how I manage my blood sugar without medication
“…you’re diabetic. you need to start dealing with that.”
In February of 2024 I got an email from my doctor. Routine bloodwork. My A1C was 6.5 — the threshold for a type 2 diabetes diagnosis. I read it twice. Then I sat with it for a while.
It was the last thing I expected. I was active. I ate reasonably well. I’d kept most of the my weight off most of the time. I didn’t have a family history of diabetes. And yet there it was, in an unexpected email on an otherwise ordinary Friday.
What I did next is what I want to tell you about.
Back in 1998, when I was pregnant with my first son, I was diagnosed with gestational diabetes. My doctor at the time told me clearly: you have an elevated risk of developing type 2 diabetes later in life. Watch your weight. Watch what you eat. Stay active.
I heard him. I mostly did those things. And for twenty-six years I didn’t think much about it.
Then the email came.
My first appointment was with an endocrinologist. She asked me a question I hadn’t expected: did I want to try medication, or did I want to try diet and lifestyle first?
I chose diet and lifestyle without hesitating.
She was not enthusiastic about what I did next. I went looking for what a real dietary intervention for type 2 diabetes could look like and found a program through my health insurance called Virta Health. True ketogenic eating — not fad keto with creative net carb math, but actual nutritional ketosis. A whole structured program with medical oversight, coaching, and accountability.
My endocrinologist told me keto was too restrictive and that people couldn’t stick to it. She steered me toward a more moderate low-fat approach.
I did Virta anyway.
The first six months were the hardest. True keto is genuinely restrictive and I’m not going to pretend otherwise. But I was determined, and more importantly I understood why I was doing it. Carbohydrates raise blood glucose. If you are a type 2 diabetic eating a low-fat, higher-carb diet your glucose will not be managed. That’s not a controversial statement — it’s basic physiology. And yet it is not what the mainstream medical system typically recommends.
I retrained my body to burn fat for fuel instead of carbs. I lost eighteen pounds. And I got my A1C down from 6.5 to 6.2. That’s not small.
My endocrinologist was unmoved. I found that interesting.
Here’s what my approach actually looks like now, two years in:
I still follow the Virta program. Once my body adapted to burning fat for fuel, I was able to gradually become less strict without losing the benefit. I still don’t eat a lot of carbs. When I’m on vacation or in a situation where refusing carbs is a genuine inconvenience, I eat them. Then I go back to keto like nothing happened. My body returns to fat-burning mode and sheds the fluid retention that comes with carbohydrate intake. It has never failed to work, because I did the really hard work first following the Virta process of very strict low carb–about 30 carbs per day, monitoring my ketones and blood glucose daily, and getting some exercise.
I also do intermittent fasting. It works well with keto because fat and protein makes me feel full. I don’t feel hungry throughout most days. My eating window is typically breakfast and dinner with about a ten-hour gap between them, followed by a three-hour snacking window in the evening, then fasting until morning. High protein, low carb breakfast. This structure keeps my glucose stable in a way that grazing throughout the day never did.
I do yoga and strength training at home a few times a week using Apple Fitness. David and I walk outdoors regularly with our dog, Emma. Movement is non-negotiable — not because I love exercise, but because I understand what it does for insulin sensitivity and I’ve decided my health is worth the inconvenience. It doesn’t need to be intense exercise; that makes you hungry and requires carbs for fuel. 20-minutes of moderate intensity a few times a week.
BioTe hormone therapy isn’t directly part of my glucose management, but it gives me the energy and mental stamina to sustain a restrictive diet and stay motivated to move my body. Everything in this system supports everything else.
I want to say something plainly, because it’s what I actually believe and this is my site so I’m going to say it.
The story I’ve told myself about the American medical system is this: a patient cured is a customer lost. The system appears to be designed — whether intentionally or just structurally — to keep us returning for appointments and purchasing expensive prescriptions. I was genuinely surprised that the first doctor I saw offered me a non-medication path. I was less surprised when she discouraged the one dietary intervention that the research most strongly supports for glucose management.
I am not telling you to ignore your doctor. I am telling you not to be afraid to think outside the box. To ask challenging questions. To do your own research. To understand that western medicine doesn’t hold all the answers, and that sometimes the path that works is the one your doctor didn’t recommend.
I’ve proven that to myself with this. I’ve proven it in other areas too. And I’ll keep proving it.
If you’re newly diagnosed or struggling to manage your glucose and you want to know more about Virta Health or the ketogenic approach to diabetes management, I’m happy to talk about it. Leave a comment or reach out directly. This is one of those things that changed my life and I don’t mind saying so out loud.
LW
