Dr Ergin Answers Friday: Part 2 | Real Answers to Diabetes & Blood Sugar Questions

All right, welcome back to Dr. Urgen Answers Friday. We're going to do some rapid fire question and answer. Okay, I pulled your questions from the comment section and we are going to go through them basically one by one with real practical answers that you can actually use. So let's get into it. So this user or a subscriber cannot read the name really well. It says acceler 8530. So question is, is diabetic basmati rice okay to eat? Well, it's a great question. Let's clear this up. So there is no such thing as diabetic rice. Okay, it's a marketing term. Basmati rice, especially the long grain variety, does have a lower glycemic index than jasmine or standard white rice because the starch structure digests slower. But it still turns into glucose very rapidly, especially if the portion is large. So if you love rice, here's how to do it intelligently. Keep the portion to about half a cup cooked. Half a cup cooked, that's tops. Always add protein and fat in the same meal and ideally eat them before and ideally add fiber like vegetables or salad. So half of your plate should be full of vegetables and salad. Ideally, you should eat them before your meal. Even better, cook your rice, cool it in the fridge, then reheat it. This actually increases the resistant starch in there, which lowers the glucose spike. So yes, basmati is the best of the rices among the white rices. But portion and pairing matter far more than the label and we have videos on YouTube about rice specifically. So El Kohadani is asking, are there any restaurant chains that cook with less seed oils? Well, the honest answer is very few. Seed oils like soybean, canola, corn oil, they're cheap, right? They're shelf stable. They're used everywhere in commercial kitchens. Even restaurants that sound healthy often cook with them, but you can navigate around it, right? So, look for Mediterranean restaurants. They will use more olive oil. And steak houses are another great option because you can ask for grilled meats with no oil added. And Thai restaurants often use coconut oil, but it varies by location. Chipotle, for example, uses rice brand oil, which is still a seed oil, but slightly better refined. But the safest approach is to order foods that don't require sautaying, right? So, for example, grilled chicken, roasted meats, steamed veggies, salads with olive oil and vinegar, and baked dishes. And yes, ask ask. Some places will use butter or olive oil if you request it. Carolyn McFersonen says, "I have been on Monjaro for 12 months, lost 3 kilograms. That's like 7 lbs, but diabetes still borderline. My doctor says it is genetic. What is your take?" Well, genetic diabetes, especially when a patient is thin or not losing much weight, tells me we need to dig deeper. So there are several forms of diabetes that look like type 2 diabetes but they are not. So one of them is called modi that's the real genetic uh monogenic form of uh diabetes. Another one is lada right which is an autoimmune diabetes that progress slowly presents in adulthood. And yes your GP may be right that gen genetics play a role but genetics are rarely the whole story. That's what I recommend here. Ask for a ceptide to check how much insulin your pancreas is producing. Ask for insulin antibbody testing. Check your fasting insulin. If your pancreas is making very little insulin, like so your CPEP diet is low, no amount of weight loss will fix it. You need the right medication strategy in that case. So if your genetics are really strong, medications that protect beta cells like GLP-1s and metformin are worth continuing. So you're not failing. You just need a more specific diagnosis instead of a vague ah it's genetic kind of thing. Now yadhish tanapan. Oh that's a long one. Uh the I can't tell the name. I'm sorry. What's the best time of the day to take insulin? Well that depends right. For basil insulin like lontis baslar trica to consistency is more important than timing. So morning or night will both work for you because they're long acting. Just make sure it is the same time every day. Couple hours, maybe it's okay to move a couple hours, but tracibba is very forgiving because it lasts over 24 hours. So if you're doing it like even 8 hours late, you'll be okay with that. Now, but when it comes to rapid acting insulin like him, Novalog, Aedra, Loomjab, you ideally want to take it 10 to 15 minutes before your meal. That's when you take it. I've seen people taking it like after midnight. I'm like, what are you doing? That's like a suicide. But your insulin starts working when you take it before the meal because it takes time to kick in, right? Not after your blood sugar is already spiked. A lot of people do that. They say, "My blood sugar is normal right now. I'll just wait." And and then they give the insulin way later and then they drop because insulin lost in their system for 4 or 5 hours, but the sugar is gone after 2 to 3 hours. So not a good idea to do it later. If you