different disciplines involved to effectively cater to the
patient’s needs.”
Empowering patients
Arguably, one of IJN’s key strengths in diabetes care
is the expertise of its diabetes educators. These health
professionals are specifically trained to help patients
through the process of understanding and controlling
the condition. IJN principal diabetes educator Siah
Guan Jian explains that the patient themselves will
play the most important role in keeping their diabetes
in check.
“Patients are the ones who have to manage what
they eat, be diligent about taking their medication, and
have to learn how to manage their sugar levels. With the
latter especially, they need to understand how to monitor
sugar levels, and how to evaluate them accurately.
So education is a big part of what we do – we aim to
empower patients with information so they can have
better control over the disease,” she says.
Siah, who is currently serving as president of the
Malaysian Diabetes Educators Society, adds that
IJN’s diabetes educators also take the time to work
through patients’ fears of administering injections.
“We understand that many people have a real fear of
injections,” she says. “But it’s something that can be
overcome with proper guidance and patience; we take
the time to help patients work through these fears, and
get them more comfortable with administering such
treatments.”
“Many mistakenly think that having to receive insulin
injections means that they’re at the last leg of the
disease – it’s not true!” adds Dr Azhari. “Sometimes you
may have to start insulin treatment early to control the
condition better; ultimately, any treatment the doctor
is advising you on is for the sake of better long-term
outcomes.”
Between trying to interpret blood sugar readings
and switching up lifestyle habits, patients can feel
overwhelmed by everything that they need to do.
“Research has shown that over 60% of diabetics
experience depression after being diagnosed because
of this,” says Siah. “That’s why we take the time to offer
emotional support to help patients cope with adjusting to
living with the condition.
New and more effective treatment
While most are familiar with insulin-based treatments
for diabetes, there are actually now a wider range
of medications and treatment options available
to patients. For example, sodium-glucose co-
transporter-2 (SGLT2) inhibitors and glucagon-like
peptide 1 (GLP-1) receptor agonists are two of the
latest and proven classes of drugs that can help
patients with Type 2 diabetes control their blood
glucose levels while considerably reducing the risk
of cardiovascular death. Both of these are tablet
medications.
SGLT2 inhibitors work by preventing the kidneys from
reabsorbing glucose back into the blood. Meanwhile,
GlobalHealthAndTravel.com
IJN senior consultant cardiologist Datuk Seri Dr Azhari Rosman
GLP-1 receptor agonists mimic naturally occurring
hormones called incretin, which help the body lower
post-meal blood sugar levels and reduce appetite.
What has been a game changer for patients in
particular, are continuous glucose monitoring (CGM)
systems. These devices enable both doctors and
patients to accurately monitor patients’ glucose levels
over a period of time, giving them a more comprehensive
overview of the patient’s blood glucose control. “This
enables the patients to directly see their how their dietary
and lifestyle habits have been affecting their glucose
levels,” says Siah.
She adds that while CGM is not new, the system used
by IJN is a more stable and less invasive. “In the near
future, we will be introducing an even more advanced
version that is connected to a smartphone app, so
patients will be able to view their glucose levels in real-
time,” she says.
With many more types of drugs and treatments
currently in the pipeline, IJN also aims to provide
patients with resources of the latest in treatment. “We
are focused on educating healthcare providers as
well, because not everyone is familiar with the various
combinations of treatments that are currently available,”
says Dr Azhari. “In our conversations with general
practitioners especially, we’ve found that many of them
simply do not have the time or resources to educate
patients all the finer points of living with diabetes . This
is why our diabetes educators accept referrals from
doctors outside of IJN as well.”
He adds that the centre also plans to introduce even
more diabetes services in the near future, including a
weight-loss clinic. “I feel that our model is a benchmark
for diabetes services, as we’ve had a 13-year head-start
in this area; in order to effectively help patients, we need
to look at the condition holistically, and help patients
manage all aspects of it easily,” he says.
Between trying
to interpret
blood sugar
readings and
switching up
lifestyle habits,
patients
can feel
overwhelmed
by everything
that they need
to do.
MAY 2020
57