'Cortisol isn't the enemy' - Your guide to cortisol with Dr Monika Sharma

Social media is making a lot of noise about cortisol right now. But what exactly does this hormone do? How does it interact with other hormones in the body? What should someone with type 1 diabetes be aware of when it comes to cortisol?

Today I’m digging deep with the wonderful Dr Monika Sharma, whose sister’s experiences with type 1 diabetes prompted her to pursue a career in medicine. We’re bringing you the facts away from the social media noise to discuss what exactly cortisol is, why we need it, how to figure out if you’re interrupting its function, what you can do to regulate it, and whether a morning routine really matters. 

This is something Dr Monika has personally lived through, shifting her own lifestyle and work routine as a GP to achieve better health. So whether you’re feeling exhausted, stressed out and pulled in 100 different directions, or simply curious to learn more about hormonal health, this episode is for you. 

CONNECT WITH DR MONIKA
Connect with Monika on Instagram.
Follow Monika on TikTok.
Take a look at Monika’s YouTube channel.

DISCLAIMER
Nothing you hear on Type 1 on 1 should be taken as medical advice. Please consult your healthcare team before making any changes to your diabetes or health management.

JOIN THE TYPE 1 ON 1 COMMUNITY:
Come and say hi @studiotype1on1 on Instagram.
Visit the Type 1 on 1 website.
Subscribe to the Type 1 on 1 newsletter.

SPONSOR MESSAGE
This episode of Type 1 on 1 is sponsored by Dexcom. Using Dexcom CGM has given me so much confidence to make informed diabetes treatment decisions in the moment.

You can choose to wear it on your arm or your abdomen, and all Dexcom CGMs have the share and follow feature even when connected to an insulin pump, so family and friends can see your glucose levels and get alerts, giving that extra bit of support when needed.

Head to Dexcom.com to request a free Dexcom ONE+ sample.

Always read the user manual for important product aspects and limitations. Talk to your doctor for diabetes management terms and conditions and terms of use. 

Episode Transcript

Speaker 1 (00:00):
This episode of Type one on one is sponsored by Dexcom.
More on that later. Just to say, as with every
episode of Type one on one, nothing you hear within
this podcast episode is intended to be nor should be
taken as medical advice, and you should absolutely seek the
advice and guidance of a healthcare professional before making any
changes to your diabetes management. If you want to come

(00:21):
and say hi, you can do so at Studio type
one on one on Instagram and I I'd love to see
you there. Hi, everyone, and welcome to Type one on one,
a podcast that delves into the obscure, complex and challenging
world of life with type one diabetes. I'm Jen Grieves,
and each week, with the help of some brilliant guests,

(00:44):
I'll be showing that there is no normal when it
comes to handlingk this whopper of a chronic condition, because
we're all pretty much figuring out the messiness of day
to day life with diabetes as we go, and most
of all, even though it doesn't always feel like it,
we are absolutely not alone. Doctor Monica Sharma is an

(01:04):
nhs GP and content creator. After many years of following
what could be considered a traditional path in the medical profession.
Doctor Monica began to question whether there was another way
to show up as a GP that would give her
more autonomy and better serve her own health and well being,
which ties in rather nicely as today we're going to
be digging into all things cortisol, hormones and stress, and

(01:27):
I'm really looking forward to getting into this from someone
with so much expertise and sort of personal kind of
experience in carving your own path and making sure that
you're looking after yourself. So welcome Dr Monica to type
one on one. Thank you so much for having me.
I'm so excited. I was so happy to have you
here today.

Speaker 2 (01:47):
How are you?

Speaker 1 (01:47):
Where are you between the five to nine and the
nine to five? As I know, you've kind of reshaped
things for yourself.

Speaker 3 (01:54):
Hill, Thank you very much.

Speaker 4 (01:55):
I am working from home to seeing which works out
well for me, so I'm not having a mad morning routine,
which means I'm starting off a little bit more balanced
this morning, which is great.

Speaker 1 (02:07):
Yeah, that's such a kind of beautiful way to start,
isn't it. Where you're just like, oh, I've actually managed
to take a breath this morning.

Speaker 3 (02:13):
Absolutely.

Speaker 4 (02:14):
I feel like sometimes I just I am literally on
autopilot in the morning and I forget to actually just
take a step back and be like, Okay, I'm not
going to get this morning again, so maybe I should
just try and enjoy one thing from it.

Speaker 1 (02:27):
Oh, I love that so much. Gosh, I'm taking that
away already. Okay, thank you. Podcast is done.

Speaker 3 (02:33):
I love it.

Speaker 2 (02:35):
We've fixed it all. Yeah.

Speaker 1 (02:37):
I was just really struck by your message when I
came across you online, and I think, you know, it
may be a little bit selfish because in a slightly
different way and in a different field, I stepped out
of a nine to five myself and went freelance, which
was in part to do with my health, my health needs,
my health condition. And I was struck by how you
kind of share parts of your health journey, not just

(02:58):
showing life life as.

Speaker 2 (03:00):
A GP, but life is a GP as a human being.

Speaker 1 (03:03):
And I think as someone who has a lot of
touch points with the medical profession, it's so easy to
go into those appointments and be like, what do I
need from this? But I think you can sort of
talk me through this a bit. But for me, it
feels like you're kind of leveling that playing field of
any perceived or true hierarchy in terms of, you know,

(03:24):
we're all out here trying our best and we're all
works in progress. So can you talk to me just
a little bit before we get into kind of the
cortiso and the hormones, Like what prompted you to start
reimagining this and also what prompted you to start sharing
that as well.

Speaker 4 (03:39):
Yeah, I think I haven't actually taken time to kind
of reflect on the kind of pivotal point until recently,
but I think over time, obviously, you know, from a
young age, I kind of geared myself to give myself
up to do medicine, and I think in my head
the expectation of what I was going to be doing
wasn't really matching the reality when I started doing the job,

(04:03):
and kind of the stereotype of the doctor was someone
who kind of spent every living, breathing moment at work
and didn't really have a life outside of their job.
And I feel like, you know, growing up, when I
would see, you know, healthcare professionals, I would kind of
just see them as very professional in the workplace, nothing
else outside. And I realized, I'm during my training as

(04:25):
a resident doctor that I was really sacrificing parts of
myself for my job in terms of, you know, just
not enjoying my life outside because whether I was at work,
you know, working long hours, night shift, so I was
just too tired and fatigued. And then, you know, as
I became a GP and now I'm kind of self employed,
I had a bit more economy over my time, and

(04:47):
it almost felt like a luxury, Like I was able
to choose how my day went, you know, like I
could choose pinic hours, I could choose whether I started
later because I wanted to go to a class.

Speaker 3 (04:58):
In the morning.

Speaker 4 (04:59):
And I kind of almost felt a bit like a fraud,
and I thought, well, maybe I shouldn't deserve this luxury
because I don't see anybody else having it. And I
feel like, you know, at the beginning, when I was
doing lots of clinical sessions, I felt like I couldn't
give what I wanted to to my patients because I
was just so tired. I was mentally exhausted, and I
wasn't really filling up my cup outside of work. And

(05:21):
so I kind of tried to play around with it.
And now I'm showing it online and showing that you
can have a life outside of your job and hopefully
slowly trying to change that narrative.

