‘Portable pancreas’ for better diabetes control

‘Portable pancreas’ for better diabetes control
Jurutera rugi RM60,000 ditipu wanita laman sosial
Starbucks coffee opens its door in style
Egypt bus blast near Israel border ‘kills three tourists’
Petronas, Yayasan Sabah reach out to Imbak Canyon community
70% of school building not safe for use – rep

Posted: 16 Feb 2014 06:07 PM PST

A PALM-sized pump which administers insulin to diabetics via an infusion set can help reduce episodes of low blood glucose level

Mr Wong Leng Hoe, a diabetes patient and user, dubbed it the "portable pancreas".

Worn discreetly on the body, the palm-sized, pager-like insulin pump delivers the hormone round the clock. It mimics closely the normal discharge of insulin by the pancreas to regulate the body's glucose or sugar level. Insulin is needed to convert carbohydrates into energy, and without it, sugar builds up in the blood, which can lead to serious health problems.

Mr Wong, who switched from injections to using the insulin pump in July 2013, carries the device with him 24/7. "I used to forget to inject the insulin – or not do it altogether – when it was inconvenient to do so, like when I was having lunch with clients.

"With the pump, I don't have to excuse myself to go to a quiet place to prepare the insulin and inject myself. I merely press a button to deliver the (higher) dose of insulin needed before a meal. And I don't have embarrassing blue-black marks on my body because of the injections," he said.

Diabetics need to adjust the amount of insulin they use before meals or sports, as their blood sugar levels can go up (after a meal) or down (when exercising).

Mr Wong, who is in his 50s, was diagnosed with Type 2 diabetes more than 15 years ago. This form of the disease, also known as adult-onset diabetes, is associated with obesity and an unhealthy lifestyle, unlike Type 1 diabetes where the pancreas isn't able to produce insulin.

Type 1 diabetes is an autoimmune disease and is often diagnosed in childhood. Type 1 diabetics require insulin treatment from the onset of the disease, while treatment for Type 2 involves medication, or insulin injections when the disease progresses and medication is not enough to control the disease. Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin to control the amount of sugar in the blood.

According to Dr Bee Yong Mong, Consultant, Department of Endocrinology, Singapore General Hospital (SGH), insulin pump therapy is a good option for people who have poor control over their diabetes. Mr Wong, for instance, struggled to control his diabetes even after starting insulin therapy more than 10 years ago. "Over the years, we've had to increase his insulin dosage significantly," said Dr Bee, who is also Director, Diabetes Centre, SGH.

With the pump, "fast- or rapid-acting insulin is delivered via an infusion set which includes a short, soft tube, called a cannula, that sits comfortably under the skin of the abdomen," said Dr Bee.

The device pumps out insulin in a steady, measured and continuous dose 24 hours a day (this is known as the basal rate), and is also capable of discharging a surge of the hormone when needed (this is known as the bolus dose).

Before a meal, a patient decides how much more insulin he needs based on his blood sugar reading, and presses a button on the pump to push extra insulin units into his body. The extra insulin is needed to account for the carbohydrates consumed, and to bring the patient's glucose levels back to a specified target range.

After a month on the pump, Mr Wong's diabetes was better controlled. He no longer saw large swings in his blood glucose levels, and he could be more flexible about what and when to eat.

Studies elsewhere have shown that patients on insulin pump treatment can achieve better diabetes control and reduce the incidence of hypoglycaemia, a condition where the blood sugar levels are abnormally low, Dr Bee said. When hypoglycaemia occurs, diabetics can lose consciousness if they don't eat something sweet quickly to raise their glucose levels.

Insulin pumps have been in use in Singapore for more than 20 years, but few patients opt for it, mostly because of the cost. The pump is expensive and is not covered by local medical insurance, unlike in the US for instance.

Prices range from $2,500 to $9,000 for a pump, and consumables like the infusion sets will set the patient back by another $150 to $200 a month. The infusion set, which includes the cannula, needs to be changed every three days.

"In the US, 50 per cent of Type 1 patients are on pump treatment, as they can claim the costs from their insurance. In Singapore, the adoption rate is low," Dr Bee said, noting that only about six patients at SGH – mostly Type 1 diabetics – use the pump.

Mr Wong paid about $2,700 for his – a mid-range model – but he is just glad that he now needs less insulin than when he was on injections.

Diabetes affects about 10 per cent of Singapore's population, with the Type 2 form of the disease accounting for 90 to 95 per cent of sufferers.

New location, more facilities

THE refurbished Diabetes Centre in Singapore General Hospital (SGH), which relocated to its new location at SGH Block 1 Basement 1 in June 2013, has more consultation rooms. It also has a facility for staff to create fundus photographs that show clear pictures of the retina and other parts of the inside of the eye.

Diabetes patients can lose their sight if diabetic retinopathy, a complication of the disease, is not detected. The disease has few symptoms until it is at an advanced stage.

By then, the patient may have limited or no vision.

At the centre, patients can now have their retinas tested and their results ready before they see their doctors.

