WEBVTT 1 00:00:00.440 --> 00:00:08.160 It's with Dan Ray un Boston's final hour of Night Side. 2 00:00:08.400 --> 00:00:14.640 If you or someone in your world, family, neighbor, boss, 3 00:00:16.079 --> 00:00:20.879 has diabetes as an issue, get comfortable for this hour 4 00:00:20.960 --> 00:00:24.679 because this gentleman is looked upon as one of the 5 00:00:24.719 --> 00:00:33.119 most intelligent physicians in the world of diabetes, well respected 6 00:00:33.119 --> 00:00:36.960 across the country. At one time he was my doctor, 7 00:00:37.079 --> 00:00:41.240 growing back about twelve years or so ago. Doctor David 8 00:00:41.359 --> 00:00:44.240 Nathan is here, doctor, thank you for a green to 9 00:00:44.240 --> 00:00:47.359 come on. And you know how much I appreciate getting 10 00:00:47.399 --> 00:00:50.799 a chance to share you with thirty eight states. 11 00:00:51.039 --> 00:00:53.280 Morgan, my friend, Thank you. It's always a pleasure. Thanks 12 00:00:53.280 --> 00:00:54.479 for having me, all right. 13 00:00:55.200 --> 00:00:59.960 You and I both know there are so many commercials 14 00:01:00.240 --> 00:01:02.119 that are on TV, and I know you and Rob 15 00:01:02.119 --> 00:01:05.359 were talking about this as he called to set you 16 00:01:06.159 --> 00:01:11.760 in our system for this interview. They are making promises 17 00:01:12.560 --> 00:01:17.560 there are at least a half a dozen medicines that 18 00:01:17.680 --> 00:01:22.200 are allegedly good for you if you are a diabetic, 19 00:01:23.000 --> 00:01:28.760 and I want to begin at the starting point, explain 20 00:01:28.840 --> 00:01:33.879 to people how you become a diabetic. 21 00:01:36.200 --> 00:01:40.920 Well, diabetes comes in several different flavors, one of them 22 00:01:40.959 --> 00:01:44.280 which is relatively rare and which usually affects younger people 23 00:01:44.400 --> 00:01:48.079 is called type one diabetes, and that's a disorder in 24 00:01:48.120 --> 00:01:52.319 which the your own immune system attacks the insulin secreting 25 00:01:52.599 --> 00:01:56.599 cells in your pancreas, wipes them out over time, and 26 00:01:56.680 --> 00:01:59.920 you end up being totally insulin deficient. And that is, 27 00:02:00.799 --> 00:02:04.200 you know, a disease that we've known about from antiquity. 28 00:02:04.400 --> 00:02:08.240 It effects probably in the US a total of maybe 29 00:02:08.280 --> 00:02:11.400 one and a half million people, and we've known about 30 00:02:11.400 --> 00:02:14.280 it for a long time. It was an entirely deadly 31 00:02:14.400 --> 00:02:18.360 disease until insulin was developed in the early nineteen twenties. 32 00:02:18.960 --> 00:02:21.840 The type of diabetes that most people are suffering with 33 00:02:22.039 --> 00:02:25.520 are struggling with, is called type two diabetes, and that's 34 00:02:25.560 --> 00:02:29.599 a combination of several factors. It's firstly, it's multi it's 35 00:02:29.599 --> 00:02:33.560 publicly called polygenic, meaning it's not one gene. It's a 36 00:02:33.599 --> 00:02:36.840 combination of a whole bunch of different genes, each of 37 00:02:36.879 --> 00:02:39.800 which contributes a small amount of risk. But you know, 38 00:02:39.879 --> 00:02:43.840 people don't generally get this kind of diabetes unless one 39 00:02:43.879 --> 00:02:47.560 of three things happens. One is that they get overweight 40 00:02:47.719 --> 00:02:51.319 or obese. Number two is that they decrease and this 41 00:02:51.439 --> 00:02:55.599 contributes to their overweight. They decrease, their activity levels, and 42 00:02:55.680 --> 00:02:59.000 this has happened to many people all over the world. 43 00:02:59.280 --> 00:03:02.159 And number three, when people get older. That's also So 44 00:03:02.199 --> 00:03:04.759 those three factors are the ones that have led to 45 00:03:04.800 --> 00:03:07.439 this being an epidemic. And not only it's not just 46 00:03:07.520 --> 00:03:09.840 one and a half million people as with the type one, 47 00:03:10.439 --> 00:03:12.639 but type two affects more like, you know, thirty five 48 00:03:12.719 --> 00:03:15.479 million people. So you know it's one of the most 49 00:03:15.520 --> 00:03:17.240 common chronic diseases there is. 50 00:03:17.560 --> 00:03:23.439 And you mentioned the three causes. Number two and number 51 00:03:23.479 --> 00:03:28.120 three overlap. As you get older, you get less interested 52 00:03:28.280 --> 00:03:34.400 in taking care of yourself exercise, so there are two 53 00:03:34.439 --> 00:03:36.000 things working against you. 54 00:03:37.520 --> 00:03:39.159 Yeah. Well, you know, we're at a time in our 55 00:03:39.319 --> 00:03:42.960 in the human history when we are living longer, older 56 00:03:43.000 --> 00:03:45.439 than ever before. And you know many of us who 57 00:03:45.439 --> 00:03:48.439 are so I'm in my seventies and my knees are 58 00:03:48.479 --> 00:03:50.639 hurting a lot. And you know, we just weren't designed. 