Diabetes is one of the leading causes of morbidity globally due to its systemic effects on nerves, blood vessels and organ morphology. Singapore is estimated to have the “second-highest proportion of diabetics” when compared to other developed countries. An estimate has suggested that approximately a million Singaporeans are at risk of developing diabetes by 2050 – a figure which represents a significant burden of diabetes on the local healthcare system.

Recently, a research has revealed that Asians are more predisposed to developing diabetes due to an impaired ability to produce insulin in response to high blood glucose levels. The study was conducted by the National University Hospital (NUH) in Singapore in conjunction with Janssen pharmaceuticals. This finding has important implications as it means that Asians need to moderate their diet more strictly in order to prevent the onset of type II diabetes.

Increased risk of complications caused by high blood glucose among Asian population

Ethnic differences in the occurrence of diabetes were always thought to be contributors to the disease. However, the research has now validated that Asians produce less insulin in comparison to the Western population. This means that Asians are at heightened risk for complications associated with hyperglycemia such as infection, lethargy, poorly healing wounds and detrimental changes to blood vessels.

The study however sampled only a small number of participants – approximately 140 individuals, who were predominantly Chinese. In order to obtain a more generalised perspective of the effect of ethnicity on diabetes, other Asian races may need to be included in future studies. Despite the small sample size, Dr Toh Suh-Anne, principal investigator of the study, comments that, “The results were significant enough that we were able to clearly identify the biological characteristics that may predispose Singaporeans to developing diabetes, and we think that this study can help us to define what makes Asian diabetics different from Caucasians.”

BMIs on the upper end of the healthy range can still present a significant risk of diabetes

It is estimated that approximately 400,000 individuals in Singapore currently suffer from the disease, while approximately one in every three individuals faces a risk of developing diabetes throughout their lifetime. Even with BMIs such as 23 – that are deemed healthy in Caucasian populations – approximately 8% of the Chinese population can develop diabetes. This further emphasises the role of adhering to a diet low in processed sugars and fat and exercising regularly.

Mr Alan Phua, a 34-year-old businessman, was found to have a heightened risk of diabetes as a result of the study. He expresses that he was “surprised and slightly depressed” to learn that he had a greater risk. Despite his lifestyle which includes regular exercise and a healthy diet, he was deemed to be pre-diabetic. Following the study, he is committed to prevent the onset of disease by making diet changes such as by reducing his intake of white rice.

Comparing healthy individuals with pre-diabetic individuals

Pre-diabetics are estimated to produce approximately 36% less insulin in comparison to their healthy counterparts. This means that they are more prone to developing hyperglycaemia following sugar-rich meals and therefore diabetes in the long-term.

The study investigating the prevalence of diabetes in the Asian population is called Assessing Progression to Type 2 diabetes, and will be conducted for approximately five years. The study aspires to recruit individuals from a mixture of races within the Asian community to obtain a fairer representation of diabetes occurrence in Asians.

These findings have important implications for Asians especially in terms of adopting beneficial lifestyle changes. Individuals should aim to eat five servings of fruits or vegetables in a day along with a diet that consists of primarily complex carbohydrates – such as whole wheat bread or pasta. The study also raises questions about whether the population should be screened for pre-diabetic individuals in order to encourage them to adhere to a healthier lifestyle and reduce their risk of diabetes in the future. MIMS

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