Mastering Diabetes, Diabetes, Lunch and Learn,Cyrus Khambatta, Type 1 diabetes, Type 2 diabetes

LLP140: Reverse Insulin Resistance Permanently With Robby Barbaro, MPH

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In this week's episode of the Lunch and Learn with Dr. Berry we have Robby Barbaro, MPH who is the co-founder of Mastering Diabetes, a coaching program that teaches people how to reverse insulin resistance via low-fat, plant-based, whole-food nutrition. Robby was diagnosed with type 1 diabetes in 2000 and has been living a plant-based lifestyle since 2006.

This episode is going to be a welcoming change of information for those suffering from diabetes who have been told carbs are the enemy.

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[showhide type=””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””post”””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””” more_text=””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””Episode 140 Transcript…”””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””” less_text=””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””Show less…””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””] Introduction Dr. Berry: Welcome to another episode of the Lunch and Learn with Dr. Berry. I'm your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of, as well the CEO of Pierre Medical Consulting. Helping you empower yourself for better health with the number one podcast for patient advocacy, education and affirmation. This week on Season 4, we bring you the discussion of Diabetes, which is such a hot topic. Especially when we talk about the level of complications associated with diabetes. I've told my patients, and if you're a diabetic, you're at a top five risks for going blind. You're at a top five risk for cardiovascular disease. You're at the top five risks for infections. You're at the top five risks for amputations. Once you get diagnosed with diabetes, your risk factors for all of those things I just mentioned kind of shoot up through the roof. But thankfully we have someone here who's going to help us master diabetes, right? That's right. We have Robby Barbaro who is the co-founder of Mastering Diabetes, which is actually a coaching program that helps teach people how to reverse insulin resistance via low fat plant-based and whole food nutrition. And guys, notice I said nothing about carbs, right? And I definitely had to press Robby on that question because a lot of times, especially in our world as a physician, first time when I tell a person a diabetic, the one of the first things I say is, hey, watch your carbs, watch your carbs. But this is actually changing that situation and say, hey, you know what, carbs might not be the big issue of concern here. So I'm definitely can't wait for you guys to get a chance to listen to this episode. Remember, I needed you to share this with 10 other friends so they can all listen to this episode. Especially if you know someone with diabetes. If you know someone with hypertension. If you know someone with complications of diabetes. If you know someone with complications of hypertension. If you know someone who has issues with their diet. All of these things can really be honed in on this disease process. And Robby does a phenomenal job helping us get to the point where we understand that food can be a weapon in our battle against diabetes. And sometimes it could work against us, but we can also work for us as well. So, I can't wait for you guys to get this episode. Like always, share, subscribe, five stars on Apple podcast and make sure you review, tell a friend and tell a friend. Let's get ready for another amazing episode here on the Lunch and Learn with Dr. Berry. Episode Dr. Berry: Alright, Lunch and learn community. You just heard another amazing introduction on a topic that we've approached here on the subject, where we talk about diabetes and we talk about what is diabetes, treatment of diabetes. Now we're going to find out how to master diabetes. And I know this episode is going to really touch a lot of my Lunch and Learn listeners, because you guys, you like to hear that certain medication, treat it right. But you also like to hear what about the diet. What other things outside the traditional medications? The doctors like myself are always prescribing that, I can actually get ahold of it. I don't want to just have diabetes. I want to beat diabetes. And this guy today and this program and what they got going on. I'm definitely excited. Like I said, I am hype for the discussion to really bring to you guys. So definitely excited. First of all, thank you for coming on to the Lunch and Learn episode and getting ready to educate our community today. Robby Barbaro: I'm really excited to be here. Thank you so much for having me. And you're right, we have a lot of important stuff to talk about. Dr. Berry: I gave them a little bit of your introduction, but what typically happens, especially my Lunch and Learn listeners, is that, they speed through it. They want to get to introduction, they want to get to do a little commercial and then they want to get right to episode. So for those who do, because I know you guys like to do it right? Give them a little, I guess a background to know who you are, what is mastering diabetes and what are we going to really get into today? Robby Barbaro: My name is Robby Barbaro and before we hit record and talking about public health, just recently actually graduated and got my Master's in Public Health. I'm really passionate about really making a big change in a lot of people's lives. And so we have a brand new book coming out, it's called Mastering Diabetes. And the subtitle is The Revolutionary Method to Reverse Insulin Resistance Permanently. In Type 1, Type 1.5, Type 2, Pre-diabetes and Gestational Diabetes. So that's how it really gives you context of what we're doing at Mastering Diabetes is we are treating in some resistance or teaching people how to reverse insulin resistance, which is at the root of all forms of diabetes and blood glucose variability. So we'll get into that in more detail. But myself personally, I've been living with Type 1 diabetes for just about 20 years now. So I'm sure your audience knows the difference between Type 1 and Type 2. My pancreas does not produce sufficient quantities of insulin. So I inject insulin to eat food and I tried many different diets in my journey of trying to get my best day one see to control my fasting blood glucose to avoid the complications that we're all told were at higher risk of. And over the course of time I've tried to sort of Weston A. Price low carbohydrate diet. I've tried sort of a plant based keto genic diet where I ate lots of greens, nuts and seeds, lots of oil. So while I did that diet, the interesting part is that my insulin sensitivity, which I can calculate quite easily living with Type 1 diabetes, we do a 24 hour carbohydrate to insulin ratio. That's one way to measure insulin sensitivity. So I would consume for every 3 grams of carbohydrate that I consumed, I needed to inject one unit of insulin over a 24 hour period. That's a three