Tuesday, February 7, 2012

Diabetic girl, 4, gets 5 jabs a day to stay alive

Did you know that one in nine adults in Singapore is diabetic?

Diabetes has been gaining ground here.

In 2004, 8.2 per cent of those aged 18 to 69 had the disease. In 2010, that figure went up to 11.3 per cent.

These worrying figures are from the latest National Health Survey (NHS), published at the end of last year by the Ministry of Health.

But the figures do not capture the number of young diabetics among us, such as four-year-old Corrinne Chua.

Little Corrinne was diagnosed with Type 1 diabetes when she was just 16 months old.

Type 1 diabetes, unlike Type 2, is currently not preventable, according to the World Health Organisation.

Back then, Corrinne's blood sugar level was so high (about three times that of normal people) that her blood became acidic.

She nearly went into a life-threatening coma.

Since then, the little girl has needed at least five insulin injections every day.

Her blood sugar level also has to be tested four times a day - when she wakes up, at lunch and dinner, and before she goes to sleep.

If she falls sick, she has to be tested every two hours and the number of injections she gets goes up to seven a day.

 Starting to ask why

When Corrinne was younger, she accepted the injections, but as she grew older, she started to question why she had to take them, said her mother, Madam Gillian Pua, 37.

Said the IT network engineer: "When she complains of the pain and doesn't want to be injected, I jab myself and say, 'See, Mummy tried. It's not painful'.

"It's something my husband and I have done to understand what it's like for her to have diabetes," she said.

Neither Madam Pua nor her husband has a family history of diabetes, so Corrinne's diagnosis came as a shock to the couple.

Madam Pua said there is a perception that having diabetes means ill-health and rotting limbs.

"But if you learn to manage it well, you can have a full life. And that's what I want for Corrinne," she said.

Self-control

"I don't stop her from eating anything. She knows how to limit her intake of sweet things and is very aware of what her body can take," Madam Pua said.

For example, Corrinne loves chocolate muffins, but she will stop after taking at most three mouthfuls of her favourite treat.

The little girl's self-control would stand many in good stead when it comes to preventing Type 2 diabetes, which can be triggered by lifestyle habits.

Dr Kevin Tan, a practising endocrinologist and vice-president of the Diabetic Society of Singapore, said that over the last 10 years, he has seen a rising number of young people being diagnosed with Type 2 diabetes.

He said it's because young people here are leading increasingly unhealthy lifestyles. Said Dr Tan: "They are eating more high-calorie, energy-dense foods, and they're not exercising enough."

Housewife Susan Lee, 53, believes her diet had a part to play in her developing Type 2 diabetes.

When she was diagnosed with the disease in her late 30s, she took it positively.

"Even if I moan or cry, it doesn't change anything," she said.

As a Peranakan Chinese, she feels that the rich food she used to eat contributed to her condition.

"The way Peranakan food is cooked is more oil-intensive. We also use a lot of spices and other ingredients like coconut milk," she said.

According to the 2010 NHS, which is conducted every six years, diabetes is most prevalent among Indians (17.2 per cent), followed by Malays (16.6 per cent) and Chinese (9.7 per cent).

Genes and lifestyle

Dr Tan said this could be the result of an "interplay of genes and lifestyle". By lifestyle, he is referring to diet and insufficient exercise.

Dr Natasha Lim, Singapore Medical Group's medical director for Centre for Eye Surgery, added: "Certain cultures have carbohydrate-heavy meals and are more sweet-toothed."

She said a recent study performed in Singapore on Singaporean Malay diabetics showed that 35 per cent of the 3,261 participants had diabetes-related eye disease.

Beyond vision loss, diabetes can also lead to kidney damage, result in limb amputations, and cause impotence in men and pregnancy problems in women, said Dr Tan.

"We worry about diabetes not only because of the death that results, but the suffering that comes before death," he said.

Often, diabetes goes undetected because of a lack of awareness.

More than half - or 51.4 per cent - of those who were diagnosed with diabetes because of their participation in the NHS 2010 (as the survey involved a blood sample test), didn't know they had the condition.

