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Life Beyond Diabetes with Teresa Owens, ARNP - Part 1

From diagnosis to diet, there are a myriad of issues, frustrations, feelings, and discoveries that one goes through in learning what the disease is, and how to manage it.

Some of this weeks episode highlights are:
12:20 Diabetes: I didn't do anything to deserve it, I was, according to the world, doing everything right. I just didn't win the genetic lottery.
14:09 Things I've learned: Shame and blame only hold you back. They don't serve any purpose in your life, and having diabetes takes the time of an unwanted part time job!
38:14 In many of us, the pandemic brought on a ""pandemic insulin resistance"" caused by anxiety. For some, the result is our bodies have become fat storage machine.

--- Full Raw Transcription of Podcast Below ---

Dr. Angela Zechmann (00:00):
You are listening to the, keep the weight off podcast with Dr. Angela, episode number 24.

Introduction (00:07):
Welcome to The Keep The Weight Off podcast, where we bust all the dieting myths and discover not just how to lose weight, but more importantly, how to keep it off. We go way beyond the food and we use science and psychology to give you strategies that work. And now your host, Dr. Angela Zechmann.

Dr. Angela Zechmann (00:28):
All right. So welcome back to the podcast everyone. I am so happy that you are tuning in today or this evening. I have a really special guest today and this is my friend and colleague and her name is Teresa Owens. Say hi Teresa.

Teresa Owens (00:46):
Hey, everybody.

Dr. Angela Zechmann (00:48):
Teresa is a nurse practitioner who practices obesity medicine in Seattle. And we actually met about it's been seven years. Can you believe that Teresa, like I was just thinking about that the other day.

Teresa Owens (01:02):

Dr. Angela Zechmann (01:03):
Yes. Philadelphia - at the Obesity Medicine Association conference seven years ago in 2014, it was awesome conference and we just became fast friends. And we have been ever since, and Teresa is one of these people that is so brilliant and so compassionate. And I just really, really respect her. As a matter of fact, I respect her so much that when I go on vacation, she just comes to my house and she comes to my clinic and she just becomes me.

Dr. Angela Zechmann (01:32):
And she takes care of all of my patients. For me. She takes care of my house and my animals and my staff just loves her. And so that's how, I mean, that's the kind of relationship we have and I think it's really, really special. So I think you'll really love hearing Teresa because she's got an awesome story to tell. So welcome. Welcome. Welcome Teresa.

Teresa Owens (01:55):
Thank you. That is such a kind introduction.

Dr. Angela Zechmann (01:58):
You're welcome. Now, here's the interesting thing that I want you guys to understand about Teresa. She's not only an expert in obesity medicine, but she's an expert in diabetes. She actually has diabetes and she's taken a very special interest in getting getting a really clear understanding of diabetes and taken special classes to learn more about diabetes. And so what I want you guys to know, all of our podcasts listeners to know is that diabetes is actually really, really common.

Dr. Angela Zechmann (02:36):
So the likelihood is very high that someone listening to this podcast, probably many people listening to this podcast already have diabetes. Some of them may already know they have it, and some of them might not know they have it. So I looked up some statistics and in 2020, these are the latest statistics from the CDC. They they, the prevalence of diabetes at 34.2 million people. So that's about one in 10 adults with diabetes. So I want you to think about yourself and maybe nine other people in your life, friends or relatives, and it's possible probable that at least one of you has diabetes. And the other interesting thing is that of people with diabetes, one in five has it and doesn't know it. So it's possible that there's one of you or your nine friends that doesn't know they have diabetes as well. Now, in my experience, I think this statistic is much higher.

Dr. Angela Zechmann (03:41):
I think there are a lot of people walking around with diabetes and they don't know it because I diagnose it all the time. And I'm noticing that I'm diagnosing it in younger and younger people all the time. And you know, it just really, really frustrates me when I have a 22 year old young woman and she walks in and she's got diabetes and she has no idea. She's just like, I just need to lose weight. You know? So so I just want you all to realize that the diabetes is very, very prevalent now. Teresa is going to tell us about her journey with diabetes, and we're going to break this up into two different podcast episodes. So in this first segment, she's going to talk about her experience with diabetes from a personal standpoint. And the second episode, she's going to tell us about all the new diabetes medications out there and how to think about going about managing this disease.

