August 7, 2024 • 40 mins
Morgan White Jr. for NightSide:
Although a serious disease that requires a round-the-clock commitment, diabetes is thoroughly manageable with the right plan. Morgan welcomed Dr. David Nathan, Director of the Diabetes Center at Massachusetts General Hospital, to discuss how to keep diabetes in check, or avoid it altogether.
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Although a serious disease that requires a round-the-clock commitment, diabetes is thoroughly manageable with the right plan. Morgan welcomed Dr. David Nathan, Director of the Diabetes Center at Massachusetts General Hospital, to discuss how to keep diabetes in check, or avoid it altogether.
Ask Alexa to play WBZ NewsRadio on #iHeartRadio!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
It's with Dan Ray un Boston's final hour of Night Side.
Speaker 2 (00:08):
If you or someone in your world, family, neighbor, boss,
has diabetes as an issue, get comfortable for this hour
because this gentleman is looked upon as one of the
most intelligent physicians in the world of diabetes, well respected
(00:33):
across the country. At one time he was my doctor,
growing back about twelve years or so ago. Doctor David
Nathan is here, doctor, thank you for a green to
come on. And you know how much I appreciate getting
a chance to share you with thirty eight states.
Speaker 3 (00:51):
Morgan, my friend, Thank you. It's always a pleasure. Thanks
for having me, all right.
Speaker 2 (00:55):
You and I both know there are so many commercials
that are on TV, and I know you and Rob
were talking about this as he called to set you
in our system for this interview. They are making promises
there are at least a half a dozen medicines that
(01:17):
are allegedly good for you if you are a diabetic,
and I want to begin at the starting point, explain
to people how you become a diabetic.
Speaker 3 (01:36):
Well, diabetes comes in several different flavors, one of them
which is relatively rare and which usually affects younger people
is called type one diabetes, and that's a disorder in
which the your own immune system attacks the insulin secreting
cells in your pancreas, wipes them out over time, and
(01:56):
you end up being totally insulin deficient. And that is,
you know, a disease that we've known about from antiquity.
It effects probably in the US a total of maybe
one and a half million people, and we've known about
it for a long time. It was an entirely deadly
disease until insulin was developed in the early nineteen twenties.
(02:18):
The type of diabetes that most people are suffering with
are struggling with, is called type two diabetes, and that's
a combination of several factors. It's firstly, it's multi it's
publicly called polygenic, meaning it's not one gene. It's a
combination of a whole bunch of different genes, each of
which contributes a small amount of risk. But you know,
(02:39):
people don't generally get this kind of diabetes unless one
of three things happens. One is that they get overweight
or obese. Number two is that they decrease and this
contributes to their overweight. They decrease, their activity levels, and
this has happened to many people all over the world.
And number three, when people get older. That's also So
(03:02):
those three factors are the ones that have led to
this being an epidemic. And not only it's not just
one and a half million people as with the type one,
but type two affects more like, you know, thirty five
million people. So you know it's one of the most
common chronic diseases there is.
Speaker 2 (03:17):
And you mentioned the three causes. Number two and number
three overlap. As you get older, you get less interested
in taking care of yourself exercise, so there are two
things working against you.
Speaker 3 (03:37):
Yeah. Well, you know, we're at a time in our
in the human history when we are living longer, older
than ever before. And you know many of us who
are so I'm in my seventies and my knees are
hurting a lot. And you know, we just weren't designed.
We weren't engineer to last as long as we are
now living. And one of the things that happens is
that our muscle mass decreases. As you get older, the
(03:59):
proportion of your body mass that is fat increases. Even
if you're not overweight, your relative amount of fat increases.
And all of those factors conspire to cause type two diabetes.
And it's epidemic. I mean, you know, it's affecting once
you're a rage of sixty five, it's affecting one out
of every five people or so. I mean, you know,
it's really incredibly common.
Speaker 2 (04:19):
And I've noticed this is observational on me, it's not scientific,
but I've noticed thinner people by comparison, that have developed diabetes.
There was a time you could see somebody who had
a tummy and pretty much guess in their world they
(04:39):
were suffering from diabetes. But that's no longer a guarantee
or am I wrong?
Speaker 3 (04:46):
Right? No? No, no, no, it's the kind so there.
It's you know, when we say that being overweight and
less activity levels, lower physical activity levels are major environmental
contributors to this true, true, But it doesn't mean that
people who are thinner might also not get diabetes when
they're older. And in those folks, interestingly, they probably have
(05:08):
a limited capacity to secrete insulin themselves. That is, their
pancreas doesn't make as much insulin, and as they get
older they may need a bit more insulin and their
pancreases just can't keep up with it so they can
develop diabetes. Their diabetes looks a little bit more like
the type one I described before. That is, they tend
(05:29):
to be more insulin deficient compared with insulin resistance. Those
are the two factors we talk about in type two diabetes,
and i'm more resistance. Yeah, go ahead, sir.
Speaker 2 (05:40):
I meant to say this in the beginning. We always
you and I always make this statement clear to the listeners.
The circumstances descriptions that we will cover between now and
the end of the hour are generic. They necessary. We
don't point at you specifically, you need to get from
(06:04):
your doctor your specifics. We can indicate or point you
in a direction, but necessarily the information that we are
giving won't cover your issues so nobly.
Speaker 3 (06:20):
Yeah, I'm glad you point that out. More right. I mean,
I play I play a doctor on radio and TV,
and I am some people's doctors, but I'm not you know,
the people on the radar, I'm not their doctor. They
absolutely need to talk to their healthcare professionals about their
health care issues, including diabies.
Speaker 2 (06:37):
Nor Now, if you're listening right now, you'd like to
call in. You're waking up three four, five times a
night to urinate. You know the different warning signs, and
you have a question. Yes, doctor Nathan can respond to
your question. But again what he tells you might indicate
(07:02):
the church to be in, but not the pew to
sit in the church, to use that old analogy. But
I'll give you the phone numbers if you want to
call in. Six one, seven, two, five, four, ten, thirty, eight, eight, nine, two, nine,
ten thirty. He is doctor David Nathan, and he is
(07:22):
well respected across the country and dealing with issues revolving
around diabetes. And he always gets kind of sheepish when
I say this. He made a difference in my life
going back about twelve years, and I thank him for
(07:44):
the positive things that he helped me realize and take
care of a dozen years ago. You're very kind And
on that note, let's take our break. You want to
call in. I gave you the phone numbers. Time here
on Nightside eleven sixteen sixty five degrees.
Speaker 1 (08:07):
Now back to Dan Ray live from the Window World
Nightside Studios on WBZ News Radio.
Speaker 2 (08:14):
Dan will be back on the twelfth of August. I
am here obviously for the rest of this evening Thursday
evening tomorrow evening and Friday evening, but nightside goes on
whether Dan is here or not. My guest this hour
is doctor David Nathan, and we're talking about diabetes, and
(08:34):
doctor there may be people out there that are getting
warning signals but they're not paying attention to it. The
deterioration of vision, frequent urination. I'll let you're the doctor,
so I'll let you tell people things that should make
them possibly get in touch with their physician, because as
(09:00):
it could be that they have diabetes, one way to
find out is to get a professional.
Speaker 3 (09:08):
Right. Well, you know what you described, Morgan are the
classical symptoms of diabetes, because when your blood sugar rises,
it goes into the urine and that pulls water along
with it. So frequent urination is a common complaint, or
when diabetes is out of control can be a common complaint.
(09:29):
And with that people get a little bit more dehydrated,
so they're more thirsty, they may be unusually fatigued. Vision
can be blurry, as you point out, but it's worth
pointing out that the majority of people actually don't have
those symptoms. That most people can be running around or
walking around walking slowly around with diabetes and not even
(09:51):
know it, which is why we recommend strongly for people
who are adults and certainly over the age of forty five,
that they have annual blood tests done when they see
their doctor, because they will pick up an elevated blood
sugar or a test called the hemoglobin A one c
which measures average blood sugar, and that doctor can do that,
(10:11):
and you know, if it's elevated, then they will pick
up the uibts even though you didn't have didn't have
many symptoms or any symptoms.
