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Transcript for S20 Ep22

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Cary Hall

And now America's Healthcare Advocate, Carry Hall. Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. You can find out more about us by going to the website America's Healthcare Advocate dot com. Send me an email. I'm happy to answer them. I get quite a few, so I don't answer each and every one the same day, but I do answer each and every one in studio with me today.

00;00;27;18 - 00;00;45;04

Cary Hall

Ron Hoyler back with us today. He is working at Saint Luke's. He is in charge of the Saint Louis Diabetes Education and Management Program. We're going to be talking about the topic of diabetes today, and I'm going to tell a little personal story about why I asked him to come in studio today and talk about this topic. So welcome back, Ron.

00;00;45;07 - 00;00;46;10

Ron Hoyler

Thanks for having me.

00;00;46;10 - 00;01;07;27

Cary Hall

Glad to have you here. Our producer, Mr. Darren Wilhite behind the microphone, Dave Thiessen behind the cameras. All the shows are recorded and posted on YouTube. We are at 425,050 views. It's really quite amazing. I never would have imagined we could get that many views on YouTube, but we have. So we have our own channel on YouTube. America's Healthcare Advocate.

00;01;07;27 - 00;01;26;21

Cary Hall

You can certainly find it if you Google it. No problem. There also 15 podcast platforms. We're on Spotify, we're on Audacy, we're on iHeart radio platform, we're on SoundCloud, you name it, we're probably on it in terms of podcast platform. So when you hear one of these shows, maybe it's something you want to share with somebody or tell somebody about.

00;01;26;25 - 00;01;53;16

Cary Hall

Maybe you've got a family member struggling with weight and diabetes, type two diabetes, pre-diabetes, pre-diabetic like I was. That's the purpose of this show today. I'm doing this today, using myself as an example, and I ask Ron to come in here to talk about this topic and the fact that we have an epidemic in this country. If you think not, we have 136 million Americans, 136 million Americans, either diabetics or pre diabetics.

00;01;53;18 - 00;02;11;02

Cary Hall

We only have 385 million people in this country. So what does that tell you? It tells you we got a lot of people with problem. Okay. So as I said, Ron is an expert in this topic. That's why we brought him in studio today. He is at Saint Luke's Health care system here in Kansas City. He holds a master's of Business Administration and

00;02;11;02 - 00;02;33;17

Cary Hall

Health Care administration is a master of Science in Nursing, a Bachelor of Arts and Personal Administration, an associate Applied Science nursing. He is a wonderful individual. He has to be one of the men at my Bible study group, and I know him very well and been very fortunate to get to know him, and I wanted to bring him into the studio today just to talk about this issue and to help people understand how how to deal with it.

00;02;33;17 - 00;02;52;00

Cary Hall

So now I'm going to tell you a little bit about me, okay. So I've been struggling with weight for the last probably three years that I have not been able to get below 250 pounds. I don't care what I did, I might get down to 245 if I'm lucky, but I couldn't get below that number. Maybe 244. That was probably the best it ever was.

00;02;52;03 - 00;03;13;07

Cary Hall

And I went in for a physical, had the bloodwork done right, and I came back pre-diabetic and it scared the hell out of me. Okay. Because I did not want to become a type two diabetic. Okay. So, I went to my primary care physician and I asked for some help, and she sent me to a place called, a health care clinic here in town.

00;03;13;09 - 00;03;30;15

Cary Hall

and I and I got involved in that clinic, and it was called Heartland Weight Loss. They've done a wonderful job. And I sit here and talk to you today. I weigh 230 pounds. Now, here's the point I want to make. I'm not taking Ozempic and I'm not taking Wegovy. I made some lifestyle changes, okay? Some pretty significant ones.

00;03;30;17 - 00;03;45;29

Cary Hall

I'm still quite happy with my lifestyle, but I made some life lifestyle changes. We'll talk about those as we get into the broadcast. But you can solve this problem. You don't have to become a type two diabetic. You don't have to become a type one diabetic if you are type two diabetic. And that's why we're doing this show today.

00;03;46;05 - 00;04;08;20

Cary Hall

I'm passionate about this because I went through it, okay. And I had a hell of a time trying to solve the problem. I was very fortunate. I used this man as a coach. He helped me. Okay. and help you go through this process. But I went to the folks at Heartland. I've had doctor, the doctor from Heartland on here, along with one of the clinicians, and, and they've done a great job for me.

00;04;08;20 - 00;04;20;25

Cary Hall

What I'm trying to get the message I want to get across to you is you can fix this if you want to. You have to start with the desire to want to do it. So let's just talk about this 135 million Americans.

00;04;20;27 - 00;04;21;24

Ron Hoyler

Crazy isn't it?

00;04;21;25 - 00;04;46;16

Cary Hall

Ron, that that that should scare the hell out of people in this country. you know, there's a constant chatter about the cost of health insurance, the cost of health insurance, the cost of health insurance. Well, you know, for 26 years. Okay. I was a health insurance broker. All right. And I will tell you, there's there's an old adage in this business, 20% of the people drive 80% of the claims.

