This week, a look at a way of eating for all types of diabetes that sounds – frankly – really hard to do. But the guys behind it say it's the key for lowering insulin resistance for all types of diabetes.

Check out Stacey's new book: The World's Worst Diabetes Mom!

Robby Barbaro, MPH is the co-author of a new book called Mastering Diabetes. We'll talk about what he actually eats now and why he's so passionate about this. He has a pretty compelling story.

Join the Diabetes Connections Facebook Group!

Robby mentions Volumetrics (more here)

In TMSG – when an avid scuba diver is diagnosed with type 1, she finds a way to get back in – and under – the water. Plus, a little bit of a control iq update for us – we'll tell you how it's working out.

This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

-----

Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! -----

Get the App and listen to Diabetes Connections wherever you go!

Click here for iPhone Click here for Android

Episode transcription

Stacey Simms 0:00

Diabetes Connections is brought to you by One Drop created for people with diabetes by people who have diabetes, by Real Good Foods, real food, you feel good about eating, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.

Announcer 0:21

This is Diabetes Connections with Stacey Simms.

Stacey Simms 0:27

This week, I look at a way of eating that sounds frankly, really hard to do. But the guys behind it say it's the key for lowering insulin resistance in people with all types of diabetes, even so, it seems a little extreme.

Robby Barbaro 0:42

And I come down to the Christmas Day meal and I literally have a pyramid of bananas. We're talking four bananas on the bottom and three then to the true pyramid of ripe bananas. And that's how the practice was done. They were just shaking their head like this. They were kind of laughing and thinking this is not And Alas, there's no way because they've seen me try out different diets over the years.

Stacey Simms 1:03

Robby Barbaro is the co author of a new book called Mastering Diabetes. We'll talk about what he actually eats now and why he is so passionate about this. He has a pretty compelling story in Tell me something good. When an avid scuba diver is diagnosed with type one, she finds a way to get back in and under the water. Plus a little bit of a Control IQ update for us. We'll tell you how it's working out. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.

Welcome to another week of Diabetes Connections. I'm your host Stacey Simms, so glad to have you along. We aim to educate and inspire by sharing stories of connection when it comes to type one diabetes. My son was diagnosed right before he turned two and that was 13 years ago now. My husband lives with type two diabetes. I do not have Diabetes, but I do have a background in broadcasting in radio and television local news. And that's how you get the podcast.

A lot to talk about this week, we will get to Mastering Diabetes in just a moment. But I want to give you a quick update on our experience transitioning over to tslim X2 insulin pump along with a Dexcom G6 continuous glucose monitor. And then the Control IQ is the software that is in the pump. If you're not interested in this, if you're not using this kind of pump, or if you are on MDI or, you know, just skip ahead a few minutes. I do have time codes as always in these newer transcribed episodes for this year. So you can open the episode homepage, open the notes, and you can skip right ahead to the interview. But if you want to know about our control IQ experience, here's how it's going.

We were able to get the new software very early On we got it I want to say the third week of January, we did not get it without issue. Benny's pump was one of the few that could not be updated by plugging it in. There was some issue with the software update that was already in the pump. And even everybody who had that version of the software, only a very small percentage, my understanding couldn't actually plug into the computer and update. Anyway, tandem sent us a new pump with Control IQ on it. And of course, I was to send the old pump back. So we updated immediately it started doing its thing. I will go into more detail about after a month of using it, we're going to sit down and talk about it. But Wow, it really made a difference right away.

The problem was that it was tanking him he was going low, overnight, every night. And I try to not make changes until about two or three days. Right. We have to kind of see how things go. You don't want to overreact. So he went low the first three nights. And then of course we changed it because I'm talking down to 40 you know for extended periods of time. We cut way back on basal. We also cut insulin sensitivity, which really shouldn't affect it when it's in that sleep mode because the sleep mode doesn't give boluses. But we cut back on that anyway because it seemed to be having some issues with corrections during the day really making him go lower than he should have been having to suspend insulin. After that. It really smoothed out. He was using less insulin. He was in range in a very much increased amount of time. You could see his numbers were coming down. It was really cool. Even on a day where he completely forgot to bolus for a big brownie in the afternoon. He went way up, but he didn't stay up. And if you've done that, you know that at least for us, you know if you have like, I mean really, let's be honest, 50 uncovered carbs 40, 50 uncovered carbs. You're going to go up to 300 and stay there for a while. But Control IQ. He did have to bolus but Control IQ brought him down really quickly. It was great.

But unfortunately, it didn't stay great. About two weeks in his pump, the brand new pump that they had just sent us with the update, gave us one of those alarms that you can't reset. Oh my goodness. So I was actually on my way out of town. That was the weekend I was heading to Maine. And Benny was going to be leaving that afternoon for the two day wrestling tournament. So again, he could have done shots, but we were just like, oh, my goodness, you know, what are we going to do? Well, I hadn't actually sent that other pump back yet. It was on my list of things to do, I promise, but I hadn't gotten around to it. So luckily, he put on the old basal IQ pump, the previous software, my husband called tandem, and you know, they went through the troubleshooting is this an alarm that can be cleared? It could not. So they overnighted another Control IQ pump, and I put return the pump on my list of things to do yet again, but then, okay, so then he is at a two day wrestling tournament. It was supposed to be one day, unless they won, which they did, which meant they went to the state championships which spoiler alert, they won. So it was two days of travel and crazy food and then celebration food. parties. Oh my goodness. And as you know if you've been listening while Benny's not actually wrestling this season, he's actually more like the manager because he hurt his knee. So he's doing great, very exciting to be a freshman and have the first school state championship for the wrestling team was very, very cool.

