Mastering Blood Sugar: The Yates Protocol Explained

Hi everybody, I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most natural way. Hi everyone, welcome to another episode on the Holistic Dentistry Show. I am so excited to have with us today Dr. Beverly Yates, and she and I know each other now for a few years through our Mindshare community, but we connected over the topic of diabetes because as a periodontist, I always, always check to see if somebody has bleeding gums that are uncontrolled. Hey, do you have diabetes? And also, it is so, so important for periodontal disease purposes to treat the diabetes in order to actually get control of the gums. So today I want to talk about all about diabetes, what's new, how do we treat it holistically. And I know there's some new gadgets maybe that we can measure the blood sugar with, and so we can talk about that. So, Dr. Yates, welcome to the show.

Hey, Dr. Sanda Moldovan, I am delighted to be here. Thank you for the invitation. I've appreciated how our professional relationship has grown over the years. As you know, and we'll talk about separately, my mom had quite an adventure with oral health that really was completely avoidable. But at the time, we didn't know about biological dentistry. And, you know, when we think about diabetes, blood sugar, blood sugar regulation, there's so many things that people just don't know. So we're here to dispel myths, Spread real information and lift up actual lived experiences.

Yay, I'm excited. But yeah, I know you're on a mission to help 3 million people. That's a lot of people heal from type 2 diabetes and prediabetes, which is pretty amazing.

Yeah, definitely. No, this is one of those chronic illnesses, in my opinion, it's the most sensitive chronic illness that responds to lifestyle measures. This is the one that you really have the opportunity to get to remission and ideally to reversal. But you got to know what to do because today's world does not make this easy. The old advice of just eat less and move more is not enough. And in fact, for a lot of people, they're already doing that. Now what? You know?

Exactly. So true. But I want to talk about you first because, you know, you're an internationally recognized speaker today, an expert in diabetes and heart disease, but you started as an engineer.

I did. I did.

That was so amazing. Tell me, where did you— how did you go from an engineer? You said one day, okay, I'm just going to go to naturopathic school, or how did that come about? What drove that decision?

Yeah, I have to say, of all the questions I get, that is by far the number one question. What's the connection? So, you know, like, let's connect the dots here. I started out as an MIT electrical engineer, graduated from school, did all the work, and I went to MIT at a time, you know, the Massachusetts Institute of Technology did not have a lot of women at that point. We were probably fewer than 20%. Of the undergraduate student body in that moment. And in that, I came, like so many electrical engineers, to Silicon Valley. This was before Silicon Valley was Silicon Valley. This was in the mid-'80s. This was as the boom was starting, was going to start happening. The semiconductor industry was well established at that point, but other things were going to come down the pike. And along my journey there as an engineer, I've always loved science and math. It just speaks to my soul in a very interesting way. The challenge was for me, the professional work culture was not a good fit, and I felt very isolated and left out of things in a really weird way. You know, women weren't particularly welcome, and people of color, as far as I can tell, weren't particularly welcome either. And I was all of the things. So I, I really didn't appreciate that environment. It wasn't a good fit for me. Meanwhile, I still had this love of facts, of science, of data, of research. And so we moved from Silicon Valley, my then boyfriend and myself, we became fiancés when we moved to the Pacific Northwest where it's very rainy. Unfortunately for me, it turns out I'm quite sensitive to mold. And at that time there was so much rain in the Portland metro area, you know, it's basically a temperate rainforest, or it was. With climate change, that seems to be shifting. If you'd ever told me then they could have wildfires in the Pacific Northwest, I'd say you're right. Things have changed and they've changed quickly. But back then it was—

We lived in Portland for 1 year, in Portland, Oregon.

I hated the rain.

Way, way, way too much rain for me.

It's too rainy and gray, right? We used to escape on weekends to places warm and sunny. Eventually we figured out we would need to move, but that mold damn near killed me. And, uh, I'm very sensitive to it, it turned out. And so, the place that we were renting, a very nice home, it had black mold, but did not smell musty. We had no idea. We happened one day to take off a baseboard. We wanted to get some information for the property owner on an unrelated matter with the carpet. Only to discover there's all this black mold. And then it explained my strange symptoms. I used to have these profound, deep, body-wracking sneezes. Oh my God, the congestion. My brain felt so foggy. My natural energy— I'm blessed to have the energy of 5 people— it went down to like half a person. I mean, you know, here I am, 22, 23, 24 years old. I'm in the prime of life. There's no way I shouldn't be feeling fabulous, right? Yeah.

