Singaporeans might have found it unusual that Prime Minister Lee Hsien Loong chose to cite diabetes as a pressing concern in his National Day message last week. The other two areas on which he focused - improving preschool education, and embracing technology in the drive to be a smart nation - were more in the traditional mould of national messages. However, Mr Lee's decision to mention diabetes drew attention to the fact that unlike palpable threats and underlying concerns, such as terrorism and trade protectionism, diabetes is an insidious threat to the health of the nation precisely because many Singaporeans do not recognise its dreaded nature and do not seek to prevent its onset until it is too late.
Diabetes might well qualify as the national disease. It is race-blind (and can also cause blindness). According to the Diabetic Society of Singapore, it afflicts about 9 per cent of the adult population. If the young try to take heart from the statistic that 90 per cent of people with diabetes are over the age of 40, they should be aware that they themselves will become more vulnerable as they grow older: As it is, almost a third of those over 60 have the disease. Diabetes is associated with severe ailments that range from heart problems to kidney failure. Every five hours here, one person loses the use of his kidneys and needs a transplant or dialysis. This puts pressure on the biggest dialysis provider, the National Kidney Foundation, where places are not unlimited.
Combine all this with the threat of amputations, and the stark nature of the disease becomes clear. It was reported last year that Singapore has one of the highest rates of lower-extremity amputation in the world, with public hospitals here needing to conduct about four amputation procedures a day. At one hospital, a study showed, one in five diabetics died within a year of having part of their legs amputated owing to the condition.
Yet Singaporeans by and large appear to refuse to take diabetes as the mortal threat that it is. A healthy diet and moderate exercise can help in the war on diabetes, but not enough Singaporeans are willing to go into battle. Exercise at least is a needed act of commission, but eating well takes but the will to sign on to an act of omission. Regularly eating generous servings of mouth-watering white rice, matched with suitably oily dishes which are washed down with sugary drinks, contribute to the self-indulgent mythology of Singapore as a food-loving nation. However, such unhealthy eating habits, passed down from one gastronomic generation to the next, are a recipe for national disaster. It is one thing to love food; it is another to love it to death or to obesity and diabetes. In poorer times, eating well meant to eat a filling meal. It is the curse of prosperous times that people tend to forget that they do not live to eat but eat to live. Diabetes is a reminder.