Displaying publications 81 - 100 of 1983 in total

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  1. Feisul IM, Azmi S, Mohd Rizal AM, Zanariah H, Nik Mahir NJ, Fatanah I, et al.
    Med J Malaysia, 2017 10;72(5):271-277.
    PMID: 29197881 MyJurnal
    INTRODUCTION: An economic analysis was performed to estimate the annual cost of diabetes mellitus to Malaysia.

    METHODS: We combined published data and clinical pathways to estimate cost of follow-up and complications, then calculated the overall national cost. Costs consisted of diabetes follow-up and complications costs.

    RESULTS: Patient follow-up was estimated at RM459 per year. Complications cost were RM42,362 per patient per year for nephropathy, RM4,817 for myocardial infarction, RM5,345 for stroke, RM3,880 for heart failure, RM5,519 for foot amputation, RM479 for retinopathy and RM4,812 for cataract extraction.

    CONCLUSION: Overall, we estimated the total cost of diabetes as RM2.04 billion per year for year 2011 (both public and private sector). Of this, RM1.40 billion per year was incurred by the government. Despite some limitations, we believe our study provides insight to the actual cost of diabetes to the country. The high cost to the nation highlights the importance of primary and secondary prevention.
    Matched MeSH terms: Diabetes Mellitus, Type 2/complications; Diabetes Mellitus, Type 2/economics*
  2. Fuziah MZ, Hong JY, Zanariah H, Harun F, Chan SP, Rokiah P, et al.
    Med J Malaysia, 2008 Sep;63 Suppl C:37-40.
    PMID: 19230245
    In Malaysia, Diabetes in Children and Adolescents Registry (DiCARE) was launched nationwide in August 2006 to determine and monitor the number, the time trend of diabetes mellitus (DM) patients, their socio-demographic profiles, outcome of intervention and facilitate research using this registry. This is an on going real time register of diabetic patients < or = 20 years old via the e-DiCARE, an online registration system. To date were 240 patients notified from various states in Malaysia. The mean age was 12.51 years (1.08-19.75) and 46.4% were boys. The mean age at diagnosis was 8.31 +/- 4.13 years old with an estimated duration of diabetes of 4.32 +/- 3.55 years. A total of 166/240 (69.2%) have T1DM, 42/240 (17.5%) have T2DM and 18/240 (7.5%) have other types of DM. Basis of diagnosis was known in 162 patients with T1DM and 41 patients with T2DM. In T1DM patients, 6.0% of the girls and 19.1% boys were overweight or obese. As for T2DM, 64.3% had their BMI reported: 66.7% girls and 91.6% boys were overweight or obese. Most patients (80.4%) practiced home blood glucose monitoring. Patients were seen by dietitian (66.7%), diabetes educator (50.0%), and optometrist or ophthalmologist (45.0%). Only 10.8% attended diabetic camps. In the annual census of 117 patients, the mean HbAlc level was 10.0% + 2.2 (range 5.2 to 17.0%). The early results of DiCARE served as a starting point to improve the standard of care of DM among the young in the country.
    Matched MeSH terms: Diabetes Mellitus, Type 1/epidemiology*; Diabetes Mellitus, Type 1/physiopathology; Diabetes Mellitus, Type 2/epidemiology*; Diabetes Mellitus, Type 2/physiopathology
  3. Nawawi HM, Muhajir M, Kian YC, Mohamud WN, Yusoff K, Khalid BA
    Diabetes Res Clin Pract, 2002 Jun;56(3):221-7.
    PMID: 11947970 DOI: 10.1016/s0168-8227(02)00009-8
    This cross-sectional study compared serum lipoprotein (a) [Lp(a)] concentrations in type 1 and type 2 diabetic subjects and examined the determinants of Lp(a) concentrations in both types of diabetes. Serum Lp(a) was measured in 26 type 1 and 107 type 2 diabetic patients and 126 non-diabetic controls. HbA(1c), fasting lipids and urinary albumin were also assayed. Lp(a) concentrations were higher in both type 1 and type 2 diabetic patients compared with controls (P<0.0001 and P<0.0001, respectively), and were higher in type 1 than type 2 diabetic patients (P<0.05). Waist-hip ratio (WHR) was an independent determinant of Lp(a) concentrations in both type 1 and type 2 diabetes.
