Is Malaysia's rising cost of living contributing to an increase in local diabetes cases?

By D. KANYAKUMARI

THERE is no sugarcoating Malaysia's diabetes problem.

According to the National Health and Morbidity Survey (NHMS) 2019, the prevalence of diabetes among Malaysian adults has risen from 11.2 per cent in 2011 to 13.4 per cent in 2015 and 18.3 per cent or 3.9 million people currently.

This explains the government's introduction of various measures over the last few years, including the launch of the National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2016-2025, health awareness programmes, and wellness screenings.

But first and foremost, medical practitioners say, bad eating habits must be tackled.

True, it is common knowledge that poor nutrition choices can lead to serious health conditions, says Hospital Kuala Lumpur paediatrician Dr Shazline Amrishe. Nevertheless, rising cost of living is exacerbating the problem. Hence, the stories of mothers being forced to buy cheap condensed milk instead of milk formula for their kids are no longer anecdotal.

Worse, it appears that Malaysians from all levels of society are putting their health on the line due to higher prices of food and other essentials.

Says Dr Shazline: "A few months ago I met a patient who'd come in with serious hypertension concerns. Upon examination, we found that the woman, who runs a small business, was diabetic.

"When I saw her again in April, however, her condition had deteriorated. She said she'd neither the means nor the time to take care of herself. She explained that she had six kids, four of whom are still schooling. So, instead of spending on medication and high-quality food for herself, she said she had to prioritise her kids' expenses."

Feeling the pinch

Dr Shazline's patient is, of course, not the only Malaysian who is finding it tough to deal with their medical conditions while also struggling to put food on the table.

Indeed, the NHMS 2019 study already established that there is a correlation between economic status and the prevalence of non-communicable diseases (NCDs) like diabetes, and that income directly affects an individual's health. It also noted how high-income countries like Japan had a lower prevalence of NCDs.

But with everything going up in price in the aftermath of the COVID-19 pandemic, including the cost of medical treatment, more and more people are finding it hard to eat healthier and protect themselves from diseases like diabetes.

In fact, even those in the upper-income bracket claim to be struggling.

For instance, homemaker Denise Koo Lim says that she always tries to opt for healthier food options for her family. But it is challenging when eating healthier means spending more.

"My kids and husband love this particular brand of yoghurt drink. But my husband is diabetic. So whenever I can, I try to get the lower sugar version. But here's the kicker — a pack of five of the lower sugar variety is RM5.10 while the regular variety is RM0.40 less. I really don't understand why," says Koo.

"Yes, RM0.40 may not seem like a lot. But it can make a substantial difference when you factor in other provisions. So what do we do? We opt for the more affordable option and tell ourselves that we'll just not drink as much."

For the record, Malaysia's inflation rate has been steadying in recent months. However, not only are consumers still claiming to feel the pinch, checks reveal that healthier food options cost significantly more, with certain sugar-free food items priced at RM3 more than the regular variant.

Even so, cost is not the only issue when it comes to managing diabetes. There is also the concern of individuals turning to unhealthy comfort food in times of stress and thereby, increasing their risk of diabetes.

"You can't control things like cost of living and global warming. So, of course, you just turn to food," admits Koo.

No longer an old person's problem

Incidentally, according to the National Diabetes Registry Report 2013-2019, the average age of people with type 2 diabetes is 63 years old, with the average age of diagnosis being 53 years old.

However, medical practitioners say younger and younger people are being found to be diabetic.

"Gone are the days when only 'old' people got heart attacks, diabetes and strokes. Now, we even see people in their twenties with these conditions," says Dr Umesh Shanker Aiyar, a medical officer at Hospital Universiti Kebangsaan Malaysia.

He adds that it is particularly alarming that the morbidity rate among people who are at the "peak" of their lives is getting higher, and notes, too, that increasing living costs may have a part to play.

The reality, however, Dr Umesh says, is that food items like instant noodles cost a fraction of a small bag of brown rice. So, are people really going to choose healthier food options?

"Sometimes as doctors, we feel guilty when we tell patients to opt for things like legumes and brown rice because the cost of those is significantly higher," he says.

"So, instead, we advise them to try and maximise healthier options. For instance, you could reduce your intake of sugary beverages, avoid processed foods and the like. Unfortunately, for so many, especially low-income earners, unhealthy food is part of their lifestyle."

Elaborating on the matter further, Dr Umesh points out that when food aid is provided for those in the lower economic group, healthy options are not often considered. And that may also be contributing to an increase in diabetes cases.

He says: "During festive periods like Hari Raya, for example, you see organisations providing the needy with flour, condensed milk, instant noodles and canned food. But we really have to realise that (beyond charitable intentions) these foods can affect one's health and lifestyle."

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