Diese Präsentation wurde erfolgreich gemeldet.
Wir verwenden Ihre LinkedIn Profilangaben und Informationen zu Ihren Aktivitäten, um Anzeigen zu personalisieren und Ihnen relevantere Inhalte anzuzeigen. Sie können Ihre Anzeigeneinstellungen jederzeit ändern.
Ministry of Health 
Malaysia 
Current Burden of Diabetes 
in Malaysia 
Feisul Idzwan Mustapha MBBS, MPH, AM(M) 
Public Hea...
Proportional mortality, Malaysia 
(% of total deaths, all ages, both sexes) 
2
Premature mortality due to NCDs, 
Malaysia 
3 
The probability of dying between ages 30 and 70 years 
from the 4 main NCDs...
DALYs attributable to risk factors 
4 
Poor Water & Sanitation 
Underweight 
Physical Inactivity 
Alcohol 
High Cholestero...
Deaths attributable to risk factors 
Poor Water & Sanitation 
Underweight 
Alcohol 
Physical Inactivity 
High BMI 
High Ch...
NHMS 2011 
(Volume II, NCD risk factors) 
• Full report published in January 2012. 
• Pdf copy available from the Institut...
7 
11.6 
15.2 
8.0 
7.0 7.2 
4.5 
4.2 
4.9 
16 
14 
12 
10 
8 
6 
4 
2 
0 
NHMS III (2006) NHMS 2011 
Prevalence (%) 
Prev...
8 
0.0 
Prevalence of Diabetes, ≥18 years, 
0.8 0.8 
2.6 
by age groups (2011) 
3.4 
7.6 
9.1 
15.1 
17.9 
23.1 
25.5 
20....
9 
Prevalence of Diabetes, ≥18 years, 
by age groups (1996, 2006 & 2011) 
2.9 
4.1 
6.4 
9.8 
10.7 
13.1 
18.2 
16.1 
15.3...
10 
56.0 
24.6 
15.0 
2.5 1.6 0.2 
60 
50 
40 
30 
20 
10 
0 
Percentage 
Usual Place of Treatment (2011)
11 
12.0 
10.0 
8.0 
6.0 
4.0 
2.0 
0.0 
Prevalence % 
Male 
Female 
High blood sugars in adults, ASEAN 
region, 2010
National Diabetes Registry 
• Web-based application. 
• Went live on 1 January 2011. 
• Supports the implementation of the...
Number of Active Registered 
Patients; as of 28 Feb 2014 
State Number of active patients 
Johor 117,363 
Kedah 52,271 
Ke...
Glycaemic Control: Percentage of T2DM 
Patients with HbA1c <6.5%, 2009 to 2013 
2009 2010 2011 2012 2013 
Johor 14.0 18.3 ...
Diabetes Clinical Audit (2013) 
Variable Targets 
Total no. of 
tests (n) 
Meeting 
Target (%) 
Mean 95% CI 
HbA1c < 6.5 %...
Diabetes Clinical Audit (2013) 
Complications 
Present Absent Not known 
n % n % n % 
Retinopathy 8,640 7.50% 89,118 77.32...
Cost of Diabetes in Malaysia 
• People diagnosed with diabetes have access to diabetes care 
and treatment in Malaysia. 
•...
Cost of Diabetes in Malaysia 
• Cost of managing diabetes in Malaysia: ~RM19,000.00 per 
patient per year 
• Conservative ...
Complications drive costs! 
• While there are no studies in Malaysia that outline the breakdown 
of diabetes costs, a stud...
Summary 
• The prevalence of diabetes has increased 31.0% in 5 years, 
from 11.6% in 2006 to the current 15.2%. 
• Mostly ...
Sub-analysis of NHMS 2011 data 
• At least 15% (18 years and above) already with known NCD 
risk factors (diabetes, hypert...
22
23 
Global NCD 
Targets 
Source of icons: World Heart Federation Champion Advocates Programme
Thank you 
dr.feisul@moh.gov.my 
Facebook: Feisul Mustapha 
24
Nächste SlideShare
Wird geladen in …5
×

