Prevalence of diabetes in pregnancy and microvascular complications in native Indonesian women: The Jogjakarta diabetic retinopathy initiatives in pregnancy (Jog-DRIP).

OBJECTIVES: To report the prevalence of total diabetes in pregnancy (TDP) and diabetes-related microvascular complications among Indonesian pregnant women. METHODS: We conducted a community-based cross-sectional study with multi-stage, cluster random sampling to select the participating community health centers (CHC) in Jogjakarta, Indonesia between July 2018-November 2019. All pregnant women in any trimester of pregnancy within the designated CHC catchment area were recruited. Capillary fasting blood glucose (FBG) and blood glucose (BG) at 1-hour (1-h), and 2-hour (2-h) post oral glucose tolerance test (OGTT) were measured. TDP was defined as the presence of pre-existing diabetes or diabetes in pregnancy (FBG ≥7.0 mmol/L, or 2-h OGTT ≥11.1 mmol/L, or random BG ≥11.1 mmol/L with diabetes symptoms). Disc and macula-centered retinal photographs were captured to assess diabetic retinopathy (DR). Blood pressure, HbA1c and serum creatinine levels were also measured. RESULTS: A total of 631/664 (95%) eligible pregnant women were included. The median age was 29 (IQR 26-34) years. The prevalence of TDP was 1.1% (95%CI 0.5, 2.3). It was more common in women with chronic hypertension (p = 0.028) and a family history of diabetes (p = 0.015). Among the TDP group, 71% had a high HbA1c, but no DR nor nephropathy were observed. CONCLUSIONS: Although a very low prevalence of TDP and no diabetes-related microvascular complications were documented in this population, there is still a need for a screening program for diabetes in pregnancy. Once diabetes has been identified, appropriate management can then be provided to prevent adverse outcomes.

Patients' Satisfaction with Ophthalmology Clinic Services in a Public Teaching Hospital.

Purpose: To evaluate patients' satisfaction with ophthalmology health services in a teaching clinic of a tertiary public hospital. Patients and Methods: This was a cross-sectional study in ophthalmology clinic of Dr. Sardjito teaching hospital, Yogyakarta, Indonesia conducted in 2019. Patients were surveyed using the Patient Satisfaction Questionnaire-18 (PSQ-18). PSQ-18 subscale score was analyzed based on patients' characteristics. The main outcome was the odds of reaching top satisfaction score (TSS) of 4-5 from a Likert scale 1 to 5. Results: Our study recorded 269 participants who consisted of 138 males (51.3%) and 131 females (48.7%) with median age of 52 (18-87) years old. Variables with higher odds of reaching TSS on "patient overall satisfaction" was public health insurance (OR: 7.959 [95% CI: 1.989-31.852], p=0.003) while examination time (OR: 0.955 [95% CI: 0.923-0.988], p=0.008) had lower odds. Examination waiting time (OR: 0.992 [95% CI: 0.985-0.999], p=0.027) and examination time (OR: 0.941 [95% CI: 0.908-0.976], p=0.001) had lower odds of reaching TSS in "general satisfaction". Family monthly income (OR: 1.829 [95% CI: 1.038-3.223], p=0.037) had higher odds of reaching TSS in "technical quality" while examination time (OR: 0.961 [95% CI: 0.931-0.993], p=0.017) and education (OR: 0.549 [95% CI: 0.322-0.934], p=0.027) had lower odds. Comorbidities (OR: 0.533 [95% CI: 0.301-0.944], p=0.031) had lower odds of reaching TSS in "financial aspects". Retina subspecialty clinic (OR: 3.436 [95% CI: 1.154-10.232], p=0.027) had higher odds of reaching TSS in "time spent with doctor". Registrar as attending physician (OR: 0.427 [95% CI: 0.205-0.89], p=0.0230) and examination time (OR: 0.957 [95% CI: 0.924-0.991], p=0.013) had lower odds of reaching TSS in "accessibility-convenience". Conclusion: Examination time and examination waiting time should be shortened, specialist doctors should always see the patients whenever possible, and registrars' technical and communication skill should be improved. Alternative funding for patients without health insurance also should be provided to increase satisfaction.