Joint efforts at multiple levels to combat diabetes mellitus

The Ministry of Health (MOH), Malaysia continues to strive towards achieving the optimal glycaemic target and reducing the impact of diabetes complications among patients.

“Our battle against diabetes is at multiple levels; from its prevention to minimizing the debilitating complications,” said Dr Lee Boon Chye, deputy health minister, at the opening of the 12^th International Diabetes Federation Western Pacific Region (IDF-WPR) Congress and 10^th Asian Association for the Study of Diabetes (AASD) Scientific Meeting, which is jointly organized by Diabetes Malaysia (DM), Malaysian Endocrine and Metabolic Society (MEMS), National Diabetes Institute (NADI) and Malaysian Diabetes Educators Society (MDES).

The government aspires to facilitate the work of NGOs, professional associations and civil societies such as DM, MEMS, NADI and MDES through education, patient empowerment and multidisciplinary collaborative efforts. Future health campaigns should include participation from these NGOs, professional bodies, universities and societies, either via consultation or delivery of activities, said Lee.

The worldwide prevalence of diabetes increased from 4.7 percent in 1980 to 8.5 percent in 2014 among adults over the age of 18. The latest estimates from the International Diabetes Federation (IDF) showed 425 million people with diabetes worldwide and 1-in-2 were undiagnosed.

In Malaysia, the National Health and Morbidity Survey (NHMS) 2015 reported that the prevalence of diabetes among adults in Malaysia was 17.5 percent (3.5 million) with 9.4 percent (1.8 million) undiagnosed and untreated. Indians have the highest (22.1 percent) prevalence, followed by the Malays and Chinese. One of the risk factors is obesity, whereby obesity is observed in 75 percent of Malaysians with type 2 diabetes.

Newly diagnosed diabetes in pregnancy is another growing concern as patients are inflicted by this chronic disease at a young age. The National Obstetric Registry Report in 2010 reported that almost 1-in-10 pregnant women had newly diagnosed diabetes in pregnancy and again the prevalence was highest amongst the Indians.

MOH established the National Diabetes Registry (NDR) in 2009 to keep track of clinical outcomes of patients managed at primary healthcare clinics (Klinik Kesihatan). As of 2012, more than 600,000 patients were registered and only a quarter of them achieved the target glucose control. The hospital-based diabetes care delivery study (DiabCare) in 2013 reported at least a third of patients had nerve and eye damages; 1-in-10 had heart disease and required interventions, and 61 percent of new dialysis patients had diabetes.

Other efforts include promotion of healthy lifestyle with tax exemptions for sports equipment and fitness centre membership; reduction of sugar subsidy and increased taxation on sugar containing beverages.

The prevalence of diabetes is projected to reach 31.3 percent by 2025 and this will affect more than 7 million people, said Professor Dato’ Dr Ikram Shah Ismail, president, DM.

The IDF-WPR has the largest population of all seven IDF regions and almost 40 percent of all people living with diabetes in the world. “We face a great challenge in dealing with the threat of diabetes in our region and the better way to prevent and manage diabetes is especially needed,” said Professor Linong Ji, regional chair, Western Pacific, IDF-WPR.

To meet the challenge, the IDF-WPR congress has been held every 2 years in different parts of the Western Pacific region over the past 2 decades. This year’s congress highlighted the theme ‘Enhancing knowledge and skills transforming diabetes care’ with a focus on the latest advances in prevention and treatment of diabetes.

Professor Yutaka Seino, chairman, AASD, added: “In this century, scientific research and diabetes treatment have become more demanding due to the rapid and large increase in patient numbers.” Hence, the importance of this joint meeting in coalescing the research and medical community to improve standard of care and keep up-to-date with the field of diabetology.