Stuff You Should Know - How Diabetes Works

Episode Date: July 3, 2018

Diabetes is one of the biggest killers of people on the planet. And yet, it also seems to be tied to diet and exercise, which makes it preventable. Learn about the fascinating mechanisms that can make your body go haywire and lead to this disease.  Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

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Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Hey everyone, we're coming to Salt Lake City, Utah in Phoenix, Arizona this fall. Yeah, October 23rd, we're gonna be at Salt Lake City's Grand Theater, and then the next night, October 24th, we'll be in Phoenix,

and we added a second show to our Melbourne show, right? That's right, a second earlier show in Melbourne, so you can get all the information for all of these shows at sysklive.com. Welcome to Stuff You Should Know, from HowStuffWorks.com. Hey, and welcome to the podcast. I'm Josh Clark.

There's Charles W. Chuck Bright. There's Jerry over there, and here we are, doing maybe what's gonna be the best episode of Stuff You Should Know we've ever released. Jerry's back. Yeah, welcome back, Jerry, from Hospice, you said. She just threw her can of carbonated water down and belched. I was gonna name check it, but...

I'm glad you didn't, man. We do enough buzz marketing as it is. Seriously. We can never do enough of that. Yeah, I agree. So how are you feeling? Blood sugar okay? Yeah, I feel like this article's ticked me off, though.

It's not that Freud and Rick, who, is that who wrote this? Yeah, the only PhD at HowStuffWorks ever. It wasn't, he didn't do anything wrong. Like the logic behind the copy layout is what does it. It is almost like designed to keep from sticking in your mind, the information you're reading. It's like if a person who owned a grocery store put the milk together with the canned spinach in an aisle

and expected people to be able to find it. All right, all right, it's gotta be worse than that. The cheese puffs and the... This is a new game. The cheese puffs and the cashews. Actually, they're not in the same aisle. I can do this. Maybe by the end of the episode, I'll have it.

But the point is, there's just... How about the oatmeal with the pickled herring? Okay. It's funny that you were picking things or still in the same universe. I know, my imagination died at age 10. I just thought... I turned into a robot about that time.

I thought it was a pretty dry article though. That was like none of the character of HowStuffWorks articles. It read like a medical journal from the 1950s. A diabetes how-to article. Yeah, I was like, boy, how are we gonna make this fun? Well, that's our job. I know.

So let's get started making this fun, huh? Yeah, how about some stats? All right, you wanna do some stats? Yeah, cause these are pretty outdated. Yeah, I saw that too. It's gotten way worse since this article was read. It has, and we're talking about in the United States, but in the last 20 years, type two diabetes has tripled.

84 million Americans now have pre-diabetes and 90% don't know. Yeah. That's startling. Yeah, we'll get into pre-diabetes in a minute. And about 30 million people currently have diabetes in America. Type two or total?

I think total, at a total cost of, including lost wages, about $327 billion a year. In the United States alone. I saw worldwide something like 400 million people have diabetes. And America makes up how many of those? Oh, 30? Yeah.

Okay. Which is surprising because it didn't used to be that way. It used to be like a wealthy Western disease and all of a sudden it's starting to spread throughout the world, which is really kind of shocking and jarring. Like this is a huge increase in this disease. It's become a really big problem

for not just like healthcare networks, but the people with diabetes too. They're dying from it. Something like a million and a half deaths a year in the world. Yeah, it's the seventh leading cause of death in the United States right now. And it's, here's the thing.

It's a type two diabetes is from what we understand, utterly preventable. It looks like it is utterly preventable. From what I've seen, not one single person who has type two diabetes has to have it. Like they were genetically destined to have it. Although there is some other evidence that we'll talk about that suggests otherwise,

but I don't wanna give anything up. Yeah, but I mean, we can pretty much say now that it is, let's just go ahead and say largely caused by being out of shape and being overweight. And eating like terrible stuff all the time. Yeah. I love this article, Chuck, because it's one of those ones where it's like,

oh, all of this makes total sense. Like I love the body. Just like I love earth sciences. It's just we can kind of, it forms a system that we can understand. And like when you understand this one part, you're like, oh, this other part that happens makes total sense.

That's diabetes. Yeah, I hate the body and earth sciences. I like mysticism and cosmology. Right. And dreadlocks. Oh boy, why did we do that show on that? I was thinking of one the other day that we did. Jack Amherst.

No, it's even worse than that. Oh, I can't remember. But I was like, why did we even attempt that one? Occasionally I'll look through the old list when we're picking out selects and then just go, what? You know, what was that one? I don't know. It's weird.

All right, so we need to break down. Ha-ha, didn't mean that pun. A lot of breaking down in this show. You know what I mean? That's true, yeah. That was sort of a deep pun. That was a foreshadowing pun, however it was. But we do need to break down the whole spiel

with glucose and insulin. Because that's the root of it all. It's a disorder of glucose. That's what that means. It's a disorder of insulin. Yeah. It's a disorder of both, we'll say. Yeah, either high or low or none.

Yeah, so, okay, well let's talk about glucose first. All right, well before we even talk about glucose, we need to define what a simple sugar is. Or a simple carbohydrate, it can be called. These are carbs that are absorbed very quickly for energy. And they're called simple because they only have one or two units of sugar, as opposed to like a complex carbohydrate.

Right. And glucose is a simple sugar. Right, and since it's a simple sugar, I think that means it can be broken down from different types of complex sugars. So not just like sugar, but carbs, like you said, right? Yeah, and this is the sugar that gives all the cells in your body energy to do celly things.

