:23,911amazing medication or drugs thatare now beneficial in treating 22400:17:24,391 --> 00:17:28,787diabetes more effectively and also in treating obesity more 22500:17:28,827 --> 00:17:33,220effectively, and now, with thesemedications, it allows these 22600:17:33,359 --> 00:17:38,111patients, instead of following alot of the over the counter or 22700:17:38,511 --> 00:17:43,884the media driven types of suggestions for how to live 22800:17:43,943 --> 00:17:47,891healthy. Now we have better science and we have a stronger 22900:17:47,951 --> 00:17:51,346scientific basis that allows us to be able to treat these 23000:17:51,405 --> 00:17:56,181patients more effectively and that can save their lives and 23100:17:56,221 --> 00:18:00,214cause them to have a healthy life. As a diabetic, certainly 23200:18:00,255 --> 00:18:03,826you're aware of the important things to have in your food 23300:18:03,866 --> 00:18:09,443pyramid and certainly at the bottom of your pyramid, that you23400:18:09,443 --> 00:18:13,032can eat a lot of certain vegetables and fruits and dairy 23500:18:13,073 --> 00:18:20,087products, breads, and the top ofthe pyramid is meats. I'm sorry23600:18:20,087 --> 00:18:22,993, at the top of the pyramid is sweets that you want to be 23700:18:23,034 --> 00:18:26,326careful and make sure that you don't eat a lot of sweets, but 23800:18:26,346 --> 00:18:31,328we're going to come back to the sweet part a bit later. So it is23900:18:31,328 --> 00:18:33,917important to have a very, very balanced diet if you're a 24000:18:33,938 --> 00:18:37,426diabetic and it is important to watch what you eat, and one of 24100:18:37,446 --> 00:18:41,983the simple ways that I have found to do that that works is 24200:18:42,384 --> 00:18:45,835the more color in your diet, probably the healthier your diet24300:18:45,835 --> 00:18:50,186is, and so if you have colors of green and orange and red and 24400:18:50,267 --> 00:18:55,799yellow in the foods that you eat, those foods probably tend to 24500:18:55,839 --> 00:19:00,127be more healthy than the other types of foods. Exercise, 24600:19:00,469 --> 00:19:06,126likewise, is just as important, and that one is not better than 24700:19:06,166 --> 00:19:09,817the other. You want to do them both together. You can do. You 24800:19:09,958 --> 00:19:12,585can check your blood sugar, if you're diabetic, before you 24900:19:12,645 --> 00:19:16,082exercise and then check it afteryou exercise. But I encourage 25000:19:16,102 --> 00:19:19,469you to exercise and, again, do what works for you. Now some 25100:19:19,509 --> 00:19:23,788patients run marathon, some go out and run a couple miles a 25200:19:23,848 --> 00:19:26,740week, but let's say, maybe you're not one of those folks 25300:19:26,759 --> 00:19:31,011and that's okay. Incorporate your exercise into your normal 25400:19:31,051 --> 00:19:35,122daily activity, and one of the things that I've seen patients 25500:19:35,182 --> 00:19:40,451do is, for instance, when you goto grocery shopping, instead of25600:19:40,451 --> 00:19:44,609parking your car right next to the store, park your car at the 25700:19:44,730 --> 00:19:48,843other end of the parking lot Andthen that way you get in more 25800:19:48,923 --> 00:19:53,936steps and you're exercising within your normal routine. When25900:19:53,936 --> 00:19:56,943you're in the store, when you pick up the item that you want, 26000:19:58,146 --> 00:20:01,432take five or 10 minutes and walkall the way around the store 26100:20:01,901 --> 00:20:05,387area, maybe a couple of times. Again, you can pick up another 26200:20:05,729 --> 00:20:10,787four or five hundred steps. Thisis exercise. So the content of 26300:20:10,826 --> 00:20:14,382the exercise the location of theleg exercise is not is not 26400:20:14,442 --> 