Fix Your Blood Sugar Before Diabetes

Hi and welcome to How Humans Heal. I'm Dr. Doni Wilson, and today I have with me Dr. Beverly Yates. Dr. Beverly is also a naturopathic doctor like me, and she's an MIT-trained engineer. She's also an internationally recognized speaker and the author of her book, The Yates Protocol: 5 Simple Steps to Fix Your Blood Sugar and Reverse Type 2 Diabetes, which I think is such an important topic and one that I'm talking about with my patients each and every day. So I'm so glad that you're here to talk about this with me and share with the How Humans Heal audience. Thank you so much, Dr. Beverly.

You're very welcome, Dr. Doni. I'm really glad to connect with you. And, you know, we've had a chance to be together in person, and we're certainly colleagues and on a similar mission around helping people reclaim their health. And so the theme of your podcast, How Human Heals, Perfect. How humans heal. Perfect.

I know, right? It's, it's like, that's how we think about, like, as a naturopathic doctor, our focus is different. It's not about, oh, let's just pick another medication that's going to get you through the next few years. Hopefully we're looking at it as like, what's going on under the surface so we can actually reverse this situation? And that's what's, I think, so such an important distinction in the steps that you about in your book, um, and I want to get into that. And first, I wonder if we can just really help people to understand how to know if you should be thinking about your blood sugar, because I personally think that we need to be thinking about it way before it becomes diabetes. I mean, certainly we can help if and when it does become diabetes, but right, like, there's so much we can do before it becomes diabetes to prevent it from ever getting— reaching that point.

Absolutely. Absolutely. You know, my family hosted a book launch party for me and a dear friend was there. And then the next morning after she'd gone, she texted me because she started reading my book. She bought it at the party and she said, wow, I realize I'm making some fundamental mistakes and I'm about to get into trouble. So this applies to everyone. And this isn't the stuff we're taught, you know, in naturopathic medicine. Our focus is— and what we teach the people we work with is all about caring for health. So healthcare is central to what work we do is not disease management. That's a different thing. That's where it's a pill for every ill. You know, injections, etc., when no one was taught the basic lifestyle steps that make the difference. And, you know, medications have their place, but a lot of times when it comes to diabetes and blood sugar regulation, it's got so much more to do with lifestyle. It's why I focus on this, because it's so hopeful to me. I can encourage people and make sure they understand their role and what they can do to be in charge of this. So if you want to prevent it, if you have a family history, you don't have a family history. Maybe you're watching other people struggle with this, knowing that nutrition is central, but it's not the only thing. The time of day you eat your meals, your stress levels absolutely can get you into trouble, and you can wind up with type 2 diabetes even though you're doing everything else right, or so you think. Your sleep, if you have compromised sleep, poor sleep, you have sleep disorders like sleep apnea, that absolutely primes the situation for you to become a diabetic. And then finally, Exercise with an emphasis on strength training. The fastest way out of danger is to get strong, is to build your active working muscles because that's where your blood sugar is going to be used up quickly and help you get out of that danger zone. But people aren't taught this at all.

It's— and thank you for mentioning, I mean, that's already like the core fundamentals, right, of, of, uh, what we think of in naturopathic medicine, right? Let's start with, yes, what can we do with our diet, but also what can we do with our stress recovery, our sleep, our exercise, because those day-to-day things we can do in our day-to-day routine can make such a difference in preventing many different health issues. And the thing about blood sugar levels is that when blood sugar levels even start to go high, even if it's not all the way to being diagnosed as diabetes, it's not only increasing risk of diabetes, but it's increasing risk of heart disease, dementia, Right? So many— even cancer is associated with higher blood sugar levels. So when we solve the blood sugar issue, we're solving a lot of issues at the same time.

Absolutely, absolutely. And there's all kinds of early warning signs wherever you may be in your life stage. You know, we have a third of the teenagers in the US are pre-diabetic. That is crazy. We can't let that happen to our kids. They need to be able to be fully healthy adults. And so a lot has to change. And then for us as women, as we go through the stages of health for our own lives, As we approach menopause and after menopause, we really have to have an eye on blood sugar and insulin sensitivity and avoiding or dealing with insulin resistance so that we can be healthy and well and be able to have all of our years be the best of our years, not just the ones before a certain time. And to do that, you know, you really need to have the understanding about what's essential and how to get back on track if life is unkind. Because I know sometimes, as the kids say, life is lifing. All sorts of things can happen to someone and they wind up either being stuck in an unhealthy situation or doing unhealthy things, not knowing that it's unhealthy specifically for them. And what's unhealthy for one person might not be a problem for the other. Let me give a simple example. You know how a preschool teacher loves and adores children and has all kinds of patience for them, is not stressed out when children are crying or if children are unreasonable or they're having a tantrum or whatever it is, right? Because they're children, you know, they're just really in that place. That same person, though, if you were to swap shoes, let's say someone is a martial arts instructor, that same woman who is really fond of martial arts and can teach other women how to be safe and how to defend themselves or go on the offense if necessary, she's comfortable in that. Other people would feel really stressed. So if you swapped a preschool teacher, put her in the martial arts setting, she might be stressed. You take the martial arts teacher and put her in a preschool setting, she might be stressed. For either of those women, when they're in something really different, that extra stress could lead to problems with their blood sugar. But if they're in their zone of excellence, their flow zone, right, their zone of genius, they're going to be fine. And so more than likely, they're not going to have a big release of cortisol, a core stress hormone, and therefore a blood sugar release to go chase it, get on the blood sugar roller coaster, you know, all those things, right? It just depends. We aren't all identical. We don't respond to things in our environment the same. And it's no It doesn't make sense to give people like a one-size-fits-all thing. Instead, you want a personalized approach so you can do what's relevant to you.

