ah mm mm i welcome to was a part of type 2 diabetes is one of the call with data lists. the flexion of more than time predominant as it is preventable. it's ravishing effect on with $900.00 complications are well established, but also award the other way around. you can call it 19 con diabetes will discuss it now joined by holmes in professor diabetes as menache university and astrology. and founder of the international diabetes institute ism,

it is good to see you. good to talk to you. thank you very much for your time. lovely to talk to. now i know that you have devoted many years of your life. warning about the dangers and the snowballing nature of diabetes is ravaging effects on the body is higher, rocketing race around the globe. but i wonder before this current or on the wire, it's been demick structure. didn't ever occur to you that diabetes would find such a powerful and cunning ally as it didn't start for me to i think it's a very good question to stub. and i certainly didn't expect the pandemic obviously . but people with diabetes, for a number raises, whether it's not adequately managed or that they have some immune problem. then their risk of infections and something like the coven 19 pandemic,

was very bad news. the people diabetes. and we considered as one of the very high risk situations in terms of people being in now correct me from wrong. but my understanding is that what these 2 viruses or 2 conditions actually produces some sort of a hybrid monster who was viral nature, get amplified by the pre existing chronic conditions you just that in your wrote about in before the most nations prove unprepared for but the condemning but wasn't really so hard to predict because as you just mentioned, we have known all along that form of the bulk how predisposition to all sorts of ours is go hand in hand. well, it was bound to happen. we just didn't expect that. and, and this has been a shock for socio economic reasons and many other reasons. and certainly in

terms of diabetes and it's twin brother are based on t. these are 2 of the very high risk situations. now it's been clear from the beginning of it's been done that diabetes substantially increases the profitability of both making mortality complications. but starting from late last year in the medical community has been buzzing about the reverse possibility. that is the experience i'll call at $900.00 triggering diabetes. i know that your institute is keeping your register all 5 cases from around the world. how widespread it is. well, we are collecting data fully funded mind just as the room as it goes with the research in collaboration with kings college in london. and we've now since the band to make staff is all the we've been experiencing it.

we've rolled something like people from about 4550 countries now who are reporting cases into the register for us to look at and the well, i think we have something like now that we're heading for 400 cases and the cause, this is a way of an under estimate because many people in the developing countries don't have the facilities only the way of collecting data that we would name for the register, but it is a significant problem. now i know that there are several hypothesis as to what may produce such an office. what is it, what it is in the composition experience that may lead to diabetes? which of these hypothesis looks more likely to you at this point? well, that's a good question. and there are still people in our profession could and convinced

actually that code is causing all this trouble. because many of the people who may have just develop but may have had pre existing diabetes. and we know time to be adult forms can be very modeling symptomatic, can not be picked up from the many years. in terms of the theories, one of the one is that there is a direct attack by the virus on the insulin producing cells in the pancreas. which will result in type one diabetes, right? time will type one, but also it can type 2 in the sense that it doesn't cor complete because complete destruction. there's of course, the fact that when the virus gets in the cell and into an organ gone, inflammation and inflammation is a trigger for diabetes. and people who may have

a family history of diabetes, or even if they don't have it. and the real sneaky thing about this is that in every cell we have what we call a receptor in the wall of the reset of the cell. and if a hormone comes along, it gets into the seal going through like a gateway. this key virus has worked out how to get into the still using this gateway, which is a normal in someone who hasn't got diabetes, who is a normal pathway for any woman to given the cells in different organs. so it's called the ice receptor, and that is a theory. a lot of people are hanging the car. now, if i understood you correctly, let me know if i'm wrong here. obviously this is still much on there if there's subject, but from what it says you're saying is that covered,

i think cause some sort of hybrid diabetes. so it's not strictly type one, no strictly type to, but that makes the both of them with compromise capacity for insulin production and also compromise come back before the insulin resistance or rather a triggering wind resistance. well, i think you put a very good case there. i think we are seeing type one diabetes to, to direct destruction of the pan cuz but if you're looking at the whole picture, you're not seeing just one or the other. and we know there are issues that the virus, when with the diabetes, creates a situation in people with diabetes that they may need more insulin, for example, to treat it. so i think there is this background of an in flam or tree effect. there is now one more similarity been called 19 and diabetes is the so called

metabolic syndrome. i mean it's well known. the diabetes is associated with metabolic syndrome. but there seems to be quite a lot of cases when the recovery from called at 19, even if it doesn't produce a diabetes, it produces some sort of like long term chronic consequences on something. but sufferers and i, personally, you are a few people who after again seemingly having recovered from 1900, died of a heart attack a few months later how much you would know about the long term effect of, of 19 we know just about 0 and this is our concern. i wouldn't call that the metabolic syndrome. this is what we're calling long kind of, we don't understand yet. the long term impact on someone who may have had the infection and sort of recovered the could've affected the heart, the kidneys,

