April 5, 2025 • 39 mins
My guest, Ron Hoyler is a diabetes Educator for St. Luke's hospital in the Kansas City metro, and he tells us "once you have diabetes you're at a greater risk for not just dementia, but the complications from dementia. Some of the specific, diseases that come under the dementia umbrella, like Alzheimer's, but cognitive impairment in general, you know, that fog that you'll sometimes hear it called where you are just suddenly in the moment, not quite sure what you were thinking or doing that can be related to the high blood sugars that you might be experiencing".
Ron has some shocking information, including the fact that we have 165 meds to treat diabetes with. And in this episode, we're going to get into how the doctors decide which meds to treat you with. But that number alone is pretty shocking, and technically there's over 800 combinations of meds and doses that can be applied together, so how does a physician decide which one's right for you or their other patient or their other patient? It's almost a crapshoot, really.
I''m Cary Hall, America's Healthcare Advocate and the fact is that diabetes is such a prevalent disease, and one of the most common chronic disorders in the world and it is a disorder that we could do so much better at in taking care of than what we do now.
The thing that drove me to bring Ron Hoyler back to the show is that he and I have been having conversation about this and some of the other comorbidities that are related and I wanted to bring his vast knowledge to all of you. Not just to shock you, but also to show you the most amazing and affordable new device for understanding your own metabolism, blood sugar, glucose, A1c... all of it. And rather than just 2 super basic readings per day... it gives you hundreds!
Regardless of your age, your health... and even if you are not diabetic or pre-diabetic: This show is a must listen.
Let's get started!
For more information about this visit: https://www.saintlukeskc.org/condition/diabetes Ron Hoyler: https://www.linkedin.com/in/ron-hoyler-rn-msn-mba-hca-cdces-a02a3b1a/
This is episode 2106.
Learn more about me, Cary Hall: America’s Healthcare Advocate:
I have a strong desire to empower my fellow Americans and cancel the noise and confusion surrounding the US healthcare system. My goal is to enable you to become the expert for your own healthcare management, saving you time, money, and effort. Learn more: https://www.americashealthcareadvocate.com
As always, if you need help or have something to share? Contact me with this form on my website and let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns. https://www.americashealthcareadvocate.com/contact-us
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
Ladies and gentlemen, you.
This is America'sHealthcare Advocate broadcasting coast
to coast across the USA.
Your guideto protecting your personal health.
Bringing you simplified answers to thecomplex questions surrounding health care.
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(00:21):
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Hospital empowering you to take controlof your health and wellness.
My very special guest today, Grace MarieTurner, president of the Galen Institute.
Welcome back Grace Marie.
It's a pleasure to be with you.And I do have to say.
You are the most knowledgeableabout health policy.
(00:44):
Just superlative!
And now, ladies and gentlemen,gentlemen, gentlemen.
And now.
America's Healthcare Advocate, Cary Hall.
Hello, America.
Welcome to America's Healthcare Advocateshow broadcasting coast to coast
across the USA here on the HIARadio Network.
My producers, Mr..
Dave Thiessen behind the cameras and Mr.
(01:06):
Garner Cowdery behind the microphoneshere in our Cumulus studios
in Overland Park, Kansas.
America's Healthcare Advocate is to show
are we separate fact from fictionabout the subject of health care?
We're really goingto get into one of those subjects today,
and I think you're going to find itamazingly informative,
and you're going to learn a lot todaythat you had no idea
(01:27):
how to deal with a certain disease.
And the breakthroughs that are happening,
or we're going to exposeall of that today, because Ron Hoyler
from Saint Luke's,who is the educational director
at Saint Luke's for the diabetesprogram, is going to walk us through
a whole series of informationthat we've never seen before.
And I think you're going to find it'sgoing to make a big difference.
Also, if you want to listento one of these shows or tell
(01:48):
somebody about the show after it airs,you can go off on our podcast platforms.
There are 16 of them.
You can find us almost anywhere and listento America's Healthcare Advocate.
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All the shows are posted up there by Mr.
Dave Thiessen.
So you could actually see the videoof the shows and the information
(02:08):
that we're producing on the broadcast.
I want a little shout out todayto KNSS 1330 in Wichita, Kansas.
We're very happy to be back on the airup there in Wichita, Kansas,
one of our oldest affiliates,and we've been off for a while.
We're back on thereand we're very happy about that.
So we want to thank all of themfor putting us back on the air at KNSS.
(02:29):
If you are looking for Medicare insuranceor ACA, the lovely Carolee Steele
at RPS Benefits by Designcan help you anywhere in the country.
I got a great e-mail from a ladythe other day who she had helped,
who was in Florida.
Again, if you if you're
looking for ACA coverage or Medicare,she certainly can help you.
Also, if you're a 1099 employee,they have some great programs over there.
(02:52):
There is a product called Gig Carethat they can help you with.
If you're a 1099 employee,you might find that to cost a lot less
than an ACA plan with better benefitsif you're not getting a subsidy.
So I'll put that caveat there.
But if you're not getting a subsidyor getting a very small subsidy,
you may find that the gig care programmight be better for you.
Again, you can call them at 877-385-2224.
(03:15):
And if you're looking for employersponsored health care, Maria Ahlers
has some pretty unique, opportunitiesthat she can also help you with.
So once again,877-385-2224 RPS Benefits by Design.
As I said,Ron Hoyer is joining me in studio.
Is this the thirdone of these we've done? I'm happy.
It is.
It is third in our series on diabeteseducation.
(03:37):
So what you're going to learn todayis probably going to shock some of you
about how
we're treating this disease nowand how it's not being adequately treated.
You're going to be a little surprisedto learn some of those facts.
We're also going to show you a solution.
It's really quite remarkableand can help you manage diabetes,
whether you're type one or type two,in a way never before available to you.
(03:58):
This is going to be pretty interesting.
Ron Hoyler has a masters of BusinessAdministration, Care Management,
a master of science nursing,a Bachelor of Arts
and Personal Administration, an Associateof Applied Science in Nursing.
He is a certified DiabetesTechnical clinician,
certified Diabetes Care EducationSpecialist,
a Pump Certified Trainer PatientExperience Champion for Children's Mercy
(04:21):
Hospital, 2010, the nominee for the DaisyAward for Extraordinary Nurses.
This.
He's got a whole list of theseand I'm just reading a few the point
and telling you all that is to tell youthat Ron Hoyler
really knows what he's talking aboutwhen it comes to diabetes.
And here's why this is important, okay?
And this will scare you.If it doesn't, it should.
Three out of four Americans over the ageof 65 have diabetes or prediabetes.
(04:45):
And you're looking at one of them.
Okay, I was diagnosed as pre diabeticabout eight, nine months ago.
And I decided to do something about it.
I did I got involved with it
with a, with a weight lossclinic and I dropped the, the weight down
and I started changing my dietand I've got it under control.
But the point is,if you don't take this seriously,
(05:07):
the comorbidities, we'regoing to talk about those in this segment.
In the next segment,
the things that you're puttingyourself at risk for are very serious.
And and in my opinion,I think they're pretty scary.
So let's just dive right in thatwhen I saw this on the notes,
or I was up doing showprep at 530 before we got in here,
and I'm like three out of four.
(05:28):
I think that's the first timeI've seen that number.
I knew one out of three Americans havediabetes or prediabetes, but this over 65,
and you're looking at the guy at 75 here,by the way, just so you know.
Okay.
That's a that's a shocking number Ron.
Scary stat, isn't it? Yeah.
So so, you know,
the thing that drove methat bring you back in here is you
(05:50):
and I've been having conversationabout this,
some of the other comorbiditiesthat we're talking about here.
So let's go through some of those.
Yeah.
Some of the most commonyou've got adult blindness
in stage renal disease,neuropathy, amputation.
We all know that type one diabeticshave a great risk for that
is the seventh leading cause of deathin the United States.
(06:11):
And someone dies of diabetesevery five seconds.
In the world.
Those numbers are. Shocking. Yeah.
They are.
So it's such a prevalent disease.
And for being one of the most commonchronic disorders in the world,
it is a disorder that we could doso much better
at in taking care of than what we do now.
(06:32):
Yeah.
And that's so, so here's, here's a numberthat will knock your socks off.
We have a 165 meds to treat diabetes with.
And we're going to get intohow the doctors decide
which meds to treat you with.
But that number alone is pretty shocking.
Yeah. How do you 165 meds.
(06:52):
Okay.
Now I went on metformin for six monthsto get myself turned around,
and I'm off of it
now, but if I had to go back on it,I would have no issue with doing it.
But the point I'm
making is, you know, I was able to usethat med to get it under control.
But, you know, again, I don't want toI don't want to,
you know, talk about this now because Iwant to get into it in the third segment.
We're really going to surprisesome people with what we have.
(07:14):
But that's got to be extreme.
You're a clinician. Yeah.
Look, you when these patientsare coming in to see you,
you get 165 beds to choose from, Ron?
Right.
Well, and technically there's over 800
combinations of meds and dosesthat can be applied together.
