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Type 2 diabetes is a condition that is related to modern day lifestyles, characterised by insufficient physical activity, unhealthy diets and weight gain.  These are associated with a condition known as hyperinsulinaemia (high insulin levels in the blood). Insulin is the fat-storage hormone, and so excess insulin in the body leads to storage of fat, particularly in the abdomen and the internal organs such as the liver and the pancreas. This excess fat means that these organs cannot function properly, leading to the glucose stores in the liver leaking out into the bloodstream, and over time, to the pancreas not being able to produce enough insulin. Both lead to high blood glucose levels and to diabetes.

My approach to treating this condition is to tackle these problems head on. As most cases of type 2 diabetes are related to modern lifestyle, it therefore makes sense to revert back to some aspects of the lifestyles of our parents or grandparents. Specifically, to become more active and to focus on eating a healthy diet made up of fresh, real food. As high insulin levels are part of the problem, it is important that everything possible is done to enable these levels to reduce. And as carbohydrates in the diet lead to more insulin being produced, my focus is to encourage people to reduce the carbohydrates in their meals.

So what does this look like? It means avoiding highly processed foods and ready meals (they often contain high amounts of salt, sugar and unhealthy fats). It means cooking one’s own meals, and having generous portions of leafy green vegetables. And it means avoiding meals that are high in carbohydrates, such as large portions of potato, pasta or rice. Rather, these starchy foods should form just a small part of any meal, if at all.  My books ‘Busting the Diabetes Myth’ and ‘The Low Carb Diabetes Cookbook’ provide more detail on how to go about making these changes. 



The other aspect to a healthy lifestyle is increasing physical activity. Any increase in activity is beneficial, and as a start, I encourage people to identify how they can include extra activity into their everyday lives. So rather than thinking about having to go out for a walk or to the gym, think about making walking part of your routine.  For example, walk or cycle rather than use the car for short journeys; when travelling by bus, get off one stop before you need to, or if using a car, park 200 metres from your destination so that you have to walk as part of your journey.


It is also important to avoid long periods of sitting down. So for those who have a job that involves sitting at a desk all day, get up and walk around for a few minutes at least every hour, and go out for a walk at lunchtime. The same applies when sitting down in front of the TV – getting up and walk around between programmes or in the ad breaks really does make a difference.

The only way to know whether lifestyle changes are having the right effect is to measure blood glucose. Not everyone with type 2 diabetes has access to home blood tests, but if necessary, it is possible to buy a meter and test strips and do just a few tests a week to see how meals affect blood glucose levels. Doing a blood test just before and two hours after one breakfast, one lunch and one evening meal each week can provide so much useful information that helps one make further adjustments to the diet where necessary. Using a Freestyle Libre or similar device is even better for those who are able to afford it.

Finally, it is important to recognise that many people need medication to treat type 2 diabetes. However if this is the case, my approach is to use medications that will help lifestyle changes have the biggest effect, and not work against them. So I try and avoid recommending medications that increase insulin levels, or that cause weight gain, so that means not using insulin or sulfonylureas wherever possible. It is also important to recognise that even if someone has been on medication for many years – even insulin – it is possible to come off that treatment if changes to diet and lifestyle lead to normal blood glucose levels.

Type 2 diabetes: Text
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