00;04;46;23 - 00;04;50;23

Cary Hall

Guess who? The largest number of people in that 20% category are.

00;04;50;25 - 00;04;51;21

Ron Hoyler

People with diabetes.

00;04;51;21 - 00;05;13;29

Cary Hall

They're people with diabetes. Yeah. Okay. Yeah. Yeah. So. So how did we get here? and then you know, we'll get into the let's talk about the problem. How do we get here, what the problem is, and then we'll talk about the solutions. Ron, so how did this country evolve to a point now where we're we're seeing, you know, this number 136 million either pre-diabetic like I was.

00;05;13;29 - 00;05;22;20

Cary Hall

By the way, I am not now and I'm not even classified as as obese, because I've dropped the weight level so significantly. But how did we get here?

00;05;22;22 - 00;05;48;06

Ron Hoyler

Well, I think there's a lot of factors that have contributed to this. Technology is one of them. When we look at how technology has made our life easier, that means we're spending less physical energy doing things right, less time walking because we can drive, we're spending more time eating because there's fast food restaurants on every corner. Not only that, every fast food restaurant wants to supersize your meal.

00;05;48;09 - 00;05;50;12

Ron Hoyler

Of course you want to get that extra.

00;05;50;18 - 00;05;56;23

Cary Hall

Large French fries at Five Guys, I'm telling you, there's more French fries to that bowl than you could possibly eat. And that's a regular size order.

00;05;56;23 - 00;06;27;22

Ron Hoyler

So we end up taking in far more calories, carbs, sugars, sodium than we ever are going to use or need for that matter. And as it accumulates in our body, it affects our body. right now, almost 90% of Americans are overweight. And when we are overweight, certain metabolic processes become somewhat dysfunctional. the insulin our body creates and how effectively the body can use it is one of those systems that's affected.

00;06;27;22 - 00;06;49;08

Cary Hall

So talk about that. And what is it what does that mean to diabetes? The glucose levels, those issues and and how does that relate to diabetes. How does that curve using processed foods, artificial sweeteners, all the things that we consume in our body that translates into that problem, which then makes you either pre-diabetic or type two diabetic.

00;06;49;10 - 00;07;14;19

Ron Hoyler

Sure. Well, first let's understand what, type two diabetes is. It's also similar to insulin resistance. When we eat certain foods, those foods serve a purpose. For instance, eggs, meat and cheese. Those are classified as protein. Our body needs protein to maintain muscle and to repair tissue. so when we eat proteins, we are helping to maintain our important muscle.

00;07;14;21 - 00;07;40;00

Ron Hoyler

that's why you see athletes and bodybuilders doing the extra protein shakes. Now, when we eat other foods like rice or pasta or potatoes or corn, or bread, those are classified as carbohydrates. And our body needs carbohydrates. Carbohydrates is not a dirty word, but our body converts it into the fuel our brain and muscles need. And that fuel is called blood sugar.

00;07;40;02 - 00;08;04;08

Ron Hoyler

And when we have blood sugars circulating in our system, in our brain, our muscles need it. Our body produces a hormone called insulin. Think of insulin like the key that unlocks the door. It opens up the pathway for the blood sugar to get out of the bloodstream, into the muscles, and into the brain. When we have type two diabetes, the insulin we're making, it's dysfunctional.

00;08;04;08 - 00;08;26;01

Ron Hoyler

It's not getting the address of which door to go unlock. And so our blood sugar levels rise up, our blood becomes thicker and stickier. That's harder on the heart to pump it’s harder on the kidneys to filter. It's harder to circulate thick blood through the tiny blood vessels in your eyes and in your gums. It's hard to circulate it all the way down to your feet.

00;08;26;03 - 00;08;37;13

Ron Hoyler

So then, after years of higher blood sugar, we begin to see complications. The problem is that this is somewhat silent. This is not an acute situation that we see happen.

00;08;37;13 - 00;08;42;20

Cary Hall

No, it creeps on you. It creeped up on me. I fought this for four years. Okay.

00;08;42;22 - 00;09;07;09

Ron Hoyler

And, so then what we do, like, in America, we do with several diseases and disorders as we look to a medicine to take and the unique ness of diabetes is that it's not just a medicine. It's a trifecta that needs to be used for a solution. So we're talking diet, exercise and medicine.

00;09;07;09 - 00;09;25;13

Cary Hall

When we come back from the break, we're going to talk about that because that's what I did. I am not on Ozempic and I'm not on Wagovi. If you thought that when I told you that I lost 20 pounds and got from 250 down to 230, that's not how I did it. Okay, we're going to talk about those medications, and we're going to talk about the side effects and some of the issues associated with them.

00;09;25;18 - 00;09;42;16

Cary Hall

And then we're going to talk about how to do it without doing that okay. So stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocates broadcasting here on the HIA radio network. Coast to coast across the USA.