And how does a physician decidewhich one's right for you
(07:35):
or their other patientor their other patient?
It's almost a crapshoot, really.
It's really what it sounds like.
And what would really behelpful would be getting feedback
or informationthat's adequate about your blood sugar
and what's happening on a daily basiswith it. Yeah.
And that and we're going to talk aboutthat.
Believe me, the third segmentis going to be a big surprise
(07:55):
to a lot of people,especially if you're diabetic
or have somebody in your familyat risk for diabetes.
But let's talk about what kind of drove usto come back in here today
to do this show.
And that was and we'll get into thisin the next segment.
But let's talk about the cognitive issues.
This is something that was new to me.
And you brought this up.I was like, for real.
Yeah. So let'swe got about two minutes left here.
(08:17):
Let's talk about thatbefore we go to break. Yeah.
I think, you know,andtechnically there’s over 800
combinations of meds and dosesthat can be applied together.
And how does a physician decidewhich one’s right for you
or their other patient
or their other patient?
It’s almost a crapshoot, really.
(08:42):
And when we have high blood sugars, thatinterrupts the efficiency of the brain
to take in this fuel to run efficiently,it makes it harder to,
to do certain processes daily living,
remembering things, doing processes of,
balancing your checkbookor making decisions.
(09:03):
And knowing when to take your meds.
That would be another one.
Knowing when to test your blood sugar,remembering where you live.
In fact, people with diabeteshave a 50% greater
chance of developing dementiathan someone without diabetes.
And that's just scary.
As we get, more and more peopleinto our population that are aging,
(09:24):
that's shocking.
And how big is the risk?
Does that risk grow for over 65?
Well, first, people over 65get diabetes more so than under.
So that's going too.
Create three out of four right.Pretty big number.
And then beyond that,once you have diabetes you're at a greater
risk for not just dementia,but the complications from dementia.
(09:48):
Some of the specific, diseasesthat come under the dementia umbrella,
like Alzheimer's,
but cognitive impairment in general,
you know, that fog that you'llsometimes hear it called where you are
just suddenly in the moment, not quitesure what you were thinking or doing
that can be related to the high bloodsugars that you might be experiencing.
(10:10):
So when we come back to the break,we're going to get into this in detail
because this is a piecethat we have not talked about
before, the risk here, remember,you know, the key issue here,
three out of four of youlistening to this broadcast out there
over the age of 65either have diabetes or prediabetes.
So that's that's why this becomes an evengreater issue on your quality of life.
(10:31):
We'll be right back after the break.
You're listening to America'sHealthcare Advocate
Broadcasting here on the HIARadio Network.
Coast to coast across the USA.
Stay tuned. We'll be right back with more.
Welcome back.
You're listening to America's HealthcareAdvocate show, broadcasting coast to coast
(10:53):
across the USA here on the HIARadio Network.
You know, you're listening to this,and maybe you've got somebody in
your family is diabeticand you're you're concerned, okay.
About what
I just told you of what Ron just told youand what you're hearing and information.
Go up to one of the podcast platformswe're on, every Spotify Rumble,
you name it, iHeart radio.
(11:14):
We're on.
We're on 16 of them.
Okay, you can definitely find this, right?
SoundCloud. There's more.
You can find us up there and have themlisten to the show,
or you can go to the YouTubechannel, America's Healthcare Advocate.
The shows are all posted up there.
They've post the shows up there so you canwatch them, listen to them, whatever.
But that's a great way to educate somebodythat may have this disease.
(11:35):
Maybe you're strugglinggetting that family member.
Pay attention and do what they need to doto correct the situation with diabetes.
The reason I do these kind of showsand bring experts in here
who take time out of their day,like Ron Hoyler to do this,
is so I can educate and inform,and that's what we're trying to do.
All right.So we're going to switch gears. Now.
We're going to talk about,
(11:55):
as I said, the thing that really caughtmy attention was this whole cognitive
issue and how diabetes affects is becausewe have not talked about that before.
So it's called big brain age gap.
And I'm going to show you a picturenow of what that looks like okay.
And then I'm going to askRon to explain this so you can see exactly
what we're talking about here.
(12:16):
These are concreteexamples of what happens if you're a type
one type two diabetic, and you are notkeeping this disease in check.
Ron, walk us through this.
We have a lot of different ways we canmeasure different functions in the brain.
And one of the things that we can do iswe can look at it and the processes
and how fast it works.
(12:36):
And if, if we're really doing,the things we want our brain to do
and we can, accumulate that informationfor an age group,
and we can say,this is your brain age for this.
Yeah. The what the brain scan does,it does an amazing job.
Yeah, I've seen those before.Those are excellent.
And what we can do then is we canlook at somebody who has diabetes
(12:58):
and we can say,is your brain front function
working at the same chronological ageas what you are
or compared to somebody your agewithout diabetes?
And, data demonstrates
that diabetes can cause brain atrophyand that affects
the brain age of your brain,and that makes it go further
(13:22):
and further from chronologically,what it should be when you have diabetes.
And no surprise that the worse control
you have with your diabetes,the greater the distance
between what your chronological brain ageshould be and what it actually is.
Okay, so you're 75 years old.
You're not paying attentionto your diabetes.
(13:43):
You're letting it rage out of control.
You're doing the things you shouldn'tbe doing.
So instead of having a 75 year old brain,you've got a 97 year old brain.
Well, I'm giving you an example.
That that's maybe a little bitmore of a gap than what the statistic
indicates, but it certainly indicates,let's say that if your,
hemoglobin A1c or 8% or greater,
(14:04):
that on average that's about a four yeargap or deficiency.
You're going to continue to.
Yeah,most likely among other things. Right.
Because as we talked aboutin the last segment, your risk for,
other functions in your brainbeing affected or the risk of dementia,
or, impairmentare significantly increased.
(14:24):
The worse blood flow you haveinto the brain from the high blood sugar.
So I will tell you, okay.
Personally, for me,and I did not know this, but, you know,
I've been very aware ofI've done a lot of shows on Alzheimer's.
So we've had Steve Sanborn on heretalking with the Wavi brain scan
and his group Neurologic, what they doand what a difference that makes.
(14:46):
That's one of the thingsthat is terrified me about aging
was am I going to wind up?
I've got a very good friend, a guyI served with overseas in Vietnam.
He washe and I were partners the whole time
we were there as dog handlers.
And he's got dementia.
And I worry about George.
We're back and forth every week talking.
He lives down in Texas, East Texas,and as a cattle ranch
(15:08):
and, you know, very concernedabout his dementia.
And, you know, himbeing able to keep it in check.
And this is exactly why I wantedto do this show today and talk about this,
because I will tell you,as a seasoned citizen,
one of usthat is chronologically challenged,
this is the one thingthat terrifies the hell out of me.
And it should terrify all of youto be sitting there
(15:30):
and not have control of your mindand your own thought
process, and be able to care for yourselfin any form.
And then, you know, in additionto, you know, you're being that person
that has this problem,what does that do to your family?
Right?
What a hardship did.
That whole burden.
Yeah. Over to your wife and your children.
Because you weren't paying attentionto something that you knew,
(15:53):
was a possibility.
And the thing.
I keep going back to this numberbecause it just shocks the hell out of me.
Three out of four Americans over 65. Yeah.
So if they're, you know,if they're not paying attention to this,
you can almost guarantee they're going towind up with that problem.
Sure.
And, you know, to be clear, you can havedementia without having diabetes.
(16:16):
Of course you can.But do you want to add to the risk? Right.
Exactly.
You're tipping the scale the other way.
Okay, let's hurry up and get dementia,okay. Yeah.
That's what we want to do, right?
That makes a hell of a lot of sense that.
No. Well, that's why this informationis so important for people to understand
so that they can stack the oddsin their favor,
right, of not having to dealwith those kind of complications.
(16:37):
And, and the first thing is, and we,you know,
we're going to come up on the break herein about three minutes.
But the first thing is thatand kind of explain to people
why it's so critical
that they get that A1c initiallyand find out if they're at risk.
Yeah, yeah.
You think you don't have a problem.
You don't know that truth. Yeah. Okay.
Yeah.
That's why, you know,
you're going into your doctorfor an annual physical and lab work
(17:01):
because there are a whole lot of waysthat we can easily and quickly
or, early on detect somethingso that we can fix it.
Always easier to fix itwhen you catch it early on.
Right. Cancers,
all kinds of stuff, diabetes included.
And, one of the quick thingsthat they can do at a physical is check
a blood sugar,
(17:22):
take a urine sample,see if there's glucose in the urine.
They get an indication.
Do you seem to bein that prediabetes stage
or possibly already in the diabetes stage?
And the earlier you catch it, the earlieryou can start to intervene
and get it under control.
Now I want to tell you something.
You may think, hey, I'm physically fit,I workout.
(17:43):
You know,I've been a gym rat all of my life, okay?
Ever since I got out of the military,
I've always workedat least 3 or 4 times a week.
I still couldn't shake this.
