March 11, 2026

I Just Got Diagnosed With Type 2 Diabetes, Now What? - 89

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Season 1Labs & Health

If you just got a diabetes diagnosis and walked out of that doctor's office with a pamphlet and a prescription and no real answers, this episode was made for you.


Brian Parana has spent 23 years coaching driven men through the kind of health wake-up call that most people get and do nothing about. This episode is for the man in his 40s or 50s who is running a business, managing a team, raising a family, and suddenly staring at an A1C of 8.3 with zero idea what to do next.


Brian opens up about both of his grandmothers living with type 2 diabetes, including watching his mom's mom lose both legs and spend the last decade of her life in assisted living after going from the matriarch of the family to someone the world largely moved past. That story is the reason he takes men's metabolic health as seriously as he does.


This is not a generic overview of diabetes. It is a full walkthrough of what the diagnosis actually means, what the first 30 days look like on medication and blood sugar monitoring, and how to deal with the insurance and pharmacy friction nobody warns you about.


More than that, it is a practical roadmap. Brian breaks down the nutrition strategy, the movement plan, and a month-by-month process for bringing your A1C from a diabetic range back below 5.5 using habits that work inside a real, busy life. He backs it up with clinical research from major diabetes remission trials so you know this is not wishful thinking.


The episode also covers what happens to your energy, your focus, your productivity, and your family when blood sugar goes unmanaged for years, and why men who are serious about performance in business and in life can't afford to treat a diabetes diagnosis as something to deal with later.


***


**What this episode covers:**


- The early warning signs most men dismiss for years before a diagnosis

- What an A1C of 8.3 actually means and what the path back to below 5.5 looks like

- How Metformin works, what the real side effects are, and how to navigate the pharmacy and insurance process

- Blood sugar monitoring, CGM basics, and how to read your numbers without obsessing over them

- The impact a diagnosis has on your family, your work, and the people around you

- What the clinical research actually shows about diabetes remission through lifestyle change

- A simple plate structure and three food swaps that lower blood sugar starting this week

- Post-meal walking and a basic strength routine that improve insulin sensitivity without a gym overhaul

- A month-by-month step-by-step plan from diagnosis to remission

- The long-term consequences of unmanaged diabetes that most men don't fully understand until it is too late


***


**Free resource mentioned in this episode:**



Grab the Improve Your Blood Panels Scorecard and the 3-Day Metabolic Reset Protocol at brianparana.com.



Built for men whose labs are trending the wrong direction and who want a structured starting point, not another generic health tip.


Also book a private lab review to go over your personal labs and walk away with a clear gameplay you can apply in your life.


https://brianparana.short.gy/privatelab







Sources


Research Referenced In This Episode


DiRECT Trial (2018, 2024): Primary care-led weight management produced diabetes remission in 46% of participants at 12 months. At 5 years, those who maintained meaningful weight loss continued to show significantly better blood sugar outcomes than the control group.


Full study at pubmed.ncbi.nlm.nih.gov/29221645 and pubmed.ncbi.nlm.nih.gov/38423026



DIADEM-1 Trial (2020): An intensive lifestyle intervention reversed type 2 diabetes in 61% of participants within 12 months versus 12% in the standard care group.


Full study at pubmed.ncbi.nlm.nih.gov/32445735


Research at pmc.ncbi.nlm.nih.gov/articles/PMC8912639


This episode contains health education and coaching information, not medical advice. Work directly with your physician on all treatment and medication decisions.



Want help applying this to your own health, weight, energy, or lab numbers?

Coach Brian Parana offers Health Hot Seat coaching segments for men who want a clear next step with nutrition, fitness, weight loss, blood pressure, cholesterol, A1C, or daily consistency.

Learn more about The Call To Rise, a 100-day coaching program for driven men over 40 who want to lose weight, improve their health, and rebuild confidence:

www.thecalltorise.com

To connect with Coach Brian:
brian@brianparana.com

Disclaimer: This podcast is for education and coaching support only. It is not medical advice. Always work with your physician before changing medication, treatment, or medical care.

