Sumeet: The topic today is so interesting and so important that I believe Edward himself with all his wealth of knowledge will be able to enlighten us and guide us in the right direction. Today's topic is Diabetes. Diabetes is something that is very very prevalent across the world, across the U.S. I will tell you that the numbers as of September 2021 is 34.2 million people in U.S. are diabetic. 34.2 million - that is 10% of the United States population is diabetic and 88 million, in addition to the 34.2, 88 million of United States population is pre-diabetic. 

Now, we will look at the nuances of diabetes and pre-diabetes as we go through the session. But it is a very very concerning number and it is continuing to grow. When I was growing up, I had a first-hand experience of what diabetes could do. I believe I was 8 when we found out that my father has diabetes, very very high levels of diabetes and the way it happened was we realized that for good 2-3 weeks he was amazingly lazy. He was sleeping more than he used to sleep and we told him hey you need to go and get yourself checked. And to our utter surprise he was diabetic. He was diagnosed with very very high levels of diabetes and why utter surprise is because he was very active and his health was very normal. He was not obese. He used to eat a lot of green vegetables. Actually, interestingly enough he used to eat the maximum amount of green veg and healthy food at home. So, everyone in our family was surprised and there was no family history as well in this particular scenario.

And then we saw tremendous deterioration in his health. He was losing weight. We could see muscular degeneration. Several things happened and then as he aged, that transformed into you know health, heart issues. He had to go have bypass surgery and then his eyes started getting affected.  So diabetes can be very very lethal if not taken care of. He has been very proactive. He has always been very proactive with his health so he was able to manage it bring things down to controllable levels. But yeah so we need to be very aware of what is diabetes and that's why we wanted to have this session.

So, Edward let's start with what exactly is Diabetes? What in terms of medicine, in terms of you know your engagement with friends and family, how do you define Diabetes?

Edward: Yes, I mean first of all, I'm sorry that you had to testify for your dad having gone through such a devastating condition. And yes it does affect in such a way that it is a silent killer in a way because it doesn't give any any symptoms to begin with up until it is too late.  Yes, diabetes is considered a metabolic syndrome and what happens in this particular case is the body has the ability to store into the cells so the glucose that we may have in excess by using a hormone called insulin and this insulin actually captures the floating glucose sugar in the blood and takes it into the muscle, takes it into the cell for further usage. 

The problem comes that when you for whatever reason have an excess of glucose in your blood and if your body does not produce enough insulin, to put those stores away then that continues to float in your system and that's when it creates havoc in your different organs, start target organs that diabetes actually affects. There are many considerations there are many factors that may trigger at one person to go into being a full-blown diabetic. 

Pre-diabetes it is a condition where the glucose levels in your blood are high but they have not reached yet a point where they give you symptoms. So, you basically are a person carrying a huge amount or higher amount of sugar in your blood without really knowing it. And that's the problem because if you don't know it, if you don't feel anything different then you can go years and years with that condition affecting little by little your systems until it's too late. 

Sumeet: Okay so you're saying that even pre-diabetic condition can be harmful?

Edward: Well of course, pre-diabetes actually speaks about you having already a large amount of glucose circulating in your blood, but you're being able still to kind of manage that your body is still being able to you know hide that glucose in cells and take it to the muscles and all that, until there is a moment in time the pancreas is an organ, it's a gland that is actually producing insulin and I believe that must be some kind of a limited storage or a limited capacity of your pancreas of producing insulin that will put that glucose away and in the long run your pancreas loses the ability to produce enough insulin and eventually then you will be developing the typical symptoms of diabetes as you mentioned at the very beginning where the patient feels thirsty all the time. You've been tired all the time and you actually described the very accurately the symptoms of diabetes.

Sumeet:   So Edward, I read this thing called insulin resistance. What is insulin resistance and does that contribute to diabetes?

Edward: Yes insulin resistance is a term that is it is used when your body, your cells cannot take that glucose into themselves carried by the insulin because they are either blocked in some ways metabolically speaking or there's not enough insulin circulating so your body becomes bloated with sugar, loaded with sugar in a way that they cannot accept anymore. So the insulin has this has lost the capacity of actually carrying that glucose into the cells and therefore it doesn't matter how much insulin you're producing or how much insulin you put in once you are diagnosed as a diabetic that may actually start causing organ damage. 

