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.

BackgroundAs the country with the 7th largest number of People with Diabetes (PWD) in the world, the 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.MethodologyThis study is a cross-sectional study using a national scale web survey. This research was conducted in Indonesia enrolling 1,124 PWD aged 18 years or older. Diabetes complications are defined as any incidence of hypoglycaemia, 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.ResultsDiabetes 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 sugar 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.ConclusionThe COVID-19 pandemic and LSSR have a substantial impact on diabetes management and indirectly increased diabetes morbidity in Indonesia.

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Background: The utilization of technology in diabetes management, especially self-monitoring blood glucose (SMBG), is growing rapidly. However, the effectiveness of SMBG applications on the smartphone is not yet known. This study aims to assess the effectiveness of using a smartphone-based SMBG application in type 2 diabetes mellitus (T2DM) patients in the Indonesian population.Methods: This is a quasi-experimental (before and after) study conducted at three tertiary hospitals in Jakarta and Malang, Indonesia. Inclusion criteria were T2DM patients aged 18 years and above who have been familiar with performing SMBG  and manually record the results. All subjects were asked to use a smartphone-based SMBG application named Teman Diabetes application for six months, and patients' SMBG performance was assessed at the end of the study Bivariate analysis using T-test or with the Mann Whitney U test performed. Chi-square test is used to analyze the categorical with Risk Ratio (RR) and 95% Confidence Interval (CI). The p-value <0.05 (two-tailed) is considered statically meaningful.Results: From 100 patients enrolled in the study, 78 patients completed the follow-up. We found that the use of the SMBG application helped the subject overcome the difficulty in remembering to perform SMBG (p=0.004), helped change the subject's perception of the benefits of SMBG (p=0.049), improved the subject's diet pattern (p=0.006), and decreased the number of subjects who stopped performing SMBG due to self-perception of lack of benefit SMBG activity (p=0.049).Conclusions: The study found that using the SMBG application helps manage diabetes in T2DM patients.

Introduction:This study aimed to review the clinical characteristics and outcomes of COVID-19 patients presented with in-hospital hyperglycemia or pre-existing type 2 diabetes (T2DM). Methods: This is a retrospective study conducted in Fatmawati General Hospital, Indonesia, from March 18th-Apr 30th, 2020. We reviewed medical records of 27 COVID-19 patients presented with either in-hospital hyperglycemia (11, 12.2%) or pre-existing T2DM (16, 17.8%) from a total of 90 confirmed COVID-19 cases admitted in our hospital. Results: Critical conditions occurred in 50% of T2DM and 54.55% of the in-hospital hyperglycemia group. Mortality was documented in 68.75% of T2DM and 81.82% of in-hospital hyperglycemia group. Hypoglycemia, diabetic ketoacidosis, lactic acidosis and ketosis were found in 12.5%, 25%, 18.75%, and 25% of individuals with T2DM, respectively, resulting in a high mortality rate. Meanwhile, diabetes-related complications were rare among the in-hospital hyperglycemia group. However, respiratory failure (45.45% vs. 6.25%) and septic shock (27.27% vs. 6.25%) were more frequent than in the T2DM group. Conclusion:In this preliminary study, a high mortality rate was documented among COVID-19 patients with preexisting T2DM and in-hospital hyperglycemia. In T2DM subjects, diabetes relatedcomplications contributed to a higher mortality rate, while inhospital hyperglycemia group, respiratory failure and septic shock were more frequent.