The best-selling crime writer Peter James has invited Diabetes.co.uk to tea. His Swedish partner Helen has prepared a really sweet cake. But surely people with diabetes can’t eat sweet cakes? Or can they?
And what about exercise? James spends hours every day slaving over his Apple Mac as he dreams up new adventures for the Brighton-based hero of his best-selling series of thrillers – Det. Superintendent Roy Grace. Sedentary lifestyle? Yes and no. In between the long and lonely hours at his keyboard, James goes for a daily jog in the hills near Lewes, and plays tennis at least twice a week in the summer.
“Running is especially energising for me as a writer sitting motionless for much of my work day, and keeping fit is crucial for diabetics”, he says.
James eats sparingly for reasons which become apparent when you learn that he has Type 2 diabetes He is healthy because he has to be. “If you’re sensible, Type 2 diabetes is actually good for you” he says, with a touch of good-humoured irony. “You’re stuck with it. At the moment there’s no medical research that will enable you to get rid of it. There’s continuing work on it, which includes pancreas transplants, stuff like that, and I think eventually it will be possible to cure it, but probably not in my lifetime? So as far as I’m concerned keeping it under control forces me to have a healthy lifestyle.
“The big advantage of being a diabetic is that the more popular a disease you have, the more money is thrown at it. You don’t want to have a disease that only 50 odd people have because there’s no money in it for the pharmaceutical industry – so no research. There are over two million diabetics in the UK alone.”
“Popular” or not, it was quite a shock for James when he was diagnosed soon after his 50th birthday. “I think the big shock was the realisation that you’re not immortal” he says. “But I am of course! As Woody Allen said: ‘I don’t want to live on through my work – I want to live on in my apartment!’ But joking apart, it was a massive shock to discover I had a life-threatening disease. My first reaction was absolute fear. The second was that my days as a chocoholic (I was addicted to Maltesers) were over! Then when Sir Steve Redgrave won his gold medals at the Olympics, as a diabetic, it made me realise being diabetic didn’t really need to affect my life in any way whatsoever.
Peter James, fruitbat.
“OK, I eat a little less fruit than I used to – friends at school used to call me ‘fruitbat’ because I used to mix 10 bits of fruit in a blender. I was a bit of a health fanatic back then and that was enhanced by living for a while in Canada. An uncle of mine emigrated to Canada and became Chief Scientific Adviser to Pierre Trudeau and the Canadian government, and he got into nutrition and fitness. And he’s a pretty good living example: he’s 90 years old, plays tennis twice a week and is still very active mentally.
“The Canadians were into all kinds of healthy stuff long before the Brits, like low cholesterol spreads rather than butter – that kind of thing. I went out there when I was 22 and got quite into that. (I’d been a good athlete at school in spite of discovering poker and smoking!)
But other than skiing I did no regular exercise until I was 35, and embroiled in a tough corporate lawsuit. At night I was kept awake by blinding headaches and frequent pins and needles. After seeing a TV programme on stress, I began jogging every morning. By the third day of running all my symptoms had gone. I started running every day – literally every day. I still do, anything from two to five miles a day. And I play tennis quite a bit to keep fit, too. So I thought ’why have I got diabetes?’
“One known reason for the rise in number of people with diabetes is increasing obesity and lack of exercising. But I think that stress is another. It is established that stress can be the trigger for a number of diseases – and I don’t think it is coincidence that I was diagnosed with diabetes in the immediate aftermath of my divorce. I was married to Georgina for 19 years. Our breaking up was a nightmare in which I was torn apart by the sheer magnitude of what divorce really entails. I ended up first in therapy, then in London’s Cromwell Clinic with a nervous breakdown. It was absolutely the worst period of my life. I’ve always been in charge of my destiny, so it was terrible to suddenly feel out of control. We finally divorced in September 1998. In January 1999 I was diagnosed with Type 2 diabetes.
“It was discovered by my GP when I went for a check-up. Yet I’d had no symptoms at all – so no thirst or frequently needing to pee, no blurred vision as a result of dry eyes, no tiredness. Many people don’t have any symptoms. This is why it’s called the Silent Killer.
“But diabetes also runs in the family. The gene runs in my family and as a child I had seen the effects on my grandfather who was Type 1. He had it really badly in the days when it was hard to treat. He used to bring this bizarre injecting equipment with him with horrible big needles when he visited. Later he lost his leg and went blind from it. That was a big lesson to me. As well, my mother had Type 2, but she controlled it carefully and lived until she was 83, untouched by it.
“In fact, I now realize I was incredibly lucky that I got diagnosed when I was aged 50. With no symptoms, many people don’t get diagnosed until they’re much older, so I could have been 75 with all the damage that 25 years of untreated diabetes had inflicted.
“Until the discovery of insulin at the University of Toronto in 1922 (you see, once again Canada was at the forefront), if you were diagnosed with Type 1 you had a life expectancy of about two years. Type 2, which I have, is called ‘late onset’, and you tend not to get it until mid-life.
“I like to think that by being open about my diabetes I can help other people. I get really angry when friends of mine – people I care about – ignore their diabetes, and risk their health deteriorating. One good mate, the same age has men, has just had a toe amputated. I’m just astonished to see what some diabetics eat and their lack of exercise.
“If you have uncontrolled diabetes, you’re up to five times more likely to suffer heart disease, stroke, foot infections due to nerve damage, and an eye condition called retinopathy which can cause blindness.
I had another very close friend, a smoker, who was exactly the same age is me – even the same birthday – who completely ignored it. He died two years ago.
“Mercifully the treatment is much better now than in my grandfather’s day. I nailed it right from the start. I learned everything I could possibly learn about it and tried every alternative. I was probably in denial at first, but only for a couple of days. Then I thought – actually, how do we deal with it. And I realised that if you control it, it’s the same as not having it. I’ve had a couple of medicals when doctors haven’t even noticed I have it. The signs would be high blood sugar , and that’s what you have to control.
“The difference between us is that if you binge on that Swedish cake we’re having this afternoon you’ll be alright, but my blood sugar would go through the roof. Two hours later, if you had a blood test your blood sugar would be somewhere between 4.7 and 7. The blood glucose of a person with diabetes could be anything from 9 or 10 up to 30+.
Looking after yourself
“That’s what has to be controlled. Diabetes makes you look after yourself because I don’t have the option of not looking after myself. So you keep your weight down and eat healthily. Exercise is the best as it stimulates the pancreas. When it comes to blood glucose meters I use a OneTouch UltraEasy and test every morning, first thing, two hours after breakfast, before lunch, two hours after lunch, before evening meal, before bed and during the night, if I wake up.
“I always carry glucose tablets. Eating regularly is vital for keeping a balanced sugar level so I need to plan ahead. For my research, I regularly go out on patrol with the Police, and there are times when they are following a villain and I can hardly say, ‘Hey, let’s stop because I need my lunch!’
“Five years ago I switched from control by tablets to injecting as well and life has become much easier. I take one 24 hour injection in the morning and a smaller dose with each meal. If I want to have a sinful treat I can, and just up the dosage. It’s brilliant! In fact, I’ve got really good at it. I can surreptitiously jab myself under a napkin while out at a restaurant. Just like with some of the criminal characters in my novels, nobody would suspect a thing.
My life expectancy is normal – I should get to at least 1000. Which I am planning to do!” Just think how many Roy Grace novels Peter will have time to write in the next 940 years!
Peter James’s novella, “The Perfect Murder” has recently been published by Pan MacMillan on March 4, and his new Roy Grace novel, “Dead Like You” will be out on June 2nd.