Speaker 1 (05:33):
Yeah, it's really interesting though what you say about that
structure that's just kind of the standard, but actually, in truth,
it's not really serving anyone, yourself or the people that
you're trying to help. And how has that been that transition?
Do you feel like you've got more time to consider
who you are in all of this, or just more
autonomy in your day to, as you say, do things

(05:56):
that actually then do benefit the people that you're serving
in your work.

Speaker 4 (06:00):
Yeah, I still sometimes kind of find myself like pitching
myself and thinking like is this my reality? Because I
still can't believe that some days I'm able to kind
of choose something outside of a nine to five or
you know, like an eight to six, and I don't
have to do weekends or night shifts unless I want to.

(06:22):
And so I'm slowly coming to terms with it, and
I'm learning a bit more about myself each day in
terms of what I like and what I don't like,
spending more time with myself, and I'm learning so much,
which actually is so powerful. So I'm definitely on a
journey and I'm hoping that you know people who are
coming through the same process, whether you're a medical student

(06:43):
or somebody in a high functioning job that feels like
they can't have this life outside actually showing that you can.
And I think obviously having the content creation side has
also allowed me to have that flexibility, which I'm super
grateful for, and it allows me to of have their
creative outlets. So yeah, I feel like at the moment,

(07:03):
I've got really good balance and I'm just very fortunate.
I kind of count my lucky stars each day.

Speaker 1 (07:09):
Yeah, but I also think in the same breath, just
as someone who sort of lived this journey a little
bit in a as I said, a completely different way.

Speaker 2 (07:16):
I work in entertainment and TV.

Speaker 1 (07:18):
It's not the same as helping their patience on a
day to day basis, but that's stepping away and that
carving and then being like, wait, this is actually doable,
like feeling like a fraud and also being like why
aren't more people doing it? I think that fear of
kind of stepping out of what's what you see all
around you and how much we should all be quote
unquote suffering. It's like, you know, it works for some

(07:38):
people that structure completely works, but it doesn't mean that
it works for everyone. So yeah, I just think it's
amazing that you're kind of showing that there is another alternative,
and we know the system is stretched. People listening have
very very regular touch points with the medical world and
the NHS in the UK, so yeah, I just I

(07:58):
just think it's fantastic that you're showing that that is possible,
and also kind of the process of it as well,
because it is a bit like shaky, isn't it. It's
not oh well, I'm going to go and do it
this way and that's it.

Speaker 2 (08:09):
You know, you're sort of like, Okay, it feels a
bit this way and.

Speaker 1 (08:12):
Then maybe a bit that way, and I've done too
much over there, so we're going to pull back over here.
Is that's something you've kind of found as you've gone
on this path.

Speaker 4 (08:20):
Yeah, thank you so much. I really appreciate you saying that.
But yeah, I think every day I'm learning something new,
you know, whether I feel like, you know, I'm missing
clinics sometimes where I want to kind of keep on
top of my clinical acumen by doing more clinics one
week than another. So I feel like I am learning
and there are so many opportunities, especially when it comes

(08:41):
to kind of content creation, and opportunities that I never
dreamt of having, you know, speaking at panels, coming on podcasts,
speaking to yourself, like learning from so many other people
I think has been really valuable. So I'm kind of
at the moment feel like I'm a bit of a sponge.
I'm just soaking everything up that I'm kind of interacting
with and learning in the process.

Speaker 2 (09:00):
Yeah, amazing.

Speaker 1 (09:01):
Okay, so probably should have started with this one, but
we'll go in now. I'd love just in your words,
for you to tell us a little bit about what
it is that you do and who you are. I guess, yeah,
just a little bit of background.

Speaker 3 (09:16):
So I am an NHSGP.

Speaker 4 (09:18):
I became a GP kind of two ish years ago, now,
just under two years ago, but I've been an adopted
for about eight years. And it feels odd because I
even though I say that I'm not defined by my job,
I kind of start by saying that that's what I
am because I feel like you're a large part of
my life. That prison is my identity, you know, Well,

(09:40):
that's what I do.

Speaker 3 (09:41):
I kind of I'm a GP.

Speaker 4 (09:43):
I love helping people and I feel like that's kind
of carried through on terms of the content creation side.
So the reason why I start as social media was
to help kind of one person and originally started about
five years ago, not really being consistent with it, but
it was mostly to promote kind of healthy lifestyle and
healthy living for people who may have, you know, conditions

(10:07):
like heart seas, increase riskal stroke. So I am South
Asian and that's prevalent and higher actually in the South
Asian community. And I didn't really see anybody that looked
like myself online and so I kind of wanted to
be that person that someone could relate to. But then
over time, obviously as I evolved and as I went
through my medical journey and became a GP, then my

(10:29):
content kind of evolved into what it is now. So yeah,
I guess I am a GP, but I also am
striving for the mental well being of fellow doctors, but
you know, other healthcare professionals, and trying to kind of
change the narrative in knowing that you can have a
work life balance.

Speaker 1 (10:46):
And can you describe a little bit for me what
you found going being within the system, if you like,
because as I mentioned, you know, everyone listening is listening
because they're connected in some way to type one diabetes,
which is obviously a condition, and that doesn't mean they
don't also have other touch points with the system for
other reasons, but just in the sense of really telling

(11:08):
us from within what you saw among your peers and
your colleagues in terms of their own health and wellbeing,
and this drive and this motivation to want to help
others as much as possible, but trying to balance that
with your own health needs, and yeah, trying to serve
everyone from all sides, including yourself.

Speaker 4 (11:27):
Yeah, I think it's really tough because I think that
when I started as a medical training service, you know,
like a medical student, but even as a resident doctor,
we didn't really speak about well being as much. And
I think, you know, we're on a rota, and that
rota has you know, normal days where it's like nine
till five. Then you'll have OnEnd coursehos which are twelve hours,

(11:49):
and then you'll have nightshifts which can be kind of
twelve to thirteen hours.

Speaker 3 (11:52):
So I feel like that shift work.

Speaker 4 (11:55):
Mentality was kind of ingrained in us from right at
the begin and that means that obviously you are sacrificing
certain aspects of your life, whether it's you know, your sleep,
or big life events or whatever. It may be time
with your friends, time with your family. And I think
only maybe after COVID, I've realized that there's been a

(12:16):
slight shift in the narrative within the NHS that maybe
we should be prioritizing our wellbeing because I feel like
healthcare professionals are we see a lot and I think
we see a lot of trauma. We deal with a
lot of stress, We deal with with a lot of
high risk decision making, and I think over time that

(12:39):
can really impact you. And I think, you know, to
this day, it will still impact me in certain ways
things that I've seen during COVID, but also the day
to day decisions that I make. And I always second
guess and question myself. You know, within ten minutes, have
I made that right decision? You know, I made that
send that patient home? But you know, at three am
last night and I was awake thinking, oh, should I

(13:00):
have done something else?

Speaker 3 (13:02):
Or I hope they're okay?

Speaker 4 (13:03):
And I think that over time builds up, and I
think that can really impact your mental health. So I
think the narrative within the NHS is changing, but the
actual job is still demanding and it is high risk,
and I think it's about how we can manage that
better for everyone involved.

Speaker 2 (13:23):
Yeah, thank you so much for that insight. Really appreciate
you sharing that.

Speaker 1 (13:27):
You actually also have a link to type one diabetes,
don't you, which I didn't realize when I reached out.

Speaker 2 (13:31):
So do you want to tell me a little bit
about that.