Did you know about black mold back then? Did you even know that was like a thing?

I did not know about that. Any of this stuff, no sinus drainage, black mold, none of it. Right. And so again, I'm an engineer, so this is all new to me, but I'm feeling unwell and I know I don't want my whole life to unfold this way. I went to see a conventional medical doctor, not knowing of any other options. That person prescribed a series of desensitizing injections for me. I think they were trying to do something with my immune system to calm that response. My problems with it were one, it wasn't effective. And as an engineer, I care about results. Very much as a naturopathic physician. I care about results very much. We want the result, right? Number 2, I was like, what are you all shooting me up with? I have the science background. Give me the big words. Tell me, what is it? Right? Like, I don't just want to get injections every week for 2 years, 3 years. And they would never explain. And I felt really disrespected and insulted and like I was just a piece of meat. Like, just come in and get your shot and leave, lady. Like, that seemed to be the vibe. And I was like, okay, no. No, I'm out. This is not, this is not working. I've been into it for a year now. Meanwhile, my husband, my now husband, then fiancé, cuz we got engaged and we moved up to Portland. He was working with a person at Intel in the west side of the Portland metro area who had gotten wonderful health results from seeing a licensed doctor of naturopathic medicine, right? So Oregon is one of the states that licenses naturopathic medicine. So I went to see this wonderful naturopathic physician and you know what, Dr. Sanda Moldovanova Moldovanova, I was shocked. Our first visit, he spent an actual hour with me and the man looked me in the eye and listened to what I had to say. He asked me really great questions about how I was feeling, what was going on with this fatigue. You know, I had been a varsity athlete with Division III MIT for the women's basketball team, other sports, et cetera. And I had like no energy. I wasn't playing softball, volleyball, you know, I wasn't doing any of the things I would normally do, rock climbing, just, you know, no energy. So as we uncovered it, I saw him for about 3 visits and there was dramatic change in my symptoms, which meant my quality of life improved quickly. And from there, I was like, wow, talk about results-oriented. This is amazing. I see one person for a year continue to feel horrible. I see another person briefly feel a whole lot better. Now we're on a healing path, a healing journey. What is this naturopathic medicine stuff? I've never heard of it. And so that uncovered a whole nother career opportunity for me. And a few years later, I changed careers because I realized it would be a better fit. So this way, these problem-solving skills I have, this analytical brain, could be in the service of people's health, particularly with more complicated situations where it may not be obvious what's wrong. And so the whole idea of, of discovering and dealing with the root cause became prominent in that journey.

Yeah. So, so you became a naturopathic physician and, uh, did you start with a brick and mortar practice at the time?

Back in the day. Yeah, absolutely. Brick-and-mortar practice. And as a solo practitioner, sometimes I was part of a larger healthcare entity. And then when we moved to Hawaii, had a bigger clinic. I had another naturopathic physician who worked with me, a wonderful woman. I miss her. She had a midwifery practice in addition to naturopathic medicine. And we were a great pair, you know, we could really support each other. So if we were away, the other one could pick up the slack and I could split my schedule. At the time, I did not have children, so I had some days of the week where I was in the office earlier and some days of the week later to meet what the patients needed because there in Hawaii, a lot of people are in the service industry and the tourist industry. So they might work earlier hours or they might work later hours. This way I could catch what they needed and that let me go and be in the ocean and go snorkeling and just enjoy and have a quality of life that I couldn't have had without that split schedule. So I felt like that worked for all of us. That's beautiful.

And then now you're specializing in diabetes, you published a book on diabetes, and you're about to have another one.

Yay!

There it is, The 8-Protocol: Simple Steps to Fix Your Blood Sugar and Reverse Type 2 Diabetes. A lot of people actually don't even know you can reverse type 2 diabetes.

