Blood Sugar Issues can sneak into your life, despite doing the “right” things

Are there natural ways to prevent insulin spikes? Addressing blood sugar issues can be a worthwhile endeavor to decrease the chances of other health conditions developing that have been linked to blood sugar such as Alzheimer’s. Cassie Brown and Dr. Amy Brenner go over tips that can help people currently experiencing rapid blood sugar spikes or simply want to introduce healthier habits into their daily lives.

Dr. Brenner shares her own experience in dealing with blood sugar spikes and the steps she personally has taken to help keep her levels in a healthy range. She is joined by an Amy Brenner MD & Associates Wellness Coach, Cassie, to discuss how insulin spikes can affect a person, why it’s so important to address it early on and the steps to take to soften the blood sugar spikes.

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Show transcript:

Welcome to the HealthiHer podcast your host Dr Amy Brenner is a board-certified ob/gyn with additional certifications in functional and integrative medicine this podcast is meant to help women find reliable relevant information to help them feel better, look better and live better. Here you will hear in-depth information about hormones, sexual medicine, Aesthetics, Cosmetic Gynecology and functional medicine.

 

Hey everyone and welcome back to another episode of HealthiHer I think you’re really gonna like this episode, we have Cassie Brown one of the wellness coaches that works in our practice. So welcome Cassie.

 

Thank you so much for having me. I’m excited.

Yeah so you’ve never been on the podcast, just give everybody a little bit of your background and how you got into Wellness coaching.

Yeah so like Dr Brenner said my name is Cassie Brown I’m a clinical nutritionist, Masters and a certified holistic health practitioner I’ve been doing Wellness coaching for around 10 years or so and I went back to graduate school and got my masters in

science and clinical nutrition and my specialty has been metabolic health

and cognitive health. I really love to help you know men and women. But

mostly women step into their power and regain you know control of how they’re feeling and how they show up in life ultimately and I’m you know, new to Dr Brenner’s office for a couple months now and it’s just been fabulous it’s been great.

So in our practice we use the term wellness coach for those that um are listening some people might not even know what that means, what does it even mean to work with a wellness coach? Or what does a wellness coach do?

Yeah so wellness coach varies depending on your, you know Specialties and your educational background, your certifications and degrees and things

like that. But really it’s all about accountability you know you may go to a

doctor’s appointment or you may see a PDF or you may have a specific Health journey and it’s kind of closing that gap between, what we know we need to do and actually doing it right? They kind of just fill in that gap of um really pinpointing the awareness around the cause and effect of your actions and just bringing awareness to things that we’re too close to see sometimes and you know when we’re too close to things we’re like I don’t know what’s going on and kind of tetrising everything to to uh make it easier for you to reach your health goals.

Yeah, kind of like a trainer for your health.

Absolutely yeah beautifully put. [Laughter]

So today we’re going to talk about insulin or blood sugar spikes

um and some practical things you can do to you know help help soften those those

spikes but first of all what what is, let’s explain to people, what does that even mean of an insulin or a blood sugar spike?

Yeah so both insulin and glucose, we’re looking for how extreme, it’s kind of

like a roller coaster, a lot of people use this example. How extreme these spikes are after you eat a meal and so we you know in our practices we like to say glycemic variability and what we’re looking for is instead of Rapid spikes of glucose and Insulin we’re looking kind of for softer Hills instead of you know mountains and and valleys. And we want that glycemic variability to be low and so yeah basically how high your blood sugar is postprandial or after you eat.

Dr Thieman and I did a whole episode, I think it’s episode 10 – if you haven’t

listened to it where we talk specifically about insulin resistance and some of the problems with that how to get diagnosed, and I know you’re obviously with your criteria you’re not a physician not a nurse practitioner so you’re not ordering lab tests. We do that in the medical side of our practice but once somebody is maybe diagnosed with insulin resistance um we actually refer to you and our other Wellness coaches um for those specific uh tools and lifestyle Medicine of how to prevent

those roller coaster Hills of insulin and blood sugar.

Maybe we could just give a brief summary of, well what’s the problem…?

Why do I even care about this…? And what’s what’s even the problem with insulin or

blood sugar spikes?