00;09;42;18 - 00;10;12;20

Steve Kuker

The golden rule treat others as you want to be treated. I'm Steve Kuker, and this is one of the founding principles of my firm, Senior Care Consulting. Since 2002, our value statement has included. Honor our mother and father. Respect our elders. Care for those in need, and treat your family as our own. We've been honored to help hundreds of families make one of the most difficult decisions they could ever make.

00;10;12;24 - 00;10;43;25

Steve Kuker

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00;10;43;27 - 00;10;48;18

Unknown

You.

00;10;48;21 - 00;10;49;11

Unknown

Welcome back.

00;10;49;12 - 00;11;07;00

Cary Hall

You're listening to America's Healthcare Advocates Show broadcasting coast to coast across USA. Remember, you know, this is a very important show for a lot of people out there. 135 million people with this issue to deal with. If you've got a family member, you know, this is broadcasting around the country. It's going to be upon the podcast channels.

00;11;07;07 - 00;11;25;04

Cary Hall

It's going to be on the YouTube channel as well. Have them go to the website and watch the show America's Healthcare Advocate, or have them listen to the podcast. Maybe that's your husband. Maybe it's your wife. Maybe it's your grandfather, maybe it's your father, maybe it's your mother. And they're just not dealing. You know, they're significantly overweight.

00;11;25;04 - 00;11;47;16

Cary Hall

You know, they're either already a type two diabetic or they're at risk for it. Have them listen to this and see if this is something that motivates them to make the changes in their life. They can turn this around, believe me, it's worth it. I know, because I did it and that's why I'm doing this show. And that's why I ask Ron to come in here and take time out of his day to talk to you about this issue.

00;11;47;18 - 00;12;05;18

Cary Hall

So this is interesting. We talked about this off here. I want to talk about it now. Type one versus type two I thought and I was wrong that you if you had type two diabetes it could morph into type one. Type one diabetes you said is basically a genetic issue that can develop over time. So talk about that.

00;12;05;18 - 00;12;07;02

Cary Hall

And then the difference between the two.

00;12;07;04 - 00;12;40;01

Ron Hoyler

Yeah. So basically type one is an autoimmune disorder in which your body's immune system mistakenly, thinks that the cells that make insulin are a threat and it goes and it systematically destroys them so that your body can no longer produce the hormone insulin. Type two, while it has a genetic function, it is more a, process of time where our body becomes dysfunctional with the way it is using and producing the insulin so that it can't get the job done.

00;12;40;07 - 00;13;06;24

Cary Hall

So basically, here's the deal. All right. you know, overweight and obesity, lack of physical activity. If you're a couch potato, 31.9% of physical inactivity defined as getting less than ten minutes a week of moderate, vigorous exercise. Yeah, well, that's a problem. Okay. You know, if you're sitting on the couch eating that bag of potato chips and drinking Budweiser every night, you're probably not going to do much for yourself in terms of health issues and resolving.

00;13;07;00 - 00;13;23;15

Cary Hall

If you are a type two diabetic or pre-diabetic, you're going to stay there. You're going to get worse. Okay, high blood pressure. This surprised me. This another thing. But I went in this last time to Heartland and they took my blood pressure. And I'll talk about the chart that they do every time I go in there. But I went in there.

00;13;23;18 - 00;13;48;00

Cary Hall

My blood pressure was the lowest it has ever been in my life. Okay. I was absolutely floored by what my blood pressure was because it was just that low. I had never seen blood pressure that low before. It was like 129 over 70 and I was like, I've never been in that category. I'm on blood pressure meds. I might be able to start getting off of them now because I've lost so much weight and because I've changed my diet around as a result of that.

00;13;48;00 - 00;14;13;22

Cary Hall

But that's that's one of the issues is high blood pressure, high cholesterol. That's a huge problem. And then smoking, clearly if you're smoking, you're making yourself more at risk for these issues by combining all of that together. So now we have this trifecta. we have processed food, we have all these sugars, we have obesity, okay, inactivity. And that all comes together and it creates this problem.

00;14;13;24 - 00;14;33;09

Cary Hall

let's talk a little bit about how that affects people's lives. And then in the next segment we get into the long segment. We'll talk about how you overcome that and how you can change how you have the ability, okay, to change that. But let's just talk about some of those things that happen. I mentioned some of it, you know, the it affects your vision.

00;14;33;11 - 00;14;44;24

Cary Hall

I've got friends of mine, people that I've known that that have lost limbs literally. I mean, amputations, toes, feet, those kind of things. So talk a little about that Ron.

00;14;45;00 - 00;15;07;18

Ron Hoyler

Well, diabetes is ravaging what it does to your bodies and the systems of your, in your body over time. And the unfortunate thing is that doesn't have to happen. It doesn't have to happen if we can get people educated. I say that diabetes is a disease of inconvenience. And really, that's that's not giving it full justice.

