I'm in a position where I've heard so many personal stories of why people struggle to manage their health and, as someone who I would say, i don't struggle, i'm thriving right. I love problem solving, i love trying out this approach to nutrition and seeing what happens, and trying out this approach to exercise and seeing what happens. And so one thing is personality, but what all of my experience in hearing people's stories has taught me is that there are so many struggles that get in the way of someone eating a nearly perfect diet or exercising every day, and and those struggles are so specific and personal and detailed, why not give them a tool that can meet them in the middle, that can help make those other things a little easier to choose?

Speaker 2: 1:19

I think one thing that we're not educated when we're diagnosed with type one diabetes is the fact that not only insulin doesn't work, but nor does a hormone called amylin that helps with satiety and ozympic allows and helps with that welcome back.

Speaker 3: 1:38

This is episode number 144 of the healthy diabetic podcast. As always, before we get started, please remember that nothing that you hear on this podcast should be considered medical advice or otherwise. Please always consult your medical team before making any changes to diabetes management. New to the show? welcome. Make sure you hit that subscribe button so you're notified when new episodes drop every single week. Also, i'm gonna ask you to do me a favor if you know anybody that you believe will get some really good value out of these conversations that we're having every single week, please share the show with them. I know that these conversations are really powerful and a lot of people can relate to a lot of these conversations, so I really encourage you to share the show with someone that you believe was gonna get some really good value out of it.

Speaker 3: 2:26

Okay, let's dive into today's guests and yes, i said guests plural, because I've got Kelly and and ginger on to talk about ozampic. Ozampic and these weight loss drugs that are out right now for diet type really type two diabetics, but now type some type ones are taking them. Um, all this is a hot topic right now and I this whole conversation is really brought about by a post that ginger made about ozampic and really people and trying she's trying to advocate for people that are on ozampic. And when I first read the red and saw her post and saw her video that she posted up and I'm gonna put a link to that post also in the show notes but when I first saw her post, i really wanted to comment with the utmost compassion for individuals on these medications, but also reiterating my personal belief of I believe that these medications are being pushed too fast, that we're not looking at the whole, entire confines of the issues. You know, what's your relationship with food? what's your exercise routine like, what's your mental state, what's your relationship with diabetes, like all of these other components that really can lead to not being able to lose weight? and I'm really glad that I didn't do that, because there's another perspective that I was educated on as I communicated with ginger about this and as I communicated with ginger and Kelly, who is also on ozampic, throughout this conversation. So I'm really excited that I didn't take that first step and make a comment. Instead, i reached out to ginger and we were able to talk in a professional way about ozampic and about medications and and and all these things. So I think this is going to be a really powerful episode. I'm really excited to share both of these ladies knowledge, with one being on ozampic and understanding the mechanisms of the medications.

Speaker 3: 4:25

So, without further ado, let's get with Kelly and ginger. All right, thank you both of you. Cal ginger, i'm so excited about this conversation. Um, ginger, i want to start with you because this whole conversation is really coming about by your amazing advocacy of one being a type one, doing what you're doing and talking really about ozampic and I I'm going to give full transparency too, like with ozampic, these weight loss drugs that are out metformin.

Speaker 3: 5:07

I have a personal bias about these drugs coming from the healthcare or the health professional with weight loss, with a bunch of different things which I would love to get. Both of your feedbacks with um, and the fact that both of you are also on ozampic makes this even more special because we can talk about using it as a type one and that type of stuff. So, ginger, i'm gonna um, i'm gonna push over to you and have you just kind of tell the story and then tell your story with ozampic. We'll have Kelly chime in on her story with ozampic too, and let's, let's start there, yeah well, i want to start with the fact that I also work and work in the fitness world for years as competitive athlete, as a personal trainer, as a yoga instructor, yada, yada, yada and and I am very active.

Speaker 1: 5:57

Today I'm very lean. Today I'm like very pro exercise, eat healthy food, make the most that you can, um. But I'm also very pro things like ozampic and metformin and I don't know if five, six years ago and really what the difference is for me is just understanding even more about what my body doesn't do properly for me as a type one and what these drugs help repulate.

Speaker 1: 6:24

Rep can help, not rep regularly but, um, yeah, regulate and compensate, yeah, right. So I also take metformin. I started taking metformin before ozampic because I couldn't get ozampic. So my recent post that Ken saw was really a rant on instagram about, um, the shaming and scolding that's coming from. It's coming from tons of places, but though I saw one in particular and I'm not going to name names, but I saw one in particular coming from a two and d fitness guru who also, i believe, is a cdcs, which for me, makes it even kind of more heartbreaking, and it was just, it was just more um, misinformation, misdescribing how glp ones like ozampic and trucity work, why they're beneficial, why they lead to weight loss and why um it's, and a lot of scolding for anyone that wants to use it.

