Understanding Diabetes: The Basics and Beyond with Jennifer Wright, MS, RD, LD, CDCES

Diabetes can feel overwhelming until the pieces click. In this episode, Registered Dietitian Jennifer Wright joins us to break down what diabetes is, how blood sugar and insulin work, and what those numbers like A1C and fasting glucose really mean.

We cover early warning signs, simple lifestyle changes that make a big impact, and how stress, sleep, and even caffeine can affect your blood sugar. Jennifer also shares practical tips for building sustainable habits—like tapering soda, walking after meals, and making balanced food choices that last.

Plus, learn how MedLink Georgia’s Diabetes Self-Management Education and Support program can help you take control with personalized guidance.

No crash diets. No gimmicks. Just real tools to help you live healthier every day.

Episode Transcript

SPEAKER_01 (00:02):
Welcome back to the MedLink Health Connections
Podcast.
I'm your host, Tangela, andtoday we're diving into an
important topic, diabetes.
Whether you're living with it,know someone who is, or just
want to learn how to lower yourrisk, this episode is packed
with helpful info.
Joining me is Jennifer Wright, aregistered dietitian here at
MedLink, Georgia.
She's been with us since 2020and works with patients of all

(00:27):
ages, helping them managediabetes, weight, and overall
nutrition.
Jennifer, thanks for joining me.
Let's start with the basics.
What exactly is diabetes and howdoes it impact the body?

SPEAKER_00 (00:39):
Great question.
So diabetes is a condition wherewe have blood sugar levels
higher than we want them to be.
And if you've ever been to thedoctors before and they've
talked about your blood sugarlevel or blood glucose level,
those are the same thing.
You might have even gotten ablood test called an A1C check.

(01:02):
That's a long-term look at ourblood sugar levels.
And they can all kind of helpindicate whether our blood
sugars are within a range that'sappropriate for our health.
And I mean, we might kind of youmight get to this later, but uh
diabetes, if it's leftuncontrolled, if you're left

(01:24):
with blood sugar levels that arejust too high for too long,
sometimes it can affect ourvision, it can affect our kidney
health, it can affect our nerveendings.
Um so if it's something whereyou do have diabetes, we want to
get those numbers uh down to anappropriate level as as fast as
we can for sure.
Of course.

SPEAKER_01 (01:44):
There are two different types of diabetes.
Um, can you explain thedifference between type 1 and
type 2?

SPEAKER_00 (01:51):
Sure, sure.
Good question.
Um, so type one is an autoimmunedisease.
Um, out of everybody that hasdiabetes, probably only 10% of
them have type 1.
So it's much, much more uncommonto have type 1 diabetes.
Um, because it's an autoimmunedisease, that means that the
body is kind of attacking yourown organ cells.

(02:14):
Specifically, the organ we'retalking about with diabetes is
your pancreas.
Um pancreate, your pancreas iswhat produces insulin, and
insulin is a vital hormone forlowering your blood sugar
levels.
Um, so with type 1 diabetes, thebody produces zero insulin.
And so that means that peoplewith type 1 diabetes have to

(02:37):
rely on taking insulin in theform of injections for all of
their meals and usually a doseat nighttime to help them be
able to digest those bloodsugars.
Um, without it, it would not bea pretty sight.
Whereas uh type 2 diabetes,which is the much more common
form, 90% of the people withdiabetes have type 2, um uh can

(03:01):
be more of a kind of like afamily history of type 2
diabetes can put us more atrisk.
Usually it's seen a little bitlater in life, but it can
definitely be seen earlier, asearly as kind of the teenage
years as well that we're seeingnowadays.
Um, and that's more so an impactof just our body not being able

(03:25):
to use its own insulineffectively.
You're still producing insulinwith type 2 diabetes, um, but we
think of insulin as like a keyto help unlock some doors inside
the cells of our body.
And with type 2 diabetes, youhave keys, but maybe they're not
fitting in the locks, they couldbe damaged, and so essentially

(03:46):
the body then still has troubledigesting those uh blood sugars
and lowering them.
Uh, but there's lots ofdifferent types of medication
options for type 2 diabetes.
It's not just insulin, there'soral medications that help to
make the body more effective atusing its own insulin.
More so it's also, you know,controlled through diet and like

(04:09):
lifestyle changes for type 2diabetes as well.

SPEAKER_01 (04:13):
Okay.
So, what are some early signs orsymptoms that people should
probably pay attention to foreither one of these?

SPEAKER_00 (04:22):
Yeah, so um some of them kind of overlap, uh,
especially if you are at riskfor type 2 diabetes, you have a
family history of it, um, youknow, we're maybe don't have the
best diet, not being veryphysically active.
Some of the symptoms that arevery common are frequent
urination, um, as well asexcessive thirst.