I could not get out of thispre-diabetes zone
with this A1C and I, you know,I took the steps.
I did the right thing.
I went to a group here called Heartland
Weight Loss, and got myself back under...
(18:06):
dropped about 18 pounds,and got my A1c down
and I, you know, I've got labscoming up here in a couple weeks.
Time to go right back inand check it again.
But if you, if you think, oh gee, I'min good health, I don't have this problem.
No, you don't know.
And that's Ron's whole point.
You need to get physical,get the A1c check if you're in that range.
(18:28):
I was in the range for pre-diabetes.
I was not diabetic yet,but I was right there.
I could cross the line pretty easily.
That's when I changed my dietand, you know, made a difference.
Like I saidI went on metformin for six months.
Got it under control. Now I'm off of it.
I'm staying under control,but I'm paying attention to it.
If you're not paying attention to this,you get further down the road.
(18:51):
You might not be ableto correct it, right.
Then it shifts over into type 2?
And now you got a big fight on your hands,
a really big fight on your hands, and it'sgoing to affect everything in your life.
So that's why we're doing the showtoday, is to try to explain to you.
Now, when we come back from the break,
we're going to talk abouthow this disease is treated,
how it has been treated historically,and about a major breakthrough
(19:15):
that literally is going to change the waydiabetes gets treated.
Stay tuned.
You're listening to America'sHealthcare Advocate
Broadcasting here on the HIARadio Network.
Coast to coast across USA.
Don't goanywhere. We'll be right back with more.
(19:37):
Welcome back to America's
Healthcare Advocate, broadcasting coastto coast across the USA.
By the way,I've been getting a lot of emails lately.
People that have questions, issues
that lady up in West Virginiathe other day, etc.
if you want to send me an email,
go to the website America'sHealthcare Advocate.com.
America's Healthcare Advocate.com.
I get the emails.
Dave makes sure that I answer him.
(19:58):
If I don't, he tells me I missed okay.
And then I answer them.
So if you've got a question for somethingI can help you with or you have an issue,
please feel free to reach out to me.
Use the websiteAmericasHealthcareAdvocate.com.
All right.
So now this is going to be interestingbecause I'm going to I'm going
to use an analogy here.
And then I'm going to have Ron explainthat analogy
(20:19):
as we talk about this new wayto manage this disease.
So would you buy a carwithout a speedometer.
I would not.
And and because that would be foolish,it would would.
Yeah.
You know, I tell patientsthat managing your diabetes
without constant informationis going to set you up for failure.
(20:39):
And I use an analogythat, let's say you rented a car
to travel across the United Statesfrom the East Coast to the West Coast.
And the car they want to giveyou doesn't have a speedometer.
How comfortableare you feeling about driving?
Not knowing your speedand not being able to assess
if you are going the appropriatespeed limit?
Yeah, obviouslyI'm not going to drive that car, right?
(21:01):
Yeah.
And because you recognize thatthat incoming data is necessary
for you to be in a safe situationand not get yourself in trouble.
And diabetes is no different.
The amount of information coming in aboutyour blood sugars needs to be frequent,
and it needs to be somethingyou can see readily, and that's something
that we're not appropriately using,like we could with the technology
(21:23):
we have today.
Yeah. So let me just give youan example of what we do now.
Then I'm going to ask Ron to explain this.
This is a typical, chart,
if you will, that a doctor seesif you are getting A1c.
So we're going to explainA1c here in a minute.
And you're having a check.This is what it looks like.
This is what he or she has.
Or Ron in the case of a nurse,if they're treating this
(21:47):
to go by to decidewhich one of those 165 medications
that we were talking about,this is how he,
he or she is supposed to knowwhich one to give you.
You might as welljust get a dart board and throw a dart.
It feels that way sometimes. No.
So you, first of all, let's explain A1cand then let's talk about this.
Sure. This this this idea.
(22:07):
So we got a little history lesson herebecause,
we've only had blood sugar meters,which is what this is.
These are, examples of somebodywho has checked their blood sugar twice
a day, which is often, the number of timesdoctors ask you to check or,
maybe the number of times your insurancewill allow you to check daily.
And, it is some points on the board,random points.
(22:30):
And a clinician is supposed to be ableto look at that and somehow, ascertain
how your medicine is going,how your daily life is going,
how the decisions you're makingare working to manage your diabetes.
And so that is just nota lot of information.
It certainly is not.
So that is blood sugars right now,
(22:50):
one of the common ways to get at leasta ballpark idea of your average blood
sugar is what's called an A1c, in which,this has been around for decades.
It's a quick, fast, cheapway to get an idea of somebody
who maybe doesn't check their blood sugars
or simply doesn't have any ideaof how their blood sugars are looking.
(23:10):
We measure, we take a drop,
a red blood cell, and measurethe amount of blood sugar on it.
And because a red blood cell has a lifespan of three months, we know that
that is a three monthaverage of your blood sugar.
Now, that is some information.
And for years, really for decades,it was kind of the gold standard.
(23:31):
And the problem is that an averageis often misleading.
Let me give you an example.
If half of your blood sugars are highand half of them are low,
they're going to average out correctto a nice A1c right.
If you're simply going by A1c,you may say, oh, I'm doing great.
But the truth of the matter is,when you have that kind of variability
(23:53):
in your blood sugarsfrom high to low and high to low,
that's creating oxidative, oxidativestress on the cells that's damaging them,
interrupting blood flow efficiencyinto the brain and other organs.
And so an A1c while it issome information, it is not the best
indicator for your diabetes managementand overall health of your diabetes.
(24:15):
So now we're going to shiftto this breakthrough technology.
And you know, we live in a worldwhere things are changing rapidly
with technology.
This breakthroughtechnology is called CGM.
This is what I want to have Ronexplain that.
But this is what a chartlooks like from a CGM.
You see the difference here?Just the visual difference.
And looking at this okay,this is the difference.
(24:37):
Now explain what that means.
First of all,what is the CGM. Let's show them.
Yeah well so a CGM is just a little deviceabout the size of a dime.
Sticks on your arm or,there's other places on your body.
It's waterproof.
And you can wear it for either 10or 15 days.
It continually monitors your blood sugar.
And that's why you get this really nice
(24:59):
graph layout herethat shows everything, high.
Low when it's high,when it's low during the day.
Except. Right.
Well, not only that,but that information goes directly
to my doctor's officeif he or she wants to see it.
And is it on your phone?
It is also the the. Alright.
So for me, I can just touchthe icon and it's going to
(25:23):
show me,
where, where I'm at, sayI want to look at my time and range.
Well. Let's hold thatso the camera can see that.
Yeah, yeah.
So what I know is that the decisionsI've been making
have been keeping my blood sugar in range.
The reason that's significantis because many researchers and providers
(25:44):
feel that time and range is the bestindicator of your overall diabetes health,
because going back to an A1,see, as I said, you could have a nice A1c
the A1 that Ada recommends and A1c of it,because we just talked about averaging.
If you get the average right,you know you're not because you're
you're it's a falseit's a false narrative.
(26:05):
Well, use this again.
This CGMdownload shows me in this particular case
that this patient was in range59% of the time.
70% is the goal.
So they have some work to do. Right.
However, it also gives me an indicatorof what the KG or what the A1c would be.
(26:26):
And I think it has it at 7.2 here.
So if you were just going by A1c you'd gowow, look
how close I am to doing really wellnow that's not telling the whole picture.
Number one,we're not getting our time and range.
But number two,
remember I talked about the variabilitythat causes the oxidative stress on cells.
This shows me the variability andif it is matching up to a healthy range.
(26:51):
And so now I'm getting
not just a little bit of informationI'm getting the entire picture.
I also see a graph of where you gohigh or low throughout the day,
so that I know where we need to pinpointspecifically
either the medicinewe're taking at that time or the dose, or.
How you're. Eating or how you're eating.
So my Saturday morningdonuts are going to show up, not doing
(27:14):
only Saturday.
So that's not true Saturday and Sundayokay.
But you okay. Yeah.
So the point is simply this thatwith an abundance of information,
I can make a more accurateand timely clinical decision
to help you manage your diabetes,but you also are able to.
Yeah.
So the that's the partI want to get to here.
This is what's so critical about thisthis piece of technology.
(27:38):
What it does.
You now can treat
your own know how to treat your diabetesokay.
To help to help your clinician,your doctor, your nurse, whoever it is,
keep your diabetes under control becauseyou have a constant flow of information
going back to your physician,which you see.
So if you decide that I'm going to havetwo martinis that evening,
(28:00):
you're going to see your blood sugar jump.
Okay.
You know,
if you decide you want that piece of applepie with with ice cream on top of it,
you're gonna see your blood sugar jump,
but you're going to knowwhat you're doing, okay?
And where you are.
How do those foods affect your behavior?
So I think this is absolutely remarkable.
Now here's the $64,000 question.
(28:21):
Or are the insurance carrierscovering this.
Yes and no. Is Medicare covering.
It? Medicare will only cover itif you have a diabetes diagnosis
and you're on insulin,or you have a history
of hypoglycemic eventsthat you are unaware of or in danger of.
