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  1. Tohid, H., Md Monoto, E.M., Ooi, C.F., Leong, Y.H., Mohamad Ngasri, N.E., Ismail, M.I., et al.
    Medicine & Health, 2020;15(2):246-261.
    MyJurnal
    Tabiat langkau waktu makan adalah kaedah lazim untuk mengawal diet. Namun, amalan kaedah permakanan ini oleh pesakit diabetes melllitus (T2DM) masih belum diketahui berikutan kekangan kajian. Matlamat utama kajian ini adalah untuk mengenal pasti selazim mana pesakit T2DM melangkau waktu makan. Kaitannya dengan faktor sosiodemografi dan klinikal, HbA1c, makan di luar rumah dan kecelaruan gaya pemakanan turut dikaji. Kajian keratan lintang ini telah dijalankan pada tahun 2015 dalam kalangan 203 pesakit di klinik kesihatan awam di Kuala Lumpur. Borang soal selidik yang diisi sendiri oleh subjek termasuk borang Skala Kecelaruan Gaya Pemakanan dalam Bahasa Melayu. Seramai 41.4% subjek kerap melangkau waktu makan dan 61.6% subjek sering makan di luar. Hanya 2% sahaja yang mempunyai masalah kecelaruan gaya pemakanan. Regresi logistik berbilang menunjukkan subjek berbangsa Cina mempunyai kaitan yang kuat dengan tabiat melangkau waktu makan berbanding dengan subjek berbangsa Melayu (nisbah ganjil selaras: 0.36; 95% sela keyakinan: 0.16-0.77; nilai p: 0.009) setelah mengambil kira faktor usia, status pekerjaan, tahap pendidikan, HbA1c, komplikasi, jenis rawatan, makan di luar dan kecelaruan gaya pemakanan. Kesimpulannya, tabiat melangkau waktu makan merupakan satu amalan lazim begitu juga dengan makan di luar rumah. Namun, kecelaruan gaya pemakanan jarang dijumpai. Tabiat melangkau waktu makan tiada kaitan dengan amalan pemakanan ini dan juga kawalan gula dalam darah. Faktor budaya dan keagamaan berkemungkinan mempengaruhi amalan pemakanan individu. Kajian lanjut perlu dijalankan bagi mengenal pasti tahap keselamatan dan penerimaan berkaitan dengan amalan ini. Walau bagaimanapun, kesannya daripada sudut klinikal perlu diperiksa dengan teliti untuk mengelakkan komplikasi kesihatan.

