The Way We Were

“Can it be that it was all so simple then? Or has time re-written every line? And if we had the chance to do it all again, tell me... Would we? Could we?”

Some favourite words of mine, from an oft-performed classic, sung most famously by two of the all-time great voices, Barbra Streisand and Gladys Knight. The latter version, from 1975, is a particular favourite of mine – listen here

There is no doubt that older age brings on wistfulness and nostalgia, although I am always amused that even teenagers are more than ready to reminisce about their younger days. Nostalgia is a universal human trait, hard to resist, yet often futile and even sometimes destructive. A recent short-lived social media craze of looking back at 2016 shows that we all tend to use these round number anniversaries to reminisce. 2016 was quite a year.

Wistful nostalgia certainly welled up in me when I saw a Google Photos memory from 10 years ago of the meet-up of people living with diabetes in Nottingham at the end of February 2016: a reminder that  a full decade has passed since what proved to be the zenith of the original GBDoc, the online community of people living with diabetes. For me, this reminder of what I was doing a decade ago brings an inevitable perspective on the evolution of the online diabetes community.

It was on February 27th 2016 that a gathering known as #PWDC2016 took place at an hotel in Nottingham: the second, and as it turned out final, real-world gathering of the original GBDoc, which had developed and flourished from around 2012, largely on Twitter - back in the days when Twitter was still a pleasant place to be. Does anyone think that the changes since it became X are for the better?

PWDC 2016 - 27th February 2016

GBDoc was, in those early years, a truly lovely community, where many of us for the first time interacted with others living with diabetes. Its founder and de facto leader intended it to be a community for people with all types of diabetes, but in practice it was and still is an overwhelmingly Type One community: it was the very real sense of camaraderie that is felt among those who feel themselves to be victims of the fickle finger of fate that was the driving force which made the community such a success. For all the commendable attempts to seek out common ground between all types of diabetes, it remains the case that for people living with Type One, by far the biggest irritant is when people fail to understand the difference between a randomly occurring autoimmune condition and a condition which is strongly connected to factors of lifestyle and diet. If the truth be told, I don’t feel “stigmatised” by such ignorance; I feel something more akin to an amused sense of superiority. A gathering with fellow Types Ones, whether just one or two others, or a whole roomful, remains a uniquely bonding experience.

So, a look back at 2016 is for me, and for others who were part of that community, a very real dose of nostalgia. Before turning to some thoughts on how that community has evolved, some observations about the risks of over-doing nostalgia:

False nostalgia for the so-called good old days is understandable, and often valid. But it can be at best futile, and at worst destructive. False nostalgia is a driving force for some of the most toxic and destructive trends in contemporary society, and has driven many perfectly well-meaning people to support and even promote populist politicians like Trump and Farage whose appeal is based on blaming all society’s ills on things that are “not like they used to be”. Simplistic solutions to complex problems have landed us, and future generations, with Brexit, Trump, cheap Chinese-made flags tied to lampposts by bits of plastic, and potentially - heaven forbid - a government led by the opportunistic and frankly repulsive Nigel Farage. Nostalgia is fine, but not if it leads to an assumption that the past was somehow better than today. It often wasn’t.

Change is everywhere, always has been and always will be. It is healthy to be open to change, and as I approach my 70’s I remain convinced that the world is still, all in all, a better place than it was when I was born and is indeed an improving place. The bad stuff is just more visible, and the toxic voices are just louder than they used to be.

I therefore try to resist the temptation to portray the GBDoc of 2012-17 as some kind of peer support nirvana. It wasn’t, and in any case it imploded spectacularly a year or so after that gathering in Nottingham when its prime mover lost the confidence of the community which he had done so much to create and promote, amidst accusations of a less than transparent blurring of the boundaries between his community work and his business interests.

Nevertheless, those early years should not be forgotten and dismissed, because what has been achieved through the existence of an identifiable patient community has been truly transformative, and for that alone, we all owe a debt of gratitude.

The GBDoc was never unique, but it certainly quickly evolved some features that have made it a largely benign and beneficial part of the internet. Aside from being commendably blind to background, wealth, age, gender, sexual orientation and whatever else so often divides people, its other main distinguishing feature from those early days was the way in which it brought together in an egalitarian spirit those living with diabetes and those whose job is to care for and support them, either as healthcare professionals, as charities, or as businesses selling diabetes technology. 

The openness and transparency of the early years of Twitter - free from the always problematic issue of designating people as “friends”, which was and still is a significant drawback of its original rival, Facebook - meant that anybody could interact with anybody in a concise and uncommitted manner. In terms of the GBDoc, this meant that healthcare professionals specialising in diabetes, leaders of the diabetes charities and the big pharma companies could far more easily see what those living with the condition were saying and thinking, and if they chose so to do, to interact with them.

Thus, from the earliest days of GBDoc, Partha Kar, originally “just” a consultant at a hospital in Portsmouth, started his journey to becoming the familiar mover and shaker that he is to this day simply by being open to talking online with ordinary people living with diabetes. Other consultants, GPs and DSNs also made themselves known and available and were as a result able much better to understand the needs and wishes of the patient community. The CEOs of the two big charities, Diabetes UK and (then) JDRF also became familiar names and faces in the online community, and tech companies - sometimes rather more obtusely – were able to read the community far better than could ever have been achieved with hand-picked focus groups. The medical technology companies were able to see unfolding in real time users’ reactions as products were launched on the UK market. 

My own personal journey with diabetes through the past decade leaves me feeling genuinely blessed to have got to know people from all these sectors of a genuinely broad online community. Among them are many with whom I remain in regular contact, and with whom I still chat all the time and occasionally meet up, these days often in contexts completely removed from the diabetes sphere. 

However, the community through which I got to know these people has now become fragmented, less active and far less visible. Its original home, Twitter, has lost the characteristics which made it such a fertile place for the community to develop, and whilst there remains, in theory at least, a diabetes online community on its successor ‘X’ and on other social media platforms, it has nothing like the reach or influence that it had a decade ago. Tweetchats - a term which now sounds archaic in the fast-moving world of social media - are still organised by some admirable volunteers, but whereas a decade ago the numbers actively participating, let alone silently lurking, were often many dozens, they are nowadays joined by no more than a handful of enthusiasts. The sense of a large community meeting up online has long since gone and looking at the questions and responses on a recent tweetchat, every topic under the sun has already been covered multiple times.

So, was it all for nothing? 

Was the GBDoc just a supernova, burning brightly then crashing to earth? Absolutely not.

Is there still life in the community? Absolutely, yes.

