Hilda Labrada Gore: Daphne Olivier is a “registered, yet unconventional” dietitian, certified diabetes educator and owner of My Food Coach in Lafayette, Louisiana. Daphne is passionate about real food and enjoys coaching individuals and groups. Daphne, I see that diabetes is on the rise in the U.S. population, is that right?
Daphne Olivier: Absolutely. There are millions of people who have diabetes and even more who have not yet been diagnosed with prediabetes or type 2 diabetes. Diabetes is definitely on the rise.
HG: Is diabetes a natural thing that happens as you age?
DO: Not at all. It is a metabolic dysfunction. Typically, by the time someone gets a diagnosis, they already have been experiencing blood sugar changes for five to seven years. Part of the challenge with diagnosing diabetes is that health care providers usually check blood sugar in the morning before we have had anything to eat or drink, but blood sugar effects occur after we have something to eat, when our body has a hard time bringing down our blood sugar. It can take many years for something to show up on the test.
HG: Why would the body have trouble digesting or metabolizing sugar?
DO: The whole endocrine system gets disrupted. Whenever you eat something that has carbohydrates, this is broken down into glucose that your body has to find a way to use as its energy source. A variety of different factors—including bad food, stress and sleep disturbances—can disrupt the hormone balance that ordinarily tells the body to produce insulin or enables the cells to use glucose once it gets into the cells. It’s a whole metabolic dysfunction that happens, and it starts off really slowly. You don’t realize what’s going on until you have this metabolic catastrophe.
HG: Children are getting diabetes, too, right?
DO: Yes. Even children are getting both type 1 and type 2 diabetes. Type 1 diabetes is an autoimmune disease where the body starts to attack the pancreatic cells that secrete insulin. What’s more prominent in our society is type 2 diabetes; that’s typically when the cells are not recognizing insulin. Initially, with type 2 diabetes, the body can produce insulin, but the cells can’t recognize it. Eventually, once the disease progresses, the body starts to lose its ability to produce insulin. When we think of kids with diabetes, we mostly think of type 1, but nowadays, because of our diet, more and more kids at younger ages are developing type 2 diabetes, which used to be an adult disease. It’s sad because many children are being brought up on poor-quality food, and that’s all they know. They don’t really know any differently or have the capacity to make different choices.
HG: Is there any way for diabetes to be resolved in adults or children?
DO: If it’s caught early, it is possible to get blood sugar to be more controlled. I hesitate to say we can cure it, but we can reverse it if we catch it early enough and address the underlying metabolic issues. We really have to start with some activity program—movement or exercise. We need to move our bodies more frequently than what the typical American does. We have to be cognizant of what we’re eating. Movement and exercise are one part; diet is another part. Other lifestyle factors, such as sleep and sleep disturbances, also definitely play a role. A growing number of people have sleep apnea or insomnia, and these factors play a role in insulin resistance, which is a precursor to developing diabetes. Stress is also a factor because it plays a big role in sugar balance. We need to find ways to keep our lives happy, fun and less stressful, which means learning to manage the day-to-day stressors of life.
HG: We can do something about these things you are mentioning. It sounds like a lot of these factors are within our control.
DO: Absolutely. I really enjoy working with people who have diabetes because, in many cases, it takes just a little bit of change and you start seeing corresponding changes in blood sugar. Now that we have the technology that allows us to check blood sugar at home, people don’t have to wait for their next doctor’s appointment. They can check their blood sugar every day wherever they are. They can start making changes to their diet and monitor their blood sugar to see how the changes are affecting their blood sugar. Or they can go for a walk and see how that’s affecting their blood sugar. A lot of what’s happening with type 2 diabetes is lifestyle-related. I view diabetes as the ultimate stress symptom. We need to work toward the best lifestyle, lowering our stress or paying attention to the way that we handle stress and making sure that we’re getting enough sleep. Many people think of sleep as a luxury—something that we do when there’s nothing else to do—but it really is a very important part of our metabolic system. If someone has sleep apnea or any kind of obstruction, it has to be addressed because it changes the whole metabolic system. It just doesn’t make the person tired the next day, it changes all of their hormones and the way their hormones talk and interact with one another.
HG: I think a lot of our listeners address the food piece but forget the other things like stress management and sleep, which are important factors in how we manage our health.
