1 in 2 S'porean adults will have Type 2 diabetes by 2050

SINGAPORE - By 2050, one in two adults in Singapore will suffer from Type 2 diabetes in their lifetime.

These projected figures were obtained from a pilot project conducted by the National University of Singapore (NUS) Saw Swee Hock School of Public Health (SSHSPH) earlier this year.

The project is based on a simulation model called the Demographic Epidemiological Model of Singapore (Demos).

The model forecasts the impact of diseases which affect the country and how public-health intervention can mitigate it.

About 400,000 Singaporeans, or 11.3 per cent of the population, were diabetic in 2010, said NUS. Type 2, or adult-onset, diabetes is linked to a person's diet and lifestyle.

It occurs when the body becomes more resistant to insulin - a hormone produced by the pancreas that allows the body's cells to use blood glucose for energy - and the cells that store and release insulin start to fail.

Demos takes into account aspects that have been found to have a link to diabetes, such as obesity and genetics.

The launch of Demos was announced yesterday at the inaugural two-day Singapore International Public Health Conference, jointly organised by SSHSPH and the Chapter of Public Health and Occupational Physicians, Academy of Medicine, Singapore.

The conference, held yesterday at the Grand Copthorne Waterfront Hotel Singapore, was attended by over 400 health-care workers, researchers and academics from 15 countries.

A $15-million research grant for the next five years, called the Communicable Diseases-Public Health Research Grant, was also announced. It will be used to support evidence-based public-health risk assessment and policy formulation, besides other areas.

The Health Sciences Authority and SSHSPH also signed a Memorandum of Understanding (MOU) at the event.

The MOU is aimed at encouraging knowledge exchange and enhancing academic and professional competencies to promote the protection of public health and advancement of public-health science.

Local study shows diabetes patients not managing disease well

SINGAPORE: A local study has shown that almost eight in 10 patients suffering from diabetes here are not managing their disease well.

Experts warn that if unmanaged, diabetes can lead to blindness, amputations and heart disease.

Seventy-three-year-old Mr Wong Wai Khew has been a diabetes patient for 13 years.

Mr Wong had to get used to taking nine pills daily.

"When we travel, we have to bring a lot of medicine. If we travel for a week, we have to pack enough medicine for two weeks. If there are any delays at the airport, we will run out of medicine," he said.

Not many are as conscientious as Mr Wong.

A survey by the Diabetic Society of Singapore showed that only about half of the over 150 respondents take their medicine regularly.

One in four patients said they're frustrated at having to pop so many pills.

Seven in 10 are not self-monitoring their blood glucose, while more than six in 10 do not exercise three times a week for 30 minutes each time.

Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that converts sugar and other nutrients into energy needed for daily life.

Vice president of the Diabetic Society of Singapore, Dr Kevin Tan, thinks that education is key in helping these patients.

"If we can educate them as to the importance of medication... not to just control the blood sugar in diabetes but also blood pressure and cholesterol, why they need to exercise and why they need to control their weight... I think more would be keen to control their condition," he said.

Families and friends too can do their part.

Two in three patients feel they need help with their condition, and many hope their companions can eat healthily with them.

There's also a new drug now that can help patients reduce the pill load.

With Kombiglyze XR, patients who take two pills daily can halve that dosage.

The drug may be prescribed for patients with Type-2 diabetes, often associated with obesity and a family history of the disease.

Doctors said the price of the drug is comparable to similar ones in the market.

The drug is available in private clinics. It will be six to 12 months before the drug is made available at hospitals.

TCM product lands 1 in ICU, another with bone fracture

SINGAPORE - A man in his 80s has been warded in the Intensive Care Unit (ICU) after consuming an illegal traditional medicine product that was sold as herbal medicine to treat arthritic and joint pain and promote blood circulation. A second man who took the same capsules is suffering from serious adverse reactions.

The first man had consumed the pills for about one year for the relief of chronic back pain, and had bought the capsules from a peddler locally, said the Health Sciences Authority (HSA). He is now in critical condition.

