More than 30 million people in the United States have diabetes, according to the Centers for Disease Control and Prevention. Nearly another 85 million adults have prediabetes. As one of the fastest-growing health issues of our time, the prevention and treatment of the disease is critical to helping Americans lead longer and healthier lives.
PeaceHealth’s Dr. Garrett Jeffery is a champion for helping people manage or prevent diabetes. The 33-year-old physician moved to the area in 2017 after practicing family medicine, including obstetrics, at Sound Family Medicine in Puyallup, Washington. Although Jeffery offers a wide range of care for patients of all ages, he has particular interest in addiction medicine and diabetes management.
The latter topic is especially close to his heart, as Jeffery himself has Type 1 diabetes. He wears a continuous glucose monitor that sends real-time data to his smartphone. Diagnosed at age 5, Jeffery says having the disease at a young age likely made for an easier treatment road: for many, a later diagnosis often means having to rework years of dietary and exercise habits.
“To me, it was no different than anyone else growing up,” he says. “I just didn’t get as much birthday cake.”
Jeffery has served on the board of directors for the Juvenile Diabetes Research Foundation and until recently volunteered as a camp physician at Camp Leo, a summer camp for children with Type 1 diabetes.
Jeffery has also spearheaded efforts to improve the wellness of fellow PeaceHealth caregivers, donating healthy snack options for providers during their often-brief breaks. He says he got the idea from reading stories about tech companies providing food for workers, as it successfully boosted productivity and provided significant return on investment.
The usual trend of bringing cakes and cookies for workplace celebrations, Jeffery says, isn’t much benefit to someone working to maintain a healthy diet. So far, healthy snacks have included granola bars, trail mix, and fruits like mandarins. Jeffery hopes to add things like yogurt, hard-boiled eggs and cheese sticks in the future, and make the snacks a permanent addition to caregiver break rooms.
“I looked at the big picture and thought, ‘This is a win,’” he says. “If food is the best return on investment, then why are we not investing in it?”
Connecting the Dots
The psychological components of treating diabetes and addiction often overlap, Jeffery says. Instead of just explaining to a patient what’s wrong, and then telling them what to do, he believes in identifying a patient’s motivations and developing a treatment plan that capitalizes on them.
“I try to find those patterns, just like I would with drug use,” Jeffery says. “Why are you motivated to come off of alcohol, or opioids, or whatever it is?”
Exploring those motivations can greatly increase the chance patients will sustain the positive changes they’re making to their lifestyles. Of course, changing any ingrained pattern of behavior, especially those related to diet and exercise, can be a challenge for patients with diabetes.
“For someone who’s not controlled, and not coming into your office saying ‘I want to be controlled,’ changing behavior is one of the more difficult things we do,” Jeffery says. After all, while doctors can dispense advice, they can’t stand over a patient’s shoulder at home telling them not to eat something.
If you are managing your diabetes properly and meeting goals, however, Jeffery also says it’s probably okay to discuss with your doctor ways that you may reward yourself. “You don’t need to just eat cardboard.”
For example, some cultures have diets that revolve largely around white rice, which is very high in carbohydrates. Instead of asking a patient such as this to stop eating rice, he has had success negotiating with the patient who ultimately agreed he should try eating moderate amounts of brown rice, wild rice, or quinoa as a substitute for high-carb white rice.
Whether you have diabetes or prediabetes, Jeffery says prevention trials highlight diet and exercise as the single biggest things you can do to manage or prevent the disease.
“I tell people, ‘The first and second most important pieces of your recovery are diet and exercise,’” Jeffery says. “Three and four are also diet and exercise; more important than any medication I can give you.”
For those with prediabetes, Jeffery says he tries to reiterate that it isn’t always a person’s fault, as modern society plays a role.
“We’re asked to work longer and harder,” he says. “We’re eating quicker foods, and many of these foods are high in salt, sugar and carbohydrates. And the fact of the matter is that they taste better. We have receptors for them on our tongues. You give someone a potato chip, and it tastes a lot more satisfying than a rice cracker.”
When implementing changes to your lifestyle, Jeffery says to “start low and go slow.”
“Make small, subtle changes,” he says. “Addressing your concerns and building something that works for you around that, I think, is really important.”
Take prescribed medications for high blood pressure, high cholesterol, and monitor your glucose levels, if needed. Also monitor for signs of developing diabetes, including increased thirst, fatigue, excessive urination, and darkening of the skin around the shoulders, arm pits, neck, or other skin folds.
While diabetes can be both prevented and managed, it can’t yet be cured. To prevent complications of this condition it is important to get help early, Jeffery says, before it’s too late.