If anyone else told us they were taking a holistic, naturopathic medicine to treating type 1 diabetes, we'd probably have rolled our eyes. Not so with Jody Stanislaw, a longtime type 1 herself in Idaho who's taken a fascinating approach to helping her fellow PWDs (people with diabetes) by becoming a unique type of "diabetes consultant."
She's involved in a movement you might call "the low-carb revolution in diabetes care." And she recently released a new online course, in response to people grappling for her expert coaching services. Read on to learn why you might want to sign up, and to hear Jody's story.
DM): Hi Jody, can you start us off with your diabetes diagnosis story?
JS) I was diagnosed with type 1 as a child, at age 7 in 1980. I was born and raised in Seattle. I spent a week in the hospital, and honestly I loved the adventure of it. The biggest challenge at the time was when they told me I couldn’t eat sugar. Otherwise everyone was so helpful and nice, and that’s really the week that I decided I wanted to be a doctor. It sounded like a great job to be able to help people.
Did you continue dreaming of becoming a doctor?
Yes, every one of my oral reports in elementary school had a little needle on it, or stethoscope and thermometer, and I was always talking about medicine, eating well, and healthiness growing up.
But then when I started college, the entire practice of becoming a doctor became so terrifying. I ended up dropping out of college my freshman year because of a drinking accident that landed me in the hospital for four days. I changed schools, studied in Italy for a year, and eventually decided it wasn’t meant to be. My childhood dream wasn’t going to come true, because life wasn’t allowing me to finish my pre-med classes. After graduating, I had a business degree but was baffled because I’d always thought I would be a doctor. So I had no idea what to do with my life. I tried to avoid the question, traveled by myself and backpacked through Australia and New Zealand, waited tables in Italy, and finally came home.
And then you found your way to the Pharma industry?
That’s when someone told me I should work for Eli Lilly, as an insulin rep. That seemed cool, being able to help doctors better understand insulin. As a type 1, that’d be easy. I ended up working there for three years, and absolutely hated it… I was not a respected person, but rather was looked at as an annoying sales rep. That was not my vision.
Within the first year of having the job, I chose not to work toward getting a promotion in the diabetes division (you had to work your way into it, instead of that being an entry-level position you could apply for). Once I understood how pharmaceutical sales worked, I didn’t even want that position.
Was that the catalyst for you to return to medicine?
Yes, I went back to med-school in that first year for those pre-med classes I’d never finished, and just knew I had to get that done. I stayed in sales after Lilly, for two more years at Disetronic selling insulin pumps. By the end of that five-year time, I’d finished my pre-med classes and found a holistic-minded med school, and entered that med school at the age of 30.
That took another five years, and then I decided I didn’t want to stay in a hospital or a little doctor’s office all day. So I figured out how to turn my training into an online business, and now I act as a type 1 diabetes consultant for patients around the world – right from my couch.
Wow, what a journey! You’ve certainly achieved that childhood dream, no…?
Absolutely. I became a physician in June 2017. This may not have been the traditional route I had thought it might be, but I’m living that dream.
Can you tell us about your holistic medicine approach to T1D?
There are only four medical schools of this kind in the country that specialize in naturopathic medicine. Many people don’t know what a naturopathic doctor is and they get skeptical. It’s a pre-med degree, a five-year doctorate program, and I took as much science and pathology as you get in regular med school. But we also take nutrition, counseling, meditation, exercise, and herbal medicine courses. We really focus on helping the body be healthy and not just prescribing drugs. It’s a very rigorous medical school, and I can’t imagine stuffing more into the cirriculum.
Why don’t we hear more about holistic medicine in the mainstream?
Unfortunately, a lot of people scratch their head when they see that word and don’t think it’s legit. Also, it’s unfortunate there aren’t more opportunities to do residencies at hospitals, because those are agreements between the hospital and medical school, and not enough have these agreements with naturopathic med schools. So the opportunities are quite limited for those of us with an interest in naturopathic medicine. In the next five years, I would love to see a shift that parallels conventional medicine curriculum and our holistic curriculum.
That’s the biggest weak link in our training and opportunities -- that there isn’t a residency aspect. But as soon as I graduated, I could open my own practice. And I decided to focus on type 1 diabetes, because I have that experience from living with it. I also did apply and get the accreditation as a Certified Diabetes Educator (CDE), because that’s a certification that could help people feel more comfortable with me.
Tell us about the launch of your diabetes services business?
