- [Announcer] Support for this series comes from Inland Empire Health Plan a health plan with a mission to heal and inspire the human spirit, serving over 1.5 million members in the Inland Empire.

- Don't internalize everything and try and, like, battle it yourself because there are people that love you and care for you and want you to be healthy.

Don't really try and take everything alone.

- Behind every diagnosis is a person, a family, a story.

Hi, I'm Leticia Juarez and on this show we are listening to patients and the medical professionals who walk beside them, sharing their struggles, breakthroughs, and the lessons learned along the way.

Together, we're making healthcare clear, compassionate, and closer to home.

So, join me on this journey of Health Caring.

[soft piano music] ♪ - [Leticia] Today's episode shines a light on chronic illnesses, specifically diabetes and hypertension, which are the most widespread, yet often misunderstood.

We'll speak with three individuals to learn what it truly means to live with these conditions.

The challenges, realities, and resilience to take it day-by-day.

Among the experts giving us insight into the long-term health effects is Dr.

Balu Gadhe whose extensive experience in managing diabetes and hypertension offers valuable perspective and hope for patients everywhere.

- I'm happy to be on this program because educating the families and community on chronic health is a big passion of mine.

So, I'm a board-certified internal medicine physician and have been practicing in medical field for over 30 years, primarily in the hospital medicine.

- For people who don't know, I mean, you hear of the word "hypertension?"

It's a medical term, but what does it mean?

In just general terminology, what is hypertension?

- So, hypertension is also called high blood pressure.

So, when there is high pressure in your blood vessels, then it affects all the organs in the body.

So, the high blood pressure is same as hypertension.

- Is hypertension preventable?

And, why does this matter to you as a physician?

- Hypertension could be preventable because there is genetic component and then there is a lifestyle component.

And, majority of it is lifestyle component.

So, if you are able to address your lifestyle and stay-- live a healthy lifestyle, then your chances of developing high blood pressure or hypertension goes down.

Why is it important?

Well, it's really important because it can cause a lot of damage to your body.

And, hypertension is one of the silent killers.

It can affect your whole body, starting from brain in the way of stroke, and dementia, blindness, heart attack, kidney failure, amputation, and a lot of other problems.

So, it's a very, very serious medical condition.

So, anytime I see a patient who may have high blood pressure, I really want to educate them so that they can prevent it from getting worse.

- [Leticia] Sammie Luna thought she was too young, too healthy to worry about high blood pressure.

It wasn't on her radar until it became impossible to ignore.

Now, she's learning that awareness isn't fear.

(knocking sounds) It's power.

(door clicks) - [Leticia] Hi, Sammie.

- Hi, Leticia.

Come on in!

- Thank you, Sammie, for having us in your home today to talk about the very important topic of hypertension and high blood pressure.

- Thank you so much for being here.

It's great to have you guys.

- How did you first realize that there was a problem?

- Well, it all started with when I was doing my regular checkups at the doctor as well as dental visits.

Every time they would take my blood pressure, they would say, "Oh, your blood pressure's high."

And, they would take it a second time.

You know?

And I, "Oh.

Well, you know?

I had some coffee."

That was kind of the first indicator, but I kind of just blew it off.

- Did you experience any symptoms before your official diagnosis?

- So, no.

I didn't, actually.

At least not until after I was diagnosed did I start noticing symptoms.

And, maybe that was because I was maybe ignoring those symptoms.

But, those symptoms continued to get worse after the diagnosis.

- [Kanita] Because hypertension is something that does not always have an outward manifestation, it goes unchecked.

Because most people are not just randomly checking their blood pressure until somebody tells them to do so, and usually people tell them to do so.

If you had a parent who had high blood pressure or you're just sitting there with a cough and it's like, "Okay, fine."

If you go to your provider regularly, even if you have a high blood pressure reading there, most people dismiss that as white coat syndrome, right?

Because, yeah.

"I'm in a provider's office "and the fluorescent lights are "blinding me and "I don't know what you're gonna tell me!

So, yeah.

(laughs) My blood pressure is goin' up!"

- Yeah.

- And, there's fail-safes there.

Right?

When you have a high blood pressure reading in the provider's office, they're supposed to wait a while and then check it again.

And if it's high again, wait a while and check it again.

But, everybody doesn't do that because again, we dismiss it as white coat syndrome, right?

