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  1. Fulltext Effect of diaphragmatic breathing on heart rate variability in ischemic heart disease with diabetes
    Kulur AB, Haleagrahara N, Adhikary P, Jeganathan PS
    Arq. Bras. Cardiol., 2009 Jun;92(6):423-9, 440-7, 457-63.
    PMID: 19629309
    BACKGROUND: Reduced heart rate variability is associated with an unfavorable prognosis in patients with ischemic heart disease and diabetes. Whether change in breathing pattern can modify the risk factor in these patients has not been definitely proved.
    OBJECTIVE: To evaluate the effect of diaphragmatic breathing on heart rate variability (HRV) in ischemic heart disease patients with diabetes.
    METHODS: Study population consisted of 145 randomly selected male patients of which 45 had ischemic heart disease (IHD), 52 had IHD and diabetes (IHD-DM) and the remaining 48 had IHD and diabetic neuropathy (IHD-DN). HRV was assessed by 5 minute-electrocardiogram using the time domain method. The intervention group was divided into compliant and non-compliant groups and follow-up recording was carried out after three months and one year.
    RESULTS: Baseline recordings showed a significant decrease in HRV in ischemic heart disease (IHD) patients with or without diabetes (p<0.01). IHD patients had higher HRV than IHD patients with diabetes (p<0.01) or diabetic neuropathy (p<0.01). Increase in HRV was observed in patients who practiced diaphragmatic breathing for three months (IHD-DM: p<0.01; IHD-DN: p<0.05) and for one year (IHD-DM: p<0.01; IHD-DN: p<0.01). The HRV significantly decreased after one year in non-compliant patients. The regular practice of diaphragmatic breathing also improved the glycemic index in these patients.
    CONCLUSION: The regular practice of diaphragmatic breathing significantly improves heart rate variability with a favorable prognostic picture in ischemic heart disease patients who have diabetes. These effects seem to be potentially beneficial in the management of IHD patients with diabetes.
    Matched MeSH terms: Diabetes Mellitus
  2. Fulltext Preventing diabetes: The task of the family doctor
    Rajakumar MK
    Asia Pac Fam Med, 2003;2(1):8-9.
    Matched MeSH terms: Diabetes Mellitus
  3. Fulltext Is the Edinburgh Claudication Questionnaire a good screening tool for detection of peripheral arterial disease in diabetic patients?
    Khatoon R, Khoo EM
    Asia Pac Fam Med, 2007;6(1).
    Aims: To determine whether the Edinburgh Claudication Questionnaire (ECQ) can be used as a screening tool for detecting peripheral arterial disease in patients with diabetes mellitus. 
    Methods: A cross-sectional study of 200 patients with diabetes over 18 years of age who attended a primary care clinic at a teaching hospital in Kuala Lumpur, Malaysia. Face-to-face interviews were conducted using the ECQ for the presence of intermittent claudication. Blood pressure and peripheral neuropathy were assessed. Ankle brachial pressure index (ABPI) was measured and used as a gold standard for the diagnosis of eripheral arterial disease (PAD), which was defined as an ABPI of < 0.9 on either leg. 
    Results: The overall prevalence of PAD was found to be 16% among patients with diabetes based on ABPI. Among these 32 patients with PAD, eight (25%) had symptoms of intermittent claudication based on the ECQ. The ECQ was found to have a low sensitivity (25%) but a high specificity (99.4%), with a positive predictive value of 88.9% and a negative predictive value of 88% for diagnosing PAD in patients with diabetes. 
    Conclusions: The ECQ is not a good screening tool for detection of PAD among patients with diabetes due to its low sensitivity. Key words: ankle brachial pressure, diabetes mellitus, Edinburgh Claudication Questionnaires, intermittent claudication, peripheral arterial disease.
    Matched MeSH terms: Diabetes Mellitus
  4. Fulltext Continuity of care of diabetic patients in a family practice clinic: How important is it?
    Hanafi NS, Teng CL, Yasin S
    Asia Pac Fam Med, 2003;2(1):10-15.