He was diagnosed to have developed Cushing's syndrome and is in hospital for complications resulting from chronic unsupervised steroid consumption.

Cushing's syndrome is a disorder that occurs when a person's body is exposed to high levels of steroid hormones. This condition is characterised by a round 'moon face', and upper body obesity with thin arms and legs.

The second patient, in his 40s, took the capsules which he purchased from his friend to relieve gout pain.

As a consequence of long term consumption of the adulterated capsules, his bones were affected and he sustained a fracture and needed surgery, HSA said.

HSA also received a third alert from a female in her 50s, who experienced rapid pain relief for her stiff neck after consuming only a few of the illegal capsules, which were obtained from a friend.

One of her family members immediately suspected that the product was adulterated and reported the case to HSA.

In all three cases, the implicated capsules had a similar appearance and were either green-white or blue-white in colour, and packaged in transparent bottles.

Tests done by HSA revealed that the pills contained the potent western medicine dexamethasone, which is a controlled substance under the Poisons Act.

Dexamethasone is a very potent steroid used for anti-inflammatory purposes and should only be taken under strict supervision by doctors, HSA said.

It can cause serious adverse effects such as increased blood glucose leading to diabetes, high blood pressure, as well as eye, muscular and bone disorders.

It can also cause serious symptoms upon withdrawal, including weakness, fatigue, weight loss, nausea, diarrhea, low blood pressure, joint pain and bowel obstruction due to the slowing down of intestinal contractions.

"Traditional or herbal medicines that claim to offer quick relief of chronic conditions such as back and joint pain, especially if they are poorly labelled or packaged often contain potent medicinal ingredients such as steroids," said Associate Professor Chan Cheng Leng, Deputy Group Director of the Health Products Regulation Group, HSA.

Anybody who suspects he or she has consumed the above-mentioned capsules is advised to consult a doctor as soon as possible. They are also advised to not stop taking the product on their own to avoid symptoms of steroid withdrawal.

It is an offence for an unlicensed person to import, sell or possess for sale any product containing substances controlled under the Poisons Act..

Anyone found guilty can be fined up to $10,000 and imprisoned for up to two years.

Members of the public who have encountered these illegal products or any other suspicious products are encouraged to report them by calling HSA at 6866 3485 or emailing hsa_is@hsa.gov.sg.

9 factors to watch out for in stroke prevention

Primary prevention to reduce the incidence of stroke should be targeted at the whole population and groups that are at increased risk by increasing awareness and promoting healthy lifestyles that reduce the risk factors for stroke.

The brain's functions depend on a constant blood supply for the oxygen and nutrients needed by its cells. The restriction or stoppage of this supply leads to damage, and possibly death of the brain cells.

A stroke, which is also called a cerebrovascular accident (CVA), is a condition in which the blood supply to a part of the brain is cut off. It is a medical emergency and the earlier treatment is provided, the less likely will be the damage.

Strokes are the third most common cause of death in Malaysia. It is estimated that there are about 52,000 strokes per annum (i.e. every hour, six people experience a stroke).

The risk for recurrent vascular events after a stroke or transient ischaemic attack (TIA) is about 5 per cent per year for stroke, 3 per cent per year for heart attack, and 7 per cent per year for any one of stroke, heart attack or vascular death. The risks are higher in patients who are at an increased risk of CVA or who have carotid stenosis.

It has been estimated that without treatment, the likelihood is one in 10 that a stroke will occur within a month after a TIA.

As strokes lead to disability and even death in some instances, TIAs should be treated as seriously as strokes.

Risk factors
A risk factor increases the chances of getting or having a certain health condition. Some risk factors for stroke cannot be changed, but others can be prevented. Changing risk factors over which a person has control will assist in achieving a longer and healthier life.

Strokes are preventable as lifestyle changes can reduce many of the risk factors. However, there are some risk factors that are not preventable. They include:

1. Age
The risks are increased in the older person, although about a quarter of strokes occur in the young. The risk doubles in each successive decade after 55 years of age.

