Why should you know about Diabetes?

This video is a transcript of the Facebook live session that was held on 25th July. The link to talk is here.

Hello! My name is Mugdha Pradhan, I am the founder and a functional nutritionist at iThrive and what we do at iThrive is we reverse chronic diseases, and by virtue of that diabetes is something that we work with, almost every single day. 

Given the fact that India is the diabetes capital of the world, it's not even surprising that almost everyone who comes to us has something going on in terms of diabetes or insulin resistance in their body. So today's session is very important to me, and I think for everyone else who is attending.

Initially, I just thought I'd talk about diabetes and then as I started researching about it, I discovered that there is a very huge link between COVID and diabetes. Well before we start, you know what I just want to run a quick poll. I just want to take you through the flow of the session and then I'll go through my story of what happened this morning.  Just hang on. So this is what we're doing today.

We have an hour with us, which is very little time to actually discuss everything that I want to talk about, but we'll go through the introduction; we'll talk about why we're discussing diabetes; why should you be learning about diabetes; we'll talk about Indians and the diabetes connection; how did we become the diabetes capital of the world. And I’ll speak about the root causes of diabetes, I'll speak of the cost of untreated diabetes what really happens when you don't treat diabetes; I  will also speak of the cost of living with diabetes; I will speak of the symptoms of undiagnosed diabetes and then we'll go to the COVID-19 and diabetes connection. And then we'll talk of how to reverse diabetes, okay so it's a lot. I've packed in as much as I could in one hour. I want to give you guys time for q&a as well.

Now, I just want to run a quick poll before we start, this is not really going to happen for Instagram people who are attending it. A lot of the fun stuff is happening on the zoom and FB live, but I’ll try and make it fun for you guys also. So a quick poll before we start off.

So one is, which language would you prefer me to speak in? And the second is just with reference to diabetes itself.  How many of you have been diagnosed with diabetes? 

Okay, so we'll wait for everyone's answers to come in.

Alright.

If there is anyone on Instagram the question I'm asking is, which language, would you prefer me to speak in English or Hindi or a mix of both?  And have you been diagnosed with diabetes? Here are two questions I'm asking so you could just give your answers there in the chat and I'll try and incorporate your ideas as well. Alright, so another 10 seconds or so then we should see our results.

A majority of you are asking for this session to be done in English. Some of you are asking for it to be in a mix of both Hindi and English which is okay. But if most of you would have told me pure Hindi then I would have been really stumped.

And have you been diagnosed with diabetes? So, there are a few people who've been diagnosed with diabetes. So I want to end the polling and we're going to get started with our session.

I'm going to share the results, so that you guys can see.

So, this is a session flow, we're going to talk all of these things and in the end, we want to come to how to reverse diabetes because if I had started a session without helping you understand how to reverse something that's there as a reversible disease then there would be no point of the session at all.

Alright.

Now here's the thing, so I'm just going to stop sharing my slides for a minute. And I'm going to look at you guys. Can you turn on your videos? I'd love to see your face. It's so much easier talking to a screen when you can see other people's faces so if you can turn on your videos. If you don't mind doing that, Please do it.

See the reason why diabetes is such a big disease is how people just think of it. You know high blood sugar;  Sugar aa gaya hai;  Mein sugar ki dawai le rahi hoon...  Those are the kind of statements, we usually hear without people really understanding the long term consequences. So Kya ho sakta hai diabetes diagnosis se, what does it mean? Does it just mean that you can't eat sweets for the rest of your life or does it have a bigger implication?

I'm going to go back to sharing the screen. So, what we have seen in our work is that diabetes as a disease has an impact on the entire body from your brain, your eyes to your skin to your kidneys to your feet. Harr jagah diabetes ka asar ho sakta hai and that is what I just want to show you in the next slide. So I'm going to go back and share my screen with you and Instagram guys I really wish I found some way of bringing my slides to you but for now I'm just sharing with the zoom in the FB live folk.

This is what I was talking about right so if you have high blood sugar levels, I'm not going to go into the technical details of how this happens because then this will be an eight-hour talk, but you could have anything from a stroke to a diabetic foot right so you could get a clot in your brain and in fact what they are seeing now is Alzheimer's.

Jo Alzheimer's disease hota hai jo hum sochte hai jo buddhe logo ko hota hai. Like now they are calling Alzheimer’s as Type- 3 diabetes, so the root causes which means whatever is causing diabetes in the first place can also cause a disease like Alzheimer's; so diabetes complications can affect the brain diabetes; it can result in heart attacks, diabetes can cause something called a peripheral artery disease which means the arteries that run through your legs. Those can get affected because of high blood sugar.  Also if your blood sugar levels are high for a long time then they also remain impacted.

