PD Presentation: Diabetes Mellitus

Health promotion is a very important strategy in addressing public health problems as health aims to reach an overall state of physical, social and mental well-being and not just the absence of disease or illness. The definition of health promotion is given by WHO as it is a process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions. (WHO,1986). Therefore, health promotion is not just focused on health sector but it also focused beyond a healthy lifestyles and well-being.

What makes the different between disease prevention and health promotion is that it involves actions or procedures that can reduce or eliminate the risks that might incur disease, disability or even death. (WHO, 2019).

Treatment is normally being given before the signs or symptoms of the disease occur, or shortly thereafter. Out of many public health issues, diabetes mellitus is one the common type health issues that occurs in every country.

Diabetes is a disorder of metabolism. It is a chronic disease when the body have difficulties to produce insulin by pancreas or cannot respond appropriately towards it. It is important to curb diabetes because the insulin produced is used to absorb the excessive glucose to lower down the glucose level in the body. Inefficient of insulin produced will cause the blood glucose level to maintain high in the blood streams and this will eventually lead to health problems.

National Diabetes Institute (Nadi) executive chairman Datuk Dr Mustaffa Embong said that Malaysia has the highest rate of diabetes in Asia and had becomes one of the highest in the world.

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About 2.5 million of Malaysian aged 18 and above suffered from diabetes. (TheStar,2018). About 387 million diabetic patients have been reported in 2014 globally and 2.5 million of them were Malaysian and the prevalence of diabetes in Malaysia was 16.6%. (Redhwan, et al.2017) This has shown that Malaysia has a very serious problem toward diabetes and they are not aware of it because it acts as a “silent killer”. Type 2 diabetes shows no symptoms and 90% of all the diabetic cases were type 2 diabetes.

If diabetes is not treated properly, it will cause long term health related problems that is closely related to the macro- and microvascular complications. The most common problems for diabetes are damage to the blood vessels of the heart, brain, kidney failure, eyes and others more. Moreover, others part of body will also be affected by diabetes include digestive system, skin problems, teeth and gums, and the immune system. For those patients who are still working, diabetes might affect their job employment and work productivity. Diabetes may cause the workers to increase their absentees and thus decrease their work productivity. Not only that, having diabetes problems might cause them to have employment discrimination. (Tunceli, et al.2005)

Statistic shown that the number of diabetic cases has increased annually. So, in order to control the problems, there are some actions that Malaysia has done to overcome it. First, Malaysia has organized World Diabetes Day every year as one of the health promotion strategies. This event is held on the 14th of November. The purpose of this event is to raise awareness, gives education, commitment and support to Malaysian. A few programs are associated to support the event such as free body mass index (BMI), blood pressure and blood sugar tests, free eye screening, an exhibition on diabetes and diet patterns, special blood tests and also bold donation campaign. (Sibon, 2016). The health promotion strategies that used by Australia

Prevention strategies that used by Australia and Malaysia is almost the same that is by having a healthy lifestyle. Having a sedentary lifestyle and a poor diet will be a risk factor to type 2 diabetes. A proper diet such as limit the intake of sugar, reduced processed foods, high intake of fruits and vegetables and drink more water. High sugar intake will increase your blood glucose level and thus increase the secretion of insulin by pancreas and will eventually lead to diabetes. Fruits and vegetables have high fibre contents and will help you to keep your blood glucose level in a healthy range and thus leading to a lower risk of diabetes. Processed food contains a lot of salt, cholesterol, saturated fat and calories and these all can link to some sorts of health problems such as diabetes, obesity, heart disease and others more.

Drinking plain water will help you to avoid those beverages that contain high in sugar and other questionable ingredients. Beverages such as soda can be linked to an increase of both type diabetes. The most important part for a healthy diet is to avoid having meals with large proportions. Having meals with large proportions can cause you to increase blood glucose level leading to more health problems. (FMT. 2016) Maintaining a healthy lifestyle is hard for some people but it is a prevention strategy for people who have diabetes. Exercise regularly is a basis preventing diabetes. Being physically active can help you to manage your weight and reduce the risk factors of type 2 diabetes.

