Saturday, July 2, 2016
Malaysia - Diagnosing diabetes
KUALA LUMPUR: Diabetes is known to be one of the top 10 deadliest diseases in this country. However, many appear unperturbed by the silent killer.
In fact, the 2015 National Health and Morbidity Survey revealed that 1.8 million of the 3.5 million diabetics in Malaysia were not even aware they were afflicted with the chronic disease.
The statistics also showed that the number of diabetics in the country have increased to 17.5 percent in 2015 from 15.2 percent in 2011 and 11.6 percent in 2006.
“The health report shows the number of diabetics aged between 18 and 30 years old have increased. This is a concern as many of them are not even aware that they have diabetes.
“They would eat whatever they wanted to and this bad habit is exacerbated by their sedentary lifestyle. So when they fail to detect the disease early and receive due treatment, it would expose them to multiple complications.
“Among the main risks are of coronary disease, stroke, damage to the organs such as the kidneys, blindness and amputation,” said the Malaysian Metabolic and Endocrine Society President Prof Dr Nor Azmi Kamaruddin to Bernama.
Diabetes is described as a condition where a person’s glucose level exceeds normal level following the pancreas’ inability to produce sufficient insulin.
The presence of insulin is crucial in processing glucose into energy. However, diabetics are unable to produce enough insulin for the process.
This in turn prevents glucose for entering the cells, leaving it to accumulate in the bloodstream instead.
The high sugar levels in the blood eventually spill over into the small intestine, causing glucose to be present in the urine, thus making the person diabetic.
“There are two types of diabetes. The first is caused by pancreatic damage, causing the absence of insulin hormones in the body.
The second type is when the body cannot produce enough insulin to manage the level of sugar in the blood. “In Malaysia, up to 99 percent of diabetics are of the second type, said Dr Nor Azmi, who is also the Consulting Specialist for Diabetic Medicine and Endocrinology at Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM).
He said the unmanaged increase in blood glucose levels could expose patients to a host of lifelong diseases.
Those who delay treatment may find it a fatal mistake as it could cause coronary disease.
Globally, diabetes is one of the main causes of cardiovascular disease, which is ranked the number one killer disease around the world particularly in developing countries.
In Malaysia, 35 percent of deaths are caused by cardiovascular disease out of which 69 percent are also diabetics.
The symptoms related to diabetes should therefore not be taken lightly. These include constant fatigue, the urge to urinate often, particularly at night and the constant feeling of thirst.
Malaysia is the number one country in Southeast Asia with the highest number of diabetics.
Cognisant of the situation, the Health Ministry is constantly beefing up on its services for diabetics in Malaysia.
One of the measures include launching the fifth edition of the Clinical Practice Guideline Management of Type-2 Diabetes Mellitus during the 2016 World Health Day celebration recently.
The guideline among others introduced a simple test called A1c for detecting diabetes.
“It will become the official document to guide health workers in giving not only the most effective form of treatment for diabetics but also for performing screenings and effective preventive measures at the primary level,” said Health Minister Datuk Seri Datuk Seri Dr S. Subramaniam when launching the World Health Day celebration recently.
The text of his speech was read by Deputy Minister Datuk Seri Dr Hilmi Yahaya.
For this year’s celebration WHO has chosen the theme Beat Diabetes: Scale up prevention, strengthen care, and enhance surveillance.
Dr Nor Azmi said it was previously more difficult to screen for diabetes as it required a person to fast for eight hours prior to going for a blood glucose test.
“In addition to that, some situations required them to consume drinks that contain 75g of glucose in a 300ml cup which must be downed within three to five minutes.
They were not allowed to go home or walk about as it would affect the glucose reading as well.
“After remaining in a sedentary position for two hours, they were then asked to take another blood glucose test. Not many were willing to go through the complicated process,” he said.
In contrast, the A1c test does not require patients to fast or consume a glucose drink to effectively screen for diabetes. In fact, the results can even be obtained within two hours.
“Previously, the glucose test only measures the amount of glucose in the blood at a given time. A1c, however, measures the average reading of glucose in the red blood cells which have a lifespan of between three and four months, thus giving a more accurate result,” he said.
FIRST IN ASIA
Making A1c one of the recommended tests to screen for diabetes in the country puts Malaysia as the first country in Asia to do so.
The test is previously only used by the US, Europe and New Zealand to diagnose diabetes.
Japan, meanwhile, only allows the use of A1c to screen for diabetes if it is run simultaneously with the standard glucose test that requires eight hours of fasting and the glucose drink test.
The A1c test is now readily available at any private or government hospitals or clinics.