Naturopathic Approaches to Type 2 Diabetes – How to Regulate Blood Sugar Naturally

So moving into diabetes now so the question here is sort of like well why why is this important why.

So moving into diabetes now so the
question here is sort of like well why why is this important why is this why is
this something that’s worth talking about so when I did my research
residency I ended up doing some research on diabetes and I looked at basically
what what are NDs doing in this realm and what kind of outcomes are they providing
and basically like is it is it useful to see an ND for diabetes in terms of some
background diabetes is a huge problem it causes around 5% of global deaths
according to the WHO and when we look at different countries especially
especially in our case looking at North America it’s becoming more and more
prevalent more and more costly so in Canada for example the the standard of
care is is in the double-digit billions of dollars and so people are suffering
people are suffering and people are dying and when it comes to naturopathic
medicine or when it comes to diabetes we know that diet lifestyle and natural
therapies can have a large impact on multiple parameters so they can they can
in some cases prevent the development of the condition or in other cases they can
they can help basically provide better numbers so better blood sugar control
less symptoms or it can help with other risk factors that tend to show up for
people who have diabetes so the other thing here is that NDs do see
diabetic patients in practice and they can often they’re often better
positioned to use these therapies and when I say these therapies I mean diet
lifestyle and natural therapies because NDs have several advantages in these
realms so some of those advantages include that a large proportion of
education is geared towards that so there they’re just extremely
knowledgeable but the second large advantage is is
often time so it’s they have they have a much longer amount of time with their
patient visits as opposed to the typical medical doctor and so instead of let’s
say giving someone a pamphlet or just telling someone you know just go eat
better we can really go into detail and and that can include things like full
diet tracking going into details about recipes and it can also include and and
I would say very importantly working with patients on obstacles so you know
it’s it’s often times when it comes to working with patients it’s it’s not
often a problem of information it’s usually a problem of action or a problem
of behavior and so for the most part what that means is NDS have this
additional opportunity to help people work on that level work with their
behavior and work with what they’re actually doing or with where they’re
struggling and then coming up with solutions to those problems okay so what
actually happens in reality so in reality NDs do have the capabilities
to run diagnostics so we can certainly run lab tests we can do an intake which
consists of asking little questions a series of questions we can do physical
exams all of these these basically pathways help us get an answer as to
what’s actually going on and to get a diagnosis in reality we find that most
patients who actually come to see NDS already have their diabetes diagnosis so
we find many of them have they’ve been tracked by their medical doctors over
time they do routine lab work and they find like yep it’s coming back with the
diagnosis of diabetes and many of them will also be already medicated so so
it’s sort of like they have diabetes they’re medicated and they’re usually
looking for additional therapies turn ative therapies or they’re still
not feeling great and they want to feel better so that’s number one is we kind
of although we have access to all these diagnostic systems we usually usually
find people already come in with their diagnosis the second thing is that it’s
in my experience it’s been rare that patients come in just with diabetes and
nothing else looking for naturopathic care so it’s it’s often the case that
there are multiple complaints so here I’ve listed pain fatigue digestive
issues stress mental health issues come up for people
weight loss comes up for people cholesterol like there’s a long list of
things that usually come up but it’s rare that that people are just coming to
see you for blood sugar regulation so that’s I guess another benefit that can
be provided by NDs in the sense that we we also have the tools to diagnose
assess and treat these separate conditions and we can also look at it
holistically and see okay are are many of these items linked and if so then
what makes sense at what takes priority in terms of treatment so the treatment
itself can also be very thorough so the next question I ask is so what can NDs
do exactly so you see here is a list of therapies used this is when I did my
research so basically I was looking at a subsection of patients in the largest
teaching clinic and saying okay for the diabetic patients what are NDs actually
doing and what you can see on the left side I’ve basically broken up the sort
of standard naturopathic therapies so that would be Clinical Nutrition herbal
medicine or botanical Medicine physical medicine homeopathy traditional Chinese
medicine and counseling or talk therapy and what you can see is it’s heavily
skewed towards the left so basically the large majority of NDs who see diabetic
patients are prescribing supplements they’re using clinical nutrition so that
that basically means at lifestyle exercise and supplements
