Ministry of Health and Local Experts Rally to Call Malaysians to “Check, Confirm, Consult and Change”

WORDS LIM TECK CHOON

On 24 April 2024, YB Dato’ Lukanisman Awang Sauni, the Deputy Minister of Health Malaysia, launched the public health promotion campaign, Stand Against Prediabetes; Don’t Sugarcoat It’ (SAPd), in Putrajaya.

WHAT IS PREDIABETES?

Prediabetes is a condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes.

Nonetheless, this higher-than-normal blood sugar levels will put one at an increased risk of developing type 2 diabetes, heart disease, and stroke in the future, if preventive measures are not taken to control their blood sugar levels.

YOU MAY HAVE PREDIABETES IF YOU HAVE:
  • HbA1c 5.7%-6.2% (39 to 44 mmol/mol).
  • Fasting plasma glucose of 6.1 to 6.9 mmol/L.
  • Oral glucose tolerance test shows that your blood glucose levels are 7.8 to 11.0 mmol/L.
WHY IS THERE A NEED FOR A PREDIABETES CAMPAIGN?
  1. An estimated 3.5 million Malaysians may have prediabetes.
  2. Because prediabetes has no symptoms, many may not be aware that they have it unless they go for a medical check-up.
  3. 1 in 10 people with prediabetes are likely to develop full-blown diabetes within a year, while up to 7 out of these 10 people may face the same outcome in 10 years.
  4. These individuals are already at risk of developing cardiovascular disease, vision loss, nerve damage, and chronic kidney disease even before diabetes sets in!
MORE ABOUT SAPd
FEATURED EXPERT
DR NURAIN MOHD NOOR
President of the Malaysian Endocrine and Metabolic Society (MEMS)

Dr Nurain Mohd Noor said during the launch: “MEMS initiated SAPd and invited the collaboration of seven other medical and allied health societies, as well as the involvement of Ministry of Health Malaysia.”

These societies include Malaysian Diabetes Educators Society (MDES), Malaysian Dietitians’ Association (MDA), Malaysian Family Medicine Specialists’ Association (FMSA), Malaysian Medical Association (MMA), Malaysian Pharmacists Society (MPS), National Heart Association Malaysia (NHAM), and The Chapter of Chemical Pathology & Metabolic Medicine, College of Pathologists, Academy of Medicine Malaysia (CPath AMM).

The SAPd programme is supported by Merck Malaysia.

Dr Nurain further remarked that SAPd managed to attain several important achievements over the last 2 years:

  • Successfully promoted the adoption of standardized prediabetes blood glucose test values in over 200 private chain, independent and hospital laboratories, as well as over 2,000 government clinics and 100 government hospitals.
  • Trained more than 2,000 healthcare professionals including doctors, nurses, pharmacists, and dietitians to enhance their effectiveness in the management of prediabetes.
  • Published a clinical guide for the reference of healthcare professionals, as well an educational website, booklet, and pamphlet for the public.
THE 4Cs OF SAPd

CHECK Your Prediabetes Risk

  1. Take the online risk checker at the SAPd website (link opens in a new tab).
  2. If the results show that you are at risk, ask for a simple finger prick blood glucose test at your community pharmacy, private GP clinic, or government health clinic.

SAPd aids to enlist 700 community pharmacies nationwide to provide complimentary finger prick blood glucose tests by mid-May of this year.

CONFIRM the Presence of Prediabetes

If your finger prick blood glucose test results show a higher-than-normal blood glucose level, you will need to get a proper blood test from a laboratory, clinic or hospital.

CONSULT Your Healthcare Professional

The guidance and support of a healthcare professional is important to determine the best approach for you to manage prediabetes with lifestyle intervention and medication, if required.

By attending follow-up visits, your healthcare professional will be able to monitor your progress and keep motivating you to achieve the results you desire.

CHANGE to Reclaim Your Health

The five pillars of prediabetes management are:

  1. Lose excess body weight and maintain healthy weight.
  2. Increase physical activity and exercise.
  3. Adopt healthy lifestyle habits (getting enough good quality sleep, managing stress, and quitting smoking, vaping, alcohol and other substance abuse).
  4. Take your medications as prescribed.
  5. Team up with healthcare professionals.
Visit the SAPd website for more information and free educational downloads (link opens in a new tab). The website is available in English and Bahasa Melayu.

