Characteristics and Care Quality of Patients with Type 2 Diabetes in Indonesia: A Study of DISCOVER CaReMe Registry Program
Keywords:
DISCOVER CaReMe study, Type 2 diabetes mellitus, quality of care, HbA1c.Abstract
Background: Type 2 diabetes mellitus (T2DM) is considered one of the top 3 causes of death in Indonesia. However, the current scenario regarding the management of T2DM in Indonesia remains unclear. Thus, the present study aimed to describe the baseline characteristics, treatment types, and quality of care indicators in T2DM patients under the DISCOVER CaReMe Registry program. Methods: DISCOVER CaReMe Registry program is a multi-centre, prospective, and observational study conducted over 3 years from 2018 to 2021. The data were collected from five different sites across Indonesia. Results: A total of 539 patients with a mean age of 58.98 ± 9.76 were enrolled in the study. Among them, 62% (334/539) of patients were females. Further, the mean glycated haemoglobin (HbA1c) levels were 8.54 ± 2.88%, which was much higher than the American Diabetes Association (ADA) recommended target of 7%. Overall, 69% of the patients had HbA1c levels of >7%. First-line treatment in patients was mostly metformin (26%). As per the quality-of-care indicators, 72.2% of patients use glucose monitoring equipment and receive education about diabetes treatment and management. Furthermore, the knowledge of T2DM among patients was assessed in over 85% of cases, and misconceptions about the condition were clarified by healthcare professionals (HCPs). HCP advised a “diabetic diet” to 69.4% of patients. Conclusion: Despite a good knowledge and quality of care indices in patients with T2DM, the proportion of patients with HbA1c levels of >7% is still higher. There is an urgent need for diabetic management programs to prevent such complications in the Indonesian population.References
Bramlage P, Lanzinger S, van Mark G, et al. Patient and disease characteristics of type-2 diabetes patients with or without chronic kidney disease: an analysis of the German DPV and DIVE databases. Cardiovasc Diabetol. 2019;18(1):33.
International Diabetes Federation. IDF Diabetes Atlas. 9th ed. Brussels, Belgium, International Diabetes Federation (2019) https://www.diabetesatlas.org/en/, Accessed 23rd July 2022
Owolabi MO, Yaria JO, Daivadanam M, et al. COUNCIL Initiative. Gaps in guidelines for the management of diabetes in low- and middle-income versus high-income countries: Systematic review. Diabetes Care. 2018;41(5):1097-105.
Usman MS, Khan MS, Butler J. The interplay between diabetes, cardiovascular disease, and kidney disease. Chronic kidney disease and type 2 diabetes. Arlington (VA): American Diabetes Association; 2021 Jun.
American Diabetes Association. Glycemic targets: Standards of medical care in diabetes—2021. Diabetes Care. 2021;44 (Suppl.1): S73–S84.
Aminde LN, Tindong M, Ngwasiri CA, et al. Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocr Disord. 2019;19(1):35.
Matthews D, Del Prato S, Mohan V, et al. Insights from verify: Early combination therapy provides better glycaemic durability than a stepwise approach in newly diagnosed type 2 diabetes. Diabetes Ther. 2020;11(11):2465-76.
Marín-Peñalver JJ, Martín-Timón I, Sevillano-Collantes C, et al. Update on the treatment of type 2 diabetes mellitus. World J Diabetes. 2016;7(17):354-95.
Foma MA, Saidu Y, Omoleke SA, et al. Awareness of diabetes mellitus among diabetic patients in the Gambia: a strong case for health education and promotion. BMC Public Health. 2013;13:1124.
Ji L, Bonnet F, Charbonnel B, Gomes MB, et al. Towards an improved global understanding of treatment and outcomes in people with type 2 diabetes: Rationale and methods of the DISCOVER observational study program. J Diabetes Complications. 2017;31(7):1188-96.
Gomes MB, Rathmann W, Charbonnel B, et al; DISCOVER investigators. Treatment of type 2 diabetes mellitus worldwide: Baseline patient characteristics in the global DISCOVER study. Diabetes Res Clin Pract. 2019;151:20-32. doi: 10.1016/j.diabres.2019.03.024.
Putri PM, Murdi PB. Pelayanan kesehatan di era jaminan kesehatan nasional sebagai program badan penyelenggara jaminan sosial kesehatan. Jurnal Wacana Hukum. 2019;25(80):10-33061.
Hidayat B, Ramadani RV, Rudijanto A, et al. Direct medical cost of type 2 diabetes mellitus and its associated complications in Indonesia. Value Health Reg Issues. 2022;28:82-9.
Cholil AR, Lindarto D, Pemayun TGD, et al. DiabCare Asia 2012: diabetes management, control, and complications in patients with type 2 diabetes in Indonesia. Med J Indones. 2019;28(1):47-56.
(PERKENI) PEI. Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia: PB PERKENI; 2019.
Shi L, Shu XO, Li H, et al. Physical activity, smoking, and alcohol consumption in association with the incidence of type 2 diabetes among middle-aged and elderly Chinese men. PLoS One. 2013;8(11):e77919.
Ramachandran A, Jain SM, Mukherjee S, et al. Suboptimal glycemic control among subjects with diabetes mellitus in India: a subset analysis of cross-sectional wave-7 (2016) data from the International Diabetes Management Practices Study (IDMPS). Ther Adv Endocrinol Metab. 2020;11:2042018820937217.
Soeatmadji DW, Rosandi R, Saraswati MR, et al. Clinicodemographic profile and outcomes of type 2 diabetes mellitus in the Indonesian cohort of DISCOVER: A 3-year prospective cohort study. J ASEAN Fed Endocr Soc. 2023;1-7.
Paul SK, Klein K, Thorsted BL, et al. Delay in treatment intensification increases the risks of cardiovascular events in patients with type 2 diabetes. Cardiovasc Diabetol. 2015;14:100.
Soewondo P, Ferrario A, Tahapary DL. Challenges in diabetes management in Indonesia: a literature review. Global Health. 2013;9:63.
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Copyright (c) 2025 Rulli Rosandi, Herman Bagus Trianto, Aywar Zamri, Harli Amir, Roy Panusunan Sibarani, Samuel Sulaiman, Achmad Rudijanto Cholil
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