Tackling Malaysia's Growing Diabetes Crisis

Tackling Malaysia’s Growing Diabetes Crisis

According to global estimates, 537 million adults between the ages of 20 and 79 are living with diabetes, more than 75% of whom live in middle- and low-income countries.

This figure is expected to rise steadily in the coming years, with the International Diabetes Federation recently acknowledging it to be one of the fastest growing global health crises of this century.

Of these adults, about 90 million live in Southeast Asia. In 2021, Malaysia ranked fifth in the Western Pacific, with 4.4 million adults living with diabetes. The top four countries were, in order, China, Indonesia, Japan and Thailand.

This public health concern prompted the Malaysian Ministry of Health to develop the National Non-Communicable Diseases Strategic Plan (2016-2025), one of the objectives of which is to stem the rise in obesity and diabetes.

Dietary intervention is one of the cornerstones of diabetes management. However, adherence to the lifestyle recommendations given to people with diabetes in Malaysia remains low, and this is an area that requires active investigation and new solutions.

Another critical issue is the rise in pre-diabetes in Malaysia, with analysis showing it stands at 11.6%.

While preventing diabetes is imperative to avoid future complications, it is also beneficial in reducing the individual and national economic burden in terms of healthcare expenditure. Therefore, it is essential that steps are taken to prevent pre-diabetes from progressing to overt diabetes.

Local studies show that people with pre-diabetes are at higher risk of poor quality diets.

Nutritional interventions are essential to prevent the progression of prediabetes. These strategies ranged from specific nutritional supplements to combination diets incorporating a mix of food types.

Our review of dietary interventions for prediabetes found that two-thirds of studies focused on a selected food group or type of food rather than combination diets such as low-fat or low-carb diets.

The poor diet quality of pre-diabetic Malaysians and the lack of evidence on effective local intervention programs in this group are of great concern.

A global diet also lacks feasibility when considering interindividual variability. This phenomenon can be attributed to differences in gut microbiota, genetic polymorphisms of gut transport proteins, and various host factors such as age, sex, and metabolic status. Therefore, a “one size fits all” approach to the dietary management of prediabetes may not be supportive.

We also found that a third of the interventions focused on dietary education rather than a closed experimental setting with strict observers.

Typically administered by a registered dietician or nutritionist, these educational interventions involved multiple follow-ups and regular dietary reviews to ensure compliance. Implementation of nutrition education has the potential to not only exert long-term health effects on participants, but also to reflect real-world feasibility – something not typically seen in non-educational nutrition interventions.

Given the heavy burden of diabetes in Malaysia, it is becoming increasingly evident that the pre-diabetic state represents a golden opportunity for prevention strategies.

The poor diet quality of pre-diabetic Malaysians and the lack of evidence on effective local intervention programs in this group are of great concern.

Going forward, stakeholders including the Ministry of Health, non-governmental organizations, nutrition researchers and health professionals may need to explore potential interventions focusing on dietary and lifestyle strategies. adapted to local communities.

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