26: Managing Type 2 Diabetes: Lifestyle, Medications, and Monitoring

Hey everyone.

Welcome back to the so Freaking Healthy podcast.

I am Donna.

And I'm Megan.

And for our grand finale in the Diabetes Awareness Month series, we're going to bring it all together.

The first two episodes we talked about pre diabetes, which I think is highly overlooked.

And today we're going to unpack managing type 2 diabetes from understanding what the treatment options are, how to monitor your blood sugar, and to the very, very real and most important is your daily choices that you make during your lifestyle.

Right.

I mean, it's all about simplifying the complex, creating routine and staying empowered.

And listeners, remember, Megan and I are here as health coaches, not doctors, sharing evidence based information from respected sources like the UK National Institute for Clinical Excellence and the American Diabetes Association.

And, and none of this is medical advice.

So always talk to your doctor or healthcare professional.

Yeah, absolutely.

I mean, type 2 diabetes is certainly a multifaceted disease and also it's a multifaceted way of treating it.

So it's all about blending your lifestyle choices, monitoring, and sometimes even some medications.

But the ultimate goal with those three things is to give you more control of your life.

So hopefully you don't have to think about diabetes all the time, but that you can just live your life.

So these episodes are not actually only for someone who discovered they're pre diabetic or diabetic.

This is great knowledge for everyone to understand in order to avoid those.

So, Megan, let's get to the core of it.

What's really going on in the body with type 2 diabetes and how can someone new to this diagnosis wrap their head around it?

Yeah, so the simplest way to talk about it is to imagine.

Well, you don't have to imagine you have a hormone called insulin, but imagine that it is a key.

And every little insulin is a key to let glucose or sugar into your cells for your cells to use as energy.

But with type 2 diabetes, that key, your insulin, might not work so well or there might not be enough keys to open all the cells.

So those are the two different types of ways that insulin might not be helping you or serving you as well as you can, because there's no keys and the glucose can't get into the cells.

Then the glucose builds up in the bloodstream, which can lead then to long term health issues.

Okay, so essentially the treatment journey is about finding ways to help that key work better.

Whether it's lifestyle changes, medications, or even monitoring, monitoring blood sugar levels, it's about keeping that balance.

Right, Exactly.

And everyone is different, everybody is unique, everybody's body is Unique.

But the most important thing is managing the blood sugar.

And when you manage the blood sugar, you're gonna help prevent issues like nerve damage and heart disease.

And yeah, as you said, treatment often involves a very personalized blend of lifestyle changes, monitoring, and then also medication to help keep you in that range to help prevent those long term complications and issues with type 2.

Gotcha.

So before medications, we have lifestyle.

One of the most empowering parts of managing type 2 diabetes, if I may say so myself.

Megan, if someone is just starting out, where do they focus?

Right?

So if you've listened to our other two episodes on pre diabetes, a lot of this is going to sound familiar because it's exactly the same.

And just to reiterate, when you're diagnosed with pre diabetes, the opportunity is to avoid type 2 diabetes.

So the first is always what you're putting in your mouth.

What are you eating or diet?

Not a diet, but your diet.

So key is to focus on whole foods, a lot of fiber, a lot of lean proteins and healthy fats.

This is nothing new.

There's no specialness about this.

But it is just sometimes it's hard for people to actually do that.

So we just want to reiterate, that's all it takes, is just to eat whole foods, fiber, lean proteins and healthy fats and do this consistently.

Then there is exercise, or I like to say movement, because I feel like if you say exercise, people think that they have to like put on their shoes and go do something.

Movement is a little bit more accessible because everybody can move a little bit.

And so even a 30 minute walk daily can make a huge difference.

And that 30 minutes doesn't need to be all at once.

It could be 10 minutes after breakfast, 10 minutes after lunch, and 10 minutes after dinner.

And those two, those 10 minute walks are going to make a big impact in your blood sugar.

And finally, and a lot of people miss, this one is stress and stress management.

It is super overlooked in terms of how it affects your blood sugar because stress hormones raise your blood sugar levels because if you're stressed, you need to run away from an animal, which means you need more glucose into your muscles and into your bloodstream so that you can run away really fast.

But if you're just stressed sitting at your table, your glucose can also still rise in your bloodstream.

So exercise, diet and stress.

Megan, you just gave me an idea.

Let's do a stress buster.

Pause right here.

Love it.

Listeners, let's take a second, take a deep breath with us.

