Displaying publications 81 - 100 of 145 in total

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  1. Mitochondrial disorder, diabetes mellitus, and findings in three muscles, including the heart
    Bhattacharjee M, Venugopal B, Wong KT, Goto YI, Bhattacharjee MB
    Ultrastruct Pathol, 2006 Nov-Dec;30(6):481-7.
    PMID: 17183762
    The authors describe the case of a 50-year-old man with chronic progressive external ophthalmoplegia (CPEO), diabetes mellitus (DM), and coronary artery disease. The patient had no cardiac conduction abnormalities. During coronary artery bypass surgery, his heart and two skeletal muscles were biopsied. All three muscles showed ragged red fibers. The heart muscle showed significant glycogen accumulation. Analysis of mitochondrial DNA (mtDNA) showed a 5019-base-pair deletion, with no duplications. There were morphologically abnormal mitochondria in all 3 muscles, with clinically apparent difference in preservation of function. The combination of diabetes mellitus and mtDNA deletion is fortuitous, as they can be causally linked. The cardiac pathology allows speculation about the possible adaptive processes that may occur in the heart in DM. There are few reported cases with CPEO and excess glycogen in the heart. Most show deposition of fat and poorer clinical outcomes as compared to those with glycogen deposition. This observation may lend support to the hypothesis that in the myocardium, adaptive responses are mediated via changes in glucose handling, whereas alterations in fat metabolism likely represent maladaptation.
    Matched MeSH terms: Diabetes Complications/pathology
  2. Fulltext Tuberculosis in diabetic patients: a clinical perspective
    Nissapatorn V, Kuppusamy I, Jamaiah I, Fong MY, Rohela M, Anuar AK
    Southeast Asian J. Trop. Med. Public Health, 2005;36 Suppl 4:213-20.
    PMID: 16438212
    This retrospective and descriptive study was a report on the clinical situation of tuberculosis in diabetic patients, with 1,651 patients recruited. The mean age of TBDM patients was significantly higher than that of non-diabetic patients (p<0.05). Moreover, TBDM patients had a higher ratio of male to female than the other group. The significant proportion of TB appeared to increase steadily with age in diabetic patients compared to non-diabetic ones (p<0.05). However, they showed similarities in terms of sex, race, marital status, present address, and occupation. A higher percentage of pulmonary tuberculosis (91.4%) was shown in the TBDM group. We found that both groups had no differences in the radiological findings, with opacity or cavity of the upper lobe involvement being 89% and 91% in TBDM and non-diabetic groups, respectively. TBDM patients were shown to have more treatment success (33.3%), particularly the pulmonary type of tuberculosis in the longer duration ( 9 months). Further findings demonstrated that a lower proportion of the TBDM group defaulted in their treatment (19.8%) and experienced resistance to anti-tubercular therapy (1.4%) compared to non-diabetics.
    Matched MeSH terms: Diabetes Complications/physiopathology*
  3. Type 2 diabetes in youth from the Western Pacific region: glycaemic control, diabetes care and complications
    Eppens MC, Craig ME, Jones TW, Silink M, Ong S, Ping YJ, et al.
    Curr Med Res Opin, 2006 May;22(5):1013-20.
    PMID: 16709323 DOI: 10.1185/030079906X104795
    OBJECTIVE: To describe the glycaemic control, diabetes care and prevalence of complications in youth with type 2 diabetes from the Western Pacific Region.
    RESEARCH DESIGN AND METHODS: Cross-sectional, clinic-based audit of 331 patients aged < 18 years from 56 centres in Australia, China-Beijing, China-Shanghai, China-Hong Kong, Indonesia, Japan, South Korea, Malaysia, Philippines, Singapore, Taiwan and Thailand. Clinical and management data were recorded along with glycated haemoglobin (HbA(1c)), lipids and complication rates.
    MAIN OUTCOME MEASURES: Glycaemic control, complications, diabetes management.
