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When the Italian mountaineer, Marco Peruffo, was eight he was diagnosed with diabetes. 'I was a very difficult patient. I rebelled against blood tests, was undisciplined about my diet and made a fuss about taking medicines. But my father, a keen mountaineer and also a diabetic, took me on mountain walks. The landscape, the immersion in nature, the joy of achievement captured me.

'At 15, I caught the bug of rock climbing. To be able to do this, I had to be in top shape and so I became a model patient.'

Now 33, and working in the local health department in Vicenza, he already has an impressive curriculum vitae: 250 rock climbs, 100 glacier climbs and four expeditions outside Europe. In 2002 he climbed Cho Oyu in the Himalayas, named after the goddess of turquoise and at 8,201 metres the sixth tallest peak in the world.

The ascent of Cho Oyu was not only a mountaineering achievement, but also a scientific experiment. Six diabetics and 10 non'diabetics took part, undergoing meta'bolic and other tests at sea level and at 4,000 and 6,000 metres. The result showed no difference in efficiency between diabetics and non'diabetics, even at the highest altitude.

Peruffo reached the top alone, after a nine'hour climb at temperatures ranging between '39 and '50 degrees centigrade. His non'diabetic companion stopped 70 metres short of the peak, because his condition was such that if he had gone further he would have imperilled both their lives. 'This was a great lesson,' says Peruffo. 'It takes more willpower to hold back than to overstep.'

The expedition did not use sherpas nor oxygen. They carried away all their inorganic rubbish and burnt all their organic waste.

The expedition was organized by ADIQ (Diabetic Mountaineers at High Altitude). ADIQ's message is twofold. If diabetics do not take their treatment seriously, they risk severe damage or even death; at the same time they should not let their ailment limit their activity. Any sport is a great stimulus, but mountaineering teaches you an extra lesson: if you want to do well you have to exert yourself to your maximum, but overstepping can be fatal. 'It is all right to reach the top,' says Peruffo, 'but my wife is waiting for me.'

ADIQ's message is relevant to the general public as well as to diabetics. We all need to take care of ourselves, and at the same time to achieve the best we can. 'And of course,' adds Peruffo, 'it is much more fun to get the message in a light way, interspersed with stunning mountain views.'

The association has met some resistance from the medical world. 'There are still some who consider us raving madmen, but it is not true,' says Peruffo. 'We have always been very careful to make sure we were ready for the next step. We did all the training and took all the tests to make sure we were ready, then off we went! We hope to go to Pakistan next year and reach another 8,000 metre peak, not so high as Cho Oyu, but a more difficult climb.'

Adriano Costa