DO: Food is one big part of it, but if the food is causing a lot of extra stress, then you’re not doing a whole lot of good by perfecting your food habits. And then there’s the exercise part, too. As a society, we have the idea that exercise is doing thirty to sixty minutes of exercise and then sitting down at a computer or television and not having a lot of activity throughout the day. A lot of studies show that activity and movement, no matter whether your heart rate increases or not, play a big role in helping manage blood sugar. We need to look at the big picture. There are many things that we can do. I like to use a stair-step approach by first identifying and working on the things that are causing the biggest challenges. Even though I am a dietician, I don’t always focus on diet first. Sometimes we first need to make sure we are getting adequate sleep. If you’re not sleeping well, you don’t have as much energy or focus to be able to pay attention to your diet.
HG: Speaking of sleep, let’s talk practically. I know you’re a mom with kids. How do you do it? Do you have any personal tips for our listeners?
DO: Being on a schedule is key. It is important to go to sleep at about the same time every night, wake up at roughly the same time every morning and get at least seven hours of sleep every night. Allow yourself the time to sleep. Sometimes we need to push other things aside. It works the same way with putting your children to sleep at a certain time. When the body learns to expect that you’re going to sleep at a certain time, it starts to prepare itself and allows sleep to come easily so that you’re not having to chase sleep all the time. This is difficult to achieve if your sleeping schedule is erratic.
HG: One of my first encounters with someone with diabetes was with a friend when I was a teenager. We were out and she was feeling faint and we had to grab a candy bar from her purse for her to eat. She said she was diabetic. Is this what people with diabetes do, carry around candy? Is that supposed to help them stabilize their blood sugar?
DO: Unfortunately, that’s pretty common but not necessarily the right choice. I guess the definition of diabetes is the inability to manage blood sugar. Without diabetes, your blood sugar has the mechanism to stay fairly stable; it will go up a little bit whenever you eat, and then your pancreas secretes insulin and the blood sugar comes down. For someone who has diabetes, the problem can be a couple of different things: either their blood sugar goes up and their body has a hard time with the secretion of the insulin so there’s not enough insulin to bring the sugar down, or when the blood sugar comes down, it comes down too much. In fact, blood sugar going down and having low blood sugar is much more dangerous than high blood sugar in the short term. We are supposed to have a very specific amount of glucose, or blood sugar, in our blood. If the blood sugar starts to come way down, then we need to quickly eat something with glucose to bring it back up. Unfortunately, a lot of people will grab something like a candy bar because it has fast-acting glucose that’s going to bring the blood sugar up quickly. While it’s not the best way to handle it, you have to have sugar or glucose during that time to bring the blood sugar up because otherwise the situation can become very dangerous. You’re more likely to pass out. Children and elderly persons who are taking insulin are more likely to have this type of hypoglycemic reaction, meaning their blood sugar comes down dangerously low.
HG: Since most of our listeners are focused on diet, let’s talk about how we can improve our health or help resolve or manage diabetes through diet.
DO: The term “diet” simply means the foods that you eat. It’s not a restriction of food, but our culture has turned it into foods that are allowed and foods that are not allowed on specific diets. There are many diets that can help with managing blood sugar. Two of the most commonly used diets are low-carb and low-glycemic diets. A low-carb diet limits the amount of carbohydrates that someone consumes, no matter where the carbohydrates come from, and a low-glycemic diet limits the amount of foods that are known to increase blood sugar significantly. Those are the two primary diets that are used for diabetes. There also are people who have gotten a good response from what I’ll call “traditional” diets, which includes the Weston A. Price diet. Another one is the ketogenic diet, which has a significant amount of fat; this can be helpful for managing blood sugar in the short term, but I would not encourage a ketogenic diet for a long period of time. The bottom line is that there are a lot of foods that are allowed on all of these diets, including meats, organ meats, fats, dairy foods, eggs, nuts and seeds, greens, all non-starchy vegetables and small amounts of sweet potatoes and winter squash. Where it gets a little sticky is with fruits because they have carbohydrates that will turn into glucose. We have to be careful with what kinds of fruits we eat, and, more importantly, how much fruit we eat.
HG: Do you know anybody right now who has diabetes who changed their diet and has seen some improvements?
DO: Absolutely. I work with people who have diabetes on a regular basis. I work with people who are newly diagnosed and those who have had diabetes for many years and who may have already explored many diets. I help them fine-tune what they should eat.
HG: Are there people who think that diabetes is something that they just have to live with for the rest of their lives? Are there people who give up, thinking that there’s no way to manage it beyond what conventional medicine has to offer?
