1.Awareness, knowledge, attitudes and practices on the management of diabetes mellitus patients with periodontitis amongst Malaysian primary care practitioners
Norul Nurdiyana Nordin ; Rathna Devi Vaithilingam ; Roslan Saub ; Nazrila Hairizan Nasir ; Ahmad Sharifuddin Mohd Asari ; Baizury Bashah ; Maimunah Mahmud ; Nik Mazlina Mohammad
Malaysian Family Physician 2021;16(3):44-55
Introduction: The bi-directional relationship between periodontitis (PD) and diabetes mellitus (DM) has been confirmed. Medical practitioners (MPs) serve an important role in relaying this information to patients. This study aimed to investigate the awareness, knowledge, attitudes and practices (KAP) in the management of DM patients with PD in primary care clinics under the Ministry of Health (MOH) of Malaysia.
Methods: A self-administered questionnaire on KAP in the management of DM patients with PD was posted to 725 medical officers (MOs) and family medicine specialists (FMSs) in MOH clinics in Kedah, Terengganu, Johor and Negeri Sembilan. Collected data were tabulated and analysed using descriptive and regression analyses (simple and multiple). Statistical significance was defined as p < 0.05.
Results: A total of 549 MPs responded. The majority of MPs were MOs (92.6%) and female (75.8%). FMSs had a greater awareness of PD when compared to MOs (p = 0.002). All MPs had good knowledge, except for the incorrect notion that excessive sugar causes PD (94.3%). Overall, FMSs had better knowledge when compared to MOs (p=0.026). The majority of MPs agreed that ‘they should update their knowledge on the association between systemic disease and PD’ (89.6%) and claimed that ‘it was not their responsibility to examine DM patients for PD’ (83.1%). Most MPs did not enquire or examine for PD in their DM patients. More FMSs (67.5%) referred patients to dentists compared to MOs (31.6%).
Conclusion: Most MPs have sufficient knowledge on PD, but a negative attitude in the management of PD in DM patients. The reasons for not referring included workload and patients refusing referral.
2.Management of prediabetes in Malaysian population: An experts’ opinion
Mafauzy Mohamed ; Ee Ming Khoo ; Zanariah Hussein ; Nor Shaffinaz Yusoff Azmi ; Guan Jian Siah ; Feisul Idzwan Mustapha ; Noor Lita Adam ; Azhari Rosman ; Beng Tian Lee ; Siew Hui Foo ; Nagammai Thiagarajan ; Nik Mazlina Mohammad ; Kevin Moses ; Hannah Loke
The Medical Journal of Malaysia 2020;75(4):419-427
Introduction: Prediabetes, typically defined as blood glucose
levels above normal but below diabetes thresholds, denotes a
risk state that confers a high chance of developing diabetes.
Asians, particularly the Southeast Asian population, may have
a higher genetic predisposition to diabetes and increased
exposure to environmental and social risk factors. Malaysia
alone was home to 3.4 million people with diabetes in 2017; the
figure is estimated to reach 6.1 million by 2045. Developing
strategies for early interventions to treat prediabetes and
preventing the development of overt diabetes and subsequent
cardiovascular and microvascular complications are therefore
important.
Methods: An expert panel comprising regional experts was
convened in Kuala Lumpur, for a one-day meeting, to develop
a document on prediabetes management in Malaysia. The
expert panel comprised renowned subject-matter experts and
specialists in diabetes and endocrinology, primary-care
physicians, as well as academicians with relevant expertise.
Results: Fifteen key clinical statements were proposed. The
expert panel reached agreements on several important issues
related to the management of prediabetes providing
recommendations on the screening, diagnosis, lifestyle and
pharmacological management of prediabetes. The expert panel
also proposed changes in forthcoming clinical practice
guidelines and suggested that the government should advocate
early screening, detection, and intensive management of
prediabetes.
Conclusion: This document provides a comprehensive
approach to the management of prediabetes in Malaysia in
their daily activities and offer help in improving government
policies and the decision-making process.