This brief report describes an interview that was conducted on 3rd January 2021. The interview was between my friend, Peter, and his uncle Andrew who has had lifetime challenges with diabetes. Peter provided me with the interview transcript, which I used to develop this report on Andrew’s case. Andrew was advised to isolate and avoid public gatherings due to the risk of contracting COVID-19. Isolation and limited interactions with the outside world initially negatively impacted his mood. However, his condition improved as he accessed a diabetes care team comprising a physician, dietician, therapist, and physiotherapist. The interview was conducted with strict adherence to current COVID-19 protocols, including social distancing and mask mandate.
Disease and Illness
When Andrew was ten years old, he was diagnosed with Type 2 diabetes. Unfortunately, he experienced substandard care in the 1990s, and after signs of no improvement, he failed to return to the clinic for a follow-up for ten years. Andrew also received wrong guidance and instructions from this specialist, which resulted in severe hypoglycemia crises after changing his insulin. This caused him to fall and suffer a broken leg. It also resulted in other concerns, including persistent depression and anxiety. He was followed up by his primary care physician about his insulin medication, who convinced him to return to a medical specialist, Dr. Ali, for a reassessment of his diabetes treatment. He had an excellent encounter in this case, and Dr. Ali recommended the Dose Adjustment For Normal Eating (DAFNE) course (Walker et al., 2018). Although there was a 34-week waiting period, the specialist engaged directly with the diabetes care team regarding Andrew’s case. Thus, the team decided to prioritize him, and he was given a course within four months.
Andrew highlighted how the seven-day training transformed his life. More importantly, he observed that self-isolation was not bad after all since members of his care team frequently visited him to check on his health and conduct additional assessments. Andrew also expressed optimism that his mobility was improving, and he attributed this to the untiring commitment of the physiotherapist. Stated towards the end of the interview, “I did not know I could ever walk again, but here we are. I walked from my bedroom to this place without assistance. Indeed, the physio did a great job.” He also showed no signs of depression, which he attributed to his therapist’s assistance. “The mood swings and feeling of loneliness have reduced, and my therapist has been fundamental in making me understand that self-isolation is for my sake.”
Reading this interview report provided me with a better understanding of individuals’ experiences with chronic illnesses and associated vulnerabilities. The first-person narration immersed me into the patient’s world in a manner that secondary sources would not. I could feel Andrew’s loneliness, indecisiveness, and optimism in his responses. I realized that patients with chronic illnesses require patient-centered care for optimum care. Such care should prioritize the patient’s needs and preferences and align them with the care coordination plan. For diabetes patients, I realized that high-quality care would most likely occur if treatment is undertaken from an interdisciplinary perspective. This is evident in Andrew’s case as he showed improvement under a multidisciplinary team which significantly contrasts his previous bad experience. Fundamentally, I realized that mostly, we view patients as sick people who need treatment, forgetting that they are also humans.
Walker, G. S., Chen, J. Y., Hopkinson, H., Sainsbury, C., & Jones, G. C. (2018). Structured education using Dose Adjustment for Normal Eating (DAFNE) reduces long-term HbA1c and HbA1c variability. Diabetic medicine: a journal of the British Diabetic Association, 35(6), 745–749. Web.