lungs. and of course the pancreas, and we do know from the south lip, a demick in china and hong kong, back in 20 to 2030, was something that, in fact there were, there were cases of diabetes caused by the corona virus. and in some of the people who got it, they actually the diabetes did disappear afterwards. so at the moment we're very concerned about the long term effects and need to monitor people been infected already. now when i said metabolic syndrome, i didn't mean a medical name for it, but i think in terms of the mechanics, it's pretty similar because it's a long lasting systemic a fact. in fact, many systems of the body. and i know that you before that, that the metabolic syndrome associated with diabetes was one of the greatest threat

to human health. but in order for it to be manifested to become is news. i'm sorry for saying that the people usually don't like to hear that. but it's usually a consequence of people's lifestyles. i mean it's nice to when it comes to type 2 diabetes in order to be for that to be manufactured, usually takes years if not decades. but the one thing you care about it 19 is that similar degenerative or fax on the body seem to happen in a matter of just the mom. so even we is the correct understanding of how it works. we don't, we have enough information yet on only this aspect. we do, we do not have these. there is critical organs, particularly ones. i've got this receptor that i mentioned earlier, wrong. it's quite common in the heart. it certainly in the lungs. one of the

reasons why so many people get this pneumonia is that the virus gets in probably through this receptor into lung tissue. and i think we're really going to have to follow up, you know, coverage been around. just overlook one and a half years or so now almost. and the way we really haven't had the opportunity we've been concentrating on the situation and the symptoms of intended k units and whatnot. and take quite a long time now over into, in years to work out what is the long term damage now for now, the preferred prevention strategy around the world is vaccination. do you think that's enough? is there anything that people around the world could be doing apart from lining up for their shot if they decided to take it that's, that's a difficult question. and,

and really we're concerned here in australia or even that the vaccination isn't going as well as we would hope to. and i think we have to rely, i'm not an expert on the, on the concept, the more people that are vaccinated, the sooner we'll get on top of this. and i can see, you know, obviously one has to be careful about getting infected all the things we've been doing for over a year now. but the vaccination is important, and that really worries me, for example, in that most even mind patients, when i said you should get back soon as i saw, don't worry, the vaccines got the virus is gone because you know, we've had much lower rights. but here today actually we've got a cluster just assembling here in victoria with a government getting very well even they did for chicken virus and gone. diabetes

is here to spam. they could be maybe more viruses that bill find you know, in the future. absolutely. now, speaking by myself, i'm a big fan of, as you mentioned, fasting, all outdoor jogging, especially during the long russian winters. and i find it 1st of all, very affordable. it doesn't actually take any money. it doesn't even much commitment because it's a very gratifying and various active experience in terms of both rate, man maintenance and overall immunity. i haven't had any calls like many, many years. but i gave up on trying to convert people to house the lifestyle because everybody or a lot of people, they seem to outdoors, their responsibility for their house to somebody else. the doctors you know, and attrition as society at large. the parents who didn't seem properly, etc. i wonder how do you persuade people to be more read

with that, how to proceed that help as you know, that treasure that they should keep onto as much as possible rather than being so wasteful with it. again, i didn't pull the point. i've been working more recently in the air of satiety and rhythm, the body clock, and the body clock. there isn't enough information to the public or understanding. i've been pushing here in australia for actually public health programs about looking after your body and that best sleeping well, eating well, exercising well. avoiding stress plenty of sunlight, these a key elements. you know, it's a healthy lifestyle and not just a matter of what you want to eat or, or don't leave. well, how much in drink and it's a package. and once we, we have a clock in,

in our brian and in every cell in our body there isn't clock linked to that. and when things like stress or poor nutrition or whatever, come along the whole body gets disturbed. and there is not enough understanding of it by the population and not enough education to make children and young adults and older adults understand why it's important to have a healthy life. well, we have to take a very short break now, but we will touch upon this issue in a few minutes station. ah, me or finance survival guide. liquid assets are those that you can convert into cash quite easily. but keep in mind, no, i mean to inflation better watch guys reported me

ah shoot. don't do leave, you know, should move a new he will tell which one ready to love me because she knew she wouldn't be a little girl. and the study assist me if you sure you can totally traditional moving machines, etc. if you want to put it, you see the one in the best for me, please don't read for me to last with metro. yeah. so

i love this and this is what i need from the new new new which is about what is the new i see executable football once you put up on that got moved up when i got it up on that. got me the me or i welcome back to all the holes in the professor, diabetes menache university in founder and national diabetes institute professor, even before cove at 900. you talk about diabetes and decency being the biggest

academic in human history. and what's interesting about it is hold it in pretty much one, maybe one and a half generation. i know there are many factors contributing to it, but what would you say is the most important, the most influential, why you wouldn't ask that because there are multiple factors and certainly the genetic background is very important. we should talk about it as a base of the nutrition and of course exercise. so you know, there's a key elements. one is important to understand though everyone thinks i did as one stage that it was all genetic and the same with the base of the but we now talk about a phone call every genetics where because people thing you inherit the

risk and through life. but even if you didn't have the genetic element, we now see this what we call epi genetic phenomenon. when during the allies, the j there can be changes in your gene, not is not actually in the structure of the janes, but it's made up of little mato acids little you protein units and they link with the chains and whatnot. and it says chains rust a little bit and they can rush because people drink too much or they, they will or in, in a famine, incense people are in leis, alive for diabetes now basically and had trouble. so there is this concept now that you actually, and it's very important during pregnancy that women don't smoke or don't drink. and

