A healthy lifestyle and timely intervention are key to delaying the onset of, or even preventing diabetes, says Dr Kevin Tan, Consultant Endocrinologist with the Kevin Tan Clinic for Diabetes, Thyroid and Hormones

Nearly 1 million Singaporeans are projected to have diabetes by 2050. A Ministry of Health (MOH) survey reveals that 430,000 or 14% of Singaporeans aged 18 to 69 are diagnosed with pre-diabetes. Unfortunately, 35% of individuals with pre-diabetes are likely to progress to type 2 diabetes.

“Diabetes, short for diabetes mellitus, is a chronic and progressive condition characterised by high blood glucose levels. Type 1 diabetes is an autoimmune disease where the pancreas is unable to produce insulin  because the body’s immune system attacks its own insulin-producing cells; while people with Type 2 diabetes are unable to effectively utilise the insulin and later on do not produce sufficient insulin. Therefore, sugar (glucose) remains in the bloodstream and continues to increase,” explains Dr Kevin Tan, Consultant Endocrinologist with the Kevin Tan Clinic for Diabetes, Thyroid and Hormones.

Both Type 1 and Type 2 diabetes are chronic diseases, but the latter can be managed and even prevented with healthy lifestyle habits.

Risk factors and symptoms

While the exact causes of diabetes are not yet fully understood, but certain factors can increase the risk of developing diabetes.

Obesity accounts for 80-85% of the risk of developing Type 2 diabetes because fat cells release pro-inflammatory chemicals which disrupt the body’s ability to respond to insulin, making it less sensitive to the hormone.

“Age is another risk factor, with the proportion of cases almost doubling with each decade of life. Only 1.9% of 30-39 year olds were diabetic, but about 25% of individuals aged 70 and older have diabetes. According to the same report, diabetes was also more prevalent in men (9.7%) than in women (7.3%), and in individuals with primary education (23.2%) compared to just 4.7% in those with post-secondary education,” explains Dr Tan.

Some of the common symptoms of diabetes include:

  1. Increased thirst and hunger
  2. Frequent urination
  3. Fatigue
  4. Unexplained weight loss
  5. Blurred vision
  6. Genital itching
  7. Numbness or tingling in hands and feet
  8. Very dry skin
  9. Sores that heal slowly and potentially become infected

“Unfortunately, diabetes is linked to several comorbidities, including obesity, heart disease, hypertension, hyperuricemia (elevated uric acid levels in the blood), and chronic liver disease. Diabetes significantly increases the risk of coronary heart disease and chronic kidney disease (CKD),” says Dr Tan.

Diabetes has also been identified as the leading cause of end-stage kidney disease, with Singapore ranked first in the world for diabetes-induced kidney failure.

Dr Kevin Tan, Consultant Endocrinologist with the Kevin Tan Clinic for Diabetes, Thyroid and Hormones

Dr Kevin Tan, Consultant Endocrinologist with the Kevin Tan Clinic for Diabetes, Thyroid and Hormones

Early detection and screening

Early detection is the first step in facilitating timely treatment. Dr Tan recommends that all adults aged 40 onwards to undergo diabetes screening – a simple finger-prick test to determine your HbA1c (haemoglobin A1c) levels, which is a marker for diabetes.

“In general, a blood glucose reading of below 6mmol/l is normal, while anything between 6 and 6.9 mmol/l indicates pre-diabetes. A reading of 7 and above confirms the presence of diabetes,” he says.

The Screen For Life programme by Singapore’s Health Promotion Board’s (HPB) enables individuals aged 40 and above to sign up for free or subsidized blood glucose screenings. Those under 40 can also take HPB’s diabetes risk assessment to determine their risk of developing Type 2 diabetes.

Preventing diabetes with healthy living

Lifestyle modifications and healthy living are the cornerstones for diabetes management, at any stage of the disease. Dr Tan shares some tips on how to manage blood sugar levels, while also reducing your risk of CKD:

  1. Embark on a healthy diet: The types of foods you eat affect your sugar levels. While no single food is strictly off limits, you should consume plenty of vegetables, fruit, and whole grains, while reducing foods that are high in refined sugar, carbohydrates, and trans-fats. A Mediterranean diet has also been proven to reduce the risk of diabetes by 83%, even without calorie restrictions.
  2. Exercise: In addition to decreasing your body’s cholesterol levels, exercise moves sugar into the muscles for storage and promotes insulin sensitivity, hence reducing the risk of diabetes. Diabetic adults are recommended at least 30 minutes or more of moderate cardiovascular exercise (jogging swimming, biking) daily, as well as two to three sessions of resistance exercise (yoga, weightlifting, calisthenics) a week. It is advisable to break up long bouts of physical inactivity (such as working at a laptop) with walking or light activities every 30 minutes, to help control blood sugar levels.
  3. Lose weight: Did you know diabetes can be reversed if patients simply lost weight? A Newcastle University study of 280 diabetic patients, showed that nine out of 10 participants who lost 15kg or more, not only reversed their condition to the point of no longer needing medications but also enjoyed normal blood glucose levels after one year, proving that lifestyle modifications alone can combat this deadly condition.


Featured photo by Dreamstime.
Dr Kevin Tan photo courtesy of Dr Kevin Tan.