    RESULTS: Median age was 14.9 years (interquartile range 13.2-16.4 years) and median diabetes duration 2.3 years (1.4-3.6 years). Median HbA(1c) was 7% (5.9-9.9%) and HbA(1c) was > 7.5% in 40% of patients. In multiple regression analysis, glycaemic control varied significantly between countries (p = 0.02); higher HbA(1c) was associated with fewer home blood glucose measurements (p = 0.005) and higher insulin dose/kg (p < 0.0001). Blood glucose monitoring was performed by 65% of patients (range 33-96% by country). In 25% of patients, management consisted of diet alone or no treatment (range 0-53% by country); oral anti-diabetic drugs alone were used in 49%, insulin alone in 11% and both in 15%. Microalbuminuria was found in 8% and hypertension in 24%. The risk of hypertension increased with higher BMI (OR 1.16, 95% CI 1.09-1.24, p < 0.0001); antihypertensive agents were used in 4% of patients.
    CONCLUSIONS: The management of type 2 diabetes in youth from the Western Pacific Region varies widely. Hypertension and microalbuminuria were frequent, but not commonly treated. Further investigation into the natural history and risk factors for complications in youth with type 2 diabetes is required to assist in developing evidence based management guidelines.
    Matched MeSH terms: Diabetes Complications*
  4. Fulltext The statin studies: from targeting hypercholesterolaemia to targeting the high-risk patient
    Ong HT
    QJM, 2005 Aug;98(8):599-614.
    PMID: 16006501
    The landmark HMG-CoA reductase inhibitor (statin) studies have practical lessons for clinicans. The 4S trial established the importance of treating the hypercholesterolaemic patient with cardiovascular heart disease. Next, WOSCOPS showed the benefit of treating healthy, high-risk hypercholesterolaemic men. CARE, a secondary prevention trial, showed the benefit of treating patients with cholesterol levels within normal limits. This was confirmed by the LIPID trial, another secondary prevention study, which enrolled patients with cholesterol levels 155-271 mg/dl (4-7 mmol/l). The importance of treating patients with established ischaemic heart disease, and those at high risk of developing heart disease, regardless of cholesterol level, was being realized. In the MIRACL trial, hypocholesterolaemic therapy was useful in the setting of an acute coronary syndrome, while the AVERT study showed that aggressive statin therapy is as good as angioplasty in reducing ischaemic events in patients with stable angina. By showing the value of fluvastatin after percutaneous intervention, LIPS confirmed that benefit is a class action of the statins. The HPS randomized over 20 000 patients, and showed beyond doubt the value of statins in reducing cardiovascular events in the high-risk patient. Although PROSPER showed benefit in treating the elderly patients above 70 years, statin therapy in this trial was associated with an increase in cancer incidence. The comparative statin trials, PROVE-IT, REVERSAL, Phase Z of the A to Z, ALLIANCE and TNT, all showed that high-dose statins will better reduce cardiovascular events in the high-risk patient, although the adverse effects of therapy will also be increased. ALLHAT-LLT, ASCOT-LLA and CARDS showed that for statin therapy to demonstrate a significant benefit, hypertensive or diabetic patients must be at sufficiently high risk of cardiovascular events. The emphasis is now on the risk level for developing cardiovascular events, and treatment should target the high-risk group and not the lipid level of the patient. No therapy is free of adverse effect. Treatment of those most at risk will bring the most benefit; treatment of those not at high risk of cardiovascular disease may expose patients who would not benefit much from therapy to its adverse effects.
    Matched MeSH terms: Diabetes Complications/drug therapy
  5. Fulltext Diabetes Care in Malaysia: Problems, New Models, and Solutions
    Hussein Z, Taher SW, Gilcharan Singh HK, Chee Siew Swee W
    Ann Glob Health, 2016 4 25;81(6):851-62.
    PMID: 27108152 DOI: 10.1016/j.aogh.2015.12.016
    BACKGROUND: Diabetes is a major public health concern in Malaysia, and the prevalence of type 2 diabetes (T2D) has escalated to 20.8% in adults above the age of 30, affecting 2.8 million individuals. The burden of managing diabetes falls on primary and tertiary health care providers operating in various settings.

