Chew Boon-How, Lai Pauline Siew Mei, Sivaratnam Dhashani A/P, Basri Nurul Iftida, Appannah Geeta, Mohd Yusof Barakatun Nisak, Thambiah Subashini C, Nor Hanipah Zubaidah, Wong Ping-Foo, Chang Li-Cheng
Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Family Medicine Specialist Clinic, Hospital Sultan Abdul Aziz Shah (HSAAS Teaching Hospital), Persiaran MARDI - UPM, Serdang, Selangor, Malaysia.
Health Syst Reform. 2025 Dec 31;11(1):2417788. doi: 10.1080/23288604.2024.2417788. Epub 2025 Jan 6.
There are approximately 220 million (about 12% regional prevalence) adults living with diabetes mellitus (DM) with its related complications, and morbidity knowingly or unconsciously in the Western Pacific Region (WP). The estimated healthcare cost in the WP and Malaysia was 240 billion USD and 1.0 billion USD in 2021 and 2017, respectively, with unmeasurable suffering and loss of health quality and economic productivity. This urgently calls for nothing less than concerted and preventive efforts from all stakeholders to invest in transforming healthcare professionals and reforming the healthcare system that prioritizes primary medical care setting, empowering allied health professionals, improvising health organization for the healthcare providers, improving health facilities and non-medical support for the people with DM. This article alludes to challenges in optimal diabetes care and proposes evidence-based initiatives over a 5-year period in a detailed roadmap to bring about dynamic and efficient healthcare services that are effective in managing people with DM using Malaysia as a case study for reference of other countries with similar backgrounds and issues. This includes a scanning on the landscape of clinical research in DM, dimensions and spectrum of research misconducts, possible common biases along the whole research process, key preventive strategies, implementation and limitations toward high-quality research. Lastly, digital medicine and how artificial intelligence could contribute to diabetes care and open science practices in research are also discussed.
在西太平洋地区,约有2.2亿成年人(区域患病率约为12%)患有糖尿病及其相关并发症,且无论是否知晓,都存在发病情况。2021年和2017年,西太平洋地区和马来西亚的糖尿病医疗费用估计分别为2400亿美元和10亿美元,同时还伴随着无法估量的痛苦以及健康质量和经济生产力的损失。这迫切需要所有利益相关者齐心协力,做出预防性努力,投资于转变医疗保健专业人员,并改革医疗保健系统,优先考虑基层医疗环境,增强辅助医疗专业人员的能力,为医疗服务提供者改进健康组织,改善健康设施以及为糖尿病患者提供非医疗支持。本文以马来西亚为案例,供其他具有类似背景和问题的国家参考,探讨了优化糖尿病护理方面的挑战,并在一份详细路线图中提出了为期5年的循证倡议,以实现动态高效的医疗服务,有效管理糖尿病患者。这包括对糖尿病临床研究领域的审视、研究不当行为的维度和范围、整个研究过程中可能存在的常见偏差、关键预防策略、高质量研究的实施及局限性。最后,还讨论了数字医学以及人工智能如何有助于糖尿病护理和研究中的开放科学实践。