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Type 2 DM is a growing epidemic in Malaysia. The prevalence
of T2DMhad risen from 11.6% in 2006 to 15.2% in 2011 in adults
aged
≥
18 years and is expected to rise to about 22% in the
year 2020. DiabCare is a project started in Europe to provide
large scale, standardized information about status of diabetes
management and diabetes related complications. The data
could facilitate healthcare policy and improve the status of
diabetes care. DiabCare Asia started in 1997 and involved
many countries. The methodology involves collecting data on
demographics, treatment, diabetes control and complications
on a standardized case record form. Questionnaires on patient
health, treatment adherence and hypoglycemia were also
administered. In Malaysia, as a result of previous DiabCare
studies, the Ministry of Health had set up Diabetes Resource
Centres, trained more diabetes nurse educators, made HbA1c
test widely available and implemented standardized follow-up
protocols.
In DiabCare 2013, 19 hospitals with a total of 1,668 patients
were involved in the study. Mean age of the patients was 57.8
years; BMI 29.0 kg/m
2
; 48.7% led a sedentary lifestyle; mean
HbA1c 8.5%; 23.7% had HbA1c <7.0%; mean LDL 2.62 mmol/L
with 90% on treatment; mean BP 139.8/78.7 mmHgwith 86% on
treatment; 10.9% had history of myocardial infarction; 7.0%
had history of stroke/TIA; 27.8% had microalbuminuria and
23.4% had macroalbuminuria; 23.6% had non-proliferative
and 12.0% had proliferative retinopathy; 41.0% had peripheral
neuropathy. The most common OAD used was metformin
(78.6%) followed by SUs (35.4%); 65.4% were on insulin and the
most common insulin used was premix insulin (44.6%). Only
26.0% adhered completely to diet advice; 19.1% to exercise
recommendation; 72.5% to oral medications and 54.0% to
insulin injections treatment.
In summary, DiabCare studies had provided valuable input in
determining diabetes care in Malaysia. DiabCare 2013 had
shown improvement in the care of diabetic patients but more
efforts need to be done to achieve better control and reduce
complications.
S01-2
Diabetes care in Australia
Margaret M
C
GILL
1
.
1
Diabetes Centre, Royal Prince Alfred Hospital,
University of Sydney, Sydney, Australia
Australia is not exempt from the burden of diabetes. Fortu-
nately however, universal health insurance (Medicare) pro-
vides free or subsidized diabetes treatment in primary care
and public hospitals. People with diabetes can choose to have
health insurance and access private specialist/hospital dia-
betes care. Common diabetes medications are subsided by
the government Pharmaceutical Benefits Scheme. Australia
has a National Diabetes Strategy which contains 7 goals but
the challenge is its implementation which needs both top
down and bottom up strategies to reduce the diabetes burden.
Unique to Australia is the National Association of Diabetes
Centres (NADC). The NADC supports organizations rather
than individuals. Membership (n = 109 Centres) is via a
stringent accreditation process and sets standards for 4 types
of membership (i) Centres of Excellence, (ii) Tertiary Centres
(iii) Care Centres and (iv) Affiliate Centres. A major function of
the NADC is the biannual, cross-sectional Australian National
Diabetes Audit (ANDA) which provides, through the standar-
dized collection of a minimum dataset, an overview of the
clinical status of people who attend specialist services. ANDA
results provide a mechanism for establishing benchmarks so
that participating organisations can evaluate their individual
site against peers. A fundamental role of the NADC is also
to provide an annual forum for organisations to showcase their
successful and innovative clinical strategies, thus promoting
sharing and learning. This meeting is in addition to the annual
scientific congress. The NADC developed and promotes the
“
Diabetes Management in General Care Settings
”
coursewhich
is a national program focusing on the educational needs of
nurses and allied health professionals working in primary
care. In recent years there has been an increasing focus on the
role of primary care in providing diabetes services. This change
in themodel of care has highlighted the importance of integra-
tion of services underpinned by data collection between
primary and tertiary care. An example of this is the research
findings from the Royal Prince Alfred Hospital Diabetes
Centre. Through interrogation of our extensive Diabetes
Centre database we have shown the poor prognosis of youth
onset type 2 diabetes with outcomes much worse than for
type 1. A minimum data set from local primary care net-
work demonstrated equally poor indicators. These outcomes
have ramification for clinical practice and demonstrated the
need for innovative translational programs for the better-
ment of care to the community we serve. The burden is high
and requires strategies to focus urgently on prevention, early
detection and improved care.
S01-4
Meeting the needs of diabetes care in old people
Nigishi HOTTA
1
.
1
Japan Organization of Occupational Health and
Safety, Chubu Rosai Hospital, Nagoya, Japan
As the patients with diabetes become older, they face
physiologic, cognitive, financial, and personal changes which
they may have little control. It is known that at least 20% of
peoples over the age of 65 years have diabetes. In Japan,
there are about 25% over the age of 65 years among the total
population. This number can be expected to increase rapidly in
the coming decade. Thus, it becomes the serious matter in
Japan.
Older persons with diabetes are at an increased risk for func-
tional limitation with diabetic complications and/or comitant
of other diseases. Therefore, it is important for all older
persons with diabetes primarily responsible individual goals
and priorities in collaborations with the health care team.
Functional ability is the degree of independence with which a
person is able to perform common activities of daily living.
Each patient
’
s total functioning is divided into fourmajor areas
such as physical, cognitive, emotional, and psychosocial.
In my presentation, cognitive dysfunction in older patients
with diabetes is talked from the viewpoint of prevention and
treatment.
S01-5
Current diabetes care status in Korea
Dae Jung KIM
1
.
1
Ajou University, Suwon, South Korea
Diabetes mellitus is an increasing global health problem.
Mortality fromdiabetes was 1.3million people in 2010, twice as
many as in 1990. Furthermore, diabetes increases the risk of
disabling and life-threatening complications such as retinop-
athy, neuropathy, nephropathy, cardiovascular, and cerebro-
vascular diseases, peripheral artery occlusive diseases.
The prevalenceof diabeteshas increased significantly in recent
decades. And the International Diabetes Federation states that
382 million people worldwide were suffering from diabetes in
2013, expected to rise to 592 million people by 2035. In a
nationally representative sample of Korea aged 30 years or
older, the prevalence of diabetes increased from 8.6% to
11.0% from 2001
–
2013. This number is expected to rise to 5.5
million by 2030, about 10.9% of the adult population aged 20
years or older.
The prevalence has especially increased in aged 70 years or
older; the rate of diabetes was 27.6% in 2013, approxi-
mately twice as high as in 2001. In addition, obesity, which is
the major causal factor detected in prediabetes and diabetes,
increased from 29.2% to 31.8% during the same period. Also,
there is an inverse linear relationship between body mass
index (BMI) and age at the diagnosis of diabetes among
those who are newly diagnosed. Average BMI decreased from
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