Speaker 2 (10:19):
And what is a number that indicates maybe you should
pay attention with your A one C and or blood
pressure number.
Speaker 3 (10:31):
Right, So, the if you're going to do a blood
sugar a blood glucose test, it's usually done fasting, and
a fasting test that's greater than one hundred and twenty
six is what is commonly accepted as the definition for diabetes.
The hemoglobin A one C is a blood test, and
these are simple blood tests. They're inexpensive. The hemoglobin A
(10:53):
one c can be drawn taken at any time of
the day, and it's being used increasingly, and if your
value is greater than six point five percent, that is
considered diabetic and not infrequently when people are starting to
get older. These are done as part of the routine
annual physical examination.
Speaker 2 (11:11):
It used to be seven instead of six point five.
Speaker 3 (11:15):
When did that, well, go ahead, No, So I think
what you're mistaking is that greater than six point five
is the level at which diabetes occurs. The target that
we're aiming for with therapy is to lower it below
seven percent in general. So again six point two over
six point five diagnosis diabetes. But when we treat people,
(11:36):
we try to get their value less than seven percent
because that's been shown in many high quality studies to
reduce the risks of die. You know why do we
care about diabetes is because it's accompanied. You know, it's
the greatest cause of vision, loss, of kidney failure, of amputations.
It increases the risk for a heart disease. I mean,
there are these just awful complications that occur. But we've
(11:59):
shown through really very high quality studies that you can
reduce those risks if you keep your average blood sugar
in a certain range, and that range for most people
is less than seven percent immagomina ONEC. At the same time,
you want to control your blood pressure and your cholesterol
because heart disease is the other major killer that accompanies diabetes,
(12:22):
and you can improve your chances with that not only
through blood sugar control, but through controlling your blood pressure
and your cholesterol levels.
Speaker 2 (12:31):
Are there any new philactrimated term inventions to help people
who are suffering from diabetes?
Speaker 3 (12:42):
Oh boy? Yeah. So with the epidemic of diabetes, which
has increased just dramatically in the last thirty to fifty
years and has gone up and up and up and up,
the pharmaceutical industry and our basic scientists have developed a
whole host of new medications and if anybody watches television
or listens TOLA radio or reads the newspaper, they will
(13:05):
see them. You know, I'm not sure that people in
this kind in the US recognize that we are one
of only two countries in the world where drug companies
can advertise directly to the consumer. So, you know television,
I think it's Brazil, all right, So so just two countries.
Everybody everywhere else advertising of that sort. You know, the
(13:28):
dancing guys who are advertising the wigov or the some
magmatizer of those drugs, and they're on constantly, and it's
turned into a giant, giant and even more so than
it used to be in the past. A giant industry
that is diabetes medications. So the new things that have
come about are a series of new and exciting drugs.
(13:49):
I mean, they really do help you.
Speaker 1 (13:51):
Now.
Speaker 3 (13:51):
Interestingly, the ones that everyone knows about that are advertised
most widely are these called drugs called the g LP
agonists or receptor agonists. And that's I'll give I don't
usually I'm trying not to advertise any medications here, but
the magletide and what go be and those drugs that
(14:11):
people see advertised, or ozempic those and you.
Speaker 2 (14:15):
See them, they were five times a day, and that's
not that's not an over exaggeration. Maybe even more than that.
You know, I've got talked to diabetes, but I manage
it well.
Speaker 3 (14:28):
Stocks in my head, no, no, so you can't get
the songs out of your head. That means the advertising
is working.
Speaker 2 (14:34):
Apparently, I take my pills from charity ins and and
I've seen several of those commercials that all focus on
an office dancing, a woman getting off the bus downtown
and everybody's dancing. They grab your attention.
Speaker 3 (14:51):
No, these are these drugs are well known to cause
dancing you're taking these drugs and you start dancing in
the streets. That's just the way they were, right. So
the two new classes of drugs. One of these are
the glps, and interestingly, those drugs were invented in my
hospital at the Mass General many many years ago, and
the pharmaceutical industry went wild with them and developed a
(15:14):
lot of interesting and good formulations. And those drugs are
actually becoming increasingly popular because of their weight loss side effect.
So they're being used not only to treat diabetes, but
if people are overweight, these drugs are more effective than
drugs we've had in the past at causing leading to
some weight loss, and in fact, people with diabetes are
(15:37):
sometimes struggling to get them because everyone who's overweight in
the country is now ordering them and trying to use them.
So that's one class. The other one is the jardians.
These are called the that's called empiglephalazin, and that's a
group of drugs that have another effect, that is, they
work differently, but they're also effective to treat diabetes. They
(15:59):
drop people's wait a little bit. And both of these
classes or drugs also reduce the risk of heart disease.
No no, not enormously, but enough that it's a recognized indication.
So they're being used for several different purposes, not only
to treat diabetes, but to reduce the risk of heart disease.
They can help with kidney disease as well. So, as
(16:20):
often happens, you know, diabetes specialists have this, they finally
have something that you know. Unfortunately it is epidemic, but
it's something they can pay attention to. But now the nephrologists,
the kidney experts, the cardiologists are all using these diabetes
drugs to help treat these other conditions. And they're quite effective.
These are good drugs. They're important and if it wasn't
(16:42):
for the endless advertising, I'd be even more enthusiastic about.
Speaker 2 (16:45):
Let me take a call before I have a break.
I get two people on hold. First, as Paul in
Rhode Island. Paul, thanks for calling Knight's side. You've got
doctor David Nathan.
Speaker 4 (16:56):
Yes, hello, doctor Nathan. I was a patient of yours
in Boston in the early nineteen eighties at Mass General,
and I'm a Type one diabetic and now I've been
a Type one for fifty six years. I'm doing fantastically
my last A one C was six point four. I
(17:23):
really credit you for how I'm doing so well. I
really appreciate that the care you gave me at that time.
And I'm I just I just want to want to
stress the importance of keeping up with the testing and
(17:49):
the diet and everything, and it really pays off in
the end.
Speaker 2 (17:54):
Paul, you were so right, and I like you had
doctor Nathan as my physician, and I can't thank him
enough because here I am in my world twelve years later,
still here, and here you are in your world fifty
years later. So there you go.
Speaker 3 (18:15):
So Paul, thank you, Yeah, thank you for your con comments.
I should point out which Paul and Morgan both know,
is that type one and type two diabetes are enormously
self care diseases. It because we eat constantly and because
we have to pay attention to the blood sugars constantly,
and we have to you know, for type one, of course,
(18:37):
it's a question of figuring out how much insulin to
give before any given meal using the technology that's been developed.
But when it comes down to it, this is a
lot of work for young people who when they first
developed diabetes and through a lifetime and Paul. You know,
as Paul probably knows, if we were talking forty years ago,
no one survived with fifty years of type one diabetes.
(19:00):
The majority of people with type one diabetes were had
died by the time they were fifty years old, So
that you know, sixty percent to die by fifty these days,
because of the new methods they're treating diabetes, the importance
of keeping bloodshers and tight control medications, we live normal lifespans. Yeah,
they live normal lifespans without blindness, without kidney founder and
(19:22):
so like Paul, I hope Paul's story is the story
that hopefully we'll be talking about from now on.
Speaker 2 (19:28):
Paul, thank you for your call.
Speaker 5 (19:30):
Thank you, all right, good night to you, Paul.
Speaker 2 (19:33):
I'm about to take a quick news hit. A couple
of commercials will be in there. Gary, you are on deck.
Anyone else who wants to do what Paul and Gary
have done. Six point seven two five four ten thirty
or eight eight eight nine two nine ten thirty, We're
talking diabetes with doctor David Nathan here on Night Side. Well,
(19:53):
the time is eleven twenty nine sixty five degrees. It's
night with Dan Boston's News Radio. In case you haven't noticed.
Dan has been on vacation. He should be back on Monday.