Right, it enters the bloodstream through the intestine and all the cells are like, give me some sugar, baby. Yeah, and this comes from the food that you eat. It really does, right? So you eat some food, particularly say a carbohydrate rich food, and your guts start to break it down. And it breaks down ultimately to that glucose, the simplest form of sugar that the body can use for energy

without being stripped down further. And it shoots out through the bloodstream. And it's just a free for all, right? Cells, like you said, use this stuff. And some cells in particular use nothing but glucose. Some use glucose and like other stuff like ATP. Yeah, which are those? Red blood cells, brain cells, quite importantly.

Use nothing but glucose for energy. So glucose is extraordinarily important. Yeah, and what your body wants to do, we always talk about that homeostasis. This is another example that your body wants to keep a constant glucose supply for your cells. We don't want it to be super high or too low. And it does this in a pretty interesting way.

Otherwise, when we like right after we eat, we'd be great. And then if we didn't eat for a while or went to sleep at night, we'd die. Potentially. Organs would shut down. If we slept long enough. Because again, this is the stuff that fuels your cells. Your cells need fuel 24 hours a day.

It doesn't care whether you're sleeping or not, right? That would solve everything if your cells went to sleep. It would when you slept. They just stop yapping for once. No, they're always talk, talk, talk, moving. Which actually I guess is good, because again, if your cells stopped working, then you die. Right.

Okay, so that's glucose. Energy that powers cells, some cells exclusively. And your body wants to keep a nice, constant level. Yeah, and you get it through food, which could conceivably spike your glucose. So, when you eat something and all of a sudden you have a surplus of glucose, rather than that even keel homeostasis glucose

in your bloodstream, your body has a way of dealing with this. And it's called insulin. And insulin is one of two chemicals that are made by the pancreatic islets. IS-L-E-T-S, islets, right? I don't know, did you look that up? I think it's islets, like islands. Like it means like tiny islands.

That's probably it. And they're called tiny islands. That's what we're gonna call them from now on. Cause I don't wanna get it wrong for the rest of the episode. But they're called tiny islands because they're indeed little endocrine cells inside your pancreas.

So they're embedded like a journalist with a troop detachment basically. Yeah, so your pancreas in this case is producing two insulin and glycogon, I'm sorry, glucagon. Glucagon. Glucagon are alpha cells produced by alpha cells and secreted by alpha cells.

Insulin are the beta cells. All of it's produced in the pancreas, like you said, with those little islands. But so let's focus, and here's a better one than a military analogy. A post office in an airport. It's like here, we're gonna serve you our customers. We're just gonna go to you.

Do they have those? Yeah, some do. Man, that's nice. I think there's one in the Toronto airport. Yeah, there is. Yeah. YYZ. So who thought that was gonna come up, huh?

I know. So you've got these little cells that are specialized to create insulin, to release insulin from the liver, or no, from the pancreas, I'm sorry, in response to glucose becoming abundant in your gut as you're digesting it. Your gut sends out signals saying,

hey, got a bunch of glucose here. You guys wanna do something? Yeah. And the beta cells say we're on it and start releasing insulin. So insulin enters the bloodstream, and this whole jam is to take the glucose that enters the bloodstream and give it two cells.

And it doesn't just push it down the cells' throats. Apparently, the cells have some sort of say in whether they accept glucose or not. Sure. But the only person they're gonna accept glucose from is insulin. So insulin will take this glucose to different types of cells,

and with different cells, different things happen to it, right? Yeah, like it depends on what part of your body, if you're the liver or muscle cells is gonna store that glucose in something called glycogen. Yeah, it's like just chains of glucose, right? Yeah, it's gonna stimulate fat cells to form fats from fatty acids and glycerol.

Yeah. Then the liver and muscle cells is gonna make those make proteins from amino acids. Yeah, and these are like the three base protein, or base nutrients that you get from eating food, right? Amino acids, fats, fatty acids, and glucose. Correct. And then your body makes use of those

because insulin delivers them to cells around the body. Yeah, then it's gonna inhibit the liver and kidney cells from making glucose. And this is something called gluconeogenesis, which is, confused me just a little bit. Why? Why? Yeah, because it just, I don't know,

it's something about the metabolic pathway, like, I don't know, I didn't fully grasp it. I think what it is, is- Or maybe my answer is just, I'm not smart enough to get it. I don't think that's it at all. If anything- What did you get it?

If anything, yeah, it's your problem. If anything, it was the article, Chuck, not you. Well, no, this article is pretty stinky. But also went to kids' health sites, like I always do. But it makes sense in that if you will die, if you don't have the source of energy, you're gonna have some backup plan. And the backup plan is, well,

we probably have some constituent parts that we can put together to make our own glucose. So that's like plan B, is make your own glucose. And that's gluconeogenesis. Okay. That's what I think, I mean, that's my interpretation. Genesis, huh? And I play a doctor on TV.

Dr. Draco Ramore. What's that from? That was Friends. You probably didn't watch Friends, did you? I saw it in an episode or two. I loved that. Were you into Friends? Oh yeah, man, I still am.

How much does this reruns? Oh, really? Yeah, it's funny, it's a very dated show now. Oh, man, the clothes, the hairs. The white people. Yeah, I mean, everything about it. They hung out at a coffee shop when that was new. Yeah, if you cast that show today,

it would look like a Benetton color's ad. For sure, and rightly so. Probably so. All right, so at the end of the day though, insulin is gonna store nutrients right after you eat that meal, but by reducing these concentrations of glucose, and like you said, the fatty acids and amino acids,

those three main components. Right, which is pretty interesting because you really only hear of insulin dealing with blood sugar, but it deals with the main three nutrients. I didn't know that before, did you? I don't think I did. It's a pretty handy little hormone to have,

and by the way, it's a protein hormone. Glucose gets all the headlines. It does, because it's the troublemaker, and we'll see what happens when insulin can't do its job. What you get is diabetes and the symptoms of diabetes, and we'll talk about that later, but first, let's talk about glucagon. I thought you said for a second,

the Simpsons of Diabetes. The symptoms. Yeah, I know. The symptoms, no. Who would have diabetes on a Simpsons? No, probably Homer and Wiggum. Yeah, I guess so. And Barney.