    OBJECTIVES: This review focuses on the current status of diabetes in Malaysia, including epidemiology, complications, lifestyle, and pharmacologic treatments, as well as the use of technologies in its management and the adoption of the World Health Organization chronic care model in primary care clinics.

    METHODS: A narrative review based on local available health care data, publications, and observations from clinic experience.

    FINDINGS: The prevalence of diabetes varies among the major ethnic groups in Malaysia, with Asian Indians having the highest prevalence of T2D, followed by Malays and Chinese. The increase prevalence of overweight and obesity has accompanied the rise in T2D. Multidisciplinary care is available in tertiary and primary care settings with integration of pharmacotherapy, diet, and lifestyle changes. Poor dietary adherence, high consumption of carbohydrates, and sedentary lifestyle are prevalent in patients with T2D. The latest medication options are available with increasing use of intensive insulin regimens, insulin pumps, and continuous glucose monitoring systems for managing glycemic control. A stepwise approach is proposed to expand the chronic care model into an Innovative Care for Chronic Conditions framework to facilitate implementation and realize better outcomes in primary care settings.

    CONCLUSIONS: A comprehensive strategy and approach has been established by the Malaysian government to improve prevention, treatment, and control of diabetes as an urgent response to this growing chronic disease.

    Matched MeSH terms: Diabetes Complications/epidemiology*
  6. Fulltext Trial of everolimus-eluting stents or bypass surgery for coronary disease
    Park SJ, Ahn JM, Kim YH, Park DW, Yun SC, Lee JY, et al.
    N Engl J Med, 2015 Mar 26;372(13):1204-12.
    PMID: 25774645 DOI: 10.1056/NEJMoa1415447
    BACKGROUND: Most trials comparing percutaneous coronary intervention (PCI) with coronary-artery bypass grafting (CABG) have not made use of second-generation drug-eluting stents.
    METHODS: We conducted a randomized noninferiority trial at 27 centers in East Asia. We planned to randomly assign 1776 patients with multivessel coronary artery disease to PCI with everolimus-eluting stents or to CABG. The primary end point was a composite of death, myocardial infarction, or target-vessel revascularization at 2 years after randomization. Event rates during longer-term follow-up were also compared between groups.
    RESULTS: After the enrollment of 880 patients (438 patients randomly assigned to the PCI group and 442 randomly assigned to the CABG group), the study was terminated early owing to slow enrollment. At 2 years, the primary end point had occurred in 11.0% of the patients in the PCI group and in 7.9% of those in the CABG group (absolute risk difference, 3.1 percentage points; 95% confidence interval [CI], -0.8 to 6.9; P=0.32 for noninferiority). At longer-term follow-up (median, 4.6 years), the primary end point had occurred in 15.3% of the patients in the PCI group and in 10.6% of those in the CABG group (hazard ratio, 1.47; 95% CI, 1.01 to 2.13; P=0.04). No significant differences were seen between the two groups in the occurrence of a composite safety end point of death, myocardial infarction, or stroke. However, the rates of any repeat revascularization and spontaneous myocardial infarction were significantly higher after PCI than after CABG.
    CONCLUSIONS: Among patients with multivessel coronary artery disease, the rate of major adverse cardiovascular events was higher among those who had undergone PCI with the use of everolimus-eluting stents than among those who had undergone CABG. (Funded by CardioVascular Research Foundation and others; BEST ClinicalTrials.gov number, NCT00997828.).
    Matched MeSH terms: Diabetes Complications/therapy
  7. Systolic hypertension and duration of diabetes mellitus are important determinants of retinopathy and microalbuminuria in young diabetics
    Wan Nazaimoon WM, Letchuman R, Noraini N, Ropilah AR, Zainal M, Ismail IS, et al.
    Diabetes Res Clin Pract, 1999 Dec;46(3):213-21.
    PMID: 10624787 DOI: 10.1016/s0168-8227(99)00095-9
