Interview 28

Age at interview: 23

Age at diagnosis: 7

Brief Outline: He has been doing his insulin injections since he was eight years old. He started to self-manage his diabetes when he was 15 years old. About seven years ago he changed his insulin from Humulin S to glargine and Humalog. The main reason for changing his insulin regime was the lack of flexibility regarding eating times. He admits that he no longer does glucose tests except when doing things differently such as changing insulin regimen, exercising more, changing diet, etc. A few years ago he was diagnosed by a private consultant as being clinically obese. The consultant put him on a diet and on Metformin tablets. Since then he has loss a total of five stones. Says that his obesity was the product of a bad diet and lack of exercise rather than because he is diabetic.

Background: Works full-time as a customer service adviser; lives at home. Says that the children's diabetic clinic was very good but his impression of the adult team is that basically they do not care.

Be positive and give solutions to problems, and avoid doom and gloom.

Like I said before, give them positive, give them a, if they've got a problem give a, give them a solution; don't just say, 'You've got a problem, sort it out', because, I don't, I didn't respond to that. It got, it got to the point where I don't want to go to hospital when I think it's a waste of time, if I'm honest. I know, I understand, you know, I get hassled and it's doom and gloom, so don't keep going on about all the stuff that can go wrong. I know you have to, but all I've had since I've had it is, you know, if you've got diabetes, you can go blind, you can have kidney failure, you're going to lose your legs, you're going to - you know, all this sort of thing - and then you must take care of yourself. Well, it's boring. It's, in the end say well, if it's going to happen, it's going to happen and then it just puts you off doing anything at all, if I'm honest. I mean, now, well again, I've sorted myself out. When you're a teenager it's probably even worse, you think, oh, you know, you want to run away from it. But if you, if all you're going to get is doom and gloom you just, you get to a point where you think well, I can't be bothered then, what's the point. If I'm going to go blind, I'm going to go blind, you know. That's all I've ever had, and that's why it annoys me and that's why I don't, that's why it got to a point where I don't, I didn't, I just don't really want to go to hospital because it wasn't, it wasn't the stuff I wanted to hear. Well, I know, you know, diabetes affects everything and it's a pain, but you've just got to give, you know, a positive kind of outlook, a bit of help, and a solution to the problem, that's what I say.
 

Talks about the young adult clinic and the nurses' approach to his weight problem. He knew he needed to lose weight but he wanted them to be more positive.

As, as far as care goes, I mean, the clinic, the, the child clinic when I first started and the, and the diabetic nurses I think, [name], they were really nice. The children's clinic was cool. Apart from one nurse who couldn't, like, try taking a blood test from me couldn't do it and she attempted, like, eight times. You know, it was just like she was new so in the end, I didn't like her after that. She's left now, but generally speaking the child clinic was really good, like they were really nice. They're down at [hospital] And now I go to the one, the adult one. They're alright, I mean I'm not going to say anything too bad about them, but when I, when I had the fit in the summer I went to see a lady in [city] and she was much better, if I'm honest, than the ones in [hospital].

In which way?

Well, she just seemed, she had like ideas. I mean, she got me on the Metformin tablets because I was fat and to help me lose some weight. And then she seemed more, kind of, she knew what she was talking about more than, okay, well, I get the impression at [hospital] they don't really care, to be honest with you. They can, the guy I usually see, I don't know, I just get the impression - he told me when I had the fit in the summer you, you can't wake up from a fit and that's it, you die unless someone finds you, sort of thing, and you don't, you know what I mean, wake up afterwards because whatever it is affects your liver or something, makes, makes you send sugar. So, I don't know, really, I don't know, but there again it's close and I haven't got a car at the moment, so, it's, you know.

Honestly, I get the impression, I don't know, I, they just kind of see me, yeah, yeah, blah-de-blah, and then you go, to be honest. I don't feel I get any positive help. Like this lady, I mean, they could've offered me the pills at [hospital] if they, if they wanted to, I mean, just like what you said about the fit and it was wrong, I mean, that's the impression I got, it may be it's, I don't know, but compared to the two, this lady in London seemed much better. But, it's just too far to go, I don't want to go to London every time I want to go to the clinic, so'

Much better in terms of the information she gave you?

