Effective diabetes management in Singapore

1st May, 2023

Key points

  • Rising prevalence of diabetes: Diabetes is a growing concern worldwide, with a significant increase in the number of people diagnosed with the condition, particularly Type 2 diabetes, which accounts for the majority of cases.
  • Role of physical activity: Regular physical activity is crucial in managing and preventing diabetes, as it helps control blood glucose levels, reduces the risk of complications, and improves overall health.
  • Physiotherapists’ involvement: Physiotherapists play a key role in managing diabetes by providing guidance on safe physical activity, screening for risk factors, and educating patients on lifestyle modifications.
  • Health complications of diabetes: Diabetes can lead to severe complications such as cardiovascular disease, nephropathy, neuropathy, and musculoskeletal issues, which can significantly impact the quality of life.
  • Importance of early intervention: Early identification and management of risk factors for diabetes, through lifestyle changes and medical interventions, are essential in preventing the onset and progression of the disease.

Overview of the article

The article “The Role of Physical Therapists in Fighting the Type 2 Diabetes Epidemic” explores the critical role physiotherapists can play in managing and preventing diabetes, particularly Type 2 diabetes. It highlights the importance of regular physical activity in controlling diabetes and reducing the risk of complications. The article also discusses the various health complications associated with diabetes and the need for early intervention to manage these risks effectively.

Diabetes in Singapore

As of 2023, it is estimated that about 1 in 9 adults in Singapore has diabetes, which equates to approximately 11.3% of the adult population. This percentage reflects both diagnosed and undiagnosed cases, with Type 2 diabetes being the most common form of the disease in Singapore. The prevalence of diabetes is expected to rise as the population ages and lifestyle factors such as diet and physical inactivity continue to impact public health.

Is diabetes a problem in Singapore?

Yes, diabetes is a significant public health issue in Singapore. The country has one of the highest rates of diabetes among developed nations. The Ministry of Health Singapore has identified diabetes as a critical healthcare challenge, leading to the declaration of a “war on diabetes” in 2016. The increasing prevalence of diabetes poses a substantial burden on the healthcare system and highlights the urgent need for effective prevention and management strategies.

Why is physical activity important?

Physical activity is important because it helps control blood glucose levels, improves insulin sensitivity, and reduces the risk of diabetes-related complications such as cardiovascular disease and neuropathy. Regular exercise also aids in weight management, which is a crucial factor in preventing and managing Type 2 diabetes.

What is diabetes mellitus?

Diabetes mellitus is a group of chronic metabolic conditions characterised by elevated blood glucose levels due to the body’s inability to produce insulin, resistance to insulin action, or both. There are several types of diabetes, including Type 1 diabetes, Type 2 diabetes, gestational diabetes, and other forms caused by specific genetic or environmental factors.

Modifiable and non-modifiable risk factors for diabetes

Modifiable Risk Factors

Non-modifiable Risk Factors

Overweight/obesity

Age (>45 years)

Physical inactivity

Family history/genetic predisposition

Poor diet

Race/ethnicity (e.g., higher risk in American Indians, African Americans, Hispanics)

Hypertension

Sex (male)

Smoking

Socioeconomic position

Alcohol use

History of gestational diabetes

Depression

Low birth weight

Stress

What are the health complications of diabetes?

Diabetes can lead to several serious health complications. Below is a table summarising the complications and their prevalence:

Health Complication

Prevalence

Hypertension

82.5%

Cardiovascular disease

26.9%

Nephropathy (kidney disease)

26.8%

Neuropathy (nerve damage)

19.5%

Cerebrovascular disease (stroke)

9.7%

Peripheral vascular disease

5.4%

Retinopathy (eye damage)

3.2%

What is the role of Physiotherapists in diabetes?

Physiotherapists have a vital role in managing diabetes through:

  • Promoting physical activity: Physiotherapists guide patients in safely increasing their physical activity levels, which is crucial for managing blood glucose and reducing complications.
  • Screening for risk factors: Physiotherapists screen patients for diabetes-related complications, such as musculoskeletal issues, and modify treatment plans accordingly.
  • Patient education: They educate patients on the importance of regular exercise, healthy eating, and lifestyle modifications to manage diabetes effectively.

As someone with diabetes, what can I do?

Individuals with diabetes can take several steps to manage their condition effectively:

  • Engage in regular physical activity: Aim for at least 150 minutes of moderate-intensity aerobic exercise per week, spread over three days.
  • Monitor blood glucose levels: Regularly check blood glucose levels to ensure they are within the target range.
  • Follow a healthy diet: Eat a balanced diet rich in whole grains, vegetables, and lean proteins while avoiding refined sugars and processed foods.
  • Manage stress: Practice stress-reducing techniques such as meditation, yoga, or deep breathing exercises.
  • Seek regular medical care: Attend routine check-ups with healthcare providers to monitor and manage complications.

Key recommendations for physical activity in people with diabetes

Patient Characteristic

Recommendation

General diabetes management

150 minutes per week of moderate- to vigorous-intensity aerobic activity, with resistance and flexibility exercises.

Musculoskeletal impairments

Engage in non-weight-bearing exercises such as swimming or cycling to avoid foot complications.

Cardiovascular complications

Monitor heart rate and blood pressure during exercise; adjust intensity as needed.

Neuropathy

Emphasise low-impact exercises and monitor for signs of foot injuries or ulcers.

Obesity

Combine resistance training with aerobic exercise to improve overall health and manage weight.

References

Harris-Hayes, M., Schootman, M., Schootman, J. C., & Hastings, M. K. (2020). The Role of Physical Therapists in Fighting the Type 2 Diabetes Epidemic. Journal of Orthopaedic & Sports Physical Therapy, 50(1), 5-16. https://doi.org/10.2519/jospt.2020.9154

Frequently Asked Questions

What are some ways to prevent diabetes?

Preventing diabetes involves maintaining a healthy weight, engaging in regular physical activity, eating a balanced diet, and managing stress.

What are the symptoms of diabetes?

Common symptoms include increased thirst, frequent urination, unexplained weight loss, fatigue, and blurred vision.

How can I control diabetes without medication?

Controlling diabetes without medication can be achieved through regular exercise, a healthy diet, weight management, and monitoring blood glucose levels.

What foods should I avoid with diabetes?

Avoid foods high in refined sugars, processed carbohydrates, and saturated fats, such as sugary snacks, white bread, and fried foods.

What level of blood sugar is dangerous for type 2 diabetes?

Blood sugar levels above 200 mg/dL are generally considered dangerous for individuals with type 2 diabetes.

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