But what if we didn't, especially for those populations that we know have a higher propensity for this silent killer.

- [Sammie] I began to think that maybe I was in perimenopause, even though I felt like I was a little too young for that.

- What kind of symptoms were you experiencing?

- So, when I would go for walks during my work, I would feel very lightheaded, very dizzy, almost like I wanted to faint.

The other thing was I would wake up in cold sweats.

But, once my doctor diagnosed me and she gave me medication, I was still in denial.

I told her, "Oh, no."

I said, "I'm too young for this.

How can I have it?"

And, she asked me if my parents had high blood pressure and I said, "Yes, both of them do."

And, she's like, "It's genetic."

- And, obviously, and I asked you how you felt.

You said, "I feel too young to be-- experience this."

May I ask how old you were?

- I am 47 now, but at the time I was 43.

So, I didn't feel (laughs) like it warranted me having high blood pressure!

- Yeah.

Did you just associate high blood pressure with a certain age?

- I did, yeah!

My parents didn't start taking high blood pressure medication till they were, like, in their 60s.

- Does having high blood pressure change now your daily routine in a way?

- I do make extra efforts to make sure I incorporate exercise and salads!

(laughs) Yeah!

I just try to be a little more healthy than I was previously.

- So, with everything that you've now done, medication, obviously you've changed your diet, what is your blood pressure now?

How is it?

- As a matter of fact, I had a doctor's appointment yesterday!

(chuckles) It was good.

She was like, "Oh, you have great blood pressure."

I said, "Yay, the medicine's working!"

But, I have been on the medicine for quite a while now.

So- But, every time now that I get my blood pressure taken, it's always good.

- Does it give you, like, any pause knowing that this is something you're now dealing with?

It's considered a chronic illness.

- Yes, because I always thought of myself as a healthy person.

But, yeah.

I definitely wanna make sure people are more conscientious and aware, and are proactive instead of reactive.

Or, in denial like I was.

You know, 'cause I kind of wonder if I would've continued to be in denial, what would've the results have been?

Would I have had a stroke?

Would I have had a heart attack?

It's a good lesson.

I hope other people will also take pause and listen to their body.

- [Kanita] What is really healthcare?

Usually, it's sick care.

Like, "I go to the doctor because I don't feel well."

You know, some people do their annuals.

But, what is really teaching us how to eat, how to exercise, how stress affects our body, or how our family's DNA affects our bodies?

A lot of that is prevention and a lot of that is probably where the solution is gonna come from.

- So, prevention.

And that includes, like, diabetes, for instance.

That's another killer in the population.

- Yeah.

- How does diabetes relate?

- Usually if you have one, you have the other.

Or if you don't have the other yet, most likely you're gonna get the other.

- [Balu] Diabetes and hypertension, they both have kind of synergistic relationship in a bad way.

When somebody has both of these conditions, it increases the risk of dementia, the stroke, the heart attack, kidney failure, amputations.

And, when somebody has this if-- at an early age, the rest of their life is very complicated because of that.

- [Leticia] Wanting to understand diabetes beyond the statistics, I sat down with Dr.

Codorniz an endocrinologist who's helped countless patients navigate life with the condition.

- [Leticia] I think we've all heard the term diabetes, but what is it?

What is diabetes?

- So, at the core of diabetes is a mishandling of sugar.

Sugar is so important because it is what-- It's like the gasoline in our car; what keeps our body moving, and forward.

Without sugar, we can't perform normal daily functions.

In type 1 diabetes, you're not making the insulin that unlocks the door to let the sugar into the cell.

- Got it.

- Right.

- And, the type 2 is you have too much.

- In terms of type 2 diabetes, it's more of a resistance to insulin, actually, where it is normally due to sedentary lifestyle, overweight, and other factors that contribute to that resistance.

And so, that sugar, the gasoline can't make it into the cell as well.

Actually currently in the United States, approximately 12% of the population have diabetes.

It's grown exponentially over time.

Every time they do statistics, I'm just kind of baffled.

And, even more concerning is the pre-diabetic population, which is kind of that pre-stage before you get to diabetes.

About 97 million people in the United States have pre-diabetes.

And, I always say, you know, our Californians, we think we're maybe immune to that.

You think of people running on the beach- - Mm hm!