Actually, at first, I wasn’t focused on type 1. That happened several years after graduation. I took a one-year online business course about using the Internet to reach people. Because I’m an outgoing, adventurous person who lives to travel instead of living in a doctor’s office all day long, I learned how to create this online business. I was thinking about creating events and retreats, and programs for people who wanted to be healthy in general. That wasn’t working, because there was no niche.
It wasn’t until 2012, that I established that niche in type 1. I really hesitated, because I didn’t know if I wanted to live and breath it personally and professionally, because it was already so time-consuming. But if I truly wanted to make this work, that T1 focus would be the most brilliant niche to pick. That has really taken off, and led me to where I am today.
And now the meat of it: what can PWDs expect to learn in this new online course that's grown out of your core practice?
Really good diabetes care is so hard to find. I hear every day how patients go to their doctors, and they don’t get what they’re looking for. I have patients across the world and it’s the same thing. Type 1 is a rare and complex enough condition, so getting the right training is quite hard.
That’s why I'm so excited to launch this online course, which went online in late April 2018. I used to refer to this as thriving with diabetes, and that acronym THRIVE stood for Testing, Hormones, Ready, Insulin, Vitality, Enthusiasm. But I’m not using that anymore.
Now, it’s the Five Essentials of Type 1 Diabetes Management.
- Understanding Basal, Long-Acting Insulin: There's just so much more to know about the peaks and effects of these insulins.
- Understanding Rapid-Acting Insulin (and the insulin-related Highs and Lows): Standard medicine doesn’t do enough to adequately explain this. They give us formulas – here’s your rate – and we patients expect this to work, but it doesn’t because there are so many other variables. Expecting formulas to work leads to disempowerment and burnout.
- Food and Dosing: My personal philosophy is to eat low-carb and whole foods most of the time. I don’t believe just eating as many carbs as you want and dosing insulin to cover them is ever going to get someone a healthy life or A1C. I have a ton of advice and recipes, along with tips.
- Exercise: From going Low to how exercise sometimes raises blood sugar, delays in hypoglycemia and all that.
- Emotional Care: This is a lot of work and there’s going to be burnout, because you’re going to get overwhelmed at times. This has to be better understood. This is the part that I think makes me the most unique, bringing in that emotional experience from a T1 and a female touch to diabetes care -- just like I don’t care if you have a 6% A1C if if you're miserable and you hate life. I want to make sure you’re helping yourself as a person first, and diabetes is after that. I don’t just focus on numbers.
CDE Gary Scheiner, who is a good friend, helped me co-create this course. There are over 40 videos that are all about 5-7 minutes long, and about 30 handouts. I do think it’s one of a kind, as there's nothing else like it online to help people with T1D diabetes like this. It's all done at your own pace, and as soon as you buy the course, you have immediate access to everything. I do also want to offer more private coaching and consults with me, in the future.
How do people access the course, and what's the cost?
You can just sign up my website Dr. Jody. There’s a free trial option, where you get one video from each of the five essentials. There is a starter $150 option where you’ll get two videos from each section. And then there’s the full option for $700 (or three payments of $250) where you get the full course and materials. To me, the value is priceless and life-changing. But I want to make it accessible for as many people as possible, so that’s why there are a few options with different prices, and that will shift over time because eventually we’ll have more. This is the launch package.
As a diabetes consultant who developed a class like this, what does a typical work day look like for you?
Ironically, a bulk of my time is spent sitting in my home office talking to a patient. To get my name out there, I’ve spoken at medical conferences and volunteered at diabetes camps and events, and it was really the online Diabetes Summit (hosted by Dr. Brian Mowll) that got me early recognition.
How did you get involved in the Diabetes Summit?
It’s a three-day online summit that has free resources online to give thousands of people access to this needed information. I was interviewed by Emily Coles of the (now defunct) Diabetes Hands Foundation in 2014, and Dr. Brian Mowll reached out to her about people specializing in both type 1 and a holistic approach. The Summit is very type 2-focused, but it’s all about living healthier in general. Many have found me through that Summit, along with about 30 speakers who are well-known in this area.
You also host a series of in-person retreats?
Yes, I did a weekend retreat a in June 2017 in Idaho, with about 25 patients. It was amazing. We had a dinner, and went hiking on Saturday morning, followed by a cooking course and then we cooked dinner that night. We went hiking again and had lunch on Sunday, and had discussions all afternoon. It was such a hit, I’m doing it again this summer and down the road. I really want to take these across the country and world, and am doing one in November 2018 in New Mexico.
Didn't you also help establish a new nonprofit called the Low Carb Diabetes Association?