(04:46):
And not so much to the to thepoint where, like, you know, I
think all of us have on a hotday been kind of thirsty.
This is excessive thirst whereyou just can't seem to get
enough hydration or going to thebathroom countless times
throughout the night.
Um, those would be two big signsthat maybe we want to go to the

(05:07):
doctor and get some stuffchecked out.
Um, with type one diabetes,those things are still true, the
frequent urination and um theexcessive thirst.
Sometimes with type 1 diabetes,we also see some weight loss
associated with the onset ofdiagnosis.
Uh, so weight loss that'sunaccounted for that could also
be seen in type two.

(05:28):
Um, so you know, something whereyou unexpectedly without trying
or losing weight would be a signthat something's going on as
well.

SPEAKER_01 (05:37):
Okay.
How would you say that these arekind of diagnosed?
And can you help us understandwhat terms like A1C or fasting
glucose mean in a plainlanguage?

SPEAKER_00 (05:49):
Great question.
Uh, so yeah, so the way that wediagnose diabetes is with blood
work most often.
Um, so those two labs that youmentioned, either the A1C or the
fasting blood glucose, are twoof the most common.
I'll start with the A1C.
So the A1C, uh, like I saidbefore, is a long-term look at

(06:10):
your blood sugar levels.
So your A1C looks back at yourblood sugar levels for about the
past three months.
Um, the way I like to explain itto people is it's looking at how
many sugars are attached to yourred blood cells.
So we have all a bunch of redblood cells, right?
If you have a lot of sugarsattached to your red blood

(06:32):
cells, you're gonna have a highpercentage of A on your A1C.
So your A1C is in a percentageform.
So it could be 5.0% all the wayup to 14%, which would be very
high.
Um, but it's looking at thepercentage of sugars on your red
blood cells.
Um, the reason it's every threemonths is because your red blood

(06:52):
cells usually have a lifetime of90 days or three months.
So after 90 days, you would formnew red blood cells, and
essentially you could get a newA1C taken, and it might have a
different amount of sugarsattached to the red blood cells,
leading to a differentpercentage.
Even if you got your A1C checkedthe next month, you still have

(07:14):
some red blood cells that havereached their 90-day limit, they
have died off, no new ones haveformed, and you you still have a
different average.
Um, so it's still a way thatsometimes we check even on a
monthly basis just to see if theaverage of your A1C is going
down.
Uh, usually if your A1C is above6.5%, that's when we start

(07:37):
looking at a diabetes diagnosis.
Um similar to the fastingglucose or the fasting blood
sugar, that is just like in themoment, what is my blood sugar?
So it could be affected by whatyou had to eat that morning,
which is why we like it to befasting.
So no food, no beverages otherthan water.

(08:00):
Um, usually if your blood sugarsare above 126 and they're
measured in milligrams perdeciliter, if they're above 126
on two separate occasions, thatusually is associated with the
diabetes diagnosis.
We do two separate occasionsbecause sometimes other things
can affect our blood sugarlevels, stress, pain, emotional

(08:22):
stress.
So if you just have one timewhere it's a kind of a fluke
high fasting blood sugar, andthen that never happens again,
you don't necessarily justautomatically get diagnosed with
diabetes because you had it onetime.

SPEAKER_01 (08:36):
Okay.

SPEAKER_00 (08:49):
Yeah.
Um, so generally if you're overthe age of 45, um races like
Black, African American, orHispanic are more at risk.
Um, if you have a family historyof type 2 diabetes, so
especially like if you haveimmediate family members, if

(09:11):
your parents have type 2diabetes or siblings.
Um, and then usually if our dietis poor or very high in like
high highly processed foods, um,fast foods, sugary beverages,
and then also if we're just notbeing very physically active or
are all risk factors.

(09:31):
Um if you know you're at risk,um, the best thing you can do is
start making tiny changes toyour diet.
Um, if you're consuming sodasregularly, I I personally like
to help people kind of wean offof them in a gradual manner
because I'm not a big coldturkey person.

(09:52):
Um, I don't think a lot ofpeople do well with cold turkey,
some people do, and that's greatfor them.
But um, you know, if you'redrinking three sodas every
single day, try to go to twosodas every day, and then one
soda every day, and theneventually one soda every other
day, and so on and so forthuntil you've kind of decreased
that.
Um, and then again, physicalactivity, great.
Even it doesn't have to be, youdon't have to get a gym

(10:14):
membership.
Just a walk, just a 10-minutewalk after you eat a meal can be
extremely helpful to your bloodsugar levels.
Um, and and it can be separatedif you work at a desk job,
having five-minute breaks whereyou just take a walk around the
office, you know, five times aday, that still counts, even if
you're breaking it up into kindof little tiny, tiny exercise

(10:38):
habits.
Um, you could use that samephilosophy for eating.
If you don't eat all day andthen you eat one giant meal at
the end of the day, it's a lotharder for our bodies to process
all of that food all at once.
You're better off to havesmaller, more frequent meals
throughout the day to help yourbody be able to take the time to
absorb a smaller meal easierthan absorbing all of the, you

(11:01):
know, sugars that might comefrom one super large meal.