00:20:18,075important. The important thing is that you do it. So make it 26500:20:18,276 --> 00:20:21,406easier yourself, but just incorporate it into your normal 26600:20:21,446 --> 00:20:24,880routine And then that way you'remore likely as compared to 26700:20:24,900 --> 00:20:27,946going to a gym. There's nothing wrong with going to a gym, but 26800:20:27,988 --> 00:20:31,923that takes time and effort and money. But do those things that 26900:20:31,983 --> 00:20:34,150work for you and you'll find that that'll be much more 27000:20:34,190 --> 00:20:37,290efficient and allow you to do the things that you need to do. 27100:20:37,972 --> 00:20:40,542And, of course, we are familiar with the complications of 27200:20:40,583 --> 00:20:44,595diabetes, and these complications can include things27300:20:44,595 --> 00:20:49,786like stroke or other cerebral vascular disease, eye damage, 27400:20:50,106 --> 00:20:53,773poor eyesight Diabetes is one ofthe leading causes of blindness27500:20:53,773 --> 00:21:00,288in this country Heart disease, kidney disease, neuropathy, 27600:21:00,630 --> 00:21:07,786nerve pain and foot disease Whenyou are diabetic. There are 27700:21:07,885 --> 00:21:11,443four important stages of your diabetes. One first stage is 27800:21:11,463 --> 00:21:14,577when you're first diagnosed. Fora number of individuals again 27900:21:14,617 --> 00:21:18,146we're talking about adult onset diabetes This may be in your 40s28000:21:18,146 --> 00:21:21,580, the 50s or 60s. That may be when you're first told that 28100:21:21,621 --> 00:21:25,748you're diabetic. Or you may havebeen told that you're 28200:21:25,808 --> 00:21:30,104pre-diabetic, meaning that your HV A1C that's the blood test 28300:21:30,424 --> 00:21:33,837that measures. Your blood glucose level is high, but it's 28400:21:33,917 --> 00:21:38,007not in the diabetic range, and so that's an important stage 28500:21:39,509 --> 00:21:42,641when you're initially diagnosed as a diabetic. The second 28600:21:42,681 --> 00:21:47,230important stage of your diabetesis when you develop a 28700:21:47,290 --> 00:21:52,003complication of the diabetes. You develop eyesight problems or28800:21:52,003 --> 00:21:56,752eye pain or some other complications associated with 28900:21:56,772 --> 00:22:01,991diabetes. The third important step is when you're on your 29000:22:02,071 --> 00:22:05,641medication and as you're gettingyour regular blood tests, 29100:22:05,942 --> 00:22:09,347however your physician has prescribed it, she tells you 29200:22:09,907 --> 00:22:15,585that for some reason, your HV A1C is increasing, in spite of 29300:22:15,605 --> 00:22:18,471the fact that you're on medication and doing different 29400:22:18,511 --> 00:22:23,590things. And the fourth stage of your diabetes management and 29500:22:23,631 --> 00:22:28,002self-management in education is when you become older, and my 29600:22:28,063 --> 00:22:33,232definition of older is when you become 60 plus, because we know 29700:22:33,394 --> 00:22:35,906that what happens is that there's some things that just 29800:22:35,967 --> 00:22:40,602occur to us as we get older. Is this like any other system that 29900:22:40,682 --> 00:22:45,576over time, becomes less and lessefficient, and many times that 30000:22:45,636 --> 00:22:51,211combines with the diabetes that we may have and creates other 30100:22:51,271 --> 00:22:55,301additional problems. Well, let'sspecifically talk about the 30200:22:55,402 --> 00:23:01,516myths of diabetes. The first myth is diabetics can eat sugar.30300:23:01,516 --> 00:23:06,506That is not true. You can eat sugar if you are diabetic. Now 30400:23:06,625 --> 00:23:11,759you want to have it in moderate proportions, but this whole idea30500:23:11,759 --> 00:23:17,012that grandpa can eat a piece