then careful the nutrition because they can make changes in the baby's cheese. every genetic changes which an adult life leads to type 2 diabetes. now are always good at many factors beyond our control that are influencing our disposition to this condition or that condition. and i home or my personal experience, the people who are obese they, they tend to blame the genes or the parents or. busy having them being express option degree, no pun intended, here. and he also said that at least 50 percent of all cases ultimately come down to your genetics. aren't you concerned that people may take it as a license of not ask you more of them? because sure, you know, you may have a hopper load down to your neighbor on this particular issue, but we'll have our talent or abilities just because it's been

a little bit more difficult for you personally. doesn't mean i suppose that you cannot deal with it as fast as manner. i probably won't give you the answer. one been very complicated and this whole blaine game people, a blind for being a base and the gold fat. and as a whole, it's a hosting. and i really think there is a, an element here that people need understand and then the socio economic there's just so many things in certain populations, for example, in the pacific to be big, you know, base is very prestigious. so there are a lot of community concept for example, which actually people stay in the white because in the community, except i know that i want to be very contrary and here. but when we, when,

you know, in the countries that believe you are in a trailer in russia, we can also include the united states, western europe, your conditions are pretty good for the majority of the people. sure. you know, somebody for somebody is richer, but overall there's no famine. for the most part, there's no war stress. yes it does, but it's also manageable. it's not comparable to was people experience, let's say 2 centuries ago when they had to bury pretty much every child that they gave birth to have to work around the flow. so i'm not trying to downplay the influence of the socio economic factors, but i, my concern is that with, with all the possibilities that people, me may actually be asking a little bit less of their so they can actually produce because at the end of the day, regardless of whom we believe is the person who start printing from

a decent year from suffering from the diabetes who is quite literally bearing the consequences to could come back to the aiden story again here. and there are people actually putting on weight during this pandemic. and then they're under stress because they are losing their job, a lot of elements and background to a basically. and it's very hard to put it in one package to look at it. of course, you know, the strains are great in the olympic games and get plenty of metals that or other sports, etc. but i thought it all very complicated. there is a very important element of self discipline here that you have to be in the situation. you know, the, the economic, the social and other situations where you're able to not have to katie and system disrupted. i mean, there's

a huge amount of money going into mental health. now in this country, i've seen it in the u. k. and i suspect it's happening in russia to deal with all the problems during this pandemic. and it magnifies what happens usually. so i think there's a lot more to come out in that in terms of how we behave and how the external forces and body and drive this obesity epidemic. now if i'm asking about this, what aspect of it? because a carbohydrate addiction is it is a major factor in becoming healthy and actually getting enough willpower to do what you want to do with your body rate with your life. a lot of countries and now considering imposing taxes on sugar, it's written beverage. and do you think that would be enough human be that are there role that carbohydrate sugars play in the industrial chain?

again, i think it's a good question. i'm actually i should get tax isn't going to be the big winner. you have to have the other elements we live, we know that can cross the border and get things which are being held back through the government, listening to industry. and i think you always have to look at the other, the social side, the psychological side, the exercise center. there's so many, you know, some people, we've got a good lifestyle, but there are a lot of people around the world who don't have that same lifestyle. and obesity tends to be much more common in those communities in dispossess communities. so i wish i had the answer and i've been a lot of time in the field and i've been concentrating more on diabetes in

a base in terms of my own professional work. because it's such a hard job. now thinking about hard job, one of the things that has puzzled me for quite some time is why there are so many overweight people among doctors and nurses. and then i came across your lecture on how shift work influences a person to predict physician to both ability and other conditions as well. wouldn't be fair to say that people who are committing themselves to helping others, especially in the around the law setting, as has been the case over the last year or so. they're actually paying with how i this again is another good point. and the front line who health workers actually the ones who are getting very high right infection. thank goodness, the vaccines and now coming along. but for nearly a year or over a year,

they've been working at the forefront and sacrificing potentially their own lives. and i've actually got in a experience, mind family, fortunately by good care of by themselves. they haven't been infected. i suppose it's not just that for sending it to the viruses, but also the way that work day is structure that influences that house outcomes. speaking about the 17 and arrest from the body clock. do we understand the point, which is the chicken, which is they act isn't the disturbance in believe that makes people on that or is it the disruption? in fact, metabolism does make people lose their sleep. in the main point, isn't the people who are doing shift work, for example there that yes, sleep is very important for your health and accounting to size that now and then

comes back. sure to come back to katie and, but that's part of the deal. but also people in schiffwood often don't have the opportunity to get the right foods as fast food because they have a quick meal. they, unless they get the exercise they should get. so it is dangerous and there is a the women study in the united states range of nurses, very high rates of heart disease and stroke as a long term effect. as having been shipped blood professor, we have to live there, but i'm very grateful to you for spending some time with us and sharing some of you with them. and i've learned a lot from you. thank you very much and thank you for watching. i hope to hear again next week on walter part of

the me me the i choose choose .

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