They don't. They don't get that message. And, you know, part of the issue, honestly, Dr. Sanda Moldovanova, is that we, at least here in the United States, our healthcare system is actually a sick care system. It's about disease management. It certainly isn't about helping people with that kind of chronic illness. Get a hold of it, understand what are the things that they actually can do for themselves. What can you control? Some things you can't control, but for the things you absolutely can control, what's going to be the most sensitive to help you get out of blood sugar danger and back to the healthy zone? That's just not what the vibe is. It's usually about pills and injections. And there's a vat really of shame, of blame, of stigmatization, sometimes judgment, and certainly demonization of the people who have type 2 diabetes or prediabetes. There's a thousand assumptions that are made. Before the person ever has a chance to sit down and say what their experience has been. In fact, a lot of practitioners, whether it's doctors, nurses, therapists, counselors, whoever sees them, physician's assistants, don't ask those open-ended questions. They make assumptions about what got the person to the dangerous levels that get you the diagnosis of type 2 diabetes when it comes to your blood sugar.

Yeah. So, so speaking of diagnosis, like how do you diagnose somebody? Let's say they come in the office, What are some of the symptoms actually that someone might have that might indicate they have diabetes?

In the earlier stages, unfortunately, and this is one of the hallmarks of this disease, and it might be why some of the clinicians don't take it very seriously, the symptoms can be very subtle and quiet. So the person might notice a gradual shift and loss in their energy. They're becoming increasingly fatigued without having a more physically demanding life. For many people, They'll notice, "Boy, I used to be able to do blah, blah, blah, but now, God, I don't even want to get off the couch." Other people will notice changes in their skin, right? So your skin might develop skin tags around your neckline typically, maybe in your armpits, maybe in your groin, under your breasts if you're a woman, or if you're a man for that matter, if you have significant mammary tissue, you know, any place that's sweaty where skin comes together, you may well have changes in skin color and the development of skin tags. The changes in skin color is called acanthosis nigricans, and the skin tags are something that you can readily observe for yourself. Like, particularly for women, we might see them, I think of it as like a necklace around the neckline. There's often multiple tags. Sometimes they're in the back. With the skin color changes called acanthosis nigricans, that can get skin that changes color relative to whatever your baseline skin color is. It will be darker and the texture of the skin might feel a bit velvety. To the touch. So even if you don't have eyes in the back of your head, if you get in a mirror and you use your smartphone to take a picture in the back, if you live alone, or if you're at a doctor's office, they can do an examination. There's a lot of ways to determine this. Those are great classic signs of insulin resistance and often are the leading precursor symptoms to the actual diagnosis. Many people are never screened. And so for yourself as a dentist and for all of your colleagues as dentists, you are great partners in the fight to help people understand whether or not they have diabetes because people who have bleeding gums who have good oral hygiene, it could be a symptom of diabetes. It could be in combination with maybe the pH of the mouth isn't right, the microbiome for the mouth isn't right. If they've been on multiple rounds of antibiotics, there's lots of things that can set up this whole situation.

Yes, but now I'm going to be looking at their neck too, because I did not know about the skin tag.

Yeah, yeah, yeah, because you're right there, you're here and just, you know, have a look, you know, let them know. And if you see a collar, like 5, 6 skin tags, change of color relative to their own base color, however richly melanated their skin is, that skin will be darker. You can catch it. The same for gynecologists, because they're going to see armpits, especially women, you know, they're checking for their breasts, your vaginal area. For men, the same thing around the penis and the scrotum. Again, there are telltale skin color changes. It's absolutely readily observable for you just as a person with a body, as well as the health professional you see.

So then, okay, if you suspect somebody has diabetes, what kind of lab test do you do for screening? And can this be done at home, by the way, or people need to go to an office?

Here's the good news. Now, different than when I first started practice over 30 years ago, now these lab tests are available over the counter. People can get them and order them for themselves. They may not know how to interpret it, but at least they can get the data and then go to someone with those numbers. So let's get some definitions out of, um, set up here. I'm gonna go through the lab tests and then there's one in particular. I'm gonna give you the ranges so that people have it clear in their head. What's reversal? What's remission? What is she talking about? Okay. Oh, everybody probably has heard, or most of us have heard of the A1C because we have ads now that promote medications, prescription drugs where people are singing and dancing and talking about an A1C. Okay, we know that, right? The abbreviation is A1C. It stands for glycosylated hemoglobin, A1C, and it's looking at the amount of blood sugar that literally is stuck on the heme molecule on your red blood cell. Red blood cells deliver oxygen in your body. So through their magic, they like release carbon dioxide and bring in the oxygen. And so we don't want them gummed up with extra glucose, also known as blood sugar. Otherwise, it interferes with these very basic functions, thus the fatigue. Okay, so that's one. Another is your fasting morning blood sugar number. That one gives us a really good idea of how well your body regulates when you're asleep. Now, here's the news. Think about it. When you're asleep, right? What's true when you're asleep? You're fasting. You are not eating. You're not drinking because you're asleep. Exactly. We have yet to find anybody to hack that one, right? That wouldn't work.