00;15;07;25 - 00;15;30;15

Ron Hoyler

It is terrible to have to think about diabetes every time you want to eat something each day, every time you want to do some kind of activity when you go to bed, it is a disease that is constantly on your mind and so you don't ever get away from it. Some people choose to ignore it. Some people hope that just taking medicine will do the trick.

00;15;30;18 - 00;15;44;29

Ron Hoyler

And when I had said trifecta earlier, I meant there's medicine and that's great to help. But really predominantly what you do for yourself is you get to an ideal body weight by watching what you eat, and you do some exercise or activity.

00;15;44;29 - 00;16;02;17

Cary Hall

So now we're going to talk about silver bullet. You know, I can't tell you the number of people I know that are doing Ozempic or Wegovy. I didn't do it. In fact, I was offered it by my doctor and I said no, okay. Because it scares the hell out of me. The side effects from it, all kinds of things are happening now.

00;16;02;20 - 00;16;19;18

Cary Hall

Darren told a story in the break there. Gwyneth Paltrow had, a guest in her home. Who? One of the side effects. This is massive diarrhea. And they had a horrible attack in her home. I guess while they were having some kind of a dinner. I've got a friend who we were supposed to go out to lunch with on Saturday.

00;16;19;21 - 00;16;32;18

Cary Hall

They had to pass. He just started Ozempic and when we were talking he said, I really apologize, but I said, well, you know, I said, what you're dealing with is probably a side effect. So talk about that. Okay.

00;16;32;18 - 00;16;58;13

Ron Hoyler

Well, you know, most all medicines are at risk for some side effect. And what we're doing is we're weighing is it worth it. You know, but in certain terms we're robbing Peter to pay Paul. Right. One of the side effects of Ozempic is often some people have the diarrhea, the bloating, the constipation. But I should mention that there are some people that don't, and it works very effectively for them.

00;16;58;16 - 00;17;16;09

Ron Hoyler

But that is a potential side effect that can be embarrassing and it can be very, very uncomfortable, to deal with. And so we always are going to say, make sure that you've talked with your doctor about any medication and what the side effects are and if it would be right for you.

00;17;16;09 - 00;17;17;18

Cary Hall

So what about Wegovy?

00;17;17;21 - 00;17;41;18

Ron Hoyler

So Wegovy is essentially like Ozempic like a stronger version? And it is FDA approved for weight loss specifically. Now, Ozempic was FDA approved for people with diabetes. It just turned out that one of the effects of it was that it slowed down your digestion to so that you felt full longer, and if you felt full longer, you would eat less.

00;17;41;18 - 00;17;44;18

Ron Hoyler

And so the natural consequence of that was that you would lose weight.

00;17;44;18 - 00;18;01;03

Cary Hall

And so, you know, a lot of people look at this like it's a silver bullet. I've got, you know, friends, associates, business folks that I work with who've lost ten, 20, 30 pounds on this stuff. But there's a problem there. Okay. One of the things that I get every time I go to Heartland is they do a complete chart on me.

00;18;01;03 - 00;18;17;29

Cary Hall

They do weight, they do body fat, and they do muscle mass. And so what we're trying to do when they do that is we're trying to line those three up. If you can get this to be an eye, they all line up, then you've made progress. Well I'm I'm pretty close. I mean if you look at this chart, I'm not that far off right now okay.

00;18;18;01 - 00;18;34;13

Cary Hall

That's great. Yeah. And I'm officially not obese anymore. But I didn't use I didn't do the medications because I was really concerned about long term effects. They don't know the long term effects of some of the things that are going to go on with this, because it hasn't been used for this for that long. Okay. But it is a silver bullet.

00;18;34;13 - 00;18;49;13

Cary Hall

But if you're not doing what what was explained to me, it will go into this next segment a little more was if you're not building that muscle mass while you're doing this, you're you're going to have a problem down the road as a result of that. So that was one of the reasons for it. And so that is an issue.

00;18;49;13 - 00;18;59;18

Ron Hoyler

Correct. Well, we have so many functions that, are dependent on other functions that we do. Right. You can't just take a weight loss medicine but not change the way you eat.

00;18;59;20 - 00;19;17;09

Cary Hall

Okay, there you have it. And when we come back, the next segment I'm going to talk about that. What are the consequences of that okay. if you do the silver bullet but you don't do the rest of it, what's going to happen? Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA radio network.

00;19;17;16 - 00;19;30;20

Cary Hall

Coast to coast, across the USA. We'll be right back with more.

00;19;30;22 - 00;19;50;21

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA here on the HIA radio network. If you want to find out more about us, go to the website America's Healthcare Advocate.com. All the shows are posted up there as well. Also, as I mentioned earlier, we are at 450 some thousand views on YouTube.

00;19;50;24 - 00;20;07;20

Cary Hall

It's growing. Thanks to all of you out there and listening audience. We greatly appreciate you watching it on YouTube and listening on all the podcast channels. Again, you know, the purpose of these shows is to educate, inform. And that's why I brought Ron Hoyer in here today. He is an R.N. at Saint Luke's Health Care System.