But anyway, alright, so back to the pump situation. So then on Sunday, he's home. He's got the new control, like pump on and then early Monday morning, I want to say five o'clock in the morning, transmitter failure. Not you know, we're not sure not sensor error, not sensor failure, transmitter error for the Dexcom. So Benny turned it off. I didn't even know he just kind of clicked off and went back to sleep until six. I mean, he got one more hour of sleep. That transmitter was two weeks old. It's not supposed to crap out that early, of course. So we had to pull the sensor the transmitter put a whole new set on. Of course I called Dexcom. They replaced everything. But then we're another day really a day and a half between everything that was going on with that. Control IQ so I can say what it's working thumbs up when the technology's not working, which will happen, right? He's fine. I mean, we could always go back to shots, certainly, but who wants to do that? So little frustrating, but we moved forward.

The only advice I have if you're about to start Control IQ, if you're thinking about it, if you haven't made the switch over yet, is, I would highly recommend and please talk to your endocrinologist before doing this, make the change for insulin duration, change over to five hours now, because that's not negotiable on the Control IQ system. And most of us have it set frankly, incorrectly, because we're making up for it in other ways. A lot of studies have been done in this I'm sure if you're familiar at all with Control IQ, you've heard this, but if you haven't, one of the things we did was set the insulin duration to five hours several weeks before starting. And I think it really helped us in the transition. Something to think about something to talk to your endo about and then you just Gotta be patient, make changes slowly and let it do its job. It's so hard when we're used to managing these dumb pumps, right and do this, do that and stay on top of that. To let it do its thing is very difficult.

Okay, let's get to Mastering Diabetes in just a moment. But first Diabetes Connections is brought to you by Real Good Foods and new brand new from them stand alone crusts, so you can create your own pizza but whatever toppings you want, but this is a cook and serve pizza crust, grain free. It's made with cauliflower. I mean, you know Real Good Foods. They're delicious. high in protein, low and carb grain free gluten free. Lots of varieties. I mean, they have the pizzas that have great toppings on them. They have stuffed chicken, they have breakfast sandwiches, huge variety. I like it because it's really easy to find in my grocery store freezer, but you can go online and order the whole shebang. Find out all the different products that they have and mix and match. Find out more go to diabetes dash connection. dot com and click on the Real Good Foods logo.

My guest this week is one of the authors of the new book Mastering Diabetes. These guys also have a podcast, Robby Barbaro and Dr. Cyrus Khambatta say, focusing on lowering insulin resistance through food is the key to living well, with all types of diabetes. Robby lives with type one. And I promise he's really not saying anything out of bounds here, like, you know, this is going to get you off insulin or this is a cure, but there are some unconventional thoughts that he shares in this interview. As always, when I talked to people who are focusing on a particular way of eating, and I do this all the time, we've talked to people who eat low carb people, you know, high fat keto, people who are making these claims on the podcast. This is not something that I verify or confirm during the interview, and do my best to give you all the information. But again, before you make any changes, please talk to your endo. I really did enjoy talking to Robby. Here's our conversation.

Robby, thank you so much for joining me. I am so intrigued by everything I have read and heard. Thanks for coming on,

Robby Barbaro 10:09

Stacey. It's really an honor to be here. I love your show. And the fact that I'm getting to be on it is just really exciting to me.

Stacey Simms 10:15

Oh, thank you so much. We have so much to talk about. I have so many questions for you. But I want to start at your beginning. You had a fairly typical from what I seen onset of type one diabetes as a teenager as a tween, really, but you were diagnosed by your brother.

Robby Barbaro 10:31

Yes, it truly is a fascinating story. So I'm on January 26. That'll be the day that I have lived with Type One Diabetes for 20 years. So I was 12 just about to turn 13 and I complained to my mom, I said, Mom, I am thirsty all the time. I'm going to the bathroom all the time. I think I have diabetes, just like Steve so I have two older brothers. The middle one Steve was diagnosed with Type One Diabetes eight years prior to me and I was pretty sure I had diabetes around said no, no, I don't think you do. Don't Don't be silly. I said, Okay, fine. And then eventually, she went out of town to go look at homes in Florida where we eventually moved. So it was just myself and my middle brother at home. And she called the check in and she said, Hey, how are things going? I said, Mom, I couldn't sleep last night, I was cramping. She said, Okay, go upstairs. Use your brother's bug because meter test yourself. And I was well over 400. And my brother said, right there in there, okay. You have Type One Diabetes pack, your bags are going to be the hospital for a few nights. So we went to the regular general doctor, they ran a few tests. And I remember the doctor coming in said, Yep, you have type one diabetes, we're going to send you to the hospital.

And that was the first time I had seen my brother crying, as you know, as an adult. And he said, Oh, man, just sorry. You have to experience this too. And my parents flew home the next night. And this mother thing that really stayed with me as my dad saying, Don't worry, it's just an infant. convenience, you can still do whatever you want in life. And that was really the mentality that my parents had. And really, they were very, very supportive, very encouraging. And really let myself and my brother really take charge of our diabetes care. And, you know, we were we were both already, you know, type a people that really were on top of it, and we had good medical care from the Mayo Clinic. So it didn't really crush me. You know, I really had a really supportive environment had the tools I needed, and it just began a new life with Type One Diabetes.

Stacey

I'm really intrigued by your brother's reaction because on the one hand here, you have a brother who's nine years older than you you look up to him, I'm sure and you see that he's probably doing pretty well with this. So on the one hand, it's okay I'm gonna be fine. But then he gets emotional. And he says for you, so that's the had to have been tough to digest as a kid, like I'm going to be okay but there is the sadness too

Robby Barbaro 12:55

play the sure the whole thing was honestly it kind of like, I can I sort of remember certain bits and pieces. I remember driving in the car and talking to my parents on the phone. And just it didn't really, it didn't hit me like I didn't kind of fully understand what was going on. But I guess I just ease into it. And at some point, I guess you just you don't really have a choice. It is what it is, you know? Yeah,

Stacey Simms 13:19

no doubt. So the years go on, I assume that you were treated more traditionally in terms of you start on insulin, you're eating particular diet, you know, your parents are keeping you busy in school. But you had other health issues as a teen

Robby Barbaro 13:35

I did. I had plantar fasciitis, which was frustrating. I was a competitive tennis player. So that's really a painful, painful feeling in your feet when you're walking and trying to run so I would wear these big blue boots at nights to try and help with passive stretching to do plantar fasciitis. I had chronic allergies are all the time, so I took Nathan x and Claritin. D and I would still get sick. As a teenager. I had cystic Acme, which was really frustrating and I tried everything microdermabrasion treatments, laser treatments, oral creams, like oral medical or eye creams for my face and oral medications. Eventually, they put me on Accutane. And that's one of the most serious drugs you can take for acne, your parents actually have to sign a waiver, because some people have committed suicide and that drug. So I also had warts on my feet. So these were just a collection of you know, frustrating, I think, standard symptoms that a lot of people have. Wow.