Sure. Yeah, and that'll become clear as we explain diabetes more. Right. But let's talk about glucagon real quick because you've got insulin doing its thing, and it's pretty clear now what insulin does, but there's another hormone that does the exact opposite

that comes from those pancreatic tiny islands, too. Yeah, this, I thought, was pretty neat as far as that homeostasis. The body has two methods to deal with this. Right, you know? Yep, so like you said, if you go without eating or you sleep, if your cells don't get that glucose that they need, they starve and die.

So while you're sleeping and not eating, your cells are still powering. They still need that energy, so your body has a way to deal with this, and it is by producing glucogen, right? Yes, it's a little confusing because it's glucagon and glucogen, but they're both with a G.

Glucagon is what I'm talking about. Okay. That's how your body deals with a lack of a flood of new glucose being introduced from food. That's right. And that comes from the alpha cells of the pancreatic islets, right? Yeah, and it acts on those same cells,

but it just has the opposite effect, which is pretty cool. Like in the end, it's gonna, like when you're sleeping and when you're not eating, it's gonna mobilize glucose and where it's stored up your body and say, hey, we need this stuff now. Right, so it goes to the liver cell and...

And the muscles. And the muscles and says, hey, you remember the glucogen? Isn't that what the chain of it's called? Yes. Glycogen. So the glucogon goes to the liver cells and the muscle cells, right?

Yeah. And it says, hey, you remember the chain of glucose that you made, the glycogen the other day? Yeah. Well, we need it. Yes. And so break it up and spit it out to me and I'll just get it into the bloodstream.

And it does that to the liver and muscle cells. It also tells the kidneys and liver. It says, by the way, liver, while I'm here, why don't you kick off some gluconeogenesis too? Make some glucose. Right. And so all of a sudden, the low blood sugar in your bloodstream comes up to normal

and your cells all say, hooray, we're saved. And insulin gets lifted up on everybody's shoulders and all the cells carried around for a triumphant fist shaking parade. Yeah, and it's pretty great because this is all happening while you're sleeping. This is what... Or not eating.

Right. So all this, this is how your body keeps homeostasis for your blood sugar in your bloodstream and your cells powered if you're healthy. Right. If this goes wrong, well, you'll find out all about that right after these messages. Yes.

Yeah, definitely on this podcast. Also, I'm also having a blast with that latest Straße I've been working on this for a long time. What is this Facebook article? to come back and relive it. It's a podcast packed with interviews, co-stars, friends,

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And a different hot, sexy teen crush boy bander each week to guide you through life step by step. Oh, not another one. Uh-huh. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Oh, just stop now. If so, tell everybody, ya everybody,

about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts or wherever you listen to podcasts. So I don't think we mentioned that, uh, there is an ideal level here and that's about 90 milligrams per 100 milliliters of blood

for your blood glucose concentration. Or 5 millimolar. Yeah. And they, uh, you know, you can get this tested. They have little strips where you can, uh, poke yourself in the finger and bleed on the strip. Yeah. So this is apparently the most complex thing

since the breathalyzer. You, a glucose tolerance test, um, with a, or I'm sorry, I guess that's not it. It's a glucose meter. You prick yourself and bleed onto that little strip of paper like you were saying. That, the blood reacts with a chemical or with an enzyme, I'm sorry, on the strip and it's called glucose oxidase.

Yeah. And so that creates an entirely new compound, gluconate, which combines with another chemical and that turns the strip blue, right? Yes. And so you would think, oh, okay, well, if it's blue, it's, um, it's, it's, uh, I'm diabetic or I'm in trouble.

If it's not blue, I'm fine. No. What the, what the diabetes testing apparatus, I think that's what they're called, does. It analyzes the shade of blue that that turned. Robin's egg. That's complicated. That's maybe the best blue really.

Maybe. Sure. It's a good second. That's the only two blues, right? I mean, but that'd be pretty cool if that's how it did do. It's like, oh, this is Robin's egg. That's navy. Right.

This is cerulean. And it made a little chirpy sound. Cerulean, you're in trouble. Well, that's not how they used to test it though. In fact, uh, the, the full name for diabetes is diabetes, malitis, M-E-L-L-I-T-U-S. And that literally means sweet urine because in ancient times, the, the tests involved the physician drinking your urine and going,

tasting sweet, you're in trouble. You're in trouble. You're in trouble. You're in trouble. So if you say that you have that sweet diabetes, malitis, you're saying you've got that sweet, sweet urine. You know, I wrote a, uh, back in the day when I was writing, uh, spec scripts, when I lived in LA, I wrote a 70 show script.

Oh yeah. And, uh, it was a Halloween episode where Eric peed his pants at a haunted house and the title of the episode was urine for a treat. Oh, that's great, man. I thought that was enough. It was like, man, they're going to see that. That's it. You got to publish those.

I'm going to be, how should I pick that up? Surely. I mean, I don't have like a digital copy. I'd have to literally find the paper. Take a, how many pages do you think? I think it was like 24 to 30. Perfect. Take a photo of each page.

I'm like 180. I wonder why they didn't like it. Post it on Instagram, a page a day for a month. People will go crazy for it. They would love that. That's probably one of the better things they ever wrote. Oh, good. Out there.