Speaker 1: 7:21

It's just this assumption that they're lazy, they're not trying, they're trying to take a shortcut and hoping for some magical fix. And I just, i know so many people who have used this medication. They're not lazy, they're not stuffing their faces with donuts all day. Not all of them went on it for weight loss, because it does so many other things which we'll get to in a moment. Um, and, and it can be really life changing. But once you, i'm life changing I say with a grain of salt. I life changing for a person with type one who spends all day trying to stay in range right, yeah.

Speaker 1: 7:58

I'm not even talking about losing 100 pounds. I'm saying so I I mean nearly the same weight that I was when I started on ozampic right and I, and so is Kelly. She just said so. What is cdc? yeah you mentioned that oh, that's the ridiculous new term for cdc they just added like 17 more letters to it because we needed that yeah, yeah, um, so I'll stop there for a minute. I'll stop my rant before I keep going.

Speaker 3: 8:31

I love it. I? I just when I saw this post and, like I said the beginning, like I had my own thoughts about it, i was going to like comment and Not not shame not, but but like definitely state in my own words, like are we and maybe this is the next question for both of you, because i feel, like with different medications like this, that the medical system, doctors, are pushing people to these medications maybe faster than we should By not, by not looking at other holistic ways, whether that's what your relationship with food? how much sleep are you getting? Are you eating the right foods? what the quality of the foods that you're consuming? are you actually exercising? Like going down the route?

Speaker 1: 9:14

are you. The doctors have been trying to go down the route for so long and there's just so many people.

Speaker 1: 9:20

So i even So, today i work in diabetes research. I'm not the research, but i write about these research, right, so i see first hand all of kind of this, the struggles that people deal with in their health, and telling someone to just eat a healthier diet is only gonna go so far. Such a Such a limited piece of advice. Because one thing that i also coach people in diabetes in my own coaching business for several years and then i interviewed Time to people for stories as a writer, right. So i just am in a position where i've heard so many personal stories of why people struggle to manage their health And as someone who i would say i don't struggle, i'm thriving, right, i love problem solving, i love Trying out this approach, nutrition and seeing what happens, and trying out this approach to exercise and seeing what happens, and that is part of my personality. It's not because i'm better than somebody else it is.

Speaker 1: 10:20

It's really i, like i can look at my dad and be like i inherited this personality from my father. He used to get up at four am, go for a bike ride. I'd be waking up the serial at six and he would bike a hundred miles. You know, i mean. And so one thing is personality, but what all of my experience in hearing people stories has taught me Is that there are so many struggles that get in the way of someone eating a nearly perfect diet or exercising every day, and And those struggles are so specific and personal and detailed and i mean it's, it's a huge gamut of like someone being sexually assaulted as a child and using food to cope for the rest of their life. Right, i'm, so i'm having an addictive personality, and food becomes part of an addiction. Because they stopped smoking cigarettes or using cocaine or whatever, and so food right.

Speaker 1: 11:18

I had a friend who she was like she was nearly suicidal, so she was going on antidepressants. Antidepressants truly helped feelings of suicidal depression, but they made her constantly hungry, right? so she had to decide do i want to be fifty pounds heavier or do i want to be suicidal? Unfortunately, she chooses to be okay with being fifty pounds heavier and constantly trying to resist that desperate need for the house might sound like extreme examples, but they're really just the bigger I'm brothers of a huge number of things that could fall under those more yes and we have to have compassion for that, for just There's also just social anxiety not even knowing how to go to the gym and not having the confidence to go do it right.

Speaker 1: 12:07

I mean, i can go on and on. I will stop right now.

Speaker 3: 12:10

I love that because It's it's one thing, coming from the strength coach, like the heart of the strength coach of me, of understanding The concept of every person is not, does not have the personality or the willingness or the understanding to go to the gym and be successful, or go and not go to mcdonald's every day, every single day, or Right, right in my brain.

Speaker 1: 12:38

I don't need fast food. I competed in powerlifting, right, i follow those programs. But we can't just expect everyone to want to do that. And if their only choices are Be better or struggle, why not give them a tool that can meet them in the middle, that can help make those other things a little easier to choose right, because We don't do that with other things. We don't say, just get a better mood for your depression. We give people medications to help them, right. And yes, there's gonna be, there's gonna be people who don't do the other steps to help improve their mood while they're also in the antidepressant. But at least we can give them antidepressant, right. And there's gonna be people who don't take the other steps to improve their health while taking those and that. But at least we give them a tool that can help.

Speaker 3: 13:29

Yeah, i can. I ask, please, can i?