Stacey Simms 14:33

So when did all the fruit stuff start? When did you decide?

Robby Barbaro 14:38

I mean, I'm sorry. Yeah. I mean, I'll tell you the journey to get into the fruit stuff. So growing up, this is when I was living in Minnesota, you know, doing standard diabetes care. I went to the Mayo Clinic in Rochester, Minnesota with a Vincent cloud, and we would go there and they just had a great team. We had an endocrinologist. I had a dietitian, I had a psychologist. So it was a team effort. There. And the key thing I remember learning from them was like using a log book and actually got quite good at that. But I had standard care. And my dad was into selling supplements through a network marketing company and getting exposed to what they were teaching and some of their educational material was the very beginning of me really considering Okay, wait a minute, there's something to nutrition there's something to diet outside of just following a standard American diet, not really thinking about it. So that was the beginning. And it was a slow evolution of learning. Okay, wait a minute, you know, trying to avoid additives or foods like MSG, like that's good. That's a good idea for your overall health. And I slowly progressed. Eventually, I came across many different lifestyles.

But as I was on this journey of learning as much as I could, I came across a book called natural cures they don't want you to know about by Kevin Trudeau. Now, I'm not recommending this book. This guy ended up in jail. Yeah, there's, there's some things I'm not recommending it. But I came across this book, and it planted a seed in my mind that you know what, maybe it's possible to reverse type one diabetes. If I just eat as healthy as humanly possible and I take care of my body. Maybe I can put myself in such a healthy state that my body will regenerate new beta cells. And now it's just it was the theory the hypothesis. Okay, wait a minute. Like, I know other people haven't done this. But hey, somebody has to do it first.

You know, for example, Roger Bannister was the first person to run four minute mile. And before he did, the smartest people in the world said that's impossible, your heart will explode. And once he did it, other people started doing it. So I do think we're gonna we're gonna figure this out at some point some way how to get beta cells to work again. Naturally, I do believe that but that's not happened. So I go down this mission of Okay, I will do anything and everything to give my body the best chance of healing itself. So I started learning about the concept of fasting. So fasting is when you when you go to bed at night, you're doing like a mini fast and you in the morning you eat breakfast you're breaking your fast and healing and regeneration happens over that time. So it's okay, you know what type of dietary habits can I do to increase the chance of my body healing itself. And this led me to try summarize, the first thing I tried was a Weston a price foundation diet, and that was eating a lot of grass fed beef. They advocate for raw milk, I remember going to farmers markets, and I would buy milk for cats because you can't sell raw milk to humans. And again, I did see some improvements as I cleaned up my diet and got rid of any sort of junk and processed food. There was definitely some improvements but I didn't see anything specific happen to my diabetes health or my insulin intake or my blood glucose control.

So I continue to learn more and learn more, and eventually, I came across a dive by the name of Dr. Gabriel cousins and He was in a movie and he produced a movie called raw for 30 days. And in this movie, he showed how people following his protocol, which is essentially a plant based ketogenic diet. He didn't call it that at the time because ketogenic diets weren't really popular, but that's what it was. I would eat lots of nuts and seeds, lots of vegetables and oil. Like that's basically where my calories are coming from on this phase one, Gabriel cousins program. And you gotta remember, everything I'm doing here is with this mindset of Okay, I'm going to reverse type one diabetes, I'm going to heal this is a strong live a strong motivation. So at this point, I am a freshman in college at the University of Florida.

Stacey Simms 18:42

Okay, I'm gonna stop you right here for the question. So you're trying this experiment, you're experimenting on yourself, basically, I mean, to boil it down. And were you still seeing your endocrinologist? Were they telling you dude, you know, you're losing weight. Let's be careful was anybody giving you a push back at that point?

Right back to Robby will find out what is endo said. But first Diabetes Connections is brought to you by One Drop. getting diabetes supplies is a pain not only the ordering and the picking up but also the arguing with insurance over what they say you need and what you really need. Make it easy with One Drop. They offer personalized test strips plus you get a Bluetooth glucose meter test strips lancets and your very own certified diabetes coach. Subscribe today to get test strips for less than $20 a month delivered right to your door. No prescriptions or co pays required. One less thing to worry about. not that surprising when you learn that the founder of One Drop lives with type one, they get it One Drop gorgeous gear supplies delivered to your door 24 seven access to your certified diabetes coach, learn more, go to diabetes, connections calm and click on the One Drop logo. Now back to my interview with Robby and I'm asking him if with all the weird things he was doing with This end of gave him any pushback.

Robby Barbaro 20:06

Okay, it's a great question. Yes, I would see my endocrinologist every three months you know, you got to get your prescriptions and whatnot. And here's the interesting part I think probably a lot of people with type one are gonna have a similar experience which is unfortunate but they never asked me about my diet. Oh my god, I kid you I kid you not I have been through except for the Mayo Clinic Mayo Clinic they were very detailed. They asked me everything I need, they log it, they kept track of it, but after that, they had two different endocrinologist in Florida. And I think I've had one different one in Los Angeles and not a single one of them not a single appointment. Have they asked me exactly what foods do you eat? Not one.