    Aim: To assess the importance of continuity of care among diabetic patients attending a primary care clinic and to correlate degree of continuity of care with diabetic control. Methods: A cross sectional survey was carried out among diabetic patients (n = 166) attending follow-up consultations in a family practice clinic of a teaching hospital. Face-to-face interviews were carried out on patients' perception of continuity of care and various aspects related to diabetes. Diabetic control was assessed by glycosylated hemoglobin. Retrospective chart audits of each patient over the previous 28 months were done to assess the degree of continuity of care, measured with the Usual Provider Continuity Index (UPCI). Results: The UPCI ranged from 0.18 to 1.00 with a mean value of 0.60. The average number of visits per patient over the 28-month period was 11.7 visits. The majority of patients saw five different doctors for all their visits. There were no statistically significant associations between the degree of provider continuity with diabetic control (r = 0.054) and diabetic self-care behavior (r = 0.065). The majority of patients (89%) felt that it was important to have a regular doctor. The main reason given was that a regular doctor would know the patient's problems. Conclusions: Continuity of care was highly valued by diabetic patients attending a hospital-based family practice clinic. Even though the degree of continuity was not associated with the degree of diabetic control, patients felt that it was important to have doctors who are aware of their problems.
    Matched MeSH terms: Diabetes Mellitus
  5. Fulltext Plasma adiponectin concentrations are associated with dietary glycemic index in Malaysian patients with type 2 diabetes
    Loh BI, Sathyasuryan DR, Mohamed HJ
    Asia Pac J Clin Nutr, 2013;22(2):241-8.
    PMID: 23635368 DOI: 10.6133/apjcn.2013.22.2.04
    Adiponectin, an adipocyte-derived hormone has been implicated in the control of blood glucose and chronic inflammation in type 2 diabetes. However, limited studies have evaluated dietary factors on plasma adiponectin levels, especially among type 2 diabetic patients in Malaysia. The aim of this study was to investigate the influence of dietary glycemic index on plasma adiponectin concentrations in patients with type 2 diabetes. A cross-sectional study was conducted in 305 type 2 diabetic patients aged 19-75 years from the Penang General Hospital, Malaysia. Socio-demographic information was collected using a standard questionnaire while dietary details were determined by using a pre-validated semi-quantitative food frequency questionnaire. Anthropometry measurement included weight, height, BMI and waist circumference. Plasma adiponectin concentrations were measured using a commercial ELISA kit. Data were analyzed using multiple linear regression. After multivariate adjustment, dietary glycemic index was inversely associated with plasma adiponectin concentrations (β =-0.272, 95% CI -0.262, - 0.094; p<0.001). It was found that in individuals who consumed 1 unit of foods containing high dietary glycemic index that plasma adiponectin level reduced by 0.3 μg/mL. Thirty two percent (31.9%) of the variation in adiponectin concentrations was explained by age, sex, race, smoking status, BMI, waist circumference, HDL-C, triglycerides, magnesium, fiber and dietary glycemic index according to the multiple linear regression model (R2=0.319). These results support the hypothesis that dietary glycemic index influences plasma adiponectin concentrations in patients with type 2 diabetes. Controlled clinical trials are required to confirm our findings and to elucidate the underlying mechanism.
    Matched MeSH terms: Diabetes Mellitus, Type 2/blood*
  6. Fulltext Prevalence of overweight and obesity among adult Malaysians: an update
    Wan Nazaimoon WM, Musa KI, Md Khir AS, Ismail AA, Ismail IS, Khalid BAK, et al.
    Asia Pac J Clin Nutr, 2011;20(1):35-41.
    PMID: 21393108
    A total of 4428 adults (>18 years old) from 5 different selected regions in Peninsular and East Malaysia participated in this health survey. Using World Health Organization recommendations for body mass index (BMI), the prevalence of overweight and obesity were found to be 33.6% (95% CI= 32.2, 35.0) and 19.5% (95% CI= 18.3, 20.7) respectively. There were more females who were obese (22.5%, 95% CI=20.9, 24.0) compared to males (14.1%, 95% CI=12.3, 15.9). Highest prevalence of obesity were among the Indians (24.6%, 95% CI=20.3, 29.3), followed closely by the Malays (23.2%, 95% CI=21.6, 24.8%) and lowest prevalence was among the Chinese subjects (8.2%, 95% CI=6.2, 10.6). More than 43% of the 531 younger subjects (<30 years old) were either overweight (20%, 95% CI=16.6, 23.6) or obese (13.9%, 95% CI=11.1, 17.2%). All subjects who claimed to be non-diabetes were required to undergo 75 g glucose tolerance test. Compared to subjects with normal BMI (18.5-24.9 kg/m2), there was a 3- and 2-folds increase in the prevalence of newly diagnosed diabetes and impaired glucose tolerance respectively, among obese subjects (BMI>30 kg/m2) who initially claimed to have no diabetes. This study highlights a need for more active, inter-sectoral participation advocating a health-promoting environment in order to combat obesity in this country.
