The Happy Pod: Diabetes Awareness Month special

Summary

Global News Podcast: The Happy Pod – Diabetes Awareness Month Special (Nov 29, 2025)

Episode Overview

This edition of BBC World Service’s "The Happy Pod" is a Diabetes Awareness Month special, co-hosted by Harry Bly and Alex Ritson—both living with Type 1 diabetes themselves. The episode weaves together personal stories, advocacy, medical innovation, and global efforts to raise diabetes awareness and improve education, community, and care. Instead of focusing solely on challenges, the episode celebrates advancements, empowering narratives, and hope for the future.

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Key Discussion Points and Insights

1. Understanding Diabetes (02:04)

• Diabetes Defined: “It’s a range of conditions where there’s essentially too much sugar in your bloodstream.”
  — Alex Ritson [02:04]
• Types Explained: Type 1 (autoimmune, unknown cause), Type 2 (lifestyle-related, with additional risk factors), Gestational, and rarer types.
• Misconceptions & Risks: Symptoms of low blood sugar can be mistaken for drunkenness; fear of lows sometimes leads people to tolerate unhealthily high sugars, risking organ failure and blindness.

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2. Stories of Innovation, Advocacy, and Education

a) Lea Leleta Suma and the Power of Representation (Bosnia) [04:00–09:08]

• Background: Lea wrote a children’s book, “Leia and Her Diabetes,” to help newly diagnosed children in Bosnia understand and accept their condition.
• Motivation: “There were no such resources for children in Bosnia...that was the initial push or spark for me.”
  — Lea Leleta Suma [05:29]
• Impact: Children use the book to educate classmates; parents report it helps their kids open up about diabetes.
  “Through this project, I also healed little me because I didn’t know many people with diabetes growing up.”
  — Lea Leleta Suma [08:13]
• Memorable Excerpt:
  “I asked my sisters, Irina and Anida, why they don’t have to do these things. They told me that I am special, so I have to do some special things. They also told me that my injections are actually magical and others don't get to have these magical injections.”
  — Narrator [07:37]

b) A Barbie Doll with Type 1 Diabetes: Mainstream Representation at Play [09:45–14:25]

• Emily Mazreku’s Story: As both a person with diabetes and a representative from Breakthrough T1D, Emily helped design a Barbie doll with insulin tech.
• Visibility Message: “We see you. This collaboration is a shared commitment to make sure that the millions of people with type 1 diabetes are seen, heard, and empowered.”
  — Emily Mazreku [11:22]
• Personal Touch: Barbie’s CGM phone display is based on Emily’s own glucose monitor readouts.
• Impact on Children:
  “It’s a Barbie and it has a pump like me. And a sensor on the arm there. I really like it... I’ve always wanted a doll that looks exactly like me, and I’m sure other kids have too.”
  — Children’s reactions [13:36]
• Emotional Response: “No words. Absolutely no words...I’m tearing up because that’s the feeling that we knew it would mean so much...”
  — Emily Mazreku [13:50]

c) Sally Tiem: Drag, Art, and Diabetes Advocacy [15:11–19:16]

• Profile: Drag artist and “RuPaul’s Drag Race UK” competitor Sally Tiem (diagnosed at age 10) openly discusses diabetes complications and stigmas.
• Acceptance and Ownership:
  “I’m not surviving with diabetes. I’m living with diabetes. It’s not holding me down as an individual.”
  — Sally Tiem [16:05]
• Performance Challenges: “You could be the peak top athlete, but...a hypo could easily take you out of it.” [17:21]
• Art as Advocacy: Incorporates diabetic experiences into her outfits, e.g., dress printed with her retinal scans.
• Battling Stigma: “People are so misinformed and often make jokes about it—to the point where it’s like, please read a book or some form of information...” [18:39]
• Loneliness and Connection: “I remember being a child and literally feeling so alone because no one around me had diabetes.” [18:39]

d) Personal Stories from the Hosts [19:17–20:17]

• Low Blood Sugar on Air: Alex recalls experiencing hypoglycemia live on the BBC World Service—an event later used for global medical education.
  “I went from fully sensible to incoherent in less than a minute...that tape is used by doctors all over the world.”
  — Alex Ritson [19:36]

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3. Global Progress: Screening and Policy

a) Italy’s Nationwide Type 1 Diabetes Screening [23:21–26:30]

• Interview with Prof. Emmanuel Bozzi:
  • Screening detects pre-clinical autoantibodies, allowing early education and intervention.
  • “If type 1 diabetes is not treated by insulin, it’s a lethal disease. There is still a residual mortality...because type 1 diabetes is not recognized.”
    — Professor Bozzi [24:16]
  • Economic perspective: up-front costs outweighed by reduced hospitalizations and complications. “In the long term, certainly...invariably require hospitalization and sometimes even intensive care.”
    — Professor Bozzi [26:19]
• Key Symptom Reminder: “If ever someone in your life complains of an unquenchable thirst, it could well be diabetes. Get them to go to the doctor right away.”
  — Alex Ritson [26:30]

