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Summer
This is eat the rules, a podcast about body image self worth, anti dieting and intersectional feminism. I am your host. Summer innan, a professionally trained coach specializing in body image self worth and confidence, and the best selling author of body image remix, if you’re ready to break free of societal standards and stop living behind the number on your scale, then you have come to the right place. Welcome to the show.

This is episode 322 and I’m joined by weight inclusive registered dietitian Jessica Jones, who is the CEO and co founder of diabetes digital. We’re dispelling some of the common myths that people have around pre diabetes and diabetes. Do you need to cut out carbs? Do you have to lose weight? And we’re talking about what actually works in the long run to help manage blood sugar. Plus we’re talking about how the hormonal shifts that happen during perimenopause and menopause can impact your blood sugar, and what might help you can find the links mentioned at summer innan.com, forward, slash, 322,

I want to give a shout out to her happy feet, who left this review. This podcast is very helpful in learning to accept your body and just enjoy life. Thank you summer. Thank you so much for leaving that review. You can support the show via ko fi. If you go to KO fi.com forward slash summer, in and in you can make a monthly contribution for as little as $5 a month, and help to support this podcast to keep it on the air, and you’ll get access to my mini course conquering negative BodyTalk. If you don’t have the financial means to do so, you can also support the show by going to Apple podcasts, search for eat the rules and then click ratings and reviews and click to leave a review, or just subscribe to the show via whatever platform you use. I’ve got free resources on my website at the body image coach.com. You can get the 10 day body confidence makeover there. Or if you’re a professional who works with people who may also have body image struggles, you definitely want to grab our free body image coaching roadmap at summer innan.com. Forward slash roadmap.

I’m really excited for this episode. I feel like I get so many questions from people who are worried about getting a diagnosis of diabetes, or who have received a pre diabetes diagnosis, or have had a doctor tell them, Well, you just need to lose weight to prevent diabetes. And Jessica is coming on the show to dispel all of these myths and help us understand what actually will help you to manage blood sugar in the long run. Jessica Jones is a nationally recognized dietitian and diabetes educator as CEO and co founder of diabetes digital she leads an insurance covered telehealth platform offering culturally inclusive nutrition counseling for diabetes and pre diabetes. She co hosts the diabetes digital podcast, and co founded food heaven, a platform with over 250,000 followers. She’s also co authored the 28 day plant Powered Health reboot and a diabetes guide to enjoying the foods of the world. And she’s done so much more. I’m so honored to have her on the show today. Let’s get started with the show.

Hi Jessica, welcome to the show.

Jessica:
Thank you for having me summer. I’m so excited to be here.

Summer:
I’m excited to have you here too. I know that the people I work with and our listeners are always curious about how to navigate different health issues and struggles from an intuitive eating Health at Every Size, weight, inclusive lens. So I am really happy to have you here today to talk about diabetes and just managing blood sugar and everything related to that. So thank you for being here, and I’d love you to start by just telling everyone a little bit about how you how you got into this work like, why did you start diabetes digital and what was sort of like your your journey to get there?

Jessica:
Yes, well, first off, thank you again for having me. I’m very excited to be here and that our values align, because I am a weight inclusive dietitian, and I have been working as a dietitian, I would say, since like, 2012 so you know, over 10 years, and I was trained in like a weight normative approach. And I’m sure your listeners know what I mean when I say weight normative, right? Where it’s like weight loss is going to fix everything. And that’s like the prescription for people who have diabetes or who have pre diabetes and everything else under the sun. And it wasn’t until I was kind of introduced to the work of Evelyn triple A, who wrote the intuitive eating book. I did her training, as well as, like the work of Christy Harrison, who is another weight inclusive dietitian. She wrote the book anti diet, that I started opening my eyes a little bit more and seeing like a from my clinical experience.