2. Gender
The risks are increased in males (except in older adults, when it evens out).

3. Ethnicity
The risks are increased in Indians and Malays because the incidence of diabetes and hypertension are higher in these groups.

4. Medical history
The risks are increased if one has had a heart attack, stroke or TIA. The risks are also increased in pregnancy, abnormal heart beats, chronic renal disease, cancer, some types of arthritis, and in those with abnormal blood vessels or weakness in the wall of an artery.

5. Family history
The risks are increased if a close relative has had a stroke.

Primary prevention is vital in any programme to reduce the incidence of stroke. This should be targeted at the whole population and groups that are at increased risk by increasing awareness and promoting healthy lifestyles that reduce the risk factors for stroke.

Secondary prevention are measures used to prevent recurrence of a stroke. They are individualised depending on the person's pathogenesis based on neuroimaging and other investigations.

The prevention of stroke is similar to the prevention of coronary heart disease.

High blood pressure
High blood pressure (hypertension) is a major risk factor for stroke. The incidence increases in proportion to both the systolic and diastolic blood pressures. Isolated systolic hypertension (systolic blood pressure of more than 160mm Hg and diastolic blood pressure of less than 90mm Hg) is an important risk factor for senior citizens.

A reduction in blood pressure reduces the incidence of stroke. A reduction of the systolic blood pressure by 10mm Hg is associated with a reduction in risk of stroke by about a third, regardless of the baseline blood pressure levels.

Hypertension is controlled by diet, exercise and medicines.

Hyperlipidaemia
There is an association between raised blood lipids and risk of ischaemic stroke. Hyperlipidaemia is controlled by diet, exercise and medicines.

The use of statins in those at increased risk, e.g. those with cardiovascular disease, diabetes, reduces the incidence of coronary events and ischaemic strokes even in individuals whose blood cholesterol levels are normal (less than 5.0mmol/L).

Diabetes
Diabetes increases the risk of ischaemic stroke by 1.8 to 6 times. The incidence of stroke is significantly reduced by stringent control of hypertension in diabetics.

Scientific studies have indicated that strict control of the blood glucose (Hb A1c less than 6 per cent) is critical.

Diabetes is controlled by diet, exercise and medicines.

Diet
Foods rich in fat lead to fatty deposits in the artery walls. The overweight are at risk of hypertension. A low-fat, high-fibre diet, which includes abundant fruits and vegetables (at least five servings daily), is recommended.

Unsaturated fats which increase the blood cholesterol, e.g. meat, ghee, lard, should be avoided. However, a balanced diet has to include some unsaturated fat like fish, olive and vegetable oils.

The daily intake of salt should not be more than 6gm (0.2 oz), which is about one teaspoonful.

Exercise
A combination of a healthy diet with regular exercise is the best method to maintain a healthy weight, which reduces the risk of developing hypertension.

Regular exercise ensures that the heart and circulation are efficient, keeps the blood pressure normal, and lowers the blood cholesterol.

The recommendation is that there be at least 150 minutes of exercise of moderate intensity, e.g. fast walking, per week (about 30 minutes daily).

A person who has had a stroke should discuss with his healthcare provider about possible exercise plans. It may not be possible to have regular exercise immediately after a stroke, but exercise should begin when there has been progress with stroke rehabilitation.

It is essential that weight be maintained at healthy levels. Many people go on weight reduction programmes only to find that they gain back the kilogrammes they lost. It would be better to accept a steady rate of weight loss instead of overnight success.

Programmes that promise an ideal weight within a short period of time do not usually work out in the long term. The key to keeping the weight loss is to make changes to diet and lifestyle that one can live with. One has to adhere to these changes for life; they have to be part and parcel of everyday life.

Smoking
Both active and passive smoking increase the risk of stroke. Smoking doubles the risk as it leads to narrowing of the arteries and increases the likelihood of the blood clotting.

Smoking cessation can reduce the risk of a stroke by up to half. In addition, it will also improve general health and reduce the risk of developing other serious conditions like heart disease and lung cancer.

Smokers who have stopped for more than five years have the same risk of stroke as non-smokers.