There is something called diabetic retinopathy where your eyes and your vision start getting impacted so your retina, the retina in your eye that is responsible for a light response that can start getting damaged, and then you can develop cataract so your eyes can big-time get impacted by high diabetes levels. There is something called diabetic nephropathy which is the kidneys right and we have seen this at iThrive that people who have diabetes for a very long time get their kidneys impacted. So one is the blood sugar levels and the glucose that the kidney has to flush out all the time. Secondly, if you're taking diabetes medication, then the diabetes medication itself affects the kidney.

And then peripheral neuropathy so whatever happens in your eyes how your nerves start getting damaged. Similarly, even the nerves in your legs can start getting damaged by diabetes, there is a condition called diabetic foot where you know the wounds on your feet and they don't heal and it gets really gross. In fact, it's a very difficult condition for people who have to live with it.

A lot of people don't know about erectile dysfunction which is triggered by diabetes. So if you've had diabetes for long, it can impact your sex life and when we go to the impact of diabetes, we'll talk about that the emotional consequences of living with diabetes but diabetes can also cause erectile dysfunction. You know it's one single label that is ‘You have diabetes.’ Aapke sugar levels high hai but uss ek label se aapke body ka kya kya asar ho sakta hai jaanna jaruri hota hai.

It's really important that you understand that the body is one unit, you know you don't have a head separately that you can take to a neurologist so you don't have a heart separately that you could take to a cardiologist, everything is in the same body, and it's in your body so if one thing is going to get affected then the rest of the body is going to be impacted by it. That's why you should be worried about diabetes, even if the COVID-19 situation was not there.

So this is Pre-march 2020 these are all the reasons why you should be worried about diabetes, and more moving on to the next slide, which is what as an Indian as a person; who treats people in India; as a person who is working with the most number of Indians this is something that really concerns me. We'll go to the research papers here but in 2019, 30 million people were already diagnosed with diabetes and I'm not even talking off undiagnosed diabetes. I'm actually talking about people who received a diabetes diagnosis, there were 30 million people in 2019 with a diabetes diagnosis, which means all the conditions that I mentioned before, could likely happen in their body.

India has the highest number of diabetes than in any country in the world. If you look at any country, even the US, even the number of diabetes diagnoses we have in India is leading in that it's a shameful thing to be leading in. But we are the world leaders when it comes to diabetes, and we will quickly go to some papers that tell us why that is happening like why is it that Indians are more predisposed to diabetes right.

Why is it that Indians are more susceptible to diabetes right? What really is triggering it? Is it that our eating habits? 

Not really because if you look at the US; if you look at other countries, there's an equal amount of junk food being eaten. McDonald's came to the US before it came to India. KFC came there with fried food. I mean you know all these processed foods first came over there before it came to our country. So why is it that despite us having more home cooking and more eating at home kind of practice? Why do we still come up as the diabetes capital of the world?

So again you Instagram guys are going to miss out on this but here is a research paper that talks of this one of the reasons are the glycemic load, as in the how our body relates to sugar is also largely dependent with the muscle mass and Indians by genes; whatever has happened to us genetically over years by the way our bodies are structured we are smaller in stature, we don't have the kind of muscle mass than Caucasians do. Now we are adapting to a Western so you're eating the kind of food the Caucasians do without really our genes changing too much and then that metabolic load is what makes it worse for us and that's one of the reasons why Indians are leading the world in terms of diabetes.

And then there’s another paper that's talking of Asian Indians with pre diabetes they have similar skeletal muscle. We'll go to this one and a little more in detail when we talk of undiagnosed diabetes.

The third reason why India is leading in terms of diabetes numbers is we have a lot of undiagnosed diabetes cases. So, diagnose diabetes when you visit the doctor and they do the blood tests out there and then they tell you that your blood sugar levels are high and you have diabetes right so that is how diabetes gets diagnosed. 

Now, a lot of people suffer from the symptoms of diabetes without going for those tests and they don't even know that they might actually be having diabetes and that is one reason why we are becoming the diabetes capital so you people suffer from diabetes symptoms for very long they don't know those can be reversed; they don't know those can be modified. And then suddenly one day when the symptoms become really bad or they have some other health issue they go to the doctor. And, you know, the doctor runs these tests and then they say oh you have diabetes and by now the diabetes levels have become really high. So one of the reasons is why India is the diabetes capital of the world because of the undiagnosed uncontrolled diabetes that's going on.

