Three preventive actions to consider in war on diabetes

There are about 400,000 diabetics in Singapore, or 7 per cent of the population. Diabetes has been with us for a long time and is endemic here (“Campaign launched to help Malays fight diabetes” (Sept 26).

As Type 2 diabetes is a lifestyle disease, the situation can deteriorate in time unless we take preventive actions. Diabetes is a long-term, progressively debilitating disease, and I suggest three areas for stakeholders to consider.

First, the Health Ministry’s current clinical practice guideline for the Fasting Plasma Glucose test is that a reading below 6.1 millimole per litre (mmol/l) is considered normal.

As many medical authorities consider 5.6 mmol/l as the onset of prediabetes, however, it would be useful to include this benchmark in laboratory reports as a tool for doctors to help their patients make informed judgements on their lifestyle.

I understand that authorities worldwide do not want to create a panic, but patients can reduce their blood sugar level by exercising, reducing weight and monitoring their diet.

Second, I observe that family physicians usually take a patient’s blood pressure and weight as a routine protocol. Perhaps the medical authorities may want to recommend including the pinprick test as part of the protocol, especially for at-risk patients.

Family physicians can then be an active first line of clinical defence against diabetes. It would be a bonus if doctors include this as part of their consultation service to their regular patients.

Some patients may not want it, so it could be optional. The test can also be done without needing patients to fast, as the guideline can be adjusted accordingly.

Finally, the current awareness campaign should emphasise a key point: That preventing the onset of diabetes can be managed by reducing the blood sugar level, which can go down through exercise.

This can be demonstrated during roadshows. When people see the quick results of the effort put in, this adds to the motivation to do something for their health.