A NEW drug has been approved for use that will take a load off the mind of diabetic patients.

Sitagliptin, an oral medication, is now available in Singapore by prescription. Unlike conventional therapies, this new drug has the added advantage of helping patients control their blood sugar levels without causing them to gain weight.

'Obesity is one major cause of diabetes, but the irony is that many diabetic medications actually cause weight gain,' says Stanley Liew, a consultant endocrinologist at Raffles Hospital. 'Sitagliptin is different and it will be beneficial especially for those who are already struggling with weight issues.'

Sitagliptin was approved for use in the US last year and was given the green light by Singapore authorities just recently. It works by regulating the level of insulin the body produces after eating.

'There are quite a few new therapies for diabetes recently, but only Sitagliptin has made it to Singapore so far. However, several other drugs are currently under review and these may become available soon,' says Dr Liew.

One innovative drug in the pipeline for approval here is an insulin inhaler, which works exactly like a Ventolin inhaler for asthmatic patients.

'The insulin inhaler will be useful. While short-acting, it can be used just before meal times to cover the sudden surge in glucose,' explains Dr Liew. The regulating Food and Drug Administration (FDA) in the US has already given Pfizer's Exubera the go-ahead.

Such new therapies, however, do come with bigger price tags. Sitagliptin, for example, will cost around $3 for a day's dosage, compared to about $1 for conventional medications.

The new types of diabetic drugs afford better control of blood sugar levels, which is crucial in managing the potentially debilitating condition. 'Diabetes is a life-long, chronic condition which can lead to multiple complications like heart attack, kidney failure, stroke or blindness if not properly treated. It is essential that a patient's HbA1C, which measures blood sugar levels, be capped at 7 per cent.'

A normal person's HbA1C ranges from 3.5 to 5.5 per cent. According to Dr Liew, almost half of all diabetics in Singapore have blood sugar levels above that range.

He fears this would lead to an escalation of healthcare costs at a later stage.

'For every 1 per cent increase in a diabetic's HbA1C, the corresponding risk of a heart attack increases by 14 per cent, and that for visual impairment increases by 37 per cent, so you're not just looking at healthcare costs for one particular disease, but for multiple ailments. These can add up to quite a lot.'

Already, more than 8 per cent of the population here is diabetic - one of the highest rates in the region. An increasingly sedentary lifestyle and an ageing population will probably mean that the figure will continue to rise.

Dr Liew says diabetes can affect people of any age, and those with risk factors should go for screenings at least once a year and, if diagnosed, begin drug therapy as soon as possible to keep the condition under control.

'There is a genetic component to diabetes, so those who have diabetics in the family should go for regular checks, especially if they're above 40 years old, have high blood pressure or high cholesterol,' advises Dr Liew, who adds that periodic screening for diabetes is important because the symptoms are usually vague or absent.

'The early symptoms, if any, can seem quite harmless, such as frequent urination or excessive thirst. Some people may have weight loss or feel hungry,' explains DrLiew. He adds that children are not immune to the disease, although the risk of diabetes does tend to increase with age.

'The number of children diagnosed with type 2 diabetes in Singapore has increased quite significantly over the past five to 10 years and the major cause of this is obesity,' says Dr Liew.

Research has shown that lifestyle changes can prevent or delay the onset of type 2 diabetes. Modifying one's diet and adding moderate exercise such as walking has been found to reduce the development of diabetes by almost 40 per cent.

'Diabetes is a condition which can and should be prevented in many cases. What you can do on your own is to monitor your body mass index and keep it to below 23,' says Dr Liew.

As for whether eating sugary stuff such as doughnuts causes diabetes, Dr Liew set the record straight, saying, 'In itself, sugar does not cause diabetes. But it may lead to obesity, which could cause diabetes.'

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