It seems so counter-intuitive. That the food you eat is killing you, more or less quickly.

How is that?

How is it that the bread I make, very simply, from a basic recipe handed down in the family, each of us varying it a little over the years, and which fills the house with such an amazing smell as it bakes, is actually shortening my life, even as it sustains me? I celebrated that bread-making in one of my earliest blog posts. Surely it’s mad to think of it as effectively a poison, especially when people have eaten bread for millennia?

The last few days, recognising that this chest infection is still clinging on five weeks after I first had it, have been something of a wake-up call. Ironically, it may even be unrelated to my condition.

It should have come before now, really. There were plenty of moments when I could have woken up and “got it”.

The unquenchable thirst that plagued me in Germany back in 2008 (was it then that I was diagnosed?) which I tried to sate with pints of real Coca-Cola should have given it away. (Yes I know, I was a bloody idiot, but I didn’t suspect diabetes at the time, even though a year earlier I’d had a close shave with 7.0 in a blood test). The lactic acid build-up on that same holiday, which brought me literally to my knees in a Franconian valley, out of range of mobile signal (and beer) and with several hundred metres of steep valley to climb after a twelve mile hike. The tiredness. The diagnosis of Type 2 diabetes. The nurse encouraging me to cope with understanding the implications. The doctor telling me that if I didn’t make drastic changes to my lifestyle the condition will kill me.

All should have prompted me to action.

And yet. And yet. It is like living every day in a beautiful house and not noticing the deterioration and decay because, to you, every day the house still looks the same. You don’t notice the minor changes in you, so slight, so subtle, so insubstantial as to be dismissed as merely a blip – a very minor wrong that will right itself soon enough.

Such is the capacity for denial and self-delusion.

But then there are things that start to gnaw away at you in quieter moments. The cut that takes longer to heal, the blood not coagulating quite as it used to. The skin taking longer to heal. The sudden tiredness that can descend from nowhere. The peculiar light-headedness after a fresh croissant.

But can it really be that what I eat is doing this?

So many of our personal stories are written around food. The dinner party with friends. The Sunday roast with family. The romantic meal with a lover. The quick bite at the late night van after a gig. The fish and chips on the sea front. The snatched sandwich in a meeting. The wedding breakfast. The thrill of tasting strange cuisine in new, exotic places. The popcorn and sweets munched at the cinema. The microwave meal cooked alone after a long day.

The list is endless but it is often the people and events and places that are recalled, not the food that graced plate and table. The food may enhance or detract from the experience, but it is rarely the thing talked of, except in passing. Yet in the making of the moment its role is central and it is enjoyed with surprise and delight, a treat for the senses to be enjoyed not meditated upon.

And perhaps in the thoughtlessness of it lie the seeds of what has happened since.

Perhaps if I had been more aware of what I was eating, the quantity of foods that I know now are fast carbohydrates, if I was less concerned with taste and the immediacy of the desire to sate hunger, but rather more concerned with what that food was really doing to me, I might have a different tale to tell. Perhaps if I had been less in denial about what I already knew about those foods then that tale might have been different.

I think now on the meals I enjoyed, thinking at the time I was writing different stories, and can see that each was a line in this particular story. My eighteenth birthday. My boozy dinners at work and Conference. The way I gave up cooking when I was alone again. The lazy detours via the chip shop or the garage. The Sunday teas with grandparents. The bread cooked optimistically on a Saturday morning, uplifted by the smell and the prospect of sharing it with friends.

All have helped lead me here.

Type 2 diabetes is estimated to be present in 2.9 million people – or 4.5% of the population. Diabetes UK predict that this number will rise to 4 million by 2025.

I am, in theory, on at least three doses of two different medications for the rest of my life, assuming, optimistically, that it doesn’t deteriorate. That is estimated to cost £300 to £370 per year. yes, I have paid my taxes and far more than that. But is that really what I was paying them for?

