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The role employers can play in combating the southeast asian diabetes crisis

 

Diabetes and its complications are a growing concern in Southeast Asia.

Asians have a higher risk than other genetic groups of developing the condition, and according to the latest estimates from the International Diabetes Federation (IDF), over 60% of people with diabetes live in the Asia-Pacific region.

Clearly this isn’t an issue that can be solved by one group alone – it requires a collaboration that is both planned and sustained. And since there is no doubt that the diabetes problem impacts both employee health and productivity, there are roles for all of us to play here. 

Costs and solutions: managing diabetes in Asia

Ninety-five percent of cases of diabetes are type 2 – the type that’s associated with lifestyle risk factors such as obesity and poor diet.

Ninety-five percent of cases of diabetes are
type 2 – the type that’s associated with
lifestyle risk factors such as obesity and poor diet.

If diabetes isn’t diagnosed or managed well, over time high blood sugar can result in damage to the body, causing a whole host of complications, including cardiovascular disease, kidney disease, nerve damage, a digestive condition known as gastroparesis, eyesight damage and Alzheimer’s disease. Estimates suggest that life expectancy is shortened by an average of nine years in those with the disease.

There is an economic burden as well. Productivity is lost, causing costs as high as USD 1bn per year in 2010 in Singapore. Since diabetes has many related conditions, this has a knock-on effect – according to a 2012 study in the Journal of Korean Medical Science, the annual direct medical costs in Korea for a patient with complications of the circulatory system (which can be linked to diabetes) were between 1.5 to 2.7 times higher than the medical costs of patients without complications.

While much needs to be done at a national level in the way of research and the implementation of screening programmes, educational measures, and training of medical staff, there’s a great deal that insurance companies and employers can do when it comes to supporting employees in diabetes prevention and management. 

Let’s look at those in detail. 

1. Encourage healthy lifestyles: There’s a lot of truth in the old adage ‘prevention is better than cure’ and this is certainly the case with diabetes. Employers can generally encourage staff to follow healthy lifestyles by implementing wellness strategies. These can include providing subsidised gym memberships, healthy snack machines, nutritional information in the canteen, smoking cessation, and weight-loss programmes. 

 

2. Provide education: For those diagnosed with diabetes, pre-diabetes or who are at risk due to a strong family history of the condition, personal prevention and management products can be adopted. Education is key in regards to lifestyle information on diet, exercise and other prevention tactics. This can be given in the form of newsletters and printed information with health tips, plus some healthcare providers also feature clinical resources and expert advice that can be accessed online via telemedicine or smartphone services.  

3. Use technology: Rising costs in treatment and care have prompted an increase in technological innovations focused on prevention. Artificial intelligence-driven, personalised health and fitness solutions are among the tools likely to gain traction over the coming years.

4. Implement comprehensive diabetes care packages: The most valuable diabetes care packages should include interactive patient medical questionnaires as well as management of their medical records. Regular access to glucose monitoring, blood pressure and pulse measurement are also important factors in managing long-term conditions such as diabetes. Priority care should also be included in the cover, given the rapid rise in private health insurance, making it harder to get appointments and increasing wait times.

5. Consider concierge services: Some insurance providers also offer concierge services for diabetes care. These include 24-hour hotlines and management services to help patients find the closest network provider, schedule and prepare for appointments, access discounts for medical supplies and services and receive reminders to renew their prescriptions. It’s also easier to access health services while travelling and coordinate priority care. 

Diabetes care in Southeast Asia

So the points mentioned above are an ideal-world scenario. But what is being done currently to both diagnose and treat the condition?

Despite the high prevalence of diabetes in Asia,
almost half of all cases are likely to
remain undiagnosed.

Despite the high prevalence of diabetes in Asia, almost half of all cases are likely to remain undiagnosed. Unfortunately, people are usually unaware that they are in the process of developing the condition. According to the US Centers for Disease Control and Prevention, just 10% of people who are in a pre-diabetes stage (when their blood sugar is raised) are aware they are at risk. However, early diagnosis and intervention of pre-diabetes is an important step in helping patients make healthier lifestyle choices, possibly preventing the development of type 2 diabetes altogether.

Treatment availability for type 2 diabetes in countries such as Indonesia usually includes oral anti-diabetic drugs, a combination of these drugs and insulin, or insulin on its own.

However, it’s a lack of good long-term management that’s the challenge. Regular checks of those with diabetes are infrequent in Asia, with just 15.3% of diabetic Indonesians (in Jakarta) undergoing a regular eye examination. The lack of knowledge of complications such as diabetic retinopathy, which can lead to blindness, was the main reason cited by people with diabetes for not attending checks. Another was cost.

Thailand has tried to boost diabetes screening by launching the Thailand Healthy Lifestyle Strategy 2011 – 2020 Plan. The plan includes approaches to decrease the prevalence and complications of diabetes via public policies, social and public communication efforts and surveillance care systems. However, nationwide screening and prevention programmes are still not fully implemented.

Since 2016, the Thai population has had access to free insulin vials and blood sugar checks at health facilities. While these measures certainly signal progress, continuity of care is an issue, since specialists tend to rotate between hospitals. Also, there is a shortage of general practitioners, with many doctors specialising in one condition. As diabetes brings a lot of potential complications, this means that the approach isn’t always cost-effective, with patients needing to see lots of different doctors for different aspects of their care.

Moving forward

The number of people with type 2 diabetes in Southeast Asia is predicted to rise. It’s a fact that a major factor to blame for the increase is rapidly changing lifestyles. Swift economic growth across countries such as Indonesia, Thailand and Malaysia has led to increases in urbanisation. This has been accompanied by a decline in physical activity and weight gain due to changes in diet, with city dwellers consuming more processed foods, refined carbohydrates and saturated fat. Alcohol consumption and smoking are also known risks.

The number of people with type 2 diabetes
in Southeast Asia is predicted to rise. It’s a fact
that a major factor to blame for the increase is
rapidly changing lifestyles.

However, while diet and obesity are major risk factors, it’s important to note that compared with Europeans, even low levels of weight gain can dramatically increase the diabetes risk in Asians. Despite a generally lower body mass index, Asians tend to be diagnosed with diabetes up to a decade earlier.

Without the implementation of prevention programmes across Asia, the region is likely to face growing social, healthcare and economic challenges from the diabetes pandemic. This means that comprehensive prevention and management strategies from both corporations and insurance providers are key when it comes to optimising the health of workers and ultimately productivity.

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Inova care is an industry leading consulting and health care administration company specializing in managed care, clinical pathways and cost containment solutions for corporations and insurance companies.

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