It's a problem because we don't know that 80% of the diabetic population in Korea is diabetic.

[News FM Lee Ik-seon Choi Soo-young Issue & People]
□ Broadcast Date: 18th October 2024 (Fri)
□ Host: Lee Ik-seon, Choi Soo-young
□ Cast: Woo Chang-yoon, professor of endocrine medicine at Asan Medical Center in Seoul

* The text below may differ from the actual broadcast content, so please check the broadcast for more accurate information.
◆ Lee Ik-seon: You've been exhausted for a week and you're going to charge here. knowledge of health Batteries for short Today, we are with Professor Woo Chang-yoon, an internal medicine specialist at Asan Medical Center in Seoul. Welcome.

◇ Woo Changyoon: Hello, I'm Woo Changyoon.

◆ Lee Ik-seon: Knowledge of Health Battery Today, I'm going to take a closer look at diabetes, which has become a concern for all generations. If you have any questions about this, please text me from now on. If you give it to me late, I can't answer you until the end of the program. #0945 #0945 Paid Text YTN App, please leave it in the YouTube comment section.

■ Choi Soo-young: We have diabetes. What is the exact definition of diabetes?

◇ Woo Chang-yoon: When it comes to diabetes. People think it's hard, but we eat food. We ate it to make a living, but in the end, we ate it to make our cells eat. We digest it well and even make this glucose. Then, tens of trillions of cells in our body need to eat this glucose, but it's a disease that we can't eat. Cells can't eat it. That's right. So, of course, there's a lot of glucose in the blood because we ate food. The cells are starving because they can't eat this glucose in the blood, but the glucose is increasing in the blood. We feel hungry. Because the cells can't eat. But this glucose is sticky with sugar water. So they actually stick to proteins or lipids and make them rusty. There's no place that doesn't go to the blood vessels in our bodies. So all the blood vessels in our bodies become clogged and burst, which is a disease like poverty in abundance.

◆ Lee Ik-seon: I see. I've heard a lot about diabetes, and this is the first explanation. But why can't you eat it?

◇ Woo Chang-yoon: This cell doesn't have a mouth. That's why I need insulin. If you have insulin, the cells can open their mouths like a key, and if this insulin doesn't work or the key hole breaks down, or if the key disappears because the insulin itself doesn't exist, the cells can't open their mouths, so they can't eat it, and the blood has more glucose and problems.

◆ Lee Ik-seon: So how many types of diabetes are there?

◇ Woo Chang-yoon: There are largely Type 1 and Type 2, but as I said earlier, this one without the key itself is Type 1.

◆ Lee Ik-seon: Insulin-free?

◇ Woo Chang-yoon: That's right. There's no insulin at all, and type 2 has heard of insulin resistance at least once if we don't have good lifestyle habits. The key started not to fit. Our bodies make more keys because the keys don't fit. There's a lot of insulin, but since it doesn't fit, blood sugar continues to be high, and eventually, the factory that makes this insulin is the pancreas, and the pancreas gets tired. Then if even insulin doesn't come out, blood sugar rises dramatically and there's a problem now.

◆ Lee Ik-seon: That's type two. Which one is more dangerous?

◇ Woo Chang-yoon: It's dangerous if you don't control both. If proper treatment is not provided, the disease that insulin does not come out usually occurs when you are young. This is a kind of autoimmune disease that destroys the pancreas. during adolescence So, if not treated properly at that time, it was a disease that died within two to three years before insulin came out. Originally, it's not like that now.

◆ Lee Ik-seon: So compared to the whole nation, so what about type 1 and type 2 with % compared to diabetic patients?

◇ Woo Chang-yoon: There are a lot more type 2. Type 2 is now coupled with our lifestyle habits, and when the number of diabetic population is now 6 million, most of the increase in type 2 is an increase.

■ Choi Soo-young: We often have diabetics, but don't we have pre-diabetes patients? There are reports that there are 15 million patients in the pre-epidemic stage.
◇ Woo Chang-yoon: Yes, that's right.

■ Choi Soo-young: What is the status?