and then the second most common is botanical so we see almost about 70-75 %
of NDs are using herbal medicine and what what
that’s but that should tell you is basically they’re they’re most likely
using items that will help regulate blood sugar so they’re using it very
much from a medicinal perspective on the right side of this chart what you see is
more specific therapies so we have omega-3 fish oils or fatty acids
chromium coenzyme q10 ala magnesium gymnema and cinnamon this was just to
get a sense of in terms of the various options because there’s a really long
list of options I mean I would say anywhere from 20 to 30 different options
the question was you know what what do people tend to gravitate towards or what
do they tend to use most and so the answer we kind of get back here is one
there’s there’s a wide range so people really kind of go all over the place but
– there are there are ones that are more common so maybe three fatty acids was
the most common supplement used what’s interesting is that omega-3 fatty acids
as far as I know don’t have a direct impact on blood sugar so omega 3 fatty
acids tend to have more of an effect on inflammation and and on cholesterol and
those are both issues that that are very very common with diabetic populations
especially the inflammation component arguably so that’s interesting to see
and then chromium the next one is is itself a blood sugar regulator so it’s
sort of like NDs have a number of options and they seem to use options
that both directly target blood sugar and directly target diabetes and they
use options that indirectly target diabetes and work on some of the
alternative risk factors okay so that’s sort of what the overview
looks like but what does it actually feel like to see a patient and what is a
typical experience with a diabetic patient so this is what I’ve put
together here is sort of like a conglomeration or sort of like a
psychographic demographic of like what the average patient would look like so
this is Bob he’s a 50 year old male he’s got a low fitness level he takes
medication to control his blood sugar and he in the process experiences mild
side effects and his case he has some abdominal discomfort so his blood sugar
measures we’ve got a couple of different ways to measure blood sugar one of the
better ones is called hemoglobin a1c or it’s a shorter form it’s just hba1c if
you have an hba1C that’s above six and a half then usually that’s
diagnostic for type 2 diabetes the higher the hba1c is that means
basically the worse the diabetes the reason why the a1c is such a good
measure is because it tends to look at blood sugar measurements over the last
few months as opposed to if you were to do a blood test and just look at glucose
are basically like what’s the sugar level in the body that fluctuates quite
a bit and so you can have a random glucose which means you’re taking it on
any time of the day or you can have a fasting glucose which means the patient
hasn’t eaten food for a stretch of hours and so so those but even so those are
still only giving you a snapshot whereas the a1c is really looking at a wider
window so anyhow our typical patient tends to have an a1c around 8.5 so we
can say you know anywhere from like seven to nine kind of in that range
which is basically telling us that their blood sugar is not well controlled and
there are different levels of that statement so for example you know if we
had someone whose a1c was 6.9 we might say okay
that’s that’s mildly elevated or mildly you know not well controlled if they had
an hba1c around ten we might say okay yeah that’s that’s more
moderately not well controlled so the higher gets the worse it is typical
patient also has or tends to have other metabolic concerns so bob has high blood
pressure and he also deals with some stress at work so what does he wants
what’s he looking for why is he coming to see the ND he wants
help controlling his blood sugar he doesn’t want to take more medication so
his his medical doctor might have told him that his blood sugar is still not
well controlled with the current dose and at that point that means he’s gonna
have a couple of options one is he may need to increase the dose of the
medication he’s taking the patient is worried because he’s already
experiencing mild side effects and he doesn’t want those to get worse the
other option the patient may have is to start a new medication and obviously
anytime you add in a new medication you’ve got risks and benefits so the
patient is looking for alternatives to kind of avoid going down that line so
what do we do so the first step is we’re gonna look at the patient’s diet so
we’re gonna look at we could do this in two ways we could do what’s called a
24-hour diet recall or we just ask the patient you know tell me what you had to
eat in the last 24 hours or tell me what you had to eat yesterday or we can do a
seven-day diet diary which is a little more accurate because if patient have an
off day or their days where they’re different you get more of a sense of
what a typical diet looks like some practitioners will have the patients
track these really accurately so they’ll use third-party services like My Fitness
Pal where you can put in all the calories and exactly all the quantities
others just want to get a generic sense of what the patient’s consuming the end
of the day typically what the ND will do is look and see okay there are some
foods that cause blood sugar to spike and to rise and to stay at a at a high
