Diabetes Q&A: Expert Answers on Insulin, Genetics, and Long-Term Care

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Coming up on this episode of the
Healthy, Wealthy and Wise podcast.

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How does insulin resistance
affect the kidneys?

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Welcome to the Healthy, Wealthy
and Wise podcast with Dr.

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William T.

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Choctaw, MD, JD, where the doctor
helps you unlock your full potential by

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equipping you with tools and knowledge in
the areas of health, wealth, and wisdom.

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Anchored in his experience as a
business executive, a physician,

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the surveyor for the joint
commission, a former mayor, and over.

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50 years of experience
as a general surgeon.

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You've got questions, he's got answers.

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So let's get started.

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Here's Dr.

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William t Choctaw, md, jd,
are there any questions

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as you're thinking?

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Um, uh, my hope is that you are having
a, um, a terrific, uh, um, Saturday.

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You know, I'm looking at the Zoom
screen and I see the name Preston.

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Preston is my son.

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So let me give a shout
out to my son, Preston.

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Thank you, kind sir, for
joining us on this, um,

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presentation today.

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Say hello to the family.

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And let me also, while I'm
doing this, uh, my grandson.

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Uh, Vincent Julius Choctaw graduated
from high school, um, this past week,

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and so I want to give a shout out
to him and another congratulations.

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Sister Mason.

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Yes, Sister Mason.

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Yes, uh, uh, Dr.

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Choctaw, could you provide
information about how, uh,

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insulin resistance, pardon me?

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Yeah, go ahead, give me your question.

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How does insulin resistance
affect the kidneys?

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Okay, excellent question.

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Insulin resistance affects the
kidneys indirectly because as the

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insulin resistance increases, it
decreases the effectiveness of glucose

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getting into the cells in the kidney.

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And because the glucose cannot
get into the cells in the

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kidney in sufficient numbers.

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The kidneys can't function the way
they normally should function and then

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end up becoming more and more damaged.

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Any other questions?

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You're welcome.

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I have a question.

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You had mentioned that when babies are
born, they're born without insulin.

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Uh, when do, when does
the human body develop?

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No, no, thank you for
asking that question.

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My point was in type 1 diabetes,
those are the babies that

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are born without an insulin.

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Because that's the definition of type 1.

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Most people don't have that.

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And I'm glad, thank you
for asking that question.

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Um, uh, uh, insulin decrease or
whatever, uh, diabetes can occur at

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any age and usually the blood tests are
done on all babies to see whether they

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have a sufficient amount of insulin.

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If they have insulin, but it's
not a sufficient amount, then the

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physicians can give them that insulin
and they may be able to be type two.

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But if they have no insulin,
none whatsoever, then

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that's a different entity.

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Okay.

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And their type of blood and they
will need insulin provided to

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them for the rest of their lives.

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That was going to be
my follow up question.

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Would that be for the rest of their lives?

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And that's a genetic thing, I'm assuming.

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Well, it's, it's genetic.

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Well, yeah, because they're born that way.

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Yeah, so what, what could argue this?

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Yes.

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So type one, you're born with it.

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Type two, you, you become
diabetic later in life.

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You might have to restate
that, because I can't hear her.

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Type 1.

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Type 1 means you are
Type 1 means you have MS.

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Type 1 means that your body
has no insulin whatsoever.

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And that occurs at birth.

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Type 2 means you have insulin.

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But the insulin may not work well,
or it may not be enough insulin.

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Or the insulin resistance may
diminish its effectiveness.

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All three of those can be a type two.

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And that's where different things have
to be modified or addressed to make sure

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that your body can function normally.

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Type one is way, in my view, is
obviously way more serious because

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from the very beginning, uh,
they have to have a very serious

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monitoring process, um, from birth.

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Uh, all the way through childhood,
et cetera, et cetera, et cetera.

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It's impressive.

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And families, uh, type 1, uh,
insulin patients are extraordinary.

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Because you can imagine what
the family has to go through

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to take care of those children.

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And some of them are just,
you know, just extraordinary

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academically, et cetera, et cetera.

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Yes.

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So the type 1 patients will take
insulin for their whole lives?

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Yes.

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It's because insulin is a
requirement for the energy of the

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cells, but it's, it's necessary.

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Systemation.

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Yes.

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Systemation.

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Uh, last, yeah, last question.

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How, could you explain, I think I
understand, how does, um, diabetes

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affect the eyes, cause blindness?

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Excellent question.

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Diabetes affects the eyes
because, it, it, it, it, the eyes

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have very tiny blood vessels.

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I'm not sure why, I'm not
sure anybody knows why.

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Diabetes appears to be most
devastating for those organs with

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the very, very small blood vessels.

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like the eyes.

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And so what it does is it causes
damage to the membranes of the eyes.

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So material leaks out into the
retina, which affects vision.

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It causes inflammation of the eyes.

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Um, so that that also directly
and indirectly affects the vision.

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Um, so there are a number of different
ways where it causes spots in the eyes.

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It probably increases the
risk of cataracts in the eyes.

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Um, uh, it is, it is clearly
one of the most common reasons,

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if not the most common reason,
for blindness in this country.

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Okay, um, I had a nonna that had
diabetes and she had a weeping eye.

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And, um, She didn't know that she was,
she said she didn't know she was blind.

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She just knew that her
Her left eye was weeping.

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So it looked like she was crying.

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So I took her to the doctor and
the doctor said she was blind.

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And that to my shock and surprise,
but she didn't realize that she

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was blind at eye, but she had,
um, a lot of weeping of the eyes.

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So I guess I'm just trying to
figure out when, what are the, what

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are the signs when you say, Hmm.

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I wonder.

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that you may be on being
blind because of diabetes.

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Is it, is it the blurred, blurred vision?

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And you said you start seeing
spots, but spots could be

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attributed to something else.

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Right.

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Well, part of it, and I
obviously in the case of being

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visual, but we have two eyes.

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Okay.

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And let's say for sake of discussion,
let's say we don't wear glasses, but if,

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if, but we use those two eyes to see.

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And so it may very well be over time,
um, uh, depending on how closely

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her vision is being monitored.

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She was adaptive to being able
to see with that vision prior to

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coming from that dominant eye.

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Uh, and so back to her
functionality that much.

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So from her perspective, yeah, I can
see how we walk 10 feet or whatever,

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but that vision may be coming from
one eye, not from the other eye.

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And it's one of the reasons why
it's important, I think, for us

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to have eye checkups on a regular
basis, because frequently this

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can happen gradually with time.

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It may not be just
overnight type of thing.

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So I, again, knowing the intimate
situations, nobody knows for sure,

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but that could be one explanation.

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Um, um, and that there could be others,
but because we use, we use both eyes, um,

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she was seeing out of that dominant eye.

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And had adapted to not
seeing none of the non done.

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Okay, thank you.

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You're very welcome.

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Any other questions?

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Okay, if not, thank you all
very much for being with us,

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have a terrific day, God bless.

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God bless, thank you.

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You're welcome, thank you.

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Thank you for listening to this
episode of the Healthy, Wealthy,

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and Wise podcast with Dr.

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William T.

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Choctaw, MD, JD.

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You've been listening to the Healthy,
wealthy, and Wise Podcast with Dr.

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William t Choctaw, md, jd.