The Reversing Diabetes Programme, a collaboration with the Tanoto Foundation, aims to achieve diabetes remission through sustained behavioural changes by targeting dietary patterns and physical activity. This complements the national Healthier SG initiative, improving population health by tackling the second leading cause of death and illness in Singapore.
Diabetes is the second leading cause of death and illness in Singapore, contributing 10% to the national disease burden. One in three individuals is at risk of developing diabetes in their lifetime, and undiagnosed or poorly managed diabetes can result in serious complications such as heart disease, stroke, and amputations.¹. This iterates the importance of diabetes-related research in advancing diabetes care in Singapore.
It has been found that substantial weight loss in obese patients with early Type 2 diabetes leads to normalising of blood sugar levels without the need for medications.². While bariatric surgery is one way to achieve substantial weight loss, this can also be effected through dietary changes and regular physical activity.This led to the development of the NHG Reversing Diabetes Programme in August 2022, funded by the Tanoto Foundation and NHG Fund, which seeks to work with patients with early Type 2 diabetes to achieve diabetes remission through targeted and sustained dietary and lifestyle changes, without the use of medication or surgical intervention.
Through the Living with Diabetes Survey, the study team identified key demographics, behavioral and health-related factors influencing weight loss, physical activity and dietary patterns among individuals with Type 2 diabetes. The survey outcome suggested that clinicians could adopt a multi-pronged approach such as providing education, offering support, and redesigning the environment to motivate Type 2 diabetes individuals to lead a healthy lifestyle.
In addition, the Diabetes Remission Clinical Trial was established to study the effectiveness of weight management in achieving diabetes remission. Promising early trial results have shown that individuals with early diabetes and obesity can achieve diabetes remission through weight loss by adopting total meal replacement strategies, under the supervision of a qualified dietician. This serves to provide empirical evidence for therapeutic and preventive clinical strategies.
As part of its community engagement efforts, the team conducted healthy grocery shopping tours to educate individuals with diabetes and their caregivers on reading food labels and understanding nutritional information, leading to increased awareness in making informed dietary choices. The team is also developing a cookbook for healthy living, which features 100 diabetes-friendly recipes thoughtfully designed by NHGP dieticians in collaboration with the Centre for Applied Nutrition Services at Temasek Polytechnic. It aims to make healthy eating both accessible and enjoyable for those managing diabetes, and includes traditional Asian recipes that promote balanced nutrition without sacrificing taste.
Initiatives from the Reversing Diabetes Programme have demonstrated that proactively controlling disease progression through behavioural change whilst working with primary care and community partners could potentially be key to shape impactful interventions that will relieve the burden on the healthcare system and gain a foothold in the war against diabetes.
1 Epidemiology & Disease Control Division, Ministry of Health, Singapore (2010). Singapore Burden of Disease, 2010: diabetes burden measured in terms of disability-adjusted life years (DALYs) lost due to premature mortality and years of life lost due to living with ill-health or disability
2 Khalik, S. (2022, August 5). Lose the weight - and the diabetes: S'pore healthcare group's latest battle plan in war against disease. The Straits Times.
