Stuart's Type 2 Diabetes

by Rosie Peters

Stuart scowled into the mirror at the red spot on his neck.

'Not another boil! I'm sick of them.'

'That'll be the third,' said his wife, Carol. 'Perhaps you're run down. You've not been right lately. Why don't you go and see the Practice Nurse?'

'If she could stop me getting boils I'd be glad to. But it's a holiday I need not a nurse. I'm just worn out.'

'I've noticed that. You've done less in the garden recently. This time last year I couldn't keep you out the veggie patch. It was straight down there after work each day. Now it's a jungle.'

'I know love. I'm ashamed of the weeds but a day in the office knackers me. I just want to put my feet up when I get home.'

'I understand, but what puzzles me is how you've managed to lose weight when you're sitting around so much. I know you're much heavier than you should be but you definitely look thinner in the face. Perhaps that's what's making you tired.'

'Possibly.' Stuart knew he'd made no effort to eat sensibly. At first he'd kidded Carol his small weight loss was due to cutting down on beer at the pub.

That night Stuart couldn't settle. Carol lay sleeping beside him. Four times during the night he crept out of bed and went to the bathroom to pee and twice he went down to the kitchen to get a drink of water.

'Did your boil trouble you last night? You seemed very restless.'

'It's sore but didn't keep me awake.'

'Well something did.'

'I thought you were asleep.'

'Not all the time. You were so fidgety. Were you worrying?'

'I was. Perhaps I should tell you.'

'Tell me what?'

'I think I might be taking after my father.'

'What, going bald? You're not stressed about that are you?' Carol laughed and patted the top of Stuart's head. She ruffled his thin grey hair. 'I'll still love you when you're a baldy locks.'

'No, it's not that. I'm concerned about getting diabetes like Dad. I've got some of the symptoms.'

Carole frowned and Stuart put an arm around her. The spot on Stuart's neck was knocked by Carole's head as he pulled her close.

'Ouch! That ruddy boil. I'm going to let the nurse check it.'

'I'm more bothered about your general health especially if you think you could have diabetes. You've certainly not been yourself lately.'

Stuart nodded, feeling guilty when he thought about his lack of vigour and romance in the bedroom. He saw Carol had the pinched expression on her face that she always had when she was about to get her own way.

'You must get seen today, and make sure you tell the nurse everything. She'll know what to do.'

'Ok, I'll go this morning, but I'm dying for a cuppa. Just let me get some brekky first.'

It was almost lunchtime when Stuart came back from the surgery with a thick wad of white gauze taped to his neck.

'It's popped. Feels better now.'

'That's good, but how did you get on? Did you tell nurse how you've been feeling?'

'I did. Nurse Jean was great. She listened to everything I had to say, and then she asked me for a urine sample.'

'And?' Carol leaned forward, her brow wrinkled.

'I had sugar in my urine'

'You were right. You've got diabetes.'

'Keep calm! I might not have it. Not everyone with sugar in their urine has diabetes. I've got to go back tomorrow first thing and have a blood test. That should tell us. Nurse said she'd have another look at my boil too.'

Stuart noticed Carol twiddling with her wedding ring, the way she always did when she was anxious.

'Come on love, it's a gorgeous day. Let's sit outside and have a coffee. I could do with a drink.'
Carol put the kettle on while Stuart set two canvas seats and a folding table under the shade of the pear tree. He sat back and glanced round the garden. Weeds were poking up through the colourful clumps of flowers in the herbaceous borders. Stuart sighed. If only he had more oomph. The large plot was becoming too much to manage. It wasn't so bad when James and Philip came home from university. They were always happy to help by cutting the grass. A gentle breeze blew some creamy blossom from the tree on to Stuart's lap. He remembered twenty years ago, pushing the twins' pram under this same tree for their morning nap and wondered if they could have smelt the honeysuckle as he could now. It had become rather a tangle as it clambered over the pergola. Sometime he must get around to pruning it. Perhaps if he had a really good holiday he'd have more energy. Carol hurried from the house with two mugs of coffee.

'Sorry, I got waylaid. Your mother phoned. I told her about your boil. She said your father had some once. Apparently people with diabetes are prone to skin infections.'

'Mmm, I'd heard something like that. I know some get thrush.'

'Well, I hope you haven't got diabetes.'

Three days later, Stuart received a letter asking him to make a doctor's appointment to discuss his recent blood tests. He couldn't settle to do anything.

'I just need to know,' he kept saying.

The next day Stuart and Carol arrived at the surgery twenty minutes before the appointed time. After checking in with the cheery receptionist Stuart picked up a running magazine. Flicking through the pages he kept wishing he'd led a healthier lifestyle.

'Will you come in with me love?'
Carol squeezed his hand. 'That's fine, if the doctor needs to tell you something, it's best I'm there too.'

Stuart wasn't surprised to find out he had diabetes. Doctor Strong told him the blood tests proved it. Carol started fiddling with her wedding ring and biting her bottom lip. Stuart wondered if he should have seen the doctor on his own.

'I'm glad you've come in,' said the doctor, smiling at Carol. 'There can be quite a lot to take in and he'll need your support. Diabetes is a lifelong condition, but with care, usually it can be controlled.'

'What is diabetes, Doctor?' asked Carol. 'I know there's more than one kind.'

