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Listen to Dr. Mowll reveal insights on how to prevent or reverse diabetes.
Dr. Brian Mowll is the founder and medical director of SweetLife® Diabetes Health Centers and serves clients worldwide as The Diabetes Coach™. He is a master licensed diabetes educator (MLDE), CDE, and was one of the first doctors to be certified to practice functional medicine by the prestigious Institute for Functional Medicine. Since 1998, Dr. Mowll has been helping people with all forms of diabetes properly manage their complex health conditions. Additionally, with type 2 diabetes, pre-diabetes, and metabolic syndrome, his goal is to not just manage but to reverse these conditions using a natural, personalized lifestyle approach.
Dr. Mowll has spent over 20 years studying and applying clinical nutrition, physical activity, lifestyle management, functional medicine, and diabetes self-management education. He is the host of the popular “Diabetes Summit”, as well as a prolific writer, blogger, and speaker.
In addition, he has written hundreds of articles about diabetes and natural health and has been a featured speaker and contributor on diabetes. Dr. Mowll treats clients locally in the greater Philadelphia area and nationally through his acclaimed Mastering Blood Sugar™ programs.
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[00:01] REENA JADHAV: Hi everyone its Reena Jadhav with the live longer podcast and health bootcamps and here with Dr. Brian Mowll talking about testing for diabetes. Dr. Mowll tell us about what are the traditional tests, what are the numbers and frankly most important what I’m excited about is what’s coming down the pipe, are there going to be easier ways to track and monitor diabetes? So let’s get started; what are the tests out there for one to check if we have got any diabetic conditions?
[00:31] DR. BRIAN MOWLL: A great question and if you have watched some of the previous videos you learned that type 2 diabetes and pre diabetes and even station diabetes is caused by insulin resistance; so if we really want to test and measure whether or not we are developing diabetes, type 2 diabetes we really need to evaluate for insulin resistance and I’m going to talk about that in just a few minutes. But before I get to that lets talk about some of the standard convectional tests that are done. So generally most people during a routine blood test at their physician’s office will have what’s called a metabolic panel which includes a fasting blood glucose test and several other tests. The fasting blood glucose test is sort of your base test for blood sugar and it should be between 76 and 92 ideally is right around the mid 80, 83-85 range, once it gets over that 90-92 area you are on your way towards develop pre diabetes and type 2 diabetes. Pre diabetes is diagnosed over 100 that’s milligrams per deciliter, so over 100 but under 126 is considered pre diabetes and once it moves over 126 then its considered type 2 diabetes. So what we are talking about really here is just a degree of scale, how far along that spectrum or that process are you; it’s all the same problem, it has all the same root cause and it’s just a matter of progressing to the point where it’s bad enough that you have lost the ability to control your own blood sugar naturally and that’s called type 2 diabetes. There is another test that can be done called the hemoglobin A1C that’s being done more and more it’s a test that I think everyone should get requested from your doctor because it’s a marker of liquation or damage by elevated blood sugar in your system. Its often times described as a three to four months average of your blood sugar which is one way to look at it, it’s a more stable test than just a snapshot of your blood sugar like you get with the fasting glucose test. So the hemoglobin A1C test is the percentage of the receptors on the protein that carries oxygen in the red blood cells that have sugar on them, I know it’s a mouthful probably just confused everybody but think about it this way, you have red blood cells and there is a part of red blood cells called hemoglobin, if that gets sugar coated or caramelized basically coated in glucose or sugar we are going to see that percentage rise and the higher that percentage is the more damage it’s done to that red blood cell; and we can extrapolate that to say there is damage being done to the brain, to the heart, to the cardiovascular system, to all the other organs like kidneys as well. So this is an important test and it should be somewhere between about 4 and 5 1/2 percent. So when you get a hemoglobin A1C test its going to be a number like 5.2 or 6.1and that a percentage so normal is about 4 to 5 1/2 percent; once it gets over 5.7 but under 6.5 again we are in pre diabetes range and once it gets over 6.5 again we are in the type 2 diabetes range, so this is another way of measuring blood sugar, it’s a more stable measurement its often times used to evaluate how well you are controlling your blood sugar even once you are diagnosed. They are a few other tests that I will mention one is a standard lipid test which is important we look at cholesterol and triglycerides level each cholesterol and this are important because they are essentially a way to measure how well we are burning fat and fat burning is really important for people with blood sugar control. So when your triglyceride numbers are elevated over 100 in fact that tells us that you are not burning fat very effectively and you are likely insulin resistance. So this is one of the ways that we can evaluate insulin resistance. In my clients are eating a really good diet and taking care of themselves and on a good blood sugar control program, their triglycerides will often get down into the 40s or 70 range and often times you will see them up above 100 even sometimes 200,300 and 400. So triglycerides are important ones to look at and the last test I will mention is fasting insulin- this one is hardly ever done but if you ask for it your doctor should do it for you and fasting insulin is a good way to evaluate whether or not you are insulin resistant. When we become resistant to insulin we make more insulin to overcome that resistance or insulin levels rise, Normal insulin despite what you might see on the lab reference range if you get this lab test done normal is about 3 to 6 and once it gets over 6 we are starting to see elevated insulin levels when it gets above 10 that’s indicative insulin resistance. There is actually a score that you can do called a HOMA-IR score it’s a model for evaluating insulin resistance its used in research and you need the fasting insulin fasting glucose number and by looking at those two you can actually come up with a score that will tell you whether or not you are insulin resistant. So the first way of getting the raw data so, you need to get the fasting glucose, fasting insulin and I also recommend lipid panel and hemoglobin A1C.
[07:07] REENA JADHAV: Sounds like a lot of test, a lot of great tests that need to be done. Now in our health bootcamps if you do have those tests we are going to have live calls with Dr. Mowll where you can actually get an interpretation of asking questions you know get some answers on what does this mean and what do I need to do in terms of managing this test results. Dr. Mowll how often should someone who has had some bad numbers on these tests, how often should they be repeated?
[07:35] DR. BRIAN MOWLL: Typically every 90 days; the last thing I will mention is that glucose monitoring at home is really important as well so certainly if you have type 2 diabetes or just station diabetes, if you have pre diabetes it’s not often recommended but I do recommend testing and in fact if you are just interested in your own health I think it’s a great thing to look at. You can get over the counter glucose-meters that test your blood sugar there some inexpensive ones available some of the chain stores out there and you can check your own blood sugar in the morning, after meals and really get a sense of what’s going on with your blood sugar when you eat and throughout the day. But as far as those main lab tests that I mentioned about every 90 days.
[08:23] REENA JADHAV: What glucose meter do you recommend because I actually swear by keeping one at home, tracking it seeing what is it that you are reacting to, it’s a little bit of work early on but I think if you try it out for a week you get hooked to it because you want to know how your body reacts to this you know when you look at those numbers they are so horrifying that you know I no longer eat five brownies at one sitting because I see what it does to my body and it’s not very good. So what glucose meter do you recommend?
[08:58] DR. BRIAN MOWLL: For both cost and accuracy I like there is one called the precision by Abbott that is sold over the counter you can get it at walmart and CBS and other places like that, it runs around 20 dollars and the test strips are less than 50 cents apiece which is pretty good and its accurate it’s a good meter so precision by Abbott.
[09:24] REENA JADHAV: That sounds great, alright thank you so much for answering those questions on testing and for the rest of you make sure to tune in to the rest of the series because there are some amazing questions being answered by Dr. Mowll and do check out health bootcamps for the beat diabetes program with Dr. Mowll. Alright I will see you on the next one.
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