Like it was a legit 70 show episode. I never tell you about the Simpson script I wrote. Not enough. About, um, so remember the one where it turns out that Principal Skinner is actually Armand Tanzarian? Oh yeah. That's one of the great episodes. This one is a, if you, if you remember, you know,

it's Matt Groening's most hated episode, I think. What? He hated that episode. I love that one. I didn't know that at the time because I wrote this on spec too, hoping that they'd notice it, um, although I never sent it in, um, but the, at the end of that episode, they, the judge says that it's, you, you're never allowed to speak of this punishable by death or something like that.

So my episode starts with one of Armand Tanzarian's old friends coming to Springfield to start his life anew. That's a great idea. And he sees Principal Skinner and says, Hey, Armand, Armand Tanzarian. And all of a sudden the police surround him and he's taken away to jail and held, um, and it gets out, he escapes, I think, gets out. And then Clinton was president when I wrote this, um, he gets out. Somehow it gets to like Clinton that this town is like holding people hostage,

basically unconstitutionally. And so Springfield gets invaded. And yours was 180 pages long. No, I think it was like appropriately length. Yeah, I think so actually. Can you imagine a different life where, uh, I wrote for the 70 show, that 70 show when you wrote for the Simpsons and we like ate lunch together on the Fox lot.

Can I, that'd be pretty cool. You know, can I tell you something though? Sure. I would, I prefer this. Oh yeah. Yes. I prefer what we do. As someone who's never written for the Simpsons.

I prefer, I prefer this. Hey man, I've, I've been to the writer's room before. I know what it looks like. They chain them to the desk. I like it. We get to, we don't have to live in LA. Yeah, I like LA. I've noticed a lot of our friends from New York are starting to move to LA.

Have you noticed that? Yeah. It's like a, a hemorrhaging. All right. Should we get back to diabetes? We should probably just edit all that out. No, I think that's a nice tangent. Okay.

All right. So in the case of diabetes, like we said, um, it is, uh, well, we already said what it was, but there are three types. Type one, type two and gestational diabetes. Type one is by far the, in the minority, it's, um, it says here five to 10%, but I saw like kind of a straight up 5% number, uh, for the number of diabetes cases overall. Okay. But they say five to 10% in this article.

Or it's called juvenile diabetes or insulin dependent diabetes. And this is caused by a lack of insulin, either not much insulin or sometimes no insulin at all in their blood. And this is, this is clearly genetic, right? It says, and also could be environmental, but yeah, they think it's possible, possible that it's caused by a virus exposure to a virus early in childhood that sets off an autoimmune reaction. And so your immune system attacks your beta cells that produce insulin and just destroys them. Yeah.

And so you don't produce insulin and it happens in your younger years, maybe adolescents, which is why it's called juvenile diabetes. And you, when you have type one or juvenile diabetes, you are, you're dealing with it for life. And we'll talk about, you know, managing and treating diabetes, um, but there's no cure for diabetes. But the idea that it's possible that this is the result of a virus has made some people call for research into a type one diabetes vaccine.

Oh, interesting. Which would just change everything. For some people. Yeah, because I mean, like I don't, like it's certainly not like a, you get what you deserve kind of thing with type two diabetes, but type one diabetes man, you got zero say in this whatsoever. Yeah. So type two is the one that's most prevalent between 90, 95% adult onset diabetes.

That is when you are usually over 40, usually between 50 and 60 even. I'm so nervous. You are usually overweight. Why are you nervous? I'm just nervous. I'm going to end up with type two diabetes. Oh, I thought you meant you were going to say something wrong. No, I'm nervous.

You're nervous about diabetes too? Yeah. It sounds like it's virtually predestined that we're going to get it. I don't think it's in my family, but I'm overweight and 47 years old. Yeah. And like need to get my act together like now. Yes. It's not like, yeah, I'll wait another five or six years and then tackle it.

And there's no reason for us to like just put it off until the end. We can say like you can reverse prediabetes through diet and exercise. Even if you have prediabetes, which is you have higher than normal blood sugars we'll see, but you don't have full-blown diabetes yet, you can actually reverse course. Like it's not too late. Doing something like what you're talking about can be very helpful. And it's great. This is a wake-up call.

Like your body literally can inch up to that line. And if you do the right thing, it can go, whoa, all right. I'll back off then. I like the way you're going here. Like what I'm seeing. Give me some more of that celery, baby. Get on that peloton, Chuck. That was some buzz.

That was a buzz market right there. Well, they're an advertiser with us. Are they still? Well, they were. And I still have that thing. I love it. It's nice. I just need to love it every day.

Right. Not like, I love it every couple of weeks. Crush that hill. You know. Anyway, type two, like I said, is about 90, 95%. And this is when you have higher insulin in your blood, not lower, like the case of type one. Right. Because you have a lot of insulin.

It's just not working, which is why type two diabetes is also called insulin-resistant diabetes. Is that right? Non-insulin-dependent or insulin-resistant. Yeah. Okay. Yeah. So that means that your body's producing insulin just fine.

But for some reason or another, and this seems to be the mystery at the heart of diabetes, your cells don't respond to insulin anymore. They won't say, oh, it's insulin. Sure, bring me some glucose. I'll turn it into a chain of glucose. Yeah. They don't know exactly why, right? I mean, for sure.

That's what I'm saying. That's why it's the mystery at the heart of diabetes. They don't know what the problem is with insulin. If they could figure that out, I think that they could actually cure diabetes. Right. Instead, what they've learned to cure is some of the problems associated with it. Right, but they do definitely know it's for sure linked to obesity. Yes, they do.

So that's type two. We'll talk a little more about how that actually works as far as the effects that it has on your body. But some other research I found was that there's some evidence that it's possible that type two diabetes, the actual mechanism of it, is the results of misfolded proteins. The same type of thing as mag cow disease or curu that you get from eating like brains with some sort of spongiform disease, right? Remember that? We talked about that.

