I started this journey with diabetes when I became concerned about my lab results for hemoglobin A1C
creeping up toward the pre diabetic range.

I had been following a health-oriented eating plan for many years thanks to my Mother’s good example!
She developed serious heart disease in her forties; she was told that she was not a surgical candidate, so
she and my Dad started on a largely plant- based and very low fat diet. They read up on the Pritikin diet
program for heart health and this was so successful that she lived until she was 99 years old!  

Although heart disease limited her activities she was able to be active in gardening, cross- country skiing,
hiking and volunteering for Fish and Wildlife as a guide. I was inspired by reading an article in Parade
magazine that former president Clinton had embraced a plant-based and oil free diet. I couldn’t wait to
read the book that made a vegan out of our cheeseburger-loving former president: “How to Prevent and
Reverse Heart Disease” by Dr. Caldwell Essylstyn Jr.” The information in this book amazed me and I
pushed myself to follow the plan he lays out which is very low-fat, no oil and largely whole foods.

As a result, my lab tests for triglycerides, low- density cholesterol and total cholesterol have been great
for many years. I also exercised consistently-walking, running some marathons and a few
ultramarathons (until my hip and knee joints couldn’t take it), working out with weights, swimming,
cross-country skiing and bicycling. Exercise felt like the right thing to do and also made me feel good! I
liked keeping track of lab tests to make sure I was not headed for the family challenge of heart disease.

When I saw the hemoglobin A1C rise to 6.1 in 2021, I decided it was time to get help and get started to
reverse this problem.

I went to see my primary physician at the time to get some direction. He asked if I had a family history
(no) and said that since I was slender and active there was nothing to be concerned about.
I asked him if there was anything I could do with diet and exercise to bring down the A1C of 6.1 and he
said no.

This didn’t make sense to me, so I made an appointment with a local endocrinologist who asked me the
same question about family history and told me that there was nothing to worry about and no diet and
exercise approach to address the 6.1 A1C, since I was already at a normal weight and active.

His dietician made a follow-up call to give me some test results and suggested that I should lean towards
a low carbohydrate diet – limited fruit and beans, for example. This made me curious since my plant
based “Esselstyn” program had helped me slim down and feel great years ago.

I googled “plant-based programs for prediabetes” and found masteringdiabetes.org.
They described a great deal of evidence-based peer-reviewed nutritional research that supported a
low-fat, whole food, plant-based approach to reversing prediabetes and reversing insulin resistance for
type 2 diabetics. I have a health science background so I ate this up!

I ordered their book that day and started on their program immediately. I got a glucose meter at the
drugstore and started testing my blood in the mornings to see what my fasting blood glucose was. I was
hoping for non-diabetic (under 100), but mine were consistently over 100!

After a few weeks I signed up to get a coach through their program. She helped me with some lifestyle
tweaks that were new to me, such as not eating after dinner, avoiding snacks, and emphasizing green
leafy vegetables at every meal, (Esselstyn favors green leafys, but I had ignored that!). Since I no longer
used my primary physician, she gave me the name of a great primary care practitioner who helped
follow up on my concerns.

By then I had taken the C peptide test that is described in the Mastering Diabetes book. This test
measures the amount of insulin that the pancreas is putting out which gives an indication of the function
of the beta cells in the pancreas.

My test results were very low which indicated that my pancreas is not able to produce adequate insulin
for efficient blood glucose management, and that successful treatment would likely require basal insulin
and mealtime insulin using multiple daily injections (MDI).

My new primary care practitioner (PCP) followed up with several antibody tests to rule out the
possibility of an autoimmune disease attacking the beta cells of my pancreas.

Some adults have this condition, called “type 1.5” or LADA (latent autoimmune disease of adults) and
this typically progresses to full loss of beta cell function. My tests were negative and the practitioner
started me on a basal (once daily, slow acting) insulin. I was happy to get the insulin, since seeing my
higher fasting blood glucose every morning concerned me! I was pretty freaked out about injecting the
basal insulin at first! I watched a few YouTube videos before I got up my nerve to do it myself!

A couple weeks later I asked my coach what my diagnosis was. She was surprised by the question and
told me it was type 2! So much for prediabetes! This was still a path forward – even before starting on
insulin, the A1C had dropped. The coach also helped me find a plant-based endocrinologist. I had to wait
a couple months to get in with this specialist which was very difficult; I felt pretty confused without
direction from an endocrinologist.

I have been binge listening to podcasts on diabetes: Mastering Diabetes,2 Type Ones, Juice Box, Just My
Type, and now Insuleoin. I have also listened to TCOYD – endocrinologists who have some great current
information. Although I highly respect their knowledge and the effort they spend sharing it to help us, I
wish they would educate themselves more on the incredible power of lifestyle changes to support
health. I wonder if experienced physicians sometimes become discouraged by all the folks who fail at
lifestyle change.

Dean Ornish has given us such a great example of the power of community in supporting the big changes
that are so health giving! His lifestyle program is even reimbursed by Medicare since it is now evidence
based! Even insurance companies will get behind us if they can see the connection in savings of health
care dollars.

My endocrinologist has been wonderful! I now have a continuous glucose monitor (Dexcom) which is a
total game changer!

I was doing finger sticks ten times a day to track fasting blood glucose, before and after meals, before,
after and during exercise and before bedtime. I discovered that I was having after meal spikes and
getting low during my longer bike rides and swims. This explained a lot of my fatigue and a few bouts of
what I had thought was heat exhaustion from pre- diagnosis.

With the CGM, I can watch my glucose levels while I am biking and eat fruit or take glucose tabs to stay
ahead of the drops in blood glucose that come with prolonged lower-intensity exercise. I am figuring out
how to get my CGM receiver to work during my open-water swims. (Dexcom tech support had some
good ideas – they have been great!).

My endocrinologist started me on mealtime insulin (multiple daily injections) to address the meal time
spikes. He suggested an insulin pump, but I want a bit of time to work on understanding things, like the
insulin-to-carbohydrate ratio for planning the mealtime insulin doses. It looks like those using the pump
do have tighter control of their blood glucose level; this is a big goal of mine!

There are so many factors that affect the amount of insulin I need at each meal! Every time I get through
a meal without needing to correct for a low, (food or glucose tablets) or high (usually going for a walk)
blood glucose, I feel like a ninja!

I am starting to see that nailing the perfect dose regularly is not a realistic goal.

The podcasts I have been listening to all emphasize the importance of connecting with our diabetes
community to support our progress on this healing journey. I have pushed myself to find these apps and
The Diabetes App even got me to get started on instagram!

Diabetes is not only giving me the gift of a very healthy lifestyle, but also helping heal my perfectionism
and my relationship with food!

I have been able to see how amazing people can be: the TSA agent chatted with me about her nephew’s
diabetes and shared podcast ideas, Sami from Just my Type responded to an instagram message, Ken
and Graham from 2typeones answered questions about exercise, new friends support each other on
these apps, Donna from the app sends such kind messages, each person who maintains a podcast or
works on an app gives so much of their time and love to help us, and my poor husband listens to me talk
about blood glucose a lot!

I want to maintain the best blood glucose I can in order to be healthy, active, and contributing in our
communities!

Susan Nash
August 9, 2022