(20:15):
I am here now. I'm Morgan Morgan White Junior. I'll
be here tomorrow, Thursday, and as well Friday. Don't forget
my show on Saturday at ten and tomorrow. I mentioned
I'm here. Alison and Grim from Little House on the
Prairie that's celebrating their fiftieth anniversary. She will be here.
(20:38):
She's supposed to be with me Monday. Unforeseen things happened,
so she'll be joining me tomorrow as well. Former ABC
newsman Bill Dial and then Susan Brakeman, who's written a
number of books. She's currently working on a book about
candy specific to Massachusetts. She wrote a book about Route
(21:03):
one north shore of Route one. And my buddy, former
lieutenant for the City of Newton Police Department, Bruce of Potheca,
will be here. That's my scheduled show for tomorrow. Right now,
I've got full lines. Believe it or not, all want
(21:23):
to talk to my guest, doctor David Nathan about diabetes.
So Gary wooburn your first this segment with doctor Nathan.
Speaker 5 (21:34):
Hello, Gary, Yes, her doctor bad news on my report.
I've had diabetes since I was thirty six years old,
type two, and I got type one in the past
five years, five five pounds. I'm very direct the way
I talked, as you can tell, I'm a bad boy
(21:56):
when it comes to eating. I can't stop you. I
can't even exercise, even though I have a physical job
where I move around a lot. And also I'm going
into long periods of sleeping where even if I didn't
work hard the night before, so they work second and
third chif type of job, I sleep into six to
(22:19):
eight hours to ten hours instead of back in the
younger days of four to six and I just can't
motivate myself. I take insulin and you take it from
their doctor.
Speaker 3 (22:34):
Well, Gary, so I mean, you are not that different
than lots of other people around the country who are,
you know, quite overweight, have been so for a long time,
struggle to lose the weight. And you need to talk
to your healthcare provider, you know. I mean, you could
see a diabetes specialist if you're not seeing one already,
an endocrinologist, or even through your primary care doctor. But
(22:55):
there are these new medications available which are really quite remarkable.
I mean, they you know, they're not going to get
you down to what you weigh in high school. That's
probably not realistic. But these medications kind of help people
lose twenty five thirty five pounds pretty reliably. The problem
with them is that a Number one is that they're
quite expensive, although insurance tends to pay for most of them,
(23:17):
but that you have to stay on these medicines probably
you know, forever, because once you stop taking them them,
the weight comes back. There are other options, which I'm
sure I suspect that your doctors may have mentioned to you,
and that there are surgical approaches to people who are
very big and who have struggled to lose weight. And
these are what are called gastric restriction or gastric bypass
(23:40):
procedures can really help people lose weight forever, but it
does require you know, it's a modest surgical procedure generally
very very safe, but you need to talk to your
physicians about that. I think your healthcare providers, because you know,
depending on what age you are, I mean, if you're
one hundred and two years old, then probably doesn't matter, okay,
because you know no one will forever. But on the
(24:01):
other hand, if you're a middle aged or even you know,
not very old, with a lot of years in front
of you. It's much easier to control the diabetes if
you've been able to lose weight effectively, and there are
different ways of doing that.
Speaker 2 (24:14):
Gary, does that help you?
Speaker 5 (24:16):
Oh? Very myself? Thanks doctor all right.
Speaker 2 (24:18):
Garry, thank you for your phone call. Good night to you,
and now let's go to Wall Fame and speak to Joan.
You're next, are on nightside, Joan, You've got doctor David Nathan.
Speaker 6 (24:29):
I'm alganon doctor Nathan. I read a study that the
drugs like ozembic are linked to I strokes. Do you
know anything about that?
Speaker 3 (24:43):
There has been one recent report, So let me just
say firstly that these drugs, this class of drugs has
been studied in tens of thousands of people, and that
particular that particular complication that was just I saw the
same news report that you did. That same study was
a single study that demonstrated an eye problem. But in fact,
(25:06):
none of the other studies have picked anything up like that,
and I must say that clinically we certainly haven't seen it.
So again, it's something you know, new drugs, especially when
they're going to be used by tens of thousands of people.
You sometimes find things, whether they are directly related to
the drug or whether someone had a problem and they
have to be taking the drug and then one is
(25:27):
associated with the other. You know, you always have to
be a little cautious about that because again, these drugs
are being used by lots and lots of people. I
got to say that the studies that have been done
and again in tens of thousands of people in the aggregate,
have not seen that in the past.
Speaker 6 (25:41):
Oh that's good news.
Speaker 3 (25:43):
So so yeah, I mean I think it's something yeah,
to be you know, to keep aware of, listen to
the news. But again, as far as I'm concerned, it's
not something I'm very concerned about.
Speaker 6 (25:53):
Okay, my husband does have diabetes and has been taking
montano He did have an eyestroke multiple interactions in his brain,
but his heart doctor doesn't think it was attributed to
the medicine. He thinks a little piece of plaque broke
off his a order. He has concerned me that maybe
(26:15):
he should stop taking it.
Speaker 3 (26:18):
Yeah. I think he should talk to his doctor and
they you'll weigh the benefits against the potential risks, like
with any medication, and he should talk about it about
that his concern with his healthcare pro letter. Absolutely, I'm the.
Speaker 6 (26:32):
Idea that there's been lots of studies and don't show
that result, So that makes me feel better.
Speaker 2 (26:37):
Anything else that will do it.
Speaker 6 (26:39):
Thank you very much, thank you for the call.
Speaker 2 (26:42):
Good evening to you. Let's go to Brighton and speak
to Susannah. Susannah, thank you for calling. Welcome tonight's side.
Speaker 7 (26:50):
Morgan, thank you so much for taking my call on
doctor Nathan. Good evening. How wonderful to have you.
Speaker 3 (26:56):
Well, aren't you nice?
Speaker 7 (27:00):
Well, this is a very very important discussion because my
brother died from complications of type one diabetes. They just
didn't have a med that could get his blood sugar
under control. And my mother died of pancreatic cancer is
past February. And one of the things that they called
(27:21):
it type three, which is the geriatric kind of diabetes.
Now what I did, well there there's actually a question.
And you mentioned GLP twice and may I assume, yikes,
that G means glycemic.
Speaker 3 (27:40):
You know though, Actually GLP and I'm sorry to use
you know, abbreviations, it's called glucagon like peptide. So this
is a chemical that we all make in our intestines. Okay,
it's a naturally occurring substance that we make in our
small intestine. And what it does is when we eat,
it is released from the intestine. It goes to the
(28:02):
pancreas and it tells the pancreas to wake up. You know,
food's coming, Food's on its way. You better start making insulin.
So that's what that is. The medications that we're telling
you know, some maglatide and will goovi and ozempic and
all of those, and manduro as well. What they do
is they are synthetic forms of this substance. And the
(28:24):
way they've been formulated is that they can now be
given once a week by injection. So that's pretty cool.
I mean, to have to take a medication only once
a week by injection, it lasts for a week. All
of these medications, the first ones that came out, by
the way, had to be given twice a day, but
now they're once a week, so that makes it very convenient.
The GOOGDLP is not glycemic. It's glucagon like peptide, and
(28:47):
glucagon is unnaturally As I said, these are naturally occurring substances.
It's just that these are more powerful, and we give
them as an injection and they really stimulate insulin secretion
from the pancreas. That was the way they were developed.
So I was actually the first person to ever give
one of these things to a human being back in
nineteen ninety nineteen ninety, So it took you know, thirty
(29:10):
years for these to really come into you know, to
the foe in terms of treatment. And the weight loss
is actually a side effective, it's not the major effect.
It turns out to be a side effect. They were
originally developed to try to help increase insulin production.
Speaker 7 (29:26):
Are there any foods or any kind of nutrients or
supplements that can do that? I'm not talking about gummies.
Speaker 3 (29:35):
Definitely no gummy. Right, Gummies are all the rage, aren't they?
Speaker 7 (29:39):
So yeah, I know, so I rue the day that
they started doing.
Speaker 3 (29:44):
Gummies, you know, like the gummies, I know, the ACV
gummies by the real thing, don't you know? So those
are advocates why as well? Right? So no, No, the
answer is that there are no foods that I know
of as far as I know that shown to have
the same effect.