- eating their avocado toast!

But, we've done epidemiologic studies and UCLA did one several years ago that showed almost 50% of Californians have pre-diabetes.

- What are some symptoms that maybe people are overlooking before they go in to get diagnosed?

Like, when you see people for the first time, your patients, what is it that is bringing them into your office?

- We can build up what's called ketones in our body and that can really lead to problems with nausea and vomiting.

We call it "diabetic ketoacidosis."

So, that's one of the presenting signs of type 1 diabetes.

And, type 2 diabetes, there's a very good percent of people that actually don't have any symptoms at all.

When people do have symptoms, you're drinking more water, you're having, like, an insatiable thirst, and you're urinating more because the sugar in the bloodstream is high and you're trying to filter that out through the kidney.

So, you're urinating out a lot of that water, and then you're so thirsty because you've been urinating a lot.

So, those are some of the major symptoms that we see in our type 2.

But, again, it can be insidious, and sometimes people really don't have symptoms and that's why screening can be important.

- [Leticia] Leonard Sánchez, a teacher at Chaffey Union High remembers constantly reaching for water, never feeling satisfied.

It was the very symptom Dr.

Codorniz had warned about.

- [Leticia] From what I understand, you are a coach in our local community?

- Yes, I'm a coach for right now high school basketball at Chaffey High School in Ontario.

But, I've coached multiple sports at Chaffey High School.

Baseball, most recently girls' tennis, boys' tennis, and girls' golf.

So, I've done a lot of coaching in addition to my teaching.

- So, did you find it surprising when you were told that you had diabetes?

- Yes and no.

No, because it's kind of run in my family.

And, you know, unfortunately both my grandfather, my dad, I remember them having to have one of their legs amputated.

And, you know, it was kind of in my brain like I may be heading here.

And then, sure enough.

I's been a while.

It's been, like, over 20 years since I was diagnosed.

- How old were you?

- I was in my 20s.

Yeah, late 20s.

I was working with my aunt and uncle and they have an office.

They do fireplace distribution and I was working at the phone desk for them.

And, my aunt noticed, "You're drinking a lot of water!

Like, I see you drinking a lot."

I said, "I'm always thirsty.

I don't know what's going on."

And, I went to the doctor not too long after that and that's when they did the testing and, like, diagnosed me as being a type 2 diabetic.

Started with prescription pills.

And, up until about five years ago, they switched me to insulin where I have to inject insulin every day.

- [Dr.

Codorniz] There is one really interesting piece of evidence that children who have a parent that has diabetes, they're about three-and-a-half times more likely to have diabetes.

So, again, that's someone-- if you have that history with-- that you know of within your parents and your first-degree relatives, then you're talking to your healthcare provider earlier on.

You know, "Hey, is this something "where I need to be screened now?

When should I screen myself?"

And, having that relationship with a healthcare provider earlier on.

I think the majority, though, is that sedentary lifestyle, obesity.

Also, factors including hypertension and cardiovascular disease may go along with diabetes, as well.

- [Leticia] Got it.

So, because my dad has diabetes, his dad had diabetes.

- Exactly.

- There is probably a good chance that even if I have a good lifestyle, I'll still get it?

- Not necessarily.

So, with the right lifestyle and trying to prevent, it's all about prevention.

So, if we can do anything before you get to that stage, that's where we're gonna protect you from all those different complications down the road.

- [Leticia] What have you had to change, like, when that first diagnosis came to the doctor?

Talk to you about changing your lifestyle or doing anything different?

- Yeah, it's been-- You know, a lot of it was you have to lose weight and being so active.

But, I think I got away with a lot of my bad habits, and when-- and I was managing.

And then, for me personally, right around COVID time, had a little tough stretch.

And, probably ate too much, drank too much, enjoyed too much.

You know, I put off 30 pounds.

- What do you think is the biggest challenge for you living with diabetes?

- [Leonard] Trying to manage food, really.

I've been able to adjust over the last few years on foods that really affect me that I've grown up with, you know?

We're Latino.

We don't eat beans and rice, and tortillas with every meal, but I do enjoy them, you know?

And, I remember when they first put me on insulin, they said, "You're probably gonna gain weight."

And, it's like, "Wait!

You want me to lose weight, but you're giving me something that may have me gain weight?"

So, it's that constant battle and constant back-and-forth that is a challenge.