Dr. Angela Zechmann (04:39):
We do want to say from the beginning, both of us want to say this from the beginning that we're not giving any specific medical advice for any particular person here. We're just going to provide information so that you're going to have a better understanding of diabetes and how it's managed, but you need to make your own medical decisions with your own healthcare provider. So that's a caveat right off the bat. Okay. So Teresa, tell us about your experience with diabetes. Like, how did you find out you had diabetes. How old were you at the time?

Teresa Owens (05:18):
I was 34 years old. I was a full-time nursing student at the time. So my husband and I were living with our daughter in a little tiny apartment. They very big dog. We had moved into this little tiny part with a very big dog because we had sold our house while we were waiting for our new house to be finished.

Dr. Angela Zechmann (05:41):
So if you can think of all this stuff, I'm juggling all of that. Trying to be a full-time nursing student. I went in just for my routine annual appointment and because there's a history of thyroid disease in my family. My doctor happened to do annual blood work on me. So this is not something that is typical necessarily at the age of 34, but at least it wasn't, you know, nearly 20 years ago it might be more common now, but because she happened to do blood work on me I went home that day with a diagnosis of diabetes and it came completely out of the blue. I wasn't feeling great, but I thought I wasn't feeling great because I was living in a tiny part with a big dog and a preschooler and a full-time nursing student. It was just like all of the standard moms stuff that was happening.

Teresa Owens (06:34):
Turned out that I actually had you know, I didn't just have pre-diabetes I had full blown type two diabetes was my diagnosis and it was pretty shocking. And my doctor handled it very poorly is all I can say. She walked into the room and I think that she was also really surprised. And she kind of didn't know how to handle it. And she walked into the room almost kind of gleefully because I think she didn't know how to put on her. What kind of face to put on. Cause she wasn't expecting this either. And she said, well, you've got diabetes and now we need to get you skinny. And oh no, those were the words that came out of her mouth.

Dr. Angela Zechmann (07:15):
Oh my God.

Teresa Owens (07:15):
I was like, I know I'm like, so I have to say that that has absolutely informed a lot of how I, lot of, a lot of how I give news to patients in any setting, we're going to have some news here. And I have to get over my own thing about news when I'm giving patients. So if anybody has a story about how they learned that they have diabetes and it's worse than mine, I kind of want to hear it. So it's like, this is crazy. And I didn't cry. I didn't say, I mean, I kind of was like, what in the world? What do you mean? I have diabetes. I, that we were checking my thyroid and we need to get you skinny. And I'm thinking, okay, I'm, I'm a little bit overweight. You know, I'm a mom with a preschooler and a nursing student, but I'm exercising all the time. Hardly have time to eat. I'm not sure why I'm not able to lose the weight that I'm trying to lose. I've been doing all the things, right. But she told me the thing that she wanted me to do.

Teresa Owens (08:18):
She said, here, here's a blood glucose meter, go start taking your blood sugars, you know, eat better and exercise and come back and see me in a few months. And if you want, we can refer you to the diabetes education people. I was like, yes, please refer me to the diabetes education people, because I need to know more about this and I didn't get any information. And and all I could think was I'm already finding a way to work out an hour, a day. I'm already eating what I think is what I'm supposed to be eating and, you know, running myself ragged. How can I do more? And, and I didn't cry until I got to the car and I got out to the car and there's not a lot that I remember about the whole experience, but I got out to the car and I cried.

Teresa Owens (09:07):
And then I went home and my doctor, or my husband said, so how was your appointment? And I said, oh my thyroid's fine. And I didn't tell him.

Dr. Angela Zechmann (09:16):
You didn't tell him?

New Speaker (09:18):
No, because when you have diabetes, you're fat and stupid and lazy. And that's what I thought. That's what you thought. Oh, that's what I thought. I was a nursing student. And I heard that from all the people, oh, you know, people with type two diabetes, they did it to themselves. It's a lifestyle thing and you can fix it. And if you get it, it's because you didn't take care of yourself. Oh, here I was. I wasn't even an old lady. I was only 34 years old. I wasn't even 35 and oh my goodness, how broken must I be?

Dr. Angela Zechmann (09:51):

Teresa Owens (09:52):
If I had done this to myself as a nursing student, so who's supposed to know better. I was so embarrassed. And so horrified that I had, that I had gotten this illness that only people who are fat and stupid get.

Dr. Angela Zechmann (10:07):
Oh my.

Teresa Owens (10:08):
Okay. So let me be clear. That's not what I believe at all.

Dr. Angela Zechmann (10:11):
That's what you were thinking at the time.

