For author and former The Age editor Michael Smith, 63, a type 2 diagnosis was just the wake-up call he needed.
Old-school journalists have a reputation for working and playing hard. Were you guilty of that?
I was a journalist for 25 years and my lifestyle was disgusting. I didn’t eat regularly, and what I did eat was bad. I drank too much alcohol, smoked, didn’t exercise and put on too much weight.
I spent several years as a medical reporter and knew about diabetes, but I didn’t follow the advice I was giving my readers. I was young and thought I was bulletproof. It sounds crazy, but that’s what happened.
You were initially diagnosed with type 2 in 1995. What did you do to get your health under control?
For a year or so I exercised every day. I went to the gym and the pool, walked and cycled. I ate plenty of fresh fruit and vegetables, protein in moderation, and minimal fat and sugar. I lost about 10 kilos, but then my diabetes became so stable that I was lulled into a false sense of security and slackened off. Subconsciously, I thought I’d beaten it. Over the next few years, I slowed down on the exercise, until I was going for several weeks at a time without exercising. I gained weight. I was working very hard and I was stressed.
My blood glucose levels started to go up and I couldn’t control them. I needed more medication and, eventually, had to go on insulin. And then I had a heart attack, which really woke me up. That was seven years ago.
So, in a strange kind of way, a heart attack saved you?
I remember staring up into the lights in the cardiac catheter lab at my wife, kids and grandkids, not knowing whether I would pull though. That’s when I decided to change my ways. I could have died. I had a 90 per cent blockage – it wasn’t trivial – but they put in a couple of stents and I immediately felt good. In fact, I felt better than I had in 10 years. I was extremely lucky. I didn’t deserve that second chance, so I was determined to repay whoever gave it to me by not abusing the gift.
Was that when you decided to write a book about diabetes?
After having the stents put in, I was told I would have to stay in hospital. I needed something to keep me busy. The reporter in me took over and I started to learn about heart disease and what I had to do so it wouldn’t happen again. I wrote my book, Downsize Me: How to Fight Diabetes and a Heart Attack. The book has a chapter on diabetes, because it is one of the biggest heart-attack risk factors and the origin of my problems.
Did you decide you needed a complete lifestyle makeover after having your heart attack?
You don’t have to be a cloistered nun to live a good, healthy lifestyle with diabetes. You just have to make sensible, permanent changes. Quitting smoking was one of them for me. I used to say it was easy to give up smoking – I’d done it 100 times! But after my heart attack, I gave it up immediately and never wanted a cigarette again. That’s how powerful that epiphany was. I cut stress out of my life, too. I run my own PR business, so I jacked up the fees. I ended up earning more money, doing less work with less stress, and losing 20 kilos in 18 months.
What changes did you make to your eating and exercise regimes?
If there are 21 meals in a week, I aim to get 19 of them near perfect. I eat mainly carbohydrates, protein in moderation, plenty of fibre and fresh fruit and veg, and avoid fat and high-sugar foods. Following this plan for 19 out of 21 meals gives me two wildcards a week, so I can go to a restaurant and loosen the reins a bit. I get great satisfaction out of taking a brisk walk for an hour every morning. I love it when the weather is bad – when it is wet and cold – because I’m doing it despite the elements and nothing is going to stop me. I give myself five exercise wildcards a year, for when I’m sick or travelling. If I use one of my wildcards, I generally make it up – I do two sets of exercise in one day, to get it back.
Were there any challenges you didn’t anticipate?
Decoding food labels, because the food industry is so clever in making us buy things we shouldn’t. It’s almost as though the food labelling system in Australia was designed to confuse you. But if you stick with it, and learn the basic rules and what to look for, you can decipher the code.
Have you done it all on your own, or did you need support?
My wife, Kay, has been trying to save me from myself for 45 years, with some success recently. My heart attack didn’t surprise her. But she didn’t abandon me. She gave me 100 per cent love and support to make sure it didn’t happen again.
Devoted mum Kelly Belcher reveals her secrets for achieving the ultimate balancing act between managing 13-year-old son Will’s type 1, and letting him still be a kid.
Did you have any sense that Will was seriously unwell before his diagnosis?
