According to World Health Organisation (WHO), 80% of diabetes deaths are

now occurring in low- and middle-income countries and diabetes is predicted to

become the 7th leading cause of death in the world by the year 2030. NHMS 2011
reported diabetes mellitus cases in Malaysia has increased from 11.6% at the year of
2006 to 15.2% at 2011. It is also indicated that in Malaysia, there are total of 2.6
million of adults 18 years and above are having diabetes. With that figure, Malaysia
is leading in Asean for having the highest number of diabetes mellitus and sixth in
the western pacific region.
Based on National Diabetes Registry (NDR), which is a web-based
application, its report stated that from 2009 to 2012, there were 657,839 patients
registered in the system, of which 653,326 were diagnosed with type 2 diabetes
mellitus. Figure 1 shows the distribution of Type 2 Diabetes Mellitus patients at
diagnosis by ethnicity. The chart shows that Malay leads the distribution of type 2
diabetes mellitus by ethnicity proportion with 58.9% followed by Chinese and Indian
with 21.4% and 15.3% respectively.

Figure 1

Figure 2 shows the prevalence of diabetes mellitus based on age group for
each of the NHMS report. There is a huge increment from each year of report to
another year of report. From each NHMS report, it is so evident that the diabetes
case is so high in the age of 60-69 whereby Perlis is leading in terms of states,
followed by Kedah and Kelantan (Figure 3).

Figure 2

Figure 3

In Malaysia itself, the diabetes costs are estimated to account for 16% of the
national Malaysian healthcare budget thus placing Malaysia among the top 10

countries in the world in terms of percentage of healthcare budget spent on diabetes.

An estimated RM 2.4 billion was spent on diabetes-related healthcare in the year of
2010.
One of those main factors that lead to diabetes mellitus cases in Malaysia is
obesity. According to Ismail M.N et.al, obesity appears to be more prevalent in
women than men and the rate in female Indians and Malays is particularly high
whereas male Chinese show the greatest prevalence of obesity. He stated that the
increase in the rate of female Indians and Malays reflects dietary pattern and
physical activity behaviour among them. The prevalence of obesity in male Chinese
might recorded a high number due to their urbanised lifestyle where they live
predominantly in the urban setting whereas the Malays and Indian groups dominate
the rural community.
Overall prevalence of obesity was highest for those r who had primary
education (14.6%) or no formal education (13.0 %), followed by those with
secondary education (11.2%). Those with college or university education had the
lowest prevalence of obesity which is 8.8%. In overall, the prevalence of obesity was
slightly higher in the urban areas (12%) as compared to the rural areas (11.3%).
Besides that, physical inactivity also caused the increment of prevalence of
diabetes mellitus case in Malaysia. NHMS 2011 reported that 43.7% which is 5.5
million of physical inactivitys prevalence among Malaysian adults. K.C. Yeong and
K.P. Bee (2013) stated there are few determinants of participation in physical activity
in Malaysia. One of the determinants is age where the study observed that older
individuals were less likely to be physically active than younger individuals. The
biological process of aging is likely to be the reason for this outcome. Older

individuals tend to face a more serious deterioration in health than younger

individuals, and thus have greater difficulties in performing physical activity. Income
also plays a role in determining the participation in physical inactivity in Malaysia. A
plausible explanation is that higher income earners tend to incur greater opportunity
costs of nonworking time than lower income earners because they earn higher
hourly wages. Therefore, higher income earners are more inclined to substitute
working for leisure-time physical activities, causing them to live a more sedentary
lifestyle.
Other determinant of physical inactivity is gender. Male were more likely to
participate in physical activity than females. Women had a lower likelihood of
participating in physical activity than men because women possess the natural
characteristic as a family care taker, women tend to allocate more time for home
activity than leisure-time physical activity. Moreover, the daily tasks performed by
men involve more travelling activities, men are usually more physically active
compared to women.
Apart from that, marital status is also significantly associated with physical
activity, as single individuals have a higher likelihood of adopting a physically active
lifestyle than non-single individuals, Single women were more likely to participate in
physical activity and also spent more time in physical activity than non-single
women. Family commitment may be the contributing factor for this outcome. Single
individuals do not carry the responsibilities to look after their children and spouse,
thus, they may have more time on hand for physical activity than non-single
individuals.

The influence of regional factor also plays a vital role in determining the
physical inactivity. Residents in Peninsular Malaysia are more devoted to spend
time on physical activity compared to residents in East Malaysia. This might be due
to the inadequate facilities in East Malaysia compared to Peninsular Malaysia. Other
than that, rural population have a higher likelihood of being physically active. Two
plausible reasons may explain the fact that urbanites have a lower likelihood of being
physically active compared to rural dwellers. Firstly, urbanites often live a busy and
hectic lifestyle, and thus would be less likely to allocate their time for physical activity.
Secondly, owing to the lack of advanced infrastructures in rural areas, the daily
activities performed by rural dwellers may be more physically demanding. In addition
to this, job characteristics is also a determinant of participation in physical activity in
Malaysia. Different job characteristics of workers may face a different level of stress
associated with the job, which, in turn, influences the workers physical activity level.
Unemployed individuals have a lower likelihood of adopting a physically active
lifestyle than employed individuals because unemployed individuals possess fewer
work commitments, they often live a laid-back lifestyle and consequently would be
less physically active.
In comparison, prevalence of physical inactivity in Malaysia is comparable to
that of Japan and Taiwan which is 43.3% and 42.3% respectively. However, China,
Hong Kong and India reported a lower number of prevalence compared to Malaysia.
China recorded 6.9% of prevalence of physical inactivity whereas Hong Kong and
India registered 15.3% and 23.4% respectively.
Last but not least, poor eating habits also contributes to the high prevalence
of diabetes mellitus case in Malaysia. Eating out had become a trend among urban
workers, students and even families. Factors such as working away from home,

working mothers and food varieties contributed to this trend. The lack of
consideration of nutrient contents, irregular eating time, poor food quality and
premises cleanliness might expose the practitioner to health, social, family and even
safety risks. According to Malaysian Youth Index (MYI) 2015, Youths only scored
43.52 for the eating habit indicator, which was the lowest score received out of the
seven indicators under the health domain in the survey. This shows that many youths
are not eating right in accordance with the healthy food pyramid and they prefer to
eat fast food.
WHO recommended that the intake of sugars should not exceed 10% of total
energy in order to prevent diet-related chronic disease meanwhile The American
Heart Association (AHA) recommended the intake of sugars should not exceed 100
calories per day for women and 150 calories per day for men. Nevertheless, 2003
Malaysian Adult Nutrition Survey (MANS) proclaimed that on average, Malaysian
adults consumed 30 grams of sweetened condensed milk (equivalent to 16 grams
sugar) and 21 grams of table sugar per day.
A recent study conducted by Taylors University to observe the eating habits
and food cultures of the Malaysian population disclose that more than 64% of
Malaysians eat at least one meal per day outside of home and of the remaining 36%
who eat at home, 12.5% have at least one meal that comes from outside. In a recent
press release by our honourable Health Minister Datuk Seri Dr S. Subramaniam, he
said that Malaysians, aged 18 and above, are consuming between 500 and 700
calories extra on a daily basis.
Based on a 2003 study on adult food intake, the average Malaysian adult
consumed 2,500 kilocalories (kcal) daily, as compared to 1,500 kcal recommended

for women and 2,000 kcal for men. In a 2005-2007 report, the United Nations (UN)
food and agriculture organisation revealed that the average Malaysian consumed
2,910 kcal daily. This is the highest intake as compared to other Asean countries
such as Indonesia (2,540 kcal), Thailand (2,530 kcal), The Philippines (2,520 kcal),
Myanmar (2,440 kcal) and Cambodia (2,250 kcal).

REFERENCES

Chan,Ying Ying., Lim,Kuang Kuay., The,Chien Huey., Lim,Kuang Hock., Hamizatul

Akmal Abd Hamid, Mohd Azahadi Omar, Noor Ani Ahmad & Kee,Chee Cheong.
Prevalence and Factors Associated With Physical Inactivity among Malaysian
Adults. 2014.

Feisul M,I. & Azmi S. National Diabetes Registry Report, Volume 1, 2009-2012.
Ministry of Health Malaysia. Kuala Lumpur. 2013.

Ismail,M.N., Chee,S.S., Nawawi,H., Yusoff,K., Lim,T.O., & James,W.P.T. Obesity

Reviews. July 2002. 203-208

Letchumanan,G.R.,Wan Nazaimoon,W.M., Wan Mohamad W.B., Chandran,L.R.,

Tee,G.H., Jamaiyah,H, Isa,M.R., Zanariah,H., Ahmad Faudzi,Y. Prevalence of
Diabetes in the Malaysian

National Health Morbidity Survey III 2006.2006.

National Health and Morbidity Survey 2011 Fact Sheet www.moh.gov.my (Retrieved
10 December 2015)

Norimah,A.K., Safiah,M., Jamal,K., Siti Haslinda, Zuhaida,H., Rohida,S., Fatimah,S.,

Siti Norazlin, Poh,B.K., Kandiah,M., Zalilah,M.S., Wan Manan,W..M, Fatimah,S. &
Azmi,M.Y. Food Consumption Patterns: Findings from the Malaysian Adult
Nutrition Survey (MANS). Article in Malaysian Journal of Nutrition. March 2008.

Rampal,L., Rampal,S., Geok,Lin Khor , Azhar M.D., Shafie Ooyub, Ramlee Rahmat,
Sirajoon Noor Ghani & Krishnan,Jayanthi. A national study on the prevalence of

obesity among 16,127 Malaysians. 2007. 561-566

Yeong,K.C. & Bee,K.P. The Determinants of Participation in Physical Activity in

Malaysia. 2013.

Zhang,P. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes
research and clinical practice. 2010. 293 301.

www.heart.org (Retrieved 12 November 2015)

www.themalaymailonline.com (Retrieved 12 November 2015)

www.thestar.com.my (Retrieved 12 November 2015)

www.who.int/diabetes/en/ (Retrieved 9 December 2015)

www.youthpolicy.org (Retrieved 4 November 2015)