Zaiton Ahmad

Determinants of uncontrolled hypertension in adult type 2 diabetes mellitus: an analysis of the Malaysian diabetes registry 2009

BackgroundUncontrolled blood pressure (BP) is a significant contributor of morbidity and even mortality in type 2 diabetes (T2D) patients. This study was done to determine the significant determinants of uncontrolled blood pressure in T2D patients in Malaysia.MethodsBetween 1st January 2009 to 31st December 2009, data from 70 889 patients with Type 2 diabetes was obtained from the Adult Diabetes Control and Management Registry for analysis; 303 centers participated in the study. Their demographic characteristics, the nature of their diabetes, their state of hypertension, treatment modalities, risk factors, and complications are described. Based on their most recent BP values, subjects were divided into controlled BP and uncontrolled BP and their clinical determinants compared. Independent determinants were identified using multivariate logistic regression.ResultsThe mean age of patients at diagnosis of diabetes was 52.3 ± 11.1 years old. Most were women (59.0 %) and of Malay ethnicity (61.9 %). The mean duration of diabetes was 5.9 ± 5.6 years. A total of 57.4 % were hypertensive. Of the 56 503 blood pressure (BP) measured, 13 280 (23.5 %) patients had BP <130/80 mmHg. Eighteen percent was on > two anti-hypertensive agents. Health clinics without doctor, older age (≥ 50 years old), shorter duration of diabetes (< 5 years), Malay, overweight were determinants for uncontrolled blood pressure (BP ≥130/80 mmHg). Patients who were on anti-hypertensive agent/s were 2.7 times more likely to have BP ≥130/80 mmHg. Type 2 diabetes patients who had ischaemic heart disease or nephropathy were about 20 % and 15 % more likely to have their blood pressure treated to target respectively.ConclusionsMajor independent determinants of uncontrolled BP in our group of T2D patients were Malay ethnicity, older age, recent diagnosis of diabetes, overweight and follow-up at health clinics without a doctor and possibly the improper use of anti hypertensive agent. More effort, education and resources, especially in the primary health care centres are needed to improve hypertensive care among our patients with diabetes.

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.

A multicomponent exercise program's effects on health‐related quality of life of institutionalized elderly

Objective To determine the effects of a multicomponent exercise program on health-related quality of life (HRQOL). Design A quasi-experimental pretest-posttest design was used in the study. Setting Participants were recruited from the public-funded shelter home located in Seremban, Negeri Sembilan, Malaysia. Participants The experimental group consisted of 27 volunteers older than 60 years who performed 60 minutes of aerobic, strength, flexibility, and balance training 3 times a week for 12 weeks, supervised by a physiotherapist. The control group consisted of 25 volunteers who continued with their current level of activity. Main outcome measures Physical health component summary (PCS) and mental health component summary (MCS) of the 12-Item Short Form Health Survey HRQOL. Results The exercise group increased in the level of PCS and MCS by 8.4% (P < .05) and 2.9% (P > .05), respectively. The control group shows decline in PCS and MCS by 9.3% (P < .05) and 6.8% (P > .05), respectively. Conclusions This study suggests that a multicomponent exercise program may improve HRQOL among institutionalized elderly.