Teresa Owens (10:13):
That's what I was thinking at the time. That was the message that I, that was coming into my brain was that I'm so broken. And I did this to myself. Wow. So it was probably a few days before I told my husband. And from there we moved, we moved on, I went to see the diabetes educator, the diabetes educator told me that it was not my fault.

Dr. Angela Zechmann (10:40):
Oh. So you did find somebody that was compassionate.

Teresa Owens (10:43):
Yes, I did. I found a healthcare provider that was compassionate. Goodness. Okay. Yes. And she fortunately was the same person who had lectured actually to our whole nursing school class.

Teresa Owens (10:59):
And so she was somebody that I knew was somebody that my prestigious university recommended as an expert. So it wasn't just somebody telling me no, no, no. You're okay. It was this woman that my university recommended as the expert on diabetes. Okay. She told me that I wasn't, that I wasn't broken. I just had a disease. All right. And that was the first glimpse that I got that. Okay. Maybe this isn't my fault. Okay, good. I still had a lot of years of work to do. I didn't tell anybody for a long time. I'm actually curious to know. And you don't have to answer this. I'm curious to know how long it was. We knew each other before you knew I had diabetes.

Dr. Angela Zechmann (11:49):
I think it was pretty quick, actually.

Teresa Owens (11:52):
That would be, I must have really trusted you because most of our obesity medicine colleagues did not know for a long time.

Dr. Angela Zechmann (12:02):
Ah, okay.

Teresa Owens (12:03):
They do now more because I've realized that it's important to talk about it. And I talk about it much more freely than I used to do, because I've realized that the less, I talk about the less that talk about it the more it encourages the shame. Yeah. Okay. Let's, let's get things out in the open. Anyway. I didn't do anything to deserve it. I was, I was according to the world doing everything right. I just didn't win the genetic lottery. That's how it worked out for me. So from that early experience and the things that have happened since then big, you know, one of my life missions now is to help other people particularly women who have families to come to this place much earlier than I did. Yeah. There's nothing broken about them. There's nothing wrong with them. This is just like any other disease and we can pick ourselves up and figure out how to deal with it and get through it.

Teresa Owens (13:10):
Just like any other chronic illness that there's, that there's nothing wrong with you. And just because they call this a lifestyle illness does not mean that there's anything about your lifestyle that made this happen. And you're not.. there's nothing about you that's broken - just some things about your body that don't quite work the way that everybody elses does. Yeah. So, yeah. Yeah. And, and it took me a long time to realize that people that don't get diabetes aren't any better than people who do.

Dr. Angela Zechmann (13:39):
Right. Exactly.

Teresa Owens (13:41):
You know, there's, there's a lot of righteousness that goes around, you know, people talk about, well, I don't know, even within your insurance people, I don't want to pay for all the people that have diabetes. I just heard that the other day, like, well, I'm not going to pay for that because those people have diabetes there, but by the grace of God.

Dr. Angela Zechmann (13:59):
Yeah. Right. Yeah. Yeah.

Teresa Owens (14:02):
So they're not any better than me. Right. They just happened to win the genetic lottery. So the other things I learned besides learning that shame and blame really just hold me back. They don't serve any purpose in my life about diabetes. I learned that diabetes - having diabetes takes the time of an unwanted part-time job.

Dr. Angela Zechmann (14:26):
An unwanted part-time job. Yes. It's interesting. Cause cause we had a diabetes conference that we went to, they said it's like a full-time job managing diabetes.

Teresa Owens (14:37):
Well maybe at first it is. But I don't. I mean, if you think about a full-time job as 40 hours a week, I'm going to say a part-time job is 20 hours a week. So 20 hours a week managing your diabetes, I would say now I probably spend at least 10 hours a week and I've been doing this for what 17 or 18 years.

Dr. Angela Zechmann (14:56):

Teresa Owens (14:56):
And I've gotten really good at it. I've I've taken my, the time that I spend doing it way down. But if you think about, you know, learning how to take your blood sugar, all the doctor's appointments that you have to go to learning how to eat, counting carbs, counting, you know, adjusting your medications, figuring out, you know, just all of the things that you have to be thinking about constantly. You know, we talk a lot about the mental load that women already have, that we already carry the mental load of knowing where the kids need to be knowing if the laundry has been done, knowing what we're going to eat for dinner. No, you know, all the stuff that we carry as a mental load, if you add the mental load of a chronic disease on top of that, so already women already have an extra job going on.