SPEAKER_01 (11:05):
Okay.
I've heard of like prediabetes.
So could you explain exactlywhat that is and how someone
would know if they have it?

SPEAKER_00 (11:15):
Yeah, so prediabetes is where your blood sugars are
kind of elevated, but they'renot so elevated where we would
diagnose you with diabetes.
Um, prediabetes can bedetermined also through an A1C.
Uh, usually an A1C anywhere from5.7 to 6.4% is considered in the

(11:36):
prediabetic range.
Um, and if you are pre-diabetic,the good news is that
prediabetes is totallyreversible.
Um, so essentially the samething, lifestyle changes are the
biggest factor with prediabetes.
Um, a lot of research shows thateven just losing maybe 5 to 7%

(11:58):
of your body weight can help getyou out of that pre-diabetic
range.
So, food choices and thenphysical activity are again two
ways at getting that A1C to comedown.
Um you know, with with type 2diabetes, type 2 diabetes, if we
get to that point, is notreversible.
It's very treatable, it's verymanaged, um, and it can be very

(12:22):
well managed for the long term,but we can't go back to not
having diabetes once we havediabetes.
Um, whereas prediabetes, we canwe can get rid of that.
Um, we would still want to makesure we're following the
lifestyle changes we made to getrid of pre-diabetes so that we
don't get it again.

SPEAKER_01 (12:42):
Okay, what are some of those?
You kind of talked briefly onlike not not necessarily it
being durable, I guess, but moreso like preventable for type 2
diabetes.
What are some of those likepractical steps you might would
say someone could take to holdoff that diagnosis a little

(13:02):
longer for like if you'repre-diabetic or you're just
trying not to get type 2diabetes?
Um I guess both.

SPEAKER_00 (13:10):
Okay, um, sure.
So one would be I like if I'mlooking specifically at
someone's diet and they'retrying to kind of prevent the
onset of type 2 diabetes, wewant to make sure we are
increasing our intake of thingslike fruits and vegetables,
decreasing our intake of highlyprocessed food, like

(13:32):
sugar-sweetened beverages andfast food options.
Um, also trying to consume leanproteins, so like your chicken,
fish, eggs, maybe turkey aregood choices.
Um, and then getting into like aregular exercise routine.
The key with with any sort oflifestyle change is you you need

(13:56):
it to be sustainable for thelong term.
You need it to be something thatyou can picture yourself doing
for for the long term.
I mean, that's that's how we'regonna prevent it for as as long
as possible.
Um, so if you go into kind oflike a really drastic dietary
change or like you're trying togo to the gym for an hour every

(14:19):
single day and you've never beento the gym before, usually we're
not super great at keeping upwith those changes because
they're so extreme and we'rejust we get real tired of them
real easily.
So it doesn't have to be all ornothing, just making tiny
changes every day is gonna leadto a big change that can be more

(14:40):
helpful because you're able tostick to doing it longer.

SPEAKER_01 (14:47):
I feel like that's so much it's that's the complete
opposite of I feel like what youhear on like social media and
stuff, but I feel like that's somuch more effective, if that
makes sense.

SPEAKER_00 (15:01):
Yeah, and I'll tell you a secret is that all of the
things you see on social mediaabout like try this crazy diet
and do this and you'll lose Xamount of pounds in two weeks.
All diets were designed to fail.
All of them are meant to not besustainable.
They want you to try it, theywant you to fail it so that

(15:22):
you'll move on to the next diet.
You know, we there was a bigboom of the keto diet, and and
that's incredibly hard to stickto for the long term.
So people might do it for acouple of weeks, a couple
months.
Eventually they're gonna stopdoing it, but then they're on
the lookout for the next bigthing that's gonna promise them

(15:43):
all these results.
Um, and that's how the dietindustry keeps going, is because
they know that what when onefails, they're gonna have
another one to kind of take itsplace that people are gonna be
interested in trying.
Um, it might it might honestlybe the boring answer, but just
healthy eating and exercisereally is the key.

(16:05):
Um, sometimes we want to believein those, like a magic pill or a
magic gummy, or if I just dothis diet for three weeks, you
know, all my problems will besolved.
But I promise if there was alittle magic solution like that,
I'd be I'd be telling everybodyabout it.
Um and it's just there, therethere just isn't.

SPEAKER_01 (16:27):
So let's kind of take a bit of a different uh
turn here and let's talk alittle bit about like stress.
So could things like stress orthe lack of sleep really affect
your blood sugar levels?

