Apologies for the variation in font size and spacing in this article - this blog refuses to maintain the choices I make in such things and I have no idea how to put it right in a way that will remain right after I publish it.
Louise
What are little girls made of? Basically, sugar.
Those of you who are
my age might remember US comedian Mark McKinney from the late-eighties cult
sketch show Kids in the Hall and later from his stint appearing on, and
writing for, Saturday Night Live. More recently, he played Glenn Sturges, the
absurd, incompetent, naïve, weird-voiced manager of a chain store in St Louis,
Missouri, in the highly enjoyable sitcom, Superstore. I mention him here because Glenn was my favorite
character from that show, and one of his funniest moments was when he told his
colleagues that, having been pre-diabetic for years, he had just found out that
he was now fully diabetic. The joke was that he announced this news as if it
was an achievement, a cause for celebration. He had finally worked his way up
to actual diabetes!
I was thinking about this when the nurse told me last week that my HbA1c test result [testing blood glucose level] had shot up to 98 and I now officially had Type 2 diabetes. Believe me, it didn't feel like a cause for celebration. In fact, my reaction was shock, fright, horror and guilt.
The guilt was because Type 2 diabetes is
one of those conditions that is often viewed as being the patient’s fault. There's a widespread tendency, in the media particularly, to suggest that those with
Type 2 diabetes are greedy and lacking in self-discipline, allowing themselves
to get obscenely fat and bringing the disorder on themselves. Comedians often
make jokes about Type 2 diabetes, frequently getting it wrong. I’ve used the flippant
line ‘I ate myself into a diabetic coma’ myself in the past, intending it as a
light-hearted quip that uses hyperbole for its effect. One of
Seth MacFarlane’s cartoon sketches springs to mind: a grossly fat detective sits in an armchair at a murder scene, asleep while his svelte partner does all the
work and keeps trying to wake him up.
It's difficult to deny that diabetes mellitus, the other name for Type 2 diabetes, is one of those medical
conditions that is often viewed as being almost a punishment for ‘bad’ personal
choices, in the same way that obesity itself is. Most people are intelligent
and empathetic enough to realise that, even if there is a degree of
self-indulgence involved in over-eating, it is a self-indulgence most
of us are guilty of, but sufferers themselves often feel
responsible for their own misfortune. The reality is that people can develop Type 2 diabetes
without being overweight – I have a friend who did – and not all overweight
people develop Type 2 diabetes. And no one deliberately sets out to become
diabetic. Seeing it simply as the result of a life of idle gluttony is incorrect, and it dismisses and diminishes the condition as being trivial, when in fact it is a serious
illness.
I admit that I personally am overweight. I do very little exercise. I’ve always hated physical activity, though I have been through periods when I’ve forced myself to do it – walking, swimming, aerobics and yoga on the Wii [surprisingly effective], keep-fit classes. But I’ve rarely enjoyed it. I’ve always over-eaten. I’m hungry most of the time and rarely feel completely full. Presumably I was born like this. I can only assume, because some people aren’t overweight, that those people either:
a) simply don’t enjoy food as much as I do, and have few cravings for it;
b) have phenomenal self-control and live their entire lives in a state of self-denial; or
c) defy the laws of physics and eat as much as they want but never get fat.
I've never understood the attraction of exercise - it makes you sweaty, it makes you hurt, it requires specialist clothes and sometimes equipment, it takes up time that could be spent doing something more enjoyable [such as eating!], it increases your risk of injury, it can breed an unhealthy competitiveness. Also, I'm extremely bad at it - I'm short, with short arms and legs, poor eyesight, poor balance, poor coordination, little strength, no stamina and little agility, and I find it difficult to understand the arcane rules of team sports. As a child, I was good at riding my bike, I loved swimming pools, and I enjoyed dancing, but that's as far as my physical prowess or interest extended.
