The Diabuddies -Holistic Diabetes Management and Functional Medicine

#39 Diabetic Alert Dogs - Zach from Cedar Oak Kennels

In this episode, Dr. Grady and Dr. Garrett have the pleasure of interviewing Zach from Cedar Oak Kennels where he trains Diabetic Aert Dogs (DADs). He walks us through the training process, the breed that is best suited to be a DAD, and his why. All while sprinkling in some great success stories.

 

If you are interested in getting to know more about what Zach does and how to get ahold of him, you can visit his website, Instagram, or send an email.

 

Instagram: diabetic_alert_dog_training

Website: https://cedaroakkennels.com/

Email: cedaroakkennels@gmail.com

 

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 Time Stamps

0:25 - Introduction

1:10 - What Is a Diabetic Alert Dog? How Long Has Zach Been Doing This Work?

14:50 - What is the training process?

32:55 - Why British Labs are the best.

41:40 - Are there other breeds that Zach trains?

49:35 - How many people utilize DADs?

55:40 - How much does a DAD cost?

1:16:35 - Burst My Beta Cells

 

#38 T1D Can’t Stop You! - Olympic Lifting, Running, Crossfit w/ Eric Zucaro

In this episode, Dr. Grady and Dr. Garrett interview Eric Zucaro who is a fitness fanatic. He has competed in a wide variety of events such as CrossFit, ultrarunning, obstacle racing, and Olympic lifting. We ask him about his training, diet, and how he was able to do all of this despite being T1D.

 

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#37 Does Leaky Gut Cause T1D

In this episode, Dr. Grady and Dr. Garrett review a research article titled "Zonulin Upregulation Is Associated With Increased Gut Permeability in Subjects With Type 1 Diabetes and Their Relatives." We define what leaky gut is, how/why it develops, and how that relates to autoimmune and T1D. We discuss the importance of this information and the hope that it provides in the treatment of T1D. Research Article discussed: "Zonulin Upregulation Is Associated With Increased Gut Permeability in Subjects With Type 1 Diabetes and Their Relatives" https://diabetes.diabetesjournals.org/content/55/5/1443.long

 

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Time Stamps

0:25 - Introduction

2:10 - What is leaky gut

9:30 - Paper: Zonulin Upregulation Is Associated With Increased Gut Permeability in Subjects With Type 1 Diabetes and Their Relatives

21:50 - What causes increased zonulin and leaky gut?

25:00 - How does leaky gut lead to Autoimmune (T1D)?

32:20 - Does what you eat cause diabetes?

35:00 - Can you reverse T1D? Dr. Grady goes without insulin.

44:00 - What are other things that can affect your immune system and impact autoimmune besides diet?

47:00 - What is THE CURE of T1D?

49:50 - Stopping the development of a second autoimmune disease

54:00 - Burst My Beta Cells

#36 Boxes Up #2 - Diabuddies That Lift Together Stay Together

In this episode, Dr. Grady and Dr. Garrett are "in studio" with each other after a few days of working out and hanging out. We talk what we ate, how we dosed insulin, and managed blood sugar while doing two very different workouts and eating out at a restaurant.

 

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 Time Stamps

0:25 - Introduction: Garrett Is In Town!!

2:20 - Yesterday’s HIIT Workout And How We Managed Our Blood Sugars Through It

9:03 - Managing BG after the workout and eating and while running out of insulin

15:50 - Today’s “bodybuilding” workout

18:50 - Dosing Our Insulin For Our HUGE Breakfast Before The Workout

27:40 - Not Being Afraid Changing Basal Rates And Dangers of Lows

33:40 - Our BG Post Workout

38:50 - Muggles Thinking That 160 BG Is Way High

40:30 - The Balance Of Enjoying Life And Monitoring Your Diabetes

44:49 - Burst My Beta Cells

 

#35 Sweet Dreams Are Made Of....Good Blood Sugars

In this episode, Dr. Grady and Dr. Garrett discuss all things sleep and blood sugar. We go over how what you do during the day (food, exercise, etc) affects your blood sugars through the night, the impact that your blood sugars have on your quality of sleep, the importance of sleep itself, and how that impacts your blood sugars the next day. 