Yes, I am a founding board member. We’re kind of like a lemonade stand trying to overcome Amazon -- the Amazon here being the American Diabetes Association.
Dr. Mona Morestein is a naturopathic doctor based in Arizona who wrote a book called Master Your Diabetes. She doesn’t have type 1, but knows probably more than anyone else out there. She’s not classic, standard Western medicine but has naturopathic medicine as her focus for type 1 and type 2s. She gets so angered by the fact that ADA recommends higher carb meals, that they refuse to state there isn’t any value to how many carbohydrates patients with diabetes should eat. And they have all these high-carb items on the covers of their magazines and materials. The power and influence the ADA has motivated Mona to start her own group. A bunch of us in that circle helped found it, and we follow her trademarked Eight Essentials of Holistic Diabetes Care on these things that are proven to make our lives better. It’s a website right now with valuable resources online, and the board members are always writing new articles to post.
What’s your own personal approach to low-carb and how you talk with patients about that?
You can eat anything you want and take insulin for it. That’s absolutely true. But if you want balanced blood sugars that are easier to manage, you can’t get that with standard American diets. First of all, the most important thing – whether you have diabetes or not – is to eat whole foods like nuts, vegetables, seeds, low carb fruits, and healthy proteins. That’s just basic nutrition. By doing that, you’re already low-carb.
Whenever I work with parents, I don’t even make this a diabetes issue because it’s about families just eating healthier. Not a “You Can’t Eat This” message that comes with stigma and emotional baggage. I personally rebelled against all the food rules I had as a kid, and ended up in an eating disorder rehab center for two months in my 20s. So I don’t take food rules lightly; while people are very passionate about it, that’s why I try to be mindful about it. I like the 80-20 Rule – eat healthier 80% of the time, and keep the cupcakes and other treats to the 20% part. That's especially useful at diabetes camps, where kids wake up either 40 or 400 mg/dL because of all the carbs they ate and then dosed insulin for. It’s so dangerous. This isn’t an extreme stand here.
Isn’t there a balance needed, between being too aggressive and tolerance of lower-carb eating?
Yes, there does need to be. I’ve been trying to use the term “low-er,” so that people don’t think I’m an extremist. I do know that Dr. Richard Bernstein, a low-carb pioneer, is followed by many people. To me, he takes it too far. Sometimes those following him seem like extremists, and unfortunately turn people off from low-carb. I think he scares a lot of people off, and it doesn’t have to be that extreme. To me, the definition is under 30 or 20 carbs at a time. And if they’re food items that are lower on the Glycemic Index like black beans with 40 grams of carb, that’s fine. But if you’re going to have 40 grams of something very fast-absorbing like white rice or pineapple juice at every meal, that’s just a diabetes headache waiting to happen. It matters per-time, per-meal how many carbs you’re eating, not how many you’re having for a full day.
Food can be a senstive topic for sure...
Yes, it’s funny how many people in the diabetes community have such strong opinions about food. I gave this TEDx talk that’s gone viral, and it was intended to reach the masses about “Let’s eat less sugar!” You only have 15 minutes to talk about the differences in types of diabetes, and how sugar can be difficult… Reading through the comments, some people write “Sugar is poison!” That’s an extreme. I too, want to have a chocolate chip cookie every now and then, and we can do that even with diabetes. We just need to eat less sugar, that’s the point. There are daggers of negative comments whenever food comes up, and it just feeds into the extreme positions that stop people from seeing the practical, real-life aspects of various food choices.
Finally, what diabetes technology do you use, and encourage for patients?
I’m a huge fan of CGMs, and think they’re the best tool. I don’t care if my patients are on a pump. I’ve seen many who were on them for years, and now have scar tissue and poor absorption that leads to glucose variability. I was on a pump for about five years, but have personally been on shots for a while now. The only time I’ve been in DKA was when I was on a pump, and I didn’t realize it wasn’t delivering insulin.
There are Pros and Cons to everything, and I’m a fan of encouraging people to know about all the options and be able to choose what works for them. Many in the medical profession don’t do that, but just slap pumps on people immediately without giving them the chance to learn what it’s like to be on shots or learn how carbs work differently beyond just what the bolus wizard tells you. 'Expect to adjust' is one of my taglines – and that goes against what many tech companies market. We PWDs are not a formula and there are endless variables that the technology can’t account for.
Thank you Jody, for offering an "alternative" approach to D-care that is surely of great value to so many. We hope to see these ideas become more mainstream soon!