Wednesday 19 August 2015

"Living by Numbers" - my Diabetes Story

It's not been a good week to be diabetic. We woke up on Monday morning to news headlines revealing a 60% surge in diagnosis of diabetes over the past 10 years. The mid-market tabloids featured front pages screaming about the "epidemic" which would "bankrupt the NHS", quoting our poor diet, sedentary lifestyle and bulging waistlines as the cause of this menace. 

Daily Express, Monday 17th August 2015
You had to look very hard to find any reference to the two types of diabetes. TV and radio did rather better, making clear from the outset that this story was largely about Type Two, but even so there was a sense that diabetes was being demonised.

Small wonder then that people with diabetes were soon up in arms on social media. In particular, the familiar call to re-name Type One was getting another airing, and many Type Ones took to social media to post pictures illustrating how active and healthy they are using the hashtag #RealLifeDiabetes, as well as reminding others how hard it is to live with this complex condition. It really is very frustrating when you have Type One, a condition which strikes randomly and has no connection with the victim's previous diet and lifestyle, to feel tarred with the brush of Type Two, which is always portrayed as a disease of a greedy and over-indulgent modern society.

I am not inclined to get too involved in the Type One/Type Two debate: it is not fair to accuse anyone of causing their own illness. If we set off down that route, we might as well start "blaming" people for having cancer, given known links between at least some cancers and diet and lifestyle. Nobody gets ill on purpose. I would prefer the two conditions to have different names, but it isn't going to happen.

However, perhaps this is a good moment to share my diabetes story on my blog , just as a reminder that  - like all other Type One diabetics - I am the victim of the fickle finger of fate, and not the author of my own misfortune and a drain on the NHS.

I was diagnosed at the end 1997, at the age of precisely 40. Until then, I had lived a life with minimal contact with the health service. I had a couple of standard childhood illnesses, leading to a couple of spells off school before the age of 10; I then managed an entire secondary school career without a single day's absence. I fell off my bike at the age of 13 and suffered a straightforward arm fracture, which mended in the standard six-week time frame. And that was about it. Prior to my diagnosis with diabetes in 1997, I had worked for 17 years as a teacher with a total of about four days off sick (two lots of two).

Moreover, I was a slim, healthy and active person: as a child I cycled to school, played football as a recreation and spent holidays fell-walking with my family. As an adult I cycled to work, tended an extensive garden and walked from my home to the local shops rather than driving. And I still do.

Then, at the age of 40, I had a very bad case of 'flu in the week running up to the the Christmas break at school - a week's absence for the first time ever. No real cause for alarm: there was a big epidemic and a number of colleagues were off at the same time. Then, on the day after I had started to feel better again, my condition took a nosedive, and I went to my GP, alarmed at this apparent recurrence of an illness from which I had just recovered. I felt tired, thirsty and run-down, but just thought it was a hangover from my first real illness in years. A routine urine test revealed very high blood sugar, and an alarmed GP (parent of three children whom I taught) informed me that she was pretty sure that it was diabetes, referring me to her colleague at the practice who was the specialist in diabetes. He told me to "cut out all sugary foods" and see if the sugar level fell. This puzzled me somewhat, as I have always had a famously "unsweet tooth"- there was little or nothing to cut down on. However, I agreed to do so, and came back a few days later to discover that my sugar level was higher than ever. "OK, said the doctor, we'll put you on medication" He was assuming, from my age, that I was Type Two. Looking back, I have to say this was a questionable diagnosis in the face of all evidence - I was slim, ate healthily and exercised plenty - but again, I went along with it and took the pills for a few days (including Christmas Day). 

It was only when I reported back with an even higher blood sugar level and no sign of feeling better that he finally wondered if it might be late-onset Type One. Off to hospital I went (only as an out-patient), where a consultant agreed it certainly must be Type One, and referred me to the clinic to learn the noble arts of injection and blood testing. I did all this without missing any days off work, despite feeling very tired. My school were very good to me, and as I live near to the school, I was able to come home for a rest at lunchtime and leave early when not teaching.

Two different insulins, two pens 
- my permanent companions.
Once the insulin started to have an effect (and that effect comes on almost instantly, as anyone with Type One will tell you), I was soon back to normal. By the Easter four months after diagnosis, I led my annual residential school trip to France with about forty pupils and five colleagues. I continued to do this every year whilst it remained part of my role at the school. By the June six months after diagnosis I was planning, setting up, organising and running the end-of-exams Ball for 200 Sixth Formers, a demanding job I undertake every year. In day-to-day terms over the 17 years since, I have continued to take on all that life and work throw at me, all with an unblemished attendance record in a very stressful job. I am certainly not a burden to anyone, and other than the cost of my insulin and test strips, the annual flu jab and my annual clinic review, I don't bother the NHS at all.

But let's not pretend it's easy Living by Numbers (to quote my chosen title). Living with Type One diabetes is a 24/7 challenge that we face on top of all as that we do in life, whatever that may be. You can never forget or overlook it for more than a few minutes. Every action, every piece of food or drink, every event needs to be thought through. Any departure from routine is potentially risky. Most infuriatingly, insulin - the treatment that you self administer every day in order to preserve your life - is precisely what threatens to bring you down in day-to-day terms. I think is fair to say we have a love-hate relationship with it!

My Diabetes drawer - all the stuff we need to keep going
An yet it could be worse. Let us not forget that. It was a lot worse until the discovery of insulin therapy by Canadian Frederick Banting in 1922, when Type One was in effect a death sentence. It is a whole lot worse in many less fortunate countries  where access to insulin is still limited or non-existent. The 400 000 of us who live with the condition in the UK have good cause to be grateful to our doctors, nurses, designers and makers of insulin delivery methods and blood testing kits who enable us to live normal, active lives. 

People with diabetes are also remarkably supportive to each other: in one of the best illustrations there is of the good side of social media, thousands of diabetic people of all ages, both genders and all backgrounds regularly support, help and encourage each other online in a spirit of togetherness and cheerful acceptance of a condition which can at times make its victims feel frustrated and lonely. It's no fun having Type One, although it is fun being part of a worldwide community of people who are very good at making the best of a cruel stroke of luck.  Ironically, I think that Type Ones are so good at looking after and understanding our bodies that we actually end up being disproportionately healthy in old age. So please, don't accuse us of being responsible for this illness, or of "bankrupting the NHS".


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