ofcandy or a donut or whatever is30600:23:17,012 --> 00:23:23,628just hogwash. You can eat sugarif you are diabetic. The second30700:23:23,628 --> 00:23:29,366myth is diabetes is caused mainly by obesity Huge myth, 30800:23:29,708 --> 00:23:35,547wrong, wrong, wrong, wrong. Not true. As we have said earlier, 30900:23:35,586 --> 00:23:40,375there are some patients who become diabetic not because they31000:23:40,375 --> 00:23:44,150are obese or overweight. They become diabetic because it was 31100:23:44,210 --> 00:23:50,832passed down to them in their genes. Okay, so obesity can be a31200:23:50,832 --> 00:23:55,104contributing factor to diabetes, just like stress can be a 31300:23:55,163 --> 00:24:00,272contributing factor to diabetes,or poor exercise can be a 31400:24:00,313 --> 00:24:07,133contributing factor to diabetes,and genetics or genes can cause31500:24:07,133 --> 00:24:12,913diabetes. Another myth is that you are too skinny to be a 31600:24:12,973 --> 00:24:17,872diabetic Not true. Again, as we've said before, you can be 31700:24:17,951 --> 00:24:23,665skinny and still develop adult onset diabetes, because maybe 31800:24:23,705 --> 00:24:27,734you're diabetic, because you inherited it from your parents 31900:24:27,775 --> 00:24:31,971and grandparents and the parts of your family tree, or there 32000:24:32,011 --> 00:24:35,990may be other factors. But my point is this whole idea and if 32100:24:36,010 --> 00:24:40,367there's anything you remember from this discussion today, is 32200:24:40,428 --> 00:24:45,865that obesity is not the main cause of diabetes. It is not the32300:24:45,865 --> 00:24:51,410only cause related to diabetes.It is a contributing cause of 32400:24:51,430 --> 00:24:56,426diabetes, like three or four other things. Another myth is 32500:24:56,507 --> 00:25:00,931you're too young to have diabetes. You can have diabetes 32600:25:00,990 --> 00:25:04,611at an early age And I'm talking about you can have type 1 32700:25:04,651 --> 00:25:08,826diabetes, which you're born with. This discussion is not 32800:25:08,866 --> 00:25:12,776primarily on type 1 diabetes, but the difference, just very 32900:25:12,816 --> 00:25:16,914quickly, is that type 1 diabeticpatients do not have insulin, 33000:25:17,325 --> 00:25:22,205so they have to take insulin from the time of birth. But most33100:25:22,205 --> 00:25:25,272of our purposes today we're talking about adult onset 33200:25:25,854 --> 00:25:32,032diabetes. Another myth is it's possible to just have a little 33300:25:32,073 --> 00:25:36,708diabetes or a touch of diabetes.That is not true. Either you're33400:25:36,708 --> 00:25:40,096diabetic or you're not diabetic. It's like being pregnant 33500:25:40,244 --> 00:25:42,527Either you're pregnant or you'renot pregnant. You can't be a 33600:25:42,606 --> 00:25:47,566little pregnant or just have a touch of pregnancy. Diabetes is 33700:25:47,586 --> 00:25:52,666exactly the same Either you haveit or you don't. Now, to avoid 33800:25:52,708 --> 00:25:55,753confusion, there may be some of these physicians who abuse the 33900:25:55,794 --> 00:26:01,270term pre-diabetic, and again, that's where your HB A1C is 34000:26:01,371 --> 00:26:05,898increasing, but it is not yet inthe range of being diagnosed as34100:26:05,898 --> 00:26:09,234diabetes And a number of physicians will many times try 34200:26:09,255 --> 00:26:12,767to have patients, will try to intervene with patients at that 34300:26:12,827 --> 00:26:17,597time to start doing some things that may very well help them to 34400:26:18,144 --> 00:26:22,387mitigate the whole possibility of diabetes. And again, these 34500:26:22,448 --> 00:26:26,135are the ones where it's not genetically inherited, or maybe 34600:26:26,155 --> 00:26:31,170the majority who are not genetically