According to the DiabCare 2013, despite the effort in improving diabetes care in Malaysia, glycemic control and the prevalence of many diabetes related complications were unchanged over the years.1 There is still an inertia in getting the patients to clinical targets early with the right treatment. In view that global real-world data on the management of type 2 diabetes (T2D) are limited, the global DISCOVER study was initiated with the primary objective of describing disease management patterns and disease evolution over 3 years in patients with type 2 diabetes initiating a second-line glucose-lowering therapy.2
DISCOVER is a global, prospective, non-interventional study conducted in 38 countries, including Malaysia, across six continents. The study has enrolled about 15 000 patients, who will be followed up for 3 years. Data are collected during routine visits from three different sources: electronic medical records, when available, electronic case report forms (eCRFs), which include additional patient clinical data provided by the investigator, and patient-reported outcomes questionnaires completed by patients.2
Dr Radhakrishna Sothiratnam, the principal investigator for the DISCOVER Study in Malaysia, has recently presented the baseline Malaysian DISCOVER data at the 9th Malaysian Endocrine and Metabolic Society Annual Congress in Kuala Lumpur, Malaysia on Monday 4 May.
Of the 14 DISCOVER sites in Malaysia, 92.9% were in urban areas, 28.6% were primary care centres, 28.6% were general/community hospitals and 7.1% were university/teaching hospitals. The Malaysian DISCOVER investigators were primary care physicians (64.3%) and endocrinology/diabetology specialists (35.7%). Baseline data were collected from 330 patients in Malaysia, 91.0% of whom received metformin monotherapy as first-line treatment and 72.5% of whom received a sulphonylurea with metformin as second-line treatment. Malaysian patients had worse glycaemic control at baseline than the global DISCOVER population (mean HbA1c level of 9.0% versus 8.3%). At baseline, 9.9% of these patients had macrovascular complications and 26.3% had microvascular complications. The most common microvascular and macrovascular complications were chronic kidney disease (present in 14.6% of patients) and coronary artery disease (present in 4.2% of patients). Overall, these results highlight poor glycaemic control and high levels of vascular complications among DISCOVER patients in Malaysia, which indicates a need for more intensive management of type 2 diabetes.3
As part of the continuous effort in providing more real-world data on diabetes, AstraZeneca has also initiated the DISCOVER Global Registry, and Malaysian is once again part of this global initiative. The registry intends to provide real world data on patient characteristics, disease management, healthcare utilization, and outcomes in patients with type 2 diabetes and established micro- and/or macrovascular disease.4
- Mohamed M, Hussein Z, Nazeri A, Chan SP. Med J Malaysia. 2016 Aug;71(4):177.
- Ji L, Bonnet F, Charbonnel B, Gomes MB, Kosiborod M, Khunti K, Nicolucci A, Pocock S, Rathmann W, Shestakova MV, Shimomura I, Watada H, Fenici P, Hammar N, Hashigami K, Macaraeg G, Surmont F, Medina J. Towards an improved global understanding of treatment and outcomes in people with type 2 diabetes: Rationale and methods of the DISCOVER observational study program. J Diabetes Complications 2017;31(7):1188–96.
- Radhakrishna R, et al. Poster presented at the 9thMEMS Annual Congress, 4-6 May 2018, Kuala Lumpur, Malaysia.