She seemed more knowledgeable, yeah, about the information, the pills that she offered me. She just seemed, she had, like, she seemed to have answers for the sort of problems I had instead of just not. I mean, I've been going to [hospital] for ages and no one ever mentioned those pills to me, and they could have done, you know.

No. Yes, they knew I was fat, but they, but they didn't tell me, like they didn't say, 'You've put a bit of weight on,' they never, they didn't mentioned it before. You know, I don't think they mentioned it at all. But she turned round to me in London and said, 'You're overweight, you're fat, you're clinically obese, 28 per cent, 38, 28 per cent body fat and you need to lose it.' So she put me on this diet and give me the pills. Whereas [hospital] didn't do anything. They didn't say, 'You've put a bit of weight on and you need to lose it.'

Okay. 

But they don't give you, didn't give you any [sniff] positive - you know, what I mean, ways to sort it out they just kind of tell you bugger off you're fat. That's the impression I got but obviously they don't say it like that but, you know, it's just kind of like - sort of, I just can't, I don't really like going to them, I go because I have to otherwise I get hassled, so I go, and then that's it really. 

I think, generally speaking, I think it's good t

He started doing his injections twice a day when he was eight years old. Doing his insulin injections hasn't been a problem for him.

Well, I mean, I started doing my injections like when I was about eight, I suppose, eight or nine, but, I mean, obviously I kind of just did it, people left me to it. Well, yeah, you just get on with it, I suppose

Were you still at school when you started doing the four injections a day?

No, I'd left, had I left? [pause] No, yeah, no, I must have, I'd left, I wasn't doing four injections then at school. I never brought, I never brought my insulin into school.

Okay.

So it might, yeah, it might not been that long ago. I suppose, what'

So you left school at sixteen?

No, I went to sixth form as well, but I can't remember - no, maybe I didn't, maybe I didn't start until I was eighteen, then, I suppose, doing the four injections a day.

You had a fixed regime until you were eighteen?

Then I moved to four injections a day.

How did you find it, I mean?

When they tell you are going to have four injections a day you think oh, God, you know, this is really bad I'd better stay on two, but then when you do it, it's much better. I mean you can't, I couldn't live on two injections a day without eating a certain amount and eating at certain times, you know, you just can't do it, so. Four injections a day is just better because, you know, you can eat when you want, what you want.

So was it difficult when you were a teenager to have these two injections a day, this very fixed regime?

Well, not really, because I was quite sporty, I mean, when you are at school everything is, you know, time slotted anyway so it was easy at school, you just eat at lunch and you eat, you eat, eat at morning and you eat at tea, so it's not an issue, you know. You just get on with it. I mean, at the end of the day I'm glad I got it when I was seven instead, and not when I was eighteen, if I'm honest. I'd much rather, at least I knew I had it and I was used to it by then instead of getting it when you're eighteen and when, you know, you're trying to have a laugh, I think that would be worse. 

So, injecting for you wasn't a big issue?

Not really. It wasn't, you know, my mates knew I did it. But now I don't have a car, I do it whenever I'm in a restaurant, I do it at the table. I refuse to go to every, I refuse to have to be banished to the toilet in a restaurant, I was, it annoys me when people ask me to go, I don't. I do it, I don't obviously stand up and make a big scene, but I do it at the table in my arm. I refuse to, I don't see why I to have to go and visit every toilet in every restaurant that I ever go to, especially when most of them are really nasty. So, I do it at the table.
 

In his teens he was eating a lot but did not have a weight problem because he was doing lots of sports.

