My Type 2 Diabetes Story

Managing Type 2 Diabetes Naturally

This is Diablo’s Type 2 Diabetes Story, a newsletter about Managing Type 2 Diabetes Naturally.

Without having any prior health conditions I was diagnosed with type 2 diabetes. My instinctive reaction was to want to heal this condition. While medical treatment was available it was in the form of medication and directed at the symptoms rather than the cause. This story is about my journey to address the causes naturally.

Preliminaries

• I am not a doctor and have no medial qualifications. Any understanding I have developed is my own, but I cannot assert any of it is qualified medical fact or advice.

• My intent is to share my experience so it is available to others in case it may be of some interest.

• Everything I state is as I have come to understand it from the research I have done. My main sources for the research:

  • Web searches leading me to articles/videos on the topic

  • A few books written by doctors specialising in the area or type 2 diabetics who have lived with the condition for many years

  • Various ad hoc conversations with those who have some interest or qualifications in health and health promotion

  • Diabetic forums where others are experiencing the same and sharing their experience.

• I must disclaim that nothing constitutes medial advice, or even medical fact, and the reader bears sole responsibility for any reliance they choose to place on what they read. My own experience involved hearing/reading conflicting information and ultimately I had to decide what I felt was right. I would usually seek multiple sources of information validating something that felt right together with trawling through multiple discussion threads on forums which often gave a practical insight alongside the theory.

Lifestyle Background

I had considered myself to be leading a healthy lifestyle:

• Office based job

• Exercise: c.2x per week yoga, sometimes walked to/from work c. 2 miles each way, but weather and time dependent. This pattern in force for 15+ years. Holidays tended to be active and walked for day to day activities (did not even own a car).

• Diet: Vegetarian of many years, non-smoker, very light alcohol consumption (1 or 2 units per week)

• Remained overweight for 15 years, with the last 10 probably nearing clinical obesity (i.e. BMI approaching 30).

Diagnosis

It was only in the last couple of months before my formal diagnosis that my symptoms surfaced to the point that they were noticeable. In hindsight I think there were some symptoms that very very slowly may have arisen over time but so slowly that they were not noticeable.

Main symptoms – slowly occurring:

• Energy was less. Happened very slowly so I didn’t notice but then I was getting to the point where I was not confident in doing vigorous exercise.

• I was eating persistently, including sugary snacks (crisps, biscuits, chocolate). My main diet included a lot of high carbohydrates foods (bread, pasta, commercial cereals, fruit juices).

Main symptoms – noticeable in the last couple of months before diagnosis:

• I was consuming a few litres of drinks per day. Sometimes it was orange juice or diet soda and sometimes it was water. This too increased slowly so I did not realise it.

• I was peeing frequently. I did not think this particularly odd as I was drinking lots of fluids.

• Eyesight started changing.

• At the end of a work day, I would have to lie down for a couple of hours before I could make my evening meal.

• When I went to bed at night I heard a whirring noises in my abdomen as if my body was audibly processing all the intake of food and liquids

• In the night, I would wake with a startle. Sometimes it would be as if something in my chest/heart area got out of rhythm..

• My sister had a blood pressure monitor and my blood pressure was 140/90 and resting heart rate over 100.

Informal Diagnosis

Looking up these symptoms it suggested diabetes. But my parents did not have diabetes and I had not considered myself that unhealthy. When I saw that my blood pressure and resting heart rate was so high I did start to think something was wrong. I bought a glucose monitor online together with some test strips. Annoyingly, the first few strips didn’t give me a reading as I had to get used to the finger pricking and testing procedure. One that did give me a reading had a measure of 28, and another of 33. I thought that I had gotten the wrong unit of measure as normal ranges were between 4 and 7. I got some more strips and also tested my sister who had a reading of 5.5 or so. I then ordered some control solutions which test the monitor for accuracy and they showed that the glucose monitor was accurate. At this point it was unquestionable that I had severely high blood sugar.

