Looking 5 years back and 5 years forward

I’m not far past the 5 year anniversary of my Type 2 diabetes diagnosis. And, I’ve recently had my annual diabetes check up so I’m in a reflective mood. Those 5 years have gone past very quickly.

Over the last 5 years there have been many advancements, here are a few key ones:

• The introduction of GLP-1-based therapies that promote weight loss and improve insulin secretion.
• Greater accessibility to intensive lifestyle and weight management programs, such as the NHS Type 2 Diabetes Path to Remission Programme.
• A focus on population level interventions such as new government policies including taxes on sugary drinks.
• Multiple technology advancements; CGM, Sports watches/trackers, food and calorie trackers and insulin smartpens.

In that time period my main personal achievements have been:

• Seeing my HbA1C drop from an initial 96 mmol/mol at diagnosis to a current level of 50 mmol/mol.
• To gain a decent level of control and an understanding of my blood sugar triggers.
• To maximise the benefits of using technology to support me. Such as moving from finger pricking to wearing a CGM and from using individual insulin pens to having a reusable smartpen.
• Sharing my experience with others by joining the diabetes community and volunteering.

And for balance my main personal disappointments have been:

• That I was advised to move from tablets to insulin. This felt like a big step although I actually find it very convenient with no obvious side effects.
• That my commitment to taking good care of myself can still be ‘boom or bust’. I jump off the diabetes wagon and then need to remind myself to start taking care again.

If I look forward to 5 years, what do I want to see happen around diagnosis and treatment of diabetes and prediabetes? For me personally I have some specific ambitions:

• Reduce my daily dose of long acting insulin. The expectation is that it increases over time however I want to reduce it.
• Maintain my weight and my exercise regime as I know both of those help my physical and mental health.
• To see some of the diabetes research projects I’ve been involved in progress.
• To keep my diabetic retinopathy at Level R1 and be able to keep my driving license.

And for the wider T2 diabetes community my 5 year list is quite long:

• That the best type of diabetes is no diabetes, so a focus on diagnosis of prediabetes, prediabetes interventions and a continual focus on remission from T2.
• That NICE guidelines are updated in order that CGMs are available more widely on the NHS.
• That the supply and prescription of GLP-1s is reliable for patients who would benefit.
• That there is a personalised approach to medication, moving from the current standard that everyone starts on Metformin.
• That hybrid closed loop systems are available for appropriate T2 insulin users.
• The ending of T2 being labeled as a lifestyle disease thus reducing the stigma and mental health burden.
• That the great breakthroughs in T1 treatments are pulled through into T2 where there is potential cross over.

For my wish list to happen there needs to be an increase in funding across the NHS and continual funding of targeted research projects. Currently 10% of the NHS budget in England, is spent on type 2 diagnosis and treatment (approx £10 billion annually). This figure includes the treatment of preventable complications. The amount spent on research specifically on Type 2 is harder to calculate. DiabetesUK stated they invested £5.4 million into new research projects in 2024.

Jo Sellwood

Author

Let me introduce myself as I start sharing my diabetes connected thoughts via a set of blogs for Tesu Health. I’m a relatively newly diagnosed Type 2 diabetic if you’d say that 5 years is newly diagnosed. To me it still feels like I am learning about diabetes, how to manage my own diabetes and how the medical and research community are moving forward to help us all. My diagnosis was only confirmed after I was unwell with a completely unrelated condition. It was a surprise as I thought I was fit and healthy. A vegan marathon runner probably isn’t the first person you’d expect to have T2. Over the last 5 years I’ve moved through different medication regimes and am currently injecting slow acting insulin once a day. For me, this works well in conjunction with my (self-funded) Continuous Glucose Monitor. As a way of better understanding diabetes and my own lived experience, I volunteer with DiabetesUK. I am fortunate to be an Expert by Experience as part of their Diabetes Research Steering Group which is planning the next research into the causes of diabetes. I am a huge advocate of enabling people living with diabetes to have the knowledge, skills and support to take action and thrive. I hope you enjoy reading my blogs. You can read more through my LinkedIn posts.