RESUMEN
BACKGROUND: The aim of this study was to determine the effect of a Self-Monitoring Blood Glucose (SMBG) intervention package through a subscription model in improving HbA1c and health parameters among type-2 diabetes mellitus (T2DM) individuals in Malaysia. METHODS: This is a quasi-experimental study involving a total number of 111 individuals with T2DM (mean age 57.0 ± 11.7 years, 61% men) who were assigned to intervention (n = 51) and control (n = 60) groups. The intervention group participants were the subscribers of SugO365 program which provided a personalized care service based on self-recorded blood glucose values. Subscribers received a Contour® Plus One glucometer which can connect to Health2Sync mobile app to capture all blood glucose readings as well as physical and virtual follow up with dietitians, nutritionists, and pharmacists for 6 months. Outcome measures were body weight, body mass index (BMI), random blood glucose (RBG), glycated haemoglobin (HbA1c) and health-related quality of life (HRQoL, assessed by SF-36 questionnaire). Data were measured at baseline, third and sixth months. RESULTS: Repeated-measure analysis of covariance showed significant improvement in HbA1c level (Æp2 = 0.045, p = 0.008) in the intervention (baseline mean 7.7% ± 1.1%; end mean 7.3% ± 1.3%) as compared to control (baseline mean 7.7% ± 0.9%; end mean 8.1% ± 1.6%) group. Similar trend was observed for Role Emotional domain of the quality of life (Æp2 = 0.047, p = 0.023) in the intervention (baseline mean 62.8 ± 35.1, end mean 86.3 ± 21.3) compared to control (baseline mean group 70.5 ± 33.8; end mean 78.4 ± 27.3) group. Negative association was found in HbA1c changes using Z-score and Physical Function domain (r = - 0.217, p = 0.022). CONCLUSION: A 6 months SMBG intervention package through a subscription model improved blood glucose control as measured by HbA1c and health-related quality of life, particularly the Role Emotional domain. Elevated HbA1c levels are correlated with decreased physical function.There is a need to further examine the efficacy of SMBG intervention package using a larger sample and a longer period of intervention and to determine its cost efficacy.
RESUMEN
The aim of this study is to investigate the prevalence of metabolic syndrome (MetS) and its predictors among Malaysian elderly. A total of 343 elderly aged ≥ 60 years residing low cost flats in an urban area in the central of Malaysia were invited to participate in health screening in community centers. Subjects were interviewed to obtain socio demography, health status and behavior data. Anthropometric measurements were also measured. A total of 30 ml fasting blood was taken to determine fasting serum lipid, glucose level and oxidative stress. MetS was classified according to The International Diabetes Federation (IDF) criteria. The prevalence of MetS was 43.4%. More women (48.1%) were affected than men (36.3%) (p<0.05). Being obese or overweight was the strongest predictor for MetS in men and women (p<0.05, both gender). High carbohydrate intake increased risk of MetS in men by 2.8 folds. In women, higher fat free mass index, physical inactivity and good appetite increased risk of MetS by 3.9, 2.1 and 2.3 folds respectively. MetS affected almost half of Malaysian elderly being investigated, especially women, and is associated with obesity and unhealthy lifestyle. It is essential to develop preventive and intervention strategies to curb undesirable consequences associated with MetS.