    This cross-sectional study looked at the prevalence of microalbuminuria and retinopathy in a cohort of 926 young, Type 1 and Type 2 diabetes mellitus (DM) patients, and determined the factors which were associated with these microvascular complications. The prevalence of microalbuminuria, defined as the albumin:creatinine ratio > or = 2.5 (for males) or > or = 3.5 mg/mmol (for females), was 13.4% in Type 1 DM, 69.5% in insulin-requiring Type 2 DM and 16% in Type 2 DM treated only with oral hypoglycemic agents. Compared to those with normal renal functions, these patients were older (P < or = 0.01), had significantly elevated blood pressures (P < 0.01 or P = 0.0001), and in the case of Type 1 DM, with a higher body mass index (P = 0.0001) and waist-hip ratio (P < 0.01). The prevalence of diabetic retinopathy in Type 1 DM was found to increase with the duration of diabetes, from 1.4% in the newly-onset (< 5 years), to 9.9% in those with 5-10 years disease, to 35% among patients with more than 10 years of diabetes (P < 0.0001). In this study, it was also observed that 10% of the Type 2 DM patients already had retinopathy within 5 years of diagnosis, and the prevalence increased significantly to 42.9% (P < 0.0001) among patients who had been diabetics for more than 10 years. Stepwise multiple regression analysis showed that besides the disease duration, systolic blood pressure was the most common and significant determinant for both microalbuminuria and retinopathy in both types of DM, thus implying that in order to reduce the risk of microvascular complications in diabetes mellitus, systolic and not just the diastolic blood pressure, should be effectively controlled.
    Matched MeSH terms: Diabetes Complications*
  8. Curcumin-laden hyaluronic acid-co-Pullulan-based biomaterials as a potential platform to synergistically enhance the diabetic wound repair
    Shah SA, Sohail M, Minhas MU, Khan S, Hussain Z, Mahmood A, et al.
    Int J Biol Macromol, 2021 Aug 31;185:350-368.
    PMID: 34171251 DOI: 10.1016/j.ijbiomac.2021.06.119
    Injectable hydrogel with multifunctional tunable properties comprising biocompatibility, anti-oxidative, anti-bacterial, and/or anti-infection are highly preferred to efficiently promote diabetic wound repair and its development remains a challenge. In this study, we report hyaluronic acid and Pullulan-based injectable hydrogel loaded with curcumin that could potentiate reepithelization, increase angiogenesis, and collagen deposition at wound microenvironment to endorse healing cascade compared to other treatment groups. The physical interaction and self-assembly of hyaluronic acid-Pullulan-grafted-pluronic F127 injectable hydrogel were confirmed using nuclear magnetic resonance (1H NMR) and Fourier transformed infrared spectroscopy (FT-IR), and cytocompatibility was confirmed by fibroblast viability assay. The CUR-laden hyaluronic acid-Pullulan-g-F127 injectable hydrogel promptly undergoes a sol-gel transition and has proved to potentiate wound healing in a streptozotocin-induced diabetic rat model by promoting 93% of wound closure compared to other groups having 35%, 38%, and 62%. The comparative in vivo study and histological examination was conducted which demonstrated an expeditious recovery rate by significantly reducing the wound healing days i.e. 35 days in a control group, 33 days in the CUR suspension group, 21 days in unloaded injectable, and 13 days was observed in CUR loaded hydrogel group. Furthermore, we suggest that the injectable hydrogel laden with CUR showed a prompt wound healing potential by increasing the cell proliferation and serves as a drug delivery platform for sustained and targeted delivery of hydrophobic moieties.
    Matched MeSH terms: Diabetes Complications/drug therapy*
  9. Comparison of transepidermal water loss and skin hydration in diabetics and nondiabetics
    Lai CCK, Md Nor N, Kamaruddin NA, Jamil A, Safian N
    Clin Exp Dermatol, 2021 Jan;46(1):58-64.
    PMID: 32619023 DOI: 10.1111/ced.14363
    BACKGROUND: Pruritus is common in patients with diabetes mellitus (DM), and may lead to complex dermatological conditions if left untreated. Pruritus can be caused by increased transepidermal water loss (TEWL) and reduced skin hydration.

