Tuesday, 25 April 2017

I'm Still Standing

This is an adapted version of the talk I delivered on Saturday 22nd April, 2017 to #TADtalk2017, a day conference for people with diabetes organised by a group of specialist doctors and sponsored by diabetes charities and medical companies. The pictures are taken from the accompanying powerpoint. 

The title of my talk was Diabetes: Something or Nothing, but as it's one of my blog posts, it needs a song title. Elton John's I'm Still Standing fits the bill perfectly. It is, of course, an 80s classic with an iconic video starring a young Bruno Tonioli. But it's a brilliant diabetes song. Not only are the lyrics about resilience in the face of adversity, but it's musically subtle and very appropriate to diabetes: the melody switches from major in the verse to minor in the chorus, reflecting the everyday ups and downs, triumphs and disasters of life with diabetes.

My aim was to demonstrate that Type One diabetes, whilst a serious and burdensome condition, is no barrier to a busy, fulfilling and even fun life. I hope that by publishing it as a blog post I can enable those unable to attend the conference the chance to read it. The content is intended to be positive and good-humoured, but not deadly serious. In particular, I would not wish to insult the many people who find life with diabetes a physical and emotional burden for some or all of the time. I am well aware that having developed Type One at the age of 40, in otherwise good physical and mental health, I have had the good fortune to live well with diabetes. This is not always the case, and should not be taken for granted. Here is what I said to this large and diverse audience:-

Looking out at this audience, I can’t help but reflect on the unexpected turn that my life has taken in recent years. What am I doing here? I’m in a lecture theatre in London addressing an audience of people who were complete strangers to me, and indeed to each other, until fairly recently. Some of you I’ve already met, and some are people I’ve yet to meet, but many of you I “know” through Twitter - in my experience a remarkably accurate filter. So it’s great to meet you in the flesh. And yes, I’m Talking about diabetes.
Five years ago, Talking about Diabetes was the one thing I didn’t do unless strictly necessary. Nothing silly or deep-seatedly psychological. I wasn’t in denial, distress, burnout or anything like that; I was just too busy and had better things to do. I couldn’t be bothered with diabetes if the truth be told.

I had developed this serious, pesky but perfectly manageable condition at the age of 40, when I was in the prime of a very busy career as a teacher, fully involved in the life of a growing family of three children and in the life of the community in which we lived.

This photo is of me with my wife and family, taken the year before diagnosis, dressed in medieval costume to celebrate my town’s 700th anniversary of its royal charter. I was one of the organisers of a festival to mark the event. At that time, I was a conspicuously healthy adult on the brink of middle age, having barely troubled the NHS in almost forty years. A couple of childhood illnesses, a broken arm – that was about it. Diabetes struck me with almost no warning in the last month of 1997, a few weeks after my fortieth birthday, and whilst it was a shock suddenly to find myself as a vulnerable patient with a lot to learn, some complex needs and a lengthy repeat prescription list, I didn’t let it interfere with my life and work. 

My diagnosis is a story which I have told on social media, but for the benefit of those of you who don’t know, here, briefly, is the story:

It started with a very bad case of 'flu in the week running up to the 1997 Christmas break at school - a week's absence from work for the first time ever. No real cause for alarm: there was a big ‘flu epidemic and a number of colleagues were off at the same time, although I wasn’t used to being unwell. Then, on the last day of term, after I had started to feel better, my condition took a nosedive, and I went to my GP, alarmed at this apparent recurrence of a severe illness from which I had just recovered. (this was back in the days when you could phone the GP & get an appointment the same day). I felt tired, thirsty and run-down, but just thought it was a hangover from my first real illness in years and a long, hard term's work.
A 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.
Her colleague - stepfather of another pupil at my school (such is the venn diagram of life in a small town) - told me to "cut out sugary foods" and see if the blood 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 try, and came back a few days later - just before Christmas - 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 highly 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). This was pre-internet, pre-google, so I knew next to nothing about diabetes, the different types and so on.
It was only when I reported back after Christmas 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. I was told this was exceptionally rare at my age. Off to hospital I went (only as an out-patient), where a consultant confirmed it was 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. 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.
I wasn’t trying to be stoical or heroic: it’s just the way I am. I don’t like a fuss – it’s a lifelong and sometimes annoying habit which was already in me as a toddler: my late mother used to tell a tale of me at the age of about three, getting trapped under a fully loaded clothes horse which she had seen fall over without realising I was under it. She was busy doing something else at the time, so she finished what she was doing before attempting to pick it up. Only then did she discover that I had been lying under it for about 5 minutes, trapped by its weight but not injured. Apparently, I said, in so many words, that I was fine and thought she was busy so “didn’t want to bother her”. When I was thirteen, I fell off my bike and broke my arm but failed to tell anyone for about a week, until my nearly-blind grandmother noticed that my arm was an odd shape. 