00;20;07;22 - 00;20;20;00

Cary Hall

By the way, if you are having an issue like this and you would like to make an appointment to see Ron or one of the specialists at the Saint Luke's health care system, the website SaintLukesKC.org.

00;20;20;03 - 00;20;38;16

Cary Hall

That's the hospital and the health system my wife and I have used for 20 some years. Great people. They do a wonderful job and we're very fortunate to have them here as clinicians in this community. All right. You said something off-air that I really liked. Make diabetes fit in your life, not live your life around diabetes.

00;20;38;16 - 00;20;39;12

Cary Hall

What does that mean?

00;20;39;15 - 00;20;47;20

Ron Hoyler

Well, diabetes is a chronic disorder. It doesn't go away after a week of antibiotics or after a couple of rounds of steroids.

00;20;47;26 - 00;20;48;11

Cary Hall

no it doesn’t.

00;20;48;12 - 00;21;15;09

Ron Hoyler

And, that means you're living life with it. You're married to it, so to speak, and there's no divorcing it. So you have to learn how you're going to still be able to live your life and be happy. And that means you have to master the diabetes. You make the diabetes fit into your life. You don't live your life around the diabetes, worried about every single thing you put into your mouth, worried about any activity that you want to have that's letting the diabetes win.

00;21;15;12 - 00;21;36;25

Ron Hoyler

And we don't have to do that anymore with the things that we know about diabetes. We've learned more in the last 25 years about diabetes than all the previous centuries combined. And with that knowledge, we're able to, give you a winning strategy, to help you succeed and to help you still be able to live your life and, and be happy.

00;21;36;27 - 00;21;55;21

Cary Hall

All right, so, I'll use my self as an example here. I like having a martini in the evening. and I may want to have a glass of wine. Okay. And that was. That was a regular thing for me. It's not a regular thing anymore. I had to walk away from that, that. So on the weekends. Yep.

00;21;55;24 - 00;22;13;01

Cary Hall

I'll have a martini and I will have wine with dinner or one or the other. Okay. But I had to walk away from that. I love desserts, I love desserts, I have a real sweet tooth. candy and desserts. You know, typically in the evening, I would have maybe a piece or two, of See’s candy, or maybe some dessert.

00;22;13;01 - 00;22;33;16

Cary Hall

I don't do that anymore either. And I watch the carbs. Okay. You know, it's protein, meat and cheese, vegetables that that we, you know, my wife cooks very healthy meals. And basically I made those changes. I increased my workout schedule, the way, you know, I work out three times a week, I walk at least a mile, mile and a half every day.

00;22;33;19 - 00;22;49;13

Cary Hall

Okay. And I added to my workout schedule, which is three times a week, but I added reps and more time to it to make it more difficult. And I've been able to accomplish this. Did I, you know, I had to make some changes. The point is, you know, it's not going to happen. You can do the Ozempic, you could do Wegovy.

00;22;49;18 - 00;23;06;10

Cary Hall

But, you know, when I go in and and I'm checked, they're measuring muscle mass, body fat. And those are the muscle mass needs to go up. Body fat needs to come down. And I've been able to accomplish that. But it's a combination of things to make that happen. So talk talk about how people do that.

00;23;06;10 - 00;23;29;25

Ron Hoyler

Well, for instance, when we get closer to our ideal body weight, we know that the insulin becomes more efficient, more sensitive. We know that when we have more muscle mass, we consume more of the energy, more of the fuel. We work our blood sugar down when we have that exercise. That helps with the muscle, and it also helps get rid of the fat.

00;23;30;01 - 00;23;53;29

Ron Hoyler

So we are metabolically improving ourselves and making those hormones work more efficiently. the same with the dietary aspect of it. and I'll point something out to you from what you said earlier, when I say I want, diabetes to fit in your life, not you live your life around your diabetes. I mean, I want patients to understand you do not have to be in range 100% of the time.

00;23;54;00 - 00;23;54;20

Cary Hall

I'm not.

00;23;54;20 - 00;24;14;16

Ron Hoyler

Okay. People sometimes think they are. And, and as, as far as we would like them to be in range as much of the time as possible, I want you to have that piece of birthday cake. I want you to be able to celebrate special occasions. And if your blood sugar is going to be high, that's going to be okay.

00;24;14;16 - 00;24;43;19

Ron Hoyler

We'll get it right back down. It's a long race. It's not a short run. And what we're looking at doing is good habits for the things that affect our blood sugars. And it's tough because we know there's over 42 identifiable variables that can affect your blood sugar. That's a lot to try to juggle. And so we have to have the right perspective of what a chronic illness is, and that it's okay to sometimes not always be perfect with our blood sugar.

00;24;43;21 - 00;24;59;14

Cary Hall

And this is interesting because one of the things I learned by going to heartland and they do a great job of this was, hey, you know, you can fall off the wagon on Friday and Saturday, but you get back on the wagon on Sunday. You go through the rest of the week. So that means on Saturday morning I'm having a donut.