Speaker 2: 13:32

Everything. I'm ginger. I'm just so flattered to be in an interview with you. We got a dream. Diabetes is the fact that not only island doesn't work but nor does a hormone called amylin helps with satiety and ozzympic allows and helps with that. There's G lp one, the ozzympic mimicking hormone receptors, all out all throughout our body and on our brain. That was a big helps our body sense, sense satiety. But i didn't know i was lacking amylin, another hormone, and ozzympic helps with that. And i got on it because i echoed to my doctor like i feel like i'm a growing teenage boy with my appetite And it had helped with my appetite, did not lose weight, i maintained weight but it just made my blood sugar is a lot easier.

Speaker 1: 14:24

Yeah. So, kelly, thank you, because this is a huge thing. I've known about amylin for a long time, but i recently learned that there are actually six total hormones that get screwed up In type one diabetes six. So obviously insulin gets attacked the cells that produce insulin in the island of longer homes, which is in your pancreas. The island longer homes produces a variety of cells. Beta cells produce insulin, but it is so.

Speaker 2: 14:56

You got.

Speaker 1: 14:57

Beta cells are also responsible for producing amylin. So amylin does a few things. It gives us a feeling of hunger, it tells our brain when we're full. We literally is type ones. We're not getting that message. And then it also suppresses appetite after eating. Go ahead.

Speaker 2: 15:19

The biggest thing it does is it slows gastric emptying, which could be gnarly thing, and that's where a lot of And that's it.

Speaker 1: 15:28

Yeah, and that's a fancy term for saying it delays how quickly the food that's digesting in your stomach gets emptied into your blood sugar, which means it delays how quickly the food you ate spikes your blood sugar. So when the type one is in there, there's more okay. So it also suppresses how much glue to go on your liver releases all day long. Right, your your. As type ones, we are over producing with the gun. We are producing more sugar without even eating and i'm not a medic friend And that means we need more and more to keep our blood sugars in range, which means we are more likely to be storing that excess sugar as body fat, which makes it that much harder to manage our weight. And as someone who is lean, i can tell you i work. Before i was in big, i would work really hard to resist those feelings of constant hunger.

Speaker 1: 16:25

I would and yes, i was successful. Not right, kelly, you're saying you were you had, but it was a conscious effort every day and was like why am i still hungry? i just ate. And some people say why i've never felt that. You know, because i've had these conversations with people and it's like Congratulations that you've never felt that there are varying degrees, first of all of see peptide levels, and There's also the ectomorph versus endomorph body types. Some people just stayed naturally very lean, pretty effortlessly. I am not that body type to my siblings we gain weight easily. That's why i was really good at powerlifting. I can build muscle really well To my siblings. They really lean, they, you know they can't gain weight if they try.

Speaker 1: 17:11

But wait, i want to tell you what the other hormones, so your, your alpha cells, produce glupin. Those get dysregulated. So Beta cells are what's attacked and destroyed. But we have other hormones, other cells sorry, that get dysregulated and the hormones are dysregulated. So glupin prevents lows right, we know that we're not very good at preventing our own lows naturally. And pancreatic polypeptide is produced by the gamma cells from my little longer hands. This also regulates glupin that stored in your liver and how much it's really. Delta cells produce almost that, i don't know how to pronounce this. So much to statin. It inhibits the secretion of glupin and insulin To maintain homeostasis, so that's dysregulated again. We're over producing glupin and then the cells epsilon produce ghrelin, which they do talk about a lot in the fitness world. i think Ghrelin is responsible for stimulating appetite, managing fat storage. It also has been shown to have abnormal secretion levels in the new onset of type 1 diabetes. I don't take a breath there. I just get really fired up about it because nobody fucking talks about all these other things right?

Speaker 3: 18:31

Yes, because we're also worried about the weight loss piece. Everyone, no matter which side of the pendulum you're on, And I think this is why I really wanted to get both of you on and to talk about this and not just about the drug and the mechanisms and everything, how it works, but also your own personal experiences, Because before I saw that post-ginger, I was not thinking 100% in my head that all kinds of type ones could even go on it in the first place because it's regulated as a type two drug. That was my first thing. And then the second thing I was always thinking like okay, well, why does type ones need to even be on it? Or why do people need to be on it if you're not struggling with losing weight? And now I've got two perfectly good people in front of me of showing us why people need to be on it. People need to be on it outside of what we lost.

Speaker 2: 19:30

Yeah, and I think in the type one space. I know that you have all kinds of listeners hoping to improve blood sugar control to your podcast, but in the type one space there's so many, there's a high percentage of double diabetes where type ones have such insulin resistance, and this helps zap that entirely because we're missing a slew or having dysregulation of those hormones Ginger had mentioned.

Speaker 1: 19:52

Yeah, there's so many type ones that qualify as obese, right, and I really want us to resist the urge to just shame them as being lazy and having a poor diet because they have all of these things that set them up for the struggle, being so much harder to manage their weight.

