Mariko Horigome, a writer, teacher and businesswoman based in Sydney, lives with type 3c diabetes. This more recently discovered form of diabetes can arise after inflammation or illness within the pancreas.

Her diabetes developed following the discovery of a tumour and subsequent removal of her pancreas. Now, five years later, Mariko tells the story of her diagnosis.

“I was out for a meeting, and I decided to get the bus home. And, you know, the bus driver was so rough, I was getting thrown around to the point that I threw up and couldn’t move.

“So the next day I went to the doctor for a check-up, and I was given some painkillers that I just couldn’t keep down. After that, the doctor wanted to check my abdominal area, even though I hadn’t been hurt there.

“And they found something strange, I had a cancer in the pancreas. Really I have to thank this rough driver, who without I wouldn’t have found the cancer.

Following on from that fateful bus ride, Mariko’s life has been a series of gentle adjustments to her body’s new requirements. Exercise and live fermented whole foods are regular parts of her day, along with a healthy dose of positivity.

“I get up, I deal with my blood glucose. And then – you know, I never cooked in my life – but after my operation I started to be more conscious with what I’m eating.

“I cook simple things. I make Japanese pickles, with okra, cucumber, carrots, radish and koji. I eat that with white rice, nori and natto (fermented soybeans). And miso soup, which I put any kind of vegetables and seaweed in.

“For five years, I’ve been having that. It could be the key to my survival, I don’t know.

“When I’m bored of Japanese food I’ll make a typical Aussie lunch, a crumpet with Vegemite and cheese.

“Usually I go for a walk in the afternoon with Sally the labradoodle – she’s always pushing me out to walk, and that helps me.

“Of course, all the while, I deal with my blood glucose levels. It’s not always easy to deal with, but I have to do it.”

Mariko maintains a strong linkage to Japan and likes to return regularly. Her experience of the different healthcare systems provides a fascinating window into diabetes care across the world.

The one, crucial constant, is the high level of care she has received from the practitioners she has encountered.

“I’ve been looked after well by both Japanese and Australian doctors. Australia has a very good system, and the Freestyle Libre is a great invention: the sensor is lifechanging. I am the luckiest person, really, I feel like the luckiest person in the world.

Living with a niche form of diabetes can mean that forming community connections with people who share that experience can be challenging, Mariko admits.

“My type of diabetes, and my type of cancer, is rare. I’ve never met someone in real life who has had the same experience. But I did become friends, via Twitter, with a Japanese gentleman who also lived without his pancreas.

“Someone else is Yoshi Majima, the head of PanCAN Japan. Two members of his family had pancreatic cancer, and he himself has had it. We became friends, because I really respect him and what he’s doing.”

Mariko’s beautiful, bubbly energy is delightful. Combined with a pragmatic, practical outlook to what her body needs, she looks at each day as an opportunity for quiet triumph.

“People ask me how can I live without pancreas? But I am living. This is what I have to do, for my life.

“Every day I make sure I dance, I sing, I listen to music and I talk.

“I was talking to my friend who lives in Queensland, she’s been terribly flooded. I asked her if she was okay and she said, “I am okay, I’m dealing with it.”

“And then she said, “Mariko, are you okay?”, and I said, “Yeah, I’m okay, I’m dealing with it!”

“Having kind, encouraging words around you is more important than anything else.”