Participants: Agatha Thrash, Don Miller, Wynn Horsely
Series Code: HYTH
Program Code: HYTH000175
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00:01 Hello! I'm Agatha Thrash, a staff physician at
00:04 Uchee Pines Institute, a place where we see a lot 00:08 of people with diabetes. 00:10 In fact I think probably my favorite disease to treat 00:14 is diabetes. 00:16 It's very common, it also has a lot of ramifications and 00:21 interlacing with other types of diseases, 00:23 and another thing is that it responds so well to the 00:27 very simplest of treatment. 00:29 We hope you will join us for this discussion on diabetes 00:33 and related issues. 00:55 Welcome to: 00:57 with Dr. Agatha Thrash of Uchee Pines Institute, 01:00 and now here is your host, Dr. Thrash. 01:03 Having had diabetes in my family it's always been 01:08 a disease that interests me. 01:10 But as I have practiced medicine, 01:13 the longer I have been in medicine, the more I realize 01:16 that this disease is very wide spread. 01:21 A lot of times people don't know that they have it, 01:24 in fact we have people who have had a large number of years 01:30 of experience with diabetes before it was ever made 01:33 by the laboratory. 01:34 So we have things that we can say that the laboratory says 01:39 they have diabetes so we will look back in the patient's 01:42 chart and see yes, you've had diabetes for many many years. 01:47 The major way of making the diagnosis of diabetes is by 01:52 the laboratory tests. 01:53 We can get a good idea about the person's metabolism of 02:00 sugar and the whole metabolic process that has to do with 02:06 dealing with sugar, salt, fats, proteins, and all of these 02:14 are involved in the diabetic syndrome. 02:17 We can get a lot of idea about this by the patient's history, 02:20 but to actually make the diagnosis, we need to have 02:25 laboratory testing, so I would like to show you 02:28 what we see with the laboratory. 02:30 Here you see a graph that shows the time on the bottom, 02:36 and the level of the blood sugar along the left side. 02:41 Notice that the blood sugar starts at 70 in this person, 02:46 and at one hour it is up to about 130, then at 02:53 one and a half hours it has come down a little bit, 02:55 then at two hours it's just slightly below where it started, 03:00 maybe 69, just a little below where it started, 03:05 now that's normal, or essentially normal. 03:09 There are a little variations on this, but essentially 03:11 that's normal. 03:12 Now lets see what a mild diabetic would be, 03:16 it starts at about 90- 95, maybe 100, then goes up 03:22 rather sharply and higher than it does in the normal 03:25 and does not come back down to normal in two hours. 03:29 Now lets take a person who is a severe diabetic, 03:32 it starts at a higher level, it can start at 110, 140, 03:37 it can even be at 200, and then as you can see it is 03:41 almost going off the graph over there at 250, 03:44 it can go even higher than that, 3, 4, 500. 03:49 At two hours it isn't anywhere near back down to normal, 03:54 it isn't even turning downward. 03:56 Sometimes people will keep this kind of curve 03:59 much of their lives, the higher the blood sugar is, 04:04 the greater the likelihood the person is to be producing 04:08 too much insulin, and we will talk with you about 04:11 what too much insulin does for you. 04:13 Before that I would like to show you one of those things 04:16 that we use to treat diabetics with and that is diet. 04:20 In the diet we promote a purely vegetarian diet, 04:24 and one might think, would I be able to do a vegetarian 04:29 diet and I have heard that it takes spending hours every day 04:33 in the kitchen to produce a vegetarian diet 04:37 and I will tell you to both of those, yes you can do 04:39 a vegetarian diet, and no it does not take many many hours 04:47 I have asked Lidia Seda who is an excellent cook to show... 04:52 Oh, this looks so good and it smells so good Lidia. 04:56 This is Lidia Seda who is one of my colleagues at Uchee Pines, 05:01 umm! What is the name of this roast, it smells so good? 05:05 - Cashew Nut Loaf - Cashew Nut Loaf 05:08 What are the major ingredients? 05:10 Rice, cashews, it has different types of seasonings. 05:15 - I think I can smell a little sage is it? 05:18 - Sage, it has Thyme, a little Oregano, and it's real simple, 05:23 you just get all the ingredients together, 05:24 place it in a loaf pan, I decided to use a round loaf pan 05:29 instead of a square one, and place it in the oven and bake it 05:32 for about 30- 40 minutes. 05:34 - My, that's pretty and it has a little bit of a meat like 05:42 texture, not that I require that not having eaten meat 05:45 in 35 years, nearly 40, so I don't think it would 05:51 appeal to me, but for people who appreciate meat 05:55 it would certainly look somewhat like it. 05:58 - I tried this about a week ago and it's quite tasty. 