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Background: Diabetic ketoacidosis (DKA) is increasing in patients with type 2 diabetes in Asian countries. However, there is little information regarding the frequency and characteristics of DKA for Malaysian population. Objective: To identify the different clinical and biochemical features of DKA between adult patients with type 1 and type 2 diabetes. Methods: A cross-sectional, retrospective study was performed at University Malaya Medical Centre (UMMC) between January 2000 and December 2005. All patients (aged \>18 years) with type1 or type 2 diabetes were included in this study. Clinical and biochemical characteristics of DKA were studied. Precipitating factors for the development of DKA were also identified. Results: One hundred and twenty patients (61.9%) presented with DKA had type 2 diabetes. Both type 1 and type 2 patients had similar symptoms. Nausea (44.0%) and vomiting (66.4%) were most common symptoms of DKA. Infection (40.5%) was main precipitating factors of DKA. Blood pH level in previously-diagnosed type 1 diabetes patients was lower than that in previously-diagnosed type 2 diabetes (7.18±0.18 vs. 7.26±0.16, p \< 0.0001). Conclusion: A high proportion of DKA occurs in patients with type 2 diabetes. DKA developed severely in newly-diagnosed type 2 diabetes patients more than in previously-diagnosed type 2 diabetes patients.
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Background: Self-monitoring of blood glucose (SMBG) has become a more common practice among type-2 diabetes patients, but there is limited information available regarding the patients’ practice and knowledge of SMBG. Objective: To assess patients’ practice in terms of timing, frequency, performance and utilization of blood glucose value from SMBG as well as the relationship between patients’ SMBG knowledge and demographic characteristics. Method: A cross-sectional survey was conducted on 285 outpatients at the University Malaya Medical Centre of Malaysia from November 2006 to February 2007. Results: Education level and ethnics were significantly associated with reading of the user manual. Age had no significant influence in patients’ SMBG knowledge. Conclusion: More education programs pertaining to SMBG should be carried out, especially for patients with low education.
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Background: Sliding scale insulin is frequently utilized in hospitalized diabetes patients. However, most of the studies done concluded that sliding scale insulin causes hyperglycemia and hypoglycemia episodes in patients receiving it. Objective: To assess the rate of hyperglycemia and hypoglycemia in diabetes patients receiving sliding scale insulin. Method: Data was collected prospectively for 3 months and a total number of 52 patients were included. Rates of hypoglycemia and hyperglycemia episodes during the use of the sliding scale insulin were evaluated. Results: The rates of hyperglycemia and hypoglycemia episodes were 19.7 and 0.7 per 100 glucose measurements respectively. There were an equal number of patients with uncontrolled diabetes and acute hyperglycemia receiving sliding scale insulin. Conclusion: Hyperglycemia episodes were more prominent than hypoglycemia episodes in diabetes patients receiving sliding scale insulin. The rate of hyperglycemia was much higher than the previous studies.
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This survey studied the different types of Complementary Alternative Medicine [CAM] usage, the reasons of CAM usage and the out-of-pocket expenditure incurred by CAM users with Type 2 diabetes. This was a descriptive, cross-sectional survey that involved 132 Type 2 diabetes patients. A total of 30.2% of the patients used dietary supplements, followed by traditional Chinese medicine [TCM] [25.1%] and traditional Malay medicine [17.9%]. Two main reasons for using CAM include: the need of patients for more control of their diabetes and also dissatisfaction with conventional medicine. More than half of the patients spent around USD 7.2 to USD 13.9 per month on CAM as an out-of-pocket expenditure. Less than 20% of the patients consult their physicians before using CAM. About 57% of patients stated that their diabetes control did not show any improvement or worsen after CAM usage. CAM was widely used among Type 2 diabetics as an adjunct to their conventional therapy. More than half of the patients found that CAM did not give improvement nor worsens their diabetes control. CAM was one of the alternative treatments considered by Type 2 diabetes patients in complement with the conventional treatment for their diabetes control