Not at all. He’d just had bad tummy aches. But the weirdest thing happened on the way to see the doctor. Quite out of the blue, Will said, ‘I wonder if I’ve got diabetes.’ To this day I don’t understand where that question came from. I said, ‘No way. You’re just really constipated. I’ll fall off my chair if you’ve got diabetes.’ Will is the first person in our family to be diagnosed with type 1, so we didn’t know the first thing about it. It wasn’t on our radar.
Did you flip out when you got the news?
No, funnily enough, I was totally relaxed because I didn’t really understand the severity of it and Will looked fine. The doctor told us to go to the hospital and I said, ‘I’ll just pop home first and put some clothes on the line.’ The doctor replied, ‘No, you really need to go to the hospital right now.’
What has Will’s little sister made of it all?
Cailyn may only be three, but she loves keeping her big brother on track. She says, ‘Test your levels, Will’, and tells him where to put in the cannula in his tummy. Will always smiles and says thank you.
So Will has an insulin pump?
Yes. For the first 18 months he was injecting himself with insulin every day, but now he has a pump. He has to change the line and rotate the cannula site every three days or so.
Has the pump made life easier?
It has, but things can still go wrong. We got a scare recently when we tested him at midnight and it read 20, when he should have been between four and eight. It turned out he hadn’t fully clicked his cannula in after his shower, so he wasn’t getting any insulin for a few hours. We learned yet another lesson from that alarming experience. He also got down to 1.4 recently, which was his lowest reading ever. That was a bit frightening. We had climbed a hill to watch planes take off and land at the airport, and he didn’t eat enough food quickly enough. It’s such a tricky balancing act.
Does he have lots of medical paraphernalia?
He started off with a small cooler box and moved up to a larger plastic container. Then he needed a couple of storage boxes for all of his ketone strips, reservoirs, fusion sets, sharps containers and alcohol wipes, and the rest. Now he has started taking over my pantry, which is something I wouldn’t normally let anyone do. He has a whole shelf!
Do you do stocktakes on his supplies?
My husband and I decided early on that it was important for Will to manage his own supplies, and to make sure he never runs out of anything. One day he is going to move out and will do it on his own, so the training starts now.
What has helped you rest easier?
I think the more you understand something, the less you fear the unknown, so I decided to study a Certificate II course in Diabetes Management. Understanding more has been really good, but it’s also heartbreaking to realise the damage that occurs when you don’t have good control. When Will’s blood sugars aren’t in range, I think, ‘What is going on with your heart, veins and arteries, right now?’ I know we’re doing the best we can and we’re managing it well. But I still lie in bed at night sometimes wondering if I am doing the right thing or if there’s anything I could be doing to manage it better.
What has been the hardest thing to explain to Will about his condition?
Will has always been obsessed by planes – his room is full of them – and his dream is to be a pilot in the air force. It was horrible breaking the news to him that he would never be able to fly a commercial plane or fly with the defence force. My husband and I were worried it would kill his passion, but it hasn’t. He’s now looking at becoming an engineer, so he gets to work on planes. And he also plans to get a private pilot’s licence and buy his own plane so he can fly for fun.
Is it hard letting go when Will isn’t by your side?
We live in Cairns and, recently, he went to an airforce cadet camp in Toowoomba, 1700 kilometres away. I found that hard because it was the first time Will was entirely responsible for managing his diabetes. But he was fine. Right from birth Will has been an old soul, but the diagnosis has forced him to grow up quickly and be responsible. He loved the camp. He got to fly a Cessna aircraft, and came back so excited that he started looking into getting his private pilot’s licence. He’s now counting down until he is 14 years and nine months so he can get a job and start saving for it.
Keen traveller Margaret Fordon-Bellgrove, 82, hasn’t let a type 2 diagnosis keep her from exploring the far corners of the world ‘I knew if I looked after myself I’d be alright,’ says Margaret, who has been to 31 countries since her diagnosis.
We hear you’re a bit of a globetrotter…
I’ve travelled to 31 countries since I was diagnosed with type 2 diabetes 13 years ago. I usually travel on my own, but sometimes I go with a friend. On my last trip, I went from Amsterdam to Budapest on a cruise ship, and then I met some lovely people in Canada and Alaska. I was away for two-and-a-half months.
