Glycemic Control and Its Factor in Type 2 Diabetic Patients in Jakarta

Abstract

Poor glycemic control is a primary risk factor for the progression of complications. This study aimed to determine the status of glycemic control and associated factors among type 2 Diabetes Mellitus (DM) patients at primary health care of Cakung District, Kebon Jeruk District and Rawa Bunga Village, Jakarta. This study was conducted from July to August 2019, and adopted a cross-sectional design. The respondents' data included sex, age, occupation, education, long suffered with diabetes, diagnosed chronic disease, antidiabetic and other regular drugs were obtained through a questionnaire. Measurement of glycated haemoglobin A1c level was carried out in a standardized laboratory in Jakarta. A total of 126 respondents met the inclusions and exclusion criteria, of which 70.6% were female. The mean age of patients was 61.46±9.086 years (35–85 years). HbA1c level was measured, and the results showed that 45.2% of respondents had good glycemic control (<7% of HbA1c level), while 54.8% had poor control (≥7% of HbA1c level). On the bivariate analysis, the number of antidiabetics was significantly associated with glycemic control (p<0.05). The poor glycemic control was significantly higher in patients with polytherapy (72.6%) antidiabetic compared to single antidiabetic (37.5%) (p=0.01). These findings highlighted the need for proper management of patients with polytherapy, in order to prevent the complication of type 2 DM.Keywords: Glycemic control, Jakarta, primary health care, type 2 diabetes mellitus Kontrol Gikemik dan Faktor yang Berhubungan pada Pasien dengan Diabetes Melitus Tipe 2 di JakartaAbstrakKontrol glikemik yang buruk merupakan faktor risiko utama terjadinya komplikasi pada pasien diabetes melitus (DM). Penelitian ini bertujuan untuk mengetahui kontrol glikemik dan faktor yang berhubungan pada pasien DM tipe 2 di Puskesmas Kecamatan Cakung, Kecamatan Kebon Jeruk dan Kelurahan Rawa Bunga, Jakarta. Penelitian dilakukan pada bulan Juli–Agustus 2019. Desain penelitian yang digunakan adalah cross-sectional. Data responden antara lain jenis kelamin, umur, pekerjaan, pendidikan, lama menderita penyakit DM, penyakit kronis lain yang diderita, obat DM dan obat rutin lain yang digunakan didapatkan melalui instrumen kuisioner. Pengukuran kadar HbA1c dilakukan di laboratorium yang terstandarisasi di Jakarta. Sebanyak 126 responden memenuhi kriteria inklusi dan eksklusi terlibat dalam penelitian ini, dan sebanyak 70,6% adalah berjenis kelamin perempuan. Usia rata-rata pasien adalah 61,46±9,086 tahun (35–85 tahun). Hasil penelitian menunjukkan bahwa 45,2% responden memiliki kontrol glikemik yang baik (<7 level HbA1c), sedangkan 54,8% responden memiliki kontrol glikemik yang buruk (≥7 level HbA1c). Hasil uji bivariat menunjukkan bahwa jumlah antidiabetes yang digunakan berhubungan dengan kontrol glikemik. Kontrol glikemik yang buruk secara signifikan lebih tinggi ditemukan pada pasien dengan politerapi (72,6%) dibandingkan pada pasien dengan terapi tunggal antidiabetes (37,5%) (p=0,01). Temuan ini menyoroti perlunya manajemen yang tepat pada pasien dengan politerapi untuk mencegah komplikasi DM tipe 2.Kata kunci: Diabetes melitus tipe 2, Jakarta, kontrol glikemik, puskesmas

Glycemic Control for Type 2 Diabetes Mellitus Patients: A Systematic Review

“…This systematic review included 12 articles that met the eligible criteria (Table 1) [16][17][18][19][20][21][22][23][24][25][26][27]. The included articles were published either in 2021 [16][17][18][19][20][21][22] or in 2020 [23][24][25][26][27]. No articles were published in 2022.…”

“…There were 10 cross-sectional studies [16,[18][19][20][21][22][23][24][25]27], whereas the remaining two studies were either retrospective observational [17] or retrospective [26]. Among the cross-sectional studies, there were seven studies that reported a cross-sectional design only [18][19][20][22][23]25,27], whereas the remaining three studies reported that the studies were prospective cross-sectional [16], descriptive-analytical cross-sectional [21], and descriptive cross-sectional [24]. The overall prevalence of poor glycemic control was 45.2%…”

“…The risk of poor GC was increased two-fold among patients on oral anti-diabetic drugs + insulin compared to oral anti-diabetic drug alone, and patients who didn't understand the instructions of pharmacists as well as patients who had poor practice. The included 12 articles were from nine different countries: two studies from Ethiopia [16,22], two studies from Saudi Arabia [18,26], one study from Iraq [17], two studies from Indonesia [19,25], one study from Brazil [20], one study from Burkina Faso [21], one study from Morocco [23], one study from Eretria [24], and one study from Egypt [27]. There were five studies reported from Arabian countries [17][18]23,[26][27].…”

“…Glycemic control was determined majorly based on HbA1C as reported in 10 studies [17][18][19][20][21][23][24][25][26][27], whereas only two studies considered glycemic control based on fasting blood glucose (FBG) [16,22]. Two studies considered poor glycemic control at HbA1C ˃7% [19,21], whereas one study considered poor glycemic control at HbA1C=7% [26], and others considered it at HbA1C≥7% [17][18]20,[23][24][25]27]. Regarding the level of FBG, one study considered good glycemic control with FBG at 70-130 mg/dL and poor glycemic control with FBG of less than 70 and more than 130 mg/dL [16].…”

Single Nucleotide Polymorphism in the 3’ Untranslated Region of PRKAA2 on Cardiometabolic Parameters in Type 2 Diabetes Mellitus Patients Who Received Metformin

“… 5 Studies related to metformin efficacy either monotherapy or combination in Indonesian population found that our patients tend to have poor glycemic control. 6–8 …”