Association between blood glucose level with glycemic load, physical activity and compliance to medication among Diabetes Mellitus (DM) patients in Buleleng District General Hospital, Bali Province
DOI:
https://doi.org/10.53638/phpma.2017.v5.i2.p09Keywords:
glycemic load, physical activity, compliance to medication, diabetes mellitusAbstract
Background and purpose: The prevalence of diabetes mellitus (DM) in Indonesia is increasing, including in Buleleng District, Bali Province. Studies regarding determinants of blood glucose control in DM patients show varied findings. This study aims to examine association between blood glucose level with physical activity, compliance to medication and glycemic load among DM patients.
Methods: A cross-sectional survey was conducted in Buleleng District General Hospital from March to April 2017. A total of 73 patients were concecutively recruited to participate in our study. Data were collected through interview, observation and measurement. Data collected included socio-demographic characteristics, fasting blood glucose level, 1-hour and 2-hour postprandial blood glucose levels, carbohydrate intake, body mass index, glycemic index, glycemic load, physical activity, genetic or family history, and compliance to medication. A bivariate analysis was performed to examine association between independent variables and blood glucose levels. Multivariate analysis was also conducted to calculate adjusted odd ratio using a binary logistic regression.
Results: Our study found that blood glucose levels of most respondents were relatively well managed–63% for fasting, 61.6% for 1-hour postprandial, and 63% for 2-hours postprandial. Multivariate analysis revealed that fasting blood glucose level were associated with regular physical activities (AOR=74.09; 95%CI: 7.52-729.69) and compliance to medication (AOR=11.90; 95%CI: 2.24-63.29). Furthermore, 1-hour postprandial blood glucose level were associated with breakfast glycemic load (AOR=0.63; 95%CI: 0.47-0.85) and compliance to medication (AOR=27.29; 95%CI: 2.29-323.95), while 2-hour postprandial blood glucose level were associated with breakfast glycemic load (AOR=0.69; 95%CI: 0.54-0.89) and compliance to medication (AOR=19.81; 95%CI: 2.31-170.14).
Conclusions: Factors associated with fasting blood glucose level were regular physical activities and adherence to medication, while 1-hour and 2-hours postprandial blood glucose levels were both influenced by breakfast glycemic load and compliance to medication.
References
World Health Organization. Global report on diabetes. Geneva: World Health Organization; 2016.
International Diabetes Federation. IDF Diabetes atlas seventh edition. Brussels: International Diabetes Federation; 2015.
International Diabetes Federation. IDF diabetes atlas sixth edition, 2014 Update. Brussels: International Diabetes Federation; 2014.
Sarah W, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projection for 2030. Diabetes Care. 2004; 27(5): 1051.
Ministry of Health of Indonesia. Riset Kesehatan Dasar (Riskesdas) Provinsi Bali tahun 2007 [Basic Health Survey for Bali Province 2007]. Jakarta: Ministry of Health of Indonesia; 2009.
Ministry of Health of Indonesia. Riset kesehatan dasar dalam angka Provinsi Bali tahun 2013 [Basic health survey in number for Bali Province 2013]. Jakarta: Ministry of Health of Indonesia; 2013.
Buleleng District General Hospital. Laporan tahunan RSUD Kabupaten Buleleng tahun 2016 [Annual report of Buleleng District Hospital 2016]. Buleleng: Buleleng District General Hospital; 2017.
Program Planning and Information Department. Bank data: 10 besar penyakit rawat jalan dan rawat inap [Bank data: top 10 diseases for in-patient and out-patient services] [cited 2017 Jul 28]. Available from: https://rsud. bulelengkab.go.id/bankdata
Smeltzer SC, Bare BG, Hinkle JL, Cheever K. Handbook for brunner & suddarth’s textbook of medical surgical nursing. twelfth ed. Philadelphia: Lippincott Williams & Wilkins. 2010: 255-275.
American Diabetes Association. Standards of medical care in diabetes-2016. Journal of Clinical Appleid and Research Education. 2016; 39: S23–S35.
Fitri R, Wirawanni Y. Hubungan Konsumsi karbohidrat, konsumsi total energi, konsumsi serat, beban glikemik dan latihan jasmani dengan kadar glukosa darah pasien diabetes mellitus tipe 2 [Association between carbohydrate consumption, total energy consumption, glycemic load, physical activity and blood glucose level among type 2 DM patients]. Jurnal of Nutrition Health. 2014; 2(3): 15–6.
Wiardani Ni K, Sariasih NN, Swandari Y. Indeks glikemik menu makanan rumah sakit dan pengendalian glukosa darah pada pasien diabetes melitus rawat inap di RSUP Sanglah Denpasar [Glicemic index of the hospital menu and the control of blood glucose level among DM in-patients at Sanglah General Hospital Denpasar]. Jurnal Skala Husada. 2012; 9: 44–50.
Fahmiyah I, Latra Nyoman I. Faktor yang mempengaruhi kadar gula darah diabetes di RSUD Dr . Soetomo Surabaya menggunakan regresi probit biner [Factors associated to blood glucose level among DM patients at Dr. Soetomo District Hospital, Surabaya City using the probit binary regression]. Jurnal Sains dan Seni ITS. 2016; 5(2): 456–461.
