Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

TYPE 2 DIABETES MELLITUS PATIENT PROFILES AND DISEASE CONTROL AT FOUR PUBLIC HEALTH FACILITIES IN MALAYSIA- A CROSS-SECTIONAL STUDY FROM ADULT DIABETES REGISTRY 2009

Author

Chew BH 1 , Shariff-Ghazali S 1 , Lee, PY 1 , Cheong AT 1 , Ismail M 2 , Taher SW 3 , Haniff J 4 , Mustapha F 1,5 , Bujang MA 4

Institution

1. Department of Family Medicine, Universiti Putra Malaysia
2. Klinik Kesihatan Seremban, Negeri Sembilan
3. Klinik Kesihatan Bandar Sungai Petani, Kedah
4. Clinical Research Centre, Hospital Kuala Lumpur
5. Disease Control Division, Ministry of Health Malaysia, Putrajaya

Abstract

Objectives: We examined type 2 diabetes mellitus (T2D) patient profiles and their disease control at four health facilities in Malaysia.

Methods: This study analyzed data from diabetes registry database, the Adult Diabetes Control and Management (ADCM). A total of 303 centers participated and contributed a total of 70848 patients. The four public health facilities were hospital with specialist (HS), hospital without specialist (HNS), health clinics with family medicine specialist (CS) and health clinic without doctor (CND). Independent associated risk factors were identified using multivariate regression analyses.

Results: The means age and duration of diabetes in years were significantly older and longer in HS (ANOVA, p< 0.0001). A significant larger proportion of T2D patients at HS were having diabetes-related complications (2-5 times). There were significantly more patients on insulins (31.2%), anti- hypertensives (80.1%), statins (68.1%) and anti- platelets (51.2%) in HS. Patients at HS compared to those at CS had significantly lower means BMI, HbA1c, LDL-C and higher mean HDL-C. Compared to HS, the CS was more likely to achieve BP target < 130/80 mmHg (adjusted OR 1.32 95% CI 1.14 to 1.54), the HNS was 3.6 times (95% CI 2.72 to 4.78) more likely not achieving LDL-C target < 2.6 mmol/L and HbA1c target < 6.5% (adjusted OR 0.52 95% CI 0.40 to 0.68).

Conclusion: Public hospitals with specialist in Malaysia were treating older T2D patients with more diabetes-related complications and prescribing more medications. Patients attending these hospitals achieved better glycaemic target but poorer in attaining BP target as compared to public health clinics with family medicine specialist.