Shanna M 00:11
Hello and welcome to the Adventist HealthCare & You podcast. I'm Shanna, joined by Nimeet.

Nimeet K 00:15
Hi Shanna.

Shanna M 00:16
Hi Nimeet, how are you doing?

Nimeet K 00:17
It's going great, its coming fall. And you know, leaves are turning brown.

Shanna M 00:23
That's true, but they're turning orange and they're pretty red color. So we're definitely getting into winter and fall. And November is Diabetes Awareness Month. So we have a special guest today, Dr. Ogechi Anyaoku. She is a internal medicine physician with Adventist Medical Group in Fort Washington. Welcome, Dr. Anyaoku.

Ogechi Anyaoku, MD 00:45
Thank you for having me.

Shanna M 00:46
Thank you for being here. Thank you for coming. In recognition of Diabetes Awareness Month, we're going to talk a little bit about diabetes. And this is a topic that we've done in the past not on this podcast, but in other ways through webinars and other things. And it always is a topic that draws a lot of interest. And I think it's because somebody has a family member or they themselves have diabetes. And so we're just going to offer some information today for our listeners on, you know, what is type 2 diabetes, and how can we manage it and look out for. So I know this is something that in your practice, you treat quite a bit or manage a lot of so I'm going to just let you take it away from here, what is type 2 diabetes?

Ogechi Anyaoku, MD 01:31
Type 2 diabetes really just means that you have a lot of sugar in your blood, it usually comes about from insulin resistance or not producing enough insulin. And insulin is a hormone that's produced by the pancreas. And it's secreted whenever you have a meal. And then it helps to push the sugar that you eat from your meal into your cells so that it's not floating around in the blood. So when you have a disruption in the insulin being able to work properly, and push the sugar into the cells, you can develop diabetes. And the importance of that is having too much blood sugar in your blood for a long period of time can lead to consequences in the long run.

Shanna M 02:11
What is the difference between type 1 and type 2?

Ogechi Anyaoku, MD 02:15
Type 2 diabetes is oftentimes developed later on in life. And it's much more so associated with obesity, it's much more so associated with lifestyle. So people who have central fat people who have a very non physical lifestyle, also, it's associated with genetics and your family history, such as type 1 diabetes, but the patient looks very different. Typically, like I said, they're a little bit older in age, although sometimes now we're seeing it in younger patients. But it's more so associated with lifestyle factors like overweight, as opposed to type 1 diabetes is oftentimes diagnosed in when you're much younger. And those patients often look very different, they're usually thinner. And for all intents and purposes, the pancreas is just not secreting insulin at all, as opposed to in type 2 diabetes. Initially, the pancreas is still secreting some insulin, but it's more so the insulin resistance the cells that are not being able to kind of use the insulin and bring the sugar into the cells.

Shanna M 03:16
Thank you for that explanation.

Nimeet K 03:18
What causes type 2 diabetes, you know, for our listeners?

Ogechi Anyaoku, MD 03:22
Yeah, so it's actually complex. So it is an interplay between your genetics and your environment. So the genes that you inherit from your family members, as well as your lifestyle, your environment, meaning your exercise activity level, the types of foods you eat, your stress level, smoking, and just kind of your everyday, day to day life. It's really an interplay of all of those things that can cause you to develop diabetes.

Nimeet K 03:50
It looks there's a lot of choices people make that that causes, you know, this type 2 diabetes, at least.

Ogechi Anyaoku, MD 03:55
Absolutely.

Nimeet K 03:56
Yeah. What are some of the symptoms for for type 2 diabetes?

Ogechi Anyaoku, MD 03:59
Some of the most common symptoms would be fatigue, a lot of time patients can experience frequent urination, frequent thirst, even frequent hunger, they can have visual changes. And that happens to be like the fluctuations in the blood sugar that causes the visual changes. So it's mostly fatigue and frequent urination.

Shanna M 04:19
What are some of the stages of type 2 diabetes? Do you just start with it all of a sudden? Or does it kind of incrementally get worse?

Ogechi Anyaoku, MD 04:30
Diabetes is really a disease that lives on a continuum. So starting with somebody who has a normal blood sugar, so that person may, you know, have a genetic predisposition to diabetes, but not necessarily develop diabetes because of their environment, right, so that somebody who has a normal blood sugar, they're secreting insulin normally, and they're able to get their sugar into their cells.

Ogechi Anyaoku, MD 04:53
Now, from there you can be on any part of the continuum at any time just based on kind of what you're doing in terms of your lifestyle. So from a normal blood sugar level and somebody who does not have diabetes, they can develop what we call insulin resistance, or they can have a metabolic syndrome. And the metabolic syndrome is basically, again, somebody who has a lot of central obesity, somebody who's overweight, they may have high blood pressure, high blood sugar as well. And then high cholesterol, what is really significant is that central obesity or central fat distribution, because it's the fat, and the chemicals that are released from the fat cells, that really is what we think causes the insulin resistance, and causes patients to develop diabetes. And then from that point, you can go into prediabetes from the insulin resistance. And at that point, that's when we really start to kind of say, hey, we really need to start controlling things, because you can develop diabetes, after prediabetes and in prediabetes, what we see mostly is slightly elevated blood sugar, you know, your fasting blood sugar in the morning before eating is, is greater than 100. And then the a one C, which is another marker that we use for diabetes control is around 5.7, to 6.4.