    AIMS: To compare TEWL and skin hydration in patients with DM and controls, and to investigate associations between TEWL and skin hydration with glycated haemoglobin (HbA1c), fasting blood sugar (FBS), treatment, peripheral neuropathy (PN) and age in patients with diabetes.

    METHODS: This was a prospective, case-control study carried out at a tertiary medical centre in Kuala Lumpur, Malaysia. TEWL and skin hydration measurements were taken at six different body sites in both groups.

    RESULTS: In total, 146 patients (73 cases, 73 controls) were included (24 men and 49 women in each group). No significant difference in TEWL or skin hydration was seen between patients with DM and controls, but there were significant reductions in skin hydration in patients with DM who had FBS > 7 mmol/L (P  6.5% (P  1 U/kg/day (P  45 years old, there was a significant reduction in TEWL (P = 0.04) and hydration (P  8 mmol/L and increased in patients with higher insulin requirement.

    Matched MeSH terms: Diabetes Complications/physiopathology*
  10. Fulltext Multimorbidity in patients with heart failure from 11 Asian regions: A prospective cohort study using the ASIAN-HF registry
    Tromp J, Tay WT, Ouwerkerk W, Teng TK, Yap J, MacDonald MR, et al.
    PLoS Med, 2018 03;15(3):e1002541.
    PMID: 29584721 DOI: 10.1371/journal.pmed.1002541
    BACKGROUND: Comorbidities are common in patients with heart failure (HF) and complicate treatment and outcomes. We identified patterns of multimorbidity in Asian patients with HF and their association with patients' quality of life (QoL) and health outcomes.

    METHODS AND FINDINGS: We used data on 6,480 patients with chronic HF (1,204 with preserved ejection fraction) enrolled between 1 October 2012 and 6 October 2016 in the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry. The ASIAN-HF registry is a prospective cohort study, with patients prospectively enrolled from in- and outpatient clinics from 11 Asian regions (Hong Kong, Taiwan, China, Japan, Korea, India, Malaysia, Thailand, Singapore, Indonesia, and Philippines). Latent class analysis was used to identify patterns of multimorbidity. The primary outcome was defined as a composite of all-cause mortality or HF hospitalization within 1 year. To assess differences in QoL, we used the Kansas City Cardiomyopathy Questionnaire. We identified 5 distinct multimorbidity groups: elderly/atrial fibrillation (AF) (N = 1,048; oldest, more AF), metabolic (N = 1,129; obesity, diabetes, hypertension), young (N = 1,759; youngest, low comorbidity rates, non-ischemic etiology), ischemic (N = 1,261; ischemic etiology), and lean diabetic (N = 1,283; diabetic, hypertensive, low prevalence of obesity, high prevalence of chronic kidney disease). Patients in the lean diabetic group had the worst QoL, more severe signs and symptoms of HF, and the highest rate of the primary combined outcome within 1 year (29% versus 11% in the young group) (p for all <0.001). Adjusting for confounders (demographics, New York Heart Association class, and medication) the lean diabetic (hazard ratio [HR] 1.79, 95% CI 1.46-2.22), elderly/AF (HR 1.57, 95% CI 1.26-1.96), ischemic (HR 1.51, 95% CI 1.22-1.88), and metabolic (HR 1.28, 95% CI 1.02-1.60) groups had higher rates of the primary combined outcome compared to the young group. Potential limitations include site selection and participation bias.

    CONCLUSIONS: Among Asian patients with HF, comorbidities naturally clustered in 5 distinct patterns, each differentially impacting patients' QoL and health outcomes. These data underscore the importance of studying multimorbidity in HF and the need for more comprehensive approaches in phenotyping patients with HF and multimorbidity.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT01633398.
    Matched MeSH terms: Diabetes Complications/epidemiology
  11. Non-alcoholic fatty liver disease in diabetics--prevalence and predictive factors in a multiracial hospital clinic population in Malaysia
    Chan WK, Tan AT, Vethakkan SR, Tah PC, Vijayananthan A, Goh KL
    J Gastroenterol Hepatol, 2013 Aug;28(8):1375-83.
    PMID: 23517307 DOI: 10.1111/jgh.12204
    BACKGROUND AND AIM:
    There is currently no published study comparing prevalence of non-alcoholic fatty liver disease (NAFLD) and associated factors among diabetics of different ethnicity in the Asia-Pacific region.

    METHODS:
    Cross-sectional study of consecutive patients in the Diabetic Clinic in University of Malaya Medical Centre. The Global Physical Activity Questionnaire and a semiquantitative food-frequency questionnaire were used to assess physical activity and dietary intake, respectively. Diagnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake.

    RESULTS:
    Data for 399 patients were analyzed (mean age 62.3 ± 10.5 years, 43.1% men). The racial distribution was Chinese 43.6%, Indian 33.1%, Malay 22.3%, and others 1.0%. The prevalence of NAFLD was 49.6%. On univariate analysis, factors associated with NAFLD were age < 65 years, race, obesity, central obesity, glycated hemoglobin ≥ 7.0%, and elevated serum alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase levels. Patients with low physical activity were more likely to have NAFLD (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.06-2.63, P = 0.020). The prevalence of NAFLD was highest among Malays (60.7%), followed by Indians (51.5%), and lowest among Chinese (42.0%) consistent with higher prevalence of central obesity and higher percentage calorie intake from fat in the former groups of patients. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR = 2.20, 95% CI = 1.29-3.75, P = 0.004) and elevated serum ALT level (OR = 1.98, 95% CI = 1.21-3.25, P = 0.007).