The GBDoc has evolved, rather than disappeared, and its often-mentioned fragmentation is just a reflection of its success and its consequent size. In those early days, online interaction was still in its relative infancy, and those who discovered fellow Type Ones on the internet were relatively few. It was therefore easy for a group of only a few hundred to become closely integrated, but as the word spread, it grew in numbers and hence in diversity, such that subgroups and so-called cliques inevitably formed. Fragmentation is not necessarily a bad thing; the term clique is a pejorative one easily thrown at those who are part of a group by those who are not. I prefer the more positive “find your tribe” principle, because this is what happened for me and, I suspect, many others as the GBDoc has developed: I got to know a large number of people, some of whom I had a lot in common with, others less so. And over time, I remained more in touch with the former than the latter. One close friendship with a fellow Type One has been for me a true and enduring gift.

Yet the overall community does still exist, and in a variety of ways, it proves its strength and resilience: 

For a start, a far larger community than the original GBDoc is very much present in the background of all the often noisy, crowded and even fractious online spaces, enabling instant connections to be made or re-made. It has the power to support and encourage campaigners and fundraisers, most recently in the case of John Story, the father of tragic Lyla, who died as a result of undiagnosed T1D. 

In so doing, he and others advocating on behalf of others are strongly supported by the diabetes charities, and in particular Breakthrough T1D and Diabetes UK, as well as by healthcare professionals whose connection to, and knowledge of, lived experience is so much greater thanks to over a decade of association with the all-important patient voice. As well as Partha Kar, already mentioned, many other HCPs have engaged with the community in a spirit of humility and learning, and foremost among them is the wonderful DSN Forum team, whose reach extends way beyond their day jobs thanks to an individual and collective mastery of social media.

The aforementioned online chats, facilitated and used by true enthusiasts, continue, and in so doing allow those new to T1D, or indeed just new to its online presence, to benefit from the camaraderie, peer support and information that can be such a huge help in living well with the condition.

And then there’s TAD; I make no apology for leaving till last what is - in my biased view – the best. TAD - Talking About Diabetes - also celebrates a decade anniversary in 2026, having first been held a few weeks after that second GBDoc get-together. 

The concept is simple, and enduringly popular: a real-world gathering of people living with Type One, as well as their friends and families, to hear and share stories of the challenges, successes, the highs and the lows of life with a uniquely frustrating condition. Over the years we have heard stories from people of all ages, some famous, some just ordinary folk, some achieving remarkable things despite their T1D, other just getting by. But all of them sharing a unique bond.

What stands out about TAD - and what makes me most proud to be part of its organising group - is the fact that it happens thanks to a true alliance of healthcare professionals, diabetes charities, tech companies and people with T1D. It was the brainchild of a team of consultants led by Partha Kar, and it thrives and prospers because of the generous sponsorship of the companies who develop, make and sell the kit which sustains us, the support of volunteers from the charities, and above all the commitment of four good friends from the patient community and a consultant diabetologist, Reza Zaidi, who goes way beyond the call of duty.

The sense of shared experience that comes from this once-a-year feeling of not being the odd one out is powerful one and reminds me every year of the truly life changing moments that I experienced a decade ago in Nottingham.

Living with Type One can be a frustrating and often lonely experience, and much has changed for the better in my own 28 years of it. However, it is hard to resist concluding that the pace of that change has accelerated over a timescale which neatly matches the growth of a Type One lived experience community.

So, whilst in some ways, my chosen title for this piece suggests nostalgia for a lost past, in many ways it celebrates the start of a process which is still very much in progress. The community has grown up and abandoned its original home on Twitter but remains a place where those who care more about others than themselves can and do make their own and others’ lives better.

I look forward to seeing many of them on July 11th in London, as we celebrate 10 years of TAD, and rather more than 10 years of the Type One Community. 

Just in case you’re reading this and haven’t heard of TAD, here’s the link to apply for the ballot for a place at TAD2026: 

https://forms.office.com/r/5fGVtc98ew 

Everybody Wants to be a Cat - or maybe not

Everybody wants to be a Cat - a Disney favourite from The Aristocats, loved by successive generations, and rightly so. A great song, a classic animated sequence, but is it true? Does everybody want to be a cat? Of course not, but it works well as a title for some thoughts on how those of us with a hidden medical condition portray it, both in the real world and online.

It is often said that cats are good - too good perhaps - at hiding their symptoms. It’s a survival strategy for a solitary species, as opposed to those who live in groups, herds, packs or other groupings. To show weakness is to encourage predators, such that the cat that walks alone prefers to keep its troubles, pains and discomforts private - a poorly cat will often be found hiding somewhere as if hoping nobody will notice. However, those species which live in groups may make more of a fuss, perhaps even looking for sympathy with the proverbial hangdog expression. We human beings, of course, have a choice, and according to our personality type, we may react to illness or disability by quietly withdrawing from interactions with others, or by making it something about which we are loud and proud, a dominant or even defining part of our persona.

So it is with diabetes, and with the growth of social media-based communities such as #GBDoc, a more visible divide has become apparent between those who portray their diabetes as a defining part of their identity, and in many cases a burden to be borne; and on the other side those who portray it as a nuisance alongside many other nuisances in life, but not something which they will allow to dominate their thoughts, words and deeds.

Social media has brought these contrasting attitudes into clearer focus. Some accounts of people living with diabetes flaunt their condition with pride and defiance, detailing their every success or failure, sometimes railing against the curse of T1D, and maybe raging against society's ignorance, or health care professionals' insensitive ignorance. On Twitter, these people are often those who choose a user name featuring a reference to diabetes and have a profile picture or bio that leaves nobody in any doubt that T1D is a big deal for them.

Other social media accounts of people living with diabetes carry little or no clue to their owner's medical condition. The giveaway is often just whom they follow or friend, or maybe just a passing reference in their bio. Their feed may well be about anything but diabetes, or just an occasional reference to it. Their Twitter name is less likely to reference diabetes.

To pursue the animal analogy, the former group are the diabetes pack animals, and are likely to talk frequently about their diabetes, both in real life and online, whereas the latter group are the solitary creatures, the cats if you like, who prefer to keep their condition private and who consequently seldom draw attention to it. Like most divisions, it’s not binary, and most of us have a nuanced attitude, sometimes wanting the world to know that we live with this damn thing and sometimes wanting nobody to know.  And above all, there are no rights and wrongs - just differences. However, my sense is that nearly all people living with diabetes of any type tend towards one type or the other. So which am I? A cat or a dog?

Well I am very much a cat. No surprise there, given my lifelong love of cats, so this post is about being a cat - hiding an already hidden condition.

