Bridgette Allan

Wellness coach


2017-07-04

Misdiagnosed and mismanaged. Reversing T2 diabetes. A patient profile

patient profile T2DM.jpgI first consulted with *Nadya, a young lady in her early 20’s, in March 2017 when she was referred to me by a GP who she had consulted for the first time for treatment for ingrown toenails. 

Nadya is a non medical aid (medical insurance) patient meaning that she either has to pay cash for consultations with private practitioners or she can visit local state clinics and hospitals. Sadly state health care facilities here in South Africa are in a dismal condition and because of this many patients do consult private practitioners when and if they can afford to. 

It was on taking Nadya’s medical history that her new doctor quickly realised something was amiss. Nadya told him that she had Type 1 (ONE) diabetes which had been diagnosed in childhood. A few things raised alarm bells right away. Firstly, Nadya was obese. Uncommon for youngsters with T1D and according to Nadya and her mum, had been morbidly obese at the time of diagnosis.  Nadya complained that she was experiencing regular bouts of hypoglyceamia and needing to keep sugary drinks at hand to combat the episodes of hypoglycaemia, although she was on low doses of insulin and eating a high carb diet.

Nadya’s GP ordered a few blood tests and it was evident that Nadya did not have type 1 diabetes but rather type 2. 

HISTORY - At age 12 Nadya complained frequently of stomach cramps and vomiting. She was taken to the doctor who repeatedly diagnosed a stomach bug and gave her treatment for such. Eventually Nadya experienced severe and ongoing vomiting and was admitted to hospital for investigation and IV re-hydration. At this point her blood glucose levels were checked and found to be very high. 70mmol/L ! Although she was morbidly obese, with a strong family history of type2 diabetes, a history of very poor, carb dense diet and no other symptoms of DKA (diabetic ketoacidosis) Nadya was diagnosed with Type1 diabetes and sent home on an insulin regime that remained unchanged for the next 10 years.

In spite of clinic visits every month to obtain her insulin as well as 6 monthly visits with a CDE doctor who ran the diabetic clinic at the state hospital, not once was the diagnosis questioned. She was told to keep sugary drinks and sweets at hand to counter hypoglyceamia rather than reduce her insulin dose. Dietary management was never discussed. Nadya’s mum was actually told by the diabetes doctor not to restrict anything in the diet but rather to just manage portion sizes. 

Of course the news that Nadya had been misdiagnosed came as quite a shock to her and to her family but they eagerly embraced the new diagnosis with the possibility that Type 2 diabetes could be reversed. 

bloods 1g.jpegbloods2i.jpeg

Nadya got the hang of low carb eating right away and as a result all insulin was stopped within a few days of starting the diet. She had been prescribed Glucophage but did not tolerate it at all, experiencing vomiting and diarrhea throughout the day. Because Nadya was 100% compliant with diet, she was taken off all medication and asked to give feedback with her blood glucose readings 3x a day. From the time Nadya started on a low carb diet her blood glucose levels remained consistently between 3.7mmol/L and 6.8mmol/L 

Although to date Nadya has lost 15kgs, it is interesting to note the normalization of blood glucose levels BEFORE weight loss occurred. 

During regular follow ups Nadya shared that she was feeling well, full of energy and had no trouble complying with the change in eating. She has managed to adapt it easily to her culture and her lifestyle and does not in any way feel deprived. 

Follow up blood tests on 24 June 2017 show non diabetic results with HBA1C OF 5.4% and fasting insulin of 5.3 Bloods will be repeated again in 3 months. 
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*name changed to protect patient privacy

Admin - 10:51:48 @ diabetes, patient profiles | 1 comment

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    2017-11-09

    Excellent Blog! I would like to thank for the efforts you have made in writing this post. I am hoping the same best work from you in the future as well.

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