Today, not tomorrow 16 June 2023 Group education programs for people living with diabetes are fantastic tools for improving an understanding of the best ways to look after health, but occasionally they offer an even more profound learning opportunity. Linda Uhr, Accredited Practising Dietitian and Diabetes Educator, shares the story of Graham, who experienced a “penny drop” moment during a FootSmart© program in South-Western Sydney. A participant shared a deeply personal story about his long journey with type 2 diabetes. The condition had caused neuropathy (a loss of sensation) in his feet and this meant giving up on the activities in his life that brought him joy and normality. He was genuinely scared about what the future held for him. As a facilitator this is always a tough moment. I remember looking around the room and seeing many of the group like me, welling up and lost for the right words to say. After a moment of silence Graham, another member of the group, spoke up in a sincere and respectful way. Although his exact words evade me now, he essentially said how this moment – right now – was his wake-up call. “Mate, I think I am you… but maybe 10 years earlier,” he said. This was a penny drop moment; so sudden and so clear that no one in the room could ignore it. As a health professional, passionate about prevention and early intervention, I was blown away by Graham’s words. They seemed far more powerful and meaningful than my own. Behaviour change research shows that people have a far greater tendency to listen to someone they identify with. With this in mind, Graham has kindly agreed to share his experience of pre-diabetes, diabetes and how early action is key. Graham’s story Graham spent 16 years in the Australian Army, worked as a commercial diver, a professional driver, an office worker and a senior manager. He was diagnosed with diabetes eight years ago and was told he needed to make changes. “But men are stubborn!” says Graham. “I’m a man – I thought I was 10-foot-tall and bullet proof and that I’d just deal with it when it became a problem. I thought I could just get it fixed. But what did I know? “I’ve had more than my share of stress. All wonderful environments to learn bad habits in, and now it’s become a problem. “What I have to change now has been pretty overwhelming and I am at the point that I really don’t have a choice. Why? Because I didn’t act on what I was told back then. “Diabetes is a silent issue but it’s not taboo, it needs a voice. Had I looked into it earlier, I honestly believe my eyes would have been opened. The gentleman that was sitting to my left with foot issues presented an extremely powerful symbol to me. I felt for him, but also I wanted to do whatever I could do to not be in that position.” Insulin resistance: The warning light Insulin resistance is fancy terminology for describing the warning light that comes on to alert you that changes are happening in your body and that something needs to be done. When you are healthy, you can process carbohydrates easily. They get eaten, digested into glucose and enter the bloodstream to make its way to all the cells in your body that require it for energy. The pancreas detects glucose in the bloodstream and releases a hormone called insulin to allow the ‘lock’ on your cell doors to be opened. This is often why insulin is described as a key. Insulin resistance refers to those locks becoming rusted and making it more difficult for the glucose to enter your cells. You can be living with insulin resistance for many years, with no knowledge that anything is wrong. As Graham said, it can be silent. Over time insulin resistance means your pancreas needs to work really hard. You may start to notice symptoms and be diagnosed with either pre-diabetes or type 2 diabetes. If left untreated you leave yourself open to the serious complications of diabetes. Reducing the risk of diabetes complications We know it’s tough to be given a diagnosis of pre-diabetes or type 2 diabetes, but it is a huge opportunity to address things early on. “If you act early, the changes you need to make are small and you will barely notice them,” says Graham. “But the longer you let it go, the bigger the changes need to be. Visit your GP, health professional or diabetes specialist and ask what could happen if you don’t act now. Ask your mates if any of them have diabetes. I guarantee there will be more out there than you think, and they will tell you the same. Go to a specialist and listen to what they say, then act on it.” Although insulin resistance and type 2 diabetes has a genetic component, along with other factors you can’t change, there are some things you might be able to address. Unfortunately, as we age we simply cannot continue to live a life full of extremes, at least not without consequences. Think about your diet, exercise, reducing stress and sleeping well. These are all things that can act as the WD40 to help reduce the rusting. In other words, they help reduce insulin resistance. You have the power, especially in the early stages, of significantly reducing your risk of diabetes complications in the future. You could even potentially turn things around. “Good luck, but if you make changes now, as early as possible, you won’t need luck. There is an incredible support structure out there, tap into it and listen!” says Graham.