In a decade-long diabetes study, researchers from Khoo Teck Puat Hospital (KTPH) found that among those with Type 2 Diabetes Mellitus (T2DM), Malays and Indians are at higher risk of cardiovascular diseases compared to Chinese patients.Malay patients had two times higher risk while Indians had 1.7 times higher risk of diseases such as heart attacks and strokes, compared to Chinese patients with T2DM, according to findings of a study released by the healthcare cluster that manages KTPH, Alexandra Health.
According to the National Health Survey 2010, 1.7 million Singaporeans have a body mass index (BMI) of 23 or above, and they are at risk of obesity-related diseases such as diabetes, heart diseases and stroke. HPB says one million Singaporeans with BMI of 23 or more are either already pre-diabetic, or suffer at least one or more chronic condition such as diabetes. The One Million KG Challenge aims to get Singapore residents to collectively lose one million kilogrammes by 2016.
These community initiatives reflect a greater awareness of the need to combat obesity in order to curb the increasing prevalence of diabetes, amongst other lifestyle diseases. While community initiatives like this are highly commendable in their efforts to inspire the general public to lose weight and improve their health, the bigger challenge lies in how to maintain the weight lost and to persist in living a healthy lifestyle after the challenge is over.
A new diabetes prevention website has been launched in an attempt to stop what doctors say is a worsening epidemic in Asia. Studies have shown that Asians are at higher risk of developing type 2 diabetes, when compared with people of European ancestry. Asians are also more likely to develop the disease even at a lower BMI. This means that even though some Asian populations currently have a lower prevalence of overweight and obese individuals than populations in the West, they have a disproportionately high percentage of people with diabetes. Currently, 60% of the world’s diabetic population is Asian.
In Singapore, already 11.3% of adults have diabetes, and the numbers are set to worsen with the aging population and increasing obesity prevalence.
Another new drug canagliflozin has been approved for the treatment of diabetes in the UK. This is a new class of anti-diabetic medication that has joined the existing armory of oral agents in treatment of diabetes. Very soon, the drug will be available in Singapore similarly. The potential market for type 2 diabetes drugs is enormous and growing. An estimated 382 million people worldwide have diabetes, according to the International Diabetes Federation, with numbers set to worsen in many countries with aging population and increasing prevalence of obesity. While the addition of new treatment for diabetes is welcome, no drug is perfect enough to be a miracle panacea for the treatment of diabetes. Successful management of diabetes requires the concerted effort of appropriate medications, the sound clinical judgement of an astute physician, conscientious lifestyle modifications, consistent dietary habits, and most importantly, the patients’ motivation and desire to control their diabetes well.
The number of British adults with diabetes has risen to more than 3.2 million – up by a million in just seven years. New figures show 163,000 people were diagnosed with the condition last year, the biggest total in a year since 2008. This brings the total to 3,208,014 adults with diabetes – or one in 17 of the population. In 2006, the figure was 2.2 million. Diabetes is exceedingly expensive. The NHS in UK spends £14 billion a year – 10 per cent of its budget – treating diabetes and its complications. The authorities in UK feel they are in the middle of an unfolding public health disaster that demands urgent action.
Singapore is similarly not spared from the diabetes tsunami. In year 2004, only 8.2% of Singaporeans age 18-69 was affected. In year 2010, this number has increased at an alarming rate to 11.3% of Singaporeans. This makes Singapore one of the developed countries with the highest incidence of diabetes. In Europe, it is generally around 6 to 9 percent, and worldwide it is 8.5 percent. There are many more out there who are probably unaware and are undiagnosed. The rise of diabetes in Singapore mirrors the rise in obesity from 6.9% in 2004 to 10.8% in 2010. Besides obesity, one of the other biggest risk factor of diabetes is aging. For many people out there, it is no longer a question of whether they will get diabetes, but rather when they will get diabetes.
Diabetes causes a host of health complications ranging from blindness to kidney failure, poor circulation leading to limb amputations, heart attacks and strokes. Besides living an active lifestyle, the other important advice would be to actively screen for the disease and treat the disease aggressively while it is still in the early stage, so as to reduce the risk of succumbing to these dreaded complications.
A study, conducted from 2004 to 2007 by the National University Hospital, Singapore General Hospital and Khoo Teck Puat Hospital, with some 5,000 Singaporeans showed that 48.1 per cent had high cholesterol. But 17.3 per cent were unaware of their condition until they were tested during the study.
Leaving high cholesterol untreated increases the risk of debilitating heart attacks and strokes. Some patients remain reluctant to take statins (a class of medication used to treat hypercholesterolaemia), for fear of side effects such as liver inflammation and muscle aches. However these side effects are fairly uncommon and generally reversible upon cessation of the medication. Moreover, whenever a doctor makes a recommendation for a patient to go on medication, an assessment as to what the relative risk and benefit is, would have been made. And the doctor will make a recommendation for treatment when the benefit is clearly greater than the risk. Hypercholesterolaemia is a highly treatable condition, often with significant reduction of vascular risk upon treatment. It is advisable for patients to go for regular screening and actively discuss treatment options with their doctors for this common and potentially hazardous condition.
Thyroid diseases are common. In the US, more than 12% of Americans will develop a thyroid disorder during their lifetime. Many people with vague symptoms like feeling sluggish or weight gain, turn to dietary supplements that promise to jump-start metabolism by bolstering their thyroids with a mixture of vitamins and minerals. However these over-the-counter products may also contain thyroid hormones that should only be dispensed by prescription. In some cases these supplements contain amounts of thyroid hormone as high or higher than delivered by prescription medications. Indiscriminately use of such supplements that contain thyroid hormone may lead to serious side effects including nervousness, insomnia, heart problems and thinning of bone.
In Singapore, such products are not widely seen or available as yet. However given the ease of online orders, it might be relatively easy for these products to be obtained from overseas. Anyone with suspected thyroid disorders should consult a physician for a proper work up rather than relying on supplements to resolve their symptoms.
One in nine Singaporean adults aged between 18 to 69 years were obese in a survey in 2010, and Singapore’s obesity rate is increasing at about 1 per cent per year. It is likely the obesity rate currently in 2014 is even higher. Many people frown upon obesity because of the negative vibe in terms of physical appearance. But the true perils of obesity lies in its associated metabolic disorders (including diabetes, hypertension, hypercholesterolemia), and the complications downstream as a result of these metabolic disorders. These complications include heart disease, stroke, sleep apnea, gallstones and even cancers. The incidence of these metabolic disorders and their complications will most certainly aggravate as the obesity rate increases further. However, not all is lost. Obesity and its associated metabolic disorders can be treated to good effect as long as the patient is motivated and is positive about working with the doctor to optimize their metabolic profile.
Singapore may have as many as 1 million diabetics by 2050, as we get older and fatter. This trend is worrying of course. However it has to be emphasized that with early detection and good treatment, many diabetics can live very normal, good quality life, free from debilitating complications. The key is early detection and good treatment with regular monitoring and active intervention. So although news like this is worrying, we take comfort in the fact that diabetes still remain a very treatable disease as long as you are motivated to do so and you want to live well and healthy.
Jet Li is receiving treatment in Singapore for hyperthyroidism, a condition marked by an overly active thyroid. The thyroid is a gland that regulates the body metabolism. Although the condition is debilitating, the good news is there are very effective treatment nowadays to bring this condition under control.