    Matched MeSH terms: Diabetes Mellitus/diagnosis; Diabetes Mellitus/epidemiology
  7. Fulltext Optimal cut-off levels to define obesity: body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia
    Mohd Zaher ZM, Zambari R, Chan SP, Muruga V, Ng B, Appannah G, et al.
    Asia Pac J Clin Nutr, 2009;18(2):209-16.
    PMID: 19713180
    Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44+/-14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.
    Study site: 93 primary care clinics (klinik kesihatan and general practice clinics) in Malaysia
    Matched MeSH terms: Diabetes Mellitus/epidemiology*
  8. Fulltext Low physical activity and energy dense Malaysian foods are associated with non-alcoholic fatty liver disease in centrally obese but not in non-centrally obese patients with diabetes mellitus
    Chan WK, Tan AT, Vethakkan SR, Tah PC, Vijayananthan A, Goh KL
    Asia Pac J Clin Nutr, 2015;24(2):289-98.
    PMID: 26078246 DOI: 10.6133/apjcn.2015.24.2.15
    To study the dietary intake and level of physical activity (PA) of patients with diabetes mellitus and the association with non-alcoholic fatty liver disease (NAFLD).
    Matched MeSH terms: Diabetes Mellitus, Type 2/complications*
  9. Fulltext Evolution of diabetes management in the 21st century: the contribution of quality of life measurement in Asians
    Goh SG, Rusli BN, Khalid BA
    Asia Pac J Clin Nutr, 2015;24(2):190-8.
    PMID: 26078234 DOI: 10.6133/apjcn.2015.24.2.04
    Diabetes mellitus (DM) is a complex and chronic disease with multiple complications leading to increased mortality and poor quality of life. Current studies have shown that lowering glycosylated haemoglobin (HbA1c) confers protection against microvascular complications. However, with more intensive glucose control to achieve HbA1c of less than 6.5%, there seems to be a significant increased risk of mortality and cardiovascular events. The current recommendation worldwide is for "tailoring" of DM management to risk and also quality of Life (QOL) which is a crucial component in determining the success or failure of DM management. In Asia, DM has become a health crisis but there is a lack of QOL assessment tool that is specific for Asians with wide spectrum of ethnicity, languages, religions and socio-economic differences. In this review, we discuss the evolution of DM management over the decade and the issues pertaining to QOL among people living with diabetes in Asia.
    Matched MeSH terms: Diabetes Mellitus/physiopathology; Diabetes Mellitus/psychology*; Diabetes Mellitus/therapy*
  10. Effect of vitamin E on plasma malondialdehyde, antioxidant enzyme levels and the rates of wound closures during wound healing in normal and diabetic rats
    Musalmah M, Fairuz AH, Gapor MT, Ngah WZ
    Asia Pac J Clin Nutr, 2002;11 Suppl 7:S448-51.
    PMID: 12492633
    Vitamin E is composed of various subfamilies that include tocopherols and tocotrienols. These compounds have antioxidant properties but differ in structure, dietary source and potency. In this study we evaluated the efficacy of alpha-tocopherol as an antioxidant and its role in wound closure in normal and streptozotocin-induced diabetic rats. The healing of 6 cm linear incisions created on the back of each male Sprague-Dawley rat (250-300 g) was monitored by measuring the length of the wounds daily. The rats were divided into two categories; normal and streptozotocin-induced diabetic rats. For each category, the animals were further divided into two groups; those untreated and those receiving 200 mg/kg bodyweight alpha-tocopherols daily by oral gavage. All rats were fed standard food and water ad libitum. Blood samples were taken at 0, 5 and 10 days after the wounds were created for the determination of malondialdehyde levels and red cell superoxide dismutase, catalase and glutathione peroxidase activities. The results showed that alpha-tocopherol reduced plasma malondialdehyde levels, increased glutathione peroxidase activity and accelerated the rate of wound closure in treated rats.