◇ Woo Chang-yoon: In a 2020 study, about 15 million people came out in the pre-diabetes stage, and about 6 million people were diagnosed with diabetes. But what's really scary about this is that about 80% of people who are in the pre-diabetes stage don't know if they are in the pre-diabetes stage. And more than 30% of people with diabetes, about 37% of them, and this is more than 2 million people. That much population doesn't know if they're diabetic. It says it's a test, but there are a lot of people who took a self-test, but they don't know it, so this is very scary. Diabetes is a race of time. You have to do it quickly. Because I told you earlier that glucose eventually increases in sugar in your blood, causing problems. They are constantly sticky, so they stick to the proteins and lipids that make up our blood vessels and make us use rust or something. But the most important thing here is time. It's okay if you have high blood sugar for a second. But in about five years, all the small blood vessels start to fail.

◆ Interest line: The eyes or something like that.

◇ Woo Chang-yoon: That's right. Express that it's starting to rust.

◆ Lee Ik-seon: Then the pre-diabetes stage is usually referred to as glycated hemoglobin. Where does the figure range from to?

◇ Woo Chang-yoon: Usually, when we talk about pre-diabetes, we talk about fasting blood sugar and glycated hemoglobin. With that fasting blood sugar, we usually say that when we reach 100 or more, we are in the pre-diabetes stage, and glycated hemoglobin is the average blood sugar level for three months, and below 5.6 we are normal.

◆ Profit line: 5.6 or less.

◇ Woo Chang-yoon: Yes, from 6.5 onwards, we call it diabetes, but if it's in between,

◆ Lee Ik-seon: 5.6 to 6.4

◇ Woo Chang-yoon: Yes, then it's in the pre-diabetes stage, and many people will know it as fasting blood sugar. Because it's in the examination. So if your fasting blood sugar is higher than 100 below 126, you can know that it's in the pre-diabetes stage.

◆ Profit line: between 100 and 126.

■ Choi Soo-young: You said the pancreas makes Koreans. The pancreas is a little small, so it's naturally a little vulnerable. What do you think of this analysis?

◇ Woo Chang-yoon: That's something that's been studied in Korea for a long time. I thought it was only for Koreans, and Asians as a whole, the size of this pancreas itself is about 12%. It's smaller, but unfortunately, the actual insulin secretion ability is lower than this size. It is said to be about 20-30% lower than that of Westerners, but now they eat the same. Now that I eat the same as the West and drink the same sauce, the pain and stress of our pancreas are different when blood sugar rises. So, the pancreas of Westerners only needs to exercise a little, but now the pancreas of Asians is under stress like hitting with a whip when blood sugar rises sharply.

◆ What should I do with the pancreas?
◇ Woo Chang-yoon: In fact, they're overstressed and they have a lot of free oxygen that spreads faster, so now they have more pre-diabetic diabetes.

◆ Lee Ik-seon: So what should I say? Is the rate of evolution not keeping up with the rate of food feeding?

◇ Woo Chang-yoon: That's right. In the end, it's been about 100 years since it's been changed, so our bodies haven't been able to keep up with it yet.

■ Choi Soo-young: Then what's the cause?

◇ Woo Chang-yoon: When it comes to the cause of diabetes, many people are usually curious about type 2 diabetes. Type 1 diabetes is usually caused by genetic causes, so you can think of type 2 diabetes as a result of genetic immunity, so for now, the pancreatic function is gradually deteriorating. If you ask why the pancreas is functioning, you can think of it as rain in many cases. Now, visceral obesity, especially when visceral obesity occurs like this, insulin resistance occurs. As I said earlier, this key doesn't fit in this keyhole. Our bodies keep sending signals to the pancreas to make more insulin because our cells keep getting hungry.

◇ Woo Chang-yoon: Then the pancreas is small and it's this weak, but you have to continue to make more insulin, so the stress accumulates in it. So at first, I follow it to a certain extent. The pancreas follows, and this pancreas also proliferates and just follows, and as stress builds up in the process, insulin resistance also increases. So in the end, when the pancreas starts to spread and at some point my pancreas can't keep up with this insulin resistance, then my blood sugar starts to go up like crazy. So, for the first time, people who were diagnosed with diabetes who were very confident in their health, obese people, always say that it's okay to have a health check-up, but suddenly, when they are diagnosed for the first time, their blood sugar is diagnosed like 300,400. The reason is that until then, the pancreas was told to die, and if the pancreas bursts at this moment, diabetes will occur from then on.

