Brave New World

Life after T2 Diabetes Remission

In October/November 2021 I was diagnosed with Type-2 Diabetes (T2D hereafter). It wasn’t a total surprise, but it forced change on me. When I mentioned my diagnosis on Twitter and my blog, my North American friends immediately told me about their experiences with medication; by contrast, my doctor here in Edinburgh, Scotland, said we should look first at ‘lifestyle issues.’ In passing, she said I could do worse than have a look at one of Dr Michael Mosley’s books.

I didn’t follow the programmes that Dr Mosley recommends, but from his book I got a much better understanding of what T2D is and determined to do two things:

• stop putting sugars into my body

• deal with the sugars already in my blood and stored as fat.

It worked.

On diagnosis, my HbA1c reading was 54 mmol/mol) (7.1%) - diabetes is diagnosed when the reading is above 48 (6.5%). Four months later, in February/March 2022, my HbA1c was 37 (5.5%), below the diabetic threshold. I had dropped two trouser sizes, lost 20kg (44lbs) and both my HDL cholesterol and triglycerides had improved.

One year later, the reading was 31 (5%). I’ve dropped another two trouser sizes and lost a further 10kg (22lbs) My HDL and triglycerides have improved even more, as has my creatinine.

The definition of remission in the case of T2D is an HbA1c reading below 48 sustained for 3 months without medication. My T2D is therefore in remission and this Substack is about how I plan to keep it that way.

How did I achieve remission without medication? I treated refined sugar as poison, ate a low-carb diet, avoided processed food, cooked from fresh whenever possible and, once I’d lost substantial weight from the diet alone, I went swimming and completed a couch-to-5K programme. I go into a bit more detail over on my blog.

So why start a Substack?

Because after that initial suggestion that I read Michael Mosley, I was more or less on my own to figure it out. That isn’t a criticism of my doctors because the practice has been under immense and sustained pressure like every other GP practice across the country. I’m still figuring it out, and I want to share what I’m doing, what works, what doesn’t, and other thoughts here. I could, and will, keep posting stuff on my blog, but I think Substack is likely more discoverable, especially if network effects kick in.

That’s my story so far; what more is there to say? Quite a lot.

Shortly after my doctor confirmed that I am in remission, an article appeared in the Observer about the work of Dr David Unwin. You’ll find the article here. Intrigued by the similarity with what I had managed, I watched several of Dr Unwin’s talks on YouTube and was introduced to some of the things that I hadn’t figured out for myself. Chief amongst these was the notion of Glycaemic Load (or GL).

I was aware of GL but didn’t grasp it’s significance. When figuring things out for myself, I reckoned that if I restricted carb intake and selected predominantly those with a low Glycaemic Index (GI) score I wouldn’t go far wrong. I’d tried to stick with that all through 2022 and the results speak for themselves. But I didn’t understand why my median weight before breakfast this year had risen 2-3kg (4.4-6.6 lbs) above where it was in August 2022, nor why my blood pressure was creeping up from where it was when I was in ketosis in early 2022.

GL is a measure of the impact of any particular food on your blood sugar level. It is conventionally expressed as a multiple of the effect of one gram of glucose. Unfortunately, we don’t think in terms of grams of glucose. More helpful is that a teaspoon of refined sugar has a GL of 2.73. That means that you can think about foods as the equivalent number of teaspoons of sugar.

In my case, I like to have fruit and nuts with Greek yoghurt. Great! and I get my five-a-day. But hang on, that banana has the equivalent impact of 5 to 6 teaspoons of sugar? I make my own bread and am quite good at it. I felt really pleased that I was using low-GI grains, without thinking of the glycaemic load each slice delivered.

So while I thought I was doing the right thing, and had excellent results, it looks like I’d got complacent and more carbs than I thought had crept back into my diet.

How can I be sure? I’m not yet, but I’m testing it. For the next eight weeks I’m going back into ketosis to see what happens to my weight and my blood pressure. Today is day six of the experiment. I’ve lost 1.3kg (2.86lb) so far. It’s too early to draw any conclusions about blood pressure, but at present my average systolic pressure is down by one point and diastolic down by 2.

Oh, and I forgot to mention. I currently buy jeans with a UK 30” waist (down from 38”). By the end of this experiment, I hope to be in a 28” waist, something I haven’t been since the early 1980s.

---

Finally, this Substack is and will remain free. I had to figure this stuff out for myself and I’m passing it along to whoever might find it helpful. However, please note that I am not a doctor and you shouldn’t treat what I write as being in any way medical advice. My body and circumstances are not your body and circumstances.

Having said that, I reckon that, for most of us, sugar is metabolic poison and should be treated as the enemy. The UK government is currently prescribing national medication in the face of what they see as an ‘obesity epidemic’ (and running into trouble). They are wrong; we don’t have an obesity epidemic, we have a sugar epidemic. In future posts, I hope to set out some of my reasoning for that, go into more detail on my thinking when I set out to do something about my T2D and quite likely have a rant or two about the unhelpfulness of food labelling.

Thanks for reading my Substack! Subscribe for free to receive new posts.