 

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Time Stamps

1:02 - Introduction: Garrett’s Current Sleep Regime 

2:12 - Why is sleep so important for Type 1 diabetics

7:24 - High Blood Sugar Leading to Increased Urination And Yo-Yoing 

10:40 - Is Having High Blood Sugar At Night Better Than Being Low?

15:47 - Grady’s Near-Death Experience

26:00 - Having A System To Protect You From Dangerous Lows At Night When Living On Your Own 

29:40 - What You Do During The Day Effects What Your Blood Sugar Is Like Through The Night

34:00 - Taking Control of Your Diabetes And Being Comfortable Changing Insulin Dosage

38:36 - How What You Eat And When You Eat Affects Your Blood Sugar Through The Night

44:50 - Exercise’s Effect On Blood Sugar Through The Night

53:35 - How Does Sleep Effect Blood Sugars The Next Day

2:08:55 - Grady And Garrett’s Daily Wins And Losses

#34 BOXES UP #1 - Wrastlin’

In this episode, Dr. Grady and Dr. Garrett loosen up and shoot the breeze about their "wrastlin" days. We dive into the struggles we faced managing blood sugars throughout our wrestling careers, as well as blood sugar's effect on performance and what could have been. Then we share some "war stories". 

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Time Stamps

1:02 - Introduction: Boxes Up and Wrastlin’

2:55 - Garrett’s Terrible Weight Loss Strategies and The Effect on Performance

14:00 - Using Diabetes As An Excuse To Get Out Of Things

23:20 - If You Aren’t T1D Don’t Even Try Talking To Me About It

29:30 - Strategies For Managing BG Through Practices

46:00 - Diabetic Wrestling Stories

#33 Controversy Over Dexcom Super Bowl Ad

WE HAVE A NEW WEBSITE!!!!! CHECK IT OUT!!!!

https://thediabuddies.com

 

In this episode, Dr. Grady and Dr. Garrett discuss the controversy surrounding the Super Bowl ad that Dexcom made on Sunday. What was the goal/purpose of the ad? Was it to spread awareness of type 1 diabetes? Was it to spread awareness of the high prices of diabetes care? Or was it an advertisement for their product?

 

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#32 Diabetes Tech: When It Fails and How To Recognize It

In this episode, Dr. Donohoe and Dr. Panno discuss the frustrations of diabetes "tech" failing, such as the pump, glucometer, CGM, insulin, etc. We walk through our thought process when we see a high blood glucose reading. Is it due to food, our physiology, or our "tech?" We also talk about the mental/emotional tax that it has on you when you do everything right and yet you have poor blood sugar control due to something that is so unexpected and not necessarily your fault. 

 

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Time Stamps

1:39 - Start/Introduction

3:13 - You See A High BG Reading What Is Your Problem Solving Thought Process

27:05 - When Tech Fails: Pumps and MDIs

31:42 - Glucometer and CGM Failure

39:51 - What Do You Do When One Hand As A Different BG Reading Than The Other?

49:10 - Emotional Impact Of Tech Failing

 

#31 Diabetes 101: Metformin VS Berberine

In this episode, Dr. Donohoe and Dr. Panno discuss two of the most commonly used interventions, both in mainstream medical and functional medicine fields, Metformin and Berberine. Dr. Panno recently wrote a paper on this topic where he read through numerous research articles in order to gain more clarity and understanding of these two products (how they work and how effective they are). We get into the science behind them but also the clinical takeaways and what it all means. Below we reference all the articles used. 

 

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 Time Stamps

1:10 - Start/Introduction

6:25 - Berberine: What Does It Do And How Effective Is It?

16:30 - Where Does Berberine Come From?

22:45 - Where Does Metformin Come From?

31:30 - How Does Metformin Work? (MOA)

39:50 - How Does Berberine Work? (MOA)

44:10 - Can you take Metformin and Berberine Together?