These are such good points, and I'm so glad you're talking about helping to understand, you know, how your body's responding as an individual, especially to the various stresses in our life. And it, it may be that one stress affects one person and throws off their blood sugar, and it doesn't bother another person's blood sugar at all. And you also are explaining this connection to cortisol, because I think a lot of times hear about cortisol as a stress hormone, but we don't necessarily understand that when cortisol goes up high, and even when cortisol is low, it affects our blood sugar levels. And so it's like, that's why it's so essential to address your stress and understand how the stress is affecting your cortisol, and then choose differently, right? How do we either try to make choices to reduce our stress exposure, or like I talk about in in my book, Master Stress Reset Your Health, how do we help ourselves recover from the stress in at the same time? So if we're helping ourselves recover from stress, we can correct those cortisol levels in the moment. And this way, you know, because there's a lot of times there's stress in our lives that we, we feel like we can't do anything about, right? It's just stress happens. So, but what we can do is we can help ourselves recover from the stress so that it doesn't have this negative impact on our blood sugar and other areas of our body.

Yeah, having that key awareness that, oh my gosh, I feel stressed, or having objective data to support it. So I'll give you an example. There's a woman I work with as a client, you know, via telehealth, and she's an executive in Manhattan. And one of the things that's happening for her is she had this weekly meeting Tuesdays in her time zone around 1 o'clock, 1:30 in the afternoon. So it didn't seem to matter for her what she ate for lunch because at first when we started working, we thought maybe it was lunchtime that was putting her into the blood sugar roller coaster phenomenon. And instead what we discovered was that Tuesday weekly meeting at that time apparently really, really got her cortisol going because her blood sugar would just take off. She might as well have had cotton candy for lunch. That wasn't what she was eating, but it might as well have been. And it took a while. She's like, wait a minute. It's always this meeting. And she's like, oh my God, I did not know I was feeling so stressed all the time. You know, she since has changed jobs and all. I mean, that really in her case was the solution. Just get out of the situation. But it's that hidden stuff. So in her case, she was using a CGM, a continuous glucose monitor applied, you know, the back of her arm, gave her objective data, and it gave her the opportunity to reflect on what is happening in my life with such regularity every Tuesday afternoon that I know I'm going to have this big blood sugar spike and then a crash on the other side. And having that objective information sometimes gets people to be more inward and be able to reflect on, "Okay, what's happening in my life on such a regular basis that is causing a blood sugar catastrophe?" And I'm so glad you're talking about the continuous glucose monitors because they really can make such a big difference.

I see it, too, with my patients where I say, "Just try it for—" It's a 14-day, right? You put it on your arm 14 days and you track. What are you eating? What is your blood sugar? So you can, like, like your patient noticed, like, you could line up what did I eat and what am I doing at that time and when is my blood sugar spiking. And it can give you such good information instead of guessing, right? It's like so much of the time we're thinking, oh, I have no idea what's going on with my— or I think this is when my blood sugar is high, but it could be completely different. Um, so tell me, tell us more about How do you— when should someone consider using a continuous glucose monitor? And what are some tips with using them that you found?

Sure, I'm happy to do that. So I think some good framing for this is something that you brought up a little bit before, which is what to look out for. So this would be whether or not you have a family history, whether or not you have a personal history, or you're starting to be concerned, like, hmm. Some of the things you might notice are brain fog that you really can't explain, noticing that you go into a food coma. And I say food coma, not other kinds, but a food coma, particularly in the afternoons. And so you have to discern, is it a drop in cortisol in the late afternoon time? I call it tea time. You know, many people are in line at Starbucks, or culturally they drink tea around 3 or 4 o'clock in the afternoon. It happens to be a natural decline in cortisol then. But for some people, it's a crash. Or is it what you ate at lunch? Is it like the person I explained? She has this meeting that really knocks her off her game, you know? So the food coma phenomenon is where someone eats and they notice an hour, hour and a half later they're exhausted. They're really tired. They get very sleepy. You know, they're doing this faceplant on their desk, right? That's the food coma. And if you know that that certain time of day triggers that for you and you know it, like say your lunchtime meal maybe was full of very simple carbs, you know, basically sugary stuff like pastries and danishes and things like that, or you're eating food in the wrong order. You know, there's things you can observe. Other things you might observe are issues with being able to feel inwardly like you're stable. Sometimes, particularly women, will have that internal sense of feeling a little jittery or a little anxious. And it isn't necessarily a mood disorder. Sometimes it's your blood sugar talking to you, and it could be that your blood sugar is too low. You might have hypoglycemia. That can absolutely happen. Other things people might notice that would point to a blood sugar-based issue is where they have cravings, and their cravings typically could be for sweet or salty foods, especially after a poor night's sleep, independent of menopause. So this could be before menopause has started. This could be the premenopausal window and actually the onset of menopause and in its conclusion, postmenopausally. If you're noticing that you have cravings for sweets or savory foods, but high-carb foods, right? Because they can either be savory, like, say, biscuits and gravy, or sweet, you know, like donuts. And if you're noticing, like, wow, after I have a bad night's sleep, the next morning I really want to eat stuff that's sugary and sweet. It's not just wanting emotional comfort for a crappy night's sleep. Your blood sugar is responding to what happened during that poor night's sleep. And it could be that it has disrupted your hormonal balance, whether it's insulin It could be the conversation between the twins, as I call them, ghrelin and leptin. Ghrelin for your stomach growling. It's not spelled like growling, it's spelled like ghrelin, G-H-R-E-L-I-N, right? That says I'm hungry. And then leptin, which says stop, it's time to stop eating. And for some people, they get the hunger signal, the ghrelin signal is strong and leptin is pretty much silent. They don't know when to stop. So if you start to feel like your appetite is getting out of control and it doesn't make sense, You aren't an Olympic athlete. You aren't preparing for something really intense physically, right? And you're noticing you're craving foods you know are not good for you, crappy foods. That's a signal, a big clue that something might be going on with your blood sugar and it would be great to go get tested. Get your fasting blood sugar numbers done. Get your A1C level done. And we can describe that because people might not know what these things are.