When I first got it I put on weight, because I was getting used to the insulin. Yeah, so there's, there's school photos of me - one was quite skinny, next one I had diabetes I was really fat, like you know, puppy fat, and then again after, I lost it again. But I was doing quite a lot of sport - I used to swim and play rugby. But, yeah, you, I think when you first get it you do, you probably, you get fat because of the insulin and then you lose it again, so that's not an issue really. Well, it might affect people when they get older, I don't know what it's when you, you know, like at my age getting it, I don't know, but it's a bit of a pain in the arse, but yeah, I mean, fat, I, the reason I got fat before was because I was eating loads, sitting around doing, giving myself masses of insulin. And I stopped doing sport - I was doing loads - so.

And that was around what age?

I started getting fat [pause] I suppose really round about nineteen when I started going out with my ex-girlfriend.

But when I, when I first got it, though, I was doing loads of sport, so I don't know what it would have been like if I wasn't. And then I've stopped, due to injuries and stuff, and then I just got fat like anyone would, I suppose. I wouldn't say it was because of diabetes. I did put a bit of weight on, but then lost it, because of diabetes when I was younger, but then I got fat it wasn't due to diabetes, it was due to what I was eating. 

But at the same time you had to sort of do a new kind of management of your diabetes in order to lose that weight and to put'?

Yeah, you just change your diet and lower your insulin, which, at the time I was eating loads of rubbish and giving myself loads of insulin and not doing any exercise, as a normal person would I suppose, so. I wouldn't say I got fat just as a direct result of diabetes, it was because you know, I was eating loads of rubbish and not doing any exercise. 

And you didn't put on weight before because of all the sport you were doing?

Yeah, so I can't say if I would have put on weight if, because of diabetes, because I would have, I was doing, I was burning it off. So I might, I might have done, but I don't know. 

Yeah. And you had a diet that worked?

Well, I imagine you will probably put on weight because the, it's a hormone stimulant and insulin is a thing that is making you fat. The more insulin you give the more fat you get, so, yeah, I'm sure when you first start doing it, when you're sorting out your levels and what-not, you're going to, yeah, you're going to put on weight. 

Did you find it difficult when you were starting to be a teenager to control your diabetes because I have been talking to other kids who just find it very difficult around the ages of fifteen'?

Yeah, you see, because you go through puberty that's why I had those, those fits that I had and, yeah, it messes you up. But again, I mean I suppose, yeah, but that was I doing, I suppose I was doing blood tests at that point. It's just, yeah, it's just one of them things, you sort of go through it and then you get out the other side and you're alright again. I've got to be honest, I can't remember.

Were you doing sport at that time?

Yeah, I was doing loads. Loads of sport. I was eating like a horse - something like six Weetabix in the morning and, oh, I was eating obscene amounts but I did not get fat because I was doing

Two years ago he was eighteen stone and said he got to it through eating too much of the wrong food and not doing any exercise.

Oh yeah, when I, before, when I was fat I was eating a couple of pasties, that was it, for tea. But I mean, I can't really remember what I had now. Pretty bad stuff so couldn't be bothered basically. It was that it just got to a point where I eat because I had to eat and it would become a chore, you know what I mean, it was just like you eat, because you have to, you know, because you don't enjoy it. You go out for a meal - I eat my food probably, like, as twice as quick as everyone else just to eat it, it's just the thing you have to do until I got to a point where I couldn't be bothered so it was just like microwave . To be fair, I mean, when I first started I was cooking quite a bit - to be fair I haven't cooked a lot recently because I've been really eating crap. Not like crap right, I've just been eating, you know, easy stuff like sandwiches or whatever. But, it's not as bad as I was because before I was eating loads. 

You were eating the wrong type of food most of the time, or all the time?

Yeah, it was just, well, I just, yeah I mean like pasties are supposed to be the worst, aren't they? And because I was, yeah, I was on, what, 34 units which now seems obscene, because like well I'm only on 6 now, because I was eating crap, because I was fat and when you're fat you get more insulin you need, so it's just like a vicious circle. So, it's just like, yeah, sorting out, sorting out the diet is pretty much it, it's the main thing that helped me out losing weight. Then I lowered the insulin, and then I'm laughing now, so.

