When you say that it is very difficult to start, does it crank quickly or slowly. If it is not cranking fast enough, it could well be your batteries or corroded connections.
If the truck is cranking normally, it could very likely be your grid heaters. Make sure that your batteries are charged, then turn the key to the on position. Watch the voltmeter and if it is down near 8-10 volts, your grids are running, if it is near 12-13 volts, your grids are not running. The usual cause of this is that the relay has stopped working. If the wait to start light is going out immediately, it is also possible that it is your intake air temperature sensor.
If the grids are working and the engine cranks quickly, the next thing to check is fuel. A common problem is that the fuel system develops an air leak either in the fuel lines or fuel heater. Any air in there will make the truck crank for a while before firing. It may also require throttle to fire. If it fires with a little throttle, also check your idle speed, it may be too low. The final thing to check would be your shutdown solenoid. When you turn the key on and bump the starter, it should pull up and stay there until the key is turned off. The solenoid is on the back end of the injection pump.
A little more info would be helpful in diagnosing it. Good luck getting her running again.