  • I just got diagnosed with type 2 diabetes. Now what? If that's you, a diabetes diagnosis, you just walked out of the doctor's office with a pamphlet and a prescription and no real answers. This episode I purposely made for you. I'm Coach Brian Pran. I've spent 23 years coaching men, women, young, old, healthy, sick, chronically ill, people who know a lot about this and don't.
  • I've had type one, type two diabetics, pre-diabetics, insulin resistance. You name it, I have seen it and dealt with it. This is the kind of wakeup call that you do not want. Be proactive, not reactive. Just blankly going to throw that out there. But if you end up getting in this situation, then this is the next best situation for you to do is to manage your A1C and start improving.
  • I'm going to go through this conversation with a about a client. He had a A1C of 8.3. 5.5 is when we start getting into that pre-diabetic range. And soon as you're into six, then you become diabetic. And your doctor will call you out on that. and want to put meds. At an 8.3, you definitely will end up being put on meds.
  • Now, this is episode 89 of Driven for Health podcast. Want to throw that out there so you can listen into a lot of other episodes that I have that educate you around nutrition, around fitness, around lifestyle. And why am I even talking about this in the first place? Well, both of my grandmothers had type 2 diabetes. My dad's mom controlled it a lot better than my mom's mom.
  • Actually, it was a late diagnosis for her. Now, my dad's mom, she would, Ellen was her name, she would just eat whatever and balance it out with the appropriate amount of insulin. She would test her blood sugar levels and give herself the adequate amount of insulin to manage that. And then it would that's how she managed. She'd have glucose tablets.
  • she didn't really necessarily eat healthy in a sense to be able to manage it without insulin and manage and and improving it. And unfortunately, that's just not where she was at. Now, my other grandma, Pat, she got type 2 diabetes and it was late diagnosed. It robbed her of 10 years of her life in a very bad way.
  • double leg amputation and lost a lot of sight, taste, smell, and functionality. She ended up living in assisted living homes for 10 years. And she went from the matriarch of our family. We always went over to her house and saw her every weekend. It felt like spent the night and all that. I have very, very fond memories of my grandma Pat.
  • But the last 10 years was just incredibly tough to see her do it. So, diabetes has been in my life and that's why I'm bringing it to you. We don't want to think of this as a generic overview of diabetes. I'm going to do a full walk through of what diagnosis actually means, what the first 30 days look like on medication and blood sugar monitoring, how to deal with insurance and pharmacy challenges that nobody warns you about.
  • Of course, I always have to throw this out. Consult your medical provider. This I this is not medical advice. This is just to help you understand where you're at and start giving some actionable, tangible things. So, you always have to consult your doctor. I'm going to throw that out there.
  • Might have to bring it up at the end, too. The road map that lies ahead is going to break down some nutritional strategies, a movement plan, a month-by-month process to help you bring your A1C and from a diabetic range below 5.5 using real life strategies, habits that work in busy life, with family, with kids, with work.
  • and I've used on my clients time and again. Unfortunately, I wouldn't have had an impact on my grandparents because I didn't know any of this stuff then. I was in high school and not 24 25 going into heavy amounts of nutrition in my field. This also is going to cover what happens to your energy, your focus, productivity, your family life, and and the people around you when your blood sugar goes unmanaged for years.
  • And why men who are serious about performance in the business and in life can't afford to even get diabetes as a diagnosis in the first place. So, we're going to go over early warning stages and signs of what's happens before a diagnosis, what an A1C of 8.3 actually means, and the path to get down to 5.5, what metformin, how it works, what the real side effects are that nobody really talks about, how to navigate the pharmacy, blood sugar monitoring, continued glucose monitoring type units that you put on your body and
  • can measure with an app on your phone, how to read them, what the numbers mean, the impact of the diagnosis it has on your family, the clinical research that actually shows that diabetes can be put into remission and you can reverse it and get back to normal healthy A1C levels, simple structure around how to have nutrition built up, uh, postmeal strategies, basic strength training and all this.
  • And I have an improve your blood panels score card that you can find in the show notes. It helps you easily identify what is inside your blood panels, what the numbers actually mean. You can just literally see it and read it really quickly and understand. Then also a 3-day meal plan specifically designed to help reverse this and help you lose some weight and get your blood panels back in order and stabilize your blood sugar levels through proper nutrition.
  • Lastly, if you are interested, I do have a private lab review, a phone call, 15, 20 minutes or so. You can give me your labs. I can review them with you and give you an actual game plan. I have done this hundreds and hundreds of times over the years with people to help them understand that. And you can see in some of my online websites and things I've helped people reverse type 2 diabetes.
  • There'll be a number of sources that you'll find in the actual episode as well. So, here we go. You're sitting at the doctor's office. And maybe you felt off for months and more tired than you can explain. Thirstier than what makes sense. You wake up two, maybe three times a night to go to the bathroom for no good reason.
  • And maybe this time at the doctor's office was supposed to be a regular checkup in and out. And then the doctor walks in, sits down on the crinkly paper next to you on the the table that they have you sit in. They sit down, they look at your chart. Your A1C came back to 8.3. You have type 2 diabetes. Everything after that goes underwater.
