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.