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  1. 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.

  2. Gilcharan Singh HK, Sinnasamy P, Wan Yi T, Chiao Wei C, Chee Siew Swee W, Shyam S
    Asia Pac J Public Health, 2024 Mar;36(2-3):172-183.
    PMID: 38483070 DOI: 10.1177/10105395241237635
    Food environment (FE), an interface where people interact with a broader food system, is critical to health. Understanding the Asian FE may help to tackle the "triple burden of malnutrition" through informed research and policy. This review identifies FE domains assessed in the Asian context and collates the tools/measures used in these evaluations. We further synthesized the reported associations of FE with diet and health outcomes and identified knowledge gaps. Forty-two articles were reviewed (East Asia, n = 25, 60%; South Asia, n = 8, 19%; and Southeast Asia, n = 9, 21%). The results showed that FE was frequently examined in children, adolescents, or adults, but data were scarce in older adults. Food availability (n = 30) and accessibility (n = 19) were popularly studied domains. Furthermore, FE was measured using geographic information systems (n = 18), market (n = 7), or stakeholder (n = 21) surveys. Twenty-eight (67%) articles assessed associations of FE exposures with diet (n = 12) and health (n = 21). Increased food availability and accessibility were associated with poorer dietary and health outcomes despite nonexisting validity and reliability reporting in 62% of articles. Limited high-quality studies emphasize the need for harmonized definitions, better study designs, and validated FE measures/tools in Asia. Improving the quality of FE research is critical to designing effective interventions to improve public health nutrition in Asia.
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