    Matched MeSH terms: Diabetes Mellitus, Experimental/blood; Diabetes Mellitus, Experimental/enzymology; Diabetes Mellitus, Experimental/metabolism*
  11. Fulltext Body composition in the pathogenesis and management of diabetes: a Malaysian perspective
    Osman A, Khalid BA
    Asia Pac J Clin Nutr, 1994 Mar;3(1):33-9.
    PMID: 24351204
    There is an increasing prevalence of diabetes mellitus around the world associated with rapid sociocultural development and changing lifestyles. Increased prevalence of obesity, with a higher consumption of animal products and lower consumption of fruits and vegetables, increases the risk of diabetes mellitus and other chronic degenerative diseases. Insulin-dependent diabetes (IDD) is caused by insulin deficiency, whereas the main feature of non-insulin-dependent diabetes (NIDD) which accounts for more than 90% of diabetics, is hyperinsulinemia and insulin resistance, which may eventually lead to actual insulin deficiency. Hyperinsulinemia is undesirable because it increases the risk of developing vascular disease. In Malaysia, the prevalence of NIDD in some communities now exceeds 5%, and of impaired glucose tolerance 10%. Along with these increases in prevalence of hyperglycemia are increases in prevalence of overweight (BMI>25) and almost certainly abdominal fatness. In terms of management, nutrition is given priority. Insulin and hypoglycemic drugs (sulphonylureas or biguanides), where required, may adversely affect body composition if overused. Newer therapeutic strategies require greater attention to the underlying problem in NIDD of abdominal fatness by attention to the relevant nutritional factors, physical activity and other lifestyle factors like cigarette smoking and alcohol. The greater impact of obesity and diabetes on Malaysian women as opposed to men also needs to be addressed.
    Matched MeSH terms: Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2
  12. Fulltext Nutritional status of women and children in Malaysian rural populations
    Ali O, Isa ZM
    Asia Pac J Clin Nutr, 1995 Sep;4(3):319-24.
    PMID: 24394359
    This study was conducted to investigate the nutritional status of the rural population in Malaysia, especially women and children. A total of 262 women aged 18 and over and 183 children aged 2-6 years were selected using multistage cluster sampling from four locations in rural areas. It was found that the prevalence of malnutrition among children 2-6 years old ranged between 25.5% in the Malays Felda settlement scheme to 80% in the Orang Asli settlement. Malnutrition was associated with worm infestations, bottle feeding and early weaning. More than 30% of Orang Asli women were malnourished compared to less than 15% of Malay Felda settlement women. On the other hand, Malay women in the land settlement scheme had a higher risk of developing overweight and diabetes. Goitre was found among 11.5% of children; however, no cretinism was found. Breast feeding was still a common practice among rural mothers, but inadequate health education tended to reduce the duration of breast feeding and increased early weaning. Upgrading women's status in the rural areas will ultimately improve the nutritional and health status of the children and community as a whole.
    Matched MeSH terms: Diabetes Mellitus
  13. Glycaemic and insulin responses of diabetic patients to traditional Malaysian meals and the effect of guar gum
    Khalid BA, Lee LF, Samad AH, Ng ML
    Asia Pac J Clin Nutr, 1996 Dec;5(4):239-43.
    PMID: 24394617
    The aims of the project were to determine the glycaemic and insulin responses of non-insulin dependent diabetic patients (NIDDM) to 3 traditional Malaysian meals compared to oral glucose, and to determine whether guar gum would affect these responses. Patients with NIDDM were tested with 75 g oral glucose and three common breakfast meals of the three main ethnic groups of Malaysia. When compared with the oral glucose group, significantly by lower blood glucose responses were seen at 90 and 120 minutes post prandial for nasi lemak (p<0.05) and at 60, 75 and 90 minutes for mee sup (p<0.05). No significant difference was seen for roti telur. There was no significant difference in plasma glucose at any time point of the study when the three test meals were compared with each other. Addition of 5g granulated guar gum mixed with water taken prior to the glucose significantly lowered the plasma glucose at 60, 120 and 150 minutes postprandially (p<0.05). Similarly for the test meals, guar gum significantly lowered plasma glucose concentration between 15 and 45 minutes (p<0.03) postprandial for nasi lemak and between 15 and 30 minutes (p<0.03) for mee sup but not with roti telur. With addition of guar gum, there was no significant change of insulin responses with the three meals but a significant increase was seen at 30 minutes (p<0.02) after ingestion of glucose.
