Monday, 26 September 2016

War on Diabetes: Feedback and suggestions wanted to get people to live healthy

Wanted: Feedback for war on diabetes
Responses to six-month exercise will help in drawing up action plan to be rolled out in 2017
By Linette Lai, The Sunday Times, 25 Sep 2016

How do you motivate people to eat properly, exercise regularly, watch their weight and stay healthy?

These are the questions that the Diabetes Prevention and Care Taskforce hopes to answer through a six-month crowdsourcing exercise that was launched yesterday.

It is the next step in the "war on diabetes" declared by Health Minister Gan Kim Yong in April.

Feedback from the exercise will go into an action plan that the ministry will roll out in stages next year.

Mr Gan, who heads the 16-member task force with Acting Minister for Education (Schools) Ng Chee Meng, stressed the importance of arresting the spread of diabetes.

"Diabetes can lead to serious complications, such as stroke, heart attack, kidney failure and lower limb amputations," he said.

From now until December, the task force will look at the factors stopping people from leading a healthy lifestyle.

In the first two months of next year, it will seek more detailed feedback on the earlier suggestions.

Apart from reaching out to regular Singaporeans, the task force will speak to representatives from the food-and-beverage industry, academia and non-governmental organisations.

Supporting the task force will be three workgroups, which will offer strategies to get people to live healthier, help existing diabetics manage their condition, and raise public awareness of the chronic disease.

But getting different segments of the community to adopt healthy behaviour can be difficult, said Speaker of Parliament Halimah Yacob, who is part of the task force.

She recounted how during a food-distribution exercise for needy residents earlier this month, most opted for white rice despite being given the option of healthier brown rice.

"They are mostly senior citizens, and they've grown up eating white rice - that's the only thing they know," said Madam Halimah.

Making sure that people have easy access to healthier options is also critical, she added.

"You go to the hawker centre and the food is mostly oily, salty or very sweet," she said. "Are there alternatives that people can consume so they can eat healthily?"

Endocrinologist Ben Ng of Arden Endocrinology Specialist Clinic said the trick is to help people make changes that they can continue with in the long term.

"The secret is to make sustainable changes that start at the family level," Dr Ng said.

"Simple things like getting the family to exercise together, for example, by making it part of family time."

Get tested early to keep disease in check
By Salma Khalik, Senior Health Correspondent, The Sunday Times, 25 Sep 2016

Diabetes is one of the biggest preventable drains on the healthcare system. This one disease alone costs the country $1 billion a year, in terms of treatment as well as lost man-hours.

If nothing is done to prevent the steady rise in the number of diabetics here, it is projected that it will cost the country more than $2.5 billion a year by 2050.

There are two types of diabetes.

There is no known way to prevent type 1 diabetes - where the body does not produce insulin - which usually hits the young.

Type 2, where there is too little insulin or the body cannot use the insulin effectively, is preventable, and by far the more common, accounting for about 90 per cent of diabetes cases worldwide. It is largely caused by a sedentary lifestyle and a diet consisting largely of simple carbohydrates like white rice and sugary drinks.

Insulin is needed to move sugar from the blood to tissues in the body.

More than 11 per cent of adults here aged 18 to 69 years are diabetic. The incidence is higher among those aged 70 years and older. This is one of the highest rates among developed countries, exceeded only in the United States.

Aside from more people getting diabetes every year, they are also getting the disease at a younger age.

Preventing complications from the disease is something people with either form of diabetes can work towards. The problem is not just having diabetes, but, more importantly, not being able to keep the level of blood sugar in check.

Uncontrolled, diabetes is the underlying cause of a host of major medical problems, such as heart disease, kidney failure, blindness and amputations.

In Singapore, every five hours another person loses the use of his kidneys and goes on dialysis. About two in three kidney failures are caused by diabetes.

It is a major reason for blindness and results in two limbs being amputated every day.

