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When rower Sir Steve Redgrave won his fifth Olympic gold medal in Sydney he had a secret stash on-board with him. Sellotaped to the inside of his boat were some sachets of sugar.
This wasn't just in case he got hungry. It was there if his blood sugar dropped too low. For just three years earlier, in 1997, Steve, who at the time was an impressive 6ft 5in and 16st, was told he had type 2 diabetes.
'I suddenly thought, “What if something happens out there” - sugar was the only thing I could grab quickly,' he recalls.
Heroic: Redgrave saluting his support after winning his fifth consecutive gold medal at the Sydney Olympics in 2000. Sir Steve stashed sugar on board with him
'As it turned out I didn't need it and I forgot all about it until the boat was packed up and brought back to a museum here, and the guys who unwrapped it called me asking why there was sugar there.'
Type 2 diabetes is normally associated with obesity and a couch potato lifestyle - not heroic athleticism. Even now no one can tell for sure why he developed it - but it could be that it was unlucky genes.
'My paternal grandfather was diagnosed with it in his late 70s but died soon after of an unrelated matter,' says Sir Steve. 'It seemed to skip a generation, because neither of my parents got it - it just seems to be me.' There are 3.8 million people with diabetes in Britain and 90 per cent have type 2 diabetes like Sir Steve. While type 1 is caused when the cells that produce the hormone insulin are destroyed, type 2 diabetes occurs when the insulin produced becomes less effective - normally as a result of being overweight and inactive. The body needs more and more insulin to try to keep blood sugar within a normal range.
Although the biggest risk factor for type 2 diabetes is weight, genes can also have an important role.
'Genetics are more important in defining your risk of type 2 diabetes than in type 1 diabetes,' says Professor Anthony Barnett, emeritus professor of medicine and consultant physician, University of Birmingham and Heart of England NHS Foundation Trust.
'If one parent has type 2, then you have a 30 per cent chance of developing it. If both parents do, then that risk is 50 per cent. It is possible to develop type 2 diabetes even if you are of a normal weight - just because of the genetics you inherited.'
Diabetic: Sir Steve's paternal grandfather was diagnosed with Type 2 diabetes, but the only other person in the Redgrave family to get it thus far has been Steve
Diabetes UK estimates that as many as 850,000 people have undiagnosed type 2 diabetes and seven million people in this country are at risk of type 2 diabetes and don't know it.
'Unfortunately, at the moment 50 per cent of people have a complication of the disease by the time they are diagnosed with type 2 diabetes,' says Libby Dowling, a clinical adviser to charity Diabetes UK.
The condition causes complications such as nerve damage, heart disease, kidney damage, stroke, sight loss and amputation - diabetes is the leading cause of amputations and blindness in Britain.
And these don't just strike people who fail to manage their condition; they affect even the most vigilant of patients.
A few years ago Sir Steve lost a friend to the disease. 'He stepped on a thorn and his foot went black and rather than tell anyone he kept his socks on at night so that even his wife wouldn't see,' he says. He had to have his lower leg amputated and ultimately it killed him.'
Professor Barnett adds: 'Unfortunately most people - even if their condition is well controlled - will have some complications.'
Now Sir Steve is just starting to suffer from complications. 'I get my eyes checked every year,' he says. 'I am told there is just the beginnings of a slight change to my eyesight.'
This damage is thought to have been caused by high blood sugar levels damaging vessels in the eye.
'I'm not aware of it yet and it's nothing that will cause any problems in the near future, but it's something that I need to be aware of,' he adds.
But he does have signs of nerve damage. 'I go to see a diabetic specialist every six months and have tests on my feet, and they are not as sensitive as they used to be,' says Sir Steve. 'There's a slight sensation of numbness - a bit like when the anaesthetic wears off after you have been to the dentist.
'I feel that if you stuck something sharp in my toe, I would not feel it as keenly as if you stuck it into my hand. Complications of this are something I worry about, but I think it's better to keep aware of them.'
The disease tends to come on slowly and many ignore the early symptoms. 'Most of the early symptoms are vague and non-specific - such as increased thirst, passing more urine than usual, excessive tiredness and slow-healing cuts and grazes,' says Libby Dowling. Sir Steve was diagnosed 16 years ago after feeling unusually thirsty one day after training.
'I drank around four to five pints of fluid and still didn't feel as if my thirst was quenched and I thought, “That's a bit strange”,' he recalls.
'I get my eyes checked every year. I am told there is just the beginnings of a slight change to my eyesight. I'm not aware of it yet and it's nothing that will cause any problems in the near future, but it's something that I need to be aware of.'
'They'd always come back negative. I thought I'd check it again and this time it was positive - so I phoned my wife, who is a doctor, and she said, “You better go to your doctor.” '
A further blood test confirmed that his blood sugar reading was sky high - 32 - more than three times what it should be. He saw a specialist later that day.
'I was thinking that my career was over. I was being quite matter of fact about it - I thought, well I have got four gold medals, that's pretty good,' says Sir Steve.
'Then I went to see the specialist who said, “I can see no reason why you can't continue with what you want to do for three years”. What I didn't know was he had no idea how we were going to do that.'
Normally, diabetics are advised to follow regular eating patterns and try a standard low glycaemic index (GI) diet - i.e., foods which release energy slowly. However, Sir Steve's lifestyle made this extremely difficult.
'I needed around 7,000 calories a day to keep me going through four or five training sessions a day and used to eat a lot of carbohydrates, and things like doughnuts,' he says. 'On this new low-GI diet I would wake up feeling great, then my energy would suddenly run out - it was like switching a light off. So my specialist put me back on my old diet.'
This meant experimenting with his insulin levels - he injected eight to ten times a day after meals - and it took months before he got it right. While training in South Africa he hit a low.
'There were 16 of us there and each session we did I was coming bottom out of everyone - I had never been bottom in my life before.
Fatigued: On Sir Steve's low-GI diet, he would wake up feeling great but then his energy would suddenly run out
'I called my wife who had wanted me to retire after the Atlanta Olympics in 1996 and said, “I can't do this, I'm coming home”. But she surprised me by saying, “Yes you can, we will find a way”.'
Sure enough he did - with the sugar stash just in case. But after winning his fifth gold at the 2000 Games he quit professional sport and had to change the way he managed his diabetes again.
'It was like starting all over again,' he says. 'I wasn't burning off the blood sugar like I had been and I had to take a lot more insulin.'
Six years ago he switched to a pump which is occasionally used by type 2 diabetics. The size of a pack of cards, it is usually worn on a belt and contains insulin which runs down a tube with a needle on the end. The needle is inserted into a fatty part of the body - in Sir Steve's case the abdomen. He inserts the needle himself.
'It's great - you only have to inject yourself once every three days when you change the insulin and you can take if off when you go into the shower,' he says.
Sir Steve's attitude to his diabetes has always been 'it lives with me, I don't live with it'.
He says: 'You don't have to be wrapped up in cotton wool. Yes there are jobs you can't do - you can't be a pilot and you can't join the Armed Forces - but you can still reach your goal like I did.
'OK, I would prefer not to be checking my blood sugar all the time and wearing this pump, but I have no choice - I just have to get on with it.
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