Yeah, the hemoglobin A1C. Yes. So, because they don't— when you go in for the doctor, like, if you go in for an annual blood work, they might do your glucose because they're doing a complete metabolic panel, but they might not do a hemoglobin A1C unless you ask for it.

Isn't that crazy? A lot of times people's A1C is not checked. I had one woman I was working with, she was 66. She'd seen however many doctors over the course of her entire year. Cardiovascular illness person. She'd had a prior history of heart disease and we were working with her on that. And no one had checked her A1C her whole lifetime. I'm like, "With heart disease? Are you kidding me?" Are you kidding me?

I know, right? I know. It really should be done. I agree. So if any of you are going in for your annual blood work, make sure to ask your practitioner to order the hemoglobin A1C, or what we call A1C for short, along with the fasting glucose, right? And is there anything else that you recommend they get in their blood work to start to get some hints at what's going on? Sure, sure.

I think another partner in there would be fasting insulin. I love to see it in the single digits, so 9 or less. If it's 10 to 20, I'm not necessarily upset, but we're going to keep an eye on that. We don't want to go in higher. If it's above, say, 18 to 20, then we know that insulin resistance is setting in, and we want to do what we can to turn the tide back the other way so you're promoting insulin sensitivity so that that hormone insulin can grab up the glucose, the blood sugar in your bloodstream, and put it inside yourself for energy. Otherwise, it takes the excess and it stuffs it into the liver or other parts typically of the belly, of the abdominal area as belly fat. And, you know, it's a whole metabolic conversation, right? So let's back up just a minute because I don't want to leave anybody behind. I know these are areas of confusion. So then hemoglobin A1C that Dr. Doni Wilson mentioned, A1C is an objective number that pretty much can change about every 3 months. Why is that? Every day of your life, your bone marrow puts out a fresh new set of red blood cells, but they don't all turn over daily. It is constantly putting new ones out into your bloodstream. And by the time 90 days has gone by, you've gotten a whole brand new fresh set of red blood cells. Those are the ones that can get so coated with extra glucose. Glucose is also known as blood sugar. So if those cells get coated with too much blood sugar, not enough of it's going inside the cell, that can be objectively tested and measured as an A1C. The fasting glucose number, the fasting blood sugar number, typically taken in the morning because most of us, when we're asleep overnight, of course, We're not eating or drinking. So you go to the lab, right? So you've had a period of at least 8, ideally 12 hours or so of fasting. Get that number, your fasting blood sugar number, and that lets you know, it's a snapshot in time, where your blood sugar was at that particular morning. The fasting blood sugar number and the A1C number are not the same information. I hope that was clear. Right, but it starts—

the more pieces we get, pieces of information we get, we can put together this puzzle and go, "Oh, is your insulin a little high?" Is your— hemoglobin A1C a little high, even before it goes— What is your— What do you love with hemoglobin A1C? What is— What are you wanting people to aim for?

Yeah, well, ideally, you know, I want them in the healthy range. So an A1C of 5.6 and lower is optimal. It's in the healthy range. The prediabetes range got changed about 27, 28, maybe even 30 years ago. To shift. It used to be that the prediabetes range was actually higher and they lowered it. So now the A1C range that's considered prediabetes is a 5.7 to 6.4, and type 2 diabetes is diagnosed as an A1C of 6.5 and higher. So whatever number someone's starting with, I'm absolutely trying to get them to that 5.6 or lower range and help them have sustainable ways, practical ways, ideally enjoyable ways to stay there. So the things that I'm focused on with them and what the book talks about are the things that people can do for themselves, because it's one of the reasons why I'm so passionate about this work. I feel strongly that of all the chronic illnesses, type 2 diabetes, prediabetes, type 1 diabetes for that matter, the most lifestyle sensitive. Now, I don't want to confuse anybody. Type 1 is autoimmune onset where the pancreas no longer makes any insulin. And based on what we know today, people have to take insulin for the rest of their lives as a prescription medicine. We don't yet have a cure or a way to reverse that. I want no ambiguity about this, but everybody can benefit from that blood sugar information and knowing how to not get on the blood sugar roller coaster and to have their blood sugars be as even as possible on a 24/7 basis, both for personal safety as well as preventing some of the other things you talked about, like heart disease, like dementia and its most common subtype, Alzheimer's, cancer, etc. They do have a big overlap with chronically high blood sugar.

And you mentioned the word metabolic, and I would love to talk about this a little bit because people, I think, are going to start to hear this more and more and more because it's a word that we see in the research and hear about, you know, in our training. And yet I'm not sure that it's so clear to everybody else, like, what are we talking about, metabolic and metabolic syndrome? Because what's happening then is is what you're talking about, where it's, instead of just focusing on the blood sugar, we start to look at how there is a, a whole syndrome, a whole series of things that tends to group together, and that's what's leading to the increased health risks. Yeah. So talk us through that.

Sure. This is a great question. So metabolic syndrome is something that was identified, I'd say, maybe 22, 23 years ago and talked about a lot before then, but they came up with this cluster of symptoms. It's typically 5. Which are considered to be interconnected risk factors. So that is weight gain predominantly in the belly area around the abdominal wall, high blood pressure, right? So the person has hypertension and the, of the 5, typically there's 2 or 3 present. Sometimes all 5 are present. So the next ones would be high blood sugar. So it could be prediabetes, type 2 diabetes, or some other blood sugar dysregulation along with high triglycerides, that certain kind of fat in the blood, a certain blood lipid. Along with low HDL cholesterol. HDL is high-density lipoprotein cholesterol, and that's the one that's considered to be protective, fluffy, buoyant. And for women, as we age, we often get an increased amount of HDL cholesterol as a protection, which is great. Not everyone experiences that, but it's wonderful if it does happen as we get older. We often hear as women so many things that go wrong as we get older, but that's something that can go right.