level and there are other foods that don’t do that as much
these are called foods with basically foods have a specific glycemic index so
the ND will typically recommend the patient starts to shift their diet
towards foods with lower glycemic indexes meaning they won’t cause blood
sugar to spike as much and this in terms of this first step this is this is
something that will almost always happen right away
but because you may want to get the week long diet diary and because you may want
to make incremental changes it’s something that maintain that may you may
continue discussing with the patient over several visits and just working
with the patient on on what improvements can be made the second step will be
reviewing exercise and so here I would say the recommendations based on the
evidence need to be quite aggressive so ND tells Bob you need to exercise
intensely a lot hard a lot and the patient’s gonna say like well what does
that mean exactly and the way that I would describe it is you know you got to
do weights you got to do cardio you got to get your heart rate up you got to be
sweating like has to be quite intense so the minimum recommendation is 5 times
a week for 30 minutes hitting 60 to 80% of maximum heart rate problem is if you
tell a patient that they may not know what what that means what does hitting
60 to 80% of max heart rate mean and a lot of people will come back reporting
oh yeah like I walk or I play tennis or you know I do weights but it’s it’s it’s
almost always not hard enough I’m sort of having a heart rate monitor
and and measuring it the the easiest way that I would describe it for patients is
you have to feel like you’ve done very hard work not just hard work so you have
to feel tired you have to you have to feel sweaty you really have to work hard
and and not just work hard but work hard a lot so five times a week which is for
a lot of people very very difficult okay so moving on then the question is what
happens after that and usually what happens after that is patient tells you
they can’t exercise that much because it’s too hard and the diet they
understand the concept but they can’t make all of the changes
that they’re recommending for a variety or that all the changes you’re
recommending for a variety of reasons part of that could be because they
simply don’t want to give up certain foods part of it could be because they
don’t like adding certain foods so they’re gonna be a wide variety of
reasons but basically they’re they’re gonna do their best they’re gonna try
they’re gonna definitely increase their activity they’re gonna definitely make
some changes in their diet maybe take out the worst foods and add in a couple
of the better ones but they’re not going to be able normally to do everything you
said perfectly and that’s totally fine so they’re gonna keep trying so then on
your end your next step then is to prescribe supplements so basically
saying okay we got you from maybe zero to forty or zero to 50 out of a hundred
using diet and lifestyle now we’re gonna use supplements to take you the rest of
the way so some examples of supplements prescribed are chromium which we saw in
the chart previously as well as gymnema so chromium itself is a mineral can be
taken as a capsule or a tablet and that helps to regulate blood sugar so for
example again if the patient had an a1c of 8.5 then we would expect with a
chromium prescription over a number of weeks that that number would come down
another one is gymnema so that’s a herb herbs can be taken either dried in
capsule form or they can be extracted in liquid usually alcohol and water and
then prescribed as what’s called a tincture and that also can help to
regulate blood sugar levels the way that medications work when it comes to
regulating blood sugar they usually work one of two ways so they either increase
the output of insulin in some capacity or they make it easier for insulin to
work in the body they make it more sensitive and it’s not unusual that
supplements work in similar ways so usually what the supplements can do is
they can basically provide an additional benefit or sort of like a bonus effect
of what what the drugs would do and of course with that there comes safety
considerations because hypoglycemia or low
sugar can be quite dangerous so what you want to do is you want to advise the
patient to track their blood sugar keep an eye out for their symptoms and retest
and then see how things look over time so there might be a process whereby you
say you know what we’ll start on low dose we’ll do that for a little bit
well retest we’ll see where you’re at then maybe we’ll increase the dose or
we’ll add in another supplement wait a few weeks again or a month and will
retest again so it can be done in a sort of safe slow process typically the
overall outcome of all this so the diet the lifestyle and the supplements
whatever they end up being usually gets the patient to lose a few pounds they
usually increase their muscle mass which by itself helps with insulin sensitivity
and usually we’ll see then decreases in two with their a1c or where they’re with
their fasting blood glucose and hopefully shoot them into the normal
range now these are some of the things that I’ve seen in my experience the
first is that the worse the patient is when they come to see you so let’s say
you see a patient with an hba1c of 20 the more of an impact the ND can have
and that’s I know I realize that’s kind of obvious but it basically basically
what I’m saying is if there’s a lot of room for improvement you’ve got a better