I was wary of contacting my GP surgery due to my previous experience. A friend suggested I use the doctor services through my work whereby I could have a call. I explained my symptoms and my readings and the doctor I spoke to said I have to contact my GP as, if it was diabetes, it could only be addressed that way as it would require ongoing care. He wrote a letter confirming this. I asked him about stress being a factor in the cause of diabetes and he said stress isn’t usually a factor in the onset of diabetes.

Formal Diagnosis

I contacted my GP who ordered blood tests and my HBA1C came back with a reading over 150. Under 42 is considered normal range, 42-49 pre-diabetic and over 49 diabetic. I later asked a couple of doctors who I know and they said the highest reading they had ever seen were like mine.

I was called to attend my doctor’s surgery without delay and with a forewarning that I may immediately be admitted to hospital. The doctor made the comment that “I was walking around” which was a good sign but also explained that there was a risk diabetic ketoacidosis. I later read this is very serious and could lead to death. It was clear to me the doctor’s were very worried, but after taking my ketone levels and consulting with the hospital it was decided not to admit me to hospital.

I was however given medication to commence immediately. Metformin 1 x 500mg tablet daily for a week, to be then raised to 2 x daily after a week, then 3 x daily after a further week. I was also told that I would likely to have other drugs on top of this.

I had a strange call a week later from another doctor at the practice who said to up my metformin 4 x 500mg daily and that sometimes it was even advised to take up to 6 x 500mg. He did not explain what triggered his call or why his advice differed from the previous doctor who saw me face to face. I felt uncomfortable with this revised advice.

I also felt despondent as I suspected that the doctors were preparing me to take insulin. I felt that from having no ailments, to suddenly having a chronic illness, with increased risk of kidney failure, blindness and amputation as well as most other serious illnesses (cardiovascular disease, cancer, etc.), I would also have to inject insulin for the rest of my life with all the restrictions that entailed. Some activities such as diving, high altitude activities, even driving were things which could be affected as insulin users are at risk of very low blood sugar (or “hypos” if the injected insulin lowers their blood too much) which can result in a coma. In short it felt that life had changed forever.

Consultation

Initial Consultation

My GP had referred me to a hospital consultant. It was a couple of weeks before the consultant was able to speak with me on the phone. I’d actually been testing my blood glucose daily once I had got my glucose monitor. I’d also already removed all sugars from my diet and was reducing my refined carbohydrate intake replacing those foods with others that had no sugar and very low carbohydrates. I’d done this because it was very clear from, even a small amount of online research, that this was an almost universal approach adopted by type 2 diabetics who’d manage to improve their condition. Within days my blood glucose monitor reading began to drop rapidly, from the twenties to the high teens, to the low teens. When my GP called me into the surgery it had dropped to about 15 and I was pleased, but the GP said the normal range is between 4 and 7. The blood sugar continued to drop in the couple of weeks after I saw the GP up until I spoke to the hospital consultant. By that time I had readings in the sevens and sixes. I had also lost a lot weight, probably a stone and half in about three weeks of stopping sugar and carbs. I’d stopped eating persistently and was only drinking water but my thirst had gone down. The noises in my abdomen (which I know believe to be my kidneys working to emit excuse glucose through my urine) had subsided. This sort of whirring noise ceased and for the first time in a long while my abdomen felt at rest.

So by the time I spoke to the consultant, I was very keen to explore to whether I could moderate the increases in Metformin dosages. To my delight the consultant said I could because I was monitoring my blood glucose daily but if it approached 10 then I should increase to 3 x daily. Upon hearing that I’d drastically reduced my carbohydrate intake I was advised that that was not normally recommended.

What happened after the initial consultation was that my blood glucose readings remained within the 4-7 range and while I did eventually increase to 2 x daily I did not think that is was necessary. I went back down to 1 x daily and there was no worsening in my daily blood glucose readings. I did not re-introduce any carbohydrates into my diet.