Today is my diaversary. It was at 5pm on this day in 1997 that I went to see my GP, alarmed by a sudden recurrence of symptoms after I'd recovered from a week in bed with ‘flu. She had asked me to bring a urine sample and I can still picture her concerned and somewhat puzzled face as she told me that it revealed very high sugar levels, and probably diabetes.

I've told the story many times: it actually took several weeks for me to be diagnosed as Type One; back in 1997 it was still widely believed that Type One very rarely came on in adults: we now know very much otherwise.

Twenty Five years. A quarter century. One third of the average male lifetime. Most significantly for me, more than half of my adult life. So it's a day for much reflection, and indeed a blog post. There's much to think over, and whilst in many ways that dark and chilly December evening when I was told that life-changing news remains very clear in my mind, in other ways it seems like a very different life in a very different world.

Over those twenty five years, my attitude to diabetes has varied, and in particular the level of noise that I make about it, has varied due to circumstances as much as anything, but overall I have always tended towards saying less rather than more. As mentioned above, in diabetes as in all else, I want to be a cat.

Over the first 16 years or so, through very much the peak of my working career, diabetes was firmly in the background of my life, my concerns and my interactions with others. My diagnosis came at the end of a week off work confined to bed with ‘flu, but that was the last day off for sickness between then (1997) and my retirement 20 years later. (Other than routine appointments). So living with Type 1 had no impact whatsoever on my working life, indeed less than four months after diagnosis I was leading a group of 45 teenaged schoolchildren on a week-long school trip to France, as I had done for years before and continued to do for years afterwards. I remained the same busy person that I had been before T1D came to join me on my journey through life, and I often reacted with wry amusement rather than boiling anger as I watched others - notably work colleagues - moan about how busy and tired they were, or how much they were struggling with whatever short-lived ailment was troubling them. Very occasionally, I would drop the T1D bomb into a conversation or situation, as for example when a colleague was planning a day of interviews in which I was involved, and he said to me “It’s going to be a full-on day, with no time for eating” When I gently suggested that I would have an issue with that, he sheepishly remembered and re-jigged the schedule a little.

Outside work and home life, I also avoided diabetes and anything other than strictly necessary talking about it. I joined the British Diabetic Association on diagnosis (sounds so archaic now, but that’s what Diabetes UK was still called back then), and then ignored a series of letter invitations to local group meetings, not least because the subjects of their meetings were always about low-carb eating and getting more exercise, a clear sign that this was predominantly if not exclusively frequented by people living with Type 2.

However, the world of diabetes care and management was on the threshold of very significant change at the time of my diagnosis, and has come a long, long way in those years - as those whose lives with Type 1 predate mine will readily attest. Whilst by 1997 we had already reached the era of disposable pens and needles and electronic blood glucose meters, we were still two decades from the near universal availability of non-invasive glucose monitoring, and indeed the rapid advance in the availability and use of lightweight insulin pumps and closed loop technology. Yet the Rise of the Machines was already under way by the time I joined the ranks of the pancreatically challenged, and although I am not among those who are desperate to have the benefits of an insulin pump rather than MDI, I have from the very start been convinced that the quantum leap has been the ability to measure blood glucose levels without finger pricking: I was one of the earliest adopters of FreeStyle Libre back in 2015, and with Libre 2 now the norm, I am free from the fear of unforeseen hypos which was a genuine worry for me for the first 20 years or so. I was fortunate enough recently to be given a two week trial of Libre 3*, and whilst I remain unconvinced of whether I need or want a full CGM to remind me every minute of every day what my levels are, I can well see that this latest version is a state of the art which will be welcome by many and will sooner or later end up as the norm.

Equally striking when comparing 1997 and 2022 is the impact of the revolutionary advances in connectivity brought about by the internet. The birth of the World Wide Web is rightly quoted as 1992, but it was not until the late 90s that the internet started to reach ordinary homes on a large scale. We got our first internet connected PC in early 1998, but at first the internet was really just a giant online library. Emails were there from the start, but they were really just instant letters. The notion of real-time “conversations” with friends and family across the world would have seemed fanciful, and for me, any sense that ICT and the web would be of any significant connection to my new condition would have seemed very odd.

Yet for me, like many others, it was online connectivity that brought me out of my diabetes closet and connected me for the first time with fellow Type Ones. It’s a story that I have shared before, for example here and I have no hesitation in saying that connecting with others living with Type 1 was a life-changing move, which has brought me connection with 100s, friendship with dozens and a close and lasting bond with a few.

And yes, online diabetes connections and friendships are all about the sharing, and therefore only really of any value if those involved are prepared to talk about their condition, at least in some small way. From around 2013 onwards, I did indeed start talking about diabetes with others, and as a result became aware of the rapid advances in diabetes care and technology that were at that time starting to proliferate.

And yet……

I remain a cat. I remain a man of relatively few words in any setting, real world or online, and especially in the context of diabetes. My regular social media feeds only occasionally feature diabetes content, and my Facebook is a largely diabetes-free space. I sometimes think I should be more vocal, more of an “awareness raiser” or even a so-called advocate, but my heart just isn’t in it. Others clearly feel more strongly about it, and have more to say, whereas for me, the core of my relationship with this lifelong condition is that it is a nuisance, rather than a burden, that I will not allow to take over my life. To rant and rave about it seems to me to be a largely futile exercise, in which I would either be preaching to the converted or risk becoming a bore.

I am enormously grateful to and hugely respectful of those who define their persona so much by diabetes. In so doing, they are being generous and beneficial to others: we would not be nearly so far down the road to accessible diabetes technology for all according to their needs and wishes, nor would we have anything near the levels of camaraderie and peer support that we enjoy, without the efforts of those for whom diabetes is a big deal.

I certainly have no wish or intention to shy away from the diabetes community, indeed I interact with others living with Type 1 every day, and my best friend is a fellow Type 1. Yet outside the world of the diabetes community, I seldom if ever remind others of what I live with. Sometimes to my cost.

So when it comes to sharing my condition, I am a cat, whilst gladly accepting that not everybody wants to be a cat. I conclude this “Silver Diaversary” piece with a sincere thank you to all the individuals and organisations whom I have encountered as a result of that life-changing diagnosis twenty five years ago: healthcare professionals, diabetes charities, medical tech companies and above all diabuddies. I may be a cat, but as all cat lovers know, our feline friends do actually crave and appreciate company and attention. They're sometimes just too stubborn to admit it....

Illustrations? Well it had to be a throwback to the days when "#OfGBDoc" was a thing. This was a collage of cats belonging to GBDdoc folk which I made back in 2017/18. 

I am aware that some of those kitties are no longer with us, so I hope that the memories are warm and not too sad.

*  #ad #sponsored: I was given a FreeStyle Libre 3 sensor free of charge for evaluation purposes. The opinions in this post are my own and were not influenced or reviewed by Abbott.

