Tujuan: Mengumpulkan informasi mengenai penanganan dan komplikasi diabetes, serta kesadaran pengendaliandiri sendiri penderita diabetes di Indonesia. Studi ini juga mengevaluasi perspektif dokter, aspek psikologis, dankualitas hidup pasien.Metode: Studi non-intervensi, potong lintang, merekrut 1832 pasien dari pusat kesehatan sekunder dan tersierdi Indonesia. Data mengenai demografi , riwayat medis, faktor resiko, dan laporan pemeriksaan klinis termasuklaboratorium dikumpulkan dari rekam medis pasien. Sampel darah dikumpulkan untuk pengukuran HbA1c yangtersentralisasi.Hasil: Di antara 1832 pasien, 1785 individu memenuhi syarat untuk dianalisis. Rata-rata usia adalah 58,9+9,6tahun. Lamanya menderita diabetes 8,5+7,0 tahun. Mayoritas pasien (97,5%) menderita diabetes tipe 2.67,9% pasienmemiliki kontrol diabetes yang buruk (A1c: 8,1 ± 2,0%). 47,2% pasien memiliki kadar Glukosa Plasma Puasa >130mg/dL (161,6±14,6 mg/dL). Dislipidemia dilaporkan pada 60% pasien (834/1390) dan 74% (617/834) di antaranyamendapatkan obat hipolipidemik. Neuropati merupakan komplikasi paling umum (67.2%); komplikasi diabeteslainnya antara lain: katarak: 14.5% Retinopati diabetik non-proliferatif: 8.3%, kreatinin serum>2 mg/dl: 3.6%,ulkus yang sudah sembuh: 3.8%, angina pectoris 9.9% dan stroke 5.6%. Sekitar 81.3% pasien menerima terapi obathipoglikemik oral (OHO) (± insulin), 37,7% pasien menerima terapi insulin (±OHO). Penggunaan biguanide diikutioleh sulfonylurea. Mayoritas pasien menggunakan insulin manusia 73,2%, regimen premiks 58,5%, insulin analog24,9%. Mayoritas respon indeks kesehatan WHO-5 jatuh dalam teritori positif.Kesimpulan: Kontrol glikemik yang buruk pada mayoritas pasien diabetes perlu diperhatikan. Terdapat kebutuhan untukpenyesuaian terapi dari sebagian besar pasien menuju terapi farmakologis yang lebih intensif dan pendekatan multidisiplinerharus digunakan. Temuan studi ini perlu dikomunikasikan kepada pembuat kebijakan dan dokter untuk membantumereka memberikan perawatan kesehatan dan fasilitas yang baik.
Abstract
Aim: To collect information on diabetes management, diabetes complications, and awareness of self-control indiabetic population of the country. This study also evaluated the physician perspectives, psychological aspects, andquality of life of diabetic patients.Methods: This was a non-interventional, cross-sectional study, which recruited 1832 patients from secondary andtertiary medical centers across Indonesia. Data on demography, medical history, risk factors and clinical examinationreports including laboratory assessments were collected from medical records of patients. Blood samples of all patientswere collected for centralized HbA1c measurements.Results: Among 1832 patients, 1785 individuals were eligible for analysis. The mean age of the patients was 58.9+9.6years. The mean duration of diabetes was 8.5+7.0 years. Majority (97.5%) of the patients had type 2 diabetes. 67.9%had poor control of diabetes (A1c:8.1 ± 2.0%). 47.2% had FPG>130 mg/dL (161.6±14.6 mg/dL). Dyslipidemia wasreported in 60% (834/1390) and 74% (617/834) of those received lipid lowering treatment. Neuropathy was most commoncomplication (63.5%); other complications were: Diabetic retinopathy 42%, nephropathy 7.3%, severe late complications16.9%, macrovascular complications 16%, microvascular complications 27.6%. About 81.3% of patients were on OADs(± insulin), 37.7% were on insulin (±OADs). Majority used biguanides followed by sulfonylureas. Human insulin was usedby 73.2%, premix regimen 58.5%, analogues usage was 24.9%. Majority of the WHO-5 well being index responses fell inpositive territory.Conclusion: Poor glycaemic control in majority of patients is a concern. There is a need for a large proportion ofpatients to be adjusted to more intensive pharmacotherapy and a multi-disciplinary approach for management shouldbe adopted. The study fi ndings should be communicated to policymakers and physicians to help them provide properhealthcare and its facilities in Indonesia. |