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4. Celebrating Achievement and Changing Perceptions

a) Breaking Records: Nathan Kilcorse’s Marathon [26:57–30:08]

• Nathan Kilcorse: British teacher sets Guinness World Record for fastest marathon by a male with Type 1 diabetes (2:28:05).
  • “It was tough...I had to run pretty much the whole marathon on high blood sugar levels.”
    — Nathan Kilcorse [28:58]
  • Raised over $2,600 for Diabetes UK; impact extends to students and charity.

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5. Technology, Hope, and the Road Ahead

a) Personal Experiences with Tech [30:34–31:40]

• Advances: Hybrid closed-loop insulin systems, continuous glucose monitoring, and automated insulin delivery transforming lives.
• Challenges: Adapting to trust the technology; desire for access everywhere.
• Hope: “Reducing the constant decision making would make such a difference.”
  — Emily Mazreku [31:35]

b) Expert Perspective: Professor Partha Carr [32:14–36:11]

• Tech Evolution:
  • Automated sensors and pumps now handle most daily tasks.
  • Driven by the principle: “If any of my loved ones had Type 1 diabetes, this is what I would want them to be on. And if that’s what I want for my loved one, it’s my job to get it to you.”
    — Prof. Partha Carr [34:10]
• Access and Equity: Global charities and advocacy are key; worldwide expansion is optimistic but ongoing.
• What’s Next?: Smaller, more accurate sensors; early detection via immunotherapy; cautious optimism for a cure.

c) Diabetes in Art: Sarah Warren’s Musical Work [36:11–36:48]

• Creative Reflection: Sarah Warren, living with diabetes, turns glucose readings and pump sounds into music.
• Hosts’ Reactions: They find it relatable and moving—a unique “soundtrack of reality.”

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Notable Quotes & Memorable Moments

• “Through this project, I also healed little me because I didn’t know many people with diabetes growing up.”
  — Lea Leleta Suma [08:13]
• “When I look at that doll, I see me. I see my daily burdens, from mental to physical...I see that newly diagnosed 22-year-old, not sure where she would go in life and what this condition would mean for her life. I see that person and I see, wow, look at all of the things that we can do, look at all of the things we’ve done.”
  — Emily Mazreku [12:44]
• “I’m not surviving with diabetes. I’m living with diabetes. It’s not holding me down as an individual.”
  — Sally Tiem [16:05]
• “I went from fully sensible to incoherent in less than a minute...that tape is used by doctors all over the world.”
  — Alex Ritson [19:36]
• “If ever someone in your life complains of an unquenchable thirst, it could well be diabetes. Get them to go to the doctor right away.”
  — Alex Ritson [26:30]
• “If any of my loved ones had Type 1 diabetes, this is what I would want them to be on. And if that’s what I want for my loved one, it’s my job to get it to you.”
  — Professor Partha Carr [34:10]

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Timestamps for Important Segments

• [02:04] – What is diabetes?
• [04:00–09:08] – Lea Leleta Suma: Children’s Book and Bosnian Advocacy
• [09:45–14:25] – Barbie with Type 1 Diabetes: Emily Mazreku and Representation
• [15:11–19:16] – Sally Tiem: Drag Performance, Disability Advocacy, and Stigma
• [19:17–20:17] – Alex Ritson’s On-Air Hypoglycemia
• [23:21–26:30] – Italy’s Nationwide Screening: Prof. Emmanuel Bozzi
• [26:57–30:08] – Nathan Kilcorse: Guinness World Record Marathon
• [30:34–31:40] – Wearable Tech and Patient Hopes
• [32:14–36:11] – Prof. Partha Carr: Tech Progress and Future Horizons
• [36:11–36:48] – Diabetes in Art: Sarah Warren’s Music

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Tone and Final Impressions

The episode feels open, supportive, and hopeful—balancing candid, sometimes tough realities with stories of empowerment and progress. The hosts and guests are witty, direct, and compassionate, contributing to a lively and deeply human conversation. This special is a testament to the power of representation, evolving technology, dedicated advocacy, and global community—making it uplifting and illuminating for those living with diabetes, their loved ones, and anyone interested in public health progress.

Transcript

[Alex Ritson]

This BBC podcast is supported by ads outside the UK.

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[Harry Bly]

Hello and welcome to a slightly different happy pod from the BBC World Service. I'm Harry Bly.

[Alex Ritson]

And I'm Alex Ritson. In this edition, we're marking Diabetes Awareness Month, highlighting stories about innovation, advocacy and education. Like Leah, whose children's book has helped children come to terms with diagnosis.

