Annabel Middleton, 44, found out that she had diabetes quite by accident in 2002, at the young age of 28 years.

Annabel Middleton enjoying a sunny day out at the beach. (Photo courtesy of Annabel)

She thought it was just PMS

“I did not suspect I had diabetes at all,” says Annabel. “I was about to go on a trip to the Philippines, but decided to see a doctor to get some cortisone cream as I had been suffering from a genital itch that just wouldn’t go away.”

However, the doctor felt compelled to do a blood test on the spot and discovered that her blood sugar was sky-high, she says. This was naturally a shock to Annabel, who had until then attributed the itch to pre-menstrual syndrome (PMS), which had been going on for some time.

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There were signs

While one of the most probable causes for her having diabetes could be a family history – Annabel’s mother and maternal and paternal grandmothers had diabetes, including aunts and uncles from both sides – she regards her lifestyle as a major catalyst for its early onset.

“I was tired and stressed all the time”

Annabel, who is now a freelance writer, was working full-time in the publishing industry at that time. Work stress and long hours coupled with a variety of extra-curricular activities such as performing with singing groups and church ministries, left her with no time for “self-care”. Lack of me-time also meant making bad dietary choices.

“I was tired and stressed all the time,” she reveals, attributing it to just overwork. But they were also warning signs, which she did not realise until she was diagnosed.

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“Another thing that struck me only much later was that I had been rather irritable and snappy with the people around me. Again, I had attributed it to stress or my lack of patience with inefficient people or ineffective work systems. However, I later discovered that irritability is one of the symptoms of diabetes,” she says.

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(Photo courtesy of Annabel)

Change in lifestyle

Her shock in discovering she was a diabetic made Annabel determined to find ways to cope. She read voraciously on the subject, and changed her lifestyle. “This meant testing my blood glucose levels before and after every meal, revamping my diet and upping my exercise,” she says

It was an exercise in mathematics too: “I had to figure out what ‘one carb portion of 15 g’ meant for each type of food (For example: 15 g of carb = one portion = ½ an apple = 2 tbsps of rice = 6 squares of chocolate… ).”

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She has since figured out that her body can only efficiently metabolise two or at most three carb portions.

“The most important thing is that you get back on after you slip up.”

Through time, Annabel has learned to manage the balance, while also learning to cut herself some slack when she slips up. “The most important thing is that you get back on after you slip up,” she asserts. Diabetes has taught her not to take her body for granted.

“In a way, I have to thank diabetes for getting me back on track towards better health. If I had not had this ‘wake-up call’, I would not have done something about the state of my health. Today, I feel much healthier and fitter than when I was first diagnosed!”

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Pooja Jain, 40, found out she had diabetes when she was seven months pregnant with her baby, Tanesha.

(Photo courtesy of Pooja)

It manifested during pregnancy

“My mum had diabetes but I never knew it was genetic or that I would need to watch my own diet and lifestyle,” says Pooja Jain, who is a freelance learning designer.

All she knew at the time was that her mother’s diabetes was a side effect of the medications she was taking for some other ailments she had.

“It was waiting to happen and found pregnancy as a vehicle to manifest itself.”

Although she found out she had diabetes when she was pregnant, it wasn’t just gestational diabetes. “My doctor informed me that it was waiting to happen and found pregnancy as a vehicle to manifest itself,” she says. 

Add to that the fact that Pooja had a difficult pregnancy, which involved a few hospitalisations prior to delivery. “Our focus at that time was to follow Doctor’s advice and not overthink anything,” she says “I stuck to the prescribed diet but since I was on complete bedrest, it was extremely difficult to manage my blood sugar levels with diet alone. I had to be put on insulin injections prior to every meal.”

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This meant timing her meals and insulin shots, and carefully watching what, when and how much she ate, she says.

(Photo courtesy of Pooja)

A learning curve

Although Pooja struggled with being overweight, Dr Ben Ng at Mount Elizabeth Specialist Centre told her that her diabetes was more a result of her unmanaged and untamed blood sugar levels and had less to do with her weight.

“The oral medicines he prescribed turned my life around. As you know, weight management is a crucial part of fighting diabetes. His prescription helped me shed weight and start leading an active lifestyle,” she says.

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Finding the balance

“The biggest challenge was to keep a level mind and not get overwhelmed by the number of changes required to bring a substantial change,” she says.

Pooja with her husband, Mayank. (Photo courtesy of Pooja)

It started with her diet – Pooja reduced her portion sizes, which meant no processed foods and less carbs as well, and increased the frequency of her meals – this was complemented by practical exercise.

“I started walking everywhere.”

“I started walking everywhere. It was killing two birds with one stone: Get healthy and reduce my carbon footprint. Instead of taking buses or taxis, I would walk to the theatre, to the library, to the mall… literally, everywhere. Places that were too far to walk, I cut them out of my to-do list,” she says.

As a result, her fitness and energy levels have increased and she has managed to bring down her blood glucose levels (Hba1c) from a whopping 9.5 to 6.7.

But it’s a work in progress: ”Regular health checks are a must. We women often tend to relegate our needs, but it’s crucial to monitor Hba1c every three to four months and plan changes that are easier to sustain,” she says.  

Finding the balance also meant managing family and friends’ often well-meaning, but often unsolicited advice on how much exercise was too much. “As long as you know your body and mind can handle the changes, don’t let family and friends bring you down,” she says. “They don’t have diabetes. You do. Consult your doctor and do what you think works best for you.”

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Text: Sandhya Mahadevan