Diabetes mellitus remains a critical non -communicable disease challenge globally and within Brunei Darussalam. While public health initiatives are ongoing, the rising prevalence and associated costs of disease complications continue to pose significant systemic hurdles. This report evaluates the continuum of diabetes care in Brunei, which includes prevention, early detection and clinical management. Furthermore, it identifies systemic barriers and proposes future strategic interventions aimed at flattening the prevalence curve and reducing the health economic burden of diabetes

Diabetes mellitus remains a critical non -communicable disease challenge globally and within Brunei Darussalam. While public health initiatives are ongoing, the rising prevalence and associated costs of disease complications continue to pose significant systemic hurdles. This report evaluates the continuum of diabetes care in Brunei, which includes prevention, early detection and clinical management. Furthermore, it identifies systemic barriers and proposes future strategic interventions aimed at flattening the prevalence curve and reducing the health economic burden of diabetes

Objective: This study aims to characterize the presentation, biochemical status of children with T1DM at diagnosis, the type of subcutaneous insulin regimens initiated, and to determine the incidence of T1DM in Bruneian children aged 18 years and younger. Methodology: A retrospective electronic and paper medical chart review was performed on patients aged 18 years and younger diagnosed with T1DM from 2013 to 2018 in Brunei Darussalam. Results: A total of 31 children with a mean age of 10.2 ± 3.6 years old were diagnosed with T1DM, of which 66.7% presented with diabetic ketoacidosis (DKA), a majority in severe DKA with an intercurrent illness (p=0.021). The mean HbA1c was 13.6 ± 2.7% with a mean serum glucose of 37.0±14.9 mmol/L at diagnosis. In the majority of the children (67.7%), multiple daily injections of subcutaneous insulin were initiated. The incidence of T1DM in children aged 18 years and younger was 4.9 per 100,000 for the year 2018. Conclusions The majority of the patients in this study presented with severe DKA with an intercurrent illness. This highlights the importance of childhood T1DM awareness among the public and healthcare providers. The incidence of childhood T1DM in Brunei Darussalam is similar to other countries in the Asian region, being relatively low, compared to the rest of the world.
Diabetes Mellitus, Type 1 ; Diabetic Ketoacidosis

Bone metastasis is the most common diagnosis considered for lytic lesions in the bone. Parathyroid cancer presenting as overt bone disease with diffuse lytic lesions secondary to untreated hyperparathyroidism (HPT) is a rare entity nowadays. We report the case of a 50-year-old Chinese lady who presented with diffuse bone lesions consistent with Brown tumours, vertebral body collapse and hypercalcaemia mimicking bone metastasis and was later diagnosed with parathyroid cancer.
Adenocarcinoma ; Osteitis Fibrosa Cystica ; Hyperparathyroidism ; Parathyroid Neoplasms

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