DiabCare Asia 2012: diabetes management, control, and complications in patients with type 2 diabetes in Indonesia

Achmad Rudijanto Cholil; Dharma Lindarto; Tjokorda Gde Dalem Pemayun; Wismandari Wisnu; Poppy Kumala; Happy Helene Sulung Puteri

doi:10.13181/mji.v28i1.2931

Authors

Achmad Rudijanto Cholil Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar Hospital, Malang
Dharma Lindarto Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Adam Malik Hospital, Medan
Tjokorda Gde Dalem Pemayun Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro, Kariadi Hospital, Semarang
Wismandari Wisnu Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Poppy Kumala Novo Nordisk Indonesia, Jakarta
Happy Helene Sulung Puteri Novo Nordisk Indonesia, Jakarta

DOI:

https://doi.org/10.13181/mji.v28i1.2931

Keywords:

diabcare, diabetes complication, diabetes mellitus, hypoglycemia, prevention, treatment adherence

Abstract

BACKGROUND Indonesia was a part of the most recent edition of DiabCare Asia held in 2008. DiabCare Asia 2012 is modeled after a similar project to provide the latest information to facilitate healthcare policymaking in this area.

METHODS This was an observational, non-interventional, cross-sectional study of patients with type 2 diabetes mellitus from primary, secondary, and tertiary care centers in Indonesia. Patient data collected included demography, medical history complications, eye and foot examinations, diabetes management, and most recent laboratory investigations. Blood samples were collected from all patients for the analysis of glycated hemoglobin (HbA1c).

RESULTS

A total of 1,967 patients participated in the study, with a mean (SD) age of 58.4 (9.5) years and a median (range) duration of diabetes 6.0 (0.1−47.0) years. The percentage of patients with HbA1c <7.0% was 30.8% and the mean (SD) HbA1c level was 8.3 (2.2%). The proportion of patients using insulin was 34.7% with a mean (SD) total daily dose of 37.9 (24.1) IU. The most common diabetes-related complications were peripheral neuropathy (59.1%), erectile dysfunction (32.4%), and eye complications (29.1%).

CONCLUSIONS Glycemic and metabolic control remain unsatisfactory in type 2 diabetes patients in Indonesia. Efforts are needed to optimize control and prevent complications in these patients.

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References

IDF Diabetes Atlas. 6 ed: International Diabetes Federation; 2015.

Noncommunicable Diseases in the South-East Asia Region: 2011 Situation and Response. World Health Organization; 2011.

Action plan for the prevention and control of noncommunicable diseases in South-East Asia, 2013-2020. World Health Organization; 2013.

Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301(20):2129-40. https://doi.org/10.1001/jama.2009.726

Low WY, Lee YK, Samy AL. Non-communicable diseases in the Asia-Pacific region: prevalence, risk factors and community-based prevention. Int J Occup Med Environ Health. 2015;28(1):20-6. https://doi.org/10.2478/s13382-014-0326-0

IDF Diabetes Atlas. 8 ed: International Diabetes Federation; 2017.

RISKESDAS, Basic Health Research, Indonesian Ministry of Health, Health Research and Development Body, 2013.

Nitiyanant W, Tandhanand S, Mahtab H, Zhu XX, Pan CY, Raheja BS, et al. The Diabcare-Asia 1998 study--outcomes on control and complications in type 1 and type 2 diabetic patients. Curr Med Res Opin. 2002;18(5):317-27. https://doi.org/10.1185/030079902125000822

Chuang LM, Tsai ST, Huang BY, Tai TY; Diabcare-Asia 1998 Study Group. The status of diabetes control in Asia--a cross-sectional survey of 24 317 patients with diabetes mellitus in 1998. Diabet Med. 2002;19(12):978-85. https://doi.org/10.1046/j.1464-5491.2002.00833.x

Mohamed M, Diabcare-Asia 2003 Study Group. An audit on diabetes management in Asian patients treated by specialists: the Diabcare-Asia 1998 and 2003 studies. Curr Med Res Opin. 2008;24(2):507-14. https://doi.org/10.1185/030079908X261131

Mafauzy M, Hussein Z, Chan SP. The status of diabetes control in Malaysia: results of DiabCare 2008. Med J Malaysia. 2011;66(3):175-81.

