From the Guidelines
Approach to Palliative Care for Patients with Diabetes in Malaysia
The approach to palliative care for patients with diabetes in Malaysia should focus on overall comfort, prevention of distressing symptoms, and preservation of quality of life and dignity.
- The primary goals are to avoid hypoglycemia and symptomatic hyperglycemia while reducing the burdens of glycemic management 1.
- Strict glucose and blood pressure control are not necessary in palliative care, and simplification of regimens can be considered 1.
- The intensity of lipid management can be relaxed, and withdrawal of lipid-lowering therapy may be appropriate 1.
- Deintensification of treatment is recommended as organ failure develops, and one or more agents may need to be discontinued 1.
- For patients with type 2 diabetes, discontinuation of all medications may be a reasonable approach at the end of life, while for type 1 diabetes, a small amount of basal insulin may be maintained to prevent acute hyperglycemic complications 1.
- Patient-centered care is essential, and the decision process should involve the patient, family, and caregivers to develop a care plan that is convenient and effective for the goals of care 1.
From the Research
Approach to Palliative Care for Patients with Diabetes in Malaysia
- The approach to palliative care for patients with diabetes in Malaysia is not explicitly outlined in the provided studies, but some insights can be gathered from the available evidence.
- A study on diabetes care in Malaysia 2 highlights the importance of multidisciplinary care, including pharmacotherapy, diet, and lifestyle changes, but does not specifically address palliative care.
- Another study on palliative care in Malaysia 3 discusses the challenges faced by non-governmental organizations in providing palliative care, including financial matters, perception issues, and logistical concerns, but does not focus on patients with diabetes.
- International studies on palliative care for patients with diabetes 4, 5 provide guidance on managing diabetes at the end of life, including the importance of individualized care and addressing patient needs, but may not be directly applicable to the Malaysian context.
Palliative Care in Malaysia
- Palliative care in Malaysia has made significant progress since its introduction in 1991, with an estimated 26 non-governmental organizations and 68 government hospitals providing palliative care facilities and services nationwide 3.
- A study on the development of palliative care in Malaysia 6 highlights the importance of collaboration between government and non-governmental organizations to maximize development and benefit patients.
- However, there is limited information available on the specific approach to palliative care for patients with diabetes in Malaysia, and further research is needed to address this gap.