Said Dr Bee Yong Mong, Consultant, Department of Endocrinology, and Director, Diabetes Centre, SGH: "The patient comes to us, we take a picture of his retina and the image is sent to SAILOR (Singapore Advanced Imaging Laboratory for Ocular Research). The report comes back to us quite quickly and we can see the patient on the same day. This frees up the doctors' time and improves the care of patients too."

In the past, doctors like Dr Bee had to interpret the results, which took time. But now the images are transmitted instantly to SAILOR – part of the Singapore Eye Research Institute (SERI) – for interpretation by accredited technicians (pictured left).

Since July 2013, the technicians have examined the retina images of 163 SGH patients, of which 47 were referred to the Singapore National Eye Centre (SNEC), said Ms Haslina Hamzah, Programme Manager, SAILOR (pictured standing). Of the patients referred to SNEC, 25 were found to be suffering from diabetic retinopathy.

She said that about 30 per cent of diabetes patients in Singapore have diabetic retinopathy, with 10 per cent having a severe form of the disease.

One-week training before patients start on insulin pump treatment

PATIENTS who opt for the insulin pump treatment are trained for a week by a team comprising a doctor, a dietitian, a diabetes nurse and a representative from the insulin pump supplier.

"We will work with the patient to get him acquainted with the equipment, his diet and to improve his knowledge of the insulin pump. The doctor will then decide on the amount of insulin that he should use," said Dr Bee Yong Mong, Consultant, Department of Endocrinology, and Director, Diabetes Centre, Singapore General Hospital.

• This story was first published in Singapore Health, Jan/Feb 2014.

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Jurutera rugi RM60,000 ditipu wanita laman sosial

Posted: 16 Feb 2014 04:56 PM PST

KUCHING: Padah mempercayai wanita yang kurang sebulan dikenali menerusi laman sosial, seorang jurutera terpaksa berputih mata dan mengalami kerugian lebih RM60,000.

Menurut sumber, wanita berkenaan memintanya mengirimkan sejumlah wang bagi membolehkan barang yang kononnya dikirimkannya kepada lelaki berusia 38 tahun itu dilepaskan oleh kastam.

Wanita sama turut meminjam wang sekitar RM30,000 daripada mangsa dan memintanya memasukkan wang itu ke dalam akaun bank yang didaftarkan atas nama orang lain.

Wanita berkenaan terus meminta lelaki berkenaan memasukkan sejumlah wang lagi dengan alasan wang yang dipinjamkan tidak mencukupi.

Lelaki dari Jalan Arang itu mula mengesyaki dirinya ditipu namun wanita berkenaan mengugut akan menyuruh polis ke rumah mangsa kerana berurusan dengan dadah.

Sumber turut memberitahu, lelaki berkenaan turut berkenalan dengan seorang lagi wanita.

Wanita berkenaan dikatakan meminta mangsa mengirim duit sebanyak RM300, juga untuk tujuan, kononnya pelepasan kastam.

Lelaki berkenaan yang sekali lagi dikatakan tidak mengesyaki apa-apa terus mengirimkan wang berkenaan, sekali lagi ke dalam akaun bank milik orang tidak dikenali.

Wanita kedua itu turut meminta wang RM30,000 untuk didepositkan ke tiga akaun berbeza.

Dia hanya menyedari dirinya ditipu sekali lagi setelah wanita terbabit menyatakan duit kiriman itu tidak mencukupi.

Dia kemudian membuat laporan polis untuk siasatan lanjut.

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Starbucks coffee opens its door in style

Posted: 16 Feb 2014 04:53 PM PST

BANDAR SERI BEGAWAN: Starbucks Coffee opened the doors to its first store in the Sultanate yesterday officiated by Her Royal Highness Pengiran Anak Isteri Pengiran Anak Hajah Zariah who together with Hansberry, Quays and Dato Francis Lee, CEO of Berjaya Food Berhad, cut the ribbon signifying the grand opening of the store, Brudirect reported.

Also present were YAM Pengiran Anak Hajah Taiyibah Qalbul Bolqiah and Pengiran Haji Mohammad Hakimmuddin bin Pengiran Haji Hashim, YAM Pengiran Anak Hajah Ruqiyah Mataul Bulqiah and YAM Pengiran Anak Mansurah Izzul Bolkiah. Ricky Ho, Director of Berjaya Food Supreme Sdn Bhd was also present to witness the ceremony.

The store was located in the heart of Brunei's Capital at the bustling hub of the Mabohai Shopping Complex in Bandar Seri Begawan.

With 43 years of coffee heritage and expertise, the store experience is built on sourcing the highest quality Arabica coffee and operates more than 4,000 stores across 15 markets in its China and Asia Pacific region.

The ceremony witnessed the store featured the traditional coffee bar and also a 'slow bar' which allows customers to savour the taste of coffee using the 'pour-over' brewing method. The 'slow bar' was first of its kind in the Southeast Asian region.

President of Starbucks China and Asia Pacific Jeff Hansberry said they were pleased to bring the unique Starbucks experience to Brunei.

Managing Director of Starbucks Coffee Malaysia and Brunei Sydney Quays said they are looking forward to being a part of the growing coffee culture in the country.