Speaker 2: 20:09

Yeah, and there are ways to improve your GLP ones without taking those in big or with Jovi And would Jovi is a higher dose of medication of ozympics, so more people going for weight loss or going for the would Jovi versus ozympic. But I will say as a type one, it was so hard to get insurance to cover my ozympic, it was so hard.

Speaker 3: 20:32

That's just because it's not regulated or whatever, or it's not approved for type one.

Speaker 1: 20:37

Use It's not FDA approved in type one, so your doctor is gonna have to file prior authorizations. Some doctors won't even do it because they're skeptical, and I'm gonna send Ken a bunch of links to. We have several great articles on this at T1D exchange Awesome.

Speaker 2: 20:57

I will say my looks on ozympic were at first were probably some of the scariest because when I would go look and first started it would be a freight train like double arrow down, but faster.

Speaker 1: 21:09

I have one of my scariest lows on ozympic too. Let's, kelly, can you get into the impact when you first started it?

Speaker 2: 21:18

Yeah. So I went to a CDE it was a diabetes association here in Columbus, ohio dinner And I was sitting around the table with other health practitioners who were type one that I've known for years and years And somehow they brought up truacity And I was like, what's truacity? And they're like, well, it's the same as Victosa. And I'm like, well, what's Victosa? So then I got entirely educated at these medications were. So I scratched my head and asked my endo And I said you know, listen, i'd really like to try some of these medications. I've learned a bit about them And my endo was incredibly hesitant to give it to me.

Speaker 2: 21:50

But she said you're so hyper focused on your blood sugars and you sense, have a good sense of how your blood sugars are doing beyond your devices. She's like I'll allow you to try it, but she's like I will not give this to most type ones because the lows are so dangerous. And when I did have lows they were freight train lows, like I had to respond with maple syrup, where usually I just use a dry date. So it was a little tricky. It was very scary but my stability of blood sugars they just get so sticky and they were far more beautiful and my mood was more subtle And who doesn't want easier diabetes? So I've stuck with it. I did Victosa, which is a daily injection. I did not like that one as much. I felt more nauseous. And now I'm on ozympic, but a very low dose and I've been on it for a few years.

Speaker 3: 22:42

And Ginger, you said Were you surprised? Yeah, Ginger.

Speaker 2: 22:45

When I told you yesterday Ken called me.

Speaker 3: 22:47

Yeah, i was very surprised. I did not know And it's funny because I would have been like questioning it that I heard it the right way if Ginger hadn't made that post. honestly, because I'm like, what did she just say? She said she's on. I think I heard her wrong. I would have that's what I probably would have went through my head.

Speaker 2: 23:09

Well, i kind of stay quiet about it because my endo was like I do not want to prescribe this to a lot of my type 1 patients, just because of the fear of seizureing and dying really.

Speaker 1: 23:19

I mean so that issue with the lows, because I've had a couple people ask me about that And once you get your, you have to relearn your insulin doses because ozempic makes you much more sensitive to insulin, or ozempic is reducing your insulin needs for a few reasons, because you're not producing as much glucagon all the time. You're eating less, presumably, but I'd say, now that I've been on it for several months and I have not increased my dosage, i'm on the lowest dose you can take. My appetite is normal, but I just feel full sooner, but it's really. And then that delayed digestion. So I had my worst low on ozempic, one of my worst lows on ozempic because I took my insulin too soon And this was in the first couple months I was on it And the meal was digesting slowly, as it's supposed to, and I just woke up and the room was spinning and I was conscious and everything, but my blood sugar didn't even look.

Speaker 1: 24:23

I mean, i think I was like 50 or something, but I felt, like Kelly said, it was hitting me like a train And I gave myself a G-Voke injection of emergency glucagon, which is only one milligram versus like three milligrams which is in some of the other kits And then I had like two bowls of cereal And I was like I'm going to bed, i'm not taking any insulin, even though I know I over-treated this low, but it was so intense that I was like I want to over-treat this low to make sure that I can just go to sleep and feel okay. But yeah.

Speaker 2: 24:55

And I was just going to. if people do I had a client if they do try Ozympic, Victosa, Trullicity with Jovi and they're on insulin, like drinking alcohol, you know, alcohol can make some of us low. I had someone who drank alcohol in the first month they were on Ozympic and they just had that really scary low. So it's not always just insulin, Okay.

Speaker 1: 25:18

But I would argue that once you figure out what your new doses are, so like Ozympic immediately will cause you to need a reduction in your basal insulin dose, and then probably again a week or two later because you're also going to lose weight. And even regardless of Ozympic. something people really don't understand is if you start a new exercise routine or you start eating a healthier diet, you need immediate changes in your basal insulin And then you need them again a couple of weeks later if you stick with it right, like it's a gradual reduction. So if you're having lots of lows, it doesn't mean the new diet or the exercise you're getting too much of. the Ozympic is evil. It means you're getting too much insulin. You need to make a dramatic reduction. And it also for me like hugely reduced my meal boluses, but I would say Matt Foreman also hugely reduced my meal boluses. So Matt Foreman helps also compensate for some of those hormones that we don't produce properly. Yeah, but in a in a gentler way.