That's the good news. OK, so if you— if a person start— if you're looking at your blood work and you can look at— now you know you're looking at the fasting glucose, you're looking at hemoglobin A1c, you can look at the insulin, fasting insulin level, and then you can also look at these other levels like the, the triglycerides and the HDL cholesterol, and then looking at your blood pressure. So you start to see, oh wow, if all of these things start to be affected, or even if 2 or 3 of them, then you, you can know that they're interrelated. Because I think it's, I think it's, um, one of the things that I find most common when I'm talking to patients is that— that's a surprise to them— is that most people don't realize that their blood sugar has an effect on their cholesterol levels. So maybe we can talk about that a little bit, like, what the heck, you know? Because for so long we're thinking, oh, cholesterol, we think of fat in our diet, but actually so much of the time cholesterol and triglycerides are related to the blood sugar. Right. And your carbs in your diet, right?

Yeah, definitely. It's one of the reasons why these things travel together. So just to be clear about this, there's this relationship, correlation, if you will, between heart disease and diabetes. And the thing they have in common is inflammation. And so in the presence of inflammation is where the damage happens. So someone can have cholesterol numbers of whatever level and be physically fit and still have a heart attack. Why? Inflammation. So you look at someone like, say, one of the trainers on that show, The Biggest Loser, you know, Bob Harper, who had a heart attack. And for him, he was in a gym when it happened, so he wasn't at home by himself. So thankfully, when he collapsed and fell off the bike, there were people right there to help and they got him treated immediately. And then they discovered he'd had a heart attack. And it turned out he had a familial cholesterol issue that was otherwise hidden. The man is beyond fit. So fitness was not the issue. I just want to be really clear. More than 50% of the people who show up in a Western medicine emergency room with heart attacks don't have abnormally high levels of cholesterol. What's hidden, what's not obvious, and too often doesn't get tested are the inflammatory markers. Things like hs-CRP, high sensitivity— excuse me, high sensitivity C-reactive protein. So if your lab test says CRP, that's not as specific. You want the hs-CRP. High sensitivity C-reactive protein, specific as a cardiovascular marker and an inflammatory marker because it lets you know whether or not you're in an inflamed state that matters for your heart health. If that's elevated and you have high blood sugar, you are now also at risk for not just increased risk of heart attack, but increased risk of stroke. Why? Because the cholesterol is inflamed. That's in your bloodstream. It makes it more sticky. When cholesterol is in the bloodstream, it's not just randomly doing harm. It's just going throughout your blood. Your blood lipids, your blood fats are there and they're normal. You know, cholesterol is the building block for all of your sex hormones. That's androgens, you know, testosterone, progesterone, estrogen, right? DHA. They all have that as a substrate. Cholesterol is not the enemy. What your body is doing with it is far more important. And I feel like there's so much misinformation out about that because people are just trying to bash cholesterol. I'm like, "I wish they were as excited about inflammation.

It's far more important." I completely agree, Beverly, because it's true. And as soon as, you know, a lot of times people go into the doctor's office and all the attention is on the cholesterol. And I'm like, "Wait a minute, that isn't even the major problem." We need to be making sure we're testing the blood sugar levels and testing the CRP to look for inflammation and addressing those things that's what's going to be preventing a heart attack or a stroke in the long run. And it's— yeah, I'm so glad you're mentioning that because people, you know, I think right now that's a real source of confusion.

Yes, definitely. It's a missed opportunity for healing, right? So if we talk about how humans heal, the title of your podcast, this is part of how you heal. And when you think about the marketing of pharmaceuticals and how much they promote things, It skews the conversation because again, the actual underlying mechanisms are not discussed. They're not promoted. And, you know, in a conventional medical setting, there frankly isn't the time to talk to people in depth about this. You're not going to get these concepts across in 7 to 12 minutes or less, plus all the other things that they have to cover in that visit. You know, the, the, the marketing and the financial incentive are simply not there. They're just not. It's conflict of interest. So, you know, to sum it up, it's just important that people educate themselves with real information, what actually works. And so inflammation is behind all of that. And that's why diabetes can drive so many different problems, whether it's gangrene and amputation, whether it is causing the kidneys to finally give up and shut down and go into CKD, chronic kidney disease, stage 4. And then the person is on dialysis for the rest of their life and awaiting a kidney transplant if they're able to find a match. And all of that goes with that. Changes in vision. That's another warning sign. If you find that you're starting to lose your vision, lose your visual field, things are getting less and less clear, and it's this creeping clouding of your vision, go get checked for diabetes. It's the number one reason people lose their vision and go blind. It isn't parasite infections anymore. It is diabetes. Other things with diabetes, wounds that won't heal, you know, problems with the immune system. Loss of sexual function in men, you know, erectile dysfunction and all of the promotion of the drugs when really what might be behind that could be the blood sugar and inflammation, things that cause the circulation in the smaller blood vessels to be compromised. Similarly for women, clitoral dysfunction or lack of arousal can absolutely be tied to blood sugar. You know, we just aren't taught that because particularly for women's health, there's nowhere near as much focus on sexual pleasure and fulfillment as there is for men. That's not right. We're the majority of the world's population, et cetera, et cetera. And so without diving into the politics of it all, I find it just not right. We need to make that a more equitable situation.

I also find, by the way, that the— that— because I help so many women with abnormal pap smears and HPV, and what I see in the research and clinically is that when women have higher blood sugar levels, they're more likely to test positive for HPV and have an abnormal Pap smear. So this is something that I also talk with them about is, hey, let's help get your blood sugar to optimal because it's only going to help your immune system protect you from HPV and other infections. Yeah, it helps with everything.

Blood sugar is connected to so many aspects of health, and it makes sense. Our blood goes everywhere.

It really does when you start to break it down like that.

