THE STAR, FRIDAY 13 NOVEMBER 2020
WORLD DIABETES DAY
MALAYSIA has the second-highest
percentage of diabetes occurrence
after Saudi Arabia. According to
2015 statistics, about one in six
Malaysians is diabetic. Given
Malaysia’s 32 million population
today, there should be over five
million diabetics among those
diagnosed by blood testing.
Many more are believed to have
never been tested – walking around
seemingly fine, asymptomatic in the
disease’s early stages before
complications start setting in. Being
also the most obese nation in Asia,
Malaysia’s general population runs
an increased risk of being pre-
diabetic with metabolic syndromes
and, eventually, contributing to the
final official statistics for diabetes in
the country.
About 70% of diabetics will die of
cardiovascular events. When
diabetes is diagnosed, six years are
shaved off a patient’s life
expectancy. If diabetes and
cardiovascular disease are
diagnosed together, 12 years of life
expectancy will be lost. As early
diabetes is asymptomatic, an
annual blood test starting from the
age of 30 is the least that people can
do so lifestyle changes such as diet
and exercise can be instituted
before diabetic medication is made
compulsory to reduce blood sugar.
Being diagnosed as diabetic is no
laughing matter as diabetes
presents many complications
Preventing amputation with
hyperbaric oxygen therapy
affecting patients from head to toe.
Starting with the head is paralysing
strokes and damage to the eyes,
with diabetes being the world’s
No.1 cause for blindness –
overtaking accidents and trauma.
Kidney failure is common among
diabetics on long-term dialysis.
Whilst high blood sugar causes
heart diseases or heart attacks, low
blood sugar can cause arrhythmias
(irregular heartbeats).
One in six diabetics will develop
diabetic foot ulcers, a common end-
organ damage requiring long-term
good wound care to prevent
amputations or bacterial blood
poisoning (septicaemia). Whilst it
takes just a 1% drop in sugar level
to reduce amputation risk by 43%, a
study by the United Kingdom’s
National Health Services found that
80% of the country’s amputations
could have been prevented.
A medically recognised treatment
for wound care is hyperbaric
oxygen therapy (HBO), which
delivers 100% pure medical-grade
oxygen to the lungs under a
pressurised environment. In the
lungs, the oxygen dissolves into
blood plasma before it is carried
to the rest of the body.
MSU Medical Centre medical
officer and hyperbaric specialist
Lt Col (Rtd) Dr Mohd Hakimi
Abdullah says, “In non-salvageable
cases, amputation is the only
option; but in most cases, the
wounds can be treated to
recovery. Combining HBO
with good wound care by a
specialist physician can save
limbs and toes.”
Diabetes causes organ/tissue
damage by destroying blood
capillaries, consequently cutting
off nutrient and oxygen supply.
With HBO, new capillaries will
grow through a process called
angiogenesis in as few as eight
sessions. The new capillaries will
resupply the formerly oxygen-
deprived wound, allowing
granulation of new tissue to take
place. The oxygen delivered
stimulates the wound’s
collagen production, speeding
up tissue growth.
Oxygen has the capability of
stimulating white blood cells and
neutrophils to mount an attack on,
contain and kill wound bacteria.
It also generates superoxide, which
is toxic against bacteria – thus
reducing the severity of the
wound infection.
Molecularly, oxygen increases
antibiotic porosity to the bacterial
surface membrane, easing
penetration of the bacteria to kill
them. Once the tissue has
sufficiently grown, the skin starts to
close the wound in a process called
epithelialisation, aided by HBO.
In treating radiotherapy-induced
wounds, HBO’s angiogenesis
enhances the blood supply and
health of heavily irradiated tissues
and, secondarily, improves tissue
oxygenation. HBO reduces fibrosis
and minimises scar tissue
formation in conditions such as According to Dr Mohd Hakimi,
osteoradionecrosis of the mandible combining hyperbaric oxygen
in head and neck cancers, radiation therapy with good wound care by
cystitis in the bladder, and radiation a specialist physician can save
proctitis in the rectum. limbs and toes.
6 World Diabetes Day
Choosing the
right protein source
is key to good health
PROTEIN is built from building blocks called
amino acids. Good quality protein contains
all 20 amino acids, including the nine
essential amino acids which the body
cannot produce and must obtain from
dietary sources.
According to a 2013 study titled
Macronutrient intake and risk of urothelial
cell carcinoma in the European prospective
investigation into cancer and nutrition, long-
term consumption of high animal protein
(meat) can have detrimental effects on bone
health and lead to a long-term risk of
developing diabetes. Animal protein is
highly laden with saturated fats and
cholesterol which may lead to obesity. A
2000 study titled Overweight, obesity, and
health risk is among the findings that
showed a high intake of animal protein is
positively associated with insulin resistance
– thus increasing the risk of developing Type
2 diabetes.
