In our continuing GBMC local health awareness and education series here at Baltimore Positive, we welcome Certified Diabetes Care and Education Specialist Allison Ashcraft, who helps Nestor with ways to better assist his wife Jenn, who is a Type 1 diabetic, and to improve lifestyle for those at risk of the complications of the disease.
Nestor Aparicio discusses with Allison Ashcraft, a Certified Diabetes Care and Education Specialist, about managing diabetes and improving lifestyle for those at risk. Nestor shares his personal experience as a caregiver to his wife, a type 1 diabetic diagnosed at 19. Allison explains the differences between type 1 and type 2 diabetes, the importance of new technologies like continuous glucose monitors and insulin pumps, and the role of nutrition, physical activity, and medication. She emphasizes the need for a support system and proper education to manage diabetes effectively. Nestor also highlights the challenges of traveling with diabetes and the importance of self-awareness and discipline.
Introduction and Purpose of the Segment
- Nestor Aparicio introduces the segment, mentioning the Maryland crab cake tour and the Maryland lottery partnership.
- Nestor discusses his brother and friends giving birth at GBMC and mentions the hospital’s anniversaries and campus events.
- Nestor shares a personal story about his wife, a two-time cancer survivor and type one diabetic, to introduce Allison Ashcraft.
- Nestor welcomes Allison Ashcraft, a Certified Diabetes Care and Education Specialist, to discuss diabetes care and lifestyle improvements.
Nestor’s Personal Experience with Diabetes
- Nestor recounts the night he met his wife, who was sugar crashing and didn’t want to reveal her diabetes.
- Nestor describes the challenges of managing diabetes, including meal planning and monitoring blood sugar levels.
- Nestor shares an emotional story about a friend’s son diagnosed with diabetes and the support his wife provided.
- Nestor emphasizes the importance of a support system and good practitioners in managing diabetes.
Types of Diabetes and Management Techniques
- Allison explains the differences between type one and type two diabetes, including the role of insulin and insulin resistance.
- Allison discusses the importance of continuous glucose monitors, insulin pumps, and other technologies in managing diabetes.
- Nestor shares his wife’s experience with insulin pumps and the emotional impact of managing diabetes.
- Allison highlights the role of certified diabetes educators in providing education and support to patients and their families.
Lifestyle Changes and Prevention
- Allison provides tips for managing type two diabetes through healthy eating, meal timing, and water intake.
- Allison emphasizes the importance of physical activity, strength training, and daily movement for overall health.
- Nestor discusses the challenges of managing diabetes while traveling and the importance of carrying quick-acting carbohydrates.
- Allison advises on recognizing symptoms of low blood sugar and the importance of family support in managing diabetes.
Success Stories and Personal Insights
- Allison shares success stories of patients who have improved their blood sugar levels through diet, lifestyle changes, and medication.
- Nestor reflects on the impact of living with a diabetic and the importance of self-awareness and discipline.
- Nestor shares personal anecdotes about his wife’s diabetes management and the emotional challenges of living with the condition.
- Allison discusses the importance of sleep in managing diabetes and overall health.
Conclusion and Final Thoughts
- Nestor expresses his appreciation for Allison’s expertise and the support provided by GBMC.
- Nestor mentions his upcoming colonoscopy and the importance of men’s health.
- Nestor reiterates the importance of diabetes education and support for patients and their families.
- Nestor concludes the segment by thanking Allison and GBMC for their contributions to diabetes care and education.
SUMMARY KEYWORDS
Diabetes care, Certified Diabetes Educator, Type 1 diabetes, Type 2 diabetes, Insulin management, Blood sugar monitoring, Nutrition advice, Physical activity, Sleep importance, Continuous glucose monitor, Insulin pumps, Lifestyle changes, Gestational diabetes, Healthy eating, Patient support.
