Podcast 23 – Diabetes (Type 1 & Type 2)
Transcription
Dr. Chad: This is Dr. Chad Edwards and you are listening to podcast 23 of Against the Grain.
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Announcer: Welcome to Against the Grain podcast, with Dr. Chad Edwards. Where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready, because we are about to go against the grain.
Brian: This is Brian Wilkes. Today I’m joined by the Dr. Chad Edwards who believes that 80% of medical conditions, recommendations, conditions is a bad terminology are crap. It sounds very Donald Trump like. Technically speaking, he’s the author of Revolutionize your Health with Customized Supplements and he served in the US army for 23 years as both an enlisted soldier and an officer, and as a physician. He graduated from the medical school at Oklahoma State University. He’s the founder of revolutionhealth.org and this very podcast Against the Grain. How are you doing today Dr. Chad Edwards?
Dr. Chad: I am doing amazing.
Brian: It’s an impressive resume. It’s a tongue twister a little bit for me.
Dr. Chad: Yes.
Brian: It is. It is.
Dr. Chad: Thank you.
Brian: Yes, that’s impressive.
Dr. Chad: I appreciate.
Brian: You don’t look old enough to have served in anything for 23 years. That’s the only compliment that I’m ever going to give you to your face.
Dr. Chad: I sure don’t act old enough.
Brian: Yes, that’s pretty impressive.
Dr.Chad: I enlisted when I was 17 and did the enlisted thing for 11 years, and then said, “Ready to go to medical school.” Got my commission, went off and did that.
Brian: Curious, what drew you to the military? Not to get off subject completely.
Dr. Chad: I knew I wanted to be in the military since I was a little kid.
Brian: Why?
Dr. Chad: I don’t know.
Brian: Just something.
Dr. Chad: Yes.
Brian: Pretty impressive.
Dr. Chad: I liked their equipment, it was cool.
Brian: You wanted to shoot? I think every man, real man wants to shoot a gun.
Dr. Chad: Yes, and like they said in G.I. Jane, you get to blow stuff up.
Brian: That’s exciting. Can I talk about something else exciting?
Dr. Chad: Yes.
Brian: The sugar. Do you know what that’s code for? The sugar?
Dr. Chad: Let me guess.
Brian: Diabetes.
Dr. Chad: I remember the other podcast that we did on diabetes, and you went into this whole story of about the sugar. So yes I do remember.
Brian: The sugar. I think three fourths of it was edited.
Dr. Chad: [laughs] Probably, in case you went off on this.
Brian: I went off on this. Yes. Marshall over here is, it’s a full-time job for this guy over here to edit everything we got to do.
Dr. Chad: He earns his keep.
Brian: He earns his keep. So tell me, what’s the difference between this show and the last show that we did on diabetes?
Dr. Chad: Here, we are going to talk about the difference between Type 1 diabetes and Type 2 diabetes. We’ll talk about it just briefly.
Brian: It’s getting complicated already for me.
Dr. Chad: Yes, yes, yes.
Brian: 1 and 2.
Dr. Chad: It does matter because the way you treat it matters. You may care less as a patient but when it comes to how do you manage this, it becomes very, very important.
Brian: It’s a big distinction in other words.
Dr. Chad: Absolutely. So how do you know what is Type 1? What is Type 2? Because I remember when I was a — This is my HIPAA compliant story.
Brain: We have a button.
Marshall: HIPAA, Health Insurance Portability and Accountability Act.
Brian: Marshall’s voice. That’s Marshall’s voice on that?
Dr. Chad: It’s awesome.
Brian: It’s a really good voice.
Dr. Chad: It doesn’t sound anything like —
Brian: That’s a strong voice.
Dr. Chad: Sounds nothing like a girl.
Brian: Okay, you want to fight? Military guy. Let’s get it.
Dr. Chad: [laughs]
Brian: You probably going to win, but those are fighting words. Okay, keep going.
Dr. Chad: This guy, I remember, it was right before we deployed to Iraq, and there was aguy that came in to see me. He was new to our unit and he was six foot, three or four, and thin. Very thin. Did not at all meet the typical criteria —
Brain: Like over-weight-ish kind of guy.
Dr. Chad: Right. Who you would think would be a Type 2 diabetic person. He came to see me and said that he was diagnosed with diabetes. They had said it must be Type 1, because of how it looked. They said, “You must have Type 1 diabetes, so you need to be on insulin and all these kinds of things.”