Is a type two diabeticor pre-diabetic able to get this paid for.
(28:44):
In some instances?
Maybe in some instances,one of these, devices has got a, program
where they will sell you a sensorat a fairly reasonable cost.
What's reasonable.
Whether about $85 a month. That's fine.
But $85 a month to know that I'm not goingto move toward dementia.
Right? Yeah.
And and all the other comorbiditiesthat we talked about here
(29:07):
amputations,seizures, renal disease, neuropathy, etc..
I would say it's worth $85 a month.
Well, you know, my heart and my braintell me what I would
really want to see is why do we even needprescriptions for these?
Yeah, we have watchesthat tell us our heart rate,
that tell us how many steps we getthat tell us, you know,
(29:28):
our oxygen saturation for every daywe have all that information.
If diabetes is such,such a dynamic disease
affecting us right now,why aren't we making the tools available
more readilyfor people to be able to be healthy?
Okay, so it's called the CGM.
You can ask your physician about it.
You may qualify for itif you're a type two diabetic.
(29:51):
Possibly. Okay.
If you're pre-diabetic, it'snot going to be covered by insurance.
You can almost guarantee thatif it's worth $85 a month to you.
And I can assure you
that, you know,
when I walk out of this studio,that's the first thing
that I'm going to dois I'm going to get that monitor
and I'm going to have it on my phone
so I know what I'm doing because I,you know, I've got six grandchildren.
Okay?
(30:11):
I want to continue to enjoy my lifewith my wife and be able to do
the things I want to do,and I'm not going to put myself at risk
for something like thiswhen I don't have to.
That's why we do this radio show.
So we'll be right back after the break.
You're listening to America'sHealthcare Advocate
broadcasting coastto coast across the USA.
Stay right there.We're going to wrap it up. Next segment.
(30:36):
Welcome back.
You're listening to America's HealthcareAdvocate Show broadcasting coast to coast
across the USA.
If you want to tell somebody about thisshow,
you want to listen to it againor you want to introduce it to a family,
maybe you've got a husband,a wife or grandfather father, whatever
the case may be, a grandmotherthat you think has this issue,
get them to go up to the podcast platformto listen to it.
There are 16 podcast platforms out there.
(30:57):
You can certainly find thiswithout any trouble.
You can also go to the YouTubeplatform, America's Healthcare Advocate
and the shows are all postedup there by Dave, so they can listen to it
and understand this is a better wayto deal with this issue of diabetes.
Okay?
And that's why I do these broadcastsand that's why we're doing this today.
So it's importantthat you have that information.
(31:18):
I want to thank Saint Luke'sthat by the way, if you wanted to see
Ron Hoyler, saintlukeskc.org is website.
saintlukeskc.org. Make an appointment.
Get going there.
Sit down and talk with him
and find out what you can do to startgetting your diabetes under control.
It is critically importantthat you get it under control.
So as Ron, like say you livewith the diabetes, not the diabetes
(31:42):
telling you how you have to live.
And we'll talk a little bitabout that here in this segment.
So this is interesting.
We just talked about Medicarewhat they cover and what they don't cover.
You know how much I love governmentrun health care.
And I'm on Medicare one half of the budget
that Medicare allots for for caregoes to diabetes and diabetes programs.
(32:03):
So do you think maybe by implementinga program like this,
we could see a
significant savings that maybe DOGEneeds to get involved in this.
Okay. And explain.
There is a better way to do thisusing technology.
Okay.
That would drive downthe cost of the whole Medicare budget.
Half of the budget is alotted to diabetes.
(32:24):
For complications from diabetes.
So that's spending the money on the backend instead of the front end
with the CGM, like Dexcom and Libre,
that can help you see what's going on soyou can more effectively manage your diet.
And take control of your life.
And look, you know what we talked aboutthe 165 diabetes medications.
(32:45):
With a sensor.
I can more appropriately see whichmedication is working and which isn't.
So now I have a better choiceof what's going to work for you.
Yeah.
So the clinician is not workingoff of this okay.
They're working off of somethingthat's going to tell them, listen to this.
Every five minutes, 288 readings
a day of your bloodsugar range increase range
(33:08):
18 to 70 in increased time in rangefrom 18 to 74%.
Reduce this blood glucose to 286 to 158.
That's a 100 point drop.
I mean, this is remarkable.
All because he's got that little disc,
on his armthat allows you to know where you're at.
(33:29):
And most important part isit feeds that information to your doctor.
Yeah.
And I should just mentionthat this is not surgery or anything.
This is sticking on like a band aide,Okay.
Yeah. It's noninvasive people.Okay. Believe me.
Right. Okay.
So, so I, you know, when I look at this,this gives me a lot of hope.
Yeah, well, you know, it's no mystery that
(33:49):
with all this appropriatedata, you're going to do better.
The mystery probably is thatwhy aren't we doing it more?
Well, because.
Because we've got to go throughthe hurdles with the insurance carriers
and then we've got to gothrough the hurdles to CMS.
And God knows how longit will take them to figure it out. But
therein lies the problem.
Yeah. Okay.
Is, you know, you would think,
(34:10):
given you know, how significantthe difference is between
these two ways of treating this diseaseand the people that have it
and the frequency of peoplethree out four,
65 or older, are they going to have itthat they would be all over this?
Yeah.
In terms of handing it out to people sayhere, all you have to do is use it, okay?
Because it's kind of, it's goingto prevent all of these comorbidities
(34:33):
going down.
What does it cost to treatAlzheimer's, dementia, you know, type
two diabetes, moving to type one diabetes,you know, all the rest of this.
So this big brouhaha aboutthe cost of insulin and how to bring the.
Well, that's not treatingthe problem is you're already you've
you're already crossed
the Rubicon in terms of where you're atwhen you're going on to an insulin pump.
(34:56):
Right.And that talk about a change in lifestyle.
There's a change of sure, sure.
Well, you know,insulin is just one of the medications,
right,that you can take, to manage diabetes.
Unless you of course have type one.
Right. And remember, type one,your body can't make insulin, right.
So you have to take it. Right.
But that's only about 5% of peoplewith diabetes have type one.
(35:18):
The vast majority of people have type two.
And that'swhen your body can make insulin.
But it's not making itvery well to be able to do its job.
So we supplement that with one
or several of these other drugsthat can help adjust your blood sugar.
But how well is it working?Is it the right dose?
Do you remember to take it?Do you have side effects?
All of those variablescome into play then, and that's why
(35:42):
understandingwhat that's doing for your blood sugar
really helpsyou make the right decision for this man.
It gives the it it gives thethe clinician, the doctor, the nurse.
It's it's treating you.
There's a roadmap on to okay.
Well that didn't work.Maybe metformin didn't work.
And you needor you know, one of the things
that was surprisingto the nurses that put me on metformin
(36:03):
was they kept asking me every weekbecause I was going to be checked out.
How about side effects for you?
I didn't have any side effects,but I was like, I wasn't even taking it.
It was remarkable.
I had no issue. Some people,a lot of people do.
A lot of people have side effects.I was very fortunate.
But for folks that have side effects,being able to use this
with these kind of measurements thatI just talked about, 288 readings a day.
(36:27):
That's a whole lot of informationthat makes a big difference.
Well, let's go try this medand then we'll see.
We'll actually be able to measure. Sure.
Whether it's working or not beyond meds.
Look, if you're trying to lose weightand you're making that conscious effort
to eat betterand or eat less or eat more of the things
that you've been told to do,this shows you the results.
And when we see results,
(36:48):
that motivates us,that keeps us going down the right path.
If you're just guessingbecause you jump on the scale once a day,
that's just not enough informationto tell you if you are truly doing
something that is going to keepyou going down the right path.
Knowledgeand information are critically important
when you're trying to do anythingin managing this disease.
(37:09):
I think they're even more criticallyimportant, because the risks that you run
by not knowing where you're at interms of this issue is significant, that
we just went through a lot of theseco-morbidities, and they are real.
I'll show you something real quickthat's easy for all of us to understand.
When I look at this,you'll see that around lunchtime.
What is happening after my blood?
(37:30):
What's happening to my blood sugar?
Okay. Skyrockets. Yeah.
Just that information alone tells me.
What are you eating? Let's discuss that.
What medication do I haveyou on that works at this time of the day?
Because one of those thingsneeds to be adjusted.
Because we go up 100 points hereafter we eat lunch.
Not so much at breakfast,not so much at dinner.
(37:50):
Just a quick glance already
has given me so much more informationthan a couple of random numbers.
Yeah, so. It's night and day.
And yes, of the stark difference between
the information that the folks have,you know, thank you for doing this today.
I really
I really think these kind of broadcastsmake a huge difference to people's lives.
(38:11):
I've gotten phone calls from people.
We've done these shows,and it does make a difference
if you don't know if you these littleif you're over the age of 55 or 60
and you don't know whether you've got typetwo diabetes or you're pre-diabetic,
you really need to find outif you are pre-diabetic and you know it.
