Diabetes is a huge drain on NHS resources, costing the health service millions to treat. By more effectively managing their own health patients can help themselves, their practices and the NHS believes Richard Shaw, the author of Conquer Type 2 Diabetes. In this article he describes his story and some personal strategies patients can use to take better control of their own health
When I was first diagnosed with type 2 diabetes, aged 49, I assumed I was destined for a lifetime of medication and a slowly progressive illness that would bring with it multiple side effects as I got older. However, thanks to the research being done by the Diabetes UK-funded DiRECT clinical trials in Newcastle and Glasgow it’s become clear that, for a significant number of people with lifestyle-induced type 2 diabetes like me, it’s possible to get rid of the internal ‘visceral’ fat that is often responsible for compromising the body’s natural insulin function.
The odds for remission improve the earlier in the diagnosis people achieve weight loss, but debates rage about the best way to both achieve weight loss and maintain it in the long term.
The DiRECT clinical trials restricted patients to three, ultra-low calorie meal replacement liquid shakes and 200 calories of leafy vegetables a day but, personally, I like good food too much to take on such an austere challenge. Other people champion plant-based diets – or the 5:2 diet – or intermittent fasting – or a combination of all three. The NHS promotes its own ‘Eatwell Guide’ as a diet for those with type 2 diabetes and there are passionate online advocates championing the benefits of everything from green tea to coffee to cider vinegar.
The advice is contradictory, baffling and, for a newly diagnosed type 2 diabetic, it can a challenge to work out what’s true and who to believe.
For 30 years, both in the UK and the US, the medical profession has focused on pharmacological interventions (which are really only maintenance strategies), lifestyle suggestions and controversial dietary advice to combat T2 diabetes but emerging science tells us that, if we want to change the course of this disease, we need vigorous nutritional interventions designed to deal with the most prevalent cause of adult-onset T2 – the excess internal fat that compromises insulin function which, if caught quickly enough, can offer the real prospect of remission for many.
I settled on a low-carb, moderate, natural fat diet, banishing all foods that contained more than 10% of carbs per 100g, all processed foods and all refined sugars from my diet. It was a diet high in protein, meat, chicken, seafood and rich in fresh leafy vegetables and some fruits, moderately high in natural fats and very low in carbs – and I walked briskly for at least 30 minutes a day. I created one or two other rules at the start of the regime around portion sizes and alcohol consumption, but nothing too onerous for someone who wanted to make a significant change to their lifestyle.
Five months in I had, to my enormous surprise, lost over 30kg. My blood scores, cholesterol and triglyceride scores had all returned to normal for the first time in five years. I came off all medications and repeated the tests a year later – again all normal.
Cope or cure?
Maintenance after remission is a different issue altogether. The difference between ‘remission’ and ‘cure’ when it comes to type 2 diabetes is a hotly contested subject and many will question whether it is ever accurate to say that a chronic illness is ever technically ‘cured’. For those in prolonged remission, like me, there is, of course, a self-evident predisposition for symptoms to return without an enduring long-term commitment to a permanently changed lifestyle.
People’s experience of remission (just like people’s experience of the disease) is different. Some people are controlled diabetics who need to ruthlessly monitor/control everything in their diet and/or who choose to remain keto/LCHF in the long term. Other people regain the ability to have a very flexible diet – including resuming eating carbs and sugars, to varying degrees, without abnormal spikes. The key issue is the capacity of the pancreas to regain and maintain normal function as measured by the extent/duration with which insulin spikes after consuming certain food groups, which itself depends on the capacity for pancreatic beta cell recovery.
Diabetic remission is a reality for many people. I – and thousands of others – have achieved it through a dramatic change in diet and lifestyle. However, it’s not possible for everyone, and not all type 2 diabetes is brought on by the same poor choices that led to my diagnosis. For those who want to give it a shot, it’s very important to stay in touch with your doctor or a nutritionist while you do it.
There can be some very significant risks associated with changing your diet or attempting a low-carb regime and, for some people, these risks can be far greater than the original diagnosis itself. Seek medical advice before you change your diet and don’t change your medications without talking to your doctor first.