Stacey Simms 20:48

You know it's interesting because I don't think our endo and Benny's a child obviously. So he hasn't really asked me what do you eat but the they sent us to a dietitian or a nutritionist years of years ago. We never really followed up but You know, he's asked us just kind of like, you know, what are you especially when he was little? What are your favorite foods? What's your favorite fruit? What's your favorite vegetable? You know, he would kind of play. He was great with kids, you know, and ask him about that. But we definitely talked about food and he knows how we eat. So that's really fascinating. All right, so you're on the sly, nobody's following up on you. You're doing fine.

Robby Barbaro 21:17

Yeah, I mean, and the thing the key thing was, I think, from the endocrinologist perspective, give them a little bit of credit, I guess, is that my a one sees were always quite good.

Stacey Simms 21:27

There was no need for them to go into.

Robby Barbaro 21:29

Yeah, exactly. There wasn't a need to like pride and how can I really help this guy? I appeared healthy. I all my other blood work was fine. My agency was fine. I think they did. Like Okay, he's doing great. Like, let's let's just call him the next patient. So at this point, this is where it gets interesting. Here's where I love to talk about the diabetes nuances because your audience because you're gonna understand this stuff. At this point. I'm a freshman at the University of Florida. And again, my mindset is how can I you know, take less and less insulin and eventually not need any That's the goal. And in hindsight, what I realize is What really matters is if you're taking lesson lessons one that's only really significant in regards to reversing type one diabetes, if you know you are also starting to produce more of your own, if your your C peptide level is increasing, if your beta cells are, you know, starting to become functional again, that would be a good thing. But in this case, I was dropping and dropping man. So I took at this point, I was taking 10 total units of insulin per day, I was using only fast acting insulin. And I was actually still doing it through MDI, which I would not recommend, but I would actually take small injections throughout the night, and I was eating 30 grams of carbohydrate per day no more than 30 grams. So my carbohydrate insulin ratio was three to one, and that's a metric of insulin sensitivity.

So you can calculate your 24 hour insulin sensitivity by taking your total carbohydrate consumption, dividing it by your total insulin consumption. This was good like I was getting so excited. Eventually I reached a plateau I thought it was dropping and dropping and dropping that just fader on 10. And the problem was, I had terribly low energy and I was losing weight. That was the big problem. I couldn't keep weight on. And I was on campus, several situations I just basically blacked out, I'd have to stop, you know, that feeling of Okay, wait a minute what's going on, I have to like, recalibrate, you know, get home rest. And it was scary. So I went back to my naturopath who I'd seen throughout high school who helped me with a lot of supplements and food sensitivities, stuff like that and say, Okay, what can I do next? And she's okay, maybe you could benefit from therapy. And I was like, okay, maybe I'll do that. But it was gonna be very expensive. And I was gonna have to drive from Gainesville, Florida to Tampa, Florida, to be able to do this. And I was ready to commit to it. I would do anything to continue pursuing this path. Now, before I committed I heard a podcast and this is where the fruit comes in.

So I heard a podcast from this guy, Doug grant, he's a chiropractor, and he was talking about how people who eat you know, healthy diets and you know, the fruit, that that can actually also help detoxify your body like the nutrient, the nutrient density can help your body eliminate, you know, heavy metals and toxic substances. So I'm like, Okay, wait a minute, this guy's tell me I get to eat all this fruit. He's telling me it's going to have these healing properties. This sounds a lot more exciting than doing the collation therapy. So I'm going to give this a shot. And that was the beginning of the journey of eating fruit. So this guy, this guy, Doug Graham, he teaches basically, you know, basically a fruitarian diet to a certain extent, I would not cannot comment on fruitarian I don't think I follow a fruitarian diet, but I started working with him. And in this is September of 2006, in December of 2006, is when his book comes out. And I read the book straight through and one of the testimonials in the back of the book is my my co founder of Mastering Diabetes, Cyrus Khumbatta. So his testimonials in the back he's also living with Type One Diabetes. He had this amazing transformation of his health and his insulin. sensitivity. And I was blown away. So I go Google his name. I learned some more. I see pictures of him on the internet like, wow, this guy's ripped. He's fit like, this is awesome. I'm really optimistic. I'm going to do this. And so I started working with Dr. Graham and I start eating lots and lots of fruit like literally the first week Ain't nothing but bananas. The second week, I hate bananas and lettuce. And then I continue to add model meals of fruit like this is the beginning I even much differently now. But

Stacey Simms 25:26

I can't wait to hear because this sounds horrible, but go ahead.

Robby Barbaro 25:30

It was really as kind of like, it was like an elimination diet to a certain extent. This is around Christmas time now of 2006. And I remember my, my grandmother was was in town for the holidays. And I come down to the Christmas Day meal and I literally have a pyramid of bananas. We're talking four bananas on the bottom and three then to the one true pyramid of ripe bananas. And that's how they eat for Christmas dinner. They were just shaking their head like this. They were kind of laughing and thinking this is not going to last so No I cuz they've seen me try a lot of different diets over the years and a little bit No, it's it's basically lasted for for 13 years now but again, here's the change the changes that I started eating all this fruit, you would think that I would then need absurd amounts of insulin to eat all this fruit so I'm eating nowadays 600 700 sometimes 800 grams of total carbohydrate per day, and the insulin I'm injecting is somewhere between like 25 and 35 units I mean, depending on how active I am, depending how consecutive my fitness has been, but like I have some Instagram story how so people can see all the details recently, it's actually been under 30 units. But the here's the the percent change. If you can't do the math of that say, like little over 30 units per day and like 700 grams carbohydrate, you're going to come up with a 24 hour insulin sensitivity ratio somewhere around like 22 to 124 the 126 to one that is a 600% change in total this instant sensitivity going from three to one to 25 221 so I'm eating all of this carbohydrate energy, but I'm not needing excessive amounts of insulin, I'm actually using a physiological normal amount of insulin. I think that's an important goal for people living with Type One Diabetes is to live a lifestyle where the insulin you're injecting is close to what your pancreas would have normally been succeeding prior to being, you know, having beta cells and not working properly.

