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1.  Prevalence of Abnormal Glucose Tolerance and Risk Factors in Urban and Rural Malaysia 
Diabetes Care  2011;34(6):1362-1364.
OBJECTIVE
To determine the prevalence of prediabetes and diabetes among rural and urban Malaysians.
RESEARCH DESIGN AND METHODS
This cross-sectional survey was conducted among 3,879 Malaysian adults (1,335 men and 2,544 women). All subjects underwent the 75-g oral glucose tolerance test (OGTT).
RESULTS
The overall prevalence of prediabetes was 22.1% (30.2% in men and 69.8% in women). Isolated impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were found in 3.4 and 16.1% of the study population, respectively, whereas 2.6% of the subjects had both IFG and IGT. Based on an OGTT, the prevalence of newly diagnosed type 2 diabetes was 12.6% (31.0% in men and 69.0% in women). The prediabetic subjects also had an increased prevalence of cardiovascular disease risk factors.
CONCLUSIONS
The large proportion of undiagnosed cases of prediabetes and diabetes reflects the lack of public awareness of the disease.
doi:10.2337/dc11-0005
PMCID: PMC3114358  PMID: 21498788
2.  Glycemic Control among Pregnant Diabetic Women on Insulin Who Fasted During Ramadan 
Background: Ramadan fasting for pregnant women with diabetes remains controversial and underreported. The objective of this study was to determine the glycemic control in pregnant diabetic women on insulin who fasted during Ramadan.
Methods: This was a retrospective study carried out over a period of three years including pregnant diabetic women, who were on short-acting, intermediate-acting, or a combination of them, and opted to carry out Ramadan fasting. Glycemic control was assessed before, middle and after Ramadan fasting.
Results: Thirty seven women opted to fast with 24 (64.9%) of them had type 2 diabetes mellitus and 83.8% of them required combined insulin (short- acting, intermediate-acting) therapy. The age of the participants was 32.13±4.68 years, and the age of their pregnancies was 25.60±7.12 weeks when the study was performed. The median number of days fasted was 25 days, and most of the women were able to fast for more than 15 days. There was no difference between glycemic control of type 2 diabetes mellitus and gestational diabetes mellitus women prior to fasting. In the middle of Ramadan, serum fructosamine decreased in both groups. However, only serum HbA1c reduced in gestational diabetes mellitus after Ramadan.
Conclusion: the findings indicate that pregnant diabetic women on insulin were able to fast during Ramadan and that their glycemic control was improved during fasting period. They may also suggest that instead of absolute ban on fasting for pregnant diabetic women more practical approach and close consultation with health care providers might be more helpful.
PMCID: PMC3470278  PMID: 23115409
Fasting; insulin; diabetes; pregnancy; gestational diabetes
3.  A case of Hashimoto encephalopathy in a Malay woman with Graves disease 
BMJ Case Reports  2009;2009:bcr01.2009.1501.
Hashimoto encephalopathy (HE) is a poorly recognised steroid-responsive encephalopathy, with prominent neuropsychiatric features. Diagnosis is often difficult due to its heterogeneous clinical presentation, especially since the thyroid status or anti-thyroid antibody titres may not be related to the disease state. Here, the case of a 23-year-old Malay woman with Graves disease who presented with progressive encephalopathy diagnosed as HE is presented. She responded dramatically to high dose intravenous and then oral corticosteroid. A month after the initiation of treatment, she regained full independency.
doi:10.1136/bcr.01.2009.1501
PMCID: PMC3027930  PMID: 21709844

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