    Matched MeSH terms: Diabetes Mellitus, Type 1/blood*; Diabetes Mellitus, Type 1/physiopathology; Diabetes Mellitus, Type 2/blood*; Diabetes Mellitus, Type 2/physiopathology
  4. Nazaimoon WM, Ng ML, Khalid BA
    Ann Acad Med Singap, 1993 Nov;22(6):861-3.
    PMID: 8129344
    Fasting serum growth hormone (GH) levels of different groups of diabetic patients were measured and compared to age-matched normal subjects. Insulin-dependent diabetes mellitus (IDDM) children (aged 12-17 years) were found to have significantly lower fasting GH levels than age-matched normal children (p < 0.001). In the adult age groups of 18-44 and 45-76 years, the IDDM patients showed increased fasting GH levels compared to age-matched normal subjects (p < 0.06 and p < 0.001 respectively) and non-insulin-dependent diabetes mellitus (NIDDM) patients (p < 0.05 and p < 0.001 respectively). The fasting GH levels of IDDM patients of the age group 18-44 years also showed significant correlations with glycated haemoglobin (r = 0.510, p = 0.002) and fasting blood sugar levels (r = 0.571, p = 0.01).
    Matched MeSH terms: Diabetes Mellitus/blood*; Diabetes Mellitus, Type 1/blood; Diabetes Mellitus, Type 2/blood
  5. Law GR, Gilthorpe MS, Secher AL, Temple R, Bilous R, Mathiesen ER, et al.
    Diabetologia, 2017 04;60(4):618-624.
    PMID: 28105519 DOI: 10.1007/s00125-017-4205-7
    AIMS/HYPOTHESIS: This study aimed to examine the relationship between average glucose levels, assessed by continuous glucose monitoring (CGM), and HbA1clevels in pregnant women with diabetes to determine whether calculations of standard estimated average glucose (eAG) levels from HbA1c measurements are applicable to pregnant women with diabetes.
    METHODS: CGM data from 117 pregnant women (89 women with type 1 diabetes; 28 women with type 2 diabetes) were analysed. Average glucose levels were calculated from 5-7 day CGM profiles (mean 1275 glucose values per profile) and paired with a corresponding (±1 week) HbA1c measure. In total, 688 average glucose-HbA1c pairs were obtained across pregnancy (mean six pairs per participant). Average glucose level was used as the dependent variable in a regression model. Covariates were gestational week, study centre and HbA1c.
    RESULTS: There was a strong association between HbA1c and average glucose values in pregnancy (coefficient 0.67 [95% CI 0.57, 0.78]), i.e. a 1% (11 mmol/mol) difference in HbA1c corresponded to a 0.67 mmol/l difference in average glucose. The random effects model that included gestational week as a curvilinear (quadratic) covariate fitted best, allowing calculation of a pregnancy-specific eAG (PeAG). This showed that an HbA1c of 8.0% (64 mmol/mol) gave a PeAG of 7.4-7.7 mmol/l (depending on gestational week), compared with a standard eAG of 10.2 mmol/l. The PeAG associated with maintaining an HbA1c level of 6.0% (42 mmol/mol) during pregnancy was between 6.4 and 6.7 mmol/l, depending on gestational week.
    CONCLUSIONS/INTERPRETATION: The HbA1c-average glucose relationship is altered by pregnancy. Routinely generated standard eAG values do not account for this difference between pregnant and non-pregnant individuals and, thus, should not be used during pregnancy. Instead, the PeAG values deduced in the current study are recommended for antenatal clinical care.
    Matched MeSH terms: Diabetes Mellitus, Type 1/blood*; Diabetes Mellitus, Type 1/metabolism*; Diabetes Mellitus, Type 2/blood*; Diabetes Mellitus, Type 2/metabolism*
  6. Akhtar MT, Bin Mohd Sarib MS, Ismail IS, Abas F, Ismail A, Lajis NH, et al.
    Molecules, 2016 Aug 09;21(8).