to one 24 hour insulin ratio. Then I started learning about this new approach, low fat, plant-based, whole foods. Okay. And I started eating lots of fruits and vegetables in massive quantities. So I now eat 600, 700, 800 grams of total carbohydrate per day. You guys might be scratching… Dr. Berry: I cannot wait to ask because I know my audience is like hold on, they told me carbs weren't good. They told me, what is happening here? Robby Barbaro: We're going to talk about that. And it's one of my favorite topics to address because it really is the elephant in the room. We're talking about on the public health scale here. People are confused. What should they eat? People living with diabetes are told, look, you have high blood glucose readings, therefore eating carbohydrate rich food that's full of glucose is going to raise your blood glucose level. That's the standard teaching. So we're going to get into why that is not actually the real truth of the matter. But in my own personal story, I started to see, wait a minute, I just increased my carbohydrate content dramatically and my insulin sensitivity was improving dramatically. So now I can eat upwards of 22 grams of carbohydrate for every one unit of insulin. So that's a 600% change in insulin sensitivity. And people living with Type 1 diabetes, we are fantastic test subjects for insulin sensitivity because we know exactly how much insulin we're injecting. We count our carbohydrate consumption and we measure our blood glucose many times a day and many of us wear continuous glucose monitors. So I have a Dexcom G6. I get our new reading on my phone every five minutes after every meal. I can see exactly what happened over night. People like you, Dr. Perry, when you eat a meal, you're not sure how much insulin your pancreas secreted. You're not getting minute by minute blood glucose data. So we're fantastic test subjects for this. My co-founder of mastering diabetes, Cyrus Khambatta, he is also living with Type 1 diabetes. He had a very similar story of beginning to eat, way more carbohydrate, needing a lot less insulin, improving his insulin sensitivity and just having a dramatic change. And so we started mastering diabetes in 2017. We joined forces together and we started it. It's a coaching practice and an educational platform for people living with all forms of diabetes and really addressing this root cause, in some resistance. Which is the cause of pre-diabetes, the cause of Type 2 diabetes, a major cause of gestational diabetes and for living with Type 1 and Type 1.5 diabetes. When you're living insulin resistance, your blood glucose is much more challenging to control. It's harder to lose weight. You have lower energy. And so this is really, it's an issue that's important for a wide range of reasons in addition to just blood glucose readings and A1C. So I know you might have a technical audience here who understand some nuances. So A1C is right now it's 5.4% that's my latest one. I've been doing this, I started in 2006 so I've been doing it for over 13 years now and my A1C has never been above 6.6%. That was only one situation where it was that. Every other time it's been between 5.3 and 6.2%, that's my A1C. It was 13 years of eating well over 600 grams of carbohydrate per day and most importantly, injecting a physiologically normal amount of insulin. So the human pancreas secretes roughly 25 to 50 units of insulin, a healthy normal, insulin sensitive human being is going to eat normal healthy food and secrete about that much insulin. So when you're living with insulin dependent diabetes, the goal is to inject the same amount of insulin your pancreas would have normally secreted before your beta cells were damaged. So I'm eating this large amount of carbohydrate from fruits, primarily all that's coming from fruit and I'm injecting a normal amount of insulin. So in addition, my CGM data, I can track my time in range. So the diabetes community has agreed that for people living with Type 1 diabetes or Type 1.5 or insulin dependent Type 2, our goal is to stay between 70 and 180 for a minimum of 70% of the day. So that's 70 milligrams per deciliter to 180 milligrams per deciliter. Now I am seeing my 90 day average, which I can get from my Dexcom clarity app, is showing that I have 90% time in range. Now the Type 1 community, the average is somewhere between 50 and 65% that's what most type ones are getting. So I'm eating way more carbohydrate… Dr. Berry: And that percentage is when someone's excellent? Robby Barbaro: I mean the goal is 70%. I mean I don’t want to over boost myself here, but the 90%, if anybody here listening to this works with his endocrinologist and works with type ones, they will understand that a time and range of 90% is absolutely extraordinary. In addition to that number being absolutely extraordinary is the fact that I don't use a closed loop pump. So I'd do this with multiple daily injections. So people read, you'll read articles about time and range. The people who are actually getting to 90% are people who are using closed loop pumps. It's also known as an artificial pancreas. So the pump is communicating with the CGM and it's making micro adjustments throughout the day, particularly overnight, which is helping people improve their time and range over a 24 hour period. So again, I'm just an N of one so I could sit here and talk all day about my own personal story, which is definitely demonstrates something very important. But beyond that, we have worked with hundreds of people living with Type 1 diabetes who get this similar results and thousands of people living with prediabetes and Type 2 diabetes who also reversed insulin resistance. And in most cases can get off all their medication, no longer diabetic. And it's a thing of the past. They've addressed the root cause of prediabetes and Type 2 diabetes. So that was a long-winded answer to diabetes. Dr. Berry: We love those answers because it's so eye opening, especially for a listener base who has, unfortunately, again, I'll jump in the line of fire, have been told consistently, when you talk about diabetes, is the blood sugars, is the blood sugars, is the carbs, is the carbs. So here you guys are coming with like a different approach. Like no, no, no, it's not the carbs. And I love how you stress it's not about the carbs, it's the insulin resistance. That's really the fundamental problem with diabetes. And I think that's for some reason, unfortunately it gets glossed over. I'm not sure why we went after carbs in the first place. I'm not sure if it was just an easier approach. I'm not sure what the actual origin is. But I love that we're coming in and saying like, no, we want to actually attack the problem. The question I want to know, especially you've been in Type 1 all your life and you're starting to read, you're starting to learn more and you're going from a process where you're starting eating way more carbs you know you've ever eaten it before. What was that mental change like? Robby Barbaro: it's a great question and it's so true because we work with thousands of people and we have them go through that same mental shift of, wait