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Stop and Reverse Pre-diabetes

Find out more about pre-diabetes and how you can reverse it by making some changes to your lifestyle.

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Pre-diabetes is a warning sign for diabetes. Early detection can make a difference.
Take the first step to check your risk at letsbeatdiabetes.sg/dra today.

The Diabetes Risk Assessment is developed for those between 18 – 39 years old.
If you are 40 years old and above, please see your doctor for a health screening (including pre-diabetes).

Take the DRA ​​​​

Be aware

What
is pre-diabetes?

The blood glucose is higher than normal

Pre-diabetes describes a condition in which blood sugar levels are higher than normal, but not high enough to be considered Type 2 diabetes. In other words, it is the precursor to Type 2 diabetes.

The good news is studies have shown that a few lifestyle changes, such as adopting a healthier diet, regular exercise and maintaining a healthy weight can reverse pre-diabetes, as well as reduce the risk of Type 2 diabetes.

  • PRE-DIABETES

     Normal > Pre-diabetes > Type 2 Diabetes  Normal > Pre-diabetes > Type 2 Diabetes

    Pre-diabetes is when your blood sugar level is higher than normal but not high enough yet to be diagnosed as Type 2 diabetes. Studies show that if pre-diabetic persons lose weight and maintain a healthy Body Mass Index (BMI), adopt a healthy diet and engage in regular physical activity, they can reduce their risk of developing Type 2 diabetes

  • Type 2 Diabetes

    Type 2 diabetes is usually found in people aged 40 and above who are overweight and physically inactive. In some people, the condition is mild and they are able to control their blood glucose with just diet and exercise. However, if the condition gets worse, they may require oral medication or insulin injections in addition to making lifestyle changes. For those who are overweight or obese, losing weight can be significantly beneficial, even if it is a small amount.

  • Type 1 Diabetes

    Usually diagnosed in children or young adults although it can occur at any age, Type 1 diabetes results when the pancreas no longer produces insulin. Hence, persons with Type 1 diabetes need insulin injections daily.

  • Gestational Diabetes

    Due to the hormonal changes in pregnancy, some women may show high blood glucose levels during pregnancy. These women require specialised obstetric care to prevent complications to the unborn child. In gestational diabetes, the blood glucose levels often return to normal after delivery. However, these women may be at an increased risk of developing Type 2 diabetes later in life.

Risk Factors

Diabetes can affect anyone. Knowing your risk of diabetes will help identify the changes you need to make to your lifestyle.

You are at an increased risk of developing Type 2 diabetes if you:

A parent or sibling with diabetes

Have a parent or
sibling with diabetes

BMI is 23kg/m2 or higher

Have a BMI of
23.0 kg/m2 or higher

Inactive sedentary lifestyle

Lead an inactive
(sedentary) lifestyle

Abnormal blood cholesterol or lipid levels

Have abnormal blood
cholesterol/lipid levels

History of gestational diabetes

Have a history of
gestational diabetes

40 years old and above

Are 40 years old
and above

Impaired glucose tolerance or impaired fasting glucose

Have impaired glucose tolerance or impaired fasting glucose

Prevention

While family history and age greatly affect the chances of pre-diabetes, being overweight, having an unhealthy diet and a sedentary lifestyle also increase the risks.

Leading a healthy lifestyle improves overall health, and can slow or even reverse the development of diabetes.

Screening

Diabetes is a ‘silent’ disease in its early stages, and you can feel perfectly well until complications occur. However, a late diagnosis can result in serious and irreversible complications that could have been otherwise prevented through screening. It is therefore important to get yourself screened even if you feel perfectly healthy and experience no symptoms, for regular health screening is the best way to detect diabetes early and obtain timely treatment.

Going for screening

40 years old and above is the recommended age for screening  
The fasting blood glucose test is done once every three years  

Screening for chronic diseases, including diabetes, is recommended under HPB's Screen for Life programme for those 40 years old and above. It is conducted through a fasting blood glucose test, done once every three years. 

Under HPB's Screen for Life programme offered by most CHAS GP clinics, chronic disease screening (including the doctor consult charges) is available at the following subsidised rates :

Pioneer Generation

If you are a Pioneer Generation cardholder, the screening test and the first post screening consultation (if assessed that a consultation is required) will be $0.

Health Assist (CHAS) Card Holders

If you are a CHAS cardholder (blue or orange card), you will only need to pay $2 for the screening test and the first post screening consultation (if assessed that a consultation is required). Applicable for both males and females aged 40 and above.

