In the earlier articles, we had looked into two of the five fronts under the Ministry of Health (MOH)’s efforts to combat the growing problem of diabetes. This article focuses on the third front – ‘Control’ – which seeks to adopt better disease management to prevent or delay complications and ensure a good quality of life at all stages.

The initiatives under ‘Control’ can be seen as the follow-up to the second front ‘Screening’, which sought to promote early screening and intervention for individuals at risk or those who are unaware that they have diabetes.

As mentioned by Health Minister Gan Kim Young, while MOH gear up its efforts on the provision of health screening on the ground, the ministry would also be “careful not to neglect follow-up after screening.” Here we will look at the efforts that have been done vis-à-vis the screening stage to better help manage diabetes.

1. Diabetic Health Bus

The first of the four roving Diabetic Health Bus was launched in June 2016. This initiative by the National Kidney Foundation (NKF) seeks to address kidney failure, but also to help ensure that patients have a good quality of life by giving dietary and lifestyle counseling.

Staffed with NKF nurses, the bus would venture out into the community every three months. The services they provide include free screening sessions and free blood tests at partnering clinics. Each screening session would last about 30 minutes and can serve up to two diabetic patients at one time.

The nurses would also provide dietary and lifestyle counselling to patients to improve their management of diabetes. General practitioners (GPs) could also refer their patients to Diabetic Health Bus to receive the abovementioned services.

2. National Healthcare Group (NHG) Mobile Community Centre

This was launched on 7 February 2015 by the National Healthcare Group and People’s Association and seeks to address the complications of damage to the retina and problems in the feet caused by diabetes. It helps to ensure a good quality of life by counselling patients on self-care and lifestyle.

Although NHG Mobile Community Centre was launched a full year prior to the ministry’s declaration of War on Diabetes, the services it provided contribute and complement the nationwide efforts to control and manage diabetes.

The NHG Mobile Community Centre is essentially a 24-seater bus, equipped with medical equipment and staffed with one nurse and one patient service associate. Every month, the bus would make monthly stops at 17 different locations including at community clubs and Housing Development Board (HDB) carparks to make more accessible health screening services to the people.

There are three major services provided by mobile CCs. The first is diabetic retinal photography, a special photograph service which help detect early signs of damage to the retina due to diabetes. This service would also help prevent further damage to the eye, which in severe cases could lead to blindness.

The second services is diabetic foot screening to help address the complications that could arise in the feet due to diabetes. In severe cases, diabetic patients may have to face amputation if their condition is left unmanaged. The last service is counselling, which provides personalised education on treatments, lifestyle changes and self-care management skills for patients.

The mobile CHC will support more than 300 general practitioners in central Singapore, who can refer their patients to the service. According to the Director of Regional Health at NHG, Pamela Ding, the services provided by mobile CHC would benefit patients with diabetes foot problems most as they need to travel less.

3. Diabetic eye screening

This was announced at the MOH Committee of Supply Debate 2017. It seeks to address diabetic retinopathy, a complication of diabetes that can result in bleeding and swelling of the retina

As mentioned above, diabetes could damage the retina in the long term, leading to severe complications like blindness. In October 2016, Minister of State for Health, Dr Lam Pin Min, who leads a workgroup to identify areas of improvement in the clinical management of diabetes, mentioned that the government is looking into ramping up efforts to target complications that could arise from diabetes.

During the Health Ministry’s budget held earlier this month, Health Minister Gan Kim Yong mentioned that diabetic patients will have more access to diabetic foot and eye screening services as they will be located more conveniently at the Primary Care Networks (PCN) General Practitioner (GP) clinics. This is another initiative to better manage the complications that could arise from diabetes. MIMS

Read more:
NTU Singapore and Japan’s RIKEN collaboration
War on diabetes: Early screening and prevention – Part 2
War on diabetes: Preventing the onset of diabetes – Part 1