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Welcome back to the Diabetes Podcast show notes. In this episode, Richie and Amber break down mitochondrial dysfunction in simple terms. We explain what mitochondria do, what goes wrong in type 2 diabetes, which meds may help, and the daily steps that power your cells back up.

If you’ve been doing “all the right things” but still feel tired, foggy, or stuck, this one is for you.

• Mitochondria are the “power plants” inside your cells. They turn food into usable energy called ATP.
• In type 2 diabetes, mitochondrial dysfunction makes it hard to turn fuel into energy at the right time.
• This leads to high blood sugar, fatigue, brain fog, and slow recovery.
• The good news: mitochondria are very responsive. Movement, food, sleep, and stress care can build new mitochondria and make them work better.
• Some medicines can also help.

This is part of our 12-core-defects series on type 2 diabetes. Next week is the last one: inflammation.

• Think of mitochondria like tiny engines or refineries in each cell.
• Your body brings carbs (glucose) and fats to the refinery.
• Mitochondria “refine” that fuel into ATP, your body’s energy currency.
• When demand goes up (like after a meal or during a workout), healthy mitochondria match the demand.

This fuel-switching skill is called metabolic flexibility.

• In mitochondrial dysfunction, the “refinery” gets stuck or slows down.
• Even after meals, cells keep burning fat instead of switching to glucose.
• That causes “traffic” inside muscle cells and leads to insulin resistance.
• Blood sugar stays high because glucose can’t get into the cells well.
• Your cells end up underpowered, even when fuel is available.

Amber calls this “metabolic gridlock.”

Fun (not so fun) fact: A study found people with obesity and type 2 diabetes had about 30% fewer mitochondria in muscle cells. The ones left were slow and less efficient.

• Low energy and afternoon crashes
• Brain fog and low mood
• Hard time recovering after workouts
• Weight gain or stalled weight loss
• Feeling “hangry”
• High blood sugar after carb-heavy meals

Important: This is not a willpower problem. It’s a power problem.

• Refinery: You can’t use crude oil in a car. You need gas. Mitochondria turn food into usable “gas” (ATP).
• Battery/Charger: Mitochondria help “charge” your energy. If the charger is weak, everything feels harder.
• Gridlock: Fuel is everywhere, but it’s stuck in traffic. It can’t get where it needs to go on time.

Talk to your clinician before starting or changing any medicine.

• Metformin (a biguanide)
  • May make mitochondria more efficient over time by activating AMPK, a key energy signal.
  • Common side effect: GI upset (start low, go slow up to 2000 mg/day).
• Pioglitazone/Actos (a TZD)
  • Activates PPAR-γ, improves insulin sensitivity in fat and muscle, helps lipid handling, and supports mitochondria in muscle.
  • Side effects: weight gain (often fluid and subcutaneous fat), fluid retention; CHF warning applies.
• GLP-1 receptor agonists
  • May help indirectly by improving insulin function and lowering glucose and inflammation.

Meds can help the “refinery” run better, but lifestyle is what builds more refineries.

You can build new mitochondria and make existing ones work better. Small steps add up fast.

• Take a 10–15 minute walk after meals (especially dinner).
  • Helps move glucose into muscle even when insulin is not working well.
  • Signals your body to build more mitochondria.
• Strength train 2–3 days per week.
  • Builds muscle. More muscle = more “sockets” to plug in glucose and burn it.
• Sprinkle in short bouts of movement during the day.
  • Climb stairs, quick bodyweight sets, or short walks.
• Optional: brief, safe higher-intensity intervals if your doctor says it’s okay.

Tip: Movement tells your body, “We need more energy—build more power plants.”

Focus on a fiber-rich, whole-food, plant-forward plate. These foods lower inflammation and protect mitochondria from “rust” (oxidative stress).

• Antioxidant- and polyphenol-rich foods:
  • Colorful veggies and fruits, beans, herbs, spices, tea, coffee (unsweetened or lightly sweetened).
• Fiber-rich foods (also great for your gut bugs → more short-chain fatty acids → happier mitochondria):
  • Beans, lentils, peas; oats and other whole grains; veggies; nuts and seeds.
• Magnesium foods (needed to make ATP):
  • Beans, greens, seeds (pumpkin, sesame, chia), nuts, whole grains.
• B vitamins (help run energy steps):
  • Whole grains, beans, leafy greens; B12 often needs fortified foods or supplements if plant-based.
• CoQ10 (supports the electron transport chain):
  • Highest in organ meats and fatty fish; also in smaller amounts in spinach, broccoli, cauliflower, peas, soy, nuts, seeds, and whole grains.
  • Your body also makes CoQ10.
• Omega-3s (support healthy mitochondrial membranes):
  • Flax seeds, chia seeds, walnuts; fatty fish like salmon, sardines, mackerel.

Simple plate example:

• Half non-starchy veggies
• Quarter beans or whole grains
• Quarter lean protein
• Add nuts or seeds
• Water or unsweetened tea

• Aim for 7–9 hours per night.
• Deep sleep helps “wash” the brain and repair cells.
• Poor sleep = less ATP, more inflammation, higher blood sugar.
• If nighttime bathroom trips wake you, front-load fluids earlier in the day when possible, and discuss options with your clinician.

• Chronic stress raises cortisol, which hurts mitochondria and raises blood sugar.
• Try:
  • Slow breathing (4 seconds in, 6 seconds out)
  • Prayer or mindfulness
  • Short nature breaks
  • Light stretching
  • Gratitude journaling

• After each meal: 10–15 minute walk.
• Two or three days: 20–30 minutes of strength training.
• Daily: Build a fiber-rich plate (beans + greens + whole grains + nuts/seeds).
• Add magnesium and omega-3 foods.
• Lights down and screens off earlier; aim for 7–9 hours of sleep.
• One stress tool each day: breathing, prayer, or a short nature walk.
• Hydrate well during the day.

• Mitochondrial dysfunction is a core driver of type 2 diabetes. It’s about cell power, not willpower.
• You can build more and better mitochondria with movement, food, sleep, and stress care.
• Some meds can help, but daily habits unlock the biggest gains.
• When mitochondria wake up, energy rises, blood sugar improves, and progress gets easier.

Next week we finish the 12-core-defects series with inflammation. Don’t miss it.

If this episode helped you, please subscribe and share it with someone you love. Take a walk, take a breath, and remember: healing is powerful. You can do this—and we can help.

Disclaimer:

The information in this podcast is for educational and informational purposes only. It is not medical advice, diagnosis, or treatment, and it does not replace a one-on-one relationship with your physician or qualified healthcare professional. Always talk with your doctor, pharmacist, or care team before starting, stopping, or changing any medication, supplement, exercise plan, or nutrition plan—especially if you have diabetes, prediabetes, heart, liver, or kidney conditions, or take prescription drugs like metformin or insulin.

Results vary from person to person. Examples, statistics, or studies are shared to educate, not to promise outcomes. Any discussion of medications, dosing, or side effects is general in nature and may not be appropriate for your specific situation. Do not ignore professional medical advice or delay seeking it because of something you read or heard here. If you think you are experiencing an emergency or severe side effects (such as persistent vomiting, severe diarrhea, signs of dehydration, allergic reaction, or symptoms of lactic acidosis), call your local emergency number or seek urgent care right away.

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