A dynamic quad for stronger
muscles, bones and body
strength
Plant protein, on the other hand, can
provide all the essential amino acids
packaged with plenty of fibre when
consumed in the right combination – such as
from non-genetically modified soy and pea.
Several studies, including A plant-based diet
for the prevention and treatment of type 2
diabetes published in 2017, showed that the
consumption of plant protein is associated
with lower glucose levels and a reduced risk
of developing diabetes, as plant protein can
improve insulin sensitivity and glucose
metabolism. Additionally, people who meet
daily protein requirements maintain bone
health better than those eating less than the
recommended levels, according to a 2006
study titled The underappreciated role of
muscle in health and disease.
Calcium is a key nutrient for bone tissues
as it constitutes a great part of them.
However, supplementation with calcium
alone is not enough to maintain optimal
bone density. Several studies including the
Synergistic Interplay between Vitamins D and
K for Bone and Cardiovascular Health: A
Narrative Review and Vitamins D and K as
Pleiotropic Nutrients: Clinical Importance to
the Skeletal and Cardiovascular Systems and
Preliminary Evidence for Synergy have shown
that a combination of calcium with other
nutrients such as magnesium, and vitamins
D3 and K2 significantly improved bone
health as magnesium and vitamin D3
facilitate the absorption and utilisation of
calcium, while vitamin K2 helps improve
bone density by effectively depositing
calcium to the bones and teeth for proper
storage. Hence, they all work synergistically
with one another for effective calcium
utilisation and metabolism.
Biogrow HPF-5 PLUS is a new, improved formula with a unique blend of plant protein and
digestive fibre.
The Scientific Opinion on the substantiation
of health claims related to vitamin K and
maintenance of bone, blood coagulation, and
function of the heart and blood vessels
pursuant to Article 13(1) of Regulation (EC)
No 1924/20061 in the EFSA Journal states that
vitamin K2 (Menaquinone, MK-7) is a highly
bioavailable form of vitamin K that helps
maintain healthy bones.
Biogrow HPF-5 PLUS is a new, improved
formula with a unique blend of plant protein
and digestive fibre – enhanced with bone
health nutrients such as calcium,
magnesium, and vitamins D3 and K2. One
scoop of Biogrow HPF-5 PLUS
(approximately 16g) daily can provide:
l Greater than or equal to 61% of plant
protein (non-genetically modified organism
or non-GMO soy and pea proteins), complete
with all nine essential amino acids for
protein synthesis
THE STAR, FRIDAY 13 NOVEMBER 2020
l A synergistic effect with magnesium,
and vitamins D3 and K2 for better
absorption, retention, utilisation and
deposition of calcium
l More than 18% of digestive fibre to
regulate bowel movement
l No added sugar, no cholesterol and
lactose-free
l Suitable for all ages, including diabetic
patients and lactose-intolerant individuals
Biogrow HPF-5 PLUS is available in all
leading pharmacies nationwide and the
Biogrow Official Store at Shopee Mall.
This article is provided by Legosan
(Malaysia) Sdn Bhd.
n For more information, call 03-7956 2220
(Mondays to Fridays, 9am to 5pm) or email
enquiries to info@biogrow.com.my
THE STAR, FRIDAY 13 NOVEMBER 2020 7
8 World Diabetes Day
Patients’ need for empowerment
INAPPROPRIATE lifestyle choices
and a lack of exercise have
contributed to the latest alarming
figures on diabetes. The prevalence
rate of diabetes in adults has
increased from 13.4% in 2015 to
18.3% last year, according to the
National Health and Morbidity
Survey 2019 by the Ministry of
Health Malaysia. It is estimated
that 3.9 million adults in Malaysia
aged 18 and above had diabetes
last year, compared to 3.5 million
in 2015. That is equivalent to one
in every five adults in the nation.
There are reasons to believe that
many Malaysians take diabetes
lightly as if they would never fall
victim to this non-communicable
disease (NCD). Subang Jaya
Medical Centre consultant
physician and endocrinologist Dr
Hew Fen Lee says patients often
take their health for granted. He
says, “Patients still think they are
Superman. They feel it would
affect other people, but not them.
That is a very dangerous mindset.”
As a result of taking personal
health lightly, many people fail to
realise the importance of
managing diabetes properly.
Empowering patients is crucial in
the process of recognising the
problem and getting on top of it.
Empowerment is to enable
patients to manage diabetes
appropriately. It serves to
encourage patients to explore
and gain knowledge to take
responsibility for their own lives.