00;24;59;16 - 00;25;17;08

Cary Hall

I'm telling you right now, I'm having my donut. I may have two actually right on, on occasion. All right. and there will be dessert on Saturday night. almost always. my wife has some kind of. She makes homemade ice cream, you know, I'll have ice cream on Saturday night, but during the week, Monday through Friday, that's not going to happen.

00;25;17;13 - 00;25;34;09

Cary Hall

Okay. so you have to make you have to be willing to make those changes, right? That does it. Yay! Yesterday I told him off-air I went and got Five Guys. You got a double double with bacon, and I order French fries. Okay. I haven't had Five Guys in probably two months, but I had it yesterday. Okay.

00;25;34;15 - 00;25;43;12

Cary Hall

So. Yeah. you don't you're not. It's not like you have to do this every day, but you've you have to be willing to make some changes. Right?

00;25;43;12 - 00;26;10;28

Ron Hoyler

Right. But understand those changes aren't just improving your blood sugars. They're improving your life in so many different aspects. We know, for instance, that by losing some weight, we're also improving. Often our heart health, our cholesterol levels, so many other functions. We know that, by reducing stress, we are reducing some of the hormones that cause us to have other issues.

00;26;10;28 - 00;26;32;19

Ron Hoyler

High blood pressure. the exercise helps with high blood pressure. They're all interrelated. So any effort that you make is going to be helpful. You don't have to be Superman in the gym every day. You don't have to eat the perfect food at every meal. But making positive steps is going to yield positive changes on several different health fronts.

00;26;32;19 - 00;26;38;21

Cary Hall

Let's talk about one of the other things that you know that I see in the show notes. Before we did the show was sleep issues.

00;26;38;21 - 00;26;39;08

Ron Hoyler

Yeah, yeah.

00;26;39;09 - 00;26;46;29

Cary Hall

So talk about that. I mean, sleep apnea is an issue for me. I have a machine. Okay. But I'm noticing I'm sleeping a lot better.

00;26;47;01 - 00;27;10;16

Ron Hoyler

Well, I think, I believe statistically about half of people with diabetes do have sleep disorders. but sleep is significant when it comes to your blood sugar levels, because when you're sleeping, your body is actually doing using hormones to try to balance your blood sugar. Right? Because we're not eating and we're not exercising while we're sleeping. And so the body is compensating with hormones.

00;27;10;18 - 00;27;35;21

Ron Hoyler

And if one of those hormone levels is off, the others try to compensate. this can result in, blood surge, blood sugar surge, in the early morning hours called dawn phenomena. but more importantly, we know and I believe actually we mentioned this or it was mentioned on a previous show of yours, sleep deprivation raises your, insulin resistance.

00;27;35;24 - 00;28;00;12

Ron Hoyler

And so when we're not getting enough sleep, it raises our blood sugars. we know that, to correlate that, that more than ever, we're looking at our phones or looking at TV, and the blue light disrupts our ability to get to sleep and stay asleep, which then the effect is we're not getting enough sleep. The effect of that is that we're more tired, but also our blood sugar levels go high.

00;28;00;15 - 00;28;09;17

Ron Hoyler

These things just go hand in hand and they compound each other. And so again, any positive change we make can help us in so many other areas.

00;28;09;17 - 00;28;18;04

Cary Hall

So people, you know, someone they see their faced with this and say that's a, that's a hard climb. You don't have to do it all on the first day, do you Ron?

00;28;18;05 - 00;28;18;14

Ron Hoyler

Right.

00;28;18;18 - 00;28;21;22

Cary Hall

I mean, how do you you know, you you you write, you have a.

00;28;21;28 - 00;28;25;29

Ron Hoyler

What’s the saying about a journey of a thousand miles begins with the first step.

00;28;25;29 - 00;28;26;20

Cary Hall

There you go.

00;28;26;20 - 00;28;38;17

Ron Hoyler

So, any education that you can get to help you understand the strategies that today I'm willing to do tomorrow, I'm willing to do this one. All of those add up as positive influences.

00;28;38;17 - 00;28;50;12

Cary Hall

So as a clinician, as somebody who this is your life that you teach, you help people with this issue. When people come into you and they're faced with this, how do you get them started? What do you say to them to get them started?

00;28;50;16 - 00;29;12;18

Ron Hoyler

Well, I think you have to meet them where they're at. It begins with where they are, how they feel, what their, ability is, what their resources are. Each person is individual, and likewise, diabetes is individual to each person. And what I mean by that is there's not just one medication and one dose that does the trick.

00;29;12;21 - 00;29;16;21

Ron Hoyler

There's over 800 combinations of oral medications and doses.

00;29;16;21 - 00;29;17;19

Cary Hall

I had no idea.

00;29;17;19 - 00;29;22;23

Ron Hoyler

that a provider can choose from, to try to address diabetes.

00;29;22;26 - 00;29;41;12

Cary Hall

And that's why you take the time. And the first step in that journey of a thousand miles is to go see a provider. You're listening to this around the country. Okay. you know, find a health care system in your town, your city, and seek out their diabetes program if you've got to go talk to. That's what I did.

