How to Prevent Diabetes

March 8, 2008

Anti-Aging Psychologist, Dr. Michael BrickeySteve Freed Pharmacist/Diabetes Educator

  

  

  

  

  

  

  

Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Steve Freed, Pharmacist and Diabetes Educator

Broadcast: 2-17-08 on webtalkradio.net where the latest shows are broadcast and posted as podcasts

One in three Americans has or will develop diabetes—and in the vast majority of cases, it could have been prevented. Today’s guest expert, Steve Freed is a Registered Pharmacist and Diabetes Educator. His Diabetes in Control newsletter reaches 88,000 medical professionals. His Steps to Health program has been used by a quarter of a million diabetics. He has given thousands of seminars on diabetes, produced numerous training materials, and currently is co-producing a full-length documentary, Conquering Sugar Mountain. The first part of today’s seminar will focus on how you and your loved ones can prevent getting diabetes. Part 2 will focus on new treatment options. His websites are: http://www.diabetesincontrol.com/  http://www.diabetes911.net/  and http://www.a1ctest.com/

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each program I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results.One in three Americans has or will develop diabetes. This is absolutely tragic because in the vast majority of cases, it could be prevented. Today’s guest expert, Steve Freed, is a registered pharmacist and certified diabetes educator. His Diabetes in Control Newsletter reaches 88,000 medical professionals and 1,000 more laymen. His Steps to Health Program has been used by a quarter of a million diabetics. He has given thousands of seminars, produced numerous training materials, and currently is co-producing a full-length documentary, “Conquering Sugar Mountain.” The first part of today’s seminar will focus on how you and your loved ones can prevent getting diabetes, and then part two will focus on new treatment options and the controversies. Steve, you are so passionate – I think you eat, sleep, and breathe diabetes education. How did you get so passionate about this?SF: I used to own my own pharmacies for over 25 years, so I had four pharmacies in the Chicago area. And I woke up one morning, put the covers over my head and said, “That’s it, I’m out of here.” I wasn’t doing anything that I’d learned in school to become a pharmacist. I was talking to insurance companies, I was selling Beanie Babies – you know, nothing I was doing was related to the knowledge that I had. And I have a lot of diabetes in my family, Type 2 diabetes, and my grandparents on my father’s side, all my uncles, all my cousins, my sister. I’ve seen the worst and I’ve seen the best. So I always was concerned that I was going to get diabetes, so I started to educate myself. And the more I got educated, the more I wanted to share that information with patients. I saw that there was a program to become a certified diabetes educator and I worked towards that, took the exam, and became a certified diabetes educator in 1995 and started working with patients, and realized that there’s about 25 million people with diabetes, that I could probably personally help 24 millions, but I needed help with the last million. So we started a newsletter, myself and my partner, who’s also a pharmacist and a diabetes educator, to educate the medical profession about diabetes, because there it is completely lacking.

MB: What is it that our family doctors are missing with diabetes?

SF: Well, it’s not the doctor’s responsibility, per se, to educate the patient. 95% of the care of the patient has to come from the patient. You know, they have to know what foods they can eat, they have to be able to count carbs, they have to be able to read a food label, they have to understand the numbers when they get their blood sugar results back or when they test their fingers. So 95-98% of the care of a patient with diabetes has to come from the patient, because the doctor is not with them when they’re eating the wrong foods or when they’re not being physically active or not checking their blood sugars. So in order for a patient to control their diabetes, they have to become educated. If they’re not educated, they will fail 100% of the time. The doctors get five to fifteen minutes. It’s not their responsibility. They can’t get reimbursed for it. That’s not their responsibility. Their responsibility is to get the patient educated. That is their responsibility. And that’s where they fall down. They think they can write a prescription, give it to the patient, tell them to come back in 90 days, and it doesn’t work. It fails. And we know for a fact that it fails because the average blood sugar in the United States is close to almost 300, 250 to 300 mg per deciliter, which is completely out of control. And those people will all get the complications of diabetes, but it’s 100% preventable. That’s why I have a passion, because with a little bit of education, when I sit down with a patient for an hour or two, I can change their lives. I will prevent them from losing their eyesight, their kidneys and their limbs, and prevent strokes and heart attacks, Alzheimer’s, cancer, every disease known to man I can prevent, because we all know that diabetes is related to elevated blood sugars. We all know that Alzheimer’s is related to blood sugars. We all know that dementia is related to blood sugars. Our quality of life is directly related to our blood sugars. And they just did a study that they published and they said that if you get diabetes by the time you’re 50, you ‘re going to die 12 years early and you’re going to be miserable for the last 15 years of your life. And that comes from the CDC. So I can prevent all that, just with educating my patients and getting them motivated to make lifestyle changes.

MB: Not everybody can sit down with you. To whom should the doctors be handing off the education piece to?

SF: Well, first of all, there’s a lot of information out there. The problem is there’s a lot of misinformation out there. I see it all the time. People – there’s so much different information out that people get confused. You know, the best thing, though, that people can do is to find out where their education programs are in their area. Usually they’re hospital-based, and you can call the local hospitals and see if they have a diabetes education program. You can certainly get a book and read or you can get CDs and listen. But if you don’t do that, you are doomed for a miserable life.