59 00:03:50.639 --> 00:03:53.599 We weren't engineer to last as long as we are 60 00:03:53.639 --> 00:03:55.960 now living. And one of the things that happens is 61 00:03:56.000 --> 00:03:59.120 that our muscle mass decreases. As you get older, the 62 00:03:59.240 --> 00:04:02.159 proportion of your body mass that is fat increases. Even 63 00:04:02.199 --> 00:04:05.280 if you're not overweight, your relative amount of fat increases. 64 00:04:05.639 --> 00:04:09.560 And all of those factors conspire to cause type two diabetes. 65 00:04:09.599 --> 00:04:12.039 And it's epidemic. I mean, you know, it's affecting once 66 00:04:12.080 --> 00:04:14.960 you're a rage of sixty five, it's affecting one out 67 00:04:14.960 --> 00:04:17.240 of every five people or so. I mean, you know, 68 00:04:17.480 --> 00:04:18.959 it's really incredibly common. 69 00:04:19.360 --> 00:04:23.439 And I've noticed this is observational on me, it's not scientific, 70 00:04:24.120 --> 00:04:31.560 but I've noticed thinner people by comparison, that have developed diabetes. 71 00:04:31.920 --> 00:04:34.800 There was a time you could see somebody who had 72 00:04:34.839 --> 00:04:39.560 a tummy and pretty much guess in their world they 73 00:04:39.600 --> 00:04:45.000 were suffering from diabetes. But that's no longer a guarantee 74 00:04:46.040 --> 00:04:46.680 or am I wrong? 75 00:04:46.759 --> 00:04:49.160 Right? No? No, no, no, it's the kind so there. 76 00:04:49.199 --> 00:04:52.199 It's you know, when we say that being overweight and 77 00:04:52.279 --> 00:04:57.560 less activity levels, lower physical activity levels are major environmental 78 00:04:57.959 --> 00:05:01.399 contributors to this true, true, But it doesn't mean that 79 00:05:01.439 --> 00:05:04.720 people who are thinner might also not get diabetes when 80 00:05:04.720 --> 00:05:08.519 they're older. And in those folks, interestingly, they probably have 81 00:05:08.920 --> 00:05:13.399 a limited capacity to secrete insulin themselves. That is, their 82 00:05:13.439 --> 00:05:16.680 pancreas doesn't make as much insulin, and as they get 83 00:05:16.720 --> 00:05:19.600 older they may need a bit more insulin and their 84 00:05:19.600 --> 00:05:22.399 pancreases just can't keep up with it so they can 85 00:05:22.439 --> 00:05:26.720 develop diabetes. Their diabetes looks a little bit more like 86 00:05:26.800 --> 00:05:29.879 the type one I described before. That is, they tend 87 00:05:29.920 --> 00:05:34.759 to be more insulin deficient compared with insulin resistance. Those 88 00:05:34.800 --> 00:05:37.879 are the two factors we talk about in type two diabetes, 89 00:05:37.959 --> 00:05:40.240 and i'm more resistance. Yeah, go ahead, sir. 90 00:05:40.839 --> 00:05:44.199 I meant to say this in the beginning. We always 91 00:05:44.319 --> 00:05:48.480 you and I always make this statement clear to the listeners. 92 00:05:50.040 --> 00:05:55.079 The circumstances descriptions that we will cover between now and 93 00:05:55.160 --> 00:06:00.199 the end of the hour are generic. They necessary. We 94 00:06:00.279 --> 00:06:04.759 don't point at you specifically, you need to get from 95 00:06:04.879 --> 00:06:10.040 your doctor your specifics. We can indicate or point you 96 00:06:10.120 --> 00:06:15.000 in a direction, but necessarily the information that we are 97 00:06:15.040 --> 00:06:19.680 giving won't cover your issues so nobly. 98 00:06:20.399 --> 00:06:22.279 Yeah, I'm glad you point that out. More right. I mean, 99 00:06:22.319 --> 00:06:24.920 I play I play a doctor on radio and TV, 100 00:06:25.639 --> 00:06:28.399 and I am some people's doctors, but I'm not you know, 101 00:06:28.439 --> 00:06:31.160 the people on the radar, I'm not their doctor. They 102 00:06:31.240 --> 00:06:35.120 absolutely need to talk to their healthcare professionals about their 103 00:06:35.160 --> 00:06:37.240 health care issues, including diabies. 