    Matched MeSH terms: Diabetes Mellitus, Type 2
  2. Chee CS, Chang KM, Loke MF, Angela Loo VP, Subrayan V
    PeerJ, 2016;4:e2022.
    PMID: 27280065 DOI: 10.7717/peerj.2022
    AIM/HYPOTHESIS: The aim of our study was to characterize the human salivary proteome and determine the changes in protein expression in two different stages of diabetic retinopathy with type-2 diabetes mellitus: (1) with non-proliferative diabetic retinopathy (NPDR) and (2) with proliferative diabetic retinopathy (PDR). Type-2 diabetes mellitus without diabetic retinopathy (XDR) was designated as control.
    METHOD: In this study, 45 saliva samples were collected (15 samples from XDR control group, 15 samples from NPDR disease group and 15 samples from PDR disease group). Salivary proteins were extracted, reduced, alkylated, trypsin digested and labeled with an isobaric tag for relative and absolute quantitation (iTRAQ) before being analyzed by an Orbitrap fusion tribrid mass spectrometer. Protein annotation, fold change calculation and statistical analysis were interrogated by Proteome Discoverer. Biological pathway analysis was performed by Ingenuity Pathway Analysis. Data are available via ProteomeXchange with identifiers PXD003723-PX003725.
    RESULTS: A total of 315 proteins were identified from the salivary proteome and 119 proteins were found to be differentially expressed. The differentially expressed proteins from the NPDR disease group and the PDR disease group were assigned to respective canonical pathways indicating increased Liver X receptor/Retinoid X receptor (LXR/RXR) activation, Farnesoid X receptor/Retinoid X receptor (FXR/RXR) activation, acute phase response signaling, sucrose degradation V and regulation of actin-based motility by Rho in the PDR disease group compared to the NPDR disease group.
    CONCLUSIONS/INTERPRETATION: Progression from non-proliferative to proliferative retinopathy in type-2 diabetic patients is a complex multi-mechanism and systemic process. Furthermore, saliva was shown to be a feasible alternative sample source for diabetic retinopathy biomarkers.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  3. Abdulameer SA, Sulaiman SA, Hassali MA, Subramaniam K, Sahib MN
    Patient Prefer Adherence, 2012;6:435-48.
    PMID: 22791981 DOI: 10.2147/PPA.S32745
    Diabetes mellitus (DM) is a pandemic and chronic metabolic disorder with substantial morbidity and mortality. In addition, osteoporosis (OP) is a silent disease with a harmful impact on morbidity and mortality. Therefore, this systematic review focuses on the relationship between OP and type 2 diabetes mellitus (T2DM). Systematic reviews of full-length articles published in English from January 1950 to October 2010 were identified in PubMed and other available electronic databases on the Universiti Sains Malaysia Library Database. The following keywords were used for the search: T2DM, OP, bone mass, skeletal. Studies of more than 50 patients with T2DM were included. Forty-seven studies were identified. The majority of articles (26) showed increased bone mineral density (BMD), while 13 articles revealed decreased BMD; moreover, eight articles revealed normal or no difference in bone mass. There were conflicting results concerning the influence of T2DM on BMD in association with gender, glycemic control, and body mass index. However, patients with T2DM display an increased fracture risk despite a higher BMD, which is mainly attributable to the increased risk of falling. As a conclusion, screening, identification, and prevention of potential risk factors for OP in T2DM patients are crucial and important in terms of preserving a good quality of life in diabetic patients and decreasing the risk of fracture. Patients with T2DM may additionally benefit from early visual assessment, regular exercise to improve muscle strength and balance, and specific measures for preventing falls. Patient education about an adequate calcium and vitamin D intake and regular exercise is important for improving muscle strength and balance. Furthermore, adequate glycemic control and the prevention of diabetic complications are the starting point of therapy in diabetic patients.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  4. Bukhsh A, Khan TM, Lee SWH, Lee LH, Chan KG, Goh BH
    Front Pharmacol, 2018;9:339.
    PMID: 29692730 DOI: 10.3389/fphar.2018.00339