a minute, I don't believe you. I just holding this apple makes my blood glucose go up. Okay, let alone eating it. So for me, I had tried so many different diets in the past, but I was open minded and I was working with a coach and the coach really instilled a lot of confidence in me. And even with all the confidence and all the testimonials, I was still apprehensive. There's no question about it, but I was willing to try it. And because I made the transition. I basically made it overnight, which is not something we recommend, read the people that works for it. And happened to be Cyrus and I, it works for us, but for most people it's better to transition slowly. But because I just jumped in and I just changed all my meals right away, I ended up seeing very rapid results and that was encouraging. And even people who change one meal at a time, they can also see quite rapid results and it really begins to really affect your mind. You're like, wow, all this time the doctors, my friends, everybody has been telling me that this is not going to work and I am seeing it happen in my own body. The blood glucose meter is not lying. (Nope). I'm eating more carbohydrates. Dr. Berry: Numbers are not lying here. Robby Barbaro: And my passing bug is going down. People are really, it's mind boggling but really encouraging and again, once you see those results it's just makes you want to keep going. You're losing weight very quickly. Your medication needs can drop quickly depending on what people are starting with. Somebody comes to us with insulin dependent Type 2 diabetes or are living with Type 2 diabetes and they're injecting insulin. They might need to drop that insulin use within days because their body is still producing enough of its own insulin. So that's a huge distinction there. And most people living with Type 2 diabetes do have plenty of insulin production more than enough to eat a healthy whole food plant based diet and not need exogenous insulin. So the answer to your question is you see results very quickly and you start to stick with it because you're like, this is working. That's really what happened to me. Dr. Berry: And we've brushed over it and we talk about how the big culprit of diabetes and the lack of control, most importantly, we're revolves around this, this factor of being insulin resistant. For those who again, they may be diabetic, they have family friends who are diabetic and they're going to listen to this and they're going to say, hey, do you know where your insulin resistance is? What is that? And how does someone know when they got to that point? Robby Barbaro: I'm so glad you asked. This is such an important question. The dictionary definition of Insulin Resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose from the bloodstream into muscle and other tissues. So what does that mean? That means that if you're living with insulin resistance, your body is struggling to take glucose out of your bloodstream and into the cells that need the glucose. Therefore, you now have elevated blood glucose levels because the glucose is trapped in your bloodstream. That is what is going on in an insulin resistant state. Now, what causes that to happen? What is the reason that the glucose ends up getting trap in your bloodstream and can't get into your cells? So there are several causes of insulin resistance. The biggest one, the primary one is having a diet where you have consumed too much fat, particularly saturated fat, and that fat has been stored in cells that are not designed to store fat. So when you have excess fat in your muscle tissue in your liver tissue, that can be a cause of insulin resistance. That's actually the biggest cause of insulin resistance. You're supposed to have fat and adipose tissue, that's where it belongs, and you're supposed to have a little bit in muscle and liver cells, but not too much. And basically what happens is that fat stored inside those cells is messing up the communication for insulin to be able to open the door and allow blood glucose into yourself. That's insulin's primary function. There's a lot of different things… Dr. Berry: I love that analogy. Robby Barbaro: Yes. It's a hormone that is supposed to open the door, that's what's going on. Now there's other problems that can happen. You can consume too many AGE – Advanced Glycation End products and that can mess with the signaling. You can basically, inflammation in general can also mess with this signaling of the ability of the door to be open. So the bottom line is when you follow the mastering diabetes method, which is the protocol that we have created and the system, you end up addressing insulin resistance on all levels. So you're going to get rid of the fat inside tissues that are not designed to store fat. You're going to address inflammation by eating whole plant foods. You're going to address sodium is an issue here. So there's, there's many issues. But again, the primary one to focus on is people consuming too much fat and this includes even plant foods, but saturated fat in particular is the cause of insulin resistance. Now I also want people listening to understand insulin resistance sets in many, many years before even pre-diabetes appears. Insulin resistance, you can set it almost 10 years before even anything shows up. An insulin resistance can set in before you see elevated blood glucose levels. Because your pancreas is capable of creating extra insulin to overpower the insulin resistant state. So you can still see a great A1C, you can have a great fasten bug, a close level, completely be non-diabetic, but still insulin resistant. And that is at the root of people who have trouble losing weight or people who again, who have low energy of many other chronic conditions such as heart disease, fatty liver disease, cancer, erectile dysfunction, high blood pressure, triglycerides, you name it, insulin resistance is that the root of all of those. Dr. Berry: What I love about that is because you definitely mentioned a lot of things when we say, hey, these are risk factors if you are a diabetic. Behold, they may have been the sequelae of it. Because of this insulin resist is now look at all of this stuff that you are now at risk for because of it. Robby Barbaro: That's exactly right. Dr. Berry: And we talked about the diet, how much, of course we don't want to blame, but how much would you put on the onus of just our regular diet, I guess the American quote unquote diet as a contributing cause to a lot of our problems now? Robby Barbaro: Dr. Pierre, I'm going to put it all on that. I mean, it really is. I mean, the food that we are eating at large is killing us. It is absolutely the cause of insulin resistance. No questions to ask. And people can absolutely take matters into their own hands and turn it around and they can demonstrate to themselves that they are absolutely in control of their diabetes health. It is not a chronic progressive condition that you can't do anything about. That is the standard teaching. I believe the American Diabetes Association is still teaching that, which is unfortunate that it's just a chronic progressive condition and