From being in denial to Diabetes Support Group member, Christine Lee, 62, talks about her 22-year tryst with diabetes. She tells us how she changed her life around, and her take on hawker food.
When were you diagnosed?
In August 1993 when I was about to undergo an operation. I was then 40 years old.
What were the early symptoms?
My only symptom was that I always felt very thirsty and loved gulping down F&N Sarsaparilla (aka “Sarsi”). The thought of diabetes never crossed my mind.
Is there a history of diabetes in your family?
Yes, my maternal grandmother was a diabetic.
What is your present condition?
My condition is presently fairly well controlled with an average HbA1c of 6.2% for the past 2 years. (Diabetes is diagnosed if an A1c test is equal to or greater than 6.5 percent.)
Please describe your experience of managing diabetes.
In the early days, I was in denial and didn’t bother following my GP’s advice of exercising and losing weight although I took the medication, Glibenclamide, as instructed.
Subsequently my medication was changed to Metformin.
In 2000, my control was getting no better and I sought the services of an endocrinologist. He was a sweet, gentle elderly doctor. He tried his best to coax me to exercise and also to pack my lunch to work but my excuse was always “no time”. He also tried out various medications, eg. Avandia, which did not work for me, and even suggested changing to Insulin at one stage, which I rejected.
His DNE (Diabetes Nurse Educator) also tried to educate me on the complications of diabetes, but it did not really register in my mind and I continued in my usual way. My average HbA1c readings hovered between 7.2 to 10.0%.
I was encouraged to join the Diabetes Society of Singapore (DSS), which I did, but promptly forgot about.
After a few years with this endocrinologist, he passed on, and the clinic referred me to another endocrinologist, a strict, no-nonsense Dr Tan.
Dr Tan changed my medication, encouraged me to exercise, suggested recipes and actually showed me samples of the different types of staples to eat, gave me lots of advice that finally managed to register in my head.
I also went online to search for DSS and discovered the Diabetes Support Group (DSG). I am now actively supporting the DSG in their monthly walks and other activities.
What medications are you on?
I am on 25mg Januvia, plus 500mg Metformin after breakfast and 500mg Metformin only after dinner for diabetes. I also continue to take 5mg Tritace and Nuerobion every morning, which my GP had recommended.
Were there any side effects of the medicines?
No.
What were some of the challenges you faced and what is your advice to patients who face similar challenges?
For many years, my greatest challenge was finding healthy hawker food as I was working 6 days a week in a stressful environment. I was also not disciplined enough with my meals…. always thinking that the medications will counter the effects of what I ate.
I guess that was because most doctors do not have the time to really make us understand the impact of complications that diabetics can have.
As a working person, it takes a lot of discipline to wake up earlier to prepare breakfast and lunch to bring to the office.
I also had to overcome my laziness and find time to exercise regularly.
Have you learnt anything in managing in your condition that you wish you knew before?
Yes, I wish I had more wisdom and had the time to read up more on my condition. I learnt that no matter what the Doctors & DNEs may advise me, ultimately, it is up to me to take control of my condition and do what is right for myself.
What brought on this realisation?
I realised that if I do not take responsibility for myself and move my butt, my diabetes will never be controlled. I do not want to be a burden to my children or siblings in the future too. I had also joined the DSS & DSG by then, and through these activities and sharing with other diabetics, I realised that I can IF I wanted to try to improve my lot in life. I was also deeply impressed by the support from the various nutritionists, DNEs and Group Leaders who accompany us on the Monthly Walks organised by DSS/DSG.
Did your poorly managed diabetes in the early days lead to any diabetes related complications?
I have very dry skin and I believe it is a result of poorly controlled sugar levels. I also suffered from frozen shoulder a few years ago.
What kind of specialists do you consult and how often?
In 2000, I sought the services of an endocrinologist at a private clinic. In the beginning, I see him once a month & gradually it was pushed back to 2, then 3 months and finally once in 6 months.
Since 2011, Dr Tan (Endocrinologist) has been seeing me once in 6 months.
I also see my Eye Doctor once a year.
I have also seen a Cardiologist and had a heart perfusion test done last year.
What resources are available to you in your city to help you manage the condition?
In Singapore, all Polyclinics, Hospitals and other privately run Hospitals have their own Diabetes Clinics. We also have the Diabetes Society of Singapore (DSS), Diabetes Support Group (DSG) as well as Touch Diabetes for Diabetes based support. Khoo Teck Puat Hospital also has a good Diabetes Clinic, running some very good programmes.
There are many resource books that can be borrowed from the National Libraries.
Have you had to make some changes to your lifestyle because of your condition?
Yes, I no longer eat with abandon but choose my food carefully, especially when eating out.
I wake up around 6 am to cook my breakfast of oats, instead of eating out, and also prepare my lunch for the day to take to work.
I learnt to read labels when shopping for groceries.
I drive less often and take the MRT and/or buses to work, thereby increasing my walking time. I walk to the Church, to the Wet Market, Supermarket, etc.
During family functions, I become the unofficial photographer, baby-sitter, cleaner, etc. These activities keep me away from the buffet table successfully….
Do you eat at hawker stalls now? What do you eat?
The only foods I am able to eat without guilt is Yong Tou Fu soup (with vegetables and tofu items instead of deep fried items); Fish Ball Bee-Hoon Soup & Fish Soup. However, I do not drink much of the soup as most, if not all, soups at hawker centres contain sugar, MSG & salt.
If I crave Laksa, I eat the bee-hoon, and, at the most, 2 or 3 spoonfuls of the laksa gravy.
Some economical rice stalls do offer a choice of unpolished rice instead of white rice, but the vegetables and meat dishes are mostly smothered in sauces that may contain sugar or they come deep-fried. So I normally have to make the correct choice of more vegetables, steamed tofu, fish or egg items sans the sauces. If you patronise a stall often enough and always remind the hawker that you do not want any sauce, he or she will remember that and automatically omit the sauces for you.
I may eat chicken rice but must remember to ask the hawker to hold the sesame oil & light soya sauce. Most chicken rice stalls do give a choice of white rice as well as rice cooked with chicken fat.
Once in a while, I also indulge in illegal foods like “Chao Guo Tiao”, fast food and desserts but the important thing is to revert to your diet as soon as possible.
Have you tried complementary medicine or therapies, like homeopathy or yoga?
No.
Has it been difficult emotionally to cope with your condition?
No, being a stoic and pragmatic person, I do not believe in indulging in my emotions.
How has your family supported you?
They will remind me not to eat sweet stuff, ask about my condition, etc. When we have family functions, there will always be bottles of plain water instead of sugary drinks. The caterers are reminded to use less oil, and sauces for food are placed separate from the food.