Vaguely. So they think that it's possible that type two diabetes is the same thing, misfolded protein. The third one, it relates to type two diabetes, it seems as well, gestational diabetes. Yeah, this is, if you're a pregnant woman, you can have or acquire, I guess, gestational diabetes. The good news, it usually will go away after your baby is delivered, but it can put you at risk for type two later on.

You're more at risk if you're over 25 having a baby, if you have a baby over or have had a baby over nine pounds, if you are overweight, if you have a family history of it, or if you are African American, Hispanic, Latina, or Native American Pacific Islander, and I believe that's it. Which is interesting. It really is, and I didn't see anywhere why they thought that. Different ethnicities? Yeah, why they would be at a higher risk than I don't know.

I think that, I get the impression, Chuck, that there's been like the American Diabetes Association has been around for a while and all that stuff, and they've been trying to do what they can, but then this enormous spike in diabetes cases in the West, and now the world has really kind of drawn attention and funding to it, and we're now really diving in to figure out what's going on, but we haven't figured it out yet, which is where we are right now. I'm sorry, one more thing. Gestational diabetes, they think can actually be passed down as type two diabetes to the offspring. Oh, interesting.

Yeah, so we're just learning about all this stuff now. All right, so symptom-wise for all three versions and types of diabetes, Polly, why should I say that when I can just say you're very thirsty? Polly dips you. You mean you're very thirsty, you urinate a lot. If you're always hungry, but you are also losing weight, and you can't explain that? Yeah, I didn't know that part about diabetes, but now that I understand diabetes, it makes sense. Yeah, glucose in the urine, that sweet, sweet taste of urine, fatigued a lot, tired, blurred vision,

specifically like changes in your vision, numb hands and feet, fingertips, slow healing wounds, and then abnormally high frequency of infection. Right, so those are the symptoms, and they'll make sense once we explain what's going on behind them, right? Yeah, but in some of these symptoms though, in fact, a lot of these symptoms can be other things too, which is why it's sort of distressing to be doing research on this and be like, well, wait a minute, I need glasses to read now, but that also happens. Diabetes. So for 40, I'm tired a lot.

That also happens when you have a three-year-old. Diabetes. I have a lot of slow healing sores. No, I'm just kidding. My foot was just amputated because I had no sensation. I do. I get numbness in my hands and feet sometimes when I sleep, but that's been happening since my early 30s here and there, and that just could be because I sleep with my arm up and stuff like that.

So, you know, I'm reading this stuff and I'm freaking out. Go to the doctor. No, I do. And last time I went there, my blood sugar was fine. When? I go every March. Oh, you're good. Except I didn't go this March.

I didn't either. I've been going every year and then skipped this year. And now we're about to, I think we just found a new doctor who specializes in diabetes. I'm so nervous. I'm like, is she one of those doctors who is like a hammer so everything looks like a nail? She's going to be like, you have diabetes and I'm going to trick myself into actually thinking it? Yeah, I did the dumb thing this year, which was, oh, geez, I gained weight last year. Like, I'm going to take your off and get back in shape.

I'm like, I can't. This, which is the opposite of what you should do. Yeah. But I was like, I can't face my doctor because when I go in there, he's like, what are you doing, dude? Yeah. He's very just matter of fact about everything. It's like, what are you doing? You want to be one of those old guys with diabetes?

Right. Laying around? He'll say that stuff to me. I'm like, no. It's like, good. Well, you know, it's up to you. It's good to hear that. Yeah.

I mean, you need that kind of straight talk from a doctor. You know, they say, or I've read that weighing yourself every week, if you're trying to lose weight. It's bad? No, it's good. Oh, yeah. Or I should say, I've seen some studies. I weigh myself four times a week. I've seen some, you shouldn't, it's too much.

Really? Yes. Because your weight fluctuates so randomly throughout the week that you can get demoralized. You want to do it once a week at the same time, usually right after you get up. Uh-huh. Oh, yeah. The same morning every week, and then you will see whether you're going up or down. You'll really be able to see.

Four times a week, you're just like all over the place. It doesn't make any sense. Yes. You can't make heads or tails of it. Once a week at the same time, that makes sense. And it has the psychological effect of being like, well, I don't want to see it go up. So I'm not going to eat that chocolate cigar. No, you have to step on the scale.

Oh, yeah, yeah. Like I said, I weigh myself too much, but I'll kick it down to once a week. All right, let me know how it goes. Thank you. Thanks for doing that for me. Oh, should we take a break? Is this episode still going on? I think so.

All right, then, yes. All right, we'll be right back. On the podcast, HeyDude the 90s called David Lasher and Christine Taylor, stars of the cult classic show HeyDude. Bring you back to the days of slip dresses and choker necklaces. We're going to use HeyDude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it.

It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting frosted tips? Was that a cereal? No, it was hair. Do you remember AOL instant messenger and the dial-up sound like poltergeist?

So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to HeyDude the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough,

or you're at the end of the road. Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place, because I'm here to help. This, I promise you. Oh, god. Seriously, I swear.

And you won't have to send an SOS, because I'll be there for you. Oh, man. And so my husband, Michael. Um, hey, that's me. Yep, we know that, Michael, and a different hot, sexy teen crush boy bander each week to guide you through life step by step. Oh, not another one. Kids, relationships, life in general can get messy.

You may be thinking, this is the story of my life. Oh, just stop now. If so, tell everybody, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. All right, Chuck. Yeah, now we get to the point of the article that's called,

Let's Try and Confuse People as Much as Possible. This is where the grocery store starts putting weird stuff next to other stuff and expects you to just pretend like everything's normal. I tried to just mark the relevant parts to make it all make sense and streamline it, and it still was confusing. Okay, allow me. Great. Everybody, I just cracked my knuckles.