is always so much you can do. And here's the medication. And so the people, the reason somebody has elevated blood glucose levels or can't, has issue losing weight or whatnot, it's not because of the lack of the medication. That wasn't the cause. Dr. Berry: Because we've definitely got lots of medications out here. Robby Barbaro: There's something else going on here. There's no question. We have a diet right now that's high in red meat, high in white meat. We have a diet that's very high in processed food. So we're talking to people, drinking sodas, people having lots of processed bread. It's a disaster. It really is. It's as far, far, far away from what we're teaching as far as the low fat, plant-based, whole food nutrition, which is part of the mastering diabetes method. Dr. Berry: What’s interesting and I definitely wanted you to expand upon the aspect that when you have all the diet that we have, and then someone says, hey, I know I want to try something different, but they go to, let's say they go to do their Google and they say like, give me a diet that I can try different from here. But there's like 50 different diets out there. How does one, because obviously we want that, I want to end on the diet you know, with mastering diabetes promotes right? But how does one sift through and know why one diet is better than the other? We’ve mentioned Keto, we’ve mentioned the Paleo diet easily. What are some pros and cons and got us to the point where I said, no, this is the type of diet you're going to need. The plant-based, get lots of carbs, which again, I know it's probably still blow people's mind as I listened to it. It's like, oh no, no, no. He says he eats fruits all day. I love fruits and I can never even get it because someone told me it was bad. Robby Barbaro: I want to add to that point you just made of. I'm sure there's plenty of people listening right now who they themselves may be living with some form of diabetes or they know somebody who is or they have a patient who is and they absolutely see the experience where somebody eats a banana, they eat a pair and they see the blood glucose just skyrocket and they're like, Robby, how can you tell me that the fruit isn't what caused the high blood glucose, you gotta be kidding me? And I have to remind people that it's not the fruit, it's what you ate prior, which puts your tissues in an insulin resistance state where you could not process the glucose in that meal. The fruit is an innocent bystander here. (I love it). And we have to understand the root cause. Now you're asking a great question here. There’re so many diets. There's so many bestselling books from many different world renowned doctors at world renowned institutions saying the exact opposite and my answer for how to figure out what is the best solution for you is going to be through personal experimentation and I am here promising you 100% if you apply what we're teaching with the mastering diabetes method, you will see results that you did not even believe were possible. I don't want to comment on every other diet and go into every other nuance of why we would basically suggest somebody doesn't do that. I really want to focus on why try this and let this be so successful. Let it work so well that you don't even need to explore anymore. You don't need to ask any more questions because it's just working so well. You're loving the food, you're saving money, you're getting to your ideal weight, your skin is clear and you have more energy than ever before. That's the place I want people to get to. So when you start to apply what we're teaching here and you really do it exactly as it's taught and you get the results that they just start to make. You want to keep doing it. Dr. Berry: I love it. And so I think we're at the point where, I think people are antsy right now. They want to know, what is mastering, what does that even mean? How can I, even more importantly be a part of it? Because they're itching now because we've already left them and we've probably already shocked their minds 20 minutes ago. They're still there. So let's bring it home and say like, well, what is Mastering Diabetes? What is someone going to be? What can someone expect when they join a group, when you get the book and all the amazing names about the happen to their life. Robby Barbaro: The Mastering Diabetes method has four components. The first component is low fat, plant-based, whole food nutrition. And I will go into that in detail in today's show. The second component is intermittent fasting. Then the third component is daily movement. And the fourth component is decision tree. I'm going to talk about one and four. Low fat, plant-based, whole food nutrition, we have created a very simple green light, yellow light, red light traffic foods to understand exactly what foods to put in your body that are going to maximize your insulin sensitivity. Lower your fasting blood glucose, lower your A1C, help you lose weight, have you gained energy hands down, no questions asked. The Greenlight category includes fruits, starchy vegetables, lagoons, lentils and peas and intact whole grains. Those are the first four categories in the Greenlight food, system. Now there's also going to be leafy greens. There's going to be non-starchy vegetables, herbs and spices and mushrooms. Those last four food groups, everybody agrees on anybody's going to say you should eat those, eat more of those. Even the Keto crowd, every doctor's yes, more vegetables, more herbs and spices, more mushrooms. Those are great. Those are going to absolutely help your buggy control. Now the first four categories is where it gets confusing and people are like, wait a minute. No, no, no, no, no. That's the exact opposite. We have those foods listed. First fruits, starchy vegetables, but essentially, you got beans, peas, and lentils. That's really what I meant to say. Beans, peas and lentils and intact whole grains, because those are the foods you need to be satisfied. So there are a lot of people that try to adopt a plant based diet. They eat a lot of salads and they get hungry an hour later, two hours later, and like, wait a minute, this is not working for me. (I'm done. I’m still hungry). This diet doesn't satisfy me. They go get a cheeseburger, they go eat some chicken nuggets and all of a sudden they feel good again. But wait a minute, I have energy. And the reason is because they finally got the calories. They need it. So that's what's going on here. Now when you eat those foods, those are all low fat. They're high in water, vitamins, minerals, antioxidants. These are the foods that are going to help you clear out the fat that's stored inside yourself. And that's the biggest culprit when it comes to insulin resistance. So that's the green line category and we're really emphasizing those first four categories and obviously the other ones are important as well. Now, the Yellow light category, I also want to emphasize in the Green light category, you get to eat as much as you want. There is no limit. When you want to sit down, you want to have some potatoes, some rice and beans you want eat some fruit because there's