Table Box 5.

Patient 2: ‘Poor–Good’

Case history

A 50‐year old, divorced man who on entry to the study had had diabetes for 8 years (I just sort of ignored it. I didn’t think there was anything wrong with me). I was always a social animal and played a lot of football. After training I had a drink. At weekends I had a drink. Then I went through a divorce and I had more to drink. I was living the lifestyle that I shouldn’t have done. Then I settled down. I kept getting ill. I just used to go to the GP or the nurse. They used to say, ‘take the tablets’. She never used to say, ‘You should be doing this’ or ‘You shouldn’t be doing that’ so I just carried on. His expectations were few: I didn’t expect really anything. I thought it was a bit of a chat.

Perspective at baseline

He received excellent advice: some of it has gone over my head sometimes, but I come off the phone and I think, ‘Crikey what has she said!’…. I’ve phoned back and said ‘sorry I’ve missed that one,’ or ‘what do I do?’ It has helped in bringing you into line with normality, for example, in relation to blood sugar levels and control in general with beneficial consequences for his social life. It’s been a struggle but I feel as though I’m getting there. He is more relaxed, totally relaxed about doing it now (monitoring and maintaining control of my diabetes). The advice has increased his confidence and it’s a little bit of a comfort zone. In summary, I’m willing to do anything to help myself to get back (to normality).

Perspective at 2‐year follow‐up

I was invited onto the study–I have never looked back since. I don’t think I would be here if I had carried on the way I was…. Within 12 months, I was down to low numbers and now, I am in the 7s. I have cut the drinking down by 70%. I am a little bit healthier…. Three years on I’m still keeping the bloods in check…. I am feeling good and three years on my overall health has improved. The information, changing over time, has improved me and I think it is invaluable. The call centre has met all my expectations even gone above them….

Changes

I only used to take my blood sugars before when I felt like it (which wasn’t very often). I didn’t really bother but I know that taking them more regularly has helped. At one time, I took four per day but now I just do them twice. He also eats regularly (which is pretty difficult when you do shift work) and cut down on his drinking. Just basic lifestyle changes and I exercise a little bit more. Overall, there were a few big changes and a lot of little ones but it seems to have come together. I sometimes didn’t want to say what I had eaten but it did me good. Before PACCTS, I never told anyone about the diabetes. Since then, I started to sort myself out and I also talked to the managers at work …. Being able to talk about my condition has helped me to cope…. The tele‐carer has also spoken to his girlfriend (it has made her more aware of what might happen).

Sustainability

Yes, it is going to be hard but you will just have to get on with it.

The relationship

It is a friendly voice. It is positive. Even if you have done something wrong, they don’t tell you off. They will help you. They will advise you. They will encourage you.