    PMID: 27517894 DOI: 10.3390/molecules21081026
    Andrographis paniculata is an annual herb and widely cultivated in Southeast Asian countries for its medicinal use. In recent investigations, A. paniculata was found to be effective against Type 1 diabetes mellitus (Type 1 DM). Here, we used a non-genetic out-bred Sprague-Dawley rat model to test the antidiabetic activity of A. paniculata against Type 2 diabetes mellitus (Type 2 DM). Proton Nuclear Magnetic Resonance (¹H-NMR) spectroscopy in combination with multivariate data analyses was used to evaluate the A. paniculata and metformin induced metabolic effects on the obese and obese-diabetic (obdb) rat models. Compared to the normal rats, high levels of creatinine, lactate, and allantoin were found in the urine of obese rats, whereas, obese-diabetic rats were marked by high glucose, choline and taurine levels, and low lactate, formate, creatinine, citrate, 2-oxoglutarate, succinate, dimethylamine, acetoacetate, acetate, allantoin and hippurate levels. Treatment of A. paniculata leaf water extract was found to be quite effective in restoring the disturbed metabolic profile of obdb rats back towards normal conditions. Thisstudy shows the anti-diabetic potential of A. paniculata plant extract and strengthens the idea of using this plant against the diabetes. Further classical genetic methods and state of the art molecular techniques could provide insights into the molecular mechanisms involved in the pathogenesis of diabetes mellitus and anti-diabetic effects of A. paniculata water extract.
    Matched MeSH terms: Diabetes Mellitus, Experimental/blood; Diabetes Mellitus, Experimental/drug therapy*; Diabetes Mellitus, Type 2/blood; Diabetes Mellitus, Type 2/drug therapy*
  7. Ismail IS, Nazaimoon WM, Mohamad WB, Letchuman R, Singaraveloo M, Pendek R, et al.
    Diabetes Res Clin Pract, 2000 Jan;47(1):57-69.
    PMID: 10660222 DOI: 10.1016/s0168-8227(99)00104-7
    Recent studies have shown that good glycaemic control can prevent the development of diabetic complications in type 1 and type 2 diabetes. We wished to observe the glycaemic control in patients from different centres in Peninsular Malaysia and the factors that determine it. We recruited 926 patients with diabetes diagnosed before age 40 years from seven different centres, with proportionate representation from the three main ethnic groups. Clinical history and physical examination were done and blood taken for HbA1c and fasting glucose. The overall glycaemic control was poor with geometric mean HbA1c of 8.6% whilst 61.1% of the patients had HbA1c greater than 8%. Glycaemic control in patients with type 2 diabetes varied between various centres and ethnic groups, with the best control obtained in Chinese patients. Significant predictors of HbA1c in both type 1 and type 2 diabetes include access to nurse educators, ethnic background and WHR. In type 2 diabetes, use of insulin was a significant predictor, while in type 1 diabetes, household income was a significant predictor. Socioeconomic status did not have a significant effect in type 2 diabetes. There were no significant differences in the glycaemic control in patients with different educational status. In conclusion, glycaemic control in big hospitals in Malaysia was poor, and was closely related to the availability of diabetes care facilities and ethnic group, rather than socioeconomic status.
    Matched MeSH terms: Diabetes Mellitus, Type 1/epidemiology*; Diabetes Mellitus, Type 1/therapy*; Diabetes Mellitus, Type 2/epidemiology*; Diabetes Mellitus, Type 2/therapy*
  8. Goh SY, Hussein Z, Rudijanto A
    J Diabetes Investig, 2017 Sep;8(5):635-645.