It's Getting Better: thoughts for World Diabetes Day 2020

November is Diabetes Awareness Month, and as happens every year in the first half of the month, leading up to World Diabetes Day on November 14th, there is a growing frenzy of activity and excitement in the online world of diabetes. This year, that online world is the only forum in which the diabetes community can interact to any extent, and so this frenzy and hyperactivity seem particularly intense. Moreover, we are approaching the centenary of the discovery of insulin therapy (January 11th 1922), so no doubt next year’s WDD celebrations will be even bigger and better, not least because we can all hope that celebrations will by then be back in the physical world, rather than the virtual one.

Amidst all the frenzy, it’s a good moment to ponder developments in the world of diabetes, in its treatment and care. In so doing it is impossible to avoid noting how much has changed in recent years, and difficult to avoid the conclusion that the pace of that change is accelerating.

My own thoughts at this time of the year are always shaped by the awareness that I am approaching another anniversary of my own diagnosis, my “diaversary”, which falls on December 19th, this year marking 23 years since I was joined for the second half of my journey through this world by my unwanted friend. Any reflections on what is going on in the diabetes world are necessarily shaped by thoughts on the passing of time, and the increasing longevity of my life with diabetes - I have lived around one third of my life, and more than half of my adult life, with diabetes.

So, in the words of the late, great David Bowie’s last big hit before his premature passing, Where are we now?

I find it very hard to resist being bullish in my response, not least given that healthcare in general is under unprecedented logistical and financial pressure from the global pandemic. In saying so, however, I must qualify it with the very significant caveat that my thoughts apply to those like me living in a prosperous country which provides free healthcare for all. I am painfully aware that any bullishness does not apply to much of the world, including parts of the world like the USA where the state’s prosperity should enable universal healthcare to be a reality. So the thoughts that follow are made in the full and somewhat guilt-ridden awareness of my own relative good fortune.

When I was diagnosed in 1997, diabetes care and therapy had already advanced significantly beyond what many of my friends who have lived with diabetes for far longer than me can remember. A good diabetes friend, of similar age to me but living with Type One since the age of 2, has lived from the days of testing by urine strips and injecting with large syringes, to nowadays using an insulin pump and a CGM. He keeps an impressive personal archive of some of the primitive-looking gadgetry that kept him alive in his early days.

My introduction to diabetes came when injection pens with pre-filled cartridges were fully established, and small electronic meters providing rapid and accurate figures on blood glucose level from a finger prick test had become the norm, albeit fairly recently. More importantly in some ways, I came in at a time when advances in insulin types were starting to give far greater flexibility by mirroring with increasing accuracy the workings of the pancreas. Within a year or two of my diagnosis, I had moved to the basal-bolus régime which is essentially the one that I follow to this day. So things were already pretty good for a Type One here in the UK, and I never at any time felt threatened by it; however, better days were to come!

I am in no doubt that the biggest technological advance in recent years has been the arrival of non-invasive blood glucose monitoring giving more than just a snapshot of levels, and giving it in such a way that it can be done unobtrusively, frequently and painlessly: I refer, of course, to low-cost continuous monitoring devices, and in particular to the FreeStyle Libre flash monitoring system. The advances in diabetes technology have been stunning, and are accelerating as they become cheaper in real terms: this mirrors the way that, in our everyday lives, we all now keep in our pockets a mini computer of infinitely greater power, capacity and capability than the lumbering desktop with its hefty CRT screen that sat on our desks back in 1997. 

Commercially available devices have in turn been the stimulus for creativity and amateur expertise which has enabled patients to drive progress towards closed loop systems, with the prospect of a widely available de-facto artificial pancreas now looking more achievable than the proverbial “ten years from now” cure.

Alongside medical technology, information and communication technology has also made an astounding difference to those of us living with diabetes. When I was diagnosed I felt very much “at the mercy” of diabetes, and therefore very reliant on the input of the doctors and nurses assigned to my care. 1997 was very much in the pre-internet age (I first went “online” in early 1998, and as such I was an early adopter of home computing at a time when the internet was seen by many as the province of nerds and teenagers). My knowledge of diabetes at diagnosis was minimal, and beyond what HCPs told me, my only source of information was the printed word in books and magazines. What a different world it is now, with our first port of call on a medical issue being, for better or worse, Dr Google. These days, a person newly diagnosed would be signposted to a vast amount of information, to websites, to YouTube videos, to blogs, to peer support groups and a whole lot more. The problem must be to decide which resource is good, which is bad and which is ugly.

However, I believe that an equally important change in recent years is not a matter of kit and technology, but rather a far less tangible change of attitude on the part of both those living with diabetes and those who care for them. The irony is that this, too, has been driven by technology. There are still some who decry the influence of the internet in general and social media in particular, but what strikes me in the context of diabetes is that people have used technology in a very human and personal way, and that it has built bridges and brought people together in a way that harnesses the best that technology has to offer with the best and simplest of human virtues: friendliness.

Back in 1997, I would never have believed how connected we were all destined to become. I would never have believed that I would be talking, during a global pandemic, to people all over the world in little boxes on my computer screen, or that I could be constantly conversing in real-time written messages with friends. These days, my best source of “breaking news” is my best diabuddy whom I only know because we both have diabetes and started talking about it on Twitter. When anything good or bad happens in the news, or in either of our lives, our first response is to message one another. Many other people with diabetes enjoy similar, relatively new, but close, friendships.

But it’s not just peer-to-peer: we in the UK are privileged to have an online diabetes community in which patients and healthcare professionals interact freely, safe in the knowledge that each has something equally important to bring to the relationship: lived experience on the part of the patient and clinical expertise on the part of the professional. I count myself blessed with the personal friendship of many HCPs whose initial connection to me was through the diabetes community.

The community has no leaders as such, but is led by many: I shall deliberately avoid mentioning names, but we all know that there are doctors, DSNs and pharmacists of national professional repute who freely share their expertise and time online, yet just as importantly they share their lives, their interests, their passions and much more from well beyond their professional lives. Likewise, we all know that there are people with diabetes - and parents of children with diabetes - who freely share the experience and know-how that comes from living with diabetes, yet also their own personalities, their lives, their passions and much more, again from well beyond their lives with diabetes. During the pandemic, we have seen individual initiatives, notably by the organisers of the weekly tweetchat, like Zoom quizzes and the Fantasy Football league, and also larger initiatives like the Art1st Project, run by a coalition of people with diabetes and healthcare professionals. What these have in common is that they are about the people, not the condition, and it is this generosity of spirit that has enabled the community to flourish despite the inevitable fragmentation that has resulted from its growth in numbers. Alongside the partnership between patients and HCPs, the diabetes charities, Diabetes UK, JDRF, and DRWF have also become part of the community, not least through the personal and personable engagement with patients by their staff and leaders.