Stacey Simms 27:28

Wait, wait, let me stop you there, because and I had lots of questions about the food. But what you're saying about the normal amount of insulin is not what I was taught. I was always taught that if my son didn't have diabetes, his pancreas would produce whatever amount of insulin he would need. So I mean, let's say you know, we're not talking about someone who's going to spend 20 years eating high fat foods, fast foods, people cupcakes every day. Let's say someone who has you know what kind of an everything in moderation diet, wouldn't their body just produce whatever amount of insulin they would need? Or have I? Is there a study or something that says no, no, you should only be producing 30 units of insulin a day?

Robby Barbaro 28:06

So it's a great question. It's an important question. So there is research that shows how much insulin a healthy human will produce, you know, over a 24 hour period, and it's somewhere between, you know, 25 and 50 units per day. That's fascinating.

Stacey Simms 28:22

I'll have to look those up. Because I really didn't realize there was a, you know, kind of a standard or normal, I just thought it was okay, if you're eating this, then that's what your body does. If you're a teenager, then this is what your body puts out if you're pregnant.,

Robby Barbaro 28:36

Absolutely. No, there's like there's definitely a range. And you know, this definitely goes into the whole research of insulin resistance and what's happening in pre diabetes and type two diabetes and you know, doctors who monitor fasting insulin levels and sort of markers like bad or to get an idea of somebody's state of health, which, again, I think it's an important conversation. That's not happening. often enough in the type one world, which is the fact that we actually can very easily monitor our insulin sensitivity type ones are the most fascinating test subjects for insulin sensitivity on a meal by meal basis. And that's sort of why part of the reason Cyrus are so passionate about what we do is because as people living with Type One Diabetes, we live, eat, sleep, and breathe insulin sensitivity on a millennial basis. And we know that that is the solution to people living with pre diabetes and type two diabetes that is the cause of their condition. It's insulin resistance. If you can learn how to reverse that and maximize insulin sensitivity and be able to utilize insulin that your pancreas is still producing, then they can just become free of diabetes. And this has been shown in peer reviewed research for almost 100 years now.

Stacey Simms 29:56

Okay, so let's go back to the food because If you told me that I was going to eat a pyramid of bananas, or Ooh, maybe add some lettuce, I would tell you that's not happening. Get out of the car, we're done. So tell me a little bit more about what you eat on a day to day basis, if you don't mind and I won't, you know, we all well, I won't judge I'm just going to say, tell me a little bit more about what you eat on a day to day basis.

Robby Barbaro 30:23

It's such an important question and I will get to what I eat. But I first I want to start off with the passion and understanding that satisfy both have for making sure that people who decide to you know follow our program or join our coaching program. Absolutely love every single meal. Like we are very passionate about that and we really work with people about getting specific feedback about the types of foods they like the texture, you know, the different flavors to add and like there's so many different ways to do this. You know, low fat plant based whole food approach that we're talking about. So we've actually put it into a very simple, easy to follow like traffic light system.

Stacey Simms 31:08

Okay, so tell me about that a meal about like a client would eat perhaps rather than what you're obviously able to limit yourself in certain ways.

Robby Barbaro 31:17

Yeah, so So basically, it's going to come down to picking specific ingredients. So we have a green light yellow light red light category. So the green light foods include fruits, starchy vegetables, lagoons, intact whole grains, then you have leafy greens, non starchy vegetables, herbs, and spices, and mushrooms, those are all the foods in the green light category. And any given meal we teach people can include any combination of those ingredients that they desire. And the reason they're green light on our program is because those are all they're very nutrient dense, they're high in water content, they're high in fiber, those are not unprocessed foods, and they also are low in their fat content. So that's really the key of what we're doing here. That's why I can eat so many grams of carbohydrate and not need an excessive amount of insulin and actually just use a physiological normal amount of insulin. It's because we have reduced our fat intake.

Stacey Simms 32:09

Okay, so give me an example of a green light meal like break it down, I'm looking at my plate what's on it.

Robby Barbaro 32:14

So for breakfast, you're going to have one to four of your favorite fruits. So this could be berries, pears, mangoes, papaya, bananas, you name it for your favorite fruits, then you're gonna have some some greens or non starchy vegetables. So it could be lettuce could be a rula. It could be cucumbers, could be zucchini, stuff like that. And also ground flaxseed or ground chia seed in order to make sure you meet your essential fatty acid requirements as an insurance policy. So just by having a small amount of those ground up, you literally automatically right then and there just in your breakfast meal have met your essential fatty acid requirements, even though it's not completely necessary because if you eat enough calories from Whole Foods You would also meet your requirements, but we're sort of doubling up and giving people an insurance policy. So fruit is our primary recommendation for breakfast. You can also have things like, you know, hash browns for breakfast, or, you know, this being breakfast dishes, there's a variety of things their lunch would include, for most people, much more starch, heavy meal. So that's things like potatoes, butternut squash, like a bean stew, something like that. But again, it's going to also have vegetables going to have herbs and spices going on, sometimes mushrooms, the after like a dinner meal. And again that that afternoon meals, the starch focus is allowing people to eat the bulk of their energy at that meal because that's when people are most active. And then you didn't have like a snack in the afternoon fruits a great snack, you know, potatoes are great snack, stuff like that. And then dinner would include, again, there's going to be a starch component of being component, maybe a fruit component, but it's going to be heavier on Vegetables because we are not as active in the evening most of us and that's a good time to really focus on the vegetable nutrient density. And then again like people could have like a dessert like a fruit based dessert. I like have something like an ice cream or something you take banana as you put it through a blender, combine it with some wild blueberries and you have it's really amazing it's delicious. So they're very simple meals like and again everything is is whole that's the that's the really the key nuance if somebody wants to like truly do it 100% but I also want to emphasize you don't need to do and hundred percent to get the results but that's unrefined whole ingredients combined into bowls. That's really how it goes. Right got

Stacey Simms 34:41

That's very, very eye opening. That's very clear. Thank you. But I have to ask I know a lot of people listening said potatoes hash browns arm people with diabetes, not supposed to be able to eat that.