104 00:06:37.360 --> 00:06:41.120 Nor Now, if you're listening right now, you'd like to 105 00:06:41.160 --> 00:06:45.800 call in. You're waking up three four, five times a 106 00:06:45.879 --> 00:06:51.560 night to urinate. You know the different warning signs, and 107 00:06:51.600 --> 00:06:56.079 you have a question. Yes, doctor Nathan can respond to 108 00:06:56.120 --> 00:07:01.800 your question. But again what he tells you might indicate 109 00:07:02.519 --> 00:07:05.879 the church to be in, but not the pew to 110 00:07:06.000 --> 00:07:09.560 sit in the church, to use that old analogy. But 111 00:07:09.680 --> 00:07:11.439 I'll give you the phone numbers if you want to 112 00:07:11.439 --> 00:07:17.800 call in. Six one, seven, two, five, four, ten, thirty, eight, eight, nine, two, nine, 113 00:07:17.839 --> 00:07:22.839 ten thirty. He is doctor David Nathan, and he is 114 00:07:22.920 --> 00:07:29.000 well respected across the country and dealing with issues revolving 115 00:07:29.040 --> 00:07:33.839 around diabetes. And he always gets kind of sheepish when 116 00:07:33.879 --> 00:07:38.959 I say this. He made a difference in my life 117 00:07:39.240 --> 00:07:44.800 going back about twelve years, and I thank him for 118 00:07:44.879 --> 00:07:50.360 the positive things that he helped me realize and take 119 00:07:50.439 --> 00:07:56.079 care of a dozen years ago. You're very kind And 120 00:07:56.279 --> 00:07:58.879 on that note, let's take our break. You want to 121 00:07:58.920 --> 00:08:01.399 call in. I gave you the phone numbers. Time here 122 00:08:01.439 --> 00:08:05.720 on Nightside eleven sixteen sixty five degrees. 123 00:08:07.879 --> 00:08:11.079 Now back to Dan Ray live from the Window World 124 00:08:11.160 --> 00:08:14.639 Nightside Studios on WBZ News Radio. 125 00:08:14.759 --> 00:08:18.360 Dan will be back on the twelfth of August. I 126 00:08:18.399 --> 00:08:22.639 am here obviously for the rest of this evening Thursday 127 00:08:22.680 --> 00:08:27.519 evening tomorrow evening and Friday evening, but nightside goes on 128 00:08:27.600 --> 00:08:31.079 whether Dan is here or not. My guest this hour 129 00:08:31.279 --> 00:08:34.759 is doctor David Nathan, and we're talking about diabetes, and 130 00:08:34.960 --> 00:08:39.679 doctor there may be people out there that are getting 131 00:08:39.960 --> 00:08:45.480 warning signals but they're not paying attention to it. The 132 00:08:45.519 --> 00:08:51.279 deterioration of vision, frequent urination. I'll let you're the doctor, 133 00:08:51.360 --> 00:08:54.879 so I'll let you tell people things that should make 134 00:08:54.919 --> 00:09:00.240 them possibly get in touch with their physician, because as 135 00:09:00.879 --> 00:09:04.519 it could be that they have diabetes, one way to 136 00:09:04.559 --> 00:09:06.679 find out is to get a professional. 137 00:09:08.919 --> 00:09:12.679 Right. Well, you know what you described, Morgan are the 138 00:09:12.840 --> 00:09:18.159 classical symptoms of diabetes, because when your blood sugar rises, 139 00:09:18.440 --> 00:09:21.600 it goes into the urine and that pulls water along 140 00:09:21.639 --> 00:09:26.399 with it. So frequent urination is a common complaint, or 141 00:09:26.519 --> 00:09:29.480 when diabetes is out of control can be a common complaint. 142 00:09:29.840 --> 00:09:32.320 And with that people get a little bit more dehydrated, 143 00:09:32.360 --> 00:09:37.000 so they're more thirsty, they may be unusually fatigued. Vision 144 00:09:37.080 --> 00:09:39.720 can be blurry, as you point out, but it's worth 145 00:09:39.759 --> 00:09:42.399 pointing out that the majority of people actually don't have 146 00:09:42.480 --> 00:09:46.679 those symptoms. That most people can be running around or 147 00:09:46.759 --> 00:09:50.960 walking around walking slowly around with diabetes and not even 148 00:09:51.000 --> 00:09:54.480 know it, which is why we recommend strongly for people 149 00:09:54.559 --> 00:09:57.960 who are adults and certainly over the age of forty five, 150 00:09:58.360 --> 00:10:01.159 that they have annual blood tests done when they see 151 00:10:01.200 --> 00:10:04.480 their doctor, because they will pick up an elevated blood 152 00:10:04.480 --> 00:10:07.519 sugar or a test called the hemoglobin A one c 153 00:10:07.879 --> 00:10:11.519 which measures average blood sugar, and that doctor can do that, 154 00:10:11.639 --> 00:10:13.759 and you know, if it's elevated, then they will pick 155 00:10:13.840 --> 00:10:17.000 up the uibts even though you didn't have didn't have 156 00:10:17.039 --> 00:10:18.759 many symptoms or any symptoms. 