00;29;41;15 - 00;29;58;24

Cary Hall

I went and talked to my primary care physician, Doctor Bosart, and she said, Cary, you know, you're going to keep fighting this until you get some help. And I didn't know how to do this. I tried all this stuff on my own. It didn't work. That's why I went to Hartland. And out of Hartland came a program. And now where I'm at, I'm in a much better place.

00;29;58;24 - 00;30;16;22

Cary Hall

If you want help here in Kansas City, saintlukeskc.org is the website. Go up on the website. You can access their diabetes program and make an appointment to go see one of their conditions. And get on the road to recovery. Change your life for the better. We'll be right back after the break.

00;30;16;22 - 00;30;25;29

Cary Hall

You're listening to America's Healthcare Advocate, broadcasting on the HIA radio network. Coast to coast across USA.

00;30;26;02 - 00;30;41;09

Cary Hall

Welcome back. You're listening to America's Healthcare Advocates Show, broadcasting coast to coast across the USA. Here on the HIA radio network. You can find out more about us to go to the website. AmericasHealthcareAdvocate.com. All right. So in studio with me Ron Hoyler.

00;30;41;09 - 00;31;00;18

Cary Hall

He is an R in at Saint Luke's health care system. The topic today is diabetes. What to do about it if you're pre-diabetic what to do about it if you are diabetic, if you're a type two diabetic, and how you can overcome that chronic condition and disease if you take the first steps to do so and get on some type of regimen to change your life.

00;31;00;20 - 00;31;19;15

Cary Hall

So here's a part that I find fascinating. There's a big emphasis on this country and the constant increase in the cost of health care, specifically health insurance. And what most people do is they look at the health insurance companies and they say they're the problem. Well, maybe, maybe they're some of the problem, but they're certainly not all of the problem.

00;31;19;15 - 00;31;42;27

Cary Hall

And I'm going to give you an example. $413 billion is what we are spending on diabetes in this country, $413 billion. That's what happens from those people that get amputations, those people who have vision issues, those people who have a whole host of things that are outcroppings of this particular disease. So that's why, you know, we're doing this today is to talk about that.

00;31;42;27 - 00;31;53;10

Cary Hall

So if you're an employer out there, you know, there are programs available, you know, and let's talk about that. Sure. The insurance you said pays for it, Medicare pays for talk about it, Ron.

00;31;53;10 - 00;32;22;25

Ron Hoyler

I mean, they are recognizing more and more that preventative medicine education can prevent, right. It can stop some of these issues from happening before they even begin. A or it can lessen the burden that they create. I've told you this before, and, the information I have was that one third of the entire Medicare budget is allotted towards the complications of diabetes.

00;32;22;28 - 00;32;37;12

Ron Hoyler

That 33% of the Medicare budget for complications from diabetes. Why are we waiting until there's a problem, when we can work on it on the front end and prevent some of the millions, if not billions of dollars that we have to spend?

00;32;37;17 - 00;32;59;00

Cary Hall

And that's so here's here's some just, you know, if you're an employer out there listening to this, you know, you've got a health care plan for your employees. You know, you want to do something that's going to help put out, put out it, put out a memo, get on, you know, have a meeting for people that have have somebody come in and talk to them from Saint Luke's or from wherever, okay.

00;32;59;00 - 00;33;24;08

Cary Hall

About about what this means to have type two diabetes here. Excess costs associated with medications constitute 44% of the direct medical burden. Hello. That's your health insurance budget. That's a premium that goes up every year. 2020. A total of 7.86 million hospital discharges were reported with diabetes, and any listed diagnosis among U.S. adults aged 18 or older. Here's another one.

00;33;24;13 - 00;33;44;14

Cary Hall

In 2020, 16.8 million emergency room visits were reported, with diabetes listed as a diagnosis among among among adults 267,000 the hypoglycemic crisis and 202,000 from hypoglycemia. Talk about hypoglycemia. What that is, how that works.

00;33;44;14 - 00;34;04;12

Ron Hoyler

It's scary. It's, it's the medical term for low blood sugar. And, you know, much like if your car were low on gas and would begin to sputter, it's not going to it's not going to go. It's not going to get you where you need to go when your body's blood sugar levels get low. You, are not able to get the appropriate amount of fuel to your brain to think straight.

00;34;04;14 - 00;34;11;10

Ron Hoyler

your muscles aren't going to work the way you want them to. It's a dangerous situation to be in. It's a scary situation to be in.

00;34;11;10 - 00;34;12;25

Cary Hall

And that's brought on by diabetes.

00;34;12;26 - 00;34;35;06

Ron Hoyler

Well, what happens? Insulin is a hormone that lowers. It works to lower the blood sugar levels. And as I mentioned earlier, you have counter regulatory hormones that actually try to raise it up and balance it out. And, that can be directly impacted by medications that you're taking, by the amount of activity that you're doing, by the type of food you ate or didn't eat.