MB: Where is the bad information?

SF: Well, I hate to say this, but the bad information – and I know that I’ll get in trouble for saying this, but the bad information comes from the American Diabetes Association.

MB: What are they saying that’s off?

SF: Well, what they’re saying is that you should have 60% of your nutrition should come from carbohydrates. All carbohydrates turn to sugar – good, bad, complex, simple – it all turns to sugar. Anybody realizes you don’t give people with diabetes who have sugar problems 60% of their diet being sugar – does that make any sense? Why do you think that the most, 90% of the people out there, or certainly at least 75% of the people out there, are out of control? Because they’re eating too many carbohydrates. They don’t understand it. And if they really understand diabetes, they really understand it, they’re going to know that you can’t eat any many carbs as they would like.

MB: What about people who don’t appear to have diabetes. Is the 60% carb also a bad idea for them?

SF: Well, if you’re not susceptible to diabetes, okay, and you’re eating 60% carbohydrates in your diet, you’re going to get fat – unless you’re running five miles a day, you’re going to get fat. And you know that we have an obesity epidemic in this country. You know, we said, “Don’t eat fat, don’t eat fat. Go on a low fat diet; it’s healthy for you.” Well, we did that for the last fifteen years and now everybody’s fatter, so obviously that didn’t work. You know, it’s the carbs – the carbs turn to sugar, sugar turns to fat, and we get fatter. It’s that simple. And people just don’t see it. And it’s a crime, too. And ADA just two weeks ago came out with a statement that low carb diets are okay. Before that, they were adamantly against it, but the studies are showing that people that are on low carb diets can control their diabetes much more effectively than eating high carb diets. It just makes so much sense.

MB: So if people are on the low carb diets, what do you want them eating instead?

SF: Well, I want them to stay away from some of the carbohydrates – the rices, the pastas, the breads, you know, all of those things that basically turn into sugar. I have a question that I ask my patients, and I say, you know, your grandmother calls you up and she says she wants to invite you over for dinner and she’s making this fantastic dessert. She wants you to stop at the grocery store and pick up some sugar wafers – and they both have diabetes. So you go into the store and you see two packages of sugar wafers. One package says “sugar wafers” and that has 20 grams of sugar per serving. The other one says “sugar free sugar wafers.” That has 0 grams of sugar per serving. You know, it’s not a trick question. Which one would you buy for your grandparents that have diabetes? Would you buy the one with the 20 grams per serving or the one with 0 grams per serving? Which one would you think you might buy?

MB: Well, the sugar free one.

SF: And you’d be wrong. And why would you be wrong? Because you’re only looking at the sugar! If you’d turn the package over and just read the label, you will see that the sugar free has more carbs than the one with sugar. So not only are you killing your grandparents, you’re paying three times as much to kill them. That’s where the education comes in. I get people to read food labels. You go to the store, you pick up two bottles of salad dressing. One is Caesar salad dressing, has 0 grams of carbs per serving, the other one is thousand island. And you look and it says there’s 5 grams of carbs per teaspoon. Well, how many people eat one teaspoon of dressing on their salad? Most people have 3 tablespoons, so you have to multiply it by 15 times 5. So one’s got 75 grams per serving and the other has 0. Well, if you just take the one that has fewer carbs, you’re going to lower your blood sugars – just by doing that, just by reading a food label. You can make a difference in your life just by reading it, because you’re going to make intelligent decisions, if you understand.

MB: Are there other big mistakes people are making?

SF: Well, certainly. You know, there’s one thing – and we developed a whole program around it. We all know that physical activity is good for you. Every person on this planet knows physical activity prevents every disease known to man, and it keeps you healthy, it gives you energy, it improves your memory, it gives you a better sex life, it grows hair, it gets wrinkles out of your skin. Okay, it prevents colds and flus and yeast infections – everything you could thing of, you know, by increasing physical activity – we all know this. Everybody on the planet knows it but nobody does it. Figure that one out. When you go to the hospital, okay, right in front, all the front parking spaces, it says “Reserved for the Chief Surgeon.” You know, your doctors, okay, don’t want to walk, so they park their cars in front. If they were smart, they would put a sign up saying, “All our doctors park in the back of the lot. The front spots are for people that don’t understand.”

MB: Great idea.

SF: So physical activity, along with counting your carbs and understanding of good nutrition, you know, will not only have an impact if you have diabetes, but it’ll have an impact for everybody – not just for people with diabetes. I tell patients, if you want to live healthy, live like a diabetic.

MB: I think you had a statistic that we’ve got millions and millions of Americans who have diabetes and don’t even know it. How do we miss it so often?