so much water and fiber, those two put together create bulk. There's so much that it's very difficult to be too much. It's very, very difficult. They end up being naturally calorie restricting in a sense that you will eat a lot. You will get that bulk in your stomach, you'll feel satisfied, but you'll have eaten far less calories than you may have eaten previously at the same meal when you eat food that was more calorie dense. So that's a huge distinction there. Now, the Yellow light category, these are foods that we want people to be cognizant of, how much they're consuming. These are healthy foods. It can be a great part of your journey of maximizing your insulin sensitivity and losing weight and gaining energy. But the issue is they're either too high in fat or they're a little bit more processed in the Green light category. So in the Yellow light category, we have nuts and seeds. We have avocados, coconut meat, olives, and soy products. Those are all plant foods that can be eaten in a whole state. So edamame a is the most whole form of soy that you can consume. Tempe, tofu, those are all great as well, but they're just a little bit more processed and they're all higher and fat. Those are at least 40% of calories coming from fat. Nuts and seeds, we're talking 70, 80% of calories coming from fat, avocado, same thing. So you just have to be careful about how much of those foods you consume, otherwise you're going to still be contributing to insulin resistance in your muscle and liver tissue. Now we have things like brown rice, pasta, bean pasta, lentil pasta, Ezekiel whole grain breads. Those are sprouted breads, but these are good foods, but they're all just a little bit more processed. It's better to have brown rice and brown rice pasta. It's better to have millet bread. Whatever the bread was made out of, just eat the whole intact aspect of that then. The calorie density also increases when you produce bread. So you have the same volume of food will go into your stomach, will provide more calories per bite, and if you just ate the intact whole grain. So it's really also a mechanism of helping people reach their ideal weight to focus on the Green light version. Now the Red light category, these are foods we suggest people limit or completely avoid. This is all animal products and it's also oil and then processed foods. So some people are surprised that oil is put in a Red light category because people, I've heard it's so healthy and necessary and we people, number one, whatever the oil was made out of, just eat that. So if you want some olives in your life, eat some olives. If you want coveralls, eat some coconut meat, drink some coconut water and have a little bit eat those foods. In the yellow category. You don't need a process concentrated form of any of those ingredients. You're simply just adding unnecessary calories. There is no food that is more calorie dense than oil. Oil has about 4,000 calories per pound. And when it comes to calorie density, it's a constant. It doesn't matter how much of it you eat. So something like watercress I think is 60 calories per pound. So that means there's over a 43 X difference between the calories and watercress than oil. And no matter how much of it you eat, you're still having 43 times more calories for the same volume of food. And so there's a big continuum in here. Fruits are going to average maybe 300, 400 calories per pound. You're going to get up and down. Meat products, maybe roughly a thousand or so. So you want to increase your nutrient density and eat foods that are lower on the calorie density. And that's where you're going to find all the green light foods are 700 calories per pound or less. They're all going to fit in that category. So again, you get to eat a lot of food, you get to fill up your stomach and feel satisfied and satiated between meals, but you're actually consuming a small amount of calories and now there's a lot of processed foods. People will go and think they're doing a plant-based diet when they go to the freezer section and grab a veggie burger of some sort. It is if foods are absolutely in the Red light category. They are processed, they have oils, they have additives, it's not a healthy food. So you want to stick with the whole foods in the Green light category and the more Green light foods you eat, the better results you're going to get. And we're not here to, it's not about perfection. It's not about doing everything right every single meal. It's just not about that. As you eat more of these foods, you get fantastic results. And I could tell you testimony. I'm a testament of the testimony. One of my favorite ones is Tammy. She came to us. She started out with a 7.1% A1C. She slowly started to incorporate more of the Green light foods. She was originally taking 2000 milligrams of Metformin. Her fasting insulin level was 17.4. Her fasting blood glucose used to be 123. She's living with fatty liver disease and she had debilitating pain in her knees where it was frustrating to be able to walk. So she starts eating more Green light foods. More of the foods that people are told, hey, if you eat a bunch of fruit, if you eat potatoes and if you eat chemo, your insulin levels are going to go up and your blood glucose levels are going to go up. That's the standard thought. So here's what happened to Tammy. After seven months of following the program, her A1C dropped to 5.3%. She lost 38 pounds. That fasting insulin level, which was 17.4 severely elevated, dropped to 5.2 and our fasting blood glucose went down to 93 she stopped taking 2000 milligrams of Metformin. She reversed her fatty liver disease and a debilitating pain is gone now. So I can tell you story after story like that. Again, just demonstrating the exact opposite of what people are believe will happen when they eat more Green light foods. Dr. Berry: What I love is that you're saying like, hey, we want you to eat. Because a lot of times, especially when I was doing outpatient medicine, the first thing and when I would have to deliver the news like, hey, you're a diabetic, the first thing they think is like, oh, now I can't eat anything. That's what I see. And you see it in the hospital as well. One of the biggest things is when once you tell a person they can't eat, whether it's, I can't eat for six hours before about to go to surgery or whether I can't eat this certain type of food. Whenever you tell the person they can't do something specifically eating a specific meal. It messes up their whole day. And but here we are where we're saying like, no, no, no. Remember those foods they've been telling you to avoid for years? It's back on Robby Barbaro: The solution – the more you eat, the better. And I am not exaggerating. The more you eat, the better. You're going to get better results. You're going to feel more satisfied. You're going to have more energy. You're going to want to move your body. All those foods in the Green light category are extremely nutrient dense and it's just a game changer. Dr. Berry: Absolutely love it. And so now all of a sudden, we have our categories. We have the Green light. And then you said you