00;34;35;13 - 00;34;48;11

Ron Hoyler

So many variables. And it's a balancing act, right? And sometimes that tips to the low side, and that can cause a situation that can be dangerous, it can be embarrassing and it can be deadly.

00;34;48;18 - 00;34;53;20

Cary Hall

So we do yo yoing back and forth is what you're basically saying here. Okay.

00;34;53;20 - 00;34;55;22

Ron Hoyler

Certainly something that can happen. Variability.

00;34;55;28 - 00;35;11;08

Cary Hall

That's interesting. You know, and the thing about this is it is interesting to me from the health care side and from the health insurance side, these dollars are dollars that don't have to be spent people. These are dollars that they can go back in to improving employee benefits, doing lots of other things if there's a program in place.

00;35;11;13 - 00;35;26;15

Cary Hall

So how big a role does education play in this? I mean, this is what you're doing at Saint Luke's, which is extremely important how big a role does, does educating people and getting them to recognize the problem so they'll do something about fixing the problem?

00;35;26;22 - 00;35;57;11

Ron Hoyler

Yeah. Well, it's a big part of the equation because this is not, as I said earlier, just something a condition that you get a prescription for. This is a condition you live with. And the actions and decisions that you make directly affect it. And so what you're choosing to do, if you're choosing to supersize what you're choosing to eat, how much if you're choosing to do any activity or exercise, how much, how little, if you are going to your doctor or not going to your doctor.

00;35;57;18 - 00;36;06;28

Ron Hoyler

All of these play a part in the equation. That's going to make it a little bit easier for you to manage diabetes, or maybe have devastating effects from not taking care of it.

00;36;07;04 - 00;36;22;15

Cary Hall

And if you've got a family member this dealing with this, how important it is to get that family member in front of a clinician like yourself to understand before it causes a crisis. And if it's your mom that your dad, maybe you're a caregiver for your grandmother or your mother. Let's talk about that. Yeah.

00;36;22;15 - 00;36;35;17

Ron Hoyler

Well, I mean, the complications are devastating from diabetes. You're talking that it's the most common cause of end stage renal failure. That means dialysis 3 or 4 times a week for several hours. That's not how you want to live your life.

00;36;35;20 - 00;36;37;23

Cary Hall

These are the calories. No life when you're doing that.

00;36;37;23 - 00;36;56;29

Ron Hoyler

Well, that's what we want to try to avoid. And we can, by becoming educated on not just the diabetes, but when you're getting the diabetes education, our dietitians are talking to you about the diets and food labels and understanding the amount of sodium that's coming in and other issues that just make for a healthier lifestyle.

00;36;57;00 - 00;37;16;15

Cary Hall

Yeah, it's funny because one of the things I learned at Heartland, because there is I do meet with a dietitian. I read the labels on everything I buy in the store. Now, if it's got, corn with a corn sirup, sweetener or artificial sweetener, the level of sugar like, I like yogurt, I eat yogurt, I eat sugar free yogurt, now I fat.

00;37;16;15 - 00;37;24;11

Cary Hall

It's not bad. It's actually pretty good. I've kind of gotten used to it. but I never paid attention to that stuff before. Again, it's back to education.

00;37;24;14 - 00;37;30;26

Ron Hoyler

Well, and even if you do try to pay attention, it's tricky. Those labels will talk about this is really good.

00;37;31;03 - 00;37;31;23

Cary Hall

For.

00;37;31;23 - 00;37;36;12

Ron Hoyler

Fiber. What they don't tell you is that it's also full of sugar and sodium, right.

00;37;36;15 - 00;37;54;12

Cary Hall

What the ingredients are. And I've learned to do that. That's all part of this process. That's why I wanted to do this. Okay. Thank you for coming in here. And absolutely we'll do some more of these. But again, you know, this is I'm talking about my personal journey here because I think it's important. I'm 75 years old. I've got six grandchildren.

00;37;54;16 - 00;38;12;07

Cary Hall

Okay. I want to be around a while. Okay. And I knew if I didn't do something about this, it was going to get significantly worse and I was going to have bigger problems. So I did. And I'm telling you, you can do the same thing. You remember what he said? You know, Ron said, you're not you don't have to go a thousand mile journey and start out at 100 miles a day.

00;38;12;09 - 00;38;27;27

Cary Hall

But you do what you do the first mile. You take one step, you get, you get in front of somebody. If you've got a family member, what's this issue? Urge them. Get them to listen to the show go up on the YouTube channel. It'll make a difference. Thank you for doing this. And now I leave you with this thought from Doctor Martin Luther King.

00;38;28;04 - 00;38;54;29

Cary Hall

Americans must learn to live together as brothers and sisters are we will surely perish together as fools. I think we're living in those times right now. You might want to take that to heart. Thank you for listening to America's Healthcare Advocate broadcast here on the HIA radio network. Coast to coast across the USA. Goodbye, America.

00;38;55;01 - 00;38;57;06

Cary Hall