[Harry Bly]

The woman who Inspired a type 1 diabetic Barbie doll, how one drag queen.

[Alex Ritson]

Here in the UK is using her platform to raise awareness of diabetes.

[Harry Bly]

Plus Italy, which has become the first country to implement a nationwide type 1 diabetes screening program. But before we get started, let's talk about what diabetes actually is.

[Alex Ritson]

It's a range of conditions where there's essentially too much sugar in your bloodstream.

[Harry Bly]

It's estimated more than 9 million people around the world have type 1 diabetes, including me and Alex.

[Alex Ritson]

But there are others type 2. And the differences are essentially, type 1 is an autoimmune condition we don't yet know. Doctors don't yet know what causes type 1 diabetes. And then there's type 2, which is more lifestyle related. There are other factors such as age, family history and ethnicity. And then a couple of rarer sorts. Gestational people have it during pregnancy and other forms that develop during adulthood. And it's a condition that has many misconceptions. The symptoms of a low blood sugar attack are similar to drunkenness, and many a young person has suffered badly or even died because of that and with pressure to avoid those low sugar attacks, many people allow their sugars to run high, but high sugars over time cause organ failure and make you go blind.

[Harry Bly]

As we'll hear in our first story, the most common treatment and the way many begin treating their diabetes is using a blood glucose meter and a finger pricker to test their levels and a pre filled insulin pen to deliver insulin to the body to keep blood sugars stable. Now, an increasing number of people, including us, use a patch usually worn on the upper arm or leg that continuously measures sugar levels and an insulin pump which delivers a steady supply of insulin to the body, mimicking a natural pancreas. So let's start. In Bosnia and Herzegovina, a final year university project that's gone on to help children newly diagnosed with type 1 diabetes come to terms with their condition as well as educate others about it. And it all started with a chance encounter. It was in September 2024 when Lea Leleta Summa received this unexpected text message.

[Lea Leleta Suma]

From a I. I got a message from Jay, who I've met at one of the idf, the International Diabetes Federation Europe scams for people with type 1 diabetes. And he just sends me this screenshot that Harry posted being saying like, hey, I'm on vacation in Sarajevo and I need a new sensor. And he just sent me the screenshot and he's like, do you have a spare sensor? Can you help out? And I was like, oh yeah, sure.

[Harry Bly]

This Harry, who was travelling there and needed a glucose monitoring sensor was me.

[Lea Leleta Suma]

I can imagine what kind of shock it must have been to be somewhere on vacation, especially in a country like Bosnia where we don't have all of these things.

[Harry Bly]

In Bosnia and Herzegovina, there is limited availability of CGM sensors that people with diabetes use to monitor their blood glucose.

[Lea Leleta Suma]

In Sarajevo, we can get the bare minimum. Whenever I needed sensors, I would turn on the car and I would drive to Croatia. And not only me, so that's most of the people that live here with type one.

[Harry Bly]

Luckily, Lea did have a spare sensor for me. And it was at this meeting late one evening in Sarajevo's Old Town, that I met Lea in person and learnt about the children's book she had written as a university student two years prior. Lea was diagnosed with type 1 diabetes when she was two years old and lived in the Netherlands. There she had been given books which helped her better understand her condition. But when researching for her own project, she found there were no such resources for children in Bosnia.

[Lea Leleta Suma]

That was kind of the initial push or spark for me to create something to help mostly children out there to understand, okay, this is what I have to live with and I'm not alone.

[Harry Bly]

Her book, Leia and Her diabetes is based on her own life, written in the first person, where the main character, Leia, talks about being diagnosed. Here's an extract from the book.

[Narrator/Reader]

I found out I had diabetes when I went to the doctor with my mum and dad. She pricked my finger with a special needle. I thought it was very scary and I felt afraid. But don't worry, it doesn't hurt. The doctor put a drop of blood in a little device to see if I was okay. This is called measuring the blood sugar and that's how I see if I'm okay. Most of the time I am, but if I'm not okay, my mum gives me a different injection in my leg and then I feel great again.

[Harry Bly]

The book also talks about what diabetes is in a way that children can understand and aims to combat the stigma associated with having it. Ask anyone who has diabetes, especially as a child. Coming to terms with a condition like this is hard, and so is being open with those around you. This is an important message Leah wanted to convey in her book.

[Lea Leleta Suma]

There's one illustration when my friend is sitting across me and she's like, hey, you don't look quite well. Maybe you should check your blood sugar. Which immediately lets everyone who reads the book know that I was talking with my friends about it. So they knew. And that is a very, very important aspect. Especially here in the Balkans, and definitely in Bosnia, there's still this stigma about diabetes and that children shouldn't talk about it. Not only children, but generally adults kind of hiding the fact that they have diabetes.