shot of doing some real good the second thing that I see is that if the patient
is compliant meaning that they listen to the recommendations or they do a really
good job like for example let’s say they follow 90% of your recommendations they
can really get quite significantly better so I have seen several situations
where patients are compliant they they follow instructions they exercise they
eat well they take supplements and it really lets them they’re their numbers
basically become normal and for some patients that means that they’re able to
actually go off their medications obviously depends on sort of how far the
condition has progressed and for other patients that means that they don’t need
to increase their medications which also is a huge
win the other thing that I’ve seen which is really cool is that patients who are
pre-diabetic so in other words they have their a1c sort of at like a borderline
amount let’s say 6 to 6.4 if these patients follow recommendations and do a
good job they can actually avoid and prevent diabetes and this is this is so
amazing when you think about all of the things all of the suffering and all of
the costs that come with actually having diabetes and having it progressed or get
worse being able to prevent that is an absolute huge win so the biggest thing
there I would say is the the patients who actually make dramatic shifts to
their diet and who makes dramatic shifts to their lifestyle so for example if
they were not exercising before but now they take on a regular exercise routine
these people are going to see massive benefit so it’s really cool the other
thing that I’ve seen may be maybe on the sadder side is that a lot of people do
realistically have trouble following recommendations so what that means in
terms of the work on the end of the naturopathic doctor is that it it just
means you’re working with people on a one-on-one basis helping them to
troubleshoot helping them to figure out ways to overcome their obstacles and and
basically try to find solutions just just working to find solutions and and
use critical thinking the the reality here again going back to what I said
earlier is I find for the majority of patients it’s usually not a problem of
lacking information so most people know they should eat better
most people know they should exercise more that doesn’t that doesn’t tend to
surprise everybody but what what they end up struggling with is the actual
implementation so how to actually do that or how to actually take steps to
change for what many people is just regular life habits okay so that sort of wraps up what I
want to talk about diabetes I’m just a little offshoot here about what I love
most about naturopathic medicine and I kind of alluded to some of this already
so for me the entrepreneur potential is really what’s most exciting that
basically means the ability to ask what problem is out there what is happening
to people out there they have a problem and how can I solve that problem and and
what stems from that is basically business ideas so what products or
services can I then create or manufacture or provide or deliver in
some way where I’m solving that problem and I think that whole process is just
super exciting the second is that there’s no you’re not really forced into
any particular stream or any particular direction so you can be a
jack-of-all-trades you can be really good at a number of different things but
if you want to get really good at one thing you can totally do that as well so
it’s almost like you have you have all of the benefits of being a specialist if
you want or a generalist if you want and then as a result of that for me in
particularly with this is super important is that I tend not to get
bored because the work is always changing and the work that I that I end
up kind of following always requires critical thinking so I always feel like
I’m being well challenged and there’s this sort of zone of what many of you
have probably heard of called flow which is where you’re working at just the
right intensity in other words it’s just hard enough to keep you stimulated but
it’s not so hard that you feel overwhelmed and hopeless and I find that
with a lot of work in naturopathic medicine it really hits that zone well
for me all right so looking forward what are my
future plans um that’s a good question my future plans are to continue
developing my existing businesses I’m really happy with where things are at
now I’ve been I’ve been working at this for almost a decade now so I’ve had a
lot of iterations and a lot of trials and a lot of failures and so I’m at a
point now where the stuff that’s working is actually working quite well and so my
plan is basically to continue putting in effort into into these successful
avenues in terms of advice for prospective students what I wish I knew
well you’ve got a lot of great lessons just by not making the mistakes I made
which is ask questions about what you’re getting into so try to find out as much
as you can about naturopathic medicine what is the education like what is the
process like once you’ve graduated once you have your license what is the work
like so that’s kind of step one is like get as much information as you can get
really well-informed the second piece of information that I would suggests that I
wish I knew ahead of time is that it would be good to know that you will be a
business owner you will be an entrepreneur or let’s say 99.9% of you
will so it’s something really important that you need to know ahead of time