SF: Well, 25% of the people that have actual diabetes, okay, are undiagnosed. There’s another 60 million people that have the metabolic syndrome, but now we – you know, diabetes wasn’t bad enough, we had to give it a new name called pre-diabetes. That’s like being a little bit pregnant, okay? There’s no reason for people to have that diagnosis of pre-diabetes. Why not just call it like it is? It’s diabetes. The definition of diabetes used to a fasting blood sugar of 180. Then they reduced it to 140. Then they reduced it to 126. and now, instead of reducing it to 100, we came out with a new disease called pre-diabetes, and the reason we did that was pretty much because if we called it diabetes, those 60 million people, okay, that are self-employed, would lose their insurance all in one day. And if 60 million people lost their insurance in one day, it might cause a little uproar. So we gave it a new terminology called pre-diabetes. But the reason that we miss it is very simple – and I teach this to medical professionals all the time – diabetes starts out as an after-meal elevation of blood sugar. It’s called postprandial. Postprandial is a two-hour blood sugar after you eat. That’s when it’s the highest. So you go to the doctor for a physical, like most people do, and he has you do a fasting so that he can do your triglycerides, because we have to be fasting to get our triglycerides. So you go to the doctor’s office, he does a venous draw, and he sends it out to the laboratory, and it comes back that your fasting blood sugar is 85. Now, if it’s under 100, it’s normal. If it’s 100 to 125, it’s pre-diabetes. Anything over 126, it’s diabetes. It comes back, it’s 85. So you don’t have diabetes. He doesn’t even make a note of it. Okay, that same day, you go out for dinner and you have a big pasta meal with three pieces of garlic bread and a piece of cake and your blood sugars are 350. Well, the definition of diabetes, two hours after you eat, is anything over 200 is diabetes. 140 to 199 is pre-diabetes. So you’ve got a blood sugar of 350 – you have diabetes. Now, who knows that? The doctor didn’t say you have diabetes so you’re not checking your blood sugars. You won’t see that 350. This goes on, time and time again. Next year, you go back to the doctor and your fasting blood sugar is 98. Well, that’s still normal. He’s not going to say that you have diabetes or pre-diabetes. And that same day, you go out for dinner, you have a big pasta meal, and your blood sugar’s 450. Well, you have diabetes but nobody knows it. So we’re not looking at where we should. Now, there is a test called the glucose tolerance test. If you’re overweight, if you have diabetes in your family, they give you 75 grams of glucose in a cola. You drink it in the doctor’s office, you stay there for three hours, and they check your blood sugars every 15 minutes, and you’re putting as much pressure as you can on your pancreas to have it spill over. And that’s how you can tell if you have diabetes, by taking the glucose tolerance test. And then there’s another test called the A1C test-

MB: Okay, but most doctors aren’t going to do that unless you’re at high risk, though, right?

SF: Absolutely. But those people that have diabetes that are not at high risk, because the doctors – you know, they may not be that much overweight, those people are 25% of the 25 million people that are walking around with diabetes and don’t have a clue, because you don’t get the symptoms for years. By the time you go to the doctor and your fasting blood sugar is over the 126, when you’re diagnosed and you have a fasting blood sugar over 126, you’ve already lost 80% of the cells that make insulin in your pancreas. Now you’re running out of time. Now, if we catch it early, we can make small changes in your life and have a huge impact. But when you get it – when you’re diagnosed with a fasting blood sugar over 126, you’re running out of time, and that’s what happens with people with diabetes.

MB: Why aren’t doctors routinely doing the A1C test during annual physicals?

SF: Honestly, it all boils down to dollars and cents. You know, they’re not going to do a test that they don’t feel is going to give them the results they’re looking for. First of all, the A1Cs are not – according to the ADA – are not recommended for diagnosis, and that’ because not all A1Cs are standardized. And what I mean by that is we know that a standardized A1C is 6%, it’s a single digit number which represents your blood sugars every second of the day for the last 90 days. I call it the quality of life test. That test not only determines whether you’re going to live or die, that test actually represents how smart your doctor is. Because if you have an elevated A1C of above 7, certainly for a year or two, then I don’t care who he is, I don’t care what his title is, I don’t care what his education is, okay, you change doctors immediately. Don’t ask questions, just do it. Because in this day and age, with all the knowledge, with all the technology that we have, with all of the medications we have, there is no reason why anyone in the United States today should have an elevated blood sugar of above 6, and certainly I would hope not above 5, 5% A1C.

MB: When a person goes to their family doctor for that annual physical, what should they say to him to have their doctor give them an A1C test and do it correctly?

SF: Well, they should ask the doctor – if they have any diabetes in their family, okay, if they’re a few pounds overweight or their cholesterols are elevated or their blood pressure is elevated, those are all symptoms – okay, tell the doctor you want him to do an A1C test. This is not an expensive test. I mean, I think the labs charge 25 bucks for it or something like that. But pretty much, that will give the doctor a good idea. So if it comes up that it’s somewhere between 5.5 and 6.1, there’s a good chance that you have pre-diabetes. And if it’s over 6.1, there’s a good that you have diabetes. Now he can do a glucose tolerance test to double-check that. But certainly, ask the doctor to do an A1C. They did a study, by the way, called the EPIC-Norfolk Study. It was done about a year and a half ago. And they took, I think it was 15,000 people, and they compared the A1Cs of those people with a 5 and those people with a 6%, so they compared 5% versus 6%, irregardless of whether they had diabetes or not. And what they discovered was those people that had a 6% A1C compared to those that had a 5, had a 28% increase in cardiovascular death. So irregardless of diabetes, it’s a good cardiovascular risk test also, because if you think about it, the higher the percentage of sugar attached to the red blood cell, the stickier it is, and the stickier it is, it increases your risk for stroke and heart attack because it’s clogging your blood vessels. So the A1C is also indicated in cardiovascular risk factors, whether you have diabetes or not. A normal A1C, for someone who does not have diabetes, who is in good health, who is not overweight, is 4.3 to 4.5. According to the ADA, if you have diabetes, your A1C should be below 7. According to the Endocrinology Association, it needs to be below 6.5. But to me, I tell my patients, do you want it at 6.5 or do you want it at normal?