That means it's, you just turned his chair around backwards. Prepare for the monotony. You ready? The monotonous droning. Right, which is basically how does this, how does a lack of insulin affect your body? By Josh Clark. Yes. So, well, let's take different ones, right?

You've got blood, well, see, here's a good example. You've got glucose appearing in your urine above urinating frequently, but logically, glucose appearing in your urine should follow after it and be in the same thing. So, we're going to start with, you urinate frequently. Polydipsia, I think is what, or no, polysuria is what it's called. Right. Polyuria. So, that just means you pee a lot.

Way more than you normally would if you didn't have diabetes. And this is actually easily explained, right? You've got a lot of glucose in your kidneys. Yes. Because it's in your bloodstream and your kidneys are, the filter, one of the main filters for your body. Yes. And so, when you have liquid waste, it goes to the kidneys.

And in that liquid waste is a lot more glucose than your kidneys are used to processing. And so, they become overloaded. There's like a backup of glucose, right? Yeah. Pretty simple, easy peasy. So, since there's a backup of this stuff, the actual thing that shoots urine off to your urethra, right? The tubule lumen, it becomes backed up with glucose as well.

Yeah, because glucose retains water. Right, which means the tubule lumen says, well, I should probably get rid of some of this and I'm going to start peeing. So, you start peeing more and more, right? Okay, that's one effect of it. And that'll also help make you thirsty, which is another symptom. That's another, it's like a vicious cycle, right? So, you start drinking more and that is another symptom.

So, you're drinking more, but you're just peeing more because there's so much glucose in your blood. Now, because there's more glucose in your blood and you're peeing out more water from your bloodstream than usual, your blood actually becomes a little thicker. Yes, and you're also losing sodium. Okay, right. So, you're peeing a lot more, you're drinking a lot more, but you're just peeing it right out.

Your blood's becoming thicker, so your body says, whoa, whoa, whoa, something's a little off. I need some water. I'm becoming dehydrated. Sending out this thirst signal isn't working. I'm going to steal some water from the organs. Right. They actually become a little dehydrated,

but the problem is that it doesn't solve the problem because there's still all that glucose overloading your kidneys. You just pee that water out. So, again, you're constantly thirsty. There's glucose that appears in your pee, which is how ancient doctors said, yeah, you've got the diabetes. And your organs are dehydrated, which is a bad jam. Yeah, and I think they liken the thickened blood to a molasses consistency.

Right. Not good. This article doesn't touch on it, but that leads to another thing that's often comorbid with diabetes is hypertension, high blood pressure, because your heart is requiring more energy to pump this blood because it's thicker, and it's actually really hard on your blood cells as well, and that can lead to all sorts of things, from cardiac arrest to stroke. So, you can get all those in addition to diabetes just from having thick, sweet blood.

That's right. Molasses blood. Dickened sweet is usually good. Yep. But not in this case. No. Maybe if it's in the syrup that you're eating, that will eventually give you diabetes. It's good.

All right. Now, where does that put us? Are we going back up to the top? Yeah, we should participate in confusing people along with this article. Oh, my God. So, the whole reason you have high blood glucose levels is because your body is not responding to insulin, right? Right.

So, because the insulin is running around going, guys, guys, what I do? What's the problem? Take this glucose, and the cells just turn their back on the insulin, and the insulin is sad. You'll have a lot of insulin in your bloodstream that's not doing anything. And so, there's some other secondary alarms that your body sets off saying, we've got a lot of insulin in the bloodstream,

but our cells aren't getting any energy. They're starving. So, we need to start producing our own glucose. Right. And that's where the glucagon, the alpha cells secrete that glucagon, and those levels rise in your bloodstream. That acts on your liver and muscles like we talked about to break down that glycogen. And releases, well, too much glucose into the blood in that case.

Right, which is one reason why you suddenly lose weight inexplicably, despite eating all the time or being hungry all the time. Because as far as your body's concerned, it's pretend like your body can't tell that there's a problem with the insulin. All it knows is that the cells are starving. Yes. It's like it lacks some sort of gauge to show how much blood sugar there actually is in the bloodstream or how much insulin there is.

And that there's something wrong. It just knows the cells are starving. So, it kicks off this thing where it makes its own glucose, which just raises the levels even further and exacerbates the problem. Right. Okay. So, you're constantly hungry because your body thinks your cells are starving, but you start to lose weight despite eating because it's also attacking those stores

of glycogen, those glucose chains. And you start losing weight despite eating a lot. Yeah, you're tired. That was another one of the symptoms because you're not absorbing that glucose. So, it doesn't have anything to burn for energy. Your hands and feet, remember I talked about them feeling numb or cold. That's because it increases osmotic pressure of your blood. It draws the water from your tissues.

That means your cells becomes, everything becomes dehydrated. And again, that goes back to the kidneys. The water in the blood is lost as urine because you're peeing so much. You're literally pissing it away. Yeah, seriously. And that basically, that's what makes that blood thicker, which leads to poor circulation. It's all, it sounds confusing, but it all kind of makes sense in a cyclical way. And so, the poor circulation leads to its own cascade of problems, right?

Poor circulation means that you have less feeling and sensation in your extremities, which means that if you stub your toe or cut it open or something like that, you might not even notice. So, you have a wound that's left to fester because you're not treating it. And then on top of that, because of the poor circulation, your immune system can't go to the site and help it as easily. And you're more prone to infections, which can lead to gangrene, which can actually lead to amputation, all because your blood is too thick to circulate properly.

