Enhancing Glycaemic Control: The Impact of Medical Nutrition Therapy on HbA1c Reduction in Malaysia's Primary Healthcare Clinics (2017-2022)

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Published: May 25, 2026
Keywords:
Diabetes Mellitus, HbA1c, Medical Nutrition Therapy, Dietitians, Glycaemic Control, Malaysia

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Murnizar Mokhtar
Centre for Nutrition Epidemiology Research, Institute for Public Health, National Institute of Health, Ministry of Health of Malaysia, Blok B5&B6, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor
Nurul Huda Ibrahim
Centre for Nutrition Epidemiology Research, Institute for Public Health, National Institute of Health, Ministry of Health of Malaysia, Blok B5&B6, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170 Shah Alam, Selangor
Norasimah Binti Kassim
Family Health Development Division, Ministry of Health of Malaysia, Aras 7, Blok E10, Kompleks E, Pusat Pentadbiran Kerajaan Persekutuan, 62590 Putrajaya
Mohammad Zulkarnain Mohammad Ikhram
Klinik Kesihatan Merlimau, Ministry of Health of Malaysia, 8437, Jalan Muhibbah 9a, Taman Merlimau, 77300 Merlimau, Melaka
Rozlinizam Kudori
Klinik Kesihatan Sg Chua, Ministry of Health of Malaysia, Kawasan Perindustrian Sg Chua, Kajang, 43000 Selangor
Aisyah Muhamad
Klinik Kesihatan Batu Pahat, Ministry of Health of Malaysia, Jln Kluang, Taman Limpoon 83000 Batu Pahat, Johor
John Kong Jian Pei
Klinik Kesihatan Bintulu, Ministry of Health of Malaysia, Jalan Tun Ahmad Zaidi 97000 Bintulu Sarawak
Mohd Fauzee Mohd Zaki
Klinik Kesihatan Bandar Jerantut, Ministry of Health of Malaysia, Pahang
Siah Woan Yie
Klinik Kesihatan Batu Berendam, Ministry of Health of Malaysia, 1286, Jalan Batu Berendam, Kampung Sungai Putat 75350 Melaka

Abstract

Background: Diabetes Mellitus (DM) presents a major public health challenge, leading to serious complications. Medical Nutrition Therapy (MNT), provided by dietitians, is crucial for reducing HbA1c levels and improving glyceamic control. Objective: To evaluate the impact of MNT on HbA1c reduction in adults with Type 2 diabetes (T2DM) attending public health clinics in Malaysia, highlighting the importance of dietitian coverage in diabetes care. Methods: A retrospective cohort study was conducted among 4,680 adult T2DM patients who received MNT from 2017 to 2022. Patients with baseline HbA1c levels >8% were included, while those with chronic kidney disease, psychiatric conditions, pregnancy, or bedridden status were excluded. Pre- and post-MNT HbA1c levels were analysed using paired t-tests and regression models. Results: The mean HbA1c level dropped significantly from 10.83 ± 1.88% to 8.65 ± 1.92% post-intervention (p < 0.001), with an average reduction of 2.18%. Significant predictors of HbA1c reduction included pre-consultation HbA1c, gender, and ethnicity, with the strongest association seen in pre-consultation HbA1c. A target HbA1c ≤6.5% was achieved by 12.5% of patients. Conclusion: This study affirms MNT as a critical component of diabetes management, significantly improving HbA1c outcomes. Expanding dietitian services in Malaysia’s primary care is essential to provide equitable access to effective diabetes care.

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Murnizar Mokhtar, Ibrahim, N. H., Kassim, N. B., Mohammad Ikhram, M. Z., Rozlinizam Kudori, Aisyah Muhamad, John Kong Jian Pei, Mohd Zaki, M. F., & Siah Woan Yie. (2026). Enhancing Glycaemic Control: The Impact of Medical Nutrition Therapy on HbA1c Reduction in Malaysia’s Primary Healthcare Clinics (2017-2022). Malaysian Journal of Medicine and Health Sciences, 22(2), 1536. Retrieved from http://mjmhsojs.upm.edu.my/index.php/mjmhs/article/view/1536
Issue
Vol. 22 No. 2 (2026)
Section
Original Articles

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