September 2015. My GP’s notes said “tired plus plus, weight gain.” Written twice.
I didn’t think much of it at the time. I was on the medication, I was seeing the GP regularly, I was doing what I was told. That felt like being looked after. Thirteen months later my blood sugar had already moved from normal to borderline. Nobody mentioned it.
I’ve got NHS blood tests going back to 2012, and not long ago I went back through every single one to work out where this actually started. Not where I got diagnosed. Where it started. It’s years earlier than I’d have guessed, and once I saw it laid out properly, I understood why nobody had flagged it at the time.
The Idea That You’re Being Looked After
If you’re on medication and you’re getting your bloods checked regularly, you’re being looked after. The system’s working. Someone’s watching the numbers.
That’s the whole point of “managed,” isn’t it. Statins manage cholesterol. Allopurinol manages uric acid. Inhalers manage asthma. You take the tablet, the tablet does its job, you get on with your life. It’s in the NHS leaflets, it’s what your GP tells you, and on the surface it makes complete sense.
I believed that for the best part of a decade. Six medications by the end: statins, ezetimibe, allopurinol, two asthma inhalers, cetirizine. Every box ticked. Blood tests every few months. GP appointments kept. By any reasonable definition, I was being a good patient.
There’s a researcher called Smadar Shilo, based at the Weizmann Institute, who does a lot of work on how we actually test blood sugar. She found something that stopped me in my tracks. A single fasting glucose test can properly mislead you. Forty percent of people who tested normal the first time got reclassified as prediabetic on a second test, just days later. Which tells you something uncomfortable: normal on the day isn’t the same as fine.
And to be clear, that’s not me having a go at my GP. Twelve-minute appointments, a standard panel, dozens of patients a day. Nobody’s got the bandwidth to sit and trace a trajectory across a decade. That’s not a failure of any individual. It’s just not what the ten-minute appointment was ever built to do.
What Was Actually Happening in the Background
Here’s what the data showed when I finally walked through it properly, year by year, instead of appointment by appointment.
September 2015. HbA1c 38. Technically normal, top of the range, but normal. GP notes on the blood request form: “weight gain, tired, tired plus plus, weight gain.” Written twice. Someone was noticing something, even if nobody joined the dots out loud.
Thirteen months later, October 2016, HbA1c 40. Borderline. Pre-diabetic territory. Two points in just over a year. In that same window, cholesterol came in at 7.0, triglycerides 1.8, both outside range, while I was taking statins and ezetimibe daily. Following the guidance exactly.
That’s the part that got me when I looked back at it properly. Two separate biomarkers, HbA1c and lipids, drifting the wrong way at the same time, on medication designed to stop exactly that. Not one number having a bad day. A pattern.
By 2020, cholesterol was sitting at 7.30 to 7.40. Uric acid 449 to 502, both flagged High. HbA1c 43.2, pre-diabetic, confirmed. Still fully medicated. Still doing everything I’d been told.
October 2022, HbA1c 47. One point off an actual diabetes diagnosis.
And the worst reading of the whole thirteen years landed in December 2023. Cholesterol 8.0, described on the report as Very High. ALT 69, elevated liver enzymes. HbA1c still sitting at 46. Eight years of medication, and my worst numbers came right at the end of it, not the beginning.
My GP’s response through most of that period was, fairly reasonably, “let’s keep monitoring.” Which is the correct thing to say when nothing’s dramatically wrong yet. But eight years of slow, steady drift in the wrong direction, while medicated the whole time, isn’t nothing wrong. It’s just wrong slowly enough that nobody flags it.
Jack Mosley has a way of describing insulin resistance that’s stuck with me ever since I read it. Picture a lecture hall. The speaker’s at the front, talking all day. Something goes wrong with the loudspeaker, it starts muffling. The host speaks louder to compensate, then louder again. But the audience still can’t hear clearly.
The pancreas is the host. Your cells are the audience. Years of elevated insulin means the cells have heard the signal so often they’ve stopped responding properly. So the pancreas shouts louder. The audience tunes out further. That’s not the pancreas failing. It’s the whole communication system slowly breaking down, while everyone in the room assumes it’s working because there’s still a voice coming from the front.
So that’s what was happening in the background, for eight years, while every appointment said things were being managed. Have a think about that.
Why This Isn’t in the Ten-Minute Version
This isn’t a case of the NHS getting it wrong. The guidelines are built around a single snapshot: today’s fasting glucose, today’s cholesterol, compared against a reference range. That’s sensible when you’re trying to process thousands of patients fairly and consistently.
