Type two diabetes — and my dad
June is National Diabetes Awareness month, so it’s a good opportunity to discuss this condition, the fastest growing modern chronic disease that costs the NHS £10 billion every year. It’s estimated to affect around one in 16 adults in the UK, while prediabetes, where blood sugar is raised but not yet at the threshold for a diabetes diagnosis, is thought to affect one in three adults.
The causes of type one diabetes are unknown, although there is suspected to be some genetic element, and it is not related to lifestyle, so this is not what we are talking about here.
Type two, however, is almost completely dictated by diet and lifestyle and so can be dramatically improved in a matter of weeks.
To understand how diabetes develops, we need to think about how the body processes our food and raises our blood sugar.
When we eat carbohydrates (refined and unrefined), they break down quickly into sugar.
The blood can cope with only around 4-5ml (one teaspoon) of sugar at a time.
When we have too much glucose (sugar) in the bloodstream, the hormone insulin is released to shuttle glucose from the bloodstream into the cells, where it can be used for energy.
Any leftover glucose is then stored in the liver, or as fat.
The problem with this process starts when, over a number of years of constantly flooding our body with carbs and sugar, our cells can no longer take on any more.
So now we have high blood sugar and high insulin — both of which are inflammatory. This is known as insulin resistance and it is what drives diabetes, leading to high blood glucose levels, high insulin and also nutrient deficiencies.
Sugar can’t hang out in the blood, so the body makes more insulin to help out.
But after a while, the insulin can’t keep the blood sugar in normal range, so the blood sugar levels and insulin start to rise — and this leads to type two diabetes and a host of accompanying health issues.
Pre-diabetes is thought to affect one in three adults in the UK’
WHAT WE CAN DO
Since we know that carbohydrates break down quickly into sugar, raising our blood sugar levels and requirement for insulin, it makes sense for people living with diabetes to monitor their carb intake and consumption of processed foods which are usually high in sugars and starch.
When we eat protein and healthy fats, on the other hand, our blood sugar is raised minimally, if at all.
So, for a diabetic, it means having a balanced meal of all three food groups.
This way, the protein and healthy fats (oily fish, olive oil, avocado, nuts, seeds) and fibre, can slow down how fast the carbs break down into sugar, reducing a sugar spike and the need for insulin to be produced.
MY DAD’S STORY
Last year, at the start of the pandemic, I encouraged my dad to take control of his type two diabetes and see if we could work together to bring it into remission. He used intermittent fasting — not eating at night after 9pm — to bring his blood sugar levels down to normal. If considering intermittent fasting, take advice from a doctor or nutritionist; I supervised my father.
We focused on unrefined carbs like vegetables, cut out processed foods, and added good quality protein and healthy fats at each meal.
He also added exercise to his daily routine, with walking and some strength exercises.
Brisk walking and weight-bearing exercise have been proven to lower insulin resistance. Any exercise that increases muscle mass means better insulin sensitivity.
The blood test HbA1C is the standard test in the UK to monitor blood glucose levels over a three-month period. A result of 49mmol/mol and over would mean a diagnosis of diabetes and 42-48mmol/mol is the range for pre-diabetes. For my dad, before we made these lifestyle changes, his HbA1C was 49mmol/mol, having been at 62mmol/mol a few years prior (before going on medication). It remained at 49mmol/mol for three years, which is still diabetic, despite the medication.
We started making changes in March 2020 and by November his HbA1C reading was 37mmol/mol which is an incredible difference. It brings him out of diabetic range and even out of pre-diabetic range too, right back into the normal, non-diabetic range.
His doctor was delighted with this turnaround and took him off his medication, and it has remained at this level ever since, and he has maintained the accompanying weight loss.
This is so rewarding, and indeed a privilege for me, to know that I have helped my dad improve his health in this way, and now I’m helping others who would like to achieve the same results.
Other factors in diabetes are stress (since stress also contributes to raised blood sugar, so finding ways to relax during the day is vital) and sleep, because poor sleep lowers our insulin sensitivity, increases blood sugar, and makes us more likely to make poor food choices the next day.
It’s important to emphasise that this is just an account of what worked for my dad — not general or medical advice. I always work with people on an individual level, as we are all unique in terms of our diet, lifestyle, hormones, microbiome, digestion, exercise ability and it needs to be bespoke for each person.
But it does show that by making lifestyle changes it really is possible to bring type two diabetes into remission, and live without this diagnosis and the long-term effects on health that this entails.
Poor sleep makes us more likely to make poor food choices’