Age at interview: 70
Brief Outline: Sandra has put on weight since being diagnosed with type 2 diabetes in her 40s. Since then, she has developed complications from her condition, and has limited sight and mobility. This makes it difficult to go out, and sometimes Sandra feels stressed and depressed because of her health. Sandra doesn’t know how she can lose weight whilst controlling these conditions, but feels that healthcare professionals need to offer more information and support to patients who have been diagnosed with diabetes.
Background: Sandra is 70 and is married with 4 adult daughters. She used to work in a plastic factory but retired early due to her health. She is white British.

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Sandra was diagnosed with type 2 diabetes in her 40s, although she was not overweight at this time. Since then, her weight has increased, which she believes is caused by her condition. Another factor that Sandra feels has led to her weight gain in recent years is her lack of mobility. Her lack of mobility has been made worse by other health problems including leg ulcers, retinopathy, pain in her hands and feet, arthritis, and lymphedema. Sandra finds this stops her “doing things” such as take her grandchildren out, which is “heartbreaking”. Sandra also has high blood pressure. She has also heard her doctor mention that she has heart disease, though she has not been told details about this.

Sandra feels that the public have a negative and rude attitude towards people who are overweight or have mobility needs. When she became ill and had to give up work, Sandra lost a lot of her friends. She also found strangers treated her with disrespect or ignored her in public, “I want to cover my scooter with fairy lights or something because they just don’t see me… As big as I am I feel invisible”. Others are inconsiderate of her scooter, “people just envelop me”. Although she was referred to a day center by her occupational health unit, Sandra stopped going as the staff had problems with her injecting insulin at the table, and parking her mobility scooter near to the entrance. These experiences have stopped Sandra from wanting to go out. Due to her eyesight and mobility issues, Sandra now only leaves the house if one of her daughters or her partner can go with her. Because her husband works, Sandra hasn’t received much support for her disabilities. They have had to save up to buy her wheelchair, scooter and stair lift.

Since losing her sight and mobility, Sandra goes through phases of feeling stressed, upset, and wanting to die. “I feel I’m absolutely useless now. I can’t do anything. All I do is sit here and entertain myself…I was on Facebook but I can’t see Facebook any more”. Her doctor has prescribed her antidepressants, which Sandra finds “help with the tears”. Her daughters have also encouraged her to work through these feelings, and she tries to keep going for her them, “I’ve tried to accept what I’ve got now”. Although Sandra knows her weight is a danger to her health, she has a feeling of “well let’s get it over with”.

Sandra feels that communication needs to be improved between patients and healthcare professionals following a diagnosis of type 2 diabetes. Sandra wasn’t told the causes of her condition, except that she was “bound to get it” due to her family history, but Sandra did not know why this was. After her diagnosis, Sandra was given an information sheet about food groups she could eat. However, the health professional didn’t explain the nutritional values of foods, which meant that Sandra ate lots of fruit without realising the sugar content, “They need to do it. Tell you something and then finish telling you all about it before they start on another subject”.  Similarly, she wasn’t told about the possible complications from her diabetes, such as retinopathy, or the pain in her hands. She suggests that health professionals should hold classes to support patients who are newly diagnosed. Sandra hopes that with more information and advice for patients, outcomes could improve, “maybe if they do all of this people will understand how bad it is and maybe can prevent some of this happening to them”.

A lack of information and support around her diabetes was also a problem when Sandra tried to lose weight in the past. Several years ago, Sandra was referred to a weight management clinic. Choosing healthy options like salads, Sandra lost a stone. However, even after giving herself an injection, her sugar would go too low, “I had a lot of hypos and a lot of not knowing what I was doing with my insulin”. Since then, Sandra isn’t sure how she can lose weight whilst keeping her other conditions under control. She doesn’t know what health professionals could do to aid her weight loss, but feels a personalised approach could help, “I need a private trainer to be honest with you, one-to-one. Somebody who cares if I lose weight”. Access to GP appointments is another barrier to good care, “they are so overworked now. They just don’t have the time now for many one-to-ones”.
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