Health experts predict diabetes will heavily burden Malaysia's healthcare system in future

KUALA LUMPUR, Nov 5 — The increasing number of young people in Malaysia who are diagnosed with diabetes will be a heavy strain on the country’s public healthcare system in the near future, Channel News Asia (CNA) has reported.

That’s because diabetes could lead to further health problems like kidney and heart diseases, stroke, blindness, and nerve damage. In worse cases, limbs may be amputated or a person might have to undergo dialysis for life.

The National Kidney Foundation chief executive officer Khor Xin Yun told CNA that diabetes has been identified as the primary cause of kidney failure in Malaysia.

“There has been an increase in those below age 45 requiring dialysis, making up 21.3 per cent of patients last year, up from 19 per cent in 2012,” she was quoted as saying.

Khor highlighted the significance of early detection, medication adherence, and management of diabetes to prevent the onset of kidney disease.

She pointed out that 52 per cent of new dialysis patients in Malaysia last year were diagnosed with diabetes and this trend has persisted over the past decade.

Khor also emphasised that private dialysis treatment can be costly, with expenses potentially reaching up to RM50,000 annually for patients, adding that, the number of new individuals requiring dialysis has increased from 6,700 in 2012 to 9,600 last year.

The Singapore-based news outlet reported several Malaysian diabetes experts calling for a massive national education and awareness campaign and stricter laws and policies to dial back this trend, starting with reducing the consumption of sugar drinks.

Diabetes Malaysia president Ikram Ismail told CNA that Type Two diabetes, also known as diabetes mellitus, accounts for 95 per cent of diabetes cases in the country.

“With people getting diabetes at a much younger age – during their late teens and early 20s - it means they must live with the disease for a much longer period of their life, resulting in more complications and a lower quality of life,” he was quoted as saying.

He said lifestyle changes must be made if Malaysia is to see the cases going down, and advocated changes to the kinds of food and drinks locals take and increased physical activity.

“People were more active before. They worked in the fields, and they didn’t use the car so often. They were more active, and their diet was healthier.

“They didn’t eat so much fast food and because of that the diabetes appeared much later. We had people getting diabetes only when they are 60 while some might not even develop it during their lifetime,” Ikram was quoted as saying.

He said the number of diabetes cases in Malaysia are rising at a faster rate now, surpassing earlier expectations.

“Unfortunately, diabetes has become very common in Malaysia these days,” he was quoted as saying.

One in five people aged 18 and above have the disease, CNA reported yesterday, citing data from Malaysia’s 2019 National Health and Morbidity Survey.

That was roughly 3.9 million people four years ago.

The survey, which is conducted every four years, showed the prevalence of diabetes has steadily increased from 11.2 per cent in 2011 to 13.4 per cent in 2015 and further spiked to 18.3 per cent in 2019.

Public health expert Professor Sharifa Ezat Wan Puteh from Universiti Kebangsaan Malaysia told CNA that diabetes and other non-communicable diseases (NCDs) like cardiovascular conditions among younger individuals will increasingly strain the healthcare system in the future.

“Before, the recommended health screening was for those aged 40. But there might be a need to move this to the age of 30 because people are getting diabetic and hypertension at a much younger age,” she was quoted as saying.

She also emphasised that the allocation for diabetes treatment, accounting for about 13 per cent of the Health Ministry's budget, could potentially be utilised more effectively on other healthcare priorities.

She added that this expenditure only covers diabetes treatment and does not encompass the additional costs associated with complications like kidney failure, cardiovascular diseases, and stroke, further straining government resources.

Sharifa also expressed scepticism about the impact of Malaysia’s increased tax on sugary drinks, suggesting it may not be sufficient to discourage consumption.

Noting the surge in sweetened beverages on the market which is contributing to the rise of diabetes, she stressed the importance of government initiatives to promote healthy eating habits and exercise among young people in schools.

Prime Minister Datuk Seri Anwar Ibrahim announced a 10 sen increase in the excise duty on sugary premix drinks, from 40 sen to 50 sen per litre for Budget 2024.

He said on October 13 while tabling next year’s budget that the increased revenue will be directed towards diabetes treatment and support for dialysis centres.

The Consumers Association of Penang, like Sharifa, said the 10 sen increase in tax is insufficient to cut down Malaysia’s increasing diabetes rate.

Its president Mohideen Abdul Kadeer wants the government to remove the price ceiling on domestically sold sugar, currently capped at RM2.85, which is said to be one of the lowest in South-east Asia.

“People will not feel the pinch with a 10 cent increase and they will just keep on paying for these drinks. The duty could have been increased by at least 50 cents.

“There are many factors that cause diabetes but sugar plays a main role,” he was quoted as saying.

Mohideen also hoped Malaysia would follow Singapore's lead in mandating nutrition labels on sugary drinks.

Singapore’s Health Ministry implemented a grading system based on sugar and saturated fat content in pre-packaged beverages in December last year.

The Singapore government also requires food and beverage outlets in the republic to display nutrition labels on their menus by the end of this year.

CNA cited a report from August 2022, jointly conducted by the Ministry of Health and the World Health Organisation, highlighted that the healthcare and economic burden associated with NCDs is projected to escalate in the future.

The report underscored that NCDs will progressively consume a larger portion of the national health budget.

It stated that the direct healthcare expenses for three major NCD categories - diabetes, cardiovascular disease, and cancer - amounted to approximately RM9.65 billion in 2017.

Kuala Lumpur Diabetes Malaysia chairman Dr S. Inthirani told CNA that for every known case of diabetes, there is likely another undiagnosed.

Dr Inthirani said that diabetes is not solely tied to sugar consumption, but also influenced by carbohydrate intake.

“People must realise that it is beyond just sugar but the amount of carbs one consumes.

“Many youngsters are more exposed because many eat out late after midnight while watching football matches in 24-hour mamak shops. They come back and then sleep. That is an issue,” the former government clinician was quoted as saying.