Snita’s story: Managing the challenges of maintaining type 2 remission

I had gestational diabetes with my eldest son. Afterwards, I was told I could develop type 2 diabetes later in life, but at the time I wasn’t made to feel that it was really important. 
 
Then when I was 40, I visited a relative who had type 2 diabetes and told her that I was feeling unwell and tired all the time. She urged me to go to the doctor, and a test at my GP confirmed that I had developed type 2 diabetes. 
 
I asked my doctor if I could try to manage it with my diet, but she said my blood glucose levels were too high and that I needed to bring this down with medication. After I was diagnosed, I was in shock and almost afraid to eat anything. But I started taking the medication and eventually I thought, “well that’s taking care of everything.” 
 
After the initial shock, I didn’t think too much about my diagnosis. I took my medication and would eat what I wanted. Within five years, I was taking the maximum dose of metformin and was advised by my doctor that I needed to start taking more medication. I begged for some more time and went home to talk to my family. My husband suggested I join a running club. I hadn’t done any exercise since school, but I had nothing to lose, so I joined a beginners’ running club, which I came to really enjoy. I even learnt to ride a bike and swim, and started doing triathlons. But my diet still wasn’t what it needed to be.  
 
As I approached my 50th birthday, I sat down with my sons to make a list of things I wanted to do before entering a new decade. One of the things they suggested was putting my diabetes in remission.  

I found out about the Diabetes UK-funded DiRECT trial, which was in its early stages at the time.

DiRECT looks at using low-calorie diets for weight loss to help put diabetes into remission. I wasn’t in the right geographical area to take part in the study, but with the help of a book telling me how to follow an 800-calorie diet, I managed to start losing weight.

After a couple of weeks, I got the most amazing release of energy. I started running faster, and my swimming and cycling improved, too. Mentally, I had never felt so good. My GP supported me to reduce my medication as I started to lose weight, and a blood test shortly before my birthday confirmed that my diabetes was in remission.

Initially, I was doing great; I was exercising and my diabetes was in remission. Then I fractured my ankle and was unable to exercise – I just couldn’t do anything. This made me feel really down and I started to eat whatever I wanted. With sitting around and not exercising, I then began to put the weight back on.    
 
As I gradually got better, I returned to my exercise routine, but sadly while I was away on holiday in Barcelona, I fractured my ankle again. Luckily it wasn’t as bad this time, it was a much smaller fracture and I’m back on my feet again. However, I had to take things easy and not put too much stress on the ankle, so just light yoga and aqua exercises. I couldn’t do the same type of activity I was doing before, which meant my blood sugar went up and my weight went up, too.  
 
I was feeling really low and unable to do much, and this was made worse when my doctor wanted to put me back on metformin, as my blood sugar was going up. That was so upsetting to hear knowing how hard I had worked to get into remission. I had spent years working to achieve and remain in remission. He said to take the tablets for a little while and see how I got on, and that I might be able to come off them again.   

While sitting at home with my injury, I did a lot of research around nutrition and my diet. What I’ve recently started, and has been life changing for me, is a plant-based diet that is low in fat. I eat a lot of vegetables and fruit – it’s like a vegan diet. I’ll be on this diet for a while until I reverse my insulin resistance, which is where my insulin and pancreas are clogged up with fat and not working properly.  
 
I’ve been following this diet for over a month, and I’ve lost weight, my tummy feels full and I’m not craving sugar or chocolate – just some fruit works for me. I’m not wanting to eat between meals, I’m cooking without oils and fat, and having massive salads and loads of green veg to fill myself up.

I’m slowly losing the weight, which is good, and this is reversing my insulin resistance. My body is starting to accept carbs again which I couldn’t eat before. I’m having small amounts at the moment but hopefully I should be able to have more in time. However, I must stress  that there are different diets and people might find another approach that is better suited to their lifestyle, but I can’t tell you how happy I am.

My blood sugar is improving and my HbA1c, which was around 61mmol/mol, is now down to 51mmol/mol. I feel as if I’m working towards remission again, and I think if I carry on with this regime and manage my sugar levels, then I’m happy to continue with this eating plan for the rest of my life. 

You have to be motivated and I had to find the right way for myself. I think clinicians are great at the job they do, but they were unable to give me all the information I personally wanted. I felt I needed to do my own research into nutrition, to give me confidence and find a way forward that's right for me. If that means experimenting and trying different things, then so be it, and if it doesn’t work then I’ll try something else.  
 
At the moment I’m just so happy that this is working for me. In about three months I’ll go for a blood test and see my doctor to check if I’m in remission. I’ll take it from there and continue with my reviews, such as my annual diabetes review and retinal eye screening, which are still so important.   
 
I don’t think you need to do extreme exercise; I’ve just started back with walking our dogs with my husband, I go to the gym and enjoy aqua aerobics and light yoga, which both protect my ankle. I find that’s enough for now. 

When I was feeling at my lowest with my ankle and not being able to exercise, my main thought was that I didn’t want my diabetes to get any worse. I don’t want to be sick when I’m old or experience serious complications as a result of my diabetes. I want to be proactive and do things for myself by taking charge of my condition.  
 
It's important to talk about remission; to give hope to people who are working towards this or have perhaps come out of remission and feel they can’t do it again. Many people have experienced similar challenges and are now back in remission. It’s also important for people to know that you need to work at it, and that it doesn’t come easy. 
 
I believe once you have type 2 diabetes it’s not necessarily forever, but it’s a condition that you need stay on top of and work at. It encourages you to have a good healthy lifestyle but equally if you take your eye off the ball, it gives you that nudge to check what you’re doing and make changes if need be.