Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
Disease Control Division, Ministry of Health Malaysia, Federal Government Administration Centre, 62590, Putrajaya, Malaysia.
Sci Rep. 2023 Oct 13;13(1):17338. doi: 10.1038/s41598-023-44564-y.
Diabetes is one of the quickest-growing global health emergencies of the twenty-first century, and data-driven care can improve the quality of diabetes management. We aimed to describe the formation of a 10-year retrospective open cohort of type 2 diabetes patients in Malaysia. We also described the baseline treatment profiles and HbA1c, blood pressure, and lipid control to assess the quality of diabetes care. We used 10 years of cross-sectional audit datasets from the National Diabetes Registry and merged 288,913 patients with the same identifying information into a 10-year open cohort dataset. Treatment targets for HbA1c, blood pressure, LDL-cholesterol, HDL-cholesterol, and triglycerides were based on Malaysian clinical practice guidelines. IBM SPSS Statistics version 23.0 was used, and frequencies and percentages with 95% confidence intervals were reported. In total, 288,913 patients were included, with 62.3% women and 54.1% younger adults. The commonest diabetes treatment modality was oral hypoglycaemic agents (75.9%). Meanwhile, 19.3% of patients had ≥ 3 antihypertensive agents, and 71.2% were on lipid-lowering drugs. Metformin (86.1%), angiotensin-converting enzyme inhibitors (49.6%), and statins (69.2%) were the most prescribed antidiabetic, antihypertensive, and lipid-lowering medications, respectively. The mean HbA1c was 7.96 ± 2.11, and 31.2% had HbA1c > 8.5%. Only 35.8% and 35.2% attained blood pressure < 140/80 mmHg and LDL-cholesterol < 2.6 mmol/L, respectively. About 57.5% and 52.9% achieved their respective triglyceride and HDL-cholesterol goals. In conclusion, data integration is a feasible method in this diabetes registry. HbA1c, blood pressure, and lipids are not optimally controlled, and these findings can be capitalized as a guideline by clinicians, programme managers, and health policymakers to improve the quality of diabetes care and prevent long-term complications in Malaysia.
糖尿病是 21 世纪全球增长最快的健康紧急情况之一，数据驱动的护理可以提高糖尿病管理的质量。本研究旨在描述马来西亚一个 10 年回顾性开放队列 2 型糖尿病患者的形成过程。我们还描述了基线治疗情况和糖化血红蛋白（HbA1c）、血压和血脂控制情况，以评估糖尿病护理的质量。我们使用了国家糖尿病登记处的 10 年横断面审计数据集，并将 288913 名具有相同识别信息的患者合并到一个 10 年开放队列数据集中。HbA1c、血压、LDL-胆固醇、HDL-胆固醇和甘油三酯的治疗目标基于马来西亚临床实践指南。使用 IBM SPSS Statistics 版本 23.0，报告频率和 95%置信区间的百分比。总共纳入了 288913 名患者，其中 62.3%为女性，54.1%为年轻人。最常见的糖尿病治疗方式是口服降糖药（75.9%）。同时，19.3%的患者使用了≥3种降压药，71.2%的患者服用降脂药。二甲双胍（86.1%）、血管紧张素转换酶抑制剂（49.6%）和他汀类药物（69.2%）分别是最常开的降糖、降压和降脂药物。平均 HbA1c 为 7.96±2.11，31.2%的患者 HbA1c>8.5%。只有 35.8%和 35.2%的患者血压<140/80mmHg 和 LDL-胆固醇<2.6mmol/L。分别约有 57.5%和 52.9%的患者达到了各自的甘油三酯和 HDL-胆固醇目标。总之，数据集成是糖尿病登记处的一种可行方法。HbA1c、血压和血脂控制不理想，这些发现可以为临床医生、项目管理人员和卫生政策制定者提供指导，以提高马来西亚的糖尿病护理质量，预防长期并发症。