157 00:10:19.120 --> 00:10:25.039 And what is a number that indicates maybe you should 158 00:10:25.039 --> 00:10:29.320 pay attention with your A one C and or blood 159 00:10:29.320 --> 00:10:30.120 pressure number. 160 00:10:31.240 --> 00:10:34.039 Right, So, the if you're going to do a blood 161 00:10:34.279 --> 00:10:38.720 sugar a blood glucose test, it's usually done fasting, and 162 00:10:38.799 --> 00:10:41.639 a fasting test that's greater than one hundred and twenty 163 00:10:41.720 --> 00:10:46.600 six is what is commonly accepted as the definition for diabetes. 164 00:10:46.919 --> 00:10:49.600 The hemoglobin A one C is a blood test, and 165 00:10:49.639 --> 00:10:53.240 these are simple blood tests. They're inexpensive. The hemoglobin A 166 00:10:53.320 --> 00:10:55.720 one c can be drawn taken at any time of 167 00:10:55.759 --> 00:10:58.759 the day, and it's being used increasingly, and if your 168 00:10:58.840 --> 00:11:02.840 value is greater than six point five percent, that is 169 00:11:02.879 --> 00:11:06.399 considered diabetic and not infrequently when people are starting to 170 00:11:06.440 --> 00:11:08.879 get older. These are done as part of the routine 171 00:11:08.919 --> 00:11:10.399 annual physical examination. 172 00:11:11.120 --> 00:11:14.200 It used to be seven instead of six point five. 173 00:11:15.200 --> 00:11:18.679 When did that, well, go ahead, No, So I think 174 00:11:18.679 --> 00:11:21.240 what you're mistaking is that greater than six point five 175 00:11:21.799 --> 00:11:26.320 is the level at which diabetes occurs. The target that 176 00:11:26.360 --> 00:11:29.679 we're aiming for with therapy is to lower it below 177 00:11:29.799 --> 00:11:33.039 seven percent in general. So again six point two over 178 00:11:33.080 --> 00:11:36.720 six point five diagnosis diabetes. But when we treat people, 179 00:11:36.759 --> 00:11:39.360 we try to get their value less than seven percent 180 00:11:39.759 --> 00:11:43.240 because that's been shown in many high quality studies to 181 00:11:43.320 --> 00:11:45.120 reduce the risks of die. You know why do we 182 00:11:45.120 --> 00:11:48.600 care about diabetes is because it's accompanied. You know, it's 183 00:11:48.639 --> 00:11:53.440 the greatest cause of vision, loss, of kidney failure, of amputations. 184 00:11:53.600 --> 00:11:55.720 It increases the risk for a heart disease. I mean, 185 00:11:55.720 --> 00:11:59.279 there are these just awful complications that occur. But we've 186 00:11:59.320 --> 00:12:02.879 shown through really very high quality studies that you can 187 00:12:02.960 --> 00:12:06.600 reduce those risks if you keep your average blood sugar 188 00:12:07.159 --> 00:12:09.879 in a certain range, and that range for most people 189 00:12:10.240 --> 00:12:14.120 is less than seven percent immagomina ONEC. At the same time, 190 00:12:14.159 --> 00:12:16.600 you want to control your blood pressure and your cholesterol 191 00:12:16.639 --> 00:12:21.559 because heart disease is the other major killer that accompanies diabetes, 192 00:12:22.039 --> 00:12:24.639 and you can improve your chances with that not only 193 00:12:24.679 --> 00:12:28.799 through blood sugar control, but through controlling your blood pressure 194 00:12:29.039 --> 00:12:30.759 and your cholesterol levels. 195 00:12:31.120 --> 00:12:39.120 Are there any new philactrimated term inventions to help people 196 00:12:39.120 --> 00:12:40.879 who are suffering from diabetes? 