Teresa Owens (15:45):
And then you add another one on top of that. And I love him to pieces, but my husband had no idea. And I actually sometimes will say like, when I get frustrated, I'll be like, you, you need to stop. Do you see that, that this process, not even a thought about things that I'm doing, but this thing that I have to do to manage my diabetes, you're going to stop and sit with me while I do it. So you can see how much time it takes. Yeah. And because he'll get kind of like, well, why is this taking something? Why does it take you so long to get out the door in the morning? I am not a person who wears makeup. I am not a person that I'm like, I am a dry my hair and put my clothes on and go kind of person. It's like, why does it take you so long to get out the door? You know, if you had to take your insulin and make sure you had all the right food and check your blood sugars and all that, I'm like, it would take you a long time too. Yeah. And so I make them sit down and actually do this stuff with me and then he leaves feeling, oh, okay. It does take all that.

Teresa Owens (16:49):
So there's the, there's the time of the job. And then on the flip side of that, it also costs like, I like to, I don't like to think of it, but it just like thinking about the expense of it because people think, oh, well, insurance is going to cover all of that. The it's a very, very expensive disease as well. Because even though you have insurance, there's copays on everything. There's time off that you miss from work for appointments. There's, you know, you have to eat quality food. There's again, all the time. And there's a lot of things that aren't covered by insurance. And a lot, a lot of the better medications are high copay medications or there you have to meet your deductible. You know, we have high deductible insurance. We know that we're going to meet our deductible every single year.

Teresa Owens (17:48):
Yeah. And that's only because I have diabetes. Yeah. You know, my husband's healthy. He doesn't ever meet his part of the deductible, which is great.

Dr. Angela Zechmann (18:00):
Thank goodness. Right.

Teresa Owens (18:02):
But you know, it's very expensive and it again adds up. So, you know, other ones I hit the deductible. I'm like, okay, well, what else can we throw in? Right. But, but it, it adds up, it becomes very expensive. So I'm putting in the time of part-time job and then paying out like for the privilege of that as well.

Dr. Angela Zechmann (18:21):
Yes. Okay. Got it.

Teresa Owens (18:23):
So and I think that these, and I'm not saying this to say, oh, woe is me any party. But I think that we don't acknowledge these things. I don't think that we, that this is it's very lonely. I think that the people that I talk to don't acknowledge that it's hard because nobody else does nobody else takes the time to, you know, chronic disease is hard anyway.

Teresa Owens (18:56):
But I think a chronic disease that requires constant monitoring and constant adjustment takes a lot more time. And if you're not doing it completely right. It's exhausting. I mean, because it's physically, you don't feel good.

Dr. Angela Zechmann (19:10):
Physically. Yeah. Yeah. Yeah.

Teresa Owens (19:12):
So, you know, it's exhausting mentally, but then physically, if you're, if you're just feeling as bad as everybody else who has any other chronic disease, so you've got that to, you know, hopefully you're not feeling hopefully if you're doing it well, you're not feeling poorly. You're feeling okay. Like my body feels great because I'm well managed. Yeah. But I mean, that is, I guess one benefit of diabetes as a chronic disease is a lot of times it can be well managed to the point that your body doesn't feel ill.

Teresa Owens (19:41):
And that's a nice trade off, I guess, if you have to do all the management, at least.

Dr. Angela Zechmann (19:45):
Yeah. At least you should know some benefit.

Teresa Owens (19:48):
At least now, you know, I feel pretty well managed and my, my body feels pretty good most of the time.

Dr. Angela Zechmann (19:53):
Awesome. So, so I'm just envisioning 34 year old woman with a tiny apartment and a big dog and a husband and a four-year-old full-time nursing student. You're learning how to manage this disease. You're getting it under pretty good control pretty quickly. Or what happened? How did it go for you?

Teresa Owens (20:13):
So I have to say, honestly, I don't remember right away what happened. I think it was, it wasn't terrible. Right. At first I think I started on Metformin as people do. And that kind of took care of it a little bit. I did some reading right away because I went to see the diabetes educator and then I went to see a dietician.

