Delusion, denial and diabetes

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


  • 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


  • 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.

World Day for Water, the wonder of PlayPumps and apologies for lateness

In 1992, the United Nations designated March 22nd as the World Day for Water in Resolution 193 of the Forty-seventh Session of the General Assembly.

The World Day for Water was first proposed in Agenda 21 for the 1992 Rio Summit, the meeting that hugely raised awareness of the role of local government and local communities in tackling global environmental and climate issues.

Since 1993 the day has been observed consistently, drawing attention to the plight of the estimated one billion people plus who each year have to rely on dangerous sources of water to survive.

Having travelled a little in India and Africa,  turning on a tap and being able to drink a handful of clean, cold water is still something for which I am profoundly grateful. Whilst it is easy to take it for granted, when I think about it I can’t begin to imagine what it would be like not to have it.

A year or so ago we had a small taste of what it was like to lose our mains supply for just a few hours. The sense of worry as you wonder when you might be able to wash clothes or make drinks again is out of all proportion to the scale of a relatively small inconvenience. It does, however, cause you to pause and consider how it would be to have to walk miles a day to a potentially polluted stream and draw water you’d be uncomfortable watering the garden with.

The IRC International Water and Sanitation Centre reports the stark analysis of the World Health Organization:

Each year more than 1 billion of our fellow human beings have little choice but to resort to using potentially harmful sources of water. This perpetuates a silent humanitarian crisis that kills some 3900 children every day and thwarts progress towards achieving the Millennium Development Goals (MDGs). The consequences of our collective failure to tackle this problem are the dimmed prospects for the billions of people locked in a cycle of poverty and disease.

The root of this underlying catastrophe lies in these plain, grim facts: 4 of every 10 people in the world do not have access to even a simple pit latrine and nearly 2 in 10 have no source of safe drinking-water.

Thankfully, the appalling situation is not something that the UN/WHO are prepared to see continue:

To help end this appalling state of affairs, the MDGs include a specific target (number 10) to cut in half, by 2015 the proportion of people without sustainable access to safe drinking-water and basic sanitation. In addition, the UN Millennium Project Task Force on Water and Sanitation recently recognized that integrated development and management of water resources are crucial to the success or failure of all the MDGs, as water is central to the livelihood systems of the poor.

Among the more innovative ideas for drawing water to the surface, one particularly caught my attention, marrying the desperate need for fresh water to a completely different and endless resource: the playful, optimistic energy of children.

Water for People provides a very clear explanation of how these amazing inventions work:

  • While children have fun spinning on the PlayPump merry-go-round (1), clean water is pumped (2) from underground (3) into a 2,500-liter tank (4), standing seven meters above the ground.
  • A simple tap (5) makes it easy for adults and children to draw water. Excess water is diverted from the storage tank back down into the borehole (6).
  • The water storage tank (7) provides a rare opportunity to advertise in outlaying communities. All four sides of the tank are leased as billboards, with two sides for consumer advertising and the other two sides for health and educational messages. The revenue generated by this unique model pays for pump maintenance.
  • The design of the PlayPump water system makes it highly effective, easy to operate and very economical, keeping costs and maintenance to an absolute minimum.
  • Capable of producing up to 1,400 litres of water per hour at 16 rpm from a depth of 40 meters, it is effective up to a depth of 100 meters.

Innovations such as this, which show the application of creative, lateral thinking, create a real hope that the challenge of providing clean water can be met. Days such as the World Day for Water play a crucial part in alerting all of us to the need to act sooner – not later.

The video below, again from Water for People, is quite uplifting.

Vodpod videos no longer available.

Finally, by way of a footnote, I clearly should have written this yesterday – but being tired after a long day I didn’t. So my apologies for lateness (something I seem to do far too often).

The soft drink calorie horror – check out the seriously scary doughnut value!

Men’s Health America has decided to scare the pants off us with a journey through the soft drink horror stories of the United States. Before we all scoff (ho ho), cluck and roll our eyes in knowing despair at our American cousins, we should remember that many of these brands are available here and we see them in school lunch boxes by the hundreds of thousands.

