Diabetes in Singapore: Who Really Needs a Continuous Glucose Monitor?

SPEAKER_1 (0:01)

Best of Live Well with Michelle.

Michelle Martin (0:05)

It is now time for Live Well with Michelle, and today we're talking about diabetes. The latest National Population Health Survey puts diabetes prevalence at 9.1 percent. Obesity has risen. It's one of the top risk factors for type 2 diabetes. So for people already living with diabetes, managing your blood sugar means watching what you eat, taking your meds, checking your glucose levels. I know those continuous glucose monitoring devices are becoming quite popular. Lots of people buying them, sticking them in themselves. It's a small sensor worn on the body that tracks your glucose levels throughout the day.

It sends you alerts as well. I have a friend who's diabetic and so I was hanging out with her and then I heard these sort of like alarm bells going off during the day, which triggered her to have more sugar, take a sweet drink, just have more water. It was just amazing. So, what are these sensors, these continuous glucose monitoring sensors? Do you know Singapore now subsidizes these glucose monitoring devices for eligible patients with type 1 diabetes and certain rarer forms of diabetes as well, but generally not for those with type 2 diabetes. So, what can you do if you have type 2 diabetes? We're going to figure all that out with Dr. Anuradha Negi, who is Senior Consultant Endocrinologist at the Aspen Diabetes & Endocrine Clinic. Dr. Negi, good morning, welcome to the show.

Anuradha Negi (1:27)

Good morning, Michelle, and good morning to all the listeners of Money And Me.

Michelle Martin (1:30)

Fantastic. Okay, we're going to start with the very, very basics, because that's what the show is all about. We talk about complex subjects in the most conversational ways possible. So, what's the difference between type 1 and type 2 diabetes?

Anuradha Negi (1:42)

So, Michelle, it really goes down to the hormone called insulin. Our body needs insulin to help the cells use up blood glucose. So, the key difference is in type 1 diabetes, the body sort of, you know, there's damage to the pancreas, the organ that produces insulin, and therefore, these patients have absolutely no insulin levels. On the other hand, you have the type 2 diabetes, whereby the problem is insulin resistance. So, there's insulin deficiency in type 1, but in type 2, you get insulin resistance. So, the cells do not respond to insulin very well, and therefore, the pancreas keeps mounting and producing more and more insulin, and over time, it just runs out.

Michelle Martin (2:24)

Wow! All this to do with your pancreas.

That's where insulin is produced. So, type 1 is, pancreas is not producing insulin.

Anuradha Negi (2:33)

Oh my goodness!

Michelle Martin (2:34)

Type 2 is cells, the body's cells are resistant to insulin.

Anuradha Negi (2:40)

Correct.

Michelle Martin (2:40)

Oh my goodness me! So, type 2 diabetes makes up most diabetic cases, is that right?

Anuradha Negi (2:47)

That's correct. That's the most prevalent form of diabetes in Singapore.

Michelle Martin (2:50)

Oh my goodness! Is there something we can do if we have type 2 diabetes?

Anuradha Negi (2:55)

Yes, there are lots of things that we can do to reduce our risk of developing diabetes. The first thing would be to know what our risk is. So, if we have it in the family, if there's a family history of diabetes, if I'm obese, so these are all risk factors. Gestational diabetes, if there's a history during pregnancy, that increases our risk. So, know your risk and get yourself screened, especially with the Health for Life initiatives, can get yourself screened at a very nominal fee.

Michelle Martin (3:21)

So, family history, someone in the family has type 2 diabetes or type 1?

Anuradha Negi (3:25)

Type 2 diabetes.

Michelle Martin (3:26)

Type 2 diabetes. Obesity is a risk factor as well.

Anuradha Negi (3:32)

It's funny, isn't it?

Michelle Martin (3:33)

And gestational means when you are pregnant, you suddenly become diabetic.

Anuradha Negi (3:37)

Correct.

Michelle Martin (3:38)

That's so strange. Do we know why that happens?

Anuradha Negi (3:42)

Yes. So, there are all these, you know, insulin resistance that happens because of pregnancy, hormonal changes. So, that leads to rise in certain hormones that causes development of insulin resistance in pregnancy. And over time, that increases your risk of developing type 2 much later in life.

Michelle Martin (3:58)

So, it's not over the moment the baby's popped out. You still have to monitor your…

Anuradha Negi (4:04)

Yes, you need to get yourself… diabetic risk. Yes. You need to get yourself tested, make sure that it doesn't come back as type 2 diabetes.

Michelle Martin (4:10)

Oh my goodness. I had no idea.