I did have one more research paper which was showing how our skeletal muscle mass is lower than Caucasians. I don't think that windows open here but I will send that in the follow-up email. This is one reason why Indians have a higher susceptibility; it's to do with our genes; it's to do with our body type; it's to do with our metabolic type. And the fact that we are now eating the kind of food that is not really suited to this body type and that's triggering a metabolic problem and creating diabetes.

Alright, so I'm going back to my slides so that I can actually interact with you guys and do q&a.

So then the question that one must ask is what really triggers diabetes right so I spoke of how India is the diabetes capital of the world; I spoke of the different things that diabetes can trigger; I spoke of how diabetes complications itself can lead to other health problems but the question then that I love answering and we always ask at iThrive is why did somebody get diabetes? What is the root cause?  So diabetes is just a label like telling you to have high blood sugar levels. What is really triggering for your blood sugar levels to have optimal is a question to ask. And that's what I will come into next.

How many of you have heard of the word insulin in connection with diabetes?

The thing about insulin is it's largely the reason why people get diabetes and we'll go into that quickly right now, what is the correlation between insulin and diabetes. So I'm just going to play a quick video that will make it easier for me to explain the connection between insulin and diabetes.

The pancreas located behind the stomach is involved in the body's ability to use glucose. Within the pancreas, tiny structures called Islets of Langerhans secrete hormones into the blood. These islands are composed of several cell types one cell type beta cells release insulin after every meal. Insulin along with glucose passes into the bloodstream and travels throughout the entire body.

Insulin binds to specific receptors located on cells, the binding prompts the opening of glucose gates allowing glucose to enter the cell. Diabetes is a disease in which the body has trouble using glucose. In type one diabetes, the beta cells are no longer able to produce insulin.

In type two diabetes insulin is produced and binds with the cell's receptors. However, when insulin binds with the receptor, the glucose gates fail to open, preventing the entry of glucose into the cell.

That is a short video that explains how the pancreas actually creates insulin and how insulin takes so glucose into cells. So those of you on Instagram, basically pancreas is the organ that's there right under the liver and that's the one that's making this hormone called insulin. So insulin is what opens up our cells' gates, so that when glucose is released from the food that we eat. This glucose can go and So when your doctor says your diabetes is high basically means you're measuring the amount of glucose that is there in your bloodstream. 

And how does your blood sugar level go up? And this diagram explains it pretty well so we just saw what the pancreas does; the pancreas releases insulin, the insulin goes and attaches to an insulin receptor. Once the insulin receptor opens up to insulin the insulin triggers the glucose receptors to open glucose goes and enters your cell. When glucose enters your cell, then the cells can use that glucose to make energy and to do everything it's supposed to do. 

Now, if you have type two diabetes, we'll go to type one later but I'll just take you to type two diabetes so if you have type two diabetes, which is what most of the people in India develop it is type two diabetes lifestyle-related diabetes. The pancreas will release insulin, the insulin goes to the insulin receptor, but the insulin receptor does not open up to insulin right so there is something called insulin resistance so the gate itself closes. So insulin comes to the gate but the gate is closed and the gate is not opening, and when the gate is not opening, then insulin can go inside the cell and ask the cell to open up to glucose, so insulin doesn't go inside the cell, then the glucose system floating outside only and all the glucose that is floating outside now is there in your bloodstream.

So this is what gets measured by all those Accu-chek, all those glucometers or your blood samples whatever they take to test your blood sugar levels, this floating glucose is what is getting measured in those tests. And the higher the floating glucose, the higher is your blood sugar levels, and this floating glucose protein sugar in your blood is really what causes all the damage that is associated with diabetes, all the risks of diabetes;  the kidney problem; the eye problems; the Alzheimer kind of situation; the diabetic foot, all of those problems are caused by this extra glucose floating around including weight gain.

You don't become diabetic because you're overweight, you actually gain weight because of diabetes and the root cause of that is insulin resistance so if you have extra glucose floating around in your bloodstream; if too much of this glucose is there in your body. Then the body knows it is dangerous and it has to convert it into fat to store it.

 Just glucose floating on its own can cause a lot of damage to your internal organs so the body starts converting this glucose into fat and it starts storing up. Sometimes it stores it; as if you know the body things or there's too much glucose that can be stored for future energy. It's a survival mechanism; it's an adaptation that the body has developed from our ancestral times.

 So, from one perspective it's good that your body can convert glucose and store it as fat; so in periods of starvation, you can actually always have energy sources from your body itself you don't need to eat food all the time. But if you're eating a lot of food, and you have insulin resistance and glucose is not entering your bloodstream and that is why glucose gets stored in as fat, that is what creates excess weight.

