Are you someone who has a fairly healthy diet for most of the time, with a few digressions along the way. That bit of cake on a bike café ride, or that glass of wine with dinner, a handful of jelly babies on a run, or that wonderful dessert on a celebration meal, they can’t hurt right?
That’s pretty much how I’ve been in recent years. I gave up eating meat (mostly) a few years back now, I eat lots of seafood, and a wide range of plant based food. The only dairy I eat is a bit of cheese as I’ve found I can’t tolerate dairy much at all, and I eat loads of nuts, pulses and seeds. We make most meals from scratch, although have the odd week where we indulge in takeaways a little more than is sensible. I rarely eat white bread, and am trying to switch the hubster to using more wholewheat rice and pasta instead of white. He does much of the cooking in our house. I also cut down considerably on my alcohol consumption a few years back, and have had only 1 hangover in recent years…which reminded me that it was about time to give it up entirely.
If this sounds like you, then please continue reading this blog, as it could be a life saver.
NHS Health check
I’ve reached that age when I got invited to have an NHS health check. The main idea with these checks it seems if to assess a patients heart attack risk, but also checks for other factors such as obesity stroke and diabetes risk.
Despite having a desk job, I’m pretty active the rest of the time, and given what I mentioned above about my diet, I naively assumed that I would ace all the results.
With regards to heart attack risk, my results were similar to someone half my age (I’m 55 by the way). Yessss, I was happy with that. On the weight issue, I was just on the upper limit of normal, but I know I’m packing a bit extra around my belly at the moment. Given the state of my diet & fitness, this wasn’t anything that the nurse was concerned about, especially given that I was already aware, and trying to bring it down again.
Then came the wide spectrum blood tests. They really do check all kinds of things (see below)
- Full blood count
- Urea & electrolytes
- Bone profile
- Liver function
- Serum TSH
- Serum Lipid levels
- Haemoglobin A1c
Now, I don’t profess to understand what most of these are for, but I have come to find out what the last one is, as I was in for a bit of a shock!
The Haemoglobin A1c test, is an indicator of diabetes risk, and for normal healthy people should sit between 20 – 41 mmol/mol.
See more about this test here https://www.diabetes.co.uk/what-is-hba1c.html
My result was 42, and although only just over the healthy range it classified me as pre-diabetic.
WAIT….WHAT! Me, pre-diabetic!?
I have spent the last 2 decades trying my hardest (although clearly not hard enough) to live a healthy & fit life, and now I am at risk of what I had always considered to be a lifestyle disease! Please bear with me as I now know that my preconception of Type 2 diabetes and pre-diabetes is actually incorrect.
You might say ‘but you are only just over, that will be easy to fix’. And you might be right, but I really couldn’t work out how I got here. The nurse advised that since my dad had been diagnosed as diabetic in his 60’s it is quite likely to be simply a genetic link, and that it was bound to happen as some point. Things started to make more sense, as my dad was never overweight, and had a pretty healthy diet too. I had always wondered how on earth he had ended up diabetic.
The thing with the HbA1c test is that it can return a high result even if you only had one high blood glucose element in recent months, and there isn’t really a way to determine if it was a one off, or a pattern. But the medical team were used to advising patients that had unhealthy weight and lifestyles, and she couldn’t really offer me much help as I was already doing the things she normally advises people to do.
I’ve really struggled a bit recently with this diagnosis, because without regular monitoring there isn’t really a way to know whether the situation is getting better or worse. The NHS now have me on an annual review for the rest of my life, but if I’m borderline I certainly don’t want to wait another 12 months before I know whether I’m going the right way or not.
Looking back, I realised that I’ve had symptoms, and they are mostly related to the delightful subject of my wee. Yep, we need to discuss urine.
Polyuria – in simple terms, this is the need to either pee more than normal, or pass abnormally large amounts of pee each time. The science behind this is explained in the link below, but it’s safe to say that I have been feeling a bit like a camel recently. Retaining urine quite happily, but then peeing massive amounts. I thought it was just an age thing, but it seems not. This seems to be a pretty normal state of affairs for me now, but is actually a symptom of my blood glucose levels being too high https://www.diabetes.co.uk/symptoms/polyuria.html
Sweet smelling urine – I have noticed this a lot over the last few months, and periodically over the last few years. Since I had always dismissed the fact that I could be diabetic, I usually assumed it was just because of something I had eaten. But it turns out there was a more sinister explanation.