Yeah, so recent studies in the past like five or so years have just been very indicative of our metabolic Health just not being as optimal in our country. I think it’s

you know upwards of only 90%  or so of us or actually, let me reverse it 12% of us

are actually metabolically healthy meaning 90% of us, myself included, maybe

you, Dr Brenner, like we have some work to do to try to get ourselves optimal right right? And so what’s happening is because of this we’re dealing with a lot of mood changes maybe anxiety, depression, irritability, low executive functioning and physical symptoms – you know acne um well brain fog, that’s kind of both but um rashes, I mean now oral health is coming into play and so you know dealing with um different oral symptoms.I mean the list really goes on as far as you know, lethargy ,just waking up very fatigued no matter what you try to do um that post meal slump is Extreme but energy is like the big one. Energy, brain fog, low executive functioning that’s what we’re dealing with.

So yeah so you mentioned I I couldn’t agree more is these blood sugar insulin spikes couldbe the cause of all these symptoms if you mentioned even mood not sleeping

um not not being able to lose weight is a huge one, feeling hangry um but the list goes on and on and those are the things you can feel let alone the risks that you’re putting yourself um for uh you know Alzheimer’s has been called type 3 diabetes so

um having these issues puts you at risk for dementia, cardiovascular disease and even cancer. So, so it’s really important um that you do that and I love that you mentioned how common this is and um like I actually have a problem and uh you know I like to think of myself as pretty healthy but um if I’m not paying attention to and you know  I think I eat real pretty, I’m Not perfect, but I think I eat pretty good… I work I work with you guys myself. Exercise most days of my life um I kind of do all the things and I still even have a metabolic issue with blood sugar and Insulin. It’s my Achilles uh heel, if you will. 

Yeah I think it’s everybody’s! That’s why I was like should I go in and exhaust this list? Because even premenstrual um things we’re seeing PCOS it’s so connected because on it it’s just very inflammatory having these rapid Spikes all the time um and with the brain with these symptoms Dr Brenner and I know you you know it’s so easy to sweep anxiety and stress and overwhelm under the rug and not see them as like a physical ailment because our brain doesn’t have actual pain receptors like what you’re feeling is like the tissue with the headache or a headache or whatnot but when our brain is you know dehydrated you know not drinking enough water and having these spikes our brain can’t tell us like I’m you can’t feel pain and so it’s a way of telling us it needs help is through that brain fog and through the anxiety but it’s so easy especially as women to sweep it under the rug because it’s not really calling for a doctor’s appointment right away and like you said yeah they’re calling

type 3 diabetes Alzheimer’s and Dementia and it’s getting younger and younger. I

know our patients are getting younger and younger um with this imbalance.

Yeah even kids have this issue, so, now in our practice we we do a lot of oral glucose tolerance tests, where we look at people’s insulin and glucose fasting and have them eat a certain amount of carbohydrates and measure it two hours later for those

that are really motivated we could also write a prescription where everybody can get a glucose monitor for two weeks for free and then if sometimes insurance will cover it if there is a problem or sometimes people will pay out of pocket. So on the medical side we’re actually looking at those numbers, which I think is really important to know your numbers um but even if you didn’t have a problem I think these are, I want to get into the tips of whether somebody has a problem of what

they can do to us kind of uh blunt those spikes, or what if you don’t have the

data some things that everybody can do because these are tips that we’re going to get into that could help everybody is

that right?

Absolutely!  And going back to the glucose glucose monitor I think it’s a an

amazing investment see it as like an investment versus the cost because it’s

very low just to get like you said the data and so you know because like you mentioned before Dr Brenner, what is healthy nowadays is not it doesn’t we don’t have the same response. I used to eat oatmeal all the time unfortunately my blood sugar spikes after I eat oatmeal regardless of what I put in it and so and that’s a health food but unfortunately I can’t have it. And so some things that you can start doing to blunt this and to start out with um is first I always say keep a three to

five day food journal this is something it really opens your eyes and brings awareness to what you’re eating, how much you’re eating, but also how you feel after so if you’re having your cup of coffee or whatever you’re eating really pay attention to how you’re feeling after. If you’re feeling anxious, anxious or when you’re

hungry after… because typically when your meal is balanced you should be satiated

for a good 4 – 8 Hours, four to eight hours, um feeling hunger you know an hour, hour

and a half after is indicative of you just not eating enough or eating something nutrient dense to keep that blood sugar kind of flowing um or have that um you know optimal energy and so food journal. The next is food order so don’t even pay attention to what you’re eating right now, um food order is it’s absolutely amazing. There was a study done, I think 2015 Dr. Brenner, it was from Cornell University and it was targeted towards solely diabetes patients type 2 diabetes patients that’s why it didn’t get as much awareness, I’m assuming. Um but it said that and I’ll get to this in a second it said that putting your food in a specific order reduces your insulin your post – after you eat your insulin spike by 73%! 73! and then glucose by I think it was 48%, which is crazy. So what you can do is to look at your plate and you always want to start with you know your fiber or your leafy green veggies first, your