As an adult, I've had several short-lived phases of being 'fit'. At one point, I remember realising I could run up the hill to my house without getting breathless, which was a fabulous moment. But that took hours of hard work. And what use was it, unless I was being chased by an enraged neighbour? Even at my fittest, I was still pretty hopeless at the sort of social exercise you do with other people. I could leap around a badminton court using up huge numbers of calories but I'd rarely manage to hit the shuttlecock. And, as I have grown older, my body just seems to have decided that physical activity sucks! I have fibromyalgia. My body hurts a lot of the time. And I've got fatter over the years - these days it feels like I'm carrying round an extra person or wearing a lead-lined anorak.
Like most adult women, I've spent most of my life on a diet. But I love food. It's one of life's greatest pleasures. I love cooking, I love finding out about new foods, I love cookery programmes, I love restaurants. My ideal job would be working as a food critic. But I have spent years starving myself, keeping cakes at bay, avoiding fried foods, refusing either carbs or fats [whichever is currently deemed to make you fat] or both, in order to lose pounds which I later put back on with interest. I'm fatter now than I've ever been, despite the dieting. As I've said before, quoting Geoffrey Cannon, 'Dieting makes you fat'.
I
was told I was in the pre-diabetic range in 2021, and at first I did very well,
reducing my blood sugar significantly and losing two stone in weight. But then
I got very bored by the diet and my self-discipline started to crumble. I
missed my annual blood test in 2025 due to accidentally booking it on a day I
was unable to attend, and then forgetting to re-book it [ironically, due to the brain-fog
caused by being pre-diabetic]. I acted on the 2026 reminder by immediately
booking a blood test, but the nurse couldn’t get any blood out of my arms, so – both my arms looking like they'd been infested by woodworm – I had to make another appointment for a couple of days later for a second attempt. This time it worked. I took this whole experience as a 'sign' that something was wrong.
This photo shows my face looking fat.
So, when P and I went away for a few
days the day after the blood test, I was simultaneously alarmed and unsurprised to find, on the first day of
our break, that I’d missed three phone calls from the GP surgery. The
receptionist told me I had to make another appointment as soon as possible to
see the diabetic nurse. Of course, these days, you only rarely see an actual
doctor – they are like shy woodland creatures who only come out of their
burrows when no one’s around. But the nurses are often nicer and seem more
knowledgeable, so it doesn’t really matter - except that the doctors get paid
so much more…
Anyway, as I said, it turned out my HbA1c level had shot up, well into the diabetes range. Also, though I have been
in denial about this, I have been symptomatic for some time – desperately and
constantly thirsty to the point of daydreaming about water, frequently
urinating, feeling very dizzy, experiencing intense fatigue, headaches, and the
sort of brain-fog that has made me suspect I was getting Alzheimers. I run an
online writing group and I’ve been finding it more and more difficult to do the
admin – I've sometimes found myself staring at the review rota, which I write myself, as if it is the coded plans for a covert kidnapping of Melania Trump, written in Yoruba with every third letter missing and no gaps between words. I’ve made so many stupid mistakes in the past year that I'm surprised the group members haven't staged a coup and exiled me to the Institute for Stupid People.
The ‘diabetic doctor’ told the nurse, by email, that I needed to go straight onto metformin, having never actually met or talked to me. It's these personal touches that I so admire in our medical practitioners. I collected a pack of Yaltormin SR straight after my visit to the surgery and took the first 500mg tablet that evening with my evening meal. I have to increase this to two tablets, then three and eventually four [standard dosage is 1500g-2000g]. The instructions tell me to 'increase to TWO [1g] Daily with main meal’ but they don't mention when I have to do this. I was supposed to have a half-hour 'seven-day after diagnosis' appointment with the diabetes nurse, but they couldn't fit me in until last Friday, a fortnight after my first appointment, so I decided to increase my dose of metformin after the first week. However, since then they have cancelled two further appointments because the nurse has been ill, and the appointment is now on 7 May, almost a month after my initial diagnosis. So much for the 'seven-day-after diagnosis' malarkey. Should I increase the dose further in a few days or should I wait till I see the nurse? It's great that the NHS embeds these little mysteries in our healthcare plans, to help keep our minds active.
