Patients with type 2 diabetes mellitus urged to get a better understanding of the disease as well as proper medical consultation.
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| Dr Zanariah Hussein... Knowing that early detection of symptoms can significantly reduce the risk of developing complications from diabetes, it is important to provide diabetes prevention education initiatives. |
With this in mind, MSD, a pharmaceutical company, organised a media workshop with the aim of educating the community, especially type 2 diabetes mellitus (T2DM) patients, on the highs and lows of blood sugar levels and weight gain.
The workshop, led by Dr Chan Siew Pheng and Dr Zanariah Hussein, both senior consultant endocrinologists, stressed that many individuals with diabetes remain unidentified and untreated, and therefore are at risk for complications.
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| Dr Chan Siew Pheng... Antidiabetic treatments that reduce the risk of hypoglycemia, and hence the fear of hypoglycemia, may aid adherence and help patients achieve long-term beneficial targets. |
According to the National Health and Morbidity Survey 2011 (NHMS 2011), the prevalence of diabetes in those aged 30 years and above has increased 40% in the past five years, from 14.9% in 2006 to 20.8% in 2011, with the increase mostly contributed by the increased proportion of “undiagnosed diabetes” at 8%.
The DiabCare 2008 shows deteriorating glycaemic control, with only 11.4% of patients achieving their targets.
In Malaysia, the survey also indicated that the prevalence of diagnosed diabetes is slightly higher in rural areas at 15.5%, compared to urban areas at 15.1%.
“Many people are unaware that they have diabetes until complications develop. Diabetes complications are numerous, varied, sometimes extremely frightening, but more importantly, can be life-threatening. Knowing that early detection of symptoms can significantly reduce the risk of developing complications from diabetes, it is important to provide diabetes prevention education initiatives,” said Dr Zanariah.
For individuals with type 2 diabetes, hypoglycaemia is a common adverse effect of some oral antihyperglycemic agents, principally the insulin secretagogues, sulfonylureas and insulin treatment.
Hypoglycaemia occurs when the level of glucose in the blood drops too low for the body’s needs.
While some hypoglycaemic episodes are mild, others can be severe, and costly.
The RECAP-DM (Real-Life Effectiveness and Care Patterns of Diabetes Management) Asia-Pacific study showed that more than one-third of type 2 diabetes patients reported hypoglycaemia of varying degrees of severity during the six-month period prior to enrolment.
“Symptoms of hypoglycaemia can range from mild to severe and may include faintness, headache, confusion, anxiety, sweating, tremor, palpitations, nausea, and pallor. If left untreated, hypoglycaemia can lead to serious medical problems, including loss of consciousness, convulsions or seizures, which require emergency treatment. Education and awareness on how to manage hypoglycaemia as well as knowing the treatment options are the best preventive steps,” explained Dr Chan.
According to the World Health Organization (WHO), weight gain may result in insulin resistance, in which the body is unable to use the insulin it produces effectively. Thus, progressive weight gain in diabetes may contribute to eventual deterioration of glycaemia control over time as many diabetics are already overweight (if not obese) and are prone to obesity-related cardiovascular risks.
“Antidiabetic treatments that reduce the risk of hypoglycemia, and hence the fear of hypoglycemia, may aid adherence and help patients achieve the long-term beneficial targets associated with well-controlled blood glucose levels.
“The adherence to treatment questionnaire in the DiabCare 2008 indicated that about one-third of patients were partially or not adherent to therapy-related advice. Furthermore, patients’ concerns about weight gain and its potential health consequences posed a major obstacle to initiation or intensification of prescribed treatment,” continued Dr Chan.
In addition to disease management considerations, the economic burden of hypoglycemia may be high.
Approximately 4% to 14% of patients in Asia-Pacific countries experience hypoglycaemia severe enough to require medical care.
Hypoglycaemia may thus exert a substantial economic impact in the Asia-Pacific region.
Therapies that minimise the frequency and severity of hypoglycaemia would likely reduce costs due to emergency room visits and hospitalisations.
“With two-thirds of the patients not adhering to advice on diet and exercise, and the majority of patients with formal education of less than 10 years, more awareness initiatives and efforts are needed on glucose profiling and lifestyle modification for effective management of diabetes.
“People can actually prevent or reduce the risk of developing type 2 diabetes by making healthy lifestyle choices, which include a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use,” added Dr Zanariah.
References:
1. Ministry of Health, Malaysia. (2011) Prevalence of Diabetes Mellitus in Malaysia 2011 – Results of the National Health and Morbidity Survey 2011 (NHMS 2011). Retrieve from NHMS 2011 Conference.
2. Mafauzy M, Hussein Z, Chan SP. (2011) The status of diabetes control in Malaysia: results of DiabCare 2008. Med J Malaysia 66(3):175-81
3. Chan SP, Ji LN, Nitiyanant W, Baik SH, Sheu WH. (2010) Hypoglycemic symptoms in patients with type 2 diabetes in Asia-Pacific-Real-life effectiveness and care patterns of diabetes management: the RECAP-DM study. Diab Res Clin Pract (2010). Doi:10.1016/j.diabres.2010.05.008
4. Aravind SR, Al Tayeb K, Ismail SB, Shehadeh N, Kaddaha G, Liu R, Balshaw R, Lesnikova N, Heisel O, Girman CJ, Musser BJ, Davies MJ, Katzeff HL, Engel SS, Radican L; 2009 Ramadan Study Group. (2011) Hypoglycaemia in sulphonylurea-treated subjects with type 2 diabetes undergoing Ramadan fasting: a five-country observational study. 27(6):1237-42
5. World Health Organisation. Diabetes- Who is at risk? Retrieved 18 June 2010 from www.who.int/diabetes/BOOKLET_HTML/en/index6.html
6. Sheu WH, Ji LN, Nitiyanant W, Baik SH, Yin D, Mavros P, Chan SP. (2012) Hypoglycemia is associated with increased worry and lower quality of life in patients treated with oral antihyperglycemic agents. Diabetics Research and Clinical Practice 96 (2012) 141-148
http://thestar.com.my/health/story.asp?file=/2013/5/19/health/13115198&sec=health