Second Consultation

After three months I had a face to face consultation. My HBA1C had dropped from over 150 to just over 50. While this was good, my consultant said it was still high. It was also suggested to consider statins as diabetics have higher cardiovascular risk and thus should aim ideally for a cholesterol level of 4. Mine was over 5 but not inconsistent with readings I’d had in my adult life. I did ask if there was anything I could do naturally to address the cholesterol and was advised to perhaps consider lower fat foods. When I researched statins I found that these are medications that once started were for life. I looked into side effects, etc. I was actually wanting to eliminate the one drug (Metformin) I was taking, rather than adding other drugs albeit the statins were for another purpose.

My general health over the three months since my initial consultation had come on leaps and bounds. I’d lost even more body weight, had more energy and felt very much better. I’d considered whether I could eat lower fat foods, e.g. instead of full fat yoghurt use low fat, but it actually conflicted with fact that I was getting my caloric intake in a large part from fat. Although I did not measure it specifically, I had reduced carbohydrates drastically and also the overall volume of food (eating only twice per day), but eating foods with fat actually satisfied me and I did not feel hungry. For example eating an avocado which is high in (good) fat was much better compared to corn flakes as it did not raise my blood sugar much but filled me up more than the bowl of corn flakes and for longer.

There were six months until my next consultation. However, at the three month point after my first consultation, I had another HBA1C reading and this time it was 38. It had fallen from the diabetic range, skipping the pre-diabetic range, to the normal range (20-42). I decided to stop taking metformin as the only way I could know if I could maintain my blood sugar in the normal range without medication was to try.

I had another HBA1C at the 6 month point after my first consultation and the HBA1C had fallen marginally. The HBA1C actually measures the glycation of the blood (haemoglobin) as this a good proxy for the 3-4 month average blood glucose level. As I had not been taking Metformin for three months it suggested I could maintain a normal blood glucose level without it. I had read that Metformin had been used in Europe for over 50 years and was considered safe without prevalent long term side effects. This made me feel a bit less concerned about taking it but I still preferred not to take it all if possible.

Final Consultation

When my six month consultation arrived a student doctor sat in on it with my consent. My consultant congratulated me on my progress and remarked to the student that this was something you’d rarely encounter. My consultant told me to continue whatever it was I was doing. I had broadly told her I had changed my diet and established an exercise regime but not gone into any details. I did ask about the statins previously suggested but was told it was not necessary to consider them any more due to where my diabetes was now. In fact, my cholesterol had also dropped to well below 5 despite my not cutting out fats, so I really was not persuaded to commence statins at all and would have said so if it had been suggested again.

In the post consultation report it stated I had reversed my diabetes through diet and exercise. My consultant was a really nice person, but one thing that never happened was I never went into detail about my approach to addressing my diabetic situation. I suppose time was often limited, but I could not help but think that my experience would surely be of interest to someone who presumably came across folk like myself regularly. I also wonder if the junior doctor in training who was in attendance might have been interested but she was not invited to ask any questions of me.

Biological Causal Factors

My early experience with medical professionals was that diabetes is considered a chronic condition which progresses (gets worse) over time so any medication you take is for life and will likely increase as the condition progresses. While I can see the merit in medicines to address acute (short term) conditions, for something considered chronic, I was very strongly wanting to exhaust all natural means of addressing it, before medications.

For me to decide how I was going to deal with my diabetes I had to understand better what caused it. From preliminary research it soon became apparent that high blood sugar was a symptom not a cause. I came to understand that there were a couple of main potential causes from a biological perspective.

• Insufficient insulin production. The pancreas produces insulin which allows consumed sugars (meaning all carbohydrates, not just literal sugars such as glucose and fructose, but anything which would breakdown into those more basic sugars once consumed) to be moved from the blood stream into the body cells. So the issue could be that the pancreas is not producing enough insulin any more. It seemed there were various hypotheses as to why this may have occurred:

  • Exhaustion of the pancreas. The pancreas secretes insulin via beta cells in an initial blast once you start eating, then drip-drip secretion while you are eating. If eating throughout the day then each time you eat, even if one mouthful, would trigger the initial blast. Historically, our bodies are not designed for persistent eating, but occasional eating say a couple of times a day, or going backwards even less frequently. With persistent eating the repeated trigger of the initial blast of insulin is exhausting for the pancreas and eventually the beta cells cease to function.

