Singapore Government Press Release

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Theme : Improving diabetic self care

Today, we observe World Diabetes Day. That this event is being observed throughout the world is a reflection of the status of diabetes mellitus as a major public health problem in most countries today. The diabetic population in the world today is estimated to be around 150 million. It is predicted that as the global population ages, diabetes will reach epidemic proportions – with the global number of diabetics expected to exceed 250 million by the year 2030. Much of this increase will take place in developing countries.

Diabetes is also on the rise in Singapore. It is a major public health problem, especially among older adults. It is estimated that almost 1 in 3 adults above the above the age of 65 has diabetes. We can expect the number of diabetics to rise steadily as the number of elderly increases in future. The overall prevalence of diabetes in the adult population had risen from 2% in 1975 to about 5% in 1984, and to almost 9% in 1992. Last year, it was the sixth leading cause of death in Singapore, resulting in 320 deaths. In the same year, diabetics utilised 230,000 hospitalisation days, and 750 amputations were carried out on diabetic patients. It is also the leading cause of blindness and kidney failure in Singapore.

The risk factors for diabetes are largely lifestyle-related. They include lack of physical activity, unhealthy diets and obesity. However, there is also a genetic predisposition to the disease. The Government’s Healthy Lifestyle Programme, aimed at reducing physical inactivity, unhealthy diet, obesity and smoking would, in the long term, help to lower the prevalence of diabetes and its complications in our population.

But more can be done to control diabetes in Singapore. Unlike some other diseases, diabetes is a condition where patients themselves play a very important role in the success of managing the disease. The 1992 National Health Survey showed poor control of the disease in about 40% of diabetics in Singapore. Hence, this is an area that we should focus on. Education on diabetic self-care is therefore of utmost importance. As diabetes is a chronic disease and the person can remain relatively well for years before the complications and damage to vital organs take place, the diabetic patient might not see the need to look after his condition. By the time the complications set in, it is too late to undo the damage to the many various organs.

This underlines the importance of educating diabetic patients and increasing their, knowledge and understanding of the disease they are suffering from. Diabetic patients should be made aware that they play a critical role in the outcome of their disease – that the risk of complications of the disease and premature deaths can be reduced, to a large extent, through good blood glucose control.

My Ministry has several programmes in place to improve the management of diabetes -- for example, training programmes for primary care doctors and nurses, and diabetic foot-care services in hospitals and polyclinics.

As a further step, I am glad to announce that my Ministry is collaborating with the newly formed Community Development Councils and the Diabetic Society of Singapore to set up community-based diabetes education centres for patients. The first such centre will be set up next year. These centres will provide up-to-date information and instructions on self-care skills to diabetic patients and their family members.

The new centres will also provide blood tests at a low fee and specially trained nurses will be available to screen diabetic patients for complications. Patients will be able to purchase syringes and testing strips for monitoring diabetes at bulk purchase prices, thereby reducing their medical costs.

This service will complement and supplement the care provided by GPs to their diabetic patients. Although health education is very important, most GPs are unable to devote much time to this because of their heavy patient load. I would therefore encourage GPs to refer their diabetic patients and family members to these diabetes education centres.

Living with diabetes is a life-long process. Patients will find it easier to cope with their condition if they have the understanding and support of family members, relatives, friends and the community.

One important source of support is voluntary organisations. The Diabetic Society has, for many years, been playing the role of community diabetic educator. In recent years, the TOUCH Diabetes Community Support Association and other voluntary and grass roots organisations have also joined in to provide education and support to patients. My Ministry will continue to work with these voluntary organisations to improve the management of diabetes.

As we enter the 21^st century, governments and health care providers in many countries, including Singapore, will have to face the challenges posed by diabetes. Having good treatment centres is important, but that alone will not be sufficient. Diabetic patients themselves play a vital role. They must adopt healthy lifestyles and actively look after themselves to keep their disease under control. It is through these multi-pronged approach that we can reduce the ravages of the disease and improve the quality of life for all diabetics.

With that, it is now my pleasure to declare the World Diabetes Day Celebration open.