Alcohol consumption
Heavy alcohol consumption increases the risk of stroke by three times as it can lead to high blood pressure and irregular heart beats, which are both major risk factors for stroke. In addition, alcohol causes weight gain because they are high-calorie compounds.

Consumption of more than three units a day (one unit = one glass of wine = a peg of hard liquor) increases the risk while light or moderate alcohol intake protects against all strokes.

Aspirin
Aspirin has been reported to be of benefit to women aged 65 years or more in the primary prevention of stroke due to its blood thinning effects.

There is substantial evidence of the benefits of aspirin in secondary prevention of recurrent strokes, with a 25 per cent reduction in risk in all patients with strokes who have received aspirin.

When given within 48 hours of a stroke, it has also been beneficial in reducing recurrent strokes and death.

Other anti-platelet medicines
Alternative antiplatelet medicines are prescribed in patients intolerant or allergic to aspirin, have contraindications to aspirin, or when aspirin has failed. The medicines include ticlopidine and clopidogrel.

It is essential to take aspirin or other anti-platelet medicines under the supervision of a doctor. In addition, one should take measures to avoid falls or tripping when taking these blood-thinning medicines.

In a nutshell
There are several measures that can be taken to prevent a stroke or a recurrent stroke, if one has had a stroke. The following will reduce the likelihood of a stroke or recurrent stroke:

>> Control high blood pressure through diet, exercise, and medicines, when necessary.

>> Control diabetes through diet, exercise, and medicines, when necessary.

>> Control raised cholesterol through diet, exercise, and medicines, when necessary.

>> Exercise at least 30 minutes a day.

>> Maintain a healthy weight by eating healthy foods, eating less, and joining a weight reduction programme, if necessary.

>> Do not smoke, or stop smoking. Limit alcohol consumption to one drink a day for women and two a day for men.

>> Avoid illicit drugs. Have regular medical checks and consultations with the family doctor or physician.

4 amputations before he mends his ways

Prevention is always better than cure.
 
SINGAPORE - In about eight years, he went through not one, not two, but four amputations on his right leg.

Mr Heng Liang Hai, 63, a former carpenter, was diagnosed with Type 2 diabetes about 30years ago and he did not manage his condition well at first.

Between 1995 and 2003, Mr Heng had two toe amputations and two lower-limb amputations.

First, it was his ankle, then the knee.

Said Mr Heng in Mandarin: "It was only after that last amputation that I realised I had to take care of my health."

Diabetes remains a major health issue with one in three Singaporeans developing it by the time they are 69, Professor Chia Kee Seng, the dean of the NUS Saw Swee Hock School of Public Health, told The Straits Times in an earlier interview.

Although the number of amputations caused by diabetes has been decreasing, doctors said more can be done.

Figures from the Ministry of Health (MOH) showed that from a high of 717 in 2004 (an average of two amputations a day), it dropped by 36 per cent to 457 cases in 2010.

The New Paper met three diabetic amputees who shared how their lives changed after they lost their lower limbs.

Concerns for the future
One of them, Mr S. Damotharan, 45, who lost his right ankle three months ago, urged diabetics to manage their condition and prevent amputations.

"Try not to lose anything. No point regretting afterwards," said the former canteen operator, who has four children aged between 4 1/2 and 10.

His wife, who works as an assistant engineer, is now the sole breadwinner.

While he maintains a cheerful demeanour, he is concerned about how he is going to provide for his family.

Dr Sathappan, senior consultant in the department of orthopaedic surgery at Tan Tock Seng Hospital, said it is common for diabetics to have microvascular diseases because their blood vessels clog up easily.

This results in deprivation of oxygen and nutrients to tissues in the leg. If left untreated, tissue death or gangrene sets in.

Amputation is necessary because gangrene is potentially life-threatening, said Associate Professor Aziz Nather, senior consultant for foot and ankle surgery at the National University Hospital (NUH).

Dr Bee Yong Mong, director of the Diabetes Centre at the Singapore General Hospital, said toe amputations are the most common, followed by ankle and knee amputations.