Speaker 1: 26:18

I started taking Matt Foreman and Ozympic because I was having such dramatic dawn phenomenon first thing in the morning and it was getting worse and my basal insulin needs were rising and nothing else in my life had changed And so I would increase my basal by a unit and you know, i was on like 10 units and then I'd go up to 11 and then I'd gain. a week after that I'd gain a pound and I'm a petite person, i notice a pound, you know what I mean And then I'd have to up it again and then I'd gain a pound and it was like what is going on And I was causing this, and as soon as I'd wake up my blood sugar would spike 100 points and my dawn phenomenon used to not be so dramatic, it's like it's so annoying. So I started before I got Ozympic. I started taking Matt Foreman right before going to bed. I experimented a little and I didn't.

Speaker 1: 27:07

I didn't like taking it spread throughout the day the way you're supposed to. I wanted it the biggest impact to be at 5am and it works Like I don't. I don't have dawn phenomenon anymore because Matt Foreman and Ozympic suppress liver glucose, which is what dawn phenomenon is.

Speaker 2: 27:24

Have you ever tried berberine?

Speaker 1: 27:27

I haven't. I've been reading about it a lot. I get Arnold Schwarzenegger's newsletter and he just was writing this long thing about it. I'm like it could help, but it's not the same. Have you taken it Ken.

Speaker 3: 27:41

I have. Yes, it's amazing. It's incredible. I use it also. I use it sparingly for high glycemic meals and it really helps to just destroy that big you know insulin spike, regardless of how much my pre-bolus is right. So I'll use it a lot when I eat pizza because it-.

Speaker 1: 28:04

Yes, are you saying you're taking it with the meal?

Speaker 3: 28:06

Yeah, so I'll take it because it because at least the one I take I use, the one from Ancient Bliss and hers is really cool because it's from it's like all made from herbal, like she uses, like the berberine stuff from herbal plants, not just it's so, it's not pharmaceutical-like made like other berberines. But I use it sparingly when I eat high glycemic meals, like when I go eat pizza, because it like the activation of it is like 15 minutes or whatever, like insulin almost it's like 15, 20, maybe 25 minutes. So there has to be some type of even pre-bolus with berberine if you're going to use it in that way. So I'll use it with pizza and it. It dramatically helps with my five you know four, five, six hours from when I start eating of the protein and fat insulin spike. It dramatically helps.

Speaker 3: 29:00

The first time I tried it it was really cool because the first time I tried it that was at like 163 and I take a full. I took a full dose within a half an hour without any insulin on board. It brought me down to 115.

Speaker 2: 29:15

So berberine was in a study compared to metformin and it found that berberine had similar results, if not better. So I will say berberine, but for people who can't get a doctor to write a script for metformin, which I think metformin is very controlled and accurate. Yeah, But berberine might be something to dabble with and I use berberine every night the week leading up to my cycle to help insulin resistance and So why don't either of you just take it every day to maintain increase in symptoms?

Speaker 2: 29:46

It's not good long term. It's not good long term.

Speaker 1: 29:50

Is it for you or not? as effective, say that question again.

Speaker 2: 29:55

Not good for you or not as effective, not good for you. I also cleanses the gut and you don't want to over cleanse. I have a lot of effects. My favorites designs for health I like theirs and I also like metagenics, candy-backed and BR, but they When you say cleanses the gut, do you mean it gives you diarrhea? No, but it will like clean up Yeah.

Speaker 3: 30:21

It helps with microbiome.

Speaker 2: 30:23

That's a good question, because metformin can give people incredible gastro symptoms, as ozympics.

Speaker 1: 30:30

Metformin has one of the lowest adherence rates of medications, meaning the most people stopped taking it. For me, i didn't have that. I had like one day of feeling like an urgency Yeah, to go to the bathroom, and after that I was fine.

Speaker 2: 30:42

Yeah, i have a PCOS client and she could not tolerate metformin So I had her take. I had advice She could try berberine daily. She could go to side blood sugars, especially if you have something like PCOS.

Speaker 1: 30:57

If anybody listening is considering metformin because it is super cheap and super easy to usually get covered by insurance, ask for the extended release version and start with a low dose and give yourself time.

Speaker 2: 31:12

And you just take it once a day, not twice.

Speaker 1: 31:14

I take all three pills right before bed. Yeah, yeah.

Speaker 3: 31:20

So is it pretty much last 24 hours? What's the potency of metformin and ozympic in terms of the peak It? does it peak or is it just kind of like a long?

Speaker 1: 31:30

thing It does. I notice the peak.