Speaker 7 (30:03):
Would Colin.
Speaker 3 (30:07):
Colin has been studied. It's Colin is is one of
the kind of building blocks of nerve tissue. So people
think of taking colin supplements to help with if they
have neuropathy, which is another complication of diabetes. I'm not
sure that it works very well. Frankly again, but it
turns out that the unifying factor behind all of these
(30:29):
diabetes complications is elevated blood sugar. Is that that's what
is so closely connected with the risk of getting complications.
And if you keep those blood sugars or the hemoglobin
a one C level which is the average blood sugar,
keep that under control, and you reduce the risk of
all of these complications dramatically, really quite quite dramatically.
Speaker 7 (30:51):
Okay, So any changes in diet, I mean, our parents
always told us to eat more healthily, and you can
have deserved but you know, fill up when the vegetables
fill up, you know when I'm not talking potatoes and
we're talking about the greeneres like spinach, broccoli, that kind
of stuff.
Speaker 3 (31:10):
I mean, yes, so I'll say what my grandmother told me,
and that's you know, a balanced diets in moderation, you know,
not over. The major problem we have is overeating. I mean,
it's just that we eat more calories, and that's why
the population is gaining weight, because we eat more calories
and we're less physically active, and that is the underlying
(31:32):
factor for diabetes. And once you have diabetes, you need
to talk to you a nutritionist or your doctor about
a well balanced diet. You want to avoid what we
call concentrated sweets, which are things like coke. I mean,
you know the diosadas that have sugar in them because
they make the blood suger rise very dramatically and very quickly.
(31:53):
But other than that, it really balanced. Died. I think
what you said, you know what your mother told you.
I think is probably the right, the right of the arts.
Speaker 2 (32:00):
Saying anything else.
Speaker 7 (32:01):
Thank you Morgan and doctor Nathan. I appreciate the time,
and I'm sure there are other colors behind me. So
i will, thankfully and with a lot of gratitude, hang up,
but thank you so much for everything that was.
Speaker 2 (32:17):
Thank you for making the call. And I've got a
break to take. But doctor, I'm going to give you
something to think about during the break, because it pertains
to me. I have dealt with neuropathy for at least
thirty plus years, maybe thirty four years, and I've just
(32:37):
learned to deal with it, accept it. I can still walk,
i can still meander from place A to place B,
and I'm used to that. Are my feet asleep sensation?
But when we come back, maybe you could ease my
mind to talk about neuropathy here or night side. Well,
(33:00):
the time is eleven forty seven temperature sixty five degrees.
Speaker 1 (33:08):
Now back to Dan Ray live from the Window World,
Nice Side Studios on WBZ News Radio.
Speaker 2 (33:15):
I only have around eight minutes of show to go.
If you want to call in real quick, if your
question can be succinctly put six one, seven, two, five,
four ten thirty or eight eight, eight nine two nineteen thirty,
Doctor David Nathan iss errand doctor I've just gotten used
to my neuropathy. Is that just the best way to
(33:38):
address it after all these years?
Speaker 3 (33:42):
So, I mean it's worth explaining what neuropsy is. Our
nervous system is pretty complicated. So there are these long
peripheral nerves that go through all through our body, including
down to our toes, and these started the spinal cord.
These long nerves go down and they interrovate our toes
and some of those nerves are used to control muscular
(34:04):
function others are sensory nerves, and in diabetic peripheral neuropathy,
it's usually what people will notice is that they have
kind of numbness or tingling, feels like they may have
ants crawling on their feet when they get into bed
at night. They may not feel the sheets on their
feet as well. That's especially when they notice it occasionally,
(34:26):
not often, but sometimes these can become painful. It's not
just like it feels funny and numb, but it's actually
very painful. Usually you don't need to treat that those
neuropathies unless they're painful, and then there are a number
of medications that can be used.
Speaker 2 (34:43):
Right, might have never been painful.
Speaker 3 (34:46):
No, that's good. So the bottom line is that if
it's not painful, it's not bothering you. Don't bother it, okay,
because I got to tell you every medication under the
sun as side effects, and you know, you have to
always balance the benefit against the risk. It it's not
bothering you, there's probably nothing to do about it. One
of the risks, though, of having neuropathy is that your
(35:06):
feet really don't sense pressure or pain as much as
they might otherwise, so that, for example, you can wear
a shoe that doesn't fit well, and whereas people with
normal nerve function will feel it before they get a blister,
with people with diabetes, they have to be very careful
about their foot care. They may not feel right. You
(35:27):
may not feel when a shoe doesn't fit well and
you wear it and before you know, you got a
blister and an infection. And that's one of the things
that can lead, unfortunately to amputations of the toes. So
that's something needs to be kept an eye on.
Speaker 2 (35:40):
I will keep extra eye on it. But let's go
to Framingham. Somebody called in very late, hopefully with a
quick question. Mike, you're on with doctor Nathan.
Speaker 8 (35:55):
Yes, my problem is the last few times I want
to do a lab work, is I'm pre diabetic? I'm
like five point six on the A one.
Speaker 3 (36:05):
C and right. No, So the question is what is
that all about?
Speaker 8 (36:12):
Yeah, I mean like, so is it just more like
exercising eating better? Because that's what they're telling me. So
I probably ask my own question, no.
Speaker 3 (36:23):
No, So that that's important. As common as diabetes is,
I talked about type two diabetes present in thirty five.
Thirty eight million people in the country pre diabetes affects
ninety million people ninety million in the US, so you know,
it is incredibly common. And what is pre diabetes. It
means that your blood sugars are on the rise a
(36:43):
little bit. They're not quite normal, but they're not at
a level. They're not high enough yet to be considered diabetic.
People with pre diabetes, they don't all. You know, it
sounds like, oh, everyone's going to get diabetes as pre diabetes.
That's not the case. It's really just that they're at
higher risk to get diabetes, but it doesn't mean necessarily
that they'll get it. If you are tested again annually,
(37:05):
usually by your doctor to see if you have diabetes
or pre diabetes, then what your doctor may do is say, hey,
you know what, this is a great time to lose
five pounds or ten pounds.
Speaker 5 (37:16):
Uh.
Speaker 3 (37:16):
They sometimes we'll even put you on some medications for it.
But usually what it requires is that you keep a
special eye on that, you know, trying to get the
weight loss down. If you're overweight, stay as active as
you can, and the next year your doctor will repeat
the test and see whether it's gotten better, stay the same,
or potentially gotten high enough that you have diabetes.
Speaker 8 (37:37):
Yeah, because guy, it's just like I need to lose
off my stomach and I go to see him twice
a year.
Speaker 2 (37:43):
Well, if you're keeping track and the doctor sees you
twice a year, then you're doing what you need to
do to keep it under a microscope.
Speaker 8 (37:56):
All right, Thank you Mike.
Speaker 2 (37:58):
Mike, thank you for the car and doctor. I know
I only have you on once a year, but you
can tell by the calls that come in. It's a
very helpful thing that I have you on WBZ and
I thank you very very much, especially at this hour
of the night. I hope you don't have to get
up early.
Speaker 3 (38:20):
No, I'm up late most times. Morgan, thank you for having.
Speaker 2 (38:23):
Me and we will do it again. I look forward
to that doctor. Thank you very much. You take care
you too. Bye bye. All right. I want to thank
who to have the first hour I have Barry Shire
on and he talked about his book. Give me a
(38:45):
second because I put the sheet away and I want
to give the right title of the book called the
Song is still being written. It's a photo say book.
Major artists in our generation, leading off with Joan Baez,
Bruce Springsteen have photos in this book. It's coming out
(39:11):
on September fifth. Be on the lookout for it. Mariol
McCann helping us with care of our pets and advice
if you have a wild animal as in possum or raccoon,
a skunk, whatever, that's injured on your property how to
(39:34):
handle that. Our old buddy Bradley Jay was here and
one hour was just not long enough. With Bradley. You
just heard, doctor Nathan, I just heard thirty seconds in
my ear that was spoken by Rob Brooks, Nightside regular
producer Rob. Thank you, thank you Nancy, and thank you
(39:55):
Gray next to me. And thank you to the night
Side audience. Whether you called or just listened, I appreciate
the fact that your participation was part of Nightside. See
you tomorrow night beginning at eight o'clock by Boston
It's with Dan Ray un Boston's final hour of Night Side.