    Background: Comparative efficacy of different pharmacist based interventions on glycemic control of type 2 diabetes patients is unclear. This review aimed to evaluate and compare the efficacy of different pharmacist based interventions on clinical outcomes of type 2 diabetes patients. Methods: A systematic search was conducted across five databases from date of database inception to September 2017. All randomized clinical trials evaluating the efficacy of pharmacist based interventions on type 2 diabetes patients were included for network meta-analysis (NMA). The protocol is available with PROSPERO (CRD42017078854). Results: A total of 43 studies, involving 6259 type 2 diabetes patients, were included. NMA demonstrated that all interventions significantly lowered glycosylated hemoglobin (HbA1c) levels compared to usual care, but there was no statistical evidence from this study that one intervention was significantly better than the other for reducing HbA1c levels. Pharmacist based diabetes education plus pharmaceutical care showed maximum efficacy for reducing HbA1c levels [-0.86, 95% CI -0.983, -0.727; p < 0.001]. Pharmacist based diabetes education plus pharmaceutical care was observed to be statistically significant in lowering levels of systolic blood pressure [-4.94; 95%CI -8.65, -1.23] and triglycerides levels [-0.26, 95%CI -0.51, -0.01], as compared to the interventions which involved diabetes education by pharmacist, and for body mass index (BMI) [-0.57; 95%CI -1.25, -0.12] in comparison to diabetes education by health care team involving pharmacist as member. Conclusion: The findings of this review demonstrate that all interventions had a significantly positive effect on HbA1c, but there was no statistical evidence from this study that one intervention was significantly better than the other for achieving glycemic control.Pharmacist based diabetes education plus pharmaceutical care showed maximum efficacy on HbA1c and rest of the clinical outcomes.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  5. Ugusman A, Kumar J, Aminuddin A
    Pharmacol Ther, 2021 08;224:107832.
    PMID: 33662450 DOI: 10.1016/j.pharmthera.2021.107832
    Diabetes mellitus is associated with endothelial dysfunction that leads to cardiovascular complications. Sodium-glucose cotransporter 2 (SGLT2) inhibitors demonstrated efficacy in glycemic control in type 2 diabetes patients with positive cardiovascular outcome. Recent research revealed a link between SGLT2 inhibition and improved macro- and microvascular endothelial functions. Mechanisms underlying this phenomenon could be due to the role of SLGT2 in the regulation of endothelial physiology. In this review, current knowledge and hypothesis on the link between SGLT2 and endothelial function were critically appraised and the impact of SGLT2 inhibitors on endothelial dysfunction in pre-clinical and clinical studies was discussed.
    Matched MeSH terms: Diabetes Mellitus, Type 2/drug therapy; Diabetes Mellitus, Type 2/physiopathology
  6. Kadirvelu A, Sadasivan S, Ng SH
    PMID: 23226028 DOI: 10.2147/DMSO.S37183
    Coping with type II diabetic patients is increasingly posing large financial burdens, sorely felt especially by growing economies. Self-management has been found to be an effective approach towards maintaining good control in diabetics. However, although efforts at implementing self-management have had initial success, there has been a lack of sustainability. This review examines the different components impinging on self-care among type II diabetic patients. These include the critical role of social support, the need for support from health care providers, the value of support from family and friends, the influence of sex and cultural factors in self-care behavior, the benefits of peer support, and the role of literacy in diabetes self-care. Despite the mounting evidence for the effectiveness of social support in diabetes care, and the various stakeholders including this in their clinical guidelines, there has only been a lukewarm response from policy-makers towards ensuring its implementation. Hence, more effort is required from health care providers in moving away from just understanding the effects of new drugs and subsequently putting their patients on these drugs, and going back to the basics of communicating with the patients, understanding their woes, and helping to motivate/empower their patients. This paper analyzes the various components of social support, their influence on diabetes self-care, and how health care providers can help in this process.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  7. Bukhsh A, Khan TM, Nawaz MS, Ahmed HS, Chan KG, Lee LH, et al.
    Patient Prefer Adherence, 2018;12:2377-2385.
    PMID: 30519003 DOI: 10.2147/PPA.S177314
    Objective: Association of various self-care activities on glycemic control of people with diabetes (PWD) in Pakistan is yet to be explored. The current study aimed to evaluate the association of various diabetes-related self-care activities with glycated hemoglobin (HbA1c) levels and to examine the predictive relationship of patients' demographic variables with their self-care activities.