because what that means is if you succeed it’s because of what you did and
if you fail it’s because of what you didn’t do or maybe because of what you
did and messed up so basically all of the responsibility really falls to you
and so in terms of different personality types for some people that’s awesome
it’s like they love the flexibility the autonomy the ability to be creative and
they can just power through and they’re really well driven and motivated that’s
awesome for other people and I would say this is this applies to a large
percentage of people they usually prefer structure and they
prefer being told what to do or they want like a blueprint of like okay here
are all the steps you need to follow to achieve this specific outcome and as an
entrepreneur that’s that’s often not there because you’re the one who needs
to develop the blueprint so that’s not to say you know there are resources out
there but it’s just to say it’s always going to come down to you to kind of
make sure that that process is moving forward so it’s good to not only know
what you’re getting into that’s kind of piece of advice number one but also to
know yourself and to have a sense of like are you the type of person who when
given a project or when you have a project are you highly driven are you
highly motivated if yes you’re gonna do great if you’re more the type who’s not
so highly motivated or not highly driven then you may want to figure out ways
that you’ll be able to generate a business or create a career for yourself
that’ll still be satisfying okay and I’ve got some
contact information there and you guys can feel free to reach out to me at any
time Dr. Habib thank you so much I really
appreciate your time today and as you indicated in the intro diabetes impacts
so many people across North America and across the world so this is really a
vital topic for us to understand better and who will thank you yeah you’re very
welcome so if you want to just go to the next slide I’ll I’ll cover the upcoming
events and then we can start to take some questions so I just want to let you
know that we have an introduction to naturopathic medicine occurring next
week on November 13th at 12 o’clock Eastern and it’s going to be held by
yours truly so if you are interested in hearing more about naturopathic medicine
this also happens during our naturopathic virtual fair and well if
you’ve never been to a virtual fair they’re basically a bunch of chat rooms
where each of the colleges will be present to be able to ask questions and
interact and if you miss us we’re also participating in Health Professions week
where there will be similar types of virtual forums where you can ask us
questions too and then next month we have a webinar on naturopathic
approaches to anxiety and depression so I’ve got a bunch of events coming up and
I hope that if you’re interested and want to hear more that one of these will
fit the bill so with that I’m going to start on some of the questions that have
come in so dr. Habib I think there are a few questions here on you know if a
patient was wanting to seek this out you know a lot of times some of these
supplements may be available over-the-counter but you know what
diabetes and especially depending on their blood sugar regulation how tight
it is and their meals and what-have-you you can sometimes get into some danger
zones with either dropping blood sugar too quickly or too low and so I want to
make sure that you know folks don’t just run out and go grab a bottle of gymnema start popping pills left and right and
you know and then maybe get into some trouble or you know start doing some
things on their own so can you speak a little bit about how a naturopathic
doctor guides patients safely to ultimately hopefully lower their
medication but how that interacts with the supplements and medications and
monitoring that process safely so that they’re not just kind of running out and
going and grab the grabbing these things and maybe getting into some blood sugar
trouble sure great yeah so there are a few different steps to that process and
obviously it will depend on the unique patient case and the unique patient
presentation what medications they’re on but usually the the first thing that
we’ll do is anytime that we’re considering prescribing something we’ll
do a safety check so we’ll do an interaction check to see if the things
that we’re thinking of prescribing interact with the existing medications
of the patient now the results of that can come back in a couple of ways in in
the case of diabetes that could be something like oh the supplement you’re
looking at prescribing interacts with this medication in a way that causes
harm or causes let’s say damage to an organ okay if that’s the case that that
would be very bad you you wouldn’t really want to proceed down that line
that’s that’s more of an unlikely scenario but obviously you’d want to
look at that the more likely scenario is the results come back and it says yes
there is an interaction but then the question is what exactly is the effect
of the interaction and usually the effect is it will have an additive
effect so if the medication by itself let’s say lowers blood sugar adding on
the supplement will also lower blood sugar so beware but as the prescribing
practitioner that’s actually exactly what you’re looking to do by prescribing
the supplement in the first place because that means that the blood sugar
isn’t regulated if you’re prescribing it so the way to then approach that is you