For instance, take the Rockstar Energy Drink.

According to Men’s Health America it contains the sugar equivalent of SIX Krispy Kreme Original Glazed Doughnuts.

That’s right: six doughnuts.

I mean, erm, WTH?!

Speaking as a diabetic, a few of those a day would make for an interesting experience… Seriously, though, how on earth can anyone think that has any serious nutritional value for your average, sofa-bound, pizza-gorging gamer addict?

To my mind these sorts of drinks are little more than legalised toxins. Check out the slide-show here.

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Cameron’s Conservative Party, Con-coctions and Torydiddles: Anger as Tories increase teen pregnancies (The Fib List No. 2) #toryfail

In a decimal point slip of breath-taking ineptitude, David Cameron’s Conservative Party proclaimed an increase in the number of teens getting pregnant in Britain’s most deprived areas that was hugely in excess of the official figure.

Yesterday, the Tories published a document on Labour’s “Two Nations” that, as well as serving as a vehicle for cribbing Lib Dem policy such as the pupil premium, loudly proclaimed that 54% of Britain’s poorest teenage women became pregnant before the age of eighteen. The document, issued in David Cameron’s name, laid responsibility for this 54% increase squarely on the shoulders of Gordon Brown and his Government.

The actual figure is 5.4% – and this latest row comes just ten days after the Tories were lambasted by Sir Michael Scholar, the head of the UK Statistics Agency for misusing crime figures in a way that could damage public trust in official statistics.

So how did the Tories make such a stupid mistake?

The first question is did they? A cynic might assume this was a deliberate ploy, designed to fuel the prejudices of traditional Tory voters whilst inflating a general sense of outrage at the country’s moral breakdown. It would certainly fit with the apparent Tory habit of manipulating statistics for sensational political effect.

More likely, though, it was cock-up. In that case, one has to ask how on earth such a blatantly ridiculous statistic made it past the combined fact-checking powers of the Shadow Cabinet, their advisers, the Tories’ Parliamentary Research Unit (who I assume was asked to check it) and the Conservative Party Press Office – especially when David Cameron put his name to its foreword.

The frightening thought is that perhaps they are that out of touch with the country that they simply passed it over, shaking their heads as they collectively “tut-tutted”, assuming it was true.

An increase of 5.4% is nothing for Labour to be proud of.

Britain is regularly reported as having the highest rates of teenage pregnancy in Western Europe. The most recent figures for the Organisation for Economic Co-operation and Development (OECD) puts the rate of teenage births in the UK at 24.8 births per 1000 women aged 15-19. (Note – this is teenage births. Pregnancies would be higher – and this statistic does not account for births in teenagers under 15.)

A 2001 paper by Alice MacLeod, published in the British Medical Journal said:

“In England reduced rates of teenage pregnancy have been found to be associated with proximity to youth family planning clinics.”

The lack of access to proper advice would be consistent with a more recent YouGov survey for Channel 4 that found that almost a third of teenagers want more sex and relationships education.

The experience of other European countries, who have equally sexualised societies (and arguably more-so), but more comprehensive education about sex and relationships, is that rates of teenage pregnancy are lower. For instance, there has been controversy over proposals to end the parental opt-out of sex education in English schools once pupils turn fifteen (currently parents in can opt their children out until the age of nineteen), yet no such opt-out exists in most European countries. (There is an interesting comparative paper available from the National Foundation for Educational Research which, unfortunately, doesn’t include Britain, but does look at the way sex education is structured elsewhere in the world.)

Teenage pregnancy is an issue that needs tackling with proper understanding – firmly, calmly and compassionately. That isn’t achieved when you are electioneering from the campaign scrimmage, trading the misery of broken lives for the votes of “Disgusted of Tumbridge Wells” with utterly wrong information.

Concoction or cock-up, it doesn’t leave you with any confidence about the Tories’ real commitment to tackling social deprivation beyond their election re-branding.

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