Don’t you just love those before and after photographs? Mr Fat Bastard swaps his best friend, the pizza, for little cubes of steamed tofu … and voila! A down-sizing of underpants so dramatic, he’s now singing soprano.

I’m always a little squeamish when I see such photographs. I’m a little disappointed.

When the skinny version, Mr After, takes a bow, just for the sake of showing that he can touch his toes, I tend to think: Jesus, this is the greatest achievement of your life? I reckon thinking that way is a mistake. We’ll get back to that.

Happy World Diabetes Day by the way.

There’s 1.7 million Australians with diabetes – and from what I can tell, too many of them think they’ve got it beat because they dutifully take their medication. And maybe eat a few more peas. Such people are fools.

The sad last days of Mr Fat Bastard

In August last year, I was diagnosed with Type 2 diabetes.

As it usually goes with journalists who suddenly face a serious life challenge, I wrote a story about my experience. You can read it here.

The short version: bread, noodles and pasta were the loves of my life. I also had a romance going with chorizo sausages. Together, we made a beautiful bowling-ball belly topped with overly inflated facial features.

However, I was pretty fit. I was going to the gym for up to two hours a day, most of that on the cross trainer, with some weights thrown in. This gave me a healthier appetite in that I was hungrier than ever and was able to increase my daily ration of Vegemite and toast.

Anyway, the legs and arms were shaping up, but the belly prospered. And then one day it started disappearing. A lot of weight was very quickly gone. Of course I worried that I had cancer.

But I was also desperately thirsty all the time. I thought this was because I was losing so much sweat, working out. I drank litres of water. The thirst was like some fairy tale curse. Nothing touched it.

I understood this to be a symptom of uncontrolled diabetes. I was so relieved that this proved to be the case. Better than cancer.

Let me take a moment

Dear reader, if you don’t have diabetes, and perhaps feel you’re immune to it, maybe go and read my original story. Whoever you are, get your blood-sugar levels measured.

Today’s story is for people who already have diabetes – and have so far failed to realise this is a long-haul situation. It’s a progressive disease. Or maybe you don’t give a rat’s.

So once again: Happy World Diabetes Day.

I don’t have it in my diary, by the way.

Optomerist Australia, an industry group, put out a press release “urging Australians living with diabetes to prioritise their eye health.”

Sixty per cent of Australians with type 2 diabetes “will develop some form of eye disease within 20 years of diagnosis, with Diabetic Retinopathy being the leading cause of blindness in working aged Australia.”

So you need to get your eyes checked. And your feet. And your blood.

Has COVID-19 left you overdue for a check-up?

Probably. I’m running late with my annual blood test. And way overdue in seeing a hematologist because of various complications. (Please: no flowers.)

Anyway. You have to keep on top of things.

A few days after I was first diagnosed, a theatre-nurse friend told me she’d just seen a woman getting her foot cut off.

With diabetes, you have to get your feet checked. Suddenly a podiatrist (a joke doctor, right?) is someone you’ll be visiting for the rest of your life. All that blood sugar: when it spikes, it ruins the peripheral blood vessels. Injure a toe, no localised blood flow: amputation.

This woman with the lost foot wasn’t able to reach her toes. My nurse friend had the job of preparing the woman for going home. She told me:

“The patient says to me, ‘Guess what I’m doing as soon as I get out of here. Hungry Jacks. I’m going to have Four Whoppers.’

“I said that I hoped she enjoyed them, because she’d soon be back, having her other foot cut off.”

How’s your mum doing?

When I first visited the hematologist, who was also an oncologist, he said there were plenty of patients presenting with diabetes, “and I’m saying, yeah, I know, and you’ve also got pancreatic cancer.”

He knew I worked as a science editor, and he was telling me this by way of saying how interesting his job was.

A 2016 paper found that up to 80 per cent of pancreatic cancer patients present with either new-onset type 2 diabetes or impaired glucose tolerance at the time of diagnosis.

One day I was talking to a woman on the phone, a stranger really, maybe from the water company: I can’t remember who it was (diabetes increases the risk of dementia) but she said her mother had diabetes.

I asked how she was going. She was 83 years old and doing okay except for the pancreatic cancer, she’d had it for two years – slow growing because she was old.

What kind of shape was she in?

Short answer: fat as hell. More to the point: not fit. Hers was a life ticking over.

The big blue ribbon of life

It’s always seemed perverse to me that losing a ton of weight could be your gold medal moment in life. Your greatest triumph.

And I’m morally obliged to say here that not everybody can lose weight and gain fitness with a  ‘lifestyle’ change. Some folk, generally those who are morbidly obese, need surgery. Such people are in a tough spot.

Otherwise, pull your finger out. Get advice on diet and exercise. And stick to it as best you can.

The bowling ball has gone to God, as far as I can tell. Through the lockdown, when I couldn’t get to the gym, I walked at least 10 kilometres a day. After I had a bad fall in the street, heavily bruising my chest wall, about eight weeks ago, I started walking again after a couple of days.

I could only manage three or four kilometres at first. The chest and shoulder hurt. I’m back to those 10 kilometres a day. And I’ll tell you why.

Because I still compromise my diet too much with carbs. Because sometimes I forget and will have a lousy can of tomato soup that’s full of sugar. Because sometimes the blood sugar plunges (I carry jelly beans wherever I go) and I start to feel sick and to sweat. Because it’s a pain in the arse.

This isn’t a Rocky X story. All I’m saying is, I’m very aware that I have to keep on top of diabetes. I have all these other things I want to do. Big dreams in my small world. Things to achieve. That’s where my striving is. I don’t ever want to think that making an effort to stay alive was my greatest moment.

John Elder is The New Daily‘s science editor and the host of What Does That Mean? podcast. You can follow him on Twitter here.