Like people weren’t actually able to, like, consistently lose weight and keep it off. And also, when they did, it almost seemed like not for everybody, but for many people, they would almost have to have disordered eating behaviors in order to do it, like, kind of obsessively tracking, obsessively counting. And I always will remember Rebecca scritchfield In her book that she wrote that is called, hold on. Let me think about the name her book that she wrote, called body kindness. She talks about, like, if your body was meant to lay, if your body was meant to weigh less, it wouldn’t require, like, excessive micromanagement and all these, like, very prescriptive, like, exercise regimens, and that really, like, stuck with me too. I’m probably butchering the quote, but something along those lines. So that’s when I kind of started to shift, like, my practice, my approach. I was working in a clinical setting, doing outpatient counseling and really trying to incorporate these values into that counseling, and I just found that it was so much better for people’s like, mental health or well being, they were able to stay with the, you know, change it the behavior changes longer, because it wasn’t so tied to their weight, and it just gave them, like, permission to to feel like they were okay as they were. And we’re just focusing on, like, those healthy behaviors. So it was kind of a process. And then diabetes digital came, like after like, well into my career, I was already a diabetes educator, certified diabetes educator, along with being a dietitian, because I have a family history of diabetes. So that was like, something that I wanted to learn a lot more about. And also being an African American, black woman like I know that we have a higher risk of developing diabetes, so that was something that I also wanted to kind of have a hand in, or do what I could to help other people, like learn about prevention and management things like that. And really, like me and my co founder, Wendy, we just felt like there was a need for a weight inclusive, culturally inclusive, kind of diabetes platform that focused on nutrition counseling, that accepted insurance, all the things, and that’s kind of where it was born.

Summer:
Oh, cool, yeah, I think it is probably so needed. So for people listening, who maybe aren’t familiar, can you just explain the difference between pre diabetes and diabetes? Like, what and like, what are the chances of potentially getting diabetes if you have pre diabetes? I don’t know if you know that, but just out of curiosity,

Jessica:
yeah, so okay, we’ll start with what the definitions are. So diabetes is essentially when your body is having a harder time, kind of regulating your blood glucose. So anytime you eat something that has carbohydrates in it, those carbs break down into blood sugar, and normally, your body is able to easily help that blood sugar, like kind of go into your cells for energy. But with diabetes, it’s a little bit harder, because insulin is a hormone that helps the sugar go into your cells, and you become more insulin resistant, and then your blood sugar kind of starts to build up. And that build up of blood sugar can cause damage, right? It can cause damage to our heart. It can cause damage to our eyes, like all these different systems. And so in somebody who has diabetes, like the lab value that we look at to classify that is typically their a 1c which stands for, well, it’s their hemoglobin a 1c and their hemoglobin a 1c and it’s their average blood glucose over the past three months. And that’s really what we look at. And so your a 1c would be 6.5 or above. And somebody with pre diabetes, it’s where you don’t quite have diabetes, but your body is just starting to become a little bit more, maybe insulin resistant, or just having a harder time processing that glucose like it’s a little bit above, like, quote, normal. So in that instance, your a 1c would be 5.7 to 6.4 and then anything under 5.7 is considered like, you’re not at risk, you’re in the normal range. And in terms of, like, the amount of people who will progress from pre diabetes to diabetes, like, I see different stats on this, and so it’s hard to say not everybody will, right? And it’s also, like, dependent on certain lifestyle factors, right? Because there are studies that suggest, like, if you do, and we’ll talk about, is, if you do make, you know, an effort to increase physical activity and, you know, have more fiber in your diet, more fruits and vegetables, you can delay or prevent your chance of going into diabetes. But it’s not 100% like, even if you made lifestyle changes, it’s still not going to be 100% like, you’ll never, ever get diabetes. There’s no chance, because there’s also very, for some people, a strong genetic component to it, right? And it’s like, I think that it’s hard, because some so much of what we see online makes it seem like your health is like, 100% in your control, and you can do all the things. And yes, there are things you can do, but some people are just delta, really. You know, unlucky genetic. Hard in that sense, and and in those cases, it’s not your fault, but it may progress even with you doing all the things. So it’s, you know, we might have to consider Mary, your doctor might have to consider medications and so forth in those cases.

Summer:
Yeah, thanks for explaining that. And something you mentioned there really pops out is that, like, it’s not your fault, like I feel like the feedback that I hear from from clients or people who have been diagnosed with, you know, pre diabetes or diabetes, is that I did this to myself. You know, I’m completely responsible, and I think especially when they’ve gone through this process of, like, healing from chronic dieting and so, you know, they’re allowing themselves foods that they didn’t used to eat before. And so then sometimes, if, if that kind of diagnosis correlates with that change, then there’s even more self blame. And so it’s nice to hear you say like it’s not your fault, but I would love for you to just kind of maybe talk a little bit more about that to potentially reassure people, because I know that self blame is huge.