Miss Tiffany Chew, a TTSH podiatrist who specialises in the diagnosis, treatment and management of foot, ankle and lower leg conditions, said toe amputations affect how a person walks.

"This results in abnormal pressures on the feet which may lead to ulcerations.

"With the risks of ulcerations being higher, the risk of getting amputation further up on the same limb is definitely higher," said Miss Chew.

Learning not to give up
There is also the psychological effect of limb loss.

To help patients cope with this, SGH set up an amputee support group in 1999.

Miss Grace Lim, the senior nurse clinician in-charge of the group, said: "It was important for them not to give up on themselves, otherwise their health will worsen.

"We got those who had recovered well to come back and visit the patients, inspiring them to live healthily."

Mr Heng, for example, has changed his lifestyle habits. Instead of eating two bowls of rice at mealtimes, he stops after half a bowl.

"I know of another diabetic who is younger than me. He didn't watch what he ate and he's now gone," said Mr Heng.

With his prosthetic leg, he is able to go to the exercise corner near his home every day for 30 minutes and take long walks.

As for Mr Lim Chin Huat, 41, who was diagnosed with Type 2 diabetes in 1988 and lost his left ankle in 2002, he exercises in a different way.

Mr Lim lives in a Sungei Kadut factory owned by a distant relative and his room is so far from the toilet that it takes him at least five minutes to wheel himself there.

"Imagine how bad it is when I get diarrhoea," said Mr Lim, who does not live with his family because he is not close to them.

Type 2 diabetes is caused by the body's ineffective use of insulin to regulate blood sugar levels and the risk of contracting the condition is linked to unhealthy lifestyles.

Mr Lim worked as a driver and security guard for a while but then he suffered kidney failure due to diabetes.

He had to start dialysis and would often fall sick, so he lost his job. His marriage to a woman in the Philippines also suffered as he had limited mobility and finances to travel there.

They eventually got a divorce in 2010.

He will always remember the moment he woke up from his operation: "I felt my life was destroyed. It took me at least two months to come to terms with my loss."

Amputations in numbers:
Number of diabetic patients undergoing lower-limb or toe amputations in Singapore

2004: 717
2006: 597
2008: 466
2010: 457

Breakdown of the 457 diabetic amputations bygender: Two out of three were men (66.3%)

Breakdown of the 457 diabetic amputations by age in 2010:
20-39: 1.8%
40-59: 47.7%
60-79: 42.7%
80 and above: 7.9%

Note: The percentages do not add up to 100% due to rounding error. 


Diabetic amputations are preventable
Up to half of the amputations linked to diabetes are preventable, said Dr Bee Yong Mong, director of the Diabetes Centre at Singapore General Hospital (SGH).

Here are tips from Dr Bee, who is also a consultant at the SGH endocrinology department, and Tan Tock Seng Hospital podiatrist Tiffany Chew:

1. Self-care
Inspect the bottom of your feet and between the toes daily to ensure there is no wound

Wear proper footwear at all times

Thoroughly dry between the toes after bathing or washing your feet

Apply moisturiser daily except between the toes

Cut nails straight across and not too short, then use a nail file (Those who have impaired vision should get help to manage their nails.)

2. Annual foot screening
This is a structured screening process by health-care professionals to identify patients who are at high risk of developing foot complications.

3. Podiatrist care
Specialist care is needed for high-risk patients or those who already show early signs of diabetic foot complications.

Miss Chew said any calluses and corns must betreated by a podiatrist as they are predisposing riskfactors for ulcerations when mismanaged or leftuntreated.

Associate Professor Aziz Nather, senior consultant in the division of foot and ankle surgery at National University Hospital, said Singapore currently does not have many trained podiatrists.

He said there is a need to train assistant nurses and technicians to increase the pool of health-care workers who are equipped to do foot screening and educate on foot care.

NUH runs a foot screening training course for all hospitals in Singapore and also hospitals in the regional countries.

To date, they have run five training classes and trained 116 nurses, said Assoc Prof Aziz.

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

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