also offer, actually I heard exercise, right? Exercises. How big is exercise into? Robby Barbaro: So those other components, there's the intermittent fasting, there's the exercise and there's the decision tree. So I'll touch on exercise quickly and then I'll talk about decision trees as well because it's so important and it's very unique. Something about people that might not have heard about. So exercise is huge. It's going to have a dramatic impact on people's ability to reduce their use of medication. We like to teach people to use exercise as a substitute for medication and you can do that. The more you move your body it's going to facilitate you not needing the medications that you're on. Dr. Berry: Definitely agree with that. Robby Barbaro: Absolutely. Anybody who is listening to the show or knows somebody who is, if you are using Metformin or any other diabetes drug, this is a clear sign you are living in some resistance. Period end of story. You would not need those drugs to control your blood glucose if you're not insulin resistant. And that has got to be motivation to maximize your insulin sensitivity and get off those drugs. Like look at the side effects and there's a lot of drugs. Again, if you find out that you're producing enough insulin so you can get a C peptide test and you can find out how much insulin you're producing, you can also give a fasting insulin test as well. If you find out that you are producing enough insulin to manage your blood glucose levels, you're not at some compromise level. That can be strong motivation to say, look, I have what I need to not need these medications. I just need to get the insulin my body's producing to work more efficiently. That's gotta be the mindset. That's what we want people to get to, to take charge of their health. Don't rely on these medications to get your bug goes on control and there's plenty of research showing that even lowering your A1C and lowering your fasting blood glucose with medications is not making you healthier. Actually, it's making you worse. You're making your health worse, increasing your chances of heart disease, increasing your chances of kidney disease. It's a disaster. So people are getting confused. They're getting lost in this focus of just the diabetes numbers. Now looking at the bigger picture. So back to exercise. One thing is a lot of people can get overwhelmed by exercise and they're just flat out not doing it. So for most people, the best thing we can encourage is to simply start walking a post meal walk. For people living with any form of diabetes is absolutely transformative for your blood glucose control. And if you use a continuous glucose monitor, you will see that if you're living with Type 1 diabetes, type 1.5, in some dependent Type 2, you can absolutely see that just walking after a meal will make you need to inject less insulin for that meal. And you'll see that because you'll have unexpected low blood glucose readings just because you walked. And again, particularly after a meal is a great time but anytime of day. And it's also a great opportunity to connect with people you love and to talk to people and make a phone call, walk your dog. And that connection can also be a big part of increasing your health and really reversing insulin resistance. So if you want to know the ideal form of exercise for people living with any form of diabetes, it's going to be something that combines cardio and strength. A combination of the two is going to be ideal for maximizing your insulin sensitivity and I just want to touch on the decision trees real quick. Decision trees as our version of a diabetes logbook, and this is something you can get on the mastering diabetes website. You can just go Google mastering diabetes decision trees and you'll get it. You can download a PDF and what it does is it teaches you the cause and effect relationship between how much fat you're consuming and your blood glucose readings. That's the primary thing that people will learn from filling out Decision trees. Now, will also teach you your overall lifestyle decisions. When you move your body more, when you get enough sleep, you will see your blood glucose numbers. Dr. Berry: You won't able to have a piece of paper. Robby Barbaro: The biggest eye opener when people start filling out decision trees and they learn how much fat they are consuming. So in order to fill out the decision tree, people must go and use in nutrition logging service. We use chronometer. You can use anything. You can use my fitness pal. There's many options out there, but simply just enter in what you eat and it's very easy to do. You know, you can just ballpark it. We went to the restaurant, all the restaurant food will be in software. You ate a banana, an apple, you just put in a medium banana on a medium apple. It's very simple to log the food and you will quickly learn how easy it is to consume too much fat. And our fat guideline is no more than 30 grams of total fat per day, or a maximum of 15% of calories coming from fat. And the nutrition logging software is going to provide you with that number. So as you fill out decision trees and you document all your diabetes decisions, most importantly is going to be what's your eating, your medication use, your movement, your stress. You're going to want to document those things in a chronological order and you're going to see as you lower the fat intake and increase your carbohydrate consumption from a whole Green light foods, your fasting blood glucose level is gonna drop. Your blood glucose control over a 24-hour period is going to improve guaranteed. Dr. Berry: I love it. We know the book is coming. We definitely want to talk about when the book's coming, how can someone get the book. Now the Mastering Diabetes, is this something that a person can join in now or do they have to wait for the book? How do they get involved? Tomorrow? Robby Barbaro: If somebody wants to get involved tomorrow, they absolutely can. And the best thing to do would be to join our, we have a DIY program, do it yourself. And we put a ton of effort into laying out this program in a chronological order that gets the maximum results. So anybody can join that anytime. And you get this access to videos and recipes and a step by step plan for how to begin reversing insulin resistance. So we'll maybe put a link below the show. Dr. Berry: Remember Lunch and Learn community will have all every link that we've mentioned. You'll definitely know it will be in the show notes for sure. Robby Barbaro: Absolutely. So somebody wants to get started today. That's where I would direct them. Dr. Berry: So someone, they don't necessarily have to be in a certain location. They can be anywhere and get in with the program. Robby Barbaro: That's right. So everything we do at Mastering Diabetes is completely digital. Other than we have in person retreats. But you're right, we've created a platform that people can access from all over the world. So it doesn't matter where you live, you can get the DIY program. And we also have an online coaching program. So inside our coaching you get access to the online course, which has