Having Optimal cortisol and adrenaline levels is essential for health and longevity, and yet the stress in the present and in the past can affect our cortisol and adrenaline levels, causing them to be too high or too low. The thing is that we're not all affected by stress in the same way. So over the past two decades, I've been researching and discovering how to help my patients recover from stress, and I've identified the 5 stress types, which are the 5 common patterns of disruption in cortisol and adrenaline levels. The reason why this is so important is because the treatment is different. When cortisol is too high, we use different herbs, nutrients, and other modalities to bring levels back to optimal than if the levels are too low. So that's why I, through research, developed the Stress Type Quiz, which allows you in under 2 minutes to discover what likely your cortisol and adrenaline levels are. So then you can make decisions about which herbs, nutrients, and other healing activities to choose to help optimize your cortisol and adrenaline again and improve your health now and into the future. Just go to stress type quiz.com where you can take the quiz and take it from there.

I want to go back to emphasizing menopause because you talked about that briefly, like this is a time in women's life when this becomes more of a— in the forefront. And, and that's because as estrogen levels change, it affects our insulin function. So talk about that some more, insulin resistance and Why is it that with perimenopause and menopause that women have a harder time keeping their blood sugar in an optimal range?

Yeah, that shifts, you know. We can see this to some degree sometimes with shifts on the other end of the reproductive cycle. So as puberty unfurls, sometimes we will see right before a child has a growth spurt that they literally get like little chubby cheeks, like a little squirrel, like they've got acorns stuck in their cheeks. And then, whoo, here's this growth, right? Like they're storing up their energy in the form of that body fat and then boom, they just shoot right through it and they grow. So then on the other end of the reproductive window, as the reproductive window is closing for women, insulin resistance that had shown up for the teens, hopefully briefly, can show up again as menopause goes. And in that, it could be that there— unfortunately, if there are sleep issues, that's absolutely going to accelerate this. And boost up the insulin resistance. Sometimes women will have a brief peak and then it calms down on its own. If at that time this woman is not overly stressed, if at that time her sleep is in a great place, if at that time she's able to exercise and take care of herself and do strength training. Right. I always tell people self-care is not selfish. And some of us as women, frankly, we get tapped really hard. People expect a lot out of us, and we often don't always have the time, the ability to call on other people, the money, the influence and clout to have the resources that we all so richly deserve to have a peaceful time when we're in that menopausal transition moment. Unfortunately for a lot of women, that's when real chaos can unfurl, particularly if she's in any kind of a caregiver role, whether she's caregiving for parents or other people in her family household or neighborhood, her social situation, if she has children, you know, or not. Maybe at work it's a particularly demanding time if she has a career or if she has hourly work. Like, there's so many things that can unfurl as this is going on that can really mess up your metabolism and make you far more likely to be insulin resistant and to have it just stick. You know, that's just a real thing. And in some people, from their hereditary situation, from the genetics, can have a family history where, you know, at a certain age and phase, this is what the women in this family look like, independent of everything else. This is what you got. These are the cards you have been dealt, right? So you'll want to play them as best you can. And we haven't even talked about environmental influences, like all the strange things in the air, water, and food that also push, frankly, everybody towards insulin resistance. It's really a tough environment right now. To be well and stay well.

It's true. It's true because we are getting exposed through our air, our water, our food. And those— tell us more— that also influences our insulin's ability to move glucose, huh?

Absolutely. You know, look at the microplastics. And as they're finding more and more about the effect of the microplastics, they're finding them in people's brains, they're all over the bloodstream, they're in our organs. And, you know, I don't know about you, but I know I didn't give any permission for microplastics, but they're there.

No, I know. We're like, "Wait a minute!" And these invisible things we don't even know we're getting exposed to it. We didn't even know we were— it was coming in, let alone throwing things off. And, and they can stay in the body for years, if not decades, right? So it could be from years ago, and then now it's showing up. The same thing with mold toxins, right? And, and other environmental toxins from skincare products and so on. It just ends up increasing our risk. With this, once we know, then we can work on helping people to safely detoxify. Absolutely.

You know, like Dr. Maya Angelou said, once you know better, you can do better. But first we have to be aware. And I tell you, I just feel like it just feels so multifactorial. So rather than feel overwhelmed, I tell people, pick 1 or 2 things to make better that you feel you can realistically take charge of and feel good about. And that's one of the reasons why in the book it's broken down to 5 steps. Not 27 steps. And of the 5, only 2 or 3 really matter for any given person. I've yet to see anybody who needed to be fastidious about all 5. Usually 2 or 3 really make the difference. And I say embrace it and go make those changes. And it's quick. It doesn't have to take decades because frankly, the problem usually took years, if not decades, to show up. And you know so well, Doni, from your work with naturopathic medicine and your own expertise, The good news is it doesn't take the amount of time to help somebody as it took for them to get sick, thank goodness, right?

Yes. Healing is a little quicker. Yes. And we can— you can monitor along the way. You can use a continuous glucose monitor. You can recheck the hemoglobin A1C in 3 months and you can be excited about your progress. Be like, "Oh my gosh, I see it's improving. I can see—" That's what we want to do is we want to implement and then monitor and see what's working. Let's keep doing that. And then we can If it's not enough of a change, we can add, we can use— of course, there's so many herbs and nutrients that have also been shown to improve insulin function and reduce blood sugar levels that we can use that don't have side effects and don't, you know, that actually can help people heal by dropping inflammation and so on. And so this is why, as naturopathic doctors, we have so many more tools available to help people. But do you mind talking us through, like, what are, from the Yates Protocol, the 5 simple steps? And you're saying you don't even have to do all 5, but if you just list 5 and then maybe think about, okay, what are the 2, 1 or 2 that I can start with? Sure, sure.