Jessica:
It’s so big. And even when we first started diabetes digital and we were getting our first reviews from clients, like that, was some of the first things we were seeing was like, Oh my gosh, I love that. My dietitian just spent so much time talking to me about the fact that it’s not my fault, because diabetes is such a complex condition, right? It involves so many different factors, and there’s a lot of different things that put us at risk and and also people of color are at higher risk. And we used to think like, is there a genetic component? Is it, you know, something inherently different about people of color? But really, what research is pointing to is there’s just so many kind of like systems working against us, right? So it’s like things like racism, things like living in food deserts, things like not having the best access to health care, long wait times, also weight stigma, because if you’re going to the doctor and you’re going for a pap smear and they’re telling you about your you need to lose weight, and it’s like you don’t even know me. You don’t know what I you know. You don’t know my life, and you didn’t even ask me any questions. Then people don’t want to go to the doctor. And so then, if there was maybe a diabetes, pre diabetes diagnosis, like it’s going to get delayed. So I think there’s so many factors, and I think we really have to reduce shame and blame. It also is doesn’t work. I just did a a presentation, kind of for our team on motivational interviewing, like, literally right before this. And a motiva motivational interviewing is, like a way to evoke behavior change, like with your clients. And that was another thing that we talked about, was just like people have people are valuable, and they have worth like, whether or not they do these changes whether or not they have diabetes, pre diabetes, whether or not their health improves like they are worthy, just because they are and I think that we have to, you know, remember and internalize that, and it’s hard. I also just wrote a blog post on this topic too, because we have patients with gestational diabetes. And that’s another one where it was like a very, a very commonly searched thing, like for search in for like Google, because we were looking, and that was like something that so many women were like, Oh my gosh, is gestational diabetes like my fault? It’s what did I do? And so then we had a whole presentation on that too, and just like talking about Yeah, that we have to really get across to our patients, like, whether it’s diabetes gestational and by the way, that’s diabetes in pregnancy, you’re not the problem. And you know, we need to support you wherever you are,

Summer:
yeah, yeah, yeah. So helpful to hear. So I think most people, when they get diagnosed, or their doctor says, like, Okay, you’re in the pre diabetes range. They think, Oh, my God, I need to make these, like, massive, sweeping changes, like, I need to really restrict and watch everything I’m eating. And so I’m curious to know, like, perhaps the negative consequences of that strategy, because I think most people assume like, that’s probably the best thing to do, even though, even if they know better, which I think, you know, a lot of the people listening kind of know better, even though I would say the mainstream doesn’t necessarily know better, and would sort of think like, that is what I have to do. But Are there negative consequences of doing such a thing, like to our blood sugar and to our overall health?

Jessica:
Yeah, I think that the reason people feel like they have to restrict is because sometimes that’s the message they’re getting from their doctor, and sometimes that’s the message that they might be getting from their dietitian. And I used to be the person giving that message, not a restriction message, but just like the weight loss message, because, like, one of the biggest diabetes studies, it was called, like the Diabetes Prevention Study. And basically that is, like the gold standard for how we’ve come up with, like the Diabetes Prevention Program. And you know, all the things that conventional, you know, diabetes clinics and centers follow.

And basically that suggests that if you lose like, five to 10% of your body weight, you’re gonna reduce your risk of getting diabetes, like, drastically. I think it’s like, don’t quote me on that, but I think they say it’s like 83% like 59 to 83% something around there. And so that used to be what I would teach, like, we all just have to, you know, you guys just have to lose your weight, because I would teach like diabetes, pre diabetes classes, and I would say that. And so what I know now is like, when you know better, do better, is that when they look back on those studies, yes, people who lost weight, they did reduce their risk of getting diabetes within the next five years. However, when they look back, and they had two look back studies, majority of people gain that weight back, because we know that, like when we restrict to lose weight, like we tend to regain it, maybe not immediately, but usually, you know, within five plus years. And the people who gain the weight back, as long as they were still doing the behaviors, they still had a reduced risk of developing diabetes. And so I think a lot of times, because the research is very weight centric, it can be a little biased, right? Because they weren’t necessarily, necessarily looking at behaviors in that initial study, they were using the weight loss more. So is like that marker. But for us, like with diabetes, digital we really like to focus on your lab values and the behaviors that you’re doing more so than that number on the scale. Also, because you mentioned like, blood sugar restriction can also lead to, like, those cycles of deprivation, which we know, and that deprivation we know that will often lead to overeating, which can worsen our blood sugar control. And so you know, if you’re like restricting and then binging, your blood sugar is going to be all over the place. And a lot of our clients, as long as it’s not triggering for them, they’ll use, like, a CGM, which is a continuous glucose monitor, to kind of see some of those trends and see that, maybe that you’re eating more, you know, like more at your meals, and that’s helping your blood sugar stay more stable, versus, kind of eating, you know, very light in the morning, and then, like, a lot more at dinner. So I think that, yeah, those are a couple things that we like to think about when it comes to, like, why not to restrict?

