Page last updated at 00:22 GMT, Sunday, 21 September 2008 01:22 UK

'Don't dismiss people with diabetes as fat'

By Jane Elliott
Health reporter, BBC News

Andy Reeley
Andy says he is not the glutton people accuse him of being
When Andy Reeley looks in the mirror each morning he does not see a fat man - but he sometimes wonders if he should.

Andy has type 2 diabetes, sometimes dubbed a disease of the obese.

Although 80% of those with the disease - where the body does not produce enough insulin or the insulin that is produced does not work properly - are obese or over weight, 20% are not.

Andy feels however that the stigma attached to the condition helps no-one.

Embarrassed

"It really annoys me that diabetes is continuously referred to as the 'fat person's disease'," said Andy from Gloucester.

"It makes me embarrassed to tell people what is that matter with me.

I do not think I am fat, my GP does not think I am fat, the doctors at work did not think I was fat
Andy Reeley

"I feel that I always have to defend myself when I inform people that I have diabetes, and point out that I am not obese.

"More research is needed into the real causes. It is not simply a weight related problem."

"I do not think I am fat, my GP does not think I am fat, the doctors at work did not think I was fat," he said.

Andy admitted that he was a few pounds above his ideal body weight, nudging him just into the overweight category, but said his doctors believed his sedentary lifestyle, caused by a chronic pain condition is to blame.

"I am 6ft 2ins and just over 15 stone that is not hugely heavy.''

That gives him a body mass index of 27 - the ideal range is between 18.5 and 25, although experts say this is not a precise guide of risk and that patients should be guided by their medical expert about whether their weight is an issue.

Andy Reeley
Andy feels people label him as soon as he mentions condition

Andy said that when he says he has type 2 diabetes, everyone dismisses him as a glutton.

"People tell me to cut out the sugar, but I don't have sugar. I have diet drinks and skimmed milk.

"People seem to think I am eating the wrong foods and am a glutton, but I don't eat fatty foods.

"The only thing that puts me at risk is my relatively sedentary lifestyle because of my chronic pain due to arthritis in my lower spine, hips and knees.

"I have always countered that by eating relatively healthily," he said.

"I do not eat pre-prepared food I have fresh fruit and vegetables every day."

Genetic tendency

Dipex, an internet database, which includes personal testimonies from patients suffering from diseases, recently launched a section on type 2 diabetes in a bid to quell some of the misconceptions.

Researcher Dr Kate Field and colleague Tanvi Rai recorded 40 interviews, including Andy's story, and found many of them were people who felt stigmatised by their condition.

"Several people felt that a distinction should be drawn between being obese and having diabetes, and that the two didn't always go together," said Dr Field.

"Some people felt that they had a genetic tendency in their family to diabetes and that no matter how little they ate they would have developed the disease at some point. Other people said that they had been ill or had been under extreme stress before developing diabetes," said Dr Field.

She added that others felt people had little sympathy and understanding.

"Having diabetes had affected many areas of their life including for some people their ability and desire to have sex."

Zoe Harrison, care adviser at the charity Diabetes UK, said a healthy lifestyle can prevent the condition developing.

"Most cases of type 2 diabetes are now caused by insulin resistance, when the body still produces insulin but can not respond properly to it. Insulin resistance is strongly associated with carrying excess fat, particularly around the waist.

"However, type 2 diabetes can also occur when the body is unable to produce enough insulin. This happens when there is a problem with the pancreas and is not linked to being overweight.

"Diabetes UK does a lot of work trying to prevent type 2 diabetes. This often focuses on weight management and lifestyle issues, as many cases of the condition could be delayed or prevented if changes were made in these areas.

"We do, however, very much recognise that some people who have type 2 diabetes are not overweight and we work hard to ensure everyone with diabetes receives the best care and treatment possible."


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