MALAYSIA’s long-standing problem of diabetes is expected to worsen unless the government gets serious about implementing the many strategies and action plans drafted years ago, said health experts.

Nutrition Society of Malaysia (NSM) president Dr Tee E Siong said the answer to the rising number of diabetes patients does not lie in new policies, but in the proper implementation of existing ones.

“The Health Ministry has the National Plan of Action for Nutrition for 2016 to 2025. It is the third series since the first in 1996. It details strategies and action plans including for diabetes,” Dr Tee told The Malaysian Insight.

“There is another one, the National Strategic Plan for Non-Communicable Diseases, although it is not specific to diabetes.

“We just have to implement these plans.”

Dr Tee said plans and policies must be multi-ministry and multi-agency efforts as health had a spillover effect on many other national issues.

“There has always been a lack of intra-government collaboration. It’s a serious shortcoming because health issues like diabetes and obesity are also environmental, social and educational problems.”

Recently, National Diabetes Institute (Nadi) executive chairman Dr Mustaffa Embong revealed that Malaysia had the highest diabetes rate in Asia, with 2.5 million adults aged 18 and above currently diagnosed with the disease.

Tee said while shockingly high, the numbers were not surprising as diabetes cases in Malaysia had been rising for years.

And the solution, he said, is as old as the problem itself.

“We need to start having balanced meals. This is the song we have been singing for 40 years.

“We can’t blame anyone for it. If we can reduce our calorie intake, we can make headway against diabetes as well as obesity.”

Tee said diabetes was caused by various factors including excessive eating, which also led to obesity; and insulin resistance.

“Carbohydrates from rice and other foods contribute to our blood sugar level. We take in more sugar from our kuih, syrup and cordial drink than from sugar-sweetened beverages.”

Malaysia Medical Association president Dr Mohamed Namazie Ibrahim said the spread of diabetes was directly linked to changing lifestyle as people became more affluent.

“The main cause is change of lifestyle with decreased outdoor activities and exercise and dietary changes, from a diet of traditional food to overconsumption of food including sugary drinks,” he said.

Old-fashioned education

Dr Namazie and Dr Tee both agreed education was the way to fight diabetes.

Dr Tee said while the government focused on building more hospitals, there should be equal efforts for preventive care and awareness to get Malaysians to adopt healthier and more active lifestyles.

This should start now with children in primary schools, he said.

“They are going to be adults in 20 years. We don’t want to have a young generation with high blood pressure, high blood sugar level and high cholesterol.

The Health Ministry, Dr Namazie said, should help people understand the food pyramid and the dangers of high-carb diets.

Cutting the sugar rush

In 2016, the government considered a tax on sugar-sweetened beverages to reduce the rate of diabetes.

Former health minister Dr S. Subramaniam reportedly cited Mexico’s success in imposing a 10% tax on sugar sweetened beverages in 2014, which had also led the UK to introduce a similar sugar tax on soft drinks to curb child obesity in 2016.

Dr Namazie said as Malaysians were likely to object to such a tax, the government should consider reducing the subsidy for sugar instead.

He also said the authorities must consider a law to regulate the sugar content of canned and bottled drinks.

“The government should also consider warnings labels like those we see on cigarette packets and advertisements, for sugary drinks to discourage over-consumption.”

However, Dr Tee emphasised that without the proper knowledge, raising the price of sugar or other food items deemed unhealthy would not yield lasting results.

“The trouble is most consumers don’t want the healthier alternatives because they don’t taste as good.

A worker at a 24-hour eatery in Taman Desa, Kuala Lumpur, said the majority of their customers were happy with the two and half tablespoons of sugar in each regular-sized drink.

“If they want it ‘kurang manis’ (less sweet), we will use one and half tablespoons,” he told The Malaysian Insight.

“It’s usually the elderly who ask for no sugar. So far, no one else has complained.” – August 1, 2018.