Singh Sarkaaj, Abd Raof Anis Syazwani, Lee-Boey Jian-Wen Samuel, Mohd Zaini Hana Salwani, Ooi Ying Guat, Lim Lee-Ling
Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Information Technology Department, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia.
PLoS One. 2025 Sep 9;20(9):e0331571. doi: 10.1371/journal.pone.0331571. eCollection 2025.
There is a lack of longitudinal data on type 2 diabetes (T2D) in low- and middle-income countries. We leveraged the electronic health records (EHR) system of a publicly funded academic institution to establish a retrospective cohort with longitudinal data to facilitate benchmarking, surveillance, and resource planning of a multi-ethnic T2D population in Malaysia. This cohort included 15,702 adults aged ≥ 18 years with T2D who received outpatient care (January 2002-December 2020) from Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. The mean age of participants was 54.3 ± 12.6 years, with a T2D duration of 12.7 ± 4.8 years, HbA1c of 8.9 ± 2.6%, body mass index of 28.2 ± 6.2 kg/m2, and 47.4% were men. The top three comorbidities were dyslipidaemia (87.1%), overweight/obesity (69.4%), and hypertension (62.6%). The proportion of participants achieving HbA1c < 7%, blood pressure < 130/80 mmHg, and low-density lipoprotein cholesterol < 2.6 mmol/L was 27.8%, 24.8%, and 24.5%, respectively. The most common treatments were metformin (62.4%), sulfonylurea (32.8%), and insulin (32.7%). Given the lack of implementation of urinary albumin:creatinine ratio for early detection, chronic kidney disease (defined as estimated glomerular filtration rate < 60 mL/min/1.73m2) was underestimated at 7.5%. These findings highlight opportunities for improved data collection in a middle-income country in Southeast Asia. Apart from trend analysis, this cohort will be prospectively followed for ongoing benchmarking, surveillance, and ascertainment of clinical events, including death.
低收入和中等收入国家缺乏关于2型糖尿病（T2D）的纵向数据。我们利用一家公立学术机构的电子健康记录（EHR）系统，建立了一个拥有纵向数据的回顾性队列，以促进马来西亚多民族T2D人群的基准测试、监测和资源规划。该队列包括15702名年龄≥18岁的T2D成年患者，他们于2002年1月至2020年12月在马来西亚吉隆坡的马来亚大学医学中心（UMMC）接受门诊治疗。参与者的平均年龄为54.3±12.6岁，T2D病程为12.7±4.8年，糖化血红蛋白（HbA1c）为8.9±2.6%，体重指数为28.2±6.2kg/m2，男性占47.4%。前三种合并症分别是血脂异常（87.1%）、超重/肥胖（69.4%）和高血压（62.6%）。糖化血红蛋白<7%、血压<130/80mmHg和低密度脂蛋白胆固醇<2.6mmol/L的参与者比例分别为27.8%、24.8%和24.5%。最常用的治疗方法是二甲双胍（62.4%）、磺脲类药物（32.8%）和胰岛素（32.7%）。由于缺乏用于早期检测的尿白蛋白：肌酐比值的实施，慢性肾脏病（定义为估计肾小球滤过率<60mL/min/1.73m2）被低估为7.5%。这些发现凸显了东南亚一个中等收入国家改善数据收集的机会。除了趋势分析外，该队列将进行前瞻性随访，以持续进行基准测试、监测和确定包括死亡在内的临床事件。