So the 5 Steps to the ACE Protocol to Help You Fix Your Blood Sugar and Reverse Type 2 Diabetes, subtitle is Make Peace with Food and Never Feel Deprived Again. So in this, it's not an extremist approach at all. It's about finding that balance that works for your blood sugar. This way people can do it in a sustained way. So this is not a 2-week wonder. It's more like a 20-year success package. And in that, you know, I have worked for years to cull this down so it is personalizable. It's not a one-size-fits-all approach. Step number 1 is nutrition. That's going to be the grounding place, that bullseye of our target, because many people have just bad information about nutrition. And this isn't simply clean eating. No, no, it's the order in which you eat your foods, right? So starting with protein, and leafy green vegetables, fiber-rich foods. Those two together do so much for your blood sugar. They do so much for your satiation, your ability to tell, hey, I had enough to eat, right? And to avoid cravings, things like that. The next thing that you would eat in a nutritional order would be your healthy fats. That could be your seeds, your nuts, olive oil, things of that nature. And then you end it with the complex carbohydrates that have also resistant starch and they burn slowly. So your beans, peas, legumes, chickpeas, black beans, red beans, whatever it may be, that resistant starch feeds the good bacteria in your microbiome, in your gut, helps to slow the rise of any blood sugar, and also, again, helps you to feel full. It's so good. And so that's your order. And if for some reason you want to have a simple carbohydrate, just plain old sugary things, it's dead last. Shouldn't be at all, but if you're going to do it, dead last. Start off with the protein, leafy greens, and then—

Make sure the protein's in there before you go for The extra carbs, yes.

A lot of people, they go to the thing they like, and if they like sweets or they like savory, they start there. So if they want savory, they might start with, like, say, the biscuits and gravy. Or if they want sweet, they're going to start with the sugary thing. And it's the worst thing you could do because now you've already gotten on that blood sugar roller coaster. You're on there. Question is, how high are you going to go? Right? Yeah. Okay. Yes. So nutrition is going to be number one. Next on our hit list is meal timing. The time of day you eat your food matters for blood sugar regulation a lot. Sometimes people make some basic mistakes. One woman that I worked with, and she's in the book here, Maria, you know, she owned this wonderful Italian restaurant in San Francisco, and she and her husband ran it. And the thing was, when she came in, she was one of 12— she had seen, rather, 12 other— excuse me, 11 other doctors besides myself. So I was number 12, and her daughter brought her in. Yeah, right. So, you know, when that happens clinically, you know, there's a story here, right? And Oh, she was mad. But her daughter was just like, Mommy, you got to do this. And so I'm talking to the two of them and I'm getting the story and I realize she has seen all these other experts, but nobody asked this woman when she ate her food. And so for her, she was eating like heavy, heavy food. And we all know Italian cuisine has light cuisine. It can be light.

It can be. Yeah. You just have to choose that.

Yeah. Yeah. But she was choosing the fettuccine Alfredo. I see. Okay. Yes. The other end of that cuisine. And so she and her husband would have a big old heaping plate or two of that. She'd go to sleep a half hour after that. So she's eating at 11:30 and in bed by midnight. And I'm going, oh my God, this is not— so she had high blood pressure, high blood sugar. She had cholesterol profiles that were beyond unfriendly. Talk about inflammatory. She had sleep apnea. She had gastroesophageal reflux disease, also known as heartburn. She was almost as wide as she was tall. You know, she was really severely overweight and she just had so many health problems. So I was like, okay, rather than overwhelm this woman with 85 things to do, it's like, we're going to work on your meal timing. How about that? And she was like, meal timing? I said, yes, your meal timing. You own a restaurant. You can absolutely eat whatever you want when you want. You have a staff, right? You're not the only person. Like, no, she's talking about all this stuff. I'm like, great. Guess what? We're going to carve out time for you. You're going to eat at 6:00. I'm not going to ask you when you want to eat. You're going to eat at 6:00. I just need you to eat a lot earlier. And so that was where we started the journey. Why did I choose that? Well, clinically, I knew what the heartburn was about. She was eating all that heavy food. It was going into her stomach and then she was immediately lying down. So she eats it. She's vertical. Half hour later, she's lying flat trying to sleep. This big old bunch of food now is pushing up against that sphincter. So her heart— her acid, her stomach acid is going in, is getting pushed up to her esophagus, her throat area. This area is not built for that hydrochloric acid from the stomach. Of course she has heartburn. So I thought to myself, if this woman can get out of that pain, this might give her some incentive and she'll also sleep better. Maybe we can get a lot done with that one move. Well, it worked just like I thought it would. And she was like, wow, my heartburn is gone. It's like, great, let's go on to the next thing. And so I walked with her on that path as her guide, and we just turned it back, the hands of time, one by one by one, you know. And one time she looked straight at me, she said, I'm never going to go to the gym to exercise. I said, great, I'm not going to ask you to. We're going to build it into your work. And so then I had her out with the crew when they were unloading the pallets of food for the restaurant. Now she's doing the strength training. So I didn't explain all that to her. I just had her do it. And then as time went by, I explained why it mattered. So that's the thing. You got to meet people where they are to help them get where they want to go. And so it was a wonderful story because so much got better for her in a straightforward, quick way. But she got to be the hero on her own healing journey. And so, you know, as a naturopathic doctor, how important it is to meet people where they are.

Absolutely. It makes such a huge difference. And, and also for her to, you know, for something Sometimes we don't realize what we're doing. Like, she didn't realize, oh, I'm eating and going straight to bed. She was probably just used to that and exhausted. And so sometimes you need someone else on the outside to be able to go, wait a minute, we can change this. Let's just move the time of day that you eat, and you're in a restaurant so they can bring you food whenever you want. Let's just— and sometimes as women, I think we're less likely to ask for what we need, right? We just kind of like, oh, I'm just going to eat when I've taken care of everyone else, and before I fall into bed, I'm going to eat. But what if we actually say, hey, you know what, actually, for my body and well-being, I need to eat at this time? And it's a new thing sometimes to, to voice our needs. And so how wonderful that you just helped her to do that, you know, helped her to say, hey, here's the words for saying I need to eat at 6 PM. My doctor told me so.