SPEAKERS
Allison Ashcraft, Nestor Aparicio
Nestor Aparicio 00:02
Welcome home. We are W, N, S, T. Am 1570 task of Baltimore. We are Baltimore positive. I’m trying to remain positive around here. Despite the Ravens outcomes, we are putting the Maryland crab cake tour together. It is all brought to you by our friends at the Maryland lottery. Conjunction with Liberty pure solutions, I’ll have some Raven scratch offs to give away. I am putting dates together at fadely, Cocos and Costas and Timonium. All of this will be happening, hopefully before I age, and hopefully before my colonoscopy that I’ve been talking about, because we have a great new partnership with the hospital. My brother was born. I’ve had many friends born, many friends give birth at GBMC. We talk about all the things going on over there, and anniversaries and hanging big 60s up on campus and doing things over there. But this one’s going to be a little different, because we’ve had a lot of doctors on talking about different things and important things. But this one really hits home with me. Everybody knows my wife is a two time cancer survivor. She’s had a couple of bone marrow transplants, but one of the things that made it incredibly difficult, above and beyond, what a walking miracle she is today, is that she was diabetic and diagnosed as diabetic at 19, and I’m going to welcome Allison Ashcraft in she’s not a doctor, but I’m gonna play one on the radio, if we could do that, at least today. She has a very special title that is a Certified Diabetes Care and Education Specialist, which is exactly what I need as a caregiver to a type one diabetic that I’m now 22 and a half years into my marriage and Allison, first things first, welcome. I know you’re a GBMC, and you’re good hands, and we’re good hands over there, and I’ll be in good hands when I have my special 50 something men’s care, health care that I’m going to be participating in in November. But there’s so many ways that people touch health care. And when you’re diabetic and you’re have someone you love that’s diagnosed, it becomes a kitchen issue for breakfast, lunch, dinner, snacks, sugar tablets, orange juice and all of that stuff. And there’s so much I need to know. So I’m so glad that you’re joining me today.
Allison Ashcraft 02:13
Yeah, thank you for having me. I’m glad to be here. Alright,
Nestor Aparicio 02:17
so my wife’s diagnosed at 19 the night I met her, she was sugar crashing, and didn’t want to tell me she was diabetic, because she said it scared off dates and literally. So she said, Hey, you got to run and get me, like, something to eat. And I’m like, All right, what are you hungry for? She’s like, I don’t care. Just get me something. And I’m like, okay, and I came back and lo and behold, she had a needle out and was jabbing herself. And that’s how I learned that she was diabetic, because she didn’t like say on a first date, like, Hey, I’m diabetic, and I gotta watch what I eat tonight at dinner, and I might eat too much. I might not eat too much. I might take too much insulin, and this is before pumps meters. She has the Little Reader that she moves around that mark Andrews has all the time. I’ve talked to Mark Andrews about that, anybody that we ever see who’s diabetic, we try to share information. It really is, I don’t want to say a secret society, but it’s one of these societies that I get in a yoga class and see somebody with a monitor or see somebody the empath in me first starts with, oh, they’re a little different. And I think my wife’s little tags on her would let people know that, but it is a completely different lifestyle when you’re diabetic.
Allison Ashcraft 03:36
Yeah, yeah. And it’s great that we have so many different new technologies out there to help manage it. So, like you were talking about the continuous glucose monitor, the insulin pumps, all of those things are things that we help patients to understand, know how to use. We also talk about, you know, nutrition, of course, the meal planning, physical activity aspect. And then we also talk about different medications, because there’s so many different medications out there that can be used to help manage blood sugar levels.
Nestor Aparicio 04:08
Well, my wife is sort of famously diabetic in my world to friends and on more than one occasion we I can remember an occasion right now get me emotional, but friend of mine’s son got diagnosed six, seven years old, that this kid’s 25 now, is 20 years ago, first call to my wife, hey, our son’s been diagnosed. What we do, like, and I think that this is where you come in, right? Like, when the first things first? Let’s try to stay away from type two, and we’ll talk about one and two. We’ll talk about all the education part of this. But when it happens, and when you’re diagnosed, either through gene pool, through lifestyle, whatever it is that you need to change your lifestyle, you need to involve insulin, you need to involve meters and monitoring, it becomes a family affair, very much. So, right? And I. I’m 22 years into this, and if you gave me the dumb, dumb test right now, I would fail it. My wife is diabetic and knows everything. I’m always latching on, saying, Hi, Lo, what do we need to do? But I don’t really understand that the way I need to,
Allison Ashcraft 05:14
yeah, yeah. It is absolutely a support system, and then also having good practitioners on your side. So having an endocrinologist, primary care physicians, and then, of course, a certified diabetes educator that can help, again, to understand all those pieces of diabetes as well as the nutrition that goes along with it, because it is different, whether it’s type one, type two gestational diabetes or Lata, which is that later onset of type one, so that one is it may present as type two at first, but eventually it will progress into type one. And so the difference between type one and type two is that the type one is where the beta cells of the pancreas are no longer producing any insulin, and so those patients need to use insulin when they eat to lower the blood sugar levels. Type Two is an insulin resistance. And so that is that the insulin is just not working quite as well to open the cell up to take in that glucose. And so that latter is kind of like in the middle or 1.5 where it might be type two. At first, they might still have some beta function, and then eventually they will no longer produce insulin.
