In Southeast Asia, particularly Malaysia, diabetes is not only a health problem, but an epidemic.

According to recent findings, the frequency of diabetes is steadily increasing.

Malaysia, in particular, has one of the highest rates of diabetes in the Asia and Western Pacific regions, with around one in five adults affected.

It is also alarming that more than 11% of Malaysians suffer from prediabetes, a condition characterized by high blood sugar levels.

The increasing frequency of diabetes has made it a crucial public health problem, which threatens quality of life and burdens health systems.

The economic burden of diabetes on Malaysian healthcare is also significant.

Diabetic patients often suffer from comorbidities (concomitant medical conditions), such as cardiovascular (heart) disease and kidney complications, which require extensive and expensive treatments.

Beyond the immediate healthcare costs, diabetes also impacts workforce productivity, especially as it increasingly affects younger people.

The recently concluded Seaco-CH20 (South-East Asia Community Observatory Child Health 2020) study highlights these concerns.

It found that metabolic risk factors such as high blood pressure and high fasting blood sugar are prevalent among Malaysian children and adolescents, paving the way for a high risk of type 2 diabetes during their lifetime.

Use social networks

The diabetes crisis in Malaysia is driven by rapid urbanization and changing dietary habits and lifestyles.WhatsApp groups appear to be an effective way to provide information and support to help patients manage lifestyle diseases like diabetes.

These changes are shaping the country’s health landscape, making diabetes a growing concern.

Meeting this challenge requires more than conventional healthcare; it calls for an integrated, community-centered approach that includes digital health tools and tailored public health interventions.

Together, these strategies aim to make diabetes care inclusive and accessible, reaching individuals from all socioeconomic and geographic backgrounds.

A key aspect of our approach is peer-led interventions, which show great promise in the management of diabetes and other chronic diseases.

Peer-led models train community members to offer practical advice and emotional support, fostering camaraderie and shared engagement.

Research highlights the impact of peer-led programs as they motivate individuals to make healthier lifestyle choices and overcome barriers to lasting behavior change.

Our systematic review recently confirmed that peer-led initiatives have a positive impact on cardiovascular health, which is closely linked to diabetes, through consistent, community-based check-ins, discussions and mutual support.

With the widespread use of smartphones, digital platforms like WhatsApp have become essential channels for health interventions.

These platforms facilitate real-time communication, providing immediate and accessible health education and support.

Our recent scoping study found that interventions delivered via WhatsApp and WeChat messaging apps were effective in encouraging lifestyle changes and improving diabetes management.

Social media enables real-time consultations with healthcare providers and promotes ongoing peer support – key factors for long-term behavior change.

Notably, these interventions are linked to reductions in glycosylated hemoglobin (HbA1c) levels, a primary measure of glycemic control.

This demonstrates the potential of social media as a scalable and cost-effective solution for diabetes management in regions where smartphone usage is high.

Peer and community involvement

In Johor Bahru and Kedah, our Persuade (Peer Support Program for Adults with Metabolic Syndrome) and MYCardio-PEER projects are making a tangible difference by integrating health interventions within communities and empowering residents through peer-led models.Community empowerment allows patients to tailor their physical activity to what works for them, following evidence-based guidelines, creating greater buy-in and more sustained efforts.

Both programs target diabetes, as well as related complications such as high blood pressure, high cholesterol and obesity, which are common in these regions and are frequently associated with diabetes, complicating health outcomes.

By addressing this full range of metabolic disorders, we promote a holistic approach to metabolic health that covers diabetes and other chronic diseases affecting quality of life.

Project Persuade in Johor Bahru was designed as a 12-week behavioral intervention program with peer support.

Interventions were formulated using a five-step development process: evidence review, group discussions, behavioral matrix development, module development, and feasibility and process assessment.

This was to ensure that the program was evidence-based, as well as appropriate and specific to the community.

Completion of the program revealed that participants actually saw improvements in their diabetes-related behaviors and metabolic health.

This success highlights the effectiveness of an inclusive, community-centered approach that relies on trained peer leaders within the community.

These peer leaders provide essential health information and emotional support, creating an environment in which participants feel motivated to make healthier lifestyle choices.

Peer leaders play an instrumental role in normalizing health-promoting behaviors, cultivating a sense of belonging, and encouraging lasting change.

In Kedah, the MYCardio-PEER initiative is a digitally-assisted lifestyle peer support intervention aimed at mitigating the risk of cardiovascular disease in a low-income community through the adoption of a healthier lifestyle.

This includes combating diabetes and other metabolic disorders, which are risk factors for cardiovascular disease.

The ongoing program combines digital materials and interactive activities, facilitated by trained peer leaders to provide accessible and tailored lifestyle information and strong social support.

This is a collaborative effort involving direct input from community members through group discussions.

Peer leaders and key stakeholders also participate in these discussions, ensuring the program is tailored to the needs of the community.

This participatory approach fostered a strong sense of ownership among participants, crucial for consistent engagement and, ultimately, better health outcomes.

Through community involvement in program development, MYCardio-PEER reflects the unique ideas and challenges of those it serves.

This grassroots approach allowed the program to be adapted based on community feedback, making it relevant and effective.

Rather than offering a one-size-fits-all solution, the intervention is personalized to meet local circumstances.

By involving the community at every stage, the likelihood of lasting health improvements is improved, as participants view the program as their own rather than an external initiative.

Our experience with Persuade and MYCardio-PEER highlights the value of community ownership, peer-led support, and collaborative planning to drive meaningful health improvements.

Focus on neglected groups

In the future, we will focus on marginalized and vulnerable populations, often neglected by conventional health programs.

Pregnant women with gestational diabetes, adolescents, and young adults – high-risk, but often underserved, groups – are the focus of our future efforts.

Despite their vulnerability, these people often do not have access to structured health interventions.

Through our model, which has already proven successful in other communities, we aim to create tailored programs that meet the specific needs and challenges of these high-risk groups.

Our mission is not only to improve diabetes management, but also to foster sustainable, community-rooted health practices that will promote healthier lives across Malaysia.

Dr Amutha Ramadas is a nutritionist and associate professor at Monash University Malaysia. For more information, email [email protected]. The information provided is for educational and communication purposes only and should not be considered medical advice. The star makes no warranty as to the accuracy, completeness, functionality, usefulness, or other assurances as to the content appearing in this article. The star disclaims all liability for any loss, property damage or personal injury suffered directly or indirectly as a result of reliance on this information.