◆ Profit line: Okay. Knowledge of Health: The highlight of People, an issue we meet on Friday. Today, we are looking into diabetes with Professor Woo Chang-yoon, an internal medicine specialist at Asan Medical Center in Seoul. I'll be back after hearing your message for a moment. Yes, Issue & People Friday corner battery health knowledge Today, we are talking about diabetes with Professor Woo Chang-yoon, an internal medicine specialist at Asan Medical Center in Seoul. The listener gave me a question. I am a housewife who has been suffering from diabetes for 20 years. But my fasting blood sugar level is about 202. The insulin is about 20cc right now, but I can't hold it well. What should I do?

◇ Woo Chang-yoon: If your fasting blood sugar exceeds 200, you can't control it. You can't control it, so yes, I don't know how you get insulin, but you need to control the insulin dose. There is a way to get it once a day, but there are also ways to get insulin twice a day, or four times a day, or multiple times. But first of all, it's important to lower your blood sugar once and maintain it there. Especially if you're young. So you need to control your blood sugar by controlling your insulin dose.

◆ Lee Ik-seon: You mentioned that you are a housewife who has been suffering from diabetes for 20 years, so I can assume that you are not that young.

■ Choi Soo-young: And we often hear that blood sugar spike is the problem. What is the blood sugar spike?

◇ Woo Chang-yoon: Blood sugar spike is not a medical term. No, but it comes in intuitively. I thought that my blood sugar would rise and fall like a spike, so many people are using it now, but it's because I'm drinking something like a drink. When you eat beverages or refined carbohydrates, this was originally not in the world. That's right. It's an ingredient. Especially when it comes to drinks, our blood sugar, our pancreas predicts a little and releases insulin. If blood sugar rises quickly at this angle, our body's owner must have eaten a lot and starts to secrete too much insulin. It's a little predictive, but now the absorption is very fast, so blood sugar goes up, but that's actually the end. But our bodies released a lot of insulin. It's because this angle is continuously steep, so if you do that, it falls really steeply. And on the contrary, the insulin is so excessive that it may drop slightly more than before you eat it at the end. It's called relatively low blood sugar. But I'm under both stress here. When insulin blood sugar rises like this, the pancreas becomes nervous and manages it a lot. This is a lot of stress, but blood sugar starts to drop sharply again. This is also a huge stress in our body. When your blood sugar drops, you need to activate your sympathetic nerves. There's that double stress to raise blood sugar.

◆ Is the food that causes that kind of thing like juice?

◇ Woo Chang-yoon: We tell a lot of people not to drink beverages first.

■ Choi Soo-young: Then for drinks, soda juice, sweet or unsweetened?

◇ Woo Chang-yoon: I'm okay with something like an Americano now. Grinding vegetables is fine. But when the sugar additive is added or the fruit is ground, the fruits are very sweet now. It's very sweet. It's different from the old fruit.

◆ Profit line: Sprinkle sugar when planting.

◇ Woo Chang-yoon: When I eat something like watermelon, my blood sugar goes up to 180190.

■ Choi Soo-young: Then you know the drink that comes out as Zero. What about Zero's drink?

◇ Woo Chang-yoon: Zero's blood sugar doesn't go up. Blood sugar does not rise, but for those who are a little obese or drink a lot, the sweetness of this tongue is linked to brain stimulation. But when the tongue is sweet, the brain waits. If this blood sugar spike doesn't stimulate me, I'm drinking a drink and my brain shows signs of hunger. So in the end, the total amount of food you eat goes in the direction of increasing. For those who were obese,

◆ Interest line: All right. Listeners, your wife was admitted to the ICU with ketoacidosis a few years ago and has recently been treated for insulin and diabetes. He said, "I feel bad whenever I see my wife due to side effects such as vision loss, weight loss, and motivation." But you didn't ask me this question.
◇ Woo Chang-yoon: Yes, yes, yes. If our body doesn't secrete insulin at all, we can't use glucose as energy at all. Then, we have to live our bodies. So what I'm doing is that I run the cycle of using fat as energy in a hurry. Now that's called ketone body, it's not a proper fast, but when insulin hasn't come out at all, this ketone body is excessively produced and the body becomes acidic. Then, your consciousness will drop and your blood pressure will drop.