To maintain health, adults are recommended to exercise at least 150 minutes per week for moderate-intensity aerobic physical activity or at least 75 minutes per week for vigorous-intensity aerobic physical activity. Exercise regularly can increase your body’s sensitivity towards insulin which help to control your blood glucose level. Next, stop or quit smoking as cigarette not only can contribute to diabetes, and also to many serious health problems that can eventually lead to permanent death. Smoking was found to increase the risk of diabetes by 44% in average smokers and 61% in people who smoked more than 20 cigarettes daily. (Willi, et al.2007) Getting optimal amount of sleep is important as sleeping too much or too less are more likely to develop metabolic syndrome, which can increase the risk of diabetes. (BetterHealth, 2014)

There are some roles of physiotherapy in managing diabetes. Physiotherapy helps people to overcome disability and pain related to orthorpaedic, musculoskeletal, neurological and rheumatic illness. Diabetes can be controlled by having life modification such as exercise. Physiotherapy can use their extensive knowledge of physiology and anatomy to outline an individualized exercise program for the patients. These exercise can help them to achieve an optimal blood glucose level

Disease prevention, understood as specific, population-based and individual-based interventions for primary and secondary (early detection) prevention, aiming to minimize the burden of diseases and associated risk factors. Disease prevention is a procedure through which individuals, particularly those with risk factors for a disease, are treated in order to prevent a disease from occurring. Since the average lifespan of the population in Malaysia is increasing, stroke incidence is also expected to increase

• # If the words is not enough or the introduction is too short, can add the 3 catogaries of disease prevention: primary, secondary and tertiary.
• # Dunno where to add the types of diabetes, type 1 and 2.
• # See still enough words to add the elaboration of the effect of diabetes or not.

Most of the time, those with Type 2 diabetes do not have any symptoms at all until they develop a heart attack, stroke, kidney failure, go blind or have to get amputations. Type 2 diabetes has remained prevalent in Malaysia due to poor lifestyle and made worse by co-existing medical problems including obesity.

• #World Health Organisation (WHO) through study and survey of the disease indicated that diabetes will be the seventh leading cause of global death by 2030. ( see where to add )

References

1. Al-Naggar, R.A., Osman, M.T., Ismail, N., Ismail, Z., Noor, N.A.M., Ibrahim, N.S., Ruzlin, A.N.M. and Bin Selamat, M.I. (2017) Diabetes mellitus among selected Malaysian population: A cross-sectional study. International Journal of Medical Research & Health Sciences. [Online] 6 (4). p.1-11. Available from: https://www.ijmrhs.com/medical-research/diabetes-mellitus-among-selected-malaysian-population-a-crosssectional-study.pdf. [Accessed: 3rd February 2019]
2. BetterHealth. (2014) 10 tips to help prevent type 2 diabetes. [Online] Available from: https://www.betterhealth.vic.gov.au/health/ten-tips/10-tips-to-help-prevent-type-2-diabetes. [Accessed: 6th February 2019]
3. FMT. (2016) World Diabetes Day: Five dietary tips for diabetics. [Online] Available from: https://www.freemalaysiatoday.com/category/leisure/2016/11/15/world-diabetes-day-five-dietary-tips-for-diabetics/. [Accessed: 6th February 2019]
4. Sibon, P. (2016) Diabetes Malaysia to mark World Diabetes Day this Sunday. TheBorneoPost. [Online] 11th November. Available from: http://www.theborneopost.com/2016/11/11/diabetes-malaysia-to-mark-world-diabetes-day-this-sunday/. [Accessed: 4th February 2019]
5. TheStar. (2018) Malaysia has highest rate of diabetes in Asia. [Online] 25th July. Available from: https://www.thestar.com.my/news/nation/2018/07/25/malaysia-has-highest-rate-of-diabetes-in-asia-says-nadi-chairman/. [Accessed: 3rd February 2019].
6. Tunceli, K., Bradley, C.J., Nerenz, D., Williams, L.K., Pladevall, M. and Lafata, J.E. (2005) The impact of diabetes on employment and work productivity. Diabetes care. [Online] 28 (11). p.2662-2667. Available from: http://care.diabetesjournals.org/content/28/11/2662. [Accessed: 3rd February 2019]
7. WHO. (1986) Health Promotion. [Online] Available from: https://www.who.int/topics/health_promotion/en/ [Accessed: 27th January 2019].
8. WHO (2019) Health promotion and disease prevention through population-based interventions, including action to address social determinants and health inequity. [Online] Available from: http://www.emro.who.int/about-who/public-health-functions/health-promotion-disease-prevention.htm [Accessed: 29th January 2019].
9. Willi, C., Bodenmann, P., Ghali, W.A., Faris, P.D. and Cornuz, J. (2007) Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. Jama. [Online] 298 (22). p.2654-2664. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18073361. [Accessed: 6th February 2019]