Introduction

1.1 Diabetes and Obesity Worldwide

 

 

IDF Diabetes Atlas 5th Edition, 2013; World Health Organization, March& October 2013

 

 

1.2 Diabetes in the Western Pacific Region

 

Figure 1.1    
Comparison of prevalence and estimated diabetes (adjusted to world population) among adults 20-79 years for the years 2011 and 2030

In 2012, International Diabetes Foundation reported that Malaysia had

2,082,480 diabetes cases*3

25,859 diabetes related deaths*3

The average diabetes-related expenditure is $513.01 (USD) per person*3

 

 

1.3 Current Diabetes in Malaysia

 

”Malaysia is the number one country in South East Asia for having the highest number of diabetics”*15

 

 

 

 

Figure 1.2 
Comparison of prevalence for diabetes above 18 and 30 year old in Malaysia across the years from the National Health and Morbidity Survey (NHMS IV)

• 2006 1.5 million people suffering from diabetes (NHMS III)*1
• 2011 2X increase from 1.5million to 2.6 million of diabetics. All in the span of 5 years from 2006 (NHMS IV).*1,5,12
• 
  About 2 million people in Malaysia with high blood sugar are still undiagnosed with diabetes.*1,12
• Worldwide, World Health Organization (WHO) estimates that 3.4 million4   people died from consequences of high fasting blood sugar.*20
• Many are unaware that they have diabetes until 7 or 10 years later, as there are no symptoms until complications develop.*1,13

 

 

 

1.3.1 Complications of Diabetes

 

[Adapted from International Diabetes Federation. 2013]4

Blindness

• 1 in 4 severe diabetic-related retina damage end up blind.*11
• Out of 13, 973 patients with diabetic retinopathy, 3, 311 suffered retinal damage and out of this, 774 with irreversible blindness.*11

Heart Attack

• Diabetics are 2 to 4X more likely to have heart disease & 5X more likely to suffer a stroke*8

Kidney Failure

• Out of the 5, 800 new kidney patients, 58% who require dialysis or kidney transplants have diabetes.*10

Amputation

Diabetics are 25% more likely to lose a leg.*2

More than one million people with diabetes lose a leg every year.*2

Every 30 seconds, a lower limb or a part of a lower limb is lost somewhere in the world as a consequence of diabetes.*2

Out of 34, 539 diabetics in Malaysia, 4 – 7% had undergone toe or leg amputations.*5

 

1.4 Current Obesity in Malaysia

 “Malaysia is the fattest country in South East Asia”*14

Figure 1.3 
Comparison of prevalence for obesity; overweight and obese individuals above 18 years old in Malaysia across the years from the National Health and Morbidity Survey (NHMS)

• 8.5 million Malaysians are suffering from the overweight problem while approximately 50% (4.4 million) of them are obese*9
• Obesity is an important underlying factor for Type 2 Diabetes Mellitus (T2DM).*16
• Obese subjects have a 2 to 3X increased risk of diabetes and impaired glucose tolerance.*18
• Diet and physical activity is the first line of prevention in the management of lifestyle diseases such as diabetes (T2DM) and obesity.*7

 

Lifestyle modification vs. Drug intervention

Diet and physical activity	Metformin (drug)
risk of diabetes by 58%*6,17	risk of diabetes by 31%*6