So this is the relationship between insulin and diabetes. So, anytime somebody has diabetes the root cause always is insulin not being used properly so in type two lifestyle-related diabetes it's this insulin resistance that we see that you're seeing here in this image.

In Type-1  Diabetes what really happens is the beta cells of the pancreas are not able to produce enough insulin, if you see this in the diagram here the cells itself are damaged. So when they don't produce enough insulin. You might eat food, glucose might be released but then insulin is not going to those insulin receptors to open it up, and then because that's not happening your glucose can't enter your bloodstream, and then again you have high blood sugar levels.

So these are the two ways in which insulin, either too less of your insulin, or insulin not being able to enter into your cells or the insulin resistant itself can start triggering diabetes in the human body.

The goal is always to get a person from this place back to a healthy place and this can happen. We've seen this happen in so many cases which I will show you later.

Moving on to the next.

This is something that I wanted to cover and I wanted to talk about because often, people think that once they've been given a diagnosis by conventional medicine or by their doctors, they will have to live with it. Not many people know that a lot of these lifestyle diseases are reversible including high BP, people think I have been diagnosed with BP now I have to take medications for a lifetime. Similarly for thyroid and that's what even people think about diabetes.

They think that once you've been given a diabetes diagnosis you now have to take medications and that is how I need to survive now. Okay. A lot of people think that if they take Metformin or Galvus or whatever then they can eat sweets in the evening the blood sugar won't rise but that is a very wrong approach. You're not taking the medicine so that you can eat sugar. You are being given medicine so that your sugar levels are suppressed artificially without finding out what is triggering diabetes in the first place.

But assuming you still want to do that you want to survive in the same manner where you want to eat sweets and then take medication, so the average monthly expense of somebody living with diabetes can go from 3000 to 8000. I'll tell you how right. So it's not just the cost of the medicines, you will need to consult your doctor at least once a month, if not twice so consultations itself can go to about 700 rupees if it's not a very expensive doctor, second, the doctor will want to look at your blood sugar levels then you have to do lab test topic at least of sugar, that is hbA1c and blood sugar test occurring is monthly around 500, and then medicines you take like Glycomet, Metformin other if you're dependent on insulin the insulin injections.

Generally, diabetes doesn't come alone. So diabetes comes with high BP diabetes comes with other problems. So, all of this together, usually they come up to around 6000 rupees so the lowest is 3000 highest the cost of living with diabetes on a monthly basis can go up to 8000 rupees. Plus, you will end up with other health complications right so your kidneys at some point will start getting impacted. Your eyes will start getting impacted and all the health complications we spoke about in the first slide, all of those will happen in due course of time. There is no avoiding them to reverse diabetes so they will be the added cost of those health complications.

We've had patients who come to us, who are at a pre dialysis state or they're already undergoing dialysis, and if we ask them where it all began. How did it begin often it either began with high BP medication or began with diabetes medication? So, I am not scaremongering or joking when I say that the cost of living like diabetes just keeps getting incremental and incremental.

Sometimes, over time to calculate like let's say you got diagnosed with diabetes when you were maybe 40. By the time you're 65, you would have spent nearly eight lakhs on your diabetes, I am not kidding about this.

Plus the impact on emotional health. Everybody's eating sweet in your family and you can't eat it so you feel really miserable about yourself. People are celebrating occasions and then you have to control that like you just think sweet is the root cause of diabetes so you will not eat sweet and you feel bad. 

The emotional toll of somebody not being able to eat mangoes in mango season because they have diabetes. I know what that feels like right now the impact on emotional health, when you have diabetes when you can't eat your favorite foods, then you can't socially interact now the social distancing social interaction is gone, but even then.

 Plus, if you have diabetes triggered health complications like erectile dysfunction, or frequent urinary tract infections in women or vaginal infections.You know your physical intimacy with your partner gets impacted with time and people underestimate the importance of physical intimacy, but that also can impact emotional health.

 So, this cost of diabetes impact on emotional health; I can put it in tangible numbers I can't say that oh this is like 3000 rupees per month, I can't but the person who's suffering that the person was feeling really low about life the person who's going through that will know what that cost is so it is just incremental. Now this is the cost of living with diagnosed diabetes. If you go through life with undiagnosed diabetes we'll come to the cost of that especially in the COVID-19 situation. It is the one cost people are paying for undiagnosed diabetes.

Alright, moving on to the next slide.

I'll quickly talk of the symptoms of undiagnosed diabetes because a lot of people like when I send them the email about the session or when I WhatsApp them about this session, people are asking questions about, okay, I have not done my blood test and I'm scared to go to the lab right now. Given that COVID is around, I would think labs are actually safer than your grocery stores because labs are sterilized all the time but even then if you're afraid of going to the lab.

