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Kenny's "In Remission" thread - Six Years Keto

October's results are in and much as expected.

A1c is 39, so I'm inclining more to the theory that my "real value" on current lifestyle is somewhere about 38. The variation of my results since April 2020 then being down to variation in machines and acceptable testing inaccuracies. Weight unchanged. All bloods "normal" (undefined) and for the first time ever no statin conversation. Maybe they've just given up on that.

I did remember to fast for around 18 hours before the blood draw this time. Recommended.
 
Today marks five years since my Type 2 diagnosis on 9th December 2019.

9th December 2019 is also the day that I started low carb/keto, and I've been limiting carbs ever since. In anticipation of the diagnosis, I had already read up quite a bit on that way of eating (almost all the good stuff was found on this forum). If not for the advice and support from the people on this forum, particularly in the early days, I don't think I'd be where I am now. Still using the same GlucoRxQ meter but on my third lancet.

If anyone had said to me at Christmas 2019 that by Christmas 2024 I'd not only have normal BGs (achieved by April 2020) but be six and a half stone lighter and playing football three times a week, I wouldn't have believed it. And yet here it is.

So much for keto being only a "short term fix". Keto is sustainable (some willpower is needed in the beginning) and has worked very well for me.
 
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March 2025 checkup/monitoring:

HbA1c 37. BP 125/80. Weight slightly up (14 stone/90kg), which I am not bothered about as I think it's football-driven muscle (re)gain - my waist is still shrinking - down to under 32 inches.

However, there's a story to this. The initial A1c test was done on the machine at the general practice and that returned a value of 53! I challenged it - it would have been my highest ever HbA1c - and the DN agreed to do a blood draw for a lab test. That resulted in the 37 (which is more like what I'd have expected).

I guess the moral of the story is that the testing machines can be really wrong sometimes. One rogue result in five years...... I don't think it's worth fretting much about a couple of points either way - a 39 as opposed to a 37, for example, there's just that built-in level of machine variation. But clearly machines can be seriously wrong sometimes.

So that's five years of normal, non-diabetic, HbA1c results. Next milestone - March 2030.
 
So here we are in April 2026. This year's HbA1c is 37, same as last year. That is five years of bang normal results with a start point in April 2020.

I think this means I get coded differently by the NHS - will need to check that.

Other points - didn't get weighed, no statin conversation, no foot check. Still have the BP and meds check though.
 
I had a look around for some figures, any figures, about long-term success in bg control. The best I could find was words to the effect that "it can happen, but it's rare". No figures, no estimates. Maybe nobody has ever bothered to look.

There will be figures - this is what NHS England instructs practices to do:
  1. Add SNOMED code 703138006 (Type 2 diabetes mellitus in remission).
  2. Retain the original Type 2 Diabetes diagnosis.
  3. Continue annual review monitoring.
So it should be fairly easy simply to count the number of people with the 8006 code....shouldn't it?

However - it's further complicated by the new (and to my mind ridiculous) definition of "remission" as requiring only a BG below 48mmol/l - in other words, an abnormally high level of blood glucose is accepted as an indicator of not having high blood glucose. It's clearly no bad thing to reduce BG, even if it can't be brought back to normal levels, but calling having elevated blood glucose "in remission" is positively misleading.

I may be old-fashioned but I think to mean anything, remission should be defined as normal blood glucose, non-medicated, for a fixed (and much longer than three months) period.

This is the only relevant research I've found so far, from 2022. It uses the sub-48 definition of remission, and indicates that, of the 2.8 million people coded with T2 diabetes in the 2018/9 NDA, 0.58% were coded as being in remission.

Care processes in people in remission from type 2 diabetes: A cohort study using the National Diabetes Audit - PMC

People with type 2 diabetes can enter remission but may relapse or develop legacy complications. This analysis assesses whether people with remission from type 2 diabetes continue receiving annual care processes recommended in national guidelines ...
pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov

And it's now been over six years for me - we didn't have the five years plus conversation last year thanks to the practice's own machine returning that bizarre result, fortunately overturned by the lab test.
 
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