Faculty of Medicine, Diponegoro University, Semarang, Indonesia - Indonesia
Factors Affecting Glycemic Control in Diabetes Mellitus Patients
Introduction: Indonesia ranked seventh in the prevalence of diabetes mellitus in the world. Improved glycemic control has been proven to prevent the diabetes and its complications. Adherence to treatment, weight regulation with benchmarks for Body Mass Index (BMI) indicators, activity or exercise habits, diet, and smoking history play an important role in glycemic control. Objective: The aim of this study was to identify factors affecting glycemic control in outpatient with diabetes mellitus.
Methods: A cross sectional study  among 32 diabetes mellitus patients.This study was conducted from April 2019 to September 2019 at Rumah Sakit Nasional Diponegoro (RSND), Semarang. The glycemic control status were assesed by HbA1c. Factors such medication adherence, diet adherence, smoking status, and physical activity were assesed with a structured questionnaire. Anthropometric measurement done to get the BMI status. Data were analyzed with bivariat analysis with chi square test (p<0.05).
Result: The factors that were significantly have relationship with glycemic control status are diet adherence (p=0.046), and medication adherence (p=0.040). Physical activity, smoking status and BMI doesn’t have significant relationship with glycemic control status.
Conclusion: Factors affecting glycemic control of diabetes mellitus patients in this study were diet adherence and medication adherence. History of smoking, BMI, and physical activity were not factors that influenced the control status in diabetes mellitus patients in this study.
Keywords: Medication Adherence, Diet Adherence, BMI, Smoking Status, Physical Activity.
- Almadhoun, M. and Alagha, H. (2018) ‘Journal of Clinical and Experimental Assessment of Medication Adherence and its Association with Glycemic Control among Type-2 Diabetes Mellitus Patients in Gaza – Palestine’, Clin Exp Pharmacol, 8(3). doi: 10.4172/2161-1459.1000250.
- American Diabetes Association (2018) ‘Standard medical care in diabetes 2018’, The journal of clinical and applied research and education, 41(1), pp. 1–150. doi: 10.2337/dc18-Sint01.
- Badan Penelitian dan Pengembangan Kesehatan (2018) Hasil Utama Riset Kesehatan Dasar, Kementrian Kesehatan Republik Indonesia. doi: 1 Desember 2013.
- Boffetta, P. et al. (2011) ‘Body Mass Index and Diabetes in Asia: A Cross-Sectional Pooled Analysis of 900,000 Individuals in the Asia Cohort Consortium’, PLoS ONE, 6(6). doi: 10.1371/JOURNAL.PONE.0019930.
- Bower, J. K. et al. (2017) ‘The Association of Percent Body Fat and Lean Mass With HbA 1c in US Adults’, 1(April), pp. 7–10. doi: 10.1210/js.2017-00046.
- Fiagbe, J. et al. (2017) ‘Prevalence of controlled and uncontrolled diabetes mellitus and associated factors of controlled diabetes among diabetic adults in the hohoe municipality of Ghana’, 7, pp. 343–354.
- Fiseha, T. et al. (2018) ‘Factors associated with glycemic control among diabetic adult out-patients in Northeast Ethiopia’, BMC Research Notes, 11(1), pp. 4–9. doi: 10.1186/s13104-018-3423-5.
- Id, B. H. B. et al. (2019) ‘Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes’, pp. 1–14.
- Ji-Hye-Park, Y.-E.-L. (2015) ‘Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans : the fifth Korea National Health and Nutrition Examination Survey ( KNHANES V )’, (Knhanes V).
- Lee, M. Y. et al. (2018) ‘Association Between Metabolic Syndrome and Microvascular and Macrovascular Disease in Type 2 Diabetic Mellitus’, American Journal of the Medical Sciences, 355(4), pp. 342–349. doi: 10.1016/j.amjms.2017.12.004.
- Little, J. P., Coombes, J. S. and Parker, L. (2017) ‘Exercise and Glycemic Control : Focus on Redox Homeostasis and Redox-Sensitive Protein Signaling’, 8(May). doi: 10.3389/fendo.2017.00087.
- M, A. C. et al. (2015) ‘Prevalence and Risk Factors of Poorly Controlled Diabetes Mellitus in a Clinical Setting in Guayaquil, Ecuador: A Cross-Sectional Study’, Int J Diabetes Clin Res, 2(4).
- Nanda, O. D., Wiryanto, B. and Triyono, E. A. (2018) ‘Hubungan Kepatuhan Minum Obat Anti Diabetik dengan Regulasi Kadar Gula Darah pada Pasien Perempuan Diabetes Mellitus’, Amerta Nutrition, 2(4), pp. 340–348. doi: 10.20473/AMNT.V2I4.2018.340-348.
- Ohkuma, T. et al. (2015) ‘Dose- and time-dependent association of smoking and its cessation with glycemic control and insulin resistance in male patients with type 2 diabetes mellitus: The Fukuoka diabetes registry’, PLoS ONE, 10(3), pp. 1–11. doi: 10.1371/journal.pone.0122023.
- Patel, P. and Abate, N. (2019) ‘Body Fat Distribution and Insulin Resistance’, pp. 2019–2027. doi: 10.3390/nu5062019.
- PB. PERKENI. (2015) Indonesia, P. E. (2015). Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. PB. PERKENI.
- Putri, N. H. K. and Isfandiari, M. A. (2013) ‘Hubungan Empat Pilar Pengendalian DM Tipe 2 dengan Rerata Kadar Gula Darah’, Jurnal Epidemiologi, 1(2), pp. 234–243.
- Rasheed, M., Islam, N. and Mahjabeen, W. (2015) ‘Original Article Factors Associated with Uncontrolled Type 2 Diabetes Mellitus’, 4(2), pp. 68–71.
- Sami, W. et al. (2017) ‘Effect of diet on type 2 diabetes mellitus: A review’, International Journal of Health Sciences, 11(2), p. 65. Available at: /pmc/articles/PMC5426415/ (Accessed: 17 August 2021).
- Sampath Kumar, A. et al. (2019) ‘Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis’, Annals of Physical and Rehabilitation Medicine, 62(2), pp. 98–103. doi: 10.1016/J.REHAB.2018.11.001.
- Sephora, L. et al. (2019) ‘Correlation of body composition and glycemic profile of diabetic patients 21st European Congress of Endocrinology’, pp. 13–16. doi: 10.1530/endoabs.63.EP63.
- Su, N. et al. (2014) ‘Factors associated with good glycemic control among patients with type 2 diabetes mellitus’, 5(5), pp. 563–569. doi: 10.1111/jdi.12175.
- World Health Organization (2016) World Hearth Organization, Epidemiological situation.
- Yigazu, D. M. and Desse, T. A. (2017) ‘Glycemic control and associated factors among type 2 diabetic patients at Shanan Gibe Hospital , Southwest Ethiopia’, BMC Research Notes, pp. 1–6. doi: 10.1186/s13104-017-2924-y.