    PMID: 28236664 DOI: 10.1111/jdi.12647
    Although the incidence of diabetes is rising in Southeast Asia, there is limited information regarding the incidence and manifestation of insulin-associated hypoglycemia. The aim of the present review was to discuss what is currently known regarding insulin-associated hypoglycemia in Southeast Asia, including its known incidence and impact in the region, and how the Southeast Asian population with diabetes differs from other populations. We found a paucity of data regarding the incidence of hypoglycemia in Southeast Asia, which has contributed to the adoption of Western guidelines. This might not be appropriate, as Southeast Asians have a range of etiological, educational and cultural differences from Western populations with diabetes that might place them at greater risk of hypoglycemia if not managed optimally. For example, Southeast Asians with type 2 diabetes tend to be younger, with lower body mass indexes than their Western counterparts, and the management of type 2 diabetes with premixed insulin preparations is more common in Southeast Asia. Both of these factors might result in higher rates of hypoglycemia. In addition, Southeast Asians are often poorly educated about hypoglycemia and its management, including during Ramadan fasting. We conclude there is a need for more information about Southeast Asian populations with diabetes to assist with the construction of more appropriate national and regional guidelines for the management of hypoglycemia, more closely aligned to patient demographics, behaviors and treatment practices. Such bespoke guidelines might result in a greater degree of implementation and adherence within clinical practice in Southeast Asian nations.
    Matched MeSH terms: Diabetes Mellitus/drug therapy*; Diabetes Mellitus/epidemiology; Diabetes Mellitus, Type 2/drug therapy*; Diabetes Mellitus, Type 2/epidemiology
  9. Albaroodi KA, Syed Sulaiman SA, Shafie AA, Awaisu A, Lajis R
    Value Health, 2014 Nov;17(7):A590.
    PMID: 27202012 DOI: 10.1016/j.jval.2014.08.2023
    Widespread evidence has demonstrated the negative effects of tobacco smoking in patients with diabetes. Although many studies have explored the prevalence of tobacco smoking in the general population, data are lacking regarding its prevalence in a specific population with a chronic disease such as diabetes.
    Objectives: This study aims to determine the prevalence of tobacco smoking among patients with diabetes in Hospital Pulau Pinang, Malaysia.
    Methods: A cross-sectional survey was conducted to study diabetic patients who attended the endocrine clinic at Hospital Pulau Pinang in Malaysia from March to August 2012. All the diabetic patients who attended the endocrine clinic during that period were asked about their smoking status, and their medical records were reviewed. A total of 1,118 patients with diabetes were reviewed to determine the prevalence of tobacco smoking in diabetic patients at the endocrine clinic of Hospital Pulau Pinang.
    Results: The majority of the study population was male, with Malay and Chinese patients in almost equal proportions and a smaller proportion of Indian patients. Most of these patients had started smoking before they were diagnosed with diabetes. Among the 1,118 diabetic patients, only 108 patients smoked; therefore, the prevalence of tobacco smoking in our patients with diabetes was 9.66%.
    Conclusions: A low prevalence of tobacco smoking was estimated in this study. This prevalence is close to the corresponding value in the general population in Malaysia.
    Study site: Endocrine clinic, Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Diabetes Mellitus*
  10. Chow EP, Hassali A
    Value Health, 2014 Nov;17(7):A746.
    PMID: 27202698 DOI: 10.1016/j.jval.2014.08.171
    Objectives
    To evaluate the impact of home medication review programme (HMR) towards Type 2 Diabetes patients from public primary centre in Penang, Malaysia.

    Methods
    A prospective randomised control study was conducted at Primary Clinic in Bukit Minyak, Penang. Eligible Type 2 diabetes patients with HbA1c > 6.5% and taking ≥ 3 medications who stayed at their own house were recruited and randomly allocated into control and intervention group by coin tossing. Control group patients received usual care from the clinic whereas intervention group patients received additional 2 visits at their home by pharmacist. During both visits, education on quality use of medications and life-style modifications were performed.Blood pressure monitoring, point of care for sugar and total cholesterol levels were conducted in each visit. Patients adherence and knowledge were assessed using validated questionnaire. Pill count was conducted and excessive medications were collected to calculate the costing component. Primary outcomes were medication adherence and level of knowledge. Secondary outcomes included HbA1c, FBS and total cholesterol changes as well as patients’ satisfactions towards HMR and direct cost saving from the programme.

