The Ministry of Health (MOH) has released a summary report highlighting the key initiatives and progress made on the War of Diabetes (WoD) over the past three years in addressing the rising trend of diabetes among Singaporeans. The report was launched today by Mr Edwin Tong, Senior Minister of State, Ministry of Law and Ministry of Health, at the World Diabetes Day event organised by Diabetes Singapore.
2 MOH launched the WoD in 2016, in response to the significant health and societal burden posed by diabetes, and established the national Diabetes Prevention and Care Taskforce to spearhead a whole-of-nation initiative to tackle diabetes. The vision of the Taskforce is to create a supportive environment for people in Singapore to lead lives free from diabetes, and for those with diabetes to manage the condition well.
Highlights of the War on Diabetes Summary Report
3 The War on Diabetes has seen progress in garnering a whole-of-nation effort ranging from, but not limited to healthcare professionals, industries, community partners and citizens. The WoD summary report highlights the key initiatives and progress made under the three pillars of the War on Diabetes strategic framework:
(i) Prevention through healthy living;
(ii) Early detection and intervention; and
(iii) Better disease management.
These key thrusts are underpinned by cross-cutting enablers such as public education and stakeholder engagement, as well as data and analysis, technology and research.
Prevention through healthy living
4 We have increased the availability and accessibility of healthier options for Singaporeans. The market share of Healthier Choice Symbol products across 100 food categories has increased by 7.4 percentage point from 2016 to 2018. As of 2018, one in two stalls across hawker centres and coffee shops supplied at least one healthier option on their menu, as part of the Healthier Dining Programme (HDP). Healthier meals eaten out increased seven-fold from 25 million in 2016 to 180 million in 2018.
5 More food manufacturers are developing healthier ingredients. 42 partners have come on board as of March 2019, representing a seven-fold increase in the partnership with ingredient suppliers since the Healthier Ingredient Development Scheme started in 2017.
6 Singaporeans of all ages have more support in adopting a healthy lifestyle. The Health Promotion Board (HPB) works closely with the Ministry of Education and Early Childhood Development Agency to increase the availability of healthier meals in schools to cultivate good healthy eating habits from young. As of March 2019, 1,230 pre-schools have come on board the Healthy Meals in Pre-school Programme, all MOE mainstream school canteens provide healthier food and drinks options under the Healthy Meals in School Programme and 91 food outlets within Institute of higher Learning are under HDP.
7 HPB has also increased the availability of physical activities, such as Sundays @ the Park (SATP), Sunrise in the City and National Steps ChallengeTM, to encourage Singaporeans across all ages to incorporate physical activities into their lifestyles. As of June 2019, SATP has 90 weekly sessions at 84 sites across Singapore, a 10% increase in the number of sites from 2014.
Early detection and intervention
8 Screening is now more convenient and affordable.
(i) In September 2017, MOH enhanced the subsidies for the Screen for Life (SFL) programme to encourage more to go for screenings and follow-up. More than 65,000 Singaporeans have benefitted from cardiovascular and cancer screening in the 18 months following the enhancement of SFL subsidies in September 2017. This is almost 30 times the number of Singaporeans who have come forward for screening over the preceding 18 months.
(ii) In May 2019, MOH adopted non-fasting tests to screen for diabetes to provide greater convenience to individuals to allow more opportunistic screening.
9 There is more targeted support for different population segments.
(i) The Diabetes Risk Assessment tool was rolled out in September 2017 for younger adults below 40 years old to assess their risk for undiagnosed diabetes.
(ii) Since June 2019, women with a history of gestational diabetes are also eligible for screening subsidies under SFL, as they are of higher risk of developing diabetes later in life.
Better disease management
10 Individuals with diabetes are getting greater support to manage their conditions. This includes:
(i) MOH expanded the coverage of the Chronic Disease Management Programme (CDMP) and Community Health Assist Scheme (CHAS) in June 2018, which included the increase of MediSave withdrawal limit for CDMP from $400 to $500.
(ii) In December 2018, a beta version of the National Diabetes Reference Materials (NDRM) was made available on HealthHub for newly diagnosed patients, as part of MOH’s Patient Empowerment for Self-care Framework to help individuals initiate and sustain lifestyle changes for better disease management. The full set of materials will be available by end 2019.
(iii) As of December 2018, 10 Primary Care networks (PCNs) comprising over 450 GP clinics have been established. GP clinics that are part of PCNs can deliver more comprehensive team-based care to patients with diabetes and other chronic conditions.
(iv) From November 2019, all Singaporeans regardless of income, can tap on CHAS for chronic subsidies of up to $540 per year for treatment of chronic diseases under CDMP, including diabetes.
11. We have introduced more initiatives and programmes to address common complications associated with diabetes. This include:
(i) The Singapore Integrated Diabetic Retinopathy Programme (SiDRP) commenced in 2012 to provide a centralised screening programme at all polyclinics to detect eye complications in patients with diabetes. The annual number of eye screens performed by SiDRP have increased from about 14,000 since its commencement to 92,000 in 2018.
(ii) The Holistic Approach in Lowering and Tracking Chronic Kidney Disease (HALT-CKD) programme was introduced in April 2017 to prevent and slow down deterioration of chronic kidney disease to kidney failure. Since March 2019, this programme has been implemented across all 20 polyclinics.
(iii) The National Diabetic Foot Workgroup was formed in April 2018 to develop a national strategy to reduce diabetes-related lower limb amputations. It has progressively rolled out a risk-stratified framework for diabetic foot screening, management and escalation across the polyclinics and public hospitals.
12 While the efforts to tackle the WoD have been wide-ranging, many initiatives have a longer lead time in achieving our desired health outcomes. MOH will monitor the progress and continue to work closely with our stakeholders to fight diabetes and create a healthier Singapore for all.
13 The WoD Summary Report is available to the public and can be found on MOH’s website at https://go.gov.sg/moh-wod-report2019.