would you always have to inform the patient of all the risks costs benefits
and the alternatives as well as like what
happens if they follow your recommendations and what happens if they
don’t follow your recommendations for for most people then the next step is
just to start the prescription with full with a full understanding of what the
risks are and what to look out for as well as starting slow and so not
necessarily saying okay let’s say the patient has really uncontrolled a1c or
even moderately controlled you don’t need to throw ten supplements out them
and blast down their blood sugar you know super aggressively you’ve got time
so it can it can just be a matter of using one thing at a time seeing what
the results are and then making an informed decision at every step of the
way rather than rather than having a shotgun approach another component of
that question involves people who may seek out some of the therapies on their
own and and so my answer here is a little more generic because it doesn’t
just apply to diabetes could apply to any health condition and that is that
there’s a wide range of efficacy so basically like how well things work as
well as safety and and doses so it’s not uncommon to hear something especially
through the media to hear like oh such-and-such supplement works for
such-and-such health condition but the problem is that doesn’t tell you what
the dose is that doesn’t tell you how to take it that doesn’t tell you the form
of the supplement that doesn’t tell you if it’s safe for you as
an individual based on your demographic or based on your other medications so
there’s basically a lot of extra risk there and that risk goes away when you
hire an ND or work with an ND so that you basically delegate all of that
work over to them and then they can tell you like yeah this is exactly the thing
that’s right for you and I’ve seen that I’ve seen that very commonly in practice
where someone a patient will say oh I saw that this was good so I went and
bought it and took it but didn’t work and I’ll say well yeah it didn’t work
because you were taking ten times less you add two because that’s simply the
form of the supplement you bought so yeah so I hope that answers that
question thank you so much so there there are a couple other questions here
so one of them is in regards to diabetic foot sores and and so you know I think
diabetes comes with a lot of comorbidities and many different types
of you know conditions that can start to pop up especially as the diabetes has
progressed further so can you speak a little bit to how you work with patients
who may have some limitations like you know foot sores or low-income disability
and so on and how how we work with folks gradually to get them to a place where
they can implement exercise diet modification especially if there are
some other issues on board great yeah so I mean every one of the one of the perks
is that every visit is really going to be individualized and every treatment
plan is going to be individualized so off the top of my head let’s say for
example the patient had foot sores and so they had trouble let’s say running or
applying pressure to the bottom of their foot then I would say okay well I still
want you to exercise and I still want you to exercise intensely but I’m not
going to be recommending going for a jog so in that case I might look at
alternatives so I might say okay maybe we’re going to be doing a lot of weights
maybe we’re going to be using resistance bands maybe we’re gonna be doing
swimming like something that won’t cause the problem to get worse or that won’t
cause the patient to be highly uncomfortable the other way that we
could work with that is by potentially working with other healthcare
practitioners so um perhaps looking at working with a chiropodist or basically
a foot doctor or maybe getting really comfortable orthotics or something to
help increase that comfort if the patient is let’s say adamant on doing
the specific form of exercise but yeah basically just individualizing to the
different patients and providing a number of different options thank you so much
and so another question here just in regards and again I know that the answer
is going to be probably we want stab it but on average what you know when you’re
working with the patient how long does it fine how long do you find that it
takes to come up with a plan that works for them and you know get get the get
the kinks worked out yep so further for sure it’s gonna depend but on average I
would say anywhere from maybe three to five weeks kind of in the zone of a
month plus or minus and so usually the way that that the way that that could
present would be visit one is kind of gather information do testing visit two
would be okay now we have more information we have test results so
we’re going to prescribe some kind of preliminary plan visit three would be
follow up with how how it went with the preliminary plan what obstacles came up
what alternatives need to be implemented and then visit four onwards we’d kind of
be fine-tuning and then retesting and so that’s why I kind of say like within a
few weeks or a month give or take you should be at a place where like patients
pretty happy practitioners pretty happy things are working thank you do you have
any general recommendations to empower folks to take action in their health I
know a lot of these diet and lifestyle recommendations are sometimes the
hardest to implement and so curious if there are any things that you’ve found
that help in that self motivation in that empowerment for sure so I do quite