Teresa Owens (20:45):
And I had already had a sense that cutting out sugar was a beneficial thing. And I'm talking about sugar, not carbohydrates, but you're, you know, just strictly this was in the, like around 2000 to 200?, Sometime in there when, when sugar was kind of like starting to be a big thing. And, and there were like low sugar diets. And I was looking at and people were talking a lot about Candida at the time. That was the big, big thing, Candida diets. And, and I thought, well, maybe sugar's kind of the way to go. And so I happened to find a book called Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars by Richard K Bernstein. And it changed my life. And what I know now is that Dr. Bernstein is kind of the anti-American diabetes association at the time at the time American diabetes association was not at all endorsing any sort of low carb eating.

Teresa Owens (21:57):
You know, it was eat a lot of carbs and then bring your blood sugar down with insulin. And that's how you manage blood sugars is to turn it into a calculation. Dr. Bernstein had been diagnosed with type one as a child. And he got an early glucose monitor. So glucose monitors, weren't a thing. And it was like in the fifties, I think. And it's been a long time since I read the books, I'm trying to remember correctly. So forgive me, everybody if I get the details wrong. But he had, he, he got this glucose monitor and he was checking his own blood sugars and looking to see how the different things that he ate affected his blood sugar. And what he learned was that when he cut back on carbohydrates, his blood sugar improved, and he did not need as much insulin.

Dr. Angela Zechmann (22:53):
Fancy that. Right.

Dr. Angela Zechmann (23:02):
And so I was reading this and I'm like, okay, this kind of goes along with that whole Candida diet cut out the sugar. And like, this is like in Vogue right now. So I'm going to do that. And so I went on a really low carb diet following Dr. Bernstein's recommendations. And I was taking Metformin and I got on this really low carb diet and my blood sugar went down. I got my blood, my A1C down to like right around six. It was beautiful.

Dr. Angela Zechmann (23:34):
And let me stop you for a minute because many of our podcasts and listeners might not know what the A1C is. So can you explain?

Teresa Owens (23:42):
Fantastic. Yes. So the A1C is the three month average of your blood sugar and it's and for a diagnosis of diabetes, the diagnosis, the diagnosis currently is 6.7. I believe is diabetes 5.7 is.

Dr. Angela Zechmann (24:06):
I thought it was 6.5, his diabetes, six, somewhere in there.

Teresa Owens (24:11):
I honestly pay more attention to where pre-diabetes starts because I know that's where I start really treating people. But 5.6 is where prediabetes starts.

Dr. Angela Zechmann (24:21):
5.7 is where pre-diabetes starts.

Teresa Owens (24:24):
5.6 is where pre-diabetes. Yeah, there's the end of quote, normal. And I will tell you that actually in my practice, I treat people at 5.6 as pre-diabetic.

Dr. Angela Zechmann (24:34):
Wow. I do. Oh, my A1C was 5.6 once, it's much lower now, but wow. Yeah.

Teresa Owens (24:40):
So at the time that I was diagnosed because laboratory values have changed and it's not that they, they haven't changed what the definition is. They've changed the way they run the labs at the time, 6.0, when I was diagnosed, it was 6.0. That was diabetes. Oh, really? Yes. And, and that, so, and it was shortly after that, that it changed, but I got my, my blood sugar following, being on Metformin and following this low carb diet within a year after. So it was while I was still in nursing school. Yeah. Because I graduated nursing school that following spring, I was still in nursing school and I got my blood sugar down to, I think it was five. My, my A1C was 5.6. So that is lower than a diabetic number. That was a pre-diabetic number. And and my doctor said, that's a problem. You can't have your blood sugar that low.

Teresa Owens (25:36):
Right! And I said, well, why not? And she said, well, if your blood sugar is that low, then you must be having some low blood sugars. And I said, but I'm not having low blood sugars. And so now let me explain to the listeners what her reasoning was and the reasoning is, and this actually is, is a concern. If you've got people on medications that can lower their blood sugar artificially with either insulin that takes the blood sugar, can that lowers your blood sugar with insulin or a medication that causes your own body to release insulin. And we'll talk about that in the next podcast, when we talk about medications. But she thought that I was, that my blood sugars were, my A1C was so low because remember it's the average because I must be having some really bad lows and be high most of the time.

Dr. Angela Zechmann (26:33):
I see.

Teresa Owens (26:34):
I was taking Metformin, which is not a drug that can make your blood sugar go too low. So I actually really, really well controlled diabetes at that time. And that was information that I had learned by myself from doing the research, because I wanted to figure out how to, how to be healthy, how to live. You know, I was in nursing school, I was taking care of people on the floor who had really devastating effects on their diabetes. And I did not want that to happen to me. I was taking care of amputees. I did not want to lose my leg because I diabetes. Right. And I'm like, okay, well, Dr. Bernstein says to do it this way, what have I got to lose? I was seeing amazing results. And then what she told me didn't really make sense to me shortly after that, then I decided that I needed to be seen an endocrinologist who knew more about diabetes and knew had better in depth knowledge than my family practice provider.

