Farewell to the doyen of diabetes

“So you have diabetes? Remember, diabetes isn’t a disease. It’s a condition that will make you live healthier.” These are the first words my traumatised parents and I heard when we met Professor Larry Distiller after my unexpected diagnosis of Type 1 diabetes at the age of 14.

We were guided by him on the lifetime of injections, finger-pricks, and dietary restrictions that would follow. His ability to turn crisis into calm epitomised who Distiller really was – a man who envisaged turning diabetes into a manageable condition, with which patients could live normally, free of its wretched complications.

The diabetes community in South Africa and abroad this week had the unexpected news of the sudden passing of this doyen of diabetes. Tributes, condolences, and messages of disbelief have flooded every relevant space since.

Distiller, a self-made man from humble beginnings, completed his Bachelor of Science degree, medical degree, physician specialty training, and sub-specialty in endocrinology at the University of the Witwatersrand (Wits), and soon became a dreamer. He understood that enabling patients to control their diabetes and transferring the financial risk of poor control to their healthcare team was the most efficacious and cost-effective method to control the diabetes pandemic, which has reached alarming proportions worldwide.

Distiller founded the Centre for Diabetes and Endocrinology (CDE) in Parktown in 1995, and brought to South Africa the concept of the diabetes-team approach.

Every patient would need not only a physician but an educator, dietician, biokineticist, podiatrist, and possibly even a psychologist to ensure diabetic longevity. The results of improved diabetes control in the community spoke for themselves, and under his quest to rally healthcare funders to adopt this approach, his CDE has grown in 25 years into an empire that has touched and saved thousands and thousands of lives.

“Thank you Larry for keeping me alive and well for 44 years” were the words spoken by Rabbi Anthony Gerson, a patient of Distiller’s as he paid his respects at his funeral drizzling with rain and tears at Westpark Cemetery on Sunday.

Surrounded by Distiller’s colleagues, family, and patients, Gerson announced, “Larry is dancing in the rain.” Indeed, he must have been as he finally saw the difference he had made in the world from a new vantage point.

Professor Roy Shires, a fellow endocrinologist from Wits and a man not many could educate any further, described Distiller as the pre-eminent voice on diabetes in South Africa. “I looked up to Larry, and he taught me throughout my career.”

For many years, Professors Distiller, Shires, Harry Seftel, and Barry Joffe travelled regularly to the Society of Endocrinology, Metabolism and Diabetes in Pretoria, where they gained knowledge to share. “Larry was a great inspiration,” Professor Shires said.

Dr Stan Landau, a fellow physician at the CDE, posted on social media about his devastation at Distiller’s passing, describing him as his “long-term mentor, teacher, and friend and a giant amongst his peers”. Dr Debbie Gordon, an endocrinologist formerly at the CDE and now practicing in Melbourne, described Distiller as “a pioneer of the approach to truly caring for patients’ well-being. He was a fair man – with a firm, but kind hand … a force not to be reckoned with.”

She reflected on Distiller’s faith in her abilities, and spoke of his later selfless encouragement of her to pursue overseas opportunities even to the detriment of the practice in Johannesburg. She admitted to their “Kit-Kat breaks” on a Friday afternoon that grew her bond with “this gentle giant”.

Grant Newton, the current chief executive of the CDE, and Shelley Harris, public-relations officer and long-term colleague, shared the sentiment that even though Distiller didn’t always verbally address the crowds, he didn’t need to, his stately presence achieved this. They spoke of the legacy he left, and of the revolutionary projects the CDE was undertaking, which would now go ahead without him but still be led vicariously by his calm, unwavering principles of leadership.

Distiller was far more than just a professional. He married Brenda, an actor best known for her “Cremora, it’s not inside, it’s on top” advertisement, and built a marriage that shone with love and affection. He cultivated a family that appreciated sport and wildlife. His children, Natasha, Greg, and Kevin, and his six grandchildren were the real focus of his soul. Two years after Brenda suddenly passed away, he married Barbara in 2019. She became the new focus of his affection.

Kevin, his younger son, described him to me as not only a father but a father figure to so many. “In spite of his impact, he remained humble, generous, kind, and committed to his values,” he said.

CDE biokineticist Andrew Heilbrunn expressed gratitude for Distiller’s mentorship since 1992 – a relationship that included Distiller’s speech at Heilbrunn’s wedding and the advice he still draws from it.

I wrote this piece because Distiller was my personal hero. He saved my parents from the trauma of their only child becoming diabetic at a time when modern information on diabetes management was rather inaccessible.

He looked after my diabetes for 27 years, promising me that if I followed his guidance, I would remain healthy until I became old. I’m distraught that I could prove to him how correct he was only until my 40s.

Distiller inspired me to become a doctor. We all have role models when we embark on formidable challenges. He was mine. Envisioning my potential to touch diabetic lives as a diabetic myself, he encouraged and sponsored me to do my postgraduate training in diabetes at Cardiff University, one of two universities where he held an honorary professorship.

Throughout my career, the buck has always stopped with him. With his deep commitment to evidence-based medicine, he was always the voice that distinguished fact from fiction in my patient care.

Distiller and I spoke about me contributing weekly time to practicing at the CDE in Houghton for some time now. I saw him for a regular check-up two months ago, and this time, he insisted on my commitment to practice diabetology at his centre for some sessions next year. I agreed, but had no idea that it would be without him. He has truly left an unfillable void in my life.

Darren Basserabie, a diabetic patient of Distiller for 30 years so poignantly told me that being cared for by Distiller was knowing that “the world expert was at your back, and his perspective would be spot on”. Every diabetic treated by him agrees. In his own words, Distiller lived “as strong as an ox”. With his everlasting legacy, he died “as strong as an ox” too. The world of diabetes will always be powered by that strength.

• Dr Daniel Israel is a family practitioner in Johannesburg.