06:02 - Was it? Do you have a recipe for that? 06:04 Yes, yes we do, and you can actually find his recipe 06:08 in the book, Eat For Strength, this is one of the places 06:13 you can find this recipe, Cashew Nut Loaf. 06:17 - I've seen that book before. - I'm sure you have Dr. Agatha! 06:19 - Well, I certainly hope I get to eat with you when you eat 06:26 this roast. - I'm sure you will! 06:30 The other thing I wanted to share since we are talking 06:32 about diabetes, and how individual who are diabetic 06:36 can be helped with this situation, one important thing 06:39 is Stevia. 06:41 Stevia has been used in the Orient for many many years 06:45 for diabetics in place of using a sweetener, 06:50 it has no calories and they are actually finding that insulin 06:54 can actually help the pancreas increase it's insulin capacity 06:59 because it works on the Beta Cells of the pancreas so 07:02 it's no calorie, and also it can help stimulate the pancreas 07:05 to produce more insulin. 07:07 There are many many different types of cookbooks out on the 07:10 market that have recipes with Stevia that you can find 07:15 in any heath food store that they can use. 07:18 - Well Stevia is from a plant and it's a natural product, 07:22 it has a delightful flavor if you don't use to much, 07:26 which is the same way with honey, if you don't use to much, 07:29 and it tastes good in a recipe so we are accustomed to not 07:33 using too much, so I like the fact that Stevia 07:38 can be used in sweet dishes. 07:41 - Now what about the cashews, I know they are very high 07:45 in fat, does that bother a diabetic? 07:48 - Overall, no it will not bother a diabetic, the one nice thing 07:52 about vegetarian meals is that they are high in fiber 07:56 and diabetic will do well if they have meals that are 07:59 high in fiber. 08:00 Fiber acts like a time release capsule allowing that the 08:04 carbohydrates that will be converted into sugars 08:07 so that their blood can convert that into energy, 08:10 it releases it slowly, at a steady pace and not at 08:14 a rapid pace. 08:16 - Ok, so the body because of the fiber in the food, like in this 08:22 nut roast, the fiber in the food makes it so that the body is 08:28 more slow in digesting the food, meaning that the 08:33 sugar level is going to rise more slowly. 08:36 - Exactly! 08:37 - And that does not put the burden on the pancreas 08:39 that it would if it rose very high as we saw on the graph. 08:43 - Exactly, and that's one nice thing about a vegetarian diet 08:46 besides the fact that it's simple just with a little 08:49 preparation and it's very tasty. 08:51 - How long did you spend making this dish? 08:54 - This dish actually within 40 minutes I had all the 08:57 ingredients, which in 40 minutes, actually about 09:02 30 minutes I had everything done, it was just a matter of 09:04 putting everything together, put it in the oven, 09:06 and then I went about my business doing what I needed 09:08 to do and then I had my cashew nut loaf. 09:10 - I want to ask you what you would think about making 09:15 three of these at one time, it might increase your cook time 09:19 maybe 5- 10 minutes, to make three of these at one time and 09:22 put two of them in the freezer. 09:24 - It freezes well, - uh huh, 09:26 - it really does! - Ok, so you can eat it 09:28 two weeks later. - Exactly! 09:30 - So if you want to plan ahead of time for your guests 09:32 or get this ahead of time for Sabbath, you just take it out 09:37 of the freezer and let it thaw when you go to church.. Exactly! 09:41 and when you come back it is ready to pop into the oven 09:44 and heat for 30- 40 minutes and it is ready for you to eat, 09:49 that sounds good. 09:51 I think every diabetic should understand about the 09:54 vegetarian diet so that when you are able to produce this 10:00 for yourself, you can see that there are advantages 10:03 to your blood sugar after the body becomes accustomed 10:06 to it you will do much better. 10:08 Now I have asked Dr. Wynn Hoarsly 10:10 who is one of our staff physicians at 10:12 Uchee Pines who deals with diabetes a lot to join me 10:15 in this... 10:16 Thank you for coming Dr. Wynn Horsley and together 10:21 we are going to tell you a few things about diabetes. 10:24 Dr. Horsley has had quite a lot of experience with diabetes 10:28 of course since we treat so many diabetics at Uchee Pines 10:31 and I would like to know something about how you 10:34 approach this whole problem, how you think about it, 10:36 how you explain it to the patient and that kind of thing. 10:39 First of all I like approaching it just because of what you 10:44 said is exactly my experience, it's a rather major disease, 10:49 but you can get such excellent results in many cases. 10:54 - It is such a major disease that I describe it to patients 10:58 as a process of acceleration of the aging process. 