A worringly pretty boy with a broken arm

Likewise as an adult, I didn’t want to make a fuss about getting diabetes. I simply learned to inject, test etc. and got back to work just as before. Three months after diagnosis, I led a group of forty kids and five teachers on a residential school trip to France, just as I had been doing for many years.

And I certainly didn’t want to “talk about diabetes”. I didn’t know anyone else with the condition, and didn’t go out of my way to meet anyone else with it. Just about the only fellow Type One diabetic I met in my first sixteen years of it was when a pupil joined my school having just developed Type One at the age of ten. I was more than happy to meet her and her mum and offer the reassurance of being someone in the school who knew what it was all about. Whilst I never actually taught the girl, I used to see her around the place for a friendly word, sharing biscuits and jelly babies when she was caught short after a games lesson or occasionally standing in when the School Nurse wasn’t free to supervise her injections, but my involvement went no further than that.
But then this little blue bird came into my life 

I was relatively late to social media, despite being an early internet enthusiast, and I have still not joined Facebook. I remain to be convinced of it. Twitter, however, appealed to me because of the conciseness of 140 characters and the chance to follow and occasionally interact with people I didn’t know, rather than just seeing the minutiae of the lives of people I already know or used to know. I started out on Twitter as a follower rather than a person seeking followers, and had no wish or intention of using it as a means to make new contacts or to communicate with others. I like this visual summary of the differences:-

However, at some point, as I was getting to know how hashtags work, I must have tried looking for #diabetes and started to come across the world of the #GBDOC. At first, I was what we now call a lurker - someone who watches, likes, but doesn’t say anything. In real life, I always prefer to feel my way into any group rather than speaking too soon, so my behaviour in the online world was guided by that principle. Eventually, however, when I had got the feel of what people say, I started to chip in. 

Ellie Huckle - my first #diabuddy

I recently checked my Twitter archive (did you know you can request it – great way to waste a few hours) to try and find out my first interactions about diabetes and found that it was on November 28th 2013 that I first had a conversation with someone else with diabetes, and that someone was the already established blogger and tweeter, Ellie Huckle. She’s here today – my original diabuddy, one of my diabetes heroes, and I find that very appropriate

These days I am a something of a Twitterholic, and many of those whom I follow, or who follow me, are people with diabetes – including many in this audience. 

If you do follow me, I hope you will recognise that I try to avoid too much talking about diabetes. I prefer to talk about cats or Bolton Wanderers. Of course diabetes is the reason that we know each other, but I am wary of becoming a dia-bore who just talks diabollocks. I have a short attention span and a diversive butterfly brain, so I try to reflect that in my tweeting and blogging.

Cats of GBDoc - one of the ways I try to avoid Talking about Diabetes
But I have certainly morphed into someone who is more than happy to “talk about diabetes”

So is it worth Talking about Diabetes? Is it something or nothing? Let’s see. Well, nobody here really needs reminding that diabetes is quite something, quite a big deal in our lives. It’s with us 24/7, 365/365, for life. We can never forget it for more than a few minutes – it’s a monkey on our backs – or more like a whole troop of monkeys. 

I recently attended an in-service training event for teachers about supporting children with diabetes, and although most of the content had me quietly snoozing, I was very struck by a statistic which the presenter quoted, saying that a child with Type One has, on average, 27 extra thought processes before they even get to school each day. 27? I guess that might well be true, and if so, how many extra thought processes do we all have in a typical day compared to someone without diabetes? And at what price to the rest of our lives?

