NO two people with diabetes are the same, and management of type 2 diabetes should not take a one-size-fits-all approach.
Findings from the National Health and Morbidity Survey 2023, show that one in six adults has diabetes, while slightly over half the population (54.4 per cent) are obese or overweight, a huge risk factor for type 2 diabetes.
Type 2 diabetes also accounts for 95 per cent of all diabetes incidences globally and is largely influenced by personal and lifestyle habits, which includes diet, nutrition, stress, medication use and physical activity, says Roche diabetes care cluster head of Asia Pacific mature markets, Bryan Koh.
The management of diabetes is deeply personal because no two individuals with it are exactly the same, he explains.
They have different lifestyles, preferences and diets, they manage stress differently and they also cope with certain conditions that require them to take specific medications.
"You cannot prescribe one common therapy for everybody. Treatment needs to be individualised for us to see effects."
We need to rethink how diabetes care is approached, explains Koh, adding that governments spend a lot of money to combat the disease but the number of cases keeps increasing.
"It's clear that we need to take a different view on how to tackle the diabetes epidemic."
Diabetes management is complex and personal for each individual, adds Koh.
University Malaya Medical Centre Associate Professor of medicine and head of the diabetes care unit, Dr Lim Lee Ling, says there is an urgent need to prioritise structured self-management of diabetes to reduce the financial, physical, and psychological burden of people living with it and the potential impact on the national healthcare system.
"A lifelong chronic condition, such as diabetes, requires constant care by striking a good balance between dietary modifications, fitness regimens and personalisation of diabetes management," she says.
Access to diabetes care has been made available and affordable in recent years, she adds. These include continuous support in promoting patient adherence to diabetes management, such as home glucose monitoring and scheduled follow-ups with feedback from doctors and diabetes nurse educators.
Dr Lim says diabetes requires a long-term commitment from those living with the disease and their families to manage the condition well and avoid complications. Eventually, this will improve the wellbeing of patients and reduce the burden on the healthcare system.
"We need to explore how we can help those with diabetes mitigate the challenges of managing their condition at home on a daily basis and empower them to take charge of their health.
"Diabetes is not a single person disease. Once you've gotten diabetes, you need support from your entire family and the healthcare system."
"We need to create a healthy ecosystem so those living with it, people who are obese or those who are pre-diabetic, know where to go, who to see, how to prevent the condition from progressing and what they can do to reach targets."
When people are informed that they are diabetic, the diagnosis usually comes as a shock, says Malaysian Diabetes Educators Society president and senior nurse diabetes educator and manager of diabetes care services at Subang Jaya Medical Centre, Yong Lai Mee.
Yong says patients become worried about the prospect of being put on medication, when in fact, medicines help prevent the progression of the disease and complications.
Patients are always looking for a "cure" and delay coming to the hospital, adds Yong, adding that there are people who assume that since they're still young and strong, there's nothing to be worried about even with the diagnosis.
"By the time awareness sets in, it might be too late," says Yong.
Each of us has a role in guiding individuals on their personal diabetes management journey, she adds.
"It is not an easy road to travel with many physical and psychological challenges, as each person's journey is different, we need to customise treatment therapies to suit their needs."
RISING PREVALENCE
THE 10th edition of the IDF Diabetes Atlas, published by the International Diabetes Federation (IDF), reported a continued global increase in diabetes prevalence, confirming the disease as a significant global challenge to the health and wellbeing of individuals, families and societies.
As of 2021, 537 million adults across the world, between the ages of 20 and 79 years, live with diabetes. This translates to a prevalence rate of one in about 10 people having diabetes. This is predicted to rise to 643 million by 2030 and 783 million by 2045.
DIET NOT THE ONLY FACTOR
WHILE diet and obesity are often discussed as risk factors for type 2 diabetes, sleep has an impact, too.
Persistent lack of sleep and stress are also factors that influence the condition.
Due to the daily demands of life, few people these days are able to get the required six to eight hours of sleep.
Sleep is an emerging risk factor, says University Malaya Medical Centre Associate Professor of medicine and head of the diabetes care unit, Dr Lim Lee Ling.
"It's crucial that we don't sleep too little or too much."
The influence of stress, meanwhile, is bi-directional. Stress contributes to diabetes risk and diabetes contributes to stress.
Malaysian Diabetes Educators Society president and senior nurse diabetes educator and manager of diabetes care services at Subang Jaya Medical Centre, Yong Lai Mee says stress leads to binge eating and weight gain, which in turn puts one at greater risk of type 2 diabetes.
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