Summer:
Yeah, so that makes perfect sense. And so I’m glad you brought up the whole like, weight loss thing. So, because I think that’s obviously, like, a recommendation that people get immediately is like, Okay, you just, you just need to lose weight. So I didn’t realize where that I mean, I just figured it came from, like, general medicine, because that’s sort of the, you know, weight centric approach that’s taken. So interesting to hear that it kind of came from that study and that, you know, looking back, it was actually about the behaviors that people made, and that even when they regained the weight, there was still that improvement. So I guess, like, one of the other, I think myths, or like misconceptions maybe that people have is that they have to cut out sugar, like, or carbs, you know, and so really take, like, a low carb approach. And so Is there truth to that? Like, what is you know, in your experience? Like, how do you suggest people manage, you know, carbohydrate or sugar consumption, you know, if they have pre diabetes or even diabetes,

Jessica:
yeah, there are so many things people can do other than cutting out carbs. So okay, 100% do not recommend cutting out carbs. Carbs are not the enemy. They are the body’s preferred energy source, and they play a key role in blood sugar regulation. And I think there’s, yeah, that’s just a big misconception. And even when we do interviews for our dietitians, we ask them that question. They’re like, Okay, you have a patient who comes to you and they’re like, so excited about cutting out all carbs, and they think that they’re, you know, doing what’s best for their diabetes or pre diabetes, like, what do you tell them? And so first, what we we try to understand from the client is, where did you get this information from? Right? Because maybe it came from their best friend, maybe it came from their doctor, maybe it came from online. So just trying to get that sense, and then asking them how they’re feeling with cutting out the carbs, because I also think your lived experience is kind of like one of the most important teaching tools. So often people will say, when they cut out carbs, they have low energy, or they’re irritable, or they have more cravings, or they find that they’re binging later on in the day, because, like typically, when you are low in low in a nutrient like you, for many people, they tend to like then eat more of that nutrient, Lady later in the day, Because the body’s kind of craving it. So we recommend for people that instead of, like, cutting out carbs or eliminating them, focusing on carb quality and pairing your carbs, like with things like protein and fiber to slow glucose absorption, because that is the beautiful thing about the body and about food, it all kind of works synergistically. And so when you have carbs with things like protein, fiber and even fats, it helps to slow the release of that glucose into the blood, and that can help stabilize your blood sugar over time. There was also a study that I was just looking at that was really interesting, and it was showing that they compared two different groups.

One was a Low Carb group that I believe these people had diabetes. So one was low carb, and one was a higher carb group, but high fiber, and they were looking at like their a 1c and like how their body was processing glucose. And I think most people would assume that the low carb group had a lower a, 1c and did better with, you know, processing glucose, but it was actually the higher carb, higher fiber group. So I think that’s really important, because that shows us that it’s not about the carbs, per se, yes, they’re important, but it’s like, what types of carbs are we having? How can we get more fiber into our diet? That’s so interesting. And so I like that approach, because it’s definitely more about like, Okay, where can we add stuff instead of eliminating stuff? Because I think as soon as we go into elimination, it triggers that restrictive mindset, which always leads to, you know, feeling like you need to eat the like, eat more or eat more, you know, binge and things like that. So, so that’s great to hear that that’s possible. And good about fiber too. Fiber is like a dietitian’s best friend. And of course, with anything you can overdo it, right? Like, we don’t want to just eat fiber all day, every day. You know you want to balance that fiber out with, like, other macronutrients, but most people are low in their fiber. So even there’s, like, so much research on fiber and blood glucose regulation. So even if you just try to, you know, add another five grams of fiber in your meal, like, maybe per week, until you get to, like, I don’t know, 3035 grams. Usually for women, it’s like, 28 grams. Men, it’s a little bit higher per day, the recommendation. But even if you just, you know, slowly add five grams per week until you get to that place, and then try that for three months and see what happens.

