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Tara Loader Wilkinson

Former Hongkonger Michelle Hale was 14 when she was diagnosed with type 1 diabetes, a chronic disease in which the body does not produce enough insulin.
Untreated, it causes high blood sugar levels, which can cause organ damage and increase the risks of seizures, heart disease and strokes. Treatment requires a daily regimen of insulin.
Type 1 diabetes is not fully understood, but it is an autoimmune disease that seems to start with a genetic predisposition. An environmental trigger, possibly a virus, causes the immune system to attack and destroy the body’s insulin-producing cells in the pancreas.
Since the pancreas no longer produces insulin, type 1 diabetics must take insulin daily through injections or a pump.
No one in Hale’s family had type 1 diabetes, though. Her diagnosis was all the more surprising given that she has an identical twin who is not diabetic.
Excessive thirst, frequent urination, loss of appetite, loss of weight, blurred vision and vomiting were the symptoms that landed her in the doctor’s office. Her blood sugar levels were dangerously high, and she was sent to the hospital for emergency treatment.

While dealing with the usual teenage angst growing up in Adelaide in South Australia, Hale was injecting insulin daily, monitoring her blood sugar and watching what she was eating.
“I was too old for kids’ diabetes camps and too young for adult diabetes programmes, which left me with no one,” she says. “I felt very alone, with no support, and I felt that way for 17 years.”
Types of diabetes
Type 1 cases are far rarer than type 2 diabetes cases, which have skyrocketed in number. Type 2 is often the result of lifestyle factors such as poor diet and lack of exercise. It accounts for about 90 per cent of all diabetes cases worldwide. Genetic factors can increase the risk of type 2 diabetes.
In type 2 diabetes, the body either does not use insulin well, a condition called insulin resistance, or the pancreas cannot make enough insulin to keep up with the demand. Treatment often begins with lifestyle changes in diet and exercise, as well as glucose-lowering medications. Insulin may be needed later as the disease progresses and the pancreas tires out.
Another much rarer form of diabetes, known as Mody – for maturity-onset diabetes of the young – is a genetic type that was sometimes loosely referred to as type 3 diabetes. This unofficial term has since become more commonly applied to Alzheimer’s disease as researchers explore the links between Alzheimer’s and insulin resistance that occurs specifically in the brain.

Gestational diabetes – gestational diabetes mellitus or GDM – develops during pregnancy, when hormones from the placenta interfere with the mother’s insulin uptake, leading to insulin resistance. While GDM usually goes away after childbirth, it increases health risks for mother and baby. Having had GDM puts a mother at a higher risk of developing type 2 diabetes later in life.
Prediabetes is a precursor to diabetes in which blood sugar levels are elevated but not yet in the diabetic range.
Worldwide diabetes numbers and the health risks
Globally, around 537 million adults – about 10.5 per cent – are living with diabetes. By 2045, this is projected to rise to 783 million or 12.2 per cent.
While the world’s population is estimated to grow 20 per cent over this period, the number with diabetes is estimated to increase by 46 per cent.
Aside from the physical risks, diabetes has been shown to affect mental health, with detrimental effects on self-image and self-esteem, leading to emotional upset and social anxiety.
It can also trigger eating disorders, including diabulimia – when someone with type 1 diabetes restricts or completely omits their insulin doses to lose weight or prevent weight gain. This puts the person at risk of incredibly dangerous conditions, such as diabetic ketoacidosis.

The emotional weight of living with diabetes can lead to diabetes burnout, depression and even thoughts of death, Hale says.
Sharing her experience to help others
It was only when Hale was pregnant with her firstborn son, TJ, now aged eight, and was about to move from Dubai to Hong Kong with her husband, Trevor, that she chose to switch the narrative of her diabetes from negative to positive.
Until then, she had at best ignored it as far as possible, and at worst felt shame and tried to hide it. She decided to celebrate her diabetes to help inspire others.
Hale launched a website, Global Diabetic, and the @globaldiabetic social media platform, both dedicated to empowering individuals living with type 1 diabetes.
Starting with a pregnancy shoot in which she wore a continuous glucose monitor, she was determined to show that living with diabetes should not present barriers to living a full life.
She went on to create content about the experiences she was having as a diabetic, from skydiving to climbing Mount Kilimanjaro, as well as showing off her insulin pump and monitor while wearing glamorous dresses at red carpet events or poolside in a bikini.