    CONCLUSIONS:
    NAFLD was seen in half of a cohort of diabetic patients and was independently associated with central obesity and elevated serum ALT level. Prevalence of NAFLD was different and paralleled the difference in prevalence of central obesity and in percentage calorie intake from fat among the different ethnic groups.

    © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

    KEYWORDS:
    diabetes mellitus; dietary intake; epidemiology; ethnicity; non-alcoholic fatty liver disease; physical activity
    Study site: Diabetic clinic, University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Diabetes Complications*
  12. Fulltext Prevalence and factors associated with prediabetes and diabetes in fishing communities in Penang, Malaysia: A cross-sectional study
    Rahim FF, Abdulrahman SA, Kader Maideen SF, Rashid A
    PLoS One, 2020;15(2):e0228570.
    PMID: 32040497 DOI: 10.1371/journal.pone.0228570
    BACKGROUND: Diabetes is a metabolic disorder, characterized by hyperglycemic state of the body. A silent killer, which can take the lives of victims if undiagnosed at the earliest stage. Prediabetes has become an important health concern across countries due to its huge potential for the development of diabetes and other complications. The objectives of this study were to determine the prevalence of prediabetes and diabetes and its associated factors among rural fishing communities in Penang, Malaysia.

    METHODS: A cross-sectional study was conducted among fishing communities in Southwest District of Penang, Malaysia from August to November 2017. Blood sample (finger prick test) and physical examination were performed on sample of 168 participants consented in this study. Pre-validated Malay versions of International Physical Activity 7 (IPAQ-7) and Perceived Stress Scale (PSS) questionnaires were used to assess the level of physical activity and stress levels of the participants. Multinomial logistic regression models were fitted to identify factors associated with prediabetes and diabetes.

    RESULTS: The prevalence of diabetes and prediabetes were 19.6% (95% CI: 14.3, 26.4) and 10.12% (95% CI: 6.4, 15.7) respectively. The median physical activity (interquartile range) in MET-minutes per week for those with diabetes (1071.0 (2120.0)) and prediabetes (1314.0 (1710.0)) was generally lower as compared to non-diabetes. Majority reported moderate stress (57.3%) from PSS system. Abdominal obesity, family history of diabetes and being hypertensive were significant factors associated with diabetes; while older age, bigger waist circumference and self-perceived poor routine diet were factors associated with prediabetes.

    CONCLUSIONS: The screening for prediabetes in this population gives the opportunity to implement lifestyle interventions at the earliest possible, which could prevent the development of diabetes. The identification of diabetic individuals provides an opportunity to conduct health promotion and education to ensure good metabolic control and hence reduce the risks of complications.
    Matched MeSH terms: Diabetes Complications/epidemiology
  13. Predictive factors of follow-up non-attendance and mortality among adults with type 2 diabetes mellitus- an analysis of the Malaysian diabetes registry 2009
    Chew BH, Lee PY, Shariff-Ghazali S, Cheong AT, Ismail M, Taher SW
    Curr Diabetes Rev, 2015;11(2):122-31.
    PMID: 25619541 DOI: 10.2174/1573399811666150115105206
    This study examined the factors associated with follow-up non-attendance (FUNA) and mortality among the adult patients with type 2 diabetes mellitus (T2DM). Data on 57780 T2DM patients from the 2009 diabetes registry were analyzed using multinomial logistic mixed model. Out of 57780 patients, 3140 (5.4%) were lost to follow-up and 203 (0.4%) patients had died. Compared with patients who were under active follow-up, men (OR 1.37), neither on insulin (OR 1.72), nor on antiplatelet agents (OR 1.47), having higher HbA1c (OR 1.15), higher LDL-C (OR 1.18) and complications (OR 1.33) were associated with FUNA. Older age (OR 1.09) and higher LDL-C (OR 2.27) have higher mortality. Across the four different health facilities, medication use (insulin and anti-platelet agents) to achieve better disease control in the younger age when diabetes complication is absent would not cause FUNA and might reduce mortality.
    Matched MeSH terms: Diabetes Complications/drug therapy*
  14. Fulltext Microbiology of diabetic foot infections in a teaching hospital in Malaysia: a retrospective study of 194 cases
    Raja NS
    J Microbiol Immunol Infect, 2007 Feb;40(1):39-44.
    PMID: 17332905
    Diabetes mellitus is a progressive disease with chronic complications. Foot infections are a major complication of diabetes and eventually lead to development of gangrene and lower extremity amputation. The microbiological characteristics of diabetic foot infections have not been extensively studied in Malaysia. This study investigated the microbiology of diabetic foot infections and their resistance to antibiotics in patients with diabetic foot infections treated at University of Malaya Medical Centre in Kuala Lumpur, Malaysia.
    Matched MeSH terms: Diabetes Complications*
  15. Randomized Controlled Trial of Topical Insulin for Healing Corneal Epithelial Defects Induced During Vitreoretinal Surgery in Diabetics
    Fai S, Ahem A, Mustapha M, Mohd Noh UK, Bastion MC
    Asia Pac J Ophthalmol (Phila), 2017;6(5):418-424.
    PMID: 28828764 DOI: 10.22608/APO.201780
    PURPOSE: To determine the effect of topical insulin of 3 concentrations [0.5, 1, and 2 units per drop 4 times per day (QID)] on postoperative corneal epithelial wound healing in diabetic patients.