  • Fat around the pancreas. The weight around the middle of the body means there is fat around the organs in the abdomen including the pancreas and liver. The excessive fat eventually compromises the function of the organ.

• Insulin resistance. In the normal function of the body the sugar that enters in the body does not remain in the blood stream, it goes into the cells of the body. The mechanism by which this happens is that the body produces insulin which allows the cells the receive the glucose and then store it for later use in the form of fat. If however, the fat does not get used and more and more sugar is received into the cells and stored as fat, at some point the cells will become resistant to receiving the glucose. This is known as insulin resistance as the body’s natural insulin production is no longer sufficient to have the blood sugar go out of the blood stream and into the cells. It actually seems to me a protective mechanism of the body. The issue is that once there is excessive blood sugar which remains in the blood, it is toxic to the body. My understanding is that the excessive blood sugar means there is more oxidation or oxidative stress, particularly around nerve endings and organs. This why people with diabetes have the highest incidences of blindness (resulting from Retinopathy, the eyes being at the end of the optic nerve; foot amputation (at the nerves in the feet (and indeed the hands) are the furthest and this are most at risk; and kidney disease (the kidney being another key organ). By reducing the stored fat in the body, the cells would not be so insulin resistant.

Insufficient insulin production and insulin resistance are not mutually exclusive and I expect that there is a good chance both factors are causes for my diabetes.

Excessive insulin: I am also aware of the theory that type 2 diabetics actually have chronically excessive insulin rather than insufficient insulin. In this theory, the heightened levels of insulin are due to the body producing it in response to the glucose in the blood sugar being excessive. However, it doesn’t function normally due to insulin resistance, and so both blood glucose and insulin remain persistently higher than normal. I do not think this contradicts “insufficient insulin”, but explains why it seems that there is insufficient insulin - but it would not be insufficient if there was no insulin resistance.

I would add a further biological causal factor is genetics.
Many months after I was diagnosed I found that there were others my extended family that had type 2 diabetes, although neither of my parents nor my siblings had/have it. So I think I do have some genetic pre-disposition but obviously can take no action with regard to this particular factor so do not mention it further.

Lifestyle Causal Factors and Practical Steps

The steps I have taken reflected my understanding of the life-style factors that could be causal in my type 2 diabetes. Having gained an understanding of the biological causal factors, the next step was to try and understand what caused the biological causal factors to occur. In other words what was I doing in my day to day life habits that gave rise to the biological causal factors. By identifying these lifestyle factors I could then take steps to change them with a hope to improve my diabetic condition.

Whenever I introduced any step it was on the basis it was permanent. If I did not feel something was sustainable I did not introduce it on the basis that any benefit from that particular step would be lost once I stopped. Given how severely hyperglycaemic I was at diagnosis, I was scared that I was in real danger of the common complications with diabetes such as blindness, amputation and kidney failure. It was not a time for a tentative experiment or small baby steps, and my approach was to go all in.

I think of the steps in four groups:

Diet

• Removal of all sugars from diet – at the time “sugar” to me was literally sugar but very soon I came to understand that sugar has multiple names on an ingredients list so instead referred to the nutritional information mandated on virtually all sold food products. For those foods without packaging, e.g. fruit and vegetables, online nutritional values were easily available. I did have to practically learn how to cook and take the time to cut and chop ingredients something that I’d skimped on previously.

• Removal of carbohydrates from diet – it was clear from the research that carbohydrates were as bad as sugar. I remember one article I read stated having a bowl of pasta was like having 30 teaspoons of sugar for a diabetic on the basis that the carbohydrates are very quickly (within a few minutes) converted in to glucose in the blood stream. And, as a diabetic, they remain in the blood stream rather than get into the cells.