This is a far better way to treat itwith that simple little disc.
(38:32):
And for 85 bucks a month,you can bet I'm going to be doing it.
Okay.
Just look, you know,look at think of the cost of Alzheimer's
drugs or dementia drugsversus $85 a month to make sure you're
not having that problem.
So that's why we do these shows.
Thank you again.
And thanks to the people at SaintLuke's for letting him take time
to come here at the website for SaintLuke's, is saintlukeskc.org.
(38:53):
If you haven't been checkedor you need to be checked
or you haven't had an A1c,I would strongly suggest you do.
And if you want to see Ron,go to the website.
Make an appointment.
Thank you again. Sure.
And I would just probably mention$85 is the general number.
It might be based on your insurance.
And now I leave you with this thoughtfrom Doctor Martin Luther King.
Americans must learn to live togetheras brothers and sisters,
(39:16):
or we will surely perish togetheras fools.
Truer words were never spoken.
Thank you for listening to America'sHealthcare
Advocate, broadcasting here on the HIARadio Network.
Coast to coast across the USA.
Goodbye America.
Ladies and gentlemen, you.
This is America'sHealthcare Advocate broadcasting coast
to coast across the USA.
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Bringing you simplified answers to thecomplex questions surrounding health care.
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(00:21):
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Hospital empowering you to take controlof your health and wellness.
My very special guest today, Grace MarieTurner, president of the Galen Institute.
Welcome back Grace Marie.
It's a pleasure to be with you.And I do have to say.
You are the most knowledgeableabout health policy.
(00:44):
Just superlative!
And now, ladies and gentlemen,gentlemen, gentlemen.
And now.
America's Healthcare Advocate, Cary Hall.
Hello, America.
Welcome to America's Healthcare Advocateshow broadcasting coast to coast
across the USA here on the HIARadio Network.
My producers, Mr..
Dave Thiessen behind the cameras and Mr.
(01:06):
Garner Cowdery behind the microphoneshere in our Cumulus studios
in Overland Park, Kansas.
America's Healthcare Advocate is to show
are we separate fact from fictionabout the subject of health care?
We're really goingto get into one of those subjects today,
and I think you're going to find itamazingly informative,
and you're going to learn a lot todaythat you had no idea
(01:27):
how to deal with a certain disease.
And the breakthroughs that are happening,
or we're going to exposeall of that today, because Ron Hoyler
from Saint Luke's,who is the educational director
at Saint Luke's for the diabetesprogram, is going to walk us through
a whole series of informationthat we've never seen before.
And I think you're going to find it'sgoing to make a big difference.
Also, if you want to listento one of these shows or tell
(01:48):
somebody about the show after it airs,you can go off on our podcast platforms.
There are 16 of them.
You can find us almost anywhere and listento America's Healthcare Advocate.
Additionally, our YouTubeplatform, America's Healthcare Advocate.
All the shows are posted up there by Mr.
Dave Thiessen.
So you could actually see the videoof the shows and the information
(02:08):
that we're producing on the broadcast.
I want a little shout out todayto KNSS 1330 in Wichita, Kansas.
We're very happy to be back on the airup there in Wichita, Kansas,
one of our oldest affiliates,and we've been off for a while.
We're back on thereand we're very happy about that.
So we want to thank all of themfor putting us back on the air at KNSS.
(02:29):
If you are looking for Medicare insuranceor ACA, the lovely Carolee Steele
at RPS Benefits by Designcan help you anywhere in the country.
I got a great e-mail from a ladythe other day who she had helped,
who was in Florida.
Again, if you if you're
looking for ACA coverage or Medicare,she certainly can help you.
Also, if you're a 1099 employee,they have some great programs over there.
(02:52):
There is a product called Gig Carethat they can help you with.
If you're a 1099 employee,you might find that to cost a lot less
than an ACA plan with better benefitsif you're not getting a subsidy.
So I'll put that caveat there.
But if you're not getting a subsidyor getting a very small subsidy,
you may find that the gig care programmight be better for you.
Again, you can call them at 877-385-2224.
(03:15):
And if you're looking for employersponsored health care, Maria Ahlers
has some pretty unique, opportunitiesthat she can also help you with.
So once again,877-385-2224 RPS Benefits by Design.
As I said,Ron Hoyer is joining me in studio.
Is this the thirdone of these we've done? I'm happy.
It is.
It is third in our series on diabeteseducation.
(03:37):
So what you're going to learn todayis probably going to shock some of you
about how
we're treating this disease nowand how it's not being adequately treated.
You're going to be a little surprisedto learn some of those facts.
We're also going to show you a solution.
It's really quite remarkableand can help you manage diabetes,
whether you're type one or type two,in a way never before available to you.
(03:58):
This is going to be pretty interesting.
Ron Hoyler has a masters of BusinessAdministration, Care Management,
a master of science nursing,a Bachelor of Arts
and Personal Administration, an Associateof Applied Science in Nursing.
He is a certified DiabetesTechnical clinician,
certified Diabetes Care EducationSpecialist,
a Pump Certified Trainer PatientExperience Champion for Children's Mercy
(04:21):
Hospital, 2010, the nominee for the DaisyAward for Extraordinary Nurses.
This.
He's got a whole list of theseand I'm just reading a few the point
and telling you all that is to tell youthat Ron Hoyler
really knows what he's talking aboutwhen it comes to diabetes.
And here's why this is important, okay?
And this will scare you.If it doesn't, it should.
Three out of four Americans over the ageof 65 have diabetes or prediabetes.
(04:45):
And you're looking at one of them.
Okay, I was diagnosed as pre diabeticabout eight, nine months ago.
And I decided to do something about it.
I did I got involved with it
with a, with a weight lossclinic and I dropped the, the weight down
and I started changing my dietand I've got it under control.
But the point is,if you don't take this seriously,
(05:07):
the comorbidities, we'regoing to talk about those in this segment.
In the next segment,
the things that you're puttingyourself at risk for are very serious.
And and in my opinion,I think they're pretty scary.
So let's just dive right in thatwhen I saw this on the notes,
or I was up doing showprep at 530 before we got in here,
and I'm like three out of four.
(05:28):
I think that's the first timeI've seen that number.
I knew one out of three Americans havediabetes or prediabetes, but this over 65,
and you're looking at the guy at 75 here,by the way, just so you know.
Okay.
That's a that's a shocking number Ron.
Scary stat, isn't it? Yeah.
So so, you know,
the thing that drove methat bring you back in here is you
(05:50):
and I've been having conversationabout this,
some of the other comorbiditiesthat we're talking about here.
So let's go through some of those.
Yeah.
Some of the most commonyou've got adult blindness
in stage renal disease,neuropathy, amputation.
We all know that type one diabeticshave a great risk for that
is the seventh leading cause of deathin the United States.
(06:11):
And someone dies of diabetesevery five seconds.
In the world.
Those numbers are. Shocking. Yeah.
They are.
So it's such a prevalent disease.
And for being one of the most commonchronic disorders in the world,
it is a disorder that we could doso much better
at in taking care of than what we do now.
(06:32):
Yeah.
And that's so, so here's, here's a numberthat will knock your socks off.
We have a 165 meds to treat diabetes with.
And we're going to get intohow the doctors decide
which meds to treat you with.
But that number alone is pretty shocking.
Yeah. How do you 165 meds.
(06:52):
Okay.
Now I went on metformin for six monthsto get myself turned around,
and I'm off of it
now, but if I had to go back on it,I would have no issue with doing it.
But the point I'm
making is, you know, I was able to usethat med to get it under control.
But, you know, again, I don't want toI don't want to,
you know, talk about this now because Iwant to get into it in the third segment.
We're really going to surprisesome people with what we have.
(07:14):
But that's got to be extreme.
You're a clinician. Yeah.
Look, you when these patientsare coming in to see you,
you get 165 beds to choose from, Ron?
Right.
Well, and technically there's over 800
combinations of meds and dosesthat can be applied together.
And how does a physician decidewhich one's right for you
(07:35):
or their other patientor their other patient?
It's almost a crapshoot, really.
It's really what it sounds like.
And what would really behelpful would be getting feedback
or informationthat's adequate about your blood sugar
and what's happening on a daily basiswith it. Yeah.
And that and we're going to talk aboutthat.
Believe me, the third segmentis going to be a big surprise
(07:55):
to a lot of people,especially if you're diabetic
or have somebody in your familyat risk for diabetes.
But let's talk about what kind of drove usto come back in here today
to do this show.
And that was and we'll get into thisin the next segment.
But let's talk about the cognitive issues.
This is something that was new to me.
And you brought this up.I was like, for real.
Yeah. So let'swe got about two minutes left here.
(08:17):
Let's talk about thatbefore we go to break. Yeah.
I think, you know,andtechnically there’s over 800
combinations of meds and dosesthat can be applied together.
And how does a physician decidewhich one’s right for you
or their other patient
or their other patient?
It’s almost a crapshoot, really.