Speaker 4 (13:33):
Yeah, and it's probably the reason why I wanted to
do medicine. So my sister, she's kind of throwing a
half years older, she was diagnosed with type one diabetes
at the age of five, and so being a younger
sibling managing her and my mum actually managing that condition,
it's all I ever remember. And as you know, going

(13:56):
especially as a child, you're going back and forth between hospitals, specialists, GPS,
and at that time, you know, we didn't have the
senses that they are now or the pump. So my
mom was kind of finger pricking, and I distinctly remember it,
and I used to feel like I didn't want to
have her feel left out, So my mom would like
prick her finger and then prick my finger as well,

(14:17):
just so that it was like.

Speaker 3 (14:18):
A sense of community.

Speaker 4 (14:20):
And I think I am really in awe with people
who spoaking a little bit emoture, but I am really
in all of people who are who have chronic health conditions,
especially from a young age, because I feel like.

Speaker 3 (14:31):
It demands so much maturity from.

Speaker 4 (14:34):
You as a person, and I feel like, you know,
my sister and my mum handled it with such grace.
You know, my sister had to make so many sacrifices
within her life in terms of you know, exercising and
you know, swimming at that time, and you know, just
doing so many adjustments to a child's life, which is
really really tough. And I think seeing how healthcare had

(14:57):
impacted her in such a positive way of inspired me
to want to do that for someone's sister, or someone's sibling,
or someone's daughter. And so I think that carried through
throughout my kind of adolescence and my education. And I
think my sister is also a doctor, but she was
I distinctly remember her telling me, you know, oh, it's
really hard, one like, just don't do it, pick another career,

(15:18):
and I was like, no, you know, someone has made
your life so much easier, and they've they've helped you
so much, and I kind of want to do that
for someone else. So yeah, type one diabetes have a
special place in my heart. I actually did a BSc
during my medical career in endochronology with a view that
I wanted to kind of cure type one diabetes, and
obviously endocrinology, you know, and hormones has always had a

(15:42):
safe spot in my heart, especially diabetes.

Speaker 3 (15:44):
So yeah, I have a very close connection to it.

Speaker 4 (15:47):
And I admire anyone you know who has a quantic condition,
especially type one diabetes.

Speaker 3 (15:51):
Which requires so much thought every single day.

Speaker 1 (15:57):
Yeah, oh wow, that's so powerful or how that's kind
of shaped the trajectory of your life and your mum
as well, like speaking there as you know, with a
childhood diagnosis and you being in that team and kind
of forcing I think from my perspective, it does force
you to confront sides of yourself that you maybe otherwise
wouldn't and to do that as a five year old,

(16:19):
as an eight year old, as a fourteen year old,
but also as a parent on behalf, you know, these
worries that you carry for your child, like it is
a lot, and I'm sure you've you know, you've I
think going into a medical appointment and feeling like you
can just breathe and exhale and it's not this judgment
and it's not like what are you doing right?

Speaker 2 (16:38):
What are you doing wrong?

Speaker 1 (16:39):
Like, you know, beyond those kind of questions, once you
get through anything, any kind of hesitancy that you have
around it, those people which you know, I can absolutely
imagine this is kind of how you interact with your patients,
like that unlocking of oh okay, there are things I
can do, this can be better, or okay, someone's with

(17:02):
me on this. It's not just me like that. That's
an incredible thing. So it's just it's very powerful to
hear you speak like that.

Speaker 3 (17:08):
Thank you, thank you so much.

Speaker 4 (17:10):
No, I think it's about understanding, you know, truly empathizing
with the patient and understanding that if this was me,
that I would really struggle if I had to pick
my finger multiple times a day, or inject myself with
the incident or even now, you know, checking a sensor
or using my incident pump. I think it's it's courageous

(17:32):
and it's very brave of people who manage chronic conditions themselves.
And I think it's important to remember and remember how
health is such a privilege. You know, I touch for it.
I'm healthy, and I feel like we often forget that
it's a privilege to be healthy.

Speaker 2 (17:50):
Yeah, there's this amazing quote.

Speaker 1 (17:52):
It's health is a crown that only the well ware
but only the sick can see, or something like that.
And I just think that that kind of sums it out,
doesn't it. So speaking of drochronology and hormones, I did
want to focus a little bit on quartusole today because
it does come up a lot in the conversations I have,

(18:12):
and like, I'm so aware personally of stress kind of
impacting my glucose levels. I can see it now I
have the data. But I also feel like cortisole's having
a bit of a moment, like it's the avocado on
toast of twenty twenty five or something. It's everywhere online
nervous system regulation and you need to lower your quartersole.
So I'd love to just start, first of all with

(18:33):
what actually is quartisole.

Speaker 4 (18:36):
Soqurtersole is a hormone, and it's produced by our adrenal glands,
and they are little glands that's it, just above the kidneys.
It is famously known as the stress formline, but there
are so many other kind of roles of quartersol, so
in terms of your sleep, wake cycle, blood pressure regulation,
blood sugar and metabolism, immune function, and also it's involved

(18:58):
in so many inflammatory pathway. But I feel like you're right,
it's really having its moment at the moment where everyone
was like, oh my god, you're stressed. You've got quarter
sole face. And it's crazy because sometimes obviously being online
and being a healthcare threshore, you see how misinformation just
travels so quickly. So yeah, I think it's really important
to kind of break down exactly what it is and

(19:21):
kind of debunk any myths out there.

Speaker 1 (19:24):
Yeah, okay, fantastic, We're in exactly the right place. I'm
so happy to get into this because, yeah, it's just
a word that gets thrown around a lot.

Speaker 2 (19:33):
So quartersole face is it a thing? Like what is that?
When people talk about that?

Speaker 4 (19:39):
Yeah, so when when you have excess quartersole when we
learn about it in medical school and kind of in
our in our jobs, usually people who are given exogynous
steroids to people who need steroids for you know, a
certain condition over a long period of time can develop,
you know, card soole features. So that can be kind
of having around a phase, it can be having kind

(20:00):
of fact in different areas of the body. But I think,
you know, at the moment, people are kind of just
attributing round faces to excess cord sool, And I think
what's really important to understand the fundamentals of cord soul,
kind of what its function is within the body and
how it's regulated, and then understanding your own body. So
obviously everybody is different, everybody's stresses are different, but if

(20:24):
we look at cord sool, it's actually part of a
really complex kind of messaging pathway. So we have what
we call our hyperthnamic pituitary and adrenal acxis, So it's
kind of how our brain talks to our adrenal glands
to produce cord sool. Now it works and talks to
each other all the time. So your cord soul is

(20:45):
always in kind of like a balance, and it's always
fluctuating depending on external stresses or you know, environmental factors
that you're perceiving. So say back in the day, you
were out on the road or maybe in the jungle,
and you saw a tiger, your brain would perceive that
as oh my god, that's a tiger and a potential threat. Therefore,

(21:09):
this is a stressful situation, and so it will signal
for your brain to release a hormone from the hypothalamus.
It will then cause your petuity to release a hormone
and then that will impact your adrenals and say, hey, adrenals,
we need some corsols so we can run away from
this tiger. And then your core sole is released. And
that's what we call kind of an acute stress because

(21:29):
once the tiger goes away, your body realizes you're in
a safe environment, and then that will sol We'll talk
back to your brain and say, Okay, we've got enough
in the system. Now the stress is gone, so let's
just calm down. I think what's happening now is that
in this day and age, the tiger has been replaced
by work or life stresses. And I think acute stress

(21:52):
is important for the body because that's what's going to
allow you to run away from you know, tigers or
whatever stressing may have. But it's a chronic stress within
this day and age, which is what we worry about
because if you're having elevated levels of cortsol for a
long period of time. That's when you can get kind
of issues in terms of your health and well being,

(22:14):
and it can manifest into medical conditions.