What it isn’t built to do is hold eight years of your own results side by side and ask whether the trend line matters more than any single point on it. That takes someone sitting down with thirteen years of their own paperwork, which almost nobody has the time, the records, or the reason to do.
I only did it because I’d already changed things and wanted to understand what actually happened. Most people never get the reason to look back that far.
What Changed, and What I’d Do Differently
31 October 2023, prescriptions for all six medications ended. My own decision. Not a supervised trial, not something my GP suggested. I stopped, on my own initiative, and told him afterwards once I had blood tests to show him.
That’s not the approach I’d recommend to anyone reading this. If you’re thinking about anything similar, the conversation happens with your GP first, not after.
The medications themselves fully stopped by February 2024, once the remaining stock ran out. Statins, ezetimibe, allopurinol, both inhalers, the antihistamine. All six.
The first few weeks, if I’m honest, were nervous ones. You spend eight years being told these tablets are managing something, then you stop, and part of your brain is waiting for something to go wrong. Nothing dramatic happened. No flare, no attack, no crisis. Just quiet.
Fifteen-plus months fully medication-free, tracked properly, and here’s what the data actually showed.
HbA1c normalised: 37 by April 2025, holding at 37 through November 2025. Not a one-off good reading. Sustained.
Liver enzymes down 86 percent. ALT went from 69 to 10.
Kidney function, eGFR above 90. Excellent, and it’s stayed there.
Forty-five years of asthma. Twenty-plus months without needing an inhaler.
Twenty-four years of gout. Eighteen-plus months, zero flares.
I want to be honest about the bit that didn’t fully sort itself out, because I’m not going to smooth over the numbers that are still a work in progress. Cholesterol is better. It’s not fixed. It was 6.77 in November 2025, down from that 8.0 peak in 2023, but it’s still sitting above where NICE would want it. Some things improve fast. Some things take longer. That one isn’t done.
My GP’s reaction, when I finally brought him the results properly, was somewhere between surprised and genuinely pleased. Not the reaction you’d expect if stopping medication was as reckless as it sounds written down. He wasn’t thrilled about the sequence of events. But he looked at the data and had no complaints about where it landed.
What I’d Invite You to Sit With
What my data suggests, and it’s one person’s data, thirteen years of it, but still one person, is that being managed and actually improving aren’t the same thing. I spent eight years being managed. The numbers kept drifting anyway. Fifteen months of a genuinely different approach, and most of them turned around.
This doesn’t mean everyone should stop their statins, their allopurinol, their inhalers. If you’ve got a diagnosed cardiac condition, a family history of heart disease, if your GP’s told you the medication is protecting something specific, that conversation happens with your GP, always, before anything changes. My situation isn’t a template. It’s one data point.
If you’re not on medication yet, if your GP’s ever written something like “keep an eye on that” or flagged a number as borderline and moved on, that’s worth paying attention to. It’s the same slow drift I went through, just years earlier in the timeline. You don’t need six medications and a decade of decline before it’s worth asking questions.
And if you are on medication and any of this has made you curious about your own numbers, the conversation is with your GP. Not instead of the relationship you’ve already got with them. With it.
I’ll leave that with you.
🎯 Key Takeaways
- “Managed” and “improving” aren’t the same thing: Eight years of monitored medication and my numbers kept drifting the wrong way regardless
- A single blood test can mislead you: Research shows up to 40% of “normal” fasting glucose results get reclassified on retesting days later
- The drift was visible eight years before diagnosis territory: The 2015 GP note existed. Nobody had the time or the trigger to trace it forward
- Insulin resistance is a communication breakdown, not organ failure: The pancreas shouting louder while the cells stop listening is the mechanism, not a moral failing
- Not everything resolves at the same pace: Cholesterol is still a work in progress fifteen months on. That’s honest, not a failure
Ready to Start Tracking Your Own Pattern?
If any of this has made you want to look at your own numbers properly, not just what gets flagged at the appointment but the actual trend over time, the 14-Day Rhythm Reset Guide is a good place to start structuring that.
👉 Get the 14-Day Rhythm Reset Guide (free)
💪 Want ongoing support? Join Rhythm Club for £30/month (includes FREE app access, community, and weekly accountability calls)
⚠️ Important: This is educational content based on evidence and personal experience. It is not medical advice. Speak to your GP before making changes to your fasting pattern, diet, or medication.
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