Speaker 2 (00:08):
If you or someone in your world, family, neighbor, boss,
has diabetes as an issue, get comfortable for this hour
because this gentleman is looked upon as one of the
most intelligent physicians in the world of diabetes, well respected
(00:33):
across the country. At one time he was my doctor,
growing back about twelve years or so ago. Doctor David
Nathan is here, doctor, thank you for a green to
come on. And you know how much I appreciate getting
a chance to share you with thirty eight states.
Speaker 3 (00:51):
Morgan, my friend, Thank you. It's always a pleasure. Thanks
for having me, all right.
Speaker 2 (00:55):
You and I both know there are so many commercials
that are on TV, and I know you and Rob
were talking about this as he called to set you
in our system for this interview. They are making promises
there are at least a half a dozen medicines that
(01:17):
are allegedly good for you if you are a diabetic,
and I want to begin at the starting point, explain
to people how you become a diabetic.
Speaker 3 (01:36):
Well, diabetes comes in several different flavors, one of them
which is relatively rare and which usually affects younger people
is called type one diabetes, and that's a disorder in
which the your own immune system attacks the insulin secreting
cells in your pancreas, wipes them out over time, and
(01:56):
you end up being totally insulin deficient. And that is,
you know, a disease that we've known about from antiquity.
It effects probably in the US a total of maybe
one and a half million people, and we've known about
it for a long time. It was an entirely deadly
disease until insulin was developed in the early nineteen twenties.
(02:18):
The type of diabetes that most people are suffering with
are struggling with, is called type two diabetes, and that's
a combination of several factors. It's firstly, it's multi it's
publicly called polygenic, meaning it's not one gene. It's a
combination of a whole bunch of different genes, each of
which contributes a small amount of risk. But you know,
(02:39):
people don't generally get this kind of diabetes unless one
of three things happens. One is that they get overweight
or obese. Number two is that they decrease and this
contributes to their overweight. They decrease, their activity levels, and
this has happened to many people all over the world.
And number three, when people get older. That's also So
(03:02):
those three factors are the ones that have led to
this being an epidemic. And not only it's not just
one and a half million people as with the type one,
but type two affects more like, you know, thirty five
million people. So you know it's one of the most
common chronic diseases there is.
Speaker 2 (03:17):
And you mentioned the three causes. Number two and number
three overlap. As you get older, you get less interested
in taking care of yourself exercise, so there are two
things working against you.
Speaker 3 (03:37):
Yeah. Well, you know, we're at a time in our
in the human history when we are living longer, older
than ever before. And you know many of us who
are so I'm in my seventies and my knees are
hurting a lot. And you know, we just weren't designed.
We weren't engineer to last as long as we are
now living. And one of the things that happens is
that our muscle mass decreases. As you get older, the
(03:59):
proportion of your body mass that is fat increases. Even
if you're not overweight, your relative amount of fat increases.
And all of those factors conspire to cause type two diabetes.
And it's epidemic. I mean, you know, it's affecting once
you're a rage of sixty five, it's affecting one out
of every five people or so. I mean, you know,
it's really incredibly common.
Speaker 2 (04:19):
And I've noticed this is observational on me, it's not scientific,
but I've noticed thinner people by comparison, that have developed diabetes.
There was a time you could see somebody who had
a tummy and pretty much guess in their world they
(04:39):
were suffering from diabetes. But that's no longer a guarantee
or am I wrong?
Speaker 3 (04:46):
Right? No? No, no, no, it's the kind so there.
It's you know, when we say that being overweight and
less activity levels, lower physical activity levels are major environmental
contributors to this true, true, But it doesn't mean that
people who are thinner might also not get diabetes when
they're older. And in those folks, interestingly, they probably have
(05:08):
a limited capacity to secrete insulin themselves. That is, their
pancreas doesn't make as much insulin, and as they get
older they may need a bit more insulin and their
pancreases just can't keep up with it so they can
develop diabetes. Their diabetes looks a little bit more like
the type one I described before. That is, they tend
(05:29):
to be more insulin deficient compared with insulin resistance. Those
are the two factors we talk about in type two diabetes,
and i'm more resistance. Yeah, go ahead, sir.
Speaker 2 (05:40):
I meant to say this in the beginning. We always
you and I always make this statement clear to the listeners.
The circumstances descriptions that we will cover between now and
the end of the hour are generic. They necessary. We
don't point at you specifically, you need to get from
(06:04):
your doctor your specifics. We can indicate or point you
in a direction, but necessarily the information that we are
giving won't cover your issues so nobly.
Speaker 3 (06:20):
Yeah, I'm glad you point that out. More right. I mean,
I play I play a doctor on radio and TV,
and I am some people's doctors, but I'm not you know,
the people on the radar, I'm not their doctor. They
absolutely need to talk to their healthcare professionals about their
health care issues, including diabies.
Speaker 2 (06:37):
Nor Now, if you're listening right now, you'd like to
call in. You're waking up three four, five times a
night to urinate. You know the different warning signs, and
you have a question. Yes, doctor Nathan can respond to
your question. But again what he tells you might indicate
(07:02):
the church to be in, but not the pew to
sit in the church, to use that old analogy. But
I'll give you the phone numbers if you want to
call in. Six one, seven, two, five, four, ten, thirty, eight, eight, nine, two, nine,
ten thirty. He is doctor David Nathan, and he is
(07:22):
well respected across the country and dealing with issues revolving
around diabetes. And he always gets kind of sheepish when
I say this. He made a difference in my life
going back about twelve years, and I thank him for
(07:44):
the positive things that he helped me realize and take
care of a dozen years ago. You're very kind And
on that note, let's take our break. You want to
call in. I gave you the phone numbers. Time here
on Nightside eleven sixteen sixty five degrees.
Speaker 1 (08:07):
Now back to Dan Ray live from the Window World
Nightside Studios on WBZ News Radio.
Speaker 2 (08:14):
Dan will be back on the twelfth of August. I
am here obviously for the rest of this evening Thursday
evening tomorrow evening and Friday evening, but nightside goes on
whether Dan is here or not. My guest this hour
is doctor David Nathan, and we're talking about diabetes, and
(08:34):
doctor there may be people out there that are getting
warning signals but they're not paying attention to it. The
deterioration of vision, frequent urination. I'll let you're the doctor,
so I'll let you tell people things that should make
them possibly get in touch with their physician, because as
(09:00):
it could be that they have diabetes, one way to
find out is to get a professional.
Speaker 3 (09:08):
Right. Well, you know what you described, Morgan are the
classical symptoms of diabetes, because when your blood sugar rises,
it goes into the urine and that pulls water along
with it. So frequent urination is a common complaint, or
when diabetes is out of control can be a common complaint.
(09:29):
And with that people get a little bit more dehydrated,
so they're more thirsty, they may be unusually fatigued. Vision
can be blurry, as you point out, but it's worth
pointing out that the majority of people actually don't have
those symptoms. That most people can be running around or
walking around walking slowly around with diabetes and not even
(09:51):
know it, which is why we recommend strongly for people
who are adults and certainly over the age of forty five,
that they have annual blood tests done when they see
their doctor, because they will pick up an elevated blood
sugar or a test called the hemoglobin A one c
which measures average blood sugar, and that doctor can do that,
(10:11):
and you know, if it's elevated, then they will pick
up the uibts even though you didn't have didn't have
many symptoms or any symptoms.
Speaker 2 (10:19):
And what is a number that indicates maybe you should
pay attention with your A one C and or blood
pressure number.
Speaker 3 (10:31):
Right, So, the if you're going to do a blood
sugar a blood glucose test, it's usually done fasting, and
a fasting test that's greater than one hundred and twenty
six is what is commonly accepted as the definition for diabetes.
