‍Trying to “Reverse” Type 2 Diabetes When You Actually Have Type 1

First, prediabetes

“In 2023,” Griet explained, “my doctor said my fasting glucose was 110 mg/dL, and I had prediabetes. She said it was creeping up and to keep an eye on it.

Griet is especially health-conscious as a yoga instructor, massage therapist, and avid learner of all things related to exercise and nutrition. “I asked my doctor if I could work with a diabetes educator to address the prediabetes, but she said no because my insurance wouldn’t cover that until I’m officially diagnosed with type 2.”

This highlights a painful irony in the United States healthcare system: providing a patient with preventative healthcare support via a diabetes educator might derail their progression to type 2 diabetes.

Of course, this wouldn’t have helped Griet. 

“My doctor told me to eat healthy foods and exercise more,” she laughed, considering she was already doing both. “So, I started working with a nutritionist to get on top of this prediabetes.”

One year later

In May 2024, Griet had her blood drawn for a routine physical, and her doctor panicked when she saw the results. “Are you okay? What did you do? Your blood sugar is 371 mg/dL!” the doctor said to her.

Her A1c was 9.6 percent. “I was in shock,” recalled Griet. “I had been living a very healthy lifestyle for a long time, so it didn’t make any sense. But I was glad to finally have an explanation for why I wasn’t feeling well.”

Griet and her doctor had assumed her increasing symptoms of fatigue were attributed to her stress levels. In the past few years, she’d endured a divorce followed by the more recent end of a long-term relationship. 

In the weeks right before her diagnosis, Griet had been devastatingly heartbroken, even physically shaking, when her long-distance relationship came to an end. On top of heartbreak, she had been juggling six different jobs as an independent contractor, feeling homesick for her family in Belgium while living in Hawaii, and completely exhausted as a single parent.

“I just thought I was having difficulty getting back on my feet emotionally from the breakup,” said Griet, still in disbelief at how this all unfolded. “My doctor had been so supportive, trying to help me through the stress of my breakup.”

Unfortunately, Griet’s stress levels continued to contribute to her misdiagnosis and lack of proper treatment. “I’m pretty sure once your stress levels go down, you’ll be able to reverse this in no time,” her doctor told her.

Griet was diagnosed that day with type 2 diabetes and started taking metformin — which improves blood sugar levels in several ways, including decreasing liver glucose production, increasing insulin sensitivity, and delaying the digestion of meals.

But things only got worse.

Trying to “reverse” type 2 diabetes

To be clear, type 2 diabetes cannot be “reversed.” Instead, leading diabetes organizations have determined that some people can put it into remission through proactive changes in exercise and nutrition habits that contribute to weight loss and improved insulin sensitivity.

“I was eating very healthy foods and very light meals,” recalled Griet. “My doctor tried to micromanage my diet further to help me get results — more avocado, more salmon, and no more homemade green juices.”

Griet also started testing her blood sugar every morning with a glucose meter. Meanwhile, her healthcare plan continued to focus on her stress levels.

“I wanted a continuous glucose monitor (CGM), but my doctor feared it would cause me too much stress,” Griet said. “But my fasting blood sugar levels were still over 300 mg/dL every day.”

When the metformin didn’t make an impact within the first month, she started Jardiance, an SGLT-2 inhibitor that should prevent some glucose from entering the bloodstream by passing it through the urine instead. 

“I was feeling worse and worse,” Griet recalled. “At night, I was having such vivid dreams and sweating so much because my blood sugars were so high. It felt like I was between realms. I was so sick. I was waking up with full body cramps.”

At this point, Griet was struggling to parent her children. She sent them to their father’s for three weeks, hoping she could get her blood sugar levels down. 

The early signs are had to catch

Looking back, Griet can see a four-year period during which her blood sugar levels had been gradually rising following the official separation from her husband. “I can see it. In hindsight, it was clear in my blood tests,” said Griet, knowing she couldn’t possibly have realized that was the start of type 1 diabetes (T1D). 

While a stressful event does not cause type 1 diabetes, anecdotal research suggests it can be a trigger for the full onset. (Read more about the stages of type 1 diabetes here.)

Thanks to decades of research from TrialNet and other diabetes organizations, we know the attack on the immune system actually starts years (and possibly decades) before blood sugar levels rise high enough to cause noticeable symptoms. 

The only way Griet could’ve spotted type 1 diabetes during those first few years would’ve been by getting screened for autoantibodies. Most people, of course, don’t know type 1 can occur in adulthood. And she never considered the fact that her cousin lives with type 1. 

T1D cousin saves the day

At this point, Griet had lost 17 pounds — but she was quite lean before this saga began, which meant she was “skin and bones.”

“But I was eating like a healthy pig,” said Griet. “I was eating so many vegetables, so much fish and chicken. So much clean food, but losing weight so quickly.”

Griet’s cousin, who lives with T1D, heard her full story. “This makes no sense!” her cousin said adamantly. “You need to see an endocrinologist right now.”

Considering the island life she was living, Griet had to wait three weeks to finally see a diabetes specialist. (There was no endocrinologist on the island.) Fortunately, the specialist also lived with type 1 diabetes.

“She checked my blood sugar right then in her office,” recalled Griet. “It was 390 mg/dL. She told me that my cousin was right — I clearly had type 1 diabetes. She wouldn’t let me leave her office without giving me a careful dose of insulin.”

While some doctors have trouble acknowledging mistakes, Griet’s primary care doctor was emphatically apologetic. “I am not mad at her,” said Griet with gratitude. “She was so empathetic with how much stress I was under from my breakup. She was trying to help me. She said if the Jardiance hadn’t worked, she was going to test me next for type 1.”

Recently, Griet transitioned from injections to an insulin pump. “I feel like me again!” she said with a smile and relief. “I’ve never had to be so self-involved as I have been in the last few months. But I realize, looking back, that I’ve been pouring out so much of my energy to others and not keeping much for myself.”

Griet’s diagnosis has helped her prioritize herself for the first time in a long time. “I’m turning things around and putting myself first,” said Griet. “Which doesn’t come to me naturally, and that’s been the culprit for a lot of the stressors in my life. I see that what this disease is forcing me to do is to actually take immaculate care of myself.”