Changing How We Think About Diabetes

It started with an omelette. “The morning I cracked three eggs into a pan of melted butter, I did not know I was beginning a revolution.” It was, writes Gloucestershire GP Dr Ian Lake in his new book Shifting Gears , “the first moment of clarity I had had in over two decades of living with type 1 diabetes (T1D).”

Diagnosed with T1D in 1995 while in his mid-30s, Lake followed the established regimen derived from the prevailing reasoning that carbohydrates raise blood sugar concentrations; insulin lowers them; and by calculating carbohydrates and matching insulin, the two would “meet like dance partners, arriving together, moving in sync”, and seamlessly lower glucose concentrations. But after 20 years Lake had failed to match insulin to carbs: If he didn’t sleep well or exercised too late or was stressed “or even if the weather changed, my blood glucose could spiral out of control”.