“Singapore has ramped up efforts to stem the spread of diabetes”
Diabetes is reaching epidemic proportions in Singapore and in the Asia Pacific. By 2040, the vast majority of people living with diabetes will reside in Asia (with the largest numbers in India and China). Priyanka Bajpai spoke to Prof Tai E Shyong of Department of Medicine, NUS Yong Loo Lin School of Medicine, and NUS Saw Swee Hock School of Public Health, Singapore about the current scenario of diabetes in Singapore and Asia-Pacific and the role of the government to reduce the number of cases related to Diabetes.
What is the current scenario of diabetes in Singapore and Asia-Pacific?
In Singapore, Diabetes mellitus is already the leading contributor to the burden of disease, largely from the complications associated with diabetes (heart disease, eye disease, kidney disease, stroke, amputations). In Singapore, the prevalence of diabetes is expected to increase by as much as 30-50% in the next 2-3 decades. It is also increasing all over Asia.
Efforts to prevent diabetes to reduce this increase are critical. In addition, for the millions of people who already have disease, we need to find a way to mitigate the development of complications that could lead to death or disability.
What is our effort to support the government in reducing diabetic cases?
While the government of Singapore has ramped up efforts to stem the spread of diabetes via greater awareness (e.g. the Prime Minister of Singapore singledout diabetes for national focus), public health initiatives (e.g. health screenings) and prevention (e.g. Health Promotion Board’s health progammes like National Steps Challenge), research organisations and integrated academic health systems like the National University Health System (NUHS) focus on researching novel solutions to treat and prevent diabetes.
This is where initiatives such as NUHS’ Metabolic Disease Summit Research Progamme (SRP) come in. One of the key initiatives is to develop models of care and build tools that will transform the healthcare system to optimally deal with chronic non-communicable disease. The SRP uses new and innovative models of care to engage and empower those living with diabetes to take charge and live better lives. An example of such initiatives under the SRP include the Year-ofCare model, a pilot project which will be pioneered at the National University of Singapore and National University Hospital in September 2017. The strategy involves several components. First, diabetes patients will be sent results of their blood sugar, cholesterol, weight, kidney function etc. a week before their doctor’s appointment in hopes of nudging / spurring the patients to get more engaged about discussing solutions for their condition (by talking to family, friends or online searches). At the same time, providers (doctors, nurses, pharmacists) are trained to equip them with the skills required to have open conversations to encourage patients to share their concerns and set goals, together with the provider, to improve their health condition. These are then documented and we activate the services and support required to help patients achieve those goals. This paradigm treats the consultation as a meeting of two experts. The provider is the expert in the medical condition. The patient is the expert in their lives. We hope that the lessons learned will eventually inform care transformation in National University Polyclinics (NUP) and eventually nationwide.
We are also working actively in the development of new technologies to help persons living with diabetes or at risk of diabetes. These range from formulating novel types of foods to replace the highly refined carbohydrates that form a large part of the Asian diet, development of digital tools that can be implemented in the care pathways to support patients in their daily lives and new drugs for the treatment and prevention of diabetes (DYNAMO for diabetic kidney disease as an example).
In your opinion, what the government should do to reduce cases?
The Singapore government is taking an “all of government” approach to the “war on diabetes” and we are happy to be part of that process.
Prof Tai E Shyong Department of Medicine, NUS Yong Loo Lin School of Medicine, and NUS
Saw Swee Hock School of Public Health, Singapore