It is no secret that people in Singapore love bubble tea - a phenomenon that puts boba stores in the green and our health in the red. No wonder F&B outlets are required to indicate drinks that contain higher levels of sugar come 2023. Now, that will make us think twice about that cup of pearl milk tea.
This intervention is not surprising in Singapore, where Type 2 Diabetes Mellitus (T2DM) is the most common type of diabetes . In 2010, 1 in 9 Singapore residents aged 18 to 69 were affected. What is alarming is that 1 in 3 individuals didn’t know they had the condition – a statistic telling of the latter’s insidious nature. With 430,000 Singaporeans aged 18 to 19 diagnosed with pre-diabetes, it looks like youngsters are not spared either.
Given that 1 in 4 Singaporeans could be affected by T2DM by 2050, there is no better time to start thinking about diabetes prevention. While some risk factors are out of our hands, others can be mitigated:
| Uncontrollable Factors | Controllable Factors |
|---|---|
| - Genetic predisposition - having a direct family member (parent of sibling) diagnosed with diabetes | - Weight – having a BMI of 23.0kg/m2 or higher - Leading a sedentary (inactive) lifestyle |
| - Age – risks of getting diabetes increases with age. If you are 40 years old or older, you have a higher risk compared to someone who is 10 years younger | - Smoking - Excessive alcohol consumption |
Whereas “ideal” body weight may differ across individuals, “healthy” body weight is ubiquitously measured by one’s Body Mass Index (BMI). According to Sun Life’s medical director Dr Raymond Tso, maintaining healthy body weight is one of the two most important ways of keeping T2DM at bay because people who are overweight are seven times more at risk.
BMI = Weight (kg) / Height2 (in metres)
| BMI (kg/m2) | Category (Asian cut-off) | Type 2 Diabetes Risks |
|---|---|---|
| >= 30.0 | Obese | High Risk |
| 23.0 – 29.9 | Overweight | Medium Risk |
| 18.5 – 22.9 | Normal | Low Risk (Healthy range) |
| < 18.5 | Underweight | Risk of nutritional deficiency diseases and osteoporosis |
If you’ve done the math and the result isn’t stellar, hold your horses before embarking on fad diets and the like. Weight loss should be gradual and sustainable, and a daily calorie deficit – where you consume less energy than is used – of about 500kcal is a good “day one” goal. With a proper diet and exercise regime in place, you could be well on your way to shedding between 0.5 to 1 kg a week. Start small or, better yet, have a doctor or dietician guide you along.
A diet that prevents diabetes is no different than the next healthy eating plan. Fresh fruit and vegetables provide antioxidants, strengthen immunity, and reduce risks of chronic diseases – diabetes included.
The following choices also add up:
a) Choose complex over processed carbohydrates, such as brown rice or wholemeal bread. They slow down the release of glucose into your bloodstream.
b) Swap red meat out for poultry, fish, or plant-based protein sources like kidney beans, chickpeas, tofu, lentils, edamame, and quinoa.
c) Switch to healthy fats and oils made from nuts, olives, avocados, canola, or fish. Even then, consume in moderation.
d) Picking water, coffee, and tea over sugar drinks and alcohol – however difficult that may seem in social situations.
When in doubt, HPB’s My Healthy Plate recommendations make a nifty reference.
Regular exercise not only reduces the risk of Type 2 Diabetes by improving your body’s sensitivity to insulin; it also burns excess calories and builds lean body mass. According to the Health Promotion Board, exercise should be cardiovascular in nature.
Their magic number for adults? At least 75 minutes of vigorous exercise makes you pant and sweat, or 150 minutes of moderate-intensity activities like brisk walking, hiking, cycling, or swimming every week. Importantly, pick something you enjoy so exercise becomes less of a chore. For some, that looks like breaking a sweat with friends over tennis, badminton, basketball, or soccer.A word of caution if you haven’t exercised in a long time: Get clearance from your doctor if need be, take it easy at the start, and increase your pace and intensity over time.
Listen up, night owls. Sleeping less than 5 hours per night and having one’s circadian rhythm disrupted by night shifts are risk factors for Type 2 diabetes, according to the Asian Diabetes Prevention Initiative, a joint research program by the University of Singapore and the Harvard School of Public Health. Sleep apnea, a condition where breathing repeatedly stops and starts in slumber, is yet another red flag.
For a restful night, avoid caffeine and electronic devices at night. Instead, wind down with a warm shower and keep your room dark and cool. Aim for 6 to 7 hours of sleep for a start, and sync up your internal clock by turning in and waking up at fixed times. That includes weekends, however strong the temptation to sleep in may be.
Health checks often take a backseat when there is no urgency. Ironically, when symptoms do show up, they can be much more challenging to remedy. According to Singapore’s health ministry, some profiles could use a more proactive stance than others.
For example, high-risk individuals, including those who are overweight or have a family history of diabetes, should start screening for T2DM before their 40th birthday. Even if you don’t fall into this category, it should be done every 2 years after you turn 40. Age aside, people with above-average blood sugar levels (pre-diabetes) ought to attend checkups every 3 months; then every 6 months after they’re stable.