While health professionals are
on hand to aid in diabetes
treatment, diabetic patients
themselves have an important part
to play. Patients need to be a party
to decision-making and they hold
the key to management of their
diabetes on a daily basis. Dr Hew
explains that empowering a
diabetic patient can help them in
managing diabetes better. “Patients
need to be given correct
information and encouraged to
apply the knowledge they receive
to make the necessary changes in
their lifestyle,” he says.
Challenging mission
The unfortunate truth is that
empowering patients is not an easy
Patients need to be a party to decision-making and they hold the key to
management of their diabetes on a daily basis.
According to Dr Hew, 60% of dialysis patients in Malaysia undergo the treatment because of diabetes.
task as there are still patients who
disregard doctors’ advice when it
comes to managing the disease. Dr
Hew says, “At the end of the day,
the treatment of diabetes is to
prevent complications. It has to be
made known to patients that it is
not the doctors’ or the nurses’
health at risk, but their own.
Having said that, it is still the role
and responsibility of health
professionals to convince and
impart that knowledge.”
Diabetes is a disease that can
greatly reduce a patient’s quality
of life when complications
develop. Dr Hew says, “One of the
many complications of diabetes is
blindness. In fact, 50% to 60% of
irreversible blindness in this
country is caused by diabetes.
Diabetes can also cause kidney
failure, which leads to patients
requiring dialysis treatment, and
60% of dialysis patients in
Malaysia undergo the treatment
because of diabetes.”
Dr Hew also stresses the role of
nurses as “diabetes educators”.
“Nurses are the largest professional
group involved in the treatment of
diabetes and that role has been
undervalued. Their role is to
educate and empower patients
with the correct knowledge to
tackle diabetes,” he says.
Nurses have many roles in
attending to the patients and there
is a definite need for specialised
diabetes educators in every
diabetes care team. Dr Hew
explains that knowledgeable
nurses are needed to complement
the role of doctors.
Collaborative effort
At the same time, families also
play a crucial role in helping
patients to manage diabetes. “Gone
are the days when family members
cook special foods for the diabetic
patient while the rest of the family
eats different meals. It should be
the same lifestyle that is applicable
to the whole family,” he says.
Dr Hew also notes that there is a
higher probability of family
members of diabetics developing
the disease. However appropriate
lifestyle modifications can prevent
and reduce the risk substantially.
He adds that patients need to
lead by example. Once a patient
understands the concept and the
importance of having a healthy
lifestyle, it will also have a positive
impact on how the next generation
handles diabetes – that is why
empowerment is crucial.
An effective approach
In order to empower patients
in making the right decision to
manage their diabetes, education
is the way to go. Diabetes is a
complex, chronic condition that
requires both high-quality
clinical care and effective self-
management.
Patients need to learn about
diabetes, and how to safely and
effectively care for the condition
daily. They also should be
provided resources and
information about various
At the end of the
day, the treatment of
diabetes is to prevent
complications. It has
to be made known to
patients that it is not
the doctors’ or the
nurses’ health at risk,
but their own.
Dr Hew says the journey in
managing diabetes is not hard,
unless patients make poor
decisions based on rumours and
hearsay they heard about the
treatments or medications. “For
example, they may blame some
diabetes medication for causing
side effects, and because of that,
they stop taking the medicine.
As a consequence of stopping
the medicine, this results in
high glucose levels giving rise to
more complications.
“This is because they responded
to wrong and inaccurate
information. All diabetes drugs
have side effects, but they are
very minimal compared to the
complications that arise from not
getting diabetes under control,”
he clarifies.
He shares that unfortunately,
doctors at hospitals often see
patients after their diabetes has
already progressed with multiple
treatment options, the benefits
and costs of each of these
strategies, how to make changes
in their behaviours, and how to
deal with problems and issues.
THE STAR, FRIDAY 13 NOVEMBER 2020
Dr Hew Fen Lee.
complications. “When these
patients come to the hospital, there
is always something that needs to
be dealt with straight away.
Doctors are putting out fires, and
that is why empowerment is
important – it is to stop fires from
being started.”
Dr Hew stresses that patients
need to start treating diabetes
more seriously. Proper diabetes
management is essential to reduce
complications – not only to bring
down mortality, but also to
maintain quality of life. “With
diabetes, patients can do something
about it. But what matters is
whether they want to do anything
about it.”
The recent Covid-19 pandemic
would have caused a lot of anxiety
and concerns, given the increased
risk for those with diabetes and
other chronic NCDs. The need to
impart knowledge should go hand
in hand with encouragement and
support to relieve such anxiety.
Optimal metabolic control, along
with the wearing of masks and
social distancing as advised, would
reduce such risks quite
substantially. This would not
only help to reduce the risk of
infection and thus complications,
it would also help to reduce the
spread of Covid-19 and assist
greatly to flatten the curve of this
more aggressive third wave in
the nation.
n For more information, call
03-5639 1212.