They found his diabetes incidentally. He went in for some skin infection or something like that, and they found the diabetes. His blood sugar was in the 600s or 700s or something.
Brian: The sugar?
Dr. Chad: Yes. Exactly. He came to see me and said, “I’ve got diabetes. They said I have Type 1, I need to be on insulin.” I said, “Well, not so fast, let’s take a look.” Ran some lab work and he had sufficient amounts of insulin, but —
Brian: How did they not pick that up?
Dr. Chad: He went into the emergency department and then went to the hospital. But again, they did not look at the physiologic difference between Type 1 and Type 2. Looking at labs like C-peptide, and pro-insulin, and insulin itself, and anti-GAD and antibodies, all those things, we did a lot of that stuff with him and I said, “Brother, you are not Type 1, you are Type 2 diabetes.” He was like, “But I don’t look anything like it. And they told that he didn’t look anything like it and therefore he must not —
Brian: I guess the airport is not the only place they stereotype people these days, right?
Dr. Chad: [laughs] Exactly.
Brian: We needed a button. That was a pretty good fun joke.
Dr. Chad: Is that better?
Brian: These people just basically gave him a looksee over and said, “This is what you have.”
Dr. Chad: It’s an a-typical presentation. That’s not how it normally works. But when it comes to treating patients, you have to know what it is that you are dealing with exactly. It doesn’t work to say, “It looks like this,” unless you have no other option. If you have no other option, then fine. Do the best you can with what you have.
But we have ways to answer these questions. What we’re going to talk a little bit more about is what is Type 1 diabetes? What is Type 2 diabetes? Specifically the antibodies that we look at, and some of the tests that we do at our clinic in Revolution, and what I would recommend someone to get tested on, or what labs would we recommend for a diabetic patient, because it can change, and it can change mid-stream. You could be Type 2 diabetic and that can change.
Brian: So wait. It’s not like a person get — I hate to say it is comparable, but the person gets cancer, and the cancer is not going to change from cancer to I don’t know, like indigestion. [chuckles] But diabetes, as far as it fluctuates greatly as far as a disease and the other things, right?
Dr. Chad: It can. It’s important to understand that.
Brian: Heart disease or whatever.
Dr. Chad: You can have a patient that has Type 2 diabetes and they have “sufficient amounts of insulin” but they have insulin resistance. They have chromium deficiency, chromium’s required for insulin to work at the insulin receptor. If you have a chromium deficiency, that can basically cause Type 2 diabetes.
That’s not an insulin deficiency problem, but it as a relative insulin deficiency problem because their pancreas is making insulin. You may need to give them insulin because you have to overwhelm those receptors to make them work, so to speak.
Brian: Can we back up a little bit?
Dr. Chad: Yes.
Brian: Symptomatically, what’s the difference between 1 and 2?
Dr. Chad: Like how are they different in symptoms?
Brian: As far as the guy that has one of the two, how do I feel differently symptomatically? Or is that–?
Dr. Chad: You may not.
Brian: You may not. So symptomatically they can appear the same?
Dr. Chad: They can, yes. A classic presentation of a Type 1 diabetic would be weight loss over a period of time, having increased thirst, they drink more water, they have to pee more, urinate more because the sugar that’s in their blood, the sugar.
Brian: The sugar.
Dr. Chad: The sugar that’s in their blood is an osmotically active force. It pulls fluid into the blood stream and more gets filtered to the kidneys so you pee it out. When you pee it out, it makes you thirsty. I’m drinking more, peeing more. I’m losing weight.
Brian: That’s 1? It can be both.
Dr. Chad: That can be both. Yes, I’m losing weight, losing fat. We could get into the physiology of it but I can talk about that for hours. I love that physiology. I was actually going to be on Jimmy Moore’s podcast Livin’ La Vida Low-Carb, so it’s a little plot for his webcast —
Brian: I like it. They are so much more creative than we are.
Dr. Chad: You think?
Brian: Livin’ La Vida Low-Carb. That’s an amazing creative.
Dr. Chad: That’s cool, it’s cool. But he’s been doing this for a long, long time.
Brian: Wow, that’s impressive.
Dr. Chad: I think my episode’s coming out in the middle of April. I was a guest on his show and we were actually supposed to talk about Type 1 diabetes, but we ended up just talking about functional medicine and Tulsa prolotherapy, and what we do at Revolution, which was cool. I had a great time talking with him and that guy is amazing. It was a great experience.