    Matched MeSH terms: Diabetes Mellitus, Type 2
  14. Fulltext The impact of self-efficacy education based on the health belief model in Iranian patients with type 2 diabetes: a randomised controlled intervention study
    Mohammadi S, Karim NA, Talib RA, Amani R
    Asia Pac J Clin Nutr, 2018 5 9;27(3):546-555.
    PMID: 29737801 DOI: 10.6133/apjcn.072017.07
    BACKGROUND AND OBJECTIVES: Type 2 diabetes is a chronic illness which can be managed by patients' commitment to self-care and self-efficacy behaviors.

    METHODS AND STUDY DESIGN: A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemoglobin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life.

    RESULTS: The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group.

    CONCLUSIONS: Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.

    Matched MeSH terms: Diabetes Mellitus, Type 2/therapy*
  15. Fulltext Acute effects of acarbose on post-prandial glucose and triglycerides in type 2 diabetics following intake of different Malaysian foods
    Nawawi HM, Yazid TN, Ismail F, Khalid BA
    Asia Pac J Clin Nutr, 2000 Mar;9(1):41-5.
    PMID: 24394314
    Acarbose inhibits intestinal alpha-glucosidases resulting in diminished and delayed postprandial hyperglycaemia (PPH). Studies on effects of acarbose on postprandial lipaemia (PPL) have been inconclusive. Little is known about the effects of acarbose on PPH and PPL following intake of a polysaccharide diet. We studied 30 type 2 diabetic patients on dietary and/or oral hypoglycaemic agent(s). Thirty patients were recruited for food A (nasi lemak), 28 for food B (mee goreng) and 28 for food C (roti telur), which represent the typical diets of the three main races in Malaysia. Serial blood samples were taken at 15 min before and up to 240 min after each food intake, without acarbose. Subsequently, three doses of 50 mg acarbose were given orally and the same procedure was repeated the following day. There were significantly lower mean increments in plasma glucose levels after compared to before acarbose treatment 30, 45 and 60 min for food A and at 30, 45, 60, 120, 180 and 240 min for food C, but no significant difference was noted for food B. There was a significantly lower mean fasting glucose level after compared with before acarbose treatment following intake of food A and C but not food B. Short-term treatment with acarbose caused significant diminished and delayed PPH response with food A and C but not with food B. Acarbose was more effective in reducing PPH response in polysaccharide foods with a higher and earlier postprandial glucose peak than in those with a lower and lagged peak. There were no significant differences in the mean fasting or postprandial triglyceride levels before and after acarbose treatment, following intake of all three foods for up to 4 hours. Depending on the food absorption pattern, overnight low dose treatment with acarbose leads to diminished fasting and peak plasma glucose levels, and delayed PPH but insignificant reduction in postprandial lipaemia in poorly controlled type 2 diabetics following intake of racially different Malaysian food.
    Matched MeSH terms: Diabetes Mellitus, Type 2
  16. Fulltext Ethnic characteristics of coronary heart disease risk factors and mortality in peninsular Malaysia
    Khor GL
    Asia Pac J Clin Nutr, 1994 Jun;3(2):93-8.
    PMID: 24351241
    The types and prevalence of coronary heart disease (CHD) risk factors vary somewhat among the three main ethnic groups in peninsular Malaysia. Indians consistently show the highest prevalence for hypercholesterolemia and diabetes mellitus. Among the Malays, a relatively high prevalence of hypertension and hypertriglyceridemia have been reported. Overweight is also a risk factor among the Indians and Malays. In general, Chinese tend to have a lower prevalence for these CHD risk factors than the Indians and Malays. Parallel to the rapid socio-economic development and urbanization in recent decades is a rise in the percentage of deaths due to cardiovascular disease in peninsular Malaysia, that is from 1.8% of total deaths from all causes in 1950 to about 30% in 1991. Coronary heart disease accounts for 40% of all cardiovascular diseases. The mortality rate for CHD has more than doubled between 1965 and 1991, from 24.6 per 100 000 to 57.2. While Indians have been showing the highest CHD mortality rate so far, that of the Malays has been increasing most rapidly since 1970, concomitant with the latter's increase in their proportion of the urban population in peninsular Malaysia.
