The Diabetic Features Of The Different Ethnic Groups In Singapore,the Efficacy Of Acupuncture On These Groups And Their Acceptance Level In Acupuncture As A Form Of Treatment

Objectives:The objectives of this dissertation are:1)To understand the diabetic features of the different ethnic grouPs in Singapore.2)To administer acuPuncture treatment to there ethnic grouPs to ascertain if there is any difference in its efficacy.3)To understand the acceptance level in acupuncture by the different ethnic grouPs and the related rationale.Method:1)To analyze and review the data collected from newsPaPers,rePorts from the Ministry of Health,medical journals and dissertation from other scholars so as to understand the diabetes features that are Prominent in the different ethnic grouPs in Singapore.2)To have 20 subjects for the Chinese,Malay and Indians grouPs.Each of them is given 1 acuPuncture treatment Per week,over a Period of 20 weeks.The acu-Points used are in accordance to the official text book Published in China.The main acu-Points used are:Yi Shu,Fei Shu,Pi Shu,Shen Shu,Tai Xi and San Yin Jiao.Additional acu-Points used will dePend on the signs and symPtoms disPlayed by the individuals as follow.Patients with ’shang xiao’symPtoms add Tai Yuan,Shao Fu;Patients with ’zhong xiao5 symPtoms add Nei Ting and Di Ji;with ’xia xiao’ symPtoms add Fu Liu and Tai Chong;exteme thirst add Lian Quan,Cheng Jiang,Jin Jin,Yu Ye;extreme hunger add He Gu,Shang Ju Xun,Feng Long,Zhong Wan;with constiPation add Tian Shu,Fu Jie,Yang Ling Quan,Da Dun;frequent micturition and night sweating add Fu Liu,Guan Yuan;both Yin-yang deficiency add Guan Yuan,Ming Men;blurry vision add Guan Ming,Tou Wei,Zhan Zhu;dizziness add Shang Xing;Pain or numbness on the uPPer limbs add Jian Yu,Qu Chi,He Gu;Pain and numbness on the lower limbs add Feng Shi,Yin Shi,Yang Ling Quan,Xie Xi,itchiness add Feng Chi,Da Zhui,Qu Chi,Xue Hai,Zhao Hai.Non re-useable acuPuncture needles from Mei Kang Singapore Pte Ltd are used.The dimensions of these needles are 0.30mm width with 1.5 inch in length.The fasting glucose level,2-hour after meal glucose level and the overall improvement on the signs and symPtoms are the observation criteria before and after treatment.3)The general Public involving the three ethnic grouPs is invited to take Part in the survey to discern their level of acceptance in acuPuncture as a form of treatment to control diabetes.The survey is carried out in Thomson Medical Centre and SingaPore Tong Ji Chinese HosPital.Social media such as Facebook,WeChat and email were used in order to reach the vast majority.Binary Logistic Regression was used to analyze the survey results.The main question of the survey is:"If you were diabetic,on the basis that you are already receiving conventional Western treatment for your diabetes,are you willing to do acuPuncture treatment as well?"The Participants will have 3 choices:"Willing","Not Willing","Not Sure".They will also select one of the reasons for their choice.See Table 1.Results:1)In terms of diabetic features,the Malays have higher body mass index(BMI)as comPared to the other 2 ethnic grouPs.Complications such as diabetic cardioPathy,diabetic nePhroPathy,Poor blood glucose control,atherosclerosis and lower limbs amPutation are more Prominent among the Malays.The Indians have higher diabetes morbidity,they have Poorer control over the HbAlc,higher incidence of diabetic oculoPathy and depression.Both the Malays and Indians have equally high family history of diabetes.For the Chinese,though they also have the above diabetic features,the occurrence is lower as comPared to the other two races.However,the Chinese have higher incidence of insulin resistance.2)There is no statistical significance when comparing the before and after treatment on fasting glucose level and 2-hour after meal glucose level for each of the races,with P)0.05.However,when comPare the results between Chinese and Malay as well as Chinese and Indians,Chinese fare better among the 3 races,with P ≤0.05.When comPare Malay with Indians,there is no statistical significance.3).1219 eligible survey results were analyzed.Of which,824 Participants were willing to take uP acPuncture treatment,65 Participants were unwilling and 330 of them were not sure if they want to take uP acuPuncture.Chinese were 11 times and 8 times more willing to take uP acuPuncture treatment as comPared to Malays and Indians respectively.Females were 4 times more willing as comPared to males.There was no difference in the level of acceptance when comPared the Malays with the Indians.There was also no difference when comPared SingaPoreans in their 30s versus SingaPore in their 50s.For those who are