    DESIGN: A double blind randomized controlled hospital-based study involving diabetic patients with postoperative corneal epithelial defect after vitreoretinal surgery.

    METHODS: Diabetic patients were randomized to 3 different concentrations of topical insulin (DTI 0.5, DTI 1, and DTI 2) or placebo in the control group (DNS). Primary outcome measure was the rate of corneal epithelial wound healing (mm² per hour) over pre-set interval and time from baseline to minimum size of epithelial defect on fluorescein stained anterior segment digital camera photography. Secondary outcome measure was any adverse effect of topical insulin. Follow-up was 1 month.

    RESULTS: Thirty-two eyes of 32 patients undergoing intraoperative corneal debridement with resultant epithelial defect (8 eyes per group) were analyzed. DTI 0.5 was superior to other concentrations achieving 100% healing rate within 72 hours of treatment compared with 62.5% in DNS, 75% in DTI 1, and 62.5% in DTI 2. Statistically, DTI 0.5 achieved significant results (P = 0.036) compared with the diabetic control group (DNS) in terms of mean rate of corneal epithelial wound healing from maximum to minimum defect size. No adverse effect of topical insulin was reported.

    CONCLUSIONS: Topical insulin 0.5 units QID is most effective for healing corneal epithelial defect in diabetic patients after vitrectomy surgery compared with placebo and higher concentrations. Topical insulin is safe for human ocular usage.

