Stand Against Prediabetes campaign for early detection, better management

The ‘Stand Against Prediabetes; Don’t Sugarcoat It’ (SAPd) program was recently launched in Putrajaya. The program aims to educate and motivate the public to determine their personal risk for type 2 diabetes mellitus (T2DM) and work with healthcare professionals (HCPs) to manage prediabetes to reclaim their health. The launch was officiated by Dato’ Lukanisman bin Awang Sauni, Deputy Minister of Health Malaysia, on 24 April 2024.

The SAPd program with the theme, ‘Check, Confirm, Consult, and Change’, began in 2022, said Dr Nurain Mohd Noor, President of the Malaysian Endocrine and Metabolic Society (MEMS). She added that MEMS initiated SAPd and invited the collaboration of seven other medical and allied health societies, as well as the involvement of Ministry of Health Malaysia (MOH) and supported by Merck Malaysia and Roche Diagnostics.

The societies include Malaysian Diabetes Educators Society (MDES), Malaysian Dietitians’ Association (MDA), Malaysian Family Medicine Specialists’ Association (FMSA), Malaysian Medical Association (MMA), Malaysian Pharmacists Society (MPS), National Heart Association Malaysia (NHAM), and The Chapter of Chemical Pathology & Metabolic Medicine, College of Pathologists, Academy of Medicine Malaysia (CPath AMM).

Nurain said that SAPd managed to attain several important achievements over the last 2 years.  She explained, “First, we successfully promoted the adoption of standardized prediabetes blood glucose test values in over 200 private chain, independent and hospital laboratories, as well as over 2,000 government clinics and 100 government hospitals.  Publishing these values in laboratory test reports will make it easier for healthcare professionals and their patients to ascertain the presence of prediabetes, if any.

“Second, we trained more than 2,000 healthcare professionals including doctors, nurses, pharmacists, and dietitians to enhance their effectiveness in the management of prediabetes.  We also published a clinical guide for their reference.  For the public, we produced an educational website, a booklet and a pamphlet.”

According to Emeritus Professor Dr Chan Siew Pheng, Chairperson of SAPd, prediabetes is manageable and reversible. This is the key message of the ‘Check, Confirm, Consult, and Change’ campaign. Chan shared some highlights from a prediabetes awareness survey conducted by the SAPd team in 2023 involving over 5,000 members of the public.

THE 4Cs CAMPAIGN

#1 CHECK for prediabetes risk

·       76 percent had never been tested and were unsure whether they had prediabetes.

·       Yet, 40 percent of this group had the classical risk factors for prediabetes, namely, being overweight, having a family history of diabetes, and being physically inactive.

Chan said that checking for risk of prediabetes is the first step. The public should be encouraged to take the online risk checker on SAPd’s website (https://standagainstprediabetes.my/check-your-risk). If the results show that they are at risk, they should be provided a simple finger prick blood glucose test at a private GP clinic, government health clinic, or community pharmacy. By end of May 2024, SAPd would have enlisted 700 community pharmacies nationwide to provide complimentary finger prick blood glucose tests.

#2 CONFIRM the presence of prediabetes

·       60 percent of the survey respondents did not know the blood glucose range for prediabetes.

Chan emphasized that a finger prick test cannot confirm whether people have prediabetes. So, if their results show a higher-than-normal blood glucose level, they will need to get a proper blood test from a laboratory, clinic or hospital. Table 1 shows the different types of tests available and their respective values.

#3 CONSULT healthcare professional

·       According to the survey, 35 percent of respondents were unsure or disagreed that prediabetes required treatment or intervention. There was general lack of awareness that prediabetes is serious but can be reversed.

·       Majority of respondents regarded HCPs (doctors, followed by dietitians, nurses, and pharmacists), as trusted sources of information and advice about prediabetes. 

Chan said that it can be upsetting for people if their blood test confirms they have prediabetes.  They may feel unsure of what to do next. This is why it is important for HCPs to provide guidance and support in the way of determining the best approach to manage prediabetes with lifestyle intervention and medication, if required. HCPs should monitor their patients’ progress during follow-up visits and keep motivating them to achieve the desired results.

#4 CHANGE to reclaim health

There are five pillars of prediabetes management: losing excess body weight by eating a healthy diet; increasing physical activity and exercise; adopting healthy lifestyle habits (ie, getting enough good quality sleep, managing stress, and quitting smoking, vaping, alcohol and other addictive substances); taking medication as prescribed; and teaming up with HCPs for guidance and support.

Chan encouraged those with prediabetes obtain practical tips to effectively manage the condition by visiting the SAPd website (www.standagainstprediabetes.my).  There, they can also download the e-booklet (https://standagainstprediabetes.my/static/sapd-booklet.pdf) that summarizes the key recommendations contained on the website.