Type 2 diabetes mellitus patients, profile, achievement and complications in primary health care in Surabaya, Indonesia

Abstract

INTRODUCTION The prevalence of type 2 diabetes mellitus (T2DM) continues to increase worldwide. Indonesia is no exception. The diagnoses of prediabetes and diabetes are increasing and seen in ever younger patients. Primary Health Care (PHC) plays a pivotal role in managing this disease in the community. This study aimed to determine the achievement therapy of T2DM patients in a PHC center in Surabaya, the second most populous city in Indonesia. METHODS The design of this study was cross-sectional. T2DM patients who made regular visits to a PHC center in 2018 were included in this study after providing informed consent. Respondent characteristics (age, education level, family history of T2DM, physical activity, nutrient intake), as well as BMI, blood pressure, and laboratory data, including fasting plasma glucose (FPG), haemoglobin A1c (HbA1c), serum creatinine, and albumin to creatinine ratio (ACR), were collected. Simple correlation and multiple regression analyses were performed by SPSS 17.0.0 RESULTS The mean age of the patients was 60.9 ± 10.0 years, and participants had been diagnosed with T2DM for a mean of 6.9 ± 8.3 years. The therapeutic goal (FPG ≤130 mg/dL and HbA1c <7%) was achieved in 30.9% and 23.8% of patients, respectively. Early microvascular abnormality screening (ACR) showed that 70.9% of the patients had increased ACR, while serum creatinine level was found to be high in 22.8% of the patients. FPG correlated to HbA1c, serum creatinine and ACR (r=0.64, p<0.001; r=0.39, p=0.001; and r=0.25, p=0.03, respectively). CONCLUSIONS The majority of T2DM patients in our sample did not achieve their therapeutic goals in terms of FPG and HbA1c. Those who did not achieve FPG goals were less likely to meet ACR goals and were less likely to have normal serum creatinine, most probably reflecting a pattern of poor long-term follow-up.