15 February 2016
Diabetes is a worldwide epidemic, a lifelong disease for which there is not yet a cure.
It is a curse of the modern world as our lives become more comfortable and our waistlines expand each day.
According to the World Health Organization (WHO), diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is the hormone that regulates blood sugar.
Worldwide, it afflicts more than 380 million people, and WHO estimates that by 2030, the number of people living with diabetes will more than double.
In conjunction with the 18th Asean Federation of Endocrine Societies Congress held at the Kuala Lumpur Convention Centre recently, the Malaysian Endocrine and Metabolic Society (MEMS), along with the Health Ministry, issued the newly-revised Clinical Practice Guidelines (CPG) for the Management of Type 2 Diabetes Mellitus.
The new CPG was revised by a group of medical specialists and experts in the field of diabetes management and its related complications, to equip healthcare providers with the best and most current knowledge of type 2 diabetes mellitus management for effective and safe delivery of care to patients.
Speaking at the press conference, MEMS president Prof Dr Nor Azmi Kamaruddin says: “Diabetes mellitus is on the increase in Malaysia. One in five Malaysians above the age of 30 has diabetes, and in terms of controlling it, our country is not doing that well.
“Every effort should be made to slow this progression. From 1996 to 2011, the number of diabetics in the country has increased by 80% and that is the reason why it is important for us to continuously update and revise the CPG.
“There are a lot of advances, either in drug therapy or in the various ways of managing diabetes.
“We took into consideration the studies and research into lifestyle, diet and exercise, when we revised the CPG, and we tried to make it as simple as possible.”
There are several notable changes to the fifth edition of the CPG. Eleven chapters were added, including a section on female sexual dysfunction.
A unique feature of this edition is the recommendations on assisting Muslim patients with diabetes during Ramadan.
The Epidemiology of Diabetes and Ramadan study showed that many Muslim patients with diabetes around the world insist on fasting during the holy month, thereby creating a medical challenge for themselves and their physicians.
The CPG also provides recommendations on managing diabetes in adolescents and the elderly, as well as areas such as mental health issues in diabetes, cardiovascular risk estimation, management of diabetes in acute illnesses and unproven therapies in diabetes.
Consultant obstetrician and gynaecologist Assoc Prof Dr Hanifullah Khan says there have been a lot of studies about the disease since 2009 (when the previous edition of the CPG was published), and the new guidelines will greatly help doctors and update them on the most current way of managing patients with diabetes.
“The guideline is like the bible of diabetes management, and it is becoming more comprehensive because the number of conditions and complications, such as gestational diabetes and psychiatric problems, are rising and becoming more common,” he says.
According to MEMS vice-president Prof Datuk Dr Mafauzy Mohamed, it is common knowledge that diabetes is becoming more problematic in Malaysia, and is the main cause of heart attack, stroke and kidney failure.
The five-yearly National Health and Morbidity Survey (NHMS) showed that the prevalence of diabetes in Malaysia increased by 31% in the space of just five years, from 11.6% in 2006 to 15.2% in 2011 for those aged 18 and above.
The 2011 NHMS also showed that 20.8% of adults above the age of 30 have diabetes.
“Why the diabetes epidemic is going beyond a certain percentage in Malaysia is because of our lifestyle.
“It’s mainly because we eat too much food and we do too little physical activity.
“The weather and our social environment is not conducive for people to live a healthy lifestyle and that is why we are getting fat.
“Obesity is increasing in the country, which is driving the rate of diabetes up, and we are doing everything that we can to get our people to eat less and have a better diet.
“If we can do that, then I’m sure the percentage will reduce and we are hoping for that,” says Prof Mafauzy.
This article was first published in Star2.com on 14 February 2016.
Photo credit: Star2.com