How could you find out that maybe you're having some level of diabetes going on in your body right now, like insulin resistance at the beginning of diabetes what we call pre-diabetes. Now, this chart quickly shows you some of the symptoms.

One is, you might always feel hungry like you would have eaten a meal and you still want to eat. And the reason why that's happening is that you've eaten a meal your body has broken that down to glucose, but that glucose is unable to enter your cells for energy so your body is sending a signal to your brain that oh I haven't gotten food yet, please feed me, and then you're always feeling hungry.

Secondly, you might always feel thirsty. Now, again, this gets technical, but if you have excess glucose floating around in your bloodstream your kidney has to keep dumping that out because it's a safety mechanism that your body has which, by virtue of which you will urinate a lot. So, because urinating a lot; you will also end up feeling thirsty all the time. 

Dizziness especially if you miss a meal or if you're woken up late and you had your breakfast a little later, dizziness is another symptom of undiagnosed diabetes especially early morning dizziness. Unexplained weight loss that usually happens in type one diabetes, it doesn't happen in type two we are focusing on type two right now. Unexplained weight gain is a symptom of type two diabetes, where you know you're generally just gaining one to two kgs three kgs for months even cutting down on food but is still gaining weight.

Frequent urination we spoke off. Numb and tingling hands and feet. Remember the early slide the first slide I showed you about the complications of diabetes how your nerves in your extremities can get damaged. So, when your nerves damage due to excess glucose. Then you might have tingling and numbness in your hands and feet so that's one of the symptoms of, but it's not an early symptom, if you go undiagnosed for very long, then you start experiencing tingling and numbness in hands and feet.

Candida is basically the vaginal infection that I spoke off so if you have very high blood sugar levels. That's something that bacteria love to feed on and then typically urinary tract infections and Candida kind of vaginal infections do happen if you have high blood sugar levels that have not been diagnosed.  I can't remember where I read this, I just recollected it but diabetes is like in the Greeks was a disease of the rich. People with diabetes, I think that's also where the root diabetes comes from but apparently the people who have diabetes when they urinate their urine will be so high in sugars and glucose that there will be ants in that zone. It's a fun fact you can google it I can't remember where I read it.

I don't even know how it is, but maybe it is skin problems, slow healing because like nerves are getting damaged right so even healing and everything slows down sexual health problems; we spoke off blurry vision because your retina and the nerves in your eyes are getting damaged so you start getting the blurry vision, and then irritation so this is something that a lot of people don't know and it's one of the earliest symptoms of insulin resistance, that if you miss a meal.

If you don't get your food in time, you might suddenly become like you know that movie bhool bhulaiya.. There was this monjolika character from a normal nice person you might suddenly become a monjolika kind of a person who's like getting annoyed and angry and irritable and cranky because glucose is the primary source of fuel for your brain, it's what your brain uses for energy.

And now, if your body's glucose depleted if there's not enough insulin if your cells are not getting energy then all the signals are going to your brain right so it just causes irritation that is not getting what I need and then that kind of crankiness if you miss a meal of your food gets delayed by 15-20 minutes that's typically a very sure sign off insulin resistance.

And then of course elevated blood sugar levels. I mean, like for that you would have to get a test done but that's a definite sign of your sugar levels being elevated and of you having insulin resistance and prediabetes. Feeling tired all the time can also be because of insulin resistance because maybe eating a lot of food as I said, but that glucose is not going into yourself so your body's feeling fatigued all the time. So feeling tired is a sign of insulin resistance as well.

Apart from that, what we have noticed in our work people who have excessive cravings for sweets is one of the symptoms of undiagnosed diabetes.

How many of them here have an excessive craving for sweets, especially after you finish your meal and then after that, you want to eat something sweet? You could do a show of hands I think that option is there you could do yes or no or something like that but how many of you even on Instagram whoever is watching. How many of you like after a meal you just feel the need to have something sweet? Like Kuch toh meetha khana hai ?

So that is also a symptom of insulin resistance and diabetes because again like I said you ate food and your body's trying to digest that and all the glucose is released, but the glucose is not going into your cells, where your body's going to use it for making energy so the feedback that the system gets us to get something sweet and maybe that will quickly give me energy. So that is one reason why you could have sweet cravings insulin resistance could be the root cause of it. So that's symptoms of undiagnosed diabetes for those of you who have questions around this. A lot of people ask me this like how do I know if I have diabetes or not if I've not done my blood tests. I hope this makes it clear.