Robby Barbaro 34:51

So, again, this is this is the fun part about talking to people. You know, there's many people living with type one, type two The fact that we get to test our blood glucose on niobium basis makes this condition very unique. So if somebody has heart disease or they have cancer, they can't really see that, did things get better or worse based on that specific meal, you don't really know they don't have a key metric. So I'm sure a lot of people listen to the show, have eaten a potato, eaten a starch, heavy meal, eaten some bananas, and they just saw their blood glucose skyrocket, and they're like, man, how is this guy robbing? that food is not the reason that I just saw my glucose meter go to 202 5300. And here's the deal. This is the eye opener. What's happening in that case, is you're likely again, this could be nuances around insulin timing, which I will get into for type one diabetes, but in general, let's say we're talking about type two. The reason that when you ate the banana you ate the chemo. You saw a bug because is because you're living with insulin resistance. It's because what you ate prior to that meal, which has brought about the state of insulin resistance, and what that is, insulin resistance is when your body is struggling to take glucose out of your bloodstream and into your cells. All right, and this is caused the primary cause is when there is fat stored in cells that are not designed to store fat. So your adipose tissue is designed to store fat, okay, you're supposed to have a little bit of fat in your muscle and a little bit of fat and visceral liver cells. But when you have excess, it inhibits the function of insulin, okay, influence sociopaths open the door and allow glucose to go everybody stream into yourself. When that function is not working. Your blood glucose level goes up and up and up. And that's what's happening and pre diabetes and type two diabetes that's the cause. Now, this is also a major problem for people living with Type One Diabetes Type 1.5 diabetes and insulin dependent type two. So the insulin we're injecting in Is it working as efficiently or properly, and that is the resolve. That is why a high carbohydrate meal will result in a high blood glucose reading. So as you begin to lower the fat in your diet, and these cells that have fat that's not supposed to be there starts to get cleared out, all the sudden insulin works again.

So for me, I mean, for example, I just again, I'm on this whole crazy for people but I just had a lunch today that was 230 grams of carbohydrate at one meal. And I know that's more carbohydrate than some low carb people would eat an entire week. So I had mangoes I had white supposed to I had my Mesa potay I had spinach, I had a ruler, that was my lunch, I injected 4.5 units of insulin for that meal. And then I can see on my Dexcom I can see the profile it goes up, you know, maybe 131 40 comes right back down. And this is insulin sensitivity in action and anybody listening to the show can absolutely do an experiment and test that themselves and begin to observe. How can I make insulin work more efficiently in my body, it truly comes. It's wildly simple. It's wildly simple. It truly does come down to how many grams of fat you consuming per day. And we encourage people to use nutrition software to just observe this, just just gather data, just become consciously aware of how much fat you're consuming, and most people will are. It's very eye opening. It's very eye opening fat is hidden, it's hidden everywhere. And a lot of the packaged foods, a lot of simple foods have added fat to them. And it's coming in the form of oils in a lot of cases. And I'm in simple plant foods like avocados, nuts and seeds. They have a lot of fat in a very small quantity. So we're teaching is to have people not consume more than 30 grams of total fat per day. Another metric is to not exceed 15% of total calories coming from fat. Once you meet either one of those thresholds, you will absolutely positively see your insulin sensitivity improved. And again, I know in human biology, like there's a lot of complexities a lot of nuances in science, but this one is truly black and white. I have never seen one single exception in the hundreds of type ones that we've worked with thousands of people but hundreds of type ones. I have never seen a single exception of somebody increasing their whole carbohydrate content of their diet, while simultaneously decreasing the fat and not see an objective improvement insulin sensitivity they will eat more total grams carbohydrate and they will inject less insulin every single time and it will happen in a matter of days. So we run to me seed every time with retreats.

Stacey Simms 40:00

I just have to ask you. So the flip side of that is the very popular, low carb high fat diet where you're not supposed to have more than 30 grams of carbohydrates in a day. I thought that fat kept you fuller, right isn't important to have enough fat in your diet so that you feel seated.

Robby Barbaro 40:19

Okay, this is a such a fascinating cover. so important. So we wrote about this in detail in our book. And we have a whole section on calorie density and satiety. And the leader in this whole field of research is Barbara rolls at Penn State University. And she has done hundreds of studies on satiety. These are very complex studies to try and study human society and change the macronutrients of various foods is actually quite difficult. When you read the study design. You're like, wow, that's that was brilliant and very, very complicated, but it's fascinating research. And what she has found she wrote a book called volumetrics, which I'm sure many people heard about it was actually just ranked as far as like one of the best diets for 2020

Stacey Simms 41:05

volumetrics. I remember covering this like 20 years ago, the and I, what I remember from it the most is that it was all about you eat the same volume of food every day. So maybe if you had like more soup, you know, we're more healthier. So you're getting

Robby Barbaro 41:20

Yes, you're getting hit this. So the cover of the book is a bowl of soup, because her research is that society is basically water plus fiber, its bulk. It's those two things combined, which you didn't research of them isolated, like just drinking water alone does not have the same impact on society as when you have the water in a whole food with the fiber. So your point is very valid though, because So what I'm saying is there's a lot of research to point towards the diet that we're teaching here being very satisfying because of the bulk that's included the water and the fiber in every meal. So it's definitely satisfying Don't worry about that. But again, your point is valid. There are a lot of people who are doing a ketogenic diet. They're not, you know, following those principles and having a lot of bulk, but they are staying quite satisfied. So there there is an element of truth there. But when you look at the and again, that's anecdotal stuff, which I know we both heard, I have not seen much research, peer reviewed published research on that specific topic. So I think there's more to be studied. And I honestly want to have set up a podcast interview with Barbara rolls, just to ask her that specific question.

