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Duke Al Durham: Bittersweet: The hypers and hypos of living with type 1

Duke standing outside against art smiling

Duke Al Durham is a rapper and poet living in Cardiff. He shares his view with us here about how his poetry has helped him express himself whilst living with diabetes, and raise vital awareness of the condition. Duke's latest book of poems, Bittersweet, which deals with topics ranging from the 100 year anniversary of the discovery of insulin to diabetes and mental health, is out now. 

The Pen and The Ink 

Before my diagnosis of type 1 diabetes on January 18 2018, the pen and the ink were my first forms of therapy, fighting Obsessive Compulsive Disorder (OCD). I have had OCD from a young age and it has been a challenge learning how to manage it. After all, a heavily stigmatised mental health condition was difficult to talk about! And it's a very complex condition, I will have an intrusive thought and feel a responsibility to do compulsions to prevent that bad thought from happening. Sometimes, if my insulin requirements didn't add up to a 'good' number, I'd struggle to inject and that's been quite difficult to manage. The pen and the ink allowed me to express myself to the page, and the page was there to listen. Writing about how I felt was my escape, my therapy, the pen saved my life in the form of raps and poetry. I began writing poems aged 11 and those raps and poems became therapy for me. They're a way to articulate my condition and it's a huge release.

The Insulin Pen 

Introducing the insulin pen, my second life saver, (as I am sure you are all aware of how this happens!) my second invisible condition. 

I'd been having health issues after food poisoning on holiday in 2016 which developed into sepsis. And for two years, my diabetes symptoms gradually increased in intensity. These included increasing tiredness, weight loss and needing to wee frequently. After my GP did a blood test, I was referred to my local hospital. The diabetes nurses were fantastic, they explained everything and were so empathetic. For the first couple of weeks, I took my diagnosis on the chin. I tried to look at it positively and was very accepting of my new lifestyle. Unfortunately, that positivity turned into frustration and anger. I was worried I'd never be able to reach my full potential, I've done sport all my life, and there was so much I still wanted to achieve. 

Diagnosed at 23 years old, with now two pens to keep me alive, I questioned in deep thought, is there a reason why I was diagnosed with type 1 diabetes and I also have OCD, where I use creativity to manage it? Through various difficult stages of dealing with my diagnosis, as I pondered over this question, eventually, I came to the conclusion. Yes, this is my journey, these are my life challenges, but how will I manage them both? 

There are lots of misconceptions about diabetes. People don't know how serious and relentless the conditions is so I'm really passionate about raising awareness and educating others. I started sharing my poems online and performing at open mic nights. 


After living with type 1 diabetes for a couple of years, during lockdown 2020 my Auntie Harriet whose young daughter, my cousin, also lives with type 1 diabetes, sent me a post by an organisation called ArT1st and told me to send in some of my raps and poems. So, I did! ArT1st is a creative organisation that champions various forms of art from creative people living with type 1 diabetes. The ArT1st team are made up of people living with type 1 diabetes and Diabetes Doctors and Consultants. 

Friendship and Hidden Hypos 

I received a message from Dr. Sarah Ali Racanière, who's artist is name Sarah Racanière, a team member, who loved my work and shared it on the platform. Our friendship began! We chatted about various forms of art and poetry, then I found out that Sarah is an artist who paints beautifully vivid, colourful and thought provocative paintings. Paintings that have more than a single meaning. Many call her The Colour Queen! After interesting conversations about the creative process, Sarah challenged me to write another poem, specifically about type 1 diabetes. I had only ever written one poem about type 1 diabetes before that, which at the time was named Diabetes My Story. I took on the challenge and Hidden Hypos was created! I wrote Hidden Hypos from my own experience and imagining myself in the shoes of how other people living with type 1 diabetes, would feel or be treated in different scenarios when having a hypo. The poem seemed to connect and relate with a lot of people. I was astounded by the support shown! Diabetes UK shared it across their platforms, in which I am sincerely grateful. It reached over 30,000 views with hundreds of comments about how people related, it started a conversation. 

Colour Blind 

After the success of Hidden Hypos, Sarah and I worked together on a collaborative piece called Colour Blind, raising awareness for mental health. The colourful painting of a brain by Sarah with my words from my poem inside it, made a collaborative piece fit enough to be published in the prestigious Nature Medicine Scientific Journal, where they wanted to feature how scientists and doctors used art during the pandemic to help them cope. We were making invisible conditions, visible. 

The Journey 

During the pandemic, in mid to late 2020, Sarah mentioned to me an interesting idea that she had. I have been thinking and I have decided that you should write a poetry book about type 1 diabetes.’ Sarah had challenged me again. I had previously thought about the idea before, but to hear Sarah mention it, gave me a real push and an adrenaline rush, I was nervous, excited and intimidated all at the same time. I thought about it deeply and knew it was such an important thing to do, it was an opportunity to really dive into the deep depths of what it is like to live with type 1 diabetes. I knew I could reach and potentially help so many. I think we all struggle with self-doubt sometimes and it did try to knock me over. But I accepted the challenge and began. 

The experience overall has been extraordinary. I remember when I asked Sarah if she could do the artwork for Bittersweet in the early stages, it just felt as if it was meant to be. We were meant to meet, my Auntie was meant to send me that the post from ArT1st to enter, we were meant to chat and become friends, we were meant to create Bittersweet. 

Bittersweet is not only helping make an invisible condition visible, but it also is helping other invisible conditions such as mental health, when living with type 1 diabetes, be visible. I am so proud of Bittersweet and I hope it offers support to somebody who needs it. Who knows you could see a second book next year focusing on educating the world about type 1 diabetes, watch this space.

Bonus Features 

Lastly, there are some bonus features at the back of the book, not to be missed! I am creating an audiobook! As a spoken word poet, I feel some of my poems can get give a more powerful impact when performed, so I look forward to sharing Bittersweet with you in spoken word form. 

About Duke Al Durham

Duke'’s debut poetry collection, ‘Bittersweet: The Highs, The Lows, Hypers and Hypos of Living with Type 1 Diabetes’, explores his feelings around living with diabetes. After being diagnosed with type 1 diabetes in 2018 aged 23, he used his art to articulate how he felt. Now he aims to make an impactful change using one rhyme at a time.

The views and opinions expressed in the ‘views’ section of this website belong solely to the author of each article. These views and opinions do not represent those of Diabetes UK as a charity or any of its staff members.


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