Inhale deeply.

Think of it as a Tiny reset button for your body and your mind.

Literally, you just demonstrated that it does not take a 30 minute yoga session or meditation session to start to relax yourself.

There's several different breathing exercises that you can do sitting at your desk after a stressful call.

You just had a stressful call or a meeting or you just, I don't know, whatever you just did that's making you feel a little anxious, a little stressed out.

Just take a few minutes to do some deep breaths.

So that's going to have an amazing impact on you just remembering to breathe.

Small steps, big changes.

Remember people?

Yes, definitely.

Okay, let's jump into medication.

I'm sure a lot of people have a lot of questions about it and there are so many medications out there.

What's the starting point?

Yeah, usually it is a drug called Metformin.

If medication is needed to help keep it in control, Metaph.

Metformin is the first thing that doctors will turn to and that lowers your glucose production in the liver and then it improves your insulin sensitivity.

It's like taking blood pressure medication for high blood pressure.

It, it's gonna help, but really long term, you know, the idea is that you increase your lifestyle changes.

So always bear in mind that these medications are to help make sure you're not doing long term damage and you're not going to die.

But lifestyle has the biggest impact on keeping your blood sugar steady.

So I just want to throw that in there.

So.

But the metformin basically kind of like revs up your insulin sensitivity and tones down your glucose production to help keep that balance in place.

Then next up we have sulfonylureas, which prompt the pancreas, which is where your insulin is produced, to produce more insulin.

So it kind of works in a unique way just on the pancreas.

And then for some people we have, which is in the news a lot right now, the GLP1 receptor agonists like Ozempic, which help by increasing insulin production and also assisting in weight management, among lots of other things that they do, but specifically that for type two diabetics.

And then the last is that we have an SGLT2 inhibitor which allows the kidneys to remove more glucose, extra glucose via the urine to get it out of the system.

I have to pop in and say we know that Ozempic is a hot, hot topic nowadays and we are in search of an expert to talk to us about that.

So please be on the lookout for an episode on Ozempic and its best friends.

But moving back to the medication, so we're targeting the liver, the pancreas and the kidneys.

It's fascinating that each part of the body has a different role in managing blood sugar.

It is definitely.

Obviously your whole body works together.

There's a reason why all of these things do what they're supposed to be doing.

And the combination is completely necessary.

Right.

If your liver and pancreas and kidneys, if one of them is not doing a job correctly, it's obviously going to impact more than just your blood sugar, of course.

But if we're talking just about blood sugar.

Yeah.

It's really important though, if you are diagnosed with type 2 diabetes that you work really closely with your healthcare provider because they're going to find the right mix of those things.

Just like I said with other medications, with other chronic long term diseases, a lot of times it'll take a long time to get the medication correct.

And then even as you age, that might change as well because your body changes as you age.

Right.

And again, we're not doctors, so we're just naming medications here.

But talk to your doctor, okay?

They will know best.

They have learned for many, many years to talk to you about medication.

Okay, listeners, it's time for a myth busting minute and here's a big one.

Megan, are you ready?

Yeah, I'm ready.

Hit me.

If you have type 2 diabetes, you'll eventually need insulin.

True or false?

This one is definitely false.

And actually this is something that I even having worked in the diabetes care industry for 17 years didn't realize.

I just assumed all type 2 diabetics were on insulin.

But I also had a chance to work really closely with the countries and the, and people who really understood the disease and understood that the oral medications.

So the metformin is typically what people have and type 2 diabetes with insulin is not a given.

It's not necessarily, you're going to have to always have insulin.

Now for type 1 diabetics, insulin is a must because their body just does not produce any insulin.

So they have to have that.

But again, we're not really talking about type 1 diabetics here because that's a different root cause.

But yeah, lifestyle changes in oral meds often are what people need and that's what they stay on.

And then when you hear people making consistent long term lifestyle changes and then they get off their oral meds, then you know that they're still have type 2 diabetes but they're managing those with just lifestyle changes.

That's super interesting.

How about this one?

Once on medication, you don't need to worry about lifestyle changes, please.

I think I just kind of ruined that question because I just answered it.

You can keep that in the edit, Donna, or edit it out, but either way, lifestyle is always part of the picture.

Eating well, staying active, and managing stress is the best way to help stabilize your blood sugar, and you can reduce the need for medication over time.

Some people have gotten off of it, but lifestyle is definitely important.

