Learning to live with diabetes

John McLaughlin was shocked to be diagnosed with diabetes in September 2006. He was 58 at the time and didn’t fit the typical profile for most type 2 diabetes patients.
Most of the people he knew with diabetes were overweight, smoked, drank, were physically unfit, did everything wrong and didn’t participate in regular physical exercise. However, he didn’t fit into this category.
Having played senior hurling for Wolfe Tones and Sixmilebridge for a number of years, McLaughlin from Manusmore, Clarecastle, remained active playing various different sports, particularly tennis on a very regular basis.
The previous August was very warm and he found himself drinking more and more. After a tennis tournament in Ennis, he realised he was drinking fluids like a fish. Fanta, milk, water and “gallons” of tea at home. None of them seemed to quench his thirst.
Forced to go to the toilet three or four times a night, his sleep was also disrupted. Instinctively, he knew there was something wrong so he contacted his doctor, who immediately suspected diabetes, which was subsequently confirmed after a blood test two days later.
As a type 2 diabetes patient, he is insulin-resistant. The 64-year-old has insulin in his body but he doesn’t have enough and it isn’t working properly for him.
Usually people who are obese can get diabetes if there is too much weight around the stomach as the insulin can’t get in around the system.
The same week he was diagnosed, a work colleague showed him a Clare Champion article highlighting a local information night concerning diabetes.
He attended the meeting, along with 70 or 80 others, and heard presentations from a doctor, nurse, dietician and podiatrist.
Diabetes Federation president, Dr Tony O’Sullivan, summed up the condition at the meeting, “There is no cure, put that to one side, you can still live perfectly normal life once you look after yourself”.
It is estimated 10% of diabetes patients have type 1 and 90% are diagnosed with type 2.
Two years ago, he became chairman of the Clare branch of the Diabetes Association and was subsequently elected chair of the West of Ireland branch, covering Clare up to Donegal. The West of Ireland branch meets about twice a year in Claremorris, Mayo. The national association has offices in Cork, Sligo and Dublin.
Commenting on his role as branch chairman, he jokes that now his job is like being a member of the old Republic of Ireland soccer team where it was “harder to get off than on the team” and is quick to point out that secretary, Gráinne Flynn does most of the work.
The Clare branch organise two or three public meetings for type 1 and type 2 patients with topical meetings.
Newly diagnosed diabetes patients benefit from listening to more experienced people at branch meetings.
Judging by the amount of people attending the clinic in Ennis hospital, the Clare branch estimates there are 2,000 people in the Banner County with diabetes. That number doesn’t include all the diabetes patients who are being treated by their GP, however.
The branch has access to a nurse in Galway, who gives talks and presentations and it also runs the CODE course, teaching diabetes patients how to self-manage their condition. He feels sorry for parents of children with type 1 diabetes who have to learn very fast.
The Health Service Executive (HSE) doesn’t have any official figures for diabetes patients in the region. A group of health professionals in the Mid-West have united and hope to have completed an official register by the end of the year.
McLaughlin believes one in four people either have, or know, someone with diabetes. The federation recently produced a booklet to help teachers deal with issues like diabetes and asthma in schools.
His main message for newly diagnosed diabetics is to get an appointment in the out-patients’ clinic at Ennis hospital, as quickly as possible and to attend branch meetings where they can learn valuable information and support on how to manage this condition.
He had to wait two months to get an appointment after a series of phone calls.
However, he also recalled his medication was changed after walking into the Ennis clinic without an appointment after returning from a charity trip where he had experienced an unexpected collapse after a hypoglycaemic attack, or “hypo” (a situation when a diabetes sufferer’s blood sugar falls to dangerously low levels).
A person with type 1 can get a hypo a few times a day but once they take insulin, they are fine again. A local doctor looked at his medication and suggested he should get it changed.
In March 2009, he completed a seven-day sponsored trek for diabetes with 12 others in the Arctic Circle.
John was the only one on the trip with type 2 diabetes and was also the oldest. One day, he collapsed due to over-exertion after going too long without eating. It was hard to consume food in temperatures as low as –15˚C and that day, they covered 50km in a national park near the top of Norway without seeing much habitation.
The charity volunteers used summer homes, some of which had no electricity or water and often had to dig a hole in the ice to get water.
On a light sleigh, similar to a supermarket trolley pulled by four huskies who can reach speeds of up to 20 miles per hour, John quickly learned his knees were his shock absorbers. The dogs took the shortest route over stones and snow and cut corners, resulting in a very bumpy ride.
All the participants had to reach a €6,000 target before they left, luckily John had most of the money raised before he left as some of the people on the trip had difficulty raising all of the required sum. Half of €6,000 covered travelling and other costs.
Eighteen volunteers raised €55,000 in total over a two-year period, which has been invested in diabetes research.
Diabetics with more acute conditions can travel to Limerick or Galway where there is a team of professionals whose speciality is diabetes and only deal with people suffering from the condition.
Up to 10 years ago, people with type 2 tended to be in the mid-’50s and older. However, now people are getting type 2 diabetes in their mid-’20s. While it is difficult to pinpoint an exact cause, John believes it can be attributed to lifestyle and obesity.
“I think one of problems with diabetes is that no one dies from diabetes, you die from complications of diabetes, which is heart, stroke and kidney failure. The main problems I look at for my health are heart, stroke, eyes and feet,” says John.
“Exercise covers a lot of that, particularly if you exercise regularly. Lately, there has been a huge upsurge in perception of diabetes. It is the fastest growing disease in the western world at the moment.
“It is growing problem and has caught the attention of the HSE,” he explained.
Last year, the Diabetes Federation ran a campaign on podiatry – the branch of medicine targeting disorders of the foot, ankle, and lower leg. In 2010, 390 people had amputations related to diabetes, roughly seven a week.
Most of these operations would have been preventable if these issues were tackled sooner but there weren’t enough podiatrists in the public service to resolve this issue.
“Half of all lower limb amputations are diabetes-related. I suspect a lot of people are living on their own in isolated rural areas who may not be looking after their health as well as they should. If this is left too long, it gets worse and worse and becomes a major problem,” he warned.
Following the federation’s successful campaign, the HSE has appointed 20 new podiatrists over the last six months.
The HSE are improving the delivery of retinopathy services, which have been contracted out to Breast Check who are planning to check the eyesight of every diabetes patient in 2012 and 2013.
Patients will then be categorised into high, medium or low risk. The high-risk people will be recalled for more intensive treatment.
Up to now, a lot of people, including diabetes patients, don’t get their eyes checked often enough. It is the only place where a professional can see a blood vessel by looking into the back of a person’s eye.
Adhering to a strict diet and exercise has ensured the changes to John’s life weren’t too radical.
His diet is now a lot healthier with less salt and sugar and more fruit and vegetables. All the emphasis is on eating smaller portions regularly without snacking in between. Over-eating causes a problem for any patient, who is storing up energy they can’t use. John eats high-fibre bread, which takes longer to digest but releases glucose into his system more slowly.
With some adjustments and discipline, he is happy to continue living life to the full.