    Patients and methods: A cross-sectional study was conducted on adult PWD (N=218) who were diagnosed with type 2 diabetes mellitus of at least 1 year duration. Self-care activities were examined by using the Urdu version of Diabetes Self-management Questionnaire. Linear regression analysis was conducted to examine the significant predictors for diabetes-related self-care activities and glycemic control.

    Results: Mean age of the patients was 50.77±13.3 years. Poor glycemic control (HbA1c $7%) was observed in majority of the patients (83%). Linear regression analysis revealed that glucose management (β=-0.44; 95% CI -0.438, -0.209; P<0.001) was the strongest predictor for low levels of patients' HbA1c, followed by dietary control (β=-0.19; 95% CI -0.248, -0.018; P=0.024) and physical activity (β=-0.17; 95% CI -0.165, -0.023; P=0.010), respectively. Linear regression analysis showed that use of oral hypoglycemic agents only (β=-0.218; 95% CI -0.956, -0.200; P=0.003) and higher education level (β=0.204; 95% CI 0.138, 0.777; P=0.005) were significant predictors for higher scores of patients' self-care activities.

    Conclusion: The findings support that PWD having better self-reported self-care activities achieve better glycemic control. Patients' self-care activities should be monitored on a regular basis, especially for those who are at risk of poor glycemic control.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  8. Chan JCN, Lim LL, Shaw JE, Aguilar-Salinas CA, Gregg EW, Lancet Commission on diabetes
    Lancet, 2021 06 05;397(10290):2150.
    PMID: 34090602 DOI: 10.1016/S0140-6736(21)00664-4
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  9. Hamdan A, Idrus RH, Mokhtar MH
    PMID: 32365740 DOI: 10.3390/ijerph17093111
    Thank you for your interest and the comments [1] on our review article "Effects of Nigella Sativa on Type-2 Diabetes Mellitus: A Systematic Review" [2]; we believe research into natural products needs to be supported, as they are at the forefront of drug discovery [...].
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  10. Lee JJN, Abdul Aziz A, Chan ST, Raja Abdul Sahrizan RSFB, Ooi AYY, Teh YT, et al.
    J Diabetes, 2023 Jan;15(1):47-57.
    PMID: 36649940 DOI: 10.1111/1753-0407.13346
    BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition that is associated with multiple comorbidities. Apart from pharmacological approaches, patient self-management remains the gold standard of care for diabetes. Improving patients' self-management among the elderly with mobile health (mHealth) interventions is critical, especially in times of the COVID-19 pandemic. However, the extent of mHealth efficacy in managing T2DM in the older population remains unknown. Hence, the present review examined the effectiveness of mHealth interventions on cardiometabolic outcomes in older adults with T2DM.

    METHODS: A systematic search from the inception till May 31, 2021, in the MEDLINE, Embase, and PubMed databases was conducted, and 16 randomized controlled trials were included in the analysis.

    RESULTS: The results showed significant benefits on glycosylated hemoglobin (HbA1c) (mean difference -0.24%; 95% confidence interval [CI]: -0.44, -0.05; p = 0.01), postprandial blood glucose (-2.91 mmol/L; 95% CI: -4.78, -1.03; p = 0.002), and triglycerides (-0.09 mmol/L; 95% CI: -0.17, -0.02; p = 0.010), but not on low-density lipoprotein cholesterol (-0.06 mmol/L; 95% CI: -0.14, 0.02; p = 0.170), high-density lipoprotein cholesterol (0.05 mmol/L; 95% CI: -0.03, 0.13; p = 0.220), and blood pressure (systolic blood pressure -0.82 mm Hg; 95% CI: -4.65, 3.00; p = 0.670; diastolic blood pressure -1.71 mmHg; 95% CI: -3.71, 0.29; p = 0.090).

    CONCLUSIONS: Among older adults with T2DM, mHealth interventions were associated with improved cardiometabolic outcomes versus usual care. Its efficacy can be improved in the future as the current stage of mHealth development is at its infancy. Addressing barriers such as technological frustrations may help strategize approaches to further increase the uptake and efficacy of mHealth interventions among older adults with T2DM.

