Q&A – Understanding Diabetes

Q: Who should get tested for diabetes type 1 and 2?

A: Singapore has one of the highest rates of young people with Type 2 diabetes in Asia. If left untreated, it can lead to potentially devastating complications,
such as blindness, kidney failure, heart disease, stroke, and even cancer. The main concern is that this condition does not cause any symptoms, especially in the early stages.
Individuals above the age of 18 in Singapore are eligible for screening. We recommend individuals between 18 and 39 years of age who have risk factors for diabetes to get screened every three years. Risk factors for diabetes include having a family member with diabetes, smoking, being overweight, high blood
pressure, and high cholesterol. Individuals above the age of 40 should be screened every three years regardless of any risk factors.


Q: Which tests are available?

A: The most commonly performed screening test is a fasting blood sugar where the individual fasts for atleast eight hours and then does a blood test at a clinic. A more detailed test is called an oral glucose tolerance test. Preparation for this test is similar to the fasting blood sugar, but following the test, the individual consumes a sugar drink with a repeat blood test in two hours. This test is more cumbersome but has a greater detection rate for people with borderline diabetes. Recently, a blood test called the HbA1c has been used. The advantage is that fasting is not required.

Q: What are the risks of a late diabetes diagnosis?

A: The main problem with diabetes in the early stages is that patients are asymptomatic. Unfortunately, if people do not get screened regularly, they can develop complications of diabetes. Beyond a certain stage, these complications become irreversible and can lead to blindness, heart disease, stroke, and cancer. Diabetes is the most common cause of kidney failure, blindness, and amputation in the developed world.

Q: What are the main treatments to manage the condition?

A: Diet and lifestyle remain the pinnacle of treatment in the management of blood sugars and its complications. Increased physical activity and reduction in overall caloric intake along with refined sugar and saturated fat are recommended for patients who have diabetes.
Patients need to work closely with their doctors to ensure that blood sugars are under control. People with diabetes should visit their doctor at least once every 6-12 months to ensure that the treatment is adequate. Regular review of the patient’s condition to screen for complications of diabetes,
including eye disease, nerve disease, and kidney disease, is also recommended.
Despite following lifestyle advice, a proportion of patients will still be unable to control blood sugars and will likely require medication. Medications come in the form of oral tablets and injections. Given the wide variations in people’s diet, activities, and attitudes towards health, the treatment for diabetes has to be individualised and tailored towards the individual concerned.


Dr Ben Ng
Dr Ben Ng is a consultant endocrinologist at the Mount Elizabeth Novena Hospital in Singapore.