Stacey Simms 42:34

So funny, because I was a health reporter for a lot of my career. And I remember volumetrics and I drank a lot of soup. I remember it. So before I start wrapping this up, I do want to ask you, I know that your goal initially, as you said, was to try to reverse type one diabetes, right? What's going to cure this for me? And obviously you haven't stopped taking insulin. You're not at all telling people to do that. But when you look at how you're living, and What this plan and your partnership with Cyrus has led you to? Is that still in the back of your mind?

Robby Barbaro 43:06

It absolutely is in the back of my mind that we got to figure this out. There's so it just, I mean, Stacy, do you agree? Like, it doesn't seem that complicated? I mean, why can't we beta so why can't we just go? Like, like stem cells die all the time. And then there's new stem cells that create new ones, why the beta cells so difficult to recreate?

Stacey Simms 43:28

I'm not smart enough to know but I do think it's a lot more complicated. I mean, no autoimmune disease has yet been cured. So I'm very very very hopeful Don't get me wrong, but yeah, I don't I don't know that diet alone You know, of course will ever do it but I'm very the things you mentioned right there. I'm very, very hopeful about but are you still feeling like you're the walking experiment?

Robby Barbaro 43:50

So I couldn't agree more that my after 13 years of doing this, and you know, hitting plateaus of insulin use on two different approaches. I think it's good. I'll be more than diet as well, for sure. And I, hey, I would love to be the experiment like the first person that makes makes it happen. I would love for some miracle to happen. But yeah, it's it's definitely in the back of my mind. But I will definitely say it's not as much as the forefront as it was in the beginning. So the back of my mind is really the appropriate way to describe it. I think about it. I certainly try and be active in the community of researchers who's looking into this and learn from some of their research and glean insights. And I just I want to participate.

Stacey Simms 44:31

Excellent. So the book Mastering Diabetes is for everybody with all different types of diabetes. It's not just about type one, right?

Robby Barbaro 44:39

So the answer is yes. And it's really for people who are living with insulin resistance. So that's everybody with pre diabetes as everybody with type two diabetes, that's people living with gestational diabetes, and that's majority of people living with type one is 1.5 diabetes, and it's also people who don't have Diabetes yet. So in America, we have over 80 million people living with pre diabetes that don't even know it. And there's also a nurse, a big chunk of people who are living with insulin resistance who haven't gotten to type two diabetes or pre diabetes yet. So insulin resistance is really at the core of what we're teaching here. And the reason is, is because insulin resistance is the central node for a wide range of chronic health conditions. So when you're living with insulin resistance, you're increasing your risk for heart disease, for cancer, for chronic kidney disease for high blood pressure, high cholesterol, for rectal dysfunction, for depression. It's a long, long list of unfortunate conditions that are associated in some resistance. And that's part of the reason we're passionate about getting this message out to the Type One Diabetes community as well because we don't die of high blood glucose readings. We die of the complications of diabetes, number one being heart disease. So inside this book, we also cover the science and research of people who've actually been able to reverse heart disease and that whole connection between maximize your insulin sensitivity for your long term health, but also for your short term health in having more energy for getting rid of brain fog, for reaching your ideal weight. It really truly does come back to this one simple concept. If you can focus on how to maximize your insulin sensitivity, you are setting yourself up for success in the short term and the long term. So the subtitle of the book is the revolutionary method to reverse insulin resistance permanently in type one, type 1.5 type two, pre diabetes and gestational diabetes.

Stacey Simms 46:43

I'm really excited to learn more about you and you know, hopefully down the road we can have Cyrus on the show as well. But one more question before I let you go. What are you having for dinner tonight?

Robby Barbaro 46:52

Okay, so tonight I'm going to tell you exactly how

Robby Barbaro 46:55

I enter it into nutrition software. I personally enjoy and My food into nutrition. I like dialing in the ratios I really really enjoy the confidence Okay, this is exactly what I'm having. And I feel really confident in this specific dose of insulin. And for people who don't like using nutrition software, we advocate this idea of go to meals and you sort of know this intuitively as a type one mom but you make certain meals that you've you already know the carbohydrate concept is the same thing. It's one it's this apple, it's this potato it's this But whatever it is, it's some combination of these you know ingredients and I know this amount equals this many carbohydrates this my grams carbohydrate, and you know, we can know what to do so dinner tonight is going to include lettuce or rubella, oranges, mangoes, papayas, and carrots, and it's going to be a total of 110 grams of carbohydrates. And I will also add that this meal is going to have 2.6 grams of fat And it's all by itself naturally without having to add any specifically high fat foods. And in the book, we also go into detail about how much fat you need to absorb fat soluble vitamins. And the research on that is really fascinating. So I hope people check it out. Excellent. Well,

Stacey Simms 48:18

thank you so much for joining me. It's absolutely fascinating. I'm thrilled to have you on To learn more, because I've seen pictures of the fruits and the plates and the you know, I haven't seen the banana pyramid. But I've seen lots of stuff online. So I really appreciate you taking the time to explain it. Thanks for coming on.

Robby Barbaro 48:34

It's great to connect with you. And I really appreciate you having me on. Thanks again.

Robby Barbaro 48:43

You're listening to Diabetes Connections with Stacey Simms.