protein, your fat and then your starchy carbs or sugars, right? So what this is

going to do is that fiber is going to create that mesh kind of lining in your

stomach and stop that glucose from hitting your bloodstream, raising that

blood sugar up. So I’m trying to break this down into layman’s terms so if you think about it if you eat carbs and sugar first, or starches and sugars they break down into glucose really really quick and you know it reaches your brain really fast and that’s why our brain prefers glucose because we just process it really really quickly.

Um but you want to do the opposite and so right then your blood sugar spikes up and then your ghrelin which is your hunger hormone and your leptin, your satiety hormone, there your leptin is going to be lower your ghrelin is going to be higher you’re still going to be hungry after that because then you have a blunt of insulin in your system like ah give me more stuff to put away into these cells um but if you eat your fiber first it’s creating that mesh lowering that glucose into your bloodstream but also when you fiber doesn’t need insulin to break down right especially if it’s insoluble it stays bulky and so layering that on to blunt that glucose response is going to automatically decrease your postprandial glucose and Insulin spikes.

So when you go to a restaurant you order a cocktail and then they bring your bread basket, that’s probably not a good idea?

Oh they know what they’re doing! That’s why restaurants have the chips and salsa, have the bread first because scientifically that’s more money, you know you start craving. You’ll be surprised at how many people they eat in that food order and they don’t even want the chips or the bread and and this is a beautiful thing because it’s like it’s not taking away things it’s just switching up the order, so you’re craving it less you know and you’re more satisfied.

Yeah so what should you do when the the waitress comes by and gives you the

Bread Basket? It’s hard to pass that up

Oh my gosh it’s so hard but hold on a second so I mean and we’ll talk about

um something in a little bit but just you know order like a side of veggies

like steamed broccoli or a salad and and keep the chips or the bread enjoy them

eat them first, so you like coat your stomach with that layer and then enjoy the bread after enjoy the chips and salsa after or you know eat a spoonful of guacamole and some beans or something before you do the chips and salsa.

yeah you know I have a story of, as you know, like I struggle with with blood

sugar stuff and as I was uh this was several months ago when I first realized that I actually have a blood sugar and issue and I was starting to wear a continuous CGM which I still wear. I was at a medical conference out in Utah and was at this amazing Farm to Table restaurant and uh I I ate my dinner and then everybody at the table was getting dessert and the food at this place was like so amazing and I’m not typically a dessert person but just at this place everything was homemade and all organic and I wanted this like peach pie and uh and I ate some of the peach pie and I

was expecting the alarm on my phone with my glucose monitor to like start going crazy to tell me that my blood sugar was too high um but it didn’t go off and uh and I

assume it was because I had already had my meal of Vegetables and protein and

fat and then I was able to eat dessert without my glucose alarm going crazy.

Absolutely and that that that’s really how simple it is. Obviously to start there and obviously you want to eat a whole food nutrient dense you know diet but to start just experiment with that order first because there’s been and then a few studies after that’s been done. But yeah Dr Brenner I had I know this doesn’t look like it now, but I had severe cystic acne and it was insane because both Dairy the sugar in it and

the protein along with just my insulin resistance was causing my skin, it, there

was nothing I could sweep under the rug at that point I was like okay something else is going on so it it can trigger a lot of symptoms. That’s why I think it’s hard for people to really put their finger on it but I always start there like you know let’s check your metabolic health because that’s really the foundation of many of these chronic and preventable diseases

Anything else somebody can do to lower insulin or blood sugar spikes?

Oh my gosh, apple cider vinegar. So I love ACD and it actually it’s across vinegars across the board, so balsamic and white vinegar but apple cider vinegar

as far as like drinking purposes is more tolerable. But um yeah so this is this has had

numerous studies done about a tablespoon in like a eight ounce glass of water at

no longer than 15 minutes before a meal because if you do it like an hour before Studies have shown there’s no effect so like right before a meal this blunts um the enzymes that break down carbohydrates so acetic or apple cider vinegar has acetic acid and it blocks at amylase which is an enzyme that breaks down carbohydrates. it blunts the secretion of that. So um the enzyme doesn’t come down to break those carbohydrates down as quickly and um they did a study Dr Brenner and I think the effects of apple cider vinegar were comparable to that of type 2 diabetes medication to lower glucose spikes it was insane I have to get the, I have to get the study. 