Wulandari P. Analisis faktor penyebab kadar gula darah pada penderita diabetes mellitus (DM) tipe-2 di RSUD Tugurejo Semarang [Determinants of blood glucose level among type-2 DM patients at Tugurejo District Hospital, Semarang City]. Jurnal Kesehatan VisiKes. 2015; 14(1): 52-53.
Anani S, Udiyono A, Ginanjar P. Hubungan antara perilaku pengendalian diabetes dan kadar glukosa darah pasien rawat jalan diabetes melitus (studi kasus di RSUD Arjawinangun Kabupaten Cirebon) [Association between blood glucose management practices and blood glucose level among DM out-patients - a case study at Arjawinangun District Hospital of Cirebon City]. Jurnal Kesehatan Masyarakat. 2012; 1(2): 466–478.
Purwitaningtyas RY, Putra IW. AE, Wirawan DN. Faktor risiko kendali glikemik buruk pada penderita diabetes melitus tipe 2 di Puskesmas Kembiritan Kabupaten Banyuwangi [Risk factors of poor glycemic control among type-2 DM patients at Kembiritan Community Health Centre, Banyuwangi District]. Public Health and Preventive Medicine Archive. 2015; 3(1): 81–87.
Trisnawati S, Widarsa T, Suastika K. Faktor risiko diabetes mellitus tipe 2 pasien rawat jalan di Puskesmas Wilayah Kecamatan Denpasar Selatan [Risk factors of type-2 DM among patients who accessed out-patient services at community health centres in South Denpasar Subdistrict]. Public Health and Preventive Medicine Archive. 2013; 1(1): 1-6.
Arasj F. Ilmu Gizi : teori & aplikasinya [Nutrition science: theory and its application]. Jakarta: EGC; 2016.
Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a madication adherence measure in an outpatient setting. The Journal of Clinical Hypertension. 2008; 10: 348–354.
M Al-Haj Mohd MM, Phung H, Sun J, et al. Improving adherence to medication in adults with diabetes in the United Arab Emirates. BMC Public Health. 2016; 16: 1–10.
Marks DB, Marks AD, Smith CM. Translated by Brahm U. Pendit. Biokimia kedokteran dasar : sebuah pendekatan klinis [Biochemestry for basic medicine: a clinical approach]. Jakarta: EGC; 2000.
Astuti CM, Setiarini A. Faktor-faktor yang berhubungan dengan pengendalian kadar glukosa darah pasien diabetes melitus tipe 2 rawat jalan di poliklinik penyakit dalam RSJ Prof . Dr . Soerojo Magelang Tahun 2013 [Factors associated with the control of blood sugar level among type-2 DM patients at internal medicine polyclinic of Prof. Dr. Soerojo Hospital, Magelang City, 2013] [thesis]. Jakarta: University of Indonesia; 2013.
Witasari U, Rahmawaty S, Zulaekah S. Hubungan tingkat pengetahuan, asupan karbohidrat dan serat dengan pengendalian kadar glukosa darah pada penderita diabetes mellitus tipe 2 [Association between level of knowledge, carbohydrate consumption, fibre intake, and blood glucose level among type-2 DM patients]. Jurnal Penelitian Sains & Teknologi. 2009; 10(2): 130–138.
Idris AM, Jafar N, Indriasari R. Pola makan dengan kadar gula darah pasien DM tipe 2 [Diet Patterns and Blood Glucose Level among Type 2 DM patients]. Jurnal Media Kesehatan Masyarakat Indonesia. 2014; 10: 211–218.
Salistyaningsih W, Puspitawati T, Nugroho DK. Hubungan tingkat kepatuhan minum obat hipoglikemik oral dengan kadar glukosa darah pada pasien diabetes melitus tipe 2 [Association between compliance to oral hypoglycemic drugs medication and blood glucose level among type-2 DM patients]. Berita Kedokteran Masyarakat. 2011; 27(4): 215–216.
Werdani AR, Triyanti. Asupan karbohidrat sebagai faktor dominan yang berhubungan dengan kadar gula darah puasa [Carbohydrate intake as the dominant risk factor of the fasting blood sugar level]. Jurnal Kesehatan Masyarakat Nasional. 2014; 9(1): 74–75.
Trisnawati SK, Setyorogo S. Faktor risiko kejadian diabetes melitus tipe II di Puskesmas Kecamatan Cengkareng Jakarta Barat Tahun 2012 [Risk factors of type-2 DM at Cengkareng Subdistrict Community Health Centre, West Jakarta, 2012]. Jurnal Ilmiah Kesehatan. 2013; 5(1): 7–9.
Etukumana EA, Puepet FH, Obadofin MO. Relationship between random blood glucose levels and body mass. Ibom Medical Journal. 2013; 6(1): 37–38.
Vittal BG, Praveen G, Deepak P. A Study Of Body mass index in healthy individuals and its relationship with fasting blood sugar. Jurnal of Clinical Diagnostic Research. 2010; 4: 3421–3422.
.30. Sepp E, Kolk H, Loivukene K, Mikelsaar M. Higher blood glucose level associated with body mass index and gut microbiota in elderly people. Microbial Ecology in Health & Disease. 2014; 25: 1–8.
Sluijs I, Beulens JWJ, Schouw YT Van Der, A DL Van Der, Buckland G, Kuijsten A, et al. Dietary glycemic index , glycemic load , and digestible carbohydrate intake are not associated with risk of type 2 diabetes in eight European countries. The Journal of Nutrition. 2013; 143(1): 97–99.
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