Support group

Still, Mrs Julie Seow, senior manager for Touch Diabetes Support, feels there is more awareness about diabetes today compared with 30 years ago when she was diagnosed with Type 1 diabetes.

The support group, which began in 1989 and has about 1,500 members today, is one of the two main local non-governmental organisations tackling diabetes - the other being the Diabetic Society of Singapore.

Mrs Seow hopes to see more being done to increase awareness of diabetes and support for those with the disease.

For example, she said, there is still not enough education to help the public distinguish between Type 1 and Type 2 diabetes.

There is also a lack of recognition that diabetes has to be treated holistically, she added. She said the psycho-social and emotional impact of diabetes should receive more attention.

Said Mrs Seow: "There are studies to show that people who have a strong network of support do much better in managing their condition."

The 2010 NHS also showed that 32 per cent of known diabetics have poor blood sugar control, an increase from 2004 when it was 30.4 per cent.

Diabetes cases increasing globally

Last November, the International Diabetes Federation (IDF) released its fifth edition of the Diabetes Atlas on World Diabetes Day, which falls on Nov 14 every year.

The IDF data showed that, as of 2011, 366 million people had diabetes, and that the number would rise to 552 million by 2030 if no urgent action is taken. This is equivalent to about three new cases every 10 seconds, or almost 10 million new cases a year.

IDF also estimated that as many as 183 million people, half of the total number of diabetics worldwide, are unaware that they have diabetes and remain undiagnosed.

Among Asean countries, Malaysia has the highest national prevalence of diabetes, with 11.7 per cent of its adult population afflicted. Singapore comes a close second, with a national prevalence of more than 11 per cent. Thailand and the Philippines are next with 8.2 per cent.

Worldwide, China remains the country with the most number of people living with diabetes – 90 million.

Mr Yutaka Seino, chair of IDF’s Western Pacific region, said in a press release marking World Diabetes Day 2011: “We are particularly worried that across the region, more men – around 973,000 – in their most productive years are dying as a result of the disease.”

Trend

Every country is seeing an increasing trend of people with Type 2 diabetes, prompting IDF president Jean Claude Mbanya to say, “In every country and in every community worldwide, we are losing the battle against this cruel and deadly disease”.

Diabetes caused 4.6 million deaths worldwide last year. The World Health Organisation predicts that diabetes will be the seventh leading cause of death in the world by 2030. Total deaths from diabetes are projected to rise by more than 50 per cent in the next 10 years.

Signs you could have diabetes

Diabetes is a chronic disease and there are two major forms of it.

Type 1 diabetes is characterised by a lack of insulin, a hormone that regulates blood sugar.
International Diabetes Federation (IDF) president Jean Claude Mbanya has said that although Type 1 diabetes makes up only 10 per cent of diabetes cases worldwide, it can be deadly unless sufferers are diagnosed immediately and receive insulin and skilled instruction on how to use it.

In contrast, Type 2 diabetes has a gradual onset and is due to the body’s ineffective use of insulin. It accounts for the vast majority of diabetes cases, and can remain undetected for many years.

The World Health Organisation says a healthy diet, regular exercise, maintaining a normal body weight and avoiding tobacco helps to lower the risk of developing Type 2 diabetes.

Reports of Type 2 diabetes in children – previously rare – have also increased. In some parts of the world, Type 2 diabetes has become the main type of diabetes in children.

The global rise of childhood obesity and physical inactivity is widely believed to play a crucial role. Raised blood sugar is a common effect of uncontrolled diabetes, and over time, this leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.

The IDF website lists the following warning signs that someone could have diabetes:
>> Frequent urination
>>  Excessive thirst
>>  Increased hunger
>>  Weight loss
>>  Tiredness
>>  Lack of interest and concentration
>>  Vomiting and stomach pain
>>  Tingling sensation/numbness in hands/feet
>>  Blurred vision
>>  Frequent infections
>>  Slow-healing wounds

My advice is to protect yourself early by insuring yourself with Critical Illness Coverage, contact me to find out more now.

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