    Results
    A total of 150 patients were recruited and randomly assigned in two groups (n=75 each group). Fifty patients in the intervention group completed the study. After 2 home visits there were significant improvements in the adherence score for the intervention group (mean score=6.90,SD=0.94) compared to the control group (mean score=4.05, SD=1.51). There was a significant improvement in knowledge score after HMR programme, intervention group (mean score=10.04, SD=1.75) and the control group (mean score=5.45, SD=1.89). A direct cost analysis of the medication wasted reveals that HMR can help to save RM 2805.50 (USD 855.34) throughout the eight months period.

    Conclusions
    Pharmacist-led HMR have improved patients’ adherence and knowledge as well as helping the policy makers to save money on excessive medication wastage.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  11. Harith HH, Morris MJ, Kavurma MM
    Trends Endocrinol. Metab., 2013 Nov;24(11):578-87.
    PMID: 23948591 DOI: 10.1016/j.tem.2013.07.001
    Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) has been extensively studied for its preferential ability to induce apoptosis of cancer cells. Beyond the cytotoxic capacity of TRAIL, new physiological and pathological roles for TRAIL have been identified, and there is now growing evidence supporting its involvement in the development of obesity and diabetes. This review summarizes the most recent findings associating TRAIL with obesity and diabetes in both humans and experimental settings. We also present and discuss some of the reported controversies behind TRAIL signaling and function. Understanding TRAIL mechanism(s) in vivo and its involvement in disease may lead to novel strategies to combat the growing pandemic of obesity and diabetes worldwide.
    Matched MeSH terms: Diabetes Mellitus/metabolism*
  12. Ray S, Sarkar D, Ganguly S, Maiti A
    Med J Malaysia, 2012 Feb;67(1):116-7.
    PMID: 22582562
    Latent Autoimmune Diabetes in Adults (LADA) is an autoimmune form of type 1 diabetes mellitus presenting in adulthood. It is often confused with other types of diabetes and therefore the management is frequently inadequate. Acute hyperglycemic crisis in the form of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS) are unusual findings. We report a clinical case of a 66-year-old female who presented for the first time with DKA and was subsequently diagnosed as a case of LADA. Presumptive diagnosis of LADA was confirmed with the presence of autoantibody to glutamic acid decarboxylase 65 (Anti-GAD65 antibody).
    Matched MeSH terms: Diabetes Mellitus, Type 1/diagnosis*
  13. Chew BH, Mastura I, Bujang MA
    Malays Fam Physician, 2013;8(3):11-8.
    PMID: 25893052 MyJurnal
    AIM: We examined disease profiles of patients with type 2 diabetes mellitus (T2D) at four different public health facilities in Malaysia to determine which site would be the most suitable for early and intensive diabetes care against diabetes-related complications.
    METHODS: This study analysed 57,780 T2D patients in the Adult Diabetes Control and Management registry database in the year 2009. The four public health facilities were hospital with specialists (HS), hospital without specialists (HNS), health clinics with family medicine specialists (CS) and health clinic without doctors (CND). Descriptive analyses were used to examine age, duration of diseases, intervals from the onset of diabetes to co-morbidities (hypertension and dyslipidaemia) and complication of T2D patients at the four public health facilities.
    RESULTS: Patients were significantly older in HS. Patients with T2D at HS had significantly longer duration of diabetes, hypertension and dyslipidaemia. Health clinics, both the CS and the CND, were seeing T2D patients with shorter duration of macrovascular and microvascular complications.
    CONCLUSION: Public health clinics in this country managed T2D patients who were younger and at the early stage of diabetes, hypertension, dyslipidaemia and complications. Thus, primary care physicians are best positioned to provide early and intensive diabetes care for this group of T2D patients to prevent the development of diabetes-related complications.
    KEYWORDS:
    diabetes complications; disease management; health facilities; primary health care; type 2 diabetes mellitus
    Study name: Adult Diabetes Control and Management (ADCM) 2009
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  14. Iqbal MS, Iqbal MZ, Iqbal MW, Bahari MB
    Value Health, 2015 Nov;18(7):A620.
