Lee Py

Detection of airflow limitation using a handheld spirometer in a primary care setting

Early diagnosis of chronic obstructive pulmonary disease (COPD) in primary care settings is difficult to achieve chiefly due to lack of availability of spirometry. This study estimated the prevalence of airflow limitation among chronic smokers using a handheld spirometer in this setting.

Control of glycemia and other cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: Data from the Adult Diabetes Control and Management

The aims of the present study were to assess the control of glycemia and other cardiovascular disease risk factors, and the association between age and these controls among older adults with type 2 diabetes in Malaysia.

Messages from the Malaysian Diabetes Registries on Diabetes Care in Malaysian public healthcare facilities

A persistent and increasing prevalence of diagnosed and undiagnosed diabetes mellitus has recently been reported in the National Health and Morbidity Survey 2015. This commentary recapitulates the relevant and valuable lessons in the Malaysian national diabetes registries to inform the healthcare stakeholders and policy makers on potential areas of clinical practice improvement and future researches. Under performance of the process measures and sub-optimal control of HbA1c, blood pressure and lipids profile were prevalent (<40% achieved treatment targets). Although these had improved slightly from 2009 to 2012, diabetes co-morbidities (hypertension and dyslipidaemia) and complications had also increased. Prevalence of insulin use had doubled, and lipid lowering agent use had increased about 50% in 2012 compared to 2009. We identified six clinical areas for urgent attention and improvement, and three potential areas for future research.

Predictive Factors of follow-up Non-attendance and Mortality Among Adults with Type 2 Diabetes Mellitus- an Analysis of the Malaysian Diabetes Registry 2009

This study examined the factors associated with follow-up non-attendance (FUNA) and mortality among the adult patients with type 2 diabetes mellitus (T2DM). Data on 57780 T2DM patients from the 2009 diabetes registry were analyzed using multinomial logistic mixed model. Out of 57780 patients, 3140 (5.4%) were lost to follow-up and 203 (0.4%) patients had died. Compared with patients who were under active follow-up, men (OR 1.37), neither on insulin (OR 1.72), nor on antiplatelet agents (OR 1.47), having higher HbA1c (OR 1.15), higher LDL-C (OR 1.18) and complications (OR 1.33) were associated with FUNA. Older age (OR 1.09) and higher LDL-C (OR 2.27) have higher mortality. Across the four different health facilities, medication use (insulin and anti-platelet agents) to achieve better disease control in the younger age when diabetes complication is absent would not cause FUNA and might reduce mortality.

Complication profiles and their associated factors in Malaysian adult type 2 diabetes mellitus—an analysis of ADCM registry

Early detection and treatment of risk factors in type 2 diabetes mellitus (T2D) have been proven in reducing complications, improving survival and quality of life. This study aimed to examine an overall diabetes-related complication profiles and their associated factors in adult T2D. Adult diabetes control and management (ADCM) is a prospective registry that included patients with T2D in 2009. Complication profiles were reported descriptively. Multivariate analyses adjusted for differences in patient characteristics were used to determine the associated factors for diabetes-related complications categorised as microvascular complication (microCx) such as retinopathy and nephropathy and macrovascular complication (macroCx) such as ischaemic heart disease and cerebrovascular accident and both complications (combined microCx and macroCx). Complete data were available for 57,780 patients (81.5xa0%) with a mean age of 58.3 (SD 11.27) years; 59.7xa0% were female. About one fifth (10,834/57,780) of T2D patients were diagnosed with at least one complication. Ethnicity, gender, duration of T2D and co-morbids, under hospitals with specialist (HS) care, glycaemic and low-density lipoprotein-cholesterol (LDL-C) targets were associated with complications. When compared to T2D patients without complication, patients who were older (OR 1.03), male (OR 1.48), had longer duration of diabetes (OR 1.04) and hypertension (OR 1.03) and under the care HS (OR 13.64) were more likely to have both complications. T2D patients had moderate morbidity burden. Older age and male gender were two main risk factors of all types of complications. T2D patients with these associated factors should be monitored for prevention, screening and early treatment ofxa0diabetes-related complications. T2D patients under the HS care were noted to have also more complications could be due to HS had been centres of referral for advanced diabetes care rather than the result of HS care itself.