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Kiss & Tell: Saliva Glucose Tracker

Article Written by OHT Siti Asuhada Binte Mohd Yusof

Introducing a revolutionary product called Kiss & Tell. Kiss & Tell is a glucose testing kit which is non-invasive as it does not involve any finger pricks during testing. Instead, it uses the saliva to assess the glucose level of the individual. The test kit is also very convenient and quick which makes it easy to use for people of all ages. According to DiabetesontheNet, an article talking about the fear of injections in people with type 2 diabetes was discussed in 2017 and concluded that there were many diabetics that were afraid of injections. According to Rubin et al in 2009, about 10% to 26% of diabetics were afraid of needle injections. Needle phobia is a common obstacle among diabetics which could hinder the monitoring of their condition. While some may choose to avoid doing the finger pricks all together and even going as far as missing doctor appointments, others may find the frequency of doing the finger pricks tedious and disruptive to their daily activities.

Other than the cost of medications, budget has to be set aside for medical supplies like blood test strips and alcohol swabs. Depending on the severity of one’s diabetes, more often than not, doctors would recommend the patient to do multiple tests in a day. Some examples of when a diabetic may have to do their blood test include before meals, 2 hours after meals and before bedtime. With such a high frequency, these costs can add up to be quite a sum of money. However with Kiss & Tell, patients are only required to buy a box that comes with either 7 or 50 test kits. All items needed for testing are provided in the test kit packet and no additional cost is needed.

In the test kit, there will be a user manual for individuals to read, the test cassette and a desiccant pouch to absorb any moisture in the packaging. There is also an application that can be downloaded on a mobile device for android users to record results to refer to and share to medical professionals or loved ones. On the test cassette, there is a rounded opening with a ‘e’ on one end which will be placed under the tongue to absorb saliva needed for the test. On the middle portion of the test cassette, there will be a yellow line indicator prior to testing. prior to testing.

Diabetes & What to expect

Article Written by OHT Siti Asuhada Binte Mohd Yusof

Diabetes is a lifelong medical condition that cannot be cured. Once the diagnosis has been made, the only counteraction for diabetes is maintenance. This entails regular medical checkups at the doctor’s, frequent finger pricks to test for blood sugar levels and daily consumption of medication. Individuals with diabetes should work closely with medical professionals and discuss the necessary steps that can be taken to manage the condition. Depending on the type of diabetes an individual has and how severe the condition is, the frequency of finger pricks can differ to strictly monitor blood sugar levels. Additionally, diet consultations may also be given to educate and inform patients about how their dietary choices may affect their condition and certain foods to avoid or limit the intake. They may also recommend picking up a physical activity as exercising provides a myriad of benefits - most importantly, regulating blood sugar levels. Medical professionals recommend exercising 150 minutes each week, which is about 25 minutes per day.

Diabetes is a systemic disease that should not be undermined because poor control and lack of maintenance of this disease can lead to numerous detrimental issues. Other than poorer and slower wound healing, diabetes can also affect one’s teeth and gums. According to a review focusing on the bidirectional relationship of diabetes and gum disease done by Păunică et al in 2023, it stated that diabetes can increase the risk of getting severe gum disease by up to 3 times. Severe gum disease starts off from just slight swelling and bleeding of the gums and when not taken care of early, can progress to affecting the bone level of the jaw. When this happens, teeth can start to become more shaky and loose which will begin to affect the quality of life of the individual as daily tasks such as eating can begin to be a challenge. This means that regular dental checkups should be adjunct to medical checkups, especially so in an individual with diabetes.

Other than gum health, diabetes is more commonly associated with leg amputations in the most severe cases. As mentioned in the previous articles, diabetes can lead to various other health complications like diabetic neuropathy if poorly managed. This condition happens due to the high sugar levels which causes significant damage to the smaller blood vessels that supply the nerves in the feet. Due to this issue, individuals with poorly controlled diabetes will have poorer blood circulation and experience loss of feeling in affected areas. This means that diabetics will be unable to experience pain in the event of an injury. When these small injuries are left unattended and untreated, it can become infected and begin to fester. Over time, the dead tissues can spread to the surrounding areas, eventually leading to amputation of the limb.

In the long run, diabetes can be quite costly to manage. Regular medical checkups and medication costs can sound expensive but compared to the consequences of poorly controlled diabetes, it is worth spending the money to manage the condition. Losing a limb can not only be expensive financially but is also mentally taxing for the amputee and reduce the general quality of life for the individual.

