299: Understanding the Cost of Healthcare: Preventing Type 2 Diabetes from the Start | DOCTOR IN THE HOUSE with Dr. Riz

Dr. Rizwan Bukhari  00:00

whatever lifestyle you live is then going to either promote that predisposition to developing type two diabetes or if you live a better lifestyle, you reduce that risk of developing diabetes. So I'm all about teaching people, what lifestyle things they can do to prevent diabetes.

Maya Acosta  00:19

Alright, welcome to part three of our four part series on diabetes. This is Dr. In the House series with Dr. Riz. Welcome Dr. Riz.

Dr. Rizwan Bukhari  00:30

Hi, thank you for having me back.

Maya Acosta  00:31

Thank you for being here. So in this part, we've really you know, if you guys have not listened to the other two episodes we already recorded, I'm going to kind of give you a little bit of the gist part one of this series is really explaining what is diabetes? What exactly is insulin resistance? And what are the risk factors, we cover that in the first part. So I also now doctors have created a page on our on the healthy lifestyle solutions.org website, people who want to access that all of your episodes, we'll have a link in the show notes for that. In the second part, we talked about managing diabetes, why it's important to have early detection, can a patient be too far gone to make healthy lifestyle changes, we talked about dialysis and Amputation Prevention. So in this part, part three, we're actually going to make lifestyle recommendations. Before we do that, Dr. Riz, I'd like to talk a little bit about the cost of not only managing and living with type two diabetes, but I also would like to talk about the disparities in health care, really people not having access to quality health care, and access to education. So it's become a very important topic for me, especially after we experienced a pandemic, that disease was more prevalent, especially COVID. In populations of people that have the least resources.

Dr. Rizwan Bukhari  01:56

Yeah, yeah, healthcare is a very, very complex topic. And access to health care is as well, there's access issues related to you know, it's not just financial, and but it can be cultural as well. And there's, I think certain populations of people who don't trust doctors, so they don't go to doctors, there's others that go that say that, you know, I don't have any medical issues. So there's no reason for me to see a doctor. So and they don't understand that the importance of early detection, a lot of people don't see as going to the doctor as a solution to their problem. A lot of times I say I didn't have a problem until I went to see the doctor, there are without a doubt disparities in access to health care. And it's and it's very, it's a difficult problem. And it's multifactorial, and we can talk about that. But one thing I will say is that, that, that unfortunately, what we discuss a lot about is lifestyle, medicine and prevention, and doctors are not typically trained in that. And so what you know, what I want, is I want the patients and the people themselves to be empowered to take control of their own health. And so that's what we're hoping to do by having these talks and doing these podcasts and, and educating people. But in but you know, as a part of that is to work in conjunction with your health care provider. To manage problems, if they come up, I complain a lot about how insurance is restrict a person's ability to choose their doctor. And that's why I just I focus on a, you know, taking control of your own life, educating yourself and learning. And then just being very proactive, you have to go out and be proactive about working with healthcare providers who have are similarly aligned to your belief set, healthcare is expensive. And we are probably one of the most expensive countries in the world for health care. So the best way to avoid that expense is to not get sick in the first place.

Maya Acosta  03:59

Right? I first want to acknowledge that, that not everybody has resources to have, you know, a caring physician who's well trained in lifestyle medicine and nutrition to guide them to handhold them, to refer them to a reg, registered dietitian and all of that. So I want to acknowledge that and then shout out to the American College of lifestyle medicine, because they have created an institution that does that. Before the pandemic we were at 3000 members. We just hit 10,000 members in the month of I think it was either March or April of 2023. recently, very recently. Why and who are these people? Well, health professionals, dieticians, nutritionists

Dr. Rizwan Bukhari  04:44

and lay people as well. Anybody can become a member of the American College of lifestyle medicine. And I think that's a testament to the growing awareness of living a healthier lifestyle. And people are seeking out these societies or groups where they can join? And then and then then now they have access to a wonderful resource.

Maya Acosta  05:08

Yep. Yes. All right. So having said all that, doctor was telling us about what we can do in terms of making lifestyle changes that could either help us manage and improve insulin resistance if you're living with type two diabetes, or even prevent Type Two Diabetes altogether.