1 tablespoon and a glass of water? 

Yeah about an eight ounce you want to dilute it 

And do it um 15 minutes before you eat?

Yeah I I do it like five minutes so maybe let’s narrow it down to like 10. 

Do you need to dilute it? Or can you just like chug a tablespoon? 

I wouldn’t recommend chug, you can but I wouldn’t recommend it because you want to save the acid it, it’s not healthy for your esophagus and your teeth um but I mean you can but I wouldn’t recommend it.

Gotcha and how does that taste?

I like it but I’m weird. Like, I like like earthy and just strange things so what I

found some people will do um dilute it even more maybe have a bigger glass of it um but some people put it in their tea. I’ve never tried it I’ve had people put their tea or like a carbonated like Seltzer situation with you know some fruit or something but experiment with it.

All right I haven’t been diluting mine, I’ve just been chugging it and then like rinsing my mouth out and 

oh no!

So I got a little I got a little bottle and I keep it in my purse and I just like do it and then like just drink regular water but maybe it won’t be as bad of uh mixing it with water

Yeah, no people are just like I can’t do this. I’m like try mixing it with water and I even I know this is I gotta talk to my dentist about this um

I know it can mess up your enamel, which is why I when I’m done I like swish water around in my mouth.

Yeah it’s highly acidic, that’s why I’m like don’t do it by itself and then like I said the esophagus. But um I actually squeeze a little bit of lemon in mine and put some sea salt in it. I don’t know if that’s for everybody but it tastes really good to me I don’t

know I like it

Alright, I’ll try it. Yeah okay.

Let me know!

That’s that’s one and two, anything else?

Um, mindfully eating. That’s a big one. Stress and digestion is absolutely alive and well and it’s it’s very much studied as far as if you are stressed the likelihood of you properly digesting your meal is very, – well-, is very low, because

you know we hold a lot of tension and you know if you’re like me and Dr Brenner you’re busy mommy’s like working and we just need to sit down and we can scarf our food down mindlessly sometimes and so this isn’t only gonna help with

digestion but also you know letting or what am I trying to say?  It’s going to allow us to think about how we’re feeling and you know really pay attention to our satiety because sometimes we overeat or we don’t eat enough you know but stress yeah, so um stress obviously,

So getting your lunch and eating in the car as you drive from one location to another probably not a good idea?

I always like to Advocate, to pause in between transitions, so just sit down and chew because when we’re stressed. What happens is you know everybody’s heard of the fight or flight and like you’re fighting off a lion, or tiger, bear, whatever

um your body is like oh my gosh Dr Brenner is stressed like I I need to help her fight off whatever threat is happening so your blood flow ends up flowing outwards to your extremities, it’s not flowing inwards to help go through the digestive process and to release the proper enzymes and acids needed to break down that food it’s not

thinking about digesting it’s thinking about keeping you alive and so but when we’re in a rest and digest state that blood flow goes inwards and so I always tell patients like I would rather you sit and just be relaxed and and calm and eat chocolate cake then be stressed and eat like a salad because it goes back to the healthy, “Well I ate a salad but I’m still bloated,” Well how stressed are you? How’s your sleep? Because that’s going to factor in, you know, the amount of enzymes and acid you’re

secreting to help break down that food, especially raw food.

Let’s talk about just um some things that you might think would be healthy that could cause a blood sugar Spike but is actually not healthy and I like to bring this up is there was [oh oops we just lost her, all right you there?]

Yes.

Um is there was this new juice bar that opened up here in Cincinnati and I went

to this juice bar and um you know you think like I got I got this green juice so I assume it had kale or cucumber or something and some apples in it you think like okay I’m being so healthy? My blood sugar went – and I ate that first thing in the morning when my glucose tolerance is actually not as good as it is later in the day- my blood sugar went crazy with this “healthy juice”

Yeah, I I see it all the time! I don’t mean to laugh but it’s crazy because this is why

everybody’s situation is so unique because even Dr Brenner, you could have

the same juice maybe on vacation and you may not spike is high right because you’re more relaxed it just depends but yeah because juicing so the common foods are juices because they’re stripped of that fiber especially fruit juices smoothies especially people go to Smoothie King. Do you have a Smoothie King out there?

We do.

