How To Reverse Type 2 Diabetes and Prediabetes (eBook)

CHAPTER 1

You CAN do it

The biggest myth about type 2 diabetes is that it is a condition that just gets worse over time, and there’s nothing you can do to stop that happening. This is a view that is firmly held by many people, including some health professionals. There is a good reason for this – we used to believe it was true. However, that was a long time ago. It is nearly 20 years since we first learnt that type 2 diabetes can be prevented, and over 10 years since we learnt it can be reversed. Stories of people reversing their diabetes are now quite common in the media, and you may well know someone who has managed to do just that. And yet, too many of my medical colleagues still treat their patients as if nothing has changed, as if what they were taught 30 years ago still takes precedence over more recent scientific advances in understanding. And if one of those people is a doctor or nurse helping you manage your diabetes or prediabetes, that can be quite disconcerting. Diabetes UK, which exists to support people with diabetes, states: ‘At some point, most people with type 2 diabetes will need to take medication to help them manage their blood sugar levels', implying that medication is the norm and to be expected.’1 It acknowledges that some people are able to put their diabetes into remission, but it goes on to say that this is not possible for everyone. While this is true – it is not possible for everyone – the way it is presented gives a subliminal message that goes something like this: well, it is possible to reverse type 2 diabetes, but it’s very difficult and most people aren’t up to it, and so you will probably need medication to control it.

I feel this is an unnecessarily and umabitiously defeatist approach and I often compare this with that of doctors who treat cancer. Some cancers have a very high likelihood of causing death, and yet there could be treatments that provide a small chance of achieving remission. I have personal experience of this from some years ago, when my father was diagnosed with an aggressive form of leukaemia. It was resistant to normal treatments but there was a more complex therapy that offered the possibility of success in controlling the disease. We all understood that he was very ill, and I guess deep down I knew he would not recover, but the team looking after him focused on the positive, on the slim chance that the treatment could help him pull through. During this time, a nurse kindly and gently encouraged me to stay positive by saying to me, ‘There is always hope.’ Those words, and that wider focus on the positive, greatly helped me through that time, even though his condition took a turn for the worse before he was able to start the treatment, and he died shortly afterwards.

Now the chances of achieving remission of type 2 diabetes are a lot higher than my dad’s chances of overcoming his illness. Yet many health professionals seem to focus on the negatives – it’s hard work and most people won’t manage it. However, gradually and begrudgingly, the understanding that it is possible to reverse type 2 diabetes is replacing the myth that type 2 diabetes is a condition that only gets worse. Since my last book, Reverse Your Diabetes, was published in 2014, there have been numerous research studies showing that many people have been able to reverse their diabetes. In addition, I have been contacted by many people who had read my book and told me with great joy how they too have been able to join the ranks of those whose diabetes is in remission. You can read some of their stories later in this book.

So what do we mean by reversal and remission of type 2 diabetes? In August 2021, an international consensus statement was published by the American Diabetes Association, the European Association for the Study of Diabetes and Diabetes UK, which defines remission as achieving non-diabetic levels of glucose in the bloodstream for at least three months, while taking no diabetes medications.2 This is usually judged by means of a blood test of glycated haemoglobin level or HbA1c. HbA1c provides an overview of diabetes control over the previous six to eight weeks – so it is a sort of average blood glucose level. A level of 48 mmol/mol (millimoles per mole – the standard way of measuring HbA1c – also represented as 6.5 per cent) or less, without using diabetes medication, indicates remission of type 2 diabetes. Remission of prediabetes is achieved if the HbA1c is maintained below 42 mmol/mol (6.0 per cent). Chapter 2 explains all this in more detail.

This statement also recommended that remission be the preferred term to reversal of diabetes. However, I like the term reversal and I also think there is a slight difference. I explain reversal as the process by which people can reverse what I call ‘the diabetes disease process’, which will also be explained in more detail in Chapter 2. By making lifestyle changes, people can reverse the disease process that caused their diabetes (or prediabetes). In some, the reversal will be complete, their metabolism will have normalized and they will have achieved remission; but others may reverse the process to some extent. They may lose weight, successfully reduce their doses or number of medications and achieve better control of their diabetes, but still have the condition. In other words, they could be described as having partially reversed their diabetes. They did not achieve remission, but nevertheless, they have significantly improved the outlook for their health for many years to come.

What does that mean for you? If you have recently been diagnosed with prediabetes or type 2 diabetes, there is a high likelihood that if you are able to make lifestyle changes, then you can reverse the metabolic abnormalities that drive the diabetes disease process. You might be able to reverse the condition completely, so that your diabetes is in remission, or you might be able to achieve much better control of your condition, perhaps with less need for medication. Although you will still be classed as having diabetes (or prediabetes), you will have busted the myth that type 2 diabetes is likely to get worse and require ever more medication.

If you have had type 2 diabetes or prediabetes for many years, the research suggests that complete reversal is less likely than in people who have been diagnosed more recently. However, I have known people achieve remission after many years of having type 2 diabetes, in some cases having been on insulin injections, and so can confirm that it is never too late to make lifestyle changes that will maximize the chance of reversing the disease process. Therefore, regardless of how long you have had type 2 diabetes or prediabetes, it is definitely worth considering making some changes to your lifestyle – they just might work! And with the knowledge gained during the Covid pandemic about the increased risks associated with having diabetes, it has arguably never been so important to try.

Now the fact that you are reading this book is a good start, and hopefully indicates that you are open to making some changes to improve your health. As you read on, you will gain valuable information that you can use to make choices about your diet and lifestyle to help improve your health. I deliberately used the word ‘choices’ there, to emphasize that any process of lifestyle change is by definition your choice, and yours alone. In this book I will provide advice – not insist you make sudden and radical changes to what you eat or how you live. My goal is to provide you with information that will offer you good options, and then it is up to you to decide whether you want to make any changes, which changes you want to make and when you want to make them. The whole point of lifestyle change is to make changes that will be long-lasting. They therefore have to be changes that are sustainable in the long term. That means you have to be fully on board with – and committed to making – those changes.

And the changes you make are not for my benefit or your doctor’s benefit or anyone else’s benefit. They are solely for your benefit. So rather than just coming up with a list of changes that you think you should make, or that you feel you would like to make, I suggest that, first of all, you consider why you want to make changes – in other words, what it is that you want to achieve in respect of your health. That is what I call goal-setting.

You see, just like those colleagues of mine who tend to focus on the negative, you too may be experiencing similar negative feelings. Maybe you have had diabetes for many years, and have tried to ‘follow the rules’ but always found that your glucose levels are too high. Maybe you have just been diagnosed with diabetes, but have struggled with being overweight for much longer. Perhaps you have tried different diets, maybe managed to shed a few pounds, but it was hard work, and you ended up back at square one. Maybe you have come to accept you will always be overweight, or unhealthy, as if you have constructed your own myths. That would be quite understandable. It would also be understandable if you felt cynical about your ability to turn things around, to bust your own myths.

However, I am inviting you to focus on something else – not on the negatives, however much they have been part of your experience. Rather, focus on the positives – the ‘what ifs’. Growing numbers of people in many countries have experienced the positive life-changing effect of reversing their...