MB: It’s like, how overweight do you have to be to decide it’s too much?

SF: You know, so that’s another misinformation. They never talk about the normal A1Cs. The ADA says it needs to be below 7. Well – and then I ask doctors all the time, and they say, “You know, I can’t even get my patients below 7. You’re talking about 5, 4.5. I mean, that’s crazy. I can’t do that.” Well, of course they can’t, because their patients are not educated.

MB: Did I see where you go into businesses and have the businesses do A1C testing?

SF: We have an A1C test that we help distribute. It’s an instant test. It takes five – one finger sticker in five minutes, and you get the result. So we go into offices and we do A1C testing, and we do diabetes days in pharmacies, where we’ll do A1C testing and let people know. And I did a program for 150 pharmacists, oh, about a year ago. And when I got up there, I said to them, “You know, by the time tonight’s over, I’m going to find two people in this room with diabetes and I’m going to find ten people that have pre-diabetes that don’t know it. And what we did is we checked their blood sugars before they ate, and then I did my program, which was two hours, and we checked their blood sugars two hours afterwards, and then we checked their A1Cs. And lo and behold, we found that none of the pharmacists that were there had diabetes with an A1C, and they said, “Steve, I guess you were wrong. But we did find ten people with pre-diabetes.” And I said, “No, you’re not wrong. I said we were going to check everybody in this room.” There were about ten Hispanic waiters, so we checked the waiters. And we found two waiters that did not know they had diabetes. Because I can pick them out – they’re overweight, you know. So it’s a great test to see what your risk factors are. And 75% of the people out there and the people that are listening to this, 75% of them do not know what an A1C is. And it’s in their doctor’s records. They have to do it if you have pre-diabetes or if you have diabetes – it’s in the records. And you need to ask for, okay, because that is a life and death number. We know our driver’s license, we know our license plates and our Social Security Number, which have nothing to do with our health. But the A1C number, you know, you get the result, you post on the refrigerator door, and then maybe you won’t open the refrigerator as much.

MB: You mentioned Hispanics. Which ethnic groups are particularly prone to diabetes?

SF: Well, what we’ve discovered is Hispanics, Native Indians, Pacific Islanders, Mexican-Americans – all those people, you know, one in two will have diabetes. Any child born that’s any ethnic background – African-American, all those different backgrounds – anybody who has that, one in two will have diabetes. Not one in three, one in two. And that’s because we have a gene called the thrifty gene. And I’ve discovered that most people in those geographical regions where they lived on hot climates in the Mediterranean – we’re going back 1,000, 2,000, 5,000 years ago – where they lived in warm climates. They developed darker skin to protect themselves. Those people that had light skin died out and the genes didn’t pass on. So the people with darker skins were able to protect themselves from the ultraviolet rays, so they survived. But one of the other things that happened to them, they would go through periods of famine and feasting. You know, they’d kill an elephant and they’d have enough for a month, and then they wouldn’t have any food for maybe two weeks at a time or a week at a time. So we developed a gene called the thrifty gene. And what that is, is that when we have food, it turns it into fat. So when we’re eating all this food, it turns it into fat. And then when we go through periods of famine, that fat turns back into sugar, which gives us energy. So we developed that gene to protect ourselves so we could live and become part of the human race. What happened is that we don’t go through any periods of famine anymore. I can walk out my door, walk about two blocks, and walk into a grocery store. I can go into a 7-Eleven. I mean, how far are you away from food? So obviously our bodies are not meant for it, so obviously we get fatter. And because we get fatter, we become more insulin resistant. And then when we’re – insulin is a fat storage enzyme, so insulin takes our food and stores it as fat. So the fatter we get, the more insulin we have to have. So our bodies make more insulin. And the more insulin we have, the fatter we get. And that continues until something breaks. In order to stop that, you’ve got to break the cycle. How do you break the cycle? You don’t eat as many carbohydrates.

MB: Let me take a break here. This is America’s Anti-Aging Psychologist, Dr. Michael Brickey, with Ageless Lifestyles Radio, your source for cutting-edge thinking in being youthful at every age. Today’s expert guest is diabetes educator Steve Freed. His website is http://www.diabetesincontrol.com/. It’s packed with information for lay people and medical professionals, including information, educational materials, and the latest news and developments and controversies. And that’s the source for your newsletter. You also have a website, http://www.diabetes911.net/ . What is that for?