11:03 - Yes, and of the worst killers of the aging process, 11:06 like arteriosclerosis, and heart attacks, 11:08 it accelerates that whole badness. 11:13 - Joint problems, kidney problems, eye problems, 11:17 and neuropathy, and all sorts of things are worse and start 11:23 getting complications. 11:25 - When I get into it with the patients we make a list 11:29 of the complications that diabetes gives, 11:31 who cares about a high blood sugar if it doesn't cause 11:34 any trouble. - That's right. 11:36 - One thing that I think is worth while early along is 11:42 to see just what is it that's going on at a cellular level, 11:46 so I would like to take a moment to look at the 11:50 board here. - Very good, I see you've got 11:53 a diagram there. - Yeah, this is my attempt 11:55 of sketching a cell. - Looks good! 11:58 - Here is the nucleus with all that library of information 12:03 and here is a blood vessel going by and you could take this 12:08 as even one of the tiny arterioles that finally 12:12 narrows down to a capillary where the red blood cells 12:15 are going through single file, it's so narrow. 12:18 Now of course this blood is carrying all the nutrients 12:23 to the cells, and the one that concerns us right now is the 12:25 glucose. - Uhhuh 12:26 - This glucose will come from the blood then and be out here 12:35 outside the cell, ready to go in. 12:37 Most people I believe that are not in health work 12:43 professionally, may not have done the studies about how 12:48 unique cells are. 12:49 They really are like a fortified castle, they don't let just 12:55 anything, even in the tissue right around here in the body 12:58 just automatically go in. 12:59 The environment is extremely different outside here, 13:02 here's the chemical symbols for salt, we all know that 13:06 blood tastes salty, inside the cell there is hardly 13:09 any of the sodium it makes for salt, instead you've got 13:12 potassium, I'm going to give you the chemical symbol K. 13:15 Now the cell membrane, the outside of the cell is 13:19 constantly keeping the sodium out and pumping in the potassium 13:24 well the glucose that is coming here is the fuel 13:31 of the body, the cells need it, but even glucose does not 13:35 have automatic entry into the cell. 13:36 The only way that glucose can get in is through a 13:42 special mechanism, and I like to compare it to a locked door 13:47 that even glucose can not go through this door 13:50 with this lock on it here, unless you have a key to 13:54 unlock it, and the key is insulin. 13:58 Insulin is the substance in our body that unlocks the cells 14:03 so that the glucose can pass inside, the insulin is produced 14:06 in the pancreas, one or our abdominal organs. 14:08 If you didn't have enough insulin then you can't get 14:16 that glucose getting into the cell like it should 14:18 so you get the glucose piling up outside, and the cell 14:24 is starving. 14:25 I've heard diabetes described as starvation in the midst 14:29 of plenty and I think that is a very apt description. 14:31 This very situation of not having enough insulin 14:39 is one kind of diabetes that now days they generally 14:43 refer to diabetes... by the was the full name is 14:46 diabetes mellitus, the sweet kind of diabetes where your 14:49 blood sugar is to high. 14:51 Diabetes mellitus we will abbreviate this way, Type I 14:55 now this is not the majority of diabetics, 14:58 they used to call this juvenile diabetes and I would say 15:02 10% maybe even less of diabetics are completely what we would 15:07 call type I, where there is insufficient insulin. 15:12 By the way, when we do lab testing routinely, 15:16 I think people certainly anyone who is diabetic knows 15:19 how you keep checking for glucose, but now with advances 15:24 in lab technology they can even check for insulin level. 15:27 It is a little more complicated and a lot more expensive. 15:30 - Oh yes! Absolutely! But a real interest here 15:33 because there really is what's the most common 15:37 kind of diabetes, the situation is not this one. 15:41 You do have the problem of glucose building up here 15:46 a person has high blood sugar so yes they are diabetic 15:48 and the cells aren't getting enough glucose in, 15:53 but when they check on the amount of insulin 15:56 you've got plenty, in fact it's often more 15:59 than the normal amount of insulin. 16:01 This would be the most common kind of diabetes that's 16:06 diabetes Mellitus II, what in the past has been called 16:11 adult onset diabetes. 16:13 - Why isn't it still called adult type? 16:15 - Well, in fact I just heard an endocrinologist tell me 16:19 that a friend of his is treating a number of adolescents 16:23 who have type II diabetes, which seems... 