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Image by Annie Spratt


Food Fabulous

Notes from midlife

Diabetes? Me? Surely not

My perimenopause and menopause clients often tell me their weight was creeping up on them over the years and was proving difficult to shift – despite their best efforts. Do you feel the same? Or maybe your energy levels are on the floor?

It’s easy to push to the back of your mind. Surely things can’t have got that bad… You’re not one of ‘those’ people whose food and lifestyle choices result in blood sugar levels so wonky, they find themselves in the prediabetes or diabetes trap… It’s easily done, and I see a lot of people in clinic who have been surprised to find they’re occupying that space.

It really is worth getting your blood sugar levels checked out. Once you know your numbers, you can do something about it and make a huge shift in all aspects of your health, including your weight. Whatever the tests say, I want you to know that, by making some simple changes to your diet and lifestyle, it is possible to prevent, control and, in many cases, reverse this condition.


Could be any of us. I know, right? Only last summer, I discovered my HbA1c levels (one of the markers for diabetes and pre-diabetes) was higher than I'd like. Not in any kind of danger zone but it gave me a fright. Even with a good diet (and I'm not a saint - I love a bit of cake on occasions and, for sure, more than the occasional mince pie at Christmas), once you're over 40, things change...

In fact, one in six people over the age of 40 is likely to have diabetes, with many more lurking in the grey area leading up to a diabetes diagnosis – prediabetes.

There’s no upside to having diabetes. This is what may lie in store for anyone receiving the diagnosis: risk of stroke, heart disease, visual disturbances and other eye problems like cataracts and glaucoma, higher risk of bacterial, fungal and yeast infections, high blood pressure, damaged nerves and blood vessels, and fatigue and lack of energy. The list doesn’t stop there, but I think you get my drift. Diabetes is not a good thing.


Here comes the science bit... Diabetes is a condition in which levels of sugar (glucose) in the blood are higher than normal. There are two main kinds of diabetes (type 1 and 2). Both types involve insulin, a hormone responsible for controlling the level of glucose in the blood.

Type 1 diabetic patients do not produce sufficient insulin and therefore need to inject it (this type of diabetes is the rarer kind, and often develops at a young age).

Type 2 diabetic patients produce insulin, but the cells become insensitive to it and so it fails to do its job properly. Type 2 diabetes accounts for over 90% of all people with diabetes, and the condition usually develops later in life. This type of diabetes is far more strongly associated with diet and lifestyle factors.


Diabetes is diagnosed by testing your blood sugar level. If your fasting plasma glucose level (FBG) is too high (above 7 mmol/l) or your oral glucose tolerance (OGTT) is above 11.1mmol/l, your HbA1c (a measure of long-term blood sugar levels) is above 6.4%, this represents a diagnosis of diabetes.

For prediabetes, a condition where your blood sugar levels are higher than normal and that often leads to type 2 diabetes, your FBG might read between 5.5 and 7 mmol/l, your OGTT might be between 7.8 and 11.1 mmol/l, and your HbA1c might be between 6% to 6.4%.

It’s easy to dismiss the risk, but the shift into prediabetes can happen almost without your noticing it. You may experience niggling symptoms, like low energy or your weight creeping up on you, and your usual tricks to get it down no longer work as well as they once did.

Common risk factors for prediabetes are these:

You are overweight.

You have a close relative – parent or sibling – who has a diabetes diagnosis.

You have high blood pressure or low HDL (‘good’) cholesterol.

You’re over 40.

You’ve given birth to a baby over 9 pounds.


Your GP will be able to organise blood tests for you. You can also get tested privately. I offer a range of biochemical tests and can work with you to make manageable changes to your diet and lifestyle to get your health back on track.

As a nutritionist, what I’m about to say may sound a little biased, but I have seen so many prediabetic clients receive unhelpful and incorrect advice about what to eat from doctors. Hell, it even happened to my mother the other month...

Unfortunately, doctors receive no training in nutrition and have no other option than to follow the Eatwell Guide (published by Public Health England) – which, sadly, is outdated and not evidence-based. You may have been told that you could fix this just by losing a little weight, but I’m afraid that the way you might have gone about this in the past simply is not going to work anymore. And just starving yourself into losing a handful of pounds is not going to fix the underlying problem. It won’t miraculously change the numbers that came up in your test results.


Hopefully, things will start to change with a whole generation of new doctors starting to receive at least some training in 'lifestyle medicine'. Only last week I was privileged to be lecturing to second-year students at Anglia Ruskin Medical School on why it REALLY matters to eat a well.

What does work is a whole diet and lifestyle approach. I work with my clients to guide them to make better food choices that help lower their blood sugar levels. The strategy we create is tailored to you and no one else. What you like to eat, avoiding what you don’t like to eat, making changes at a speed that feels right for you to achieve your goals. We also look at these results in a bigger context of other annoying symptoms you might be experiencing and try to mop those up as we go along, too. You would be surprised the impact you can make on your health and how you experience life.

If you know NOW is the time you need to take action to fix your diet, your weight or any other aspect of your health that is not working, you can book in for a free nutrition MOT by clicking the link HERE.


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