Speaker 2 (22:18):
Okay, So.

Speaker 1 (22:20):
Is there an optimal level of quartso in terms of
it giving and receiving these messages and what can happen
if it does get too high on an ongoing basis.

Speaker 4 (22:30):
So we spoke about this kind of brain and adrenal acxis.
But if you look at your twenty four hour day,
your cortsal also has its own kind of circle. So
we call that your circadian rhythm or your sleep wake circle.
So ideally your cordsol tends to start rising at about
three am in the morning and usually peaks depending on
the individual, but between like six and eight am, and

(22:53):
that cortsole rising will allow you to be kind of alert,
so it pimes your alertness upon waking. It gives you
kind of some energy and then also the stimuli around
you so kind of warning light that will help you
wake up as well, and it kind of support that
cortzol to rise. And then what happens is you kind
of feats and then slowly during the day it will
start dripping off and kind of goes into a trough

(23:15):
around about midnight. But you know, as it's going down
towards the end of the day, then your sleep hormones,
so your melaphonium starts to rise and that allows you
to kind of sleep. So your cordsole naturally is going
to rise in the beginning, you know, of the day,
and that's helpful. That's what we want. Whether there's a
lot to more level, I guess there's no kind of

(23:36):
number that you're going to put on it. I guess
what it is is that you're supporting that natural rise
in the morning and allowing it to fall. So say,
if you're in bed and you are consuming a lot
of kind of you know, blue lights from your phone,
or you are stressed because you're thinking about lots of
different things, it may then ask your dreamals to produce

(23:58):
more cortsols. So therefore you're not really facilitating that natural decline.
You're actually causing a bit of a quartzol spike. So yeah,
I wouldn't say there's like an opsmall level, but it's
about understanding that your course is naturally going to increase
in the morning drop and then your melotonin rises and
it's about supporting that and thinking about your environment to
allow you to support that to happen.

Speaker 1 (24:20):
Okay, So what I'm hearing is quartersolt is good in
when it's functioning properly, we absolutely need it.

Speaker 3 (24:27):
Yeah, correct, Cortsalt isn't the enemy.

Speaker 4 (24:29):
And I think that's that's the one thing to understand
is that course corsal gets a bad red.

Speaker 3 (24:34):
But actually it's not the enemy.

Speaker 4 (24:35):
It's the dysregulation of it that is the the cause
of the issue.

Speaker 1 (24:40):
Okay, So there are things that we are potentially doing
in our world, in our lifestyles, in our stresses of
living in the present, that are disrupting this natural rhythm
of this hormone. And then I guess as it pertains
to other hormones, like I've never understood. I mean, it
took me a long time to realize slash understand Slash

(25:03):
learn that insulin, as someone with typeodiabetes, is also a hormone,
and that there are lots more hormones in the body.
So my question to you is, do you know how
many sorry if I'm putting you on the spot, how
many hormones we have in our body? But also do
they all interact with each other in some way.

Speaker 4 (25:20):
I think there's about over fifty and that what we
call chemical messengers. So hormones are essentially chemical messengers, and
some of them work on the same axis. So if
you think about the hypothalamus and the pituitary, you'll have
your kind of higher up or like brain hormones or
neurotransmitters or whatever you'd like to call them messengers, and

(25:41):
then they will work. So you have the brain, and
then if you think about all your endocrine glands, So
you have your thyroid, you have your adrenals, you have
your kidneys, which secrete some hormones, you have your ovaries.
If you're a woman, you have your testes. If you're
a mad and so if you think about it and
you're pranquous, if you're you know, everyone has a mi Chris.
So brainy is talking sending out messengers, messengers, specific messagers

(26:04):
to all these different glands around your body to say, okay,
we need a constant level of what we call a
homeostasis in medicine, to a balance. How are we going
to achieve that? So, if you think about it, your
surroundings will always impact that balance.

Speaker 3 (26:22):
So say, if.

Speaker 4 (26:22):
You eat, I don't know, a donut, your pancreas is
are obviously going to try and release as much insulin
as possible to bring that glucose well down. But what
you're doing is going to impact how your hormones are
released and how they are communicating with each.

Speaker 3 (26:38):
Other to do that. And yeah, so portosol obviously is
just one of many. And I think.

Speaker 4 (26:46):
That's the message that I'm seeing online is that like,
obviously cordsol is having its moment, but there are so
many other hormones which play so many other factors and
they all talk to each other, and I think you
can't just isolate one hormone and say you need to
regulate your quartosol because actually, in all honesty, it's actually

(27:06):
that looking at your pillars of health throughout your whole
kind of life, right, so your sleep, your nutrition, movement,
mental health. Like, there's so many things that we should
really be focusing on while than they're demonizing one hormone.

Speaker 1 (27:21):
Yeah, And what I'm hearing there is like, due to
the way they interplay with each other, that if you
take these broader kind of things rather than really micro
focusing and potentially demonizing something that we actually need, it
potentially could be more beneficial because it will seep into

(27:42):
this homeostasis that you speak of as that is that correct?

Speaker 4 (27:45):
Yeah, it's actually looking at your body as a whole
rather than treating it as like car parts.

Speaker 3 (27:51):
I think, like you obviously are the vehicle. Your body
is a vehicle.

Speaker 4 (27:56):
But I think in order for everything, in order for
the car function, everything needs to be working and imbalance.
And I think if you're just focusing on one aspect,
I think you're going to miss out a lot of
the rest of the care. And I think we really
do need to take a holistic approach in managing our
well being rather than just focusing on one aspect. I

(28:17):
would actually look at the bigger picture, which I think
it tends. I mean, it's obviously harder questions arise when
you look at the bigger picture, right because it can
feel like amounting of things that you need to change.
But I would always say just to start small by
one day, like one percent better each day is kind
of what I try to live by.

Speaker 1 (28:36):
I'd like to get into that a little bit, like
where to start, but first just to because you mentioned
circadian rhythm and waking cortisol, A lot of people with
type one diabetes experience and bloodshig a spike first thing
in the morning, and my understanding is that that's like
the body preparing itself to spring into action for the day,
and we want those awake signals and we want to

(28:58):
start to be more alert and out of that sleep
kind of feeling sore. Where is the cortisol sitting within
that in relation to how our blood sugars can spike
in that foot to floor kind of way, as soon
as we wake up and start moving, we get a
bit of a blood glucose spike.

Speaker 4 (29:17):
Yees, So if your cortsolt is fire obviously in the morning,
then it can steaming like kind of glucinar genesis, which
is basically when you're getting more kind of glucose production,
and that can cause a slightly higher blood sugar level.
And I guess you see it because you're ancreous. Isn't
secreasing the incidin behind the radar, which is what myler

(29:40):
is doing. So obviously I don't know that my blood
glucose is spiking because my incidin should be doing the job.
Whereas obviously in type one, when you have little or
knowing skin production, you're obviously knowing that because you can
see the reading and then having to give yourself insulin,
and I think it's it's it's tough because I think
regular that is quite difficult because you're you know, obviously

(30:03):
the insulin in the pancreas is not it's not doing
the job. But I think it's about controlling other aspects
in the morning that you can do to help sort
of not add stress in the.

