Case study – Tania (26 years old)

Tania, a mother of two, has begun to experience pain in her legs and back while undertaking her work as a cleaner. She is concerned about her weight and her family history of diabetes.

tania-joshTania is a mother of two boys, Michael (five years) and Joshua (three years). She was diagnosed with gestational diabetes during her second pregnancy, and has been identified by her GP as being at a high risk of type 2 diabetes. She has a family history of type 2 diabetes, with her mother and grandmother having the condition. Tania is a current smoker, and smoked during both pregnancies. Her younger son has had numerous hospitalisations for serious respiratory infections during winter.  
Tania works as a cleaner, a job that requires a moderate level of fitness. Tania has a BMI of 34, and said that she often felt out of breath at work, and had begun to experience knee and back pain following her shift. Tania sees work as an opportunity to be more physically active, such as using stairs rather than elevators, but her increased muscular pain has meant that she has tried to minimise any additional physical exertion. 
Tania’s work hours are not always guaranteed, and she stated it was impossible to make plans or savings, which contributes to her stress, anxiety and feelings of insecurity. She works during the evenings, and talks about how she wishes she could spend this time with her children and family. Dinner was highlighted as being particularly challenging: while Tania and her sister are aware that the whanau’s diet is high in fatty, processed foods, she speaks of the ease, accessibility and economy of takeaways and fried food to feed a large group of people, compared to the expense (monetary and time) to prepare meat and vegetables. 
Tania and her sons have moved into her parents’ after her relationship with her children’s father ended. The house is occupied by an extended family group, including Tania’s sister and brother-in-law and their children. Tania is aware of the impact the overcrowded environment is having on her whānau - especially her son Joshua and her niece Amy, who have chronic health conditions. 

Tania's story 
'I didn’t want to move back in with mum and dad, but when Mike walked out on us, I didn’t have anywhere else to go. Mum and dad already have Janine and Tony and their kids staying too – the landlord at their old place put the rent up and right after Tony had his accident, and they couldn’t afford to stay. There are too many people staying at mum and dad’s, especially as we only have one bathroom. But what can we do? I have a bad credit history and rents are getting more and more expensive. 
When I was pregnant with Joshua the doctor said I had gestational diabetes. I had already had high glucose test results with my first baby, but it was still a shock to me, to hear it from the doctors. When Joshua was born, he was jaundiced and had low blood sugar. He been in hospital a lot for pneumonia and breathing problems. I worry about his health, because Janine and Tony’s place can get very cold, which makes his coughing worse. Janine and I are trying to not smoke in the house as much – its bad for our kids with asthma.
I have always been big, it runs in our family. Before I had gestational diabetes they told me I was pre-diabetic and at high risk of developing type 2 diabetes like mum and nana. I am working on getting more exercise, and I try to take the stairs in the office buildings I clean instead of the lifts. I am tired when I finish my shift around 11pm, it’s just easier to get dinner from a drive-thru. And I don’t want to wake up my kids by cooking – they are sleeping in the living room. 

I work doing two cleaning shifts a day. I clean at a school from 4pm to 6:30pm and then at an office building in town from 8pm to 11pm. Dad laughed when I said I was working at a school, he said it was funny because I hated school so much and wagged all the time. Cleaning is tiring work, and my hours aren’t always guaranteed, which is really stressful and makes it difficult to contribute to my family’s costs. I put my name down for extra shifts, I want to help mum and dad.' 
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