Mafauzy M, Hussein Z, Chan S P
Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.
Med J Malaysia. 2011 Aug;66(3):175-81.
DiabCare Malaysia 2008 evaluated the current status of diabetes care in Malaysia as a continuation of similar cross-sectional studies conducted previously in 1997, 1998, 2001 and 2003. The current study recruited 1670 patients from general hospitals, diabetes clinics and referral clinics to study current scenario of diabetes management. We report the results of type 2 diabetic population who constituted 92.8% (n = 1549). Results showed deteriorating glycaemic control with mean HbA1c of 8.66 +/- 2.09% with only 22% of the patients achieving ADA target of < 7%. 80.3% of patients were hypertensive and 75% were on anti-hypertensive medication. 46% of patients had LDL levels > 2.6 mmol/L; 19.8% had triglycerides > 2.2 mmol/L; 27.4% had HDL < 1 mmol/L despite 85% of the patients being on lipid lowering agents. Microvascular, macrovascular and severe late complications were reported in 75%, 28.9% and 25.4% patients respectively. The rates of diabetic complications were cataract 27.2%, microalbuminuria 7%, neuropathy symptoms 45.9%, leg amputation 3.8% and history of angina pectoris was 18.4%. Quality of life evaluation showed that about one third of patients have poor quality of life. Also, there was poor adherence to diet, exercise and self testing of blood glucose. In conclusion, majority of the patients were still not satisfactorily controlled. There is an urgent need for effective remedial measures to increase adherence to practice guidelines and to educate both patients and healthcare personnel on importance of achieving clinical targets for metabolic control.
“马来西亚糖尿病关爱计划（DiabCare Malaysia）2008”评估了马来西亚糖尿病护理的现状，作为此前在1997年、1998年、2001年和2003年进行的类似横断面研究的延续。当前的研究从综合医院、糖尿病诊所和转诊诊所招募了1670名患者，以研究糖尿病管理的当前情况。我们报告了构成92.8%（n = 1549）的2型糖尿病患者群体的结果。结果显示血糖控制情况恶化，平均糖化血红蛋白（HbA1c）为8.66 +/- 2.09%，只有22%的患者达到美国糖尿病协会（ADA）设定的< 7%的目标。80.3%的患者患有高血压，75%的患者正在服用抗高血压药物。46%的患者低密度脂蛋白（LDL）水平> 2.6 mmol/L；19.8%的患者甘油三酯> 2.2 mmol/L；尽管85%的患者正在服用降脂药物，但27.4%的患者高密度脂蛋白（HDL）< 1 mmol/L。分别有75%、28.9%和25.4%的患者报告有微血管、大血管和严重晚期并发症。糖尿病并发症的发生率为白内障27.2%、微量白蛋白尿7%、神经病变症状45.9%、腿部截肢3.8%以及心绞痛病史18.4%。生活质量评估显示，约三分之一的患者生活质量较差。此外，患者在饮食、运动和血糖自我检测方面的依从性也很差。总之，大多数患者的病情仍未得到令人满意的控制。迫切需要采取有效的补救措施，以提高对实践指南的依从性，并教育患者和医护人员实现代谢控制临床目标的重要性。