THE STAR, FRIDAY 13 NOVEMBER 2020
DIABETES is a chronic condition which is
associated with abnormally high levels of
glucose in the blood. The World Health
Organization’s Noncommunicable diseases
country profiles 2018 report states that
individuals with diabetes are at an increased
risk of developing cardiovascular diseases
such as heart disease and stroke which have
been the leading cause of mortality in
Malaysia over the years, accounting for
approximately 35% of total deaths.
According to the National Health and
Morbidity Survey the prevalence of diabetes
among Malaysians had demonstrated an
increasing trend from 13.4% in 2015 to
18.3% in 2019. While most of the rise in the
prevalence of diabetes is seen in the middle-
aged and elderly, there is an increasing trend
found in young adults as well, notes a
CodeBlue article published this year titled
Survey: 1.7 Million Malaysians Risk Three
Chronic Conditions.
In light of the Covid-19 pandemic, many
employees have transitioned to working
from home to help flatten the curve and get
the pandemic under control. While working
from home offers numerous benefits, it also
makes it easier for people to slip into
sedentary lifestyles. Other than that, the
temptation of eating unhealthy snacks –
which are often high in sugar, sodium and
fat – in between meals is a challenge faced
by most people while working from home.
Unhealthy snacking can lead to weight gain,
especially when physical activity is reduced
during the working from home period.
Consequently, weight gain can contribute to
overweight and obesity cases which increase
the risk of developing diabetes.
Hence, what can people do to bring a
different approach to staying healthy while
working from home? If the usual gym is
closed – as many now are – try at-home
workouts such as jumping jacks, push-ups,
squats and planks. Besides, numerous
research have reported that diet
modifications such as adopting high-fibre
and low glycaemic index (GI) diets can help
to regulate blood glucose levels and lower
the risk of developing diabetes.
Regulating glucose
levels, lowering risks
Not only is Biogrow Oat BG22 suitable for individuals with a high blood cholesterol level, it is
also suitable for pre-diabetic and diabetic patients.
The consumption of high-fibre and low GI
foods results in a stabilised blood glucose
level as it leads to a slow and steady rise in
the blood glucose level, followed by a
gradual drop – rather than a sudden spike in
blood glucose level which often leads to
fatigue and tiredness.
Maintaining a healthy blood
glucose level in the most natural
way
Oat beta-glucan is a soluble dietary fibre
which can be found in oat bran, the outer
layer of an oat grain. According to a 2012
study titled Oat Beta-Glucan: Its Role in
Health Promotion and Prevention of Diseases,
the high viscosity of oat beta-glucan plays a
vital role in regulating blood glucose levels,
and that such a beneficial health effect is
associated with its daily dose and
molecular weight.
The high molecular weight of oat beta-
glucan has been mainly attributed to its
ability in forming a viscous gel which acts
as a barrier in the small intestine that
delays the digestion of carbohydrates and
absorption of glucose. Thus, it helps to
prevent sudden fluctuations in blood
glucose level and abnormal insulin
secretion after a meal, resulting in
stabilised glucose availability.
The Ministry of Health Malaysia and the
European Commission have approved oat
beta-glucan and its role in controlling post-
meal high blood glucose levels with the
following approved health claims:
l 3g of oat beta-glucan daily helps to
lower blood cholesterol levels
World Diabetes Day 9
l Oat soluble fibre (beta-glucan) helps to
lower the rise of blood glucose, provided that
it is not consumed together with other food
l Consumption of beta-glucan from oats
contributes to a reduction of the glucose rise
after a meal
A daily serving of two scoops/sachets of
Biogrow Oat BG22 oat bran powder
(approximately 18g) provides 3g of clinically
proven bioactive oat beta-glucan with a high
molecular weight, which lowers the rise of
blood glucose and cholesterol levels
significantly. Bioactive oat beta-glucans are
high in molecular weight and have been
scientifically shown to produce good
viscosity effects in the gut for optimal
cholesterol-lowering results.
Hence, not only is Biogrow Oat BG22
suitable for individuals with a high blood
cholesterol level, it is also suitable for pre-
diabetic and diabetic patients as it is low in
GI (less than 55) which helps to stabilise post-
meal blood glucose levels.
Moreover, Biogrow Oat BG22 has good
solubility and is low in calories, high in fibre
and lactose-free with no added sugar,
artificial ingredients and preservatives.
Biogrow Oat BG22 is available in all
leading pharmacies nationwide and the
Biogrow Official Store at Shopee Mall.
This article is brought to you by Legosan
(Malaysia) Sdn Bhd.
n For more information, call 03-7956 2220
(Mondays to Fridays, 9am to 5pm) or email
enquiries to info@biogrow.com.my