197 00:12:42.720 --> 00:12:47.080 Oh boy? Yeah. So with the epidemic of diabetes, which 198 00:12:47.120 --> 00:12:50.559 has increased just dramatically in the last thirty to fifty 199 00:12:50.639 --> 00:12:52.679 years and has gone up and up and up and up, 200 00:12:53.240 --> 00:12:57.639 the pharmaceutical industry and our basic scientists have developed a 201 00:12:57.679 --> 00:13:01.879 whole host of new medications and if anybody watches television 202 00:13:01.960 --> 00:13:05.000 or listens TOLA radio or reads the newspaper, they will 203 00:13:05.000 --> 00:13:06.759 see them. You know, I'm not sure that people in 204 00:13:06.799 --> 00:13:10.000 this kind in the US recognize that we are one 205 00:13:10.039 --> 00:13:13.320 of only two countries in the world where drug companies 206 00:13:13.360 --> 00:13:19.200 can advertise directly to the consumer. So, you know television, 207 00:13:20.399 --> 00:13:24.600 I think it's Brazil, all right, So so just two countries. 208 00:13:24.679 --> 00:13:28.600 Everybody everywhere else advertising of that sort. You know, the 209 00:13:28.679 --> 00:13:32.360 dancing guys who are advertising the wigov or the some 210 00:13:32.519 --> 00:13:36.720 magmatizer of those drugs, and they're on constantly, and it's 211 00:13:36.759 --> 00:13:40.480 turned into a giant, giant and even more so than 212 00:13:40.519 --> 00:13:42.840 it used to be in the past. A giant industry 213 00:13:42.879 --> 00:13:45.600 that is diabetes medications. So the new things that have 214 00:13:45.679 --> 00:13:49.279 come about are a series of new and exciting drugs. 215 00:13:49.360 --> 00:13:51.320 I mean, they really do help you. 216 00:13:51.360 --> 00:13:51.440 Now. 217 00:13:51.559 --> 00:13:55.480 Interestingly, the ones that everyone knows about that are advertised 218 00:13:55.519 --> 00:13:59.360 most widely are these called drugs called the g LP 219 00:14:00.720 --> 00:14:04.960 agonists or receptor agonists. And that's I'll give I don't 220 00:14:05.039 --> 00:14:08.080 usually I'm trying not to advertise any medications here, but 221 00:14:08.360 --> 00:14:11.559 the magletide and what go be and those drugs that 222 00:14:11.600 --> 00:14:15.799 people see advertised, or ozempic those and you. 223 00:14:15.799 --> 00:14:19.320 See them, they were five times a day, and that's 224 00:14:19.399 --> 00:14:23.080 not that's not an over exaggeration. Maybe even more than that. 225 00:14:23.919 --> 00:14:26.600 You know, I've got talked to diabetes, but I manage 226 00:14:26.600 --> 00:14:27.000 it well. 227 00:14:28.559 --> 00:14:31.919 Stocks in my head, no, no, so you can't get 228 00:14:31.919 --> 00:14:33.960 the songs out of your head. That means the advertising 229 00:14:34.039 --> 00:14:34.440 is working. 230 00:14:34.480 --> 00:14:38.120 Apparently, I take my pills from charity ins and and 231 00:14:38.200 --> 00:14:43.279 I've seen several of those commercials that all focus on 232 00:14:43.679 --> 00:14:47.320 an office dancing, a woman getting off the bus downtown 233 00:14:47.399 --> 00:14:50.159 and everybody's dancing. They grab your attention. 234 00:14:51.320 --> 00:14:53.399 No, these are these drugs are well known to cause 235 00:14:53.480 --> 00:14:57.279 dancing you're taking these drugs and you start dancing in 236 00:14:57.320 --> 00:15:00.039 the streets. That's just the way they were, right. So 237 00:15:00.279 --> 00:15:02.480 the two new classes of drugs. One of these are 238 00:15:02.559 --> 00:15:06.440 the glps, and interestingly, those drugs were invented in my 239 00:15:06.519 --> 00:15:09.960 hospital at the Mass General many many years ago, and 240 00:15:10.000 --> 00:15:14.039 the pharmaceutical industry went wild with them and developed a 241 00:15:14.080 --> 00:15:17.840 lot of interesting and good formulations. And those drugs are 242 00:15:17.840 --> 00:15:23.000 actually becoming increasingly popular because of their weight loss side effect. 243 00:15:23.399 --> 00:15:26.240 So they're being used not only to treat diabetes, but 244 00:15:26.320 --> 00:15:30.279 if people are overweight, these drugs are more effective than 245 00:15:30.360 --> 00:15:33.600 drugs we've had in the past at causing leading to 246 00:15:33.639 --> 00:15:37.279 some weight loss, and in fact, people with diabetes are 247 00:15:37.279 --> 00:15:40.480 sometimes struggling to get them because everyone who's overweight in 248 00:15:40.519 --> 00:15:43.399 the country is now ordering them and trying to use them. 249 00:15:44.080 --> 00:15:46.799 So that's one class. The other one is the jardians. 