  • The fluorescent lights feel too bright. Someone's phone is ringing down the hall. The exam table paper crinkles when you shift, but it's just in the periphery. Your mind is already reeling on what does this mean to me and my life. Diabetes is the thing that took my grandma's legs, literally double amputation from the knee down.
  • And maybe you might have some experience with someone in your life that has diabetes and the impact that it has on their life, but also on someone else's in your circle. And what do you tell your wife? What do you tell your kids? How did I let this happen? These are questions that are spinning in your head. If that's what it means to you, I need you to hear something.
  • You can fix this, okay? You can absolutely fix this and find the appropriate approach for your life. You can work hard and focus. You can learn what you need to to do something about it. Now, as we get into some of the science, we'll get into some of the other spaces that we need to help you take control. how you got here in the first place, the years before the diagnosis.
  • Let's talk about Mike. He's not one person. He's every guy I've worked with who has gotten an A1C above that diabetes range of six plus. We're going to say 5 point actually like 5.5 is when you start to do there. And 5.5 to 6.4 is that pre-diabetic range. So, we're going to say his A1C was 8.3.
  • Now, for years, Mike was living with pre-diabetes, but he didn't know. His body was struggling with managing blood sugar levels properly. He just didn't know that or understand what the fatigue was, understand the urination, the thirst, things like that were some of the causes, the issues that he was dealing with. Now, it wasn't a big deal.
  • The doctor when he went in just on previous check-ins didn't think much of it. And even in being at the doctors with pre-diabetics, they might tell you that you need to do something about it, but they also uh might just try and put you on medicine as well. And we we know that sure medicine like metformin can help, but we need a big lifestyle change.
  • You when Mike was pre-diabetic, he didn't take it too serious. He just cut back from eating cookies most nights to a couple times a week and maybe dropped one beer in the week and ate out. He didn't really change his eating out habits. And this is how pre-diabetes is generally treated. It's more of like a yellow light. We'll keep a look on it.
  • We'll make sure that you it doesn't go up and we do need to get it down. You need to lose some weight. Things like that. some of the symptoms and issues that Mike was feeling that he was tired, his body weight was 20 some pounds overweight, he's in his mid-4s or 50s, and a stressful job, multiple kids, sleep schedule's not that great.
  • There's a hundred explanations on why you feel the way you do and you could blame any of those. But you just keep pushing through and just think, "Oh, this is just what life looks like, what life feels like." As we move from 5.8 to 6.1, 6.4, then at 8.3, it's an alarming conversation that has to be addressed.
  • And the progression doesn't happen just overnight. It t it can take years to do this. Years of high sugary foods and beverages of late night eating a lot of carbs and calories for the day being in a form of calorie toxicity. What I mean by that is you overeing for a long time and gaining weight.
  • You're having too many calories for your body and too much of anything can be a bad thing for humans. We need to make sure that is established and well put. So it can take a bit of time to reverse it as well. And that is something that we have to pay attention to and focus is the portions, the types of drive-through lunches, the zero exercise, the lack of quality of sleep, what your body was screaming at you for.
  • Now Mike was constantly thirsty. He'd finish a bottle of water and his mouth feel like sandpaper 20 minutes later. He'd always blame it on the Hback system at work. And in February, just like it just the environment, constant trips to the bathroom at of all sorts of different times of the day, even cutting back on fluids before bed didn't help.
  • And he always felt hungry. He'd eat a full lunch, just feel empty an hour later. And despite eating calories and especially at lunchtime, he'd still be tired. Not just kind of tired, but bone tired. Just exhausted like he needed to go to bed for the day. Didn't matter what time it was in his day. things that do happen in this time.
  • We can start to get blurry vision and he couldn't figure out if he needed reading glasses or also cuts on your body take longer to heal. A simple cut could take two, three weeks to heal instead of under a week. [snorts] There's skin infections. There are athletes foot dockage. These are symptoms that you can feel and experience and just not connect the dots.
  • That's why I'm sharing these things with you. They all look like separate problems. Oh, I was at the gym the one time and I was walking around on bare feet and now my feet are itchy because I have athletes foot from the gym. Right? That could be an excuse. Now, type two diabetes is your body losing the ability to use insulin efficiently and effectively.
  • Insulin is what lets your cell pull sugar out of your blood. All right? So, insulin storage, your blood sugar, you eat food, blood sugar goes up, and then the body will release insulin to grab onto it and pull it back in. And when that system breaks down, blood sugar builds up, your kidneys try to flush the excess out in urine.
  • That's the constant bathroom trips and the fluid loss makes you thirsty. Your cells still can't get the fuel they need. So that the brain keeps triggering hunger. Your brain is powered by glucose, by carbs, by that type of substance. So then you want more sugar. sugar cravings come and it it's just this roller coaster.
  • Now, high blood sugar levels damage small blood vessels and nerves over time. That's why cuts won't heal and that's why infections can last longer than they should. That's why your vision blurs all those little blood vessels in your eyeballs. The will change your capacity or your eyeballs to function properly or change the fluid in the lens of your eyes.
  • You might also notice tingling, numbness in hands and feet, dark velvety patches on their skin or their neck, under their arms. It's called uh those are things that we want to make sure that we are paying attention to when weird random spots show up. It's a sign of insulin resistance that your body has been trying to tell you for a long time.