The blend of timeless human virtues - kindness, sharing, listening - with technology has given us a world unrecognisable from that of only a decade or so ago. Spending so much time alone at home this year, as we have all been compelled to do, I have come quite close to feeling grateful to diabetes for giving me some of the best friends I have ever made. 

When we finally emerge into the post-Covid world - sooner rather than later, we hope - it will be in many ways different, but we can surely hope that the blend of technology-driven remote connectivity and the warm relationships that technology has help to foster will leave us with the best of both worlds.

I was going to entitle this post Where are we now, taken from that rather bleak but wonderful Bowie song referenced earlier, but given that the announcement of a breakthrough on a Covid-19 vaccine came after I had started writing it, but before I finished it, another song came into my head, and I prefer to leave that as my customary song title for this post: the uplifting 1969 classic by (Mama) Cass Elliot which speaks, I hope, of where we are heading in the pandemic, and in diabetes care: It’s Getting Better.

Happy World Diabetes Day, everyone! With thanks to all who are working so tirelessly to support people with diabetes.

People places and events from my world of Diabetes

When will I see you again? - Diabetes care and the Pandemic

Six months and counting..... 

As we popped our Prosecco corks with the clock striking midnight last New Year’s Eve, none of us had any idea what 2020 had in store for us. We have now lived for half a year in a period of unprecedented collective anxiety for all but the diminishing number who remember the severe privations and genuine suffering of the Second World War. Our world as summer turns to autumn looks and feels shockingly different to that of last winter. The list of new words and concepts with which we have become familiar is lengthy, and we have all become accustomed to routines, behaviours and attitudes which would have seemed utterly alien to us on New Year’s Day 2020. 

What would I have thought of this selfie back in January?

Tens of thousands have died in the UK alone, and many, many more have suffered, either from the effects of the Covid-19 Virus itself or from secondary consequences such as delayed diagnosis, postponed or cancelled treatments and indeed subtle longer term psycho-social difficulties yet to be fully recognised or understood. 

It’s not exactly been the jolliest year of our lives, and as we enter autumn here in the UK, with the Virus better understood and to an extent better controlled than it was earlier in the year, we are nevertheless facing questions, anxieties and uncertainties well into the future. A life of carefree interaction with our fellow human beings seem a distant memory and an even more distant future prospect. 

For those of us living with other medical conditions like diabetes, there have been well-publicised extra layers of uncertainty, and I for one have found myself more concerned about my own welfare, more careful about my own actions and choices than at any time since my diagnosis almost 23 years ago. In many ways, we who live with diabetes have been very well-served: there has been wonderful support from healthcare professionals in the online diabetes community, who have transferred their habitual enthusiasm and energy to online versions of their normal activities; the diabetes charities have been excellent sources of information and encouragement, despite suffering from significant loss of income and of course the patient community has displayed mutual supportiveness and information-sharing as always. I have been thankful for the online connectivity which we now take for granted, and contacts made through the world of diabetes have been a source of friendship throughout these difficult months, for which I am enormously grateful. 

Before we feel too sorry for ourselves, it is worth pondering what a lockdown of similar extent and severity would have been like in the pre-internet days of the not-too-distant past: no WhatsApp groups, no video calls, no instant online sharing of information, memes and funny videos, no working from home, no remote learning. Even twenty years ago, that would have been the reality of a similar scale pandemic and lockdown. 

If nothing else, surely one of the positives of the pandemic will be to convince even the most grumpy luddites that the information age is an overwhelmingly good thing, and that smartphones, tablets and laptops are a modern-day blessing, a miraculous tool for social interaction and information sharing, whose obvious faults and disadvantages are not the fault of the medium itself, but rather of the human imperfections or evils of those who use them. 

I have taken great delight during the pandemic in chatting over the garden fence with my octogenarian next-door neighbour about stuff he has found on the internet, or how much he appreciated an online video consultation with his doctor. He recently told me that he had bought a Bluetooth speaker and had googled the origins of the word Bluetooth (a 10th Century Scandinavian King in case you’re wondering). I was also delighted to receive a Facebook friend request from another octogenarian neighbour who had signed up and stumbled across me on a neighbourhood group. I really hope that the pandemic will hasten the demise of the “digital divide”, not just in terms of the older generation but also in terms of those afflicted by poverty and deprivation. 

So the pandemic has certainly taught us to value the internet. 

Now I am an irrepressible optimist. It annoys those close to me at times, but I often genuinely find doom and gloom about stuff a greater burden than the stuff itself. And this is definitely true of the pandemic. I have become far more annoyed and frustrated about the epidemic of opinion from self-appointed experts than with the disease itself. So doom and gloom is not for me, and I am already starting to look for the good that can come out of this pandemic. It’s not easy, but that shouldn’t stop us all trying: I was moved to write this post having filled in a survey for Diabetes UK about my experience of diabetes care during the pandemic. 

Here’s the link if you haven’t seen it – a short and easy survey:

https://t.co/0z17jYg22v 

I must say that filling it in made me somewhat frustrated, not least because a few weeks ago I had attempted to get some information from my hospital concerning their plans for re-scheduling clinic appointments (my last was in early December), and I received a rather vague reply indicating that I was on a list for a re-scheduled appointment “in due course”. A follow-up enquiry about the potential use of video or telephone consultation was deflected in the classic bureaucratic manner “We are also looking into the option of using video consultation within our service however plans have not yet been finalised”, whilst my suggestion that they might consider using LibreView to share my data was ignored in a manner which suggested that I was proposing something truly subversive and revolutionary. 

Surely, diabetes care is a prime case for the rapid adoption of new ways of communicating and sharing that we have all taken on over the past six months. For a diabetes patient such as me, fortunate at the moment to be living well with Type One, a six monthly face-to-face at the hospital as well as an annual review with my GP is an unnecessary burden on the system, and arguably upon me. A five minute appointment with a phlebotomist at my GP could yield my HbA1c result, and, together with a look at my LibreView data, would form the basis of a discussion which could surely be just as effective remotely as it is in a hospital ten miles from my home. 

Now of course, there are multiple caveats. My own condition is, for now, good, but might not always be so, and there are aspects that cannot happen remotely. Nobody can check my feet, my injection sites, my eyes, and in many ways most importantly, my emotional welfare, over the phone or through a shadowy face on a screen. Some sort of triage could surely be applied to people with diabetes, such that those in most need would be seen face to face, whilst others would be seen remotely. And I am not proposing online only consultations: if we are seen six monthly, then surely an annual face-to-face, with an interim online in between, makes perfect sense. 