Teresa Owens (27:30):
And so I found an endocrinologist and at the time the drug that's now very, very common was brand new on the market. I took within just months of them coming out. I took the very first in the class of the GLP-1 drugs. And we'll, again, we'll talk about those on the next podcast. And I found a really great endocrinologist who helped me manage my diabetes with this new in class drug. And it was remarkable. So for the first couple of years, I managed with my low carb diet and then also with the the GLP-1. And then I noticed that my blood sugars, even though I was still doing my low carb diet and taking the medications, my blood sugar started climbing up and I just thought, okay, well, this is what, this is what happens because diabetes is this progressive disorder, but it was, and my endocrinologist moved away.

Teresa Owens (28:35):
So I went back to primary care because I couldn't find another endocrinologist that that I liked. And I found a different primary care provider who seemed to know, or at least be willing to look a little bit differently at the guidelines than my original primary care who was managing who kept scolding me. I felt like she was scolding me for doing the right things. And so I found a different primary care and we but my blood sugar just kept going up and up and up. And my A1C, if it had been nicely at 5.6, you know, say it was in the sevens and it was going higher and higher. And, and it was one of those kind of like the I mean, I hate this analogy, but like the boiling frog. Yeah. It just kind of kept going higher and higher until I didn't even really notice how high it was getting.

Teresa Owens (29:33):
And and this is over many years that and we're, you know trying different medications and in different things. And I was looking at these numbers and thinking, I gotta, I gotta do something about this. And, and meanwhile, by now I'm a practicing nurse practitioner I'm in working in obesity medicine. I had met Dr. Angela and was working in her practice and I decided, okay, I'm going to go fully on board with ketogenic diet, which honestly is, is still for the most part, how I eat now. And, and it didn't take a lot for me to change my diet up, to cut out the few remaining carbs, to bring myself into kind of a full ketogenic diet kind of place.

Dr. Angela Zechmann (30:20):
Just for our podcast listeners. We talked with Dr. Rader a few weeks ago and he talked about how a ketogenic diet is like the bulls-eye of carbohydrate control.

Dr. Angela Zechmann (30:34):
You bring your you bring your carbohydrates down really, really low. And the goal here is that your body's burning fat for energy. It's not burning carbohydrates for energy anymore. So, and that actually generally works pretty darn well for people with severe insulin resistance, diabetes.

Teresa Owens (30:53):
It does work really well for severe insulin resistance. It does not work so great for people who don't have any insulin on board. And that was what we didn't know is that my type two diabetes was actually had been a long-term misdiagnosis of in adult type one.

Dr. Angela Zechmann (31:15):

Teresa Owens (31:17):
So I had a so what we know about type adult developing type one is that it can, instead of, as in children, it usually happens really fast in adults. It can take five, sometimes even 10 years to fully lose pancreatic function.

Dr. Angela Zechmann (31:35):
So type one diabetes for our podcast, listeners, means that your pancreas no longer produces insulin at all.

Dr. Angela Zechmann (31:41):
And typically the diagnosis is made when blood sugars go really sky high, and you have to just start taking insulin immediately. But this is not what happens sometimes in adults who develop type one diabetes. Okay.

New Speaker (31:57):
Yes. So in adults with type with, so sometimes adults do have a pretty rapid onset of type one. It's not very common that adults have a rapid onset of type one. Usually a typical adult onset type one is takes about two to five years. So my type one took closer to about 10 years.

Dr. Angela Zechmann (32:24):
Probably because he was taking such good care of yourself.

Teresa Owens (32:27):
I think so when I look back at everything, I was doing all the things, right. I was doing everything I could to preserve my pancreatic function. So I still, my, my pancreas cells were still doing what they to turn out some insulin. But what happened is that I was eating this ketogenic diet and ketones are great to fuel your body when you have insulin on board, because, but when you don't have insulin on board, insulin is the thing that clears the ketones.