Speaker 3 (30:16):
Morning, if that makes sense.

Speaker 4 (30:17):
So if it's going for a morning walk to try
and stimulate or tap into kind of the the more
calm ailing side of the nervous system, or whether it's
you know, it would be dependent actually, but if you want,
if you're into breath work or journaling or taking something
back to try and calm the body down, and I think, yeah,

(30:38):
it's it's harder because obviously corsal and blood sugar production
are so inter linked. That's like one of the main
functions of it. And obviously having type one and not
having your own incolin production, you're obviously noticing that sugar
is going to be raised, but it's about trying to
manage that. Again, I would say from a holistic approach, Yeah, which.

Speaker 1 (30:57):
Is music to my ear, is because I think for
a long time, the understanding as it was told to me,
and gratefully the thinking has changed now is have this food,
take this inculain, and you will get these results.

Speaker 2 (31:09):
And it's like it just doesn't work like that. That's
just not how bodies hormones. Humans certainly this funny works exactly.

Speaker 3 (31:17):
And I think, you know, think about life. Stress is safe.

Speaker 4 (31:19):
You have a family and you're trying to get your
kids ready in the morning, you know, and you're you're
not listening, and then you're going to say please get ready,
and then so you're naturally your you know, stress WOMO
is going to be high. Your stress levels are going
to be high because you're stressed in the morning. So
I think it's there's so many factors.

Speaker 3 (31:36):
I think.

Speaker 4 (31:36):
Rather than again saying you must eat X and then
inject yourself with X and this is why your sugar
is high, I think it's about understanding what can I
do for me as a human being to help in
the morning and make my morning's a bit more digestible.

Speaker 1 (31:55):
This episode of Type one on one is sponsored by
dex Com. Using dex Com CGM has given me so
much confidence to make informed diabetes treatment decisions in the moment.

Speaker 2 (32:05):
You can choose to wear.

Speaker 1 (32:06):
It on your arm or your abdomen, which is so
great to give those sites a break. And all dex
commcgms have the share and Follow feature even when connected
to an insulin pump, so family and friends can see
your glucose levels and get alerts, giving that extra bit
of support when needed. Head to dexcom dot com to
request a free dex comone plus sample. Always read the

(32:28):
user manual for important product aspects and limitations. Talk to
your doctor for diabetes management terms and conditions and terms
of use. So you've said mourning, is it particularly in
the morning that we may benefit the most from setting
up these kind of a bit more space, a bit

(32:49):
more time, or some little things habits routines in terms
of trying to make sure that quartersole level isn't immediately
spiking and staying there. Is the morning kind of the
most opportune and optimal time to put things in place.

Speaker 4 (33:07):
I think it's personally dependent. I think it depends on
what your day looks like. You know, when I was
doing shift work, I didn't really have a morning, you know,
doing a night shift. My morning was my evening and
you know, everything was out of whack, and I really
felt that actually because I was fighting against my body's
natural rhythm, and I think that was a real struggle.
And I think some people aren't mourning people, and that's

(33:28):
also fine. But I'm kind of a creature of sabat
and a creature of routine, and I feel like I
have a few things that I do for myself in
the morning that keeps me kind of grounded. But obviously
your corsol is going to be high in the morning.
That's what we want. It's about trying to then manage
your stress throughout the day so you're allowing it to
drop rather than going up and down, up and down,

(33:49):
or you know, having that chronic level of stress for
a longer period of time. So I think if you
are a morning person you like a good morning routine,
then that would definitely worked for you. But it's also
about understanding and listen into the cues of your body.
If you're finding yourself stressed throughout the day and it's
kind of every day and you're feeling like this, that's
when we kind of need to be taking a step

(34:10):
back and understanding what we can do to try and
reduce that.

Speaker 1 (34:14):
Yeah, I absolutely want to get into that because I
think that's where I was at for a very long
time without actually realizing, rather than these like very acute
moments where it's very.

Speaker 2 (34:22):
Clear that there's a tiger or.

Speaker 1 (34:25):
Figurative day, yeah exactly, versus this low level. Okay, I've
got all this noise in my life and actually it's
just what I've always done and I'm not even aware
of it. But over time that's having an impact on
my health. But before we come back to that, let's
stick to the morning. So if someone is looking to
start to make changes, because I don't know, as someone

(34:47):
with a chronic health condition, for a little whiles a
bit like oh yeah, writing a few lines in a diary,
Oh yeah, having my like fifteen minutes to sit. You know,
that's not going to help when I'm dealing with this
beast of a condition.

Speaker 2 (35:00):
But actually something now implemented a few things, I'm like,
oh yeah, that's done.

Speaker 1 (35:07):
So if you could kind of chat to me a
little bit about what you might suggest for someone looking
to start with a few habits in the morning to
try and set up their day as optimally as possible
in relation to stress and their hormones.

Speaker 4 (35:22):
Yeah, I think the firstly, habits are going to be
really person specific. And I think one of the questions
I ask myself, you know, before I established this morning routine,
was like, what if I was living my best version
of myself, what would her morning routine look like like?
What would she do to set herself up for success?

(35:43):
And again, it will look completely different to different people,
because you know, people's priorities are different. People have families,
they have lots of other kind of external circumstances which
will impact this view of what you want your morning
routine to look like. And so I think for me,
what I was finding before I established morning routine was
that I was waking up in the morning, my phone

(36:03):
was by my bedside, and I went into work mode
like straight away. So I would grab my phone, snooze
my alarm, either snooze it and stay in bed, or
I would stop it and then open up my emails,
open up my social media. Then I would read negative
comments and then I would get me into it a spiral,
and I'd start my day on a really negative note

(36:24):
and I could feel that I was overwhelmed, you know,
my heart was racing, I felt dittery. I was like fidgety,
I was irritable, and it wasn't even nine am, and
I was like, well, this isn't the best version of myself.
This isn't what I would want for her, this is
not what her morning routine would be. And so now,
over time, I've kind of implemented things bit by bit

(36:46):
and stonily over time built something that seems like a
good morning routine, which on most days I do. I
wouldn't say I do it every single day, but it's
something that I can fall back on on the days
where I feel like I need a system, and so
I don't look at my phone for kind of the
first thirty minutes of the day. I try and go
out for a morning walk multiple times a week, so

(37:07):
if it allows it, depending on my kind of start
times of clinic, but even if it's a fifteen minute
walk just out in the nature, listening to the birds,
I'm just having some silence that I feel like, does
me wonders if it's, you know, taking my vitamins in
the morning, so I know that I've remember star it
because I know I won't do it at the end
of the day. Setting myself up with like a nice breakfast,

(37:29):
so if I prep it the night before, if I
know what I'm having, so I know that I'm I'm
doing things for myself before I go into clinic, and
feel like I give myself to a lot of a
lot of people, or I take on a lot of
other people's stresses and burdens. So I feel like if
I can do something or one or two things for
myself in the morning, that's great. But yeah, I was

(37:51):
the same as you. I thought, what's writing a few
lines in a journal.

Speaker 3 (37:55):
Going to do for me? Wonders?

Speaker 4 (37:58):
You know, actually being able to travel, and you know,
you start the day and you think, okay, what's my
current mood, and my current moove would be I don't know.
Sometimes it can be, you know, demotivated, And then I'd
write why I felt demotivated, and then what my goals
were for the day, and all of a sudden, I
had motivation. And I was thinking to myself, if I
hadn't taken this time to reflect, I would never have

(38:19):
even processed how I was feeling because I just wouldn't
have had time to So I think, you know, journaling
isn't for everyone. But I always say, like, if you
try and you don't like it, that's fine. At least
you've tried it.