SPEAKER_00 (16:42):
Yes, yes.
There's so many, there's so manythings that can affect your
blood sugar levels, and that'swhat makes diabetes so
complicated.
Um, because even if you'resomeone with diabetes and you're
really dedicated to checkingyour blood sugar and you're
watching what you're eating,your blood sugars are gonna
always change.
Um and sometimes it'sfrustrating because I have

(17:03):
patients that say, Well, I I didthe same, I ate the same thing
for dinner, but I woke up thismorning and my blood sugars were
so much higher and I didn't doanything different.
And and it's maybe not the food,it's maybe they didn't sleep
great.
It's it's maybe because they hadmore of a stressful day.
Um, you know, all that stuff canaffect your blood sugars.

(17:23):
Uh, caffeine can affect yourblood sugars.
Even if you have just straightblack coffee, sometimes the
caffeine can make your bloodsugars go up.
So everybody's a littledifferent.
So it's kind of learning aboutyourself and trying to figure
out what foods and beverageskind of affect your blood sugars
more often or what conditionslike stress, you know, um where

(17:47):
they notice and and theyrealize, oh, when I'm having a
stressful day, you know, I knowmy blood sugars are going up
more, you know, trying to findcoping mechanisms to deal with
stress.
Again, like walking, greatoption, um, are all helpful
tools to use.
And it's it's a whole it's awhole process that includes all

(18:09):
parts of our our life and ourbody.
I mean, you know, your foodchoices, your exercise choices,
how you manage stress are allimportant.
And and one of the reasons wehave like the diabetes program
we do at Medlink is the like thewhat you mentioned, the DSMES.
It stands for diabetesself-management education.

(18:32):
You know, we we want our goal isto help people realize how to
best manage their diabetes forthem, you know, not for what
works for somebody else, butwhat works for them as an
individual, to give them thetools and the knowledge of of
knowing things that affect theirblood sugar and how to deal with
it.

(18:52):
Because, you know, they've gotthey're the ones dealing with it
on an everyday basis basis.
We're here to help.
But they want that we I want Iwant to make sure they know on
the weekend what to do if ifthey notice their blood sugar
goes up to you know 200 and andwhat and figure out why it went
up to that so that we can we canmaybe help prevent that from

(19:13):
happening as often.
So it's all about the moreknowledge, the more power.
I really do believe that.

SPEAKER_01 (19:19):
Yeah.
Um, so you mentioned thisprogram that we have here at
Medlink, and just kind of onthat lines and maybe more, if
someone thinks that they mighthave diabetes or even
pre-diabetes, what's some of thefirst steps that they should
take?

SPEAKER_00 (19:37):
So if you just yeah, if you're just worried about it,
like if you just are worriedthat you have it, I would say
the first step would be to visityour regular, have like
appointment with your doctor umor your provider, and maybe do
some blood work would be a firststep.
Um, if you're truly just kind ofwanting to know where you stand

(19:58):
in the process.
And you can always, always cometo see one of us as like a
dietitian.
You know, we're diabeteseducators, but we we do all
things related to nutrition.
So even somebody that wants tocome that's not pre-diabetic,
that doesn't have diabetes, butthey just want to make sure they
don't get it later on in life,we help them as well, just to

(20:20):
make sure that they're living abalanced lifestyle with their
food choices and their beveragechoices and their activity
level.

SPEAKER_01 (20:29):
Okay, and how would someone who does have diabetes
kind of navigate and figure outhow to get themselves into the
DSMES program?

SPEAKER_00 (20:40):
So, good question.
Usually, I mean, technically,some insurances require
referrals, most do not.
You're always welcome to justcall your local med link and ask
for the nutrition department,and they will send you to our uh
grand uh nutrition coordinator.
Her name is Marleni.
She's really great at schedulingpeople, making sure they get to

(21:03):
the best location that's forthem, because we go to a lot of
different locations.
Um if you wanted to go throughyour doctor, that's also fine.
Sometimes having a referral justkind of make sure we close the
loop with things.
Uh, but honestly, since a lot ofinsurance companies don't
require it, if a patient justcomes to us themselves and says,

(21:25):
hey, I really want to come inand just have an appointment, if
for some reason we need areferral, we ask the provider
for one if if we ever neededone.
So there's there's no reasonthat they have to go to their
doctor first just to come andsee us.
They can just call and getscheduled if they really wanted
to.

SPEAKER_01 (21:44):
Thank you for tuning in to the Medlink Health
Connections podcast.
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Remember, the information sharedin this podcast is for
educational purposes only andshould not replace professional
medical advice.

(22:04):
Always consult with yourhealthcare provider for any
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Until next time, stay healthyand take care.