“I started Global Diabetic to show that people living with diabetes can live a fabulous life. Women reach out to me all the time, thanking me for showing them it’s OK to be loud and proud about wearing medical devices, removing shame and stigma,” she says.
“I’ve shown my pregnancy pictures wearing my diabetes gadgets, and women have told me that it inspired them to have babies. Seeing someone like me, just a woman with type 1 diabetes and now a mum sharing her story, gives real hope,” she adds.
In a lighthearted way, she also shares how she manages her diabetes, including how to use tools, such as pumps, sensors and apps that help count carbohydrates and other nutrients and track exercise levels; what she takes while travelling in case her luggage or carry-on bags are lost; and how she plans meals.
Celebrities speak out on managing diabetes
Diabetes advocacy has risen in recent years, with celebrities such as Tom Hanks, Halle Berry and Nick Jonas using their platforms to promote awareness in the community.
Hanks first opened up about his type 2 diabetes diagnosis in 2013, blaming a mixture of genes and his unhealthy eating patterns; recently, he has had to warn followers of fake advertisements using his likeness to promote diabetes “cures”.
Berry was diagnosed with diabetes at the age of 22, which was said to be type 1. Later, she announced that she instead had type 2 diabetes. She has managed her condition in part through adopting the keto diet.
Jonas was diagnosed with type 1 diabetes at the age of 13 and learned to manage it with resilience. His message for others: “Know that you can still do anything you want to do with your life. I didn’t let it slow me down, and you don’t have to either.”
Retreats cater for diabetic clients

A growing number of five-star hotels now offer retreats for clients with type 2 diabetes who want to learn more about how to manage their condition in a luxury space.
The Amanpuri in Phuket, Thailand, is an example. It combines medical and wellness expertise to cater to diabetic guests’ needs, to help them incorporate dietary changes, exercise and other wellness activities to manage their condition.
Another is Ananda in the Himalayas, overlooking India’s Ganges River. It offers a two-week programme that incorporates Ayurveda, yoga, traditional Oriental therapies, physiotherapy and nutrition, and is designed to keep blood sugar levels and weight in check and to boost energy and overall well-being.
Its head, Dr Sreelal Sankar, says the resort’s commitment to “holistic diabetes care” has had good results, including improvements in clients’ blood glucose, insulin resistance and weight. Some guests have been able to lower their dependence on medication after the retreat, he adds.

Mayrlife in Austria is another. It runs a two-week detox programme for those seeking a natural and holistic approach to improve diabetes symptoms. It aims to help guests better understand how healthy eating, regular exercise and lifestyle changes can help to keep diabetes under better control.
For Hale, the growth in awareness is a positive for the diabetic community.
“The loneliness that diabetes creates can be healed beyond Western medicine, and these luxury retreats and hotels are offering what we need – a glow up to diabetes.”
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This woman shares diabetes journey to raise awareness, inspire others to live a full life

Michelle Hale wears her glucose monitor on her bare arm, helping to break the stigma surrounding the use of such wearable medical devices. Photo: Michelle Hale

Michelle Hale (right), pictured here close to term and wearing her continuous glucose monitor and insulin pump, with her twin Anna Teslikova James (left), who does not have diabetes, in November 2016. Photo: Michelle Hale

Michelle Hale proudly wears her glucose monitor on her bare arm. Photo: Michelle Hale

People with type 1 diabetes must take insulin daily through injections or a pump because the pancreas can no longer produce the hormone. Photo: Shutterstock

Halle Berry is one of several celebrities with diabetes who promote awareness of it on their platforms. Photo: Instagram/halleberry

Hale shows her insulin pump at the summit of Mount Kilimanjaro. Photo: Instagram/globaldiabetic

Nick Jonas was diagnosed with type 1 diabetes at the age of 13. Photo: Instagram/nickjonas

At Ananda in the Himalayas, in India, a two-week programme for diabetics is designed to keep blood sugar levels and weight in check and to boost energy and overall well-being. Photo: Instagram/anandainthehimalayas

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Type 1 diabetes develops when your immune system mistakenly attacks and destroys cells in your pancreas that make insulin, which is needed to help cells absorb glucose. Type 2 is caused by insulin resistance or insufficient insulin secretion. Photo: Shutterstock  

Hong Kong-based endocrinologist Dr Wong Wai-sheung. Photo: Dr Wong Wai-sheung

Singaporean endocrinologist Dr Abel Soh. Photo: Dr Abel Soh

Endocrinologist Dr Ben Ng. Photo: Dr Ben Ng

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Chandra’s blood glucose levels soon fell back into the normal range, to 6.80 from 8. Photo: Xiaomei Chen

Chandra ran 32km of the 42km Standard Chartered marathon wearing traditional Indian garb. Photo: Facebook/cravihk

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Lifestyle

Health & Wellness

Health

A woman with type 1 diabetes on living ‘a fabulous life’ with the disease, plus a look at wellness resorts catering to people with diabetes


A woman with type 1 diabetes on living ‘a fabulous life’ with the disease, plus a look at wellness resorts catering to people with diabetes.


This woman shares diabetes journey to raise awareness, inspire others to live a full life

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}A woman with type 1 diabetes on living ‘a fabulous life’ with the disease, plus a look at wellness resorts catering to people with diabetes

A woman with type 1 diabetes on living ‘a fabulous life’ with the disease, plus a look at wellness resorts catering to people with diabetes