Tests key in diabetes fight

PETALING JAYA: With millions of Malaysians being pre-diabetic, tests are important to prevent them from becoming diabetic, say experts.

Malaysian Pharmacists Society (MPS) president Amrahi Buang said prevention measures would enable crucial follow-up action to be taken.

On the proposal that pre-diabetes tests be made free at all pharmacies, he said it will depend on government policy.

“If not (for) free, community pharmacists can offer this service at a reasonable price,” he said.

At an event organised by the Stand Against Pre-diabetes (SAPd) programme last month, Deputy Health Minister Datuk Lukanisman Awang Sauni said almost five million Malaysians are pre-diabetic and at risk of being diabetic.

He also revealed that a survey of 5,000 people found that an alarming 76% of the respondents had never been tested for diabetes, with sufferers not showing any symptoms.

Lukanisman also said the disease accounts for nearly 50% or some RM4bil of the ministry’s annual treatment cost.

For MPS’ Amrahi, these findings show that health literacy is lacking among Malaysians.

The Health Ministry’s White Paper focuses on this and under the Sihat Malaysia national agenda, preventive and promotive care is being prioritised, he noted.

“Community pharmacists already do pre-diabetic tests.

“Now, they should advise more people to go for the tests to prevent them going into the diabetes stage. Refer to a doctor if necessary. This is a screening test,” he added.

At the SAPd event, which was aimed at preventing the onset of Type 2 diabetes mellitus, SAPd chairman Professor Emeritus Dr Chan Siew Pheng said that by the end of May, the group would seek the cooperation of 700 community pharmacies nationwide to provide free capillary blood glucose testing, donated by Roche Diagnostics.

Type 2 diabetes affects how one’s body uses sugar or glucose for energy. It stops the body from using insulin properly, which can lead to high levels of blood sugar, if not treated.

Over time, Type 2 diabetes can cause serious damage to the body, especially nerves and blood vessels.

Dr Chan said pricking one’s finger to test the blood glucose level would not confirm whether the person was pre-diabetic.

“If the result shows a higher-than-normal level of blood glucose, you must undergo a proper blood test at a laboratory, clinic or hospital,” she said.

Amrahi said he is pleased that community pharmacists are being recognised to play a role in this aspect.

“This move has a high impact on the rakyat and the country.

“We need to have an integrated health system supported by a proper financing scheme.

“The current healthcare system is not sustainable. What we need is the political will to do it.”

There are several types of pre-diabetes tests to check if one is at risk of being diabetic such as A1C, fasting blood sugar test, random blood sugar test and glucose tolerance test.

The first three require a finger prick.

Alpro Pharmacy professional care and development manager Ng Yi Ling said there is a tendency for many to feel “it is not a big deal” to be pre-diabetic and they may even be in denial once diagnosed.

“Many of those who come for tests are those who are already diagnosed as diabetic, (or those who are) pregnant or elderly.

“When we recommend tests, some will say they will check with their doctors. But when we explain things properly, many will be receptive to taking the tests.

“If I notice a patient has low blood sugar, I would suggest a blood glucose test without a blood prick.

“If I notice dark folds on the neck, I would recommend a finger prick blood glucose test. These cost between RM3 and RM4,” she said.

Ng said it is important to rule out false readings by ensuring that the patient did not have a sugary drink or anything sweet before the test.

“With the A1C, we can immediately know the patient’s three-month blood glucose readings.

“If the patient is found to be pre-diabetic, I would ask for the history of their diet and advise them on diet management, and, if needed, refer the patient to a nutritionist to try to get the blood glucose level to return to normal.”