People who know that they have diabetes can prevent such dire complications with lifestyle changes and medication.

The trouble is that one in three of the more than 400,000 diabetics here do not even know they have the disease. This is largely because diabetes is a silent disease, with no symptoms in the early stages.

Since people do not know they have diabetes, it is not surprising that they are not doing anything to keep it under control.

The Government's plan to move upstream in tackling this disease is the correct one.

One of the first steps in the war against diabetes is to get people to check for diabetes. Control is easier in the early stages, as little damage has been done.

Getting people to find out early means they can work towards keeping themselves healthy in spite of having diabetes.

Another initiative must be to prevent diabetes. Some of the causes are known. Obesity, for example, is a major risk factor for getting diabetes.

Another is a predisposition in children born to women who had uncontrolled gestational diabetes, a type of diabetes that develops only during pregnancy in some women. Studies have shown that four in five children born to such mothers risk becoming obese or diabetic.

It is therefore important that women take great care during pregnancy in order not to disadvantage their babies.

Among the general population, exercising regularly and being careful not to indulge too often in unhealthy food are good ways to stave off diabetes.

National database on diabetes in the works
It will give doctors better picture of patients' medical history, help them identify those at high risk
By Jalelah Abu Baker, The Straits Times, 24 Sep 2016

A national diabetes database is in the offing as the authorities gear up for battle after declaring war against the chronic disease.

The database is expected to give doctors a better picture of their patients' medical history, helping them make decisions as well as identify and counsel high-risk patients.

It was announced by Minister of State for Health Chee Hong Tat at the opening of the Singapore Health and Biomedical Congress yesterday.

"This database will consolidate data from multiple, different sources, including existing databases in our healthcare institutions, so that we can make the best possible use of our data," said Mr Chee.

He noted that there is a need for the database, which will be developed by the Ministry of Health (MOH), as existing information is not linked.

"Not only is the data not connected to each other, but also, the data in each database is a little different from each other, making comparisons of data across different databases difficult," he said.

MOH will also be able to monitor and evaluate the impact of its policies and programmes on diabetes prevalence, health outcomes and healthcare utilisation, he said.

Mr Chee did not say what kind of data will be pooled, but added that there is a lot of data on diabetes in multiple repositories at the ministry and healthcare institutions.

He did not say when the database is likely to be ready.

Currently, more than 400,000 Singaporeans have diabetes. If nothing is done, one in three Singaporeans - or more than one million - are expected to get the chronic disease in their lifetime, prompting Health Minister Gan Kim Yong to declare war on diabetes in Parliament in April.

Yesterday, Mr Chee also announced that Nanyang Technological University (NTU) and the National Healthcare Group (NHG) will jointly set up two research centres.

The Centre for Primary Health Care Research and Innovation will look at introducing new technologies and creative ways of delivering quality family medicine and primary care for patients.

The Games for Health Innovation Centre will look at serious games that can be used to motivate patients to take greater ownership and care of their health.

In a joint statement, NTU and NHG said also that the two organisations have started an interdisciplinary research partnership for infectious diseases. They will focus on outbreak management, evidence- based treatment and the monitoring of infectious diseases.

Top on the list of diseases they will address are Zika, dengue and antibiotic-resistant tuberculosis.

An early project will focus on the development of point-of-care tests, which allow rapid diagnostic tests to be done outside the laboratory and within the community.

The tests will allow healthcare professionals to make quick decisions on treatment or the need for further tests, and will save time and facilitate the testing of individuals in a more proactive way, the statement said.

NTU president Bertil Andersson said critical issues arising from a rapidly ageing population and emerging infectious diseases can be tackled through the collaboration.

"Many solutions require interdisciplinary approaches and NTU's medical school will draw on the expertise of our other schools and research institutes, such as those in life sciences and engineering, in this partnership with NHG doctors, " he said.


Six-Month Long Public Engagement to Seek Views and Suggestions on War on Diabetes

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