Speaker 1 (38:33):
Yeah. One, I've taken to like a couple of lines
in the morning just why today will be amazing, and
because like as someone with type one diabetes, like just
speaking specifically with the audience in mind, and it might
just be me. I don't think it is, but we
have all these sweirlling like things that you know, what

(38:55):
am I doing?

Speaker 4 (38:55):
Now?

Speaker 1 (38:56):
What am I doing in two hours time? Do I
need to lower my insula into account for that?

Speaker 4 (39:01):
Like?

Speaker 2 (39:01):
Have I am I running high in general?

Speaker 3 (39:03):
Today?

Speaker 2 (39:04):
Have I got a stressful meeting? Have I slept?

Speaker 1 (39:06):
Like I know that everyone in the world it has
those thoughts. But as with the extra layer of type
one on top, like it's just a swirl, like quite constant.

Speaker 2 (39:15):
So in the morning if I.

Speaker 1 (39:17):
Write literally two reasons why today will be amazing, and
then I look back and it's like, oh, yeah, I
did actually speak to my sister in law and.

Speaker 2 (39:24):
Oh yeah, the sun was shining, like they're so small.

Speaker 1 (39:27):
But then when I go to bed, I'm like looking
at maybe some things that went right, because with type
one diabetes, I do feel like, you know, you only
get the alarms now, and I'm so grateful for those alarms,
but you get the alarms to tell you that something
isn't as it should be. So a lot of the
information that we're presented with is often trying to fight

(39:49):
those fires in terms of keeping our health on track,
and it can be easy to lose track of the
rest of the day where there were no alarms because
you know, things were as they should be. So I
think for me just to kind of I don't know
if this helps anyone or not, but it has enabled
me to a extract some of those thoughts that are

(40:10):
swirling a lot and be sort of focused a bit
more on what went right as opposed to just having
that constant reminder of what's not going to plan.

Speaker 4 (40:18):
Yeah, because and you're right, I think you know, having
your chronic condition, especially something like type one's ibetes, it's
impacting every pillar of your life. So if you haven't
slept well the night before, it will impact your next day.
If you don't eat within a certain time frame, it
will impact your mood, your concentration, it will impact your

(40:38):
mental health because you think, why didn't I you know,
if I eaten on time, then this wouldn't be happening,
and I.

Speaker 3 (40:45):
Think you have your right.

Speaker 4 (40:46):
There's so much forward thinking that you have to do,
and it doesn't actually allow you to just say wow,
like I have managed this condition for so long, I
am doing a really good job, and.

Speaker 3 (40:59):
I should actually keep a sat pat on the back.

Speaker 4 (41:00):
You know what you're doing is amazing. Having that constant
regulation of you know what am I eating? How many
carbs am I eating? How much interestin doing to give myself?
Should I exercise all that? Drop my gluclose lower, do
any d something before I exercise? And if I do,
then I have to wait two hours before I can
as I get a stitch.

Speaker 3 (41:16):
There are so many.

Speaker 4 (41:18):
Factors that you have to think about, which for someone
who has a functional pancreas, it doesn't even cross my mind.
You know that my pancreas is doing all the hard
work and I don't even have to do any thinking,
and you have to do a normal day to day
and the extra thinking on top. So yeah, absolute credit
to anybody, because I don't know how you do it.

Speaker 1 (41:39):
Yeah, But again, I think, like coming back to this
sort of topic of stress and stuff, and I think
it's made me very aware of the stresses, like because
we have the data now, I can see when things
aren't serving me properly because my blood sugars are telling me.

Speaker 3 (41:54):
And I used to.

Speaker 1 (41:55):
Think that that was like the end point of the thing,
like the outcome. Actually it was a symptom of something
else that was going on in my life. And that
has kind of kind of allowed me, I guess, to
question what is in my life, what is superfluous, what
I'm over arching or or over stretching on, you know

(42:17):
for other people, where actually that's something I need to
kind of rein back for myself. So to talk about
that kind of low level, ongoing kind of raised quartersol
through the day. So we've spoken about how it should
like it will raise in the morning to get us
going and then and then steadily drop. But a lot
of lifestyle factors now are kind of interrupting that rhythm. One,

(42:41):
what are you seeing in terms of people coming in
with with this kind of chronic lifestyle of stress, I guess,
And then too, is there anything you can offer in
terms of people navigating just the whole washing machine of
life and whether we can bring ourselves into awareness a
bit more even about whether we might be running on

(43:02):
a bit of a cortisole, kind.

Speaker 2 (43:05):
Of a cord sole level that isn't helpful.

Speaker 4 (43:08):
Yeah, I think I am definitely seeing chronic stress more
and more, you know, the effects of chronic stress more
and more in my clinic.

Speaker 3 (43:16):
And I think, you know, you are.

Speaker 4 (43:19):
Seeing young people who are having conditions like high blood
pressure or anxiety or you know, a weakened immune system.
So they're getting the current infections because they are dealing
with so much. And I think within medicine, so when
you train to be a doctor, it's all about kind
of treatment, and so you see a problem and then

(43:42):
you give a treatment.

Speaker 3 (43:43):
And so what I'm trying.

Speaker 4 (43:45):
To really do with these patients is actually say, well,
how can we hold the system so that we're trying
to prevent this from happening in the future. So it's
kind of trying to reinforce ways in which you can
reduce that perceived stress in your environment. And I think,
again it will be patient specific, but it's about again

(44:06):
going back to those fundamental pillars. So things like your sleep,
your nutrition, your movement, your mental health, all those things
I think will help. And it's not going to be
a quick overnight fix. And I think That's what's really
important to say is that often when you go and
see a GP, you go with a problem and you
expect to have a treatment for that problem within that consultation.

(44:28):
Yes to you know, for some things it might be,
but I think when it comes to chronic stress, we
have to go a little bit deeper than that and
actually make it really personalized for that person so that
they will stick to it and hopefully change their surroundings
so that it's not going to cause the long term
issues in the future.

Speaker 2 (44:47):
Okay, that's really helpful.

Speaker 1 (44:49):
So I think if someone is like, oh, yeah, but
it's just my life, it's just life, Like would add
would you suggest or advise that people go and talk
to someone like what would be the advice there?

Speaker 3 (45:02):
Yeah.

Speaker 4 (45:02):
I think if you find that you can't think of
ways in which you can reduce that stress that you're
perceiving or you're having in your life, I think definitely
seeing to a healthcare professional will be useful because even
just speaking to someone can do so much good. I
think allowing yourself to vent and say this is what
my life is like. I don't even know where to start,

(45:24):
because actually somebody as an external person looking in might
be able to give you some ways in which you
can because I think once you're in it and you're
kind of feeling like you're thinking, it's really hard to
see a way out, whereas someone like me or a
healthcare professional can help pull you out from the outside.
So I think speaking to someone is really important also

(45:45):
for your mental health. I think if you ever feel
like you're waiting up on days and you think I
just feel a bit low, anyone speaking to a family,
a friend, healthcare professional, I think speaking can do such.

Speaker 3 (45:55):
A world of good. So, yeah, actually consulting a healthcare
professional number one. But then number two.