If you have diabetes, sometimes your pee smells sweet or fruity, even maybe like sugar puffs. This is because your body is trying to get rid of the excess blood sugar and is disposing of the glucose through your urine. This can be an indication of both Type 1 and Type 2 diabetes, so never ignore wee that smells of sugar puffs…unless of course you have just eaten sugar puffs.
It’s clear then on reflection that the signs have been there for a while, but I assumed that my lifestyle had precluded me from ever getting diabetes. The thing about assumptions though is that they should be challenged.
I am not prepared to wait a year, and randomly try to turn things around without knowing if they are working or not, so I’ve decided to do some research and experimentation on myself. I’ve bought a blood glucose monitor and I’m not afraid to use it.
For 2 weeks I’ll be taking regular tests, and trying to establish by blood glucose level patterns in different situations. I’ll update my posts so that you can see how I got on. At the same time I’ll also be researching Insulin sensitivity and insulin resistance and posting more on that subject too.
But for now, I’ll leave you with this…..
- Don’t under any circumstances, ignore unexplained symptoms,
- Make sure you take up the free NHS health check when offered,
- Never assume that you are not the right profile for diabetes (or any other illness),
- Don’t store up problems for later on, when it might be more difficult to address.
I have been doing a lot of thinking about this over the past few months as a scientist/medical/60 yr old.
Firstly, the evidence is very clear that you need to reset your insulin resistance and the best way to do this is the 800cal diet for 8-12 weeks. Look at the DIRECT trial which is the absolute game changer on this and may well get the designer prof Taylor in Newcastle a Nobel prize one day.
Secondly for Mark, it is pointless talking about cholesterol unless you know the LDL/HDL ratio. If you eat an unhealthy diet then your cholesterol will be high and your LDL:HDL ratio bad as well. However if you are fit and healthy and eat a low carb diet then your ratio will be good even though the total cholesterol is high. GPs and Nurses get so used to people on bad diets that they only look at the total. This happened to my wife and she was about to be started on statins when I asked what her ratio was. Her ratio was so good that she had no need of statins. Do go and ask them what the ratio is.
I’m in agreement that Insulin resistance needs resetting to avoid future issues. However, there must be alternatives to an 800 cal a day diet. After all, most people’s BMR is over 1000 so 800 cal for 8-12 weeks cannot possibly be good for health.
I know certainly that I couldn’t live on 800 cal per day, especially as I do sport as well.
Also, I think that most GP’s and Nurses do factor the LDL/HDL ratios when discussing cholesterol. Certainly mine does.
There are all sorts BUT the DIRECT trial showed that the 800cal diet was the best and most efficient way. If your BMI is over 26/27 you can certainly live on 800 calories and continue cycling. I did it for 10 weeks last summer, lost 3 stone and commuted by bike for an hour each way plus did a full days work.
How about for those who are only a little overweight. If I was to even lose 2 stone I think I would look anorexic. My BMI is in the normal range (just). It’s not all just about being overweight, some people have a genetic disposition and might be plagued despite a relatively healthy lifestyle.
So I presume you are a BMI of about 26-27? Even 6 weeks of 800cal would lose you about 10% body weight and reset your insulin resistance. I agree that there is a massive genetic component which is why there are skinny people with tpe2 diabetes!
No, I’l less. As I said, I’m in the healthy range which is up to 25.
https://www.directclinicaltrial.org.uk is the trial. It was funded nationally by the National Institute for Health Services Research and is completely safe.
Thank you for your feedback
Thank you for your observations Chris. I’ve had lengthy conversations about my cholesterol with more than one GP. My HDL is high as is the LDL. I also had a CT scan from where a cardialogist prescribed me statin and Aspirin. I had a health check when I left the military at 53 (now 57) and my risk score was 4.7% (10 year risk of developing CVD), so things have deteriated somewhat since then.
Thank you for writing Marcia. It is an interesting situation and one I can totally relate to. I’m 57 and have been fit and active all my life, running, biking, mountaineering, ex military, now trying to be a long distance cyclist as it’s kinder on my worn out joints. I was diagnosed with high cholesterol one year ago, and very shocked, much like you. I’m now on statins for the rest of my life. My lifestyle is very much like yours, healthy, non meat eater and non drinker. I’m still dealing with the shock! I have regular blood tests, once every 6 months roughly. Your article reinforces that life just deals out this stuff without prejudice, it is just the way it is and that is why we should not take our health for granted. I did to a degree as I thought I had a get out of jail card. I was wrong!