Because people often, like, try to overhaul everything overnight, and then it’s not sustainable. And then you don’t actually know, even if your blood sugar came down or your A1C came down, you don’t know what was like. The least you could have done, if that makes sense, like, it might just be, like adding a cup of raspberries with breakfast. Like, I don’t know, they’re high in fiber. They have seven grams of fiber per serving. So, yeah, don’t, don’t do too much too soon.

Summer:
Yeah, okay. I feel like that’s of a dieters, kind of all or nothing mindset. Like, even people who have really tried to heal that often still have this all or nothing mindset, so it’s helpful to hear like just do little changes over time. And so I think one of the problems with getting nutrition advice, especially online, is that it seems all very like one size fits all. So is that like, what you would suggest, or assuming that you feel like it’s probably better to have a more personalized approach.

Jessica:
Yeah, and Patients often come in wanting, thinking that they want and need a meal plan. We actually had a patient who was pretty upset that we didn’t give meal plans out. Is like, just our general practice? Yeah? Because, you know, they were like, Oh, I just really want a meal plan. And we were trying to explain that, from our experience as dietitians meal plans, I think they feel comforting, right? Because it gives us that sense of like control, but after like, a week at best, maybe a day or two, like, you’re not gonna use the meal plan, because meal plan doesn’t account for, like, your preferences. It doesn’t account for you had to drop everything and go pick your kid up from school because they fell. It doesn’t account for date night and, like, going to a restaurant or whatever it is. And so it’s not really teaching you how to navigate those different scenarios. And so for us, we’re all about figuring out who you are, what your preferences are, what’s accessible to you, right? Because you can make a ton of recommendation. It’s like recommendations and it’s like, I actually don’t have a grocery store anywhere near me and nothing delivers, or I don’t have the budget for this or that, and so I think it’s like really considering that as well, and just really trying to make things as individual as possible, and centering the patient in that journey, not us. Because I do know as dietitians like, we get very excited to share all this information, but it’s usually people kind of know inherently, like, we can offer you a menu of different options. Like, okay, you can, like, I said, maybe you add the raspberries, or maybe you walk for five minutes after your biggest meal of the day. But the patient will kind of have a sense of, like, what they think is doable, what they think would be enjoyable, and that’s where we like to kind of, you know, the direction that we like to go, yeah. And I feel like, that’s um, that speaks to, like, the power dynamic too. Instead of you being like, I am the expert over you I know what’s best, it’s more like, Okay, you’re the expert over your own life. And like, let’s like, really get this to work and fit with what works best for you, instead of like, trying to fit you Into something that you know you may not it might not be the best for that person.

Summer:
So, okay, so thinking about, like, intuitive eating, and taking an intuitive eating approach to manage diabetes, how does that look? Because I think for a lot of people, it’s like, how would that even be possible?