Right. And that poor circulation is also what's going to lead to your changes in vision as well. Right. So, there's one other thing that happens too. There's something called ketoacidosis, which is where your metabolism basically goes into the fatty acids or the fat cells and cracks them open and starts burning whatever glucose it can. There's this thing called ketoacidosis, where if you're on like a... Atkins diet.

Right. It's actually, as far as Atkins people are concerned, that's like where you want to be. Right. Because you're just burning fat cells and you're at this buzzing level. And you're losing weight, you're not gaining anything. Your skull is very prominent. It's a beautiful thing, right? Your breath is kind of stinky. Yeah, it'll seem a little sweet.

Ketoacidosis is not ketosis. Ketoacidosis is the same thing, but to the nth degree, and it can lead to all sorts of big problems because the acidic ketones build up in your liver, I think. That can cause stinky breath too, right? It can. Acetone breath. Yeah, and that can lead to central nervous system problems, heart trouble, and even it can lead to coma. Yeah, and heart irregularities too. It can mess your body up pretty bad. And this can be an extreme result of diabetes, which is one of the reasons it's life-threatening. Man, it's a big deal.

It is. So as far as monitoring this stuff, back in the day, you just had to monitor it every day. And some people still do that with the little pinprick and their glucose monitors. But now you can have them built into your body, right? That's actually, that's been around a little while. So if you're type 1, you don't make insulin, so you have to inject it artificially, externally. Right. And there's pumps that you can carry around or wear that are connected into your body that you just press a button and it delivers insulin.

But you have to test to see how much you need at any given time. Right. And if you put in too much insulin, it's going to sweep up too much blood sugar. Because it's not like there's anything wrong with the communication between your insulin and your cells with type 1 diabetes. It's just that you don't have insulin. So when you put insulin in your body, it does, it goes to work like it's supposed to. Yeah. So you have to really walk that fine line.

Well, and you probably are going to be administering it a few times a day too. Right. And so you've got it. Usually around your meals. Right. And you want to make sure that you don't, again, put in too much or else you're going to get lightheaded because your brain cells use glucose. And if you have too much insulin and sopping up too much glucose, your brain starves and you pass out. Yeah.

It's called hypoglycemia. Like you said, lightheaded, shaky. I think most people have experienced that feeling even if you don't have like pre-diabetes or diabetes. Right. Just that, I mean, people just call it low blood sugar. Right, but it's actually probably, and yeah, I guess it would be low blood sugar from an overabundance of insulin. Yeah. The only time I've noticed that is when I eat something super carby, like, and I don't really do that for, I don't eat a lot of breakfast anyway,

but if I eat just like a big fat bagel for breakfast and then don't eat again till dinner, I'll get like a little shaky. Yeah, the shakes. Yeah. But it almost feels good in a weird way. You know what I'm talking about? No. Not to me. No, it's never felt like kind of high, like you're a little high.

Oh, no, not. Every once in a while, not every time, but every once in a while, it'll strike me where I'm like shaky, but right here in my chest, in my solar plexus, I can kind of feel it glowing a little bit and it's almost like a weird high. Interesting. Yeah. Am I, is that, that's not a normal thing? Well, I mean, I can only speak for myself. I do know that though, if you are feeling lightheaded or shaky like that,

this is because your brain is not getting enough glucose and we talked about the brain was one of the specific organs that really needs it. Right. This is when you might see someone drink juice or eat a candy bar or something sweet just to get that like quick spike. But if it goes really, really low, you can go into what's called insulin shock where you lapse into a coma and that's serious business. Right. Oh, yeah. The diabetic coma is pretty bad. Yeah.

Because all sorts of bad stuff can happen to your brain at that time. Yeah. So that's mostly type one. Type two is managed differently, although similarly, you have to keep up with your blood sugar, not nearly as frequently as you do with type one. But diet and exercise are like, they just say right away like, even if you, well, let's talk a little bit about reversibility because I saw a new study. Oh, okay.

Well, let's hear it. Here's a new study that's called very low calorie diet and six months of weight stability in type two diabetes. And this was on the American Diabetes Association homepage. And they did a study basically because it's long been thought that even though they say like, you know, if you really lose weight and exercise, it'll really, really help you manage your diabetes. But it's not reversible. Like you've got it for life. Right.

You have to, if you stopped exercising and dieting, you would Exactly. develop the symptoms again, right? Exactly. But they now say that it is possible with at least the results of the study. And here's the deal. It wasn't a very robust study. It was only 30 people with type two diabetes.

I think it was, they didn't have a good enough sample of ethnicities. But some of the subject had diabetes less than four years. Some had longer than eight years. And they found that, and this is usually after a bariatric surgery, but they did find the same results of people who just, and this is dramatic calorie reduction, not just like, well, I'm going to eat a little better, like bariatric surgery level calorie reduction. They found that immediately after an eight week low calorie, very low calorie diet, 12 of the 30 participants had fasting blood glucose levels, normal fasting blood glucose

levels. And then, and this is the big finding, after six months of maintenance, 13 out of the 30 were able to keep that glucose level below that threshold. That means that 40% were seemingly reversible. Wow. But they're not making the claim like, for sure. Right. But 30 people.

But yeah, I mean, that's promising. Sure. That 40% of the people that really, really lost a lot of weight and ate a lot less and exercise were able to seemingly reverse or at least get it down to normal. But like you said, if they stopped, then it might just come right back. And that fasting glucose level is significant. I don't think we really said, but the one of the ways that they test for diabetes is, yeah, you fast overnight, go to your doctor and they give you a thing of sugar water

and you drink it and then they start testing your blood sugar for several hours afterward. And if you don't have diabetes, your blood sugar comparatively speaking doesn't spike all that much because your insulin's working and doing the right thing. So if you have full blown type two diabetes and you're in the study and you go take a diabetes test and you have regular fasting level diabetes, blood sugar, that's pretty significant for sure. I hope it extrapolates on everybody else. Well, we'll see.

