Warning bells on diabetes

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The 3rd National Health and Morbidity Survey (2006) found the prevalence of diabetes to be 14.9 per cent -- up from 8.3 per cent in 1996.

The estimated number of adults with diabetes in Malaysia in 2000 was 940,000, and the figure is expected to rise to 2.48 million in 2030.

But that is not the only alarming news.

Dr Zanariah Hussein, a consultant endocrinologist with Putrajaya Hospital, said the number of children with Type 2 diabetes is rising.
"We see an increasing number of children between the ages of 7 and 8 with Type 2 diabetes," she said.

"In most cases, both the parents are diabetic. Children are also becoming diabetic because they are overweight and not active."

The Diabetes in Children and Adolescence Registry, set up one and half years ago, has recorded more than 100 children with Type 2 diabetes.

Dr Zanariah said there is under- reporting of children with both Type 1 and Type 2 diabetes.

"Children who are diabetic at an early age will suffer complications in their 20s and 30s."

Kuala Lumpur Hospital medical department head Datuk Dr Jeyaindran Sinnadurai attributed the rise to the change in lifestyle, with more and more Malaysians living a sedentary lifestyle.

"They just don't want to walk or even climb the stairs, even if it is one floor up.

"Furthermore, Malaysians eat unhealthy food high in saturated fat, sugar and carbohydrates."

In general, he said, Malaysians tend to drink carbonated drinks which are high in sugar, and food high in carbohydrates, sugar, fat and cholesterol.

He also attributed the rise in diabetes to the fact that many were complacent about their health and were unaware that they had diabetes.

"Even diabetic patients do not control the disease. Many who are on medication are hospitalised regularly due to poor control of their condition."

Dr Jeyaindran called on doctors and pharmacists to play a greater role in educating people on diabetes and its dangers.

Diabetes is associated with significant mortality and morbidity from macrovascular disease, such as heart attack, stroke and peripheral vascular disease, and microvascular complications of retinopathy, nephropathy and neuropathy.

But because cardiovascular diseases and kidney failure are often reported as the sole cause of mortality, with no mention of underlying diabetic diseases, diabetes as a cause of death is hugely underestimated.

In patients with diabetes, the benefits of good glycaemic control to minimise the onset and progression of complications are undoubted, and this has rightly been the clinical goal for diabetics in recent decades.

However, initiation of insulin therapy is often far too long delayed in poorly controlled diabetic patients. Better use of insulin, particularly the modern insulin, may well show better control and lesser risk of hypoglycaemia.

According to the World Health Organisation, every 10 seconds, one person in the world dies from diabetes and two persons develop diabetes, which is more than HIV/AIDS.

According to WHO and the Diabetes Atlas 2006, each year diabetes is associated with 3.8 million deaths, more than one million amputations, more than 500,000 cases of kidney failure and more than 300,000 cases of blindness.

Diabetes is also one of the costliest health problems in the world.

Globally, more than 250 million people are living with diabetes. Without concerted action to fight the disease, this figure will reach 380 million within a generation.