New Users Registration  |  Useful Links  |  FAQ  |  Site Map 
Go Search


Skip Navigation LinksHealth Xchange > News
  2013 2015   Dec 2015 | Nov 2015 | Oct 2015 | Sep 2015 | Aug 2015 | Jul 2015 | Jun 2015 | May 2015 | Apr 2015 | Mar 2015 | Feb 2015 | Jan 2015 |
  2013 2014   Dec 2014 | Nov 2014 | Oct 2014 | Sep 2014 | Aug 2014 | Jul 2014 | Jun 2014 | May 2014 | Apr 2014 | Mar 2014 | Feb 2014 | Jan 2014 |
  2013   Dec 2013 | Nov 2013 | Oct 2013 | Sep 2013 | Aug 2013 | Jul 2013 | Jun 2013 | May 2013 | Apr 2013 | Mar 2013 | Feb 2013 | Jan 2013 |
  2012   Dec 2012 | Nov 2012 | Oct 2012 | Sep 2012 | Aug 2012 | Jul 2012Jun 2012May 2012Apr 2012Mar 2012 | Feb 2012 | Jan 2012 |
  2011   Dec 2011Nov 2011Oct 2011 | Sep 2011 | Aug 2011Jul 2011Jun 2011 | May 2011 | Apr 2011 | Mar 2011 | Feb 2011 | Jan 2011 |
  2010   Dec 2010 | Nov 2010 | Oct 2010 | Sep 2010 | Aug 2010 | Jul 2010 | Jun 2010 | May 2010 | Apr 2010 | Mar 2010 | Feb 2010 | Jan 2010 |
  2009   Dec 2009 | Nov 2009 | Oct 2009 | Sep 2009 | Aug 2009 |
  Health Policy and Announcements | Diseases and Outbreaks
  Medical Research | New Treatments and Technology
  Singapore   SingHealth | Health Promotion Board | Ministry of Health | Asiaone
  International   World Health Organization | Centre for Disease Control and Prevention (US)
  News Article  

Amputees’ regret

  Thursday, 26 l 08 l 2010 Source:  Mind Your Body; The Straits Times   
By: April Chong

Two men tell how their stubbornness led to their losing their limbs. Despite being diagnosed with diabetes, they made no effort to change their unhealthy lifestyles. One even ignored the medication his doctor prescribed

The bad news about diabetes is that complacency can lead to serious complications, like limb amputation.

The good news is that, for those who diligently manage their disease, such complications can be averted.

amputeeFormer factory worker Kim Joo Swan was too happy-go-lucky.

Mr Kim, 56, used to down four cans of carbonated drinks every day and would eat “all the time”. He was overweight and was more than 110kg at his heaviest.

Even after he was diagnosed with diabetes more than two decades ago during a routine workplace health check, he continued with his lifestyle and put aside the diabetes medicine he was prescribed.

He was then in his 30s.

Diabetes, a common disease here, is still all too often dismissed because many people may not see any outward symptoms.

“I did not feel unwell and I was still strong enough to carry goods weighing 43kg in each hand,” he said.

However, a cut on his right toe – which he ignored because “injury was common for his kind of work” – led to gangrene. In 2003, his badly infected right leg had to be amputated below the knee.

He was more careful about what he ate after that and took his medication but his efforts were too late. Two years later, he lost his other leg.

Not managing his diabetes well had also left him with renal failure, which requires him to go for dialysis three times a week.

His 30-year-old son and his daughter-in-law now take care of him with the help of a maid. He also has a daughter, who is married.

Mr Kim, who stopped work in 2003 after his first leg was amputated, is now able to walk slowly with the help of two prosthetic legs and walking sticks.

He now spends most of the day in his neighbourhood, sitting at the coffeeshop or at the void deck, not wanting to “waste away at home”.
diabetes typeDiabetes occurs when high levels of sugar are present in the blood, either because the body does not produce enough of the hormone insulin to metabolise the sugar (Type 1 diabetes) or the body becomes resistant to insulin (Type 2 diabetes).

About 9 per cent of people here have diabetes, with the majority above the age of 40.

Type 2 diabetes, which Mr Kim has, is more common here, affecting 85 to 90 per cent of diabetics.

