SINGAPORE – Many young adults lose weight to look good or snare a date. But, for 32-year-old Shaun Lawrence (picture), his life depended on it.
At the age of 19, Mr Lawrence discovered he had diabetes during his National Service pre-enlistment health check.
Despite having to pop pills every few hours to keep his condition under control, he did not take his illness seriously and continued consuming five heavy meals and several cans of soft drinks a day.
“At that point, it didn’t hit me that diabetes was for life. I didn’t take it seriously, even though my parents were shocked that I got diabetes at such a young age,” said the operations executive, who once tipped the scales at 117kg.
Singapore has one of the highest rates of diabetes among developed nations. Fast becoming a global epidemic, diabetes affects about 11.3 per cent of the world population.
About nine in 10 diabetics here suffer from Type-2 diabetes, which was traditionally named Adult-Onset Diabetes as it affects only adults, said Dr Tham Kwang Wei, Director of the Obesity and Metabolic Unit at Singapore General Hospital (SGH).
Experts like Dr Tham are concerned about the growing number of teenagers and younger adults who are diagnosed with the condition that affects mostly those above the age of 40.
Just eight years ago, diabetes affected only 0.5 per cent of those aged 18 to 29 years, according to the 2004 National Health Survey.
By 2010, the figure had doubled to 1 per cent.
Among 30-something adults, diabetes statistics have similarly jumped from 2.4 per cent in 2004 to 4.3 per cent in 2010.
These figures may be under-representative of the actual situation, said Dr Tham, who spoke on the topic at the SingHealth Duke-NUS Scientific Congress on Saturday. This is because more than half of those with diabetes go about their daily lives undiagnosed as symptoms can go unnoticed in the early stages.
Dr Tham, whose youngest diabetes patient is a 16-year-old, said that one in 10 of her patients is under 40 years old.
Obesity the main culprit
Dr Tham noted that, in 2004 to 2010 when diabetes rates spiked, there was a dramatic increase in national obesity rates. Excess weight messes up your body’s ability to control blood sugar levels.
“Another factor is physical inactivity,” she added.
“The majority of Singaporeans are rather physically inactive, especially when they have sedentary jobs and the convenience of modern transportation.
“Many commercially available foods are also calorie-dense and highly processed with a lack of fibre in our diet.
“All these factors lead to higher risk of obesity which in turn increases one’s risk of diabetes,” Dr Tham said.
Other lifestyle factors include stress, as well as the lack or poor quality of sleep, which are common among Singaporeans.
Dr Shanker Pasupathy, Senior Consultant of Bariatric/Metabolic and Vascular Surgery, Department of General Surgery at SGH, explained that the excess “fat mass” in overweight and obese people is the main driver for insulin resistance.
Explaining how Type-2 diabetes develops in those who are overweight, he said: “The body (specifically the beta cells in the pancreas) needs to produce more and more insulin in order to effectively lower the blood sugar level after a meal.
“This leads to a ‘burnout’ of the beta cells and, therefore, insulin levels fall, resulting in high circulating blood sugar levels.”
Chronically high blood sugar levels can damage the blood vessels and tissues, leading to severe and permanent complications such as heart failure, stroke, nerve, kidney and foot damage, Dr Tham warned.
Complications at an earlier age
There are also concerns that these potentially severe problems could occur in younger patients.
“The younger a person is at the onset of diabetes, the longer he (or she) will be exposed to (its) ill effects.
“About half of patients who have a heart attack have diabetes. This is an alarming association,” said Dr Tham.
She noted that younger patients tend not to treat their conditions seriously, since many do not experience symptoms until it is too late and have other priorities like careers and family on their minds.
For Mr Lawrence, the reality of his illness only sunk in three years ago, when his doctor told him that he had exhausted all oral medication options. If he continued with his unhealthy lifestyle, he would soon require daily insulin jabs.
Last year, he underwent a gastric bypass procedure to keep his weight under control. Since then, Mr Lawrence has shaved off about 40kg off his hefty frame and has turned his lifestyle around.
According to Dr Shanker, recent clinical trials show that there is approximately an 80-per-cent chance that diabetes may be reversed after a gastric bypass.
Although he still takes multiple meals a day, Mr Lawrence’s portions are a fraction of what he used to eat.
“I’ve also totally weaned off soft drinks. Now I’m totally off the medications I was taking for diabetes, high blood pressure and cholesterol.
“All of my friends and family are happy to see the positive change in me,” he said.