Andrew, 40

Symptoms before diagnosis:  

I had no idea I was at risk for type 2 diabetes. I was oblivious. I had decided to transition out of my job and had gone back to school to retrain so I had become really sedentary. I wasn’t feeling well. I was tired, all the time.  My eyes were getting very blurry, sometimes so bad in the morning that I could hardly see.  I was urinating a lot and I had this unquenchable thirst. I was guzzling water, craving sugary drinks, but it didn’t help. One night I was supposed to be going out with my brothers and one of them is a paramedic. I told him how I was feeling. And he said, “I think we should check your blood sugar.” He got out his glucometer, but my blood sugar was so high it didn’t register on the device, it just said “HIGH.” He said “I’ve never seen that result before. You should go to the hospital.”

Diagnosis and treatment

The same thing happened with the ER triage nurse. She tried to take my blood sugar but my result was higher than the numbers on her device. With a lab test, it turns out my blood glucose was an incredibly high 44 mmol/L (800 mg/DL) [Editor's note: This is a type 2 diabetes crisis called hyperglycemic hyperosmolar state, or HHS, which has a high risk of  diabetic coma and a fatality rate of up to 20%]. I was so dehydrated I was put in the ICU and given IV fluids as they tried to bring my blood glucose down. They told me that there was so much sugar in my blood, and I was so dehydrated, that it was like maple syrup was running in my veins. And that was why my eyesight was so blurry. There were literally sugar crystals in the little blood vessels of my eyes. I could have gone into a coma at any moment. I was in the ICU for 3 days and in hospital for about a week. It was a really scary and uncertain time.

What did you do?

When I was discharged I was on insulin injections. I had to inject insulin before every meal, and do one injection overnight. I was checking my blood glucose with a finger prick constantly. I had to  calculated the size of my insulin dose against the amount of carbs I was eating. I had to carry my insulin, and my glucometer and testing strips everywhere. And it made me depressed because the information I was receiving was that this was going to be my life, for the rest of my life.  One day, I kind of jokingly said, “Why can’t I just reduce the carbs I eat so I can reduce the insulin?” But no one could give me a good answer to that.” So I just started doing it myself. I kept a food journal and obsessively tracked and recorded everything I ate. The journaling was a very important part of the process. I was calculating how to slowly reduce carbs so I could reduce the insulin. I cut out all the sugar from my diet. I reduced all the carbs in foods  like bread, potatoes, pasta, starches. I also began measuring how much exercise, like a walk, would bring my blood sugar down. I was checking my blood sugar 40 times a day because it was a blind experiment.

What happened?

I found that if I was doing moderate to strenuous activities after each meal, like jogging or running, and taking my insulin as prescribed, my glucose levels would drop about twice as much as they would from just taking the insulin. This is when I began the process of slowly weening myself off the insulin by carefully planning what I ate and when I exercised.

After about 4 months, my blood sugar had returned to normal ranges and I no longer had diabetes. I didn’t need to inject insulin anymore. I kept journaling all my food for about 8 months, and checking my blood sugar regularly. After 8 months I knew that I had developed good habits, and my blood glucose was now safe and stable and I could stop journalling. I felt so much better. All the symptoms went away. And I have been able to stay in remission ever since. I had my last HbA1C test two months ago and it was 5.4%, so still in the normal range.

What are you doing now?

I have relaxed quite a bit. I have a  ”cheat  day,” usually about once a week when I eat sushi. Most days I fast from 10:30 pm until 2:30 pm the next day. Before eating anything, I usually exercise in the morning, like going for a run. Then at around 2:30 pm I have protein, such as eggs or a chicken breast or something like that. Dinner is a “standard”, simple dinner, like a protein, vegetables, with a small portion of starch like potatoes – but not anywhere near the amount of starch I used to eat. I don’t eat any ultra-processed foods anymore. On Sundays, I often make that a meal prep day, where I make meals ahead for the week. I really enjoy that, and it means when I’m tired from a long day at work, I have a meal ready and I don’t run the risk of getting take out because it is easier.

What is your favorite “go-to” meal?

I find foods such as chili, stews or soup the best to prepare on my meal prep day, as they hold well throughout the week, and only get tastier as the week goes on.  When I make chili, I usually use lean ground chicken or turkey instead of beef.  But my favorite meal would still have to be sushi – my cheat meal. But knowing that I can have that, and then go back to lower carb eating and still get good results and stay in remission, makes this way of life and eating sustainable for me.

What do you want others to know?

I want people to know that remission is possible. It may not work for everyone, but at least they should know it is an option. I don’t think people should do it like I did, without close medical support. They need to work with their doctor. So that means more doctors have to know about the possibility of remission and how to support and encourage patients who want to try it.

Top tips?

It doesn’t need to be complicated. If you slip up, or have time when you fall off, don’t get discouraged and stop, just get back to it as soon as you can. I have done that quite a few times. In fact I am getting back on track right now.  I will have birthday cake at parties, but the next day I am strict again. Being able to have the occasional treat makes it sustainable for me. Find a day when you can do meal prep so that you have easy things to eat in the fridge that are tasty and good for your blood sugar.  And finally, choose small goals, each day. Don’t set difficult goals you can’t sustain, like saying I’m going to do an intense workout at the gym. Set a goal like walking around the block after a meal. And if that is too hard, just walking up and down your stairs a few times to start. When that feels easy, then add a slightly harder goal.