It's normally controlled through medication, oral medication for type two. It's not like you're having to give yourself a shot every few hours or anything. Right. Yeah, that's big and there's different ways to do it. Yeah, one medication. And I guess they just tailor it to what your specific case might, they think it might warrant. Probably. But one stimulates the pancreas to release more insulin.

That's kind of a no-brainer. One interferes with the absorption of glucose by the intestine. One interferes with the absorption of glucose by the intestine. One's improves insulin sensitivity. Right. One reduces glucose production by the liver. Stops gluconeogenesis. Yeah, one helps the breakdown of glucose and the other one literally supplements insulin.

Which makes me curious, does that mean that if you inject more insulin in type two diabetes, you overwhelm the insulin resistance or something like that? I don't know. I don't either. But if you, so management is the right word for diabetes. Like you have to pay attention to your diet, your exercise. You have to test your blood sugar levels depending on what kind you have day to day. But there are like a lot of apps out there to help you do that.

And since we're buzz marketing, Yumi works with a guy or worked with a guy who's the CEO of a company called Glucco, G-L-O-O-K-O. And they're one of many. I mean, there's a bunch of them, but if you have diabetes, this is probably the most convenient time for you to keep track of your diabetes. Because apparently it's a pain to keep up with the tests and all the stuff, the data. And so Chuck, there's, like we said right now, apparently it's possible maybe to reverse it. But for type one diabetes in particular, because remember, you're just not producing insulin.

They've actually come up with a procedure, an experimental procedure, called pancreatic islet transplantation. Yeah, I saw that this has been around since like the 60s. Oh yeah. But like it's not new, but I couldn't really find out if it's like the effectiveness of it now. And like if it's working. Is it working? That's not good.

If there was nothing, if there was no follow-ups on it, that's, I don't know. It says that it showed promise, but the big problem was tissue rejection. Right. Where it's, so basically they go into a deceased donor, and they remove their pancreatic islets. Because remember that's where the insulin and the glucagon is produced. Yeah, that's like the root of the problem. And you put it into like a syringe and a catheter,

and inject it into the person with type 1 diabetes pancreas. And supposedly they'll eventually attach to a blood vessel and start producing insulin. But if that's, if the body doesn't reject the donor tissue. Yeah, I'm going to follow up on that because I couldn't find a whole lot about it in time ran short on me. But I do know that it's, I mean, it's been around legitimately for at least three decades. And then before that with like experimentation. So I don't know.

It seems like they would have had a firmer grasp on the results by now. That's what I'm saying. It's a little like a, you know, but we'll find out. Glucose. You got anything else? Glucose the app? Yeah. Yeah, go get it.

It's pretty cool. We, I checked it out. What did it say? It said, check me out. No, it's like, I don't have diabetes. So a lot of it doesn't make sense to me, but from the demonstration video, it seemed pretty. Robust. Yes.

Good. And then some, if you want to know more about diabetes, go check out this painfully confusing article on how stuff works by typing that word in. And since I said painfully confusing, it's time for Listener Mail. Hey guys, want to share some thoughts and comments on the skyscraper podcast. So we got a lot of feedback. We got, what did we get wrong, steel? Yeah.

Who cares? It's not like we were telling people who were going to go purify iron and then try to build a skyscraper out of it. I mean, for the number of things that we say, of course, we're going to get something like dead wrong once in a while. Well, this guy was nice about it. Okay, good. And we asked for corrections.

Okay. Do we not? I think you guys did a great job, Josh, of summarizing the issue with the thicker bases, i.e. pyramid, not being economical for the building owner for recuperating their initial investment. You all said a good job bringing up that elevators coincided, allowed the jump in building heights. Technology would allow us to build nearly as tall as we want. You just wouldn't be able to find someone willing to pay for it.

That said, the difference, however, between iron and steel is in fact not that steel is more pure iron. It is iron with carbon added that increases and improves the strength and ductility of pure and or naturally found iron. Different steels have other elements added in addition to carbon, but really carbon and iron are what makes steel steel. Other elements have relatively minor impact on the properties, like stainless steel has chromium, etc.

There are also multiple types of footings, not just spread footings. Spread footings spread the load on underlying soil or ideally rock because, like you said, the columns going straight into the soil would push right through. But most, if not all, skied scrapers are so heavy and sit so far above the rock that instead of spread footings, they have a deep foundation. This looks very similar to a spread footing from the bottom of the concrete footing up, but then also have columns that reach further into the ground to increase the resistance to the sinking.

This resistance usually is provided by those columns reaching down to very strong rock. Essentially, you're creating a large table with lots of legs that the whole building is built upon. Now that is an analogy I can get down with. There you go. So, I look forward to coming to another Atlanta show. This is Grant Hollis who lives right here. Thanks, Grant.

And he went to the Pinto show. Grant Hollis, man of steel. That's right. And Grant, I would normally just put you on the guest list for tickets, but Atlanta is always tight because they're friends and family, so I'm sorry. We have to like claw them from the promoter's hand. Yeah, and we have to deny friends and family. Yeah, and they're cheap, so they don't buy tickets.

They're like, all right, fine, I'm just not coming. Pretty much. Yeah. Well, thanks again, Grant. And thank you to our friends and family who show up or even consider showing up to our Atlanta shows. If you want to get in touch with us, visit us at our home on the web, stephushanot.com. You can find our social all over the place there.

And you can also send us an email to Stuff Podcast at HowStuffWorks.com. For more on this and thousands of other topics, visit HowStuffWorks.com. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it.

And now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life.

Tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts.