The Diabetes Lifestyle Programme (DLP) was launched in a bid to incorporate lifestyle intervention as an integral part of standard diabetes management practices. The intention is to improve treatment outcomes while reducing the burden of the disease on patients, their families, the healthcare system and the nation’s economy.
The programme was launched by Yang Berhormat Dr Zaliha Mustafa, Minister of Health Malaysia, who was represented by Yang Berusaha Dr Mohd Azman bin Yacob, Director, Medical Development Division, Ministry of Health Malaysia.
The launch was formalised by the signing of a Memorandum of Understanding by the principal partners of DLP, namely:
- The Malaysian Endocrine and Metabolic Society
- The Malaysian Medical Association
- The Malaysian Family Medicine Specialists’ Association
- The Academy of Family Physicians of Malaysia
- The Malaysian Dietitians’ Association, and
- The Malaysian Diabetes Educators Society
According to Datuk Dr Zanariah Hussein, Chairperson of DLP Expert Panel, the MoU embodied the partners’ passion and commitment to “become one strong voice” to advocate diabetes lifestyle to their members, medical and allied health professionals at large, patients, the media, as well as policy makers.
She remarked that this is a much-needed move because lifestyle intervention is the ‘missing link’ in how healthcare professionals and patients have traditionally managed diabetes.
Datuk Dr Zanariah, who is a Senior Consultant Endocrinologist, said: “Diabetes is a condition where one’s blood sugar is persistently high. This is a serious condition because it can lead to a host of complications, including heart attack, stroke, kidney damage, blindness, crippling nerve damage, and leg amputations.
“For too long, most healthcare professionals and patients have relied heavily on medications to control high blood sugar levels. Let’s be clear – medications are important when indicated. However, if patients continue leading an unhealthy lifestyle, they may find themselves requiring higher doses or more medications.
“By contrast, several landmark studies have proven that lifestyle changes can have powerful positive effects, too. Managing one’s diet, getting more active, monitoring blood sugar levels, and losing body weight are basic measures. Lifestyle changes that result in the achievement and maintenance of substantial weight loss will reduce high blood sugar levels, high cholesterol, high blood pressure, and even the amount of medications needed. In some cases, diabetes can be reversed entirely!
“The benefits are so evident that all clinical practice guidelines on diabetes management universally recommend lifestyle changes as the cornerstone, regardless whether one has been prescribed medications, insulin or not.
“Sadly, many healthcare professionals and patients underestimate the importance of lifestyle intervention in controlling diabetes. This is why we decided to establish the Diabetes Lifestyle Programme to enable healthcare professionals and people with diabetes to acquire basic skills in dietary management, physical activity, self-monitoring of blood sugar, and motivation to stay on course, to make a real difference in patient-related outcomes!”
Datuk Dr Zanariah remarked that the DLP partners and Expert Panel firmly believe it is the responsibility of healthcare professionals to help patients understand and make lifestyle changes successfully. As such, DLP’s first objective is to train and develop healthcare professionals into diabetes lifestyle advocates.
She said: “To date, we have trained more than 3,000 healthcare professionals from different specialities of a diabetes care team, such as medical doctors, diabetes nurse educators, dietitians and pharmacists. About 1,000 have become full-fledged DLP Advocates, 74 per cent of whom are based in government settings.
“We hope to continue our training initiatives until everyone involved in diabetes care is sufficiently competent and confident to recommend and optimise lifestyle interventions for their patients.
“Our second objective is to empower patients with the necessary knowledge, skills, attitudes and self-awareness to take charge of their lifestyle. We developed the DLP web-based application for this purpose. It features educational videos, interactive activities, free virtual dietitian consultations and supporting materials to guide patients in fundamental areas of lifestyle change.
“Using digital health technology presents us with many new opportunities. Diabetes cases are increasing dramatically among younger adults in Malaysia. In this light, we believe our web-based application would be well-suited for this growing tech-savvy group. At the same time, our web-based app will also enable healthcare professionals to keep abreast of their patients’ progress.”
Datuk Dr Zanariah described DLP’s third objective as facilitating the implementation of the programme in all healthcare settings, particularly at the primary care level. Towards this end, DLP recently embarked on a pilot project involving 60 Family Medicine Specialists from more than 50 government health clinics.
She said: “We look forward to the invaluable learnings and insights that will enable us to scale up DLP in order to benefit all diabetes healthcare professionals and patients, nationwide. We want everyone to realise that simple lifestyle changes can bring real benefits.”
For instance, apportioning one’s rice, meat and vegetables using the “healthy plate” or “suku-suku-separuh” principle will ensure a balanced diet that meets patients’ nutritional needs. Choosing wholegrain and high fibre foods that take longer to digest will help avoid the blood sugar spikes that tend to occur when we consume refined carbohydrate alternatives.
On the physical activity front, doing household chores or taking a brisk walk every day enables insulin, the hormone found naturally inside your body, to act more effectively in maintaining blood sugar levels in a healthy range.
DLP also encourages people with diabetes to perform regular self-monitoring of blood sugar to better understand their blood sugar patterns at different times of the day. The information will enable them to adjust their food intake and other lifestyle practices to keep their blood sugar levels on target.
Additionally, losing a minimum of 5 per cent of excess body weight has been shown to improve one’s blood sugar, cholesterol and blood pressure. According to Datuk Dr Zanariah, attempts to try losing weight on our own are often unsuccessful. She remarked: “Most people would benefit from professional guidance. As such, DLP provides free virtual dietitian consultations so that people with diabetes can obtain more specific advice, including meal replacement using diabetes-specific formula.”
Finally, DLP is not just about making lifestyle changes but also sustaining it as a way of life. This vital area is covered by motivational videos and other content to help people with diabetes anticipate challenges and remain motivated to stay on course.