Teresa Owens (33:00):
So insulin gets the ketones out of your blood. So when somebody is in nutritional ketosis, which is a very healthy state to be in their ketones are you know, in the single digits and the low single digits, if even a full even 1.0, sometimes they're lower than that. The highest that would be a healthy ketone number would be somewhere around five or six. Somebody with ketoacidosis... Ketoacidosis starts at around ... this is for people with diabetes diabetic ketoacidosis starts at around 15 ketones. So that's, that doesn't seem like a very broad range, but it's hard when you're doing a ketogenic diet. It's hard to get your ketones to six, much less to get them higher because your insulin is working really hard to clear them. Well, I was eating this ketogenic diet and I didn't have any insulin on board to clear my ketones and my ketones when they finally tested them in the hospital.

Teresa Owens (34:14):
I'm not sure if I've ever told you what this number was. No 82.

Dr. Angela Zechmann (34:18):
Wow. Yeah.

Teresa Owens (34:20):
So, you know, you might know what that number means. I was very, very sick. And that's when they found out that I am actually fully insulin dependent diabetes. So I now, since, since leaving the hospital and that was what, four years ago, I think or five somewhere in that four or five years ago I now have I take insulin always and I wear a continuous glucose monitor so I can make sure that my blood sugar is not going too low. I just recently got an insulin pump. Which means that I, that I don't have to be constantly taking, like I have to give myself shots every day. And my insulin pump talks to my continuous glucose monitor and it adjusts. It's very, very slick.

Teresa Owens (35:19):
I know it's pretty fancy. It's this fun piece of technology.

Dr. Angela Zechmann (35:23):
They call that artificial pancreas, right? They do.

Teresa Owens (35:27):
It's pretty, I do still have to let it know when I eat something. Cause it can't quite keep up with, with when I, when I eat. But every, all the rest of the time is making little microscopic adjustments to keep me to keep my blood sugar in a really great range. So I'm honestly, since that diagnosis, I'm like the healthiest I have been in literally decades. Oh, that's because, and my body feels great because you know, I'm not eating that differently than I did before, but all the chemicals and all the things that are, that are going on in my body are balanced the way they're supposed to be.

Dr. Angela Zechmann (36:07):
So now I have a question for you. Yes. You told me me a very interesting story about what happened to your blood sugars during the pandemic. Can you tell our listeners?

Teresa Owens (36:20):
Yes, yes. And I know this because I wear the continuous glucose monitor and I have been telling all of my own clients this because people get, so have just been beating themselves up over the weight that they've gained during the pandemic. And one of the things and I'm starting to see this and when I'm, as I'm drawing labs, you know, annual labs that are coming due about now my blood sugars. So, you know, we went into lockdown, what in March of 2020 and my blood sugar started climbing higher and higher. And I kind of was ignoring it because I have a long history of ignoring my slowly climbing blood sugars, because that just was again, boiling frog. And then I noticed, oh my goodness, they're getting out of control. This is not, not right. And I, I had an appoint with my endocrinologist and we ended up tripling my insulin and what was happening is, and I was taking pretty low doses of insulin for somebody who has who is insulin dependent.

Teresa Owens (37:32):
So, which is, again, another thing showing me that my disease is not generally insulin resistance. It is insulin deficiency. I just don't have insulin. Yeah. So that's the big difference between type one and type two type two is basically a disease of insulin resistance and carbohydrate intolerance type one is insulin insufficiency. There's just not insulin on board. So, so when a lot of type ones, if they don't have insulin resistance can, can get by with pretty low doses of insulin to cover, you know, especially if they're not eating a lot of carbohydrates. So you know, I, I, my doses of my daily dose of insulin are pretty low and all of a sudden I needed three times as much influence every day to cover. And what was happening was the stress hormones in my body were making the insulin resistance. And what I tell my clients about this is that this is a physiological response designed to keep our ancestors alive.

Teresa Owens (38:36):
Doesn't do anything for us in the 21st century other than make us sick, but it's, it's our, body trying to keep us alive. And so when the news media is telling us about, oh my goodness, how lazy we all were to be sitting around and getting fat during the pandemic. The part of the picture they're missing is that we are having a, not just a worldwide pandemic of COVID, we're having a worldwide pandemic of insulin resistance.

Dr. Angela Zechmann (39:03):
well, anxiety, yes. That is causing this insulin resistance.

Teresa Owens (39:10):
And, and so this is one of the things that even my patients that were just see me for weight loss, that didn't, that their labs didn't show insulin resistance in their annual labs. I'm seeing evidence that they're having insulin resistance that was not there before. So their insulin levels are higher than they were two years ago because I draw insulin levels on everybody.