Current Burden of Diabetes in Malaysia

6.990 Aufrufe

Veröffentlicht am

Paper based mainly on NHMS 2011 and the NDR

Veröffentlicht in: Gesundheit & Medizin
  • The recovery program is giving me the chance that I was seeking to change my life and to free me of the bulimia. For the first time in my life I feel that I am not alone trying to surpass my bulimia. I have real knowledges about my illness and how to beat them. I feel supported, pleased and liberated, with less fears and insecurities of my image. ●●● http://t.cn/A6Pq6ilz
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • The recovery program is giving me the chance that I was seeking to change my life and to free me of the bulimia. For the first time in my life I feel that I am not alone trying to surpass my bulimia. I have real knowledges about my illness and how to beat them. I feel supported, pleased and liberated, with less fears and insecurities of my image. ♣♣♣ http://scamcb.com/bulimiarec/pdf
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • Thankfully this community blesses you with the right information and tools to get through the inevitable tough times and the joy of having people who are in the same situation and helping you as you go. I'm forever thankful for having the irreplaceable support to fight for what is best for me with all force and knowledge and much love! Shaye and other girls did it, I'm doing it and do can anyone struggling from this, no matter how deep and dark it seems! One step at a time, TOGETHER! ★★★ http://t.cn/A6Pq6KF6
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • My whole life has changed. Your program has made a remarkable difference. My blood sugar level is normal. I have more energy than ever. I have lost weight. And, I am excited to be able to help others to achieve good health ... all this, because I decided to download your book. Saying thank you does not seem to be strong enough. But God bless you and your work, just begins to express my feelings. ●●● http://ishbv.com/matt1a/pdf
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • I discovered the 60-sec Habit that reversed my type 2 diabetes and melted away 56lbs of fat and discovered the real cause of diabetes... ◆◆◆ http://t.cn/AiBhrKDq
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier

Current Burden of Diabetes in Malaysia

  1. 1. Ministry of Health Malaysia Current Burden of Diabetes in Malaysia Feisul Idzwan Mustapha MBBS, MPH, AM(M) Public Health Physician, NCD Section, Disease Control Division Ministry of Health, Malaysia National Oral Health Research Conference 2014 11 November 2014 Kuala Lumpur dr.feisul@moh.gov.my
  2. 2. Proportional mortality, Malaysia (% of total deaths, all ages, both sexes) 2
  3. 3. Premature mortality due to NCDs, Malaysia 3 The probability of dying between ages 30 and 70 years from the 4 main NCDs is 20%
  4. 4. DALYs attributable to risk factors 4 Poor Water & Sanitation Underweight Physical Inactivity Alcohol High Cholesterol High BMI Diabetes Mellitus 10.7% 10.8% 8.3% 9.0% 3.1% 4.3% 5.2% 0.1% 0.7% 12.1% 10.8% 0.1% 0.7% 11.4% 5.1% 0.9% 4.3% 0.7% Tobacco High BP 15.0% 10.0% 5.0% 0.0% 5.0% 10.0% 15.0% Male Female Burden of Disease Study Malaysia, slide courtesy of Dr Mohd. Azahadi Omar, Institute for Public Health
  5. 5. Deaths attributable to risk factors Poor Water & Sanitation Underweight Alcohol Physical Inactivity High BMI High Cholesterol Diabetes Mellitus 19.4% 15.7% 7.0% 7.3% 8.5% 5.0% 2.3% 0.1% 0.2% 22.8% 0.1% 0.2% 1.2% 7.1% 8.2% 8.1% 9.1% 0.3% Tobacco High BP 25% 20% 15% 10% 5% 0% 5% 10% 15% 20% 25% Male Female Burden of Disease Study Malaysia, slide courtesy of Dr Mohd. Azahadi Omar, Institute for Public Health 5
  6. 6. NHMS 2011 (Volume II, NCD risk factors) • Full report published in January 2012. • Pdf copy available from the Institute for Public Health (IKU). • Fact sheet available at MOH website http://www.moh.gov.my/index.php/pages/view/ 115 • Results were presented at the 15th NIH Scientific Meeting 2012. • Powerpoints available at the Institute for Health Management (IHM) website http://www.ihm.moh.gov.my/index.php/en/pow er-point-presentation-15th-nih-scientific-meeting. 6
  7. 7. 7 11.6 15.2 8.0 7.0 7.2 4.5 4.2 4.9 16 14 12 10 8 6 4 2 0 NHMS III (2006) NHMS 2011 Prevalence (%) Prevalence of Diabetes, ≥18 years (2006 & 2011) Total diabetes Known Undiagnosed IFG
  8. 8. 8 0.0 Prevalence of Diabetes, ≥18 years, 0.8 0.8 2.6 by age groups (2011) 3.4 7.6 9.1 15.1 17.9 23.1 25.5 20.3 19.4 2.1 4.1 4.5 6.8 7.5 10.0 11.4 11.6 13.7 13.1 11.0 10.1 12.5 4.9 5.3 9.4 10.9 17.6 20.6 26.7 31.6 36.2 36.6 30.3 31.9 4.1 3.5 4.4 5.2 5.5 4.6 6.2 6.1 5.1 4.3 5.7 4.7 5.1 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Prevalence (%) Age groups Known Undiagnosed Total diabetes IFG
  9. 9. 9 Prevalence of Diabetes, ≥18 years, by age groups (1996, 2006 & 2011) 2.9 4.1 6.4 9.8 10.7 13.1 18.2 16.1 15.3 2.0 2.0 3.1 4.9 6.4 10.3 15.0 20.8 24.4 26.1 24.5 22.8 2.1 4.9 5.3 9.4 10.9 17.6 20.6 26.7 31.6 36.2 36.6 30.3 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Prevalence (%) Age groups NHMS II (1996) NHMS III (2006) NHMS 2011
  10. 10. 10 56.0 24.6 15.0 2.5 1.6 0.2 60 50 40 30 20 10 0 Percentage Usual Place of Treatment (2011)
  11. 11. 11 12.0 10.0 8.0 6.0 4.0 2.0 0.0 Prevalence % Male Female High blood sugars in adults, ASEAN region, 2010
  12. 12. National Diabetes Registry • Web-based application. • Went live on 1 January 2011. • Supports the implementation of the annual “Diabetes Clinical Audit” amongst Type 2 Diabetes patients in MOH Health Clinics. • First report, “NDR Report, Volume 1, 2009- 2012” was published in August 2013, available at the MOH website http://www.moh.gov.my/index.php/pages/view/115.
  13. 13. Number of Active Registered Patients; as of 28 Feb 2014 State Number of active patients Johor 117,363 Kedah 52,271 Kelantan 35,556 Melaka 54,725 N.Sembilan 67,950 Pahang 52,196 Perak 90,512 Perlis 16,384 P.Pinang 45,852 Sabah 15,643 Sarawak 70,642 Selangor 130,148 Terengganu 28,292 WPKL 42,287 WP Labuan 1,534 WP Putrajaya 2,983 Malaysia 824,338