(08:42):
And when we have high blood sugars, thatinterrupts the efficiency of the brain
to take in this fuel to run efficiently,it makes it harder to,
to do certain processes daily living,
remembering things, doing processes of,
balancing your checkbookor making decisions.
(09:03):
And knowing when to take your meds.
That would be another one.
Knowing when to test your blood sugar,remembering where you live.
In fact, people with diabeteshave a 50% greater
chance of developing dementiathan someone without diabetes.
And that's just scary.
As we get, more and more peopleinto our population that are aging,
(09:24):
that's shocking.
And how big is the risk?
Does that risk grow for over 65?
Well, first, people over 65get diabetes more so than under.
So that's going too.
Create three out of four right.Pretty big number.
And then beyond that,once you have diabetes you're at a greater
risk for not just dementia,but the complications from dementia.
(09:48):
Some of the specific, diseasesthat come under the dementia umbrella,
like Alzheimer's,
but cognitive impairment in general,
you know, that fog that you'llsometimes hear it called where you are
just suddenly in the moment, not quitesure what you were thinking or doing
that can be related to the high bloodsugars that you might be experiencing.
(10:10):
So when we come back to the break,we're going to get into this in detail
because this is a piecethat we have not talked about
before, the risk here, remember,you know, the key issue here,
three out of four of youlistening to this broadcast out there
over the age of 65either have diabetes or prediabetes.
So that's that's why this becomes an evengreater issue on your quality of life.
(10:31):
We'll be right back after the break.
You're listening to America'sHealthcare Advocate
Broadcasting here on the HIARadio Network.
Coast to coast across the USA.
Stay tuned. We'll be right back with more.
Welcome back.
You're listening to America's HealthcareAdvocate show, broadcasting coast to coast
(10:53):
across the USA here on the HIARadio Network.
You know, you're listening to this,and maybe you've got somebody in
your family is diabeticand you're you're concerned, okay.
About what
I just told you of what Ron just told youand what you're hearing and information.
Go up to one of the podcast platformswe're on, every Spotify Rumble,
you name it, iHeart radio.
(11:14):
We're on.
We're on 16 of them.
Okay, you can definitely find this, right?
SoundCloud. There's more.
You can find us up there and have themlisten to the show,
or you can go to the YouTubechannel, America's Healthcare Advocate.
The shows are all posted up there.
They've post the shows up there so you canwatch them, listen to them, whatever.
But that's a great way to educate somebodythat may have this disease.
(11:35):
Maybe you're strugglinggetting that family member.
Pay attention and do what they need to doto correct the situation with diabetes.
The reason I do these kind of showsand bring experts in here
who take time out of their day,like Ron Hoyler to do this,
is so I can educate and inform,and that's what we're trying to do.
All right.So we're going to switch gears. Now.
We're going to talk about,
(11:55):
as I said, the thing that really caughtmy attention was this whole cognitive
issue and how diabetes affects is becausewe have not talked about that before.
So it's called big brain age gap.
And I'm going to show you a picturenow of what that looks like okay.
And then I'm going to askRon to explain this so you can see exactly
what we're talking about here.
(12:16):
These are concreteexamples of what happens if you're a type
one type two diabetic, and you are notkeeping this disease in check.
Ron, walk us through this.
We have a lot of different ways we canmeasure different functions in the brain.
And one of the things that we can do iswe can look at it and the processes
and how fast it works.
(12:36):
And if, if we're really doing,the things we want our brain to do
and we can, accumulate that informationfor an age group,
and we can say,this is your brain age for this.
Yeah. The what the brain scan does,it does an amazing job.
Yeah, I've seen those before.Those are excellent.
And what we can do then is we canlook at somebody who has diabetes
(12:58):
and we can say,is your brain front function
working at the same chronological ageas what you are
or compared to somebody your agewithout diabetes?
And, data demonstrates
that diabetes can cause brain atrophyand that affects
the brain age of your brain,and that makes it go further
(13:22):
and further from chronologically,what it should be when you have diabetes.
And no surprise that the worse control
you have with your diabetes,the greater the distance
between what your chronological brain ageshould be and what it actually is.
Okay, so you're 75 years old.
You're not paying attentionto your diabetes.
(13:43):
You're letting it rage out of control.
You're doing the things you shouldn'tbe doing.
So instead of having a 75 year old brain,you've got a 97 year old brain.
Well, I'm giving you an example.
That that's maybe a little bitmore of a gap than what the statistic
indicates, but it certainly indicates,let's say that if your,
hemoglobin A1c or 8% or greater,
(14:04):
that on average that's about a four yeargap or deficiency.
You're going to continue to.
Yeah,most likely among other things. Right.
Because as we talked aboutin the last segment, your risk for,
other functions in your brainbeing affected or the risk of dementia,
or, impairmentare significantly increased.
(14:24):
The worse blood flow you haveinto the brain from the high blood sugar.
So I will tell you, okay.
Personally, for me,and I did not know this, but, you know,
I've been very aware ofI've done a lot of shows on Alzheimer's.
So we've had Steve Sanborn on heretalking with the Wavi brain scan
and his group Neurologic, what they doand what a difference that makes.
(14:46):
That's one of the thingsthat is terrified me about aging
was am I going to wind up?
I've got a very good friend, a guyI served with overseas in Vietnam.
He washe and I were partners the whole time
we were there as dog handlers.
And he's got dementia.
And I worry about George.
We're back and forth every week talking.
He lives down in Texas, East Texas,and as a cattle ranch
(15:08):
and, you know, very concernedabout his dementia.
And, you know, himbeing able to keep it in check.
And this is exactly why I wantedto do this show today and talk about this,
because I will tell you,as a seasoned citizen,
one of usthat is chronologically challenged,
this is the one thingthat terrifies the hell out of me.
And it should terrify all of youto be sitting there
(15:30):
and not have control of your mindand your own thought
process, and be able to care for yourselfin any form.
And then, you know, in additionto, you know, you're being that person
that has this problem,what does that do to your family?
Right?
What a hardship did.
That whole burden.
Yeah. Over to your wife and your children.
Because you weren't paying attentionto something that you knew,
(15:53):
was a possibility.
And the thing.
I keep going back to this numberbecause it just shocks the hell out of me.
Three out of four Americans over 65. Yeah.
So if they're, you know,if they're not paying attention to this,
you can almost guarantee they're going towind up with that problem.
Sure.
And, you know, to be clear, you can havedementia without having diabetes.
(16:16):
Of course you can.But do you want to add to the risk? Right.
Exactly.
You're tipping the scale the other way.
Okay, let's hurry up and get dementia,okay. Yeah.
That's what we want to do, right?
That makes a hell of a lot of sense that.
No. Well, that's why this informationis so important for people to understand
so that they can stack the oddsin their favor,
right, of not having to dealwith those kind of complications.
(16:37):
And, and the first thing is, and we,you know,
we're going to come up on the break herein about three minutes.
But the first thing is thatand kind of explain to people
why it's so critical
that they get that A1c initiallyand find out if they're at risk.
Yeah, yeah.
You think you don't have a problem.
You don't know that truth. Yeah. Okay.
Yeah.
That's why, you know,
you're going into your doctorfor an annual physical and lab work
(17:01):
because there are a whole lot of waysthat we can easily and quickly
or, early on detect somethingso that we can fix it.
Always easier to fix itwhen you catch it early on.
Right. Cancers,
all kinds of stuff, diabetes included.
And, one of the quick thingsthat they can do at a physical is check
a blood sugar,
(17:22):
take a urine sample,see if there's glucose in the urine.
They get an indication.
Do you seem to bein that prediabetes stage
or possibly already in the diabetes stage?
And the earlier you catch it, the earlieryou can start to intervene
and get it under control.
Now I want to tell you something.
You may think, hey, I'm physically fit,I workout.
(17:43):
You know,I've been a gym rat all of my life, okay?
Ever since I got out of the military,
I've always workedat least 3 or 4 times a week.
I still couldn't shake this.
I could not get out of thispre-diabetes zone
with this A1C and I, you know,I took the steps.
I did the right thing.
I went to a group here called Heartland
Weight Loss, and got myself back under...
(18:06):
dropped about 18 pounds,and got my A1c down
and I, you know, I've got labscoming up here in a couple weeks.
Time to go right back inand check it again.
But if you, if you think, oh gee, I'min good health, I don't have this problem.
No, you don't know.
And that's Ron's whole point.
You need to get physical,get the A1c check if you're in that range.
(18:28):
I was in the range for pre-diabetes.
I was not diabetic yet,but I was right there.
I could cross the line pretty easily.
That's when I changed my dietand, you know, made a difference.
Like I saidI went on metformin for six months.
Got it under control. Now I'm off of it.
I'm staying under control,but I'm paying attention to it.
If you're not paying attention to this,you get further down the road.
(18:51):
You might not be ableto correct it, right.
Then it shifts over into type 2?
And now you got a big fight on your hands,
a really big fight on your hands, and it'sgoing to affect everything in your life.
So that's why we're doing the showtoday, is to try to explain to you.