The launch saw invited guests, including those from Brunei's business community and the customer, were also given the opportunity to savour their first sip of coffee from this latest Starbucks store and owned the limited edition of Starbucks Brunei merchandise.

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Egypt bus blast near Israel border ‘kills three tourists’

Posted: 16 Feb 2014 03:36 PM PST

Posted on February 17, 2014, Monday

EGYPT: A blast ripped through a bus near an Egyptian resort town bordering Israel on Sunday, killing at least three foreign tourists, police said.

The cause of the blast near the resort town of Taba in south Sinai was not immediately clear.

Militants in the restive peninsula have waged a deadly insurgency against the military and police since the overthrow of Islamist president Mohamed Morsi in July. – AFP

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Petronas, Yayasan Sabah reach out to Imbak Canyon community

Posted: 16 Feb 2014 03:32 PM PST

TONGOD: Petronas and Yayasan Sabah reached out to the communities around Imbak Canyon Conservation Area (ICCA) in Tongod in the heart of Sabah,

in a briefing session, aimed at creating awareness on the effort to conserve the state's pristine heritage.

Some 140 residents from 10 villages in Mukim Pinangah attended the session on February 5.

The villages were Kampung Alitang, Kampung Saguon, Kampung Diwara, Kampung

Mankawagu, Kampung Pinangah, Kampung Melikop, Kampung Masaum, Kampung Langga,

Kampung Tudungin and Kampung Kampung Inarad are located west of ICCA.

In her speech at the event, general manager of Petronas Sabah and Labuan Regional Office, Julita Ontol, spoke of the collaboration to conserve Imbak Canyon under the Yayasan Sabah-Petronas Imbak Canyon Conservation Partnership.

"Despite all these efforts, the support of the communities around the ICCA is equally important in the conservation of Imbak Canyon," she said.

Among the activities during the one-day event was a presentation each by the ICCA, Sabah Wildlife Department, Sabah Forestry Department and Universiti Malaysia Sabah as well as a dialogue with the local community.

ICCA acting manager Robinson Rozali Rustin, in his presentation, said the local communities would benefit from Imbak Canyon's conservation efforts.

"To cater to the anticipated increase in the number of tourists in the future, there will be demand for jobs such as research assistants, and services such as guides and porters, as well as transportation, which will benefit the surrounding community," he said.

Also present were Tongod district officer Robert Stidi and Yayasan Sabah's senior manager of Conservation and Environmental Management Division, Rita Stuel Galid.

The programme also aimed at collecting information on the customs, culture and language as well as the socio-economic activities of Mukim Pinangah which would later be used to update the information at the Petronas-funded Ulu Kinabatangan Information Centre in Kampung Imbak.

The centre was opened last year along with the Ulu Kinabatangan Jetty, also funded by the national oil company.

In 2012, a similar reach out programme was held in Mukim Karamuak, one of four clusters of villages around the ICCA. The three others are Mukim Tongod, Mukim Kuamut and Mukim Pinangah.

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70% of school building not safe for use – rep

Posted: 16 Feb 2014 03:32 PM PST

by Alen Kee. Posted on February 17, 2014, Monday

TAWAU: The Semporna district Education Department has been asked to conduct an inspection at SK Simunul to ascertain the extent of problem of the school building.

In making the call, Bugaya assemblyman Datuk Ramlee Marhaban said that an inspection is paramount as the aging building of the school could endanger the safety of students.

He said many of the main structures of the school building, including walls, roofs and ceilings, were on the verge of collapse and some were found to have already collapsed.

"These problems at the school are not something new but have been going on for a long time. However, no action has been taken to rectify the problems by the authority," he said yesterday when visiting the school after being told of problems faced by teachers.

Ramlee said he felt sad and sympathetic to the problems faced by the school students, especially on safety matters as he does not want for any mishaps to happen.

Among the damage he observed were the broken down and leaky roofs, major sections of the floor and pillars were cracked, and the entire ground floor of the school building had to use iron rod support to avoid collapse.

Ramlee said the main electrical wiring system did not appear to be safe and the water piping system was not functioning, including a number of tables and chairs. In summary, he said about 70 percent of the school building was not safe for use and could pose a danger to students and teachers.

Present during the visit were Bugaya's people development chairman Abdul Suhud Jaani, district officer Mahadi Jaya, assistant district officer Suhaimi Ejip, SK Simunul principal Sarudah Arun, teachers and Simunul branch zone community leaders.

Ramlee, who is also Assistant Minister of Finance, welcomed the recent announcement by Deputy Prime Minister Tan Sri Muhyiddin Yassin that the government had identified 600 dilapidated schools across the country that needed to be refurbished to provide comfort and ensure the safety of students.

Muhyiddin said most of the schools involved were in Sabah and Sarawak. These schools just needed time to repair because the provision required for the repair work was not small, but a minimum of RM15 to RM20 million.

Muhyiddin, who is also the Education Minister, said the government had provided funding for the development of under served schools across the country this year, including RM1 billion for Sabah and Sarawak.

Ramlee hoped the provision would include the schools in Sabah, especially in Bugaya. He said the issue of damaged schools had been forwarded many times to the Ministry of Education, including at the district and state levels.

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