Okay now we go to the one thing that I wanted to talk about so I've just shared a few screenshots and then I take you to those research articles, but this is what is really scaring me and this is what you know I was telling you when I started the session that I was researching this particularly like what is really happening with COVID-19 and diabetes. Why are more people getting impacted, more people who had diabetes getting impacted by it like if you saw the slide. 

Nearly 40% of people who died with COVID-19 had diabetes right and it's interesting this morning my househelp came and she met me after many days because Pune went through its six lockdowns, and she was telling me that her husband's cousin brother who is much younger than her husband. He died of Corona, so I said how is that even possible he was young right he should have recovered and she's like Yes, he was young; he was in his 30's; he was healthy but still died. She took me through like his entire symptoms and what happened then it was indeed Corona and they did a test and it came positive and then he had all of that like the lung blood clots and in throwing up blood.

But I was not willing to accept that somebody that young could have just died without any underlying root causes because that's the data that we're seeing that Healthy People are recovering. It's like a 99.9% recovery rate. So as I started asking her more; I asked her Was he a little overweight? So she was like yes from childhood he was fat. Then I started asking if the blood sugar levels were high or not?  Then she said Yes and I was like Bingo! This is it. So whether you're young or old, it doesn't matter when it comes to COVID-19.

Right what we are seeing is, there are a few diseases underlying dysfunctions then age doesn't matter it's indiscriminate but if you have these conditions then COVID-19 becomes a really high-risk viral infection for you otherwise it's just like any other virus. So let me just take you to why that is happening.

Alright so here is the first one  COVID-19 and people with diabetes are understanding the reasons for worse outcomes. And this just came like two-three days ago this Lancet paper. So, what is happening here is with high levels of glucose.

So they're looking at not just Wuhan they're looking at Britain; they're looking at Wuhan; they're looking at India and what they're seeing is having diabetes becomes a very high-risk factor so look at this a greater risk for viral infection was observed in people with diabetes, and not just COVID; they are saying they've looked at data even with SARS and MERS and all the other respiratory infections that have happened in the past. And this is what they're seeing so there's another paper which says about why COVID-19 killing US people with diabetes at a much alarming rate.

Again, as always with all my live sessions I will send all the links that are there in the email after this session.

Basically what these articles and these research papers are saying is that because of the already elevated blood sugar levels which impact, which creates tissue inflammation. And because of the medications that people are taking. So there are a lot of cofactors that are happening along with diabetes. Look at this is an Indian paper, the risk of a fatal outcome from COVID-19 is up to 50% higher in people with diabetes right. So here it doesn't matter whether you've been diagnosed with diabetes or not, whether you're on diabetes medication or not, none of that matters. If you have elevated blood sugar levels, then your risk of a fatal outcome from COVID-19 becomes much higher and that is really dangerous.

At first for us, we were just treating diabetes as a lifestyle disease, people were coming to us and they just wanted to reverse that and you know they wanted to lose weight and they wanted to feel more energetic and healthier because of all that are great health goals. I mean, I wouldn't dismiss any of those right now. Given that there indeed is a real virus that's come whether it's being made in a lab from Wuhan. 

And whether it's something that's mutated in the last four months, I don't know I haven't studied that in that much detail but I have come to the conclusion that is definitely a virus that exists that spreads very quickly that is not fatal to nearly 99.99% of the population, but if you have diabetes, then it can be something that can get pretty messy for you so you might still recover from it but it can get really serious for you. 

They've gone through a lot of different variables, they have gone through gender, they've gone through races, they've looked at Black, Asians, British, Caucasian they've looked at all of that and they've come to the hypothesis that longer duration of diabetes prevalence of diabetes complications are then people who are older than 65 that's why most people who are older, have more fatal outcomes, but diabetes is definite co-morbidity from COVID-19.

Alright, so I don't mean to scare you. It's just the data that I have understood from research. So, I have to share it with people. And that is why I'm sharing this with you so if you have any of the symptoms we've discussed and you've not been diagnosed yet or if you want to just get your blood tests done and find out, please find out the risk of diabetes. India is the diabetes capital of the world, we have it in our genes itself from our parents and our grandparents over time.

We eat very differently, even in lockdown most of them have ordered in from restaurants rather than cooking. And in restaurant foods, it has so much oil and so many things that actually create health problems right so I wouldn't be surprised if I see like already in iThrive when we get blood reports, nearly 95% has insulin resistance or diabetes already started. The insulin resistance, the videos and all that we saw earlier. All of those are already there and people who come to iThrive. So, please, given that COVID-19 is now spreading and lockdowns have been removed we will all of us will be exposed to it at some point of time or the other, make sure you get your risk of diabetes lowered as soon as you can.