Brian: A lot of followers right?
Dr. Chad: Huge, huge following. It was a huge honor to get to talk with him.
Brian: That’s awesome.
Dr. Chad: We were actually going to talk about this topic and in preparing that, I was like, “We need to do this.” Hopefully —
Brian: So we’ve got more listeners.
Dr. Chad: Right.
Brian: Right. So that’s important to get the message out.
Dr. Chad: That’s right. I’ll end up doing this information on his podcast. It’s good information. I want to get this information out. In preparing for this, I was just looking at the differences in this Type 1, Type 2, autoimmune and how does the Type 1 diabetes affect you and this classic presentation. How do we work this stuff up? Tulsa prolotherapy
So what do we do? So there are basically Type I diabetes is an autoimmune disease, so you have autoimmune means that your immune system begins to attack something within your body. So you make antibodies against something in your body and in your pancreas. Your pancreas is what it has endocrine and exocrine functions, meaning it makes chemicals that you spill out in your digestive tract that help with digestion.
Brian: Important little organ that pancreas.
Dr. Chad: Yes, it really is. You truly can’t live without it, but it also produces insulin in certain sets of cells called the beta cells, and it produces glucagon and some other chemicals as well in some other different cells. But it’s these beta cells that are really critical, they measure your blood sugar and they kick out insulin in response to elevated levels of blood sugar.
So Type I diabetes is an autoimmune destruction your body has made antibodies against the beta cells in the pancreas. They discovered in 1974 that Type I diabetes was an autoimmune condition, so when you’re looking at Type I versus Type 2 you want to know what is it that we’re dealing with. Tulsa prolotherapy
Again I would argue that most of the time adults that develop diabetes are probably Type 2, especially if they’re obese and going along with that whole traditional paradigm that we think about with Type 2 diabetes. But I still think it’s important to check these, and we run a test Revolution called the diabetes prevention and management panel. It was a DPMP and there’s a lot of great information in that lab. Tulsa prolotherapy
Brian: Let’s do this Dr. Edward let’s talk about, let’s take a short break, and when we come back we’ll talk about this particular test that you run at Revolution Health. We will be right back.
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Brian: And we’re back with Dr. Chad Edwards how are you doing?
Dr. Chad: I’m ready to talk about some labs.
Brian: Some labs is exciting.
Dr. Chad: Is that exciting?
Brian: it leans towards the nerd factor, I won’t lie to you. I will keep it real with you, we keep it real on this show. I’m the cool guy, you’re the nerd, that is what people say.
Dr. Chad: That works.
Brian: I’m just telling you what other people say.
Dr. Chad: The feedback we get.
Brian: I’m the smart cool guy, you’re kind of the nerd in the darkroom running labs, so tell us about your labs. [Laughs] You didn’t comment on either.
Dr. Chad: That’s true. I was too busy thinking about mice, I had to come up with something.
Brian: That is always how it is you are too busy thinking about your comeback. So tell us about-
Dr. Chad: I got my come back I’m out.
Brian: I’m out, I’m out okay so tell me about this lab.
Dr. Chad: It’s actually a panel of a bunch of different labs, but one of the things that we get in this lab — Again we’re looking at insulin levels, we’re looking at c-peptide levels pro insulin levels, were trying to get an understanding of how that pancreas is actually functioning, based on how are they working? Are they efficient or not?
And we look at blood sugar itself how is your blood sugar been over 90 days through what’s called an hemoglobina1c. How it has been over the last couple of weeks through a lab called fructosamin.
Brian: Over the last couple of weeks you continue to monitor is it not a tested?
Dr. Chad: So when we test your blood we’re looking at a two week window of what your blood sugar looked like over the previous two weeks. So that’s the information I get, and so there’s a lot of stuff that were looking at in, but one of the labs in this is called an anti-glutamic acid decarboxylase or an anti-gad.
Brian: That’s a big word.
Dr. Chad: Exactly.
Brian: You are a huge nerd.
Dr. Chad: This antibody is highly correlated with risk of developing Type 1 diabetes correct, there’s a strong correlation. I don’t want to say causes it, all those things is just highly correlated with Type I diabetes. Independent of whether or not you were diagnosed with Type 2 or Type I. You can get auto the anti-gad antibody with other forms of autoimmune disease like rheumatoid arthritis, Hashimoto’s thyroiditis those kinds of things.
