Join The War On Diabetes Mellitus

Instalment 1 of 3: War on Diabetes: Battle Fronts, Prevention, and Screening By Associate Professor Goh Lee Gan, Senior Consultant, Division of Family Medicine, Department of Medicine, National University Hospital.

One important resolution each of us can make for 2017 is to support our Health Minister Gan Kim Yong’s Multi-year Plan to Fight Diabetes for our own good. He declared war on diabetes in Parliament on 13 April 20161. There are more than 400,000 people with diabetes2 in Singapore today. One in three of these people do not even know they have diabetes. Of those who know, note that one in three have poor control. People with uncontrolled diabetes face an increased risk of blindness, kidney failure, heart attack, stroke, and limb amputation.

5 BATTLE FRONTS TO FIGHT THE WAR AGAINST DIABETES

PREVENTING DIABETES

What are the most important things to do to prevent diabetes? People can delay and prevent the disease by doing these three things: healthy eating, regular exercise, and weight control. These three strategies have been shown to be effective in the Diabetes Prevention Program (DPP) – a study of 3234 people with high risk of diabetes. The 3 strategies are now the staple ways to achieve success in diabetes control and adapted to meet local needs.

  1. Healthy Eating ( 5 – 7 Servings)

Use My Healthy Plate4 to plan for each meal

• Eat every meal, do not skip meals even if you are overweight

• Boil, steam; avoid frying your food

• Eat 70% full for buffet

• Choose a calorie-deficit diet if you are overweight or obese: Consult a dietitian, if necessary

• No sugar-sweetened beverages if you are intending to lose weight

• Limit to one portion of fruit for lunch, and one portion for dinner

  1. Regular Exercise

• Aim for 150 minutes of physical activity every week5

• Brisk walk 30 minutes each day x 5 days a week6; and

• Resistance exercises x 3 times a week6

  1. Weight Control

• Maintain BMI of less than 22.9 kg/m2 (Asians)

• If overweight or obese, aim to lose 10% weight in 6 months, and lose weight progressively to reach one’s healthy weight

  1. Screening

When should one be tested for diabetes?

Anyone aged 40 or more should consider getting tested for diabetes, especially if one is overweight.

• Overweight or obesity (BMI more than 25 kg/m2; or more than 27.5 kg/m2 respectively)

• Excessive waist circumference (more than 90 cm in man; 80 cm in woman)

• Age 65 years and older, family history of diabetes – check for diabetes.

Tests for diabetes

There are several criteria for diagnosing diabetes. See your doctor for more details.

References
1. Straits Times. Parliament: Health Minister Gan Kim Yong declares ‘War on diabetes’; new task force set up. ST: 2016, Apr 13. http://www.straitstimes.com/singapore/ health/moh-declares-war-against-diabetes (accessed 2017 Jan 12)

2. MOH. The Fight Against Diabetes: A Worrying Trend. MOH: Singapore 2016. URL: https://www.moh.gov.sg/content/moh_web/home/pressRoom/highlights/2016/Budget2016/the-fight-against-diabetes.html (Accessed 2017 Jan 12)

3. MOH. Better Health, Better Care, Better Life. MOH: Singapore 2016. URL: https://www.moh.gov.sg/content/dam/moh_web/PressRoom/Highlights/2016/cos/factsheets/ COS_Factsheet%20-%20Diabetes.pdf (Accessed 2017 Jan 12)

4. HPB. My Healthy Plate, HPB: Singapore, 2015. URL: https://www.hpb.gov.sg/HOPPortal/programmes-article/HPB064355

5. HPB. Aim For 150 Minutes Of Physical Activity Every Week. Singapore, 2013. URL:http://www.hpb.gov.sg/HOPPortal/health-article/10346

6. US Surgeon General. Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities. US Department of Health, 2015.