Singapore Battles Diabetes

Type II diabetes is usually diagnosed in adults of middle age, but can also be found in children and is often brought on by obesity. While the pancreas in type II diabetes can sometimes make insulin, it may not make enough or the body will not use what is made efficiently. With diabetes comes a lot of risk factors for developing other disease and disorders. Because the main cause of type II diabetes is obesity, maintaining a healthy, balanced diet and proper exercise is key to lowering the risk factor. Those with diabetes are at risk for stroke, heart disease, kidney disease and developing eye, dental, nerve and foot problems.

Blood glucose or sugar is what the body uses for energy. Insulin, the hormone that helps to convert the glucose into energy for use in other parts of the body, is created in the pancreas. It uses the food that is consumed to create insulin. When the pancreas is unable to convert the glucose for use by the body, it stays in the blood stream and builds up causing other health issues.

How Insulin is Created and Used 

The pancreas is the home of cells known as Beta Cells. These cells create, store and secrete insulin in response to elevated glucose levels in the body. When the body has an higher than normal glucose level, beta cells spring into action secreting insulin where it’s needed, they also start production of new insulin. Additionally beta cells also secrete the amylin and C-peptide an insulin production by product. These two are important to the process because amylin will slow the rate of glucose that enters the bloodstream while c-peptide prevents vascular complications, both are excreted into the bloodstream at the same rate as insulin. This is what is supposed to happen in any case.

In Type II diabetes, the beta cells go into overdrive at the onset of the disease and will produce a lot of insulin to counteract high glucose levels this is why Type II is characterized by not only high glucose levels, but high insulin levels as well. The problem is that outside of the pancreas which converts glucose, the tissues of the body are not only resistant to pure insulin and is therefore unable to use it, when this happens the body will experience insulin overdose.

In Type II diabetes because of the high rate of insulin production, over time the beta cells weaken and will either die off or start producing much less insulin, when this happens the patient will develop Type I diabetes and will need to take insulin in order to keep glucose levels normal. Although beta cells do not have a backup system in the body, everyone in born with extra beta cells that don’t become active until the onset of diabetes. The unfortunate side effect of this is that the extra beta cells seem to contribute to the beta cell exhaustion that happens with the onset of the disease because of peripheral insulin resistance that happens when the non pancreatic tissue of the body can’t use the extra insulin produced.

Singapore’s Type II Diabetes Epidemic

Sixty percent of the world’s diabetic population resides in Asia, while an estimated one in eight Singaporeans have diabetes in comparison to one in ten for people in Hong Kong. Singapore has a population of almost two million less than Hong Kong, and diabetes-related amputations are at a high of four a day. To combat the rising epidemic, the government has set up task forces that aims to lower the risk of diabetes in the population as well as provide free medical supplies in the form of testing strips and pen needles.

Some ethnic populations in Singapore are more at risk for developing diabetes than others. Singaporean of Indian descent who tend towards more abdominal fats, glucose intolerance, insulin resistance and metabolic syndrome have an increased risk of developing Type II diabetes. The diabetes incidences in Singaporeans increased from two percent in the nineteen seventies to nine percent by nineteen ninety-eight, but the highest increases were located in the Indian population with women at fifteen percent and men at seventeen percent. Indians seem to be more susceptible to the disease that their Malay and Chinese counterparts even when behaviors were adjusted to compensate for damaging behaviors related to food and alcohol intake, smoking and obesity. They are also more prone to heart disease as a secondary complication of diabetes with a higher than average mortality rates are greater.
There are many issues that contribute to the epidemic that Singapore is now experiencing, a lack of food education is prevalent with most of the population consuming traditional dishes that while not necessarily heavy in sugars contribute to the overall spike in glucose levels in the body. By far though the largest of the many problems that have led to the rise in diabetes in the Singaporean population is a rise in obesity.

Many low income Singaporeans struggle with healthy eating as they may not have access to more healthy, low sugar foods. But in a nation where the average monthly wages hovers around thirty-seven hundred US dollars, it can make gaining access difficult. A study showed that there is a correlation between higher incidences of diabetes in between low income households, versus higher income ones. The healthier options in supermarkets such as brown rice over white rice is not something that everyone can afford as brown rice will usually cost almost three times as much as white.

Programs in Place That Aim to Help

To offset that problem the ministry of health has set in place programs aimed at making healthier food alternatives available by offering funding to manufacturers that helps them cut the cost of including more whole grains in staples such as rice and noodles along with healthier forms of cooking oils into their products as well as offering subsidies to stockists for offering healthier cooking oil options in the aims of bringing the more the price points of more expensive oils within the range of the cheaper, less healthy varieties.

Additionally the public sector has been called upon to implement and follow new guidelines for fostering healthier eating habits. In particular the newly implemented Whole Of Government guidelines aimed at caterers task them with providing more healthy options to the functions that they serve including whole grain options, a reduction in deep fried foods and more offerings of food and water. A new HealthHub Track app is also on the horizon so that Singaporeans can monitor and manage their health conditions, with the option of enrolling in a twelve week diabetes prevention program to evaluate their lifestyles for diabetes risk.

Lowering Singapore’s Diabetes Risk

The government hopes that with the implementation of all these new programs to not only be able to track new cases of diabetes before they become life threatening, but to also make the population more aware of a healthier way to lead their daily lives. It may be an uphill battle to get people to start preparing their traditional meals with less of the ingredients that they once used, and in a country known for street food, getting street vendors to comply may be a herculean task, but preventative measures are at the very least in place and the Singaporean government it hopeful that it will make a difference.