Despite the blood-curdlingly terrifying list of potential side effects on the info sheet inside the box, I’ve had no obvious side effects with the metformin, so far, except intense fatigue. I had that before I started taking it, but it's worsened significantly, and I have nodded off at inappropriate moments several times. Yesterday, for instance, I fell asleep sitting at the laptop with my chin in my hands, while I was re-reading the first version of this article. It's coming to something when I can't stay conscious while reading my own writing! I must have been asleep for quite a while as, when I woke up, it was too late to go to my local health shop [to buy a packet of chia seeds], which is what I'd been intending to do, and my hand, which was supporting my chin throughout, was extremely stiff and sore. I'm just glad I didn't wake up face-down on the keyboard as I'd have had a pattern of mosaic tiles across my cheek. I suspect the fatigue is beginning to lift now, as my brain isn't as foggy as it was.
I’m now fourteen days into the new regime. I’m still in shock. I’m hoping that, as I bring down my glucose levels, my brain will start to function properly again. I've taken to watching far too many YouTube videos about how to reverse type 2 diabetes, and I'm now spending a fortune on foods that are meant to be particularly good for you, the so-called superfoods like sweet potato, broccoli, avocado, beetroot, eggs, oily fish, quinoa, bulgur wheat, plain Greek yogurt, berries, walnuts, pistachios. olives, etc. I eat so many superfoods that I ought to be a superhero by now...
The irony is that my diet wasn't all that bad before. I don't even like sweets, biscuits, cakes or sponge puddings. I don't like desserts that are overly sweet. I don't have sugar in hot drinks. I drink mostly coffee or plain water, with an occasional Diet Coke if I'm in a restaurant. I drink very little alcohol, just a very occasional glass of wine or an even more rare cocktail. I have cut back on bread significantly in the past five years and these days I rarely have more than one or two slices a day. I eat lean meat and fish, and we have vegetarian food several times a week.
But I probably eat too much of everything, and I have gradually added a layer of 'bad food' on top of this healthy diet. I've become undisciplined. I eat treats like scones, crisps and chocolate more often than I should, often having a portion of chips in cafes to accompany my healthy sandwich, for instance. I’ve gradually become less and less able to control myself, and become more and more depressed as a result. I’ve done very little exercise in the past two years, partly due to being overweight which makes exercise difficult, and partly due to problems with my back, the pain from which makes me disinclined to move.
I am starting to go for short walks now and intending to build up to longer walks and other exercises. And I’ve cut out all sugary treats and reduced my portion size. I’ve already lost five pounds, but this has been due to shock and fear really and might not be sustainable.
It is possible to bring your blood glucose level down, even below the cut-off point for diabetes – I have
two friends with Type 2 diabetes who have done this – but not everyone can
manage it. I’m hoping initially just to stabilize it as far as I can, and get
myself feeling more normal.
I’m sharing this with you because
it makes me feel better, and also it is an important life-event for me. I’d
welcome any comments, particularly from any of you who suffer from Type 2
diabetes yourselves. One good side-effect I’ve noticed as the past week has
worn on is that my appetite seems to have decreased and I’m not craving food as
much as I was. It isn’t as dramatic an effect as Mounjaro, but it definitely
works as a mild appetite suppressant for me. This might wear off, of course.
I’ll keep you posted about my progress in
losing weight and reducing my HbA1c level.
I'd like to congratulate and celebrate my two friends, D and T, for working so hard and so successfully to reduce their HbA1c levels after being diagnosed as having Type 2 diabetes. They are an inspiration.
Apologies for the variation in font size and spacing in this article - this blog refuses to maintain the choices I make in such things and I have no idea how to put it right in a way that will remain right after I publish it.
Louise