SF: I work with a number of physicians, very well-known physicians that basically have the same philosophy that I do. And when I find physicians that have the same philosophy, I kind of promote who they are, and if they’ve written any books. And the philosophy that I kind of lean towards is that there’s no reason why anyone should have an elevated blood sugar above normal. And if a doctor can agree with that, then we promote his works. And I work with Dr. Richard Bernstein, who is the father of blood glucose monitoring, the first person to ever use a blood glucose monitor in the United States. And he’s written a couple of bestselling books, The Diabetes Solution. He’s in New York, very unique story. Here is a guy that was an electrical engineer, had Type 1 diabetes and was out of control. This was before blood glucose monitors. And he found one in a magazine because he was an engineer in Germany from the Ames Company. And he wrote away, spent 750 bucks – this was back in the ‘60s, so this machine that – you wore it in a backpack – it was huge. It had two lead acid batteries. And he would check his blood sugars 10-15 times a day. He would measure his food, figure out how many carbs there were, how much insulin he would need, and all his complications went away. And he wrote a letter to the New England Journal of Medicine and the AMA and the ADA, and he said, “You have to let people know about this machine called the blood glucose monitor. It saved my life.” And they sent him back letters – and I have copies of these letters – they said that was “the most ridiculous thing that we’ve ever heard, that people would check their blood sugars two or three times a day and adjust their own medication. On top of that, we’re not going to print your letter because you’re an electrical engineer, and we don’t print letters from engineers, carpenters, and plumbers. We only print letters from doctors.” So in order to get his paper published, he went back to medical school at the age of 47 and become an endocrinologist, and has written two bestselling books. That’s why we promote his philosophy. Anybody who reads his book will drop their A1Cs a full point, and if they read it three times, they’ll drop their A1C two points.

MB: Wonderful. So that’s http://www.diabetes911.net/ ?

SF: Right. And we also developed a set of six hours of educational CDs with Dr. Bernstein and we’ve produced and put those out for Type 1s and for Type 2s. And you can listen to the information while you’re in your car. And we guarantee that if you don’t learn something new and improve your life, you’ve got 50 years to return them, no questions asked. I’ve never had anybody return them.

MB: Steve, let me back up a little bit. Could you give us a good metaphor for what diabetes is and how it works?

SF: Yeah, sure. First you have to distinguish – there’s really two kinds – actually three, but we’ll talk about two. There’s Type 1 diabetes, which is completely different than Type 2 diabetes. Type 1 diabetes is an autoimmune disease. We usually get that at an early age where our bodies – our T-cells in our bodies attack the cells in the pancreas that make insulin and destroy them. And before 1920, before the invention of insulin, people would just die of starvation, because all of the food that they ate could not be turned into energy. Therefore, they basically – their muscles deteriorated, their organs deteriorated, and they actually died of starvation. And along comes insulin, and those people now can have normal lives, if they have their blood sugars normalized. So that’s an autoimmune disease and that’s really genetic – we think it is. It’s partially genetic; it could be partially environmental. Type 2 diabetes – now, it used to be called adult onset because you had to be an adult to get it, but we changed the name about eight years ago to Type 2 diabetes, because kids are getting Type 2 diabetes because of obesity. Type 2 diabetes is really a lifestyle-driven disease. You know, we’ll have a cure for Type 1 diabetes in a very short period of time. There’s billions and billions of dollars going into it. I see all the research – we’re so close, really so close. We know exactly what we’re doing, we know what we’ve got to find, we know what we have to do, so it’s just a matter of time.

MB: With the Type 1, then, is that likely to be a genetic engineering or medication, or what do you think the cure will be?

SF: Well, the cure is going to be – we know what we have to do, and what that is, that the beta cells are dying off when you have Type 1 because the T-cells, the killer cells, are killing those beta cells. So if we find a way to turn off those specific T-cells that are killing the beta cells, we now believe that those cells will regenerate themselves if they’re not destroyed. So – and we also found that there’s precursor cells in the liver duct that we can turn into beta cells. So there’s a lot of exciting stuff going on. I mean, really exciting stuff, but that’s for Type 1s, and that’s great, but only 10% of the population has Type 1. 90% are the Type 2s. Now, we already have a cure for Type 2. Nobody knows it, and please don’t repeat this to anyone because we’re going to patent it, and it’s called duct tape.

MB: Okay.

SF: Okay, you put it over your mouth so you don’t eat. Okay, so Type 2 diabetes is really lifestyle-driven, which means that it has to do with your lifestyle, your physical activity, and your eating. That’s pretty much what you – and you have to have it in your genes. A lot of people have it in their genes. And when you overeat and you become fat around the waist, your risk for diabetes keeps going up and up until eventually your body just can’t handle all the carbs that you’re eating and eventually you become diabetic. So we know if you have pre-diabetes or you have diabetes in your family, we can prevent you from ever getting it, by 99%.

MB: I was just reading in Life Extension Magazine that if we come up with a pill that raises everybody’s metabolism so they can eat more without getting as heavy, that actually would be kind of a disserve because we would have these high levels of fat and be converting more and more sugar, and would just aggravate diabetes and cardiovascular problems.