    Matched MeSH terms: Diabetes Mellitus, Type 2*
  11. Yip TC, Wong GL, Wong VW, Goh GB, Chan WK
    Med Clin North Am, 2023 May;107(3):449-463.
    PMID: 37001947 DOI: 10.1016/j.mcna.2022.12.003
    Nonalcoholic fatty liver disease (NAFLD) is a global public health problem. NAFLD is bidirectionally correlated with metabolic syndrome, which includes obesity, type 2 diabetes, hypertension, and dyslipidemia as major components. The presence of metabolic syndrome is associated with a higher prevalence of NAFLD, and vice versa. Also, the presence of metabolic syndrome in patients with NAFLD has been linked to a higher risk of cardiovascular diseases, liver-related complications, extrahepatic malignancies, and mortality, and possibly vice versa. Multidisciplinary care pathways including lifestyle modifications, control of metabolic risk, and potentially beneficial treatments are important to improve the clinical outcomes of patients with NAFLD.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  12. Md Isa Z, Amsah N, Ahmad N
    Nutrients, 2023 May 15;15(10).
    PMID: 37242192 DOI: 10.3390/nu15102310
    Vitamin D deficiency and insufficiency are public health concerns that have contributed to multiple negative health outcomes. Recent studies have revealed that vitamin D deficiency and insufficiency influence glycaemic control and the development of diabetes complications. The goal of this systematic review is to summarise the latest evidence on the impact of vitamin D deficiency and insufficiency on the outcome of Type 2 Diabetes Mellitus (T2DM) patients. In this PRISMA-guided systematic review, articles were sourced from three databases, namely, PubMed, Scopus, and Web of Science. The review only included literature published from 2012 until 2022, and 33 eligible studies met the inclusion criteria for this review. The included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT). According to our findings, vitamin D deficiency or insufficiency is associated with mental health status, macrovascular and microvascular complications of T2DM, metabolic syndrome, increased risk of obesity, increased blood pressure, dyslipidaemia, glycaemic control, nerve-related disease, musculoskeletal-related complications, and reduced quality of life. Due to the diverse implications of vitamin D deficiency and insufficiency, screening for vitamin D levels in T2DM patients may be beneficial.
    Matched MeSH terms: Diabetes Mellitus, Type 2*
  13. Al-Shookri A, Khor GL, Chan YM, Loke SC, Al-Maskari M
    Malays J Nutr, 2011 Apr;17(1):129-41.
    PMID: 22135872 MyJurnal
    During the past four decades, Oman has undergone a rapid socioe-conomic and epidemiological transition leading to a substantial reduction in the prevalence of various communicable diseases, including vaccine-preventable diseases. Health care planning together with the commitment of policy makers has been a critical factor in this reduction. However, with rapid social and economic growth, lifestyle-related non communicable diseases have emerged as new health challenges to the country. Diabetes and obesity are leading risks posed by the chronic diseases. The burden of diabetes has increased sharply in Oman over the last decade, rising from 8.3% in 1991 to 11.6% in 2000 among adults aged 20 years and older. The World Health Organization (WHO) predicted an increase of 190% in the number of subjects living with diabetes in Oman over the next 20 years, rising from 75,000 in 2000 to 217,000 in 2025. There is a lack of awareness of the major risk factors for diabetes mellitus in the Omani population generally. As education is often the most significant predictor of knowledge regarding risk factors, complications and the prevention of diabetes, health promotion in Oman is deemed critical, along with other prevention and control measures. Suitable prevention strategies for reducing the prevalence of diabetes in Oman are discussed. Recommendations are made for reforms in the current health care system; otherwise, diabetes will constitute a major drain on Oman's human and financial resources, threatening the advances in health and longevity achieved over the past decades.
    Matched MeSH terms: Diabetes Mellitus, Type 2/economics; Diabetes Mellitus, Type 2/etiology; Diabetes Mellitus, Type 2/epidemiology*; Diabetes Mellitus, Type 2/prevention & control*
  14. Thent ZC, Das S, Henry LJ
    PLoS One, 2013;8(11):e80436.
    PMID: 24236181 DOI: 10.1371/journal.pone.0080436
    Background: Exercise training programs have emerged as a useful therapeutic regimen for the management of type 2 diabetes mellitus (T2DM). Majority of the Western studies highlighted the effective role of exercise in T2DM. Therefore, the main aim was to focus on the extent, type of exercise and its clinical significance in T2DM in order to educate the clinicians from developing countries, especially in Asians.

    Methods: Pubmed, Science Direct, Scopus, ISI Web of Knowledge and Google scholar were searched using the terms "type 2 diabetes mellitus," "type 2 DM," "exercise," and/or "physical activity," and "type 2 diabetes mellitus with exercise." Only clinical or human studies published in English language between 2000 and 2012 were included. Certain criteria were assigned to achieve appropriate results.

    Results: Twenty five studies met the selected criteria. The majority of the studies were randomized controlled trial study design (65%). Most of the aerobic exercise based studies showed a beneficial effect in T2DM. Resistance exercise also proved to have positive effect on T2DM patients. Minimal studies related to other types of exercises such as yoga classes, joba riding and endurance-type exercise were found. On the other hand, United States of America (USA) showed strong interest of exercise management towards T2DM.