Okay, so how do you reverse one is like learning about this and then feeling a little anxious, that oh my god what happens if I have diabetes does that mean a surefire fatal outcome for me. No, that's not really the agenda of doing this talk, it's about sharing knowledge, it's about helping you learn what you can do to own your body, and it is very easy to reverse diabetes so I'm just quickly going to show you. People who reverse their diabetes.

I want to quickly show you the number of people who have successfully reversed diabetes. And then I'll actually take you through real numbers where you can see what's changed. We've just hidden their names, which means they've all agreed to share their pictures for this. But so many people have come to us with diabetes or pre-diabetic symptoms and or in the blood test we've seen those levels and we've had them get off their medication and have them actually reverse their diabetes so let me just take you to the data.

Let's just wait for this document to load. So what I'm doing on my screen I'm sharing a research paper that we are going to publish soon. This research paper has data from the iThrive tribe of people who come to us and we actually have everybody's before after results right so we have their before blood test we have their after breakfast and I'll also show you which other blood tests that someone needs to do. If you want to check for diabetes levels.

So, the people on Instagram are going to miss this but what we look at when we look for somebody whose risk of diabetes is fasting and postprandial So, before and after blood sugar levels, then we look for hbA1c. And then we look for what we call as fasting and postprandial so before fasting and after a meal, insulin levels also because just looking at your blood sugar levels is never enough, you need to also look at your insulin resistance and your insulin level.

So I am going back to the data. We've hidden their names because we don't want that to be public but we've kept their ages for you to see, you know, diabetes is quite indiscriminately when it comes. So here, you're looking at the fasting blood glucose level you're looking at the postprandial and so this is data after three months. 

The red one is like the worst when they come to us it's in a really bad state and when they end the program because we see a lot of improvement. So, we have fasting blood glucose; we have postprandial blood glucose levels. Then we have the hbA1c, and then we have fasting serum insulin and postprandial serum insulin if you look at it. In almost all, I think in every single case, we have seen an improvement from the before and after. See, not all of them are within optimal ranges in three months, sometimes if the diabetes is chronic or if they are on medications for diabetes right then the first month and a half, we'll start working on lifestyle changes, dietary changes and then we'll slowly reduce the medication. So, in some cases when we stop medication blood sugar begins to rise but gradually it reduces.

You can see in some cases hbAc decreases from 9.7 to 7.6  and  7.2 to 6.3.  265 blood sugar levels go to 218. So, if you see, it shows your blood sugar fasting in the postprandial but what I am more interested in is the serum insulin level because the more sensitive your body becomes to insulin, the better your blood sugar control will be over time so that is what we track a lot. And if you look at the numbers they're pretty amazing from double-digit numbers they go into single-digit numbers; from triple-digit numbers they go into double-digit numbers sometimes back into single-digit numbers.

So this is what just finding the root cause for your insulin resistance and working on it actively can do it can actually start reversing diabetes so you're no longer at risk for all the other lifestyle diseases like a kidney dysfunction and so many other things that we spoke off, plus your risk of COVID-19; death by COVID, really goes down.  Because you will actually lose weight; your BP medications also will stop; so this is what we do and it is really possible to make this happen. 

How to do this?  It is primarily through lifestyle changes. So you have to find out what's really triggering insulin resistance. Maybe you're eating some food that is inflammatory for you right so that could be triggering it. Maybe you're eating a lot of refined oils and those are the ones triggering insulin resistance, maybe you're deficient in something like chromium; chromium is a mineral that your body needs to make insulin so maybe you're deficient in chromium and that's why insulin is not being produced.

So that is what I wanted to talk about I am now, keeping it open to questions in case any of you have your blood tests or you want to reach out to us and ask about your own personal risk of diabetes after listening to what I've said, so you can contact me. So the number is displayed on screen here for the people on zoom but on Instagram, you can contact 7796692504, or just ping me or just DM me and I'll share the number with you, or you can send me a mail.

 And now I’ll be taking the questions. Let’s go one by one. 

Q.  Most of the symptoms seem general in nature, if we have a few of them does that mean we are at risk? 

A. See, basically, a body without disease will be symptom-free. So if you're having some symptoms it's your body's mechanism it's your feedback mechanism that your body is telling you. Hey, I'm showing you this. Something is wrong internally like you know; you're driving your car and if the suspension is broken, you're going to hear noises right or maybe the steering wheel is really tight and you can't turn enough or maybe the brakes as you know have become. I don't know what happens to brakes but something's happening. So your car will keep giving you different feedback mechanisms right to tell you, something's not right or somebody something the fuel itself might be low and you might see that indicator go down. So if you're experiencing any of the symptoms I've mentioned here, then your body's definitely trying to give you feedback saying something's wrong look at it and fix it. Does that mean you have diabetes?  Not always because sometimes you could feel lethargic because of a thyroid gland not functioning but also, but you should be symptom-free through the day; you shouldn't be needing, for example, if you need tea or coffee to wake up and get through the day or, you know, if you're feeling excessively thirsty then something's wrong for sure you may be your electrolyte balances off, but they are not general symptoms mood. They are symptoms of a specific disease.

