This article is the second part on ‘War on Diabetes’, focusing on one of the five fronts – ‘Screen’. Under this initiative, the Ministry of Health sought to provide early screening and intervention for individuals at risk or those who are unaware that they have diabetes.

During a National Health Survey conducted in 2010, it was reported that 11.3% of Singapore residents were affected by diabetes. Additionally, one in three of those affected were unaware that they had the disease. In a Straits Times article in 2012, it was also highlighted that “half the people with diabetes remain unaware of it”. It added that this group was most susceptible to complications like stroke and kidney failure, which could emerge in about a decade.

When the ‘War on Diabetes’ was announced in 2016, Health Minister Gan Kim Yong said that Ministry of Health (MOH) would “promote early screening and intervention for individuals at risk or those unaware they have diabetes, while being careful not to neglect follow-up after screening”.

It has been about a year since the ministry has announced the above. This article seeks to look into some of the major initiatives implemented to ensure that more Singaporeans would now have access to medical screening for early detection of diabetes.

1. SingHealth partnering General Practitioners (GPs) to offer free health screenings for relatives of individuals with diabetes

‘Stop Diabetes’

In April 2016, SingHealth announced its “STOP Diabetes” screening programme. Under this program SingHealth sought to partner community organisations to conduct health screenings and programmes to help educate the public on preventive health and healthy lifestyle.

With regards to screening, SingHealth has partnered GPs to offer free health screening for parents, siblings and children of individuals with diabetes mellitus (i.e. Type 2 diabetes). The screening is open to those are 30 years old and above and have no known diabetes or impaired glucose tolerance. By March this year, the programme aims to screen at least 500 of such relatives.

Why target families of those with Type 2 diabetes?

Families of patients with diabetes mellitus became the focus of this screening programme as studies had shown that their immediate family members were two to six times more likely to have the same disease.

Type 2 diabetes was known to have strong genetic and family-related risk factors. Dr Emily Ho, Director of SingHealth Regional Health System and Consultant, said that “Early detection and intervention of pre-diabetes are crucial in keeping the condition under control”. She added that “timely and active management can be administered to help those at risk to delay or even prevent complications” if programmes like ‘Stop Diabetes’ are made available to better detect diabetes earlier.

Screening and intervention

Those who signed up for this programme will be screened by GPs for diabetes, high blood pressure, high cholesterol and obesity. If the participants were found to be at risk or suffering from diabetes, they would be referred to undertake further tests. Medical follow-up care by GPs and relevant intervention programmes (like diet and lifestyle education and diabetes self-care) would also ensue.

2. Diabetes Health Bus

In June 2016, the National Kidney Foundation (NKF) officially launched the Diabetes Health Bus. This bus would venture out into the community every three months to provide screening sessions and prevent diabetic patients from developing kidney failure.

The roving bus, staffed with NKF nurses, would travel to partnering clinics to help screen diabetics at no cost. They would also provide additional support to GPs by helping clinics to manage the patients’ condition and by providing services like free blood tests and dietary and lifestyle counselling.

3. Diabetes Risk Assessment (DRA) tool & making screening more affordable

One of the recent initiatives by the ministry to encourage early and regular health screening among Singaporeans is the DRA tool. This tool would be made available online by September of this year.

By assessing risks factors like family history, age, gender, body mass index (BMI) and hypertension, DRA allows those aged between 18 and 39 to assess their risk of diabetes. There would also be a concluding assessment which informs users if they should undergo further screening.

Recognising that some of those tested positive for certain diseases including diabetes may not follow-up with consultation due to the cost involved, the ministry has worked towards simplifying and enhancing subsidies for the Health Promotion Board’s ‘Screen for Life’ (SFL) programme (a programme which allows participants to identify the screenings that they should take based on their age and gender). The subsidies provided have allowed for a fixed consultation fee of S$5 for screening and the subsequent first post-screening (if required). For eligible Community Health Assist Scheme (CHAS) cardholders, this fee will be made S$2 while Pioneer Generation cardholders will not have to pay. MIMS

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