Yes. No, not a thing.

Not yet. I hope not. So that's a beautiful healing opportunity every night when you go to sleep for your blood sugar to reset and get to the healthy zone if it wasn't there when you went to bed. For some of us, our sleep is where things go wrong. Sleep or stress, either one can run off with your blood sugar and cause you to become a type 2 diabetic, even if you've got a handle on all the other lifestyle factors, which we'll cover when we talk about the Yates Protocol. So your fasting blood sugar numbers ideally are at 99 or under. So 70 to 99 is a good range. I personally like to see people 75, not too low, 85, 89, 90. I think that is great glycemic control. Fancy way to say good blood sugar control. At 101, 100, 101, 124, that is— can be considered a prediabetes range. And a fasting blood sugar number, those morning numbers before you've eaten anything, that can be, um, if you're at 125 or higher, that's considered type 2 diabetes. That's one. Okay. We're gonna go through the A1C later because we need a little more nuance there. Other lab tests that are helpful, one is the C-peptide. That's looking at your function for your pancreas, cuz we wanna get an idea of how that's doing relative to the production of insulin and its ability to deal with blood sugar. We wanna see those C-peptide numbers lower. You look at the reference range for the lab and you wanna see it in a lower to intermediate range. You don't wanna see it high because if the pancreas is starting to struggle, this can be a precursor to letting you know for the problem. The wildness now is different than when I went to naturopathic medical school. Frankly, anybody's medical school. It used to be type 1 diabetes was known as juvenile onset diabetes because kids is who it showed up in, not adults. Unfortunately, we now have people even as old as their 40s or 50s showing up with type 1 diabetes. We also have children as young as age 8 showing up with type 2 diabetes, which is another catastrophe because that shouldn't be happening for so many reasons, right? So we've got this crisscross phenomenon, older people with type 1, younger people with type 2. Okay. The next lab test would be cystatin C. Let me spell that. C-Y-S-T-A-T-I-N. Dr. Sanda Moldovanova, and that can be a measure of your kidney function. Another early warning to let you know whether or not your kidneys might be under some kind of threat. Kidney disease in its earliest stages tends to be silent and also isn't often screened for. If you have any family history of kidney problems or diabetes, I would encourage you to add that to the list of things you check for. And then the final one would be fasting insulin. Fasting insulin gives us a clue. When you aren't eating, when you're in a fasted state, your fasting insulin should be low. Doesn't that make sense? You're not putting any demand on that system. If your fasting insulin starts rising over the course of, say, months or years, keep an eye on that one and start being proactive to do all you can to get that number back. You want it under 10. Anything from like, say, 10 to 19, 20, warning, time to get on those lifestyle things that are in the Eights Protocol. 20 or higher, uh-oh.

Yeah, exactly. I've had a patient actually in the dental office and I was very suspicious that he had diabetes, really a lot of inflammation and uncontrolled gum disease. And I was about to take out a tooth. I'm like, you know, I don't feel comfortable. I'm like, let me check your A1C. So sure enough, we have one of those blood spot tests for A1C. I think it took like 30 minutes or something. You know, you put it in this machine and it gave us the A1C number. It was like 13 or 14.

Whoa.

And I said—

We were supposed to be in the hospital. Exactly.

So I did not do an extraction. No, that's just— we have some dentists listening to this. Super important to check your A1C for patients in the office, uh, because— and what I did is I put them on antibiotics because I had an infection, and we have to get that, that A1C down. Exactly.

So high, their poor immune system is struggling. Those white blood cells are trying to swim through all that extra glucose and they're not able to be effective.

Yeah, yeah, yeah. And, and we can see poor poor healing for people.

Yeah, it makes sense though, right? Because the whole works is gummed up literally with too much blood sugar, too much glucose.

So my question to you is like, let's say somebody has an A1C like this, if they do the right lifestyle factors and interventions, how soon can we get that down to like, let's say 6, 7, or at least a normal range?