Speaker 4 (46:00):
I always just try and say, like, if there's one
thing I want to achieve today, or one thing I
want to do for myself, or one thing I want
to improve, what would it be. And if it's I
want to eat a more nutritious breakfast done, and I
actually want to get eight hours of sleep tonight because
I'm running on about five. Done, go to bed a
bit earlier, or if you want to go for a

(46:20):
walk or try a new class or do a bit
of movement done. But it doesn't have to be everything
in one go. It's just little by liberal.

Speaker 1 (46:29):
Yeah, and they're all like quite delicious things, but they
sound quite delicious to me, Like that's.

Speaker 2 (46:35):
Great, Yeah, absolutely, And you mentioned sleep there.

Speaker 1 (46:40):
I just always find it so endlessly fascinating that it's
something that we really don't give a lot of priority to,
but we over the eons of times that human has,
over the eons of time that humans have been in existence,
it's something we haven't.

Speaker 2 (46:54):
Evolved out of, so it's clearly very important.

Speaker 1 (46:58):
Can you speak just a little bit to someone who
is like, you know, it's a bit contradictory, I think
with type one because we need the alarms to wake
ourselves up, and fortunately the tech is such now that
I have so few alarms overnight due to the kind
of insulin pump that I'm on, which has just been
an absolutely incredible lease of life, to be honest, an

(47:19):
absolute game changer. But in terms of prioritizing sleep and
then seeing that play out in my glucose levels the
next day, is that related to quartersole? If I've got
a good night's sleep, I do feel like my glucose
levels are a lot more stable or like just steadier
to start with. Is that to do with like body

(47:40):
human hormone stress? Like, what's happening there?

Speaker 4 (47:43):
Well, I think if you're having a good night's sleep,
your body is recovery, right, So I feel like when
you sleep, I think a lot of people just think
that you like sulf and actually your body does so
much in your sleep in terms of like recovery and
talks to each other and says, okay, this person's so
we can do X, Y and Z. That's how I
like to think of it anyway. But I think that's

(48:04):
you know, you have no hopefully no external things happening
to you. You're just there passed out, relaxing, hopefully, and
so your body's able to do what it needs to
do to allow you to then wake up and function
the next day. And I think when that's interrupted, that's
when we really feel it. And you will. You will
feel it in all pillars again. So you will be irritable,

(48:25):
you'll be tired, you'll be you know, your recovery won't
be there. You may make moorer decisions in terms of
exercising or nutrition because you're tired. And I think, again,
that's something that I really valued when I was doing
night shifts, because my rhythm was out of wax, so
I would you know, start a shift at eight thirty pm,

(48:47):
and then I would finish at about nine nine thirty
if it run over. I would then walk home in
the broad day night, delirious, get home and not remember
how I looked up because it was just like a fog.

Speaker 3 (49:02):
And then I would.

Speaker 4 (49:03):
Go to bed, sleep for about three hours, and then
be expected to do it again. And I feel like
that for me, I really understood the true value of
sleep in terms of recovery. And so I think, yeah,
understanding your own metrics, so your own body and how
it functions. Because everybody needs a different amount of sleep.

(49:24):
Everybody will be, you know, responding to stimuli before bed differently.
But I think it's about having those pinars. So before bed,
what are you doing to give yourself the best chance
to sleep? Are you on your phone? Are you kind
of watching TV? Or are you doing a brain dump
and reading a book or listening to sleep frequencies that

(49:46):
will help or hinder kind of how you then go
into that sleep cycle. So sleep is really important, and
I think we underestimate it because I think we perceived
that we're not doing much, but actually there's a lot
of internal work that goes on when we're.

Speaker 2 (50:02):
Asleep and just touching on that a bit more.

Speaker 1 (50:06):
I joke there about all that all sounds delicious. What
would you say to someone who thinks, well, actually that
sounds delicious, but maybe they're struggling to make space for
their own health because they're busy taking care of other people,
or you know, it sounds kind of luxurious or indulgent.
What would you say to someone who would kind of

(50:28):
struggle with stepping into trusting what they need for their
health and to help themselves.

Speaker 3 (50:34):
I think it's hard.

Speaker 4 (50:37):
I think we sometimes are a bit harsh on ourselves
when we try to prioritize ourselves. I think we think
that we shouldn't be prioritizing ourselves because you know, seems
it seems that we're being indulgent or over indulgent. But
I actually, being a healthcare professional, I'm seeing how how

(50:58):
negative lifestyle choices can really impact your health. I would
say that it is not indulgent to prioritize your own health.
I think actually you are doing your future self so
much good.

Speaker 3 (51:17):
And I think.

Speaker 4 (51:20):
It's okay to be selfish when it comes to your
own health because, honestly, you know, seeing people who I
work in like a not so privileged area. And I
think I have only now realized how privileged I am
in having the health education that I had, in knowing

(51:43):
that eating well, moving and sleeping and you know, prioritizing
my mental well being, how valuable that is because I
see people who haven't had that, who haven't had the
access to that education, who then make lifestyle choices because
they don't know any better, and then you know, end

(52:04):
up having so many health problems at such a young age,
and now it's really impacting their life. So it may
seem like you're selfish, and it may seem like you're,
you know, being over indulgent in that you know you
shouldn't be doing that. But I would absolutely say you
deserve to look after yourself. I think, you know, you
have this one body, this one life, this one mind,

(52:26):
and so you absolutely deserve to look after it. And
if that's doing something for yourself, then so be it.

Speaker 2 (52:31):
Yeah. I couldn't agree more.

Speaker 1 (52:33):
And I am obviously not a medical professional and only
a sample of one. But and I have said this before,
but being a bit more boundaried, once I came to
understand the needs of my health and how much I
needed to give to my diabetes that I wasn't or
hadn't done in the past, coming to the place now
where I'm at and having built a life that is

(52:55):
more autonomous and does serve the needs of my health
as and when they strike, because they do sometimes just
come out of nowhere. I've seen that affect everyone around me.
It's how I show up at work, it's how I
show up for my family, it's you know, kind of
who I am when I interact with this stranger in
the coffee shop downstairs, Like I see that kind of

(53:16):
ripple out. So yeah, just to kind of build on that.
And I don't know if something that if it's something
that you found having kind of done a bit of
this for yourself as.

Speaker 4 (53:25):
Well abutely, and I think, you know, looking back and
compaying who I was when I didn't prioritize myself versus
who I am now, I guess shind sight is obviously
so useful. But I've I really feel like I have
started to understand myself. And it's crazy because you know,

(53:48):
over thirty, I you know, I'm over thirty, and I've
only now really tried to understand myself.

Speaker 3 (53:52):
But I think, yeah, it's it's so.

Speaker 4 (53:56):
Important, and I think doing something for yourself and I
know when I've done this, I'm like kinder to my patients.
I can feel it. I start the day on a
positive note. I'm nicer as a person, and I want
to be that person for them. I want to be
that person that is well rested, that takes care of
themselves because a I am nicer to them, but I
also want to feel like I'm a role model. I

(54:17):
don't want them to look at me and be like, well,
you don't look after yourself, so why should I listen
to you? So, Yeah, I think it is really important
and I've only realized now looking back, when I.

Speaker 3 (54:27):
Didn't prioritize myself, I'm kind of doing myself a disservice.

Speaker 2 (54:31):
H powerful. Okay, And could we touch a little bit
on stigma and judgment because I think that is something
that can potentially also be a source of extra stress
for a lot of people when it comes to health conditions,
taking care of yourself, advocating for yourself. What's your experience

(54:52):
of that, or how does this kind of present itself
with the people that you see.