Q. What’s the time period between before and after the test?

A. These ones we do after three months I mean, for every person who comes to us sometimes now in the lockdown, they get delayed but this data is from earlier patients. It's much before February also. So all of these are three months.

Q. Which Muscle building exercises are recommended for weak back to individuals?

A. I am not qualified to answer that question. I am a nutritionist, and I work with lifestyle diseases. So, in terms of workouts and all of that I am not the best person to answer that question you could follow a feed on Instagram, is this gentleman his handle is movement mechanic in. You could follow him and he'll help you with your exercises.

Q.What do you recommend on eating fruits?

A. I recommend all fruits. There are a lot of people who recommend keto diets for diabetics. I am not of that philosophy I have seen as reversing diabetes with fruits. So, we recommend all fruits, but that is given seeing the underlying assumption that you're taking care of the other things that you should not be doing so if we find out that you have insulin resistance and then you're eating a very high-fat diet along with fruits, then that's going to create a problem for sure.

Q. Any special care to be taken by type one diabetics?

A. We work with type one diabetics also and what we have been able to do with a type one diabetics is we've been able to reduce their need for insulin. So there was a lady who was taking 36 units of insulin. We actually brought her insulin requirement to 20 units within three months. So the care to be taken with type one diabetics is you have to make sure that you know your insulin and the glucose, those levels are in sync it's better if type ones actually use a continuous glucose monitor because that helps you really understand what's happening with your glucose levels through the day. 

Q. Can you also share some of the best practices that we should follow to reduce the risk of diabetes?

A. Yes for sure. So, I have seen in our work what has really worked for a lot of diabetics is making sure that they eat the right kind of food so completely avoiding processed food right like just no processed food because it is very high in polyunsaturated fats, which is something that triggers a very high level of inflammation. So, avoiding processed food, avoiding dairy I have seen helps diabetics a lot because dairy triggers a lot of inflammation in the body so we make sure anybody who comes on board, especially if they have insulin resistance because it's getting triggered by dairy. We asked them to avoid dairy.

Q. What about refined sugar?

A. If you go to the ithrive website you will see a couple of blogs that are talking about sweeteners and which ones are safe to use. So we would advise all diabetics to completely avoid all refined sugar and even jaggery, but then what can you have as sweet, is there on the iThrive website. In one of the blogs that we've written about sweetener so you can go check that out.

Q. Why is that sometimes fasting is higher than PP?

A. That happens because of something called a Somogyi effect. So the Somogyi effect is because of a stress cascade that happens through the night when you wake up your body releases a lot of sugar in the morning. You can google the Somogyi effect. I can't really talk about it like we'll go beyond the time if  I will talk about it. So, you can check that out but sometimes it can be because of an adrenal dysfunction also so see these, then this goes into the sometimes category right like I'm saying, you know, it could be this or it could be that based on if you actually have any recent practice you can send them to us, they will know more what is happening in your body.

Q. Are there any broader nutrition plan to follow in breakfast, lunch and dinner?

A. No we don't really do that because you know the thing is each person's body is unique, you have this thing called as bio-individuality right with your genes are unique to you while we are Indians while we have that base Indian genetics, still, what your parents contributed to your DNA is unique to us. So knowing which food you have to eat is a matter of really learning more about your body through your blood test and then finding out what to recommend to the broader community.  People know what is a healthy diet to eat and you can google and google will tell you that eat more fruits and vegetables; avoid processed food; avoid sugar; all that google will tell you that’s generic advice then that's good but that doesn't really help anyone.

Q. Type -1 is reversible or not?

A.   No, unfortunately in our work yet we aren't able to reverse. In type-1 what we do is manage it better. See in Type-1 what happens is the beta cells that produce insulin itself is destroyed. So it requires some external thing that is providing it energy like insulin. So the only thing we have successfully done is to reduce the need for insulin and take away other medication. But we haven’t reversed Type-1 completely.

This was interactive. I would highly recommend if you have any recent blood tests, or if you want to just figure out what it is that you need to do to reduce your risk of diabetes. Please talk to us because we are always available. We have this vision of healing 1 million people.

We'll end the session. Bye- Bye.