Yeah, procedure, you can see quick changes if they are committed to doing their parts. So you could see them get into the 6s or 7s within 3 months. I think that's realistic.

Yeah.

They might need medication for that first month or two to really give them a boost. And then from there, I want to always make sure people don't have magical thinking. They need to do the lifestyle elements, right? So when you're thinking about it, when somebody's coming in with a super high A1C, it's a 9, it's a 10, God forbid it is a 13 or 14, that's hospital time, right? Once they're out of that immediate danger, then they need to be on top of their game and have some clarity around what it is that's going to work for them, right? So let's talk about the numbers for A1C. The A1C for a type 2 diabetes diagnosis is defined as an A1C of 6.5 and higher. Prediabetes is defined as an A1C of 5.7 to 6.4. That's a range. A healthy level for your blood sugar is considered to be an A1C of 5.6 or lower. Ideally, the person can get to like, say, 4.8, 5.2, 5.3. You know, if you're dancing around 5.5, 5.6, I wouldn't have a catastrophe about that. I think that's okay. But do your best to get lower and lower, lower, because you're out of blood sugar danger. And that way, if you get a life surprise, if you get a big shock, accident, something like that, it doesn't shove you then to the higher numbers. You'll have more room, if you will, just for life's unexpected events. Having said that, the reason I designed the Yates Protocol was I couldn't help but notice in the mid-2000s on this steady stream and uptick of people coming in who had insulin resistance, who had polycystic ovarian syndrome, which is a very specific set of blood sugar dysregulation, prediabetes, type 2 diabetes coming into my clinic. And what I also know is people coming in who are younger, younger, and younger, and I'm going, oh my God, what is happening? I feel like we're all in the midst of a giant experiment whose outcome is unknown. And so with that, the ACE Protocol has 5 simple steps. It's nutrition. This will always be a focus. What you eat, what you drink matters. And next is meal timing. When you do it matters too. It can be a huge part of the puzzle for people. Stress. Stress is a big deal. Stress can mess up blood sugar all by itself. And if you have enough chronic stress, you may become a type 2 diabetic even though you aren't eating badly and you are exercising. Number 4 would be sleep. Chronic poor sleep, disordered sleep, like say sleep apnea, other kinds of sleep disorders can cause type 2 diabetes all by themselves, even if you've got everything else right. And then finally, one of the things I like to emphasize is exercise, especially strength training. Strength training more so than cardio, cardio can do wonders for blood sugar control. And the thing about strength training is think of it as a second insulin. Some of us look at movement as medicine, not movement as punishment. And all exercise is good exercise when you look at this. And you can think of exercise as your second insulin and the fastest way to increasing insulin sensitivity and decreasing insulin resistance. You want that.

I love it. I'll thank you for, for kind of summarizing that, but I'd like to go back to each of these and kind of dissect it a little topic because your book is going to be out very shortly.

Yeah.

So, and we're going to put the link, The AIDS Protocol, down in the show notes where you can purchase it. Nutrition, let's, let's go through that. Like, what's the problem today? What are most people doing and what can they change in order to have better nutrition?

Oh boy. Okay. So we're going to try and be concise.

That could be a whole hour discussion.

Right, right. That's a whole separate podcast. We're going to do our best though to be concise here.

Here's the deal, folks. Most of them, you know, let's say they just got diagnosed with diabetes, some key nutrients that are important to heal.

Here's the deal. The kinds of foods you eat and the order in which you eat them are going to be your fastest path to success. This is the things we're not taught. So your proteins and your leafy greens will be your blood sugar anchors. Your healthy fats help you to feel satiated and full, to feel satisfied and keep you from overeating. Complex carbohydrates, your resistant starch, your slow-burning carbs, are the ones that are going to be your steady drumbeat, if you will. And if you think about it in terms of your macros, it's ideal to have your proteins, your leafy greens first. Proteins, because again, they help with satiation, they help you feel satisfied, keep you from overeating, they help your blood sugar stay even. Your leafy greens, that fiber is fabulous. It's so good for your gut, it's good for your microbiome, for your mouth and your gut. And the other thing that fiber does is that we don't talk about, it absorbs both your excess blood sugar along with unfriendly kinds of cholesterol. So you're getting a lot done with that fiber. So when your mama wants you to eat those greens, she's telling you something important, right? And for some of us kids, we didn't like it, but often we can develop that taste as adults. And if this is a big change for your eating, please be kind to yourself. Give yourself 3 weeks to really change your palate. Your taste buds on your tongue turn over every 10 to 14 days. So give yourself a full 2 cycles. And improve your nutrition. So if you're not making friends and eating leafy green vegetables, now is the time. It will pay you back so richly. And if you aren't someone who naturally has a palate that enjoys those flavors, don't even worry about it. Because think about it, that's a hell of a lot less expensive than these prescription meds. It's cheaper and it's good for you in so many ways.

