Diabetes management and prevention: Start by getting informed

In 2016, Singapore declared a “War on Diabetes” campaign in an effort to rally the nation to tackle the disease. Since then, despite various campaigns by the government to educate the public about the chronic condition, the prevalence of diabetes has only dropped marginally from 8.8% in 2017 to 8.5% in 2022. Across the globe, the number of people with diabetes worldwide is projected to increase from 540 million in 2021 to 783 million by 2045, according to the International Diabetes Federation.

Some key contributors to the projected increase in diabetes are an ageing population (older adults are more susceptible to getting diabetes), decreasing levels of physical activity and increasing overweight and obesity prevalence.

Evidently, more can and needs to be done to address diabetes but with a myriad of challenges to overcome – lifestyle and dietary shifts, mental health support, caregiving –  where might be a good place to start?

Perhaps a different perspective can be adopted to improve diabetes care. One that encourages people to be more proactive in management and prevention.

Worrying gap between perception and reality

A 2024 study by the LRF Institute for the Public Understanding of Risk (IPUR) at the National University of Singapore and Diabetes Singapore found that less than half of the respondents with diabetes were aware they had diabetes, and almost 70% of those with prediabetes thought they did not have diabetes.

Prediabetes is characterised by elevated blood sugar levels that are higher than normal but not high enough to be classified as diabetes. It indicates that an individual is at increased risk of developing type 2 diabetes.

This finding paints a worrying picture of an awareness gap in Singapore and how people understand their relationship with diabetes. Other findings that emphasise this include:

• Almost 50% of those who believed they did not have diabetes actually had prediabetes(41.6%) or diabetes (5.9%).
• More than 25% of participants were unsure or did not know whether they had diabetes. Of these, more than half actually had pre-diabetes or diabetes.

A total of 994 participant responses were collected across 13 health-screening events from July to October 2024. Findings from the survey were discussed in the Diabetes Perception Report, which highlights a concerning disconnect between individuals’ perceptions and their actual diabetes status.

The key point to emphasise is that people need to be aware of their health status before any education and intervention campaigns can truly be effective. Action without information will not only cause confusion, but it might create distrust between the public and health authorities.

Get informed about your health

People need to become more informed about their diabetes status and take ownership of their health. Remaining oblivious to blood sugar levels, which in turn increases the risk of diabetes, may inadvertently jeopardise a person’s well-being, leading to complications that could have been easily avoided with proactive management.

Although information avoidance may seem like an easy route to ignorance, the long-term implications of diabetes must not be underestimated. Remember that prevention is always better than reaction. Many resources and support systems are in place, especially in Singapore, to empower people living with diabetes or at risk of getting diabetes.

Setback is not failure

Managing diabetes is a lifelong journey, and setbacks are an inevitable and natural part of the process. These setbacks are often a harsh side effect of setting health targets which can result in many viewing their condition or progress as failures rather than stepping stones to improvement. This misunderstanding could inhibit progress and lead individuals to lose motivation on their journey towards better health.

Instead, setbacks should be viewed as temporary. They should not be seen as definitive but as opportunities for growth and learning. In the long-term, this has potential to translate into resilience and optimism, with the support of a community to foster empowerment and progress.

Fostering a growth mindset

A study led by Dr Carolyn Lo analysing mindsets and self-efficacy beliefs among individuals with type 2 diabetes (T2D), found that individuals with T2D had a significantly lower growth mindset towards their blood glucose level and lower self-efficacy towards their general health, blood glucose, and cholesterol levels compared to those without T2D. Further analysis showed a pattern of higher HbA1c among those with lower growth mindsets and self-efficacy towards their general health or blood glucose level.

These findings suggest that individuals with T2D face psychological barriers that may derail intentions and efforts towards critical lifestyle changes. By extension, they may be more likely to feel “stuck”, lose confidence in themselves, or become indifferent towards managing their disease when initial endeavours fail to translate to expected diabetes improvements.

Rather than feeling stuck or blaming other factors when improvement seems stagnant, patients can adopt a growth mindset by experimenting with manageable adjustments to see whether certain changes may work better. Setbacks could also prompt patients to dialogue with other patients to gather feedback on alternative strategies and receive peer support.

A total effort to fight diabetes

The implications of all the findings highlighted reach far beyond personal health. They speak to the urgent necessity for community-based health initiatives that emphasise awareness and education. Regular health screenings should not be seen merely as optional check-ups but as critical lifelines for individuals at risk. Furthermore, diabetes care will come with many ups and downs – more support is needed to lift patients confronting psychological barriers that come with inevitable setbacks.

Despite the worrying findings, it is also a call for a change in mindsets. Communities, healthcare professionals, and policymakers have a vital role to play in creating an environment where discussing diabetes is as commonplace as talking about exercising or eating well. Imagine a community where knowledge about diabetes is woven into everyday conversations, where individuals feel empowered to actively manage their health rather than passively navigating a sea of uncertainty.