A Diagnosis That Changed Everything

Seven years ago, one of my long-term clients, whom I’ll call John, was diagnosed with Type 2 Diabetes.

John was in his mid-fifties at the time, weighed 87kg and was working as an anaesthetist. He had already been training with me for several years and, like many doctors, had developed fairly firm opinions about nutrition. He enjoyed a wide variety of foods and had never felt the need to be particularly restrictive with his diet.

Then came the diagnosis.

Unlike many people receiving this news, John knew exactly what Type 2 Diabetes could potentially do. Throughout his medical career he had treated patients suffering from its complications and had seen blindness, kidney disease, amputations and heart disease. He knew where poorly controlled diabetes could lead, and that knowledge provided him with a very strong motivation to do something about it.

What impressed me most about what happened next wasn’t the weight he eventually lost or even the improvement in his blood glucose. It was his willingness to change his mind.

Despite his medical training and years of experience, John put aside some of his previous assumptions and became a student again. He read extensively, asked questions, looked at the latest research and became open to information that challenged some of his existing beliefs. He came to believe that carbohydrates were having the greatest impact on his blood glucose and would often say, “Type 2 Diabetes is a war against carbohydrates.” That’s obviously a simplification, but it captured the way he had begun to think about managing his own condition.

One of the most useful tools for him was a continuous glucose monitor. Suddenly he didn’t have to rely entirely on general recommendations about what someone with diabetes should or shouldn’t eat. He could eat something and see what actually happened to his own blood glucose. In a sense, every meal became a small experiment.

This taught him things that would have been very difficult to learn any other way. He discovered which foods produced large glucose spikes and which had surprisingly little effect. He learnt that not all carbohydrates affected him equally and that food combinations, exercise and other factors could change his response. The immediate feedback made the consequences of his choices visible, and gradually the way he ate changed.

Alongside those dietary changes, John continued resistance training and remained physically active. His weight and HbA1c changed considerably over the following years.

Time Weight HbA1c
Diagnosis 87kg 8.2%
6 weeks 80kg 6.3%
14 weeks 77kg 5.4%
39 weeks 74kg 5.4%
1 year 73kg 4.8%
2 years 72kg 4.4%
3 years 70kg 5.0%
7 years 74kg 5.2%

Initially his weight fell to around 70kg, which we both felt was probably a little too light for his frame. Over time it settled at around 74kg, where it remains today. His HbA1c has also remained remarkably low, regularly surprising his treating doctors.

Those early results were obviously impressive, but seven years later I think the more interesting achievement is that he has sustained them. I’ve seen plenty of people make enormous changes after a frightening diagnosis. Fear can be a very powerful motivator. Maintaining those changes years later, when the initial fear has faded and life has returned to normal, is much harder.

John has done that.

He’s also careful not to fool himself about what his results mean. He doesn’t believe his diabetes has simply disappeared because his HbA1c is now excellent. His continuous glucose monitor still shows him how strongly his body can react to particular foods. A single piece of white toast can send his blood glucose to between 10 and 12 mmol/L. Two café lattes can take it to nearly 8 mmol/L. For him, those readings are a useful reminder that the underlying problem hasn’t necessarily gone away. His lifestyle hasn’t made the diagnosis irrelevant; it has allowed him to manage it exceptionally well.

Something else I’ve appreciated about working with John is what the experience taught me about coaching. People sometimes assume that being a coach means having all the answers, but John became deeply invested in understanding his own condition. He had the medical background to assess what he was reading, he was following the evidence, testing what he learnt against his own experience and getting extraordinary results.

There was no reason for me to pretend I knew more than he did about his diabetes. I didn’t need to stand in front of him and lead. I needed to stand beside him. My role was to keep him training, encourage him, support his consistency and help him maintain the physical side of what he was trying to achieve. Sometimes coaching is about providing knowledge, but sometimes it’s recognising that someone has found a path that is working and helping them stay on it.

John is now 63 and retired. He travels, enjoys music, catches up with friends, exercises regularly and lives a full and active life. He still enjoys the occasional treat and certainly doesn’t live like a monk. But the habits that initially required considerable thought and discipline have become increasingly normal to him. What began as a response to a frightening diagnosis has simply become the way he lives.

When I think about John’s experience, his numbers are impressive, but they’re not what stands out most to me. I’m more impressed by the openness that made those numbers possible. He was an experienced doctor who was prepared to reconsider what he believed, learn from new information and adopt a different strategy when the evidence suggested it might help him. Then he had the discipline to sustain those changes long enough for them to become part of his life.

Seven years after a diagnosis that could easily have been experienced only as bad news, John is healthier, active and enjoying his retirement. He still has diabetes and still has to respect it. But rather than allowing the diagnosis to progressively narrow his life, the changes he made have helped him preserve a great deal of it.

This case study describes the experience of one individual. Results vary from person to person and John’s approach should not be interpreted as medical advice. Anyone diagnosed with Type 2 Diabetes should seek advice from their doctor and appropriately qualified healthcare professionals before making significant changes to diet, exercise or medication.