Yeah, yeah, absolutely. Like, I'm a big fan of dark leafy greens. I actually have an organic garden in my backyard that my husband and I put together. So, well, I was having— actually, we— our beets are— have grown. Like, we have these beet leaves, and they taste just like spinach, actually. They taste so good. So I have it in the morning. Yeah, yeah, yeah. So, uh, beet greens— beet greens are great. So, okay, so very important about nutrition. Now, what was step number 2 of the AIDS Protocol?

Number 2 is meal timing. So you think about it, meal timing— people are like, yeah. So one of the classic mistakes is people eat their heaviest meal of the day too late, maybe an hour before going to bed. I have seen that destroy health. I've seen it disrupt sleep. I've seen it cause heartburn and dyspepsia and GERD, gastroesophageal reflux disease, and all these other problems, right? I've seen it cause irregular heartbeats. I've seen it cause a lot of different things, and people didn't know that they were eating too close to bedtime. Ideally, if dinner is your biggest meal, 3 to 5 hours before you're gonna put your head on your pillow, give your body a chance to process that. If you eat it right before bedtime, especially if it's a heavy meal, this is a recipe for making yourself sick. With the kinds of things I just talked about. It could also increase your blood pressure too. So if you have struggles with hypertension, there's a tip for you.

What are your thoughts about the intermittent fasting? You know, would that be what people skip breakfast altogether?

I think that for many people, intermittent fasting can be very healing regimen. I'm always a fan of do what works for you. We are not all the same. We could be twins, triplets, quadruplets. We are individuals. So many different research studies and just real life have affirmed the fact that we have to meet ourselves where we're at and do what works for us. We're individuals and therefore we need personalized medicine. So within that framework of those 5 steps of the ACE Protocol, you can figure out what's the most sensitive measures for you. Here's the good news. It's usually 2 or 3 things. It, it doesn't usually require that somebody be fastidious or obsessive about 5 steps. We're talking about 2, maybe 3, and it can give people that momentum where they can see their blood sugar is getting better and better. They feel better, they have more energy, they get up off the couch, they're now no longer wanting to stay away from family and friends because it's too much energy to engage socially. They want to be out and about in the community, and it's just like their whole life reawakens, right? It's really important.

I agree. Now, step 3 of the protocol—

stress.

Big one, big one. I know, I know for myself, by the way, my husband actually got one of those hand blood, uh, um, sugar monitor. I forgot the name of it.

Glucometer. Yeah.

So he was actually looking to see, like, when he was stressed out, his blood sugar would shoot up. And I think a lot of people don't know this. He's like, I didn't eat anything. Why is my blood sugar high?

Exactly. That's why I'm saying stress can hijack your blood sugar and run off with it, even though you were otherwise doing all these smart things. You know, you're eating your organic beet greens, right? And all the other things you're exercising, you know, you might really be loving your life, but if you're stressed, Your stress is gonna raise your blood sugar because here's the deal, and we don't get to ask whether or not this happens. This is how we're all built. When we're stressed, our body releases quite naturally cortisol, the hormone of stress, right? Some other things happen, but that's the leader for this part of our conversation. Cortisol, when it goes up, particularly if it's a spike, glucose is right behind it. Your blood sugar is doing that. Why? Because your body is in a mode of responding to something with a fight or flee response. Both of which require energy. Energy primarily in the form of glucose. Your blood sugar is released to help save you what your, your emotional self is thinking of as a threat. And unless you are literally fighting for your life or running from a threat to your life, your body is behaving as if you were. And there goes your blood sugar since you aren't actually working it off. Because if you were fighting for your life or fleeing, you would be working off the glucose. It's not a, it's not a big deal. That extra activity, extra exercise will bring your blood sugar back down because You're, you're doing something, right? You're saving yourself. When you're sitting at your desk, when you're driving in traffic, when you're waiting in line, whatever it might be where you're feeling so stressed, that is where the harm is done. And for many of us, we are bathing in such a constant soup of stress, we don't even realize why it is now we've got this problem with insulin resistance, or how we can show up seemingly out of the blue with a diagnosis of type 2 diabetes. People are often so shocked But when you unwind it and go back with them in time, how could they not have had type 2 diabetes? So people who are first responders, people in stressful life situations, maybe they've gotten a divorce, maybe they've lost a business, maybe they are grieving, maybe they've had a climate catastrophe. There's a lot of ways that people become type 2 diabetics in today's world.

