Thirtieth Annual Scientific Meeting Of The International Society For Pediatric And Adolescent Diabetes

03 Nov 2004

By Dr Balaji Sadasivan, Senior Minister of State for Information, Communications and the Arts and Health

Venue: Raffles City Convention Centre

Speech By Dr Balaji Sadasivan, Senior Minister Of State (Health) At The Thirtieth Annual Scientific Meeting Of The International Society For Pediatric And Adolescent Diabetes On Wednesday, 3 November 2004 At 2:30pm At The Raffles City Convention Centre

Professor Knut Dahl Jorgensen, President of ISPAD

Dr Peter Swift, Secretary General of ISPAD

Professor Martin Silink, President Elect of the International Diabetes Federation

Dr Warren Lee, Chairman of the Local Organising Committee

Distinguished guests, ladies and gentlemen

Introduction

It is my pleasure to be here this afternoon. I congratulate the International Society of Paediatric and Adolescent Diabetes on the occasion of its 30th Annual Scientific Meeting in Singapore. I understand that this is the first time that the meeting has been held in Singapore and only the second time it has been held in Asia.

Besides its annual scientific meeting, ISPAD has been running specialised science school courses to train young paediatricians in diabetes research. I understand that the inaugural ISPAD/IDF Science School for (non-doctor) Health Professionals was held in Singapore just before this meeting and trained nurses, dieticians, psychologists and podiatrists to better understand and apply research methodologies and statistical analysis for diabetes research.

Epidemiology of Diabetes

Worldwide, there are an estimated 194 million people with diabetes mellitus. Of these, two thirds currently live in developing countries, and 80 million live in Asia. By 2025, the number of people with diabetes is projected to jump to 333 million. Almost half the world's diabetics in 2025 will be living in Asia.

There are an estimated half a million children with Type 1 diabetes below 15 years worldwide, with 65,000 new cases added every year, and a rising trend of 3% per year.

Singapore is a low incidence country for Type 1 diabetes mellitus, with about 20 to 30 new cases each year.

Management of Diabetes

Children with Diabetes mellitus usually have Type 1 Diabetes. This means that they need to have 2, 3 or 4 injections of insulin every day to keep them alive and in good health. Daily blood glucose monitoring is also necessary to ensure that the insulin doses are adjusted to appropriate levels.

Today, the treatment of diabetes has been revolutionised by the introduction of newer and better insulin preparations and new delivery devices such as wearable computerized insulin pumps delivering subcutaneous insulin.

Monitoring of diabetes control has progressed from monitoring of urine sugars using test tubes and sprits lamps to home blood sugar monitoring devices able to measure pinprick amounts of blood almost painlessly, and in some instances, continuously through implantable sensors. Yet it is not enough to have the best drugs and the best devices.

It is essential that health care professionals work hand in hand with people with diabetes and their family members, to ensure that children and young people with diabetes have an age appropriate understanding of their condition, and be empowered to know how to manage both routine and emergency care situations. The emotional health and psychological development of children and adolescents with diabetes is a key factor in developing lifelong good diabetes control and personal effectiveness. Schools and teachers also need to know how to appropriately manage children with this condition and how to safely allow them to participate in most, if not all age appropriate school activities and sports, and help them maximise their potential even though some children with diabetes may require frequent hospital admissions.

In time, even with the best of care, long term complications such as microalbuminuria affecting the kidneys, diabetic retinopathy, hypertension and hyperlipidemia may surface. These complications may be initially asymptomatic, necessitating regular screening and early institution of specific treatment such as the use of ACE inhibitors to protect the kidneys. It has also been conclusively shown that better diabetes control leads to lower complications rates, so the quality of diabetes care is very important.

Conclusion

The theme of this meeting is "The Child maketh the Man". We are finding that more and more of the metabolic problems facing adults, such as impaired glucose tolerance and diabetes, have their origins in childhood.

Diabetes mellitus means a lifetime of living with a need for medication, constant monitoring of blood glucose levels, and a careful watch on food intake, activities of daily living and exercise. High quality care and education of children with diabetes lays the foundation for optimal care in adults.

Until a cure for diabetes is found, there will always be a need for well informed health care professionals to work with parents and patients to optimize care.

I congratulate members of the society on their dedication to the cause of making health and life better for children and young people with this condition. I would hope that as you meet and share the latest developments in diabetic care around the world, we would be able to share with you a little of our local experiences in these areas. I wish you fruitful discussions and lively fellowship as you meet in Singapore.

With that I would like to declare open the 30th Annual Scientific Meeting of ISPAD.