videos and PDFs and instructions and recipes and all that stuff of exactly what to do. We also have a community. So a community of other people who are going through the same process as you. But most importantly, we have coaches in there. So our coaches are answering questions within 24 hours. So the more people interact, the more questions they ask, the better. We love hearing from our clients. And coaches will answer your question. These are coaches who, we have two coaches in there who completely reverse Type 2 diabetes themselves, got off many additional medications. We have a Registered Nurse in there with over 20 years of experience working with people with all forms of diabetes. So our coaches have a lot of experience seeing thousands of people go through this program. Reverse Type 2 diabetes, reverse pre-diabetes. We've reverse stage three kidney disease. We get a person who was told they needed six stents and it decided, you know what, I'm going to follow this program first. They avoided the sixth stents, so they reversed their cardiovascular disease. You have people reversing fatty liver disease. People have arthritis. People who've been trying to lose weight for 20 years. Start losing weight within the first week and they're just like, wow, I'm eating all the foods I'm not supposed to eat. They're losing weight. What's going on here? Where people are just gaining energy. So our coaches are there to answer any question that comes up. And then in addition to that, the community pops in. Hey, I'm going to this restaurant. I don't know what to eat. Or I have this family gathering, I don't know what to do. And you have 10 other people write back to you within a couple of hours and say, Oh, this isn't how I dealt with it. Or, hey, I have a chocolate craving right now. What do you guys do to not go to the cheesecake factory and eat the chocolate dessert. How do you get around that? And someone's like, hey look, I had made this amazing chocolate cake recipe here. I found this amazing smoothie, these amazing fudge bars. It's like people have been there before and you get to tap into that group of people and it's just incredibly supportive. And when people are struggling, when people have a rough time. They may be fell off and they feel terrible and then woke up in a bug goes higher. Dr. Berry: Especially holidays. So you know those dips come in around the holidays. Robby Barbaro: That's life. That's real. So if you're willing to just share that honestly and just write to the group, the outpouring of support and encouragement that comes out in those situations is really heartwarming. It's really one of my favorite parts of the community. Those are the posts that actually get the most interaction and those people who are willing to be vulnerable end up getting over those hurdles. And those challenging experiences become a thing of the past. So we're really passionate about the coaching we have in our coaching program, but community we have in the coaching program. And we also do twice monthly live Q and A calls. So that's an opportunity to get on zoom. You can see our coaches, you can see myself, you can see Cyrus and we just answer questions and a lot of people come. They come with great questions. We answer them, and some people just listen and those are recorded so you can see them inside the coaching program. And we're really just there to help people step-by-step one day at a time learn how to get rid of the foods that no, they shouldn't be eating and start to love and enjoy the healthy Green light foods and make this a smooth, integrated part of your life. It does not need to feel overwhelming. It does not need to be expensive. It does not need to take a lot of time. We teach people how to integrate this into their life and enjoy every bite they put in their body. That is something we are so passionate about because like you said, people get diagnosed with diabetes and they're told, oh, you can't have this, you can't have sweets, you can't have your favorite dessert. And we're like, no, no, no, no. We're going to teach you how to love your food, have the most satisfying, delicious carbohydrate rich foods on the planet, and see your bug because come down, improve your blood glucose control all at the same time. Dr. Berry: Amazing. And tell us about the book. What ended up, why are we writing a book? Why do we get to the point where we should get a book out here? Robby Barbaro: We got to the point where when people kept on asking us, where's the book? I want to give something to my doctor, this is working for me. I want to give it to a friend. So at that point where like, okay, let's go down the path of writing a book and putting together a book proposal and that whole process. And we were really fortunate to have one of the major publishers. So Penguin Random House decided to work with us. They had a lot of confidence in us. And that process of working with their editors really helped us refine our message and make this crystal crystal clear in a true step-by-step manner. So the book addresses a lot of the confusion about the whole low carb versus low fat approach. We'd go into that science. We have a whole chapter on the ketogenic diet and again, the science. So what we're talking about here is an evidence based approach. This is not just built on our personal experience and we made up a program and said, oh, people should follow this. It happens to be that our personal experience collaborates with almost a hundred years of research. So there's over 800 citations in this book. Research dating back to the 1920s decade after decade after decade has shown consistently that low fat, plant-based whole foods maximize insulin sensitivity. So we cover that in the book. We also go deep into the science of intermittent fasting, the science of exercise. We really address the causes of insulin resistance in detail. We have a lot of graphics in the book, which we're really proud of. It was fun putting those together, making some teaching points and some illustrations. We go into the science of calorie density, how you can literally eat more food and way less. How literally the volume of food on your plate increases as the weight starts falling off. No exaggeration. That's what the research shows us. And we also put together a how to guide in this book in addition to our personal stories. But the how to component has really shopping tips, how to handle social situations, how to order at restaurants. A lot of those details in addition to a meal plan. So there's 30 recipes in the book. We have two different meal plans depending on how insulin resistant you are right now. Because we want people to have a good experience when they adopt this program. So if you're very, very insulin resistant, there might be some foods that are a little bit more challenging for your body to metabolize right now. But as you reverse insulin resistance, you can eat those foods. You can eat more and more fruits in a wider variety of foods that can elevate your blood glucose quicker. An example of that would be something like grapes or watermelon. It might take some time. So the fiber to glucose