You had a weight problem a year ago?

Well, two years ago, yeah, I got one. I lost four and a half stone, I got really fat, that was just through, I think through laziness, like with my girlfriend and that, just sitting around eating [laughs] so, when I, when we broke up, like, after, two years ago, I was really, I was about eighteen stone. So I got really big. 

And how many stones are you now?

Thirteen and a half.

I mean diabetes wasn't the main thing, if I'm honest diabetes is alright, I mean, I don't care. I don't know. I could look after myself better but then I know people who are worse than me, so. I mean, I always do my injections, I've never missed them out, except maybe the ones in the morning if I have a lie-in and I get up and have lunch. But I never miss one out on purpose, you know, I do sometimes, sometimes I do eat a bit more than I should. 
 

Says that such things as being overweight, breaking up with his girlfriend and having low self-esteem all contributed to him becoming depressed and suicidal.

I was quite depressed as well about two years ago and had to see a counsellor and stuff and I was, like, feeling like suicide and things like that, so I had to see a counsellor. But then I was like generally low and everything because like my ex-girlfriend, break up and stuff like that, so compared to like that, I saw her for a year so I've, I've stopped seeing her now so compared to what I was two years ago, yeah, I'm blinder at the moment. So, things are going alright.

You said about self-esteem, so how were you feeling during that period in which you were overweight?

Oh, I felt really depressed - just it was the self-esteem, like, you know, you go out with your mates and they're all skinny and they seem to be getting girls left right and centre. I used to go out, which to be fair, I mean I used to go out and get like just really depressed, we used to drink too much and that was the main reason, you know. Now I'm not so drunk. I fell in a drunken stupor so, well I mean that's what I used to do, I used to go out and just get hammered. Which again, I mean, I had issues there, you know, so, it all kind of come to a head, but being fat didn't help, so I got really depressed about it. But then, I suppose because I got to a point where I got so low, I got to probably the lowest point you can get, it's either, you know, do yourself in or sort yourself out, so at the moment I'm trying to sort myself out, to be fair, and that's, so, but it does, you know, it'll take, it'll take something to kind of kick you in the nuts and make you go and, you know, sort yourself out. And that's what, that's what happened to me and that's where I am, but, yeah, it is hard. 

But now, I mean, yeah, I'm having a wicked time at the moment, so I'm glad I didn't, you know, but at the time, you get, you get in such a state like I was in, it doesn't matter. Everything, well, I had, I had a list of things I wasn't happy with, like being fat, not having a good job, but in the end they kind of add up and then it just comes like a monumental task, I can't do anything about it, and it's just, you know, you do yourself in, you think what can I do? So really in the end but you kind of like, you sort yourself out. I mean like I was fat, but that was, I think being fat and like having this thing that I was ugly was probably the main, the main factor really, if I'm honest, of doing myself in, in the end. So, losing the weight was the main thing which I've done the best I can, really, so, I mean I'm happier now. It was all other things, I mean I was seeing a counsellor for a year and there were all sorts of, a lot, all sorts of issues to be honest. 
 

Explains about the diet that has helped him to lose weight and the benefits of seeing a counsellor.

How easy or how difficult it was for you to start on this diet?

When I first, when I first started it was easy. Because I knew I was fat and I wanted to lose weight. I mean, when I saw her in London I was probably about 2 stone more, I'd already lost about 2 stone going down the gym. So'

But you were still clinically obese?

Yes, she said I was still clinically obese and I needed to lose it, so. The diet was easy, I mean, it's, to be fair, it's quite a good diet. 

This lady in London put me on a high protein diet. So it's like 60 grams of carbohydrate a day with - and everything else just, like, fish and meat and stuff. So it's high in fat, but then you don't keep it, you see you lose the weight so you don't eat much carbohydrate and you can lower your insulin right down. So, I mean, I was on something like 36, 36, 36 and then like all day long for all my injections, and now I'm like, I think I'm 6, 6, and 8 and 16 before bed, so I've cut, I mean now have hardly any carb - insulin at all anymore, because I don't eat much carbohydrate. 