- What do you wish people knew about living with diabetes?

- [Dr.

Codorniz] For our type 2s, I want them to know that they don't need to be perfect, but they need to make some change, right?

So, no one asks for perfection.

I always say I'm not perfect and I have my days where do things that-- Man!

That's probably not the thing I should've ate that day!

Right?

But, we're not asking for perfection.

We're asking to make some small changes that add up over time.

And, we're making those habits so that we can be healthier for the future.

- [Leonard] The biggest takeaway for me is not being so self-critical and know that you're-- you don't have to be perfect.

Communicate with your doctor, communicate with your family, and let people know.

Don't internalize everything and try and, like, battle it yourself because there are people that love you and care for you and want you to be healthy.

[light background music] Don't really try and take everything alone.

- I really want our type 1 diabetics to feel empowered.

I want them to know that it's not their fault, and we have new ways of helping them to be successful and that they can do anything that anyone else can do.

[gentle music] - Hey!

Happy Friday, 'Yotes!

We're here in the Jack H. Brown College on a Friday!

(clapping) Get excited 'cause you're gonna see it and I can't wait for you to see it, 'cause it's pretty good, I think!

(laughter) Peace!

- Peace!

- [Lisa] Well, I've been on campus 20 years and I work here in the marketing department.

I don't think there's a better place in the Inland Empire to go to school!

(laughs) - [Leticia] Thank you, Lisa Gordon, for joining us today to talk about a very important topic, type 1 and type 2 diabetes.

- Thank you.

I'm glad to be here.

- So, I understand that you have a complicated diagnosis.

- I'll say that!

(laughs) - You were first diagnosed with type 2 diabetes.

Talk to me about, like, when that happened.

- Well, originally it started in pregnancy and I had gestational diabetes.

Went away after the pregnancy ended.

And then, I had a later in life pregnancy at 34, and it came back again.

And, they actually put me on insulin during that pregnancy.

When that was over, they took me off it and I seemed to be okay.

I'd say nine years ago, I got real sick here at work.

At that time, it was actually my gallbladder, but weird symptoms were happening, and they couldn't figure out why I wasn't getting better.

They took my gallbladder out, thought that would be it, and it wasn't.

And, they started treating me for type 2 diabetes.

Then we tried surgery, weight loss surgery, because type 2, that works typically with type 2.

I lost weight.

Nothing changed with my A1C.

And, that's when they let me know, "You're type 1 now and you're never gonna get off insulin."

And, you know, everything changes then when you find out that you're never gonna be able-- There's nothing you can do.

- Yeah, there's no diet.

- [Lisa] No, no diet.

- There's no lifestyle changes.

Nothing you can do.

Type 1 is forever insulin.

- Forever.

Yes.

- So, talk to us about what symptoms were you having?

So, after the gallbladder surgery, they take out your gallbladder, but you're still having those persistent symptoms.

What were they?

- You know, it's funny.

Every time I would eat a meal, I always felt like I needed to take a nap, immediately.

I tried so hard, you know?

It didn't really matter the level of carbs that, you know, was in the meal, but it always affected me.

I'd be at family functions or a party, eat something that they were serving, and immediately feel the need that I had to lay down.

And, sometimes even here at work.

- So, this was interfering with your life?

- Yes, yes.

And, being the main breadwinner of the family, you just keep going!

(laughs) You know, there's no stopping.

And so, I just had to find a way to do it sick.

And, that's what I was trying to do.

- So, when they told you you're a type 1 diabetic, you're always gonna be on insulin, what was that first thought?

- I cried.

(laughs) I cried because at that time, I was probably take-- giving myself six shots a day with a needle, testing my blood 8 to 10 times a day because my numbers were really high.

My A1C was very high.

And, not even being familiar with the process of this, I was very nervous.

I had a lot of anxiety because I went low.

You know, with a type 1, you really go low.

They talked a lot about coma.

You know, not waking up.

- Type 1.

- Mm hm.

- You're giving yourself six shots and monitoring your blood eight times a day.

That's a full-time job you are doing.

- And, you have to factor in, in the middle of the night, my alarm is going off, waking me up, telling me my numbers are high or my numbers are low off-and-on all night.

I'd say two hours at a time is my sleep pattern.

So, you never sleep.