    Conclusion: Aerobic exercise is more common in clinical practice compared to resistance exercise in managing T2DM. Treatment of T2DM with exercise training showed promising role in USA. A large number of researches are mandatory in the developing countries for incorporating exercise in the effective management of T2DM.
    Matched MeSH terms: Diabetes Mellitus, Type 2/metabolism; Diabetes Mellitus, Type 2/therapy*
  15. Alam F, Islam MA, Gan SH, Mohamed M, Sasongko TH
    Curr Pharm Des, 2016;22(28):4398-419.
    PMID: 27229720
    DNA methylation, a major regulator of epigenetic modifications has been shown to alter the expression of genes that are involved in aspects of glucose metabolism such as glucose intolerance, insulin resistance, β-cell dysfunction and other conditions, and it ultimately leads to the pathogenesis of type 2 diabetes mellitus (T2DM). Current evidences indicate an association of DNA methylation with T2DM. This review provides an overview of how various factors play crucial roles in T2DM pathogenesis and how DNA methylation interacts with these factors. Additionally, an update on current techniques of DNA methylation analysis with their pros and cons is provided as a basis for the adoption of suitable techniques in future DNA methylation research towards better management of T2DM. To elucidate the mechanistic relationship between vital environmental factors and the development of T2DM, a better understanding of the changes in gene expression associated with DNA methylation at the molecular level is still needed.
    Matched MeSH terms: Diabetes Mellitus, Type 2/genetics*; Diabetes Mellitus, Type 2/physiopathology
  16. Haque M, McKimm J, Sartelli M, Samad N, Haque SZ, Bakar MA
    J Popul Ther Clin Pharmacol, 2020 03 03;27(1):e76-e103.
    PMID: 32170920 DOI: 10.15586/jptcp.v27i1.666
    The provision of healthy and safe food is vital for human health, and the addition of unnecessary sugars in foodstuffs is an important global issue, leading to multiple long- and short-term health issues and spiraling costs for individuals and governments alike. The negative effect of excess sugar consumption contributes to adverse health conditions, including obesity, type 2 diabetes, and poor oral health in both high and low resource settings. A key plank of governmental and health promotion bodies' nutritional guidance is to raise public awareness of "hidden" sugars, salt, and fats, such as found in processed foods and sugar-sweetened beverages (SSBs), and guide individuals to reduce their consumption. This rapid narrative review brings together some of the key issues identified in the literature around the consumption of SSBs, including patterns of consumption, the general impact on human health and nutrition, specific effects on oral health and the oral microbiome, and strategies to address over-consumption. The range of long-term adverse effects on health is often misunderstood or unknown by the public. However, some strategies have succeeded in reducing the consumption of SSBs, including public health strategies and interventions and the imposition of taxes or levies, and this article makes recommendations for action.
    Matched MeSH terms: Diabetes Mellitus, Type 2/etiology; Diabetes Mellitus, Type 2/epidemiology
  17. Alam F, Islam MA, Sasongko TH, Gan SH
    Curr Pharm Des, 2016;22(28):4430-42.
    PMID: 27229721 DOI: 10.2174/1381612822666160527160236
    Although type 2 diabetes mellitus (T2DM) and Alzheimer's disease (AD) are two independent diseases, evidences from epidemiological, pathophysiological and animal studies have indicated a close pathophysiological relationship between these diseases. Due to the pathophysiological similarity of T2DM and AD, which includes insulin resistance and deficiency, protein aggregation, oxidative stress, inflammation, autophagocytosis and advanced glycation end products; AD is often referred to as "type 3 diabetes". In addition to the targeted regimens usually used for treating T2DM and AD individually, currently, anti-diabetic drugs are successfully used to reduce the cognitive decline in AD patients. Therefore, if a common pathophysiology of T2DM and AD could be clearly determined, both diseases could be managed more efficiently, possibly by shared pharmacotherapy in addition to understanding the broader spectrum of preventive strategies. The aim of this review is to discuss the pathophysiological bridge between T2DM and AD to lay the foundation for the future treatment strategies in the management of both diseases.
    Matched MeSH terms: Diabetes Mellitus, Type 2/physiopathology*; Diabetes Mellitus, Type 2/therapy
  18. 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*
  19. 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*
  20. 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*
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