Now, when we come back from the break,
we're going to talk abouthow this disease is treated,
how it has been treated historically,and about a major breakthrough
(19:15):
that literally is going to change the waydiabetes gets treated.
Stay tuned.
You're listening to America'sHealthcare Advocate
Broadcasting here on the HIARadio Network.
Coast to coast across USA.
Don't goanywhere. We'll be right back with more.
(19:37):
Welcome back to America's
Healthcare Advocate, broadcasting coastto coast across the USA.
By the way,I've been getting a lot of emails lately.
People that have questions, issues
that lady up in West Virginiathe other day, etc.
if you want to send me an email,
go to the website America'sHealthcare Advocate.com.
America's Healthcare Advocate.com.
I get the emails.
Dave makes sure that I answer him.
(19:58):
If I don't, he tells me I missed okay.
And then I answer them.
So if you've got a question for somethingI can help you with or you have an issue,
please feel free to reach out to me.
Use the websiteAmericasHealthcareAdvocate.com.
All right.
So now this is going to be interestingbecause I'm going to I'm going
to use an analogy here.
And then I'm going to have Ron explainthat analogy
(20:19):
as we talk about this new wayto manage this disease.
So would you buy a carwithout a speedometer.
I would not.
And and because that would be foolish,it would would.
Yeah.
You know, I tell patientsthat managing your diabetes
without constant informationis going to set you up for failure.
(20:39):
And I use an analogythat, let's say you rented a car
to travel across the United Statesfrom the East Coast to the West Coast.
And the car they want to giveyou doesn't have a speedometer.
How comfortableare you feeling about driving?
Not knowing your speedand not being able to assess
if you are going the appropriatespeed limit?
Yeah, obviouslyI'm not going to drive that car, right?
(21:01):
Yeah.
And because you recognize thatthat incoming data is necessary
for you to be in a safe situationand not get yourself in trouble.
And diabetes is no different.
The amount of information coming in aboutyour blood sugars needs to be frequent,
and it needs to be somethingyou can see readily, and that's something
that we're not appropriately using,like we could with the technology
(21:23):
we have today.
Yeah. So let me just give youan example of what we do now.
Then I'm going to ask Ron to explain this.
This is a typical, chart,
if you will, that a doctor seesif you are getting A1c.
So we're going to explainA1c here in a minute.
And you're having a check.This is what it looks like.
This is what he or she has.
Or Ron in the case of a nurse,if they're treating this
(21:47):
to go by to decidewhich one of those 165 medications
that we were talking about,this is how he,
he or she is supposed to knowwhich one to give you.
You might as welljust get a dart board and throw a dart.
It feels that way sometimes. No.
So you, first of all, let's explain A1cand then let's talk about this.
Sure. This this this idea.
(22:07):
So we got a little history lesson herebecause,
we've only had blood sugar meters,which is what this is.
These are, examples of somebodywho has checked their blood sugar twice
a day, which is often, the number of timesdoctors ask you to check or,
maybe the number of times your insurancewill allow you to check daily.
And, it is some points on the board,random points.
(22:30):
And a clinician is supposed to be ableto look at that and somehow, ascertain
how your medicine is going,how your daily life is going,
how the decisions you're makingare working to manage your diabetes.
And so that is just nota lot of information.
It certainly is not.
So that is blood sugars right now,
(22:50):
one of the common ways to get at leasta ballpark idea of your average blood
sugar is what's called an A1c, in which,this has been around for decades.
It's a quick, fast, cheapway to get an idea of somebody
who maybe doesn't check their blood sugars
or simply doesn't have any ideaof how their blood sugars are looking.
(23:10):
We measure, we take a drop,
a red blood cell, and measurethe amount of blood sugar on it.
And because a red blood cell has a lifespan of three months, we know that
that is a three monthaverage of your blood sugar.
Now, that is some information.
And for years, really for decades,it was kind of the gold standard.
(23:31):
And the problem is that an averageis often misleading.
Let me give you an example.
If half of your blood sugars are highand half of them are low,
they're going to average out correctto a nice A1c right.
If you're simply going by A1c,you may say, oh, I'm doing great.
But the truth of the matter is,when you have that kind of variability
(23:53):
in your blood sugarsfrom high to low and high to low,
that's creating oxidative, oxidativestress on the cells that's damaging them,
interrupting blood flow efficiencyinto the brain and other organs.
And so an A1c while it issome information, it is not the best
indicator for your diabetes managementand overall health of your diabetes.
(24:15):
So now we're going to shiftto this breakthrough technology.
And you know, we live in a worldwhere things are changing rapidly
with technology.
This breakthroughtechnology is called CGM.
This is what I want to have Ronexplain that.
But this is what a chartlooks like from a CGM.
You see the difference here?Just the visual difference.
And looking at this okay,this is the difference.
(24:37):
Now explain what that means.
First of all,what is the CGM. Let's show them.
Yeah well so a CGM is just a little deviceabout the size of a dime.
Sticks on your arm or,there's other places on your body.
It's waterproof.
And you can wear it for either 10or 15 days.
It continually monitors your blood sugar.
And that's why you get this really nice
(24:59):
graph layout herethat shows everything, high.
Low when it's high,when it's low during the day.
Except. Right.
Well, not only that,but that information goes directly
to my doctor's officeif he or she wants to see it.
And is it on your phone?
It is also the the. Alright.
So for me, I can just touchthe icon and it's going to
(25:23):
show me,
where, where I'm at, sayI want to look at my time and range.
Well. Let's hold thatso the camera can see that.
Yeah, yeah.
So what I know is that the decisionsI've been making
have been keeping my blood sugar in range.
The reason that's significantis because many researchers and providers
(25:44):
feel that time and range is the bestindicator of your overall diabetes health,
because going back to an A1,see, as I said, you could have a nice A1c
the A1 that Ada recommends and A1c of it,because we just talked about averaging.
If you get the average right,you know you're not because you're
you're it's a falseit's a false narrative.
(26:05):
Well, use this again.
This CGMdownload shows me in this particular case
that this patient was in range59% of the time.
70% is the goal.
So they have some work to do. Right.
However, it also gives me an indicatorof what the KG or what the A1c would be.
(26:26):
And I think it has it at 7.2 here.
So if you were just going by A1c you'd gowow, look
how close I am to doing really wellnow that's not telling the whole picture.
Number one,we're not getting our time and range.
But number two,
remember I talked about the variabilitythat causes the oxidative stress on cells.
This shows me the variability andif it is matching up to a healthy range.
(26:51):
And so now I'm getting
not just a little bit of informationI'm getting the entire picture.
I also see a graph of where you gohigh or low throughout the day,
so that I know where we need to pinpointspecifically
either the medicinewe're taking at that time or the dose, or.
How you're. Eating or how you're eating.
So my Saturday morningdonuts are going to show up, not doing
(27:14):
only Saturday.
So that's not true Saturday and Sundayokay.
But you okay. Yeah.
So the point is simply this thatwith an abundance of information,
I can make a more accurateand timely clinical decision
to help you manage your diabetes,but you also are able to.
Yeah.
So the that's the partI want to get to here.
This is what's so critical about thisthis piece of technology.
(27:38):
What it does.
You now can treat
your own know how to treat your diabetesokay.
To help to help your clinician,your doctor, your nurse, whoever it is,
keep your diabetes under control becauseyou have a constant flow of information
going back to your physician,which you see.
So if you decide that I'm going to havetwo martinis that evening,
(28:00):
you're going to see your blood sugar jump.
Okay.
You know,
if you decide you want that piece of applepie with with ice cream on top of it,
you're gonna see your blood sugar jump,
but you're going to knowwhat you're doing, okay?
And where you are.
How do those foods affect your behavior?
So I think this is absolutely remarkable.
Now here's the $64,000 question.
(28:21):
Or are the insurance carrierscovering this.
Yes and no. Is Medicare covering.
It? Medicare will only cover itif you have a diabetes diagnosis
and you're on insulin,or you have a history
of hypoglycemic eventsthat you are unaware of or in danger of.
Is a type two diabeticor pre-diabetic able to get this paid for.
(28:44):
In some instances?
Maybe in some instances,one of these, devices has got a, program
where they will sell you a sensorat a fairly reasonable cost.
What's reasonable.
Whether about $85 a month. That's fine.
But $85 a month to know that I'm not goingto move toward dementia.
Right? Yeah.
And and all the other comorbiditiesthat we talked about here
(29:07):
amputations,seizures, renal disease, neuropathy, etc..
I would say it's worth $85 a month.
Well, you know, my heart and my braintell me what I would
really want to see is why do we even needprescriptions for these?
Yeah, we have watchesthat tell us our heart rate,
that tell us how many steps we getthat tell us, you know,
(29:28):
our oxygen saturation for every daywe have all that information.
If diabetes is such,such a dynamic disease
affecting us right now,why aren't we making the tools available
more readilyfor people to be able to be healthy?
Okay, so it's called the CGM.
You can ask your physician about it.
You may qualify for itif you're a type two diabetic.