  • The moment in the office, let's break that down. When you go and the doctor tells you, pulls up the chart, your A1C is an 8.3, your fasting blood sugars come back at 92. That means that normal is around as low as say 80 or 90 to 100. At 110, 120, we're going to have challenges and your doctor is going to call you out at 120.
  • So 192 without eating is pretty darn high. Those numbers definitely put you in that type 2 diabetic range. When you're buy when you get that actual notice of your A1C's are high, you might start thinking about the actual real consequences. When I talk to someone that is experiencing type 2 diabetes or high blood sugar levels, I always ask them because it's important to make sure that people know and understand what they're dealing with.
  • And I ask them, do you understand what the consequences are if this goes unchecked and unckempt? and not fixed. But you could go blind, you could lose a foot, there's dialysis, there's insulin shots every day. What about your life insurance premiums? And what do you tell people? Meanwhile, the doctor is talking about metformin and checking your blood sugar level at home and cutting carbs, getting some exercise, and coming back in three months.
  • You're just nodding along and you're hearing words, but you don't actually know what all that means. You get handed a pamphlet, some stock photos are on it, people smiling, they're jogging out and and there's a prescription script for you to go to the pharmacy to get that foreman and a follow card to book your next appointment and with you finish up with any questions.
  • You just don't even know what to say. Now, in episode 49, I laid out 13 different questions that you should be asking your doctor when you have actual health issues. So, I would reference that specifically, that episode, to be more informed when you go to the doctor so that you don't just walk out with a pamphlet and a prescription feeling like you are doomed and there's no way out.
  • when you have very few minutes time. Usually it's only seven to 15 minutes. Unfortunately, because of our health care system, the way it's set up and the information that they give you before they move on to the to the next room or patient isn't that descriptive and ultimately not that helpful. 8.3 is actually pretty serious.
  • I've had people I've talked to as high as 15 and that is mindblowing. I've had as high as 400ish on fasting blood sugar levels. That is a that is crazy high. And when we have these type of issues, you do get chronic damage from the high blood sugar levels in your blood vessels, nerve endings. It can damage organs and you become a lot more insulin resistant.
  • So your body produces more insulin to deal with the same amount of actual insulin that your body needs to bring down the the blood sugar levels. Say you say it took 10 units of insulin for your body to release to get rid of x amount of blood sugar levels. Now it takes 12 or maybe it takes 15 units to lower down the same amount and that becomes really big.
  • Now bigger issues is in your feet with the with the challenges that you get and if you have foot issues then we definitely know that you are starting to get in really big issues bad shape. Now, this is the starting line, not where you're going to keep it and not certainly not go up. Please, for the love, what happens on the drive home with your family and your people and how you start to have a conversation about what is going on in your life.
  • Well, you're sitting in the parking lot, hands in the wheel, the pamphlet in the passenger seat, and you're not going anywhere yet. You call your wife or you don't. you're not sure what to tell her. She may have been on you, your partner, your spouse may have been on you to take better care of yourself, go to the doctor, lose some weight, eat healthier, things like that because they see your day-to-day habits every single day.
  • It's just part of the process of living close with people. Now, is she going to be okay with this? She going to be upset. is this going to be uh we'll figure this out and hopefully you end up on the supportive side of this and how you can manage it. Your kids are going to wonder if you're okay. What does this mean? Your co-workers are going to notice that you're in your head and you're thinking and you're not actually yourself.
  • And then these things are going to impact your day-to-day life. Especially how many times you want to poke yourself in your fingers every single day or carry around a little disc that you put on the back of your tricep and carry around to check your phone app and monitor your blood sugar levels because yes, that has to happen.
  • When I'm working with type two diabetics, I want to know morning blood sugar levels. I want to know when there are spikes and how long it takes to get back down. I want to know how much insulin units are being used to remedy the spike in and of itself because we want to get it controlled with food, which is a big big thing. So, the first 30 days, here's what the first month actually looks like, not the pamphlet version.
  • You get Metformin from your prescription. And the first line medication for type two diabetes is Metformin. It's been this for decades. It works by reducing how much sugar your liver dumps into your blood between meals and by making your cells more sensitive to insulin and it's inexpensive. Okay.
  • A generic metformin can run less than $10 for 90day supply at mostarmacies. and ask about that specifically if cost is a concern. Now, certainly it's 10 bucks isn't a lot, but it just adds up. It's just something else. Go back, rewind a little bit before continuous blood glucose monitoring units. Then you had to poke yourself and you had to test yourself.
  • You had to get lancids. You had to get things to prick your fingers, strips to test your blood. All that stuff adds up. Now, when you have metformin, some of the side effects you don't quite know. There's nausea, you get the runs, stomach cramps. Usually, it settles in about two to three weeks, especially if you take it with food, but it could be rough one month to the next.
  • And you may need to change to an extended release version. So you take some of it and it slowly dissolves in your gut to then be able to make it easier on your stomach itself and then also just the absorption in your body. You're also setting phone alarms so you don't forget. You have a weekly pill organizer that you just now you're 80 or something walking around with MTWtfs from Monday through Sunday pill organizer.
