DO NOT IGNORE these Signs of Type 2 Diabetes - Dr. G's Quick Health Tip | EP 379.B

Summary

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

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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.

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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

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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)

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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

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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."

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Note: This summary omits ads, recipes, promotional segments, and general show intro/outro in favor of pure content and clinical insights from Dr. Gundry.

Transcript

[A]

Hey, this is Sarah. Look, I'm standing out front of a.m. p.m. Right now and well, you're sweet and all, but I found something more fulfilling, even kind of cheesy. But I like it. Sure you met some of my dietary needs, but they've just got it all. So farewell Oatmeal so long you strange soggy.

[B]

Break up with bland breakfast and taste AM PM's bacon, egg and cheese biscuit made with Ktree eggs, smoked bacon and melty cheese on a buttery biscuit. AMPM too much good stuff.

[C]

Welcome to the Dr. Gundry podcast where Dr. Stephen Gundry shares his groundbreaking research from over 25 years of treating patients with diet and lifestyle changes alone. Dr. Gundry and other wellness experts offer inspiring stories, the latest scientific advancements and practical tips to empower you to take control of your health and live a long, happy life.

[D]

Lets talk about some of the symptoms that you may have with type 2 diabetes or what you should look out for. Now I've looked at various Dr. Google sites and it's interesting what they tell you to look for and I want to tell you what not to look for and sometimes ignore these. So one of the ones that they talk about is periodontist. Now that's recession around your gums. It's red redness around the gums, it's bleeding around the gums. It's deep pockets. First of all, your dental hygienist should be probing your pockets around your teeth. It's a big deal. But quite frankly, that is not a symptom of diabetes that you should be looking for. 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 it's these bacteria in your bloodstream that prompts the development of metabolic syndrome. So it's not the other way around. 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. This shows up in my patients and this is kind of what I want to see in my patients. So take that with what I see now. Darkening skin. It's got a fancy name. It's called Acanthosis nigricans. There'll be a test many times. We'll see particularly overweight individuals develop these kind of dark, thick patches on their neck and on their shoulders. And I do see this a lot. And many people are told that, oh, that's just a part of getting old. They're different than dark spots or sunspots and they're actually quite broad. This is a dead tip off that you have metabolic syndrome. The good news is these will resolve with following my program. It should be obvious if you have a slow healing sore or cut, particularly on your lower legs, this can be a tip off that your blood sugars are higher than they should be now. Changes in Vision Interestingly enough, fluctuating blood sugar levels can cause sudden visual changes. But there are many other things that perhaps are even more worrisome that can cause the same thing. I do see patients who run very high blood sugar levels who have had retinal vein thrombosis. Not a good thing because their blood has literally gotten too thick. Think about pumping honey through your bloodstream. As I like to tell my patients, we also know that there's a fairly strong correlation with diabetes to develop cataracts in the eyes or even causing lens swelling which leads to blurry vision. So blurry vision can be another sign of type 2 diabetes. Many patients with type 2 diabetes develop numbness and pain in their feet or their legs. Unfortunately, high blood sugars are notorious for killing the small nerves that are fed by capillaries and many doctors will tell you, well, this is peripheral neuropathy. There are different causes of peripheral neuropathy, but high blood sugars are one of the most are the biggie. Now you'll see on Dr. Google sites that bedwetting in children is a sign of type 2 diabetes. No it's not. It can be a sign of type 1 diabetes or juvenile diabetes, but if you're getting up to PE five times a night and you're an adult, there's other reasons going on besides high blood sugars. Now Fruity breath well, fruity breath is caused by ketones and this is typical of out of control type 1 diabetics, but in general type 2 diabetics who have too much insulin. I've never smelled fruity breath on a type 2 diabetic in my practice.

[E]

Craving something decadent like a double fudge brownie lasagna or an Almond Joy muffin that's secretly good for you. Then you'll love my Dr. Gundry newsletter. Each week I send out an exclusive recipe that not only tastes incredible, but also supports your gut, your heart and.

[D]

Your long term health.

[E]

From snacks to desserts, these recipes prove you don't have to give up flavor to eat right. You just need the right ingredients and a little guidance. So go ahead, treat yourself to food that loves you back. Sign up for my free newsletter using the link in this episode's description.

[D]

Okay, so more importantly, what tests should you ask your doctor for if you think you have diabetes? Now, the problem is most doctors are going to measure two tests for you. One is hemoglobin A1C. Everybody's heard about hemoglobin A1C. Thanks to commercials, I got my A1C down. Now, A1C basically looks at what your blood sugar is like for the previous two months. Looking backwards in time, it tells you and me how much sugar and protein you are handling during that time period. The problem is you could have a very high insulin level and have an absolutely normal hemoglobin A1C. You could have an absolutely normal blood sugar and yet you are insulin resistant and have metabolic syndrome, which is the real thing that you want to prevent. So please get those tests, but please ask your doctor to get at least one other test which is a fasting insulin level. It's an $8 test, folks. Preferably a Homa IR. H O M A IR stands for insulin resistance. If you can't get those, you could get a glycated serum protein and or fructosamine. They basically are the same test. This gives you a two week window into how you're handling sugars and proteins. It's looking for advanced glycation end products. Let's suppose you get a hemoglobin A1C. Traditionally in my practice and most other physicians practice in restorative medicine or functional medicine, we want a hemoglobin A1C lower than 5.6. In my practice, I want a hemoglobin less than 6 to tell you you're not a diabetic. But if you're between 5, 7 and 6.0 and I tell you you're a pre diabetic, that's like telling my female patients you're a little bit pregnant. There's no difference. So where do you want a fasting insulin level? I preferably want a fasting insulin level of 6 or less. 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. If you've got a fasting insulin level 10 or above, you have insulin resistance, you have metabolic syndrome. And I don't care what your blood sugar is, I don't care what your hemoglobin, globin A1C is, you're heading for trouble. Homa IR. Traditionally a Homa IR of 2.0 or less is normal, but secretly what you don't know is a HOMA IR should be one or less. It is actually quite hard to achieve. In my practice, I'll take less than 2.0, but you'll get a gold star the closer you get to 1.0 or less. A lot of my patients, because they look at the range on these tests, often get a false sense of security when they see a homa IR of 2.0. Now if it was 5 and we're down to 2.0, this is great. But we don't want to stop until we keep getting that insulin resistance lower and lower because it's really one of the most important measurements of metabolically flexible people. Just remember, 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. So what I do in my practice is my recommendation to you. But ask your doctor. Ask for these tests and they're really not expensive. And quite frankly, most insurance plans cover these tests. Medicare covers these tests.

[C]

I hope you enjoyed this episode of the Dr. Gundry podcast. If you did, please share this with family and friends. You never know how one of these health tips can completely transform someone's life when you take the time to share it with them. There's also the Dr. Gundry Podcast YouTube channel, where we have tens of thousands of free health insights that can help you and your loved ones live a long, vital life. Let's do this together.