It isn’t easy living by numbers, and in that sense diabetes is quite something. For me personally, it’s become even more of a thing since I started taking more of an interest in it. Thinking back to 2013, and my first tentative steps on Twitter, it’s remarkable that I now have what is in effect a second life thanks to diabetes. I’ve been styled as an unofficial Mr FreeStyleLibre thanks to my online enthusiasm for Abbott’s flash glucose monitoring system, and they even made a film about my use of it.
I sometimes worry that I over-do the FreeStyleLibre enthusiasm, but I honestly have found it awesomely helpful and I am very aware that I am lucky that I can afford it. Years before it was invented, I remember my wife saying that what you really need is a device to tell you in which direction your blood glucose is heading. For that and that alone the Libre is a winner for me.

Thanks to diabetes, Twitter, blogging and my Libre enthusiasm, I’ve opened up a whole new life. I’ve visited Sweden for a conference with fellow diabetics from all over Europe, and I’m due to lead a training session for Abbott at their labs in Witney in summer. And I’ve made hundreds of new friends - people whose paths would never have crossed mine without our shared affliction. In getting to know them, I’ve gained new insights not only into my own condition, but also into the lives of those who, unlike me, live with a whole lot more besides diabetes: adolescence, hormones, pregnancy, parenthood, depression, chronic fatigue, sight loss, Addisons, Aspergers, anxiety and much more besides. These are my diaheroes, and for them - and indeed me - diabetes really is quite something. 

Some of my lovely diabuddies - every one a stranger until recently
And yet in many ways, diabetes is really nothing.

I was recently asked by a Twitter friend in Australia, mother of a teenager with Type One to contribute a “letter of hope” for a project she was setting up for newly diagnosed young people and their families. She reckoned there was too much negativity in what she and her son get from healthcare professionals. I enjoyed doing this, as it tapped into my instinctive positivity. I came up with a dozen points about living with diabetes which are at worst no big problem and at best an actual bonus.
Here they are:-
It won’t kill you.
• It won’t even make you feel ill a lot of the time.
• It won’t stop you doing anything.
• You can eat whatever you want.
• You can refuse food you don’t like and blame diabetes – nobody will dare argue.
• You’ll get free prescriptions for life.
• You’ll get regular health checks for life, potentially ending up healthier.
• You get some really cool techie stuff to play with: pumps, meters etc.
• You can eat sweets and claim it’s a medical necessity. (it often is)
• You can get out of a boring meeting by claiming your blood sugar is low/high.
• If you’re at school, you can jump the lunch queue.
• You will meet some awesome and lovely people, your fellow diabetics.
I’m sure you all recognise many of those. A dozen reasons why diabetes really is nothing, certainly nothing to worry about.
I genuinely think that the past nineteen years with diabetes, and especially the last five, have not only failed to stop me from doing anything, but have also enriched my life and made me a more interesting, and more importantly, interested person. And compared to the contacts and positives that have come from my life with diabetes, the condition is, well, really nothing.
So is diabetes Something or nothing?
Well, I’m a Libre wearing Libra, always inclined to see both sides of an argument. So d’you know what, I’m going to chicken out of an answer.
Is diabetes something or nothing? Well for me, it’s both. Not something or nothing, but something AND nothing.

Sunday, 23 April 2017

Fame: My weekend at #TADtalk2017

I'm writing this as my Virgin Pendelino train speeds northwards, taking me home from a weekend in London, where I enjoyed the honour of being an invited speaker at #TADtalk2017, a wonderful day conference for people with diabetes organised by our very own Dr Partha Kar, a thoroughly modern consultant who has done so much for us.

I've been scrolling through a seemingly endless roll of tweets from people who attended, all saying nice things about the speeches made by me and five other people for whom Type One diabetes is part of their lives. 

There's something truly uplifting about knowing that some carefully chosen words and a few Powerpoint slides have been enjoyed and appreciated. Thank you to everyone who took the trouble to comment, either online or in person. And I managed to get the best selfie ever:

Compared to the other speakers, I was just a "humble peasant". I haven't run any marathons, cycled coast to coast, raised any money, led medical or nursing staff in the NHS or gained any sporting honours, and as such I felt a bit of a fraud as "just a bloke with diabetes who enjoys befriending and helping fellow diabetics". It was therefore a disconcerting tiny taste of what it must be like to be famous to find myself recognised by people whom I didn't knowingly know, and to be filmed, photographed, and publically thanked for doing something which comes fairly naturally to me: public speaking. The online diabetic community is of course, only a few hundred in number, but I guess because I use my real name and a clear photo on Twitter I am pretty recognisable, and for one day I felt like a minor celebrity.  But only a #diacelebrity. Fame: is it any wonder?