Dr. Rizwan Bukhari  05:26

On an earlier episode, we alluded to the fact that different populations have different risks for developing type two diabetes. And so there may be that genetic component, I call that again, loading the gun, but the lifestyle is pulling the trigger and pulling the trigger by me, my by that I mean, it's whatever lifestyle you live is then going to either promote that predisposition to developing type two diabetes, or if you live a better lifestyle, you reduce that risk of developing diabetes. So I'm all about teaching people, what lifestyle things they can do to prevent diabetes. But also, you know, we also talked about keeping an eye on yourself over time, so that if you are developing it, it's best to catch it earlier, because the earlier you can catch it, the more more likely it is that you can either arrest it in its tracks or even reverse it. Okay. And so again, it's these lifestyle factors that we want to focus on. Now, I'm not averse to utilizing medications in adjunct. But I don't think the medication in and of itself is the only answer. It should be that we want to particularly focus on lifestyle measures, and then add medications as needed, nutrition choices, and exercise are very important. And those are the things that I focus on 90 to 95% of the time. Now, I will say that there are other lifestyle things that are important as well. But you know, we don't spend so much time on it. And that would be having to do with sleep, and stress management. And in particular, those two things, and I'll and all I will say about those two things is that they have a tremendous impact on our hormonal levels. And in particular, our cortisol. And our cortisol cycle is very important in managing or in, in, in glucose management and insulin release. And so we release with with stress, we release a whole lot of hormones that affect our sugar levels. And our sleep levels, if they're altered, can mess with our cortisol levels. So by by managing stress and sleep appropriately, we can contribute to better diabetes management. Okay, so that's, but I think we can make and those are important, but I think we can make the most significant impact with nutrition, and then adding exercise along. Yeah. And we can discuss the details of that as we go along here.

Maya Acosta  08:00

Okay, Dr. Reyes, I started in I think, our first episode part one of diabetes talking about the myth that I once believed that the problem the root cause of type two diabetes is just eating too much sugar. Today, there's a whole group of people that continue with this misinformation, and they blame it on starchy foods. They blame it on the plant based diet. I mean, all this misinformation, since you initially talked about what causes insulin resistance, which is the fattest, impairing insulin function. Yeah, I find it interesting that when I do my little research, and I go to say, the American Heart Association's website on what to eat to reduce your risk for heart disease, they always say, you know, reduce your intake of saturated fat and trans fat and all of that, but then they never say, avoid meat, where saturated fat

Dr. Rizwan Bukhari  08:49

found, saturated fat is found in meat.

Maya Acosta  08:52

Okay, so when we talk about nutrition, we never advise people to make a significant overnight change. It doesn't it's not sustainable, and it's not realistic. You need time to figure out what are the foods to eat? What are the foods to start crowding out of your play? How to do groceries, how to meal plan, I mean, there's it's very detailed. So I first want to focus on what are the foods we should minimize? And what are the foods we should start incorporating to improve our insulin resistance,

Dr. Rizwan Bukhari  09:23

what I usually say is, if you fail to plan, you're planning to fail. And something as complex is what we eat, which is something that we've been doing since the day we were born. And there's so many things that impact how our choices are, if we don't make a concerted, organized effort on how to decide to eat and what to eat. It's not going to work. So I believe in making small, reasonable, achievable steps on a regular basis and continue to move forward and not every day is going to be a great day. But as long as you keep moving forward steadily, you're going to get to your destination. Yeah.

Maya Acosta  09:58

Those are words of encouragement. Thank you. You so much as we take that into consideration what you said, what are the foods that we want to minimize? Eating? What are the foods we want to start bringing into our diet to improve our insulin resistance?

Dr. Rizwan Bukhari  10:14

So I would actually start by saying, what do we want? What is it that we want to eat more of, and which is that we want to eat more whole food plants, plant based products, we want to eat more grains, or legumes, more fruits, more vegetables, we're talking about foods and foods in their natural state. And what we want to avoid is processed foods, sugary foods, foods with lots of salt and oil. And we want to start to get away from animal products. And why is that and that's because the foods I'm asking you to avoid are foods that are high in saturated fat, and cholesterol, which are known to contribute to these problems, especially saturated fat, which contributes to the development of type two diabetes, as opposed to the whole foods which I talked about which are high in complex carbohydrates, which are managed more effectively by your body.

