Care guides to help doctors better manage patients with pre-diabetes and diabetes


A diabetic patient undergoing dialysis treatment at Kim Keat Dialysis Centre.
A diabetic patient undergoing dialysis treatment at Kim Keat Dialysis Centre.PHOTO: ST FILE

SINGAPORE - Doctors can now refer to a set of guides to better manage patients with pre-diabetes and prevent their condition from progressing into diabetes.

The Appropriate Care Guides, published by the Agency for Care Effectiveness, will also help clinicians prescribe more tailored medication for those with diabetes.

They were developed in support of the Ministry of Health's (MOH) "war on diabetes", and complement the existing MOH Clinical Practice Guidelines on Diabetes, last issued in 2014.

The guides, which will be distributed to all doctors in Singapore and are available online, set out a systematic management pathway to improve follow-ups of patients with pre-diabetes through both lifestyle intervention and medication.

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Lifestyle changes such as a healthy diet and increased physical activity are recommended to achieve or maintain the optimal body mass index (BMI) for those with pre-diabetes. If lifestyle changes are insufficient to improve a patient's blood glucose status, doctors are recommended to consider prescribing metformin to overweight patients.

The guides also highlight the importance of individualised treatment plans, and incorporate the latest updates on oral glucose-lowering agents, and their clinical and cost-effectiveness, safety and appropriate use in patients.

More than 400,000 Singaporeans have diabetes, while another 430,000 have pre-diabetes and are at risk of developing diabetes. Lifestyle changes, modest weight loss and moderate physical activity can potentially reverse pre-diabetes and its progression to diabetes, the MOH said in a release on Wednesday (July 5).

For those with diabetes, good disease management, including lifestyle changes and medication, can also prevent or delay complications such as heart attack, stroke, kidney failure, blindness, and lower limb amputation.