Nestor Aparicio 06:28
Yeah, you know, my wife dreams of a life of not carrying needles around and stabbing herself several times a day. When I met her, she was pricking fingers a million times to check sugar meter and then the then the pumps happened, and she doesn’t take as much insulin as the normal type one diabetic does. She’s her body still produces a little, from what I understand. And I again, I’m 22 and a half years into this, and I’ve, I’ve been in meetings with people like you, with my eyes roll back, and I’m queasy about blood like you wouldn’t believe, for a guy who was a caregiver of a woman who had all sorts of blood and transfusions, and I spent 155 nights in the hospital. So I don’t think I have so much respect for everything you all do. But when a patient comes in frightened, scared as I would be if I were diagnosed with diabetes, I would I wouldn’t say I would die, but I would be like, Oh my God, because I don’t like needles. I don’t like watching my wife give needles. She does it everywhere, in the airport, at dinner, any she just whips out her needles like it’s nothing. And every time I’m like, I think about it for weeks just coming into GBMC to get anything done, because I’m that guy. People come very frightened to you, right, and probably very disillusioned about what it is now. They google it, and they’re and there are so many modern ways to make diabetes more, I don’t want to say desirable, but palatable, livable from a lifestyle standpoint. And I’ve seen this through 22 years, where I always know my wife’s number. She’s got a watch on. She knows her she knows her number in real time every minute of every day. And it wasn’t always that way. So I’ve seen where science has really come a long way. And I’m sure from your education, from what you’ve done from schooling to now, there’s things happening every day to make it better for people like my wife, right?
Allison Ashcraft 08:28
Yeah, absolutely. And that’s what’s exciting about this position, is all of the new technologies we’re always learning about, new pumps, new continuous glucose monitors, different medications that are coming out. I mean, it’s always changing and and providing that hands on training. So in the office, we have them practice, you know, sticking their finger giving an insulin injection so that that way they feel confident in being able to to self manage their diabetes. Because that’s ultimately, our goal is to empower patients to be able to self manage this disease.
Nestor Aparicio 09:04
Well, it must be self managed, right? Like there are times again I’m tethered to a diabetic 24 hours a day and and she’s really well managed, right? But, boy, when it goes down, irritability. Disagree. You know it, it is a very, I don’t speak about it much, but you know, there have been times we’ve been out public and the sugar’s gone down and it the person. There’s a personality switch that happens that I think you really need to recognize as someone who loves, someone who’s going through this very, rapid personality change, instantly at 630 at night at dinner somewhere where you’re out and you need to find sugar tablets or orange juice immediately. And we’ve been in some really, really, we’re sort of wonder less people. We’ve been in fields and in weird places needing sugar. Sugar tablets and orange juice. And my wife is maniacal about it, but there are times where, like, You got to get me something, and I spent $10 last week at the Hollywood Bowl buying a little orange juice because her sugar crashed on me on a mountain that we climbed up in Los Angeles last week. Literally, it was an expensive sugar crash, but like, she needed it, boom, strawberry banana, whatever it was, boom. We had to do it. So I this was six days ago. Wow.
Allison Ashcraft 10:30
Yeah, yeah. And having that family member support, so having them come to visits with us really does help to have them, know, like you said, identifying those symptoms of a low. And so that’s that’s usually some type of confusion, maybe some mood change, shakiness, usually sweating. And in those moments, it is important to get 15 grams of a quick acting carb. So like you were saying the orange juice, maybe 15 to 16 Skittles or jelly beans, tablespoon of sugar, or some of the glucose for glucose tablets, and so you will find that most diabetics will carry something like that with them for those moments. But remaining calm, giving them that, and then checking their blood sugar and checking in can really help to manage those lows.
