Family Members
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Baby Joy and her mother, 1950

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Baby Joy and her mother, 1950 Joy`s parents, 1947 Joy and her mother, 1954
Joy, 2007 88. 01 10g bread measures 88. 02 1940 line ration scheme front
88. 03 1940 line ration scheme back 88. 04 1940s Salter 08oz scale 88. 05 1942 Manchester Royal Infirm diet front
88. 06 1942 Manchester Royal Infirm diet, back 88. 07 1950 Park Hosp diet sheet 88. 08 1952 Lawrence diet, front
88. 09 1952 Lawrence diet, back 88. 10 1962 University College Hosp diet 88. 11 1971 exchange list
88. 12 1980 exchange list 88. 13 1982 Countdown guide 88. 14 1983 exchange list
88. 15 2005 DAFNE Portion list
 
 
Interview 88 Joy

Dietitian and family member
Born in Manchester in 1949.


Overview: Joy was born seven years after her mother was diagnosed with Type 1 diabetes and from a young age took considerable responsibility for managing her mother`s care. Her aunt and two uncles also had diabetes, so Joy grew up thinking it was not unusual for people to test their urine, measure their carbohydrate intake and eat meals at precise times. She trained as a dietitian from 1967 to 1971 and has always specialised in diabetes. She has worked as a District Chief Dietitian in Surrey for over twenty years.

Please note that Overview relates to date of recording 16 November 2007

 Short samples

1 Joy’s mother had frequent hypos and Joy had to deal with them whenever her father was absent, even when she was only four or five years old. [ 59 secs ]

2 When Joy trained as a dietitian in the late 1960s, the terms Type 1 and Type 2 were not used. [ 60 secs ]

 
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01 Mother diabetic - in hospital 3 months before my birth, 1940s. Afterwards, her diabetes uncontrolled.
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02 Mother`s sister in hospital with diabetic complications. Family remembered deaths pre-insulin. Aunt died 1950s - had diets for renal failure. Mother`s brothers developed diabetes, 1950s. When sweets off rations, no difference to us.
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03 Mother`s Globin Zinc, uncle`s soluble insulin, glass syringes, huge needles, Clinitest.
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04 No sweets or sauces. Mother weighed food. Meticulous at first – aware insulin a gift. Uncle guessed amounts - perhaps more leeway on 2 injections. Father taught me to deal with hypos.
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05 Moved south. Coped with mother`s hypo in street. Discovered not every family ate at precise times.
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06 Father had been in army medical corps - gave daily injection in bottom; didn`t mind omitting sweet food; good at treating hypos.
I accompanied mother to hospital. When moved south, mother went to GP only – inadequate to check complications.
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07 When developed pernicious anaemia, transferred to hospital, but complications already developing. She took more care of diet. Went on 2 injections. I`d qualified as dietitian – didn`t listen to me!
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08 Mother had dental clearance, aged 36.
Childhood not much affected by diabetes, but affected career choice.
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09 State school, Manchester. Private schooling down south. Went to college to study dietetics.
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10 Dietetics not all-graduate. Only degree, Battersea College, science-orientated. I preferred practical diploma, Ealing College – visited London teaching hospitals. New profession - British Dietetic Assoc formed 1936.
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11 1960s - interest in diet developed, especially renal & paediatric. I was interested in diabetes. 3 years theory, 1 year practical. Finals 1971. Council for Professions Supplementary number 1281 – only about 1100 practising dietitians.
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12 1960s - taught insulin-dependent diabetes diagnosed before age 40, non-insulin-dependent after 40. Non-insulin-dependent often died of complications before required insulin. Little obesity during & after War. No drugs to treat hypertension. In 60s & early 70s never saw insulin-requiring Type 2.
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13 First post in South Essex working with diabetes consultant in different hospitals. Dietitians rare & consultants had relied on BDA leaflets. I advised newly-diagnosed. No blood-glucose monitoring. Urine-testing unreliable. Weight important in assessing control.
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14 Moved to Surrey – no dietitians needed, so worked in personnel, then stopped work to have children, 1974-9. Returned to work at new district general hospital, part-time at first, some diabetes. Much changed. There ever since.
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15 1983, British Dietetic Assoc. guidelines – abandoned 10 gram carbohydrate exchanges, emphasised high fibre quality rather than quantity. I still thought quantity important. Blood glucose meters available but expensive. Most tested urine. (In early 90s, BDA allowed 25 grams sugar daily.)
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16 Never abandoned exchanges. 1980s - blood glucose monitoring became more common. Guildford hospital acquired DSN – had diabetic sister-in-law. We both understood patients` experiences. Both thought carbohydrate load mattered as well as type. Taught some patients carbohydrate measurement – blood glucose monitoring measured effects.
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17 Multidisciplinary team (MDT) developed, 1980s. Late 80s, as District Head of Service, I sold dietetic services to fund-holding GPs to form own MDTs - mini diabetic clinics. “Share care” meetings for primary & secondary.
Dietitians no longer seen as nasty - resource.
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18 1990s - GPs looked after most Type 2 – obese. Hospitals specialised in insulin dependence & complications. Saw more Type 2 insulin-requiring – insulin made them put on weight. Tried low calorie diets.
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19 Local university developed low glycaemic index crackers – disliked by patients. Patients must be part of MDT – underlined by Expert Patient Programme & DAFNE.
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20 DSN has done Expert Patients & we`re both learning to be DAFNE educators. Patients gained from each other. Isolated patient made me realise my mother not isolated. DCCT & other research shows attention improves results. Diagnosis traumatic – patients only take in 10% of consultation.
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21 I work with gestational diabetes – seems more common – older mums, overweight, traumatised by diagnosis.
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22 Want to be seen as resource, not threat. Now concentrate on reasons why people eat too much. Need for exercise.
Gastric banding now available.
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23 Improvements - Pre-NHS, paid for mother`s insulin. Mother in hospital 3 months before birth – not nowadays. Outcomes better. More flexibility. Diabetics lead long, healthy lives.
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