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Blood sugar and diabetes: a diagnosis tells you where you are now

When I was diagnosed with type 2 diabetes, I was scared.

What does this mean? How do I get through this? Will I be on medication for the rest of my life?

Then something happened that I hadn't expected.

At the diabetes nurse's appointment I heard that I wouldn't need to start any special diabetes diet. I could eat much as I had before and my blood sugar would be managed with medication if needed.

I was relieved.

I'd tried so many diets in my life that the last thing I wanted was one more.

Only later did I understand that the relief was a trap for me.

The relief that turned out to be a trap

I heard the advice as meaning I didn't really have to change anything.

I could carry on with my old habits. Keep stopping at McDonald's on the way to gigs and eat the way I was used to.

The medication would take care of the rest.

And that is pretty much what I did.

But there is an important difference here, one I only understood later.

The medication was not the problem. The problem was that I let the sense of security it gave me replace my interest in why I had ended up in this situation in the first place.

I didn't stop to look at my relationship with food. I didn't really even understand how much food could affect the way my body works.

And when nothing seemed to have to change right now, why would I have changed?

I carried on with my familiar life.

A diagnosis tells you where you are now. Not where you'll end up.

A diabetes diagnosis can bring up all kinds of feelings.

Fear, uncertainty, worry about the future. Maybe guilt too.

Why did I let it get this far? Could I have done something sooner?

On the other hand, a diagnosis can also bring relief. Now you know what is going on and treatment can begin.

But there's one thing worth remembering.

A diagnosis tells you about your situation right now. It does not, on its own, decide the direction of the rest of your life.

Type 2 diabetes doesn't develop overnight. Behind it there may be changes over many years, shaped by genetics, metabolism and lifestyle alike.

And even though you can't change the past, you can still influence the choices ahead.

For me, the real wake-up call came only a year or two after the diagnosis.

The turning point wasn't a blood test or a number on the scale.

It had to do with my father.

I tell more about that evening and how the direction of my life changed in my own change story.

What does blood sugar actually tell you about how your body works?

To understand why food can have such a big effect on blood sugar, it's worth looking a little at how the body works.

Blood sugar means the amount of glucose in your blood. Glucose is one of the body's important sources of energy.

When we eat carbohydrates, glucose formed during digestion is absorbed into the bloodstream.

At the same time the pancreas releases insulin.

Insulin is a hormone that helps the body use and store the energy we get from food. For example, it helps glucose move into muscle cells and affects how much glucose the liver releases into the blood.

This is perfectly normal human biology.

But in type 2 diabetes the system no longer works in the same way.

The body's cells can respond less well to insulin. This is called insulin resistance.

At first the pancreas can compensate by producing more insulin. If insulin's effect and its production are no longer enough to keep blood sugar at its usual level, blood sugar starts to rise.

And that brings us to a really interesting question.

If food affects how our body regulates blood sugar, what can happen when we start changing what we eat?

Food is much more than calories

We're used to thinking of food above all as energy.

But from the body's point of view, it is a far more complex matter.

Different foods affect, for example, blood sugar, hormones, hunger and fullness, and how the body uses and stores energy in different ways.

Even the make-up of a meal can make a big difference to how quickly glucose is absorbed into the blood and what kind of blood sugar response follows.

And it isn't only about how many calories are on the plate.

That is why I think looking at food only as an amount of energy misses a lot that matters.

When I began to understand these links myself, the way I related to food changed.

I no longer saw food just as something I had to try to eat less of.

I became curious about what different foods actually do in my body.

And that change in perspective was hugely important to me.

If you want to go deeper into the link between diet and diabetes, I also cover it in the article Type 2 diabetes and diet.

What if you already know what to do, but still don't do it?

Here's another thing I learned during my own change.

Knowing isn't always enough.

You may know perfectly well that certain food choices don't support your health. And still you find yourself making them again.

Why?

Because eating isn't only conscious decision-making.

Food comes with learned habits, feelings, memories and the influence of your surroundings.

Over the years food may have become a reward, a comfort or a way of dealing with stress.

In that case, getting a new set of dietary guidelines doesn't automatically change those links.

One of my biggest insights was that I became curious about why I actually ate the way I did.

That's why in my coaching I don't focus only on what kind of food should go on the plate.

The aim is also to understand your own eating behavior, so that making changes is not a constant battle with yourself.

I've written more about this in the article Weight loss and your relationship with food.

Can the course of type 2 diabetes change?

Yes.

This matters a lot to me, because I've experienced it myself.

Through my own lifestyle change I lost dozens of kilos, my blood sugar levels improved significantly and I came off the diabetes, blood pressure and cholesterol medication I had been taking.

My own type 2 diabetes is in remission.

I've also been able to follow the experiences of the people I coach and of a wider coaching community. In them I have seen blood sugar levels improve and the need for medication fall. Many have also talked about better sleep, more energy and better overall wellbeing as they changed their eating.

These are experiences and observations, not promises that everyone will reach the same result.

But the possibility of meaningful change is real.

Medicine today also recognizes remission of type 2 diabetes, where blood sugar levels are below the diabetes thresholds without glucose-lowering medication.

Remission doesn't mean a permanent cure, and it isn't possible for everyone. The condition can also come back.

And it's important to remember that medication can have other benefits besides lowering blood sugar.

That is why any changes to medication should always be made under professional supervision. Bigger changes to your diet in particular are worth planning with your healthcare team if you take medication that lowers blood sugar.

But that doesn't mean there isn't a lot you can do in your own everyday life.

Where can you start today?

I'm not suggesting you try to change your whole life starting tomorrow.

Start instead by getting curious about what's happening in your everyday life.

Pick one ordinary meal, for example.

What do you eat? Why did you choose that food? How do you feel after the meal?

Do you notice differences in how different meals affect how full you feel and your energy levels?

There's no need to count calories, weigh portions or start a new food diary.

Just be curious.

And if you have diabetes, of course keep up the blood sugar monitoring and care you've agreed on. How you feel doesn't replace measurements.

It's about starting to understand your body and your food choices a little better.

Sometimes one new insight can change the questions you start asking next.

Five messages I wish I had received the day before my diagnosis

I've sometimes wondered how different my life might have looked if, before my diabetes diagnosis, I had understood what I know now.

What would I have wanted someone to tell me back then?

What would I have wanted to understand about food, my own body and the possibilities I still had?

Those thoughts became a free set of five messages:

5 things I wish I had heard the day before my type 2 diabetes diagnosis.

I wrote it for someone who has perhaps just been diagnosed, heard that their blood sugar is raised or has otherwise started thinking about their own health.

For the kind of person I once was.

If you recognize yourself in this, I want to share those messages with you too.