Nestor Aparicio 11:15
I can tell you, travel messes with her too, and time zones for sure, she crashed again. I you know Allison, you know when you come up, we’re gonna talk about diabetes here, especially when she’s not here to defend herself. This is becomes even more fun for me. She crashed in the middle of Beverly Hills, in the middle of the bougiest like thing that had all sorts of like $15 orange juice and chia seed pudding and different things like that. So, I mean, I talked her into like a $6 chocolate, you know, was sort of that way. But this happens all the time, and I I’m just pleasure to have you on because I want to learn about GBMC and the program, because we kind of live near campus, around here. We’re the modern part of this, in how often someone needs to come and see you in the beginning if they’re diagnosed, and also, like my wife, has no choice, right? This is where we are. It’s she’s 52 now she’s been at this for three and a half decades, but I hear of people that say I went to the doctor, and they say I might be heading toward becoming a diabetic, or I’m trending toward this, and there’s lifestyle issues that I certainly I lost a lot of weight about 20 years ago and keep my health and the best management I can, which is why I come to GBMC, which is why I’m listening to everyone to do all the things I’m supposed to do. But for people who are borderline or at risk, maybe that you would say some lifestyle advice, and what you see with people that you keep them from having to do needles and having to do all of these things by better managing themselves.
Allison Ashcraft 12:52
Yeah, so for for type one that is an autoimmune disease, so that one we cannot necessarily, unfortunately prevent. There are medications out there that are new medications to help prevent it, but for type two, definitely that lifestyle, healthy eating is a big piece. And so there’s kind of five tips that I would say that are healthy habits that, just in general, are great for weight management and just overall health. And so that’s consuming balanced meals with nutrient dense, dense foods. And so that means foods that have a lot of vitamins, minerals and fiber in them, so fruits and vegetables are whole grains, lean proteins and then our healthy fats. Another thing that’s important is meal timing, so making sure that we’re having frequent and consistent meals, and that helps with developing a help healthy metabolism. It also helps stabilize blood sugar throughout the day, and then it can also prevent from overeating and then focusing on water intake and really limiting those sugary beverage intakes. So juices, so does our lemonade, even energy drinks and lattes, because they just add a lot of sugar and calories. So really aiming to consume the general recommendation is about eight to 10 cups of water per day. And then another healthy habit would be movement. So there’s kind of three parts to movement. One is the physical activity piece. So getting at least 150 minutes of physical activity a week, and that can be broken into 30 minutes five days a week, or whatever works for the individual. The second one is strength training. So any if you’re having any weight management or weight loss, or as we age, we tend to lose our lean body mass. So adding in a day or two of just any type of movement that’s taxing those muscles can help to maintain our lean body mass. And then the last piece of movement is just daily movement, so getting up, limiting screen time, and, you know, using the stairs instead of the elevator or parking a little bit farther away from a store. And we’ll. Walking in, yard work, things like that really add up and are preferable throughout the day. And then that final piece is sleep, and that really is important for hormone balance, and so therefore it’s important for weight management and for prevention and management of disease. So I
Nestor Aparicio 15:18
was doing okay to got to the sleep part, you know, all the rest of it, I’m being a good doobie, but the sleep part, I just like, don’t sleep enough, you know,
Allison Ashcraft 15:26
yeah, eight hours is the recommendation per night. It is tough.
Nestor Aparicio 15:31
I got things to do. You know, Allison Ashcraft is here. She is a certified diabetes care and education specialist. She’s trying to give me some care and some education. So I give my wife better care. I would just say this about the diet. Part of being married to a diabetic is that it certainly all of these things my wife is, you know, Cooley has to be maniacal about this, or she would be literally falling down. She has to manage it 24 hours a day, all day, therefore I manage it with her, therefore I eat better. I you know, I don’t sleep better, but I eat better, and I do all these things that that are a part of this, from your perspective of being able to help people give me a good news story of somebody that comes in and actually listens to you and does all these things and goes home, and six months later, doesn’t have to worry about diabetes so much anymore.
