KUALA LUMPUR, Nov 15 – 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.

In conjunction with World Diabetes Day, which falls on November 14, Alpro Pharmacy brought together a panel of health care 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

According to Basmawati Baharom, council member of the Malaysian Dietitians’ Association, who currently serves as the head of Dietetics (HOD) at Hospital Kuala Lumpur (HKL), age is a common factor for risk of diabetes. 

Older individuals have higher risks for prediabetes and type 2 diabetes, as type 2 diabetes generally occurs in middle-aged adults, most frequently after age 45.

However, the National Health and Morbidity Survey 2023 has also reported young adults in Malaysia becoming increasingly affected. 

“Health care professionals are diagnosing more and more children and adolescents with type 2 diabetes, and yet, a majority of them do not know they have diabetes,” said Basmawati.

“Some only came to the realisation by chance, for example, when their wounds did not heal and got infected.” 

While age is a risk factor for prediabetes and T2DM (Type 2 Diabetes Mellitus), there are increasing diagnoses among adolescents and young adults, with many only discovering they have diabetes when symptoms are severe, Basmawati said. 

“High-sugar beverages contribute significantly to this trend, especially in younger demographics,” she said, 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.

RM4.4 Billion Annually In Direct Health Care Costs

Dr Aizuniza Abdullah, senior assistant director of the Disease Control Division at the Ministry of Health, emphasised the economic implications of diabetes in Malaysia. 

“Diabetes incurs around RM4.4 billion annually in direct health care costs — exceeding expenses for conditions like cancer and cardiovascular disease,” she said. “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 health care access.

Testing Methodologies For Diabetes Patients Or At-Risk Individuals

HbA1c and blood glucose tests are important measurements for people with diabetes, said Dr Chooi Kheng Chiew, consultant endocrinologist, diabetologist, and physician.

“A test for HbA1c, also known as glycosylated haemoglobin, is a blood test that measures the average blood glucose levels over the past two to three months. It’s a useful tool for monitoring blood sugar control and diagnosing diabetes,” he explained.

“Reducing HbA1c levels has shown substantial benefits for reducing diabetes-related kidney complications. Every 1 per cent reduction in HbA1c correlates with a 37 per cent 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.” 

A blood glucose test, on the other hand, measures the current level of glucose in the blood, said Dr Chooi.  “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 health care providers manage diabetes effectively. They complement each other in providing a more comprehensive view of a patient’s glucose control.”

Dr Chooi advised 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: A More Innovative Approach To Diabetes Management

A quasi-experimental study conducted by Alpro Pharmacy and Universiti Kebangsaan Malaysia (UKM) on Self-monitoring of Blood Glucose (SMBG) found that the study’s participants under the SMBG intervention showed a significant 5.2 per cent reduction in HbA1c levels. Meanwhile, the control group in the study saw similar increases. 

The six-month study conducted by dietitian Chua Kai Jia, who is also Alpro Pharmacy’s Professional Care and Development manager, dietician Sa’ida from Alpro Pharmacy and researchers Dr Nurul Huda and Prof Suzana from Universiti Kebangsaan Malaysia, involved 111 patients with type 2 diabetes, men and women, around 57 years old.

“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,” said Chua.

“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.” 

In addition to improvements in blood glucose control, the SMBG group also reported enhanced mental wellbeing. 

The findings underscore a 10.4 per cent 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.

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.

The findings validate that a subscription-based SMBG model is not only feasible but has substantial potential to enhance diabetes care, said Chua. 

As T2DM is among the most prevalent chronic conditions globally, data from SMBG can allow health care 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 preventing hypoglycaemia,” said Dr Aizuniza. “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).”

To encourage early detection through screening, Alpro Pharmacy is offering RM1 Blood Glucose Check this November.