But that's very self-centred of me. The real point of #TADtalk2017 is to start a conversation and to enjoy each others' company, not to praise speakers, be they sporting heroes, nurses, doctors or even retired teachers. And my, did it do that! My Twitter timeline has never been so active. There really was something special in the air, as there is whenever we people with diabetes get together. I've said it before, but I won't stop saying it, even if that does make me a #diabore talking #diabollocks (my words).

The togetherness which springs from this chronic, all-pervading yet perfectly manageable condition has to be seen and experienced to be understood. It overrides literally everything: gender, age, status, occupation, tastes, interests, and anything else, leading to profound friendships based on nothing but a shared condition, and yet everything. Fellow diabetics feel like friends before I've even met them, and when I do meet them it feels like I've known them forever. I count among my best friends people who are a fraction of my age, live nowhere near me, have little or nothing else in common with me and whom I have only met once or twice. It's a diabetic thing, and if you're one of them and reading this, you know who you are.

So I owe a thousand thanks to @parthaskar and his team for putting on this event for us, to the sponsors @DiabetesUK @JDRFUK and @AbbottNews for supporting it and to all those #diabuddies for just being there. I sincerely hope there's a #TADtalk2018, and if there is, I'll be there applauding whoever gets asked to speak, as warmly as yesterday's audience applauded us.

And to think that four years ago, I had barely spoken to a fellow Type One. As the old BT ad used to say: "It’s good to talk". Long may the talking continue!

I shall post the content of my speech as an additional piece for those who were unable to attend, once I've had a chance to edit it into a more coherent piece of written work.

Thursday, 13 April 2017

Roll Away the Stone: Easter for sceptics

This is my attempt to give a rational, liberal Christian take on Easter, the festival which more than any other defines Christianity.

As is my silly habit, I've given it a title taken from a song: Roll Away the Stone, a wonderfully exhuberant piece of glam rock by Mott the Hoople from the gathering gloom of November 1973, has nothing to do with Easter, but works well as an Easter song. Read on, then click on the link above and enjoy the feelgood factor.

Easter is arguably the most difficult festival for Liberal Christians like me to observe. Celebrating Christmas is easy, especially if you ignore the “minor detail” of the paternity of Baby Jesus. It’s a story which demands no understanding other than that of the birth of a child, an event traditionally and easily seen as a cause for celebration. The appealing details of the tired refugee parents, the stable, the animals, the shepherds, the angels and the Wise Men are easy to depict as images, however much they are based on speculation, exaggeration or confabulation.

Holy Week and Easter are, however, different. Although there’s supposedly a happy ending, it’s not at all convincing to those of a rational and enquiring mind. 

The Crucifixion of Jesus of Nazareth, is all too easy to believe and imagine, and it is no surprise that its depiction is so central to Christian art in all its forms. We have all seen and heard enough of humankind’s capacity for evil to believe that a patently good man could be condemned to a death sentence by a fickle crowd, and that sentence carried out by a despotic occupying power.

The Resurrection is, however, so beyond our understanding, let alone our experience, that we find it hard to describe and depict. In the secular world we resort to the symbolism of eggs, bunnies and fluffy lambs, thereby turning Easter into a pagan celebration of springtime. The appeal of mainstream Christianity rests in large part on the promise of eternal life, and to a rational or cynical mind this can seem a lot like whistling in the dark. It’s a matter of having faith in a promise with no easy proof of its credibility.

For Liberal Christians like me, the challenge is arguably even greater: to recognise the reality of a living Christ without necessarily claiming he literally overcame life’s only certainty: death. And yet if we wish to give the Resurrection any meaning, it surely behoves us to explain to a sceptical world that the greatest truths are indeed invisible.

