1 diabetes: a global problem - Galen Growth Asia

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Global mortality rates have reached 4 million each year, where ... Kingdom, which provides multi-channel phone, web and
DIABETES: A GLOBAL PROBLEM For the first time in Human history, chronic diseases kill more people than infectious diseases. However, chronic disease management requires paying attention in the early stage of disease onset. At Holmusk, we are driven by “early detection, early intervention” Diabetes is an example of a chronic disease that is increasingly disabling individuals and crippling economies. Global mortality rates have reached 4 million each year, where someone somewhere dies from diabetes every 7 seconds. Without immediate intervention, drivers such as an ageing population and lifestyle changes will continue to escalate disease incidence rates and its associated healthcare spending. Several global trends reflect the pressing need to address the diabetes problem. First, lifestyle changes are triggering an earlier onset of the disease, thereby reducing productivity and incomes. In a 2010 study done in Australia, A$1.8 billion was lost, in terms of income, gross domestic product (GDP) and welfare, due to the inability to work as a result of diabetes. Second, Individuals afflicted with diabetes are often overrepresented by the poorest segments of the population. These are the individuals who are unable to seek appropriate medical attention. Third, the onset of diabetes increases the risk of suffering from secondary non-communicable diseases such as heart disease, kidney failure and depression. It is estimated that medical costs attributed to these secondary conditions cost governments an estimated to 2% of their GDP. Overall, this problem is reflected worldwide, where the anticipated economic burden due to the disease from 2011-2030 is >$30 trillion, as reported by the World Economic Forum. Singapore is not an exception. As much as 6% of Singapore’s healthcare spending has been devoted to diabetes and its complications. To address the growing problem in Singapore, a new movement has been set forth since Health Minister Gan Kim Yong declared war against diabetes in announcing the establishment of a new Diabetes Prevention and Care Taskforce on April 13, 2016. The prevalence of diabetes in Singapore has risen to 12.3% in 2013, from 8.2% in 2004 and 9% in 1998, surpassing other Asian countries such as Hong Kong (9.5%), Japan (7.2%) and Taiwan (5.7%), according to International Diabetes Federation. The Ministry of Health called this disease, ‘the biggest drain of the healthcare system’, already costing the country more than $1 billion a year. Mr Gan said: "The war on diabetes will not be a quick battle, but a long war requiring sustained effort”. The ministry proposed three key areas in the multi-year plan: 

Reduce incidence of new cases of diabetes via prevention and healthy lifestyle promotion programs

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Strengthen early screening and intervention to identify the disease early among those at risk or undiagnosed



Improve disease control and reduce complications

DIGITAL HEALTH AND DIABETES There are an estimated three billion internet users and $4.2 trillion channeled into online sales in 2016. Businesses have been forced to adopt new strategies, from the removal of middlemen to empowering consumers with more information, choices and voice during the buying process. In low and middle income countries, consumers are more familiar with the mobile phone than landlines. Although the Internet has disrupted industries through reducing transaction costs, lowering barriers to entry, removing intermediates and expanding consumer choices, healthcare has been comparatively refractory to change. However, there have been some examples where digital innovation has brought upon new initiatives, such as the deployment of digital and social media within traditional healthcare systems, to the development of consumer-driven tools. Moreover, the internet has been used for creating awareness and understanding of diabetes as well as education and information in supporting diabetes self-management. Healthcare has only just started to harness and build the power of digital technologies to improve its services and products. Given that healthcare costs have escalated at a faster pace than the gross domestic product in many developed countries, and that the amount of manpower needed to sustain or improve current levels of care will dramatically increase, it only makes sense that digital technology can be designed to effectively replace components within the healthcare sphere. Examples of the use of digital technology to improve efficiency and allow cost savings include (1) the implementation of National Health Service (NHS) Direct in the United Kingdom, which provides multi-channel phone, web and mobile service to provide remote health assessment. This saved the NHS £213 million in 2009/10 and (2) a pilot interactive app called SPARX in New Zealand, which helps adolescents manage their depression by playing an interactive fantasy game incorporating principles of cognitive behavioural therapy. In addition, multiple diabetes prevention programs have been proven to be effective (Figure 1). Overall, we propose that the digital space is a great arena to change the healthcare system, in its fight against a chronic problem like diabetes.

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Correlation of Percentage Weight Loss with Reduction in the Risk of Diabetes for Patients in the Intensive Lifestyle Intervention Arm of the DPP Trial

Percentage Weight Loss at Six and 12 Months for Translational DPPs compared with the DPP Trial

Figure 1. The reduction in risk of diabetes with weight loss and effectiveness of different types of diabetes prevention programs

Figure 2. Glyco Leap to provide scalable and effective solution to diabetes

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Figure 3. Segmentation of the population within the spectrum of diabetes

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