Stopping the rampage of diabetes
Described by experts as one of the greatest contributors to the global burden of disease, diabetes incidence is soaring despite increased awareness of the threat it poses.
THE body’s blood sugar is controlled by insulin, a hormone produced by the pancreas in the abdomen. Insulin acts on food in the bloodstream to move glucose into cells, where it is broken down to produce energy.
Diabetes is a chronic condition in which cells are unable to break down glucose into energy. This is due to insufficient production of insulin or the insulin produced does not function properly.
The former, which is much more common, is called type 2 diabetes and the latter, type 1 diabetes.
During pregnancy, it is possible for blood glucose levels to reach levels that the insulin produced is insufficient for all of it to be moved into cells (gestational diabetes).
Many people have raised blood glucose levels which are not high enough for a diagnosis of diabetes (prediabetes), which is a wake-up call that the person is enroute to diabetes.
Data from National Health and Morbidity Surveys
The prevalence of diabetes in Malaysia’s National Health and Morbidity Survey in 1986 was 6.3%.
This increased to 8.2% in the National Health and Morbidity Survey in 1996 and 17.5% in the National Health and Morbidity Survey in 2015.
At the current rate of increase, about one in five Malaysians will be diabetic in 2020.
The findings from NHMS 2015 of the overall prevalence of diabetes were:
● There was an increase in overall prevalence with age, with an increasing trend from 5.15% in the 18-19 years age group to a peak of 39.1% in the 70-74 years age group;
● The overall prevalence in females was 18.3% and 16.7% in males;
● Indians had the highest overall prevalence at 22.1%, followed by Malays at 14.6%, Chinese at 12.0% and Other Bumiputras at 10.7%.
Of the known diabetics, the findings included: ●
The prevalence of known diabetes was 8.3% with an increasing trend from 0.7% in the 20-24 years age group reaching a peak of 27.9% in the 70-74 years age group;
● The prevalence of known diabetics in the urban areas was 8.7% and 7.2% in the rural areas;
● The prevalence in females was 9.1% and 7.6% in males;
● Indians had a prevalence of known diabetes at 16.0%, followed by the Malays at 9.0%, Chinese at 7.7% and Other Bumiputras at 6.8%;
● 25.1% claimed that they were on insulin therapy and 79.1% on oral anti-diabetic medicines within the past two weeks;
● 82.3% had received diabetes diet advice from healthcare personnel;
● 69.6% had been advised to lose weight;
● 76.8% had been advised to be more physically active or start exercising;
● 79.3% sought treatment at Health Ministry facilities (59.3% at clinics and 20.0% at hospitals) and 18.7% at private facilities (15.1% at clinics and 3.6% at hospitals);
● About 1.5% self-medicated by purchasing medicines directly from pharmacies; and 0.5% were on traditional and complementary medicine.
Of the undiagnosed diabetics, the findings included:
● The prevalence of undiagnosed diabetes was 9.2%, with an increasing trend from 5.5% in the 18-19 years age group reaching a peak of 13.6% in the 65-69 years age group;
● The prevalence was 9.2% in females and 9.1% in males;
● Indians had a prevalence of undiagnosed diabetes at 11.9%, followed by the Malays at 9.8%, Others at 8.6%, Other Bumiputras at 8.1% and Chinese at 7.7%.
Of the prediabetics (the term used in NHMS 2015 was impaired fasting glucose), the findings included:
● The prevalence was 4.7%;
● There were no statistical differences by age groups, gender and between urban and rural areas;
● Indians had a prevalence of prediabetes at 7.7%, followed by Malays at 5.2%, Others at 4.3% and Chinese at 3.8%.