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

  1. Ida Ayu Kshanti
  2. Marina Epriliawati
  3. Muhammad Ikhsan Mokoagow
  4. Jerry Nasarudin
  5. Nadya Magfira

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

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.

Article activity feed

  1. Version published to 10.1177/21501327211044888
  2. ScreenIT

    SciScore for 10.1101/2020.12.01.20241588: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power AnalysisTo find out the relationship between difficulties during the COVID-19 pandemic and the incidence of complications during the COVID-19 pandemic with a study power of 95% and a 95% confidence interval, a sample of 970 diabetes mellitus patients was needed. 2.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has some limitation including reporting of complication during pandemic limited to DFU, hospital admission, or hypoglycaemia. The Questionnaire was answered subjectively by respondents. Hence, the observations may have had some biases. Furthermore, the condition of unawareness towards DFU and undetected/undocumented low or subclinical blood sugar levels, which were not assessed objectively, could result in an overall lower number of complications than what actually occurred. This study shows that the COVID-19 pandemic in Indonesia has had a substantial impact on the management of diabetes. At least one in four PWD experienced complications during the COVID-19 pandemic in Indonesia. In this study, the prevalence of DFU in diabetics in Indonesia was found in 7.4% of the total respondents. Until now, there is no national data on the prevalence of diabetes complications in Indonesia. However, a single-centre study showed the prevalence of DFU incidence in the population treated at a tertiary hospital in Indonesia was 16.7% with an amputation rate of 10.7%. [10] Meanwhile, the worldwide prevalence rate for DFU is 6.3% (95% CI: 5.4% −7.3%). [11] Given the limitations of this study, the total prevalence of DFU in diabetes in Indonesia is likely higher than what was found in this study. However, it can be concluded that when compared with the prevalence rates for DFUs worldwide, the prevalence of DFU in Indonesia during the pandemic period was higher. In this study, the in...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.12.01.20241588v1 on medRxiv