Speaker 3 (54:58):
Yeah, I think it's tough.

Speaker 4 (55:00):
I think obviously each person will have their own cultural beliefs,
kind of beliefs within society that will shape their health beliefs.

Speaker 3 (55:11):
And I think where I kind of work, there is.

Speaker 4 (55:15):
Ah, there's kind of two ends of the spectrum. There
are people who will put off seeing a doctor for
as long as possible and then present at a really
late stage, and then there are some people who kind
of see the doctor for everything and anything. And I
think there's no right or wrong. I think you need
to do what you feel comfortable with, but I think

(55:37):
the stigma and the judgment is can be kind of
detrimental to your own health in terms of you're putting
off for a really long period of time. I think
also having chronic health conditions. We know that as a
society we are only just learning about some chronic health conditions,
you know, truly, And I think it's about for me

(56:00):
when I see and maybe it's because of the experience
that I've had with my sister, but I think I
really do empathize with people who have chronic conditions because again,
it makes me understand my privilege and in terms of
my own health, but having someone so close to me
go through it firsthand, it's it gives you a new lens,

(56:22):
and I think it's it's a shame that there are
there is stigma and judgment out there, but hopefully, especially
with podcasts like this, where you're empowering people who have
type one diabetes and you're educating them, I think that's
we're definitely moving in the right direction. And I think,
you know, ten years ago, if I said to my sister,

(56:42):
you know that, did you know there's a podcast? You
know the coasts has Type one diabeties? Should start type
debt should be no way that that doesn't even exist.
And now here we are openly talking about it. And
I think conversations like this are so important. So I
think you're actually doing a really great job.

Speaker 2 (56:56):
Oh that's so generous, Thank you, thank you.

Speaker 1 (56:59):
So are there differences between men and women in terms
of how we're affected by quartiso the impact quartersol has.

Speaker 3 (57:11):
Yeah.

Speaker 4 (57:11):
So one of the things just to consider is that
women aren't small men, and I think for years in
terms of research, women weren't really included in research because
we were seen as kind of like two complex And
I think now slowly the narrative is changing. We have
a lot of a way to go. I think we're
only just watching the surface. But I think in terms

(57:34):
of quartsol and if we take our understanding performanes from
this conversation, men are kind of on a twenty four
hour cycle. So they'll wake up the next day, the
clock starts at zero, and then Tuesday clock starts at zero,
and it's like a very twenty four hour cycle. But
I think if you look at women, we are at

(57:56):
you know, anywhere from twenty one days to thirty five
days to even more or even less. And so if
you think about all those foremones that are fluctuating within
that time frame, how it's communicating, I think, yeah, it
will be different because we're not going to be a
spring chicken at nine am the next day like men.

Speaker 2 (58:18):
Yeah, that's so interesting.

Speaker 1 (58:19):
It absolutely fascinates me how relatively like completely recent, including
women in any kind of clinical trials is.

Speaker 2 (58:29):
It's mind blowing.

Speaker 4 (58:31):
And it's crazy because in medical school now, when I
look back and I think about, you know, we get
bought about pattern recingnis. So if a patient prevents with
chest pain that reallyates down the left arm, goes up
to the jaw, it's a heart attack. That's how men
presented in that study for a heart attack, and now
being a GP, I've seen women who have heart attacks

(58:55):
who don't present with central crushing chest pain and left
sided arm and joy. If anything, it feels like they
have a bit of like gastritis, or sometimes they can
have completely different symptoms. And so it's crazy because I'm
also almost questioning things that I've learned and saying, well,
is it because that's how a man presented with it
in the study, and that's what we are taught in

(59:16):
the textbooks versus women. So yeah, I mean, we have
a long way to go, but I think having insight
and knowing that you know it's it's just starting is
also really important because then you can be aware of
kind of gaps within our knowledge and our research.

Speaker 2 (59:34):
Yeah.

Speaker 1 (59:35):
Wow, with the kind of stresses of life and this
work that you're doing, and I want to reflect that
back at you, like you're helping so many people, not
only in your day to day but this content and
having this conversation with me today, it's sometimes just so

(59:55):
validating to hear from someone like yourself that what we're
dealing with and the number that we're seeing that don't
make sense on the CDMs, and you know what, we're handling.

Speaker 2 (01:00:04):
Like, yeah, it's a lot, and it's just wonderful to
know that.

Speaker 1 (01:00:09):
There are people there you who are working in the
way that you are and showing that it can be
done a different way as well.

Speaker 2 (01:00:16):
So i'd just.

Speaker 1 (01:00:17):
Love to hear if there's any sort of parting wisdom
that you'd like to give to people, just in relation
to kind of what we're handling, the stresses of modern
life and kind of, you know, to take some of
that pressure off in terms of yeah, stress cortisol, getting
caught up in all of this, being in the mix
of it, like we said, not being able to kind

(01:00:38):
of step back from it.

Speaker 2 (01:00:38):
Is there anything you'd like to offer.

Speaker 3 (01:00:40):
I think.

Speaker 4 (01:00:42):
To the listeners, especially obviously the majority of people here
you know, listening that have Type one. I think one
of the things I would say is that if anyone
hasn't told you today like you're doing a great job.
And I think it's really as we mentioned, heart because
when you're getting the alarm and you're getting the lows
or the highs, you're focusing on the bad things. But

(01:01:04):
I think what's really important is to remember that dealing
with this is incredible, and so what you're doing is
an amazing job. I think life happens, stress happens, and
I think what I want you to focus on is
knowing that if you can just focus on one thing
that you want to improve, you know, and make yourself

(01:01:26):
one percent better each day, and that's what I live by.

Speaker 3 (01:01:29):
That's enough.

Speaker 4 (01:01:30):
I think there was a quote that said, you know,
if you're functioning at like forty percent in the morning
and you only give forty percent that day, you've actually
given one hundred percent. So I think we need to
give ourselves a bit of grace as well. I think
I myself included. I put a lot of pressure on myself,
and I think I get into a negative hole very
quickly when things don't really go my way. But I think, yeah,

(01:01:54):
giving yourself a bit more grace and understanding that life
is hard some times, but I think we're all navigating
it and doing a great job. So yeah, if anyone
has told you today your guys are doing.

Speaker 1 (01:02:07):
Great, thank you so much. This has been such a
valuable conversation. I've learned a lot. Where can people find
you if they want to see more about you and
see some of this content that's out there?

Speaker 3 (01:02:21):
Yep, I'm on social media, so kind of Instagram and
TikTok under Life with Dr Mone So my handle is
at life and doctor Mone and then I'm also on
YouTube as well, which is just doctor Monkishan on a bit.

Speaker 4 (01:02:33):
Yeah, I'm happy to interact with anyone, so just send
me a message on I always say my dms are
always open.

Speaker 1 (01:02:40):
Yes, and thankfully so, because that is exactly how I
approached you to have this conversation today. So thank you
so much for your time. This has been wonderful. Thank
you so much, no wa visator, thank you so much
for having me. I hope you enjoyed this episode of
Type one on one. Please remember that nothing you hear
on this podcast should be taken and as medical advice,

(01:03:01):
I'm definitely not a healthcare professional. If you like what
you hear, hit subscribe and do leave a little review
on iTunes if you have time. It really helps to
spread the word about type one diabetes.

Speaker 2 (01:03:14):
And thank you so much for listening.