TACKLING T2DM IN ASIA: A MULTISECTORIAL APPROACH Prevention and - - PowerPoint PPT Presentation

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TACKLING T2DM IN ASIA: A MULTISECTORIAL APPROACH Prevention and - - PowerPoint PPT Presentation

Jul 10, 2023 169 likes •583 views

TACKLING T2DM IN ASIA: A MULTISECTORIAL APPROACH Prevention and Control of Diabetes: A Public Health Leadership Forum May 17, 2010 The Department of Nutrition, Harvard School of Public Health Dr Chia Kee Seng Dr Chia Kee Seng Professor and

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Dr Chia Kee Seng Professor and Head, Department of Epidemiology and Public Health Director, NUS-GIS Centre for Molecular Epidemiology Professor of Epidemiology, Kaolinska Institutet, Sweden Dr Chia Kee Seng Professor and Head, Department of Epidemiology and Public Health Director, NUS-GIS Centre for Molecular Epidemiology Professor of Epidemiology, Karolinska Institutet, Sweden

TACKLING T2DM IN ASIA: A MULTISECTORIAL APPROACH

Prevention and Control of Diabetes: A Public Health Leadership Forum

May 17, 2010 The Department of Nutrition, Harvard School of Public Health

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PREVALENCE OF DIABETES MELLITUS IN ASIA

2010 330 million diabetics globally, 92.4 million from China alone 2030 Projected 500 million globally With 50% in Asia

Singapore 247 miles2, 4.9m/3.7m

Diabetes Atlas, 4th ed, IDF, 2009

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Country/Population Prevalence (%) Nauru 30.9 UAE 18.7 Saudi Arabia 16.8 Mauritus 16.2 Bahrain 15.4 Reunion 15.3 Kuwait 14.6 Oman 13.4 Tonga 13.4 Malaysia 11.6 Singapore: ALL Singapore: Chinese Singapore: Malay Singapore: Indian 10.2 7.1* 11.0* 15.3*

* NHS 2006

TOP 10: PREVALENCE OF DM, 2010 (I DF, 2009)

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Prevalence of T2DM in Singapore

National Health Survey 2004, Ministry of Health, Singapore

1 2 3 4 5 6 7 8 9 1975 1984 1992 1998 2004 Age-std. Prevalence (%) of T2DM

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Type II Diabetes Mellitus Impaired Glucose Tolerance

National Health Survey 2004, Ministry of Health, Singapore

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AGE-SPECI FI C PREVALENCE OF T2DM

F M Total

National Health Survey 2004, Ministry of Health, Singapore

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Singapore Burden of Disease Study, 2004

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Singapore Burden of Disease Study, 2004

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Singapore Burden of Disease Study, 2004

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Type II Diabetes Mellitus

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  • 1
  • 0.5

0.5 1 1.5 2 No exercise Light exercise Hard exercise

Change in BMI (kg/m2)

1 risk allele 2 risk allele

FTO: Gene-Exercise interaction

Singapore Chinese

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MAJOR RI SK FACTORS

“Metabolically obese” Over-nutrition Sedentary lifestyle

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TREND I N PREVALENCE OF OBESI TY* BY GENDER AND ETHNI C GROUPS

Indian Malay Chinese F M Total

*BMI >=30 kg/m2

National Health Survey 2004, Ministry of Health, Singapore

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Asians are different from Caucasians and from each other in their BMI/body fat percent relationship. Obes Rev 2002;3(3):141-146

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TREND I N PREVALENCE OF OBESI TY* BY GENDER AND ETHNI C GROUPS

F M Total

*BMI >=30 kg/m2

F M Total

*BMI >=27.5 kg/m2

National Health Survey 2004, Ministry of Health, Singapore

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TREND I N PREVALENCE OF REGULAR EXERCI SE* BY GENDER AND ETHNI C GROUPS

Indian Malay Chinese F M Total

* >=3/week; >20 minutes each

National Health Survey 2004, Ministry of Health, Singapore

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Physical inactivity* in Singapore

Age

No time Too tired Too lazy Others

* Not participating in any sports of exercise

National Health Survey 2004, Ministry of Health, Singapore

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National Nutrition Survey, 2004

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PROPORTI ON OF SI NGAPOREANS WI TH EXCESSI VE I NTAKE OF SELECTED NUTRI ENTS: 1998, 2004

National Nutrition Survey, 2004

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Servings Proportion

Mean intake (servings) and proportion of subjects meeting recommended servings of basic food groups, NNS 1998 and 2004

National Nutrition Survey, 2004

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Sweetened drinks consumption: Singapore

National Nutrition Survey, 2004

Age

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Home Hawker Centre Workplace/School Restaurant Fast Food N.A. Home Hawker Centre Workplace/School Restaurant Fast Food N.A. Home Hawker Centre Workplace/School Restaurant Fast Food N.A.