SF: Yeah, there’s no question about that. And let’s be realistic. Any pill that does that is going to have some tremendous side effects. You know, right now we know the best therapy for diabetes is nutrition and physical activity. And insulin – that’s the number one best therapy, because it’s a natural hormone. Our bodies make it, so it’s not something that is foreign to our bodies. But every drug that we – almost every drug that we have in the marketplace are foreign bodies. You know, they’re carbon molecules that our bodies were not meant for. There’s side effects and contraindications and all kinds of problems with every medication because, you know, our bodies don’t produce it. It’s not natural to our bodies. So you know, people have to understand, with Type 2 diabetes, you just can’t go to the doctor and get a prescription and expect that’s going to take care of it, because it won’t. It’s a progressive disease, no matter what you do, as we get older, our bodies slow down and your diabetes will always get worse if you don’t stay on top of it.

MB: So when somebody has a certain level of diabetes, even if they take ideal care of themselves, is there any hope of reversing some of the damage?

SF: Absolutely. If you can get your blood sugars normalized, you can reduce the neuropathy, your eyes improve. If you have protein in your kidneys, which is a sign of kidney failure, that’ll go away. It improves your memory, it improves your skin, it improves your sex life. Yeah, if you control your blood sugars in the normal ranges, what we’re discovering is that the beta cells that make the insulin cannot live in an environment of high glucose. We call that glucose toxicity. And they can’t survive, and they die. When we change the environment in your body to normal levels of glucose, they can come back and regenerate, is what we’re discovering. So you can actually reverse diabetes. You’ll always be at risk for it, but you can actually reverse it, provided, you know – as I tell people, you know, if you lose your eyesight and go blind and they come out with a cure a week later, what good is it to you? You know, so yes, absolutely, by controlling your blood sugars and being educated – because you’re the one that has to do it, not the doctor – you can actually reverse most of the complications from diabetes.

MB: I know it sounds a little silly, but you know, the sticking yourself with a needle several times a day is one of the things that really makes people reluctant to monitor diabetes. Are there tests that people can do on a daily basis other than finger pricks?

SF: You know, there has been billions of dollars spent trying to find a noninvasive way to check your blood sugars, okay? And if you realize that the first blood glucose monitor, the one that Dr. Bernstein was using, used 50 microliters of blood, 50 microliters of blood to check your blood sugars. Today we use 0.3 microliters – 50 microliters to 0.3. There’s no pain, if you know how to do it. You can do it on your arm, you can do it on your palm. There’s absolutely very little, if any, kind of pain. The old monitors that used 50 microliters of blood, you needed a box cutter to get the amount of blood that you needed, instead of a little prick. But here’s a device that can actually tell you if you’ve eaten too much, if you’ve eaten the wrong foods. There’s no way to control your blood sugars on a daily basis without testing. And they’ve had devices, infrared devices that you stick your arm in and they tell you what your blood sugars are. They had a device once called Sugar Track where a thing on your ear, and it shines a light through the skin and it can see the color of the blood. You know, none of these things have come out pretty much. We do now – we have continuous blood glucose monitors. Those are very unique for people that are very proactive, that need to know. They have a monitor that checks your blood sugar just about every three minutes and it’s wireless. You know, so technology changes about every three to six months when it comes to this. So there’s really no pain involved if you know what you’re doing. But you know, monitoring your blood sugars without knowing what to do when you see a reading, what good is it? You know, the average person checks their blood sugars in this country 0.6 times a day. That’s less than once a day, you know – what do you expect to learn from monitoring less than once a day? You’re not going to learn anything. Why even bother? You know, you need to know when you need to check and that’s where the education comes in again. You know, when do I check and what do I do with that information? How can I get my blood sugars down? It all comes from the education, not from your doctor.

MB: For a person who doesn’t appear to have diabetes but wants to make sure they don’t get it, what kind of education do they need? What would you recommend they do, besides the A1C test, to make sure they don’t get it?

SF: Well, I would suggest that they get a book on diabetes, a good book like the one Dr. Bernstein writes, on our website, that tells them about how to control your diabetes. If you read the book and you understand it, you can prevent from ever getting it, because you’re going to live like a diabetic. You’re going to be healthier. Isn’t that the goal as we get older? I have my first grandchild – she’s two years old today. Today I took her to ballet school. I had a ball! That’s what life is all about. And if you have diabetes, that life is not going to be available to you. One of the things I do with my patients, I give them a blindfold, a sleeping blindfold, the kind they give you on the airlines. And I say, “I want to wear this tonight when you go to sleep, and when you get up, I want you to keep it on. Do not take it off. I want you to keep it on for 20 minutes. And I want you to shave, I want you to shower, I want you to cook, I want you to go the bathroom, even if you wet the floor. I want you to wear this thing, okay, and then I want you to take it off and I want you to call me.” And the reason I do that is not to scare people. I want them to realize what they have to lose and what they have to gain by changing their nutrition. When you woke up this morning, did you look out the window and say, “Oh my God, I can see! Look at the sun, the snow, the sky. This is fantastic. I’m going to have a great day!” Or did you get up and put your shirt and pants on and go to work? So we don’t appreciate what we have until we don’t have it. I want people to have that image in their mind so that when they go to the refrigerator or they go out – okay, I want them to tell me that that piece of pie is worth losing that eyesight. Name me one food that you’re willing to give up your eyesight for. Can you do that for me?

