Catching the disease early and seeking treatment will prevent complications


A patient undergoes diabetic foot and neuropathy treatment at D’Centers.

DIABETES has become increasingly prevalent in many countries over the years.

According to the World Health Organisation (WHO), the number of people with diabetes has risen from 108 million in 1980 to an alarming 422 million in 2014 with prevalences rising more rapidly in middle and low-income countries.

Despite the alarming figures, there are still many who do not realise they have diabetes.

Low awareness

National Diabetes Institute (Nadi) honorary executive chairman Prof Emeritus Datuk Dr Mustaffa Embong said around 50 per cent of the population in Malaysia are unaware they have diabetes until they start developing complications.

“Diabetes used to occur among those in their 50s and 60s but these days, even those in their 20s or 30s have diabetes due to factors such as food, sedentary lifestyle, and so on.

“Furthermore, there is a major misconception that diabetes is not serious because people have the idea that when they meet someone who is diabetic, he or she usually looks fine and does not seem to be sick – until, of course, they develop complications,” he told thesundaypost.

A diabetes facilitator at D’Centers guides a patient on the use of a blood glucose monitor.

He emphasised that “there is no such thing as a mild or slight diabetes” as both Type 1 or Type 2 diabetes are serious and there will be repercussions if a person with diabetes does not take care to contain the disease.

“Diabetes is a silent disease. Most people, especially those with Type 2 diabetes, which usually occurs among adults, don’t have symptoms. That’s why they do not think it’s serious because they don’t feel anything.

“However, if we take care of ourselves from the beginning, this can prevent complications from developing and 20 years down the line, we can see the legacy effect of that control, resulting in a reduction in risk of heart attack or death.”

As such, Dr Mustaffa stressed, there is a need for people to go for annual blood sugar tests even though they do not have symptoms.

Sweet blood

“We encourage people to go for this test – a simple finger prick – every year to know their blood sugar level, and not the urine test because most people with diabetes do not have sugar in their urine.

“There is a lot of misconceptions that it’s just ‘kencing manis’ but the fact is diabetics have high sugar level in their blood. It is their blood that is sweet and not the urine.”

He said the blood sugar test involved is a very simple and fast process, taking less than a minute to check whether the sugar level is high.

For those with no family history of diabetes, he advised the test could be done once every two to four years.

“But if there’s a risk such as family history of diabetes, overweight or diabetes during pregnancy, then the individual might need to test more frequently – at least once a year,” he said, adding that most of the time, the test is free or at a very minimal cost of RM1 or RM2.

With Malaysia ranked globally as one of the top countries in terms of diabetes, Dr Mustaffa suggested there should be coordination among key players to ensure the number of diabetics in the country would not continue to increase each year.

A consultant speaks to a patient on a proper diet to control diabetes.

Need for coordination

“Since 2011, Malaysia has been among the highest ranking countries for diabetes not only in Asia but around the world. Many people in government and non-governmental organisations (NGOs) are doing a lot of things for diabetes but there’s no coordination.

“We need coordination. The responsibility of controlling diabetes is not ours alone. It should also involve ministries, NGOs as well as consumers.”

To get the ball rolling, he urged government ministries to do their bit in reducing the number of diabetes cases.

“For example, the Ministry of Agriculture and Agro-based Industry can get involved by encouraging the planting of more fruits and vegetables and making them easily available.

“Even the Housing and Local Government Ministry can do their part by ensuring jogging tracks or common halls for exercise are available at housing estates as part of compulsory planning.”

He also suggested the government looks into enacting policies for reducing sugar and carbohydrates in food and beverages – similar to countries like the United Kingdom.

The UK has introduced a tax on high-sugar drinks to prevent obesity, which predisposes one to diabetes.

“Perhaps our government can look into this or even restrict excessive food availability and high-calorie food,” he suggested, pointing out that the Ministry of Education also plays an important role in guiding children on healthy eating and lifestyle – the earlier the better.

Dr Mustaffa (right) looks at some data on diabetes in Malaysia with Dr Voon.

Dr Mustaffa hopes the government will let Nadi take charge of coordinating all diabetes programmes in the country.

“Since we are stakeholders in diabetes care, we should take responsibility, on behalf of the government, to coordinate and monitor the implementation of diabetes convention and treatment programmes.

“We can work with other stakeholders so that at least we know everything is coordinated,” he added.

He said Nadi set up a Diabetes Resource Centre (D’Centers) in Klang, Selangor, four years ago to care for diabetics at either complimentary or reduced rates.

“People can go to the centre for blood tests and for those who are unemployed, senior citizens or have never been tested before, we will provide the tests for free.

“We also provide health screenings to check the kidneys, cholesterol level, blood pressure and weight.”

Currently, D’Centers is the only place in Malaysia providing services for diabetes, including free use of blood glucose monitoring system machine, test strips (for diabetic children), and counselling by diabetes facilitators and dieticians.

“If they want, they can also come for counselling or see a diabetes specialist at the centre. I will be personally be there every two weeks to see patients,” said Dr Mustaffa, a consultant diabetologist and endocrinologist at D’Centers.

D’Centers is a one-stop diabetes resource centre in Klang, Selangor, providing free or subsidised care for diabetics.

He said, for now, D’Centers serves as a test site to see whether the concept of a one-stop diabetes resource centre is useful.

“If this concept works, we are looking to expand to other parts of the country, including Sarawak. We are now discussing with the Malaysian Diabetes Association, Sarawak branch chairman Dr William Voon on starting a T1 (Type 1) Club to provide care to diabetic children, especially by giving them free monitoring machines and test strips.”

According to Dr Mustaffa, children with Type 1 diabetes have to test their blood between five and six times a day to control their sugar level and this is very expensive as the test strips cost around RM1 each and the machine about RM100.

“It’s very costly if you’re looking at RM6 a day for the test.”

He stressed the aim is to give the children proper treatment because without it, they would die young.

“If they have diabetes when they are about 10, they will develop complications and might die when they are around 20.

“But if diabetic children are well taken care of, they can live normally even up to 60 or 80. It’s not a problem.”

Dr Mustaffa pointed out that at D’Centers, the services are given free to children for a year and maybe longer if the centre had the funds.

“We have been doing this for the past two years and we want to extend it to Sarawak and also Penang,” he added.