  14. 14. Glycaemic Control: Percentage of T2DM Patients with HbA1c <6.5%, 2009 to 2013 2009 2010 2011 2012 2013 Johor 14.0 18.3 14.4 17.5 16.3 Kedah 8.5 12.8 12.3 15.8 17.0 Kelantan 8.7 9.2 12.5 11.3 16.2 Melaka 18.4 15.3 16.9 21.7 23.9 Negeri Sembilan 13.9 19.6 17.8 19.7 20.0 Pahang 13.4 19.9 13.4 15.1 16.4 Perak 14.5 16.3 13.9 18.1 21.6 Perlis 30.6 24.3 26.1 27.9 25.6 Pulau Pinang 12.3 18.5 19.3 16.5 18.7 Sabah 22.6 19.6 25.9 28.5 34.5 Sarawak 7.8 3.6 6.4 7.0 7.4 Selangor 15.8 25.2 15.1 18.4 21.3 Terengganu 19.9 20.5 17.9 16.2 17.1 WP Kuala Lumpur 12.6 27.9 17.9 24.3 30.0 WP Labuan n.a. 30.8 23.1 53.5 41.4 WP Putrajaya 15.6 26.2 15.1 29.6 32.4 Malaysia 13.3 17.2 15.6 18.1 19.8
  15. 15. Diabetes Clinical Audit (2013) Variable Targets Total no. of tests (n) Meeting Target (%) Mean 95% CI HbA1c < 6.5 % 91,944 25.6 8.1 8.1 - 8.1 BP: Systolic < 130 mmHg 106,842 47.6 135.1 135.0 - 135.2 BP: Diastolic < 80 mmHg 106,828 69.2 77.7 77.6 - 77.8 Blood Pressure < 130 / 80 mmHg 106,809 41.2 Total cholesterol < 4.5 mmol/l 91,214 29.0 5.2 5.1 - 5.2 TG ≤ 1.7 mmol/l 90,593 61.8 1.8 1.8 - 1.8 HDL ≥ 1.1 mmol/l 67,354 66.6 1.3 1.3 - 1.3 LDL ≤ 2.6 mmol/l 67,090 37.3 3.1 3.1 - 3.1 BMI < 23 kg/m2 96,954 16.4 27.4 27.4 - 27.4 Waist circumference < 90 cm (Male) 31,790 33.7 94.0 93.9 - 94.1 < 80 cm 50,008 14.4 90.7 90.6 - 90.8 (Female) Total 115,254 Patients
  16. 16. Diabetes Clinical Audit (2013) Complications Present Absent Not known n % n % n % Retinopathy 8,640 7.50% 89,118 77.32% 17,488 15.17% Ischaemic Heart 6,133 5.32% 94,448 81.95% 14,665 12.72% Disease Cerebrovascular Disease 1,519 1.32% 99,490 86.32% 14,237 12.35% Nephropathy 10,476 9.09% 90,693 78.69% 14,077 12.21% Diabetic Foot Ulcer 1,470 1.28% 101,211 87.82% 12,565 10.90% Amputation 726 0.63% 102,034 88.53% 12,486 10.83% Concomitant Co- Morbidity Yes No Not known n % n % n % Hypertension 83,765 72.68% 25,898 22.47% 5,583 4.84% Dyslipidaemia 69,157 60.00% 38,145 33.10% 7,944 6.89%
  17. 17. Cost of Diabetes in Malaysia • People diagnosed with diabetes have access to diabetes care and treatment in Malaysia. • Diabetes costs are estimated to account for 16% of the national Malaysian healthcare budget. • placing Malaysia among the top 10 countries in the world in terms of percentage of healthcare budget spent on diabetes. • In 2010, an estimated RM 2.4 billion was spent on diabetes-related healthcare. 17 Zhang P. et al. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010; 87: 293– 301.
  18. 18. Cost of Diabetes in Malaysia • Cost of managing diabetes in Malaysia: ~RM19,000.00 per patient per year • Conservative estimate from a study we did in 2007 • Not ideal treatment • Data from NHMS 2011 estimates about 1.1 million patients are on follow up at MOH hospitals and clinics • 1.1 M x RM 19k = RM 20.9 billion!! 18
  19. 19. Complications drive costs! • While there are no studies in Malaysia that outline the breakdown of diabetes costs, a study (CODE II) shows that up to 73% of diabetes-related healthcare costs result from hospitalisation and ambulatory care, as a result of complications due to poor blood sugar control. • Only 7% of the total diabetes-related healthcare cost is spent on anti-diabetic drugs. 19 Jonsson B. Revealing the costs of type 2 diabetes in the EU and findings from 8 EU countries. Diabetologia 2002;45:S5–S12.
  20. 20. Summary • The prevalence of diabetes has increased 31.0% in 5 years, from 11.6% in 2006 to the current 15.2%. • Mostly contributed by increase of “undiagnosed”. • Increase in prevalence occurring across all age-groups. • Increasing challenge in providing satisfactory quality of care to patients with diabetes. • Number of patients in MOH health clinics will continue to increase. • Referrals for specialists management will also continue to increase due to late diagnosis and sub-optimal control. 20
  21. 21. Sub-analysis of NHMS 2011 data • At least 15% (18 years and above) already with known NCD risk factors (diabetes, hypertension or hypercholesterolemia). • Undiagnosed high blood sugar, high blood pressure or high cholesterol: 42.1% (18 years and above). • Or, if include obesity: 48.3% (18 years and above). • Therefore our high risk and at risk population: 63.3% (18 years and above) 21 We are a SICK population!
  22. 22. 22
  23. 23. 23 Global NCD Targets Source of icons: World Heart Federation Champion Advocates Programme
  24. 24. Thank you dr.feisul@moh.gov.my Facebook: Feisul Mustapha 24

×