CAP: Diabetes the Silent Killer

The grave nature of covid-19 has made nations globally to take drastic measures to curb the pandemic. However there is another killer among us that yearly has taken even a bigger toll of fatalities compared to covid -19, which is diabetes mellitus.

The WHO estimated that more than 200 million people worldwide are living with diabetes and each year another seven million develop it. In 2019, there were more than 500,000 deaths among those aged 60 years and younger due to diabetes in South East Asia.

According to the Malaysian 2019 Social Statistics Bulletin diabetes is one of the ten principal causes of death in 2018.

According to recent statistics from the World Health Organisation, as of 2016, a total of 4,710 Malaysian experienced diabetes-related deaths, while 13,150 Malaysians experienced deaths attributable to high levels of blood glucose. This is a far cry from the number of death due to covid-19 in Malaysia.

Diabetes is an important public health concern. Globally there is a rising trend in the prevalence of diabetes due to many factors such as population growth, aging, urbanisation and increasing prevalence of obesity and physical inactivity.

In Malaysia in spite of numerous campaigns against diabetes its prevalence especially that of Type 2 has increased to epidemic proportions?  According to the 2019 National Health and Morbidity Survey (NHMS 2019). One in five adults or about 3.9 million people aged 18 years and above in Malaysia, suffer from diabetes, the diabetes prevalence in Malaysia has increased to 18.3 %, compared to only  1-2 percent in 1960.

Surveys have shown that for every two known diabetics, there is at least one more who never knows of having the disease (and by extension, may never seek treatment) until irreversible complications set in. Worse still, Type 2 diabetes is seen as no longer a disease of middle or old age — children as young as 10 years old suffering from diabetes (both Type 1 and Type 2) are not an uncommon sight nowadays.

Doctors found that the young diabetics were usually obese, and their condition could be traced to eating too much unhealthy food and having a sedentary lifestyle. According to a survey, Type 2 diabetes  was more apparent in people aged between 18 and 29, however there were also children below 10 years inflicted by the disease.

The disease is dangerous because it can also affect the patient’s vital organs like the heart, kidneys, nerves and eyes. If diabetes is not well controlled, it can lead to many complications. High blood glucose levels over a period of time, coupled with the features of metabolic syndrome, cause damage to the blood vessels, which in turn, result in damage to many organs. Although many serious complications, such as kidney failure or blindness, can affect individuals with diabetes, it is the complications of the foot that take the greatest toll.

Somewhere in the world every:

  • 10 seconds two people develop diabetes
  • 10 seconds 1 person dies of diabetes
  • 30 seconds a limb is lost to diabetes.

Obesity is one of the major contributing factors to diabetes, the high incidence of diabetics in the country is not surprising, as Malaysia is the most obese country in Asia with an overweight and obesity rate of more than 50%.

The easily availability of food around the clock in the country also indirectly cultivates the unhealthy Malaysian habit of taking supper. Eating at night has been linked to weight gain. Together with the mushrooming of fast food outlets which serve unhealthy foods also contribute to obesity. Fast foods which are high in fats and salt together with high-sugar soft drinks appeal to children. Continuous consumption of such foods increases their chances of getting diabetes.

Diabetes is a chronic disease that can be prevented and for those affected, diabetes can be managed to delay or prevent its complications by maintaining a healthy lifestyle and making better choices in their diet.

In view of the alarming rate of diabetes among Malaysians, the Consumers Association of Penang urges the authorities to:

  • Ban the use of High Fructose Corn Syrup (HFCS), a cheap and unhealthy substitute for refined sugar, in food products.
  • Require manufacturers to avoid or reduce sugar in their products.
  • Amend labelling laws to make manufacturers change their labels to clearly indicate the amount of sugar in their food by showing the number of teaspoonful of sugar in their foods.
  • Stop the advertisements of high-sugared and other junk food and drinks in television.
  • Ban the sale of junk food in school canteens and food hawking within a fixed perimeter around schools so that schoolchildren are not tempted to purchase unhealthy food.
  • Initiate the removal of vending machines dispensing junk food and sugary drinks from areas such as hospitals, airports and schools. Instead provide drinking water in water dispensers at these places.
  • Launch a massive campaign in the mass media to educate the public on the dangers of diabetes.
  • Launch a massive campaign to encourage consumers to engage in physical activities to avoid being obese. ·
  • Stop issuing 24 hours licenses to eating outlets
  • Consumers should reduce their sugar consumption by reducing the intake of processed foods and drinks, especially soft drinks – which are also called “liquid candy” in the West.

Letter to the Editor, 10 June 2020