Other Eligible Singaporeans

You will only need to pay $5 for the screening test and the first post screening consultation (if assessed that a consultation is required). Applicable for both males and females aged 40 and above.

Permanent Residents

You will only need to pay $10 (excluding GST) for the screening test. The prevailing doctor consultation rates will be charged accordingly by the respective CHAS GP clinics.

*These rates are only applicable at CHAS GP clinics for the screening tests that are covered under the enhanced Screen for Life subsidies.

Clinics

Health screening is available at many private medical clinics and polyclinics  

Health screening is available at many private medical clinics and polyclinics. Visit our directory for the list of screening locations, or click here to locate your nearest CHAS GP clinic offering SFL screening services.

Learn more about the screening tests and subsidies you are eligible for at screenforlife.sg.

Tests and Diagnosis

Financial Assistance

Health Screening is heavily subsidised for Singaporeans and Permanent Residents. Under HPB's Screen for Life programme offered by most CHAS GP clinics, chronic disease screening (including the doctor consult charges) is available at the following subsidised rates : 

Pioneer Generation
If you are a Pioneer Generation cardholder, the screening test and the first post screening consultation (if assessed that a consultation is required) will be $0.

Health Assist (CHAS) Card Holders
If you are a CHAS cardholder (blue or orange card), you will only need to pay $2 for the screening test and the first post screening consultation (if assessed that a consultation is required). Applicable for both males and females aged 40 and above.

Other Eligible Singaporeans
You will only need to pay $5 for the screening test and the first post screening consultation (if assessed that a consultation is required). Applicable for both males and females aged 40 and above.

Permanent Residents
You will only need to pay $10 (excluding GST) for the screening test. The prevailing doctor consultation rates will be charged accordingly by the respective CHAS GP clinics.

*These rates are only applicable at CHAS GP clinics for the screening tests that are covered under the enhanced Screen for Life subsidies.
Learn more about the screening tests and subsidies you are eligible for at screenforlife.sg.

Medisave, MediShield Life, ElderShield and Medifund schemes can help Singaporeans offset their medical expenses. Additionally, under the Chronic Disease Management Programme (CDMP), persons with diabetes can also use Medisave to help defray part of outpatient treatment fees and reduce out-of-pocket costs.

Myths and Facts

There are many myths about diabetes which people think to be true. This can be harmful as it leads to an incorrect understanding of diabetes. Get the facts below, and learn more about this chronic disease.

Myth

Diabetes is caused solely by eating too much sweet food.

Fact

Diabetes occurs when the body fails to produce enough insulin – the hormone responsible for reducing blood glucose levels. Although eating sweet food does not directly cause diabetes, a diet high in sugar and fat can lead to obesity, which causes the body to be less sensitive to insulin, thus increasing the risk of developing Type 2 diabetes.

Myth

Diabetes can be cured.

Fact

Unfortunately, diabetes is a chronic medical condition that has no cure. The good news is it can be managed with some lifestyle changes and, in some cases, medication.

People with Type 1 diabetes are unable to produce insulin due to a disorder affecting the pancreas. They require regular insulin injections to control their blood sugar levels. Type 1 diabetes cannot be helped by lifestyle changes alone, but maintaining a healthy lifestyle is still important in keeping it in check.

On the other hand, people with Type 2 diabetes are able to produce insulin, but it may not be enough or they become resistant to it. Lifestyle changes are crucial in managing Type 2 diabetes. Doctors may prescribe oral medication or insulin injections, or a combination of both.

In contrast, pre-diabetes can be reversed with lifestyle changes.

Myth

Diabetes is a chronic medical condition that has no cure. However, the condition can be controlled with lifestyle changes and, in some instances, medication.

Fact

Persons with Type 1 diabetes are not able to produce insulin due to an immune disorder affecting the pancreas. That is why they require regular insulin injections to control their blood glucose levels. On the other hand, persons with Type 2 diabetes are able to produce insulin, but it may not be enough or may not work properly. Such persons may be prescribed oral medication or insulin injections, or a combination of both by their doctor.

Myth

People with diabetes will eventually have their feet amputated.

Fact

Amputation refers to the removal of a limb or parts of a limb (e.g. foot) as a result of gangrene or death of body tissues from poor blood flow. It happens in people with long standing diabetes that is poorly controlled. People who take care of themselves by going for regular check-ups, taking medication, and living healthy lifestyles can avoid such complications.

Myth

People with diabetes should avoid carbohydrates at all costs.

Fact

Carbohydrates are a main source of energy essential for metabolism and well-being. Instead of actively avoiding carbohydrates to control blood sugar levels, people living with diabetes should be more careful about the type and amount of carbohydrates they consume, as well as the time of consumption. Diabetic individuals should get sufficient carbohydrates, preferably the complex type from whole grains like brown rice. They should also have their meals at regular times.