MB: No, not even carrot cake.

SF: Right, but that’s what they’re doing! I just want people to realize what they have to gain and what they have to lose, the quality of life as we get older. You know, there’s people walking around in nursing homes, most of them walk around in walkers. Why do they walk around in walkers? Not because they have arthritis. They walk in walkers because they lost their muscle mass and they don’t have the energy. Well, you know, physical activity can prevent that. You don’t have to be in a walker or a wheelchair. These people that get the battery-operated carts they advertise on TV – okay, for sure they’re going to deteriorate, if they won’t even get out of the go-carts to go around the house – they won’t even walk. And Medicare pays for it. You know, we don’t pay for prevention. We would rather treat diseases, give people new hearts and kidneys and limbs. You know, that’s the way our medicine is practiced. We don’t pay for prevention. And eventually we’ll have to because right now diabetes accounts for 33% of the Medicare budget. That’s with about 7% of the population. What happens when that’s 40% of the population? What percent of the Medicare budget will be diabetes? Well, there won’t be any Medicare budget because there’s no way they can pay for all those kidney dialysis machines. If you want to invest in a company, find you a company that makes these home dialysis machines, because dialysis right now is the number one payout for Medicare and it’s going to explode.

MB: With your pharmacy background, are there medications that are contributing to diabetes?

SF: No, there’s not medications – well, I shouldn’t say that, you know. We have a pill-fixing culture. You know, if there’s something wrong, there’s a pill for it and we go to the doctor. When it comes to the quality of life issues and diabetes, you know, that’s really not the issue. The issue is education and understanding your nutrition and physical activity. There are certain medications out there that are very beneficial for people with diabetes. You know, we’ve come a long way, from 1950 to ’95, 50 years, we only had oral drug for diabetes. It was called the sulfonylurea. The first one was called Orinase. Now it’s called Glucotrol or Micronase or Amaryl. And what that drug does is it forces your pancreas to produce more insulin. And that was the drug we had for 50 years. Well, what do you think happens to your pancreas when you keep forcing it to make more and more and more and more?

MB: Goes on strike?

SF: Yeah, it burns out. And you become a Type 1. All Type 2s eventually, if they live long enough and they’re not in control, all Type 2s will turn into Type 1, because they will lose the cells that make the insulin. And it’s 100% preventable. So yes, there’s good medications out there. And the combination with good medications, knowing which medications are the best for you – and I educate my patients, they know about all the medications. They go to the doctor and they tell the doctor what medicine to prescribe. They don’t wait for the doctor to tell them, because the doctors see them for ten, fifteen minutes. These people know which ones, according to their lifestyle, work best. And they tell the doctor pretty much what drug they should be on.

MB: Steve, I’m also fascinated with the documentary you’re doing, “Conquering Sugar Mountain.”

SF: Yeah, I’m working with a director and a filmmaker up in Canada. And basically he’s done all the filming. He’s looking for some support, financial support, and it’s going to be called “Conquering Sugar Mountain.” It should be out some time this spring. And basically, it’s a full-length two-hour feature document – a regular film with a story, but he built in educational components into it. He talks about A1C, he talks about Dr. Bernstein, my partner is on the film talking about diabetes. So he’s put educational components in it, and he hopes basically that it’ll be on public broadcasting TV on a series or something like that. And we helped him – put him in touch with Dr. Bernstein, and we gave him some ideas on getting more information out there, rather than just making it a film. It’s about ten kids with Type 1 diabetes that can climb Mount Kilimanjaro. And they filmed the whole sequence. And it’s a great film. You know, I’ve seen some of the cuts. There’s a lot of good information in it. And like I said, people can watch for it. It should be out some time this spring. It’s called “Conquering Sugar Mountain.”

MB: Sounds great. Is there anything else that you’d like to share with us?

SF: Well, certainly people should be aware. One of the things, when I talk about physical activity, we developed this program called “Know Your Healthy Steps.” It’s been used with 150-300,000 people in four languages, it’s so successful. And what we did is we came up with this idea that because physical activity – you know, every time you move a muscle, you basically burn sugar and you burn excess sugar if you have diabetes. So we really need to come up with a treatment that builds in physical activity. So we came up with this idea of how to teach people how to use a pedometer. A pedometer is a little device – you can buy them in any store – they cost 10, 15, maybe 20 bucks – and it monitors your physical activity because it tells you how many steps you get every day. And we’ve discovered that people monitor their blood pressure, they monitor their cholesterol, but how do we monitor our physical activity so we can document it and see? So I can correlate your steps directly to your blood sugars. So when someone sits down with me, they talk about, “Let’s get a baseline. Let’s find out what your average daily total is.” And then from that, we increase it gradually. And my patients are responsible for reporting back to me their daily steps every single week. And I can directly see that their blood sugars go down the more steps they take, and it goes up the less steps they take. So it’s a way to monitor to see exactly what we’re doing. So I teach people, during a football game, a three-hour football game – we know a football game takes one hour, four quarters, 15 minutes. What if you just got up during those other two hours, walked around in circles in front of the TV, not miss anything except the commercials on how to lose weight. You can walk five miles during a football game rather than sitting on the sofa, eating potato chips. So that’s what we teach people, you know. And when you go to the store, park your car in the back of the lot. That may be 100 steps. Well, both ways it’s 200 steps. Well, if you did that five days a week for ten years, that’s probably over 15,000 miles. Do you think you’re going to burn any calories if you walk 15,000 miles? Well, of course you will. Does it have to be in one day? No. 20 here, 30 here, 10 here, 5 here. You know, take your pajamas and bring them to your neighbor’s house so you’ve got to walk over to your neighbor’s house to get your pajamas – whatever it takes. It’s a way to monitor – it’s been very successful. Have you ever owned a pedometer?

