National Day Rally: Three key issues

3 key issues at National Day Rally 2017: Singapore's war on diabetes

The Diabetes and Metabolism Centre at the Singapore General Hospital. If nothing is done, the number of diabetics under 70 here is expected to rise to 670,000 by 2030 and to one million by 2050. Diabetes is expensive. It already costs the country abo
The Diabetes and Metabolism Centre at the Singapore General Hospital. If nothing is done, the number of diabetics under 70 here is expected to rise to 670,000 by 2030 and to one million by 2050. Diabetes is expensive. It already costs the country about $1 billion a year - and the figure is expected to climb to $1.8 billion by 2050.ST PHOTO: SEAH KWANG PENG

Singapore has been placing emphasis on pre-school education, and announced plans to combat diabetes and step up digital payments and services to be a Smart Nation. Ahead of tonight’s National Day Rally, where Prime Minister Lee Hsien Loong will elaborate on plans in these areas, Insight looks at what has been done on all three fronts, why they are significant and what more could be done.

Singapore has one of the highest incidences of diabetes among developed countries, second only to the United States.

Among adults aged 18 to 69, 11 per cent - or one in nine - is diabetic. In 1998, it was 9 per cent. Among older people, the incidence is even higher.

Today, an estimated 450,000 adults here have diabetes, an illness that is a major risk factor for other serious medical problems such as heart attacks, stroke, blindness, gangrene resulting in amputations, and kidney failure requiring either a transplant or lifelong dialysis.

Another 12 to 15 per cent suffer from pre-diabetes. Of them, generally one in three will become diabetic within eight years.

If nothing is done, the number of diabetics under 70 here is expected to rise to 670,000 by 2030 and to one million by 2050.

Diabetes is expensive. It already costs the country about $1 billion a year - and the figure is expected to climb to $1.8 billion by 2050.

According to the Ministry of Health (MOH), one in three diabetics does not know he suffers from the disease, and among those who do, about a third are unable to control their blood sugar levels.

TIME TO ACT

If nothing is done, things will just get worse, as the prediction is that one out of every three people here will get diabetes.''

HEALTH MINISTER GAN KIM YONG, when he declared Singapore's war on diabetes last year.

The incidence of diabetes is highest among Indians, with 17.2 per cent of adults affected. This is followed by Malays (16.6 per cent) and Chinese (9.7 per cent).

THE PLAN

Type 2 diabetes - which is far more common than Type 1 diabetes and which tends to occur in those over 40 - is a highly preventable disease as lifestyle plays a big role.

Obesity is a major risk factor for diabetes. The rate of obesity here has been rising, from 7 per cent in 2004 to 11 per cent in 2010.

Lack of exercise and a high consumption of sugar and simple carbohydrates such as white rice and bread also increase the risk of getting diabetes.

Another major factor is ageing.

The MOH is pushing out a three-pronged plan in its war on diabetes:

•Public education on healthy living and how to avoid getting diabetes.

•Screening to identify diabetics early.

•Managing the disease for those who are already diabetic to prevent or delay complications.

The Health Promotion Board (HPB) will target people of different age groups, from children to the elderly, with different messages and activities.

It hopes the young will pick up good habits that will last a lifetime. The young could also influence their parents and grandparents to adopt healthier lifestyles.

For those who are already diabetic, HPB wants them to be aware so that they can take remedial action.

It will launch very cheap or even free screening for people aged 40 and above. They can get screened for up to five diseases, including diabetes, as well as get follow-up consultation for $5 or less.

Letters will be sent out soon to tell people where to go for such screenings.

These screenings can also identify those who are on the verge of getting diabetes. Early action could nudge them towards better health.

HPB will also encourage better control of blood sugar levels among those who are diabetic.

Complications such as gangrene, blindness and kidney failure happen when the sugar level is high and uncontrolled.

THE HOPE

Many diseases are made more severe by diabetes.

For example, half of those who have a heart attack here are also diabetic. This is also the case for two in five victims of stroke, and two in three with kidney failure.

But diabetics account for only one in nine adults aged 18 to 69.

So they form a disproportionate number of patients of these serious illnesses.

Every day, four amputations are the result of uncontrolled diabetes.

Diabetes is also a major cause of blindness in older people.

The MOH hopes that by reducing the incidence of diabetes, and controlling the blood sugar levels of those with the disease, it can bring down the number of people who suffer from other serious illnesses, too.

When Health Minister Gan Kim Yong declared Singapore's war on diabetes last year, he said: "If nothing is done, things will just get worse, as the prediction is that one out of every three people here will get diabetes."

Dr Chia Shi Lu, head of the Government Parliamentary Committee for Health, says that in the war on diabetes, the Government can only do so much. The actual fight must be at the individual level.

He says there must be "awareness and personal dedication to making the right lifestyle choices, mainly reducing calorie intake and refined sugars".

"The key is maintaining a healthy weight," he adds.

Dr Chia says a recent study in Britain found that the health levels of people who are fat, but fit, does suffer as a result of their being overweight. "So fat but fit is a myth," he adds.

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A version of this article appeared in the print edition of The Sunday Times on August 20, 2017, with the headline 'S'pore's war on diabetes '. Print Edition | Subscribe