DIABETES MANAGEMENT

Diabetes VS Atomic Bomb Explosion

Diabetes is a chronic disease that hit the world's population. At the end of 1945 the world woke up with the explosion of the atomic bombs on Hiroshima and Nagasaki.Number of casualties is estimated between 90,000 to 140,000. But now 189 million people suffering from diabetes.WHO estimate the number rose to 324 million in 2025.

Diabetes is considered epidemic because of its number is increasing from year to year and leave severe complications such as blindness, ischaemic heart disease, renal failure ,diabetic foot ulcer and amputation.In Malaysia, the prevalence of diabetes continues to rise. What is even more worrying is the fact that almost half of our population with diabetes is unaware that they have the disease.

The Third National Health and Morbidity Survey (3rd NHMS) showed that the prevalence of the Type 2 Diabetes Mellitus for adults aged 30 years old and above now stood at a staggering 14.9% and prevalence of diabetes in 2020 was 4.5 million, Despite achieving the status of a developed nation Malaysia was burdened with the problem of chronic diseases


The Clinical Practice Guidelines (CPG) was developed to provide a clear and concise approach to all health care providers on the current concepts in the management of Type 2 Diabetes Mellitus. There are suggestions that a lower target BP may be necessary to maximally protect against the development and progression of cardiovascular and diabetic renal disease. In general, the SBP should be targeted to <130 mmHg and diastolic pressure <80 mmHg. 108.  The BP should be lowered even further to ≤125/75 mmHg in the presence of proteinuria of >1g/24 hours.

Dietary counselling should target at optimal body weight and take into consideration glycaemic control and the management of concomitant dyslipidaemia. People with diabetes should be screened for complications at diagnosis and thereafter at yearly intervals.

UKPDS data confirmed that in Type 2 Diabetes Mellitus, improvement of glycaemic control by lowering  the HbA1c lowers the risk of developing both macrovascular and microvascular complications.

Inform patients regarding lifestyle measures.Diet and physical activity form an integral part of the management of diabetes. Education on lifestyle modification should be initiated at diagnosis and reinforced regularly.

Emphasize that diet and physical activity are the mainstay of treatment. Medication can be
given at diagnosis for appropriate patients.Patients should be educated to practice self-care. This allows the patient to assume responsibility and control of his/her own diabetes management. Self-care should include: Blood glucose monitoring , body weight monitoring,  foot-care ,personal hygiene and identify targets for controlDiabetes Vs Atomic Bomb Explosion