• Cease persistent eating – only eat at meal times and nothing in between. Drinking water at any time is OK.

• Eat only in a limited time window each day – quite often referred to as a form of “intermittent fasting”, the idea that the metabolic system needs to rest and recuperate. Some parts of its recuperation function can only kick in after a minimum of four hours after eating but the longer the window between the last meal of one day and the first meal the next day the more the time for that recuperation. The default soon became twice per day: mid morning for first meal (breakfast); and mid/late afternoon (dinner). The eating window is thus around 6 hours and the fasting window was 18 hours. I did try a couple of actual fasts of a few days too as they too are said to have many benefits.

• Some foods are said to increase insulin sensitivity – those foods I have included into my regular diet are:

  • A couple of drops of apple cider vinegar in my water

  • Cinnamon – I sprinkle it on my yoghurt every other day

Exercise

• Maintain the regular exercise classes I did (yoga a couple or three times per week)

• Regular walking of 3 – 5 miles which is built in as much to daily routine. E.g. walk somewhere if I have an appointment. Otherwise I have found a scenic route alongside water and greenery of about 4.5 miles that I’d do regularly (3 times per week, but less in winter months due to less daylight and worse weather).

• Some form of cardio exercise – originally it was weekly for about 6 months, but then it dropped to about twice a month. The exercise for me was 20 mins on a running machine which is enough for my heart rate to go to its maximum safe level (an approximation to the maximum safe rate is 220 less your age). I do not exceed this as after a certain point the body’s response to cardio exercise actually raises blood sugar. I believe the hormone cortisol is produced and this in turn means that glucose is released into the blood stream.

• Some form of resistance exercise – for me I did this after the cardio to form a regular gym workout. The benefits of resistance exercise is that the effect on the exercised muscle last for a couple of days if you go to resistance. I understand that insulin sensitivity is increased which I presume is because in the couple of days after exercising some stored fat in the cells is used up by the muscles.

Sleep

• The body needs rest time. In particular the metabolic system, which to me is the system by which the body processes what we consume to serve our body’s needs, needs to rest. So good sleep is important and in the absence of it, it can raise blood sugar. My main change here was to go to bed earlier and avoid late night working/being on the computer. I cut down coffee consumption to be in the morning only so that come the night time, my earlier to bed time would not be me staying awake. I was also able to stop being woken up by an early morning alarm clock by switching it off. In this regard my work circumstances changed so that I could be less rigorous about an early alarm before I was able to more naturally awake.

Chronic Stress Reduction

• I eliminated the chronic stress that I experienced due to my work. It was resulting in worry, anxiety and lack of sleep. I had already taken the decision to cease/change the work situation before my diagnosis, but I now had a health reason. I had come to learn that stress also triggers hormones, particularly adrenaline, and consequently raises blood sugar. I would often comfort eat to deal with the stress multiple times a day – sometimes in between meetings. I came to the view that the pre-diagnosis doctor’s advice that stress wouldn’t be a causal factor in the onset of type 2 diabetes was wrong. Indirectly, chronic stress I believe is a causal factor in many diseases. The specific link to diabetes is the raising of blood sugar – which may be indirect (perhaps as in the brain demanding more fuel to deal with the stress, resulting in comfort eating) or directly raising blood sugar together with adrenaline. Sleep also is (often severely) affected by stress and associated anxiety. With the elimination of my main chronic stressor my sleep improved. Humans are designed to deal with acute stress, but not chronic stress, which is why chronic stress leads to disease.

Making these changes practically overnight in a big bang fashion was drastic but I was in a drastic situation. The changes would clearly be good for health generally so it was not a case of if but how could I introduce them into my day to day life while continuing with that day to day life. Or, where my existing day to day life would not allow me to make the change, adjusting it so I could make the changes. In other words making my health the priority and fitting anything else around it.

I found that my body adjusted very quickly to the dietary changes of cutting out sugar and carbohydrates. Within days any cravings I had subsided completely. The exercise changes were really extending what I tried to do anyway except that I did more and would not let being busy or poor weather be an excuse for not doing it. The elimination of the work stressor was a little more of a process than overnight but I am convinced it helped me to sleep far better, and as a result, gave my body much need rest.