Myth

People with diabetes can safely consume snacks that have “no added sugar”.

Fact

Snacks and candies labelled “no added sugar” or “suitable for diabetics” may seem safer than regular snack food, but the sugar could be replaced by artificial sweeteners. Such snacks may also be higher in fat and calories than their regular counterparts. Always be aware of the ingredients in processed food and limit your consumption of foods that are high in fat and sugar.

Myth

People with diabetes feel unwell.

Fact

Not everyone with diabetes feels unwell. In fact, many people with diabetes do not have any symptoms, particularly during the early stages of the condition. They can have diabetes for months, even years, without knowing it. This is why it is important to go for regular health check-ups, so that you can detect the condition early.

Myth

Alkaline water is beneficial in the prevention and treatment of chronic diseases such as diabetes

Fact

There is currently no conclusive evidence that ionised alkaline water is beneficial to health. Individuals can achieve good health by adopting and maintaining a healthy lifestyle, which includes the following:

  • Consume a balanced diet rich in fruits, vegetables, wholegrains and low in fats and sugar.
  • Adopt a physically active lifestyle by exercising regularly
  • Maintain a healthy body weight with a BMI of no more than 23 kg/m2
  • Quit smoking and limit alcohol intake
Myth

Pre-diabetes is not serious and I do not need to do anything about it.

Fact

Don’t be fooled by the “pre” in pre-diabetes. The condition affects 1 in 7 Singaporeans and puts them at increased risks of developing Type 2 diabetes, heart disease or stroke.

But it is not too late to turn things around and take control. Some lifestyle adjustments, such as committing to a healthy diet, including more physical activity and losing weight can do a lot in preventing or delaying the onset of diabetes.

​​

Signs and Symptoms

People with Type 2 diabetes can feel well and not experience any symptoms at all. However, there may also be symptoms that develop gradually and are sometimes so mild they go unnoticed.

Here are some symptoms that diabetes can cause:

Signs and symptoms of type 2 diabetes
  • Feeling hungry all the time
  • Feeling tired
  • Having blurred vision
  • Feeling thirsty despite drinking lots of water
  • Losing weight despite good appetite
  • Itching skin especially around the genital area
  • Frequent passing of urine
  • Poor healing of cuts and wounds

Complications

The high blood glucose (hyperglycemia) levels in uncontrolled diabetes can damage both nerves and blood vessels. As blood vessels supply blood to various organs, this can eventually lead to complications such as:

Kidney disease

Kidney disease

Foot disease

Foot disease such as numbness, ulcers, and even gangrene

Eye disease

Eye disease

Nerve disease

Nerve disease which can lead to problems such as erectile dysfunction and diarrhoea

Heart disease

Heart disease such as angina and heart attack

Stroke

Stroke

Tips for Caregivers

Being diagnosed with diabetes can be overwhelming. As a caregiver, you want to help your loved ones enjoy the fullest and healthiest life possible.

Caregivers should learn about diabetes

The first step to becoming a caregiver to your loved one is to learn as much as you can about diabetes and what lifestyle changes are needed. Going through the change alone can be daunting, so why not make the changes together as a team or family.

Caregivers can do lifestyle activities with loved ones to improve health

Exercise or shop for diabetes-friendly groceries together, then cook and have meals together. Many lifestyle changes that improve the health of someone with diabetes can also benefit everyone.

Caregivers can accompany their loved ones to their medical appointments

Where possible, accompany your loved ones to their medical appointments. Listen, share, and ask questions to help your loved ones get the best care possible from the healthcare team.

Caregivers should take care of themselves too

Finally, in the process of being a good caregiver, don’t forget to take care of yourself too.

Signs and symptoms of diabetes

Recognise signs and symptoms

Know what signs and symptoms to look out in a crisis so you can help the person seek immediate attention. Some crises to look out for are:

Signs and symptoms

Shakiness, sweating, weakness, dizziness, irritability, hunger, headache, mood swings, staggering gait

What to do:

  • Check blood glucose level to confirm; give a glass of fruit juice or 3 to 4 teaspoons sugar in water. Keep some sweets like a bar of chocolate to take for when symptoms occur

  • Repeat the above measures in 10 to 15 minutes if blood glucose level is still below 4.0 mmol/l

  • Seek immediate medical attention if symptoms persist or if the patient loses consciousness

Signs and symptoms

Thirst, fatigue, frequent urination, drowsiness, blurred vision

What to do:

  • Check blood glucose

  • Check urine for ketones if blood glucose is over 240 mg/dl (> 13 mmol/l)

  • Continue to drink plenty of water

  • Seek medical attention if symptoms persist

Diabetic ketoacidosis (DKA) or diabetic coma is a life-threatening condition that develops when there is too little insulin in the body. This is more common in persons with type 1 diabetes. Without insulin, the body cannot use glucose (sugar) and breaks down fat and protein for energy instead. In the process, it produces a poisonous substance known as ketones. If left untreated, diabetic ketoacidosis can be fatal.

