Diabetes in Japan

The Japanese physique is not one that is readily associated with high risk of diabetes. They’re slender folks and their small portions high seafood diet ranks among the healthier meal plans of the developed world. Yet as we know, diabetes is much more complex than what meets the eye. And in fact, when we took a closer look at the Japanese lifestyle, we realized that their diabetes problem has a few different dimensions than what we have seen in other countries so far.

Firstly, white rice is an integral part of almost every family meal, but it is also exactly the kind of refined carbohydrate that doctors advise diabetics to eat sparingly. Avoiding rice and noodles while also keeping our vegetarian diet made our meal times a little more stressful, but it doesn’t have to ruin your culinary experience. You just have to be a little more careful.

For insulin-dependent diabetics, it is important to remember to adjust your insulin take according to the new quantities of carbohydrates that you are eating. Check your blood sugar regularly until you are sure you have the right dose.

Secondly, Japan has one of the largest elderly populations in the world and this is a demographic that is more susceptible to the onset of type 2 diabetes. As Japan’s population continues to age, the prevalence of diabetes increases as well. More and more, the government must take initiative to educate the public on preventative measures and health professionals must be ready to meet the growing demand for services related to diabetes care. As of 2016, the World Health Organization reported that approximately 10.1% of the Japanese population suffered from diabetes.

For diabetic travelers, the language barrier can also be a little intimidating. Google Translate often became our secret weapon. When reading food labels, you can actually hold your phone over the word you don’t know, capture the image, and wait for the translation. Or if you’re on the go without internet, you can make yourself a small cheat sheet like this one:

炭水化物       たんすいかぶつ       (carbohydrates)

糖類 or 砂糖            とうるい                 (sugar)

Or you can go even more in depth on Japanese food labels here: http://www.survivingnjapan.com/2012/04/ultimate-guide-to-reading-food-labels.html

Time constraints made it difficult for us to get an interview with a local diabetes specialist or a health care professional but we were able to get in touch with a company known as Healthy Tokyo. When researching “how to manage diabetes in Japan”, we often referenced their website so we decided to stop by their offices and learn a little bit about what they do.

 

 What is the mission of Healthy Tokyo?

Yuko: Healthy Tokyo is all about creating everything you need to stay healthy in Japan. We really want to help not just expats or foreigners, but everybody to live a healthy lifestyle. And we don’ t have a set way to be healthy. “Being healthy” is whatever that means to you – so if you’re vegan or you want to do paleo or if you want to exercise a little bit or if you need to find a doctor – then we just try to help you achieve that goal.

We are a very multi-faceted company. We help people connect with doctors and medical facilities and we also try to help people connect with fitness spaces and wellness spaces, yoga centers, spas, etc. We also make restaurant recommendations, so if you are looking for somewhere to eat but you don’t know if they cater to your dietary preferences or you can’t read a menu, we write articles on that. And we also have an online shop so if you’re missing something special from home – like peanut butter – then you can buy it from us.

Do you work more with local people or tourists?

Mike: Foreigners who live in Japan and tourists like you guys, mostly. The number of people we serve goes up each year because tourism in Japan is rising each year. And more or less every 100th person that visits says – “hey, this is a good place to live” – and they start living here.

When did you realize that there was a need for this kind of health and wellness consulting?

Mike: Well, we started as a medical tourism site. So if you want to travel to Thailand, Singapore, Malaysia, or any of those places and get medical treatment, we have another site that does that. We started with that, particularly with Japan, because Japan was considering really making that a pillar of the economy.

They haven’t really been able to do that to the same degree as other Asian countries, but the Japanese health care is still a world class standard. And it is really inexpensive for what they specialize in and the skill level of their doctors.

But for us, from a business point of view, we know that for a medical website, we might only get visitors once a year. That’s why we expanded to health and wellness.

We are rolling out a lot of new features soon. You can make an appointment with a doctor directly on our website. You can buy all kinds of medical supplies. For example, we have a home HIV test kit that is very popular. It’s around 6,000 yen and it gets sent to your home. You take a prick of your blood, you send it out, and you get your test results back. It’s efficient.

What kind of services do you offer with respect to diabetics?

