My Journey with Type 2 Diabetes
In February 2014, shortly after I’d been called back for a second blood test in just four days by my ultra-caring and supportive GP at the Poundbury Doctors Surgery in Dorchester, he hit me with what was for me totally unexpected news ... I had type 2 diabetes. How could that be? After all, I had no symptoms, or so I thought! A serious condition, according to the GP. I was horror-struck, even though I didn’t know precisely what diabetes was. At the age of 64 I was in a state of total self-denial.
“Don’t worry, Keith, I’ll register you for one of the education sessions at the Diabetes Centre at Dorset County Hospital to see whether you can start to get things under control within the next three months. Then we’ll organise another blood test to check on progress, otherwise medication may well be needed. I suggest you take a look at the Diabetes UK website when you get home, it’s got plenty of excellent advice, articles and even recipes. In the meantime I’ll check your weight.” I vividly remember my weight that day, it came as a huge shock.
I went home and logged into the website. My concerns were soon borne out. More or less the very first article I saw was about foot amputation. Bearing in mind that I knew nothing about the condition, this turned out to be my wake-up call in life. I really didn’t want to go through anything like that. The stress was indescribable.
Several days later I trotted off to the Diabetes Centre in Dorchester and sat through an excellent and enlightening three-hour education session. The focus was on the causes and consequences of diabetes, managing the condition, understanding blood test results, and the importance of diet and exercise. This is going to be tough, was my initial reaction.
But at least now I understood what had caused my diabetes. It hadn’t run in the family, I hadn’t been on a lengthy course of steroids. And it certainly wasn’t gestational diabetes! It was down to my poor lifestyle, in more ways than one, over quite a number of years.
From excelling at football at a very high level in my youth to playing squash in the German national league a few years later, I swiftly moved on to the occasional good walk spoiled, namely golf, eventually downsizing from eighteen holes to nine holes. Inevitably my body shape changed somewhat over time, for the worse. The pounds crept on, primarily around the midriff. XL clothing became the norm.
The weight problem was further compounded by work stress and work excess. For many years my job entailed travelling around the world. My British Airways account showed that I’d flown enough miles with BA alone to go around the world nearly twenty times. Not forgetting the numerous flights with Lufthansa, Qantas, Delta, Singapore Airlines, American, the list goes on …
Frequent international travel almost inevitably means little or no exercise, long days and short nights, mostly eating rich, high-calorie, high-fat food at irregular times yet frequently being entertained in expensive restaurants and bars. I loved it, but it didn’t love my body.
So I realised that I had to change. I came to the conclusion that only I - and no one else - had been responsible for what had happened to me, so I was clearly the only one who could do anything about it. That meant a permanent lifestyle change and willpower in abundance. I set out to reverse my diabetes in the knowledge that there’s no miracle cure.
Being averse to the terms “diet” and “exercise”, I chose to use “healthy eating” and “activity” instead. I decided the best way forward was to set myself specific and achievable targets and to monitor progress. I didn’t think to download an app for my smartphone, instead I created an Excel spreadsheet which I updated daily.
My primary goal was to lose enough weight to move out of the “obese” category on the body mass index (BMI) scale to “overweight”, then down to “normal”. Tough but achievable. Other targets included eating a minimum of five portions of fruit and vegetables per day and being active for at least 150 minutes per week. Alcohol consumption was clearly on the hit list.
Healthy eating essentially meant opting for a balanced and varied choice of foods. Armed with a far better understanding of the role and importance of (starchy) carbohydrates, protein, dairy foods, fats, fruit and vegetables, I embarked upon a complete overhaul of my diet. Instead of a full English breakfast I opted for options such as poached eggs and avocado on toasted rye bread. Snacks switched away from a packet of crisps to hummus and carrot sticks. I knew from the Education Centre session that no foods were prohibited, but I decided nevertheless to cut out all highly processed and high-fat foods such as takeaways, bacon, sausages and cheese. Instead, I went for pulses, lentils, interesting salads, fruit and plenty of vegetables. I soon found that I was exceeding my target consumption of fruit and veg. Eating foods with all the colours of the rainbow became standard. And grazing on cheese snacks gave way to nuts or fruit.