So people that get autoimmune disease get autoimmune disease, so if you have one there’s a higher chance that you could have another, so some of the things that we look at. I have some patients that have very high levels of anti-gad and they’re not even remotely diabetic in any level, their blood sugar looks great.
But patients that are asymptomatic, have no symptoms and they’re not diabetic but they have this elevated antibody have a significantly increased risk of developing diabetes. So it is an important lab to get. There are other antibodies that we can get like an Islet cell antibody, so if you go your doctors and say I think I have Type 1 diabetes they might get some of these other labs.
In fact when I was doing my traditional medicine I don’t ever remember getting an anti-gad. I remember other physicians talking about insulin, auto antibodies and Islet cell antibodies and these different kinds of things. The problem is like with an Islet cell antibody it’s very difficult to test that.
There’s a lot of inconsistent with the testing so it’s not reliable and reproducible, so it may not be as helpful for us. There’s one that’s an anti-tyrosine phosphatase like protein insulin associated Type 2, not Type 2 but or an anti-IA 2. So that’s another anti-body. So we got this whole host of antibodies that you can get.
The bottom line is Type 1 diabetes is an autoimmune condition. 10% of Type 2 diabetics have at least one of the Islet antibodies, some of these patients with these antibodies will actually develop into what’s called LADA or latent autoimmune diabetes of adults and so this is how it can change midcourse. Most of these patients are over 30 years of age, non-obese like the one I was mentioning.
Brian: Like me healthy, good-looking, trim, cut, ripped.
Dr. Chad: Initially controlled by diet, so if you’ve got Type 2 diabetes they say you have Type 2. you control it by diet, you’re over 30 years of age, you’re not obese but you start getting worse, then it could be this LADA auto immune diabetes of adulthood or LADA.
These patients are going to require insulin earlier. I have a patient that we just put him on insulin like two weeks ago, this is exactly what he has, his lab is consistent with this little bit. So these patients will start developing weight loss ketosis, more unstable blood sugar levels, very low levels of glucose stimulated c-peptide.
This is one of those things coming up from the pancreas. In fact let me get in one more little statistic here, there was a study called the UK prospective diabetes study group UK PDS, they were looking at Type 2 diabetics that required insulin after a six-year follow-up.
94% of patients that had the ICA antibody were Islet cell antibody, and 84% of patients that had anti-gad antibodies, had to go on insulin, versus 14% of those that needed to go on insulin if they were antibody negative. So this is something that we need to watch your antibodies, we need to follow these because our management for your diabetes could change.
If you have diabetes, you need to find someone that’s going to check these antibodies at least once and then know what to do with them. And that’s one of the things that we are doing.
Brian: They could go to you revolutionhealth.org and a lot of this information can seem complicated and daunting, and you can find a lot of it on the website revolutionhealth.org. But again I can’t emphasize enough that if you have any of those symptoms that Dr. Chad talked about earlier recommend you book an appointment at revolutionhealth.org and go talk to them for an hour about this stuff.
It can be complicated, but I would say Chad this is kind one of these topics that we always get back to the mission of Revolution Health, and I just like them I’ve watched the episode the other day on the meat industry and how it’s growing so exponentially.
Killing cows wasn’t meant to scale like to the degree, God didn’t intend I’m going to give you a cow and here’s one and all of a sudden we have 2 billion a day or something crazy like that. So there is a deterioration of health through that process at scale, and I think one of the missions that I keep going back to with Revolution Health is the reason you put the revolution is because you don’t want to be one of those cows going to the slaughter, and you certainly don’t want to be one of those people eating the cow that’s going to slaughter with the other billion cows, that are being reproduced at high levels and I think the whole medical industry falls into that kind of category. They’re not testing for things like this because they don’t have time or the bandwidth to test for things like that.
Dr. Chad: Or know what to do with the results.
Brian: Or are going to spend the time with you to go through those results like revolution will. So I can’t emphasize enough on every one of these shows that look if you’re listening to this it’s great information and impress your friends. If you’re health nerd this is a perfect show for you, but at the end of the day if you want to get serious about it you got to go to the clinic that’s the bottom line.
Dr. Chad: Or find a functional medicine physician that will listen to you and will look at the underlying causes and the underlying reasons.
Brian: It’s good to see you today, you’re looking sharp.
Dr. Chad: It’s good to be seen.
Brian: Yes, it’s good to see you, see next time all right.
Announcer: Thanks for listening to this week’s podcast with Dr. Chad Edwards. Tune in next week where we’ll be going against the grain.
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