Global Health Asia-Pacific July 2022 - Page 16

You Ask , They Answer

Q

: Who should get tested for diabetes type 1 and 2 ?

A

: Singapore has one of the highest rates of young people with Type 2 diabetes in Asia . If left untreated , it can lead to potentially devastating complications , such as blindness , kidney failure , heart disease , stroke , and even cancer . The main concern is that this condition does not cause any symptoms , especially in the early stages .
Individuals above the age of 18 in Singapore are eligible for screening . We recommend individuals between 18 and 39 years of age who have risk factors for diabetes to get screened every three years . Risk factors for diabetes include having a family member with diabetes , smoking , being overweight , high blood pressure , and high cholesterol . Individuals above the age of 40 should be screened every three years regardless of any risk factors .

Q

: Which tests are available ?

A

: The most commonly performed screening test is a fasting blood sugar where the individual fasts for at least eight hours and then does a blood test at a clinic . A more detailed test is called an oral glucose tolerance test . Preparation for this test is similar to the fasting blood sugar , but following the test , the individual consumes a sugar drink with a repeat blood test in two hours . This test is more cumbersome but has a greater detection rate for people with borderline diabetes . Recently , a blood test called the HbA1c has been used . The advantage is that fasting is not required .

Q

: What are the risks of a late diabetes diagnosis ?

A

: The main problem with diabetes in the early stages is that patients are asymptomatic . Unfortunately , if people
do not get screened regularly , they can develop complications of diabetes . Beyond a certain stage , these complications become irreversible and can lead to blindness , heart disease , stroke , and cancer . Diabetes is the most common cause of kidney failure , blindness , and amputation in the developed world .

Q

: What are the main treatments to manage the condition ?

A

: Diet and lifestyle remain the pinnacle of treatment in the management of blood sugars and its complications . Increased physical activity and reduction in overall caloric intake along with refined sugar and saturated fat are recommended for patients who have diabetes .
Patients need to work closely with their doctors to ensure that blood sugars are under control . People with diabetes should visit their doctor at least once every 6-12 months to ensure that the treatment is adequate . Regular review of the patient ’ s condition to screen for complications of diabetes , including eye disease , nerve disease , and kidney disease , is also recommended .
Despite following lifestyle advice , a proportion of patients will still be unable to control blood sugars and will likely require medication . Medications come in the form of oral tablets and injections . Given the wide variations in people ’ s diet , activities , and attitudes towards health , the treatment for diabetes has to be individualised and tailored towards the individual concerned .
Dr Ben Ng
Dr Ben Ng is a consultant endocrinologist at the Mount Elizabeth Novena Hospital in Singapore .
14 JULY 2022 GlobalHealthAsiaPacific . com