'Not at risk' of diabetes? Maybe not

While online tests may assess risk based on key factors, take results with pinch of salt

Analyst Herman Benny filling out the Ministry of Health's Diabetes Risk Assessment to determine if he is at risk of the disease at the Diabetes Risk Assessment Roadshow at One Raffles Place yesterday.
Analyst Herman Benny filling out the Ministry of Health's Diabetes Risk Assessment to determine if he is at risk of the disease at the Diabetes Risk Assessment Roadshow at One Raffles Place yesterday. ST PHOTOS: JAMIE KOH
Members of the public who cycled for a minute at the Mobike counter at the roadshow yesterday received a $10 promo code and a free towel.
Members of the public who cycled for a minute at the Mobike counter at the roadshow yesterday received a $10 promo code and a free towel. ST PHOTOS: JAMIE KOH

A 25-year-old obese man who takes seven or more sugary drinks and exercises less than 100 minutes every week is - according to a new self-assessment tool - "not at risk" for diabetes.

The surprising result, say experts, underscores both the value and the limitations of such tests, which have gained popularity online. While they are short and, thus, easy for the public to do, the results will also need to be taken with a pinch of salt.

The Ministry of Health (MOH) launched its Diabetes Risk Assessment tool this month. Users answer seven to eight questions online and are then told whether or not they are at risk of the disease.

About 15,000 Singaporeans have used it to check their diabetes risk in the two weeks since it was made available at the online health portal HealthHub.

The questions take into account several key factors such as age, gender, family history of diabetes, body mass index and personal history of hypertension.

With this information, an individual's current risk of undiagnosed diabetes is assessed. The result does not reflect lifetime risk as a person's risk may vary with changes in some of the factors.

  • 15,000

    Number of Singaporeans who took the online Diabetes Risk Assessment in the two weeks it has been up.

  • Queries in the Diabetes Risk Assessment (DRA)

    •Date of birth

    •Gender

    •(For women) History of high blood glucose, diabetes, or gestational diabetes

    •Height and weight (to calculate body mass index, or BMI)

    •Family history of Type 2 diabetes

    •History of high blood pressure

    •Amount of physical activity in a week

    •How often one drinks sugary beverages in a week

    According to the test, a 25-year-old man who is 172cm tall, weighs 89kg and has a BMI of 30.1 (considered as obese); has a parent, sibling or child with Type 2 diabetes; has a history of high blood pressure; does little physical activity; and drinks sugary beverages at least once a day would be found "not at risk" of Type 2 diabetes.

    Asked whether other factors could affect the risk of diabetes, the Health Promotion Board directed The Straits Times to its media factsheet, which noted that "the DRA tool is a simple and quick test that is accessible on HealthHub". The test is at www.letsbeatdiabetes.sg/dra

The initiative is part of the ministry's disease-prevention efforts, which also include awareness campaigns and a $20 million investment to promote the use of healthier ingredients, first announced in March.

Yesterday, Health Minister Gan Kim Yong said Singaporeans aged 18 to 39 found by the test to be at risk of diabetes can now qualify for subsidised health screening tests.

They need to pay at most $5 for screening for diabetes, high blood pressure and high cholesterol. A diabetes screening can cost more than $50 at a private clinic. A blood pressure test, when checked by a general practitioner, might incur a consultation fee of $20 or more.

"While most of us think that age is a key factor for diabetes... age is not the only factor. Depending on your family history and lifestyle, these are also very important risk factors," said Mr Gan at a roadshow organised by the Health Promotion Board to encourage more people to do the self-assessment.

Dr Abel Soh, 41, a consultant endocrinologist, said the MOH test includes some of the important risk factors for development of diabetes such as age, body mass index and family history. "The risk calculator is definitely suitable for the general public and doctors who do not specialise in diabetes to assess risk for developing diabetes."

Dr Ben Ng, an endocrinologist at Arden Endocrinology Specialist Clinic, cautioned that people deemed "not at risk" by the test should take it with a pinch of salt.

"Other risk factors not included in the test may also play a role, including the presence of illnesses such as gestational diabetes and high cholesterol. Race and smoking may also contribute."

In the United States, the American Diabetes Association has a similar test online.

The MOH test website makes it clear that the self-assessment comes with caveats. It is developed for those between age 18 and 39.

"If you are above 40 years old, it is recommended that you go for cardiovascular risk screening (including diabetes) every three years," it wrote.

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A version of this article appeared in the print edition of The Straits Times on September 20, 2017, with the headline 'Not at risk' of diabetes? Maybe not. Subscribe