inherited. Okay, one34700:26:31,170 --> 00:26:33,878of the other areas that's important to mention before we 34800:26:33,919 --> 00:26:38,644finish is that you can't have remission of your diabetes, and 34900:26:38,664 --> 00:26:47,137I define remission is where yourHB A1C is, say, 6.5 or 6.8 or 735000:26:47,137 --> 00:26:52,451. And some things are done and those things that are done can 35100:26:53,873 --> 00:26:58,967help you to lower your HB A1C. That is possible. And in the 35200:26:59,008 --> 00:27:01,637more extreme case, and these individuals who are morbidly 35300:27:01,719 --> 00:27:08,275obese and who have elected to have gastric bypass surgery or 35400:27:08,335 --> 00:27:13,646some type of surgical procedure to mitigate their morbid obesity35500:27:13,646 --> 00:27:17,835, some studies have shown that many times they have been able 35600:27:17,894 --> 00:27:24,233to have their HB A1C blood test lowered, the range of the HB A1C35700:27:24,233 --> 00:27:28,509lowered into the non-diabetic range. The diabetes doesn't go 35800:27:28,568 --> 00:27:33,364away, but we just like to say it's dormant in terms of the 35900:27:33,443 --> 00:27:37,506negative effects or damage it can do to the body. But my point36000:27:37,506 --> 00:27:43,457is that's good news because there is hope that by doing some36100:27:43,457 --> 00:27:47,731of the right things or having some things happen, the serious 36200:27:47,751 --> 00:27:52,026problems can be mitigated in some patients. Disease, among 36300:27:52,125 --> 00:27:55,973other types of problems, is probably one of the most 36400:27:56,414 --> 00:28:01,535expensive forms of healthcare orproblems medically that you can36500:28:01,535 --> 00:28:05,027have in the country, because itspreads and involves so many 36600:28:05,086 --> 00:28:08,761other organs and so many other organ systems, because blood 36700:28:08,781 --> 00:28:11,170sugar goes all over the body andit's used by all different 36800:28:11,191 --> 00:28:14,810parts of the body, so whenever there's a problem with the 36900:28:14,851 --> 00:28:18,286initial source of the diabetes, it can then affect those other 37000:28:18,405 --> 00:28:23,173organs that we talked about blindness, heart disease, stroke37100:28:23,173 --> 00:28:29,863, etc. Etc. So, in summary, diabetes is a chronic condition 37200:28:30,443 --> 00:28:35,198and we physicians do not understand 100% the pathology of37300:28:35,198 --> 00:28:39,781it. However, we do know that there are many causes of 37400:28:39,821 --> 00:28:45,179diabetes. Obesity is a contributing factor of diabetes,37500:28:45,179 --> 00:28:52,140and we do know that diabetes can be inherited, so that things37600:28:52,140 --> 00:28:55,872that we've used four to 50 years ago to evaluate patients 37700:28:55,912 --> 00:28:59,961with diabetes or obesity or other types of problems, many of37800:28:59,961 --> 00:29:04,681those things are no longer appropriate in the 2023 area, 37900:29:05,775 --> 00:29:09,183and so we have to continue to stay abreast of the most recent 38000:29:09,203 --> 00:29:13,959developments in terms of what's best for our patients. Also, we 38100:29:14,039 --> 00:29:17,611learned that there are a number of myths about diabetes, like 38200:29:17,932 --> 00:29:22,218diabetes can eat sugar, which isa myth. Like skinning people 38300:29:22,258 --> 00:29:27,400don't get diabetes, which is a myth. Like obesity is the main 38400:29:27,480 --> 00:29:31,396cause of diabetes, which is a myth. And finally, what we've 38500:29:31,436 --> 00:29:35,686learned is that diabetes can go into remission in some patients,38600:29:35,686 --> 00:29:41,205and I've met these patients recently in my own experience. 