DO: Yes. There is a genetic component to diabetes. For example, my dad has diabetes, which puts me at a higher risk for having diabetes. Fathers passing diabetes to their daughters is pretty common. That said, our genes are not written in stone. We have a lot of influence over what happens with our genes. I don’t know exactly which genes contribute to diabetes, but there is a genetic component to it. But we know that at the point of diagnosis, we can do a lot to manage the blood sugar and get it under control so that it’s not going to cause problems later on.
HG: How do people monitor their blood sugar? I have a friend who used to prick her finger every day to do a blood test. Do people still do that?
DO: Yes. There are three ways to check blood sugar. Two can be done in-home. With the first, you prick your finger to get a drop of blood that you then put on a strip, and a meter reads it. The second way is called a continuous glucose monitor (CGM) where you insert a catheter underneath the skin, usually in your abdominal area; it will transfer information about what’s going on with your blood sugar to a transmitter, and you can see in real time what your blood sugar is doing. The third way is when you go to the doctor and they do a blood draw to check your blood sugar.
HG: Diabetes is not just uncomfortable, it is also life-threatening, right?
DO: Absolutely. A death certificate is unlikely to reflect that someone died from diabetes. Instead, the death certificate will show that they died from a heart attack, kidney disease or vascular dysfunction. Diabetes causes numerous complications, and those complications are what’s life-threatening. By managing your blood sugar, you’re managing a plethora of disease processes that happen.
HG: So the best thing to do is manage your diet, sleep and stress levels so that you won’t get there even if you have a genetic predisposition for diabetes.
DO: Absolutely. I think of it like diabetes gives you a reason to manage your lifestyle. Some people only think about this after they’ve hit a wall and have to face the outcomes of their past lifestyle decisions. It gives you a pause to reevaluate your life.
HG: Can you tell me a story of someone who has managed this successfully?
DO: A Cajun man from Louisiana was referred to me by his conventional doctor. Cajuns have a strong tie to food, having fun and partying. He was in his low thirties, thin, single and lived alone. His diet was fast food, pizza, sandwiches, cereal and so forth. He wasn’t into cooking. He’s an architect, so he spent a lot of time at work and lived a very sedentary life. His hemoglobin A1c test was about 9, which meant that his blood sugar was running about two hundred and fifty to two hundred and seventy, which is pretty high. Within three months of working with him from the time he was diagnosed, we got his hemoglobin A1c down to 6.5, close to normal. He still did not love the cooking part, but he began to do some meal preparation. He began eating much less fast food, reserving fast food for times when he was with his buddies on the weekend. He also started running, which he enjoyed, and he completely changed his lifestyle. Now he is doing really well with his diabetes. These stories happen all the time. The challenge is to make up your mind that this is something that you want to do and to put some effort into it. On the other hand, I have a friend in his early forties who was diagnosed with type 1 diabetes as a child. Because of his lifestyle, he developed what he calls “type one and one-half.” He has all the symptoms of type 2 diabetes, but his body is not producing insulin and he has to use injected insulin. I’ve tried to work with him for many years, even just socially, but he just does not want to put much effort into making himself better. In his mind, this is something he’s going to have forever, and he can’t do anything about it. The key is catching it early. Some people are scared and may not be willing to make the changes. It takes persistence and willingness to make a change.
HG: For people who have a fatalistic attitude about diabetes, do they suffer much or is it just an inconvenience?
DO: Diabetes is progressive. In the beginning, you may not necessarily feel bad or even know that you have problems with blood sugar. It’s a silent disease. It’s also different for everybody. It may take ten years, eight years or five years. As I said, before someone even gets diagnosed, they have had undetected problems with rising blood sugar for many years. People who say that it’s not worth doing anything about may then start to feel worse and start having problems like blurred vision, loss of night vision, kidney dysfunction or loss of blood circulation in their fingers and toes. These are serious side effects. Unfortunately, it can take many years to develop these side effects, and usually by that time the damage has occurred and can’t always be reversed. I tell people, “If you’re willing to help yourself then I’m more than willing to help you, but if I’m working harder than you are, then we might as well part ways until you’re ready.”
HG: As we wrap up, if listeners could only do one thing to improve their health, what would you recommend they do?
DO: Whether it’s for diabetes or health in general, I think that cutting out sugar or being cognizant of the amount of sugar that you consume—even healthy sugars—is one of the best things you can do for your health. This is because sugar has an effect not just on blood sugar but also on sleep, inflammation and thyroid dysfunction.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Spring 2017.