The Impact of COVID-19 Lockdown on Diabetes Complication and Diabetes Management in People With Diabetes in Indonesia.

Aims: As the country with the seventh largest number of People with Diabetes (PWD) in the world, the Coronavirus disease 2019 (COVID-19) pandemic, and the Large Social Scale Restriction (LSSR) policy taken by the Indonesian government to reduce the number of COVID-19 transmissions is estimated to interfere diabetes management and will increase the incidence of diabetes complications. This study aims to determine the difficulties of diabetes management and its impact on diabetes morbidity during the COVID-19 pandemic in Indonesia. Methods: This study is a cross-sectional study using a national scale web survey. This research was conducted in Indonesia enrolling 1124 PWD aged 18 years or older. Diabetes complications are defined as self-assessed incidence of hypoglycemia, or Diabetic Foot Ulcer (DFU), or hospital admission experienced by PWD in Indonesia during the COVID-19 pandemic. The correlation between diabetes management difficulties and diabetes-related complications was measured using a modified cox regression test. Results: Diabetes management difficulties were experienced by 69.8% of PWD in Indonesia. The difficulties include attending diabetes consultation 30.1%, access to diabetes medication 12.4%, checking blood glucose levels 9.5%, controlling diet 23.8%, and performing regular exercise 36.5%. Diabetes-related complications occurred in 24.6% of subjects. Those who had diabetes management difficulties during the COVID-19 pandemic are prone to have diabetes complications by 1.4 times greater (PR: 1.41, 95% CI: 1.09-1.83) than those who did not. Conclusion: The COVID-19 pandemic and LSSR have impact on diabetes management and diabetes-related complications as assessed by PWD in Indonesia.

ADA Diabetes Risk Test Adaptation in Indonesian Adult Populations: Can It Replace Random Blood Glucose Screening Test?

AIMS: The use of non-invasive and easily available assessment tools such as the ADA diabetes risk test is recommended for diabetes screening among general population. This study aims to assess the validity of the ADA diabetes risk test in screening for screening hyperglycemia in Indonesian population. METHODS: This cross-sectional study conducted at primary health care in Cibeber sub district at Cilegon city, Banten province, Indonesia. Subjects were aged ≥45 years old without a prior diagnosis of diabetes were recruited consecutively. The risk of hyperglycemia was measured using the ADA Diabetes Risk Test. Random capillary blood glucose (RcBG) with a cut-off value >140 mg/dL used as a comparison. RESULTS: From a total of 134 subjects, 23.13% of subjects (n = 31) had hyperglycemia. The ADA Diabetes Risk Test gave an area under the ROC curve (AUC) of 0.71 (95% CI: 0.60-0.81) with an optimal cut-off of value ≥5. The sensitivity of the ADA diabetes risk test in diagnosing hyperglycemia was 68% with a false-negative rate (FNR) of 32.26%. Meanwhile, at a cut-off value ≥4, the sensitivity of the ADA Diabetes Risk Test was 93% with an FNR of 9.7%. CONCLUSION: ADA diabetes risk test provides a valuable result as a diabetes screening tool in the Indonesian population, thus promotes intervention strategies for population known to be at risk.

Correlation Between Adult Tobacco Smoking Prevalence and Mortality of Coronavirus Disease-19 Across the World.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic spreading worldwide. Limited studies showed that smokers were at higher risk of having severe complications and higher mortality. We aimed to analyze the possible correlation between adult tobacco smoking prevalence and COVID-19 mortality all over the world. METHODS: this correlation study involved a linear regression to analyse the correlation between smoking prevalence data in adults and COVID-19 Case Fatality Ratio (CFR) in countries with 1000 confirmed COVID-19 cases on May 3, 2020. RESULTS: seventy-five countries included with median CFR 3.66%. There was no relationship between adult male or female smoking prevalence and COVID-19 mortality in all over the countries. The multivariate analysis showed p-values of 0.823 and 0.910 for male and female smoking prevalence, respectively. However, in lower-middle-income countries (LMIC), there was a positive correlation between the prevalence of adult male smoking with the mortality of COVID-19. Each increment of one percentage of adult male smoking prevalence was associated with increase in COVID-19 CFR by 0.08% (95% CI 0.00%-0.15%, p=0.041). CONCLUSION: there is correlation between the prevalence of adult male smoking and the CFR of COVID-19 in lower middle-income countries. Based on these findings, strengthening of tobacco control policies is essential to reduce the impact of the COVID-19 pandemic especially in LMIC. This still warrants further studies.