Jessica:
Yeah, this is another, I think, like webinar that we want to do, or like group because, and we’ve just been talking about this internally, because there are people, especially with diabetes, and especially people on insulin right, who are like, No, there’s no way I can follow intuitive eating. And one of our dietitians actually has type one diabetes and is on insulin, and she was sharing, like, her strategies and tips that she talks about with her clients, also using her lived experience on how we can use intuitive eating to help manage blood sugar. And I think there’s a couple of like key points. So I think number one is really trying to get rid of the idea of fear and restriction, and knowing that there are so many different options, right? Like, you can still have this food, and maybe if you are someone whose body isn’t able to, you know, provide the insulin that you need in order to, like, cover that meal, like, there, there are medications that you can take to help, right? So it doesn’t mean you have to just completely cut out all carbohydrates. So I think just like trying to not feel too scared or restrictive, the second thing is honoring your hunger and fullness. I think that is like, regardless of what medication you’re on, regardless of anything like that is almost the most important. And we have a whole session that we do with clients on this and really thinking about, like, what does pleasant hunger feel like for you, what does pleasant fullness feel like? Okay, now, what does unpleasant hunger feel like? What does unpleasant fullness feel like? And really trying to get into your body so that you’re not waiting so long, because that’s gonna cause your blood sugar to go up and then go down right when you’re waiting too long before eating. And also like eating past fullness, I think also like sometimes structured eating can be helpful, right? So we’re really big on meal, not saying you have to have a rigid timing, but just some kind of loose structure, because the body does like consistency. And so I think a lot of people think with intuitive eating, it’s just like, I don’t know a free for all, where I’m just not eating, or I’m eating, or it’s like cupcakes and donuts, but I fall intuitive eating, and I love having structure around my meals, meaning, like, I know that I typically get hungry within an hour of waking up. So I will, like, prep my smoothie the night before. Because I’m I don’t know if lazy is the right word. I I’m stopping using the word lazy, but like, I don’t know I feel busy in the morning. So I will, like prep that the night before, and it’s like, ready to go, right? Or, you know, I have to have lunch at a certain time so that I don’t crash. So I like to, you know, block out my calendar, so there’s, like, some structure there. And I think that can help people like you’re carving out that time for self care. And that self care is like the act of eating. And then I think another important one is gentle nutrition, right? So understanding how food does impact blood sugar without moralizing choices. So that’s where we go back to trying to have the three food groups at every meal, right? So having or at least three, so thinking about protein, carb, fat, and then as a bonus, fiber, that’s going to really help your blood sugar from kind of going up and then coming down really quickly and again, just knowing that sometimes we need medication to help us get to a healthy place, and that’s okay. Like, if you being able to, quote, like, control or manage your diabetes with like, diet and lifestyle makes you miserable, like makes your life not great and fun, then it’s probably a good idea for you to consider other ways to manage it. If that makes sense, yeah, absolutely, yeah, no, it’s good to hear like how you can mesh some of those principles and still manage diabetes. And I think the thing around structure is is helpful, right? Because I think sometimes people kind of go the polar opposite when they do intuitive eating, and sometimes that’s necessary. I, for one am, just a very routine person, so like, I have, like, very set meal times, and my body’s just like, so used to that. So I can see how that would be. That would be helpful, and it would take out some of the overthinking too, to just be like, okay, like, you want to have meals or snacks, like around these sort of times, or waiting this long between to see what works best for you.

Summer:
So one of the last things I wanted to talk to you about is just around, like, perimenopause, menopause and and metabolism and blood sugar and like, what happens there? So, yeah, yeah. How does that influence blood sugar?

Jessica:
Yes, so I will talk about how it influences blood sugar, and then share a little bit about my personal kind of experience with all this. So essentially, menopause leads to hormonal shifts that impact insulin sensitivity, right? So we have a decline in estrogen and Is a hormone that really helps to regulate insulin, helps with insulin sensitivity in the body. So essentially, the body becomes less efficient at using insulin, and that will lead to higher blood sugar levels. We also tend to have an increase in cortisol, which is our stress hormone. So again, that cortisol can increase our blood sugar and make it fluctuate a little bit more, make it run higher. We also have a loss in muscle mass, and all these things happen to me, by the way, so we estrogen helps to preserve preserve muscle mass, and when it declines, we have muscle loss. And the thing is, muscle is like such a major site for glucose uptake that losing muscle can really make blood sugar regulation a lot harder. There’s so many things going on, but there is hope at the end of the tunnel, I will say. And then we do have, like, some changes in our body that many people notice, like they will gain weight. This happened with me for sure. Even if you feel like you’re not doing anything differently, per se, people will notice maybe a shift in body fat storage as well. It might you know, before going through menopause, perimenopause, you may have stored that fat more in your hips and your thighs, and you’re noticing it’s more so in your abdominal area, which that can be linked to an increase insulin resistance and sometimes like a higher risk of some metabolic issues like diabetes. And then the most prominent for me, actually, all these were pretty prominent, but like, really hard to deal with was the disrupted sleep. Oh my gosh, the hot flashes, the night sweats. I didn’t sleep for a year. I, like, literally, I like, a couple hours every night. And as we all know, like, even just one night of poor sleep, like, it makes it can make you feel terrible, and also will lead to high blood sugar the next day. So, yeah, there’s so many things going on. Can you relate to any of these? I see you like nodding, yeah.