Speaker 2: 31:32

Yeah, i notice the peak.

Speaker 1: 31:34

That's why, yeah, i notice the peak, because I would take it at first, the way they prescribed it, morning and night. Some people type two are supposed to take it with every meal and it does hit by the. I think in my experience it has like this three to four hour delay when you suddenly see like whoa, that's really hitting my meal time lunch dose And I didn't want to have this like wave of metformin. I wanted it to mega hit me at 5 am, which it does, and I'm not eating and I'm not taking insulin beyond my long acting And so it just suppresses my and again, with any of these you have to have your basal insulin fine tune, and so many people don't.

Speaker 1: 32:17

And if you're having lots of lows every day, you're getting too much basal insulin. Chances are you could be getting even 10, 15% too much basal insulin. People are so scared to change their basal in injection or a pump. But when I listen to their stories of like I can't even go walk down the street without going low. Like you're probably getting four to five units more insulin in your basal than you need And it's like look at the facts and make the reduction.

Speaker 3: 32:46

Yeah, i think the interesting piece that you were talking in there in their ginger is when we were talking also about berberine is the or we were talking about ozempic is the fact that you have a strategic plan of why you're taking it and not just taking it for a bunch of different reasons or for you know, because you're taking a specific time. that's helping with what your goal is, which was to get rid of that phenomenon.

Speaker 1: 33:13

Yeah, yeah, and I would say, though, it reduced my meal insulin doses throughout the whole day even though I take it all at once before that. It just for me it feels like these, both of these drugs level the playing field a little bit for how hard type 1's have to work to stay in range after eating, manage our appetite and manage our weight and our insulin sensitivity.

Speaker 3: 33:35

Is it also with? because I also thought about this when I saw your post of the fact that you have another autoimmune disease too?

Speaker 1: 33:47

I've got like five.

Speaker 3: 33:49

Yeah.

Speaker 1: 33:49

I don't know if I play the role.

Speaker 3: 33:51

I don't know. I mean just because having five like that's also messing around with your hormones like in a crazy way. So it's like you know. Yeah, you know, and I thought about that.

Speaker 1: 34:02

My mom would just. My mom always says your body's so weird.

Speaker 3: 34:07

I know mom.

Speaker 1: 34:09

But I'm thriving. So there you go. Yes, you are.

Speaker 3: 34:12

Kelly what?

Speaker 2: 34:13

were you going to say Oh, i wanted to mention I have noticed a different deficiency from ozempic because I take it every Friday, so once every seven days, but I've noticed, like Thursdays, maybe Wednesday evenings, like a little bit higher blood sugars, just with no teeth. I would love to point out like and re-highlight, ozempic slows down gastric motility, the emptying of your food and your stomach. It also suppresses hydrochloric acid, which is not a good thing, so my susceptibility to foodborne illness would be higher because I don't have that acid. But it helps with satiety, helps with insulin sensitivity and helps if you had any functioning C peptides. Insulin proves better. But there's things we can do to our diet, of course. I want to talk about this To mimic what ozempic's doing too, and I did want to highlight when ginger kicked us off so well.

Speaker 2: 35:07

I've had a number of patients who've just hired me because they were so scared. They went to their physical, their annual physical, and the doctor just said, okay, start with jovie or truosity or ozempic, and they didn't even know what it was. So the doctor gave them no other advice, like hey, evaluate your diet, lifestyle etc. And just wrote them scripts and that just scared them to death that they therefore came to me to adjust those things. So I do think doctors are burned out for sure, like in the last few years, they're pushed so hard that they want to offer solutions, and it is a solution. But I think there's a layer of things that can be manipulated as well And I think just one small recommendation from a doctor can go pretty far with some people. But also doctors are about 17 to 18 years behind on nutrition research, and nutrition research is really noisy because it's messy, hard to articulate, And what works for one person's blood sugar management is as unique as their fingerprint.

Speaker 2: 36:06

But one risk of taking with jovie truosity ozempic is people are under eating and specifically under eating protein, and therefore losing muscle mass, which hurts a number of other things. So if you are taking ozempic, make sure you're having 20 to 30 to 40 grams of protein at each meal to support your muscle mass And also that protein will help with satiety. But also if you have plenty of polyphenols, antioxidants, really rich colored foods from cocoa to berries to purple cabbage and red onions.

Speaker 1: 36:37

Try to eat real food as much as you can.

Speaker 2: 36:42

Those antioxidants can help with the production of GLP-1 on its own.