There are plenty of other things which are palpably real, yet invisible, just like the Risen Christ. Try any abstract noun for a start. Just because we can’t see something doesn’t mean it doesn’t exist. Or to quote a favourite line of mine from Saint Exupéry’s The Little Prince: “And now here is my secret, a very simple secret: It is only with the heart that one can see rightly; what is essential is invisible to the eye.”

The Risen Christ, though invisible, is alive and well wherever we see good in our often evil world. No need to believe an implausible miracle, yet every reason to believe in the truth and deeper value of a festival that we all celebrate anyway.

For more Easter-themed music, here's a Spotify playlist:


Tuesday, 4 April 2017

Guest post: Football and diabetes, by one who knows

Rightly or wrongly, I've been keen since I started my blog (two years and 46 posts ago) to write about all the things that interest me, rather than just one theme or topic. I have varied interests and like to reflect that in what I write, even at the risk of being a "Jack of all trades and master of none". 

Football is a lifelong love of mine: I have followed my home town team, Bolton Wanderers, through their good times and bad since the days when I lived within walking distance of their Lowryesque old ground, Burnden Park, as a child. I was a keen but distinctly average player at school and university, the height of my career being a season playing for the second string of a small town club in rural France in the late 70s. I owe my fluency in spoken French as much to that year as to the three years of my degree course.

However, I have only written about football once on here when I wrote here about the decline and fall of Bolton Wanderers in 2015, so the chance to post a football-themed post had great appeal when I was contacted by Chris Bright, a GBDOC friend who has set up a sub-group on social media where football and diabetes are discussed. Chris asked if I could post his piece on diabetes and football and I am delighted to do so.

A recurring thought of mine since I started speaking with and  meeting other people with diabetes is my gratitude for the fact I lived the first 40 years of my life free of diabetes. With that thought comes an awareness that the challenges of life with diabetes at my age are nothing compared to those faced by infants, children, teenagers, and indeed their parents. In particular, the wish to play sport at any level, let alone a seriously compeitive one, brings with it many issues which could easily deter a would be sportsman or woman. Chris, like many others, was not deterred. Here's his story: 

I always viewed my diabetes as an extra hurdle to jump rather than a mountain to climb! I've worked incredibly hard all my life to achieve the things I have and I believe it’s time I tried to share some of my experience with people who go through the same struggles, or may go through those struggles in the future. 

I was diagnosed with type 1 diabetes in 1999 (at the age of 8) and upon diagnosis my very first question was "can I still play football?" Luckily I had an exceptional diabetes nurse who gave the answer I wanted, being "yes", but she readied me to ensure I knew how hard it would be to live out the dreams of playing football at the highest level. I’m sure I’m not alone in this first question, as in that incredibly scary moment when you know your life is changed forever, you just want reassurance that you can still live out those childhood dreams. I think healthcare professionals need to ensure they know how important these first words to a child are when diagnosed with a life changing medical condition. They can quite literally be life determining.
From that moment I had choice: I could crumble and let the daily worry, testing and sport related hypos destroy my resolve or I could come out fighting. I did the latter!

As a child, I found it difficult to manage my football on 2 injections a day on mixture insulins, they created all sorts of peaks and troughs with my glucose levels which made it extremely difficult to predict where they would be when you needed them to be stable for sport. My family and I went through lots of trial and error and learning from my mistakes but I was still battling away and achieving things but probably not to my capability as I believe it was holding me back slightly.  I still managed to captain my school football team and captain my district team. I need an improvement in my management to help me kick on a gear.

Things then changed hugely when at around 14/15 years of age I changed to the basal / bolus regime. The flexibility to adapt my life more easily around my diabetes whilst making me feel more energetic took me onto the next level in my sport. It was a huge development for my control at a difficult time as a teenager but it really enhanced my control of the condition and supported my development within my sport as I broke into county squads and showed promising signs at a club level.

I then left school and had trials with professional football teams, which never quite worked out, as injuries and diabetes found a way of scuppering me, but I honestly don’t think I was quite ready either. This then led me into the semi professional game with Bromsgrove Rovers where I got the opportunity to play at Step 4 of the non league structure, whilst during the same period of time I played for the Worcestershire FA u18s county side, travelling around the country playing for them. My performance in this time had kicked up a gear due to the regime change in controlling my diabetes and my commitment to defy the odds and enjoy football never slipped. I didn't want to let anything stop me achieving and continued to push myself to see what level I could reach.

