Health for All

We have knowed increased the number of diabetics is significant in Indonesia. The number of diabetics in Indonesia, occupies the sixth position in the world that is as much as 5 million people.

In epidemiology, in the year 2030 estimated prevalence of diabetes mellitus (DM) in Indonesia reached 21.3 million people (Diabetes Care, 2004). Based on the results of the Basic Health Research (Riskesdas) in 2007, found that the proportion of causes of death due to DM in the age group 45-54 years in urban areas ranked 2nd of 14.7%. DM ranked the 6th leading cause of death 5.8% in rural areas.

The problems that arise in the treatment of diabetes in Indonesia are:
1. Lack of early diagnosis adekuatnya
2. Limited access to comprehensive treatment
3. Kurangya recognition and early treatment of complications.
4. Inadequate education of society at large. This is contributing to high death and disability due to diabetes.

Diabetes associated with an increased risk of heart disease and blood vessels (stroke), chronic kidney disease, leg amputations, and blindness. Financing and the impact of DM complications is very high. This thinking underlies the importance of early detection and adequate intervention.

Diabetes and its impact

DM diagnosis established by laboratory tests of fasting blood sugar and blood sugar tests after eating (glucose load). Patients were asked fast 8-10 hours before the examination of blood sugar. Someone stated levels of DM when fasting blood sugar> 126 mg% and blood sugar levels 2 hours after glucose load more than 200 mg%. In general, patients were also asked to collect urine samples.

This is intended to detect glucose in urine. In normal circumstances there is no glucose in urine. If levels in the blood sugar is high, some glucose will be excreted through urine. Disorders of glucose tolerance should be alerted as early symptoms of DM. Lifestyle changes and regular laboratory tests are recommended.

In general known type 2 diabetes, namely type 1 diabetes (insulin dependent), and diabetes type 2 (non-insulin dependent). There is also a diabetes in pregnancy, and diabetes due to malnutrition. Type 2 diabetes usually begins in middle adulthood (40-50 years). The case of type 2 diabetes mellitus reported to continue to increase in many developing countries (including Indonesia). This may be caused by a number of cases of obesity (overweight) and lack of physical activity in children.

Mortality and morbidity in diabetes is more determined by the appearance of complications. Complications of diabetes are as follows: blood sugar level is very low (hypoglycemia) blood sugar levels are very high (hyperglycemia), increased risk of infection, complications of small blood vessels (microvascular), neurological disorders, and complications of large blood vessels (makrovaskuler). Diabetes mellitus is one cause of blindness in the adult group, the main cause of non-traumatic amputations, and the main cause of kidney failure.

DM issues in Indonesia

Indonesia is one country with the highest absolute DM patients in the world. Increased prevalence of DM in Indonesia has consistently appeared from time to time. Increased prevalence of DM can not be separated from food consumption patterns and lifestyles.

Various epidemiological studies consistently show that the increased prevalence of DM associated with obesity, lack of physical activity, and emotional stress. A situation which is identical to the pattern of urban life (urbanization) and the pattern of life kebaratan (westernization).

Urbanization and westernization was quite prominent in the various regions in Indonesia. Economic progress of the growing impact fast-food outlets, lack of exercise opportunities, and high emotional stress.

Another problem in the handling of DM in Indonesia is the lack of awareness and early detection. Diabetes mellitus complications will provide over time. This is what underlies the need for early detection and effective interventions as early as possible. The public is more familiar triad P (Polyuria / lots of urine, Polidipsi / lots of drinking, and Polifagi / lots of eating) as the classic symptoms of DM.

The problems that arise are a symptom triad P is not very typical for DM, and many DM patients who showed no symptoms. In many cases, the DM often with inadequate control. Fear of taking medicine regularly and failure in life style changes are often observed in many cases.

Educate the public about the dangers of DM complications is needed. In many cases, people with DM was treated when complications occur has been so bad. This will provide the burden of pain and disability are greater for people with DM and their families. DM complications handling costs will be much higher than the recognition and prevention efforts are effective DM.

Discover and control

In accordance with the theme of World Diabetes Day in 2009, ‘Understand Diabetes and Control’, then diabetes should be understood as a whole, both risk factors, diagnosis and complications.

Diabetes is very important Pengandalian implemented as early as possible, to avoid the cost of very expensive treatment. Even since the children and adolescents, healthy lifestyle by eating lots of vegetables and fruit, get exercise and not smoking is a good habit in the prevention of diabetes mellitus.

Therefore, the role of educators both formal and informal, DM educators and health cadres (doctors, paramedics, and trained community anggoat) very important role to reduce morbidity DM.
Development of partnerships with various elements in society and across sectors associated with DM in each region is an important activity carried out.

Understanding the risk factors of DM is very important to know, understand and can be controlled by the community, educators, educators and health workers in the surrounding community.

The purpose of DM control program in Indonesia is the implementation of controls to reduce risk factors for morbidity, disability and death caused by DM. DM control take priority on early prevention through risk factor prevention of DM is promotive and preventive efforts by not ignoring the curative and rehabilitative efforts are adequate.