It’s not just sugar intake: Address ‘blind spots’ in war on diabetes

It is common knowledge that obesity, excess sugar and carbohydrate intake as well as sedentary lifestyle increase the risk of Type 2 diabetes. 

However, these are often mentioned to the exclusion of other significant contributors of the disease and could lead to a false sense of security.

Equal emphasis should be given to the following blind spots:

1. Smoking

Smokers are 30 per cent to 40 per cent more likely to develop Type 2 diabetes compared to non-smokers. Smoking can also make managing the disease more difficult because high levels of nicotine can lessen the effectiveness of insulin. 

2. Central obesity

The website of HealthHub, an initiative of the Ministry of Health, states that a person who looks fat around the centre of the body, or at the waist, is referred to as having "central obesity".

A large waist circumference is a well-accepted cause of insulin resistance and Type 2 diabetes. This means a waist circumference of 90cm or more for Asian males and 80cm or more for Asian females measured around the navel.

Even those who have a normal Body Mass Index (BMI) or who look trim are not spared, if they have a beer belly or higher body fat around the abdomen. 

For instance, Asians may look trim but compared to Caucasians, if they both have the same BMI, Asians with higher body fat are more likely to develop diabetes than Caucasians.

The Academy of Medicine, Singapore recommends that "all individuals 18 years of age or older should (have their waist circumference) screened annually".

Sadly, such a simple and free measurement is not part of the national health screening programme Screen for Life for Singapore residents, whereas it is in Taiwan's national health screening for people aged 40 and above.

3. Deep-fried food

Researchers from Harvard University in the United States and the National University of Singapore’s Saw Swee Hock School of Public Health found that people who ate fried foods seven or more times a week had a 55 per cent increased risk of Type 2 diabetes, compared with those who ate fried foods less than once a week.

4. Fruit juice

It is a grave misconception that juicing is a convenient way of consuming nutrients from various types of fruits.

The juicing process strips away essential fibre — fibre that helps to slow the absorption of sugars into the bloodstream.

A representative from the Health Promotion Board was quoted in a media interview in 2019 as saying: “Without the fibre, the large amount of sugar from fruit juices enters the bloodstream quickly and causes a sugar spike, similar to what happens when we drink sweetened drinks like sodas.”

Over time, this wears out the pancreas, which produces insulin, and can lead to weight gain and diabetes, she added.

5. Sleep

Inadequate sleep is a contributor of Type 2 diabetes, a study found.

To more effectively fight this "war on diabetes", as dubbed by Health Minister Gan Kim Yong previously, we need to cover all grounds and educate people on the harmful effects of smoking, of being overweight and obese, and to help them make sound decisions in their dietary choices and sleep patterns for blood sugar control.

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