Above all, we must NEVER, in healthcare or elsewhere, allow on-screen interactions to replace face-to-face ones. Zoom, Facetime, Skype, WhatsApp or whatever are wonderful, but nothing can get near to replicating the multiple subtleties of human interaction: badly-lit faces in front of a bookshelf cannot convey body language, subtly raised eyebrows, non-verbal reactions, fear, anxiety, reluctant agreement, embarrassment. We are beautifully subtle creatures who thrive on our interactions with each other, and the human physiognomy is a truly wonderful and subtle thing. I for one am longing for a world in which I can once again see people in the real world, out from behind their masks and visors, or out from behind their webcams. I am very glad that I am retired from teaching, as I would have hated to teach from behind a mask, or to teach young people whose faces, whose reactions and responses are hidden by a piece of cloth. 

So please let’s try to take the best of what we have had to get used to during the pandemic, but also be sure to discard the worst as soon as it is safe to do so. I’ve had more than enough of zoom calls already. 

A Zoom Meeting of Diabuddies from across Europe and beyond

My enduring emotion is that of the Three Degrees song which forms the title of this post, and is a plea which applies to my healthcare team, just as much as to the many friends and acquaintances whom I am missing so much: When will I see you again?

Join Together: Why GBDoc is alive and well....and matters

This coming week, Saturday, March 7th to be precise, marks the 5th anniversary of the first significant #GBDoc social gathering of people with diabetes, held at the old headquarters of Boots the Chemist in Nottingham. The second one happened a year later, on Saturday February 27th 2016.

The Group photo from Day Two of #PWDC16

Organised by the then lead organiser of GBDoc, (the online community of people living with diabetes in the UK) this so-called “Un-Conference” was truly an iconic event for many people, myself included.

A session at #PWDC16 on diabetes and sport, led by Paul Swann

The 5th anniversary brings into sharp focus how much has changed over those five years. With so many of the current users of GBDoc being much newer to the group, and the majority of those who pioneered it back in the early days now seldom taking an active part, it is now harder to characterise such a large and diverse group of people as a “community”. The idea of gathering them all in one place for a meet-up is now fanciful, yet the demand for TAD tickets proves that there is a real appetite among people with diabetes to meet each other. 

Add to that the inevitable fragmentation that occurs in any group as it expands, the differences of motivation, the clashes of style and personality, and it is no surprise that some now consider the idea of an online-based community to have outlived its usefulness. This is, I think, mistaken, very unfair on those who are trying to keep its sense of entity (especially Paul Sandells and Julie Barcroft and their team who work so hard to promote and organise the weekly tweetchats), and very unfortunate for those who have yet to be diagnosed with diabetes, or to discover the benefits of associating with others living with the condition. More of that later.

First of all, a little history, which may be of interest to those who have discovered the hashtag #GBDoc or the tweetchats more recently:

Diabetes communities, and online diabetes chat are older than many might think: Local support groups have been around for years, and people with diabetes, and parents of children with diabetes, had been talking to each other online, sharing experiences and providing mutual support since the early days of social media. Closed Facebook groups existed, and forums (remember the term chatroom???) gave people a chance to ask and answer questions. 

However, GBDoc as a named and identifiable community was formed in 2012 by a gentleman diagnosed with Type One in middle age who was an enthusiast of social media and was seeking ideas and support for living well with diabetes. He chose Twitter because of its open access and simplicity and launched a weekly tweetchat on Wednesdays at 9pm, which quickly grew in popularity as more and more discovered it. It had a website, and its own Twitter account, which is still there, but dormant - @theGBDOC, and this community grew rapidly and was soon imitated in other countries. 

The gentleman concerned conducted the chats himself, became known to many and organised the two meet-ups, but unfortunately conflict and controversy arose between him and some members of the community over time. Without ever announcing it, he stepped aside from the de facto leadership of the community in July 2017 and has remained absent from social media ever since.

Nevertheless, the two real-life meet-ups that he organised, in March 2015 and February 2016, were outstandingly successful and life-changing for many - including me. I am far from alone in having made some very close and enduring friendships from those two events and the sense of togetherness from being in a room full of fellow diabetics for the first time was remarkable and unprecedented. 

Five years on, we should not just dismiss the old GBDoc like an ill-advised dalliance. It was wonderful for a while and many of us owe something of a “thank you” to the founder of GBDoc for the fact that we know each other.

The #GBDoc label was “rescued” in July 2017 by a small group of people who had been alerted to discontent and misgivings surrounding the founder. These people were trying to save the idea of an identifiable community yet without running it, and as the individual who offered publicly to reveal plans to save the tweetchat and the hashtag, I and the others were accused of trying to “take over”. It was a very uncomfortable time, and I was grateful for the many words of support that eventually came from well-wishers, especially when others involved revealed who they were. We set up the @GBDoctchost account as a result, and it is still used to this day.

So how is #GBDoc now? Why is it that many people - myself included - have drifted away from the tweetchats over time?

Well firstly and most simply, it’s that people move on. Stuff happens: relationships, babies, jobs - life! Moreover, many of us who live with diabetes spend more than enough time thinking about it without wanting to add a sometimes contrived and at times repetitive conversation at an artificially chosen time and place. I myself am often otherwise occupied on a Wednesday evening.

However, we MUST remember that this feeling is a product of time, and that there will always be people new to diabetes who might relish the chance to “chat” with others in a safe, supportive and accessible place, with no need to ask to “join” a group. So we mustn’t knock it just because we don’t have time or have become become bored with it.

Secondly and more contentiously, I think that some conflict and discontent is inevitable over time, often stemming from that most basic and universal of human instincts: jealousy. People don’t like leaders and some resent those who style themselves as advocates. They build them up, then knock them down. Yet a “community” cannot exist without a measure of leadership. A tweetchat needs an organiser, and just because somebody organises doesn’t necessarily mean that he or she is “taking over”. Unfortunately, that is how it is perceived.

Thirdly, there’s the question of sheer size. For my own part, I always start to feel ill at ease in any group that becomes too large and/or too noisy. So I find myself estranged from the idea of a “community”. I don’t actually like the word, because I resist being categorised and labelled. This is why what was rescued in July 2017 was just a hashtag, and it is when people start to regard it as something more than a hashtag that problems start. If an individual or group of individuals become too associated with a community, it assumes too much of their identity, and accusations of cliques inevitably follow. Twitter often looks like a clique, given the way that it can quickly become a private conversation between a few conducted in a public place. It often feels like you’re in a room on your own watching a group of others having fun and laughing loudly. Not their fault but that’s the way it can appear.