    PMID: 26533480 DOI: 10.1016/j.jval.2015.09.2170
    Objectives: To evaluate the prevalence and patterns of CAM use among diabetes patients in Pakistan. In addition, the study also focused on the perceived effectiveness of CAM over conventional therapies, information seeking behavior and CAM disclosure to healthcare providers.
    Methods: A prospective, cross-sectional and self-administered questionnaire based study was conducted in tertiary care public hospitals in Pakistan. A prevalence based sample of 350 diabetes patients attending the tertiary hospital in Punjab, Pakistan were selected for the study. All obtained data were analyzed using descriptive and inferential statistics.
    Results: Overall, 327 questionnaires were completed and included in the analysis, showing that 52.8% of diabetics had used CAM, with most (62.4%) believing that CAM therapies assist body’s natural forces to heal. CAM usage was significantly associated with gender (P=0.001), level of education (P=0.001), employment status (P=0.03) and monthly income (P<0.001).
    Conclusions: Diabetes treatment and management requires compliance to effective therapies at early stages. Healthcare providers should engage diabetics in an open non-judgmental dialogue to ascertain better understanding of diabetes and its management options.
    Matched MeSH terms: Diabetes Mellitus*
  15. Ul Haq N, Saeed S, Iqbal Q, Naseem A, Razaq G, Farooqui M
    Value Health, 2015 Nov;18(7):A865.
    PMID: 26534631 DOI: 10.1016/j.jval.2015.09.516
    Objectives: The current study aimed to determine the prevalence of Complementary and Alternative Medicines (CAM) and its types used in diabetes patients in Quetta, Pakistan.
    Methods: A cross-sectional study was undertaken with diabetes patients, attending different government and private hospitals and clinic of Quetta city, Pakistan. A self-administered questionnaire containing 16 questions (5 questions related with disease and remaining questions were for information regarding CAM use). Descriptive statistics were applied to evaluate the patient’s demographics. Inferential statistics were used to fine the association between demographics characteristics and CAM (p<0.05).
    Results: A total of 500 questionnaires were distributed and 451 were returned (with response rate of 90.2%). Out of 451 patients 148 (32.8%) used CAM for the diabetes treatment, out of which 87 (58.8%) were females and 61 (41.2%) were males. Most of the participants were uneducated 51 (34.5%) and belongs to large families 89 (60.1%). Fifty (33.8%) participants were using mind body intervention, followed by alternative medical system (33.1%) and herbal products (31.8%) respectively for treatment of diabetes. Type of family, monthly income and per month medicine cost were significant associated (p<0.05) with CAM use.
    Conclusions: The current study indicated that diabetes patients used mind body intervention, alternative medical system and herbal products are the most common CAM type used for diabetes control. Further research is recommended to evaluate the diabetes control in patients with CAM used.
    Matched MeSH terms: Diabetes Mellitus*
  16. Alsalahi A, Alshawsh MA, Mohamed R, Alyousefi NA, Alshagga MA, Shwter AN, et al.
    J Ethnopharmacol, 2016 Jun 20;186:30-43.
    PMID: 27025406 DOI: 10.1016/j.jep.2016.03.045
    ETHNOPHARMACOLOGICAL RELEVANCE: Traditionally, the leaves of Catha edulis Forsskal (Khat) are consumed by the people of Yemen primarily for its recreational effect, and secondarily, for achieving certain tasks. Additionally, Yemeni diabetics chew such leaves in the belief that this can control their elevated blood glucose level.

    AIMS: This review focuses on outlining the findings of studies that have been conducted to display the glycemic effect of Catha edulis, while trying to balance it with findings of the association of its chewing with the development of type 2 diabetes mellitus (DM).