250 00:15:47.360 --> 00:15:52.399 These are called the that's called empiglephalazin, and that's a 251 00:15:52.440 --> 00:15:55.039 group of drugs that have another effect, that is, they 252 00:15:55.080 --> 00:15:58.639 work differently, but they're also effective to treat diabetes. They 253 00:15:59.360 --> 00:16:02.039 drop people's wait a little bit. And both of these 254 00:16:02.159 --> 00:16:05.080 classes or drugs also reduce the risk of heart disease. 255 00:16:06.159 --> 00:16:10.080 No no, not enormously, but enough that it's a recognized indication. 256 00:16:10.480 --> 00:16:13.639 So they're being used for several different purposes, not only 257 00:16:13.679 --> 00:16:16.879 to treat diabetes, but to reduce the risk of heart disease. 258 00:16:17.360 --> 00:16:20.519 They can help with kidney disease as well. So, as 259 00:16:20.559 --> 00:16:23.879 often happens, you know, diabetes specialists have this, they finally 260 00:16:23.879 --> 00:16:27.279 have something that you know. Unfortunately it is epidemic, but 261 00:16:27.320 --> 00:16:30.240 it's something they can pay attention to. But now the nephrologists, 262 00:16:30.240 --> 00:16:34.480 the kidney experts, the cardiologists are all using these diabetes 263 00:16:34.559 --> 00:16:38.840 drugs to help treat these other conditions. And they're quite effective. 264 00:16:38.919 --> 00:16:41.960 These are good drugs. They're important and if it wasn't 265 00:16:42.000 --> 00:16:45.279 for the endless advertising, I'd be even more enthusiastic about. 266 00:16:45.600 --> 00:16:47.240 Let me take a call before I have a break. 267 00:16:47.320 --> 00:16:50.279 I get two people on hold. First, as Paul in 268 00:16:50.360 --> 00:16:53.919 Rhode Island. Paul, thanks for calling Knight's side. You've got 269 00:16:53.919 --> 00:16:54.960 doctor David Nathan. 270 00:16:56.200 --> 00:16:59.879 Yes, hello, doctor Nathan. I was a patient of yours 271 00:17:00.159 --> 00:17:04.559 in Boston in the early nineteen eighties at Mass General, 272 00:17:04.920 --> 00:17:10.000 and I'm a Type one diabetic and now I've been 273 00:17:10.240 --> 00:17:15.240 a Type one for fifty six years. I'm doing fantastically 274 00:17:16.000 --> 00:17:22.200 my last A one C was six point four. I 275 00:17:23.920 --> 00:17:29.960 really credit you for how I'm doing so well. I 276 00:17:30.160 --> 00:17:33.599 really appreciate that the care you gave me at that time. 277 00:17:34.759 --> 00:17:41.160 And I'm I just I just want to want to 278 00:17:41.240 --> 00:17:46.680 stress the importance of keeping up with the testing and 279 00:17:49.839 --> 00:17:53.599 the diet and everything, and it really pays off in 280 00:17:53.680 --> 00:17:54.079 the end. 281 00:17:54.519 --> 00:17:58.119 Paul, you were so right, and I like you had 282 00:17:58.200 --> 00:18:03.480 doctor Nathan as my physician, and I can't thank him 283 00:18:03.559 --> 00:18:07.799 enough because here I am in my world twelve years later, 284 00:18:07.960 --> 00:18:11.440 still here, and here you are in your world fifty 285 00:18:11.559 --> 00:18:14.720 years later. So there you go. 286 00:18:15.680 --> 00:18:19.720 So Paul, thank you, Yeah, thank you for your con comments. 287 00:18:19.880 --> 00:18:23.319 I should point out which Paul and Morgan both know, 288 00:18:23.839 --> 00:18:27.000 is that type one and type two diabetes are enormously 289 00:18:27.160 --> 00:18:31.480 self care diseases. It because we eat constantly and because 290 00:18:31.480 --> 00:18:34.720 we have to pay attention to the blood sugars constantly, 291 00:18:35.160 --> 00:18:37.200 and we have to you know, for type one, of course, 292 00:18:37.240 --> 00:18:39.680 it's a question of figuring out how much insulin to 293 00:18:39.720 --> 00:18:43.680 give before any given meal using the technology that's been developed. 294 00:18:43.920 --> 00:18:45.720 But when it comes down to it, this is a 295 00:18:45.759 --> 00:18:48.279 lot of work for young people who when they first 296 00:18:48.319 --> 00:18:51.759 developed diabetes and through a lifetime and Paul. You know, 297 00:18:52.599 --> 00:18:56.160 as Paul probably knows, if we were talking forty years ago, 298 00:18:56.920 --> 00:18:59.720 no one survived with fifty years of type one diabetes. 