Sumeet: Wow. Before we look at you know the impact of diabetes right, can you talk about different levels like what is the threshold of what would be a pre-diabetic? What would be the level of diabetes? What is A1C? What role does A1C levels play in determining diabetes? Can you talk a little bit about actual levels of glucose and A1C's?

Edward: Well and normally you have a normal level of glucose in your system that allows you to function properly with the amount of sugar circulating in your system. So in the morning, as soon as you wake up you could have you know a range of glucose level in your system ranging anywhere from 90 milligrams per deciliter to 120 milligrams per deciliter. That will be the normal amount of circulating glucose in your system. Anything below that or above that may be an indication that you're already having some problems regulating the amount of glucose in your system. So anything above 120 may be considered a pre-diabetic condition, a pre-diabetic situation. That means that you are beginning to experience problems putting away that excess of insulin and in severe cases, you can see people carrying 260/300, most severe cases up to 600 milligrams per deciliter in their body. So basically, their blood is basically molasses, when you have that much amount of sugar in your system.

On the other hand, hypoglycemia it is a condition that it is experienced when you do not have enough glucose to function properly. The levels, once you drop under 70, that it is considered to be hypoglycemia.

Sumeet: Okay, so basically once you are around 90 to 120, it's more of pre-diabetic range and then anything above 120 is diabetic range, is that a correct number?

Edward:  No, there may be certain conditions that would allow you to have such reading over 120. Sometimes infections, they trigger a high amount of glucose in your system because you need that to fight back infection. If you are using certain medications to fight back that infection, that may also raise your glucose levels.

Those levels may be taken into consideration based on the conditions that are currently happening here in your body. But if you don't have any medications, if you're not taking any medications, if you didn't have a current sickness ongoing a condition ongoing, that may be something that needs to be taken into account and maybe do some further testing just to make sure and discard that there are no other underlying conditions that are giving you those higher levels of sugar in your system. 

Sumeet: Got it. And what is A1C? And what levels should we look at when it's A1C? 

Edward: Yes, A1C it is a measure of sugar levels that have been in your system for over 3 months attached to red blood cells that are coated with sugar coated hemoglobin. So that is a measure of how much sugar you have been having in your system for the past three months and based on the amount that you have measured, you can actually talk about being pre-diabetic or a full-blown diabetic. 

Sumeet: Okay okay so when someone is diabetic / pre-diabetic, is being tested for sugar, so should we look into both these glucose level and A1C or just glucose level by itself is sufficient to say hey you know, you are diabetic, or you are non-diabetic?

Edward:  Okay yeah. Well like I explained earlier today you may have some variable blood sugar levels throughout the month based on different situations like if you eat a lot of carbohydrates let's say that you go out and have dinner and you go to an Italian restaurant where there's lots of pasta and all that. So yeah eventually if they take a random blood sugar level, your blood sugar levels are going to be high and that's why it's important to just do a random readings on occasion but always taking into consideration what was the after you know what kind of meals you had or what kind of other underlying health conditions you have. 

That's why A1C is a good measure of diagnostic. So A1C would allow a doctor, a clinician, to kind of have a clear idea of how much sugar level how much sugar have you had in your blood for the past three months. And if it's been steady as level that may mean that okay yes you are probably diabetic and not just an occurrence after having a high carbohydrate meal. 

Sumeet: Got it, makes sense. So that's why when doctors have your test for sugar levels they say do fasting before when they take the actual measurement is that correct? 

Edward: I guess it would be now that I come to think of it, yeah always when you're fasting that will allow for a more accurate reading for your blood sugar levels. So, if you have nothing, you haven't consumed any I mean everybody during breakfast for example they everybody gets a pancake or a little bun and coffee, bread, egg maybe, but all of those will contribute to get a spike in your blood sugar levels and if you had breakfast and then you go take a sample for a diagnostic purpose that may throw a false positive or a false high level that may actually, may cause you to be misdiagnosed if they are not aware of the current situation. So fasting level is always convenient to make sure that the the diagnosis that you're going to get, the measurement that you can get is gonna be accurate.

Sumeet: Got it.

If you missed Sumeet and Edward's discussion on Diabetes Management, you can still watch The CoBionic Talk Show full episode here  -->  https://www.facebook.com/cobionic/videos/191289390570220