MB: No.

SF: Send me your email address, I’ll send you one. I like to give pedometers away because I will personally add ten years of quality of life on to your life if you read the manual which I send with it, along with the pedometer. And it’s nice to be able to improve somebody’s quality of life for ten years, rather than give them a business card.

MB: Wonderful. When you were talking about physical activity, if we do have a weak moment and have that big pasta dinner, should we get physical right afterwards? Would that help?

SF: Well, it doesn’t really make any difference when you get physical. The point is you need to do something on a daily basis. You know, the Surgeon General says you need to be active 30 minutes a day, five days a week, and that’s baloney. You know what I tell people? If you eat on any particular day, you need to be physically active and get your steps. If you don’t eat, if you starve yourself for the whole day, you can sit on your butt and not do a darned thing. But if you’re going to eat, you’ve got to be physically active. So that’s seven days a week you need to be active – not five, not six, but seven days. It doesn’t mean you have to walk 50 miles. It could mean that you’ll only go out and walk for two miles, maybe ten minutes here, five minutes there, 30 minutes there. That’s why the pedometer is so effective, because people will wear it, they’ll look at it, and they’ll see, “I need to get a few more steps.” So when you go to your dentist and he’s on the 10th floor, take the elevator to the fifth and walk five floors, okay? If you’re on a bus, get off two stops early and walk. There’s ways that we can find things that we don’t have to change our lives to increase our physical activity. Instead of sending somebody an email that’s in the office next to you, you know, print the darned thing and walk over – you’ll surprise the heck out of them. You know, “Why didn’t you email it to me?” “Well, I need to get my steps in.” You know, little things like that. Yes, you can overcome. If you’re going to cheat, if you’re going to eat that piece of chocolate cake that you know you shouldn’t, go ahead for it, eat it, but know that that piece of chocolate cake is going to cause you to have to walk four miles. Now did that piece of chocolate cake taste that good that you’re willing to walk four miles? If it does, go for it. If it doesn’t, don’t eat it.

MB: So it’s like putting a price tag on each of the foods we eat.

SF: Yeah, think about the foods – the bad foods that you want to eat, and say to yourself, “You want to have those french fries? Go for it, but you’re going to have to walk an extra 15 minutes.” Okay, I’m willing to do that, so I eat it – because if not, it’s going to be turned into fat around your waist, which increases your risk for cardiovascular disease and diabetes.

MB: Steve, you’re a wealth of information. Let me wrap things up here. This is America’s Anti-Aging Psychologist Dr. Michael Brickey, with Ageless Lifestyles Radio, your source for cutting-edge thinking on being youthful at every age. We’ve been talking with diabetes educator Steve Freed. His website is http://www.diabetesincontrol.com/  where you can get the free newsletter. And he also has http://www.diabetes911.net/ which has lots of information about books and resources. And what’s the website for the test?

SF: And if they’re interested in doing their own A1C test at home, they can do it with a very unique monitor and it’s very inexpensive. It’s about $12 or $13 per test. And that is http://www.a1ctest.com/ . And it gives you all the information on how to do your own A1C test at home. So if you have diabetes or your family members are susceptible to it, you know, have everybody in your family do an A1C test. Find out what it is. Make it a contest. Give out a prize to whoever has the highest number. Make it fun.

MB: And the test kit’s only about $10 or something?

SF: Well, it comes in ten tests – you have to get a ten test. And you can do it about every month, because 50% of the result comes from the last 30 days, even though it’s a 90-day average. And the way that works is the blood attaches to the – the glucose attaches to the red blood cell. The red blood cell lives for about 90 days, so we measure the amount of glucose attached to the red blood cell. So that’s how we do that. And a 6% is equal to about 135 mg per deciliter on your blood glucose monitor, and it goes up and down about 35 points per the single digit of the A1C, so you can compare it to your blood glucose monitor. And again, that’s at A1Ctest.com.

MB: Okay. And information on Anti-Aging Psychology and my free Defy Aging Newsletter is at http://www.drbrickey.com/  or you can just go to http://www.notaging.com/  and it’ll take you there. I’d love to get your feedback and comments. You can send them to radio@drbrickey.com.