After establishing one day that my portion of cereals was a staggering four times the standard serving I understood the need for portion control. I realised that over the years I’d become accustomed to filling my plate with whatever was on offer. That had to change ... and did.
Food shopping also changed. Instead of just picking whatever appealed to me on a whim, I drew up food plans for all main meals every week and bought appropriately. I paid great attention to food labels in terms of both fat and sugar content. Reading labels became part and parcel of the shopping expedition. And buying foods that can be simply reheated at home was out. Now healthier, home-made cereals, bread, baked beans, soups and curries took over. With no added salt or sugar, but with seeds, nuts, spices and herbs instead.
Eating out with my wife changed too. Less frequently but better quality. Sharing a healthy salad main as a starter rather than two cheese-laden standard starters became the norm, as too was opting for a healthier alternative to oversized portions of fries, pasta, rice or roast potatoes with the main course.
So what else did I learn? I learned to be honest with myself. I learned to ignore “advice” from others but to appreciate the invaluable support from my highly supportive wife. I learned to fill my plate with vegetables before adding the protein. I learned to eat vegetarian or vegan at least three times per week, later four or even five times. I learned to say “no” to temptations. But I also learned to enjoy the occasional treat without feeling guilty.
More importantly, I concluded that preventing or delaying the onset of diabetes is far easier than managing it. So by making good food choices and activity a priority the more they become a lifestyle.
Healthy eating was complemented by a healthy increase in activity, which I tracked on a daily basis. I resisted the temptation to join a gym. Instead, I found that regular dog walking helped but was still not enough. I invested in a static exercise bicycle, starting out by cycling quite slowly for five minutes and gradually stepping up to twenty minutes or more. I also discovered the benefits of high-intensity interval training (HIIT) - cycle at normal speed for twenty minutes, flat out for twenty seconds, another twenty minutes at normal speed, flat out for twenty seconds again. Then there was the extra benefit of exercising in the kitchen while waiting for the kettle to boil!
I know that swimming is an excellent activity but it wasn’t for me. I just preferred to remain as active as possible, for example by getting off the bus one stop earlier, parking the car well away from the entrance to the supermarket, and by performing exercises with a resistance band, even while watching the TV. And making time for a walk after lunch at the office proved highly beneficial.
To my surprise I found that all this activity tended to make me feel less hungry, an added bonus.
Of course, I made mistakes. I read too many books on how to “reverse your diabetes within weeks”. In the early days I ate too much fruit in a single session, being unaware of the resultant blood sugar spike. And I attached far too much attention to reading food labels in detail - after all, does it really matter whether a small pot of yoghurt contains 4.5 or 4.8 per cent sugar?
The outcome was – for me at least – highly encouraging. I had achieved my goals. Within months I had lost twenty four kilos (four stone) and have maintained the same weight ever since. I no longer need blood pressure medication in spite of being the proud owner of a cardiac pacemaker for well over a decade. And my diabetes has been in remission for the past four years. I feel in better shape now than I was when I was younger. I feel strong and I’m happier in my own skin. My body, tastes, likes and dislikes have changed for good. And to think it only took a few months for those changes to make an impact for life. It’s not an easy journey, but it can be done!
Delighted with my success, my GP suggested that I could help some of his patients. So for the past few years I’ve been volunteering as a patient representative at the weekly or fortnightly Diabetes Centre education sessions, providing the truly exceptional NHS staff with support wherever possible and explaining to the newly diagnosed diabetics how I managed my diabetes.
At my latest annual review the practice nurse congratulated me on the excellent state of my feet after all the tender loving care they received in recent years, a key lesson I’d learned at the Diabetes Centre. A few days later my GP told me that effectively I’d reversed my diabetes because my permanent lifestyle change had yielded sustainable results over such a lengthy period of time. After all, my HbA1C levels now range from 31 to 35 mmol/mol, well short of the diagnostic for diabetes.
He also told me that I’d added ten to fifteen years to my life.
That’s music to my ears! Willpower prevails!
Finally, I would like to thank every single member of the dedicated NHS staff who helped and guided me along my journey. You know who you are.