16:26 - That would be 11, 12, 13 year old. 16:28 - People at that age, it's sad to see that happening but it is. 16:34 Another reason for not using the terms juvenile and 16:39 adult onset is that as a person goes on with 16:44 type II diabetes, producing extra insulin, it can exhaust 16:48 the pancreas and start turning into Type I. 16:53 Now those type I diabetics of course are older people 16:57 who have already gone through a whole length of time, "years" 17:00 of being type II, so these are not juveniles, 17:03 so again the term juvenile doesn't really fit. 17:06 It's worth mentioning here about this problem of insulin 17:13 resistance which characterizes Type II diabetes. 17:17 They have lots of insulin, lots of the key, 17:20 but it doesn't seem to be opening the lock, 17:22 so we could think of this as the lock being rusty, 17:25 and we are not able to make the key function. 17:28 - The cell won't let the insulin work. 17:31 - That's right, so in medical lingo the rusty lock is just 17:36 called insulin resistance. 17:38 Now the work that we do is largely with Type II diabetes, 17:49 and I think we need to make clear in our talk here, 17:52 that we are talking to people who have Type II. 17:57 If it is Type I, you really need further evaluation 18:02 and you will need something more than just the 18:04 diet recommendations. 18:06 - You need good professional help. 18:07 - Absolutely! 18:08 - Well I am always very interested in Type II diabetes, 18:13 because that is the one that is so responsive 18:16 to the things that we can do in the home. 18:19 Exercising, diet, regularity, drinking plenty of water, 18:25 all of those things. 18:26 - The most dramatic results of all that we see at 18:33 Uchee Pines are with even one added step, and I feel 18:38 a little unsure about whether to recommend this to people 18:41 at home, it's fasting. - Yes! 18:45 I like fasting for people and anybody can fast for a day. 18:50 - Oh yes, no problem for a day, and I really don't feel bad 18:54 about telling people to try even another day, 18:57 if they want to try two, but I wouldn't recommend 18:59 more than three days... - I should say anybody 19:02 can fast because a Type I diabetic should not fast. 19:06 - That's right. - And people with gout 19:08 should not fast. 19:09 - There's another important point that we need to make here, 19:11 and that is, even if he is a Type II diabetic 19:15 and he is taking medications, if he is going to fast, 19:19 he must stop those medications. 19:20 - Tell me what do you think about the non-insulin types 19:25 of drugs that will control the blood sugar? 19:29 How do you feel about those? 19:31 - Well in my residency, we used those and we had 19:36 various problems... Those drugs, none of them 19:40 is a chemical that is a part of our body mechanism, 19:45 my approach is do all you can without doing that. 19:53 If the diabetes is so bad that it really needs drug therapy 20:00 then the drug to go to is insulin, which is the one 20:03 that God made, and the one that works so dramatically. 20:06 - Yes and even though the insulin that we use may be from 20:10 an animal, or from another human, or something that 20:14 has been manufactured, it is still the very best one 20:18 that we can use for a person with diabetes. 20:21 I have a report here on caffeine and how it is linked to 20:25 poor pancreatic function. 20:27 With caffeine in anybody who is just having the 20:35 family background of an individual who is going to get 20:39 diabetes, they already have an appointment from their 20:42 family genetics. 20:44 Then if they take coffee, tea, or colas, or a lot of chocolate, 20:52 that increases the burden on the pancreas because 20:54 the pancreas does not work well in the presence 20:57 of caffeine and there are abnormalities in the blood sugar 21:01 that come about merely because of the caffeine. 21:04 This then can make it so that the individual is more likely 21:09 to develop diabetes, so we could say that taking 21:14 these caffeinated drinks increases the likelihood 21:18 of your getting diabetes. 21:20 What other things do you do when you instruct patients in 21:24 diabetes, and how do you treat it? 21:27 - I was wanting to say about that caffeine, about coffee, 21:29 there is a direct effect on the liver, where all this stored 21:33 glucose, in the form that is called glycogen is released 21:39 gradually between meals, well caffeine has a direct effect 21:44 to increase that process, especially when a person 21:49 takes it with his meals. 21:50 For instance a Continental Breakfast, where people take 21:53 something quite sweet which will shoot the blood sugar up, 21:55 and then they add in coffee, you are suddenly stimulating 21:59 that liver to put out a whole lot more sugar and you will 22:02 get an awfully high sugar level. 