EP044: An Interview with Dr. Cheri Ogwo, MD
An Interview with Doctor Dr. Cheri Ogwo: Clear Steps to Better Blood Sugars, Less Meds, and Real-Life Wins
“Diabetes isn’t a death sentence—today’s tools can get your risk close to zero if you take action.”
In this episode of The Diabetes Podcast, Richie and Amber talk with Dr. Cheri Ogwo, a triple board-certified physician in endocrinology, internal medicine, and obesity medicine. She shares how she listens first, acts fast, and builds a plan that fits real life. We cover labs beyond A1C, insulin resistance, simple low-carb steps, CGMs and pumps, insurance hurdles, and the mindset that makes change stick.
Who this is for
Newly diagnosed with type 2 or type 1 diabetes
Living with diabetes for years and feeling stuck
Caregivers and family who want to help
Anyone who wants clear, simple steps you can use today
The First Visit: Listen First, Then Act
Dr. Ogwo starts by listening. She wants to know your head space: ready to fight, unsure, shocked, or seeking a second opinion. This guides the first step.
Labs help make the visit count. If possible, bring labs or get them a week before. If not, her clinic draws them the day of the visit.
Beyond A1C: She checks urine protein (microalbumin), creatinine, GFR, and cholesterol. She compares A1C with fingersticks or CGM to spot morning vs after-meal spikes.
She usually starts treatment on day one. It may be simple at first. Then she follows up in 2–3 weeks with new data to personalize the plan.
Fighting A1C Inertia
“A1C inertia” is when care stalls and high numbers linger. She doesn’t wait-and-see.
Her promise: “My goal is to get you on the least medicine needed.” Start now, then remove meds as you improve—safely.
What Type 2 Diabetes Is at Its Core
Type 2 diabetes is driven by inflammation and insulin resistance.
High blood sugar is the tip of the iceberg. The root (insulin resistance) sits under the surface. Treat the root, not just the number.
How Her Approach Evolved
Early on, she followed standard steps. Over time, combining endocrinology with obesity medicine, she learned to match meds and nutrition to each person’s true struggles.
If insulin doses are high and A1C barely moves, she looks for deep insulin resistance and changes the strategy—rather than just cranking up insulin.
Metformin: Yes, But Not Always First
She doesn’t force metformin as step one. If you resist it or had bad stomach side effects, that matters.
She explains the facts: metformin does not cause kidney disease. It must be stopped as kidney function drops (she stops around GFR 45).
Sometimes she tries extended-release or a combo pill with lower-dose metformin—often with a short sample to test tolerability.
Insurance, PAs, and Real Costs
Her EMR shows likely formulary choices, and her team is proactive with prior authorizations.
The big surprise is often the deductible at the pharmacy. If costs are high, they check alternatives in the same class.
She asks patients to call the clinic if the copay is shocking so they can pivot fast.
Two Paths: More Meds vs Root Cause
“We can do it the easy way (more meds) or the right way (treat insulin resistance).”
Cutting carbs reduces how often your pancreas must release insulin, which helps insulin resistance. You can lower carbs without going extreme.
Low-Carb, Not Zero-Carb
Low-carb doesn’t mean all meat and no plants. Her own approach:
Breakfast: 1–2 whole eggs plus extra whites, or sometimes nothing
Dinner: lots of veggies (broccoli, cabbage, green beans), add salmon, chickpeas, or chicken for protein
Aim: about 40–50 grams of carbs per day; low processed foods; consider a multivitamin because the typical American diet is low in micronutrients
Start small. Swap two slices of toast for one. Pick one or two carbs per meal, not four or five. Keep familiar foods, just reduce quantity.
Mindset and Motivation
She meets “I gotta die somehow” with compassion and truth: diabetes can be a slow, painful decline. Let’s trade one soda today. Feel better. Then trade one more next visit.
Many patients don’t realize how bad they feel until they feel better. Wins often show up within weeks.
Dietitian Is Part of the Plan
In her clinic, seeing the dietitian is standard. If your A1C is at goal, it might be once a year. If not, you’ll meet more often.
Most people want to eat better; they just need simple, clear guidance for diabetes (which is not the same as a generic “heart healthy” plate).
Why A1C Matters—and Why It’s Not Everything
A1C is an average of about three months. Higher A1C often means more time above 200 mg/dL. Above 200, damage to nerves, eyes, and kidneys can occur.
After you reach around A1C 7, she focuses more on daily patterns: time-in-range, after-meal spikes, lows, and variability. Two people can have the same A1C but very different risk.
Stress, Sleep, and Morning Highs
If sugars are high in the morning, she asks about stress and sleep. Cortisol can push sugars up even if you didn’t eat.
Simple stress supports:
10 minutes of walking in nature
Journaling one thing you’re grateful for
Music and movement
Gentle mindfulness
These steps help modulate hormones and calm the body.
Continuous Glucose Monitors (CGMs): Awareness Is Power
She supports CGMs (Dexcom, Libre) for awareness. You learn how meals, stress, and sleep affect your numbers in real time.
CGM anxiety is real. If alarms cause stress and you’re not on insulin or at risk of lows, she may silence alarms.
For type 1s with hypoglycemia unawareness, CGMs are lifesaving.
Hypoglycemia Unawareness: Retrain the Body
If you no longer feel lows, she lets sugars run a bit higher for 2–3 weeks to restore awareness.
If CGM numbers drive anxiety, consider a break: go back to fingersticks briefly.
She may gently adjust carb ratios or correction factors so you’re a little higher but still safe—without 300–400 spikes.
Pumps and Automated Insulin Delivery
She tries to get type 1s and pregnant patients on pumps. Automated insulin delivery is promising, but cost and real-world use can be hard.
Tubeless options can be cheaper for some, but many still face high copays for both CGM and pump supplies.
Connectivity drop-offs and alarm fatigue are real barriers. The tech is improving every year, but it’s not perfect yet.
Hard Truth: Feeling Fine Isn’t Being Fine
Diabetes complications grow quietly. If you wait to “feel” sick, it can be late for some damage.
Own your numbers. Know your A1C. Ask for urine microalbumin, creatinine, GFR, cholesterol, and talk about after-meal spikes and time in range.
Your health is yours. No one can care more than you.
Quick, Simple Wins You Can Start Today
Schedule labs and bring them to visits; ask about urine protein and kidney numbers.
If mornings are okay but after-meal numbers jump, focus on carbs at lunch and dinner.
Pick one high-carb item to reduce this week: soda, juice, big pasta bowls, large bread portions.
Add one 10-minute walk daily, outside if you can.
If you use a CGM, review your last week: which meals spike you? Change one thing.
If meds are costly, call your clinic before you pay. Ask about alternatives in the same class.
Where to Find Dr. Cheri Ogwo
TikTok: @cheri.o.md
Clinic: SugarPros.com
Final Word
Diabetes is not a death sentence. Today’s tools—labs beyond A1C, smart nutrition, CGMs, better meds, and, for some, pumps—can lower risk and help you feel great. Start where you are. Make one change. Then another. Your future self will thank you.
Have questions or need additional support? Reach out to us at [email protected]. Take courage. You can do this—and we can help.
Disclaimer
The information in this blog post and 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.
We strive for accuracy, but health information changes over time. We make no guarantees regarding completeness, timeliness, or suitability of the content and assume no liability for actions taken or not taken based on this material. Use of this content is at your own risk.
Links or references to third-party resources are provided for convenience and do not constitute endorsement. By reading, listening, or using this information, you agree to these terms and understand that you are responsible for your own health decisions in partnership with your licensed healthcare provider.
