The Precision of Screening Questionnaires for Diabetes Mellitus Type 2 and Hypertension Compared with the Gold Standard in Primary Care

https://doi.org/10.22146/rpcpe.36219

Seta Nurhayati Mularum(1*), Hari Kusnanto(2), Wahyudi Istiono(3)

(1) Pandak 1 Community and Primary Health Care Center; Yogyakarta; Indonesia
(2) Department of Family and Community Medicine; Faculty of Medicine, Public Health, and Nursing; Universitas Gadjah Mada; Indonesia
(3) Department of Family and Community Medicine; Faculty of Medicine, Public Health, and Nursing; Universitas Gadjah Mada; Indonesia
(*) Corresponding Author

Abstract


Background: Diabetes mellitus (DM) and hypertension are health issues that are the focus of the Indonesian government, especially in the era of Universal Health Coverage/Jaminan Kesehatan Nasional (JKN). The prevalences have been steadily increasing daily. Special Region of Yogyakarta (DIY) has the highest prevalence of DM in Indonesia, while hypertension prevalence is 25.7% according to data from Riskesdas 2013. Complications from diabetes and hypertension lead to decreased quality of life and premature death, therefore it is necessary to have a better management strategy to reduce the risks. Nowadays, there are no diabetes and hypertension screening questionnaires which have been validated and implemented in the district of Bantul. Therefore, it is important to develop screening questionnaires for early detection of diabetes and hypertension as a tool for primary care physicians to perform tasks at the preventive level. Objective: This study aimed to measure the accuracy of screening questionnaires to detect diabetes mellitus and hypertension in primary care in Bantul DIY. Methods: This study used a cross-sectional method. The subjects of the study were a group of individuals aged 40-60 years in Bantul who met the criteria inclusion and the criteria exclusion. The study subjects were asked to complete the screening questionnaires of diabetes and hypertension. The results were then compared with the gold standard of fasting blood sugar and blood pressure check. The data were analyzed by using multivariate regression tests. Results: The results of multivariate analysis showed that the risk factors were a history of baby born weight ≥ 4 kg or gestational diabetes mellitus and the abdominal circumference was an independent risk factor for the incidence of diabetes in general population. Being a baby born with weight ≥ 4 kg and abdominal circumference had p = 0.001: RR 2.75 (CI 95%: 1.5 to 5.0) and p = 0.036: RR of 8.08 (CI 95%: 1.15 to 56.8), respectively. The risk factor of age was an independent risk factor for hypertension with p = 0.003: RR of 3.1 (CI 95%: 1.4 to 6.6). Conclusion: History of a baby born with weight ≥ 4 kg and abdominal circumference were appropriate for screening DM, meanwhile the age was appropriate for screening hypertension.


Keywords


Diabetes Mellitus; Hypertension; Screening; Risk Factors

Full Text:

PDF


References

1. Social Security Agency for Health. Reference guide for JKN participants. Jakarta: Social Security Agency for Health. 2014.

2. Health Research and Development Agency. Basic health research. Jakarta: Health Research and Development Agency Ministry of Health Republic of Indonesia. 2013.

3. Bantul Health Office. Profile of Bantul District Health Office. Yogyakarta: Directorate General of Medical Services. 2016.

4. International Diabetes Federation. Global Guideline for Type 2 Diabetes. Brussel Belgium. 2012.

5. Harahap H, WidodoY, Muljati S, Triwinarto A, Effendi I. Development of screening tool for hypertension. Nutrition Indonesia. 2010;33(2):96-107.

6. Emery JD, Reid G, Prevost AT, Ravine D, Walter FM. Development and validation of a family history screening questionnaire in Australian primary care. The Annals of Family Medicine. 2014 May 1;12(3):241-249.

7. Buell C, Kermah D, Davidson MB. Utility of A1C for diabetes screening in the 1999–2004 NHANES population. Diabetes Care. 2007 Sep 1;30(9):2233-2235.

8. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. Jama: Department of Health and Human Services US. 2003.

9. American Diabetes Association. ADA’s clinical practice recommendations. Diabetes Care. 2014;37(suppl):S1-S159.

10. Eriksson J, Lindström J, Tuomilehto J. Potential for the prevention of type 2 diabetes. British Medical Bulletin. 2001 Nov 1;60(1):183-199.

