Diabetes In Singapore – A Primer

Prevalence Of Diabetes In Singapore – The Statistics

Diabetes in Singapore is a serious condition affecting a substantial portion of the population. It is estimated that there were 440,000 people in Singapore suffering from diabetes in 2014. This number may rise to 1 million by the year 2050. Furthermore, it is estimated that around 430,000 Singaporeans aged 18-19 years are diagnosed with prediabetes. According to the Ministry of Health, 1 in 3 people in Singapore may develop diabetes in their lifetime.

Among the different ethnic groups, Indians and Malays has a higher prevalence of the disease compared to Chinese.

Another statistic of concern that is diabetes often go undetected. It is estimated in addition that 1 in 3 people with diabetes do not actually know that they have the disease.

What Is Diabetes? 

Diabetes Mellitus, commonly known simply as diabetes, is a chronic health condition that impacts how food is turned into energy by the body.

Under normal circumstances, the body will break down food into glucose that is released into the bloodstream. The pancreas releases insulin when blood sugar levels increase. The insulin in turn enables the cells in the body to use the blood sugar as energy. Insulin also causes the liver to store blood sugar. When blood sugar levels decrease (e.g. due to usage by the body or insufficient food consumption), the amount of insulin produced will accordingly decrease as well. The lowered insulin level causes the liver to instead release the stored blood sugar so that the body has a source of energy to use.

When a person has diabetes, the body either does not produce enough insulin, or is unable to use the insulin effectively to tun blood sugar into energy. These result in there being too much glucose staying in the bloodstream. 

Serious Potential Health Impact From Diabetes

Diabetes in Singapore is a major public health concern. People with diabetes are at greater risk for conditions such as:

• Cardiovascular disease and stroke.
• Kidney damage (diabetic nephropathy) leading to kidney failure.
• Cataracts, glaucoma and other eye conditions.
• Hearing loss
• Foot-related complications due to damaged nerves or bad blood flow. Amputation of the toes, foot or leg might be required due to severe infections.

Types Of Diabetes 

There are several different types of diabetes:

Type 1 Diabetes 

This type of diabetes is an autoimmune disease. It is more often diagnosed in younger people – children through to young adults. This form of diabetes happens when the cells in the pancreas that produce insulin are mistakenly destroyed by the body’s immune system. People with Type 1 diabetes need to take insulin every day.

Type 1 diabetes is not lifestyle-related and there is no known prevention for it. 

Type 2 Diabetes

Type 2 diabetes is a form of diabetes whereby the body either does not produce enough insulin or is unable to utilise the insulin well. This is the most common type of diabetes with 90-95% of diabetics suffering from it. This form of diabetes usually affects people who are middle-aged or older. However, there is a new trend of increasing larger number of younger patients too.

The risk of getting Type 2 diabetes can be lowered via leading a healthy lifestyle – including maintaining a healthy weight, keeping a healthy diet, and getting regular exercise.

Prediabetes

Prediabetes occurs before the condition progresses to Type 2 diabetes. It is when the blood glucose level is higher than normal but not high enough to be considered Type 2 diabetes.  

Gestational Diabetes

This form of diabetes is due to hormonal changes and affects only pregnant women (who have no prior history of diabetes). While in most cases this form diabetes will go away after the birth of the child, it does increase the risk of Type 2 diabetes subsequently. The baby is also at increased risk to develop Type 2 diabetes at some stage. 

Diabetes Risk Factors

The risk factors for diabetes (i.e. factors that will increase the person’s likelihood of getting the disease) include:

For Prediabetes And Type 2 Diabetes

• Family history of diabetes
• Obesity
• Getting insufficient regular exercise
• Personal history of gestational diabetes
• High blood cholesterol levels or blood pressure
• Age of 40 years or older
• Prediabetes (risk factor for Type 2 diabetes)

For Type 1 Diabetes

• Family history of diabetes
• Personal history of pancreatic disease

Diabetes Symptoms

The onset of symptoms of Type 1 diabetes may be sudden and intense, but for prediabetes and Type 2 diabetes, there may often not be any warning signs at first. Here are some of the symptoms of Type 1 and Type 2 diabetes to watch out for:

• Increased thirst or dehydration 
• Increased frequency of urination
• Drastic weight loss in a short period
• Feeling exhausted or weak 
• Mood changes 
• Having a blurry vision 
• Sores that take longer to heal (for Type 2 diabetes)
• Frequent infections (for Type 2 diabetes)
• Numbness or tingling in the feet or in the hands (for Type 2 diabetes)

The best way to detect diabetes is via testing the blood for elevated glucose levels.

Screening For Diabetes In Singapore

Regular screening for diabetes is recommended for those aged 40 and above (once every 3 years if there are no indications of diabetes).

Combating diabetes in Singapore is a national priority. For Singaporeans aged 40 years and above, subsidised diabetes screening at $5 or less under the Screen for Life programme is available. For people aged from 18 to 39 years old, you can find out your risk of getting Type 2 diabetes using this assessment tool from the Health Promotion Board. Those assessed to be at ‘Higher Risk’ after taking the assessment may also be eligible for subsidised screening.