I use things like that if you read the labels . It’s just all fruit and all sugar so smoothies aren’t bad it’s how we are building them. I have a smoothie Anatomy I

share with the patients and it shows you how to properly build a smoothie to satiate you into you know balance your blood sugar but smoothies, high fruit smoothies, like like I mentioned oats and muesli breakfast cereals um with coffee but it’s not the actual coffee it’s what we’re putting in to our coffee um I’m trying to think of other – like protein bars are a big one.

Oh yeah, [you] yes. I’ve I’ve had patients tell me that

as well I don’t you know I keep one protein bar in my purse basically just for an emergency but I’m not I’m not a fan, I I’m not a fan of I just don’t like them maybe because I don’t know they’re just so sweet and I don’t typically like a lot of sweet things but yeah a lot of people are surprised by their blood sugar Spike with protein bars.

Yeah what I always say is anything packaged, you want to look

beyond the sugar. You want to look at the added ingredients right? If the first

three or four ingredients are sugar, even sugars disguised sugar. That

thing’s made up of sugar and look at the carbohydrate density, so that’s how many

carbs the -and and this is carbs- like um, excuse me, -starch or sugar not the

healthy carbs um how much of the bar is made up of carbs. So you take

the amount of carbohydrates minus the fiber divided by the serving size and

you want to look for something 30 to 35 percent maybe we can put this in your show notes or higher in order for it to be green lit, like okay this is a healthier option. Because a lot of these times a lot of the times these protein bars or these granola bars or healthy bars are ranking up to like 56 to 60 percent of sugar in the bar and so what you think is healthy at after you work out or after you go on a hike or whatever is really just damaging your blood vessels and you know that uh wanting that Spike or I mean releasing that spike.

Which I think is an another topic, of you know, these hit some foods that you think are healthy that actually have a lot of sugar in them and I think smoothies, um that you get at one of these smoothie places can be detrimental. In my smoothie I like to keep, when my spinach sure greens or kale start to go bad, I actually put them in the freezer um and then I add that frozen spinach or kale to a smoothie some um I have a protein powder that I’ll add I’ll add some flax seeds some chia seeds some frozen fruit um water and when I make it at home my my blood sugar, it doesn’t get really

mad at me but uh if I would go to a smoothie restaurant like that’s a No-No

for me.

Yeah but you just built a perfect smoothie. So you want to look for four things right your protein you know and making sure you be careful with the powders because that’s another Health Food a lot of these protein powders have so much in them it’s insane and then you have your fiber and fat your chia seeds your flax seeds and then you have your leafy greens and then what I say if somebody

um is more prone to a blood sugar Spike or insulin resistance keep your berries to at least a fourth cup or less and have darker berries like dark cherries or blueberries probably not blackberries because of the seeds unless you don’t mind them um and then you know a little bit of banana if you need a sweetener but you

just built a perfect an ideal smoothie because when you go to these places they’re like all fruit, very minimal anything else so nothing’s you know creating that mesh to it’s just all being released in your bloodstream and then you’re like, ah!

Yeah and you think you’re doing something, you think you’re doing healthy.

Yeah people are like, “But I feel so energized, ” Yeah! You have a blood sugar Spike, of course. Tell me how you feel in about an hour, hour and a half, you’re probably slumped over somewhere wanting to take a nap because that’s what happens.

Yeah, you brought up oatmeal.  A lot of people, you know, I remember when I was in college or even in med school in residency in the doctor’s Lounge they had those instant oatmeal packets where you just add water so um so I ate those a lot, again,

thinking I was so healthy, so let’s let’s talk like also those are just that’s

just sugar in a package.

Let me ask you,  were you even full from those little packs? Like I wasn’t full,  I had I think a banana with it and then I would have a piece of toast with it.  Just naked carbs everywhere.

Oh yeah, I mean I thought -this was in medical school-  I would have,

talk about sugar, and I wonder why I have a problem now um in med school I would have one of those instant mail packs add banana add uh brown sugar to it have a glass of orange juice and a bagel, that was my breakfast!

Yeah and those are three

-Whole wheat bagel though! 

See those significant spikes but the thing about that is I always say if you’re starting out my thing is to add in, to crowd out. So don’t eliminate everything all at once because if that’s all you have right now how can you like tweak it dress up your carbs so you don’t have that so you can blunt that Spike. So if you only have instant

oatmeal is there like a nut butter or seed butter or avocado, egg, some sort of

fat and protein you can eat before you have that oatmeal? Can you stir in some

chia seeds or flax seeds like what can you add to this to make it better? Like

really think about that in your options.