Speaker 1: 36:50

One thing I really want to add is with all those the headlines have been so dramatic about just the side effects of ozempic. But you don't have to be on. I think people would have more success with calmer side effects if they stayed on a lower dose for longer and went up extremely slowly in the dosing increase. And I went up. I tried to go up from 0.25 to 0.5 and it was just my stomach hurt and I was like I don't want to do this. I'm just going to stay at the low dose. And I have friends that have gone up to two milligrams and they were feeling very sick. So they went down to one milligram and they're still getting the benefits. So you don't need to go on these extremely high doses in order to get the benefits. But if you combine a lower dose with healthier lifestyle habits and really working on those other things as well, you'll see the benefits of it in your blood sugars and your weight loss efforts. And just be patient.

Speaker 2: 37:56

The dosing is so weird. I'm on 0.25 plus eight clicks. When I go to my dose, I'm like 0.25 plus eight clicks.

Speaker 1: 38:07

That's like half. It's basically halfway. You're on halfway to 0.5. Yeah, but it's bizarre.

Speaker 3: 38:14

So when you say eight, you said eight clicks or four clicks. So is this like an insulin pen almost?

Speaker 1: 38:22

Oh yeah, it is an insulin pen but they've really regulated how to dose it so that you can't accidentally overdose. So on truplicity, you can't do the clicks, You just get your dose. It's much more controlled. And then in Ozenpeck there's a lot more flexibility. You could go up one click if you wanted. And I tried that of going up like very gradually to 0.5, because technically I could be up at two milligrams if I wanted And I just I didn't like how it felt and I stayed on the lower dose.

Speaker 3: 38:53

So is each click 0.25 or 0.5?.

Speaker 1: 38:58

No, no, it's neither. Oh, it's a click. It's a click, There are yeah, The reason Kelly is on eight clicks plus 0.25 is because there's 0.25 and then there's 0.5 way over here and there's like don't put me on the exact number, but there's like 14 clicks in the middle.

Speaker 3: 39:18

Gotcha That you could go to as you wind out the back. I got you. Okay, that makes sense, that makes more sense. I was like, how much is a click? Yeah?

Speaker 2: 39:28

If I overdose, or maybe it hits me. Sometimes it just hits me different each week to week. It's a hormone, but I feel like I'm first trimester pregnant. You just have this yucky. It's a yucky feeling is my symptom of overdosing?

Speaker 3: 39:45

You both talked a little bit about side effects. What are the side effects of taking metformin, ozempic, any of these types of drugs or these medications? What are the side effects that people need to watch out for?

Speaker 1: 40:06

The first month or two I definitely had little to no appetite. Then, if you're on larger doses, people, i think, have reported diarrhea. Right, kelly, it messes with how your stomach is digesting food and vomiting. But it's also because your stomach and your body is not used to having this hormone present. Right, you have not had normal amounts of this hormone present in your system. That's why titrating the dose so slowly, slower than your doctor is recommending is so important, because you really need to let your body get used to having this present. It's a lot of gastric upset. I've never vomited, i never had diarrhea because I kept my dose low and I didn't rush up to a higher dose, and I would highly recommend that.

Speaker 2: 41:02

Adding on to that, though, there's other like if it was a commercial, which I'm sure there are, and there's all the disclaimers at the bottom. Pancreatitis is one. There are some scary things, but it's measuring your quality of life on a daily basis versus those and keeping your blood sugar in better control can prevent complications Like it can. There's a risk factor of influencing the kidneys, which obviously that's a risk factor of type one, but if my blood sugars are better, my quality of life is better. Is that a risk worth considering? The other thing as a dietitian I always think of is it slows down the gut motility, and that can be really harmful to gut health. So I always think about that and I think, okay, am I having one snake a day? That's one of my sayings.

Speaker 3: 41:45

One bowel movement a day.

Speaker 2: 41:47

You always say that If you kind of make sure you're not and I do take. It's called. I take a lot of vitamins. I take a vitamin called Motil Pro. It's just ginger, it's just a bitter that helps your motility move along just to make sure you're having a bowel movement. But I'll take Motil Pro every night before bed with my magnesium and anything else I'm taking.

Speaker 1: 42:08

So I take, i don't take it regularly because metformin and ozambic kind of support each other and just making yeah, we just kind of cancel each other out. Metformin could cause loose bowels, ozambic can cause constipation, right, and so I don't really even think about it at this point, to be honest. But if I was feeling constipated I would take psyllium husk capsules from Costco. It's just pure corn husk and it just moves things along.

Speaker 2: 42:37

Yeah.

Speaker 3: 42:38

Yeah, so we've been talking a lot about the mechanisms and the fact that we're basically missing these different hormones as type ones. What about some of that type two that's going on these drugs? Is there like stuff that we that like needs to kind of be thought about with those individuals because they aren't missing these other hormones, that type ones are missing.

Speaker 1: 43:06

Oh, but they are. I mean, there's so much research. Sorry, go ahead, Kelly.