Right. You know, it's like a nutrition prescription for her. That absolutely worked, you know, to eat at 6. And then we got her eating at 6 and then changed what she was eating. But I didn't do both at the same time because for most people that's overwhelming.

Amazing. Okay, so those were two. One was the order of what you're eating. Then second one was the time you're eating. What's the next step?

Yeah, so we've touched on nutrition and mealtime. The next one is stress. Stress is completely underappreciated in its role to destroy blood sugar numbers. If someone has chronic stress or a particularly severe episode of stress, they can wind up with type 2 diabetes very easily. And that's not explained. And this is often one of the reasons why people get blamed for this diagnosis when it's absolutely not appropriate. I have not found blaming, shaming, judgment, or stigma to be healing things for anyone. It's not effective. And some people do respond more if you push or if you hug. Those are different approaches. But having those judgmental, shamey, blamey, you know, approaches, I just feel like it has no business here because to your point, how humans heal, that ain't it.

Okay, so I completely agree.

You know, I love that. Yeah, we have our inner critic between our own. We don't need anybody else in that bus, you know. So for stress, just know that stress hormones, whether it's cortisol as the primary stress hormone, you know, in the book I talk about cortisol nation. And how many people, many of us live today in cortisol nation where we're just really too stressed. Lives are too demanding. We don't have enough time to recover. And we have one strange thing after another to deal with. And we're like, whoa, what's happening? Right. We've got your neurotransmitters of adrenaline, noradrenaline. It's just too much. And we don't have the healing, calming resets throughout our day or throughout our week or a month. And it's tough. And so all of that adds to blood sugar dysregulation. Of course, we see these rising tides of prediabetes and type 2 diabetes, not only in our nation but internationally. The numbers are staggering, absolutely staggering. We've got over 586 million people with the problem, and that's the ones that are diagnosed. And it's been thought that more than half of the people who have prediabetes are not yet diagnosed. And the same is for type 2. Wow. Wow, this is not sustainable. It's not.

And we have to— it's on each of us to start to choose differently, to start to, like you said, become aware, and then we can choose differently.

Yeah, absolutely. So the next one on the list here for the 5 steps, number 4, is sleep. And because when we're asleep, we're not necessarily aware of what's going on, what should be happening is when you go to sleep, your blood sugar resets to the healthy level. So if it wasn't already there by the time you went to bed, it should be there when you wake up in the morning. Ideally, your fasting glucose numbers, your fasting blood sugar numbers when you awaken in the morning should be somewhere between 70 to 99. I love to see them in the 80s because then I know it's not too low and know we're not sneaking up too high. But 70 to 99, I'll take it. Um, what can happen is for some people, when blood sugar doesn't reset to that healthy zone in their sleep, Sometimes they either have what's called the dawn phenomenon, and so their blood sugar has gone up in the middle of the night or it's crashed. If it's crashed in the middle of the night, they go hypoglycemia, then the body senses alarm, it's in danger. And so it releases our friend cortisol, which is going to release more blood sugar, right? There's all of these things going on. This person thinks they're asleep. You would think that'd be the most peaceful part of their day. And for some people, that ain't it. That's not what's happening. Right. And then number 5 is exercise. But aerobic exercise by itself, as awesome as it is for our mind, for our soul, for our heart, for the cardiovascular system, the best thing you can do for blood sugar, particularly if you're in trouble, is strength training. It's the quickest way out of the problem. Why? Because your muscles, when you're exercising, love glucose. They want it. They literally have glucose receptors on all those cells that slurp it up. And so when you're exercising, if you're using a CGM, continuous glucose monitor, do not worry if you see your blood sugar go up. It's going up because your body is responding to the demand of the work you're putting on it. Blood sugar can rise with exercise and it is not a problem. You would expect to see it come back to a healthy place in an hour or so, a half hour, maybe an hour and a half. Don't freak out if your blood sugar goes up when you're exercising. It is a normal physiologic response. I love it.

Thank you so much. Because as people start to use their continuous glucose monitor, they start to see these patterns and you start to go, "Okay, what does this mean? How do I decipher this?" And this is something I'll tell patients, "Okay, send me, send me screenshots," or, "Let me log into your app with you and let's look through it," and we start to figure out the patterns and we can, we can dissect it and then we can solve the mystery. I wanted to, if you don't mind, I wanted to see if we could just talk a Before we wrap up in this session, thank you so much for your time, Dr. Beverly, is about weight gain. Because you mentioned how, you know, when, when our blood sugar stays too high and our insulin can't get it into our cells, one of the options is the body puts it into belly fat or stores it somewhere in, in our weight. But of course, then it's not the first thing that gets burned when we— when, you know, we think, oh, it's okay, my body's gonna use it, I can eat more now because my body's gonna use it later, but it doesn't work that way. Our body puts it into storage and then it stays in storage and our body gets, uh, energy from a different source. So then we end up with this extra weight gain. And especially when we talk about women in menopause time of their life where they start to notice they're gaining weight around their belly and their waist is growing and they're like, why am I gaining weight? And it's— can be connected to the blood sugar levels even if it's not to the point of diabetes. So I just wonder if you can help us through this because I know right now it's all the trend is the GLP-1s and how, you know, how people are not, you know, using them for diabetes, but also thinking about them when they're dealing with, "How do I lose weight?" So maybe you can talk about that a little bit for us?

