I don’t have Type 1 diabetes, but my new book’s main character does. Let me explain why

“Write what you know” is up there with “Show, don’t tell” at the very top of the list of things writers must do.

This does not mean that writers are limited or even doomed to autobiography – I have previously written about a dysfunctional marriage and a disfigured child, not because those exact experiences have happened to me but because the essential feelings of unhappiness, loneliness, being trapped and being unable to fix your children are transferable.

With my new book, though, I have chosen to write a main character with a specific condition around which I have much first-hand experience: Type 1 diabetes.

I am not diabetic, but my partner of 30 years has been for all the time I’ve known him, having been diagnosed at the age of four. Our eldest child was diagnosed even younger, at just 20 months, so I feel I know my stuff.

Inside TV chef Clodagh McKenna’s new compact kitchen: why big isn’t always better

---

Can we finally say goodbye to shaming women for letting their hair go grey?

---

100 great restaurants and places to eat around Ireland this summer

---

Robert De Niro’s raging at Trump outside courthouse was an extraordinary moment in American public life

---

There is a lot of ignorance about Type 1 diabetes. Some people suppose it is lifestyle-related and associated with obesity but this is not the case. Both my husband and son were healthy eaters, as children, and not overweight. In fact, our son was so young when he became diabetic that he’d never had sweets and fizzy drinks. This the nurses on the ward found tricky, when he was first receiving insulin manually, as they struggled to identify something sugary that he was willing to consume to boost his blood glucose quickly when required.

I had a significant fear of needles, before our son’s diagnosis, and approached the prospect of jabbing him twice daily with considerable trepidation. I was given an orange to practise on, before injecting his arm or leg, because the peel was deemed to have similar resistance – a similar “feel” – to human flesh. I almost fainted, and this was just a piece of fruit.

But you get on with things. I soon learned that managing a diabetic regime was like manually and thoughtfully balancing a see-saw which, in other people, balanced itself. Add insulin and you must add carbohydrate; increase one and you must increase the other. Above all, don’t let either end of the see-saw hit the ground, or you’ll be in trouble.

Both of the diabetics in my family use trusty glucometers, which inform you of your blood sugar status from a droplet of blood pricked from the finger. They do these tests multiple times a day and have done for years. There is now more sophisticated kit, such as sensors worn on the arm which send messages to a reader or mobile phone, but neither of “my” diabetics had discovered this, when I wrote Closing In. Neither do they have insulin pumps, so I didn’t write about either of those pieces of equipment.

Caroline, my main character, has been diabetic since childhood. Her condition is always with her. We see her checking her blood sugar regularly before deciding whether to have a snack or just a coffee. We experience the discomfort and disorientation of a “hypo” – an episode of significantly low blood sugar which can need assistance from someone else to correct. But the condition does not define Caroline. She would never consider herself to have a disability – she holds down a job she enjoys, has raised a family, is sociable and enjoys a drink. She refuses to wear a medical alert bracelet because she thinks they’re ugly, which gives her best friend cause for concern.

(Reading back the first draft of the novel, I found that I had Caroline eating an extraordinary, ridiculous number of toasted sandwiches at home over the course of the manuscript – a handy way to get slow-acting carbs into her, but I had to go back and replace some of these with other foods.)

It would risk spoiling the story to reveal precisely how Caroline’s diabetes is important to the plot, but it is.

There is a danger, in writing something that reflects a genuine aspect of your experience, that life might imitate art in a way you weren’t expecting and do not like. This happened. Weeks before Closing In was due for publication, on a family holiday in the north of England, our son, now 28, normally a very well-controlled, if somewhat maverick, diabetic had a cataclysmic hypo and collapsed in the street. The onset was so rapid that he had just put three big dextrose tablets in his mouth and, as he convulsed and turned blue, I feared he was also choking.

It was a terrifying thing, but shopkeepers rushed to help us, the ambulance came and he survived. He and his dad are now awaiting their new sensors, in the hope that neither will be ambushed by low blood sugar in such a way again.

Had the outcome not been so good, how would I have felt about my book? Pretty uncomfortable, I think.

But should we never write about diabetes/asthma/autism/bi-polar/appendicitis, in case the worst happens?

I’m seriously tempted to write a main character next who has irritable bowel syndrome, as I do. I’m wondering just how to execute it, though – there’s no risk to life from the condition for this protagonist, except possibly dying of embarrassment.