  • That's just not what you want. The first time that you go to pick up your prescription, insurance might kick back. You're not sure. The cost might be higher than you expected or the text says they need to call your doctor and come back tomorrow. Ultimately ends up being a very big inconvenience to say the least. You have to advocate for yourself.
  • Get the direct number to your doctor's billing nursing line. Patient assistance programs exist for more expensive medications if you need. Ask your pharmacist by name. Is there a manufacturer assistance program for this? That could help. We have to be conscious of embarrassment as well. Again, when you get diagnosed with this, guilt, shame, and blame can be placed on yourself.
  • And we have to be conscious not to to to go there. We just have to deal with the situation and correct it in a way that's going to maintain long-term success. We got blood sugar monitoring and the continuous glucose monitor and you have to measure it all the time. You have to be aware and the thing will beep at you if you go too high or too low.
  • We didn't even talk about being too low and the night sweats and the wondering if you're going to wake up alive. literally had someone I saw just in the last year 36 blood sugar levels. This is not good. This means that it's this is on on your way out if if blood sugar goes to zero. All right. Now, you get your blood meter.
  • Now, the first time that you go using a lancing device to to prick your fingers because it's going to hurt. You're poking yourself with a sharp metal needle, basically a razor that's gonna cut and then you have to squeeze your finger and you have to do make sure you get enough blood on the actual unit itself for the unit to test it or you just have to have that continuous blood glucose monitor.
  • All of it is a pain in the butt. You don't even know what the number means. And this is a big challenge as well. you're you're eating the same type of meals that you were back before. You're getting different readings and that is normal. The blood sugar responds to what you ate, but also how you slept, your sugar, your stress management, how you if you're fighting a cold, how much water and hydration you have.
  • We have to watch these numbers over trends over time. And that's just for the actual glucose meter itself. But if you get the continuous glucose monitor, it's a small usually you'll see it on people. They have small dots and then they have bigger units. Bigger units are usually for type 1 diabetics. They do not produce insulin.
  • That's a completely different story. All right? And and that's something that you have to monitor your blood sugar levels and insulin units constantly. I've worked with type 1 diabetics and that is truly the case. Now, also I've worked with type 1 diabetics and the last one I worked with, he was able to drop nine units a day of insulin by eating healthier, better balanced, more well-rounded meals and better portions because we could control it with food a lot better than he was doing before he met me.
  • And that's the power of proper nutrition. So these sensors are worn in the back of your arm and they read your blood sugar levels every so often throughout the day. Sends your data to your phone. Now this is the easiest more ideal way to go about it, but insurance may or may not cover it and the doctors might have to resubmit for insurance or documentation and that can be a pain in the butt.
  • The continuous glucose monitor does help, but the technology makes it easier to understand, but then we can also start seeing the real-time data of your food behaviors. You can eat something and see your blood glucose levels go up to 230 after a bowl of pasta. And now you understand what's happening inside your body with actual real data.
  • And this is really important. I've even seen endurance athletes use these things to help monitor their blood sugar levels so that they can maintain a consistent level of energy throughout their performance, which is pretty wild. Now, we're not using it for that way. So, that is something that's really important to know and understand.
  • Now, we have insurance is going to be a big thing. Back in the day, you'd have to fax things. Now we can actually just do it through email. Now do medications h get prescribed or denied? Do how many times you have to go to the doctor? The back and forth with the pharmacy to to handle this type of diabetes medications will help you be successful.
  • So these are our biggest challenges. Now, here's a little story, too. Say Mike at the first birthday celebration at work. Cake in the breakroom. Everyone's grabbing a piece and now you're trying to calculate can I have it if I eat it? How much metformin do I need or insulin units? Uh, do I skip it? You know, where do I stand on having this? And my my one grandma would just eat it and then over she just manage it with the insulin which I don't think looking back is the best way to go about it. Uh or you go to family dinner and
  • your mom made lasagna and she says you can have some just a little won't hurt you. She means well but she also doesn't understand the impact of what the blood sugar level is even if you shared it with her or not. So that is the a certain challenge there. Now these are real life situations that come up all the time and you didn't want to have to think about food but now you have to think about it all the time and it's impact on your body on your your your blood sugar levels your digestion all these things are real life impactful
  • here and it's something that you have to think about day in and day out and and certainly we don't want to go to the Reddit forums or the the Facebook groups or uh all those type of things because that can be you go down a rabbit hole in those type of groups. People giving their opinions on things, not necessarily fact.
  • All right, here's what the science actually says and where I want to stop and give you something to really focus on and and grasp. The research on lifestyle change and type two diabetes remission is is real. And these are randomized controlled trials published in major journals. The direct trial published in the Lancet took two people and also real quick these will be in the show notes.
  • They took two people they took people with type 2 diabetes and put them through structured weight loss and lifestyle programs. At 12 months, 46% of the participants were in diabetes remission, meaning blood sugar levels in a non diabetic range with no medication. At 2 years, 36% were still in remission. So 46% down to 36.
