Most of the news we watch these days centers on our present worldwide health crisis,
but we really don't hear much about how it relates to diabetics. Are
diabetics more likely to develop
complications from this virus or any other virus that they might experience?
I'll be interviewing an
endocrinologist named
Vladmir Carvalho who's living in China where all this began. And I'll be asking his insights about our worldwide health
crisis and
diabetes.
Well folks I'm happy and blessed to have Dr. Vladmir Carvalho who is
like an old friend now. I've interviewed him once before as he is studying in China, and Dr. Vladmir is an
Endocrinologist and we are thankful that he is going to share with us. Dr. Carvalho. Thank you for
participating. Being willing to do yet one more interview. Thank you so much. I really appreciate it. Thanks for having me here again.
Okay, so let's talk about
diabetes and the corona virus now. What I have read from the American Diabetes Association is that
Diabetics are not really any more likely to get the corona virus than anybody else.
But if they do get it,
they're more likely to suffer complications from it or perhaps die from it. Is that how you see it?
Yeah, people with diabetes are more likely to die from almost anything,
you know. Because right
now we're talking about coronavirus. Right? But normally there are some other viruses or other bacteria. There are many things that are trying to
that are trying to get into our body
every day, every second. But our body would normally find a way to deal with it , because our immune system...
there are cells from our immune system that can recognize any foreign body and
destroy it.
But when we have something tough like this COVID-19 like this SARS-CoV2.
That's the name of the virus. That can replicate this fast and can spread this fast,
then your immune system also has to be fast.
But for people with diabetes,
they have a few problems. You know, I made a video about A1c, and
I explained why we measure a1c, which is
glucose attached to some molecules inside the red blood cells. And
for us, we need to understand that glucose is not only in your body going up and down.
They can be attached to different things in your body. Different molecules, different proteins, lipids and different things.
so one of them is
red blood cells, and we measure it as a1c. But other
cells from your immune system, your
blood vessels, other...
you know,
signaling molecules. They can also be
Glycated. they can also have sugar attached to them. And when sugar attaches to them,
sugar can change their structure or
function, or both. And
that can
trigger your body to recognize that things have changed and start some inflammation.
That's why we say that patients with type 2 diabetes or, you know, or obese or things like that. We normally say that they have
low-grade inflammation at all times, if the blood sugar is higher than normal.
So,
it's not actually about the corona thing.
It's about your immune system that can't work properly, because
many things that are supposed to be working have sugar attached to them that will change their structure and function.
To give an example: if you look at our blood
vessel
It looks like something long, like a tube.
But it's not. It's just many cells, many small cells attached to each other that makes a long tube.
So when your immune system needs to fight an infection,
those cells, they need to be flexible and
separate from each other and let the cells from the immune system, with blood, get to the area. So that they can fight.
But for people with type 2 diabetes or any other diabetes, their blood vessels will be impaired.
So even if your immune system can come to the area,
they'll have a hard time getting to the real location.
So that's why patients with, you know, type 2 diabetes that have problems with feet. Diabetes food or Diabetic foot.
Some of them, if
the blood can't get to one area, they have a hard time
repairing that part. So that's why some times
we just
cut them. Because it's better that way. Because the blood is not getting there anyways.
So, this is the main problem with patients with diabetes. Yeah, it seems like
almost
everything that can be bad in terms of health, a
Diabetic is just more likely to get it than a non diabetic who is otherwise healthy.
One thing I've had in my own life several times. It is not pleasant, are urinary tract infections.
Is it your experience and understanding that urinary tract infections are
frequent problems for diabetics? Yeah, that one has two reasons.
The first one is what I just said, that if there's any infection we need your immune system to get to the location.
But it's very difficult for people with diabetes. And the next one is that if you get an infection, if you have
some bugs around an area, they also like sugar.
They also replicate quicker if there's sugar around. So that's why medications like
sglt2 inhibitors that increase patients urination, they cause
Urinary Tract Infection. Because they put a lot of sugar there and bugs love them.
One more thing about the corona virus is also the location.
Because everything that is happening, you know...
inflammation can happen in different places. Your arms, your legs your feet, but this one is happening in your lungs. And
your lungs, you need them all the time to breathe. And
this is a problem for everyone that can't breathe properly. And people with diabetes are one of them.
For example, people with cardiovascular disease that if they try to run for 10 minutes, they don't have breath anymore.
So they have problems breathing even in normal situations. People with type 2 diabetes or obese. They are in the same
boat. But if you are an athlete that you can breathe really well then maybe you can...
You can just stay like that for some time and wait for your immune system to deal with it. But if
before that you already had some problems with breathing. You couldn't have enough air, just sitting down and you're...
Then it will be much worse for you.
So let me ask you this. If you've got a high a1c. Let's say
10, 11 and
You through
intermittent fasting and low carb diet and some exercise and different things, and you get it down to let's say 5.5
A lot of people say well, you're still diabetic. You've just brought your numbers low, but will bringing those numbers low make you less
less susceptible to these various afflictions?
Will you be able to fight off infections, fight off diseases and viruses better
with a low a1c than you would have with a high a 1c? Yes much less
because I...
I just told you about glycation, right? The way we measure a1c
Sugar attached to your red blood cells. For example: red blood cells live for about 120 days.
But other cells in your body, they also live for some time.
Some maybe 2 weeks, some maybe 1 weeks, some maybe 2 months, and you know...
So if you have your glucose under control for a long time,
most of them will be clean.
There are some... some... there are some other ones that will still be effected a little bit. But most of them will be OK.
That's why patients with diabetes, if they're going for an operation,
for example, we prefer to tell them to go lower their a1c
before they go to the operation. Because when you lower it, your chance of fighting anything
increases. And
If you have it normal for a long time, you are almost like someone who doesn't have diabetes.
Well, that's really good news doctor, because there's a lot of people who say ok,
yeah, you've lowered your a1c. But you're still a diabetic. You're still gonna have all the problems.
You know, you just got a better number.
But what you're telling us is it you don't just have a better number.
You have a much better chance to fight off disease, to live a healthy life and so forth.
There are actually studies like that. You know, that decreasing your a1c from something like, for example,
nine to six or six point five or something can decrease your risk of
complications by more than fifty percent. Even, in some studies, more than seventy percent. So it's this
is a fact.
Well, that's wonderful
Let me ask you this suppose someone who's watching this says well, my a1c is high.
What do I do? What steps can I take to get it low?
Of course, those who watch my videos kind of know where I stand on this.
But if you had someone asking you that doctor.
What would you tell them in terms of being able to to quickly get those numbers lower where they could be healthier and more
resistant to disease and virus and so forth. For me, in normal situation,
it's the same way I told you before. I told you first diet and exercise and then
medications that help the disease, and then some other medications that do not help the disease
but they lower your glucose. Including insulin.
But in this case, I put lowering a1c first. For this
period. For this, maybe two or three months. So for me, for this
this time, I
would not go and say okay. You must do it with diet and exercise. If you can do it, that's great.
But if you can't, we should immediately use some medications, or even insulin to just get your a1c
under control. But what you do later after this, you know
COVID-19, then is another story.
But at this moment for me lowering your a1c is more important than how you do it. Right?
So to get your A1c
down close to the normal range is a really really big deal for
our health, and we should make every effort possible to do that. I think that's what you're saying.
Dr. Carvalho. Thank you for being on our
program. And you've given some excellent advice and some help. We're glad you and your wife and your
kids are all doing fine.
That is good news.
And let's pray this thing, this scourge
passes. And comes to an end, and we can be about our lives once again.
Thank you doctor. Thank you so much