Teresa Owens (39:31):
I just wanna, you know, just to make sure that everybody's to see where it's going, but because of her anxiety and what was happening, our bodies have become fat storage machines because in times of anxiety, that's what we're supposed to do because it kept our ancestors alive. That's how we survived. Yeah. It doesn't keep us alive. It makes us sick. But our primitive lizard brains don't know the difference between global pandemic and surviving the famine. Yeah. So, yeah. Yeah. I love that. I have that continuous glucose monitor that gave me that information and my patients loved having that feedback to give that to them to tell them that was going on.

Dr. Angela Zechmann (40:19):
So w we'll need to wrap this segment up here pretty quickly. I'm wondering, like, do you have any thoughts about like, is there anything you'd do differently or anything like for our patients who might be new patients and clients who might be newly diagnosed with diabetes? Like what is the most important thing for note, for them to know at this point?

Teresa Owens (40:43):
So I think, I mean, I think the biggest takeaway that I would want people to have from my story, no matter where you are in your journey is that it's absolutely okay to say diabetes sucks. And that sometimes even still, even though my body feels really great right now, sometimes I throw a little toddler size fits and I have little tantrums now I'm pretty quick to get over that because that doesn't serve me very much, but it does sometimes get over this.

Teresa Owens (41:21):
I think tantrum serve a purpose to get, get the, get the anger out and be done with it and put it away. I don't, I don't Pollyanna things. I don't pretend okay. You know, this doesn't exist. But I want people to know that they're not alone and I want people to know that probably the biggest thing that made a difference for me, the things that kept me healthy was when I was an advocate for myself. Yes. When I went looking for more information, when I thought I can be healthier than this. Yes. And, and it's okay to do that. I was just an RN and, and people who aren't in healthcare might think, well, she was an RN. She knew a lot of healthcare providers. You know, when you go into medical provider, they think, oh, she's a nurse. She thinks she's up at.

Teresa Owens (42:16):
And she knows everything. So that doesn't necessarily earn me any respect to go in and say, I'm a nurse. I know this. I went in and said, I've done some research. And I would like to talk about this medication. And I was very careful to be respectful whenever I wanted to do that, because I, you know, going in and saying, you need to put me on this medication because I read something, an article online that doesn't get me anywhere. Right. But to say, this is what I'm learning about. I really think that this might help me be healthy. Have you considered this? If not, could you please take this article and read it and let's talk about it. Yeah. And even that initial primary care provider who was not very helpful did do some things based on articles that I brought to her because I was an advocate for myself.

Teresa Owens (43:07):
Yeah. So, and you know, there are resources out there and in the next podcast, we're going to talk about some of them and Dr. Angela will post some information that can be used as information to talk with your provider about. Yeah. So be an advocate for yourself.

Dr. Angela Zechmann (43:25):
Absolutely. If someone is interested in contacting you to see them as a patient or a client, is that possible?

Teresa Owens (43:36):
Yes. If they live in the state of Washington, if they, are physically in the state of Washington, I am licensed to see them. And it can be virtually I, so I actually see most of my clients now, virtually since the pandemic, most people have realized that, you know, we'd all rather just be at home. It takes a lot less time. So yeah, you don't have to take time out of your day.

Teresa Owens (43:58):
So if anybody does want to see me you can find me at -

Dr. Angela Zechmann (44:04):, and we'll put a link up in the podcast notes.

Teresa Owens (44:12):
And again, my licensure, I'm limited to Washington state only, but if anybody is in the state of Washington, I'd be happy to see you and help you manage your diabetes.

Dr. Angela Zechmann (44:22):
Yeah. Awesome. Great. Well, thanks so much Teresa for being here with us this week, and I can't wait to hear what you have to talk about next week. We're going to talk about some of the new diabetes treatments and how we can really learn how to better manage this disease so that we can live longer, happier, healthier lives. So awesome. So we'll see you next week. Take care everyone.

Closing (44:47):
Hey, if you really want to lose weight and keep it off for good, your next step is to sign up for Dr. Angela's free weight loss course, where you're going to learn everything you need to get started on your weight loss journey, the right way, just head over to to sign up. Also, it would be awesome if you could take a few moments and write a review on iTunes. Thanks. And we'll see you in Journey Beyond Weight Loss.

New Speaker (45:11):

New Speaker (45:11):
Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars by Richard K Bernstein.

New Speaker (45:11):
Teresa Owens:


- Dr. Angela


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