Never too early - or late - to start preventing diabetes

Professor Tan Chorh Chuan said it is never too late to start taking action to prevent or manage chronic diseases like diabetes. ST PHOTO: KELVIN CHNG

SINGAPORE - Prevention of diabetes should start from a young age - perhaps even before birth, according to the Ministry of Health's (MOH) chief scientist Tan Chorh Chuan.

He noted that one in five mothers in Singapore gets diabetes during pregnancy, a condition known as gestational diabetes. Without intervention, this significantly raises the risk of both mother and child getting diabetes later in life.

Professor Tan said screening for gestational diabetes and preventing or helping to manage it can mitigate this risk and also makes the pregnancy safer for the mother.

"If we wanted to do health promotion right at the start, then that's a good place to start - in pregnancy," said Prof Tan, who is also executive director of the MOH Office of Healthcare Transformation.

He was speaking on Wednesday (Nov 25) at The Straits Times' webinar, Keeping Singapore Healthy. The webinar was sponsored by insurance provider Prudential and hosted by ST's senior health correspondent Salma Khalik.

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Prof Tan said research is under way in Singapore to examine the effects of eating habits in early childhood. While the data has yet to be published, he said it suggests children's eating habits affect their propensity for obesity later on.

But even though it is best to start young when it comes to preventing chronic diseases like diabetes, Prof Tan also said it is never too late to start taking action to prevent or manage such diseases.

He said even those who already have diabetes, high blood pressure or high blood cholesterol can get these under control and prevent further complications if they eat healthily, exercise and avoid smoking. In fact, over a third of the disease burden facing Singaporeans - a measure of the number of years of healthy life lost to disease, disability or early death - can be prevented through these three actions, added Prof Tan.

He said diet, exercise and smoking are just three behavioural risk factors that accounted for more than 40 per cent of deaths, citing a study by the British government agency Public Health England.

"I think the main message, which is important to remember, is that prevention should be started as early as possible, but at the same time, it's never too late to start prevention," said Prof Tan.

He noted that prevention works on multiple levels and does not apply to only those who are currently healthy. "Even if you're unlucky enough to have, say, a stroke... if you control your blood pressure well, you can reduce the risk of a second stroke by 20 per cent to 30 per cent. So prevention can work at many levels and still be effective."

Giving another example, Prof Tan - a renal physician by training - said the most common cause of kidney failure requiring dialysis in Singapore is diabetes, and it is preventable even if one has early diabetic kidney disease.

"If you manage that well - your blood sugar, your blood pressure - (with) regular medical care, you can actually slow down the progression of kidney failure and markedly reduce your risk of requiring dialysis."

Prof Tan noted that there is currently no such thing as a vaccine for diabetes, so one way to mitigate the complications arising from diabetes is through better prediction of the disease earlier in life.

This can be done through genome sequencing, which can determine one's genetic risk profile and identify those with a higher likelihood of developing certain diseases, Prof Tan said.

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