Aims To translate and examine the psychometric properties of the Malaysian version of the Morisky Medication Adherence Scale (MMAS) among patients with type 2 diabetes. Methods A standard “forward–backward” procedure was used to translate MMAS into Malay language. It was later validated on a convenience sample of 223 type 2 diabetes outpatients between May and September 2009. Reliability was tested for internal consistency. Validity was confirmed using convergent and known group validity. Results Employing the recommended scoring method, the mean ± SD of MMAS scores was 6.13 ± 1.72. Moderate internal consistency was found (Cronbach’s α = 0.675), the test–retest reliability value was 0.816 (p < 0.001). A positive correlation between the eight- and four-item MMAS was found (r = 0.792; p < 0.01). A significant relationship between MMAS categories and HbA1c categories (χ2 = 20.261; p ≥ 0.001) was found. The MMAS sensitivity and specificity, with positive and negative predictive values were 77.61%, 45.37%, 46.84% and 76.56%, respectively. Conclusions The findings of this validation study indicate that the Malaysian version of the MMAS is a reliable and valid measure of medication adherence which can now be used.

Patients' knowledge about diabetes is associated with better medication adherence and better glycemic control. In addition to other factors affecting medication adherence and glycemic control, healthcare providers should pay attention to knowledge about diabetes that the patients carry towards medication adherence.

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The aims of this study were to translate the Michigan Diabetes Knowledge Test (MDKT) into the Malaysian language, and to examine the psychometric properties of the Malaysian version.A standard translation procedure was used to create the Malaysian version of the MDKT from the original English version. A convenience sample of 307 outpatients with type 2 diabetes was identified between May and October 2009. All data were collected from the Penang General Hospital, Penang, Malaysia. Instruments consisted of the Malaysian version of the MDKT and a socio‐demographic questionnaire. Medical records were reviewed for haemoglobin A1c (HbA1c) levels and other clinical data. Reliability was tested for internal consistency using Cronbach's alpha coefficient.Employing the recommended scoring method, the mean±SD of MDKT scores was 7.88±3.01. Good internal consistency was found (Cronbach's alpha = 0.702); the test‐retest reliability value was 0.894 (p<0.001). For known group validity, a significant relationship between MDKT categories and HbA1c categories (chi‐square = 21.626; p≥0.001) was found.The findings of this validation study indicate that the Malaysian version of the MDKT is a reliable and valid measure of diabetes knowledge which can now be used in clinical and research practice. Copyright © 2010 John Wiley & Sons.

Objectives  To evaluate the general diabetes knowledge among patients with type 2 diabetes and to assess the relationship of knowledge scores with the control of glycaemia by patients. Methods  A cross‐sectional study design was used. The study was conducted in the Diabetes Clinic of the Penang General Hospital, Penang, Malaysia, and involved the use of the validated Michigan Diabetes Knowledge Test (MDKT). A convenience sample of 540 type 2 diabetic outpatients was identified between October 2009 and April 2010. Patients with type 2 diabetes were asked to complete a short questionnaire about sociodemographic data and their knowledge about diabetes. Medical records were reviewed for haemoglobin A1C (HbA1C) levels and other disease‐related data. Key findings  Only 505 patients were included in the final analysis, with a mean age of 58.15 years (SD = 9.16 years), around 50% males and a mean HbA1C of 7.94% (SD = 1.61%). MDKT scores ranged from 0 to 14; the total mean of the scores was 7.44 (SD = 3.08). A significantly higher score for knowledge (P < 0.05) was found in those patients with lower HbA1C levels and significant differences were found in HbA1C levels among the three knowledge groups (P < 0.05). The correlation coefficient between HbA1C and knowledge score was −0.39 (P < 0.001). Conclusions  The study identified that Malaysian patients with diabetes have knowledge in terms of the disease and its management, but that this knowledge is inadequate and still needs to be improved, especially in those with a shorter duration of diabetes, and a low level of education and monthly income.

Study aimed to determine the rate and prediction of infection in diabetes mellitus patients ≥ 18 year, with diabetic ketoacidosis (DKA). Retrospective cohort study design was adopted to achieve the objectives. Universal sampling technique was employed for data collection among Diabetes ketoacidosis patients, over a period of 3 years (Jan 2008-Dec 2010). Statistical package for social sciences used to analyze data. Over a 3-year period, total of 967 admissions were identified. Of it, 112 (11.6%) with no infection, 679 (70.2%) with bacterial infection and 176 (18.2%) with presumed viral infection. The mean WBC for all the patients was 18,177 (±9431). 721 (74.6%) had leukocytosis, as defined by a WBC ≥ 15,000/mm 3 . WBC, differential, leukocytosis, as well as sex, temperature were not significant predictors (p > 0.05) of bacterial infection. There was significant (p < 0.05) difference of age between the 3 groups, age above 57 years have high rate of infection as compared to age below and equal 57 years. The infection rate in elderly patients with DKA was high and majority of them had lack of clinical evidence. Major bacterial infections with potential serious sequel were particularly common (33.3%), among every third patient being presumed to have serious consequences.

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There is a global epidemic of diabetes with its prevalence expected to increase from 5.1% in 2003 to 6.3% in 2025. This increase in diabetes is occurring in all nations, however, developing nations are particularly at risk. It spares no group and affects men, women, the elderly, young and people from very racial and socioeconomic background. Nevertheless, certain ethnic groups including Asians are affected more than Caucasians. Large randomized clinical trials have shown that improvement in glycaemic control, together with management of diabetes-related risk factors like blood pressure and lipid control significantly reduce the micro and macro complications in individuals with type 1 and type 2 diabetes. Patient education plays a crucial role in the prevention of diabetic fool problems. In Geneva, the rate of lower limb amputations was reduced by almost 75% after an educational intervention. People with diabetes must acquire the knowledge and skills through education to provide daily self-care in diabetes management which involves maintenance of healthy living, recognition and management of diabetes problems when they arise and taking preventive measures. Some factors include patients' biomedical variables, the psychosocial environment, the knowledge, attitudes and beliefs of patients themselves, home careers and health care providers, healthcare systems' accessibility and availability and even the national political context may influence these self-care behaviors.