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Winfrey - difference between policy, programme, movement, campaign. how can we determine if our solution falls under any of these?

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Winfrey - difference between policy, programme, movement, campaign. how can we determine if our solution falls under any of these?

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Thank you Dr Shiva for your presentation! May I enquire the difference between the connected system with insulin infusion pump?

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Thank you Dr Shiva, following up on kishen's question, what if we split the physicians' percentage into smaller percentage by including other health care professionals like dieticians and pharmacists etc?

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Thank you Dr Shiva! The solution that Sanofi presented, I would assume this would cater to diabetic patients that can afford it right? What would you suggest to enable a data-driven connected healthcare response system for the lower-income population?

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My teammate, Wen Lee, asked a question yesterday: Indians (South Asians) have a higher prevalence of diabetes; is it due to their ethnicity or the structural oppression faced by them? We explored this question as a team, and similar patterns of oppression and negative health outcomes have been observed in marginalized groups. Here's a paper on Indigenous communities and intergenerational trauma (and associated health outcomes). Thought some of you might be interested in the intersections of marginalized identities!

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According to Psycho-Cybernetics book by Maxwell Maltz it takes 21 days to form a habit. But there are many more research out there stating that it takes way more than 21 days to break/form a habit. I'm wondering if they are any research done to modify Malaysian behaviors with regards to lifestyle modification to a better healthy lifestyle by MOH. And if theres any, where might i get the abstract / literature? thx

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I think there were a lot of reiteration of food choices and habitual changes that needs to be made by individuals however i think there should also be more conversations on how community should act upon a diabetic patient or how resource providers such as (1) food and business companies or (2) pharmaceutical companies should be held accountable - or at least be a part of the discourse. Is community based approach more effective or modifying the mindset of individuals

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Winfrey - question about nudging behavior

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Winfrey - question about nudging behavior

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In terms of nudging health behavior of Malaysians, our team has come up with a few concerns, would be great if our mentors could enlighten us with some example of interventions or insights:
1. How can we measue the effectiveness of the action?
2. Is the time lag significant? should we take this into account when coming up with solutions?
3. Is there any potential ethical issue or transparency issue when it comes to altering people's choices/behavior?

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Conflicting narratives and how to overcome them (Kishen)

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Conflicting narratives and how to overcome them (Kishen)

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From the previous testimonies from the diabetic patients, it seems to me that family plays a huge role on the patients mental health or them accepting diabetes, is there a programme set up in hospitals  on educating families on supporting these patients or how can the family members support these patients

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Sam - Are Malaysian Diabetic Patients Ready to Use The New Generation of Health Care Service Delivery? 

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Sam - Are Malaysian Diabetic Patients Ready to Use The New Generation of Health Care Service Delivery? 

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Malaysia's Internet Penetration as of 2020 is 68.4%, (IWS, 2020).

In response to this, and not yet taking into account the willingness to adopt telehealth, our team interestingly found that Malaysians are still arguably very much still attached to the brick-and-mortar health facilities as opposed to today's e-health services.

On top of that, we'd like to know how policies and initiatives can extend to the 31.6% that lack effective internet services to receive health services remotely

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Julian - Question about different approaches

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Julian - Question about different approaches

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We understand that every approach will have its pros and cons, whether in terms of immediate/long term effect, time lag, outreach etc. Considering that diabetes has reached a worrying level in Malaysia, what do you think should be given priority to our solution? (implementation time lag, outreach, ease of implementation whether it can be implemented immediately or much preparation needed, etc)

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Hasanah: "...the prevalence of diabetes in Malaysia was expected to rise due to unhealthy lifestyles like overeating, excessive consumption of sugar, salt and meat, poor dietary habits, and lack of exercise, sleep and rest." (MalayMail, 2020)

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Hasanah: "...the prevalence of diabetes in Malaysia was expected to rise due to unhealthy lifestyles like overeating, excessive consumption of sugar, salt and meat, poor dietary habits, and lack of exercise, sleep and rest." (MalayMail, 2020)

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This is something we all know. But with the Malaysian culture of  unhealthy lifestyles like hawker stall culture, fast food restaurants and lack of exercise, how do our interventions uproot this deeply ingrained culture?

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Ashley - question about top down or bottom up approach

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Ashley - question about top down or bottom up approach

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How can we determine if our approach falls under one of these?

What is your suggestion based on the pros and cons of these two approaches?

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Diabetes in one of the major public health concern in Malaysia, however, why is there no programmes that have been done to help tackle the problem - such as any intervention or prevention programme? I may be wrong if there are any existing ones, do let me know. Thanks!

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Diabetes Self-Management Education and Support (DSMES)

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Question on the Automated Tracking System

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Question on the Automated Tracking System

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Hi Doctor, Thank you for your time. Id like to ask if there is an example where the automated tracking system has been practiced and been successful.
-Seaan, Team 5.

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In the slides you mentioned the physicians time constraint and overwhelming requirement. Would you say there is an unbalanced doctor-patient ratio? What do you think would reduce this burden?

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I liked your slide regarding specific data required by physicians to make clinical decisions. As we move into a more digitalized world (accelerated more so by Sars-Cov-2), what are your thoughts on improvements that could be made to make the technology more easy for users? And is the use of technology a silver bullet in this case?

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Thank you Dr Shiva, may I ask how much does the whole system (glucose monitoring system and pumps) of the diabetes patients costs?

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Hello Dr. Khor! Health policies directly affect the lifestyles and choices people make. What do you think about health policies decided by public referendum?

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(Question initially addressed to Dr. Khor). When trying to pass a policy, if there happens to be direct conflicts with lobby groups, how do we still pass that policy while placating the lobby but still maintaining the integrity of the policy. Moreover, is there any way to adequately limit the influence that lobbyists have on policymakers? 

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(Question initially addressed to Dr. Khor). When trying to pass a policy, if there happens to be direct conflicts with lobby groups, how do we still pass that policy while placating the lobby but still maintaining the integrity of the policy. Moreover, is there any way to adequately limit the influence that lobbyists have on policymakers? 

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Hi Dr. Khor! Is there any policy made based on evidence based studies which might have conflict of interest? Is financial benefit their priority?
Thanks :)
-Wen Lee (Team 9)

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Question for Dr Shiva Patil (Shea Zheng)

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Question for Dr Shiva Patil (Shea Zheng)

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While looking online, so far I can't find how is Type 1 and Type 2 diabetes is clearly differentiated in terms of diagnosis. Could you share more?

I see that Hba1c count is clear enough to diagnose a patient for diabetes, but it is unclear how they test for maybe.. Insulin secretion to determine Type 1/2.

My thinking is with this diagnosis, the patient can have a better decision to start on drug treatment or not.