    Matched MeSH terms: Diabetes Mellitus
  17. Fulltext Trends and dietary implications of some chronic non-communicable diseases in peninsular Malaysia
    Khor GL, Gan CY
    Asia Pac J Clin Nutr, 1992 Sep;1(3):159-68.
    PMID: 24323170
    Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for.
    Matched MeSH terms: Diabetes Mellitus
  18. Fulltext The effectiveness of group dietary counselling among non insulin dependent diabetes mellitus (NIDDM) patients in resettlement scheme areas in Malaysia
    Talib R, Ali O, Arshad F, Kadir KA
    Asia Pac J Clin Nutr, 1997 Jun;6(2):84-7.
    PMID: 24394705
    A study was undertaken in FELDA (Federal Land Development Authority) resettlement scheme areas in Pahang, Malaysia, to determine the effectiveness of group dietary counselling in motivating diabetic patients to achieve good dietary habits, and weight and diabetes control. Sixty-one non-insulin dependent diabetes mellitus (NIDDM) patients were randomly assigned to either the experimental or control group. The experimental group received six sessions of group dietary counselling over 5 months and the control group received mass media diabetes-educational program during the same period. The one hour group dietary counselling sessions discussed general knowledge of diabetes, food groups for meal planning, the importance of dietary fibre-rich foods, types of fat in food, exercise and weight control. The experimental group met monthly with a dietitian as a counsellor. Effectiveness was assessed by improvement in food choice, and decline in percentage glycated haemoglobin (total HbA1) or body mass index (BMI). Measurements were made at a baseline visit, every two months during the six month program, and six months afterwards. Patients in the experimental group improved their food choices, resulting in a healthier diet high in unrefined carbohydrates and dietary fibre rich foods, and low in fat. There were significant reductions of their percentage total HbA1 levels and BMI following the counselling sessions, which decreased further six months after the program compared with patients in the control group. Thus group dietary counselling is effective in motivating NIDDM patients to achieve better food choice, and related weight and glycaemic control in a Malaysian setting.
    Matched MeSH terms: Diabetes Mellitus, Type 2
  19. Fulltext An analysis of targeted single nucleotide polymorphisms for the risk prediction of gestational diabetes mellitus in a cohort of Malaysian patients
    Mohd Aris NK, Md Ismail NA, Mahdy ZA, Ahmad S, Mohd Naim N, Siraj HH, et al.
    Asia-Pacific Journal of Molecular Medicine, 2011;1:1-8.
    Recent association studies have described genetic variants among type 2 diabetes mellitus (T2DM) and their related traits. Gestational diabetes mellitus (GDM) is pathophysiologically similar to T2DM and may share genetic susceptibility.However, genetic susceptibility within GDM in our own population is still not yet explored. This study was to determine the association of GDM genetic variants in the Malaysian population. We genotyped 384 T2DM related SNPs among 174 cases of GDM and 114 controls of pregnant women using Illumina’s Golden Gate genotyping assay. In this case-control study, a custom of 384-SNP plex of 236 candidate genes was designed using the Illumina’s Assay Design Tool. The data analysis showed 12 SNPs had a significant association with GDM among Malaysians with p values 0.002 to 0.048 with their respective odd ratios. The SNPs rs7754840, rs10946398, rs9465871, rs7756992, rs6823091, rs7935082,rs237889, rs7903146, rs7961581 were significant under additive model while rs10811661, rs1016472, rs2270031 were associated with GDM under recessive model. Three SNPs namely rs7935082, rs1016472 and rs2270031 had reduced risk towards GDM while another nine SNPs which were rs7754840, rs10946398, rs9465871, rs7756992,rs10811661, rs6823091, rs237889, rs7903146 and rs7961581 had increased risk as much 1.75 to 2.62 times. Twelve genetic variants of T2DM were replicated in the SNP profiling among Malaysians GDM. Thus with a more significant result in a bigger sample, SNP screening is potentially a useful method in predicting the risk of gestational diabetes mellitus.
    Study name: The Malaysian Cohort (TMC) project
    Matched MeSH terms: Diabetes Mellitus, Type 2
  20. 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 Mellitus*
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