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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Medical Journal of Indonesia Indonesian Journal of Biotechnology Global Medical and Health Communication The Indonesian Biomedical Journal Jurnal Sistem Kesehatan Universa Medicina Paediatrica Indonesiana GIZI INDONESIA Journal of Epidemiology and Public Health The Indonesian Journal of Infectious Diseases Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Tunas Medika Jurnal Kedokteran & Kesehatan Jurnal Penyakit Dalam Indonesia
Bachti Alisjahbana
Department Of Internal Medicine Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Dentistry Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Universa Medicina

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Diabetes mellitus patients in Indonesia: management in a tertiary hospital compared to primary health care Hikmat Permana; Raspati Cundarani Koesoemadinata; Nanny Natalia Mulyani Soetedjo; Nury Fitria Dewi; Novi Jayanti; Sofia Imaculata; Rovina Ruslami; Bachti Alisjahbana; Susan Margaret McAllister
Universa Medicina Vol. 41 No. 2 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.157-168

Abstract

Background The increasing prevalence of diabetes mellitus (DM) requires that patients have greater access to care, which is yet lacking in many low- and middle-income countries and the quality of which varies between health care facilities. We compare the characteristics, complications, and risk profile of diabetes in patients receiving care in primary and tertiary level health facilities in Bandung, Indonesia. MethodsAdult DM patients were recruited from 25 community health centres (CHCs) and the outpatient clinic at one referral hospital. Key data collected and compared to national guidelines were DM history, treatment, complications, blood pressure, height, weight, and laboratory examinations on glycated haemoglobin (HbA1c), lipid profile, and creatinine. Data analysis was by chi-square test. ResultsOf the 809 DM patients (median age 59 years, 63% female, 98% type 2 DM), 318 (39%) were from CHCs and 491 (61%) from the hospital. Overall median HbA1c was 8.3%, with no difference between CHC and hospital patients. Only 32% of patients with HbA1c ≥10% were on insulin (CHCs 5.9%, hospital 42.9%), and only 18% of those on insulin had glycaemic control. Hypertension was common (CHCs 62%, hospital 51%, p<0.001), and only 44% of CHC and 34% of hospital patients received antihypertensive therapy. Among those with macrovascular complications, only 32% (CHCs) and 26% (hospital) were receiving aspirin. The numbers reaching the treatment targets were low for those on antihypertensives and lipid-lowering medications (80/251 and 11/105, respectively). ConclusionGlycaemic control and management of complications of DM patients at both health care levels need considerable improvement.
Co-Authors Afandi, Ressa Novita Agnes Rengga Indrati Ahmad Sulaeman Amaylia Oehadian Andre van der Venn Angèle JGMGerver-Jansen Angky Tririni Anita Yuwita Anna Alisjahbana Ardini S. Raksanagara Ardini S. Raksanagara, Ardini S. Basti Andriyoko Budiman , Budiman Clara M Kusharto Dewi Kartika Turbawaty Dhiya Salsabila Dick van Soolingen Dida Ahmad Gurnida Dwi Agustian Edhyana Sahiratmadja Endang Sutedja Eva Mardiana Hidayat Evan Susandi Fauzian Giansyah Febriani, Ulfah Dwi Gumilang, Manik Intan Guntur Darmawan Hadyana Sukandar Hendra Subroto, Hendra Henriette A Delemarre–van de Waal Henry Chandra Herry Garna Hesti Lina Wiraswati Hidayat, Eva Mardiana Hikmat Permana Hinta Meijerink Hofiyah Djauhari Ida Parwati Ida Parwati Irvan Afriandi Irvan Afriandi Jeffery Malachi Candra Jose Batubara Juhariah Juhariah Julia Hartati Koesoemadinata, Raspati Cundarani Krishna Yana Krisnian, Tharani Kumia Wahyudi Kusumawardhani, R.N. Yasmin Lelly Yuniarti Leonardus Wiydatmoko marni banowati Menik Herdwiyanti Muhammad Yusuf Nanan Sekarwana Nanny Natalia Mulyani Soetedjo Ni Sayu Dewi B. Nisa Fauziah Novi Jayanti Nuni Sulastri Nurizzatun Nafsi Nurul Hidayah Chairunnisa Nury Fitria Dewi obin sarwita Panji Fortuna Hadisoemarto Parse, Rocci Jack Prayudi Santoso Putri Vidyaniati Raspati Cundarani Koesoemadinata Reinout van Crevel Reinout van Crevel Ressa Novita Afandi Resvi Livia Rocci Jack Parse Rovina Ruslami Rovina Ruslami, Rovina Santoso, Ida Parwati Sari Syahruni Siti Soidah Sofia Imaculata Suparman Hardinsyah, Suparman Susan Margaret McAllister Susantina Prodjosoewojo Syndi Nurmawati Teow Sheng Hao Tharani Krisnian Tjahjani M. Sudiro Tony Sadjimin Toto Subroto Trinugroho Heri Fadjari, Trinugroho Heri Tya Listiaty Ulfah Dwi Febriani Uun Sumardi, Uun Willem J Gerver Wirawan, Chevie Woro Indri Padmosiwi Yana, Krishna Yani Triyani Yani Triyani Yanti Mulyana Yeva Rosana Yovita Hartantri Yulniar Tasli