57:30 - Burst My Beta Cells

 

Resources/Links Discussed in the episode:

References

1. Arayne, M., Sultana, N., & Bahadur, S., (2007). The berberis story: berberis vulgaris in therapeutics. Park J Pharm Sci; 20(1): 83-92. PMID: 17337435
2. Bailey, C., & Day, C., (2004). Metformin: its botanical background. Pract Diabetes Int; 21: 115-117. https://doi.org/10.1002/pdi.606
3. Bailey, C., & Day, C., (1989). Traditional plant medicines as treatments for diabetes. Diabetes Care; 12(8): 553-564. PMID: 2673695
4. Center of Disease Control (2020). National Diabetes Statistic Report 2020, Estimates of Diabetes and its burden in the united states. Retrieved at: https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
5. Chang, W., Zhang, M., Li, J., Meng, Z., Wei, S., Du, H., Chen, L., & Hatch, G., (2013). Berberine improves insulin resistance in cardiomyocytes via activation of 5’adenosine monophosphate-activated protein kinase. Metabolism; 62(8): 1159-1167. PMID: 23537779
6. Chang, W., Chen, L., & Hatch, G., (2015). Berberine as a therapy for type 2 diabetes and its complication: from mechanism of action to clinical studies. Biochem Cell Biol; 93(5): 479-486. PMID: 19800084
7. Cheuh, W., & Lin, J., (2012). Protective effect of berberine on serum glucose levels in non-obese diabetic mice. International Immunopharmacology; 12(3): 534-538. PMID: 22266065
8. Choi, YH., & Lee, MG., (2006). Effects of enzyme inducers and inhibitors on the pharmacokinetics of metformin in rats: involvement of CYP2C11, 2D1, 3A1/2 for the metabolism of metformin. B J Pharmacol; 149(4): 424-30. PMID: 16940989
9. ClinCal (2020). The Top 200 Drugs of 2021. Medical Expenditure Panel Survey (MEPS). Retrieved at: https://clincalc.com/DrugStats/Top200Drugs.aspx
10. Dong, H., Wang, H., Zhao, L., & Lu, F., (2012). Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis. Evidence Based complement alternative med; 2012: 591654. PMID: 23118793
11. Elbere, I., Kalnina, I., Silamikelis, I., Konrade, I., Zaharenko, L., Sekace, K., et al., Klovins, J., (2018). Association of metformin administration with gut microbiome dysbiosis in healthy volunteers. PLoS One; 13(9): e0204317. PMID: 30261008
12. Foretz, M., Herbrad, S., Leclerc, J., Zarrinpashneh, E., Soty, M., Mithieux, G., et al., & Viollet, B., (2010). Metformin inhibits hepatic gluconeogenesis in mice independently of LKB1/AMPK pathway via a decrease in hepatic energy state. The Journal of Clinical investigation; 120(7): 2355-2369. PMID: 20577053
13. Fullerton, M., Galic, S., Marcinko, K., Sikkema, S., Pulinikunnil, T., Chen, Z., et al., & Steinberg, G., (2013). Single phosphorylation sites in ACC1 and ACC2 regulate lipid homeostasis in the insulin-sensitizing effects of metformin. Nat Med; 19(12): 1649-1654. PMID: 24185692
14. Lan, J., Zhao, Y., Dong, F., Yan, Z., Zheng, W., Fan, J., & Sun, G., (2015). Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia, and hypertension. Journal of Ethnopharmacology; 16H: 69-81. PMID: 25498346
15. Le Bastard, Q., Grégoire, M., Chapelet, G., Javaudin, F., Dailly, E., Batard, E., Montassier, E., Al, G. G. A., & Knights, D. (2018). Systematic review: human gut dysbiosis induced by non‐antibiotic prescription medications. Alimentary Pharmacology & Therapeutics, 47(3), 332. PMID: 29205415 
16. Li, Y., Wang, Y., Kong, W., Yang, P., Wang, Y., Li, Y., Yi, H., et al., & Jiang, J., (2011). Bioactivates of berberine metabolites after transformation throughout CYP450 isoenzymes. Journal of translational medicine; 9(62): 62. PMID: 21569619
17. Liang, Y., Xu, X., Yin, M., Zhang, Y., Haung, L., Chen, R., & Ni, J., (2019). Effects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and meta-analysis. Endocrine Journal; 66(1): 51-63. PMID: 30393248
18. Lyu, Y., Zhang, Y., Yang, M., Lin, L., Yang, X., Cheung, S., et al., & Zuo, Z., (2019). Pharmacokinetic interactions between metformin and berberine in rats: Role of oral administration sequences and microbiota. Life Sciences; 235: 116818. PMID: 31473193
19. Mao, L., Chen, Q., Gong, K., Xu, X., Xie, Y., Zhang W., et al., & Zhang, Y., (2018). Berberine decelerates glucose metabolism via suppression of mTOR-dependent HIF-1α protein synthesis in colon cancer cells. Oncol Rep; 39(5). 2436-2442. PMID: 29565467
20. Miller, R., Chu, Q., Xie, J., Foretz, M., Viollet, B., & Birnbaum, M., (2013). Biguanides suppress hepatic glucagon signaling by decreasing production of cyclic AMP. Nature; 494(7436):256-260. PMID: 23292513
21. Neag, M., Mocan, A., Echeverria, J., Pop, R., Bocsan, C., Crisan, G., & Buzoianu, A., (2018). Berberine: Botanical Occurrence, Traditional Uses, Extraction Methods, and Relevance in Cardiovascular, Metabolic, Hepatic, and Renal Disorders. Front Pharmacology; 9: 557. PMID: 30186157
22. Owen, M., Doran, E., & Halestrap, A., (2000). Evidence that metformin exerts its anti-diabetic effects through inhibition of complex 1 of the mitochondria respiratory chain. Biochem J; 348; 607-614. PMID: 10839993
23. Petersen, M., American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes care; 41(5): 917-928. PMID: 29567642
24. Pryor R., & Cabreiro F., (2015). Repurposing metformin: an old drug with new tricks in its binding pockets. Biochemical Journal; 471(3): 307-322. PMID: 26475449
25. Ren, G., Guo, J., Quian, Y., Kong, W., & Jiang, J., (2020). Berberine improves glucose and lipid metabolism in HepG2 cells through AMPKα1 activation. Front Pharmacology; 11: 647. PMID: 32457629
26. Yin, J., Xing, H., & Ye, J., (2008). Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism; 57(5): 712-717. PMID: 18442638
27. Yue, S., Liu, J., Wang, W., Wang, A., Yang, X., Guan, H., Wang, C., & Yan, D., (2019). Berberine treatment-emergent mild diarrhea associated with gut microbiota dysbiosis. Biomed Pharmacother; 116: 109002. PMID: 31154270
28. Zhang, H., Wei, J., Xue, R., Wu, J., Zhao, W., Wang, Z., et al., & Jiang, J., (2010). Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression. Metabolism; 59(2): 285-292. PMID: 19800084
29. Zhou, G., Myers, R., Li, Y., Chen, Y., Shen, X., Fenyk-Melody, J., et al., & Moller, D., (2001). Role of AMP-activated protein kinase in mechanisms of metformin action. The Journal of Clinical Investigation; 108(8): 1167-1174. PMID: 27654259

