A SNAPSHOT OF TYPE 1 DIABETES CARE AMONG ADULTS IN MALAYSIA

DATA FROM A SINGLE ACADEMIC MEDICAL CENTRE

Authors

  • Quan Hziung Lim
  • Hannan Nazira Nazeri
  • Caelyn Qi Ern See
  • Luqman Ibrahim
  • Jun Kit Khoo
  • Ying Guat Ooi
  • Tharsini Sarvanandan
  • Nicholas Ken Yoong Hee
  • Sharmila Sunita Paramasivam
  • Jeyakantha Ratnasingam
  • Shireene Ratna Vethakkan
  • Lee-Ling Lim

Keywords:

TYPE 1 DIABETES, T1D, DKA

Abstract

INTRODUCTION/BACKGROUND
There is a dearth of data on adults living with Type 1 Diabetes (T1D) in Malaysia.

METHODOLOGY
This descriptive study aims to systematically collect current data and identify gaps among adults living with T1D in Malaysia. Data was extracted from electronic medical records of patients registered under the T1D clinic at Universiti Malaya Medical Centre (UMMC). All patients aged 18 and above in 2023 were included.

RESULT
There was a total of 107 patients with T1D (mean age 42.0 ± 12.7, mean HbA1c 8.0 ± 1.6%, mean BMI 24.5 ± 4.1 kg/ m2 ). The majority were Chinese (52.3%), followed by Malays (24.3%) and Indians (23.4%). The median age at T1D diagnosis was 18.0 years (IQR: 14.0). Almost half (42.1%) presented with diabetic ketoacidosis (DKA) at diagnosis. One in four patients had diabetes-associated autoantibody tests done. Autoantibody positivity was in this order: GADA (22.4%), ICA (6.5%), IA2A (5.6%) and IAA (1.9%). Co-morbid autoimmune conditions were reported in 16.2%, of which thyroid disease (61.1%) was most common. In terms of treatment, the majority were on analogue insulin (89.7%) delivered using multiple daily injections (79.4%). Of the 22 (20.6%) patients using insulin pumps, 50% were using manual pumps, whereas the others were using either sensor-augmented pumps or advanced hybrid closed-loop systems. Most (81.3%) patients used self-monitoring of blood glucose (SMBG) whereas 23.4% employed continuous glucose monitoring (CGM) systems for glycemic surveillance. Incident hypoglycemia within the preceding three months was reported among 60.7%, the majority (95.4%) of which were mild, and none reported severe. The incidence of DKA within the preceding six months was 4.7%. Retinopathy (19.6%) was the most prevalent complication, followed by kidney disease (15%) and atherosclerotic cardiovascular disease (7.5%).

CONCLUSION
This data serves as a baseline for a registry of local T1D patients, whereby future longitudinal analyses may unveil patterns of disease outcomes to guide clinical care unique to our setting.

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Author Biographies

Quan Hziung Lim

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Hannan Nazira Nazeri

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Caelyn Qi Ern See

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Luqman Ibrahim

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Regency Specialist Hospital, Masai, Johor, Malaysia

Jun Kit Khoo

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Ying Guat Ooi

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Tharsini Sarvanandan

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Nicholas Ken Yoong Hee

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Sharmila Sunita Paramasivam

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Jeyakantha Ratnasingam

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Shireene Ratna Vethakkan

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Lee-Ling Lim

Endocrinology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China

Asia Diabetes Foundation, Hong Kong SAR, China

References

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Published

2024-07-17

How to Cite

Lim, Q. H., Nazeri, H. N. ., See, C. Q. E., Ibrahim, L., Khoo, J. K., Ooi, Y. G. ., … Lim, L.-L. (2024). A SNAPSHOT OF TYPE 1 DIABETES CARE AMONG ADULTS IN MALAYSIA: DATA FROM A SINGLE ACADEMIC MEDICAL CENTRE. Journal of the ASEAN Federation of Endocrine Societies, 39(S1), 33. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/4483

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