The general public may not realise how common diabetes is. Based on a conservative estimate, one out of ten in the city is prone to having this metabolic disorder. Apart from genetic factors, modern lifestyle associated with a stressful environment, lack of exercise and an unbalanced diet is believed to increase the incidence of this big killer disease.
As visible effects are typically mild or non-existent, and can be sporadic, diabetes may go unnoticed for years in a patient before diagnosis. Rebecca Wong, diabetes nurse specialist at the Prince of Wales Hospital's Diabetes and Endocrine Centre, points out that when signs and symptoms surface, the disease has already taken hold. From that point on a patient will need medical attention and maintenance throughout their life.
"It is a never-ending battle because of the chronic nature of the disease it cannot be cured by an operation or by taking a few courses of medicine," Ms Wong expands. "Controlling blood glucose levels in order to reduce the risk of potential complications becomes patients' life-long goals. They must learn to check their own status and take care of themselves everyday."
Nurse specialists have various roles in helping people suffering from diabetes. Awareness and discipline in testing and medication are vital while their first and most important task is patient education, which gives patients a better understanding of the disease and related survival techniques, from measuring blood sugar levels to insulin administration.
It is also necessary to carry out a series of follow-ups by keeping track of a patient's physical condition. Through regular consultations, nurse specialists work with medical practitioners to decide appropriate prescriptions and therapies. Depending on the situation, advice from other healthcare professionals such as nutritionists, physiotherapists, podiatrists and optometrists is required. "Since diabetes affects one's health in many different ways, we must custom design treatments for each patient," Ms Wong says.
"In addition to the medical assistance, we emphasise psycho-social support and help to build our patients' confidence in coping with the condition," Ms Wong continues. "Facing a permanent loss of health, people tend to require more care of their mental state. In some cases, we will refer the patients to social workers so that special aid can be provided. For many others, we will form support groups amongst themselves so that the sufferers of the same turmoil can share their experience with each other. When they feel that they are not alone living with diabetes, their emotional tension will be better managed."
According to Ms Wong, special attention is required for different diabetic categories. To help children fit into school life, her team has joined with other diabetes centres and a local patient organisation, Diabetes Hongkong, to run education camps. During the 3-day programme, through training and practice, the young patients are able to acquire essential skills to look after themselves.
"When old people are diagnosed with diabetes, most of them feel useless. These patients think that they are a burden to their families. Some may blame themselves for being a drain on society. What we can do, besides prescribing medicines, is to restore their self-esteem by showing them they are capable of self-management of the disease," Ms Wong points out.
Versatile and challenging profession
Today, the Diabetes and Endocrine Centre has more than 5,000 diabetic patients, all receiving long-term services. Through consistent and close contact in the centre as well as in other activities, Ms Wong has built up a rapport with many of them.
"Being a nurse specialised in this area, it is encouraging to see that people having diabetes can enjoy a full and active life. Since the disease may cause serious complications and lead to detrimental effects, it is worth all the effort to take good care of the patients," Ms Wong comments. "As a career, the diverse responsibilities make the work very interesting and the co-operation with other professionals makes me more knowledgeable. I believe that, all in all, I find a great deal of job satisfaction here."
Ms Wong began training in the field in 1985, when, there was no specialised education of nursing available in Hong Kong. Already a registered nurse, she completed a 3-month qualifications course in Australia. Afterwards, she practised at Prince of Wales Hospital. As an adjunct tutor at the Chinese University of Hong Kong, she has also been involved in an array of training for medical students from the varsity, as well as with nurses from overseas and the Mainland.
"There are so many things happening about diabetes: new drugs and advanced technologies to know; symposiums and seminars to get up to date with," Ms Wong concludes. "A job like this is never monotonous."