Working presently as Senior Assistant Medical Officer at the Department of Psychiatry and Mental Health, I had been in this profession since 1982. Global warnings over diabetes increase. Research carried out by the International Diabetes Federation (2009) reveals that around 314 million people, equating to 8.2% of the global adult population, may have impaired glucose tolerance (IGT) which is a condition that often precedes the development of diabetes.
The incidence of diabetes in Malaysia is similar to other countries in the world (Malaysian Diabetes Association, 2009). Diabetes Mellitus is one of the commonest chronic illnesses seen at primary care facilities. A past study by the Malaysian National Health and Morbidity Survey (1996) showed that the prevalence of Diabetes is increasing from 6.3% to 8.3% for adults aged above 30 in 1996.
However, there are nearly 1.2 million people in Malaysia who currently have diabetes as studies showed that the prevalence of obesity among Malaysian adults increased by a staggering 250% over a 10 year period from 1996 till 2006 while the number of overweight cases has increased by 70% as 43% of Malaysians aged above 30 suffer from diabetes (Malaysian Diabetes Association, 2010). The National Health and Morbidity Survey (2006) in a later study showed that two out of every five Malaysian adults or 43%, were either overweight or obese and a distressing situation where the number of obese adults had more than tripled over a decade, from 4% in 1996 to 14% in 2006. In addition, about 38% of youngsters aged between 12 and 18 were classified as overweight. The major causes of morbidity and mortality in the diabetic patient are heart disease and stroke (Tzagournis & Falko, 1982).
Diabetes Mellitus is a chronic and progressive disorder that can have an impact upon almost every aspect of life. It can affect children, young people and adults of all ages, and is becoming more common. Diabetes is a disease which causes the body to either not produce insulin or to not properly make use of the insulin that it does make (American Diabetes Association, 2002). When carbohydrates are consumed, the body must convert glucose into energy that can be used to do everyday tasks. Insulin is a hormone which facilitates this process and is therefore an important part of the body's normal functioning that helps to maintain an appropriate level of glucose in the blood. In the case of diabetic patient who do not produce or properly use insulin, blood glucose levels must be manually regulated or the patient may sufferer undesired consequences (Stratton et al., 2000)
A high proportion of diabetes cases are not diagnosed or are diagnosed late, which contributes to a high prevalence of complications and thus to the high cost of their management (Eliasson et al., 2005). Complications from diabetes can be reduced by better and more adapted follow-up such as blood glucose control, regular eye and kidney function examinations, lipid and blood pressure management.
2.1Classification of Diabetes Mellitus
Type-1 insulin dependence diabetes mellitus was formerly called juvenile-onset diabetes, because it mostly attacks young people. This type of diabetes mellitus is characterized by the destruction of pancreatic beta cells. The destruction of BETA cells will decreased insulin production and caused uncontrolled glucose production by the liver. It symptoms include increased thirst and urination, constant hunger, weight loss, blurring of vision and extreme tiredness (Mayo Clinic, 2010). In type-2 diabetes, the body cells are resistant to the action of insulin and/or the pancreas produce decreasing amounts of insulin. As a result, the blood glucose level becomes progressively higher over time and the body cells receive an inadequate supply of glucose – the body’s primary energy source. The symptoms of type-2 diabetes develop gradually and are not as noticeable...