Yeah. And I, I'm glad you're, you're writing about this in your book and giving us good tools at, you know, how to deal with that. That's super important. Now sleep, right? That's number 4. So another problem, right? Because, you know, sleep, sleep hygiene is such an issue today, you know, with all this like blue light everywhere, computers, and not being able to sleep properly at night, Wi-Fi. Any, uh, like data on how sleep influences diabetes?

Yeah, more and more research is being done around the world and it's becoming clearer what the overlap is here. So basically what we're seeing is a big rise in type 2 diabetes from a big rise with things like sleep apnea, whether it's obstructive sleep apnea where the throat airway closes or it's central sleep apnea, which is mediated by signals from the brain. We're also seeing with other sleep disorders that people are often in noisier backgrounds than we as humans have historically been exposed to. Some of us live places that are really noisy. So unless we're doing things to, you know, like we're soft earplugs, things like that to sleep, or maybe we have noisy neighbors, maybe there are sirens. If you live near, let's say, a hospital emergency room, that sort of thing, If your sleep partner or your lover is a noisy sleeper, if they're snoring, that's a problem as well. There's a lot of couples who do not sleep in the same bed anymore. It's estimated to be 30 to 40% because of these issues with sleep. And the thing is, for the person who isn't the source of the noise, it's a problem too, because now their sleep's disrupted and they're having the blood sugar dysregulation as if they were the one who's having the problem with breathing and snoring. Now you've got two people with the problem instead of one. So anybody listening, please take that seriously.

Yeah, absolutely. I'm glad you brought sleep apnea because that's another opportunity for dentists and hygienists to look at the signs that we cannot diagnose sleep apnea, but we can refer for a sleep test. You know, people with like a short neck, you look in the back of the throat, we cannot see the airway. I can actually even measure the volume of the airway space on a cone beam CT scan. So I could tell, and then based on, you know, questions, we know if they need treatment for sleep apnea. There's some things we can do as dentists to help patients with that.

So, absolutely, a dentist is your partner. So, if you've been told that you're snoring, please don't be in denial. Go get help.

Yeah, definitely. And last thing, exercise.

You know, I have a hard time fitting it in my day.

So, right now, I have to get up at 5 AM in order to get in my exercise because that's the only time that I actually have to dedicate towards it.

You and me both. I find that getting it done first thing in the day means it got done. Trying to put it in the rest of the day is too hard. I totally hear you, sister.

Yeah, exactly. If somebody— okay, and weight training, I like that you said that. I love weight training. Exactly. Now, how long of an exercise? Is there any data to say how much we have to exercise in order to kind of drop and be healthy, not diabetic?