Diabetes UK report that the total cost of Type 2 care to the NHS in 2010 was estimated to be £11.718 billion. That doesn’t account for the costs of treating complications arising from diabetes medication:

The cost of diabetes to the NHS is over £1.5m an hour or 10% of the NHS budget for England and Wales. This equates to over £25,000 being spent on diabetes every minute.

In total, an estimated £14 billion pounds is spent a year on treating diabetes and its complications, with the cost of treating complications representing the much higher cost.

What’s more, its prevalence can lead to a casualness which denies the severity of Type 2 if it is not treated properly. To talk of the severest consequences is to sound melodramatic and so we tend to roll our eyes and shrug and say “Yeah, I’m diabetic”, a certain resignation in the way we say it, as if it is a condition of society that is beyond our control, an inevitable consequence of our 24/7, hurly-burly existence.

I had taken a cavalier pride in the knowledge that whilst my blood sugars seemed to remain out of control, the other symptoms – blood pressure, tiredness, nerve and organ damage – were absent. I thought perhaps somehow I was different, like I was defying the usual trajectory of this condition. I felt a measure of defiance – which fed the capacity for delusion. And denial. Then last year’s optical check, which had been clear for two years, showed I had suffered very minor retinal damage. Nothing to be concerned about, nothing that would affect my vision, but something that, untreated, could lead to considerable damage to my sight and potentially blindness.

No-one else is responsible for making the necessary changes other than me. I need to eat more of some things and less of others. I need to do more, physically, and give myself the best chance of living as long as possible without becoming a burden.

And if I don’t? The reality of Type 2, not properly managed, are potential health consequences and associated complications:

Body and Organs

• Diabetic Nephropathy
• Diabetic Neuropathy
• Autonomic Neuropathy
• Motor Neuropathy
• Sensory Neuropathy
• Diabetic Nerve Pain
• Fatty Liver Disease
• Gastroparesis
• Heart Disease
• Hypertension
• Irritable Bowel Disease
• Ketonuria
• Mental Health
• Proteinuria
• Stroke
• Urinary Incontinence

Complications

• Alzheimer’s Disease
• Coeliac Disease
• Constipation
• High Cholesterol
• Cushing’s Syndrome
• Diarrhoea
• Deep Vein Thrombosis
• Erectile Dysfunction
• Fibromyalgia
• Memory Loss
• Nocturia
• Peripheral Arterial Disease
• Polycystic Ovary Syndrome
• Urinary Tract Infections
• Yeast Infections

Short Term Complications

• Dead in Bed Syndrome
• Diabetic Coma
• Diabetic Ketoacidosis
• Hyperglycemic Hyperosmolar Nonketotic Coma
• Hyperosmolar Hyperglycemic Nonketotic Syndrome

Cancer

• Bladder Cancer
• Colon Cancer

Eating Disorders

• Binge Eating
• Diabulimia

Eyes and Vision

• Diabetic Retinopathy
• Diabetic Retinopathy Symptoms
• Diabetic Retinopathy Treatment
• Diabetic Maculopathy
• Cataracts
• Eye Disease
• Glaucoma
• Visual Impairment

Foot, Bone and Skin Care

• Acanthosis Nigricans
• Amputation
• Charcot Foot

A cheery list, but one I have been too dismissive of to date. I still believe I am invincible. And I am not.

The fact that I cannot even recall the year I was diagnosed shows you something has been wrong in my attitude towards my diabetes.

Red, in the film Shawshank Redemption, makes an observation in the closing moments: “Get busy living, or get busy dying.” It’s really not that hard. As my friend Lou posted on her Facebook, in one of those nuggets of wisdom that are shared worldwide and are often trite but occasionally to the point: “Are you happy? Yes? Keep going. No? Change something.” We really do over-complicate things sometimes.

I won’t give up bread – or making it. But I should eat much less of it.

And generally eat very differently. And exercise more.

I can’t keep pretending I don’t need to make a choice.