299 00:19:00.119 --> 00:19:03.160 The majority of people with type one diabetes were had 300 00:19:03.279 --> 00:19:06.079 died by the time they were fifty years old, So 301 00:19:06.200 --> 00:19:09.359 that you know, sixty percent to die by fifty these days, 302 00:19:09.640 --> 00:19:12.759 because of the new methods they're treating diabetes, the importance 303 00:19:13.119 --> 00:19:17.799 of keeping bloodshers and tight control medications, we live normal lifespans. Yeah, 304 00:19:17.839 --> 00:19:22.440 they live normal lifespans without blindness, without kidney founder and 305 00:19:22.519 --> 00:19:25.359 so like Paul, I hope Paul's story is the story 306 00:19:25.400 --> 00:19:27.799 that hopefully we'll be talking about from now on. 307 00:19:28.000 --> 00:19:30.279 Paul, thank you for your call. 308 00:19:30.359 --> 00:19:32.720 Thank you, all right, good night to you, Paul. 309 00:19:33.200 --> 00:19:35.640 I'm about to take a quick news hit. A couple 310 00:19:35.680 --> 00:19:38.759 of commercials will be in there. Gary, you are on deck. 311 00:19:38.839 --> 00:19:40.960 Anyone else who wants to do what Paul and Gary 312 00:19:41.000 --> 00:19:44.640 have done. Six point seven two five four ten thirty 313 00:19:44.720 --> 00:19:47.440 or eight eight eight nine two nine ten thirty, We're 314 00:19:47.480 --> 00:19:53.519 talking diabetes with doctor David Nathan here on Night Side. Well, 315 00:19:53.559 --> 00:20:04.079 the time is eleven twenty nine sixty five degrees. It's 316 00:20:04.200 --> 00:20:10.240 night with Dan Boston's News Radio. In case you haven't noticed. 317 00:20:10.559 --> 00:20:14.359 Dan has been on vacation. He should be back on Monday. 318 00:20:15.200 --> 00:20:17.960 I am here now. I'm Morgan Morgan White Junior. I'll 319 00:20:17.960 --> 00:20:23.759 be here tomorrow, Thursday, and as well Friday. Don't forget 320 00:20:23.799 --> 00:20:28.200 my show on Saturday at ten and tomorrow. I mentioned 321 00:20:28.920 --> 00:20:33.839 I'm here. Alison and Grim from Little House on the 322 00:20:33.880 --> 00:20:38.279 Prairie that's celebrating their fiftieth anniversary. She will be here. 323 00:20:38.359 --> 00:20:43.759 She's supposed to be with me Monday. Unforeseen things happened, 324 00:20:44.200 --> 00:20:48.400 so she'll be joining me tomorrow as well. Former ABC 325 00:20:48.640 --> 00:20:53.559 newsman Bill Dial and then Susan Brakeman, who's written a 326 00:20:53.599 --> 00:20:57.119 number of books. She's currently working on a book about 327 00:20:57.920 --> 00:21:03.240 candy specific to Massachusetts. She wrote a book about Route 328 00:21:03.240 --> 00:21:07.839 one north shore of Route one. And my buddy, former 329 00:21:09.079 --> 00:21:14.079 lieutenant for the City of Newton Police Department, Bruce of Potheca, 330 00:21:14.240 --> 00:21:19.640 will be here. That's my scheduled show for tomorrow. Right now, 331 00:21:19.799 --> 00:21:23.480 I've got full lines. Believe it or not, all want 332 00:21:23.599 --> 00:21:28.119 to talk to my guest, doctor David Nathan about diabetes. 333 00:21:28.240 --> 00:21:34.680 So Gary wooburn your first this segment with doctor Nathan. 334 00:21:34.720 --> 00:21:38.960 Hello, Gary, Yes, her doctor bad news on my report. 335 00:21:39.440 --> 00:21:42.519 I've had diabetes since I was thirty six years old, 336 00:21:43.200 --> 00:21:46.039 type two, and I got type one in the past 337 00:21:46.680 --> 00:21:52.200 five years, five five pounds. I'm very direct the way 338 00:21:52.240 --> 00:21:56.720 I talked, as you can tell, I'm a bad boy 339 00:21:56.960 --> 00:22:02.000 when it comes to eating. I can't stop you. I 340 00:22:02.039 --> 00:22:04.880 can't even exercise, even though I have a physical job 341 00:22:04.920 --> 00:22:08.000 where I move around a lot. And also I'm going 342 00:22:08.039 --> 00:22:12.680 into long periods of sleeping where even if I didn't 343 00:22:12.680 --> 00:22:15.519 work hard the night before, so they work second and 344 00:22:15.559 --> 00:22:19.279 third chif type of job, I sleep into six to 345 00:22:19.359 --> 00:22:23.200 eight hours to ten hours instead of back in the 346 00:22:23.240 --> 00:22:27.160 younger days of four to six and I just can't 347 00:22:27.160 --> 00:22:31.759 motivate myself. I take insulin and you take it from 348 00:22:31.799 --> 00:22:32.319 their doctor. 