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

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.

Increased global online interest in diabetes during the COVID-19 pandemic: An infodemiology study

“…The pandemic resulted in fewer number of hospital visits due to the recommendations on social isolation and travel restrictions, loss of the traditional method of communication with the patient, impaired routine diabetic care, and absences of telehealth services. Previous studies have shown that the pandemic resulted in poor glycemic control and increasing incidence of diabetes complications ( Elhenawy and Eltonbary, 2021 ; Kshanti et al, 2021 ; Önmez et al, 2020 ).…”

Live experience of people with diabetes mellitus on selfmanagement during COVID-19 in remote area of Indonesia

“…In this study, a participant stated that they use Afrika leaf or Vernonia amygdalina to reduce sugar blood levels. A previous study has found that vernonia amygdalina has little effect on decreasing glucose in diabetic rats (22), but there is still no study on humans. The practice of herbal medicine to treat DM has also been known globally.…”

“…Previous studies stated that people with diabetes in remote areas in India face difficult challenges in self-management during the COVID-19 pandemic (20,21). Another study in Indonesia revealed that people with DM struggle to do self-management during pandemics and also experience psychological distress, but there is still limited qualitative study about the selfmanagement of people with DM in remote areas in eastern Indonesia (22). This study aimed to explore the experience of rural residents with DM in self-management during COVID-19.…”

The Experiences of Patients with Diabetes and Strategies For Their Management During the COVID-19 Pandemic: A Qualitative Study

“…These difficulties included attending 30.1% of diabetes consultations, 12.4% access to diabetes medication, checking blood glucose levels 9.5%, controlling diet 23.8%, and doing regular exercise 36.5%. Difficulties in managing diabetes during the COVID-19 pandemic are prone to diabetes complications [8].…”