[Harry Bly]

You do open up about some other hardships about feeling upset about having diabetes.

[Lea Leleta Suma]

I really wanted to include it because it is, for me, it is crucial to mention, yes, I did feel sad. Yes, I did cry. I mean, till today, you know, I have moments when I'm like, why me?

[Narrator/Reader]

I don't understand why I have to do these things when most other children don't. I asked my sisters, Irina and Anida, why they don't have to do these things. They told me that I am special, so I have to do some special things. They also told me that my injections are actually magical and others don't get to have these magical injections.

[Lea Leleta Suma]

To the little Leia in the book, when I was six, for me, that was so cool.

[Harry Bly]

Tell me about some of the reaction you've had. You've travelled around Bosnia and you've shared this book with children, with parents, also children without diabetes.

[Lea Leleta Suma]

They're looking at the book and they're like, is this you? And I'm like, yes.

[Professor Partha Carr]

Really?

[Lea Leleta Suma]

And I'm like, yeah. And then they start. I mean, of course they start asking everything and how is it in school? And do you drive a car and do you. Do you travel and do you do this? And then all, you know how children are. And they really kind of were hugging the book as. As if it was representing them. And that was my goal. Most of these children didn't talk about diabetes. They didn't tell their friends. I would get messages from parents and I keep them still who tell me, thank you, thank you. Because my daughter or my son, they went to school with your book. They asked their teacher, hey, could I get 20 minutes to talk about something? And then they would read the book and in the end they would say, I have this too. Every message, believe me, I was crying because through this project, I also healed little me because I didn't know many people with diabetes growing up.

[Harry Bly]

Leah Laleta Suma talking about her book Lea and her diabetes.

[Alex Ritson]

And that is such a huge issue that I can relate to. Hate having an injection and you also. You don't want to be different. And of course, diabetes gets in the way of so many things, particularly in the old days, playing sports, it really hangs over. That makes it so much more difficult. So it's good work. This year, the toy manufacturer Mattel launched a Barbie doll with type 1 diabetes. One of the women behind the design was Emily Mazreku, who works for the international charity Breakthrough T1D.

[Harry Bly]

Emily says it was an honour to be part of the process and that the doll makes her feel seen as someone with diabetes who has the same wearable monitors. She's been speaking exclusively to Holly Gibbs and started by describing what Barbie with type 1 diabetes looks like.

[Emily Mazreku]

She wears an insulin pump right on her waist and that gives her insulin throughout the day as she needs it. She's carrying a purse with her continuous glucose monitor app on her phone and. And then you'll see that patch on her arm. And so that patch will allow those glucose levels to be seen on her phone for her to treat herself and make those decisions throughout the day that you need to do with type 1 diabetes. And she also has a purse, which is really cool. It was a moment where the community, as part of the process, said type 1 diabetes is 24. 7. It's a 24. 7 condition that never stops, and those supplies that she carries in her purse are representative of that.

[Narrator/Reader]

So you are Emily, the real woman behind Barbie with type 1 diabetes. Take us back to the beginning. Where did this idea come from?

[Emily Mazreku]

Mattel and Breakthrough T1D partnered together. Actually, Mattel approached Breakthrough T1D as the leader in the type 1 diabetes advocacy and research space to launch the first ever Barbie doll with type 1 diabetes. That was about two years ago now. A little over two years ago. And from that moment, it was just an incredible honor. It was an incredible moment for us at Breakthrough T1D because we knew just how much it would mean to the community.

[Narrator/Reader]

What is the one message that you want this Barbie to portray?

[Emily Mazreku]

We see you. So this collaboration is a shared commitment to make sure that the millions of people with type 1 diabetes are seen, heard and empowered with their condition. And so one message we would always want to put forth with this doll and always want to put forth with everything that we do is we see you.

[Narrator/Reader]

And Emily, how did you incorporate yourself and your own lived experience with this Barbie?

[Emily Mazreku]

I have lived with type 1 diabetes since the age of 22. I was diagnosed almost 10 years ago as an adult. So this experience was both a professional and personal honor for me. So as part of the design process, Mattel had asked as part of the design process for Barbie's continuous glucose monitor, her CG, what a day with type 1 diabetes can look like. What does it feel like? And I was having a day with type 1 diabetes where it can sometimes feel like a roller coaster on my continuous glucose monitor graph with my glucose levels. And I said, I think I have an example. And I took a screenshot of my phone and that screenshot ended up on Barbie's continuous glucose monitor app on her phone to just show the true lived experience and what it can feel like from day to day with this condition.

[Narrator/Reader]

That is so cool that Barbie is really personalized to you and your experience. How do you feel when you look at type 1 diabetes Barbie and see that?

