4 May 2011
In Malaysia, the Third National Health and Morbidity Survey (3rd NHMS) in 2006 showed that the prevalence of T2DM for adults aged 30 years old and above had risen by almost 80% in the last decade to 14.9%1. In this population survey of those with diabetes, 73.5% attended government health facilities and 20% received treatment from private health facilities. The majority, 77% were treated with oral anti-diabetic medications only and a mere 7% were receiving insulin therapy at the time of the survey. The National Medicines Use Survey (NMUS) in 2006 reported that insulin therapy contributed to only 8.2% of overall anti-diabetic drug utilisation for the country2. These fi gures represent low rates of insulin use when compared to other countries.
A nationwide audit done by the Institute of Health Management (IHM)3, MOH in 2005 and 2008 showed that the use of insulin in MOH health facilities (primary, secondary and tertiary) was 13% and 19% respectively, mainly prescribed in tertiary hospitals with low use in primary and secondary care. A recent MOH audit in primary care (NCD Diabetes Clinical Audit 2009) found that insulin use in primary care was about 11.8% with marked differences between states. Use of insulin therapy in tertiary care was much higher at 54%4 (DiabCare 2009) and has doubled compared to 28%5 (DiabCare 2003) in patients attending specialist
clinics in MOH state hospitals and academic instituitions.
The NMUS also showed that insulin use was far greater in the public sector compared to the private sector refl ecting the burden of patients seen and managed by the public