inject rapid acting insulin at meal time or after, you know, you will still spike probably instead of preventing it. So 10, 15, 20 minutes before is best. The one time you must be very careful is your bedtime, right? So only rapid insulin at night if you are actually eating something. So if you're eating snacks or something, sometimes I tell people to take insulin, but never correct at bedtime unless instructed by your doctor because nighttime lows are dangerous. Now there's another question here. Flipflops 3 um 639 question. Should I take if my insulin is high and I'm trying to lower it? Well, if your insulin is high, that tells me you have insulin resistance. Your body is pumping out extra insulin just to keep blood sugar stable. Now, ompic directly helps with this because it reduces the appetite and then it slows the digestion and reduces glucose spikes and it lowers the insulin demand. So, over time, it can absolutely help lower fasting insulin. I'm not saying stay on these medications forever, but it's a it's a good start to help out. And here's the reality. Medication alone does not fix insulin resistance, right? The trifecta is low insulin foods, right? Protein, veggies, healthy fats, resistance training to increase your muscle sensitivity, and avoiding constant snacking, right? That's your trifecta. Think of ampic as a tool that makes lifestyle changes a little easier. It's not the whole plan, but it can be a powerful part of it. Another question, Barbara Rolf 122. My blood sugar drops at night. Orange juice helps. Can I use apple or grape juice instead? Well, yes, you can treat a low with energy. Orange, apple, grape, whatever. Because they all contain fast carbohydrates. That's why we tell them to avoid it normally unless your sugar is really low. But if you are having nighttime lows, the focus should not be on what juice to use. It should be on why you are having low blood sugar in the first place. So, nighttime low blood sugar is usually caused by too much basil insulin or medications like glucoside or gibberide that you may be taking too much or if you have kidney failure that can accumulate. So, tell your doctor that you're having nighttime lows and your do just needs to be adjusted. In the meantime, if you need to treat a low at night, use 4 ounces of any juice and then follow with a small protein snack to prevent the rebound lows. But again, the priority is medication adjustment, finding out why you're having low blood sugar, not just switching juices. Another question, Richard Poland, 6048. Could diabetes be a blessing in disguise? Interesting, right? I I lost 100 pounds, he goes, after being diagnosed. I love this question. Actually, it's really good because I have seen this happen, right? Diabetes forces you to confront your lifestyle, even pre-diabetes, right? It forces you to really learn how your body works and you find the Sugar MD channel and you become a pro. You change your lifestyle and for a lot of people it is the wakeup call that finally sparks the changes they needed decades ago. So you lost 100 lbs. That's incredible. And yes, for some people diabetes becomes the catalyst that turns their health around. So it may be a wakeup call. I have watched patients become stronger, fitter, more disciplined, more in tune with their bodies and ultimately healthier than they were before they were diagnosed. So you are definitely a perfect example of turning something difficult into something empowering. So when life give you lemons, you make a lemon juice, right? Patricia Hinman question. I am 79. I had a heart attack and a hip replacement. I have low energy. Want to get back to being active. Well, first of all, I appreciate your motivation. It's inspiring. At age 79, your number one priority for regaining energy is rebuilding your muscle. After a heart attack and a hip replacement, your body deconditions very fast because you're in the bed. You're not very active. That loss of muscle is what creates fatigue, instability, low stamina, and feeling that everything is harder than it used to be before. That's why a lot of my older patients are complaining about this fatigue because they lose a lot of muscle. Here's what I recommend. Aim for 80 to 100 grams of protein per day divided evenly through your meals. Start walking for 5 to 10 minutes twice a day. That's enough. Uh you can do more. I'm not saying don't do more. and add light some light resistance like resistance bands, chair stands, like wall push-ups, and get your vitamin D and B12 checked because deficiencies absolutely drain your energy. Skip Tylenol and energy shots. They don't fix the root problem. Your energy will return as your muscle and conditioning return. You're not too old by any means. You just need the right plan and consistency. All right. If you want more Q&A episodes like this, everybody, hit that like button and drop your own questions in the comments. I will tackle definitely more of them in the next video. But for now, take care of yourself. I'll see you next week on Dr. announcers