Signs and symptoms

Abdominal pain, nausea, vomiting, extreme drowsiness, rapid breathing, flushed skin, sweet fruity odour to breath

What to do:

  • Check that blood glucose levels are above 15mmol/l

  • Check urine for ketones. Urine dipstick tests for ketones are available for home use

  • Seek immediate medical attention

Check blood glucose level

Check their blood glucose level

Help the person monitor their blood glucose levels. This requires conducting a blood glucose test at home using a glucometer. Ask the doctor or nurse to help you buy a glucometer.

  • Wash your hands thoroughly before doing the test

  • Ensure the person's hand is clean. You can rinse the hands in lukewarm water, then dry them to improve circulation for a better sample

  • Do gentle massage of the hands before pricking the finger to improve circulation

  • When pricking the finger, use the side of the fingertip rather than the front top so it's less painful

  • Apply gentle pressure on the finger pad with the sides pushed out to get a better sample

Your doctor will advise how often the blood test is required.

Manage diet

Manage their diet

Get help from a dietician on how to plan meals and adjust the diet. Make positive affirmations each time the person makes a healthy food choice and encourage them to maintain a healthy and well-balanced diet. Here are some tips:

  • Use My Healthy Plate as a guide for planning meals

  • Choose a variety of foods from the four food groups

  • Keep meals regular

  • Be mindful of portion sizes when serving food

Physically active

Encourage them to be physically active

Encourage the person to move around more and sit less. Let them know that they do not have to exercise long and hard to reap health benefits. Short bouts of activity break up prolonged seating and improves fat metabolism.

During physical activity, be on the lookout for signs and symptoms of hypoglycemia (low blood glucose). Have some sweets or fruits (e.g. apple) on standby, in case they feel dizzy or weak.

Medication

Give them their medication

Most persons with diabetes may also have other medical condition(s) such as high blood pressure, high blood cholesterol level, and may be on medication for such problems. Know what medication(s) the person under your care is taking; understand how it works and its potential side effects. Inform the doctor immediately if the person experiences any reaction to the medication(s).

As a caregiver, ensure that medication is taken or given (in the case of insulin injections) on time and regularly as prescribed by the doctor. Some people with diabetes are afraid of insulin injections, which causes non-compliance in their treatment. Helping them overcome their fear is an important role you can take on.

Care for their feet

Care for their feet

Foot care is very important in persons with diabetes. The person with diabetes may develop foot problems arising from either nerve damage, also called neuropathy, or poor circulation. When sensory nerves of the foot are damaged, the ability to feel sensations, such as pain, is lost and one may be unaware of a wound or breakdown of skin that can lead to infection. Diabetic foot ulcers are serious because they do not heal well and cause gangrene that can lead to amputation.

It is important to keep the blood glucose level under control to minimise the risk of foot problems. As a caregiver, ensure that you assist in the care of the feet every day:

  • Wash and inspect feet daily and seek medical care if you spot a problem

  • Look for changes in skin colour or feeling

  • Gently rub skin lotion over the feet, but not in between the toes

  • Trim toenails straight across and file the edges

  • Protect feet from extreme temperatures

  • Use proper and comfortable foot wear at all times

Additionally, visit the doctor at least once a year for foot examination, and more often if foot problems arise.

RESOURCES

Screen For Life  

Screen For Life

Get screened today. Find out what screenings are best for you and your loved ones.

HealthHub. Your Health. In Your Hands.  

Your Health. In Your Hands.

With HealthHub Track by your side, you have everything you need to take control and beat diabetes.

Know Your BMI  

Know your BMI

Take the right steps and BEAT diabetes. Start by calculating your BMI.

Newly Diagnosed with Diabetes?  

Newly Diagnosed with Diabetes?

A guide for persons newly diagnosed with pre-diabetes and type 2 diabetes.

Newly Diagnosed with Diabetes? (For Care Team)  

Newly Diagnosed with Diabetes? (For Care Team)

A guide for the care team of persons newly diagnosed with pre- and type 2 diabetes.



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