  • So 10 people 10% people went back up. And the number of people who maintained their 20 pounds or more of weight loss over 2year mark was 81 were still in remission 81% were still in remission at 5 years. Okay. So if you can maintain a lower body weight, a normal body weight and have some nutrition around proper protein fibrous carbs that I call vegetables and fruits and starchy carbs, then you can have a lot more impact there.
  • There's another trial called Dadm published in Lancet diabetes and endocrinology found that 61% of participants were no longer diabetic after 12 months of lifestyle intervention. The average weight loss was about 26 pounds. Well, my call to rise program, my goal is get you to lose a 20 pounds and or more in 100 days.
  • And magic happens as the weight goes down. It's real. It really is. Seen that A1C drop right back down into normal range. Blood sugar levels are consulting controlled and consistent in it. And it it does we do real work with proper nutrition and lifestyle interventions. And for walking specifically, a structured walking program with nutritional counseling showed a statistically significant reduction in A1C at 3 months, 6 months, and 12 months. A1C dropped by nearly 0.
  • 5 points in 90 days just from increased walking and basic basic nutrition guidance like stop putting so much sugar in your mouth, drink more water, eat more vegetables. Okay, this is about consistency. Now, you heard it about 0.5 points for your A1C to go down. So if you're at 813, you've got a little bit of time that you have to really be super focused on dietary changes to be able to change that.
  • Now, you can lose it a little bit faster, but that we need to do it in a a sustainable approach. The men in these trials were not athletes, okay? They weren't dieticians. They were regular people that needed to find some structure, routine, and needed to stick to it and not be challenged with uh all the the life things that come. Now, here's what happens when you don't.
  • Okay, just I have to reiterate that this is serious. If blood sugar levels stay high for years, the damage is slow, but it compounds over time to peripheral neuropathy, meaning the tingling and numbness in your feet, the lack of blood flow. There's progressive pain, loss of sensation in your digits, your fingers.
  • Nothing will heal, gang green, potential things turning black, amputations. I'm not trying to scare you. This is just real life. Just Google what happens with uncontrolled diabetes and you'll see some pretty raw images on the internet. Kidney disease can start to develop in the background and that's something that is a whole other issue.
  • I've worked with people on dialysis and stage two three chronic kidney disease because their kidneys just don't filter properly like they did. It's bad. A dialysis can cost three to four hours, a couple times a week at the dialysis center to get your kidneys and blood your your blood filtered by an outside machine and it'll pump it back into you.
  • Is that how you want to spend Monday, Wednesday, Friday every week? You literally can't go anywhere. vision loss from diabetic retino uh retina retinopathy. There we go. Diabetic retinopathy is one of the leading causes of blindness, especially as we get older into our 50s or even 60s.
  • Heart disease risk doubles with type 2 diabetics. ED, erectile dysfunction is common and way under reported because who wants to admit to that? And again, it goes back to the ability for blood flow to happen and causes in restriction around your your blood vessels being able to do. These are real things. So, let's start with some of the nutrition changes.
  • Walking is going to be a really basic one. Drinking 100 ounces of water is a really basic one to help with your overall body functioning, but nutrition is going to be the biggest way for you to be able to get your A1C back down. So, eating better in quotations, what does that actually mean? We need some simple structure around how to build a plate, around what type of foods to pick to put on it.
  • The plate method is very simple. We have half the plate with non-starchy vegetables. I call them fibrous carbs. These are about 50 calories or less per cup. Think of things like broccoli, peppers, cauliflower, cucumbers, tomatoes, spinach, arugula, things that go on salads. That's what we're thinking about here. All right. We can cook them.
  • We can season them. We can make them fun and make sure that you actually can eat them. That's important. We need a palm size or I think of tennis balls. So tennis balls for visual sense. We want three to four tennis balls worth of the non starchy the fibrous carbs. We want about one to one and a half tennis balls for a protein source.
  • A lean protein source. Think of chicken, fish, turkey, eggs, egg whites, Greek yogurt. protein with the fiber coming from the fibrous carbs. This non starchy vegetables I just listed, those are going to blunt blood sugar levels, protein and fiber in that power combo do just that. It's just it's basic metabolic physiology and digestion with your body.
  • Now, we could look at the starch. you if you are a diabetic, you do not need to eliminate carbs. You can eat it. This thing about going keto or whatever just that's not accurate. Usually somewhere between 30 and 50 grams of carbohydrates is a reasonable amount of carbs to have, but if you're paying attention, it's that's not a lot.
  • A cup of rice has 40, and then you're basically done for a larger meal, and that could be problematic for you. And we're thinking about the portions. Go back to the tennis ball or a cup. We're looking for one tennis ball or one cup of a starchy carb. Rice, potatoes, beans, quinoa, right? People ask about the glycemic index.
  • We're not eating starchy carbs in isolation. We're literally just eating them one at a time uh in that combination of protein and fibrous carbs. three foods, four, maybe five on the actual plate in in your meals is going to make it simple and easy to actually implement. I take my guys through the what food should I eat PDF.
  • If you're interested, I can send it over to you. You just have to send me an email brianbrian.com and I can forward that PDF over to you. And it gives the structure that I have that I have built for 20 years. I've been using this thing to help people lose weight and better their health. There are three food swaps that you need to do to move the needle to in the right direction.