This is a great question. So for a while, people have struggled with this one. I think at this point, the information we have is quite clear. For people with diabetes or for blood sugar issues or who have a family history and are trying to avoid it, Your number one friend is to be consistent. And honest to goodness, this is the hardest thing for us as humans. It's to be consistent. Ideally, you're going to do some kind of exercise 5 to 6 days out of 7. That's right, 5 or 6 days out of the week. The exercise is going to be a daily thing, the same way you probably drink water, you probably have something to eat every day. Exercise needs to be right up there in your survival toolkit. Having said that, you don't need to spend an hour, hour and a half on like a treadmill. This is actually not going to be helpful to you. What you need to consider is mixing up, doing a variety of things. I always tell people the best exercise to do is the one that you will actually do. It can't be the one somebody else told you to do. It needs to be what you will actually do, because you're just going to resent the heck out of whatever it was and you won't do it, right? Most of us kind of get that— become that defiant teenager again around that. That's not helpful. If you like to dance, that is exercise. Please do it. You want to roller skate, you want to jump rope, you want to walk, you want to swim, you want to ride a bike, whatever works. Get moving 5 to 6 days a week. Strength training to me gets a huge shout out here, a big glow up, a big asterisk, because it's the cheat code. And for women, we've seen the research for women 50 years of age and older, ideally she's going to do strength training 3 times a week. You need enough time for your muscles to recover. This is important. If you want to use creatine as part of your workout, that's fine. The research supports it, especially as we age, and particularly women. Women don't build body— bodily muscle mass as readily as males do. And so we really have to be particularly, I feel, supportive and encouraging to make sure women are getting both enough protein, because sometimes women undereat, as well as are putting the demand on your muscles. You don't have to worry at all about becoming overly muscled, whatever that may mean, because you don't have the rest of the hormones to even make that happen. So forget about it. That's a silly thing to worry about. You want strength. You don't want to be falling, you don't want to be breaking your hips. All the rest, you wanna avoid osteopenia, osteoporosis. You gotta do the strength building activity that strengthens your bones. It strengthens your brain. It turns out strengthen your heart and it's helping to lower your blood sugar. So your lower average, instead of your blood sugar being up here, you start strength training, you'll see it coming down. If you're also struggling with your blood sugar, excuse me, with your blood pressure, with hypertension, you'll also see that coming down.

That's amazing. Speaking of blood sugar level, do you recommend those arm monitors?

Yeah, the CGMs. I really like continuous glucose monitors because they're easy, they're convenient. You can just put it right on the back of your arm and then you can have an app, your smartphone, done. Easy. You can really see what's happening, including when you're asleep. People are often shocked. Like you said, you know, your husband's realization about how stressed he is sometimes during the day. People are like, "I didn't know that, you know, those meetings are taking me out at work," or, "I didn't know every time the neighbor does blah, blah, blah, I'm having this reaction," or, "I didn't know that when I'm asleep, my blood sugar is having a whole nother life and it's not a good one." Exactly.

Interesting. And can now people order those on their own or you actually have to have a doctor prescribe those?

So there's two options. Here in the US, generally speaking, if you want the fully robust, as in all of the possible data that the CGM, continuous glucose monitor, can offer you that will be a prescription item that's not available over the counter. We do have over-the-counter options for continuous glucose monitors. Those don't give you as much clinically useful data, but it's, it's some information and something is better than nothing. The Stello is currently available over the counter and there's likely to be more. So people should just Google that for over-the-counter, but the over-the-counter, no prescription required CGMs, continuous glucose monitors, are not giving you all of the information that would be available in a prescription-only CGM. I make that available to people directly from my work on my website, and I know other health practitioners do because we really feel like it's more along the line of the health data you get from something like, say, a thermometer or a blood pressure cuff, something you can take and look at and get some information about what is happening to you so you can really start to unpack these clues. The same is true, by the way, for the people who struggle with low blood sugar, with hypoglycemia. I feel like they just get completely ignored.

Yeah, I mean, you're absolutely right. Most people talk about diabetes because we have such a big problem, but hypoglycemia is also a problem. It's also dysregulation of blood sugar.

Yeah. Yeah. People don't feel well when they've got hypoglycemia. That's for sure.

Yeah. And you're also giving us here a link for people that can get a free guide to the Yates Protocol, an outline of 5 steps. So we're going to post that link in the show notes.

Thank you.

Also, yeah, the link for your book so everybody can dive deeper into these topics. I know it's a, it's a big problem. There's millions of people diagnosed and millions of people undiagnosed.

Undiagnosed. It's crazy. We're working on it though. We're looking to close that gap. I know everybody will help us. They're going to share this podcast. They're going to give it a like, they're going to give you great feedback. And please folks, let's just link arms and help each other to live better quality lives. You know, all this struggling and suffering, it really can be improved. And I so appreciate Dr. Sanda Moldovan and all the work that she's doing to help be one of the people on the right side of history here.

Well, Dr. Beverly Yates, it's been a pleasure. I'm really looking forward to chatting with you soon.

Take great care, everyone.

Until next time, stay healthy. Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @DrSandaMoldovan. This is Dr. Dr. Sanda Moldovanova, and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.