Isobel Murray is a retired civil servant from South Ayrshire, Scotland, mother of two sons, and grandmother of two grandchildren. Her journey to diabetes remission began through her involvement in the Diabetes Remission Clinical Trial (DiRECT).
In June of 2011, Isobel suffered from what she described as a life threatening heart attack: “I had 30 minutes to live when they got me to the hospital, it was a shock.” Having been a smoker for most of her life, Isobel was advised by her cardiologist that while her smoking was not the sole cause of her heart attack, now was the time to stop.
It would be some 6 months later in November 2011 that, during a routine blood test, her nurse noticed that her blood glucose levels were exceptionally high. It was then that she was diagnosed with type 2 diabetes (T2D).This came as a real shock to Isobel: “I was absolutely gobsmacked. I had put on a stone after I quit smoking but I still wasn't necessarily that heavy. At the time I was diagnosed I was probably 8.5 - 9st.”
Not long after being prescribed diabetic medication to manage her T2D, she noticed that her weight started to increase, despite being more mindful of her eating. In addition to this, her work situation was becoming increasingly stressful, juggling a large workload in reduced hours as she was in the process of retiring. Isobel highlighted that while she loved her job and fellow colleagues, it was becoming hard.
Isobel was now at the point where she was becoming extremely frustrated with her diabetes and it began to weigh on her mind even more: “My medication prescription was increasing at each appointment and it was awful. My health had deteriorated quite a bit by this point. My heart was okay but generally speaking I felt terrible.”
Starting the programme
3 years later, Isobel found out about the DiRECT study from her doctor. For decades the standard approach to the management of T2D was through medication. However, a newer approach was on the horizon which aimed not just to manage T2DM, but to put it into remission without the need for medication.
Isobel jumped at the chance as her medication was now causing her more problems than it was solving. When asking her diabetic nurse what they thought about this opportunity Isobel was told: “I think you are the one person that would definitely go for this and make it work as you are so determined”.
Expectations and challenges
Isobel had some apprehension at the start of the programme, which is understandable when you are embarking on changing behaviours: “I would not say I was scared about it, but I was a bit apprehensive as I was told I was to take all this medication for years, and then suddenly on day one I was not to take any of it. I was questioning how I would react to it”.
Isobel found that once the programme commenced, it was not as challenging as she expected.“Once you get through the first couple of weeks and settle yourself down, you begin to see positive changes in yourself and this helps manage any fears”.
Reflecting back on her experience: “I am not going to say it is easy as it is not, but when you have a goal at the end of it that you are desperate to achieve and you are feeling better everyday as you are not taking medication that has been causing you more problems that it is resolving, then that really does give you that motivation to keep going and get it done”.
Isobel found that everyone around her was extremely supportive and this provided her with that extra push to keep going when things felt difficult. “The people that I made friends with at the gym were fantastic, they all heard about what I was doing and they used to walk up when I was on a bike and say... go on hen, you are doing really well, look at you!”.
Reflecting back on what kept Isobel motivated, the initial significant weight loss was key: “The fact that you start to lose weight soon after starting, and you are getting rid of all the big clothes and going out and buying newer and smaller clothes that were 2-3 sizes down was a good feeling. You can both see and feel how you are progressing.”
For some, the convenience of total diet replacement makes it easy to follow. Isobel spent a total of 17 weeks on this stage. Surprisingly, Isobel found being on the shakes and soups actually made her day-to-day life easier, as she could now forget about cooking and going to the shops. “You have to learn to get used to being on total diet replacement with just soups and shakes, and when you do, it frees you up”.
This break from cooking and shopping was something Isobel used to her advantage, as she was now able to exercise at the gym on a regular basis: “I would sometimes go for a swim in the mornings and then back again in the evening with my husband Jim”.
Isobel’s husband, Jim, was undoubtedly her biggest source of support during her time on the trial. She describes Jim as her rock: “He was so happy for me with seeing this weight falling off and seeing how well I was feeling and looking”. Isobel jokes that he even spoke at one of the interviews she did for Scottish news where he said that he actually quite enjoyed her being on the trial as he was able to eat all the foods that were in the house.
In addition to support from her husband and her friends, Isobel received a great deal of support from her dietitians and the various healthcare professionals that were working alongside her on the trial. She found the experience with the dietitians absolutely fantastic. Isobel found working with her dietetic team “extremely valuable” and she continues to use the skills she learnt 6 years on after her time on the study.
The positives gained
Isobel completed the full 2 years of the trial which is no mean feat. She showed extreme resolve and determination from day one and this is reflected in what she has achieved. Her HbA1c went down from 70 to 40mmol/L, she lost 3.5 stone (22.3kg) during the first 17 weeks and maintained 4.5st (25kg) weight loss over the full two years of the trial.
While this was a major achievement, from the very beginning, Isobel's main aim and ultimate goal was to not just come off, but to remain off, her diabetic medication. It is now some 6 years on from the start of the trial and she has not taken a single dose of diabetic medication.
“I feel like a normal person and I know that sounds stupid, but I feel like my normal self again, well and healthy and that is what is important to me and I am determined to stay that way.”
Advice to others
Isobel's advice to anyone who may be considering starting the programme is that while it can be challenging to begin with, it helps to know that you are being fully supported by healthcare professionals: “If you really want to do this, you can. If I can do it at 60 odd years old then anybody can do it. Go for it and put everything you have into it as you will reap the benefits.”