Speech by Dr Amy Khor, Senior Minister of State for Health, at the Opening Ceremony of World Diabetes Day Singapore 2015, 15 November 2015

Mr Yong Chiang Boon, President of the Diabetic Society of Singapore

Dr Kevin Tan, Chair of the Organising Committee for World Diabetes Day Singapore

Distinguished Guests,

Ladies and Gentlemen,

Good morning.

I am delighted to be here to commemorate World Diabetes Day. World Diabetes Day was started in 1991 by the International Diabetes Federation and World Health Organization (WHO) in response to growing concerns about the escalating health burden due to diabetes. Two decades later, this burden has not abated, but has instead increased over the years. According to the WHO, there are 347 million people worldwide with diabetes and diabetes is projected to become the seventh leading cause of death globally by the year 2030.[1] The worldwide World Diabetes Day campaign was launched at the World Health Assembly earlier this year, with the campaign activities planned from May 2015 to December 2015. This is part of an effort to evolve World Diabetes Day into a year-long campaign, to better reflect the realities of dealing with a chronic condition that must be managed long-term.

Burden of Diabetes in Singapore

2.         In Singapore too, the burden of diabetes and its complications is high, accounting for 10.4% of the total disease burden in Singapore. The prevalence of diabetes in Singapore has increased from 8.6% in 1992 to 11.3% in 2010. It is estimated that one in nine adult Singaporeans aged 18 to 69 is living with diabetes[2]. One in seven has impaired glucose tolerance (IGT) which is a pre-diabetes state that can progress to diabetes if lifestyle changes are not made. It is a serious condition which has many consequences if left untreated; leading to complications such as blindness, kidney failure, heart attacks, stroke, and lower limb amputations.

3.         Most people with diabetes have type 2 diabetes. People with type 2 diabetes make insulin, which is the hormone that enables your cells to turn glucose from the food you eat into energy, but their cells do not use it as well as they should. Doctors call this insulin resistance. Type 2 diabetes occurs more frequently in people over 40 years old, particularly those who are overweight and physically inactive. However, with changing lifestyle patterns and increasing obesity in the population, more young adults are getting diabetes; with some still in their adolescence when they are diagnosed. The good news is that up to 70% of Type 2 diabetes can be prevented through the adoption of healthy lifestyle habits such as engaging in regular physical activity, eating a healthy diet, maintaining an ideal weight range and going for regular health screening.

Encouraging Healthier Eating

4.         Obesity is the primary risk factor for Type 2 diabetes. A study by the NUS Saw Swee Hock School of Public Health has forecasted that by 2050, as many as one million adult residents may be affected by diabetes, taking into consideration trends in obesity prevalence in Singapore. This is because there is an increasing trend of obesity in Singapore, with the prevalence of obesity in the general population having increased from 5.1% in 1992 to 8.6% in 2013.[3]  The increase in obesity rate can partly be attributed to caloric imbalance.  In other words, people are consuming more calories than they can burn. As part of efforts to reduce the prevalence of obesity, we must encourage people to have healthier eating habits as well as increased physical activity.

5.         In April last year, we launched the Healthy Living Master Plan (HLMP), which aims to make healthy living accessible, natural and effortless for all. The Health Promotion Board (HPB) has launched several initiatives under the HLMP to encourage healthy living amongst Singaporeans. Under the Healthier Dining Programme, HPB partnered with the food and beverage industry to make lower calorie meals a prominent part of their menu offerings. More than 1,500 food and beverage outlets with a good mix of food courts and restaurants islandwide offer healthier meal options, increasing the availability and accessibility of healthier meals when individuals eat out.

6.         Another significant source of calories in the Singaporean diet is sugar in sweetened drinks. Sixty percent of Singaporeans consume two or more sweetened drinks a day. For these individuals, sweetened drinks are a source of excessive calories, contributing about 200 calories or 10% of daily caloric allowance[4]. HPB aims to reduce sugar intake among Singaporeans by working with partners to encourage Singaporeans to consume reduced or no sugar beverages when they eat out. The Match & Win Promotion which will start from 16 November 2015, with more than 1,000 participating outlets, aims to motivate Singaporeans to switch to reduced or no-sugar beverages. I, too, intend to make a commitment to cut down on my sugar intake by avoiding sugary drinks such as carbonated canned drinks.

Encouraging Increased Physical Activity

7.         Decreasing food intake should be accompanied by regular physical activity, which carries its own benefits, such as helping in weight control, decreasing the risk of chronic diseases like diabetes and hypertension, strengthening of bones and muscles, and improving mental health and mood. Besides increasing accessibility to healthier eating options, HPB has also launched a variety of initiatives under the HLMP to encourage regular physical activity among Singaporeans.

8.         The Sunrise in the City (SITC) initiative offers free fitness workouts at over 16 workplace touch-points to help working adults incorporate physical activity into their daily routine. The free programme 'Sundays-at-the-Park' offers a range of activities to residents such as Yoga and Zumba classes at our public parks. Residents can get active with family and friends every Sunday amidst the greenery.

9.         Just last week, we launched the National Steps Challenge. Participants who have successfully signed up for the Challenge and have already paired their steps tracker with the Healthy 365 mobile app can start moving to accumulate steps to earn points. The more steps you accumulate per day, the more points you get. The accumulated points can be redeemed for rewards and lucky draw chances. I therefore encourage those who have not signed up to do so, as it provides a fun way to increase your physical activity.

Encouraging regular screening and follow-up

10.       Apart from lifestyle changes, regular screening for diabetes is also crucial for early detection and prompt treatment. According to the National Health Survey 2010, half (51.4%) of Singaporeans who had diabetes had not been previously diagnosed. Prompt treatment, with regular follow-up and good glycaemic control will reduce the risk of complications and result in better health outcomes.

11.       Screening for diabetes is recommended once every three years for Singaporeans aged 40 years and above. Screening tests are available either at the neighbourhood polyclinic or GP clinics. Subsidies are available under HPB’s Screen for Life at participating Community Health Assist Scheme (CHAS) GP clinics. Eligible individuals with a Health Assist or Pioneer Generation (PG) card can benefit from the fully subsidised screening for chronic diseases under Screen for Life. In fact, screening for risk factors like blood pressure and body mass index is available today. I urge everyone here to take the first step to get screened if you have not done so. Take charge of your health today!

Conclusion

12.       Events such as World Diabetes Day Singapore, serve to remind us of the importance of diabetes prevention and early management. I applaud the Diabetic Society of Singapore for your commitment to help diabetic patients manage their condition, and to provide an opportunity for patients and their loved ones to share their experiences on coping with diabetes.

Thank you.

[1] WHO. 10 Facts about diabetes. http://www.who.int/features/factfiles/diabetes/facts/en/index1.html

[2] According to the National Healthy Survey 2010, the prevalence of diabetes among adults aged 18 to 69 is 11.3%.

[3] National Health Surveillance Survey 2013

[4] On average, an adult male requires about 2200 calories a day, while an adult female requires about 1800 calories in a day. The values indicated are calculated based on the average weight and physical activity level of Singaporean male and female. The daily calorie intake may vary depending on different factors such as age, gender, weight, and activity level. If you are an office worker, you may not require as much calories as a sales person who’s always on the move.