Summer:
No, totally. I just didn’t realize that, like, how much it impacted blood sugar as well. Like, I sort of obviously I knew, like, not getting enough sleep, you often feel like your hunger levels are sort of different the next day and stuff like that. But I didn’t realize that, like, the decline in estrogen impacted blood sugar, nor did I know that, like, muscle helped with the with the glucose uptake. Is that what you said? So, so, yeah. So, like, that’s new information for me, but I knew that things were happening. I just didn’t know the impact of blood sugar. So that’s, like, really, really helpful, right? Again, it’s coming back to, like, maybe it’s not your fault. It’s not like, how you changed your eating. It’s like you’re going through perimenopause and so sorry. Go ahead. I know you’re going to share your story around it too,

Jessica:
but no, I’m just agreeing with everything you’re saying, because, like, back to it’s not your fault, because so for me, I ended up going through early menopause. So I was like 38 at the time, and honestly, I probably started having these symptoms around like 36 and it was like a whole thing, because I went to like eight doctors, and nobody knew what was going on, even though I’m like, looking back, I was still around eight, like the perimenopause age. So I’m just like, why was this on nobody’s radar?

And the one thing, like, in addition to all these symptoms, but the one thing that also changed for me was I went into pre diabetes because, like, my blood sugar had always been fine, and all of a sudden I it was like, in that pre diabetes range, it was like 5.8 and I was like, What is going on? And yeah, I again, even me, I was like, Am I doing I’m not doing anything differently. But the thing is, like, these hormones play such a big role, and that’s why even, like with our patients, especially if they’re around that age, like, those are the questions we’re asking. Because not to say everybody needs to get on hormone replacement therapy, but I definitely like that changed a lot for me and really improved, not only like my blood sugar, but like just my life experience in general. So I got an HRT. But even with that, like, my blood sugar was still kind of, you know, above target. So we kept having to kind of tweak the regimen. And also I was like, Okay, what would I tell my patients in this scenario? Like, what are the things that I’ve been preaching this whole time, and what can I, like, internalize for myself? So I made a few changes. I started doing more strength training, right? Because, like, that’s something that I was kind of doing, but I wasn’t always fueling properly around it, like I thought I was. But then when I was, when I started looking a little more into it, especially, like, as we get older, you know, we have that muscle loss. And I even had a DEXA scan, and I saw that my muscle, you know, was not at the target that they said that it should be, which, that’s a whole nother thing, like DEXA scans. But anyways, I ended up, like seeing my muscle was like, kind of a little bit lower, so I started eating more protein. Didn’t restrict like what I was eating, just like what we talked about, adding that in. I also started going on walks, like after meals, so maybe especially bigger meals, like, maybe like a five minute walk, or even just doing walks like every like couple hours, like just around the block, like.

Five minutes, maybe eight minutes, maybe four times a day. I also, what else did I do? I well, once I got an HRT, I started sleeping. So there’s that that probably helped a lot.

Summer:
I can’t even imagine how bad you felt.

Jessica:
Yeah, like that helped so much. But I think the main thing was just like focusing on the strength building muscle, having like 25 to 30 grams of protein, like with most meals. So especially breakfast, you can add things like Greek yogurt, eggs, tofu scramble. I love a smoothie, but I’ll do like a protein smoothie. And then I went back to get another DEXA scan just to see if it made a difference, and I ended up gaining 10 pounds of muscle, which was really amazing. Isn’t that crazy? A lot of muscle? Yeah, yeah. I was like, shocked. I was like, Oh my gosh, this actually, like, just eating more and eating more protein, as well as, like, the strength training, it made a difference. And then the muscle, I think, in turn, is what helped regulate my blood glucose, because my a, 1c went from 5.8 to 5.2 so it went from that, like, you know, elevated to like, completely within normal limits. And I say that to say, like, you know, I not to share, like, you know, anecdotal, like it was a study of one, right? But just share that this is like, consistent with what we see with our patients also consistent with, you know, what the research shows about like behaviors being so important, like that muscle mass being so important. And what’s interesting is, like, I didn’t lose one pound, if anything, maybe, you know, whatever, it gained a couple pounds. And so if I would have taken that conventional wisdom of you have to just focus on losing weight, I would have not added more protein, right? I would have not done any of those things. I would have probably been more tired throughout the day, because I wouldn’t have been eating enough to support the strength I was doing. And then I don’t, I don’t think I would have built the muscle, and I don’t think then my blood sugar would have been where it’s at. So, yeah, you don’t have to focus so much on the scale. Look at the bigger picture.