#30 How Brandon Mouw Kept On Kickin’ To Get A New Pancreas And A New Outlook On Life

In this, episode Dr. Grady and Dr. Garrett have the pleasure of hearing Brandon Mouw's incredible journey from developing brittle diabetes to receiving a lifesaving pancreas-only transplant. His story is truly incredible. He has gone through so many struggles from trying to stay alive through years of battling constant lows to jumping through the hoops of trying to qualify and raise the money for a pancreas-only transplant. This is a great interview that you are guaranteed to enjoy.

If you would like to connect with Brandon follow him on Instagram (@brandonmouwofficial) or visit his website https://brandonmouw.com/ . And look for his new book coming in 2021!

 

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Time Stamps

1:10 - Start/Introduction

3:45 - Brandon’s Diabetes Management Early In Life

13:35 - The Kidney Stone From Hell That Sabotaged Brandon’s Health

16:35 - Life As a Brittle Diabetic Fighting Constant Lows

25:40 - Trying To Find Answers

31:40 - Starting The Journey Back To Life

36:20 - Brandon’s Motivation To Keep Moving Forward

42:40 - Raising Money To Get A New Pancreas 

55:40 - Waiting For THE CALL

1:01:50 - Getting THE CALL And Rushing Into Surgery

1:11:50 - The Uniqueness of A Pancreas-Only Transplant

1:19:10 - Recovering From Surgery And Preventing Rejection

1:36:00 - Coming Out The Other Side A Better Person And Trying To Stay Healthy

1:45:05 - How Does The New Pancreas Work? (I’m A Little Jealous)

1:50:50 - Burst My Beta Cells/ Diabetic Win 

1:58:35 - Brandon’s Book and Contact Info