Diabetes in Singapore
Are you aware that Singapore is currently experiencing a concerning rise in diabetes prevalence, and if current trends continue unabated, we will soon be facing a ‘tsunami of diabetes’? According to the Ministry of Health Singapore (MOH), as of 2022, over 400,000 people in Singapore live with diabetes—a number expected to soar to a staggering 1 million by 2050.
MOH also reported that approximately one in three Singaporeans face a lifetime risk of developing diabetes. What’s alarming is that it’s not just older adults; diabetes is increasingly affecting younger individuals as well, with some patients as young as 30 years old being diagnosed with the hormonal disorder.
This growing trend is likely driven by sedentary lifestyles and prolonged work hours that restrict exercise and lead to the consumption of processed sugars in fast and convenience foods. These factors, compounded by stress and time constraints, exacerbate the problem by contributing to a heightened risk of developing type 2 diabetes.
Thankfully, an increasing number of Singaporeans are getting screened for diabetes. This rising trend is heartening as early diagnosis of diabetes enables timely and effective management of the condition.
Detecting, Diagnosing and Treating Diabetes
To diagnose diabetes, any of the following tests may be recommended by doctors to patients based on their initial consultations:
- Fasting blood sugar test: A blood sample is retrieved after an overnight fast (at least eight hours).
- Casual blood sugar test: This is similar to the above, but fasting is not required.
- Glycated haemoglobin (HbA1C) test: This test can be done via a blood draw or a point-of-care test requiring only a finger prick. Results are available within 15 minutes.
- The oral Glucose Tolerance (OGTT) test requires overnight fasting followed by drinking a sugary liquid at the doctor’s office. Blood sugar levels are measured before and two hours after drinking the solution.
Based on the results, doctors can provide an accurate diagnosis and recommend the most appropriate diabetes treatment and management plan, including an insulin prescription, regular blood sugar level monitoring and lifestyle changes such as a healthier diet and exercise.
Follow-up Care and Support Services
It is important to note that there is currently no cure for diabetes. Recognising diabetes as a lifelong condition means that doctors and the team usually offer ongoing support by following up with patients to ensure they adhere to their medication, monitor their blood sugar levels, manage stress levels, and more. This comprehensive approach aims to assist patients in better managing their diabetes.
Alongside understanding the common endocrine (hormonal) disorder, it is equally important for individuals to understand the available diabetes care options and know where to seek appropriate treatment.
Understanding the Role of Varying Medical Practitioners in Diabetes Care
General Practitioner: General practitioners (GPs) are typically the initial point of contact for addressing patients’ health concerns, including those related to diabetes care. Their role may involve screening for diabetes, diagnosing the condition, providing initial management and treatment, prescribing medication, coordinating care with specialists as needed, and offering ongoing patient support and education.
Diabetes Specialist: Unlike GPs, diabetes specialists, such as Endocrinologists and Diabetologists, offer specialised care. They provide comprehensive diagnosis, advanced treatment options, and nuanced management plans tailored to each patient’s needs based on their in-depth knowledge of the condition and its complications.
Patients can directly consult these specialists for end-to-end diabetic care, including screening, diagnosis, treatment, and management planning. Unbeknownst to many, you don’t require a GP referral to consult a specialist at private clinics in Singapore. If you already understand your condition, you can contact the specialist clinic directly to schedule an appointment. Alternatively, GPs may refer patients to these specialists, especially those with diabetic complications.
Nurse: Nurses play a crucial role in diabetes care by providing patients with education, support, and guidance. They may assist with blood glucose monitoring, insulin administration, medication management, wound care, and lifestyle counselling.
Dietician: Dietitians also play an essential role in diabetes management by providing dietary guidance and counselling to patients. They help patients develop personalised meal plans, manage weight, monitor blood sugar levels, and make healthy food choices to control diabetes and prevent complications.
Endocrinologists / Diabetologists in Singapore
For optimal care, patients with diabetes may seek treatment from a diabetes specialist, an Endocrinologist (a medical expert in hormonal disorders). In Singapore, Endocrinologists are, by default, Diabetologists, too. An Endocrinologist masters a curriculum in diabetes as part of local Endocrinology specialist training and credentialing.
Choosing a Diabetes Specialist in Singapore
Patients may want to take into account the following points when selecting a reliable diabetes doctor to consult:
- Medical History: An Endocrinologist can provide specialised holistic care for all patients with diabetes. It is especially recommended for those whose diabetes is complicated by other hormonal imbalances or endocrine issues to consult an Endocrinologist.
- Educational Attainment: Assess the specialist’s expertise and experience in managing diabetes.
- Degrees: A diabetes specialist in Singapore will hold medical degrees from accredited institutions. He or she would typically have a Bachelor of Medicine and Bachelor of Surgery (MBBS) degree, a Masters in Internal Medicine (MD Medicine), and fellowships in Endocrinology (e.g. MRCP & FRCP).
- Certifications: The specialist would also have board certification obtained through rigorous speciality examinations accredited by Singapore’s MOH.
- Affiliations: Consider specialists trained at reputable healthcare institutions or diabetes centres, such as the esteemed Mayo Clinic. These places often provide comprehensive services and access to sophisticated treatments and technologies.
- Years of Practice: Experienced specialists are often more well-equipped to provide patients with an optimal care plan.
Why Should You Consult an Endocrinologist / Diabetologist
Since hormones play a crucial role in regulating blood sugar levels, diabetes is a hormone-related issue. Insulin, for instance, is a hormone secreted by the pancreas that helps regulate glucose (sugar) in the bloodstream. In diabetes, either the body doesn’t produce enough insulin (Type 1 diabetes) or doesn’t effectively use the insulin it produces (Type 2 diabetes), leading to high blood sugar levels. When this delicate balance is disrupted, as in the case of diabetes, it can lead to serious health complications. Understanding the hormonal component of diabetes is crucial for effective management and treatment.