And you called it not eating, what’d you say? Not eating naked carbs?

Yeah, dress them up a little bit! Like our bread, like, I remember I put I would put like butter and sprinkle cinnamon on it like, oh it’s cinnamon and it’s no like just dress them up a little bit! Like even your banana can you eat it with some nut butter or something your bread? I now I drizzle some olive oil on some like everything bagel seasoning on it. Like what can you just add to it, to you know not leave it naked.

Yeah, you know the other thing I recently made some vegetable soup and I uh so I got some veg, I bought some vegetable broth, at the grocery store and then I looked at the label and there was sugar in vegetable broth. Im like, what the heck? 

Those hidden sugars, Dr Brenner, they are –  the hidden sugar is everywhere. If you look in pasta sauces,  dressings, and but the thing is is you know when I lived overseas for a little bit they do add a little bit of sugar to things but

the difference is is the amount we have all the time and like overseas they’re

walking everywhere, they’re more active and you know they’re it’s it’s a

different kind of Lifestyle but it is everywhere you that’s and that’s why I always say take a moment to not just look don’t look at the calories and things look at the carbohydrate density and look at the ingredients label the added ingredients because that’ll tell you everything you need to know.

Yeah so when you go to the grocery store and actually look at the different vegetable stocks, like there’s some where it basically just says vegetable stock and usually some salt um or some had hidden you know I think it was called maltodextrin or you know these hidden names of sugars. So I actually started um making my own vegetable stock so when you cut up vegetables uh you know you peel carrots, all those vegetable scraps, I just throw them in a Ziploc bag put them in my freezer then after it gets filled then I make my own vegetable stock so then there’s nothing in it except vegetable stock or vegetables and water and it’s free.

That is it and guess what? You can put your apple cider vinegar in there and

drink it, I mean try it! It really is like and you know broth is so good for you um you know making sure if you are buying it it’s organic non-GMO if it’s from an animal but vegetable broth it’s so good for you it’s so yeah and you can make it free so

exactly don’t,  you’re reducing waste and saving money I mean what else?

Any other tips? One of the things that I like to do is um is after I eat to just try to go for a walk now.  That’s not always possible because a lot of times I eat breakfast and lunch at work so I don’t have time to go for a 10,  15 minute walk so if I don’t, this sounds kind of crazy, but I actually do like 30 squats or 30 lunges.

It’s not crazy at all and I think with the weather and because out there, it’s really cold, out here it gets really hot like I don’t even want to go outside sometimes but that’s okay and but there was actually a recent study done where they tested um a 40-minute full workout versus I think it was just walking versus one walking or doing some type of movement 30 seconds to a minute every like 25 minutes or whatever and the latter was more efficient. So that being said if you’re sitting or you know

you’re working and you don’t have time just getting up and doing like you said some squats or some jumping jacks or walking in a circle around your desk, I don’t know what it is – for like a minute or two minutes is sufficient. You know so

yeah like you said just to get up and move your body after you eat. Not immediately after you eat because you obviously want to digest your food but yeah it’s as simple as that we over complicate a lot of things which it rightfully so there’s so much information out there but just taking these small steps to blunt these spikes.

And probably in Europe um people are doing that just out of like they’re walking, they’re walking home.

They walk everywhere. I had a friend Dr Brenner who she lived over there briefly

she would take the train 40 minutes to a Starbucks and I’m like girlfriend

there’s so many cute cafes, that just walk! Why are you going to Starbucks? You’re overseas, you’re in Europe, like there’s so many cute cafes everybody’s walking and you know they walk to the store, they walk to their restaurants, everywhere.

Yeah! All right well thanks for joining us and I know as patients uh if you’re in our

practice people can actually work with you one-on-one and um not only hear these tips but I’m sure you got other tips up your sleeve that have to do with other medical issues or other concerns other than blood sugar spikes. So thanks for joining us Cassie.

 

Absolutely, thank you so much for having me Dr Brenner.

 

Thank you for listening to this episode of HealthiHer you can find us on Instagram Facebook and the web go to www.dr amybrenner.com to learn more. This podcast is for general information only and does not constitute as medical advice the practice of medicine, nursing or other health care services. No patient –  physician relationship is formed. The information in the podcast and any references material or links are at the sole discretion of The Listener and is not meant to be a substitute for professional medical advice, diagnosis or treatment. Listeners should not delay or disregard obtaining medical advice for any medical issues or diagnoses that they may have and should seek medical advice from their healthcare provider for any such conditions.