There’s a book I’d like to read. Unfortunately, I haven’t found it yet, and I’m not even sure it exists. If it doesn’t, I should probably try to write it, although that would take a lot of work acquiring the necessary knowledge or finding willing interviewees. Which may be impossible anyway.

Some background. I have been Type 2 diabetic for around 35 years. Most of that time has passed easily enough, I am glad to say: I have been fortunate enough to be broadly symptom-free and to have received good medical advice and care.

Or so I thought. A couple of years ago, it turned out that several key pieces of “standard knowledge” I had been given about diabetes were wrong: (1) my instances of feeling desperate for food (which I called “sugar lows” even if they weren’t) were caused by my diabetes; (2) I should ingest most of my calories from carbohydrates; (3) I had no choice but to expect ever increasing doses of various drugs until the day I die. The facts are the opposite: my sugar lows were caused by the gliclazide I was on; a carbohydrate-heavy diet is a terrible idea for a diabetic and in most cases, type 2 diabetes is at least partly reversible (if we’re nit-picking, doctors seem to prefer the word “remission” to “reversal”). I’m now on a very different path, with a focus on weight loss, a low carbohydrate diet and lower drug doses.

I now have a superficial understanding of some of the processes involved in my metabolism: what foods are converted into blood glucose, how my liver acts as a glucose storage device under the control of insulin produced by my pancreas, and so on. But the crucial word here is “superficial”: my mental landscape looks like a few  islands of knowledge within a sea of ignorance. By what mechanism does my body burn fat? When I’m exercising, what’s carrying energy to my muscles and how do they use it? What makes me get hungry or feel full? By what mechanism does my blood pressure rise or fall (and why does it go up and down so often)? I understand very little about any of this.

So far, I’ve read through three books that claim to shed light on the subject. Living without diabetes is by Professor Roy Taylor, one of the key researchers who demonstrated that Tpe 2 diabetes could be reversed. Busting the diabetes myth is by Dr. David Cavan, my current diabetician, who is highly exercised by the past misconceptions about diabetes (including those I’ve listed above). Outlive, by Dr. Peter Attia, is a broader book which discusses the major illnesses that people can expect as they get older – of which diabetes is only one – and recommends lifestyle changes to give one the greatest chance of preventing them.

While the three books differ in their main focus, they are similar in several aspects. Firstly, their primary genre is that of the self-help book: they are expecting the reader to read the book and follow at least some of the steps that they recommend. They are filled with standard self-help tropes like giving you checklists for setting your goals. Secondly, all three authors are extremely keen to tell their personal experiences and histories: the patients they’ve treated, the research they’ve taken part in, how they developed their present views of how things should be done. That aspect is a substantial part of all three books and it’s one that I find only tangentially interesting: it serves to tell me why my past medical advice has been so wrong, but that’s about it. I’m not particularly interested in the success that the authors have or haven’t had with patients who are often very dissimilar to me, or in the stories those patients tell about their experiences.

In all three books, the explanations of what is actually happening in your body are woefully incomplete. Roy Taylor is the strongest here, with some chapters that explain clearly enough how type 2 diabetes progresses (fat deposits in the liver cause insulin resistance, followed by which fat deposits in the pancreas compromise your ability to produce insulin in the first place). Peter Attia has huge amounts of interesting information to impart on a broad range of topics, but he and his co-author Bill Gifford do little to help the reader tie this information into an overall framework of knowledge, often making an offhand reference to some hormone or other and leaving it hanging in the air.

Which brings me to the book I want: something that explains to me, comprehensively and one at a time, each of the processes involved in my metabolism: how I get hungry, how I digest food, how that food is transformed and carried around my bloodstream into which organs, how it is consumed. With such a book, I truly believe that I would become better at “listening to what my body is telling me” and making better decisions – on an hour to hour basis – on the crucial items of what I eat, how I exercise, what drugs I take and when, how I cope with stress. I don’t want to make lifestyle choices based on epidemiology alone: it must surely be preferable to use myself as my own guinea pig than to simply accept the average of some cohort of my age, race and height.

Rather than a “self-help” book – which really means following a set of advice given by an author who has no knowledge of you in particular and can only generalise from their understanding of similar people – let’s call what I’m looking for a “self-knowledge” book, learning as much as possible about how the human body works to enable you to understand what’s happening under the surface when your body reacts in a particular way.

Of course, there are many books and papers written about metabolism for medical professionals. But these are utterly inaccessible to someone with my level of knowledge. The first result on a search for books about glycogen storage, for example, was Glycogen storage diseases with liver involvement: a literature review of GSD type 0, IV, VI, IX and XI. There’s a reason why doctors go through a decade of training.

So I’m imagining a book at the level of GCSE biology (for non-UK readers: these are the exams taken at age 16), in other words a book that it’s possible to understand as long as one understands biological basics like “what’s a protein” or “what’s a hormone”, but which doesn’t assume that you’re pursuing a medical career. I haven’t yet found anything at that level, although the exam authority AQA does have an optional syllabus section at A level (18-year olds) which deals with metabolism in some detail, so the set texts might have something comprehensible – it’s on my list to check.

Strangely, the nearest thing I found in my local library was “How the Body Works” from Dorling Kindersley, done in their usual picture-book style. Its intent is certainly in the right direction and it’s helpful up to a point, but the subject is just too complex for a guide which is 100% built around illustrations with no body copy whatsoever. I applaud DK for a noble effort which gives a lot of interesting information – but I need to go deeper on the particular subject of food and metabolism.

If anyone reading this hasopinions on this subject, I’d love to hear them, so please do leave a comment. Maybe the right book is out there and my limited web research hasn’t found it. Maybe the book I imagine is unfeasible: the processes are too complex to be explained, even on a superficial level, to someone who hasn’t mastered a substantial level of medical education. I could imagine that the our current medical knowledge might be too incomplete to be simplified in a way that would stand up to scrutiny without being riddled with caveats, or that our understanding is shifting so quickly at the moment that you can’t pin it down. Perhaps there are only a tiny number of people who would be interested.

 Or maybe, just maybe, there’s a book waiting to be written.