Singapore’s war on diabetes aims to save lives – and limbs – in a state where the disease causes four amputations a day

“Do you love your wife and your grandchildren?” the doctor asked his patient, after telling him that he had type 2 diabetes. Bagio Tomas Soliano was shocked as his doctor described the urgent lifestyle changes needed if he wanted to spend many more years with his family.

One in three of world’s adults with diabetes is in China, WHO reports

Just six months before, the 57-year-old had been given a clean bill of health during a routine check-up. Diabetes had set in quickly, with his blood-sugar level (tested while fasting) shooting up to what Soliano describes as a “crazy” reading of 18.5 millimoles per litre; normal levels are between three and six mmol/L.

Type 1 diabetics either produce too little or no insulin, a hormone that allows your body to use glucose for energy or storage, and helps to regulate blood sugar levels. Type 2 diabetics are resistant to the insulin they produce.

The doctor told him such a sudden onset of diabetes was unusual and alarming – and he wanted him to start daily insulin injections. “Hold on. Slow down. Let me see what else I can do first,” Soliano told the doctor.

This scene in Singapore plays out all too frequently in other Asian cities, too. The International Diabetes Federation estimates the number of adults with diabetes worldwide is 415 million, and is set to rise to 642 million in 2040. The Asian Diabetes Prevention Initiative says 60 per cent of the world’s diabetics live in Asia. In Singapore, one in eight adults are estimated to have diabetes, compared to one in 10 in Hong Kong, including both diagnosed and undiagnosed cases.

While both places have stepped up campaigns to educate citizens on diabetes prevention measures, Singapore has greater impetus: to save lives – and limbs.