A growing community also inevitably becomes fragmented, and dominated by those who say most. Individual differences are inevitable, so it behoves everyone to ensure that they don't regard themselves as guardians of the truth or the “right” way to do anything. Unfortunately, Twitter gives a perfect platform for people to “speak” without thinking. Things that in the past would have been just a matter of self-contained annoyance or private amusement become a public proclamation, with an air of authority and permanence that comes from the strange hybrid of communication that it is - writing as if speaking.

What have I learned from GBDoc? Above all, I have been strongly reminded about difference. Same condition, 100s of ways of handling it:

There will be some who want to hang out with others on social media, but 1000s more who don’t.

There will be some who want to meet up socially with others living with diabetes, but 1000s more who don’t.

There will be some who welcome in the community all types of diabetes, some who don't. 

There will be some who want to be all “woe is me” about the burden of life with diabetes, and others who want to be all “no big deal” about it. 

There will be some who want to be humorous and witty about it, and others will not find it funny. 

There will be some who care passionately about language and terminology, and some who don't give a hoot. 

There will be some who want to embrace technology and push the boundaries of innovation, and others who want to keep it simple.

There will be some who welcome the presence of HCPs in the community, and some who want it as a safe place for patients only. 

I could go on.

I guess the thing about a diabetes community is that the very randomness of the condition means that as a group it is more diverse than other groups to which we might be attracted. Groups consisting of people with a common interest, hobby or profession will inevitably attract a certain “type”, whereas there is nothing that unifies those with diabetes except diabetes.

And as I am fond of saying, this is a major strength, but strengths are very often also weaknesses. A diverse community with 1000s of personalities, tastes, experiences and opinions is unusual and precious, yet also a potential tinderbox for conflict.

For that very reason, I shall continue to cherish #GBDoc, but avoid over-involvement in every discussion, avoid the temptation to opine about everything, and hope that others will do likewise.

Oh, and in keeping with my tradition (which some probably find really annoying) I need a song title for this post. How about Join Together, one of the Who’s later and lesser known songs, from 1972? Some pertinent words in there:

Do you really think I care

What you eat or what you wear?

Won't you join together with the band

There's a million ways to laugh

Ev'ry one's a path

Come on and join together with the band

You don't have to play

You can follow or lead the way

Oh won't you join together with the band

We don't know where we're going

But the season's right for knowing

Oh won't you join together with the band

It's the singer not the song

That makes the music move along

Oh won't you join together with the band

This is the biggest band you'll find

It's as deep as it is wide

Come on and join together with the band

A collage of Day One at #PWDC16 - courtesy of Nichola Davis

I am a Rock: Why are the British so bad at languages?

I try very hard to be an optimist and I genuinely think that in many - indeed in most - ways, the world has become a significantly better place over my lifetime. However, there is always stuff going on to counter that rose-tinted view of the world, both in my own life and in the wider world, and just occasionally things crop up which make me succumb to feelings of doom and gloom.

One such thing greeted me in this morning’s news (February 27^th 2019), with the not exactly surprising revelation that language learning here in the UK appears to be in meteoric decline, according to a survey by BBC news. The story is here:

https://www.bbc.co.uk/news/education-47334374

For a linguist it makes depressing reading, and it is difficult to resist the temptation to link this apparent decline in our willingness as a nation to engage with the language and culture of other countries as symptomatic of the same narrow-minded insularity that drove a (very slim) majority of Britons to vote to leave the EU back in 2016.

As a retired languages teacher, I am relieved to say that this is now for me just a subject of deep concern, rather than one of professional survival, but that doesn’t mean to say that I am not very sad to see it happening. We Brits have always been bad at it, but why are we getting worse at learning languages? And why are we not more worried about it? In short, why are we so arrogant?

When I graduated and came into language teaching in the early 80s, the future for language learning looked bright. We were relatively new members of the EU, and as a nation we were rapidly becoming more familiar with our European neighbours thanks to easier communications, the boom in foreign holidays, growth in trade and a love affair with cuisine more interesting than the “boiled beef and carrots” on which our parents’ generation had been raised. It’s very hard to believe now, but pizza and pasta were exotic rarities as recently as the 1970s, whilst wine was a drink for the well-to-do or for special occasions, and baguettes, croissants and quiche were words encountered only in French lessons at school. Languages were valued and booming in schools, and a move away from élitist grammar-based teaching, with more emphasis on practical communication skills - listening and speaking - promised a bright future for the subject.

That’s the way it was in the first 25 years of my teaching career: modern languages (in the case of my school French and German) were part of the core curriculum alongside Maths English and the sciences and whilst some didn’t like them and weren’t very good at them, there was a feeling that, like Maths, language learning was somehow “good for you”. For me, a pragmatic and good-humoured approach to teaching, combined with giving pupils the opportunities for fun trips to foreign parts, made it relatively easy, and certainly enjoyable, to teach languages.

In my small school, with around 100 in each year group, all pupils took GCSE French or German, and A-Level entries of between 10 and 20 for my main language, French were the norm as recently as the early 2000s, with many of these going on to read the subject at university.

So what has gone so badly wrong with language learning, and in such a short time? These days, taking a language to GCSE has become just an option, taken up by just a few keenies, and as a result, A-Level language teachers in many schools and colleges often struggle to recruit more than a handful of candidates, with formerly mainstream languages like German having become the preserve of a tiny minority, as confirmed in today’s news report.

Part of the answer lies in a perfectly laudable broadening of the curriculum over recent decades: more apparently attractive, relevant and  - dare I say - easier subjects like Business Studies, Psychology, Photography, Physical Education and Media Studies have all proved to be an irresistible temptation to pupils burdened with a “must pass” core of English, Maths and the sciences. Moreover, some very poor choices made by the exam boards who devise specifications at GCSE and A-Level have served to make languages statistically a very risky choice for pupils, with top grades elusive. This, combined with schools leaders’ nervous pursuit of league table success has led to a “perfect storm” for languages in schools.

This is very, very sad, and in my opinion very damaging to our long-term success and well-being as a society, at two distinct levels:

The first is self-evident and practical: our unwillingness to engage with the language and culture of other countries is deeply harmful to trade and business. We hide behind the excuse that “everybody speaks English”, failing to realise that the wheels of commerce are driven by human interaction and good manners, which often amount to no more than making an effort to meet others halfway. Yes, the detailed negotiations for that lucrative contract may be carried out in English, but the small-talk and goodwill that underpin it may be immeasurably strengthened by a simple greeting in the language of the host, or maybe a “please” and a “thank you” at mealtimes or a comment about the weather. It’s amazing how much ice can be broken by trying to use just a bit of school-level language.