a bit of reading on this topic behavior change in particular and the best
framework that I’ve seen for it so far it’s from the book called “Switch” so I
would recommend in that book anyone look in the read and basically the framework
that they use is they say when it comes to behavior change you need three
different elements to to work together the first is the rational brain so the
part of us that that understands the why things work and and why they’re going to
work if we make this change so for example reducing foods with a high
glycemic index is not gonna spike your blood sugar as much which will help
reduce your risk of diabetes okay great that’s the rational brain the second is
the emotional brain so the emotional brain is is almost like our default
pathway or default habits and and the appeal there could be something like
well maybe you want to be healthy because you want to consider yourself a
healthy person or maybe you want to be healthy because you want to look
attractive and so to do that you want to build more muscle and be fit it could be
any number of different things and that’ll depend on the person but then
that’s that’s a separate kind of appeal it has nothing to do with why the thing
is actually working and then the third thing that needs to be in line is the
environment or the circumstances so for example if let’s say we’ll use the
exercise example again if your gym is you know a two-minute walk from your
house that’s a that’s very easy to go to the gym for most people that’s gonna be
a low obstacle but if the gym requires a half hour drive that your traffic and
it’s like you got to get ready you got to get in your car you got and now it’s
like ten different steps that can be quite a struggle so for for to kind of
an engineer the environment for behavior change you want to make either usually
small changes so that’s just like let’s say you put your running shoes by the
door and then the next day you put your running shoes by the door and then you
put them on and then the next day you put your ending shoes by the door and
you put them on and you take five steps out the door and it’s like slowly slowly
slowly you get used to getting a little further snowballs the second way to
engineer the environment is to remove obstacles so if you’re you’ve got a gym
that’s a half hour away and you’re like hey this is a huge obstacle I’m never
going but there’s a gym that’s five minutes away
maybe you sign up for that one instead or maybe you think to yourself like oh I
don’t have the right clothing to wear for my exercise routine well then maybe
you go and buy the right clothing so then you have it and you’ve removed that
also so looking at those three aspects the
rational brain the emotional brain in the environment working with patients
you can work on all three or you can try to figure out which one is the biggest
issue for them thank you so much uh so there there are a few other questions
that came in and one of them here is actually if you can just do you have the
author of “Switch” think it’s Chip and Dan Heath okay so thank you and yeah there
are a couple folks that asked about that can you speak a little bit I know there
there’s a lot of talk now on plant-based diets Keto intermittent fasting in the
role of some of these specified nutrition plans with pre-diabetes and
diabetic patients and and I know that there is no one-size-fits-all so for
those of you who are listening please make sure that any major diet change is
supervised by a clinician but if you want to cover that Dr. Habib that would
be awesome yeah so I don’t know that I have too
good of an answer for this one again it’s always going to depend quite a bit
I think in my experience I’ve seen that a number of different diets can be
effective so oftentimes they’re what I might do is have a discussion with the
patient and see if they have a preference so for example let’s say
let’s say I were to prescribe a keto diet to patient I say hey look I think
this is gonna be really good for your diabetes and the patient says well look
I can’t do that then it doesn’t really matter what I think
right so it’s I think I think again it goes back to working with the patients
seeing what they want and on my end I may be able to recommend let’s say an
order of priorities you know if I had my way you would eat this food if you can’t
do that then my second best option is this diet or this food and then
eventually get to a place where we can we can negotiate on a favorable outcome
but but really I’ve seen a number of different diets work successfully for
different people thank you so much there there was one question which may be a
little too technical and so if it is please feel free to let me know but
there was there was some question about the mechanism of action on gymnema
and how how some of the supplements what what their mechanisms are and how they
work to lower blood sugar and if that’s a little too technical feel free to just
point folks in the right direction to find it yeah I would say that’s probably
too technical for the purposes of this webinar but I would encourage if people
are interested in that do two things one is shoot me an email the second is you
can use google you may or may not get the right answer get the best answer
but that is definitely one way to go awesome thank you and so I guess the
last question that I have in here is just in regards to the most powerful
things I know you talked about “Switch” and making those lifestyle changes but
