Development of a Validated Diabetes Risk Chart as a Simple Tool to Predict the Onset of Diabetes in Bogor, Indonesia.

Objective: To develop a simple, non-invasive tool for predicting the onset of type 2 diabetes mellitus (T2DM). Methodology. A total of 4418 nondiabetic respondents living in Bogor were included in this cohort study. Their ages ranged from 25 to 60 years old and were followed for 6 years with interviews, physical examinations and laboratory tests. The investigators used logistic regression to create a tool for diabetes risk determination. Results: The cumulative incidence of T2DM was 17.9%. Risk factors significantly associated with T2DM included age, obesity, central obesity, hypertension and lack of physical activity. The Bogor Diabetes Risk Prediction (BDRP) chart had a cut-off of 0.128, with sensitivity of 76.6% and specificity of 50.3%. The Positive Predictive Value (PPV) was 21.6% and Negative Predictive Value (NPV) was 92.3%. The Area under the Curve (AUC) was 0.70 with a 95% confidence interval ranging from 0.675-0.721. Conclusion: The BDRP chart is a simple and non-invasive tool to predict T2DM. In addition, the BDRP chart is reliable and can be easily used in primary health care.

Urban-rural distinction of potential determinants for prediabetes in Indonesian population aged ≥15 years: a cross-sectional analysis of Indonesian Basic Health Research 2018 among normoglycemic and prediabetic individuals.

BACKGROUND: Based on Basic Health Research (RISKESDAS) conducted by Ministry of Health, Indonesia, prediabetes prevalence tends to increase from 2007 until 2018. The numbers are relatively higher in rural than those in urban area despite of small discrepancies between the two (~ 2-4%). The purpose of this study was to identify urban-rural differences in potential determinants for prediabetes in Indonesia. METHODS: This analysis used secondary data collected from nationwide Health Survey in 2018. Respondents were aged ≥15 years who met inclusion criteria of analysis with no history of diabetes mellitus. Prediabetes criteria followed American Diabetes Association 2019. Multiple logistic regression was also employed to assess the transition probability of potential determinants for prediabetes in urban and rural Indonesia. RESULTS: Up to 44.8% of rural respondents were prediabetics versus their urban counterparts at 34.9%, yet non-response bias was observed in the two. Young adults aged 30 years were already at risk of prediabetes. Urban-rural distinction for marital status and triglyceride level was observed while other determinants tended to overlap across residence. Several modifiable factors might contribute differently in both population with careful interpretation. CONCLUSIONS: The minimum age limit for early prediabetes screening may start from 30 years old in Indonesia. Urban-rural distinction for marital status and triglyceride level was observed, yet non-response bias between the two groups could not be excluded. A proper model for early prediabetes screening need to be developed from a cohort study with adequate sample size.

Association of general and central obesity with hypertension.

BACKGROUND & AIM: Hypertension as a risk factor for cardiovascular disease has growing prevalence. An increase in body weight is typically followed by an increase in blood pressure. This study aimed to investigate the association of general and central obesity with hypertension in Indonesian women using WHO and Indonesian classification systems. METHODS: Cross-sectional study of Indonesian women aged 18 years or and more (313,714 participants), using national level Indonesia National Basic Health Research (2013). RESULTS: The prevalence of hypertension in Indonesian women in this study was 32.8%. Based on logistic regression analysis, hypertension was significantly associated with residential area, educational attainment, self-reported smoking status, cardiovascular disease, chronic kidney disease, diabetes mellitus, body mass index and waist circumference. Furthermore, the odds of having hypertension for general and central obesity according to WHO classification were adjusted odds ration (aOR) 2.61, 95% CI 2.52-2.70 and aOR 1.50, 95% CI 1.46-1.53. By Indonesian classification were aOR 2.21, 95% CI 2.16-2.26 and aOR 1.48, 95% CI 1.45-1.51. CONCLUSION: By using International WHO and standard Indonesia classification systems, general and central obesity were associated with hypertension in Indonesia women. Thus, not only general obesity but also central obesity should be used to assess obesity in Indonesian women.

Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control: the case for Indonesia.

OBJECTIVES: Indonesia has the fifth highest rate of annual cigarette consumption per person of all countries worldwide. The Global Youth Tobacco Survey (GYTS) was developed to provide data on youth tobacco use to countries for their development of youth-based tobacco control programs. Data in this report can be used as baseline measures for future evaluation of the tobacco control program implemented by Indonesia's Ministry of Health. METHODS: The 2006 Indonesia GYTS is a school-based survey that included separate samples for Java and Sumatera, representing more than 84% of the population of Indonesia. Each sample used a two-stage cluster sample design that produced representative samples of students in secondary grades 1-3, which are associated with ages 13-15 years. RESULTS: This report shows that more than 1 in 10 students (12.6%) currently smoked cigarettes, with the prevalence among boys (24.5%) significantly higher than among girls (2.3%). Of the students who currently smoked, more than 7 in 10 (75.9%) reported that they desired to stop smoking now. Regarding secondhand smoke exposure, more than 6 in 10 students (64.2%) reported that they were exposed to smoke from other people in their home during the week before the survey. More than 9 in 10 students (92.9%) had seen a lot of advertisements for cigarettes on billboards during the past month and more than 8 in 10 (82.8%) had seen a lot of advertisements for cigarettes in newspapers or in magazines. CONCLUSIONS: Tobacco control in Indonesia will likely not move forward until the government evaluates and strengthens existing laws, considers passing new strong laws, and develops protocols for enforcing all laws. The Indonesian government also should strongly consider accession to the World Health Organization Framework Convention on Tobacco Control.