And please don’t tell me that speaking another language is difficult: much of the rest of the world is bilingual, and we are reminded all the time by the many lovely and capable people from across Europe who have in recent years come to live and work in our country how easy it is to become fluent in English, one of the subtlest, richest and most illogical of all languages. We all meet them every day: think of that every time you are served in a restaurant or a coffee shop, helped recover from illness by a doctor or nurse in hospital or greeted by a hotel receptionist, many of whom are non-native speakers of English.

Or how about footballers and their managers? Is there a better and more expressive user of English than Jürgen Klopp? Does anyone in Manchester speak better “Manc” than Ole Gunnar Solskjaer? These guys, and those who play for them have mastered our language because they have lived and worked here and absorbed our culture, not because they took school and university examinations.

Which brings me to the second reason for valuing language learning, a less obvious but equally important one. Yes, we need to be far better at the practical business of communicating in other languages, but what about the hidden benefits of language learning, beyond the obvious ones?

Language learning has multiple subtle benefits, way beyond the straightforward business of communicating. Thanks to the previous successes of our education system, the highest levels of every profession here in the UK are massively enriched by the presence of linguists, who benefit enormously from the subtle transferred skills derived from their knowledge of another language. Among my ex-students of A-Level French are numerous doctors, engineers, scientists, business people and teachers, as well as actors and media journalists, all of whom probably seldom if ever use their A-Level French, yet still benefit from it every day. Modern linguists, and their close counterparts classicists, are everywhere in the professions, but I fear that they will become fewer in number over time, and those professions will be the poorer for it. It came as no surprise to me when I discovered recently through my post-retirement work in the diabetes community that the Chief Executives of the two main diabetes charities in the UK, JDRF and Diabetes UK are, respectively, a Cambridge linguist and an Oxford classicist.

I took a degree in French and German at Oxford University, yet my ability to speak fluent and colloquial French comes not from my studies at Oxford, but from a year spent living and working in a small town in rural France where nobody spoke English, and playing for a non-league football team there. However, this is not to belittle my Oxford languages degree, far from it: studying for a traditional university degree in Modern Languages, with its emphasis on detailed translation of literary texts, and above all the reading and critical analysis of vast quantities of literature in the original language has given me skills such as absorbing and processing information, understanding a variety of viewpoints, and writing concise and focused English which served me well throughout my professional career and continue to do so in my post-retirement work in healthcare advocacy.

I very much hope that we can arrest the decline in language learning before it gets too late, but at the risk of concluding on a gloomy note, I fear the damage has already been done. I am loathe to politicise this issue, but it is difficult not to see a connection between the mentality of Brexit and that of our unwillingness to prioritise and promote language learning. Perhaps we are at the darkest hour just before dawn, and if a post-Brexit Britain is left marginalised, as well as culturally and materially impoverished by the short-sighted and misguided decision of a particular generation, perhaps future generations can right this wrong. I hope so.

Oh, so what's the song title for this post, as is my wont? It’s almost impossible to find a song about languages, so I’ve settled for a wonderful Simon and Garfunkel song whose lyrics I profoundly disagree with, yet whose title sums up where we seem to be heading. 

Great song, shame about the meaning: I am a Rock

High: 21st Diaversary Musings

21 years ago today, feeling exhausted and battered from all sides after an unprecedented week off work in my sick bed with real ‘flu, I made an emergency appointment with my GP, alarmed by what appeared to be a sudden recurrence of my first bout of “proper” illness since childhood.

It was a dark, wet and windy evening, and I was far from full of festive cheer on that last Friday before Christmas as I sat in a deserted waiting room at the end of the day. A urine sample test revealed sky high blood sugar and the startling revelation that I was displaying the classic symptoms of diabetes.

The full story has been told before, here.

So my diabetes is “21 today” 😊

My "diaversary" always gives me a cause for some reflection, and these days, with a little more time to spare in retirement, I hope that those who know me as part of the online diabetes community will forgive me for the indulgence of sharing them publicly.

Here I am, 21 years on, having lived a third of my life, or half of my adult life, with an incurable, 24/7 medical condition which requires constant treatment and monitoring combined with an awareness of the effects and risks of activities as basic as eating, drinking, sleeping, moving or not moving.

Sounds pretty grim, doesn’t it?

But I’m an incurable optimist, a believer in silver linings, and whilst I don’t seriously believe that “everything happens for a reason”, I do believe that we all have the power to turn negatives into positives.

So 21 years on, I can also reflect on the fact that I have in recent years acquired activities, contacts, acquaintances and friends from within the community of people with diabetes, their families, and the healthcare professionals and medical companies who help to care for them. My life has been greatly enriched by them and I find it very hard to imagine what my life would be like without the diabetes community.

And I recently came upon some proof of this: a recent printout from my GP of my HbA1c level over the past five years revealed that the two most striking improvements in my level had occurred as a result of my starting to use flash glucose monitoring in early 2015 (no surprise there) and my starting to interact with the world of diabetes online in 2013. 

My HbA1c, 2013 -2018

Coincidence? Possible, but unlikely.

I think it is highly credible that I became significantly “better” at walking the tightrope of life with diabetes once I started to associate with others who do so, or who help others to do so. The knowledge that there are others out there who “get it”, who understand the frustrations and the triumphs, is of immense benefit, and I very much hope that in receiving that benefit, I have also contributed to it in my own small way.

So thank you to all out there in the #GBDoc and well beyond it: I wish I’d known you were all out there back in December 1997, but then again, many of you didn’t even have diabetes then. Indeed one who has become one of my best friends from the community was celebrating her first birthday on that auspicious date, and was herself still eleven years from developing the condition. Such is the fickle nature of diabetes, yet it gives a strong and lasting bond, borne of a very difficult adversity which in a very strange way makes me feel blessed. Blessed, at least, to have acquired diabetes in the modern world, not that of less than 100 years ago, when it was, in effect, a death sentence. Thank you, Prof Banting!

Faces of GBDoc

Of course, all my posts require an appropriate song as their title, so for this one I've landed on a song that is exactly the age of my diabetes, and which for me evokes memories of some dark days in January 1998 as I adjusted to a life of injections, testing and clinic visits: High by the Lighthouse Family not only gives a nod to my blood sugar level in late 1997, but also has a wonderful sense of optimism, a sense that better days lie ahead. As they did for me on that dark Friday in 1997.

"When you're close to tears remember
Someday it'll all be over
One day we're gonna get so high

Though it's darker than December

What's ahead is a different colour

One day we're gonna get so high"

Listen to the whole song here:

My best wishes for Christmas, 2019 and well beyond, to all those whom I now know as an indirect result of that fateful GP visit back in 1997.