[Emily Mazreku]

It's an incredible, indescribable, deep rooted, meaningful feeling. It's something that I will never, ever forget. When I look at that doll, I see me. I see my daily burdens from mental to physical. I see that newly diagnosed 22 year old, not sure where she would go in life and what she would do and what this condition would mean for her life. I see that person and I see, wow, look at all of the things that we can do, look at all of the things we've done.

[Narrator/Reader]

And we've seen and heard some really lovely reactions from little girls who have seen Barbie with diabetes. We actually have some of their reaction here that we can play you. It's a Barbie and it has a pump like me. And a sensor on the arm there.

[Lea Leleta Suma]

I really like it.

[Narrator/Reader]

She's so amazing. She can teach you a lot about your diabetes. I've always wanted a doll that looks exactly like me, and I'm sure other kids have too. Emily, how does it feel hearing that?

[Emily Mazreku]

No words. Absolutely no words. You really can't probably see me, but I'm tearing up because that's the feeling that we knew it would mean so much to everyone living with type 1 diabetes. And these kids being able to talk about their condition and feeling empowered enough to do it, thanks to Barbie, and feeling seen. There is no greater feeling than that. And we are so, so, so grateful that kids around the world are feeling this. Adults around the world are feeling this. People who are not even familiar with type 1 diabetes are seeing this. And it's an indescribable feeling.

[Harry Bly]

Emily Mazreku speaking to Holly Gibbs. And it's quite an achievement to have inspired a Barbie doll.

[Alex Ritson]

And that Barbie doll actually reminds me of another thing, which is that now we know who the other people with diabetes are. We see them around the office. In the old days, we all had to hide in corners we thought were on our own. You know, I even spotted a UK Prime Minister once with one of these things on her arm and realized she had diabetes because of that. So it has enabled that sense of community, I think, in a way that we never had before. Now we've heard what it's like to live with type 1 diabetes, but what's it like to perform with it? You might be familiar with the TV series RuPaul's Drag Race. It's a competition that takes place all over the world to find a country's best drag queen.

[Harry Bly]

Sally Tiem is a competitor from this year's UK version of the show. She was diagnosed with type 1 diabetes at the age of 10. Sally has talked publicly and candidly about experiencing complications with diabetes, including problems with her vision. Now age 27, she uses her art and her platform to advocate for young people living with the condition. I caught up with Sally TM and started by asking her what it was like to get her diagnosis.

[Sally Tiem]

You can't really plan for it and prepare for it. It's such a life changing thing for me. I think back then I was just like, whatever it was. Actually during more of my critical years where you have to have the responsibility. The thing that really snapped for me is when I said to myself, you've got this for the rest of your life. It was harrowing to think that, like, my diabetes was Going to be there for the rest of my life.

[Harry Bly]

Tell me about the process that you went through to finally accept diabetes, because it's something that we've been through. But what was that like for you?

[Sally Tiem]

It's sad to say, but it was when I started to get complications because of my errors with being frustrated by having diabetes. Within Covid, I think it was 2020, 2021, I was diagnosed with macular retinopathy. The nurse's words were, this could be reversible, but it's looking very unlikely. And the thing is, I'm an artist, and I produce art. I do drag. There's two things that you need to create. You need your hands, and you need your eyes. So for me not to be able to have my vision and share that vision with people scared me. So I just made sure that I was doing the correct things to assure that I was able to reverse what damage I've done to my body. I'm not surviving with diabetes. I'm living with diabetes. It's nothing that's kind of. It's not holding me down as an individual.

[Harry Bly]

Tell me about what it's like to perform with diabetes, because as anyone who's ever watched RuPaul's Drag Race will know, it's. It's physically very demanding.

[Sally Tiem]

I did have a hypo during that. Really? You could be the peak top athlete, but, you know, a hypo could easily take you out of it. It's being aware of, where am I going? What am I doing in the moment. I try not to make an excuse out of my diabetes for my skill set. I'm not gonna cower behind the fact that I've got diabetes.

[Harry Bly]

Sally, how have you incorporated diabetes and your. Your openness with being diabetic? How have you incorporated that into your art, into your drag?

[Sally Tiem]

Do you know what I find really interesting? It sounds so weird when I say it, but, like, I don't get my eyes screened. Like, I really do. Like, I really enjoy seeing what, like, I can't see, which is the small, tiny blood vessels in my eyes. I went to do a screening talk in drag, and for my outfit, I screen printed on fabric and created a dress. My retinal screening. I want to share my story and it to be from a very honest approach, I think, especially with drag race. Like, I try to be so authentically myself, and I wanted to be able to use my platform of drag to raise awareness.

[Harry Bly]

What inspires you to do that? To be an advocate and to raise awareness and also to, quite literally, the expression to wear on your sleeve.

[Sally Tiem]

You.