B L D

National Nutrition Survey, 2004

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CHALLENGES

Aging Population

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CHALLENGES

Aging Population Increasing car population

100,000 200,000 300,000 400,000 500,000 600,000 700,000 800,000 900,000 1,000,000 Number of vehicle registrations Motorized vehicles Cars & station-wagons Land Transport Authority, Annual Vehicle Statistics , 2009

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CHALLENGES

Aging Population Increasing car population Increase in food establishments; slow increase in sporting activities

1998 2008 Number of food hawkers 2,261 7,892 Food establishments 8,782 12,578 Bookings of sports facilities 536,336 669,919

Dept of Statistics, Singapore Yearbook of Statistics, 2009

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GAI proposal: Tackling Type 2 Diabetes Mellitus in Asia – A Multidisciplinary and Multisectoral I nitiative

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GAI proposal: Tackling Type 2 Diabetes Mellitus in Asia – A Multidisciplinary and Multisectoral I nitiative

OBJECTIVES

  • Summarize existing knowledge of T2DM epidemic,

preventive measures and strategies. Compile various programmes and strategies in use in Singapore and Asia.

  • Convene a multidisciplinary and multi-sectoral stakeholder

group to take ownership in tackling T2DM epidemic.

  • Identify gaps in current knowledge and conduct feasibility

studies in these areas.

  • Develop a comprehensive preventive strategy and pilot

programme for implementation.

  • Develop a policy paper that will be relevant to Asia.
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GAI proposal: Tackling Type 2 Diabetes Mellitus in Asia – A Multidisciplinary and Multisectoral I nitiative

STAGES

  • Stage 1
  • Compilation and analyses
  • Convene a multidisciplinary and multisectoral Stakeholder Group
  • Stage 2
  • Presentations to Stakeholder Group
  • Identify and prioritize gaps in current knowledge
  • Stage 3
  • Conduct pilot and feasibility studies
  • Stage 4
  • Develop a comprehensive preventive strategy and pilot programme
  • Develop policy paper
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HEALTHCARE SECTOR Specialists, primary care doctors, epidemiologists, public health practitioners SOCIO- BEHAVIORAL SECTOR Sociologists, psychologists, economists, educationists FOOD AND BEVERAGE INDUSTRY Importers, production, sales, R&D CITY MANAGEMENT SECTOR Urban and transport planners POLICY AND LEGISLATION SECTOR Policy analysts, policy makers

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TASKFORCE

HEALTHCARE SECTOR SOCIO- BEHAVIORAL SECTOR FOOD AND BEVERAGE INDUSTRY CITY MANAGEMENT SECTOR POLICY AND LEGISLATION SECTOR

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PI LOT PROGRAMME

INCREASE PHYSICAL ACTIVITY

  • Paradigm shift: ‘Physical activity as part of

everyday living and not merely a leisure’.

DECREASE INTAKE OF CALORIES AND CARBOHYDRATES

  • Paradigm shift: ‘Low calories and high fibre is

good for business’.

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PUNGGOL 21

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http://www.nus-cme.org.sg/

Infrastructure for health screening and health monitoring of large number of subjects

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BP plaster Respiratory rate plaster Motion sensors plaster Heart rate plaster O2 saturation plaster

BODY AREA NETWORK

Bluetooth GPRS WiFi

NEEDED

Biosensors

USE OF MODERN TECHNOLOGI ES I N POPULATI ON STUDI ES

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TREND I N LUNG CANCER I NCI DENCE AND SMOKI NG, MALES, SI NGAPORE

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PROJECTED TREND I N T2DM PREVALENCE, SI NGAPORE

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Thank you for your attention

Department of Epidemiology and Public Health NUS-GIS Centre for Molecular Epidemiology