Q I specialise in treating diseases related to the glands because...
A I have been a life-long advocate of preventive and personalised medicine, believing that prevention is better than cure.
For example, if we can treat diabetes early and properly, we can effectively mitigate dire complications - such as nerve, kidney and eye damage - from developing.
Also, hormones regulate bodily functions, and if there is an incorrect amount, there can be serious consequences. We can prevent this by managing hormones.
Q Our hormones are fascinating because...
A They are chemical messengers that are released by glands into the bloodstream and transported to distant target organs to regulate their physiology and behaviour.
For example, the thyroid gland in the neck releases hormones that control metabolism and regulate our breathing and heart rate, among other things.
We are still learning about new hormones and their roles each day.
The quote from Albert Einstein, "The more I learn, the more I realise how much I don't know", aptly describes my humbling journey in the field of endocrinology.
Q If I were to give an analogy for what I do, I would be...
A A tailor.
To treat diabetes, we assess each patient's lifestyle, dietary habits, physical activity, age, gender, weight, duration of disease, prevailing blood sugar levels, stress, and presence of diabetic complications in order to tailor-make appropriate treatments.
It is why some diabetic patients can keep their condition well-managed through a healthy lifestyle, without the need for medication.
Even among those requiring medication, the types and dosages of their medications vary.
Q I come across all types of cases from…
A Diabetes, thyroid diseases, adrenal and pituitary gland disorders, obesity, osteoporosis, to lipid disorders and others.
I also manage the end-stage problems of poorly controlled diabetes, such as foot ulcers, gangrene and infections.
I remember a middle-aged diabetic man who came to me with an infected foot. We helped to keep his diabetes under control and prescribed antibiotics to treat the infection, so he avoided an amputation.
A happy ending like this does not happen all the time. Many diabetic patients do not realise that they are at risk of foot problems.
Q A typical day for me...
A Starts at Raffles hospital at about 8am.
I believe in looking after myself first, so a hearty breakfast is a priority before I begin my ward round to check on my patients.
My outpatient clinic sessions run from 9am to 5pm, with a lunch break.
I do an exit ward round to ensure patients are stable before I leave for home at about 6pm.
In recent months, I have been travelling to Shaw Centre in Scotts Road to see patients on Tuesday and Thursday afternoons.
Q One little-known fact about a part of the brain called the hypothalamus is that...
A It is the command-and-control centre of the body's hormonal system.
It also regulates important body processes, namely thirst, appetite, body temperature, heart rate, blood pressure, fluid and electrolyte balance, sleep, mood and sex drive.
While we know it has many key roles, we still do not understand how such a small part of the brain can perform such a myriad of physiological functions.
Q If I could change one thing about Singaporeans...
A It would be their sedentary lifestyle.
The rise in diabetes prevalence in Singapore - from 1.9 per cent in 1975 to 11.3 per cent in 2010 - is likely due to the dramatic changes in Singaporeans' lifestyle over the last few decades.
In echoing the car-free Sunday initiative by the Government, I hope we can realise our aim of making Singapore a car-lite city. This will encourage us to walk more and be more physically active.
Q Things that put a smile on my face are...
A When my patients feel better after our treatments.
The process of making a difference to my patients' well-being is what keeps me going, despite the stresses of work life.
Q It breaks my heart when...
A My patients do not follow my advice and neglect the control of their diabetes.
I know that the poor control of their diabetes, blood pressure and cholesterol levels will lead to serious health complications such as heart disease, stroke, kidney failure, blindness and limb loss.
Q I love patients who are...
A Motivated and take charge of their own health.
This is a much more rewarding way of treating a medical condition, instead of trying to fix the problem when it is too late.
Q My best tip...
A For most chronic diseases, it is always better to treat them early rather than to wait until the conditions become serious.
People who are at risk of developing diabetes - those above 40, with a family history, and have high blood pressure or high cholesterol - should go for regular screening.
DR STANLEY LIEW
Occupation: Specialist in endocrinology and consultant at the Raffles Diabetes & Endocrine Centre at Raffles Hospital
Dr Liew pursued sub-speciality training in endocrinology at Singapore's National University Hospital and Britain's Oxford Centre of Diabetes and Metabolism.
He said the early days of "hardship" when he started his career at the National Health Service in Britain were worth it.
During his first posting as a house officer in a public hospital there, his longest shift was a continuous 56 hours.
He said: "I managed to gain valuable experience in managing all sorts of acute hospital conditions like heart attack, stroke, kidney failure and meningitis."
He has been a doctor since 1994 and a specialist for the last 14 years. He is married to a dermatologist, who is in her 40s, and they have three sons aged 12, 10 and eight.
This article was first published on March 22, 2016.
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