[Harry Bly]

You wore an outfit from a retinopathy screening.

[Sally Tiem]

People are so unaware of diabetes. I think we were talking about World Diabetes Day with Diabetes UK team and this year they decided to go with the idea of stigma. And it's still a massive campaign for stigma within diabetes. People are so misinformed and often make jokes about it to the point where it's like, please read a book or like read some form of information around diabetes. I remember being a child and literally feeling so alone because no one around me had diabetes. So yeah, like the thing that I want to inspire is just there's more people out there than you think that have got diabetes.

[Harry Bly]

Sally T.M.

[Alex Ritson]

And I can relate to that hypo experience. You may remember Harry ages ago. It's probably the thing I'm most known for. Infuriatingly, I had a low blood sugar attack actually on the air while doing a news program on the BBC World Service.

[Harry Bly]

Yeah, a really, really scary experience.

[Alex Ritson]

Yeah, it was horrible. And I came back after having had this low blood sugar attack later in the program, explained to the listener what happened and I did get lots of lovely messages from all over the world. The only plus side of that awful, awful morning, and it is one of the worst mornings of my life, is it shows just how quickly these things come on in audiophile in audio form. I went from fully sensible to incoherent in less than a minute. And that tape, I am told, is used by doctors all over the world when they're trying to explain to someone who hasn't been through these things what a low sugar attack actually is.

[Harry Bly]

And for both of us working in live broadcasting, it's something extra that we have to think about before we come into work and go on air and.

[Alex Ritson]

Many other professions too.

[Harry Bly]

Coming up in this podcast, we'll find out what the future could hold in technology, treatment and beyond.

[Professor Partha Carr]

There probably is a degree of cautious optimism from some of the studies coming out as to whether there finally could be that holy grail of the cure. So I think there's a lot of good work going on in this field.

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[Alex Ritson]

Now Italy has become the first country to implement a nationwide screening program. I spoke to Professor Emmanuel Bozzi, chief physician of Diabetes at the San Rafael Hospital Clinical Research Institute, who's pioneered the program.

[Professor Emmanuel Bozzi]

Type 1 diabetes has a long pre clinical period during which people are absolutely well. Blood glucose is normal, but there is a sort of incubation of the disease. It can last a few months or many, many years. This phase is characterized only by the presence in the blood of specific autoantibodies and by doing a screening, we are able to know with a lot of advanced months or years who will develop type 1 diabetes. By knowing that, we can educate the child or the adolescent and his or her family. If type 1 diabetes is not treated by insulin, it's a lethal disease and there is still a residual mortality, even in developed countries, of a child die because type 1 diabetes is not recognized.

[Alex Ritson]

Yeah. The classic symptoms that you go to your doctor with, where your parents are having to say to the doctor, my child is drinking and drinking and drinking all the time. Most doctors ought to spot that, though.

[Professor Emmanuel Bozzi]

Well, the doctors know, but sometimes they under evaluate, but in many cases it is that the family is not going to the doctor. They think that the child is drinking because he's drinking. So with no specific reason.

[Alex Ritson]

And it is a remarkable thing that you've achieved this, given all around the world there's such pressure on health budgets, but you've managed to convince the politicians that this really could make a difference.

[Professor Emmanuel Bozzi]

Yes, in my opinion, it is not very costly because, I mean, we are talking about procedures which are not expensive. Now there are studies which are trying to evaluate the cost benefit ratio because if on one side you spend some money to do the screening and to do the monitoring and follow up, on the other you have. If you have a dramatic onset of diabetes, possibly associated with diabetic ketoacidosis, they invariably require hospitalization and sometimes even in intensive care.

[Alex Ritson]

So you think that your program actually will save health services money? In the long term, yes, in the.

[Professor Emmanuel Bozzi]

Long term, certainly in the short, I don't know. But of course I'm a supporter of screening, so my opinion could be biased.

[Alex Ritson]

Professor Emmanuel Bozzi and if you take nothing else from this podcast, it's just that unquenchable thirst that I remember from before my own diagnosis. You're just so thirsty. And if ever someone in your life complains of an unquenchable thirst, it could well be diabetes. Do get them to go to the doctor right away. You could save their life.

[Harry Bly]

Absolutely. The three thirst, toilet thinness.

[Alex Ritson]

Here in the uk, a teacher has broken a world record by completing the fastest marathon by a male with type 1 diabetes. Nathan Kilcorse beat the record by two minutes when he completed the Yorkshire Marathon. In 2 hours, 28 minutes and 5.

[Harry Bly]

Seconds, Nathan managed to double his fundraising targets, achieving just over $2,600 for the charity Diabetes UK. The achievement has now been officially verified by Guinness World Records. He spoke about this achievement, the preparation and the aftermath with the BBC's Samaya Moogle.