Maya Acosta  11:14

Awesome. So I want to focus a little bit first on those problematic foods. We addressed some a little bit when we talked about heart disease. And you know, Dr. Esselstyn is protocol of really moving the saturated fat and the trans fat and cholesterol out of your diet. And then and eating those foods that are going to be good for your arteries. And so most of those, I mean, plant based foods don't have cholesterol that I know of correct. And the saturated fat, it mainly comes from animal based products. The Trans fats are found in processed foods like cookies, and chips, and baked goods, and all of that junk food that most of us crave. And there's a whole reason behind why we crave all that. I want to also add because you and I are supporters of the Physicians Committee for Responsible Medicine, we love that organization, they have the power plate, which I really love. And there are many ways to look at what we should eat many resources. But the power plate is an easy one,

Dr. Rizwan Bukhari  12:17

we don't have to make it complex. It's just that I look at a power plate you just divided in before. And there's four components to it. And those components are fruits, that's one vegetables is another grains is another and legumes is another and then you know I try to incorporate something of those into my diet on a regular basis. To me, it's not that complex.

Maya Acosta  12:42

Yeah, we are basically saying stay away from the foods that have the saturated fat, the trans fat, the cholesterol,

Dr. Rizwan Bukhari  12:48

cheeses, anywhere from 70 to 80% saturated fat, oh my God, you're just literally it's like taking oil and eating it,

Maya Acosta  12:56

minimize those foods, add more of the healthy stuff,

Dr. Rizwan Bukhari  12:59

avoid the saturated fats and the trans fats. Okay, that's going to make your insulin sensitivity better, so that you manage your sugars better.

Maya Acosta  13:08

Please tell us how does exercise physical activity helped to regulate blood sugar levels.

Dr. Rizwan Bukhari  13:14

So exercise is really important in in affecting blood glucose levels, the major organ in our body that needs glucose is our muscles. Okay? And so another way we can temporize or minimize those glucose spikes, and therefore those insulin spikes, is by exercising. And so some simple moderate exercise after meals can help lower your blood sugar and therefore lower your insulin levels. And so I'm not talking about anything big time, we're talking about 15 or 20 minutes of moderate exercise, like a nice brisk walk, which you know, is it's not uncommon in many societies for somebody to eat dinner and then say, I'm gonna go out and take a walk. And they're, you know, there's, there's some benefit to that. So, you know, if you get a if you get an hour for lunch, eat your lunch, and then go take a 15 minute walk. And that's going to do go a long ways to helping mitigate your, your insulin levels. So because what you're doing is you're stimulating those muscles. And then those muscles want the glucose because they need that glucose for energy. And so the glucose goes into the cells and lowers your blood glucose levels.

Maya Acosta  14:25

Wow, that's wonderful. I mean, this is just so much information, Dr. Risk next week, we're going to just kind of bring it all together and add more resources that we were not able to necessarily cover in this episode, but this is a big topic. Do you have any final words as they're wrapping up this episode? What I'm

Dr. Rizwan Bukhari  14:42

getting at here is for all stages of life, healthy approach to lifestyle is going to be the best way to either prevent you from getting it or managing once you have it.

Maya Acosta  14:53

Yeah, yeah. And I really appreciate you taking the time to talk about this because again, we see the 50 to 70% Have your patients are living with type two diabetes and if we can help people to reduce those risks and become a patient of yours, that would be awesome. Follow Dr. Riz on Instagram. He's got a lot of great content and also on Facebook but on Instagram you are at Dr. Dr. underscore r i z RIS underscore Bukhari be UK Hari, you have a lot of informational videos on various health topics and now you're even covering research that comes out. So I think all of you will benefit from that. And also make sure i'll put a link again, if you want to join Dr. Resist newsletter. I'll put a link in the show notes and also if you want to drop us a voicemail and tell us how what these episodes are doing for you how they're benefiting you or if you have any question that you would like us to address go to speak pipe.com forward slash H L S and we will see you next Monday for another episode of Doctor in the house. All right, thank

Dr. Rizwan Bukhari  15:59

you very much. Take care. You've

Maya Acosta  16:01

been listening to the healthy lifestyle solutions podcast with your host Maya Acosta. If you've enjoyed this podcast do us a favor and share with one friend who can benefit from this episode. Feel free to leave an honest review as well at rate this podcast.com forward slash HLS. This helps us to spread our message. And as always, thank you for being a listener