Symposium - Working paper presented at the 1st National Diabetes Nursing Symposium

1. Diabetes Support Group
Feisul Idzwan Mustapha MBBS, MPH, AM(M)
Consultant in Public Health Physician (Non-Communicable Diseasess)
Ministry of Health, Malaysia
1st National Diabetes Nursing Symposium
8th National Diabetes Conference 2017
29 July 2017
USJ Subang, Selangor
dr.feisul@moh.gov.my
Ministry of Health
Malaysia

2. Undiagnosed
Diagnosed
6.3%
8.3%
11.6%
15.2%
17.5%
22.9%
35.1%
47.7%
Diabetes Prevalence 1986 to 2015
12.80% 13.10%
19.80% 17.20%
2011 2015
Hypertension Prevalence 2011 to 2015
32.6% 30.3%
Hypercholeterolaemia 2006 to 2015
Prevalence of Selected NCD Risk Factors
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3. CURRENT
PROJECTION
Projections for Diabetes, 2025
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4. TREN Pencapaian HbA1c 2011-2016
HbA1c <6.5%(target30%)
NEGERI 2011 2012 2013 2014 2015 2016
JOHOR 14.4 17.7 20.1 21.3 20.2 18.6
KEDAH 19.1 15.8 21.9 25.7 25.2 13.9
KELANTAN 12.5 11.6 19.1 19.8 20.2 20.8
MELAKA 17.3 22.2 26.8 33.3 24.1 23.5
N.SEMBILAN 17.9 19.7 25.2 30.2 29.3 28.6
PAHANG 14.3 19.7 21.6 22.3 20.5 18.8
PERAK 13.9 18.2 29.3 31.2 28.1 28.0
PERLIS 26.1 27.9 29.0 33.6 31.7 35.0
P.PINANG 17.6 16.1 21.0 28.9 20.7 23.6
SABAH 26.3 38.9 39.3 43.9 41.4 36.3
SARAWAK 15.8 8.4 36.0 40.3 38.6 27.8
SELANGOR 15.2 18.3 25.6 25.2 25.6 26.6
TERENGGANU 15.5 16.3 20.8 24.4 20.9 19.5
WP K.LUMPUR 18.0 24.3 33.3 35.9 26.5 23.9
WP LABUAN 23.1 53.5 0 49.8 40.0 30.9
WP PUTRAJAYA 14.9 29.8 39.8 34.8 26.5 16.9
MALAYSIA 15.9 18.5 25.6 28.9 25.6 22.7
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5. Organization of Health Care
Delivery System Design
Decision Support
Clinical Information System
Self-Management Support
Community Resources
6 Essential
Elements of
the Chronic
Care Model
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6. Multi-disciplinary care
team (in health clinics)
Post-basic training
for paramedics
Clinical practice
guidelines
Quality improvement
programs
Clinical
information
systems
Patient resource
centres
Community
empowerment
Strengthening Chronic Disease
Management at the primary care level
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7. Patient (Peer) Support Group
• Successful implementation of a Patient or Peer Support
Group Program has been shown to:
• Help patients understand their disease better;
• Help patients achieve good disease control; and
• Reduce rates of referral to hospitals due to
complications.
• Rationale – patients are more likely to accept advise
from their peers or people living with the same
condition.
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8. 8

9. ProposedScope: Based on the 7 basic
principleson the managementof NCDs
(includingdiabetes)
Basic Principles Proposed scope for Patient Support Group
1. Screening
2. Register
3. Clinical
management
• Reminder for adherence to treatment or
medications
• Know your numbers
• Know treatment targets
4. Screening for
complications
• Reminder for screening for complications
(e.g. blood tests, fundus examination etc.)
5. Rehabilitation • NOT included
6. Defaulter tracing • Reminder of up-coming appointments
7. Selfcare – Patient’s
empowerment
• Use of specified “tools” (e.g. diabetes
diary, info sheets etc.)
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10. Next steps
• Title / branding
• Implementation guideline
• Training module for peers (including notes for
“facilitators”)
• Implementation tools
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• To form small technical working group
• Based on existing MOH guidelines
• Use of ICT or social media:
• WhatsApp groups for targeted messaging / health education or
promotion

11. Subject Matter Expert
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12. 12

13. Thank you
dr.feisul@moh.gov.my
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