◆ Lee Ik-seon: It's very difficult.

◇ Woo Chang-yoon: It could be dangerous. I see.

■ Choi Soo-young: I told you earlier that patients don't recognize diabetes well, so don't we have any early symptoms, even if we don't show up at the examination?

◇ Woo Chang-yoon: This is the first boat. an increase in the circumference of a ship So, usually from the late 30s, even if the weight remains the same, the stomach starts to increase, with a men's abdomen of 90cm and a women's abdomen of 85cm or more. Then you have to be a little nervous.

■ Do I have to be nervous? Then I have to be very nervous.

◇ Woo Chang-yoon: And the second is the pre-diabetes stage of fasting blood sugar disorder from the medical examination. If you see a medical examination, just talk about the doctor there. Since there's only that much, about 80% of them don't even realize that they were this. So if people have that now, you should go to the hospital and see if you're sleeping well, eating well, or moving well.

■ Choi Soo-young: Then what about pre-diabetes symptoms?

◇ Woo Chang-yoon: The symptoms of the pre-diabetes stage are now the stomach that I talked about and the health examination shows that there is an fasting blood sugar disorder. If it's a symptom of diabetes, diabetes is when blood sugar is actually rising, especially when blood sugar is rising very high, then I pee a lot first. I get polyuria. And of course, I'm thirsty because I pee a lot.

◆ Lee Ik-seon: That's why adults use the term 'thinosis'.

◇ Woo Chang-yoon: And eat a lot. I told you earlier. After all, cells in our body didn't eat. I've been starving. Cells in our bodies keep getting hungry as we lose weight. People who have diabetes

◆ Lee Ik-seon: I see. Yes, but everyone says that diabetes is actually more scary than the disease itself. That's right. What kind of bottles can we bring in?

◇ Woo Chang-yoon: It's really scary. There's no place in our body where blood doesn't go. There's no place where blood vessels don't go, but all those blood vessels start to rust at the same time. It's been about five years as time has passed. If I don't take care of it, the very thin blood vessels start to rust and burst. Like a water pipe popping, at first, it's the eyes, kidneys, and nerves. Don't you think nerves also have very thin blood vessels that feed these nerves? Since they burst, this neuropathy starts to develop, so the sole of the foot feels strange, the gastrointestinal tract doesn't digest well, and gastropathy occurs after about five years. It doesn't take action until about 10 years. From then on, big blood vessels start to burst. In this case, stroke, myocardial infarction, and diabetes occur. Then you'll have your leg amputated or you'll die from a stroke, myocardial infarction.

■ Choi Soo-young: If I do well with treatment, can I catch it early and if I do well, will I be cured?

◇ Woo Chang-yoon: We call it "relief." Remission is about first detecting diabetes as quickly as possible and then maintaining normal blood sugar without using drugs if appropriate. However, the reason for remission is that they are more likely to go back if their lives are disturbed by life's three-axis sleep, activities, and eating. This is a cure. But diabetes can always go back if it's disturbed.

◆ Interest line: I see. Then this is an express train to diabetes. Don't just do this. You mentioned that drink earlier, so don't drink it. I think you have to do "Do Not Do It" and "Do It" together.

◇ Woo Chang-yoon: There's a "Don't Don't Don't Do It" attached. Actually, don't do it, but don't go to bed right after eating. This is really dangerous. I feel a little sleepy when I eat. As blood is pouring into this gastrointestinal tract, the blood to this brain is slightly reduced, so I feel a little drowsy. But what happens when you sleep lying down? Our blood glucose rises dramatically. After meals, they can go to fat or muscles. But when we sleep, our muscles tone is much more relaxed than just sitting down. That's right. Then the only place where that glucose can go is fat.

◆ Lee Ik-seon: Does it go better when you're nervous about your muscles?