(29:51):
Possibly. Okay.
If you're pre-diabetic, it'snot going to be covered by insurance.
You can almost guarantee thatif it's worth $85 a month to you.
And I can assure you
that, you know,
when I walk out of this studio,that's the first thing
that I'm going to dois I'm going to get that monitor
and I'm going to have it on my phone
so I know what I'm doing because I,you know, I've got six grandchildren.
Okay?
(30:11):
I want to continue to enjoy my lifewith my wife and be able to do
the things I want to do,and I'm not going to put myself at risk
for something like thiswhen I don't have to.
That's why we do this radio show.
So we'll be right back after the break.
You're listening to America'sHealthcare Advocate
broadcasting coastto coast across the USA.
Stay right there.We're going to wrap it up. Next segment.
(30:36):
Welcome back.
You're listening to America's HealthcareAdvocate Show broadcasting coast to coast
across the USA.
If you want to tell somebody about thisshow,
you want to listen to it againor you want to introduce it to a family,
maybe you've got a husband,a wife or grandfather father, whatever
the case may be, a grandmotherthat you think has this issue,
get them to go up to the podcast platformto listen to it.
There are 16 podcast platforms out there.
(30:57):
You can certainly find thiswithout any trouble.
You can also go to the YouTubeplatform, America's Healthcare Advocate
and the shows are all postedup there by Dave, so they can listen to it
and understand this is a better wayto deal with this issue of diabetes.
Okay?
And that's why I do these broadcastsand that's why we're doing this today.
So it's importantthat you have that information.
(31:18):
I want to thank Saint Luke'sthat by the way, if you wanted to see
Ron Hoyler, saintlukeskc.org is website.
saintlukeskc.org. Make an appointment.
Get going there.
Sit down and talk with him
and find out what you can do to startgetting your diabetes under control.
It is critically importantthat you get it under control.
So as Ron, like say you livewith the diabetes, not the diabetes
(31:42):
telling you how you have to live.
And we'll talk a little bitabout that here in this segment.
So this is interesting.
We just talked about Medicarewhat they cover and what they don't cover.
You know how much I love governmentrun health care.
And I'm on Medicare one half of the budget
that Medicare allots for for caregoes to diabetes and diabetes programs.
(32:03):
So do you think maybe by implementinga program like this,
we could see a
significant savings that maybe DOGEneeds to get involved in this.
Okay. And explain.
There is a better way to do thisusing technology.
Okay.
That would drive downthe cost of the whole Medicare budget.
Half of the budget is alotted to diabetes.
(32:24):
For complications from diabetes.
So that's spending the money on the backend instead of the front end
with the CGM, like Dexcom and Libre,
that can help you see what's going on soyou can more effectively manage your diet.
And take control of your life.
And look, you know what we talked aboutthe 165 diabetes medications.
(32:45):
With a sensor.
I can more appropriately see whichmedication is working and which isn't.
So now I have a better choiceof what's going to work for you.
Yeah.
So the clinician is not workingoff of this okay.
They're working off of somethingthat's going to tell them, listen to this.
Every five minutes, 288 readings
a day of your bloodsugar range increase range
(33:08):
18 to 70 in increased time in rangefrom 18 to 74%.
Reduce this blood glucose to 286 to 158.
That's a 100 point drop.
I mean, this is remarkable.
All because he's got that little disc,
on his armthat allows you to know where you're at.
(33:29):
And most important part isit feeds that information to your doctor.
Yeah.
And I should just mentionthat this is not surgery or anything.
This is sticking on like a band aide,Okay.
Yeah. It's noninvasive people.Okay. Believe me.
Right. Okay.
So, so I, you know, when I look at this,this gives me a lot of hope.
Yeah, well, you know, it's no mystery that
(33:49):
with all this appropriatedata, you're going to do better.
The mystery probably is thatwhy aren't we doing it more?
Well, because.
Because we've got to go throughthe hurdles with the insurance carriers
and then we've got to gothrough the hurdles to CMS.
And God knows how longit will take them to figure it out. But
therein lies the problem.
Yeah. Okay.
Is, you know, you would think,
(34:10):
given you know, how significantthe difference is between
these two ways of treating this diseaseand the people that have it
and the frequency of peoplethree out four,
65 or older, are they going to have itthat they would be all over this?
Yeah.
In terms of handing it out to people sayhere, all you have to do is use it, okay?
Because it's kind of, it's goingto prevent all of these comorbidities
(34:33):
going down.
What does it cost to treatAlzheimer's, dementia, you know, type
two diabetes, moving to type one diabetes,you know, all the rest of this.
So this big brouhaha aboutthe cost of insulin and how to bring the.
Well, that's not treatingthe problem is you're already you've
you're already crossed
the Rubicon in terms of where you're atwhen you're going on to an insulin pump.
(34:56):
Right.And that talk about a change in lifestyle.
There's a change of sure, sure.
Well, you know,insulin is just one of the medications,
right,that you can take, to manage diabetes.
Unless you of course have type one.
Right. And remember, type one,your body can't make insulin, right.
So you have to take it. Right.
But that's only about 5% of peoplewith diabetes have type one.
(35:18):
The vast majority of people have type two.
And that'swhen your body can make insulin.
But it's not making itvery well to be able to do its job.
So we supplement that with one
or several of these other drugsthat can help adjust your blood sugar.
But how well is it working?Is it the right dose?
Do you remember to take it?Do you have side effects?
All of those variablescome into play then, and that's why
(35:42):
understandingwhat that's doing for your blood sugar
really helpsyou make the right decision for this man.
It gives the it it gives thethe clinician, the doctor, the nurse.
It's it's treating you.
There's a roadmap on to okay.
Well that didn't work.Maybe metformin didn't work.
And you needor you know, one of the things
that was surprisingto the nurses that put me on metformin
(36:03):
was they kept asking me every weekbecause I was going to be checked out.
How about side effects for you?
I didn't have any side effects,but I was like, I wasn't even taking it.
It was remarkable.
I had no issue. Some people,a lot of people do.
A lot of people have side effects.I was very fortunate.
But for folks that have side effects,being able to use this
with these kind of measurements thatI just talked about, 288 readings a day.
(36:27):
That's a whole lot of informationthat makes a big difference.
Well, let's go try this medand then we'll see.
We'll actually be able to measure. Sure.
Whether it's working or not beyond meds.
Look, if you're trying to lose weightand you're making that conscious effort
to eat betterand or eat less or eat more of the things
that you've been told to do,this shows you the results.
And when we see results,
(36:48):
that motivates us,that keeps us going down the right path.
If you're just guessingbecause you jump on the scale once a day,
that's just not enough informationto tell you if you are truly doing
something that is going to keepyou going down the right path.
Knowledgeand information are critically important
when you're trying to do anythingin managing this disease.
(37:09):
I think they're even more criticallyimportant, because the risks that you run
by not knowing where you're at interms of this issue is significant, that
we just went through a lot of theseco-morbidities, and they are real.
I'll show you something real quickthat's easy for all of us to understand.
When I look at this,you'll see that around lunchtime.
What is happening after my blood?
(37:30):
What's happening to my blood sugar?
Okay. Skyrockets. Yeah.
Just that information alone tells me.
What are you eating? Let's discuss that.
What medication do I haveyou on that works at this time of the day?
Because one of those thingsneeds to be adjusted.
Because we go up 100 points hereafter we eat lunch.
Not so much at breakfast,not so much at dinner.
(37:50):
Just a quick glance already
has given me so much more informationthan a couple of random numbers.
Yeah, so. It's night and day.
And yes, of the stark difference between
the information that the folks have,you know, thank you for doing this today.
I really
I really think these kind of broadcastsmake a huge difference to people's lives.
(38:11):
I've gotten phone calls from people.
We've done these shows,and it does make a difference
if you don't know if you these littleif you're over the age of 55 or 60
and you don't know whether you've got typetwo diabetes or you're pre-diabetic,
you really need to find outif you are pre-diabetic and you know it.
This is a far better way to treat itwith that simple little disc.
(38:32):
And for 85 bucks a month,you can bet I'm going to be doing it.
Okay.
Just look, you know,look at think of the cost of Alzheimer's
drugs or dementia drugsversus $85 a month to make sure you're
not having that problem.
So that's why we do these shows.
Thank you again.
And thanks to the people at SaintLuke's for letting him take time
to come here at the website for SaintLuke's, is saintlukeskc.org.
(38:53):
If you haven't been checkedor you need to be checked
or you haven't had an A1c,I would strongly suggest you do.
And if you want to see Ron,go to the website.
Make an appointment.
Thank you again. Sure.
And I would just probably mention$85 is the general number.
It might be based on your insurance.
And now I leave you with this thoughtfrom Doctor Martin Luther King.
Americans must learn to live togetheras brothers and sisters,
(39:16):
or we will surely perish togetheras fools.
Truer words were never spoken.
Thank you for listening to America'sHealthcare
Advocate, broadcasting here on the HIARadio Network.
Coast to coast across the USA.
Goodbye America.
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