    MATERIALS AND METHODS: The search strategy adopted was based on a comprehensive research in Medline, PubMed, Web of Science, JSTOR, Scopus and Cochrane for articles, proceeding abstracts and theses to identify complete reports written in the English language about the glycemic effect of Catha edulis in humans and animals from 1976 to 2016. In addition, bibliographies were also reviewed to find additional reports not otherwise published. Thirty seven records were identified of which, 25 eligible studies were included in the meta-analysis using blood glucose as an outcome measurement. Studies were divided into four subgroups according to the experimental model, namely; non-diabetic animals, diabetic animals, non-diabetic humans and diabetic humans. The pooled mean difference (MD) of blood glucose between experimental and control were calculated using random effects model of the weighted mean difference of blood glucose with 95% confidence interval (CI). Heterogeneity between studies was tested using I(2) statistic and a value of P<0.05 was considered to indicate statistical significance.

    RESULTS: The scientific reports in the literature prevailed that the glycemic effect of Catha edulis were greatly conflicting with the majority of studies indicating that Catha edulis has a mild hypoglycemic effect. However, the meta-analysis indicted that the overall result showed an insignificant reduction in blood glucose (MD=-9.70, 95% CI: -22.17 to 2.76, P=0.13, with high heterogeneity between subgroups, I(2)=88.2%, P<0.0001). In addition, pooled mean difference of blood glucose of non-diabetic animals, diabetic animals and non-diabetic humans showed an insignificant reduction in blood glucose (MD=-18.55, 95% CI: -39.55 to 2.50, P<0.08, MD=-52.13%, 95% CI: -108.24 to 3.99, P=0.07 and MD=-2.71%, 95% CI: -19.19 to -13.77, P=0.75) respectively. Conversely, a significant elevation in the pooled mean difference of blood glucose in diabetic humans was indicated (MD=67.18, 95% CI: 36.93-97.43, P<0.0001). The conflict shown in the glycemic effect of Catha edulis is thought to be cultivar-related, while demographic and epidemiological reports suggested that chewing Catha edulis might be a predisposing factor contributing to the development of type 2 DM.

    CONCLUSION: It was difficult to draw a meaningful conclusion from both the systematic and the meta-analysis with respect to the glycemic effect of Catha edulis since the meta-analysis results were insignificant with high heterogeneity among subgroups and are greatly conflicting. The variation is most likely due to unadjusted experimental factors or is related to Catha edulis itself, such as the differences in the phytochemical composition. Therefore, it is highly recommended that further studies of the glycemic effect of the cultivar of Catha edulis being studied should come with the identification and quantification of phytochemical content so that a meaningful assessment can be made with regard to its hypoglycemic properties. In addition, well-controlled clinical studies should be conducted to confirm whether or not chewing Catha edulis is associated with the development of type 2 DM, since this would be a source of concern seeing that the plant is widely consumed in certain populations.

    Matched MeSH terms: Diabetes Mellitus/blood*
  17. Lim PC, Lim K, Embee ZC, Hassali MA, Thiagarajan A, Khan TM
    Pak J Pharm Sci, 2016 Mar;29(2):595-601.
    PMID: 27087103
    Involvement of pharmacists in improving medication adherence among diabetic patients is recognized globally. In Malaysian healthcare system, pharmacists are also operating health services i.e. Diabetes Medication Therapy Adherence Clinic (DMTAC). This study aimed to assess the clinical outcomes of patients managed by pharmacists (DMTAC), in a Malaysian hospital setting. This was an open labelled randomised study. Type 2 diabetes patients with HbA1c ≥8% were recruited and arbitrarily divided into the intervention group (usual care plus DMTAC) and the non-intervention group (usual care only). Those enrolled in the intervention group were scheduled for follow-up for eight consecutive visits. Improvements in lab results were compared longitudinally (pre and post analysis) between the groups. Data analysis was done using PASW 18® version. A total of 76 patients were enrolled, with 39 patients in the intervention group and 37 patients in the non-intervention group. Mean HbA1c (-0.90% vs. -0.08%, p=0.011) and fasting blood glucose levels (-3.45 mmol.l vs. +0.79 mmol/l, p=0.002) reduced significantly between the intervention group vs. non-intervention group. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) were also significantly reduced in the intervention group (TC -0.34 mmol/l, p=0.018) (LDL -0.45 mmol/l, p=0.001). In conclusion, pharmacists managed DMTAC significantly improved glycaemic control and lipid profile of diabetic patients.
