Managing diabetes is a life-long and often difficult journey for both patient and caregiver. Ms Florence Fong, Senior Medical Social Worker, Singapore General Hospital, believes that having the right mindset and support is key.
I don’t have diabetes, I have high blood sugar. How can I stop eating white rice? I don’t want to take medicine. I’d rather try bitter gourd or some other natural remedy to treat my diabetes. Why me?
These are some reactions of patients after learning they have diabetes. Having to adopt a healthier diet and lifestyle to regular monitoring of their blood glucose levels and following a strict medication regime can overwhelm them, making them feel different or isolated from those who do not suffer from diabetes.
“Being diagnosed with diabetes and having to adjust to an entirely new lifestyle can be daunting and scary,” said Ms Florence Fong, Senior Medical Social Worker, Singapore General Hospital (SGH), a member of the SingHealth group.
“It’s important to attend to the emotional struggles that patients living with diabetes face, even if they don’t say anything to the people around them. If not, it may lead to them giving up on treatment.” Uncontrolled diabetes can lead to complications like renal failure, heart failure, stroke and amputation of the limbs.
Diabetes puts stress on patients
Managing diabetes successfully requires self-discipline and a readiness to accept treatments such as regular injections and dietary plans. These demands can make staying positive and on treatment tough, especially when progress is slow or having to overcome a fear or dislike. To avoid burdening their families, some diabetics keep these feelings to themselves. But bottling them up can lead to burnout.
As a medical social worker, Ms Fong helps patients and their family members cope with diabetes. She is a member of a multidisciplinary team of diabetes doctors, nurses, dietitians and therapists who work with patients to overcome the challenges of living with diabetes and other diseases.
“We listen to patients to find out what difficulties and challenges they face in managing their diabetes. It’s easier to break down the problems and work on areas that they would like to make changes in, whether it is through reducing some obstacles or changing behaviour like putting in a bit of exercise each day,” she said.
Patients face real difficulties, not just emotional or a lack of motivation in staying the course on treatment. “I have patients with financial difficulties. They take their medications as prescribed, for instance, but they may not be able to follow advice to eat more nutritious food [because of affordability],” said Ms Fong.
“Then there are others who sometimes skip their appointments because missing a day’s work means missing a day’s income.” To help patients with money issues, Ms Fong applies to charities or community services for funds or diabetes consumables that patients need regularly.
If patients don’t talk about the problems they face dealing with their disease – be it a fear of needles to feeling paiseh about telling their doctors about the side effects they are having with their medicines – it will be difficult for the healthcare team to provide them with correct advice, she said.
“The healthcare team is more than happy to work with the patient to adjust his diet, medication and lifestyle to suit his preferences,” she said. Patients who fear the pain of a needle prick, for instance, might be offered the option of a diabetes pump, which spares them from daily multiple insulin injections.
In diabetes management, support from loved ones matter
Support from family, friends or even another person with diabetes is important, as experience suggests that patients with greater family support tend to cope much better than those who have poorer support in the community, said Ms Fong.
Making diet and lifestyle changes – cutting out snacks and soft drinks, and exercising regularly – as a family helps patients adjust better to their diabetes diagnosis. The added benefit is that such changes are good for everyone, not just the person with the illness. Encouragement and support can come in other ways, such as reminding the diabetes patient to take his medicine or to check his glucose level.
“Where friends are concerned, try to find out more about diabetes to understand why sometimes your friend has to take out a syringe to inject insulin before a meal,” said Ms Fong, adding that they shouldn’t be naggy about food or overly protective. Like everyone else, diabetics have their strengths, which can help them pull through life’s difficulties. They stay motivated and committed to treatment, for example, to keep healthy for the sake of the family, or to fulfil a lifelong dream, she added.
From film stars like Tom Hanks to political leaders, there are plenty of people with diabetes in all walks of life who have shown that a condition that is well-managed has little or no impact on their ability to perform well at work.
People with diabetes need time and space to check their blood sugar levels and administer insulin. Allowing staff to keep their medical appointments is also important, so that they can continue to manage their diabetes successfully.
“Regular follow-up can actually help patients prevent further complications with their diabetes,” said Ms Fong.
Do's and don’ts of supporting a loved one with diabetes
Understand diabetes and how to support someone with the condition
Make the healthy lifestyle change together
Work out together
Be understanding when they need privacy
Support them even when they slip up
- Don't be too vigilant or nag about what they eat or when they forget their medication
- Don't indulge in carbohydrate or sugar-rich foods in front of them
- Don't treat them differently.
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