Type 2 diabetes


I had a deep wound on my leg caused by a fall in mid July which turned bad and required medical attention and a ton of antibiotics. The wound was sloughing but not really healing so I had a blood test to see if there was a problem in my blood and that is when they discovered I have type-2 diabetes.

It’s not a huge surprise because I had gone a bit off the rails in terms of what I ate for some time and the pandemic just made everything far worse.

The measurement for type-2 diabetes is performed with an average blood glucose measure of glycated haemoglobin (known as a HbA1c test). The excess glucose bonds to red blood cells and these live for 2-3 months before the body replaces them, so the diabetes test is performed everything 3 months after first diagnosis.

To make things interesting, there are different measurements for the same reading, called IFCC which measures in mmol/ml, NGSP which measures in %.

I had a HbA1c of 51 mmol/ml (6.8%) which is how I was classed as type-2 diabetic.

The normal range for Hb1Ac is 22-41 mmol/ml (4.2-5.9%) A result between 42-47 mmol/ml (6-6.9%) is considered pre-diabetic and any number larger than 47 is considered type-2 diabetes.

However, diabetic medication is not considered unless the result is at least 64mmol/ml or 8% because the medication is capable of reducing the Hb1Ac result by 11mmol/ml or 1% in 6 months down to 53mmol/ml or 7%.

If a diabetic gets a result of 48 mmol/ml or lower, they are considered to be in remission. So when I had my diabetic assessment in February, the result was 33 mmol/ml which is classed as in remission, but I remain on the register for a couple of years and have an annual review.

Diabetes can affect our bodies in different ways, which is why retinal photography is taken of both eyes in both the front and rear of the eye. Additionally, reflexes of the feet are checked.

How the body works with carbs

When we eat carbohydrates, our body converts them into glucose the body can use as fuel. However, muscles can’t process glucose directly, they need insulin to bind with that glucose for the muscles to convert it into a type of fuel it can use.

If there is a lot of glucose in the blood, the pancreas produces more insulin and when the level of glucose falls, as does the production of insulin.

If there is more glucose in the bloodstream than is needed, the body converts it to fat and stores it in the body for times of starvation. As we use our muscles, the body produces anabolic steroids to turn glucose into muscle.

The body has a system of countermeasures in place to prevent the essential organs of the lungs, brain and heart from suffering from a reduction in glucose. In starvation, the body produces catabolic steroids that devour muscle and turn it into glucose in the short term and in the long term it uses ketosis to break down fat into glucose. 

Type 1 Diabetes

Type-1 diabetes is when the body doesn’t produce enough or any insulin from the pancreas in order for the body to process blood glucose and insulin must be injected to convert blood glucose into fuel by the body.

If there is too much blood glucose and not enough insulin, then hyperglycaemia occurs and the body starts to produce ketones as it erroneously tries to extract glucose from fat using ketosis. Hyperosmolar hyperglycaemic state is where way too much glucose is in the blood stream and the blood thickens and turns to syrup. Both these conditions can lead to diabetic coma if not treated.

Additionally, too much insulin and not enough blood glucose, (called hypoglycaemia) pushes the body into the same erroneous behaviour which also leads to diabetic coma. Injections of glycogen directly into the liver are used in emergency situations because it’s the quickest way to get glucose into the blood.

This is why type-1 diabetics use a blood glucose tester that involves pricking the fingers to draw a drop of blood.

Type 2 Diabetes

Obesity coupled with an inactive lifestyle and a diet high in carbohydrates which results in a condition known as insulin resistance, where the insulin in the blood cannot cope with the amount of blood glucose, so the pancreas has to work harder to produce more insulin.

Obesity brings other complications that make it harder to lose weight, such as breathing and sleep disorders.

A lot of the advice is to lose weight, because by losing 2 stone 5 lb (15kg), you lose 5% of your body weight and that is enough to reduce your glycated haemoglobin levels and move into diabetes remission.

The easiest way to do this is by examining what you eat and cutting out high carb treats, then you can look at a lower carb meal plan.

Aim to introduce walking into your plan too,