With these consequences, diabetes can impact not just the individual but also the loved ones around them. Changes can be difficult to implement and the commitment and willpower required to prevent a relapse of unhealthy habits is even more challenging. Support from those around the individual like family and friends could be a source of motivation. HealthHub has a multitude of resources regarding diabetes and even one how people can give their support to diabetics. Other than helping diabetics through their physical therapy and rehabilitation, loved ones can also show their support by cooking or choosing #healthier food options or joining in their exercise sessions. What’s most important is giving the utmost support and being part of their journey even if it is just providing a listening ear for them. Even with these suggestions, it is crucial to remember not to overstep their boundaries.

With all the above-mentioned information, it is important for everyone to go for regular medical checkups to monitor their health. Monitoring blood sugar levels should not be exclusive to just diabetics but should also be done for individuals who are at higher risk of diabetes or for those who have not gotten tested in a long period of time.

References

Diabetes: Affected Groups & A Path Towards a #HealthierSG

Article Written by OHT Siti Asuhada Binte Mohd Yusof

About 1-in-3 Singaporeans have a risk of developing diabetes in their lifetime. The risk of getting diagnosed with diabetes can vary depending on the individual’s lifestyle choices and habits. People who have a sedentary lifestyle and or are overweight put themselves at higher risk, as obesity can contribute to insulin resistance. According to the National Institute of Diabetes and Digestive and Kidney Diseases, incorporating regular physical exercise into a daily routine can help lower blood sugar levels, blood pressure and cholesterol levels.

It is recommended to exercise for at least 150 minutes every week. Besides the aforementioned health benefits, a systematic review by Marquez et al in 2021 discussed the effects of exercise on dopamine levels. Dopamine is a neurotransmitter produced by the body that helps regulate our mood, motivation, and pleasure. It was concluded in the review that physical exercise did lead to an increase in dopamine levels which suggests another benefit of having regular physical exercise which is having an improved mood.

In Singapore, there is a national movement and effort to rally Singaporeans to incorporate a healthier lifestyle called #ActiveSG. This platform provides Singaporeans easier access to sports facilities in various locations around Singapore under one application. Other than booking or utilising facilities, citizens can also sign up for a myriad of classes led by well-trained and licensed instructors. Additionally, for new members of the #ActiveSG, a $100 credit is rewarded into their accounts to be used on government sports facilities. This is in hopes of promoting a #HealthierSG.

Another cause of diabetes that is relevant to all of us, is stress. While stress is not a direct cause of diabetes, there are discussions about the link between stress and diabetes. According to DiabetesUK, when an individual is feeling stressed, stress hormones are released so that the body can cope with the situation. However, this same hormone makes it more difficult for insulin to function effectively. Since insulin is unable to function properly, blood sugar levels will remain high which could lead to diabetes in prolonged situations.

According to The Straits Times, recent trends in Singapore have shown that there has been an increased number of children and teenagers between the age of 12 and 16 years old in the past 10 years getting diagnosed with diabetes. In the article, medical professionals discuss the possible factors that may have contributed to the sudden change in trends. It was said that with advancements in technology, children tend to be more enamoured with social media or gaming applications instead of playing with other children their age in playgrounds, and hence less active. Another factor was an unhealthy diet that contributed to excessive weight gain, combined with the prevalence and convenience of fast food chains located all around Singapore, it is no surprise that the younger generation is at higher risk.

Another group prone to getting diabetes are pregnant women. The diagnosis is called “Gestational Diabetes” and these women only show symptoms of diabetes during their pregnancy. The condition usually resolves after the delivery of the baby, but in some cases can persist even after delivery. According to HealthHub, 1-in-5 mothers are diagnosed with gestational diabetes and it is recommended for expecting mothers to go for regular health screenings starting from the 24th week of their pregnancy. Unfortunately, even when the condition resolves, there is an increased risk of getting diagnosed with gestational diabetes during subsequent pregnancies.

As aforementioned, regular exercise is necessary to regulate blood sugar levels. Additionally, maintaining a healthy diet is also vital to ensure that blood sugar levels are maintained at a healthy range. We recommend seeking a medical professional to obtain further information on how to have balanced meals even with gestational diabetes. Be informed that frequent testing of sugar levels is necessary to monitor the health of both the mother and baby. If the gestational diabetes remains undetected or uncontrolled, it could lead to physical deformities or premature birth of the baby.

Lastly, geriatric patients also have an increased risk of getting diabetes. According to the National Population Health Survey Report posted by the Ministry of Health, 22.2% of 60 to 69-year-olds and 27.1% of Singaporeans between the ages of 70 to 74 years old suffer from diabetes. Unfortunately, due to the process of ageing, insulin production may be lower and it is said that there may also be a growing insulin resistance in elderly patients.