Allison Ashcraft 16:26
So unfortunately, we do not see pre diabetics, but weight loss really does help to prevent it. So we see patients that have now had that diabetes diagnosis, but there are good news stories of patients that will have will come in with a one CS greater than eight, maybe even up into the 10, elevens. And then we work with them to get it down to our goal is below a seven, with diet, lifestyle, medication, again, with all of the different devices that are out there. And then sometimes we can even get patients back into a pre diabetic range, which would be that 5.7 to 6.4 range, or back into the normal range, which is a 5.6 and below.
Nestor Aparicio 17:10
Well, when my wife wants to break some of us brag about, like the Ravens score, my wife brags about, everyone say, Yeah. And she do, you know, my numbers are good, so you know, and when you’ve lived with it, as long as we have as a family, I you become a little immune to it. And it’s, it’s forever, right? Like it’s, it’s just there. So part of it is when we’re out on the road, traveling what we eat, how much we eat, how much insulin to take, all of it is a little bit of a negotiation with yourself, and you have to really you learn self awareness. I don’t think there’s any question about that, and you learn a discipline that only someone that could witness. It’s inspiring. I tell my wife all the time. I say, you every time she’s sticking herself with a needle, I’m like, my eyes light up. And I’m like, I remember the first time she gave herself a needle. And I think these people are like, sort of walking heroes to me, honestly. And I see Mark Andrews running around playing sports, and we had a pitcher here named Jason Johnson. It was the original diabetic. I knew when I had a girlfriend that was diabetic, diabetic, I went to him. I’m like, hey, what do I need to know about this? You know, I think I’m in love with the diabetic because you if there wasn’t, um, a circle, maybe the way there is maybe even a GBMC, that when you’re diagnosed, you realize you’re not the only one,
Allison Ashcraft 18:29
right? Absolutely, some of these patients, they really are amazing.
Nestor Aparicio 18:34
Well, I appreciate you coming on and try. Did I leave anything out? Because if my wife reached me, make sure you ask her about this and that, because she was telling me all this, there’s something about a 1.5 or one and a half, she said to me, there’s, do you know, there’s more than type one and type two? And I’m like, Alright, so I’m going to have to ask Allison about that, right?
Allison Ashcraft 18:51
So that’s that ladder. The 1.5 is the latter that I mentioned earlier. It might onset as like a type two, but then eventually it is an autoimmune so it’s a genetic autoimmune disease, where eventually those beta cells do or the body attacks those beta cells. And so the body no longer produces insulin, but they might have some insulin use in the beginning, and then eventually it will progress into type one, to where they’ll need insulin. And and then there’s also gestational diabetes, which is a diabetes that’s just during pregnancy. And so we see a lot of those patients as well, and that’s because the placenta is secreting hormones that increase that insulin resistance during pregnancy.
Nestor Aparicio 19:34
Well, Allison Ashcraft, if I if I run into you at a cocktail establishment or a happy hour somewhere, my wife runs into you, she will just talk your ear off about diabetes. I feel terrible. She’s not here to be a part of the segment. I almost wanted to include her, because I’m like, you’ll ask Marta questions than me. I you know you’re the diabetic. I’m not, but it’s always nice to learn more about it, because I am sort of embarrassed that I don’t know enough about it, but she is. So fiercely independent about wanting to manage it that she doesn’t want me having to know her number. But then I’m on a yoga mat next to her night before last, and I see her messing around, and she’s reaching for tablets. And then after whisk what’s your number? 78 it’s going up, don’t worry. And I’m like, okay, all right, so now you speak my language, right? Yeah. I appreciate you. I appreciate our partners over at GBMC. And GBMC does so many things that can be talking about making babies. We do commercials and all of that. We’ve been talking about other things, but certainly for diabetes care and for local right here in the Towson area in Baltimore County, they do great work, and we have outpost centers all around the community as well, with our partners at GBMC. I’ll be telling you more about that, less about my colonoscopy, especially once it’s over with, and everybody tells me that I’m clear because I’ve been getting hassled, poked, broaded, encouraged, gently encouraged, to participate in men’s health, even though I’m 57 and I feel healthy, but I’m going to find out for sure here this fall, whether I really am healthy. So I’m appreciative my partners at GBMC. I am Nestor. We are wnst. Am 15 70,000 Baltimore back for more sports and more Ravens. Hopefully good news right after this on Baltimore, positive.
