Much discussion has centred around identifying and addressing lifestyle factors that contribute to diabetes and its complications.
In my opinion, there is an elephant in the room that underpins such sub-optimal lifestyle choices - socioeconomic status.
Individuals of lower educational attainment and income may be predisposed to making less optimal food and lifestyle choices.
Sugar, in many ways, may represent the most accessible form of indulgence for persons of low socioeconomic status compared with the more diverse and healthier options available to more affluent sections of society.
The time and financial pressures that people of lower socioeconomic status face, and the types of occupations they are involved in, like regular graveyard shifts for example, increase the likelihood that they eat unhealthy food and spend little time exercising.
There is ample empiric data from other countries to support this link between socioeconomic status and adverse diabetes outcomes.
It is critical to collect and disseminate data on the association between education, income, occupation and other socioeconomic factors with diabetes incidence and outcomes in Singapore.
It is critical to collect and disseminate data on the association between education, income, occupation and other socioeconomic factors, and diabetes incidence and outcomes in Singapore.
It would be instructive to know, for example, if the widely publicised ethnic differences in the prevalence of diabetes remain as stark when stratified by socioeconomic status.
Policy interventions will be effective only if accurately targeted at the most critical factors driving the development of, and morbidity from, diabetes.
I fear that we will not achieve the health outcomes we desire if the crucial impact of socioeconomic status is overlooked.
Mohamad Farid Harunal Rashid