The Dr. Gundry Podcast – Episode 379.B
DO NOT IGNORE these Signs of Type 2 Diabetes - Dr. G's Quick Health Tip
Release Date: November 27, 2025
Host: Dr. Stephen Gundry
Episode Focus: Recognizing the right signs of type 2 diabetes and understanding the most effective diagnostic tests
Episode Overview
This quick health tip episode is dedicated to clearing up common misconceptions about the early signs of type 2 diabetes, highlighting both what to watch out for and what often gets misreported. Dr. Gundry draws from his extensive clinical experience to clarify which symptoms truly indicate blood sugar problems, which mainstream advice to ignore, and—crucially—what lab tests actually offer real insight into prediabetes and metabolic syndrome.
Key Discussion Points & Insights
Commonly Misunderstood Symptoms (00:55–05:41)
-
Periodontitis (Gum Disease)
- Often listed online as a symptom of diabetes, but Dr. Gundry emphasizes it's actually a cause rather than a consequence.
- "If you have inflammation of your gums, it is one of the best ways to produce diabetes because we now know that oral bacteria invade your bloodstream constantly… and prompts the development of metabolic syndrome." – Dr. Gundry (01:34)
-
Acanthosis Nigricans (Darkening Skin)
- Thick, broad dark patches on neck or shoulders, common in overweight individuals.
- Often dismissed as 'just aging,' but, "This is a dead tip off that you have metabolic syndrome." – Dr. Gundry (02:22)
- Good news: These patches can resolve by following healthy lifestyle changes.
-
Slow-Healing Sores
- Particularly on lower legs; a clear indicator that blood sugars may be too high.
-
Vision Changes
- Sudden, unexplained changes in vision can be linked with fluctuating blood sugars.
- Dr. Gundry warns that high blood sugars may lead to retinal vein thrombosis (“your blood has literally gotten too thick”), increased risk of cataracts, and lens swelling, leading to blurry vision.
-
Numbness & Pain in Feet/Legs (Peripheral Neuropathy)
- High blood sugar damages small nerves: "High blood sugars are notorious for killing the small nerves that are fed by capillaries…" – Dr. Gundry (04:13)
-
Misreported 'Symptoms'
- Bedwetting in children is a sign of type 1 (not type 2) diabetes.
- Frequently urinating at night in adults has various causes besides diabetes.
- Fruity breath is characteristic of out-of-control type 1, not type 2, diabetes.
Recommended Diagnostic Tests (06:20–11:15)
-
Conventional Tests: Hemoglobin A1C
- A1C measures blood sugar over ~2 months.
- It can miss early insulin resistance: "You could have a very high insulin level and have an absolutely normal hemoglobin A1C." – Dr. Gundry (06:44)
-
Essential: Fasting Insulin and HOMA-IR
- Fasting Insulin ($8 test, widely accessible): Best under 6, “I’ll take under 9. Some of my patients… have fasting insulin levels like me of two or three. My wife has a fasting insulin level less than one. I tell you, I hate her. I can’t get down there. But lower is better.” – Dr. Gundry (08:06)
- HOMA-IR: Ideal at 1.0 or less; under 2.0 is acceptable. Most people falsely assured by “normal” lab ranges, but optimal targets are lower.
-
Other Useful Markers
- Glycated Serum Protein, Fructosamine: Give a two-week snapshot, good for short-term sugar/protein control.
-
Interpreting Results
- Pre-diabetes (A1C 5.7–6.0): “That’s like telling my female patients you’re a little bit pregnant. There’s no difference.” – Dr. Gundry (07:42)
- Fasting insulin above 10 signals clear insulin resistance—and impending trouble—regardless of A1C.
-
Clinical Wisdom
- "It’s far more important to fix metabolic flexibility than it is to fix a number that measures diabetes, like hemoglobin A1C. And that’s what’s been so wrong with so much of our management." – Dr. Gundry (10:27)
Actionable Advice
- Ask for the right tests next time you see your doctor:
- Fasting Insulin
- HOMA-IR (Insulin Resistance Index)
- Hemoglobin A1C (but do not rely on this alone)
- Optional: Glycated Serum Protein or Fructosamine
Memorable Quotes
-
On gum disease & diabetes:
"If you've got bleeding gums or your dentist says you got deep pockets, get it fixed. Now this is what I do in my practice." (01:28) -
On skin changes as a warning sign:
"This is a dead tip-off that you have metabolic syndrome. The good news is these will resolve with following my program." (02:32) -
On test results:
“Pre-diabetes... That’s like telling my female patients you’re a little bit pregnant. There’s no difference.” (07:42) -
On fasting insulin:
"My wife has a fasting insulin level less than one. I tell you, I hate her. I can’t get down there. But lower is better." (08:22) -
On treatment priorities:
"It’s far more important to fix metabolic flexibility than it is to fix a number that measures diabetes, like hemoglobin A1C." (10:27)
Timestamps for Important Segments
- 01:34 – How gum disease actually causes diabetes
- 02:22 – Recognizing and interpreting acanthosis nigricans
- 03:39 – Vision changes tied to high blood sugar
- 04:13 – Nerve pain, numbness, and diabetes
- 05:20 – Myths about bedwetting and fruity breath
- 06:44 – Problems with relying on Hemoglobin A1C alone
- 07:42 – The 'pre-diabetic' label demystified
- 08:06–08:22 – Fasting insulin goals and Dr. Gundry’s personal anecdote
- 09:23 – Understanding HOMA-IR and healthy ranges
- 10:27 – Why metabolic flexibility is the real goal
Takeaways for Listeners
- Don’t rely solely on the most advertised diabetes warnings—instead, look for skin changes, healing speed, vision, and nerve symptoms.
- Ask your doctor for a comprehensive set of blood sugar and insulin resistance markers—especially fasting insulin and HOMA-IR—to get the full picture.
- Metabolic health is more than blood sugar; restoring flexibility is the top target for prevention and reversal.
Empowered listeners can use these insights to request better care and catch metabolic problems sooner—well before A1C "catches up."
Note: This summary omits ads, recipes, promotional segments, and general show intro/outro in favor of pure content and clinical insights from Dr. Gundry.