[Narrator/Reader]

Did you manage to do it?

[Professor Partha Carr]

I did.

[Narrator/Reader]

Well done.

[Nathan Kilcorse]

Thank you.

[Narrator/Reader]

You're a Guinness World Record holder.

[Nathan Kilcorse]

Thank you.

[Narrator/Reader]

How does that feel?

[Nathan Kilcorse]

Yeah, amazing. Amazing. I managed to run 2 hours, 28 and 5 seconds, so just took over 2 minutes off the record.

[Narrator/Reader]

That's quite a lot. I mean, it doesn't sound like a lot, but it is a lot in running terms, isn't it?

[Nathan Kilcorse]

It is, yeah. Yeah. It wasn't as easy as that sounds. It's shaving the two minutes off. I had a really tough last couple of minutes to the race. Couple of miles. Sorry. To the race?

[Sally Tiem]

Yeah.

[Nathan Kilcorse]

Had to really dig deep to get to the finish line, but thankfully I was able to.

[Narrator/Reader]

And one of the things we were talking about and the significance of this was you were talking about your experience of living with type 1 diabetes. And I remember you saying, you just don't know what your body's going to be like on the day. And there's things you can control in terms of your training, but when you're living with diabetes, there's things that you can't. How was it on the day?

[Nathan Kilcorse]

Yeah, really tough. On the morning of the race, I had really high blood sugar levels. I think that was due to the stress and the anxiety of getting ready to run a marathon very close to the start of the race. I couldn't really make any adjustments to that, so I just had to get into the race and go. My usual race strategy, I'd have three or four gels throughout the marathon. I had none on the day, and I think that also impacted on why those last few miles was. Was so tough.

[Narrator/Reader]

Why didn't you have any gels?

[Nathan Kilcorse]

Just because it would have sent my blood sugar levels even higher than where they were at. So I had to run pretty much the whole marathon on high blood sugar levels. So, yeah, it was tough, but thankfully I was able to, like, say, dig deep.

[Narrator/Reader]

And how you. How's everybody feeling now?

[Nathan Kilcorse]

Okay. Yeah. Okay. The following day, I was really, really sore, as you can imagine. But the past few days have been a lot better and I'm starting to recover, so hopefully a few more days and I'll be okay and ready to move properly again.

[Narrator/Reader]

Well done. I mean, just running a marathon, to be fair, it's like a massive achievement to get a Guinness World Record at the same time to raise awareness for diabetes as you've done. What about your students? I know they were really backing you. Really behind.

[Nathan Kilcorse]

Yeah, well, we're on half term now, so I've not managed to see anybody, but hopefully by the time we go back, the record will be confirmed because it's under review at the minute from Guinness. So, yeah, really excited to see the kids and you are definitely going to.

[Narrator/Reader]

Be the coolest teacher in school.

[Nathan Kilcorse]

Just saying another thing, on top of that, we've been able to raise nearly double the amount of money that we initially targeted, which is also incredible. And the support's been amazing. Family, friends of everybody that's sort of been with me throughout the whole process.

[Harry Bly]

Nathan Kilcourse speaking to Samaya Moogle now.

[Alex Ritson]

Since I was diagnosed, the treatment options have advanced at great speed. I was the first patient ever in the hospital where I was diagnosed not to be given porcine insulin. That's insulin made from pigs. I've been lucky to see the great advancements in artificial insulins and blood glucose monitoring technology.

[Harry Bly]

Yes, wearable diabetes tech is advancing still. Let's hear from some of you about how it has changed your lives and and your hopes for the future.

[Narrator/Reader]

I'm on a hybrid closed loop system. It's really helped both me and my mum during the night because it changes the amount of insulin I need depending on my level. In the close future I hope not to need to tell the pump I'm eating as it's another thing to think about and I won't have any nasty annoying hides when I forget to bolus myself.

[Harry Bly]

It did take me a bit of.

[Professor Partha Carr]

Time to actually trust the insulin pump.

[Harry Bly]

Because I've had diabetes for 20 odd years before I actually got the pump.

[Professor Partha Carr]

So I was used to doing everything myself. So to trust the technology was a massive, massive jump. Once I learned to trust the pump.

[Harry Bly]

It just put my sugar levels within.

[Professor Partha Carr]

Range overnight and then that in turn.

[Harry Bly]

Just improved my sugar levels drastically.

[Emily Mazreku]

Tech like this has really taken a.

[Narrator/Reader]

Lot of the background stress away. I think my hope for the future is that the tech keeps getting smarter.

[Alex Ritson]

And takes even more of the mental.

[Harry Bly]

Load off because reducing the constant decision.

[Emily Mazreku]

Making would make such a difference.

[Harry Bly]

If it wasn't for advancements in diabetes.

