Observational research: an integral part of enhancing diabetes management in south-east Asia.

The prevailing burden of the diabetes epidemic and its associated complications poses a substantial threat to socioeconomic development worldwide. This crisis is magnified in developing and recently-developed nations including countries in south-east Asia. Estimates from the International Diabetes Federation suggest an inverse relationship between the economic status of a country and the rise of diabetes; with lower-income countries facing the greatest increase in the prevalence of diabetes [1]. In recent years, the Association of Southeast Asian Nations (ASEAN) has faced an exponential increase in the prevalence of diabetes and associated mortality rate. The current diagnosed and undiagnosed diabetes prevalence in four countries from the ASEAN region and corresponding diabetes-related mortality is presented in Figure 1 [2]. Indonesia with a reported diabetes prevalence of 7.3% in 2011 and a projected prevalence of 11.8% by 2030 ranks among the most affected 10 countries worldwide for adults of 20 to 79 years of age [1]. Although this rise is frequently attributed to population growth, ageing populations, excess calorie intake, and physical inactivity, better disease management contributing to better life expectancy with diabetes will also play a part. Nevertheless there is great scope for further improving this to contain the late adverse outcomes which cause so much of the ill health due to diabetes, and amajority of health-care costs. A shortcoming of ASEAN clinical practice guidelines is that they are often mapped by necessity to data available from western countries [3]. The establishment and implementation of clinically meaningful strategies customized to each country would logically require direction from more local data in routine clinical care settings. However, availability of such data is limited due to a scarcity in the number of clinical trials conducted in the ASEAN region.