Endocrinologists (also known as diabetologists in Singapore) diagnose and treat conditions related to hormones and the endocrine system, including the pancreas. Since diabetes is fundamentally a disorder of insulin insufficiency or insulin resistance, Endocrinologists have specialised training and experience in managing diabetes and its associated complications.
These specialists address diabetes comprehensively. This includes not only the direct management of blood glucose levels through hormonal therapies like insulin but also the treatment of complications and co-existing conditions often associated with diabetes. These can include cardiovascular diseases, kidney problems, and diabetic neuropathy. Furthermore, Endocrinologists are involved in diabetes education, dietary advice, and lifestyle management, which are crucial for effective diabetes control.
The main takeaway: When managing diabetes, Endocrinologists integrate a broad spectrum of medical knowledge and skills that go beyond Endocrinology issues. They manage diabetes not only in the context of Endocrinology issues but also as part of their overall practice.
What Are the Benefits of Consulting an Endocrinologist
They ensure patients receive comprehensive care tailored to their specific health needs. They can provide specialised treatments, manage medication regimens, and guide lifestyle changes to manage the condition effectively. By helping patients address their underlying hormonal issues, Endocrinologists enable individuals to control their blood sugar levels and boost their overall health and well-being.
When to See an Endocrinologist or Diabetologist in Singapore
If your blood sugar levels remain abnormally high despite following prescribed treatments from your GP, you will typically be referred to an Endocrinologist. You should also consult an Endocrinologist if one or more of these factors apply to you:
- Diagnosis Confirmation: If your general practitioner has initially diagnosed you with diabetes, you should consult an Endocrinologist to discuss detailed treatment options.
- Managing Complications: If you experience diabetes-related complications such as neuropathy, retinopathy, or kidney issues, an Endocrinologist can provide specialised care to manage these conditions effectively.
- Type 1 Diabetes: Patients diagnosed with Type 1 diabetes should regularly see an Endocrinologist, as specialised care is typically necessary to manage this type of diabetes effectively.
- Pregnancy: Pregnant women with existing diabetes or those who develop gestational diabetes should see an Endocrinologist to manage their condition during pregnancy to maintain good maternal and foetal health.
- Multiple hormonal conditions: Patients with diabetes who also require careful management of other endocrine-related conditions should consult an Endocrinologist. In cases where diabetes interacts with other endocrine conditions, such as thyroid disease or osteoporosis, an Endocrinologist can devise treatment plans that concurrently address the patient’s hormonal conditions. This integrated approach helps manage the patient’s overall health more effectively, ensuring that treatments for one condition do not adversely affect another.
Regular appointments with an Endocrinologist are important for all individuals managing diabetes, as they can provide specialised care, up-to-date treatment options, and expert knowledge beyond general practice.
Visit Harmony Thyroid, Endocrinology and Diabetes Centre
If you are looking for specialised, holistic care for diabetes or a trusted endocrine doctor in Singapore, book a consultation with Dr Vikram Sonawane, the Medical Director and Senior Consultant Endocrinologist at Harmony Thyroid, Endocrinology and Diabetes Centre. Dr Vikram and his experienced team are dedicated to supporting you in understanding, managing, and thriving with diabetes.
Dr Vikram has helped numerous patients take control of their diabetes condition. He is an accomplished Endocrinologist with over 12 years of experience in Endocrinology. He has more than 20 years of experience as an expert Internist. He obtained his MBBS and MD Medicine degrees from the University of Mumbai, India. Dr. Vikram also received fellowships MRCP and FRCP from the Royal College of Physicians, UK. Additionally, he underwent advanced speciality training in Endocrinology, diabetes & metabolism and was accredited as an Endocrinologist by the MOH Singapore in 2015. In the same year, he was sponsored by the MOH for a fellowship at the Mayo Clinic, USA, focusing on Clinical Thyroidology, Nodular Thyroid Disease, and Fine Needle Aspiration Biopsy of the thyroid.
Dr Vikram is an expert in screening for diabetes. Take note that early-stage diabetes is typically asymptomatic. That is, you could be suffering from diabetes even if you have no symptoms. Therefore, people aged 40 years old and above are recommended to undergo routine screening for diabetes despite feeling perfectly fine. It is often advisable for those with multiple risk factors to get screened earlier.
Learn more about our Diabetes, Pre-diabetes & Gestational Diabetes Screening Package to safeguard your health.
References
- Subramaniam, M., Lau, J. H., Asharani, P. V., Abdin, E., Roystonn, K., Wang, P., Devi, F., Vaingankar, J. A., Car, L. T., Sum, C. F., Lee, E. S., van Dam, R. M., & Chong, S. A. (2022). Sources of information on diabetes and its demographic correlates: a nationwide survey among Singapore residents. Health promotion international, 37(5), daac107. https://doi.org/10.1093/heapro/daac107
- Channel NewsAsia. (2022, January 25). War against diabetes: Singapore doctors seeing rise in young patients below 40. https://www.channelnewsasia.com/singapore/war-against-diabetes-singapore-doctors-seeing-rise-young-patients-below-40-lifestyle-habits-stress-early-screening-treatment-3921976
- Yeo, S. Q., Harris, M., & Majeed, F. A. (2012). Integrated care for diabetes-a Singapore approach. International journal of integrated care, 12, e8. https://doi.org/10.5334/ijic.810
- Mayo Clinic Staff. (2024, March 27). Diabetes – Diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451
- Diabetes screenings to play a big role in Singapore, with 1 in 3 people at risk of the disease. CNA. Published 2016. https://www.channelnewsasia.com/singapore/early-screening-key-reducing-risks-diabetes-related-complications-3070531
