At 46, Carla Francome was the fittest she’d ever been. She walked 10,000 steps daily, did circuit classes three times a week, and had just finished a four day cycle in the Alps (cycling the equivalent height of two Mount Snowdons in a single day). Then she found out that she had prediabetes.
Last September, Francome underwent a HbA1c blood test (a test that measures the average blood sugar levels) and found she was registering 46 mmol/mol. A normal level sits below 42 mmol and once you reach 48 mmol, this indicates Type 2 Diabetes.
The range that Francome was sitting in is not yet high enough to be considered diabetic, but without lifestyle changes you are at high risk of developing it. “I was really shocked. I was scared. If I really got diabetes it could affect my eyes, my legs. This is a serious condition. It was a really big wake-up call,” she tells i.
The text she received from her GP informed her that her blood sugar levels were elevated, but she didn’t realise just how bad it was until she spoke to a nutritionist five months later. By that time her level had climbed to 47 mmol/mol.
“I was a bit overweight, every year I was getting a little bit bigger and I didn’t know why,” says Francome. She exercised a lot, she was vegetarian and rarely snacked. “I might have eaten a dessert sometimes but I definitely wasn’t sitting on the sofa with a packet of biscuits. I might have two KitKats a week but I didn’t go mad.”
Following the advice of her nutritionist to explore her diet further, she ordered a blood glucose monitor for £50 online.
On the first day wearing it, after she’d finished her usual breakfast of porridge, her phone flashed an exclamation mark. “This was when the shock hit,” she says. “It kept flashing glucose going high, glucose going high [after breakfast porridge]. It went off the scale. You want to keep levels between four and 10 but mine shot to 16.”
It did the same with other carbs – toast, spaghetti, rice and sushi. As a non-meat eater, Francome’s diet had relied heavily on carbs and everyday she’d have bread and a bowl of pasta. Now she had no choice but to stop. “This was the moment my life really changed.”
According to Diabetes UK, one in nine adults (or 5.1 million people) in England are estimated to be living with prediabetes. More than 4 million live with type 2 diabetes, with an additional 1.2 million estimated to be living with type 2 who are not yet diagnosed. The issue is concerning, and rising.
Dr Deepali Misra-Sharp, an NHS GP partner who runs a Birmingham practice with 26,000 patients, says there “has never been a more urgent need to raise awareness and provide proactive care” for prediabetes. It doesn’t have many noticeable symptoms but causes can include obesity, inactivity, poor diet, age, and family history. If diagnosed, Dr Misra-Sharp says action needs to be taken to prevent progression, and it can usually be reversed. The longer the condition persists without intervention, the higher the likelihood it will progress to type 2 diabetes, says Misra-Sharp.
Recommendations to reverse prediabetes, according to Misra-Sharp
Lifestyle changes – Aim for 150 minutes of moderate exercise per week
Dietary adjustments – A balanced diet with whole grains, vegetables, lean proteins and heathy fats, with reduces processed carbohydrates and sugar is crucial. The NHS recommends a Mediterranean-style diet
Regular monitoring – It’s advisable to have regular blood tests to monitor glucose and HbA1c levels. They may be scheduled every six to 12 months depending on the individual
Francombe changed her diet overnight. Each glucose monitor lasts two weeks so she bought four of them to work out, over two months, which foods triggered her.
She swapped out her toast for breakfast for rye bread and boiled eggs, her pasta dinner for fish, potatoes and vegetables and started making soups for lunch. Carrots and hummus, or apples with a small amount of cheese, became her go-to snacks.
“Even though the monitors are for people with type 1 diabetes who need insulin, it was positive because it really scared me. It made me think completely differently.”
Changing her diet so suddenly came with some side effects and when she cut out the foods she’d enjoyed her whole life, she started getting headaches that would last for days as she adjusted to lower sugar intake. But the risk of diabetes wasn’t worth continuing to eat as she was.
Her grandmother had been diagnosed with type 2 and the memories of seeing her prick her finger everyday scared Francome into adhering to her new diet. “I can clearly remember her having diabetes. She had to give up sugar and everything. I really knew I had to get it under control. Luckily because I was scared I was really motivated to change.”
She has also implemented intermittent fasting, which was recommended by a nutritionist at Roczen, a diabetes support group she’s joined for £30 a month.
She now eats in the window of 8am to 8pm and fasts the rest of the day. As an early bird that wakes up around 6am she finds the two-hour fast in the morning difficult. She’s only allowed water or black tea. “When he told me I couldn’t have milk in my tea I replied ‘Are you insane? I start everyday with a cup of tea with milk.’ But I was told to have nothing when you’re fasting.
“It was quite a big difference. It was horrific.” Now she’s getting used to it, she feels the benefit. “You can have the odd treat. And I have so much energy. I used to always slump in the afternoon but I don’t any more.”
Francome is still waiting to joining an NHS prediabetes programme but feels she’s managing it well herself, and has brought her glucose levels down to 45.
She’s felt other benefits too. When she was diagnosed, although she was active, Francome was at her heaviest weight of over 14 stone (89kg) and wearing size 18 trousers. Her wardrobe no longer fitted and her clothes had gone into the attic and replaced with black T-shirts and leggings to try and hide the weight she was putting on.
This year, after she’s made changes, she’s lost over a stone, gone down three belt holes and fits back into the wardrobe she once reminisced about. “I lost 3in from my waist in three months. It was just extraordinary. I got all my clothes down from the attic and I could wear them. It was amazing, honestly I nearly cried. I’m a size 14 again now.”
She was able to switch back to old dresses and mini skirts. Her ultimate goal is to reach 11 stone, the same weight she was at her wedding 12 years ago.
“I’m just so excited about clothes again. I like looking like myself again and wearing nice clothes. The whole thing has felt scary but it’s been a positive thing.”
