> New campaign delves into diabetes disabilities
The article below is extracted from Medical Tribune dated 1 - 15 Oct 2005. You can download the issue from Medical Tribune website at http://www.medicaltribune.com/
New campaign delves into diabetes disabilities
by Amy Morison, Medical TribuneDiabetes has become a national disability, according to the director of the National Diabetes Institute (NADI), and with numbers rising, it is important for Malaysian doctors to detect and treat its complications more aggressively.
Speaking to Medical Tribune about the significance of the recently launched V-Protect campaign – an Emerging Pharma-sponsored incentive aimed at increasing awareness for microalbuminuria testing – NADI director and endocrinologist Dato’ Professor Mustaffa Embong stressed that early detection and intervention are essential to slowing the macrovascular problems that occur with diabetes.
“In Malaysia, there is a very high rate of microvascular complications in diabetic patients – 40 to 50 percent experience neuropathy, 35 to 45 percent have developed nephropathy and about 30 percent have retinopathy,” he said. “It is our challenge to reduce the rates of these complications.”
Moreover, complications are already evident in 30 percent of diabetics at the point of diagnosis. Which is why NADI has been collaborating with Emerging Pharma and the Malaysian Society of Nephrology (MSN) in the V-Protect campaign: to alert GOs to the importance of screening for microalbuminuria, a risk factor for major vascular problems.
The campaign is a two-pronged approach, in which GOs will first be invited to participate in a screening program and then asked to collect their patients together for microalbuminuria testing. All participating doctors will be provided with free test kits.
In addition to the campaign screening, Mustaffa said that NADI will collate data for a study that will establish the prevalence of albuminuria in Malaysia.
GPs will also have the opportunity to participate in a series of ongoing seminars about diabetes and kidney disease that are running in conjunction with the V-Protect campaign.
Head of MSN and consultant nephrologist at Hospital Kuala Lumpur, Dato’ Dr. Zaki Morad b Mohd Zaher, said the campaign highlighted the multiple advantages of managing diabetes with an early intervention strategy.
“Prior to this [V-Protect], GOS may not have been paying special attention to microalbuminuria because there was no major evidence to suggest that early intervention would make any difference to the patient,” he explained. “But now we have data from a number of large tiral that show very clearly the benefits of treating this disease aggressively.”
Reflecting on his own experience and the experience of many nephrologists worldwide, Zaki said specialists mostly see patients with chronic complications at a late stage.
“We cannot intervene at this point and, in the case of kidney disease, we simply prepare such patients for dialysis,” he lamented. “It would be better to play a role earlier and work with GPs on slowing the progression of these complications. Ideally, specialists would propose certain treatment strategies for the primary care physicians to consider.”
Besides kidney complications, Zaki further reiterated how detection of microalbuminuria can help to detect a range of cardiovascular problems, thus enabling GOS to start protecting their patients in a more comprehensive way.
“This campaign is specifically targeted at GOS so they start checking for albuminuria,” he said. “Now the test is a lot easier too. They simply collect a small urine sample and use the dipstick.”