ratio is different in those foods so you're not getting as much fiber and they can raise your blood glucose. But the point is we have meal plans for people who are severely insulin resistant and some who are more moderately in some resistance and you can just follow them step-by-step. We've made sure that these are nutritionally sound plans across the board. We address the concerns about what about fat soluble vitamins, how much fat do I need to eat in order to make sure I'm absorbing those? Is your low fat diet too low in fat? So we really, after working with thousands of clients and doing this for many, many years. I have both been coaching people prior to when we started mastering diabetes. We took our wealth of experience, our coaches experience, we took the science, we put it together, and here now we have this book that we are just so, so proud of. And I will say it's a great value Dr. Pierre, the book is thicker than we had imagined. You write it, you put it together in Microsoft word, you send it off and then the publisher type sets it and puts it together. You don't really know what's it going to feel like, what's it gonna think is it going to be, and we're really excited about it. So it's a lot of detail. It's a manual that people can refer back to for years to come. It's something that you can refer back to for inspiration. We have lots of testimonials in there and we also have a chapter all about medications. So all the medications that are now being used and the side effects and how there are actually behaving in your body. And I really, really proud of what we put together in that chapter because I think it's going to motivate people even more to want to get off those drugs, want to maximize their insulin sensitivity and take control of their health. So the book is coming out on February 18th. We couldn't be more proud of it and we can't wait for it to get in people's hands. Dr. Berry: I love it. And before we let you go. I know we talked about the website management of diabetes, but where can people follow you if they're on social media, the website, go ahead. Let's get out all the links that way people know like, hey, I can follow them on Facebook, their Facebook group, wherever mastering… Robby Barbaro: I love it. Thank you so much, Dr. Pierre. So best place to start is So go there. There'll be an insulin resistance guide that you can get. You can also fill out an insulin resistance quiz and you can find out how insulin resistant you are right now. So that's on You'll see a button right on the homepage. You can take care of that. We are also on Facebook, just type in mastering diabetes. We have a Facebook page, but we also have a free support group. So if you type in mastering diabetes into Facebook, you hit enter, you're going to get the page, you also get a support group for, that’s free and you also get the members on the group. So don't go into the members only group unless you get into coaching. But the free group is a great place to start and it's a great community and there. Lots of recipe inspiration. So go ahead and join that free Facebook group and connect with us there. Now we are also active on YouTube. We use a lot of videos there. We have one famous video that's got well over 1.3 million views and that's where my co-founder Cyrus is going into a lot of the science of insulin resistance and really the mechanism that's going on there. So that's a very fun presentation to watch. You'll see that at the top of our YouTube channel and you just type in mastering diabetes on YouTube and you'll definitely find us there. Now we're also active on Instagram. We have an app mastering diabetes account. We’re sharing recipes there. We're sharing science, we're sharing testimonials. So that's a great place and if you want to follow me personally, I'm on Instagram, @mindfuldiabeticrobby. You just type in mindful diabetic, I promise I'll show up. And on that account you're going to see me sharing everything on meeting. So I share pictures and videos of what I'm eating everyday I share exactly how much insulin I'm injecting. I share the chronometer data from the nutrition software that I'm using. I have some highlights saved so you can see it's a full day of eating just right at the top of my story and you can see all the carbohydrates I ate, all the insulin I injected, and then I measure out the insulin sensitivity of the end of the day. I also show people exactly how much glucose I'm consuming. So glucose, I take out the fruit toast, I take out the fiber and I share people share with everybody. Look, even if you want to look at these numbers, just glucose to insulin, it's still mind blowing and it will change the way people think about diabetes health. And again, I'm an N of one, but I also want to say we've again worked with hundreds of people living with diabetes. We have kept people come to our retreats, over a hundred people run through our four-day in person retreats. And I have never seen one single person living with Type 1 diabetes who did not see their insulin sensitivity improved following the mastering diabetes method. There is no exception. When you take away the causes of insulin resistance and you start eating the foods that are nutrient dense and actually resolve the insensitivity, nothing. All that happens is more carbohydrate, less insulin repeatedly. And that will happen for people who have prediabetes and Type 2 diabetes. And in that situation you get to completely reverse the condition. Dr. Berry: Amazing. And Robby, first of all, I want to thank you for coming onto the show and really, again, Lunch and Learn community, you know, I say I get hype when I know I'm about to learn some stuff and guys, I'm ready to run with some of the things I learned today. Thank you for helping. Because I know you're going to spark a couple of people who are listening to this who you probably blew their minds and I can't wait. Again, remember links will be in the show notes. Please, head over to that website because I know I got a lot of diabetics who and if I don't have a lot of diabetics, I know I've got a lot of people who have friends and family who are diabetics who you know they're struggling, right? They're struggling with their insulin, they're struggling with the Metformin and Glipizide. whatever new medications out there, they're struggling with it. They're not getting any better. I'm a hospital physician. I'm seeing a unfortunate, a lot of the end results when they're not controlled. I'm seeing amputations. I'm seeing the eye patients on a who gets strokes. I'm seeing patients who get on dialysis. I'm seeing all of these end organ damage, processes that are occurring. So please, we're not jiving you, you really need to take control of your diabetes and you know the model of Power Yourself about Better Health, right? So what better way to do that than take diabetes in your own hands, mastering your own diabetes. Again, Robby, thank you for joining the show and, you know, bless Lunch and Learn community. Robby Barbaro: Thank you for everything you're doing. Keep it up. [/showhide]

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