1. Brave New World

11 April 2023

I achieved type-2 diabetes remission by making ‘lifestyle’ changes on the recommendation of my doctor. She also suggested that I should take a look at the work of Dr Michael Mosely. I did, and the results were fast and dramatic: I reversed the diabetes within 4 months and have had remission confirmed a year later. That’s great and I’ve been celebrating it ever since.

But.

The greater achievement masks a couple of things. One is that my weight has stablilised a little above where it was when we went to the US last year, and the other is that my average diastolic blood pressure is a little too high by a couple of points. Small indicators in the great scheme of things, but actually quite significant, I think.

The primary results that I achieved – massive reduction in HbA1c, improved HBL and triglycerides, and significant weight loss – correlate to the results achieved by patients of Dr David Unwin in Stockport. Dr Unwin is active on social media and on YouTube, discussing his approach and, crucially, supporting it with clinical data. I’ve embedded one of his talks below. What struck me when watching the videos was precisely that correlation between his patients and my results. Not just correlation with diabetes, but also with my renal function (measured by creatinine) and my liver function (triglycerides.) It struck me that I have enjoyed systemic improvements.

The one area that didn’t seem to match was blood pressure reduction. Out of curiosity, I looked at my average BP readings a year ago when I was in ketosis, and guess what? They were much better than they are now. Over late 2022, my average BP crept up a little, very slowly, with a spike in the last couple of months in average diastolic pressure.

And so I thought about my numbers and my lifestyle and wondered about,

• • my median weight a kilogram or so above where it was last August.
  • drifting average BP

My conclusion was/is that I drifted into complacency and allowed ‘carb creep’ to take hold. How? well I’ve been baking a lot, and my fruit intake has tended to be on the sugary side. I suspect that accounts for the slow rise in average BP. I also suspect that the spike in diastolic pressure comes from drinking far too much coffee.

This is important to me for two reasons. One is that carb creep might/will sabotage my remission status; the second is that my preferred future has no BP medication in it, if possible. And so I’ve started an experiment to test my conclusions. Starting yesterday, I’ve gone back onto a strict low carb diet and I have stopped drinking coffee. Over the course of the next 4 to 8 weeks, I’m going to note my BP every day and calculate weekly averages. I’m measuring my BP first thing in the morning before taking my medication and again in the evening. What I expect to happen is,

• • my weight will fall
  • my average BP will fall

I’ll know by the end of the experiment whether or not I’m on the right track, and I’ll write about it here.

My doctor knows I’m doing this. If it is successful, then I’d like to have a look with the doctor(s) at my BP medication regime, because, as far as I know, my assessment 11 years ago didn’t take into account the impact of sugary blood and insulin on BP to the degree that it probably would today.