Singapore, US to create first global diabetes registry

Partnership aims to share data, tackle 'hot issues', improve treatment of disease: Experts
By Salma Khalik, Senior Health Correspondent, The Straits Times, 6 Nov 2015

Singapore and the United States will be joining hands to create the world's first global diabetes registry, with special emphasis on heart problems that affect this group.

The National Heart Centre Singapore (NHCS) will lead 10 Asian countries, as well as Taiwan and Hong Kong, in this collaboration with the American College of Cardiology (ACC) to share data. The ACC started its registry last year, and the Asian countries, this year.

In a statement issued in the US yesterday, the ACC said the collaboration "allows for longitudinal study of diabetes across all stages of the disease".

The hope is that it will generate "data-driven, evidence-based insights and solutions" that will result in better care and outcomes for patients around the world.

It said that one-third of Americans are expected to become diabetic in their lifetime. Today, there are 382 million diabetics worldwide. This is expected to soar to 592 million by 2035, with 60 per cent of diabetics living in Asia.

Associate Professor Carolyn Lam, a senior cardiologist at the NHCS who is leading this effort, told The Straits Times in a phone interview from Spain that "this is a really important partnership".

It is particularly important to Singapore, which has more diabetics than many other countries, she added. More than 11 per cent of adults here are diabetic.

"Diabetes is the single largest cause of disease burden in Singapore," she said, adding that they account for more than half of heart failure patients and the bulk of those who have gone blind.

Diabetes is also the leading cause of kidney failure here.

The number of diabetics here is expected to grow from 400,000 today to 600,000 by 2030, she said.

Prof Lam said the joint registry will provide real world data, "not just sterile data from clinical trials", which endocrinologists and cardiologists are hoping will answer some "hot issues".

They include whether some diabetic drugs are actually causing heart failure in patients. Similarly, whether some of the newer drugs actually prevent heart failure.

Many academic papers have been written on these issues. Tracking what patients are actually taking and their long-term outcomes could give more definitive answers. This, is turn, will affect how patients are treated in future.

Dr William Oetgen, an ACC vice-president, said the NHCS "has the leadership and commitment to be a strong partner". He added that Asian data can "identify and address issues unique to the region", such as why diabetic heart patients in Singapore are younger than those in the West.

Associate Professor Tai E Shyong, head of endocrinology at the National University Hospital (NUH), who is on the advisory board of the recently started Asian Diabetes Outcomes Registry, said treatments vary across countries.

Doctors can learn from places with better outcomes, he said, adding that the large size of the database will allow for strong findings and analysis.

Prof Tai said the data "will help identify treatment gaps and opportunities to improve the burden associated with diabetes mellitus".

Aside from Singapore, Asian data will come from China, India, Indonesia, Hong Kong, Malaysia, the Philippines, Sri Lanka, South Korea, Taiwan, Thailand and Vietnam.

In Singapore, data will come initially from the Singapore General Hospital and NUH, but will be expanded to other hospitals later.