Summary of Progress so far (from formal diagnosis)

• After 3 months, blood glucose daily readings in normal range, but HBA1C still in diabetic range. c.15 % body weight reduction but no calorie counting. Eat to satisfaction. Taking Metformin.

• After 6 months, daily blood glucose and HBA1C in normal range. c. 30% body weight reduction. At this point ceased metformin.

• After 9 months, daily blood glucose and HBA1C in normal range. Body weight stable at c. 30% reduction from start. BMI c. 22/23

• From 9 months onwards as above. At the time of writing, c. 2 years and counting, HBA1C in normal range with body weight/BMI remaining the same.

I do not believe I have reversed my diabetes but do believe I am managing to maintain reasonable glycaemic control (i.e. blood sugar control), and without any medication, such that the risks of the many medical complications that could arise are reduced especially compared to the point when I was diagnosed.

I’d summarise my experience of my lifestyle modifications as follows:

Diet: On a very few occasions I have tried foods that I had excluded, e.g. flat bread and have found that my blood sugar will spike. Even with the starchier complex carbohydrates (spelt wholegrain spaghetti, organic wholegrain rolled oats, brown wholegrain rice) my blood sugar spikes. So I can only conclude I am to some extent still insulin resistant, or producing insufficient insulin or a bit of both. Some foods with complex carbohydrates like chickpeas and mixed beans in small quantities and usually taken mixed with other foods, I seem not to have a blood sugar spike if eaten as a one off. It seems that the overall carbohydrate intake is the key factor, rather than whether the carbohydrates are simple or complex. While complex carbohydrates take longer to be broken down into glucose, the process still happens and too much glucose remains in the blood.

Exercise: When I have lapsed in taking exercise I do notice a slight increase in blood glucose so do feel that regular (daily) exercise is a must. One day is fine but after two or three days without exercise the effect is noticeable in my blood glucose readings.

Sleep: Poor sleep does often precede a raised fasting blood sugar so I do feel it is important to continue to develop good habit for good sleep

Chronic Stress: I have been relieved of chronic stress for much of the 2 years (at the time of writing) as I changed my work situation. I am sure if I was in a chronically stressful situation again it would adversely affect my diabetes.

Daily glucose monitoring: I continue to do this daily and record it. It has become part of my routine and alerts me to any raising of blood sugar. I’d not know otherwise. Also, measurement focuses the mind and constantly prompts me to eat, exercise and sleep properly and not fall back into past habit.

Appendices

Staple foods

• Eggs

• Avocados (on their own or in salads)

• Mixed Nuts

• Yoghurt (full fat), with frozen mixed berries (Blueberry, raspberry, blackberry, strawberry)

• Cauliflower (most often to use as cauliflower rice)

• Vegetable curries (Broccoli with paneer cheese, mushroom and leek, aubergine) to go with cauliflower rice

• Tofu (within a vegetable stir-fry or similar dish e.g. tofu skewers with peppers/courgettes)

• Salads with green leafy vegetables. Also tend to include cucumbers and tomatoes.

• Cheeses (Halloumi, Mozzarella) as part of salad

• Double cream for use with coffee

Things I add to the above due to their nutritional or insulin sensitivity value

• Cinnamon (helps increase insulin sensitivity)

• Apple Cider Vinegar (helps increase insulin sensitivity

• Nutritional Yeast (for B Vitamins)

• Chia Seeds and Flax Seeds (Many nutrients, helps cholesterol and lower blood pressure)

• Sunflower seeds

• 100% Cocoa Chocolate with no sugar. (Small amount, high in anti oxidants)

Excluded foods

• Sugar: Cakes, pastries, chocolates made with sugar, sweets

• Carbohydrates: Crisps, bread, pasta, rice, potatoes, cereals, fruit juices, all fruits other than berries. Anything made from flour or grains.