The hemoglobin A one C is a blood test, and
these are simple blood tests. They're inexpensive. The hemoglobin A
(10:53):
one c can be drawn taken at any time of
the day, and it's being used increasingly, and if your
value is greater than six point five percent, that is
considered diabetic and not infrequently when people are starting to
get older. These are done as part of the routine
annual physical examination.
Speaker 2 (11:11):
It used to be seven instead of six point five.
Speaker 3 (11:15):
When did that, well, go ahead, No, So I think
what you're mistaking is that greater than six point five
is the level at which diabetes occurs. The target that
we're aiming for with therapy is to lower it below
seven percent in general. So again six point two over
six point five diagnosis diabetes. But when we treat people,
(11:36):
we try to get their value less than seven percent
because that's been shown in many high quality studies to
reduce the risks of die. You know why do we
care about diabetes is because it's accompanied. You know, it's
the greatest cause of vision, loss, of kidney failure, of amputations.
It increases the risk for a heart disease. I mean,
there are these just awful complications that occur. But we've
(11:59):
shown through really very high quality studies that you can
reduce those risks if you keep your average blood sugar
in a certain range, and that range for most people
is less than seven percent immagomina ONEC. At the same time,
you want to control your blood pressure and your cholesterol
because heart disease is the other major killer that accompanies diabetes,
(12:22):
and you can improve your chances with that not only
through blood sugar control, but through controlling your blood pressure
and your cholesterol levels.
Speaker 2 (12:31):
Are there any new philactrimated term inventions to help people
who are suffering from diabetes?
Speaker 3 (12:42):
Oh boy? Yeah. So with the epidemic of diabetes, which
has increased just dramatically in the last thirty to fifty
years and has gone up and up and up and up,
the pharmaceutical industry and our basic scientists have developed a
whole host of new medications and if anybody watches television
or listens TOLA radio or reads the newspaper, they will
(13:05):
see them. You know, I'm not sure that people in
this kind in the US recognize that we are one
of only two countries in the world where drug companies
can advertise directly to the consumer. So, you know television,
I think it's Brazil, all right, So so just two countries.
Everybody everywhere else advertising of that sort. You know, the
(13:28):
dancing guys who are advertising the wigov or the some
magmatizer of those drugs, and they're on constantly, and it's
turned into a giant, giant and even more so than
it used to be in the past. A giant industry
that is diabetes medications. So the new things that have
come about are a series of new and exciting drugs.
(13:49):
I mean, they really do help you.
Speaker 1 (13:51):
Now.
Speaker 3 (13:51):
Interestingly, the ones that everyone knows about that are advertised
most widely are these called drugs called the g LP
agonists or receptor agonists. And that's I'll give I don't
usually I'm trying not to advertise any medications here, but
the magletide and what go be and those drugs that
(14:11):
people see advertised, or ozempic those and you.
Speaker 2 (14:15):
See them, they were five times a day, and that's
not that's not an over exaggeration. Maybe even more than that.
You know, I've got talked to diabetes, but I manage
it well.
Speaker 3 (14:28):
Stocks in my head, no, no, so you can't get
the songs out of your head. That means the advertising
is working.
Speaker 2 (14:34):
Apparently, I take my pills from charity ins and and
I've seen several of those commercials that all focus on
an office dancing, a woman getting off the bus downtown
and everybody's dancing. They grab your attention.
Speaker 3 (14:51):
No, these are these drugs are well known to cause
dancing you're taking these drugs and you start dancing in
the streets. That's just the way they were, right. So
the two new classes of drugs. One of these are
the glps, and interestingly, those drugs were invented in my
hospital at the Mass General many many years ago, and
the pharmaceutical industry went wild with them and developed a
(15:14):
lot of interesting and good formulations. And those drugs are
actually becoming increasingly popular because of their weight loss side effect.
So they're being used not only to treat diabetes, but
if people are overweight, these drugs are more effective than
drugs we've had in the past at causing leading to
some weight loss, and in fact, people with diabetes are
(15:37):
sometimes struggling to get them because everyone who's overweight in
the country is now ordering them and trying to use them.
So that's one class. The other one is the jardians.
These are called the that's called empiglephalazin, and that's a
group of drugs that have another effect, that is, they
work differently, but they're also effective to treat diabetes. They
(15:59):
drop people's wait a little bit. And both of these
classes or drugs also reduce the risk of heart disease.
No no, not enormously, but enough that it's a recognized indication.
So they're being used for several different purposes, not only
to treat diabetes, but to reduce the risk of heart disease.
They can help with kidney disease as well. So, as
(16:20):
often happens, you know, diabetes specialists have this, they finally
have something that you know. Unfortunately it is epidemic, but
it's something they can pay attention to. But now the nephrologists,
the kidney experts, the cardiologists are all using these diabetes
drugs to help treat these other conditions. And they're quite effective.
These are good drugs. They're important and if it wasn't
(16:42):
for the endless advertising, I'd be even more enthusiastic about.
Speaker 2 (16:45):
Let me take a call before I have a break.
I get two people on hold. First, as Paul in
Rhode Island. Paul, thanks for calling Knight's side. You've got
doctor David Nathan.
Speaker 4 (16:56):
Yes, hello, doctor Nathan. I was a patient of yours
in Boston in the early nineteen eighties at Mass General,
and I'm a Type one diabetic and now I've been
a Type one for fifty six years. I'm doing fantastically
my last A one C was six point four. I
(17:23):
really credit you for how I'm doing so well. I
really appreciate that the care you gave me at that time.
And I'm I just I just want to want to
stress the importance of keeping up with the testing and
(17:49):
the diet and everything, and it really pays off in
the end.
Speaker 2 (17:54):
Paul, you were so right, and I like you had
doctor Nathan as my physician, and I can't thank him
enough because here I am in my world twelve years later,
still here, and here you are in your world fifty
years later. So there you go.
Speaker 3 (18:15):
So Paul, thank you, Yeah, thank you for your con comments.
I should point out which Paul and Morgan both know,
is that type one and type two diabetes are enormously
self care diseases. It because we eat constantly and because
we have to pay attention to the blood sugars constantly,
and we have to you know, for type one, of course,
(18:37):
it's a question of figuring out how much insulin to
give before any given meal using the technology that's been developed.
But when it comes down to it, this is a
lot of work for young people who when they first
developed diabetes and through a lifetime and Paul. You know,
as Paul probably knows, if we were talking forty years ago,
no one survived with fifty years of type one diabetes.
(19:00):
The majority of people with type one diabetes were had
died by the time they were fifty years old, So
that you know, sixty percent to die by fifty these days,
because of the new methods they're treating diabetes, the importance
of keeping bloodshers and tight control medications, we live normal lifespans. Yeah,
they live normal lifespans without blindness, without kidney founder and
(19:22):
so like Paul, I hope Paul's story is the story
that hopefully we'll be talking about from now on.
Speaker 2 (19:28):
Paul, thank you for your call.
Speaker 5 (19:30):
Thank you, all right, good night to you, Paul.
Speaker 2 (19:33):
I'm about to take a quick news hit. A couple
of commercials will be in there. Gary, you are on deck.
Anyone else who wants to do what Paul and Gary
have done. Six point seven two five four ten thirty
or eight eight eight nine two nine ten thirty, We're
talking diabetes with doctor David Nathan here on Night Side. Well,
(19:53):
the time is eleven twenty nine sixty five degrees. It's
night with Dan Boston's News Radio. In case you haven't noticed.
Dan has been on vacation. He should be back on Monday.
(20:15):
I am here now. I'm Morgan Morgan White Junior. I'll
be here tomorrow, Thursday, and as well Friday. Don't forget
my show on Saturday at ten and tomorrow. I mentioned
I'm here. Alison and Grim from Little House on the
Prairie that's celebrating their fiftieth anniversary. She will be here.
