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Trying to “Reverse” Type 2 Diabetes with Extreme Diet & Exercise When You Actually Have Type 1

At 43 years old, Ana Alvarez Pagola was misdiagnosed with type 2 diabetes while living in Argentina. Now, nearly 20 years later, Ana still remembers the year of confusion quite clearly.

Trying to “Reverse” Type 2 Diabetes with Extreme Diet & Exercise When You Actually Have Type 1

“It was actually my gynecologist who noticed my blood sugar was high,” Ana recalled. “I was a smoker at the time, so they did a thorough exam and blood tests. Everything was fine, except my fasting blood sugar was 132 mg/dL.”

Next, Ana was asked to take a glucose tolerance test (GTT). A GTT involves consuming a large amount of oral fast-acting glucose during a hospital appointment, followed by a blood glucose test two hours later.

“I failed the test,” said Ana. “My blood sugar was 300 mg/dL.” They diagnosed her with type 2 diabetes (T2D) and suggested she talk to an endocrinologist. They also recommended she watch her diet and exercise more closely. Fortunately, Ana was already seeing an endocrinologist for her thyroid condition due to the removal of a benign thyroid tumor.

Ana remembered thinking the diagnosis was strange, considering she was remarkably thin. When she questioned the doctor, they said it was simply because she was over 40.

Obsessive Exercise and Restrictive Dieting 

“I bought a treadmill,” Ana said, determined to decrease her glucose levels. “I was vegetarian and relied heavily on carbohydrates, but then I tried to cut down on those too. I filled my plate with vegetables and smaller portions, often just salads.”

Despite every effort, Ana was too stressed to truly notice how awful she felt. She checked her blood sugar regularly, but her numbers didn’t budge. Something was not right. Six months into her supposed type 2 diagnosis, her doctor started Ana on basal insulin, but her fasting blood glucose remained high. 

Basal insulin didn’t help; Ana needed fast-acting insulin, too.

“I continued to lose weight,” said Ana. Also, her A1C levels hovered between 5.8 and 6.2. 

One Year Later

As her stepdaughter's wedding approached, Ana found herself in a fitting room at her favorite clothing store, determined to wear a pair of white pants. “I tried on every single pair of pants in the store, but nothing fit. Everything was too big because I’d lost so much weight. I was sitting on the floor, crying. Nothing fit. Nobody came and asked what was wrong,” she remembered. 

With her health deteriorating, Ana felt increasingly desperate.

“I’m starving. I’m exercising 24/7. My blood sugars are all over the place. I was waking up at 130 mg/dL and still not achieving what I was supposed to,” she explained. While 130 mg/dL isn’t as disturbing as some of the other misdiagnosis stories we’ve heard, it’s still significantly higher than a non-diabetic fasting blood sugar level.

Ana’s frustration was increasing every week. “I wasn’t eating anything because I was trying so hard to manage my blood sugar. I was close to just eating lettuce. It was a dark period in my life.”

In reality, she was starving herself but couldn’t see it. “I was used to working hard and achieving my goals, so realizing that I was doing everything right yet still failing was disheartening. It felt like I was screaming into a void. I just wanted answers: we need more tests.”

The same doctor, hesitant to switch diagnoses, began to suspect something deeper was wrong. Ana’s C-peptide test revealed a very low level of 0.3. 

Mystery Solved

“Oh, you type 1.5 diabetes!” her healthcare team realized. At last, the pieces began to fall into place. Ana recalled the moment with a mix of relief and disbelief. Worldwide, the medical community was only beginning to recognize that adults could develop type 1 diabetes, and Argentina was likely further behind.

Finally armed with the correct diagnosis, Ana tried to find an endocrinologist to support her new condition. Unfortunately, she discovered that the healthcare system in Argentina was fraught with challenges. 

“Very few doctors were available in the private healthcare system, and it felt like a struggle to find an endo,” Ana remembered. “And an insulin pump is very hard to get in the Argentina healthcare system. Only 20 people with type 1 were using an insulin pump at the time in one of the largest private hospitals in Buenos Aires.”

Many years later, in 2013, Ana witnessed the passing of a law that enabled anyone with type 1 to access insulin, test strips, and insulin pumps for free.

“They still try to avoid giving you a pump, though,” Ana laughed. “Because they have to pay for it. You have to advocate for yourself.”

Thankfully, Ana has dual citizenship between Argentina and Spain. “In Europe, I can get the diabetes technology I need. I don’t have to fight for it,” she said gratefully. “I get everything for free, including pump upgrades. There is no charge in Spain’s healthcare system.”

Ana with her mother and daughter

The Impact on Ana’s Mental Health

The misdiagnosis took a toll on Ana’s emotional well-being. “I just couldn’t cope. It was so hard to process everything,” she said, reflecting on how difficult it was to control her blood sugars with obsessive exercising and restricted dieting.

It is, sadly, an increasingly common story: adults misdiagnosed with type 2 diabetes find themselves undertaking rigorous physical activity combined with severely limiting calories while trying to reverse something that cannot be reversed.

Getting the proper diagnosis made all the difference for Ana’s anxiety, and she’s grateful it didn’t take as long as others who have shared their misdiagnosis stories. 

“Once I understood what I was dealing with, everything got easier,” said Ana, who embraces the challenges of T1D and daily insulin therapy with courage. “I began reading blogs, teaching myself, and learning how to live my life with type 1 diabetes.”

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