Soewondo P, Soegondo S, Suastika K, Pranoto A, Soeatmadji DW, Tjokroprawito A. The DiabCare Asia 2008 study-outcomes on control and complications of type 2 diabetic patients in Indonesia. Med J Indones. 2010;19(4):235-44. https://doi.org/10.13181/mji.v19i4.412

Latif ZA, Jain A, Rahman MM. Evaluation of management, control, complications and psychosocial aspects of diabetics in Bangladesh: DiabCare Bangladesh 2008. Bangladesh Med Res Counc Bull. 2008;37(1):11-6. https://doi.org/10.3329/bmrcb.v37i1.7793

Chetthakul T, Pongchaiyakul C, Tandhanand S. Improvement of diabetic care at Maharat Nakhon Ratchasima Hospital (the study of Diabcare-Asia from 1997 to 2003). J Med Assoc Thai. 2006;89(1):56-62.

Mafauzy M. Diabetes control and complications in private primary healthcare in Malaysia. Med J Malaysia. 2005;60(2):212-7.

Chuang LM, Soegondo S, Soewondo P, Young-Seol K, Mohamed M, Dalisay E, et al. Comparisons of the outcomes on control, type of management and complications status in early onset and late onset type 2 diabetes in Asia. Diabetes Res Clin Pract 2006;71(2):146-55. https://doi.org/10.1016/j.diabres.2005.05.007

World Medical Association. Declaration of Helsinki. Ethical principles for medical research involving human subjects. Seoul: 59th WMA General Assembly; 2008. https://doi.org/10.1515/9783110208856.233

International Society for Pharmacoepidemiology (ISPE). Guidelines for good pharmacoepidemiology practices (GPP). 2007.

World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. https://doi.org/10.1001/jama.2013.281053

International Society for Pharmacoepidemiology (ISPE). Guidelines for good pharmacoepidemiology practices (GPP). Pharmacoepidemiol Drug Saf. 2008;17(2):200-8. https://doi.org/10.1002/pds.1471

Rabin R, Gudex C, Selai C, Herdman M. From translation to version management: a history and review of methods for the cultural adaptation of the EuroQol five-dimensional questionnaire. Value Health. 2014;17(1):70-6. https://doi.org/10.1016/j.jval.2013.10.006

International Diabetes Federation. IDF Diabetes Atlas, 5th edn. Brussels, Belgium: International Diabetes Federation, 2011.

American Diabetes Association. Standards of medical care in Diabetes-2014. Diabetes Care. 2014;37:S14-80. https://doi.org/10.2337/dc14-S014

Sobngwi E, Ndour-Mbaye M, Boateng KA, Ramaiya KL, Njenga EW, Diop SN, et al. Type 2 diabetes control and complications in specialised diabetes care centres of six sub-Saharan African countries: the Diabcare Africa study. Diabetes Res Clin Pract. 2012;95(1):30-6. https://doi.org/10.1016/j.diabres.2011.10.018

Mohan V, Shah SN, Joshi SR, Seshiah V, Sahay BK, Banerjee S, et al. Current status of management, control, complications and psychosocial aspects of patients with diabetes in India: results from the DiabCare India 2011 study. Indian J Endocrinol Metab. 2014;18(3):370-8. https://doi.org/10.4103/2230-8210.129715

Omar MS, Khudada K, Safarini S, Mehanna S, Nafach J. DiabCare survey of diabetes management and complications in the Gulf countries. Indian J Endocrinol Metab. 2016;20(2):219-27. https://doi.org/10.4103/2230-8210.176347

Mafauzy M, Zanariah H, Nazeri A, Chan SP. DiabCare 2013: a cross-sectional study of hospital based diabetes care delivery and prevention of diabetes related complications in Malaysia. Med J Malaysia. 2016;71(4):177-85.

Widyahening IS, van der Graaf Y, Soewondo P, Glasziou P, van der Heijden GJ. Awareness, agreement, adoption and adherence to type 2 diabetes mellitus guidelines: a survey of Indonesian primary care physicians. BMC Family Practice. 2014;15(72). https://doi.org/10.1186/1471-2296-15-72