The National Health and Morbidity Survey 2023 has reported diabetes as one of the leading causes of death in Malaysia. In fact, 3.6 million or one in six Malaysian adults are currently suffering from diabetes. More than half of those who know they have diabetes admit that they do not have good blood sugar control.
Following World Diabetes Day, Alpro Pharmacy brought together a panel of healthcare professionals and key opinion leaders in diabetes care to discuss pressing issues, emerging trends, and innovative solutions in diabetes management.
Prevalence of Diabetes in Malaysia
Leading expert and panelist, Basmawati Baharom, Council Member of the Malaysian Dietitians’ Association, currently serves as the Head of Dietetics (HOD) at Hospital Kuala Lumpur (HKL) stated that age is a common factor for risk of diabetes. Older individuals have higher risks for pre-diabetes and Type 2 diabetes, as Type 2 diabetes generally occurs in middle-aged adults, most frequently after age 45.
However, the same National Health and Morbidity Survey 2023 have also reported young adults in Malaysia becoming increasingly affected. “Healthcare professionals are diagnosing more children and adolescents with Type 2 diabetes, and yet, a majority of them do not know they have diabetes. Some only came to realisation by chance, for example, when their wounds did not heal and got infected,” said Basmawati.
Addressing the pressing trend, particularly for Malaysians, Basmawati opined, “While age is a risk factor for pre-diabetes and T2DM, we’re also witnessing increasing diagnoses among adolescents and young adults, with many only discovering they have diabetes when symptoms are severe. High-sugar beverages contribute significantly to this trend, especially in younger demographics, adding that achieving good blood sugar control in diabetes patients is a complex challenge, primarily due to a mix of biological, behavioural, and systemic factors.
Dr Aizuniza Abdullah, Senior Assistant Director of the Disease Control Division, Ministry of Health Malaysia, emphasised the economic implications of diabetes in Malaysia. She shared, “Diabetes incurs around RM4.4 billion annually in direct healthcare costs—exceeding expenses for conditions like cancer and cardiovascular disease. Beyond these, the indirect costs, such as productivity losses and early retirements, further impact our economy.”
This issue is further complicated by variability in patient lifestyles, the presence of other chronic conditions, and factors related to socioeconomic status and healthcare access.
Testing Methodologies for Diabetes Patients or At-risk Individuals
Dr Chooi Kheng Chiew, Consultant Endocrinologist, Diabetologist and Physician, emphasised that both “HbA1c” and “blood glucose” are important measurements for people with diabetes.
“HbA1c, also known as glycosylated hemoglobin, measures the average blood glucose levels over the past 2-3 months. It’s a useful tool for monitoring blood sugar control and diagnosing diabetes.
Blood glucose, on the other hand, measures the current level of glucose in the blood. While blood glucose tests provide immediate results, HbA1c tests give a broader picture of glucose control. Both tests are used together to help patients and healthcare providers manage diabetes effectively. They complement each other in providing a more comprehensive view of a patient’s glucose control.”
Dr Chooi advises patients to monitor their blood glucose and note down the types and quantity of food they take. This helps them to understand how the food they take affects their blood glucose levels, and learn to adjust the quantity, type and timing of their food accordingly.
SMBG as a more Innovative Approach to Diabetes Management
A recent study conducted by Alpro Pharmacy and Universiti Kebangsaan Malaysia (UKM), has showcased the effectiveness of a structured self-monitoring of blood glucose (SMBG) approach for individuals with type-2 diabetes mellitus (T2DM).
One of the panelists, Dietitian Chua Kai Jia, Alpro Pharmacy’s Professional Care and Development Manager, together with colleague Dt Sa’ida from Alpro Pharmacy and two researchers Dr Nurul Huda and Prof Suzana from Universiti Kebangsaan Malaysia, conducted a quasi-experimental study involving 111 patients with Type 2 diabetes, men and women, around 57 years old, for 6 months.
The six-month study revealed that participants under the Self-Monitoring of Blood Glucose (SMBG) intervention showed a significant 5.2% reduction in HbA1c levels, while the control group saw similar increases. In addition to improvements in blood glucose control, the SMBG group also reported enhanced mental well-being. Participants feel better supported and this will allow better self-care in disease management. These findings underscore a 10.4% net improvement in blood glucose control and suggest that structured SMBG programmes may offer a sustainable model for long-term diabetes management, with the added benefit of supporting mental health.
“We split the sample into two groups: the control group and the intervention group. Members of the intervention group subscribed to a programme that provides them with a glucometer and glucose strips, allowing them to check their glucose levels by themselves at home. This is to empower patients to monitor their own glucose levels. Importantly, this intervention does not involve any additional medication, supplements, or insulin. This is what we mean by SMBG,” said Chua.
Adding on to the significance of the findings, Dr Chooi, stressed the critical role of HbA1c management to prevent complications. “Reducing HbA1c levels has shown substantial benefits for reducing diabetes-related kidney complications. Every 1% reduction in HbA1c correlates with a 37% decreased risk of microvascular issues, as evidenced by the UK Prospective Diabetes Study (UKPDS) study. This proactive approach can delay or even prevent the need for dialysis,” said Chooi.
When it comes to managing diabetes, all experts concur that the process is about the cost of treatment, as much as the quality of life of the patient. Accessibility and convenience are a few of the top factors closely associated with quality of life for patients when it comes to careful and consistent diabetes management and monitoring.
Dr Chua who is also one of the study’s primary researchers, noted that the findings validate that a subscription-based SMBG model is not only feasible but has substantial potential to enhance diabetes care. As T2DM is among the most prevalent chronic conditions globally, data from SMBG can allow healthcare providers to tailor individualised treatment plans, creating a supportive, hands-on approach to management.
“SMBG is the method of choice in assessing glycaemic control and prevent hypoglycaemia. As part of an educational initiative, SMBG should be recommended in patients treated with insulin and is desirable for those on Oral Glucose-Lowering Drugs (OGLD),” Aizuniza concluded.
To encourage early detection through screening, Alpro Pharmacy is offering RM1 Blood Glucose Check this November, and for more information and how to participate, please visit Alpro Pharmacy’s website.