◇ Woo Chang-yoon: The best thing is that when we walk or do activities, it's important to know where the energy we eat is placed. When you sleep lying down, the place where it is placed is placed in the visceral fat or liver fat. That's why you should never lie down and sleep right after eating. On the contrary, eating and walking is the most efficient investment we can use.

◆ Lee Ik-seon: How many minutes is the minimum, so the minimum?

◇ Woo Chang-yoon: It's best to walk for about 20-30 minutes.

◆ Lee Ik-seon: It's actually hard for office workers.

◇ Woo Chang-yoon: But there are studies that show that walking for at least two minutes is much better for improving blood sugar than not walking at all. At least 2 minutes is really different. Where the energy is placed, once it is placed in the province. It takes a lot of different signals to take it out and use it. So it's best to send it to your muscles in the first place.

◆ Lee Ik-seon: There's a radio studio on the 8th floor of YTN. Several people ride the elevator together on the 1st floor. There are young people who press the 2nd floor, press the 3rd floor, and press the 4th floor. At heart, I'm happy, but if I walk to the 2nd or 3rd floor, this will be solved, right?

◇ Woo Chang-yoon: That's right, that's right, that's the

■ Choi Soo-young: You pointed out the blood sugar spike earlier. How to lower the blood sugar spike, so I see a lot of dietary treatments on YouTube. Is there a way to share the real way?

◇ Woo Chang-yoon: Yes. Eating fiber or protein first is actually effective.

■ Choi Soo-young: Dietary fiber or protein.

◇ Woo Chang-yoon: So you're changing the order when you eat. If you do well just by changing the order, you can lower your blood sugar spike by about 20-30%.

◆ Lee Ik-seon: How should I change the order? For example, recommended

◇ Woo Chang-yoon: Once you come out first, most of them have salads or vegetables. I always eat seaweed or things like that first. If you have meat side dishes, you eat meat or tofu first, and then you start eating with rice. But the reason for this is that the first things that go in determine the speed of transition from the stomach to the small intestine. The carbs sent from the top go down a little bit, so the carbs that I ate after the whole thing go down a little bit slowly.

◆ Profit line: I guess the fiber is slower, too. Protein?

◇ Woo Chang-yoon: Fiber and protein make a little bit of bulk first, and then combine it with water, and they put them together even if we eat glucose carbohydrates now. Dietary fiber combines some dietary fiber, and protein and fat increase the time for the stomach to go down to the small intestine and have these two effects.

◆ Profit line: That's why it slows down the absorption of carbohydrates together.

◆ Lee Ik-seon: Since there's a feeling of satiety, the amount will be reduced, right?

◇ Woo Chang-yoon: The amount is also decreasing.

◆ Lee Ik-seon: I'm suddenly worried about what to do when there's rice left in Korea.

◇ Woo Chang-yoon: You can eat and walk. You can eat and walk.

■ Choi Soo-young: I think this will be the last question, but it's good to take this for diabetes, and I want to ask you again, and then you can't do this. So, if you give it to me?

◇ Woo Chang-yoon: The good thing is that people in Korea don't eat dietary fiber much more than I thought. 25g of dietary fiber I really recommend the ssam, especially for diabetics. Out of all the wraps, perilla leaf wraps are really good. The various micronutrients in perilla leaves are really good. And kale. Two things are because kale has a very high density of dietary fiber. It's about 4 to 10 times denser than lettuce, so it's really good to eat it with lettuce wrap or kale wrap quesam. And drink a lot of water. This is recommended, and don't ever tell perilla leaf kale to stop drinking, but for beverages, this is really... And there are a lot of people who eat a lot of fruits. Especially since it's autumn, it's good to eat an appropriate amount. The right amount of fruit is good, and for those with diabetes, it's better to eat fruit after meals. Because you can slow down the absorption a little bit.

◆ Lee Ik-seon: Fruit juice goes in too fast, so it's better to control yourself. I see. I really have a lot of questions to ask, but Asan Medical Center is too far away, so I hope you give me another chance next time. Knowledge of Health I was with Professor Woo Chang-yoon, an internal medicine specialist at Asan Medical Center in Seoul. Thank you for coming forward.

◇ Woo Chang-yoon: Thank you. Thank you.