So, you're exhausted all the time.

- Trying to live with this 2 diagnosis.

- And, the anxiety of, "Am I gonna wake up?"

- Did it eventually get better?

- Yes.

- How has it changed?

- So, everything changed about two years ago when they put me on a Dexcom monitor, and an Omnipod monitor.

So, I have an insulin pump attached to my body and I have a Dexcom attached to my body to give me my blood sugar readings, 24/7, and insulin immediately ready that I can give to myself.

And, at night, instead of me going high, it's giving me little increments of insulin, never a large amount.

And, it'll stop if I start to go low.

And, it'll-- I still get the alerts.

I still go low sometimes, not as low as I was going before.

But, it's still-- It's been a lifesaver.

I mean, I feel like I've been able to a little bit live my life again.

- So, you wear a glucose monitor?

- [Lisa] Yes.

- And, it talks with your insulin pump, and the two of them together help to manage your highs and lows?

- Yes.

(phone chimes) I can just look at my phone.

I can see what my blood sugar is.

If I was to eat some food and I know what the carbs are, I would put that in.

It tells me how much insulin to take instead of me having to figure it out.

Before, I always had to figure it out.

And, sometimes the calculations can be a little daunting.

So, it really has been life-changing for me.

I feel like I can function a little bit better in the world!

(laughs) - Do you wish you would've told yourself sooner?

Or, do you wish you would've done it sooner?

- I do!

I do.

I could kick myself.

I tell my husband, "I could've been feeling better "a long time ago if I had just gone ahead and let them, you know, give me the pump."

It was just really, you hear "pump" and it sounds scary, you know?

Nobody wants a pump on their body!

You know?

(laughs) - No!

- And, I tell people, I'm like Tamagotchi, the game, you know?

You, "Oh, feed the pet.

Feed the pet.

It's gonna die if you don't feed the pet."

That's me!

I'm all, (laughs) "Feed Lisa!

Give her-" I try to be funny about it, you know?

I try to make light of it because it's a serious thing.

And, if I think about it too much, you know, it can get to me.

So, when I can make light of it, it helps other people around me.

You know, not only does it make them feel comfortable, but other people that might be struggling with it come up to me and, you know, wanna talk to me about it.

- So, you're bringing some humor into it.

- [Lisa] Yeah.

- Sometimes a dark subject.

- Yeah.

I tend to do that with all subjects!

So- (laughs) - So, what do you tell people who are brand new to type 1 diabetes that come and talk to you?

- That it's a process, and expect that it's gonna take time.

And you're gonna make a lot of mistakes, and you need a support system.

A lot of times you need a team.

In terms of whatever, you know, your doctor, a lot of times you have an endo.

You have, you know, other people that are involved that are usually checking on you, seeing how your blood sugars have been.

So, you're not really out there on your own.

If you are, if you're a type 1 and that's happening, that's a problem.

I wouldn't recommend that.

I don't know how you would be functioning.

You won't function long as a type 1 without getting regular care.

There's no getting around it.

If you don't, if you're not treated, you won't make it.

- So, would you say Lisa is thriving now?

- Lisa is.

Lisa has to!

(laughs) You know, I just want to feel good for myself, but also show my kids that no matter what is happening with a person that you can overcome.

And, if you can't overcome, you find a way to deal (laughs) with it and still be happy, you know?

It doesn't have to take you down.

- Well, Lisa?

Thank you so much for joining us today and talking about diabetes and letting our viewers know a little bit more about it.

- I'm happy to do so.

Thank you so much for coming to talk to me.

- [Leticia] From the basketball court to the doctor's office, these stories remind us chronic illness never takes a day off.

But with early screenings, better education, and new technology, people are finding ways to manage and even thrive.

Coach Sánchez tells his players that health is about effort, not perfection.

And for Sammie Luna, listening to her body turned out to be lifesaving.

Their journeys show us that chronic illness doesn't define who you are.

Patients say the biggest lesson is simple: Listen to your body.

And when something feels off, speak up.

Advocate for yourself or find someone who can help.

Because taking charge of your health today can make all the difference tomorrow.

[light uplifting music] ♪ ♪ ♪ - [Announcer] Support for this series comes from Inland Empire Health Plan, a health plan with a mission to heal and inspire the human spirit, serving over 1.5 million members in the Inland Empire.