Although it usually hits older persons, it is affecting children too. It now accounts for a third of childhood diabetes, which was uncommon in the past. Doctors attribute this to the rising obesity in children.

Among adults, the disease afflicts those who are overweight and have high blood pressure or high cholesterol levels, said Dr Goh Su-Yen, the director of diabetes clinical services at Singapore General Hospital.

The long-term complications from diabetes include kidney failure, blindness, heart attacks and gangrene of the feet.

It usually takes years for complications to develop, said Dr Peter Eng, an endocrine specialist at Mount Elizabeth Medical Centre.

However, once skin infection and gangrene appear, they can render the limb useless within weeks.

Why are diabetics more prone to skin infections and poor recovery?

The disease causes blood vessels to narrow. The resultant poor circulation leads to slow wound healing and higher chances of infection, said Dr Steven Thng, a consultant dermatologist at the National Skin Centre.

To make matters worse, diabetes damages nerves and causes limbs to have reduced sensation to pain.
As a result, diabetics may not be aware that they have injured themselves, resulting in infections, said Dr Thng.

amputeeRetiree Narayanasamy Tharlingam, 77, is another Type 2 diabetic who did not control his condition well. He also did not realise he had a leg injury.

The former manual worker lost his right leg to diabetes about a decade ago, after an infection in his foot led to gangrene.

“I had started drinking from age 15 and easily consumed 10 to 12 bottles of beer a day,” recalled Mr Narayanasamy.

He also enjoyed his “makan”, from curries to oily stir-fried food.

Even after he was found to have diabetes when he was about 40 years old, he did not change his diet.

However, after he lost his leg, he cut down on his drinking, allowing himself only an occasional swig of beer. He now drinks coffee without sugar and Chinese tea and eats foods which are less oily such as thosai and
lentil dahl.

He also diligently takes his diabetes medication and gives himself insulin jabs twice a day in his tummy from an insulin pen injector, which dispenses a pre-set volume of the hormone.

Mr Narayanasamy, who is on the Public Assistance scheme, gets free treatment, medication and syringes from places such as the Diabetic Society of Singapore and hospitals.

He visits various hospitals about twice a month for doctors to monitor his chronic conditions, heart and eyes.

“I used to play a lot of football in my school days. Now, I can’t even leave my house without help from someone. I didn’t expect that diabetes can be so serious,” said the divorcee, who lives alone.

In his one-room flat, Mr Narayanasamy moves around on his wheelchair and uses his hands to support himself whenever he needs to get onto his bed or go to the toilet.

Now, he keeps his blood sugar levels under control. He does not want to lose his other leg to gangrene, he said.

Normal blood sugar levels fall in the range of 5 to 7mmol/L (millimoles per litre of blood) before meals and below 10mmol/L after meals, said Dr Goh.

However, targets may differ for diabetic patients of different conditions and ages. Targets are stricter for pregnant mothers and young adult patients.

Elderly patients would have less strict targets as they are at higher risk of having an adverse outcome – like falling – if their sugar levels are low, explained Dr Goh.

For example, Dr Eng said that the target for a 40-year-old man with mild diabetes would be close to the normal range but for a 60-year-old man with more serious diabetes, the target may be set higher at 6 to 8 mmol/L before meals.

To keep diabetes in check, doctors advocate a healthy lifestyle: Eat and drink in moderation and exercise regularly.

However, the number of diabetic patients is expected to rise as more people start leading urban lifestyles, eating rich foods and not exercising, said Dr Kevin Tan, the vice-president of the Diabetic Society of Singapore.

Mr Kim, who had ignored his condition for years, said: “I wanted to die when I knew my legs had to be cut off. If I had known earlier, I would have done more to control my disease.”

  Ask the Specialists - Free Doctor Q&A  
    All About Childhood Myopia
Take the opportunity to ask our specialist about childhood myopia as well as the treatment options and prevention steps available to you.
    Previous Q&As
Check out our archive for all our previous doctor's Q&As!
*Latest Update: Women's Pain, Cornea-Related Eye Conditions, Stress and Anxiety
e-Appointment Online
Health Buddy App