Telemedicine use and associated factors related with HbA1c level among type 2 diabetes outpatients during COVID-19 outbreaks in Jakarta, Indonesia : a cross-sectional study

Abstract

Introduction: The Large-Scale Social Restriction (PSBB) has been implemented in Indonesia since April 2020 as a response to the COVID-19 outbreaks. This prolonged restriction could impact routine diabetes care and glucose control among diabetes patients. Telemedicine is expected to be a solution to the disrupted diabetes care amid the pandemic. This study aimed to determine the telemedicine use and associated factors to glycemic control among type 2 diabetes mellitus (T2DM) outpatients during the pandemic. Methodology: This cross-sectional study was conducted online during March 2021. A structured questionnaire was administered to 264 subjects who were 25–54 years old, diagnosed with T2DM, domiciled in Jakarta. The survey included questions about general characteristics, diabetes conditions, consultation factors, self-care, family support and latest HbA1c level (%). For statistical analysis, chi-square was performed using SPSS software version 22. Result: The result from total of 264 T2DM outpatients found that 60.2% had HbA1c ≥7% during COVID-19 outbreaks. They were more likely to be overweight or obese (odds ratio [OR]=5.740; p<0.001), prescribed with combination of insulin and oral medication (odds ratio [OR]=3.083; p=0.016), and consumed fried foods frequently (odds ratio [OR]=5.204; p=0.005). The protective factors were having experience in using telemedicine before the pandemic (odds ratio [OR]=0.372; p=0.049), regular exercise (odds ratio [OR]=0.036; p<0.001) and consult with a doctor using telemedicine (odds ratio [OR]=0.193; p=0.029) or in-person visit (odds ratio [OR]=0.065; p<0.001). However, only 19.7% of the participants used telemedicine to consult a doctor. Conclusion: Glycemic control among T2DM outpatients during COVID-19 outbreaks tends to be suboptimal (HbA1c ≥7%). The findings highlight suggested that healthy eating and regular exercise ensure optimal glycemic control and prevent diabetes complication. Further, endorsement and technical support are needed to help diabetes patients in adopting telemedicine use for remote diabetes care which can be useful in an outbreak situation like COVID-19.