The most important concern to tackle in the ongoing “War on Diabetes” is its prevention. The Singapore government has taken ample measures to prevent Singaporeans from developing various medical conditions by promoting a healthier lifestyle. Some of the few programmes are the Healthier Choice Symbol, which helps consumers choose healthier products when buying groceries and the Healthier Dining Programme, where participating hawker centres are obligated to sell at least one healthier meal on their menu for customers to choose from.

Additionally, in 2020, seven major beverage manufacturers like Coca-Cola, Pokka and F&N have pledged to limit the sugar content in their drinks to a maximum of 12%. On top of prevention, early detection is also vital to maintain the condition before it becomes uncontrollable. Hence, HealthHub has a Diabetes Risk Assessment which is a short questionnaire that helps to determine an individual’s risk profile. Furthermore, based on the age group and the gender of the individual, HealthHub will also recommend other screenings that they should be going for to check for their risk.

Older patients are eligible for a programme called “Screen for Life”, a medical screening that is heavily subsidised by the government. This screening not only checks for diabetes but also high cholesterol levels and high blood pressure. We recommend confirming whether the clinic(s) near you are participating in this programme, and to bring along your CHAS card to the clinic for a medical checkup. Let’s all do our part and raise awareness to walk towards a #HealthierSG!

References

Diabetes and Its Complications

Article Written by OHT Siti Asuhada Binte Mohd Yusof

According to the World Health Organisation (WHO), diabetes is a chronic disease wherein the pancreas is unable to produce enough insulin, or when an individual is unable to effectively use the insulin produced in one’s own body. Insulin is the hormone that regulates blood glucose levels by facilitating the absorption of glucose into cells.

Diabetes is characterised by elevated levels of blood glucose. There is also a stage called pre-diabetes before developing the disease. Pre-diabetes is a condition wherein blood sugar levels are slightly elevated but are not high enough to be diagnosed as diabetes. Without an early diagnosis and intervention, pre-diabetes can progress into Type 2 diabetes.

Diabetes can be categorised into Type 1 or Type 2 diabetes. Type 1 diabetes, an auto-immune disease, happens when the pancreas does not produce insulin. Type 2 diabetes happens when the body builds a resistance to insulin and this can be attributed to an unhealthy lifestyle, unbalanced diet and various other risk factors. Symptoms of diabetes include frequent urination, blurry vision, extreme fatigue and impaired wound healing.

Diabetes, when uncontrolled, can lead to further health complications and increase the risk of being afflicted with various other medical conditions like cardiovascular diseases, kidney damage (diabetic nephropathy) and nerve damage (diabetic neuropathy). In some cases, foot ulcers may form and if untreated without timely and proper medical care, could lead to the amputation of the leg.

According to the International Diabetes Federation (IDF) in 2021, 537 million adults between the ages of 20 to 79 years old are afflicted with diabetes. By 2030, the number is expected to rise to 643 million adults. Global expenditure for diabetes care is estimated to have cost around 966 billion US dollars in 2021, a 316% increase over the past 15 years. Referring to the IDF in 2021, China ranks first with 140.9 million people diagnosed with diabetes, followed by India with 74.2 million people.

Locally, according to the Ministry of Health (MOH) on 22nd August 2017, more than 400,000 Singaporeans are living with diabetes and 1-in-3 Singaporeans have a lifetime risk of getting diabetes. Numbers of diabetics are projected to rise even further to 1 million by the year 2050 if current trends continue. Additionally, according to the MOH on 14 November 2017, it was estimated that around 430,000 Singaporeans between the ages 18 and 69 years old were diagnosed with pre-diabetes. In 2016, Singapore started a national movement called “War on Diabetes”. According to The Straits Time, on November 2020, Diabetes Singapore and SportsSG signed an agreement to enable patients to get personalized coaching. There is also a workshop organised by #ActiveSg to educate diabetics on how to manage their medical condition with exercise.

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Happy Gum Health Day!

According to SingHealth, 90% of Singaporean adults are affected by some form of gum disease. Dental Plaque which contains gram-negative anaerobic bacteria e.g. Treponema Denticola and Porphyomonas Gingivalis, is the leading cause of gum disease. Additionally, there are also other factors which contribute to the progression of one’s gum disease.

The factors are divided into local, systemic, psychosocial and behavioral factors which can increase an individual’s susceptibility as it accelerates the progression of periodontal disease. It is crucial to educate patients about these factors, how it may impact their oral health, and strategies to overcome the effects of these factors.

The mildest form of gum disease is Gingivitis, which is only limited to the inflammation of the gingiva. Depending on the state of the gingiva, Gingivitis can be further categorized into mild, moderate or severe. With good oral hygiene and regular dental prophylaxis, Gingivitis is a reversible condition.