I was at the very beginning of my Functional Medicine journey practicing in a large busy practice in Miranda, NSW, Australia in 2012. I had started to read about the use of carbohydrate restriction to manage and often reverse Type II diabetes. A slim Caucasian lady in her late 50s presented to me feeling tired all the time (TATT). The most common reasons we were taught that cause this included; anaemia, thyroid problems, diabetes and cancer and TATT was becoming one of those heart sink presentations. My patient turned out to be newly diagnosed Type II diabetic. I was as shocked as she was, as she was slim, Caucasian (DM is a lot more common in Asians), exercised regularly and managed her sleep and stress well. She was unfortunately following the sugar (carbohydrate) heavy Australian Dietary Guidelines and despite a good constitution succumbed to the picture of insulin resistance leading to diabetes.
I was excited but scared when I offered her an alternative solution to being put on medications for the rest of her life. I explained that it would take some time and organisation, necessitate her understanding foods, food labelling and eating out, and possibly even change her exercise style a bit. She was very enthusiastic as I sent her away with lots of websites for further reading, shopping lists and a suggestion of different kinds of meals.
I advised her to follow a low carbohydrate approach (much like out current NICE guidelines suggest), using healthy fats to cook with and consume till fullness, rather than being stingy with them. I swapped fruit for veg, sweet potato for normal potato, cauliflower rice for normal rice and got rid of excessive sugars and gluten. I advised more healthy and filling fat and protein and asked her to eat only 3 meals a day, and at times to fast. I also incorporated some light High Intensity Drills for her to do in her backyard with some hand held weights (increased muscles mass also improves insulin sensitivity).
She was supposed to return after 4 weeks as I wanted to see how she was getting on. She didn’t as she was enjoying it so much she didn’t feel a need to meet with me. I saw her again after 16 weeks and re-ordered an HbA1c and an oral glucose tolerance test: standard diagnostic test for Diabetes. I was as shocked as she was, when the blood tests revealed she was no longer diabetic. I would have been happy with a simple reduction in the HbA1c level, so this was for me, nothing short of a miracle.
This was my first ever patient on whom I practiced FM and I was lucky. She was enthusiastic, she was willing and she was very able. This ability to actually ‘cure’ or put in remission was completely new to me. I had been brainwashed for decades that DM was a consequence of poor genes, and that it was not reversible. When I saw how much impact lifestyle medicine had one on this particular patient, I was hooked and knew that I could never go back to simply suppressing symptoms again.