One of the first decisions I made on being diagnosed with Type 2 was that I was going to have to get better at asking for help. Whether it was asking my flatmate not to eat pizza with a potato topping when I was home, or asking my therapist, if I couldn't eat my feelings, what on earth was I supposed to do with them.
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I knew I was supposed to eat less sugar, but I didn't really understand what that meant. When I googled, the top result told me I was allowed 30 grams of sugar a day. According to the meal tracking app I had downloaded; one nectarine was 17 grams of sugar. I genuinely didn't understand how I was supposed to only have 30 grams of sugar.
Enter dietician Laurette Cummins. As I mentioned in last week's column, she's one of the first medical professionals who has ever made me feel empowered.
I was expecting to be handed a meal plan, one that looked abstinent and restrictive. I thought I'd be told to avoid all carbohydrates and that all I could eat was fresh vegetables and lean meat. Sworn off alcohol - especially beer - and that I could never eat cake again.
So you can imagine I was slightly taken aback when the first question she asked was how well I sleep. It's because, she says, there isn't a one size fits all approach to diabetes. What works for me, whether it is diet, exercise, or medication, might have a completely different result for you.
"I know after a diagnosis of diabetes, often people are feeling really crappy. And there's a sense of urgency, which I understand because the complications of uncontrolled diabetes are really, really scary.
"And so people feel like they have to kind of overhaul their entire life."
But, Laurette says, it's pretty easy to get overwhelmed by that, and she tries to figure out what's going on in people's lives and what their priorities are.
"Prioritising sleep can be really, really important because it gives you the energy for the next day. But also it impacts your hormones, so your hunger and fullness hormones And a lack of sleep can cause cells to be less responsive to insulin as well. So that plays into diabetes management."
I am, historically, a terrible sleeper. But over the months since my diagnosis, as I have prioritised it, it has gotten better. I won't be winning a medal for sleeping any time soon, but I can manage eight hours at time these days.
A couple of weeks ago, I asked my flatmate how obsessive I have been about food in those early months. She replied "on a scale of 1 to 10? 753." It hadn't felt like that to me, but Laurette says that's pretty normal.
"People's minds go to food and exercise, and 'how can I manipulate those things?' But there are other factors to consider as well, like sleep and stress."
Another tool is medication, but people often feel guilt or shame about using medication. (I am one of these people. More on that in a future column.)
"They're there to be used and they're effective. So when that hyperfocus on food isn't helpful for someone, there are a lot of other options."
In that first session Laurette got to know me: what my life was like, what medications I was taking, whether I liked to cook and who I had to cook for, how much I was exercising, how my stress levels were. But honestly, I was pretty fixated on whether I'd already eaten my last nectarine.
She says a lot of the people she sees are afraid of carbohydrates and sugar.
"It's super confusing for people, so learning that carbohydrates is the umbrella term for sugars, starches and fibres, and different foods have different amounts of carbohydrates in them, and the body processes different carbohydrates in different ways is helpful."
So my nectarine? The answer was yes, I could have a nectarine - sugar is not the devil, and fruit has a lot of stuff in it that's really good for you. And if I combined that carbohydrate with protein, I'd be doing my pancreas a favour.
"When we combine with proteins and fats, it can slow down the digestion of those carbohydrates. We know carbohydrates break down in the body into glucose, and then that increases your blood sugars.
"When you add protein and fat to carbohydrates, it's also more satisfying and often tastier. So it adds balance and satisfaction, but it also can help with how quickly that carbohydrate is broken down into sugar.
"That's what the body is struggling with, with type 2 diabetes, whether it's the insulin struggling to do its job, and not getting the glucose into the cells quick enough, or there's not enough insulin going around. So the idea is to give your body a bit of a chance to see how much carbohydrate, and what combinations of food is going to work best. And that's very individual."
Once I had recovered from the relief of not having to completely cut out summer fruit, this became really meaningful. I had thought that diabetes meant I would have to cut carbs entirely. No potatoes, no crumbed foods, no fruit, no bread. But what Laurette was telling me was that I could have them - and in fact carbohydrates were really important as fuel for my body and my brain - I just had to be more mindful of what I was having them with.
This is the biggest change in my diet since getting the diagnosis. I no longer think about what I can't have. I think about what I can add to a meal to make it work better for this condition. My go to post-gym summer snack became a peach and a plum, a spoonful of Greek yoghurt and some nuts sprinkled over it. If I wanted potato chips? I could have some, but I would make some dip (again, with Greek yoghurt, I should buy shares) to add protein. Abundance, not restriction.
I left Laurette's office that day thinking for the first time that my life as I knew it wasn't over. That I did, in fact, have the tools to make this all work. And that food wasn't the only tool I had - I could also manage my stress, get a decent night's sleep, take my pills, and for the first time in my life, listen to what my body was trying to tell me.
* All dietitian appointments were fully paid for by me. Please seek your own advice from health care professionals.