Yeah, so it's an interesting set of things that are going on right now. And one of the tipping points, you know, that I always wonder about is I look at pictures of women from decades ago and you can look at pictures of people's family in multiple generations and you cannot help but notice how body shapes and sizes have shifted in a short period of time. I mean, short, right? So this is quick in the span of less than one human generation. So in the span of less than 20 to 25 years. And I think that there's a number of dynamics at play. I think because of the fact that we are in Cortisol Nation and so stressed, it is interfering even more with the natural drop in menopause of estrogen and progesterone. So with those two, typically there can be that increased insulin resistance and cortisol can become more predominant. Some women find if they do fasting of any kind that they get these spikes in cortisol that just countermand anything that the fasting was supposed to do to help them. Some women do just fine with intermittent fasting or other fasting approaches or water fast. Some of them absolutely just get aggravated and don't get the benefits. Some of us are more sensitive to those things than others. I think in terms of weight loss, weight gain, having a healthy weight and metabolism, you know, if you look at diabetes around the world for type 2 diabetes, you'll find that about 40% of the people who have type 2 diabetes are underweight or emaciated. They're too thin. They're simply too thin. And 60% are overweight or obese. So it's just really interesting that the same problem can show up physically so differently. And so, you know, some people drive by doctors and make an assumption about someone's backstory without knowing their history. So those details matter. I think in that menopause, women, for many of us, some of us get a chance to have a hormonal transition that is calm and reasonable. And so we aren't going to have those genes. If we have the genes towards weight gain, they won't be kicked so strong. And other people, the stage was already set either from prior exhaustion, prior high stress, prior trauma, family genetics, whatever it might be. And so some people are absolutely more vulnerable. By the same token, some people aren't as vulnerable or genetically they're quite lean and they're going to stay lean. It's not going to matter what happens in their life. If they eat poorly, if they eat unhealthy foods, they won't look like it. And so it's just a— it's a complex conversation to navigate. So I'm always a fan of, as I know you are, test, don't guess, get objective assessment, find out what your hormonal balance is or imbalance, and then to address it ideally with bioidentical hormone replacement therapy or whatever might be indicated to help you live your best life. You know, we think about the metabolism, we think about thyroid health. That's a big player. Your genetics, your environment, the foods you're eating. Do you get good sleep? What's your stress level like? What kind of exercise are you doing and how frequently? There's a lot of factors to try to balance, you know.

And when you can, like you— like we talked about with your 5 steps, we can address those things and see what's possible. I know that I see a lot of times with patients that not only their blood sugar levels improve and their hemoglobin A1C, but also they, if they needed to lose weight, often they find that they are losing those extra pounds and they are sometimes surprised. They're like, oh my gosh, who knew just by working on balancing my blood sugar that I would lose those extra pounds? And so it's such a, I think it's a great way to put the focus on, hey, let me do the thing that's going to help my body get healthier. Overall, and that extra weight just starts to go away because the extra weight was a reflection of the original imbalance, right?

Yeah, if that's the issue. So, you know, for people who work on their blood sugar, like right now we're working on— we have a group challenge that we're doing for 21 days for a blood sugar challenge, and people are reporting that their clothes are fitting better or that they've lost weight. But that's not the focus of the challenge. The focus is correct the blood sugar because it's the central issue. And then the other goodness can unfurl from that. And that's the good news. Sometimes solving one problem and improving it can shake loose whatever the vulnerabilities are and improve multiple other things because they are related. And even if a person is on a—

let's say they're on a medication for diabetes or they're, or say they're taking a GLP-1 agonist, they can take these steps at the same time. And, in fact, probably it's a better idea to take these steps at the same time as taking the medication so you can require less medication.

So it's an interesting thing watching what's going on with the GLP-1s. And one of the benefits of the GLP-1s is it quiets food noise. So for people who are plagued with food noise, they just obsess about food. They cannot stop thinking about it. This is a gift. And I'm all for getting people in a situation where they can feel comfortable and good in their own skin. I think a lot of what goes on in today's world comes from a place of not feeling good in one's skin, just to put that simply. Meanwhile, the part of the commercial they say really fast or sometimes delete, or it's in the teeny tiny print, are these 5 steps that I'm talking about. Yes, nutrition. It is the meal timing. It is the stress. It is the sleep. It is the strength training emphasis of the exercise. So if someone is on GLP-1s, they should still be doing the things that I have packaged up as the ACE protocol. If they ever go to discontinue those meds, often this is the stuff they never learned to begin with. So, you know, it gives people more of a chance if they come off of those meds to not completely regain their weight or have their A1C just run away from them. They still need these lifestyle steps and these tools. It's a precious thing to be able to understand how your own body works and make it your friend. And you're friends with your body. You feel comfortable in the skin you're in. Rather than you're constantly at a battle or you feel like your body is somehow attacking you or has betrayed you. That's not a healthy place to be.

I always say we didn't come with an instruction manual, so we have to figure it out as we go. And I love that your 5 steps from the Yates Protocol really help people to understand their body and what it needs. It's almost like you then have your, your creating your own instruction manual, and then you can use that going forward, no matter what else is going on. Oh my gosh, thank you so much, Dr. Beverly Yates, for joining us today and explaining everything so clearly. I think now everybody's going to have a much better sense of like, "Okay, what the heck is going on with my blood sugar and where do I begin?" So thank you so much. I really appreciate it. You're welcome.

I'm glad to be here with you and your audience. Thank you for this invitation. And there it is.

Ta-da! Beautiful. You're giving me goosebumps. The Yates Protocol, which every— we'll put a link so everyone can click and find it. And you also have it as an audiobook, right?

Yes, absolutely. People can go to the preferred bookseller of choice with that link and they can get it from wherever they would like. And if you want to point a library to it, whatever, we're open to it. People have been reporting that to me, which has been fun. I get information from all over the place. People are seeing it, so that's good.

Beautiful. Wow, congratulations. And yeah, what a beautiful gift you're giving to the world to say, hey, here's things you can do to make a huge difference in your health and your future. And so thanks again, and thanks everyone for joining us today at How Humans Heal. If you're new, I welcome you to subscribe so you don't miss the next episode. Take care, everyone. Talk to you soon. Thank you so much, Dr. Beverly. You're very welcome.

Take care.

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