EP040 A Surgeon’s Guide to Sustainable Weight Loss & Diabetes Management with Dr. Pavi Kundhal, MD

Diabetes advice seems to change every week, but the habits that work haven't changed in decades. Endocrinologist Dr. Karl Nadolsky of Docs Who Lift explains what actually moves the needle for Type 2 diabetes and prediabetes. In episode 79, Richie and Amber talk with Dr. Nadolsky, an endocrinology and obesity medicine specialist. They cover the simple diet and exercise habits that still work, why the fear of insulin is outdated, and how GLP-1s and SGLT2s fit in. They also cover rapid A1C drops, why diabetes educators matter, and how to avoid influencers selling a "secret." Ready to take control of your health? Download our FREE Type 2 and Prediabetes Remission Roadmap today at: https://roadmap.thediabetespodcast.com KEY TAKEAWAYS Energy deficit is the foundation. Mediterranean, low-carb, low-fat, fasting, and meal replacements can all work. Pick the one you can stick with. Consistency beats complexity. Daily walking plus a few weekly sets of strength training deliver the most benefit. Don't fear insulin. Proper treatment often avoids or reverses the need for it. If you do need it, it's a valid therapy. Fast A1C drops can backfire. Dropping blood sugar too quickly can worsen retinopathy and neuropathy, and you may feel awful for weeks. CHAPTERS 00:00 Preview: Energy Deficit & Insulin Fears 00:53 Meet Dr. Karl Nadolsky, Endocrinologist 02:12 Becoming an Endocrinologist & Obesity Specialist 07:34 Why 15-Minute Visits Fail Diabetes Care 11:13 Origin of The Diabetes Podcast: Information vs. Implementation 13:23 Diet for Type 2 Diabetes: Energy Deficit & Remission 16:17 Exercise: Walking, Strength Training & Consistency 18:57 Nutrition Basics That Haven't Changed 20:05 Type 2 Diabetes & the Fear of Insulin 22:56 GLP-1s & SGLT2s: Benefits Beyond Blood Sugar 23:44 Keto, Low-Carb & Diabetes Remission Limits 25:06 GLP-1s, Retinopathy & NAION: Myth vs. Reality 27:47 Rapid A1C Drops & Automated Insulin Delivery 31:21 Insulin Action & Why Diabetes Educators Matter 34:23 Inside the Diabetes & Endocrinology Clinic at the Gym 39:08 Insurance, Outcomes & Value-Based Care 41:19 Big Pharma, Social Media & Compounded GLP-1s 43:54 Where to Find Dr. Nadolsky (docswholift.com) Disclaimer: The content of this podcast is for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider before making any changes to your medication, diet, or exercise routine, especially if you manage diabetes or other health conditions. Do not disregard professional medical advice or delay seeking it based on this content. If you experience a medical emergency or severe side effects, seek urgent care immediately. By listening, you agree that use of this information is at your own risk.

Tired of checking every ingredient and still wondering what you can eat? We explore ultra-processed foods, type 2 diabetes, and why healthy eating does not have to mean making everything from scratch. Amber and Richie unpack two food studies, the 500-extra-calorie finding, and the gap between a useful food label and another rule that leaves you feeling like you failed. Ready to take control of your health? Download our FREE Type 2 and Prediabetes Remission Roadmap today at: https://roadmap.thediabetespodcast.com Key takeaways Processing and overall diet quality both deserve attention. The 2019 trial found higher average intake on its ultra-processed diet; it did not prove every packaged food causes overeating. Bread, yogurt, and frozen meals can have a place in a practical eating plan. Start with a useful change you can repeat, without blame or shame. Chapters 00:00 - Ultra-Processed Foods: The 500-Calorie Surprise 00:35 - Can Processed Food Still Be Healthy? 02:25 - What “Ultra-Processed” Means: NOVA Explained 06:40 - The 2019 Study: Eating 500 More Calories 08:04 - Eating Speed, Chewing, and Feeling Full 11:40 - The 2025 Trial: Two Healthy Diets Compared 13:43 - Food Texture and the Food Matrix 14:34 - What Is an Emulsifier? 17:39 - Convenience Foods in Real Life 19:41 - Food Label Fear: Xanthan Gum and Soy Lecithin 22:48 - Natural Flavors and the “Natural” Food Myth 25:47 - Type 2 Diabetes: Fiber and the Bigger Picture 29:17 - Protein, Fat, and Your Overall Eating Pattern 31:01 - Why Bread and Soda Aren’t the Same 34:34 - Where to Start With Food Changes 36:23 - Food Choices and Type 2 Diabetes Remission 39:08 - Can Healthy Food Be Ultra-Processed? 42:36 - Reading Bread and Cereal Ingredient Lists 44:30 - Your Free Remission Roadmap Take courage! You can do this, and we can help. Disclaimer: The content of this podcast is for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider before making any changes to your medication, diet, or exercise routine, especially if you manage diabetes or other health conditions. Do not disregard professional medical advice or delay seeking it based on this content. If you experience a medical emergency or severe side effects, seek urgent care immediately. By listening, you agree that use of this information is at your own risk.

Ever feel like the moment you got a diabetes diagnosis, your plate became public property? In this episode, Richie and Amber (a Registered Dietitian and Diabetes Educator with 23+ years of experience) unpack the hidden judgment behind everyday comments like "Are you allowed to eat that?" They break down why your A1C is a biomarker — not a character assessment — why the word "noncompliant" needs to be retired, and why Type 1 vs. Type 2 comparisons do more harm than good. If you've ever felt shamed for your food, your medication, or your numbers, this episode is your permission slip to stop apologizing.

If you’ve been diagnosed with prediabetes or Type 2 diabetes, food suddenly becomes unbelievably complicated. In this episode, Richie and Amber tackle the most common question they receive: "Can you just tell me what to eat?" Discover why strict meal plans and restrictive diets fail in the real world, and learn how to build a sustainable, individualized approach to nutrition that actually fits your lifestyle and helps you achieve remission.

Did you know the American Diabetes Association's 2026 Standards of Care now name automated insulin delivery (AID) as the preferred method over multiple daily injections — even for adults with Type 2 diabetes? In this episode, Richie and Amber wrap up their three-part series on diabetes technology by tackling a question most people with Type 2 diabetes have never been asked: "If you need insulin today, why are you still doing it manually?" Amber breaks down: Why your pancreas does something injections simply cannot replicate The real evidence behind AID systems, including two major 2025 clinical trials on Type 2 diabetes How to use AID and still pursue Type 2 diabetes remission — because treatment today doesn't cancel out your outcome tomorrow What "manual mode" really means and how to prepare a backup plan Why a discrepancy between your CGM and finger-stick reading doesn't mean your technology is broken How insurance, cost, and the pharmacy-versus-durable-medical-equipment divide actually works If you're on multiple daily injections and your A1C isn't where you want it, this episode is for you. And if you're chasing remission, this episode is especially for you.