Mrs Patel - Interview 37

Age at interview: 68

Age at diagnosis: 53

Brief Outline: Diagnosed 15 years ago. Mrs Patel takes metformin and insulin.

Background: Mrs Patel is a retired shopkeeper who is married and has grown up children. Ethnic background/Nationality: Gujarati Hindu.

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Mrs Patel grew up in Zanzibar and is a practising Hindu. She and her family have always been strict vegetarians and she believes their diet has always been quite healthy. Her diabetes was diagnosed when she was 53 and still working. She took her diagnosis very seriously and read everything she could find about diabetes and used to browse through bookshops and libraries in her spare time to learn more about how the body works and what having diabetes would mean.

Mrs Patel comes from a large family and most of her brothers and sisters also have diabetes type 2. Recently one of her brothers died following various complications including heart problems, kidney failure and limb amputation. Mrs Patel feels very strongly that many people do not fully understand what diabetes means. She was part of the Expert Patient Programme (now Self-management UK). Nowadays she has less time to help others because her husband has recently had a heart bypass.

She feels her diet is good, but knows that she does not take enough exercise which is mainly because she does not enjoy walking. She has recently been transferred from hospital to primary care and is concerned that her GP will not be able to give her the expert treatment she has enjoyed up to now.

Mrs Patel has always been vegetarian and now tries not to eat food containing ghee or flour.

Ghee. Ghee we don't take it on normal basis at all. You see we make chapatti and we put ghee like you put butter on your bread, I don't cook with ghee at all. Now oil when we cook our vegetables we put a tablespoon of oil in it for the vegetables, so that maybe reduce a bit but it doesn't happen because whatever oil you are putting is for two or three people to eat that vegetable so you might get a teaspoon.

But instead of eating three chapattis, we eat two chapattis. Just reduce your food intake, that is what I do. And fruit and vegetables are okay. We don't eat eggs, no fish, no cheese, so only vegetables and plain flour what we, I mean, mould into chapatti and rice.

So where's your protein?

Protein is from the dal.

Lentils?

Lentils. But as far as what I understand, too much protein is not good for us as well because that converts into carbohydrates, and then the breakdown of that is little heavier for the body to break it down to sugar level. So protein we try to not eat so much, a little bit less than normal.

Mrs Patel knows she should take more exercise but she doesn't enjoy walking at all.

That is very good but I don't do it  [laughs].

Why?

[Laughs] You have to have an initiative to do it, it's exercise, yes I do a bit of it, because of my back, not that I, but it would help. But the exercise you see my brother as I said, he used to swim a lot. He was a very good swimmer. Every day he would swim about three, four miles in sea water, not swimming pool, swimming pool was different. And whenever you see he had controlled his diabetes so much that he whenever he goes to swim, before swimming he would check his blood sugar, look at the levels. And then he comes back and he checks it immediately. There is a drop in sugar level always, but after two hours of resting, after swimming two hours of resting, sugar level is same like before. It hasn't gone down or it hasn't been more or less but still the same and when he eats after that, obviously, it will go up.

But with exercise, you see, with him it has happened so I don't know how much will it help? It can control your weight, that is for sure you can't put on weight. But if your weight is stabilised and if it is just the same, I don't think exercise will help. But they say it is proved that exercise will help [laughs].

Have you as a family always taken exercise? I mean you said your brother loved swimming. Have you ever done anything regularly?

No, no, no. I haven't. Not now. Not after diabetes. I used to swim, I used to be a life-saver as well [laughs]. But not, not for the last forty years. I haven't gone in waters at all [laughs].

What about going out for a walk?

Yeah, that would help. That is very good but I, with me, I am a different person for walking. If I had to walk I would walk, but not on a regular basis. It is very good.

It's just when you were talking about if you take your blood glucose levels and they're too high in the morning, you said to me you'll eat one less chapatti.

Yeah.

Yeah. I mean another of approaching that would be to go for a walk.

Walk.

But you don't do that?

No, I don't do. If I do exercise, I know it is good for me and good for my health and for my physical but somehow it doesn't appeal to me. Going for a walk. It's me only. Lot of people do and it would help.

Yeah.

You see. I am sure.

Is it more difficult for people from your background, women your, from your culture to take exercise?

No, no.

No, it's not a problem?

No, no. No problem. Everybody does it, nowadays, very few, one maybe like me, [laughs] not so many.

Do they try to get you take exercise when you go to the hospital and the doctors?

They tell me and I said, I that is, I just can't do it. My husband walks three miles, with his eyesight and with all his problems, every day. He tells me to go every time, but I don't do. It's only me, as I said [laughs]. Not that, it is going to get any, I know it would benefit me.

Okay.

But is not' mentally I am not prepared to walk [laughs].

Mrs Patel and five of her siblings have diabetes which they inherited from their father.

So if I said to you why do you think you've got it, what would your answer be?

My answer? It must be genetic from the parents, you see. You see one thing is our lifestyle has changed by living in cities as well. One reason is maybe our lifestyle, the second is our food, what we used to eat before and what we are eating now. Lot of variation in food as well. So that maybe the reason and genetic. Because father had it so you pass on to us as well.

Are you worried that your children will get it?

Yeah we [are], I am, because we both are diabetic.

You and your Husband?

Husband.