Speaker 2: 43:12

Like there, might you know, type twos. Your cells become insulin resistant. Your cell stuff respond to those signals. There could be resistance to these hormones that ozambics replacing. But I mean of course Ginger said it, i've already said it too It's just make sure you're really considering like what can be adjusted with diet to make the medication work even better and really nourish yourself, yeah, doing your best there.

Speaker 1: 43:36

But like there is so much more research now on genes that are found in a significant number of people with type two that are responsible for increasing insulin resistance, right, like we don't need the shame that type two is either, because, whether their type two is caused by overeating and sitting on the couch all day, i would point at that and say that it's probably dealing with depression, anxiety and not good role models growing up, not encouraging supportive system around you, just lack of education, right, or what you know. There's a million things. Ptsd, right, like whatever it is. If those are the reasons why you're overweight, you still deserve compassionate tools to help you Absolutely, absolutely.

Speaker 3: 44:24

That's beautiful, yeah, absolutely. Well said, yeah. So this has been incredible. Ladies, thank you so much for talking about this. I feel like I'm really educated about it now, so I'm super pumped about that. If someone is trying to weigh the options of going on ozempic, not going on ozempic, and they are getting pushed back from, maybe from their physician, like Kelly, was, what are some things that they could be doing, whether it's like maybe specific questions that they could be asking their doctor or specific things they can be telling them.

Speaker 1: 45:06

I mean I would start, yeah, the day your insurance is going to decide or not decide if you have a willing doctor, right, and I sent Ken some things that he can include in the show notes. One includes tons of research from an endocrinologist who strongly believes in prescribing this to type 1s and why. But you need to convey to your doctor and message on my chart, whatever your system uses, that you're struggling with insulin resistance, post meal highs, difficulty keeping your weight down, difficulty feeling satisfied after eating. Put that in writing, okay, lay it out there so that they have the evidence to then take to your insurance company and say look, this patient is struggling with these things.

Speaker 2: 45:52

Right And perhaps was tried. Thank you, that could always help.

Speaker 3: 45:55

What's that?

Speaker 2: 45:56

Kel, Say that again. List like what you have tried Oh yeah.

Speaker 3: 46:01

That's a good idea, right.

Speaker 1: 46:02

They'll probably say you need to try Matt Forman first, and so you can try it if you have crazy diarrhea, like many people report but many people don't We only hear from the ones that have crazy diarrhea. There's lots of people that just take it and they're fine, and they don't talk about it because it just is not dramatic, right? So don't be scared of trying Matt Forman. I was scared because I've written so many articles and interviewed people about Matt Forman And then I was like, oh God, i need to like wait for the perfect weekend to take this. And yeah, i was scared, but I would encourage you to give it a try for sure, and then, if you can't tolerate it, you tell that to your doctor. I could not tolerate this drug.

Speaker 2: 46:42

I did like how my doctor highly recommended I'd take the daily Victoza before I got on the Ozympic, so I didn't have to be miserable for a week. It was just a one day, 24 hour shot.

Speaker 1: 46:55

And that's a good thing to bring up too, because Simlan and Victoza are FDA-approved in type one, but they work a bit differently and they can cause, i think, more. I've never taken them, but I've interviewed a lot of people who have, and they have to take them every day, and then they can just have a less steady impact on your insulin needs because it's in and out of your system so much quicker than Ozympic, right, ozympic is this huge umbrella over the week and Victoza is like covering, you know, hopefully a good portion of a 24 hour period.

Speaker 2: 47:31

Yeah, shameless plug. I can include a link to Fullscript, ken, if people wanted to get any of those Berberine brands we had mentioned, or Motel Pro The Ginger, to help get you a snake a day.

Speaker 3: 47:50

I love when she says that Every time I interview you I tell, literally every time I interview, i'm sure you say make sure you have a snake a day.

Speaker 2: 48:02

You don't forget it, right.

Speaker 3: 48:04

No, now, when you hear it like every single month, three or four times in the month, because you say it sometimes in your post too, oh, yeah, do you need therapy for this, ken?

Speaker 1: 48:13

Are you struggling?

Speaker 3: 48:14

No, absolutely not. I am not struggling with that whatsoever.

Speaker 2: 48:20

Well, thank you for letting me hop into this podcast date and chat with my girl, ginger too. I love it.

Speaker 1: 48:29

Yeah, it's great to meet you in cloud life. I'm glad, thank you.

Speaker 3: 48:32

Thank you so much, ladies. This has been just incredible, so fun. Thank you, ginger, for hopping on. I'm so happy that I reached out to invite you back on to talk about this because, like I said, i feel like I'm more educated about it, which is great. I love being educated about things that I'm not 100% sure about. And Kelly, thank you so much too for coming on and giving your expertise, as always. So, thank you, ladies, this was great. Thank you everyone for joining us. We'll see you guys next time. Bye.

The Healthy Diabetic

#144: Exploring the Impact of Ozempic on Diabetes Management

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