Mike: To be honest, we don’t have that many people contact us about diabetes. Foreigners in Japan can be anywhere from 18-70 in age, but it is not an issue that comes up often. We do have some older people who come to us and we put them in touch with whomever they need to be in touch with. If you need dialysis, we help you find the services you need and for just basic diabetes care, we have GPs that we can recommend to people.

The quality of care here is great and there are plenty of clinics. You don’t have anything to worry about in that respect.

Is it easy to find an English-speaking doctor in Japan?

Mike: It really depends on where you live. And more importantly, you have to make sure they can accept your insurance.

Is there universal health care in Japan?

Mike: Yes. There is a 30% co-pay but it gets capped at a certain amount per month so you never really pay that much. The procedural fees are much lower. Japan is good. They have the abuse of the system – but not like in America. It’s an ecosystem that they have created. So you bring in a new drug, for example. You have seven years to make your money on your drug and then after that your price is going to be slashed. And then every year they slash it. That promotes innovation, right? You bring in a new procedure. They are very strict about allowing a new procedure but if you can prove that that procedure is contributing and reducing the cost of health care or hospital stay, you can probably convince the government to reimburse that.

Every single person – if you make zero or you make 50 million dollars – you can still go to the same doctor.

Do you have any private, English-speaking hospitals that specifically cater to foreigners?

Mike: Not to the level like you do in Bali or Thailand. You have hospitals that are shared. Some hospitals are concentrating on getting some foreigners in. Japan hasn’t really been able to get the government together in a way to make medical tourism as big as it could be. The big problem is speaking English. It’s a lot better than it used to be, but it is not the best.

Do you think the average Japanese citizen is well informed about diabetes?

Mike: Diabetes is huge in Japan. It’s a big problem because of the aging population and the high carbs diet. White rice is a killer. People know this but rice is still a major staple of their diet so they are learning to work around it.

Most Japanese look pretty fit and people are much more active here. Young people are fatter than they used to but “fat” is relative. And if you don’t have a lot of money, you end up eating a lot of carbs. It doesn’t matter what country you live in.

Yuko: Fried food is really big and barbecue too. You can go to the convenience and get just about anything.

Mike: But actually the convenience stores have really shifted. Now you can buy chicken, a bag of salad, or other healthy options. They didn’t used to have that. You’ll see Natural Lawson. Lawson is a convenience store and Natural Lawson is where they are trying to go in the direction of being more wholesome or healthy.

As type 1 diabetic, how could Healthy Tokyo help me?

Yuko: It would really be based on your needs. If you need insulin and you need to know where you are going for emergency care, we could tell you that.

For example, the maximum licensed dose of metformin in Japan is (750mg/day). This is much lower than prescription practices in the West so that would be something you would have to adjust for.

Overall, our job is to make it easier for you to find the health and wellness information you need, breaking down the language barrier and also just making you feel comfortable and supported.

* * *

Mike, Yuko, and the rest of the multicultural team at Healthy Tokyo definitely did put us at ease. While all of their services might not be the first stop for a budget backpacker, their website is still a great resource for staying healthy in Japan.

If you are thinking about traveling or living in Japan as a diabetic, you don’t have to worry. Japan provides quality, modern health care to their citizens under a public program. If you are traveling and need to buy insulin, you will need to make an appointment with a doctor so that you can get a local prescription. Medical supplies are reasonably priced so paying out of pocket won’t ruin your vacation.

On this particular occasion, we had enough insulin with us that we did not have to buy in country. At the airport, security requested that Damián show them his home prescription and letter from his doctor but after they checked our paperwork, we were on our way..

BUT, one last note on food: fruits and vegetables are very expensive in Japan. We sometimes felt like we were being punished for trying to eat clean. Then a friend told us to do our food shops after 8pm, when most of the supermarkets significantly mark down their fresh produce, and this significantly changed our experience. We weren’t always able to organize our days to time this right, but when we did, we were able to save a good bit of money.

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One Comment

  1. Cherie
    June 24, 2018
    Reply

    My daughters in japan and her glucose meter for checking blood sugar broke. Shes in yokohama. Where can she buy a machine and test strips. Japan doesnt have the bayer contour like she has. So needs machine plus test strips asap

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