(20:38):
She's supposed to be with me Monday. Unforeseen things happened,
so she'll be joining me tomorrow as well. Former ABC
newsman Bill Dial and then Susan Brakeman, who's written a
number of books. She's currently working on a book about
candy specific to Massachusetts. She wrote a book about Route
(21:03):
one north shore of Route one. And my buddy, former
lieutenant for the City of Newton Police Department, Bruce of Potheca,
will be here. That's my scheduled show for tomorrow. Right now,
I've got full lines. Believe it or not, all want
(21:23):
to talk to my guest, doctor David Nathan about diabetes.
So Gary wooburn your first this segment with doctor Nathan.
Speaker 5 (21:34):
Hello, Gary, Yes, her doctor bad news on my report.
I've had diabetes since I was thirty six years old,
type two, and I got type one in the past
five years, five five pounds. I'm very direct the way
I talked, as you can tell, I'm a bad boy
(21:56):
when it comes to eating. I can't stop you. I
can't even exercise, even though I have a physical job
where I move around a lot. And also I'm going
into long periods of sleeping where even if I didn't
work hard the night before, so they work second and
third chif type of job, I sleep into six to
(22:19):
eight hours to ten hours instead of back in the
younger days of four to six and I just can't
motivate myself. I take insulin and you take it from
their doctor.
Speaker 3 (22:34):
Well, Gary, so I mean, you are not that different
than lots of other people around the country who are,
you know, quite overweight, have been so for a long time,
struggle to lose the weight. And you need to talk
to your healthcare provider, you know. I mean, you could
see a diabetes specialist if you're not seeing one already,
an endocrinologist, or even through your primary care doctor. But
(22:55):
there are these new medications available which are really quite remarkable.
I mean, they you know, they're not going to get
you down to what you weigh in high school. That's
probably not realistic. But these medications kind of help people
lose twenty five thirty five pounds pretty reliably. The problem
with them is that a Number one is that they're
quite expensive, although insurance tends to pay for most of them,
(23:17):
but that you have to stay on these medicines probably
you know, forever, because once you stop taking them them,
the weight comes back. There are other options, which I'm
sure I suspect that your doctors may have mentioned to you,
and that there are surgical approaches to people who are
very big and who have struggled to lose weight. And
these are what are called gastric restriction or gastric bypass
(23:40):
procedures can really help people lose weight forever, but it
does require you know, it's a modest surgical procedure generally
very very safe, but you need to talk to your
physicians about that. I think your healthcare providers, because you know,
depending on what age you are, I mean, if you're
one hundred and two years old, then probably doesn't matter, okay,
because you know no one will forever. But on the
(24:01):
other hand, if you're a middle aged or even you know,
not very old, with a lot of years in front
of you. It's much easier to control the diabetes if
you've been able to lose weight effectively, and there are
different ways of doing that.
Speaker 2 (24:14):
Gary, does that help you?
Speaker 5 (24:16):
Oh? Very myself? Thanks doctor all right.
Speaker 2 (24:18):
Garry, thank you for your phone call. Good night to you,
and now let's go to Wall Fame and speak to Joan.
You're next, are on nightside, Joan, You've got doctor David Nathan.
Speaker 6 (24:29):
I'm alganon doctor Nathan. I read a study that the
drugs like ozembic are linked to I strokes. Do you
know anything about that?
Speaker 3 (24:43):
There has been one recent report, So let me just
say firstly that these drugs, this class of drugs has
been studied in tens of thousands of people, and that
particular that particular complication that was just I saw the
same news report that you did. That same study was
a single study that demonstrated an eye problem. But in fact,
(25:06):
none of the other studies have picked anything up like that,
and I must say that clinically we certainly haven't seen it.
So again, it's something you know, new drugs, especially when
they're going to be used by tens of thousands of people.
You sometimes find things, whether they are directly related to
the drug or whether someone had a problem and they
have to be taking the drug and then one is
(25:27):
associated with the other. You know, you always have to
be a little cautious about that because again, these drugs
are being used by lots and lots of people. I
got to say that the studies that have been done
and again in tens of thousands of people in the aggregate,
have not seen that in the past.
Speaker 6 (25:41):
Oh that's good news.
Speaker 3 (25:43):
So so yeah, I mean I think it's something yeah,
to be you know, to keep aware of, listen to
the news. But again, as far as I'm concerned, it's
not something I'm very concerned about.
Speaker 6 (25:53):
Okay, my husband does have diabetes and has been taking
montano He did have an eyestroke multiple interactions in his brain,
but his heart doctor doesn't think it was attributed to
the medicine. He thinks a little piece of plaque broke
off his a order. He has concerned me that maybe
(26:15):
he should stop taking it.
Speaker 3 (26:18):
Yeah. I think he should talk to his doctor and
they you'll weigh the benefits against the potential risks, like
with any medication, and he should talk about it about
that his concern with his healthcare pro letter. Absolutely, I'm the.
Speaker 6 (26:32):
Idea that there's been lots of studies and don't show
that result, So that makes me feel better.
Speaker 2 (26:37):
Anything else that will do it.
Speaker 6 (26:39):
Thank you very much, thank you for the call.
Speaker 2 (26:42):
Good evening to you. Let's go to Brighton and speak
to Susannah. Susannah, thank you for calling. Welcome tonight's side.
Speaker 7 (26:50):
Morgan, thank you so much for taking my call on
doctor Nathan. Good evening. How wonderful to have you.
Speaker 3 (26:56):
Well, aren't you nice?
Speaker 7 (27:00):
Well, this is a very very important discussion because my
brother died from complications of type one diabetes. They just
didn't have a med that could get his blood sugar
under control. And my mother died of pancreatic cancer is
past February. And one of the things that they called
(27:21):
it type three, which is the geriatric kind of diabetes.
Now what I did, well there there's actually a question.
And you mentioned GLP twice and may I assume, yikes,
that G means glycemic.
Speaker 3 (27:40):
You know though, Actually GLP and I'm sorry to use
you know, abbreviations, it's called glucagon like peptide. So this
is a chemical that we all make in our intestines. Okay,
it's a naturally occurring substance that we make in our
small intestine. And what it does is when we eat,
it is released from the intestine. It goes to the
(28:02):
pancreas and it tells the pancreas to wake up. You know,
food's coming, Food's on its way. You better start making insulin.
So that's what that is. The medications that we're telling
you know, some maglatide and will goovi and ozempic and
all of those, and manduro as well. What they do
is they are synthetic forms of this substance. And the
(28:24):
way they've been formulated is that they can now be
given once a week by injection. So that's pretty cool.
I mean, to have to take a medication only once
a week by injection, it lasts for a week. All
of these medications, the first ones that came out, by
the way, had to be given twice a day, but
now they're once a week, so that makes it very convenient.
The GOOGDLP is not glycemic. It's glucagon like peptide, and
(28:47):
glucagon is unnaturally As I said, these are naturally occurring substances.
It's just that these are more powerful, and we give
them as an injection and they really stimulate insulin secretion
from the pancreas. That was the way they were developed.
So I was actually the first person to ever give
one of these things to a human being back in
nineteen ninety nineteen ninety, So it took you know, thirty
(29:10):
years for these to really come into you know, to
the foe in terms of treatment. And the weight loss
is actually a side effective, it's not the major effect.
It turns out to be a side effect. They were
originally developed to try to help increase insulin production.
Speaker 7 (29:26):
Are there any foods or any kind of nutrients or
supplements that can do that? I'm not talking about gummies.
Speaker 3 (29:35):
Definitely no gummy. Right, Gummies are all the rage, aren't they?
Speaker 7 (29:39):
So yeah, I know, so I rue the day that
they started doing.
Speaker 3 (29:44):
Gummies, you know, like the gummies, I know, the ACV
gummies by the real thing, don't you know? So those
are advocates why as well? Right? So no, No, the
answer is that there are no foods that I know
of as far as I know that shown to have
the same effect.
Speaker 7 (30:03):
Would Colin.