    Study site: Outpatient Clinic, Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  18. 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 Mellitus/urine; Diabetes Mellitus, Type 1/complications; Diabetes Mellitus, Type 1/urine; Diabetes Mellitus, Type 2/complications; Diabetes Mellitus, Type 2/urine
  19. Mustaffa BE
    Ann Acad Med Singap, 1985 Apr;14(2):272-6.
    PMID: 4037685
    Estimated prevalence of diabetes mellitus in Malaysia was about 2%. Diabetes was most common in Indians especially males and least common in Chinese. There was a slight male preponderance seen in Malays and Indians. Positive family history was obtained in 14% of cases most commonly in Malays, almost 1/3 of whom had more than one family member with diabetes. Familial association was uncommon in Chinese. Over 50% of patients were overweight. Obesity was noted in nearly 70% of female Malays and Indians while the majority of Chinese were not overweight. More than 80% of patients were non insulin requiring. Youth onset diabetes was considered rare; those 10 years and below were estimated to be only 0.4% and below 20 years of age between 2%-4% of the diabetic population. Females were twice as common than males in this type of diabetes and familial association was greater. Malnutrition-related diabetes and pancreatic calcification were not well-documented but youth-onset non insulin requiring diabetics with mild symptoms but strong family history of diabetes were observed. More than half of hospital-based patients had evidence of complications, mainly amongst Malays and Indians. Hypertension was the most frequent associated disease followed by foot ulcers and ischaemic heart disease. Hypertension usually associated with chronic renal failure was most common amongst Malays while gangrenic ulcers and heart diseases were seen mainly in Indians. The major causes of death were chronic renal failure, myocardial infarction, ketoacidosis, stroke and septicaemia related to gangrene.(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Diabetes Mellitus/genetics; Diabetes Mellitus/mortality; Diabetes Mellitus/epidemiology*; Diabetes Mellitus, Type 1/epidemiology; Diabetes Mellitus, Type 2/epidemiology
  20. Cheah JS, Yeo PP, Lui KF, Tan BY, Tan YT, Ng YK
    Med J Malaysia, 1982 Jun;37(2):141-9.
    PMID: 7132833
    A country-wide diabetic survey of the population (age 15 years and above) of Singapore shows that the prevalence of diabetes mellitus in Singapore is 1.99 percent. It is commoner in males (2.36 percent) than in females (1.64 percent). The prevalence of diabetes in the age group 15-39 years is only 0.40 percent and in the age group 40 years and older it is 5.08 percent. The prevalence of diabetes in Indians (6.07 percent) is significantly higher than that in Malays (2.43 percent) and Chinese (1.55 percent). Indian diabetics have an insignifi"cantly higher incidence of positive family of diabetes (12.7 percent) than Malays (10.9 percent) and Chinese (6.5 percent). Obesity was commoner in Malay diabetics (67.4 percent) than in Chinese diabetics (41.6 percent) and Indian diabetics (35.7 percent). The survey shows that 40.4 percent of the diabetics are known while 59.6 percent of the diabetics are newly diagnosed. The majority of the diabetics are treated with oral hypoglycaemic drugs (71.5 percent) and only 4.8 percent are receiving insulin injections. A mong the female diabetics, 63.0 percent have 4 or more pregnancies and large babies at birth are recorded in 12.3 percent. In the newly diagnosed diabetics, 64.3 percent have no symptoms. The complications of the diabetics are hypertension (26.8 percent), nephropathy (9.8 percent), retinopathy (8.5 percent), coronary heart disease (6.1 percent), skin infection (4.6 percent) and neuropathy (3.3 percent). The high prevalence of diabetes among the Indians is likely to be due to a genetic predisposition coupled with an environmental factor (obesity), although this hypothesis is not conclusively demonstrated by the present study.
    Matched MeSH terms: Diabetes Mellitus/epidemiology*
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