Glomerular filtration rate GFR Management of hypertension Management of dyslipidaemia Use of anti-plalelet

25

5.0 Diabetes complications

The rates of diabetes complications were quite low i.e retinopathy 4.4, ischaemic heart disease 3.2, cerebrovascular disease 0.9, nephropathy 1 and foot problem 7.3. However, majority of the patients have not had screenings for diabetes complications.

6.0 Concomitant co – morbidity

The most commonly documented concomitant co-morbidity was hypertension 40659 57.4; 21381 30.2 had both hypertension and dyslipidaemia and 46072 65 had either one.

7.0 Treatment and management 7.1. Management of diabetes

7.1.1 More than three-fourths 76.3 of the patients in the study were prescribed oral antidiabetic OAD therapy, 10.0 insulin and 3.2 diet therapy only. 7.1.2 Biguanides 83.2 and sulphonylureas 69.9 were the most frequently prescribed OAD therapies. 7.1.3 Alpha-glucosidase inhibitors were prescribed in only 4.8 of patients. 7.1.4 There was minimal use 1 of other OADs such as thiazolidinediones and meglitinides.

7.2. Management of hypertension

7.2.1 Almost two-thirds of the diabetes patients 58.2 were prescribed antihypertensive treatment. 7.2.2 The most commonly prescribed antihypertensive agents were angiotensin-converting enzyme inhibitor ACE-inhibitor followed by calcium channel blockers, beta blockers, and diuretics 63.9, 37.0, 36.5 and 23.4 respectively.

7.3 Management of dyslipidaemia

About 37.8 of the patients had known dyslipidaemia. About 41.6 received lipid lowering therapy, primarily a statin.

