As a registered nurse, Jen Avery knows all about the complications that can come with type 2 diabetes.
As one of almost 2 million Australians living with type 2 diabetes, she admits those complications worry her.
"I do feel anxiety because you know what can happen," the 63-year-old said. "You know about kidney disease, you know about diabetic retinopathy, you know about peripheral neuropathy, and the increased risk of heart disease. You know all of that stuff."
Ms Avery shares her story in the latest instalment of the ACM podcast, Voice of Real Australia. The epsiode also features Newcastle University nutrition expert Laureate Professor Clare Collins and sports medicine clinician and Defeat Diabetes founder Dr Peter Brukner, prominent contributors to ACM's Silent Assassin series on the causes and consequences of Australia's type 2 diabetes epidemic.
Ms Avery traces her diabetes to the years after the birth of her first child. Worried her polycystic ovaries would make it difficult to conceive again, she saw a fertility specialist.
"The specialist suggested that I take some medication, and that medication just banged the weight on me," she recalled. "And then from then on, that was my downhill slide. I started to get high blood pressure and then insulin resistance and then, bang, I've got type 2 diabetes."
People living with the condition face a range of terrifying potential complications - including having limbs amputated, strokes, heart attacks and going blind.
The annual cost to Australia's health system has been put at $20 billion.
Despite the huge burden and rising cases, with the right treatment and management, people with type 2 diabetes can lead long and healthy lives.
One of the medications often used is insulin, a hormone produced naturally by the body which helps with glucose absorption. When the body doesn't make enough insulin or doesn't use it properly, insulin can be prescribed.
Ms Avery says insulin doesn't work for her and she feels doughy and sluggish when she's on it.
"Insulin and I equals 'let's put on 20 kilos without even thinking about it'," she says. "I'm not saying that insulin isn't a good treatment, because it's all we've got, and it can make a big difference to people's lifestyles. But with me it wasn't working. All it was doing was putting me in the cycle of putting on weight, and then having to have the insulin increase because of the increased weight."
At her heaviest, she weighed 116 kilograms. But changing her diet helped Ms Avery come off insulin entirely.
She began following the Defeat Diabetes program in late 2020, including its recipes for low-carb and healthy-fat meals. Since then, she has lost a significant amount of weight and her diabetes is now in partial remission.
There are two other medications she takes but is working with her endocrinologist to come off those too. She now weighs about 80 kilograms.
"I discovered that my body responds to low-carbohydrate high-fat and that's how I can lose weight and that's how I can manage my blood-sugars," she said. "I'm learning to make lots and lots of better choices."