  • Meaning not needle not like the the shot, but the needle of like I want to get my blood sugar levels down. I want to get my A1C down. Number one, the easiest observation one is to get liquid sugar and calories out of your drinks, soda, pop, cola, however you want to say it, you know, need to go to the zero calorie kind.
  • What about the artificial sweeteners? Well, calories equated is the biggest thing first. And there are science studies that show that having artificial sweeteners with in comparison to sugar sweetened beverages helps people lose weight because we're cutting out the calories which is the most important thing that we need to manage from there.
  • Juice, you should not be drinking juice. Eat the fruit. Don't drink it. Eating it gives you fiber and a controlled amount. Whereas drinking it can I mean I can down this whole thing and there could be 200 calories in my little mug here if I had it with orange juice. Now it tastes so good. There's a reason. So we don't want to do that.
  • Now swap it out for sparkled sparkling water which is actually what's in the cup. There's unsweetened coffee and tea. We could do coffee with some creamer, a little bit of milk. uh some artificial sweetened Splendo or something like that could or monk fruit could be a way to sweeten it.
  • Blood sugar responds quickly in a good way. It means it doesn't spike on you after swapping out the sugar for unsweetened opportunity. Other trades are the mindless evening eating. Holy moly. Chips, crackers, candy, all these things are just carbohydrates that are going to spike your blood sugar levels. And one, you have to make sure you have enough calories available for that evening snack.
  • Two, we want to make sure that we again focus on protein and vegetables or at the very least nuts, maybe some cheese. I'd prefer Kai cheese or Greek yogurt with some some blueberries. That would be actually good because the blueberries, it's a high fiber. Put a little bit of chia seed or flax seed in there and some protein from the I like two good Greek yogurt because it's low carb. Bam. That works.
  • Another simple easy mind thing is eat protein first. I bang my drum on that one all the time. When we have protein in a six to seven ounce amount or 40 or 50 gram serving size in a meal, this is going to be the easiest way to manage your blood sugar levels and your overall calories. And if we focus on that protein first idea, then we're not putting too much carbs on the plate either.
  • What to know about carbs in and of itself? You do not need to go zero carbs. Please, you don't have to. We have to be smarter about it. We have to build a better relationship with carbs. Understand carbs like beans and lentils have protein and fiber built in. So, they raise the blood sugar levels a lot slower and help build a more comprehensive balanced meal than say white bread.
  • Potatoes when eaten with protein and [snorts] also vegetables will not spike your blood sugar levels whereas eating a McDonald's French fry will rise your blood sugars up. Context matters. What we do with uh lastly in as far as calorie goes with that. We're generally if you're overweight you need to be under 2,000 calories for sure.
  • probably under 1,800 maybe in 1,600 in that range 16-800 calories. And that divide by 3 to four meals in a day and you're looking about 400 to 500 calories on average for three or four meals depending on where you're at. Maybe 5 to 600 if you're on say three meals would be a better amount to do.
  • And when you do that consistently for weeks, you lose weight, your blood sugar levels are happier, and things work better for you. Next up is the movement plan. Simple walking after you eat or doing some form of squats or glute exercise type exercise will definitely help to blunt blood sugar levels response. And this is a high leverage ability to do after you eat enough food.
  • Not too much food, but enough. Get out and walk after you eat. plan into your your meal time routine. Uh you don't have to go to the gym. You don't have to run. 10 to 15 minutes after a meal can really help. And research consistently supports that type of situation to help you manage blood sugar levels spike and not let them spike too high.
  • And then you'll have to manage insulin as much because of it. Get to walk five days a week. I'm a big 10k a step guy. I think it just defines you as an active healthy lifestyle. Then let's get into some exercise. Ideally, two minimum, but three or four strength training sessions in a day. If you want to take a quick pause and go back to episodes 5 to 11 is the nutrition pyramid.
  • And episodes 17 to 23 is the exercise strength pyramid. These are a lot of different uh a lot of different episodes that allow for you to be able to educate yourself on what real nutrition is and how it best works for you. Now, if we add two days of basic strength training work in and we are doing squats and big muscle movements, then muscle is the easiest way to help with increasing insulin sensitivity in your tissues as well.
  • The more muscle means better blood sugar control all the time, day in and day out, morning, evening, night, middle of the night. This is the program. This is what works. Step by step for a reversal process. This is how we get your A1C from an 8.3 down. Month number one, we have to start to we want to consider it stabilize and understand what you're doing.
  • The job that you have in the first month is to stop making things worse and start learning what your behavior patterns are. Start understanding how you eat food. Understand the choices you make. Understand how you manage stress. These are all things that I have with my clients all the time to help them stop, think, and then take an action.
  • You do, if your doctor prescribed you medicine, you probably should take it. Again, this is not medical advice. This is something you have to seek out your physician for, and these are general guidelines that can help, but aren't specific to any one person. But if you get prescribed medicine, you probably should take it to help.
  • Metformin will balance out your blood sugar levels almost instantly, which can help you start to get a handle on it with the long-term solution of being off of it with food and movement management, lifestyle management. You're going to want to test your blood sugar levels, fasting blood sugar levels at least three times a week, but ideally every day because you need to pay attention to it and what gets focused on gets measured and monitored.