38700:29:42,434 --> 00:29:47,115So it's an important problem. It's an important issue And, 38800:29:47,135 --> 00:29:50,538again, we believe knowledge is power, but the more you know, 38900:29:51,522 --> 00:29:54,614the more you are able to take care of your health and to take 39000:29:54,634 --> 00:29:58,984care of the health of those around you and the ones that you39100:29:58,984 --> 00:30:03,715care about. My basic principlesGod is in charge. I am a 39200:30:03,756 --> 00:30:08,566position of faith and I believe very strongly that God has been 39300:30:09,166 --> 00:30:15,263the main reason why my life has been as well as it has and why 39400:30:15,284 --> 00:30:21,195I'm happy and healthy and wise. I don't have any bad days. I 39500:30:21,215 --> 00:30:26,376decided many years ago that I'd had enough bad days, so I 39600:30:26,417 --> 00:30:31,317decided that my days would be good days or great days. So I 39700:30:31,377 --> 00:30:36,143have no more bad days. I suggestto you that if I can eliminate 39800:30:36,182 --> 00:30:40,855my bad days, you can eliminate your bad days also. Number three39900:30:40,855 --> 00:30:43,803basic principle don't sweat thesmall stuff, and most stuff is 40000:30:43,863 --> 00:30:48,587small. I have learned that most times when things happen that 40100:30:48,628 --> 00:30:51,619they are really not that big a deal or not as big a deal as I 40200:30:51,680 --> 00:30:54,738think they are. So I have learned to put things in 40300:30:54,798 --> 00:31:00,438perspective more and to go more slowly and getting upset and 40400:31:00,617 --> 00:31:07,142angry about a situation. This basic principle forgiveness is 40500:31:07,362 --> 00:31:12,582therapy, that when someone does something to you that you can 40600:31:12,622 --> 00:31:17,337perceive to be negative. Forgivethem immediately. It does not 40700:31:17,397 --> 00:31:21,019matter who's right or wrong. Just by forgiving them, you 40800:31:21,461 --> 00:31:26,355yourself will be empowered and, more importantly, you let it go 40900:31:26,896 --> 00:31:31,566and it does not cause an amount of stress on you and things that41000:31:31,566 --> 00:31:34,642you have to deal with. My finalbasic principle is that 41100:31:34,722 --> 00:31:37,676everything is a relationship andrelationships that are based on41200:31:37,676 --> 00:31:41,395mutual respect, mutual trust and good communication. If you 41300:31:41,435 --> 00:31:43,923have those three things, you have a good relationship, 41400:31:44,304 --> 00:31:47,058whether it's husband and wife, boyfriend, girlfriend, parent, 41500:31:47,118 --> 00:31:52,236child, work in relationship, brother, sister. It's important 41600:31:52,276 --> 00:31:57,656in terms of minimizing stress inour lives, and the last words 41700:31:57,676 --> 00:32:01,384that I want to leave with you bethe change you want to see in 41800:32:01,404 --> 00:32:01,826the world. 41900:32:06,643 --> 00:32:10,115Speaker 1: Thank you, and have awonderful day. Thanks for 42000:32:10,155 --> 00:32:12,625listening to the Healthy, wealthy and Wise podcast with Dr42100:32:12,625 --> 00:32:17,384William Choctaw, mdjd. We hope you enjoyed this episode and, if42200:32:17,384 --> 00:32:20,435you found it helpful, you can support and subscribe to the 42300:32:20,476 --> 00:32:24,684podcast on your favorite podcastplatform with the key words Dr 42400:32:24,724 --> 00:32:28,863William Choctaw, click on the support the show and you've got 42500:32:28,923 --> 00:32:33,387it. This will also help ensure that you don't miss any future 42600:32:33,468 --> 00:32:36,679episodes, and then share this podcast with your family, 42700:32:36,898 --> 00:32:41,315friends and or your co-workers. They'll be glad you did. Until 42800:32:41,454 --> 00:32:45,317next time, live your best possible life the best possible 42900:32:45,357 --> 00:32:45,577way.