Medical Professionals Galvanize to Tackle Obesity Pandemic in Malaysia with Release of Revised Clinical Practice Guidelines

WORDS LIM TECK CHOON

We’ve all read about it and probably memorized the statistics by now: Malaysia is among the heaviest countries in Asia, if not the world. Perhaps unsurprisingly, there is also a high prevalence of chronic diseases such as type 2 diabetes, high blood pressure, and others that are linked to obesity.

AN URGENT IMPETUS TO CURB THE OBESITY PANDEMIC IN MALAYSIA

Obesity is classified as a chronic or long-term disease. As such, Malaysian healthcare professionals have banded together in their commitment to provide Malaysians with the best treatment options and accessibility to these treatments.

A milestone in this commitment took place on 9 June 2023, with the release of the 2nd edition of the Clinical Practice Guidelines for the Management of Obesity.

The clinical practice guidelines are jointly published by the Ministry of Health Malaysia, the Malaysian Endocrine & Metabolic Society (MEMS), the Malaysian Society for the Study of Obesity (MASO), the Malaysian Dietitians’ Association (MDA), and Family Medicine Specialists Association of Malaysia (FMSA)—a multidisciplinary collaboration comprising endocrinologists, dietitians, and more.

The launch of the clinical practice guidelines was officiated by Dr Mohd Ridzwan Shahari, the Deputy Director of Medical Development Branch of the Medical Development Division, representing Dato’ Dr Asmayani Khalib, Deputy Director-General of Health (Medical) of the Ministry of Health Malaysia.

AN UPDATED BLUEPRINT OF NEW & ROBUST STRATEGIES TO PREVENT & MANAGE OBESITY

The initial edition of the clinical practice guidelines was released in 2004. With almost 20 years since then, much had changed when it comes to prevalence of, attitude towards, and management approaches for obesity.

As Dr Nurain Mohd Noor the President of MEMS, puts it: “Overweight and obesity in Malaysia is growing with every passing year. Based on the National Health and Morbidity Survey, in 2011, the prevalence was already at 44.5%, and in 2019, it has risen to a staggering 50.1%, whereby half of the population is now classified as overweight or obese.”

As such, the revision of the existing clinical practice guidelines is most timely and necessary. Professor Dr Norlaila Mustafa, Chairperson of the CPG Development Committee, reveals that the committee attracted experts from diverse field—endocrinology, psychology, dietetics, sports medicine, family medicine, paediatric endocrinology—to revise the existing guidelines to incorporate breakthroughs and advances that offer promising solutions in the last 20 years.

Some of the revisions and expansions include:

  • Expanding the range of recommended medications and medical procedures to treat obesity.
  • Updates on medical nutrition therapy to introduce successful and effective changes to a patient’s diet.
  • Emphasis on psychological interventions, such as cognitive behavioural therapy, to motivate patients into adopting and maintaining lifestyle changes to maintain a healthy weight.

With regards to the third point, Prof Dr Norlaila brings up tools include the Binge Eating Scale, which helps to identify individuals with binge eating disorder, ‘SMART’ strategy that aids in a patient’s goal setting, and problem-solving techniques such as ‘IDEAL’ to support patients when faced with setbacks in their weight management journey.

A NEW BASIS FOR BODY MASS INDEX

A key issue raised during the launch was the need for a lower cut-off point for diagnosis of overweight and obesity among Asians.

This is because the current body mass index or BMI system was initially based on the physiology and fat composition of Caucasians.

Asians, on the other hand, typically have shorter height and higher body fat percentages. Research has shown that the risk of type 2 diabetes, high blood pressure, and other weight-associated chronic diseases tend to rise for Asians at a lower BMI point.

Hence, based on evidence gathered from research on Asians, the following BMI categories are recommended for use in Malaysia:

BMI CATEGORY
23 to 27.4 kg/m2 Overweight
27.5 kg/m2 and above Obese
A FOUNDATION FOR A ROLLOUT OF IMPROVED PREVENTION & MANAGEMENT OF OBESITY PROGRAMME IN MALAYSIA

Prof Dr Norlaila shares her hopes that the release of the revised Clinical Practice Guidelines for the Management of Obesity will become a primary cornerstone for treatment and prevention, as well as health awareness programmes in Malaysia.

She reveals that future plans include making weight management and obesity treatment services available in more primary healthcare points such as general practitioners, educational talks and programmes in schools, and more.

Interested healthcare professionals can download a digital copy of the Clinical Practice Guidelines for the Management of Obesity (2nd Edition) at the Academy of Medicine of Malaysia here (link opens in a new tab).