20% with diabetes under 40 years old

One in nine Singaporeans has diabetes.

The rate goes up to three in 10 for those aged 60 and above, prompting Prime Minister Lee Hsien Loong to flag the issue at the National Day Rally.

He also pointed to another worrying trend: The prevalence of diabetes among the younger ones is rising too.

It was once a disease associated with the elderly, but now, 20 per cent of those with diabetes here are under 40, said Dr Vivien Lim, an endocrinology specialist at Gleneagles Hospital.

"Some, who are less than 16 years of age, are even diagnosed as Type 2 diabetes in the paediatric department," she said.

There are two kinds of diabetes, Type 1 and Type 2.

In Type 2 diabetes, the pancreas can produce insulin but the body is resistant to it.

It is often associated with being overweight.

This is different from Type 1 diabetes, where the pancreas is unable to make sufficient insulin.

Both scenarios lead to a rising glucose level in the blood, which paves the way to pre-diabetes, then diabetes.

Dr Cindy Ho, a consultant from the paediatric endocrine division at the National University Hospital, said: "Insulin helps to bring down blood sugar levels to normal whenever we have a meal.

"As the carbohydrates we eat are digested into simple sugars, blood sugar levels rise in the blood, but this usually returns to normal in people without diabetes.

"However, people with diabetes are unable to do this properly and hence have high blood sugar levels that result in complications associated with diabetes."

Usually, Type 1 diabetes presents more acutely, with the child being very sick as they go into diabetic ketoacidosis, when toxin builds up in the body.

It can strike at a young age, said Dr Ho, adding that her youngest patient is a two-year-old girl.

"In fact, some babies get diabetes soon after they are born and we call that neonatal diabetes," she added.

OVERWEIGHT

As for Type 2 diabetes, Dr Ho said it is most likely to affect children who are overweight, have a family history of diabetes, have unhealthy eating habits and lack of physical activity.

Dr Lim added that the increased rates of obesity parallels the increased diabetes prevalence.

The challenge lies in detecting the ailment - 40 per cent to 50 per cent of diabetics here are undiagnosed, said Dr Soon Puay Cheow, a senior consultant endocrinologist at Soon Diabetes Thyroid And Endocrinology Clinic.

They find out only during routine health checks or incidentally while doing other medical tests, he said.

In mild cases, there are no symptoms, said Dr Lim.

"Some do feel the following (symptoms) - loss of weight, tiredness, thirst and drinking more and urinating more. But in these cases, they likely already have a more advanced disease," she said.

While diabetes cannot be cured, it can be kept under control.

Type 1 diabetes will require a regular dose of insulin, as prescribed by a doctor.

Mild Type 2 diabetes may be controlled through diet and exercise, with little or no medicine.

However, most Type 2 diabetes will eventually require oral medication to control the blood sugar level and possibly insulin injections in the later stage of the disease.

According to SingHealth, the basic treatment strategy is to maintain good control over the amount of glucose in your blood, eat a balanced diet, exercise regularly and watch your weight.

These will prevent the onset of diabetes, it said.