Summer:
Yeah, no, that’s super helpful. Like, kind of, like, case study, yeah, no, but I appreciate you sharing it, because I feel like, I mean, to me, that’s new information in terms of, like, just how the hormone hormonal changes can influence blood sugar, and how, how, focusing on, like, some of those things that are influenced by the hormonal changes, like, you know, like building muscle can then help with, with blood sugar management as well. Like, that’s, that’s totally new information for me, and I’m assuming for a lot of people listening, which is, again, so helpful. And another reason why it’s like, you’re right, like, probably losing weight would cause you to lose muscle mass, which would be even more detrimental to your overall blood sugar. So, like, taking a different approach, that seems unconventional, but actually makes a lot of sense when you think about the biology of what’s actually happening.

Jessica:
Yeah, and I think that’s one of the harms of dieting, is because typically when people are dieting, the muscle is, like, one of the first things often to go especially when you’re under eating, especially women, like we’re not, I think now more so, but like in the past, like we weren’t really doing a lot of strength training. It was more focused on, like, the cardio and so then you’re not preserving the muscle you have. And I think it just can become, like, the slippery slope. So really focusing on, like, trying to preserve the muscle you have, if not adding a little bit when you can, can be really helpful. And it’s not to say that you’ll never need meds. Like, who knows, maybe next week, I’ll test my blood sugar and it’ll be elevated again, and it’s like, okay, well, I did all I feel comfortable doing, like, lifestyle wise, maybe it is okay. You know, time to, like, try med. And so it can go either way, and neither way is my fault. It could just be, like, I have a strong genetic predisposition to it, and it is what it is. And I know that people, yeah, it’s like, so many people, like, No, I don’t want to have to take these things. But if it’s going to help you in the long run and also make it so your quality of life is not so, like, intense and restrictive, then it’s helpful to kind of reframe at times, yeah, absolutely, absolutely, yeah, and there’s absolutely no shame in medication, is like the bottom line there too. So where can people find more, learn more about diabetes, digital and find you online. Yeah? So if you are interested in nutrition counseling. You can find us at diabetes digital.co, that’s dot co, and we work with primarily with women, and we focus on diabetes, pre diabetes, PCOS, and also these, like hormone changes, like menopause, perimenopause, because all these things kind of affect our blood glucose levels. So we’re really just interested in women managing blood glucose at all stages of life. And so you go and you we have like, a little quiz you take that we gather info, we’ll look at your we’ll do a complimentary verification of your insurance benefits, because we are in network with most major insurance companies, and most people do end up getting. Like, really good coverage. Oftentimes they have unlimited visits, and they don’t have to pay for them. So then we’ll work with you. Our dieticians are all, like, very heavily trained in these areas. They’re all great, and our patients have good things to say. So definitely check us out if you’re interested.

Summer:
Yeah, and you have a podcast too, diabetes digital podcast, yeah.

Jessica:
So we have a podcast, diabetes digital we release every other week, and we go into like, all these different topics, intersections, and it can be relevant, even if you don’t have diabetes. Like a lot of stuff applies to everybody. So check us out.

Summer:
Yeah, thank you so much for being here today, Jessica, it was really awesome, and I appreciate everything that you shared.

Jessica:
Of course, thanks for having me.

Summer:
I learned so much from that episode, and even though some of it I already knew it was just really interesting to hear some of the studies that Jessica referenced, and I hope that that gives you a lot more information to make better health decisions and have better conversations with your doctor and hopefully get support via a platform like diabetes. Digital, if you need to, you can find the links mentioned at Summer in and in.com. Forward slash 322, don’t forget, you can support the show by going to kofi.com. Forward slash summer in and in. That’s ko dash, fi.com, forward slash, summer innan, or you can just always find that link in the information for this episode. Thank you so much for listening today. Rock on.

I’m Summer innan, and I want to thank you for listening today. You can follow me on Instagram and Facebook at summer innan, and if you haven’t yet, go to Apple podcasts, search, eat the rules and subscribe, rate and review this show. I would be so grateful until next time. Rock on you.