Well, I think while you're losing the weight you have like 60 grams which is like three slices of bread, so that puts you like through lunch if you're working. I mean, I used to take like a couple of sandwiches in, and I'd also have a bit of ham and a bit of salad and I add loads of mayonnaise. And like, and then in the morning you have like fish or whatever, or bacon and eggs, and then at tea you can what, whatever, really. Vegetable stir fry with meat, or steak, or whatever - there's loads of stuff you can have. So it's not that hard, to be honest with you, and it works. And then, and then once you, once you hit the weight, once you stop losing weight, you get to the weight you want to be, you can have like 100 grams, so you can have pretty much a normal amount. 

I saw that counsellor which is the first step I suppose which started to help me out and sorted out all my pro-. I mean, I've got issues, I've, I'm sure there are millions, loads of people who have been through like more stuff than you've been through but I mean, I've been through some stuff and it all kind of built up, I suppose, over the years and I didn't really talk to anyone about it and it come, it comes to a head, I suppose. The issue, yeah, you talk about it and sort yourself out and you realise what you're doing wrong, and now all I know the reason I mean the reason I wasn't getting birds, one was because you know I was miserable, you know when you're not happy with yourself people know that, you know, and that was the main thing, being wasted in a corner of a night is, people don't like that either, it's not attractive, but you don't see it like that. You think everyone else is having a wicked time, you know, and you're not, and because it's you're fat and you're a loser, and that's the main thing and it builds up and you then know, it's pretty much what happened. Well. Anyhow, I lost the weight because I didn't like, I mean, I didn't like being fat. So, I'd rather, I'd rather lose the weight. So I did. And I feel better about myself now, so.

Yeah, one day you wake up and you feel like you need to sort yourself out and you do. And, yeah, I mean, at the end of the day, to be fair I'm doing it one step at a time - I've lost the weight, I mean I saw the counsellor about the other issues I had about kind of getting, because I was depressed and what, and now I'm trying to sort out my career and I'm seeing a careers' advisor. So you do one thing at a time, but I'm getting there. So I mean, like, compared to two years ago, yeah, I'd say I'm about a hundred per cent better than I was. 

Says that he has lived with diabetes for 16 years and if hasn't stopped him from doing what he wants and most of the time he forgets he has it.

That it's not the end of the world, you get used to it. Well, I don't even think about it anymore, to be honest with you. It's, it is a pain in the arse, but it doesn't, you don't have to stop doing anything that you do, I don't think, other than maybe a job or career you're looking at, but there's not that many anyway, and they've got a new law in, so it doesn't matter, but it doesn't affect anything that you want to do, it doesn't affect going out, it doesn't affect, I mean, it doesn't affect anything really. There is support and there's support for you, it's not the end of the world. Yeah, you get used to it, I wouldn't, I mean I, you know. I mean, like I say, the issues I've had is none of them have been about diabetes, so, it's just one of them things. I mean, I've had it what, sixteen years, I don't even think about it. And it hasn't affected me in any way [laughs]. 

You can get through it, you can have a laugh - I mean I have a laugh, go out with my mates, it doesn't stop me doing anything and can go on holiday, you know, just, and after a while it's just one of them things. Yes, it's, it is a pain, and I, I suppose to people who haven't got it, but then I've virtually most of the time I forget I've got it, to a point that I don't think it's an issue anymore. Like, when doing things like this, it kind of reminds me that I've got it, if I'm honest with you because I've, the injections become part of life, you just do it. And to be honest, like when they, this cure thing, like when they bring this out I suppose that it'd be weird I suppose to a point I wouldn't know what to do. It would be strange knowing that I wouldn't have to control my insulin anymore. Actually it probably would affect me more, probably put on more weight to what I eat because at the moment I can cheat, you know. It would be weird, I suppose, having that control taken away from you and kind of going back to normal, I suppose. But it's, yeah, it's just one of them things you get used to. That's it, really [laughs].