11. Bilous R, Donelly R. Handbook of diabetes. Jakarta: Earth Medika. 2015.

12. Hartono A. Nutrition therapy and hospital diet. EGC Medical Book. Jakarta. 2004.

13. Mcfarlane SI, Banerji M, Sowers JR. Insulin resistance and cardiovascular disease. The Journal of Clinical Endocrinology & Metabolism. 2001 Feb 1;86(2):713-8.

14. Triwibowo, Rochmah W, Pramantara IDP, Bayupurnama P, Dinarti LK, Probosuseno, Widita H. Friendly with diabetes in old age. Yogyakarta: SMF Geriatri RSUP Dr. Sardjito.1997.

15. Guyton AC, Hall JE. Medical school physiology textbook 11. Jakarta: EGC. 2007.

16. Megia A, Gallart , Manuel J, Real F, Vedre J, Simon I,Gutierres C,Richardt C. 2011. Mannose biding lectin gene polymorphisms are associated with gestasional diabetes melitus JCEM. Endojournal Society. 2011;89:5881-5887.

17. Lee H, Jang HC, Park HK, Metzger BE, Cho NH. Prevalence of type 2 diabetes among women with a previous history of gestational diabetes mellitus. Diabetes Research and Clinical Practice. 2008 Jul 1;81(1):124-129.

18. Amini M, Janghorbani M. Diabetes and impaired glucose regulation in first-degree relatives of patients with type 2 diabetes in isfahan, iran: prevalence and risk factors. The Review of Diabetic Studies: RDS. 2007;4(3):169-176.

19. Wardani K. Diet and obesity as a risk factor for diabetes mellitus type 2 at Sanglah Hospital Denpasar. Yogyakarta: Faculty of Medicine UGM. 2006.

20. Tesfaye F, Nawi NG, Van Minh H, Byass P, Berhane Y, Bonita R, Wall S. Association between body mass index and blood pressure across three populations in Africa and Asia. Journal of Human Hypertension. 2007 Jan;21(1):28-37.

21. Krummel DA. Medical Nutrition Therapy in Hypertension. Di dalam: Mahan LK dan Escott-Stump S, editor. 2004. Food, Nutrition and Diet Therapy. USA: Saunders co. 2004;900-918.

22. Warren TY, Wilcox S, Dowda M, Baruth M. Peer reviewed: Independent association of waist circumference with hypertension and diabetes in African American women, South Carolina, 2007–2009. Preventing Chronic Disease. 2012;2019.

23. Guagnano MT, Ballone E, Colagrande V, Della Vecchia R, Manigrasso MR, Merlitti D, Riccioni G, Sensi S. Large waist circumference and risk of hypertension. International Journal of Obesity. 2001 Sep;25(9):1360-1364.

24. Wardoyo. Prevention of coronary heart disease. Solo: Agency Book Store. 1996.

25. Williams GH. Hypertensive vascular disease. In Book: Wilson Jean D. et al (editors). Harrison’s Principles of internal medicine - 12th ed. Spanish: McGraw-Hill, Inc. 1991;1001-1015.

26. Schwartz S, Feller A, Perlmuter LC. Postprandial systolic blood pressure and subsyndromal depression. Experimental Aging Research. 2001 Dec 1;27(4):309-18.

27. Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, Rundle AG, Zammit GK, Malaspina D. Short sleep duration as a risk factor for hypertension: Analyses of the first national health and nutrition examination survey. Hypertension. 2006 May 1;47(5):833-839.

28. Khaw KT, Barrett-Connor E. Family history of heart attack: A modifiable risk factor?. Circulation. 1986 Aug 1;74(2):239-244.

29. Mannan H, Wahiduddin, Rismayanti. Risk factors of hypertension occurrence in the work area of Puskesmas Bangkalan, Jeneponto Region. Napier: Epidemiology UNHAS. 2012.



DOI: https://doi.org/10.22146/rpcpe.36219

Article Metrics

Abstract views : 1639 | views : 1253

Refbacks

  • There are currently no refbacks.


Copyright (c) 2018 Seta Nurhayati Mularum, Hari Kusnanto, Wahyudi Istiono

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.


View My Stats