'That's right. It's really called diabetes mellitus. There's type one which is generally associated with younger people and there's type two which more often affects people over the age of forty although people younger than that may get it. Overweight people are more at risk and the condition tends to run in families.'

Stuart listened intently as doctor explained that in type two diabetes, there wasn't enough insulin produced for the needs of the body, or else the body cells failed to use insulin correctly. Sometimes it was a combination of the two.

'Do I need tablets?'

'Not at present. Your treatment is a combination of a healthy diet and exercise. You don't need to buy special diabetic food. A diet that's low in fat, sugar and salt is best, but you need to make sure you get plenty of fibre, starchy foods, fruit and vegetables. It's also important to keep your blood pressure and cholesterol down, and your weight within normal limits.'

Stuart felt pleased that when asked about nicotine he was able to say he'd never smoked a cigarette. He was also happy his blood pressure reading was satisfactory.

'Will I get my father's eye trouble Doctor? He's almost blind through diabetes.'

'We can't say for sure what will happen. You're more at risk than someone who doesn't have diabetes. The main thing is to lead a healthy lifestyle and let us see you regularly. The optometrist can check for early signs of diabetic retinopathy which is a condition that could damage the sight. You'll need to have this eye examination every year.'

'I'll make certain of that.'

'And if you have regular blood tests we can check the progress of the disease. The object is to keep you well now and prevent long term complications. I'd like you to see Nurse Jean and she'll help you with the things you need to learn.'

'What sort of things?'

'Jean can help you make any changes necessary to keep you healthy. You'll need to start testing your urine to check for sugar. She'll show you what to do.'

'My friend has diabetes. She pricks a finger to check her blood for sugar. Won't he have to do that?' asked Carol.

Dr Strong handed Stuart a clear plastic folder labelled 'Diabetes Information Pack.'

'The monitoring of diabetes differs according to the treatment required. Many patients will have to do blood tests but as we're treating Stuart without medication at present, urine tests are adequate. Any blood tests can be done in the surgery. I suggest you both read the leaflets in the information pack and make an appointment to see Nurse Jean in a day or two. She'll answer any questions you later think of.'

As Stuart left the surgery Carol grabbed hold of his hand 'It'll be all right love. Let's look at those leaflets together and see what we can learn.'

Once home, Stuart emptied the folder onto the table and spread out the pamphlets. 'I'd been worrying about diabetes but now the diagnosis has been made I feel happier.'

'Why?'

'The surgery seems well geared to help people like me. When Dad was first diagnosed he had to go to hospital.'

'GPs and Practice Nurses are experienced at dealing with diabetes these days and at least you don't need medicines like your dad.'

'Yes, as well as taking tablets every day to control his blood sugar, he has to have aspirin to reduce the risk of stroke or heart attack.'

'He has a flu jab each winter too. I expect you'll be offered one, and a pneumonia injection too.'

'Why? I thought only the elderly had them.'

'According to this leaflet, you need them because flu and pneumonia can be particularly unpleasant if you have diabetes. It says any infection can upset diabetic control so it's wise to reduce the risk.'

'There's so much I need to learn.' Stuart flicked through a leaflet entitled, 'Foot care for people with diabetes.' He shook his head. 'It's a bit overwhelming.'

'Don't feel like that love. Since you first told me you might have diabetes I've been doing some research. There's a lot of help out there. Doctor Strong and Nurse Jean are so approachable and there's the Diabetic Clinic at the surgery too.'

'I know, Carol, and I'll try and make the changes I need especially with diet and exercise.'

'I'm sure that's all you need to do for now till we've seen Nurse Jean. If we look at these leaflets then at least we'll be a bit clued-up when we see her.'

'I don't remember Dad getting all this information.'

'Things have changed. People nowadays want to know more and take control. There's so much you can do to help yourself.'

'What do you mean?'

'Brenda at work has diabetes. She was telling me about it once when we were having our break together. I remember I was eating a sausage roll. She'd got this magazine called Balance and she showed me an article about healthy eating.

'I'm not going to start reading recipes.'

'You won't need to. The magazine wasn't just about food. There was lots of stuff to help people with diabetes. Brenda's joined Diabetes UK and they send it her each month. She finds it really interesting but she's one of those who like to know things. She's even going on a course.'

'What course is that then?'

'It's an Expert Patient Programme. Brenda really went on about it. I thought she'd never stop.'

Stuart laughed. 'Isn't it enough that she's an expert in her field at work?'

'Really, love, she was quite excited about it. Apparently there are these courses that people with different types of chronic disease can go on. They learn to cope with whatever's wrong with them.'

'Do they look after themselves then without doctors?'

'No, that's not the idea. They still see health professionals but the course helps them to understand things better and manage their condition.'

'Dad never went on anything like that.'

'Most people don't but it'll suit Brenda. You'll get guidance from the medics and there's the internet too. Have you heard of www.patient.co.uk? It's a really good site for anything to do with health.'

'You've certainly been researching, Carol. It seems there's lots of help available. With your support and a good team at the surgery I hope I'll be able lead a full and active life.'

Carol nodded. 'I think if we both follow the healthy eating advice and take regular exercise, you may prevent your condition deteriorating and I might reduce my own chance of getting the disease too.'

Stuart pulled his wife close and hugged her. He felt so happy that Carol seemed keen to learn more about diabetes and was willing to undertake changes to keep them both well.