  • We need to have that structured plate most of the meals that you're eating pretty much all the time so that you are able to stay on track there. We're going to get walking after every meal, 5 to 10 minutes. That will significantly help, too. Cut out all liquid sugar or white sugars from the minute you get diagnosed. Get to bed earlier.
  • Stop staying up late. Stop purposely causing challenge with your body. Inflammation, increased cortisol. You're making it harder. Sleep deprivation alone can raise blood sugar levels. The A1C probably isn't going to move much in the first month, but if you do those things, it will respond. Your blood sugar levels will definitely respond, and that's a clear indication that we're planting the seeds to be able to grow into a new you without diabetes.
  • In month two and three, we're building momentum. Research shows measurable A1C improvements begin around 90 days with consistent lifestyle changes. Walking studies show that a drop of roughly half a point in A1C in three months. Your goal is to see that trend. And yeah, it's disappointing to say, "Oh, you mean a half per point.
  • 5? If I'm at 8.3, that would be a 7 point in three months. Yes. Shouldn't have gotten overweight. Shouldn't have gotten to the point where it was that high in the first place. And it took a much longer than three months to get there. So, it's going to take longer than 3 months to get out of this situation.
  • Now, in 3 months in my program, you lose over 20 pounds and get your nutrition right. And that will significantly help you move in the right direction. And you actually know what nutrition is, which is so important. What's in the food that you're eating, the calories, the portions, the timing, the meal preparation, the planning, the eating on the go, grocery shopping.
  • These are all things that I review with clients all the time to set them up for long-term success far beyond just the call to rise 100 day program, but for the rest of your life. So, we're walking five times a week, getting 10K steps. We're doing some strength training. We are nailing the nutrition as much as possible.
  • We have alternatives to your desserts. We've got ways to manage blood sugar levels, and it should be consistent at this point. And maybe you don't have to measure every single day because it's consistently been in a normal range, which is super important. Then you get your labs rechecked. Now A1C could drop 0.5 to 1.5 from these.
  • These are things that even in direct trials the men saw a meaningful change in the A1C reduced by a full point in these these different things that we do to help you manage your blood sugar levels versus people who don't change their habits. Now, as we get to pushing for remission, we're looking for this is your lifestyle.
  • You've integrated this into your everyday, your thought process, your patterns of behavior, the way you think about food, how you manage it all the time, how you exercise, how you live everyday life. There has to be a drastic change from who you were before to who you are now. So everything that we just talked about is just getting into your daytoday life.
  • And that's so important for you to be able to have this long-term success. And at that point, if you can prove to your doctor that your blood sugar levels are stable, that you have a very clear understanding what nutrition is, how it impacts your day-to-day life, then we're actually talking about something. And this is going to allow us to then shift into the big picture of getting away from reversing diabetes.
  • Now months six to 12, the direct trial saw 46% of participants in remission at 12 months. The Dadem trial saw 61% no longer meeting the criteria for a diabetes diagnosis. These are just everyday people. So if you do the things at least 50% of the people are going to get away from type 2 diabetes as a diagnosis and an identity.
  • You don't want to be the identity. Your month 12 target is to get below 6.5 from an 8.3 which again sounds like a long road but with consistent activity then we can get trend back to below 5.5. And this is again your I your your lifestyle has changed in a year's time. You you do things drastically different than you do now.
  • Simple way to have a a weekly scorecard on this is your fasting blood sugar levels two to three mornings per week. At this point, you still have to check them, but you don't have to do it. And we just have to make sure that you get into your A1C and get that tested so you know where you are at. I covered a lot from it's my personal story with diabetes related with my grandmothers.
  • I've gone over a diagnosis of an 8.3, what that looks like, feels like, symptoms beforehand that you might need to pay attention to. what the doctor's visits the pharmacy going over episode 49 with 13 questions to ask your doctor so you go in and you're prepared. You can listen to that on driven for health episode 49.
  • We've gone over what happens in the aftermath getting the improve your blood score uh your blood panel scorecard. You want to get that and it has this three-day meal plan template that you can run with and be very successful with. links will be in the show notes. What else we cover? We went over how to get out of that type of situation and the specific things that you do.
  • They're simple, but they're not easy because life is challenging. It throws curveballs at us all the time. I hope that this conversation is a wake-up call. And if you need more help, you can certainly look at me as as a coach to help you navigate this challenging time of the call to rise.com for my men's 100 day fat loss challenge and chronic illness improvement challenge as well.
  • You can look for a private lab review and you can just email me brianbrianprana.com and I will get that. We can actually literally book a 15-minute call and go over what your blood panels are and a real actionable plan for you to get healthier. If someone in your life has diabetes or a diagnosis or you think they might, send them this episode, like it, leave a review so we can get the word out.
  • Because type 2 diabetes, I have encountered more type 2 diabetes diagnosis in the last two to four years than I had for the first 15 years of my career. I've been doing this for 23 years, and type two diabetes is on the rise. It's unfortunate, but it's the way that our life and our consumeristic culture is. It's just unfortunate.
  • So, but you can change. You do not have to eat that way. You do not have to support companies or products that move you toward diabetes and not away from it toward better health. That's it for me. Hey, Coach Brian signing off today with this episode of Driven for