    Matched MeSH terms: Diabetes Complications/drug therapy*
  16. Control of glycemia and other cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: data from the Adult Diabetes Control and Management
    Sazlina SG, Mastura I, Ahmad Z, Cheong AT, Adam BM, Jamaiyah H, et al.
    Geriatr Gerontol Int, 2014 Jan;14(1):130-7.
    PMID: 23581598 DOI: 10.1111/ggi.12070
    The aims of the present study were to assess the control of glycemia and other cardiovascular disease risk factors, and the association between age and these controls among older adults with type 2 diabetes in Malaysia.
    Matched MeSH terms: Diabetes Complications/etiology; Diabetes Complications/epidemiology; Diabetes Complications/prevention & control
  17. Fulltext Prevalence of diabetes in the Malaysian National Health Morbidity Survey III 2006
    Letchuman GR, Wan Nazaimoon WM, Wan Mohamad WB, Chandran LR, Tee GH, Jamaiyah H, et al.
    Med J Malaysia, 2010 Sep;65(3):180-6.
    PMID: 21939164 MyJurnal
    The Malaysian National Health Morbidity Survey III (NHMS III), conducted in 2006, was a cross-sectional household survey of the prevalence of chronic diseases, involving 34,539 respondents of age > or =18 years old, in all states of Malaysia. Data collection was by face-to-face interview. Those who self-professed not to be diabetics underwent finger-prick glucose test following at least 8 hours of fasting. The overall prevalence of diabetes mellitus (known and newly diagnosed) was 11.6%. The Indians had the highest prevalence of 19.9% followed by Malays 11.9% and Chinese 11.4%. The prevalence of people with known diabetes and newly diagnosed diabetes was 7.0% and 4.5% respectively. Impaired Fasting Glycaemia was found to be 4.2%. Majority (73.5%) of the patients used government healthcare facilities for their diabetic care. Usage of insulin alone or in combination was low at 7.2% of patients. Only 45.05% of known diabetics have ever had their eye examined. Amputees formed 4.3% of the patients with known diabetes while 3.4% had suffered a stroke event and 1.6% was on some form of renal replacement therapy.
    Study name: National Health and Morbidity Survey (NHMS-2006)
    Matched MeSH terms: Diabetes Complications
  18. Fulltext Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study
    Chew BH, Hassan NH, Mohd Sidik S
    Patient Prefer Adherence, 2015;9:639-48.
    PMID: 25999699 DOI: 10.2147/PPA.S81612
    Medication adherence (MA) in adults with type 2 diabetes mellitus (T2D) is associated with improved disease control (glycated hemoglobin, blood pressure, and lipid profile), lower rates of death and diabetes-related complications, increased quality of life, and decreased health care resource utilization. However, there is a paucity of data on the effect of diabetes-related distress, depression, and health-related quality of life on MA. This study examined factors associated with MA in adults with T2D at the primary care level. This was a cross-sectional study conducted in three Malaysian public health clinics, where adults with T2D were recruited consecutively in 2013. We used the 8-item Morisky Medication Adherence Scale (MMAS-8) to assess MA as the main dependent variable. In addition to sociodemographic data, we included diabetes-related distress, depressive symptoms, and health-related quality of life as independent variables. Independent association between the MMAS-8 score and its determinants was done using generalized linear models with a gamma distribution and log link function. The participant response rate was 93.1% (700/752). The majority were female (52.8%), Malay (52.9%), and married (79.1%). About 43% of patients were classified as showing low MA (MMAS-8 score <6). Higher income (adjusted odds ratio 0.90) and depressive symptoms (adjusted odds ratio 0.99) were significant independent determinants of medication non-adherence in young adults with T2D. Low MA in adults with T2D is a prevalent problem. Thus, primary health care providers in public health clinics should focus on MA counselling for adult T2D patients who are younger, have a higher income, and symptoms of depression.
    Matched MeSH terms: Diabetes Complications
  19. Fulltext Urogenital melioidosis: a review of clinical presentations, characteristic and outcomes
    Chong Vh VH, Sharif F, Bickle I
    Med J Malaysia, 2014 Dec;69(6):257-60.
    PMID: 25934955 MyJurnal
    INTRODUCTION: Melioidosis is endemic to the tropical regions, in particular Thailand and Northern Australia. Any organ can be affected by melioidosis. Involvement of the urogenital system is common in Northern Australia, but is less common in other regions. This study assesses the characteristics of melioidosis affecting the urogenital system treated in a tertiary referral centre in Brunei Darussalam.

    MATERIAL AND METHODS: All patients treated for melioidosis of the urogenital system were identified and retrospectively reviewed.

    RESULTS: There were 9 patients with 11 episodes of urogenital infections treated over 13 years. The median age at diagnosis was 38 years old (range 29 - 63) with men predominantly affected. The major risk factor was underlying diabetes mellitus (n=9), including three patients diagnosed at the time of diagnosis of melioidosis. The median glycosylated haemoglobin (HbA1c) was 12.8% (range 6.4 to 16.6%). One patient's risk factor was only moderate alcohol consumption. Common symptoms included; fever, lethargy, rigor and anorexia. Dysuria was reported by two patients. The median duration of symptoms before presentation was 7 days (range 2 to 21 days) and the median number of sites involved were 3 (range of 2 to 6). Urogenital involvement included prostate (n=6), kidney (n=8), seminal vesicles (n=1) and testis (n=1). Radiological imaging showed that large prostate abscesses (>4.5cm) were common, and in some patients, the kidney abscess had the 'honeycomb' previously described as typical for melioidosis liver abscess. All patients were successfully treated for melioidosis and at a median follow up of 34 months (range 1 - 97), there was one death from complications of diabetes mellitus.

    CONCLUSION: Urogenital melioidosis only accounted for a small proportion of all melioidosis involvement, with prostate and kidney most commonly affected. Concomitant involvement of other sites were common. The major risk factor was poorly controlled diabetes mellitus.
    Matched MeSH terms: Diabetes Complications
  20. Fulltext Tropical calcific pancreatitis
    Tan CT, Kannan P, Sng KH
    Med J Malaysia, 1980 Dec;35(2):150-4.
    PMID: 7266409
    Matched MeSH terms: Diabetes Complications
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