How do you manage your diabetes on long trips?
I’m on a few different medications, including insulin, so I work out exactly how much I will need for the whole time I am away and then take a little bit extra. I take all of my prescriptions with me, and a letter from my doctor saying I have diabetes. I carry it all in my handbag, so it is safe, even if one of my bags goes missing.
Have you ever been unwell when overseas?
I had a hypo on the plane coming back from the Netherlands a few years ago. With all the different time zones, I was very tired and I missed one of my insulin injections. It was horrible. I felt very ill, and was trembling and perspiring. The hostesses asked three people to move so I could lie down and gave me some fruit juice. From that, I’ve learned not to get overtired and, instead of going cattle class, I now go business class. It is expensive but I can rest when I need to.
Do you carry your medical history with you?
I wear an SOS medical alert, which is gold and looks like a locket. Inside, it has a strip of paper about 40cm long. That’s where I’ve written everything medical people would need to know, along with my doctor’s name and phone number.
Is it hard to keep your diet on track when you’re travelling?
On my last trip, I was on a ship for 46 days. For breakfast and lunch you could help yourself to a buffet and eat as much as you like, but I was very careful. Every morning I had two pieces of fruit and two cups of green tea. For lunch, I had salads with not much dressing. For dinner, we chose from a menu and I usually had a prawn cocktail. I really like those! There was always fish or meat, and wholemeal rolls, but they hardly have any vegetables on cruise ships. I’d ask for vegies and they would bring me a tiny bowl. Thank goodness for the salads!
Do you have to fight a sweet tooth?
I went through the war [WW2] as a child in Holland and there were food shortages. When it was over, and we were getting some food again, I couldn’t stand the smell of sugar. I still don’t like it so that’s a blessing. I have fruit and yoghurt rather than sweets and I don’t drink alcohol or soft drinks. I have coffee, tea and water. I also test myself each day. If my blood sugars are a bit too high, I am more careful the following day.
Are you always disciplined?
I’m not always good! At my retirement village, we have monthly get-togethers and they have forbidden food. Recently, I had quiche. My dietitian said it’s okay to bend the rules once in a while. You’ve got to live a little.
How do fellow travellers respond to your eating habits?
On one trip, a lady kept encouraging me to have sweets. After I’d politely declined, several times, she told me I was too disciplined and strict. Because I look well and you can’t see my diabetes, it can be hard for people to understand. Another person on the cruise said to me, ‘It’s a very boring diet.’ I told them, ‘No, it’s a very healthy diet.’ My doctor once said people dig their own grave with a knife and a fork. I won’t be doing that.
Did your diabetes diagnosis come as a surprise?
No, I knew I was going to get it sooner or later, because it runs in my family. My parents were both diagnosed with type 2 in their early 60s. Each of them had one parent with diabetes, too. My doctor tested me every year, faithfully, and then one day he said to me, ‘You have it, I’m sorry.’ That was 13 years ago when I was 69 years old. I was then put on metformin as well as daily insulin injections. The diagnosis didn’t worry me because I felt well and I knew if I looked after myself I would be alright. I never worry about things. What will be, will be.
How much did your diagnosis change your lifestyle?
I saw a dietitian who told me to eat lots of carbs, vegetables and fruit, which wasn’t a big adjustment. Exercise wasn’t a problem, either. I was already very fit. I walked every day for at least an hour and went to the gym twice a week. In summer, I swam for an hour every day and did water aerobics twice a week.
Do you still enjoy exercise now?
I love walking. I go for a walk every day for about half an hour. If it is shockingly hot in the summer, I go early in the morning or late in the afternoon. When I need to go to the bank or down town, I leave my car at home and walk. Sometimes, I forget that I’m walking and go shopping and have to carry my groceries home!
I’m 82, but my mind says, ‘No you’re not.’ I feel young and so I do things. That’s why I have a sore knee now. I’ve been enjoying repotting some plants and mulching my garden. My doctor said, ‘No more gardening!’ That’s okay, because it’s all finished now.