349 00:22:34.119 --> 00:22:36.880 Well, Gary, so I mean, you are not that different 350 00:22:36.920 --> 00:22:39.680 than lots of other people around the country who are, 351 00:22:39.720 --> 00:22:42.440 you know, quite overweight, have been so for a long time, 352 00:22:42.960 --> 00:22:46.240 struggle to lose the weight. And you need to talk 353 00:22:46.279 --> 00:22:48.119 to your healthcare provider, you know. I mean, you could 354 00:22:48.160 --> 00:22:51.240 see a diabetes specialist if you're not seeing one already, 355 00:22:51.279 --> 00:22:55.079 an endocrinologist, or even through your primary care doctor. But 356 00:22:55.160 --> 00:22:59.519 there are these new medications available which are really quite remarkable. 357 00:22:59.519 --> 00:23:01.160 I mean, they you know, they're not going to get 358 00:23:01.160 --> 00:23:03.039 you down to what you weigh in high school. That's 359 00:23:03.039 --> 00:23:06.559 probably not realistic. But these medications kind of help people 360 00:23:06.599 --> 00:23:10.839 lose twenty five thirty five pounds pretty reliably. The problem 361 00:23:10.880 --> 00:23:13.240 with them is that a Number one is that they're 362 00:23:13.279 --> 00:23:17.279 quite expensive, although insurance tends to pay for most of them, 363 00:23:17.640 --> 00:23:19.759 but that you have to stay on these medicines probably 364 00:23:19.839 --> 00:23:23.880 you know, forever, because once you stop taking them them, 365 00:23:23.920 --> 00:23:27.039 the weight comes back. There are other options, which I'm 366 00:23:27.039 --> 00:23:29.799 sure I suspect that your doctors may have mentioned to you, 367 00:23:30.119 --> 00:23:33.119 and that there are surgical approaches to people who are 368 00:23:33.240 --> 00:23:36.200 very big and who have struggled to lose weight. And 369 00:23:36.240 --> 00:23:39.880 these are what are called gastric restriction or gastric bypass 370 00:23:40.319 --> 00:23:44.359 procedures can really help people lose weight forever, but it 371 00:23:44.400 --> 00:23:48.319 does require you know, it's a modest surgical procedure generally 372 00:23:48.440 --> 00:23:50.640 very very safe, but you need to talk to your 373 00:23:50.640 --> 00:23:54.640 physicians about that. I think your healthcare providers, because you know, 374 00:23:54.799 --> 00:23:56.160 depending on what age you are, I mean, if you're 375 00:23:56.160 --> 00:23:59.119 one hundred and two years old, then probably doesn't matter, okay, 376 00:23:59.160 --> 00:24:01.240 because you know no one will forever. But on the 377 00:24:01.279 --> 00:24:03.480 other hand, if you're a middle aged or even you know, 378 00:24:03.920 --> 00:24:06.440 not very old, with a lot of years in front 379 00:24:06.480 --> 00:24:09.279 of you. It's much easier to control the diabetes if 380 00:24:09.319 --> 00:24:12.319 you've been able to lose weight effectively, and there are 381 00:24:12.359 --> 00:24:13.440 different ways of doing that. 382 00:24:14.519 --> 00:24:15.599 Gary, does that help you? 383 00:24:16.480 --> 00:24:18.599 Oh? Very myself? Thanks doctor all right. 384 00:24:18.599 --> 00:24:21.000 Garry, thank you for your phone call. Good night to you, 385 00:24:21.519 --> 00:24:24.119 and now let's go to Wall Fame and speak to Joan. 386 00:24:25.039 --> 00:24:28.240 You're next, are on nightside, Joan, You've got doctor David Nathan. 387 00:24:29.160 --> 00:24:34.680 I'm alganon doctor Nathan. I read a study that the 388 00:24:35.559 --> 00:24:41.799 drugs like ozembic are linked to I strokes. Do you 389 00:24:41.839 --> 00:24:42.720 know anything about that? 390 00:24:43.960 --> 00:24:46.200 There has been one recent report, So let me just 391 00:24:46.240 --> 00:24:50.039 say firstly that these drugs, this class of drugs has 392 00:24:50.079 --> 00:24:54.880 been studied in tens of thousands of people, and that 393 00:24:54.960 --> 00:24:58.279 particular that particular complication that was just I saw the 394 00:24:58.319 --> 00:25:01.799 same news report that you did. That same study was 395 00:25:01.839 --> 00:25:05.400 a single study that demonstrated an eye problem. But in fact, 396 00:25:06.319 --> 00:25:08.839 none of the other studies have picked anything up like that, 397 00:25:09.440 --> 00:25:12.200 and I must say that clinically we certainly haven't seen it. 398 00:25:12.559 --> 00:25:15.119 So again, it's something you know, new drugs, especially when 399 00:25:15.119 --> 00:25:18.160 they're going to be used by tens of thousands of people. 400 00:25:18.680 --> 00:25:22.119 You sometimes find things, whether they are directly related to 401 00:25:22.160 --> 00:25:24.960