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The Dark Side of Diabetes

Diabetes is so misunderstood. If you get told you have cancer, the first question you ask is ‘How long have I got Doc?’

Diabetes means you’ve got high blood sugar – sweet…..No problem eh?

You get a diabetic foot ulcer and your odds of living more than 5 years are less than if you’d just been diagnosed with breast cancer or prostate cancer. Bet you didn’t know that did you?

Smoking… bad….shortens your life, on average by 10 years. Bad, bad, bad. Type 2 diabetes does that too. 10 years off your life expectancy. Type 1? On average, 20 years less of life to enjoy.

Not long ago I was in a meeting discussing setting up a study on diabetic foot ulcers, with a hope to reducing re-occurrence. It seems that the ‘Ethics Committee’ are really twitchy about telling patients things that may improve their chances of seeing their granddaughter going to Big School in case it violates their privacy and is seen as harassment.

Nope, I don’t understand it either – or maybe I do….

It seems that our national genome is hard wired to avoid telling anyone how it really is. Far easier to skirt around things and avoid the tough conversation. That’s easier than it seems though. Most People with Diabetes (PWDs) have around 3 hours per year with their nurse or doctor or consultant. Only 8,760 hours on your todd to work it all out. Good luck and see you next time…

Please feel free to label the next 1,000 words ‘tough love’ if you like….no apologies if it makes you feel a tad uncomfortable….

Teenagers can be lovely, or more likely a nightmare. Teenagers with diabetes have a really good chance of being in total denial about the fact that they have a life limiting disease. Anyway, teens are immortal and will live for ever, and 30 is really, really old.

Have a read of Case Study One below. Only short, but grab a drink, read it and pause for thought.


Dave was diagnosed with diabetes (Type 1) when he was 20. That day, Dave’s life should have changed for ever – a daily, lifelong regimen of blood testing and injections of insulin. Total pain.

Problem was, Dave wasn’t bothered. Life was too busy, partying, studying and doing young adult type activities. Wearing his special cloak that gave him immunity to anything nasty, Dave basically ignored his Diabetes. Any bad stuff (which wasn’t going to happen to him anyway) was years and years away.

Four years later (at 24), Dave was invited into an operating theatre and a man called a ‘surgeon’ cut one of his toes off. Just so you’re in no doubt, he didn’t mash it up skiing or anything like that – his total denial of his diabetes and appalling blood glucose control did it for him.

You know what? Four years later, same conversation, same surgeon, same outcome. Another toe gone.

Bad? Yes of course. Avoidable? Almost certainly.

Dave didn’t know that 50% of people who have a diabetes related amputation are dead within 3 years- at five years, 70% are.

‘Happy 40th Dave’. Words almost certainly never to be heard.

Sorry if that upset you- but it’s a true story. Just to let you know, more of the same to follow…

Why did it ever get to that? No-one having the bottle to sit Dave down and tell him his fortune? Nurse being too polite? Too scared? A bit like Dicken’s Ghost of Christmas Future, if Dave at 20 had been able to have a chat with Dave at 24….or 28….would things have been different? Maybe or maybe not. But I know, if I was Dave, I would have loved to have that conversation. But even better than that would be to have a HCP with the bottle to tell it like it really is – or could be if you don’t get your act together. Show me pictures of amputations and rotting feet. Scare me. Please. Don’t be nice to me – just help me live my life -please?

In another one of my musings, I’ll consider the impact of getting told you have diabetes – but that’s for another day.

Anyway, if you were under any illusion that Diabetes (Type 1 or Type 2) is the soft option, then maybe you’re thinking differently.

The trouble is with diabetes is that it messes with so much of your body. Can be like death by a thousand cuts ……slowly (if you’re lucky) you’ll start to notice stuff happening. Bits of your feet going numb and then big bits of your feet going numb. Your chance of a heart attack (nb can be life threatening J) are now the same as a ‘normal’ person who has already had one. Oh- you’re 20 times more likely to have something amputated too. You already know about living shorter lives. If you are a guy, the chance of your ‘equipment’ failing are pretty high too -up to 60% according to the scholars.

Chances of going blind are uncomfortably high too. High blood sugar and high blood pressure can do untold damage. On that note…..


Brian is a type 1 and a couple of years shy of his 40th birthday. He would admit to being a ‘diabetes denier’ in the early years post-diagnosis and often ran his blood glucose levels ‘hot’. Hot means high – usually in the low to mid-teens mmol/l. The perceived benefit is that by doing this, the chances of getting a hypo are much reduced; the bad news is that it can radically increase the chances of other diabetes related complications.

Brian has had bleeds into his eyes.

On the balance of probabilities, this is most likely to be because he didn’t get decent blood glucose control for too many years. He’s still struggling with control of his BG levels – they are still in double figures. Ideally, he’d use an insulin pump to help him get control, but he can’t see well enough to operate it. He can’t work and he can’t support his family any more.

He can’t read the paper any more, or watch television. Obviously he can’t drive.

He needs an operation to try to control the bleeding in his eyes, but his levels are too high for a general anaesthetic.

Brian is 38.

Unless you are genetically ‘bomb proof’ from the malice of diabetes, there is a good chance that at some point a life changing event will occur. Might be a foot ulcer that comes and goes (albeit taking weeks or months to heal) and that’s it. Or you could be affected whilst still young -as Dave and Brian have been.

The irony is that by doing simple things well every day, a lot of the nasty stuff can be avoided or at least slowed down. And it really doesn’t take too much time.

Research shows that on average, adults spend 1.5 hours per day on social media – some reports say up to 27 hours per week.

An educated guess would say that basic management of diabetes would be around 15 minutes a day; if you are really serious about it then maybe 30-45 minutes a day.

Let’s call it half an hour for the sake of argument.

Do you:

  1. Want to post some more pictures on your favourite social media site
  2. Tweet your friends to tell them you’ve just eaten a pizza
  3. Get a grip of your diabetes and reduce the risk of going blind, having a toe cut off or dying young?

( If it takes half an hour, you’ve still got an hour a day to be on ‘tinternet!)

The bottom line is that it’s down to you. Your body, your life, your responsibility.

Maybe this short article has made you pause to think about the dark side of diabetes. Maybe you’ll do things differently. Maybe not…

Have a think about it…

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