And I have an anecdote here because I have a friend who's on one of these GLP1, Ozempic, Waco V, Blah, blah, blah.

And they have also a friend who's on it, and this friend has done absolutely zero lifestyle changes.

No lifestyle changes.

They want to keep eating their fast food.

They want.

They don't want to exercise, and it's not working for them.

They just.

It.

This does not work.

So this is even like, super in your face that if you don't do something to change and support the medication that you're getting, it can also just not work.

So I.

I feel like that's like, the biggest anecdotal evidence that your lifestyle matters more and that you should always see this kind of medication as an assistant to help you along the way.

But you still have to do the work, because type two didn't just.

I mean, well, it snuck up on you.

But, you know, probably took 10, 15 years for you to get type 2 diabetic because of lifestyle choices.

So it's not going to turn around overnight.

And that's why we always say the small changes make the big impact.

As long as you can do things consistently right.

So there's no magic pill out there that will just make your life so much easier while you continue gorging on the stuff that probably doesn't help your body.

So that's.

No, that's a big takeaway.

Yes.

Okay.

Love it.

All right, let's dive into some listener questions that we've collected along the way.

Now, honestly, today we don't have fake listener questions, but we did research on what were the most googled questions so that we can actually help you understand.

I don't know.

Where am I going with this?

Whatever.

These are the most googled questions.

So the first question is, can I stop my meds if my blood sugar levels improve?

Yeah.

I mean, it's really great when you can get your blood sugar to stabilize, but you should never stop taking your medication before talking to your doctor, because that medication is doing something, and it could cause spikes, it could cause other problems if you don't come off of it with a gradual approach, with a doctor's guidance.

Let's put it this way.

So, no, I mean, I think this is kind of like, come on, be smart about it.

You should just never stop taking your medication without talking to your doctor.

Right.

So yet another disclaimer here.

People, talk to your doctor.

Okay, another really good one.

What do I do if I struggle to remember my blood sugar checks?

Yeah, this is also a good one.

And I like the idea of habits stacking.

If you're not in the world of habits, there's a lot of great books out there about how to build habits.

Just Google habits and the books will appear.

One of them is called habit stacking, and that is where you pair it with something that you already have a habit to do.

So, for example, like if you brush your teeth every morning before you brush your teeth, or right after you brush your teeth, check your blood sugar.

You know, that kind of thing.

Phone reminders also help, and especially if you're going to check multiple times a day.

So habit stacking is a great way, but there's a lot of different approaches to help you remember.

And I think we're going to get into that in a minute when we talk about how to monitor your blood sugar.

Yes, let's do that.

Let's jump into the details of blood sugar monitoring.

Why is it so crucial we know we have type 2 diabetes?

Like, why do I need to check every single day?

Why does it matter?

When I was in the diabetes industry, I had a blood glucose meter and I tested like I was a diabetic.

And they recommend right when you wake up that you're fasting blood sugar right before you eat your breakfast, 90 minutes after you eat your breakfast, before lunch, 90 minutes after lunch, before dinner, 90 minutes after dinner, and before bed.

So that's like eight times a day, pricking your finger every single day.

So that sounds like a pain in.

The ass, to be honest.

The pain in the fingertips.

And if you can imagine it's inconvenient because every time you do it, you have to get out your little thing.

And so there's a lot around it, why people would be like, I, I'm just not gonna do this.

I'm just gonna test it in the morning and maybe at night.

But the thing is, you're not getting a good picture of what's going on with your body.

So monitoring gives you a snapshot of how things like your food, your activity, and your stress.

Those three things, we already talked about how they impact your blood sugar.

And it is basically real time feedback about those choices that you're making.

Exactly.

And for tools, there's the classic glucometer and the newer options like the continuous glucose monitors.

We discussed it shortly in the last episode.

And those offer constant tracking without the need for frequent pricks, which I kind of like.

I'm sorry, I'm going to giggle every time I say that.

Yeah, absolutely.

CGMs are really ideal.

Although in whatever country you're in, there's different regulations on if you can even use one without a doctor's prescription.

Here in Switzerland, we can order a CGM online and have it delivered to our door for like 70 bucks and use it for two weeks.

We don't need a doctor's prescription.

We don't need anything.

But I think in the States, there's like some more restrictions around that.

And of course it is expensive.

Expensive, like to do that out of pocket.

So CGMs are making their way into the world of diabetes, but it's been really, really slow getting them covered by insurance and so on.

