April 2019 | Issue 41
Winning the fight against diabetes

The National Healthcare Group (NHG), the primary clinical training partner for LKCMedicine, has seen a slowdown of the rate of increase of patients with diabetes in the Central region of Singapore.

The year-on-year growth of the number of patients with diabetes has moderated to 4.2 per cent in 2017, from about 6 per cent in 2013 and 4.9 per cent in 2014. Similarly, the number of diabetes patients with at least one complication, such as amputation, fell from 7.6 per cent a year in 2013 to 4.2 per cent in 2017.This is despite the fact that NHG serves a population of two million that is slightly older at an average of 43.3 years old, compared with the national average of 40.5 years. For a disease such as diabetes which has no cure but requires management over a lifetime, this is a significant impact.

Teamlet photo_070319.jpg

The National Health Group has seen a slowdown of the rate of increase of patients with diabetes in the Central region of Singapore

Professor Philip Choo, NHG Group CEO and a Governing Board member of LKCMedicine, attributes this “bending of the curve” to “teamlet care” at NHG polyclinics, where patients with chronic diseases are looked
after by the same team of family physicians, nurses, care manager and care coordinator. He added that patients who have a good relationship with their doctor or nurse tend to develop healthier lifestyle habits
over time, such as exercising more, eating better, improving medication compliance, and achieving better control over their blood sugar levels.

LKCMedicine's hallmark pedagogy of Team-Based Learning (TBL), as well as clinical postings with NHG are training future doctors to treat patients as part of a healthcare team. However, NHG continues to see a high
number of new diabetes patients, at a younger age. Prof Choo said, “It starts with daily wrong choices, slight obesity, high cholesterol levels, high blood pressure and potentially diabetes, in that order.”

Thus, care needs to move upstream, before patients get diabetes. This includes identifying patients with high cholesterol and blood pressure levels, who are at risk of getting the disease earlier, and working with them to prevent it.