[Advertisement Voice]

Treatment and technology, I would never have.

[Harry Bly]

Actually stood a chance at being able to manage my type 1 diabetes properly. When it comes to the future of diabetes treatment and technology, I hope that.

[Narrator/Reader]

Focus continues to be on things like.

[Harry Bly]

Quality of life and not just keeping us alive. My hopes of the future is that.

[Professor Partha Carr]

Everyone can get access to these insulin pumps because obviously cost is always a massive, massive thing for it, but they.

[Harry Bly]

Just improve my day to day so.

[Professor Partha Carr]

Much it makes my life a lot easier.

[Harry Bly]

Thanks, George. Jai, Steph And Natalie for sending those.

[Alex Ritson]

Professor Partha Carr is the UK's National Specialty Advisor for Diabetes. He spent his career leading the charge for patients across Britain to have easier access to technology to make the daily management of the condition easier and safer.

[Professor Partha Carr]

The way I always looked at type 1 diabetes from the outside was that you had to prick your finger physically, you had to look at a number, then you had to do some mental maths with the number whether to give insulin or glucose, and then you had to give it. And I think technology has now moved on to automating a lot of that. Not fully yet. So you have sensors whereby which will pick up your glucose readings, it's available on your phone. The insulin is mostly is automated. You still have to put in a few things into the system about what you're eating, etc. But in general, about 70 to 80% of what used to happen in type 1 diabetes is now but automated. So that's the huge leap, I would say, in technology which has happened is the best thing beyond a cure that at the moment science can provide to people living with type 1 diabetes.

[Alex Ritson]

I've seen you speak at numerous conferences. You absolutely love what you do. You're not just a doctor who happens to treat people with diabetes. It looks like this is your life. You've been awarded One of the UK's top medals, the OBE, for your work in this area. What makes you want to do this? What makes you into this kind of diabetes superstar?

[Professor Partha Carr]

I think it always has bugged me that we don't provide the best care we can do. We are one of the top economies of the world and why not? So I think that's been a zeal and I've been incredibly blessed to have incredible friendships and relationship in the type 1 diabetes world. And I think it gives you an insight that no medical textbook or universities teach you and the fundamental philosophy I believe in what can I do to make your life a bit better? And I think the final thing I always say to myself is that if I, if any of my loved ones had type 1 diabetes, this is what I would want them to be on. And if that's what I want for my loved one, it's my job to get it to you.

[Alex Ritson]

I feel lucky I'm in a relatively wealthy country. For me, getting access to this excellent treatment is easy. There'll be people listening to this who aren't as lucky, who are in other parts of the world where the healthcare system's a bit more hit and miss. When's this kind of technology going to spread everywhere.

[Professor Partha Carr]

I think the work of charities is quite important. So if you look at Breakthrough T1D, for example, some of the work that they do, for example, the work they're doing in India and other places is about raising awareness. It's about trying to sort of talk to governments about how to improve type 1 diabetes care, get technology in there. So I am very grateful to charities, whether it's UK based or global based, of the work that did do. But the basic bottom line will come down to what voice the people with type 1 diabetes can get. And I think this is where clinicians like myself have a role to sort of use our privilege, for want of a better word, to open the door so that voice can be heard. So I think it will happen. It's a matter of time, I reckon. But as a global community, we are moving in the right direction. But more work needs to be done.

[Alex Ritson]

As ever, and of course, because of your role, you know better than I do what's coming. Where are we going with this? What are the bits of technology that people don't know about perhaps yet that really excite you?

[Professor Partha Carr]

So I think technology wise, the sensors probably will become smaller, it will become much more accurate, exciting research which is in the pipeline are people talking about can you detect that you might have type 1 diabetes? Talk about immunotherapy and that sort of thing. And there are finally, even though it's always spoken in hushed home, there probably is a degree of cautious optimism from some of the studies coming out as to whether there finally could be that Holy Grail of the cure. So I think there's a lot of lots of good work going on in this field, as I said, led by many charities, including Breakthrough T1D, the Holy.

[Alex Ritson]

Grail of the cure. Professor Partha Khar. Now, this music is something which, unfortunately, I've heard a lot. I really identify with this.

[Harry Bly]

Yes, me too. This is the work of Sarah Warren. She produced this from samples of sounds from her insulin pump and other medical equipment she uses on a daily basis. She calls this the soundtrack of her reality. And she also composed the music you heard at the start of this podcast, using her own blood glucose readings every hour and mapping them onto a piano scale.

[Alex Ritson]

And that is the end of this special edition of the Happy Pod. This edition was produced by Holly Gibbs and mixed by Lee Wilson. The editor is Karen Martin. I'm Alex Ritson.

[Harry Bly]

I'm Harry Bly. And until next time, goodbye.

[Emily Mazreku]

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