Speaker 3 (30:07):
Colin has been studied. It's Colin is is one of
the kind of building blocks of nerve tissue. So people
think of taking colin supplements to help with if they
have neuropathy, which is another complication of diabetes. I'm not
sure that it works very well. Frankly again, but it
turns out that the unifying factor behind all of these
(30:29):
diabetes complications is elevated blood sugar. Is that that's what
is so closely connected with the risk of getting complications.
And if you keep those blood sugars or the hemoglobin
a one C level which is the average blood sugar,
keep that under control, and you reduce the risk of
all of these complications dramatically, really quite quite dramatically.
Speaker 7 (30:51):
Okay, So any changes in diet, I mean, our parents
always told us to eat more healthily, and you can
have deserved but you know, fill up when the vegetables
fill up, you know when I'm not talking potatoes and
we're talking about the greeneres like spinach, broccoli, that kind
of stuff.
Speaker 3 (31:10):
I mean, yes, so I'll say what my grandmother told me,
and that's you know, a balanced diets in moderation, you know,
not over. The major problem we have is overeating. I mean,
it's just that we eat more calories, and that's why
the population is gaining weight, because we eat more calories
and we're less physically active, and that is the underlying
(31:32):
factor for diabetes. And once you have diabetes, you need
to talk to you a nutritionist or your doctor about
a well balanced diet. You want to avoid what we
call concentrated sweets, which are things like coke. I mean,
you know the diosadas that have sugar in them because
they make the blood suger rise very dramatically and very quickly.
(31:53):
But other than that, it really balanced. Died. I think
what you said, you know what your mother told you.
I think is probably the right, the right of the arts.
Speaker 2 (32:00):
Saying anything else.
Speaker 7 (32:01):
Thank you Morgan and doctor Nathan. I appreciate the time,
and I'm sure there are other colors behind me. So
i will, thankfully and with a lot of gratitude, hang up,
but thank you so much for everything that was.
Speaker 2 (32:17):
Thank you for making the call. And I've got a
break to take. But doctor, I'm going to give you
something to think about during the break, because it pertains
to me. I have dealt with neuropathy for at least
thirty plus years, maybe thirty four years, and I've just
(32:37):
learned to deal with it, accept it. I can still walk,
i can still meander from place A to place B,
and I'm used to that. Are my feet asleep sensation?
But when we come back, maybe you could ease my
mind to talk about neuropathy here or night side. Well,
(33:00):
the time is eleven forty seven temperature sixty five degrees.
Speaker 1 (33:08):
Now back to Dan Ray live from the Window World,
Nice Side Studios on WBZ News Radio.
Speaker 2 (33:15):
I only have around eight minutes of show to go.
If you want to call in real quick, if your
question can be succinctly put six one, seven, two, five,
four ten thirty or eight eight, eight nine two nineteen thirty,
Doctor David Nathan iss errand doctor I've just gotten used
to my neuropathy. Is that just the best way to
(33:38):
address it after all these years?
Speaker 3 (33:42):
So, I mean it's worth explaining what neuropsy is. Our
nervous system is pretty complicated. So there are these long
peripheral nerves that go through all through our body, including
down to our toes, and these started the spinal cord.
These long nerves go down and they interrovate our toes
and some of those nerves are used to control muscular
(34:04):
function others are sensory nerves, and in diabetic peripheral neuropathy,
it's usually what people will notice is that they have
kind of numbness or tingling, feels like they may have
ants crawling on their feet when they get into bed
at night. They may not feel the sheets on their
feet as well. That's especially when they notice it occasionally,
(34:26):
not often, but sometimes these can become painful. It's not
just like it feels funny and numb, but it's actually
very painful. Usually you don't need to treat that those
neuropathies unless they're painful, and then there are a number
of medications that can be used.
Speaker 2 (34:43):
Right, might have never been painful.
Speaker 3 (34:46):
No, that's good. So the bottom line is that if
it's not painful, it's not bothering you. Don't bother it, okay,
because I got to tell you every medication under the
sun as side effects, and you know, you have to
always balance the benefit against the risk. It it's not
bothering you, there's probably nothing to do about it. One
of the risks, though, of having neuropathy is that your
(35:06):
feet really don't sense pressure or pain as much as
they might otherwise, so that, for example, you can wear
a shoe that doesn't fit well, and whereas people with
normal nerve function will feel it before they get a blister,
with people with diabetes, they have to be very careful
about their foot care. They may not feel right. You
(35:27):
may not feel when a shoe doesn't fit well and
you wear it and before you know, you got a
blister and an infection. And that's one of the things
that can lead, unfortunately to amputations of the toes. So
that's something needs to be kept an eye on.
Speaker 2 (35:40):
I will keep extra eye on it. But let's go
to Framingham. Somebody called in very late, hopefully with a
quick question. Mike, you're on with doctor Nathan.
Speaker 8 (35:55):
Yes, my problem is the last few times I want
to do a lab work, is I'm pre diabetic? I'm
like five point six on the A one.
Speaker 3 (36:05):
C and right. No, So the question is what is
that all about?
Speaker 8 (36:12):
Yeah, I mean like, so is it just more like
exercising eating better? Because that's what they're telling me. So
I probably ask my own question, no.
Speaker 3 (36:23):
No, So that that's important. As common as diabetes is,
I talked about type two diabetes present in thirty five.
Thirty eight million people in the country pre diabetes affects
ninety million people ninety million in the US, so you know,
it is incredibly common. And what is pre diabetes. It
means that your blood sugars are on the rise a
(36:43):
little bit. They're not quite normal, but they're not at
a level. They're not high enough yet to be considered diabetic.
People with pre diabetes, they don't all. You know, it
sounds like, oh, everyone's going to get diabetes as pre diabetes.
That's not the case. It's really just that they're at
higher risk to get diabetes, but it doesn't mean necessarily
that they'll get it. If you are tested again annually,
(37:05):
usually by your doctor to see if you have diabetes
or pre diabetes, then what your doctor may do is say, hey,
you know what, this is a great time to lose
five pounds or ten pounds.
Speaker 5 (37:16):
Uh.
Speaker 3 (37:16):
They sometimes we'll even put you on some medications for it.
But usually what it requires is that you keep a
special eye on that, you know, trying to get the
weight loss down. If you're overweight, stay as active as
you can, and the next year your doctor will repeat
the test and see whether it's gotten better, stay the same,
or potentially gotten high enough that you have diabetes.
Speaker 8 (37:37):
Yeah, because guy, it's just like I need to lose
off my stomach and I go to see him twice
a year.
Speaker 2 (37:43):
Well, if you're keeping track and the doctor sees you
twice a year, then you're doing what you need to
do to keep it under a microscope.
Speaker 8 (37:56):
All right, Thank you Mike.
Speaker 2 (37:58):
Mike, thank you for the car and doctor. I know
I only have you on once a year, but you
can tell by the calls that come in. It's a
very helpful thing that I have you on WBZ and
I thank you very very much, especially at this hour
of the night. I hope you don't have to get
up early.
Speaker 3 (38:20):
No, I'm up late most times. Morgan, thank you for having.
Speaker 2 (38:23):
Me and we will do it again. I look forward
to that doctor. Thank you very much. You take care
you too. Bye bye. All right. I want to thank
who to have the first hour I have Barry Shire
on and he talked about his book. Give me a
(38:45):
second because I put the sheet away and I want
to give the right title of the book called the
Song is still being written. It's a photo say book.
Major artists in our generation, leading off with Joan Baez,
Bruce Springsteen have photos in this book. It's coming out
(39:11):
on September fifth. Be on the lookout for it. Mariol
McCann helping us with care of our pets and advice
if you have a wild animal as in possum or raccoon,
a skunk, whatever, that's injured on your property how to
(39:34):
handle that. Our old buddy Bradley Jay was here and
one hour was just not long enough. With Bradley. You
just heard, doctor Nathan, I just heard thirty seconds in
my ear that was spoken by Rob Brooks, Nightside regular
producer Rob. Thank you, thank you Nancy, and thank you
(39:55):
Gray next to me. And thank you to the night
Side audience. Whether you called or just listened, I appreciate
the fact that your participation was part of Nightside. See
you tomorrow night beginning at eight o'clock by Boston
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