So still a constant fight for manufacturers to get those things so more people can have them.

Because honestly, having something you do once every two weeks or every four weeks and put on the side of your arm and that you just hold your phone up to gather the data is complete game changer to sticking your fingers eight times a day.

Yeah, a hundred percent.

I mean, we've tested them out as well.

We were meant to do an episode about that.

Got lost in the.

In the pipeline somewhere.

But I have to say that it really is super, super easy.

You don't feel it.

And so time versus money, right?

You're either pricking your finger eight times a day or, or you invest in that if it's available to you.

But I personally would recommend, as you, it seems the cgm, because it is just so much easier to use.

Yeah.

Okay, so what's one way someone can make blood sugar checks feel less like a chore?

I mean, it's always going to be a fucking chore.

It's eight pricks a day.

Right.

So I think you have to change your mindset about the finger prick.

It has to be a positive thing that you're doing this to gain information and knowledge about your body.

It's like stepping on the scale and measuring your weight.

It's like having your heart rate monitor on when you're jogging and knowing what your heart rate is.

If you think about it this way, knowledge is power.

For example, if you think something might be affecting your blood sugar, but you don't know it.

You might avoid those things and say, oh, that's, that's going to spike my blood sugar.

But if you have the data from picking your finger and getting that data, maybe it's not affecting your blood sugar as much as you think it is.

Or maybe you could eat that and then have the walk right afterwards, then your blood sugar is still stable.

So that's the kind of information you want to see.

Basically, what choice did I make and how did it impact my body?

And what is, how is that going to impact my next choice in the future?

And when you're just diagnosed with type 2, this can seem very overwhelming.

Even me, who am not a type 2 diabetic, just trying to remember to do the finger pricking after every meal and all this stuff.

Those meters often have built in alarms so you can say, oh, this finger prick is pre meal.

So it automatically knows, okay, in 90 minutes I'm going to ask her to, to, to test again because I know it's going to be after the meal.

That kind of stuff can make it much easier so you don't have to think about it as much.

But in general, it has to be a mindset shift.

It has to be a mindset of, I love my body, I want to take care of my body, and this is the thing I need to do now.

Just like getting regular exercise and stress relief and all those other things that you should normally do whether you have type 2 diabetes or not.

Right?

I mean, it's as simple as, as brushing your teeth at the end of the day.

I have to say a couple of things.

One, I've seen my dad do those finger pricks pretty much my entire life.

We have to understand that it's not as time consuming, especially when you get into the habit of it.

It takes a couple of minutes at most.

So that's one good thing to look at.

And the other, which you mentioned, is the value of the information that you're collecting by just doing that and monitoring it.

That gives you a lot of empowerment.

It gives you a lot of power to say, okay, great, I know this meal was not productive in my body, was not helpful to my glucose levels.

How about we tried a different way and we talked about different ways of helping your body break down the glucose last time.

So make sure to check out our previous episode.

So today we covered a lot from lifestyle and medication to monitoring.

Diabetes management is a journey and it's all about building habits that empower you.

Yes.

And we'll say it probably 50 more times.

In the next 50 episodes.

Every small step you make in anything you do in your life makes a big difference.

Whether you're learning a language or learning of instrument or whatever, practice every day, same concept with anything to do with your health.

Little tiny things but consistently over time are going to make sure that you have the biggest impact.

And if you're looking for more structure, I have a program which is not really my curricula.

It's the CDC created a program called Prevent T2 which is a lifestyle coaching program.

I have converted this from an in person led program to a podcast format so that you if you're listening to this on the podcast, then you might be interested in listening to that as a podcast and it will take you through a whole year of lifestyle changes.

So if you're pre diabetic or you know someone who's pre diabetic, or even if you just want to get healthier, I think actually this content is good for anybody who just wants to start to move more and eat better.

So you can also just think of it this way as well.

So if you like listening to Megan's voice and I know I do, check out her program at my bestseller, we'll make sure to put it in the show notes.

This program will be life changing.

I will change your life with this serum.

You just apply this serum five times a day and your life will change.

Okay?

And remember everyone, managing type 2 diabetes is a process.

One day at a time, one choice at a time.

Try not to let it overwhelm you.

Take those small steps and trust that you got it, you know, and you've got the resources to help you with it.

Thanks guys for tuning in today.

Stay balanced, stay inspired and as always, stay so freaking healthy.

Woohoo.