A big step in many young peoples’ lives is going to university but it’s probably even bigger when you try and tackle it with something like diabetes. A testing time on blood glucose control, as the lifestyle of a student is somewhat erratic! Combining that with football games being at different times of the day, which challenges the routine you have set up for matches, it added even more complexity to an already testing time in life.

I went to Worcester University to study my degree in sport, which I loved every second of. I was even lucky enough to write my dissertation about the effects of exercise on blood glucose levels in type 1 diabetics and non-diabetics!! It was another life-changing experience which I look upon so fondly and representing the University's 1st Team and winning a league title in my final year was the icing on the cake.

However it doesn't stop there, as with anything I do, I never stop pushing myself! I continued as I left university to play for semi-professional football clubs in my local area (Bromsgrove Sporting FC, Pershore Town FC, Southam United FC, Earlswood Town FC) and enjoyed some great cup finals playing at the Ricoh arena (Coventry City FC stadium) and playing at the Bescot (Walsall FC stadium).  I then had an opportunity to take up Futsal through a friend of mine who was playing for one of the football clubs I was at. He'd thought it would suit the way I played football and suggested it would be a good idea.

In my first full season at the highest level in England (2014/15) I won player of the year at my club (Birmingham Tigers Futsal Club) and scored 15 goals in 15 games. I was hooked and enjoying it. However it did throw up some difficulties with my blood glucose levels as the intensity was very different to football (faster, shorter bursts)! I learnt a lot about blood glucose control for Futsal in those first 18 months and it clearly didn't affect my performance. Following my amazing first season I was called up to train with the Wales National Team. An amazing honour!

I then trained throughout the summer of 2015 with the squad on and off until disaster struck and I tore my groin the last session before selection. I was devastated.

However I was patient and optimistic in my approach and I received the opportunity again to train with the squad during the summer /autumn 2016. This time the opportunity didn't pass me by! I trained well and was called up for the first time to the squad to play Latvia! I won my first cap for Wales on November 1st 2016. I was then also part of the first home nations Wales Futsal squad in December. We won the inaugural championships too! Bitter sweet as I broke my foot during one of the games though!

Despite the injury heartache, it's something I'm so so so proud of and having had diabetes it's made the journey harder but as they say, "the best view at the top, always comes after the hardest climb! My god have I had a climb to get to what I have done, but when I say that the view was incredible, it really was and it continues to be! Only my nearest and dearest see what I go through on a daily basis, everyone else just sees the smile and positive attitude that drives me to achieve. It’s an invisible condition which can be so devastating without the right attitude, correct management and the support of the people around you. My unsung heroes in all of it continue to be my family and anyone growing up with a medical condition like diabetes would be lucky to have one like mine, who encouraged me to live life like a normal person, whilst ensuring I looked after my condition.

This is why the Diabetes Football Community has been introduced. I want to be able to support people wanting to play, and who are interested in football, who suffer with diabetes. I’m hoping it will fill the void which I felt was missing when I was growing up. It’s somewhere to turn to for reassurance, for advice and guidance and a firsthand experience of combining diabetes with football, one of the UK’s biggest diseases with the UK’s biggest sport.

It’s a huge honour to be doing something like this and in some ways my biggest challenge yet. I’m hoping I can put something back into the community and raise awareness of the condition to ensure diabetics can feel an extra level of support when combining the condition with football.

Chris Bright

You can find me on my social media accounts:

brighty08 on Instagram

@chrisbrighty on Twitter 

Or if you want to check out “The Diabetes Football Community” it’s on Facebook: @thediabetesfootballcommunity
and on Twitter: @TDFCdiabetes

An impressive story, I think you'll agree. Chris reminds us all that diabetes is a condition, not a disease, which we "live with" rather than "suffer from". I like to think that if I had been struck by diabetes at a younger age,  I would have taken on sporting and other challenges with the same enthusiasm.

Patience.....or patients?

It's an old joke, based like many on the rich supply of homophones in the English language: “You need patience to be a doctor” 😂😂...