22:05 - Yes! Now diabetics have a lot of other problems, 22:08 they not only have high blood sugar, but sometimes they have 22:12 high blood cholesterol as well. Why is that Dr. Wynn? 22:16 - You know the whole process of arteriolosclerosis is really 22:22 accelerated in diabetes and I think with the overloaded 22:30 nutritional factors of blood which are sugar, you then can, 22:37 when there is excess there it will make 22:40 excess fats, and cholesterol is one of those. 22:42 In fact the other fat, the more common type of fat 22:45 that nutritionally is called triglycerides is often very high 22:48 in diabetics. - Umhum, yes triglycerides 22:51 are high, in fact triglycerides and sugar seem to go together 22:54 almost like twins, and gout is another part of that 23:00 whole metabolic mechanism. 23:04 Gout is a problem with the metabolism of the purines, 23:10 individuals who have gout will have a build up of uric acid, 23:14 which is the end product of purine metabolism and they then 23:18 began to get deposits of crystalline material in their 23:22 joints and this is also related to it, it's a double 23:26 first cousin to diabetes. 23:29 I know also that people who have diabetes have an elevated 23:34 homocysteine level, have you been involved in 23:39 treating people for homocysteine? 23:42 - I've done some watching of that, that's one of the new 23:46 factors that is very related to cholesterol. 23:48 - Yes, a good way to treat an elevated homocysteine 23:55 is by using vitamin B-12, and vitamin B-6, 24:00 and folic acid. 24:01 Now you will notice right away that folic acid is very 24:04 likely to be present is a vegetarian diet, so individuals 24:10 who are vegetarians, especially life long, they may not have 24:15 a lot of difficulty with the folic acid, but they may have 24:20 difficulty with the vitamin B-12 so they often will need 24:24 to have it administered to them in the form of a pill. 24:29 The sublingual pills are among the best of those that 24:34 can be used because they add the salivary factor and 24:38 that brings the homocysteine level down. 24:40 I think that people who have the kind of metabolic problem 24:45 that makes it so that they are going to have diabetes 24:50 should be aware that the homocysteine level can be 24:54 elevated and they should be checked for a high 24:58 homocysteine level because that can increase their 25:01 likelihood of getting a number of other diseases such as 25:04 Alzheimer's disease, and arteriolosclerosis, and cancer, 25:14 so that we find that elevated homocysteine in a number 25:18 of other chronic diseases. 25:19 What else would you like to tell us about diabetes? 25:22 - Well, I think you mentioned exercise. 25:25 - Yes! That's my favorite treatment, I think it's 25:29 the best one that we have. 25:31 - It's really a crucial part, you should not just deal with 25:35 diet, you really need to get the person exercising. 25:39 It has two advantages, first of all if you exercise 25:45 you are burning up the fuel, you are lowering that glucose 25:47 because you are using it. 25:48 But another major advantage is that exercise seems to have 25:54 a direct affect on the problem of the rusty lock, 25:57 it decreases insulin resistance so you are getting just what 26:01 you want. - Yes, with exercise and 26:05 the diabetic condition, of course they are burning up 26:10 sugar that will be removed from the blood. 26:15 Now sometimes we find that mothers before the birth 26:21 of a child will get a type of diabetes called 26:24 Gestational diabetes. 26:25 Gestational diabetes can have some extremely high blood sugar 26:30 levels and mothers who have this kind of diabetes are very 26:35 likely to give birth to a baby overweight. 26:39 The overweight baby may be 10 pounds or more and 26:45 these are post mature babies and they are at a disadvantage 26:49 in being born, and the mother who has Gestational diabetes 26:53 is also very likely to increase her risk of getting 26:58 adult onset type of diabetes, or Type II diabetes 27:02 in the future... What else do you have to tell us 27:06 about diabetes? Do you have some other 27:08 nice things, that is such a big subject. 27:10 - It really is, we've talked about fiber already, 27:13 I think that is a crucial element an you know that 27:16 really points us to what kind of diet one has to be in. 27:19 Animal products have no fiber in the nutritional sense 27:24 and all the plant products in the natural state have fiber 27:28 so a person needs to be on a vegetarian diet. 27:31 I want to mention one food that is especially helpful 27:34 for buffering that glucose from rushing in, and that is 27:37 beans, a wonderful food for diabetics. 27:40 - Yes! Beans also have a wide variety of other things 27:46 that are so protective, not only for diabetics but for 27:49 others as well. 27:50 Well I hope that this very brief discussion 27:53 of diabetes will be a great blessing to you as well. |
Revised 2014-12-17