7.4 Use of anti-plalelet

Only 25.3 patients were prescribed antiplatelet therapy, primarily aspirin. 7.5 Self blood glucose monitoring The number of patients 2427 patients performing self blood glucose monitoring SBGM was very low. Only one in 30 patients 3.4 in this study practiced this self care behavior. 26 CHAPTER ONE 1.0 SOCIO DEMOGRAPHICS DR LEE PING YEIN DR SYED ALWI SYED ABDUL RAHMAN 27 1.1 Overall result of DRM-ADCM Overall types of diabetes 1.1.1 Patients distribution A total of 72742 patients were notified to the ADCM on-line system from 1 st January until 31 st December 2009. Of these, 1145 1.57 were excluded from analysis due to missing data on basic patient information date of birth, duration or type of diabetes and the population analysed was 71597. Majority of the patients have type 2 diabetes mellitus N=70889, 99.0. Only 685 1.0 patients had type 1 diabetes mellitus and 23 0 had other types of diabetes Table 1.1.1 Table 1.1.1 Distribution of patients notified with diabetes mellitus by types of diabetes, DRM-ADCM, January 1 st – December 31 st 2009 No Type of diabetes N 1 Type 2 7088999.0 2 Type 1 6851.0 3 Others 230.0 Total 71597100.0 The source of patients were mainly from KK Seremban N=6680, 9.3, KK Setapak N=3194, 4.5, KK Kampung Pandan N=2108, 2.9, KK Tanglin N=1930,2.7, KK Petaling Bahagia N=1890, 2.6, KK Batu N=1817, 2.5, KK Cheras N=1704, 2.4, KK Pantai N=1595, 2.2, KK Jinjang N=1430, 2.0, KK Bandar Tun Razak N=1356, 1.9, KK Sungai Besi N=1223, 1.7, KK Sentul N=1030, 1.4, KK Ampangan N=1029, 1.4, KK Kuala Pilah N=993, 1.4 , KK Dato Keramat N=993, 1.4, KK Port Dickson N=986, 1.4, Damai Medical Heart Clinic N=959, 1.3, KK Nilai N=855, 1.2, KK Cheras Baru N=732, 1.0, and KK Bandar Kota Bharu N=681, 1.0 Most patients with type 1 diabetes were notified from KK Selising N=197, 28.8, KK Gual Ipoh N=56, 8.2, KK Beris Panchor N=41, 6.0, KK Sungai Koyan N=35, 5.1 and KK Batu 30 N=31, 4.5. Table 1.0.2 Patients with other type of diabetes were mainly notified from KK Temangan N=16, 69.6, KK Banai N=2, 8.7, KK Gulau N=2, 8.7, KK Batu N=1, 4.3, KK Sg Bayur N=1, 4.3 and Damai Medical Heart Clinic N=1, 4.3. Table 1.1.2 Distribution of patients notified with diabetes by source data providers SDPs, DRM-ADCM, January 1 st – December 31 st 2009 No SDP Type 2 N=70889 N Type 1 N=685 N Total N 1 KK Kuala Pilah 9921.4 10.1 9931.4 2 KK Juasseh 3230.5 00.0 3230.5 3 KK Johol 1620.2 00.0 1620.2 4 KK Terachi 1150.2 00.0 1150.2 5 KK Gunung Pasir 590.1 00.0 590.1 No SDP Type 2 Type 1 Total N 28 N=70889 N N=685 N 6 KK Seri Menanti 610.1 00.0 610.1 7 KK Padang Lebar 1920.3 00.0 1920.3 8 KK Bahau 1710.2 00.0 1710.2 9 KK Bandar Sri Jempol 180.0 00.0 180.0 10 KK Palong 4,5,6 1030.1 00.0 1030.1 11 KK Palong 7,8 760.1 00.0 760.1 12 KK Serting Hilir 390.1 00.0 390.1 13 KK Lui Muda 1910.3 00.0 1910.3 14 KK Jelebu 2790.4 00.0 2790.4 15 KK Titi 110.0 00.0 110.0 16 KK Pertang 760.1 00.0 760.1 17 KK Simpang Durian 200.0 00.0 200.0 18 KK Rembau 4190.6 00.0 4190.6 19 KK Pedas 3560.5 00.0 3560.5 20 KK Astana Raja 2050.3 00.0 2050.3 21 KK Tampin 2110.3 00.0 2110.3 22 KK Gemas 130.0 00.0 130.0 23 KK Air Kuning 270.0 00.0 270.0 24 KK Port Dickson 9851.4 10.1 9861.4 25 KK Bukit Pelanduk 530.1 00.0 530.1 26 KK Linggi 530.1 00.0 530.1 27 KK Pasir Panjang 270.0 00.0 270.0 28 KK Seremban 66809.4 00.0 66809.3 29 KK Mantin 3290.5 00.0 3290.5 30 KK Nilai 8551.2 00.0 8551.2 31 KK Rantau 6761.0 00.0 6760.9 32 KK Ampangan 10291.5 00.0 10291.4 33 KK Sendayan 830.1 00.0 830.1 34 KK Kuarters KLIA 2050.3 00.0 2050.3 35 KK Lenggeng 100.0 00.0 100.0 36 KK Permaisuri 1570.2 00.0 1570.2 37 Hospital Tuanku Jaafar 5960.8 40.6 6000.8 38 Hospital Port Dickson 130.0 10.1 140.0 39 Hospital Tuanku Ampuan Najiha 230.0 00.0 230.0 40 KK Desa Sikamat 3070.4 00.0 3070.4 41 KK Gemencheh 1050.1 00.0 1050.1 42 KK Selayang Baru 280.0 00.0 280.0 43 KK Taman Ehsan 1560.2 00.0 1560.2 44 KK Tapah 3570.5 00.0 3570.5 45 KK Jelai 650.1 10.1 660.1 46 KK Simpang Kuala 1500.2 00.0 1500.2 47 KK Bandar Alor Setar 930.1 00.0 930.1 48 KK Air Hangat 2240.3 20.3 2260.3 No SDP Type 2 Type 1 Total N