Ogechi Anyaoku, MD 06:11
So this is the stage where you really can implement a lot of changes to prevent the development of diabetes, which again, comes after the prediabetes.

Shanna M 06:19
That was my question was at that stage sounds like you can start to do something about it, some lifestyle changes, or medication or something like that to really slow the progress.

Ogechi Anyaoku, MD 06:30
Right? Absolutely. And I you know, at any point you can implement that lifestyle changes, whether you're, you know, a person that does not have diabetes, doesn't have prediabetes, doesn't have insulin resistance to prevent diabetes from developing.

Nimeet K 06:43
Well, I think, you know, one of the trends we're seeing in our podcast, is that a preventing a lot of these diseases to develop from. So like, you know, when you when you assess the patient's, and they have the conversation with their primary care provider, my assumption is that the earlier you find these, the better your outcomes are, and how in that transparent conversation with their provider. And when you do testing, you know, checking this glucose levels is very important. And based on their diet, their lifestyle, it could be determined where they are, you know, the earlier the better. Absolutely, what are some of the things that people could do to manage if they do have type 2 diabetes?

Ogechi Anyaoku, MD 07:19
The first thing I always say is, again, lifestyle, that is, the best thing that you can do. That is exercising regularly, you want to make sure that you are doing some sort of physical activity on most days of the week, you want it to be at least 30 minutes in length of time, the more the better. And you want to be exercising at least three days out of the week. So exercise probably is number one. The second thing is your diet, you really want to make sure that you have a diet that is high in whole foods. So that's fruits, that's vegetables, nuts, beans, legumes, things that are unprocessed, because that's kind of where we get in trouble when it comes to diabetes is the processed foods. People say eat a low carbohydrate diet, but vegetables are carbohydrates. Fruits are carbohydrates. And you don't really want to limit your vegetables. You want to eat more of those and choose leaner sources of animal protein. And then of course, you want to eat plant proteins as well.

Shanna M 08:11
Absolutely, yeah, I know, there's medication, there's maybe some other things that people can do to either halt the progress or slow it down.

Ogechi Anyaoku, MD 08:24
Once you've gotten to the point where you do need medication, there are some very basic medications we use at the beginning, a very popular one that most people know about is Metformin, we use it in various different aspects, and not just in diabetes, but it is one of the kind of the first medications we use, very simple to use, right, easy, and it can kind of prevent you from developing diabetes, if you are prediabetic.

Shanna M 08:48
Okay.

Ogechi Anyaoku, MD 08:49
And also, when you are diabetic, it can help to control your blood sugar. But you always want to make sure that you're taking your medications, the way that they're prescribed, you're taking them daily, and you're taking them in the right way, including with your lifestyle modifications.

Shanna M 09:03
So there's lots of options that people can do. It's just understanding what's happening in their body and making small adjustments that can amount to a large change. Absolutely. You know and a big difference in their, in their health. What are some of the common questions or myths that people come to you with that we can clear up today?

Ogechi Anyaoku, MD 09:25
Yeah, so I think the first question is probably people ask, how do they prevent it? And we've said it multiple times today.

Ogechi Anyaoku, MD 09:32
You want to prevent it with lifestyle changes, people get really scared that they're going to have to completely change their diet, and they're never going to be able to have a dessert again, which is not true. I mean, definitely you want to limit the amount of processed sugars that you do eat, but it doesn't mean that you can never have something sweet again, because you want to be able to enjoy your food as well. That's part of having a full and healthy life. So I would say don't be so scared about having to completely forego all the things that you like, it's just going to be about moderation. You know, I get a lot of people that ask about family members, and I say, you know, maybe encourage them to exercise a little bit more, go on walks with them after you have your largest meal, or even, you know, follow the food plan that they might have that's developed for them just to help give them that support, and let them know that they're not alone.

Shanna M 10:13
Yup

Shanna M 10:23
I've heard those all come up before in the past.

Nimeet K 10:26
and especially the ways to support your families to, I really like that, because you know, you encourage them to just go for a short walk after meals or have healthier meals together, you know, I think that's a great idea.

Shanna M 10:37
It's hard to make a change all by yourself.

Ogechi Anyaoku, MD 10:38
It is

Shanna M 10:39
And so when you have support from family or friends, that makes a big difference.

Ogechi Anyaoku, MD 10:43
Absolutely.

Shanna M 10:44
Well, thank you for coming in. We really appreciate all your time and this excellent information.

Ogechi Anyaoku, MD 10:50
Thank you. Thank you for having me.

Shanna M 10:51
Thank you. And maybe we'll have you back to kind of go into diabetes a little bit deeper, because I know that there are specific things that you can eat and not eat. And there's questions about that. And just navigating once you've been diagnosed, your medication, how to take your blood sugar, all of that what to watch for. So we definitely have more to discuss on this topic. Nimeet, thank you for joining us always.

Nimeet K 11:13
Absolutely.

Shanna M 11:14
And to our listeners. If you want to find out more about Dr. Anyaoku, you can visit AdventistHealthCare.com. And also on our website you can find classes and events where we have diabetes webinars listed, we also have some diabetes classes listed. So check those out if you are interested. And as always, thank you for listening. And don't forget to hit subscribe or follow on Apple or Spotify to get updated podcasts from us. Thank you.