if you were able to help empower diabetic patients what would be the most
important piece of knowledge that you would want them to know the most
important thing I would want them to know is that they need to exercise far
more aggressively so it needs to be it needs to be almost like life changing
degree of exercise to be implemented and that by itself is probably the most or
one of it well certainly one of the most effective interventions because it has
so many other benefits so if if a patient is able to exercise and that
causes them to lose weight that by itself can help with their blood sugar
if they exercise and they put on muscle mass that by itself helps with their
blood sugar if they exercise and they lose fat mass that by itself helps with
their blood sugar helps with their cardiovascular health helps with their
metabolic health so their mood and so if their mood is
better that can help them eat better that can help them have better
relationships it just continually snowballs so again the biggest thing
would just be exercised really really aggressively yeah the other the other
thing that I love about exercise especially in this population as
diabetics progress in the illness and the disease progression one of the
things that is often seen is the blood the vasculature you know blood vessels
that will to have issues from chronic inflammation and exercising helps clear
those blood vessels helps create new ones helps keep circulation to the
extremities the the limbs fingers and toes means the eyes all of the areas
that tend to start to have trouble as diabetes progresses and so I love that
aspect to of diabetes or of a bit with exercise and diabetes prevention just
because those those are the things that impact quality of life so very much in
diabetics and so I agree you know when you’re thinking about why do people go
on disability from diabetes it’s because of lack of mobility it’s because of lack
of vision you know it’s maybe because they have to start dialysis and so you
know there are so many things that can be mitigated and/or prevented with you
know with with these harder to implement lifestyle choices so for so that’s you
know that’s a again I think a you know an aspect of this that is really vital
and so anyway I know that there there’s a there been a couple questions here
from person with subsequent anemia as well and the anemia makes it hard to to
exercise so Patricia I know you’ve asked a couple questions here about anemia and
I know that’s not exactly the topic of this talk but one thing I will say when
you go to see an ND as Dr. Habib will I’m sure agree to we’re not just looking
at diabetes and so you know the naturopathic approach is a whole person
approach and so if a person comes in and they
have chronic migraines or back pain or a foot ulcer like we talked about earlier
or some or anemia the the naturopathic physician isn’t just looking at you as a
patient with diabetes but you you’re a human being who’s sitting in front of us
with you know the whole symptom picture and so all of that comes into play I
remember years ago I had a patient who had he was HIV positive and he had diabetes and he was on disability with because his feet hurt
because that was a side effect from some of the medications he was on and when we
were able to get the foot pain under control he was able to put on shoes
which meant he was able to go back to work which meant that he was able to get
off disability and off of public assistance and his mood change and
everything changed and he was able to afford better food choices and and it
just it was a snowball effect Dr. Habib like you talked about earlier and so you
know I think that there are you know again when you’re looking at a
naturopathic doctor and a visit with us and maybe you can speak and kind of
close on this point about the whole person approach that we take yeah I
think you did a great job so so it’s it’s true that we do and talk like this
it makes it seem like we narrow down into one area but really any visit is
going to be individualized and and like I mentioned on one of the slides where
the typical patient has numerous concerns blood pressure concerns stress
mental health pain all of these things are taken into consideration to come up
with the most thorough and the most appropriate treatment plan thank you so much so I had included in
one of the questions about how to find naturopathic doctors near you and so
both the Canadian Association of Naturopathic Doctors and the American
Association of Naturopathic Physicians managed find an ND search search tools
so you can find naturopathic doctors local to you if this talk has been
interested in you’re a patient and you’re still wanting more information I
would definitely recommend that you have an ND tailor your treatments
specifically for your individual needs and and that’s one way to to find a
really good one so again Dr. Habib I’m gonna close off the webinar today
but I want to thank you so very much for spending time with us and for answering
these questions and and so on and so I think that that’s really am very
grateful for for your time here with us today it’s my pleasure thank you so much
and thanks everyone for joining us thank you and I will stay on just for a few
moments and and close up a couple last questions but thank you Dr. Habib for
coming on with us today and that concludes our webinar and we’ll have a
recording out for for those for those of you who interested shortly thank you

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