willing to take uP acuPuncture treatament,their main reasons are "Heard about the good effects of acuPuncture and are willing to try(34.8%)" and "Wish to enhance the treatment efficacy(29.4%)".For those who are not willing to try acuPuncture,their main reasons are:"Fear(46.1%),and "Doubt the efficacy of acuPuncture(29.2%)." For those who are not sure,their main reason is "Have little knowledge about using acuPuncture to control diabetes(56.7%)"Conclusion 1)The different ethnic grouPs have unique diabetic features.Hence,when designing diabetic Preventive measures,it is vital to take into account the different lifestyle and cultural Practices for each ethnic grouP.2)Among the three races,Chinese have better treatment results when comPare with the other two races.The reasons could be due to the fact that the Malays and Indians have higher body mass index(BMI),higher occurrence of the related illnesses caused by diabetes as well as diabetes family history were more Prominent in these two races.With these,their diabetes conditions might already be more advance uPon diagnosis when comPared to the Chinese.The overall improvement on the signs and symPtoms also differ among the three races.The Indians noticed that sleeP quality as well as the sensation on the limbs imProved noticeably.The Chinese felt that the level of thirst as well as the itchiness on the body imProved while the Malays felt that they became calmer and not as easily irritated as before.3).For those who were willing to take uP acuPuncture,their main reasons were that they heard about the Positive efficacy of acuPuncture and that they wish to better the treatment effects.This accounts for 34.8%and 29.4%respectively.Hence,it is vital to educate the general Public further so that they have the right Prospective on acuPuncture treatment.Social media such as newsPaPers,magazines,medical Periodicals are good media for Publishing acuPuncture related articles written by Physicians involved in diabetic treatment.For those who are unwilling,the mains reasons were due to fear and that they doubt the efficacy of acuPuncture.Painfulness during treatment is the greatest fear among this grouP of Participants.For them,moxibustion advocated by Sun Si Miao,a well-known Physician in the Tang dynasty,will be a good alternative.Moxibustion is one of the ancient TCM treatment methods with Proven efficacy in a wide range of illnesses.This form of treatment is especially aPtly for those who fear Pain.56.7%are not sure whether to try acuPuncture because they do not understand how acuPuncture could treat diabetes.In SingaPore,western medicine is the main stream medicine while TCM forms the adjuvant medicine.Most SingaPorean are familiar with western medicine since they come into contact with this tyPe of treatment at a very young age.However,TCM concePts such as acu-Points,meridian lines,energy and blood flow are unfamiliar.To enhance SingaPoreans’understanding on TCM,one of the methods is to introduce TCM concePts and learning using English as a media.This will allow the Malays and the Indians to have a better understand on TCM so as to make this discipline more readily acceptable by the general Public.SingaPore is able to achieved this since she has talents who are bilingual in both English and Chinese languages and are qualified TCM Practitioners.Chinese is 11 times readier to take uP acuPuncture treatment as compared to the Malays and 8 times as comPared to the Indians.This is very much due to the vast majority of Chinese in SingaPore.When comPare between the Malays and the Indians,their level of acceptance is on Par.Based on the health survey done by the Ministry of Health in 2010,the Malays and Indians have 16.6%and 17.2%diabetic morbidity while the Chinese account for 9.7%.Hence,using English as a media to introduce acuPuncture treatment will be able to reach out to the Malays and Indians more effectively.Female is about 4 times more willing to take uP acuPuncture treatment as comPared to male.This is mainly because femalesare generally more health conscious than male.In terms of age grouP,the acuPuncture acceptance level for those in their 30s does not differ too much with those in their 50s.This shows that the younger generation in SingaPore are readier to take uP TCM treatment.This is a Paradigm shift since TCM treatment is often regarded as an old fashion treatment Previously.This change is largely due to the government Policy that was launched in 2010.This Policy required all TCM Physicians to achieve the qualification level set by Ministry of Health,they must Pass the related examinations and be accredited by the TCM Practitioner Board before they can Practice medicine in SingaPore.