Stacey Simms 48:49

I will link up more information on the things we talked about including some studies and some insulin resistance stuff that you might find interesting. I gotta tell you though, I was distracted. A lot once early in the interview and he was talking about bananas and he didn't tell him this I probably should have. I hate bananas. I hate them so much. I don't like the way they smell and like the way they feel I can't stand them. I do like banana bread. It's not the flavoring so much I guess when I think about it, although it's only banana bread. I don't like banana flavored candy. I don't like banana flavored ice cream. So when he kept talking about that, I was like, oh, enough. Okay, so I will link up more about Robby and Cyrus and their podcast and their book at Diabetes Connections.com

up next Tell me something good but first Diabetes Connections is brought to you by Dexcom. And when you have a toddler diagnosed with type one like we did. You hear rumblings for a long time about the teen years everybody dreads that. But you know it hit us at full force a little bit early. I was so glad we had Dexcom Benny's insulin needs started going way up around age 11. And he has grown. I don't know, seven inches. In the last four years, along with all those hormones swings, I can't really imagine managing diabetes during this crazy time. Without the Dexcom continuous glucose monitoring system, we can react more quickly to highs and lows, see trends and adjust insulin doses with advice from our endocrinologist. I know using the Dexcom G6 has helped improve Ben he's a one C and overall health. If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions. To learn more, just go to Diabetes Connections.com and click on the Dexcom logo.

I always ask for good news stories in the Facebook group. It is Diabetes Connections, the group I really hope you can join us there if you're not there already. I love how the group is going very supportive. We talked about the podcast a bit but it's not just about that. So please come check it out and you know, find people That are well educated and smart and fun and living their best lives with diabetes. This week's Tell me something good is a story I read in another Facebook group actually and asked if I can share and Cindy said yes. So let me read you her post.

"Hi, I want to tell you about something I'm very excited about. I'm a scuba diver and an underwater photographer. I've been diving since 1985. I have over 1700 dives, but I got diagnosed with type one. Last June of 2019. I was concerned about ever diving again. That was my first question for the doctors. we dive in remote places we dive for weeks when we go but we went ahead and booked a trip in the Philippines. In January for three weeks we have been here before we know the manager we know a lot of the divers"

so she had a whole plan included wearing a Dexcom she was going to wear the Libra sensor as a backup. She brought in meter of course as a backup. She was wearing her Pump tantum pump went out of the water between dives, and bringing long acting pens for a backup. Here's what she did 56 dives in three weeks, dives were 60 to 75 minutes each. Each dive was 50 to 100 feet deep. She tried to get her blood glucose to about 140. Before going into the dive, she only missed one dive because of being low. She had to wait for numbers to trend up on another one. She did carry orange juice and snacks on the boat. She did plug in a few times to the pump to correct and she ran higher than she usually did, which you really didn't worry about. I'm so glad to hear this because it was her first time diving and overall her nights were nicely in range.

So she says "here is the exciting news." Her Dexcom worked great. She had it kind of stuck under the wetsuit with a patch. She did a couple things to kind of keep it on but it didn't come loose. The Libra also didn't come loose. You put a patch over She let everybody on the boat know that she had diabetes. She wanted to make sure that people around her were informed. Her friend and her husband would check in every single time she was about to go under with, you know, what's your number. She also carried a tube of jelly. She says you can get this on Amazon a tiny tube of sugary jelly. You can break the tip off and squirt some in your mouth regulator and all that scuba gear, the regulator. She does give a little bit of advice for other divers here. I mean, she was a diver for 35 years before she was diagnosed.

This is a post in the type one diabetic athletes group on Facebook. But if you'd like to get in touch with Cindy, if you have questions, I have a feeling she'd be more than happy to help you out and I would be more than happy to connect you. If you're thinking about scuba diving and you haven't done it before or you are interested in getting back on the wagon if you've been diagnosed. She says that she really wants people to get back in the swing of it. She also says I'm not telling you how to manage your Diabetes underwater or telling you Dexcom works perfectly underwater. I'm just sharing my experience and excitement of being able to do what I love to do. And she posted a bunch of pictures. I will I'll share a couple of these in the Facebook group. I think this is excellent advice and I'm just so happy that somebody was able to get back to doing what they love after being diagnosed with diabetes because that's what we tell our kids right you can do anything. But you know, it can be complicated.

So way to go Cindy, this is fantastic. I'm so excited for you. And the picture she posted of the fish and some of the underwater stuff is breathtaking. Let me know if you have a Tell me something good story. It can be anything like this. It can be a milestone with your kids. It can just be something that is good news for our community. Email me Stacey at Diabetes Connections. com or posted on Facebook. Just tell me something good.

A huge thank you to everybody who has posted recently about the world's worst Diabetes mom, as I travel more and do this book tour, it is just incredible to hear everybody else's worst stories. I mean, we all have them. And to learn what the what the book is beginning to mean to a lot of people, I did have some interesting feedback. When I went to Maine, they've given it to their clinic, they the group that I spoke with, bought some copies, and gave it to their local pediatric endocrinology group to give to some newly diagnosed families, which I thought was fantastic. If that's something you're interested in. If you have a clinic, or a diabetes office, or a group that is interested in having books on hand, obviously you can buy them and give them out. But please get in touch with me. Because when it's a situation like that, I'm sure we can figure something out either discounted pricing or, you know, maybe we can find something I'm pretty good with sponsors. And I'd love to make the book available to more people and that hadn't occurred to me that clinics might want it. So if you're in I was interested or if you're a health care professional and you're listening, if you're a CDE, please let me know. I'd love to start working things out. I'm going to work on this on my site as well. But just let me know.

Coming up in March, I'm going to be in Wilmington, North Carolina, Winston Salem, North Carolina, and then out to Indianapolis. Can't wait to meet so many of you, as you listen and as you read, boys this fun. thank you as always, to my editor, John Bukenas from audio editing solutions. Thank you so much for listening. In a couple of days. We've got our mini episode that airs on Thursday, and this week, I am going to be talking about when a child has a fear of diabetes, when you know, we tell our kids Oh, won't hold you back. But what happens when a parent tells a little kid No, it's not gonna hold you back and the kid says, I'm scared. I think it will hold me back and I don't want to do this new activity. This was a heartbreaker. So we're going to talk about it and kind of find out what to do. Alright, I'm Stacey Simms and I'll see you back here on Thursday.

Robby Barbaro 57:03

Transcribed by https://otter.ai

Acne