Factors that Related to Type 2 Diabetes Mellitus in Patients Aged 60-

69 Years at the Working Area of Puskesmas Kecamatan Taman Sari

Jakarta Barat 2019

Amela Aprida and Decy Situngkir

Department of Public Health, Faculty of Health and Science, Esa Unggul University,

Jl. Yos Sudarso Dhopal No. 59 Kecamatan Pulomerak, Cilegon, Banten, Indonesia

Keywords: Type 2 Diabetes Mellitus, Diabetes in Patients Aged 60-69 Years, Family History with DM, Smoke,

The History of Hypertension.

Abstract: Diabetes mellitus is a chronic metabolic disorder because the pancreas produces insufficient insulin or the

limbs do not use insulin efficiently. This study aims to analyze factors related to Type 2 Diabetes Mellitus in

patients aged 60 – 69 years at Taman Sari sub-district health center in 2019. This study used a Cross-Sectional

design, with a sample of 97 respondents. The sampling technique uses an Accidental Sampling method.

Collection method with questionnaires and interviews with a variable family history with DM, smoking, and

history of hypertension. The analysis carried out includes Univariate Analysis and Bivariate Analysis with

Chi-Square Test. Based on the results of statistical tests showed that the factors associated with the incidence

of Type 2 Diabetes Mellitus in patients aged 60 - 69 years were family history (p-value = 0,000), history of

hypertension (p-value = 0,000) and behavior in smoking (p-value = 0.105 and 0.144)not related to the

incidence of Type 2 Diabetes Mellitus.

1 PRELIMINARY

Diabetes mellitus is a chronic disease that is still a

major problem in the world of health in Indonesia.

Diabetes mellitus is a chronic metabolic disorder

because the pancreas produces insufficient insulin or

members of the body do not use insulin efficiently

(Kemenkes RI, 2014). According to WHO (World

Health Organization), Diabetes Mellitus is a cause of

hyperglycemia. Hyperglycemia is caused by many

things, but hyperglycemia is most often caused by

diabetes mellitus. In diabetes mellitus, sugar builds up

in the blood so it fails to enter the cell. The failure

occurs due to insufficient amounts of the hormone

insulin or malfunction. The hormone insulin is a

hormone that helps the entry of blood sugar (WHO,

2016).

Nearly 80% of people with Diabetes Mellitus are

in low and middle-income countries. In 2015, 8.5%

of people with diabetes mellitus were adults. The

prevalence of diabetes mellitus is estimated in Asia

at 153.2%, Europe 59.8%, the Middle East 35.5%,

Africa 44.3% and North and South America 29.6%

(Ministry of Health RI, 2016). The prevalence of

people with diabetes mellitus in Indonesia according

to the International Diabetes Federation in 2017,

Indonesia ranks 6 (six) in the world with a total of

10.3 million people and is predicted in 2045

Indonesia will be home to 16.7 million people with

diabetes mellitus (IDF, 2017).

While in Indonesia alone data obtained from the

results of the Basic Health Research (Riskesdas) in

2018 showed that the prevalence of Diabetes Mellitus

by 8.5% increase from the 2013 Riskesdas data which

was only 6.9% (Riskesdas, 2018). 2/3 of people with

Diabetes Mellitus in Indonesia do not know they have

diabetes and have the potential to access health

services in a late condition (already with

complications) (Ministry of Health Republic of

Indonesia, 2014). The percentage of deaths due to

diabetes in Indonesia is the second-highest after Sri

Lanka (Ministry of Health, Republic of Indonesia,

2014).

Impact or complications of diabetes mellitus both

type 1 and type 2 can be divided into two large

groups, namely the first acute complications arise

suddenly, this condition can be fatal if not treated

immediately including hypoglycemia (too low blood

240

Aprida, A. and Situngkir, D.

Factors that Related to Type 2 Diabetes Mellitus in Patients Aged 60-69 Years at the Working Area of Puskesmas Kecamatan Taman Sari Jakarta Barat 2019.

DOI: 10.5220/0009591702400246

In Proceedings of the 1st International Conference on Health (ICOH 2019), pages 240-246

ISBN: 978-989-758-454-1

glucose), hyperglycemia (glucose blood is too high),

and too much acid in the blood. Second, chronic

complications arise slowly, sometimes unknown, but

eventually, it becomes increasingly severe and

dangerous (Prawirohardjo, 2010).

In the first 3 months starting from January to

March 2019 cases of Diabetes Mellitus Type 2 in

Puskesmas Kecamatan Taman Sari at the age of 60-

69 years as many as 22. Diabetes Mellitus Type 2 is

also the 10 biggest diseases each year at Puskesmas

Kecamatan Taman Sari.

2 RESEARCH METHODS

This research is in the scope of health which aims to

determine the risk factors associated with the

incidence of type 2 diabetes mellitus in the working

area of Puskesmas Kecamatan Taman Sari, West

Jakarta in 2019. Based on the data there are cases of

type 2 diabetes mellitus at the age of 60-69 years in

Puskemas Taman Sari District from January to March

2019 were 221 with a prevalence of 7.27%. The

targets in this study were patients with type 2 diabetes

mellitus in patients aged 60-69 years in the Taman

Sari District Health Center in West Jakarta. This

research will be conducted in May 2019 until June

2019. This type of research is a cross-sectional study.

3 RESULTS AND DISCUSSION

3.1 Research Result

3.1.1 Univariate Analysis

Description of Incidence of Type 2 Diabetes

Mellitus at Patients Aged 60-69 Years in the

Working Area of Puskesmas Kecamatan Taman

Sari in 2019.

The distribution results show that the analysis results

for the incidence of Type 2 DM variables where the

proportion is divided into 2 categories, namely Type

2 DM sufferers and not Type 2 DM sufferers, the

highest proportion of respondents is Type 2 DM

sufferers is 60 respondents (61.9 %), while the lowest

proportion were respondents who were not sufferers

of Type 2 diabetes as many as 37 respondents

(38.1%).

Table 1: Distribution of Type 2 DM Events, Family History

with DM, Smoking, History of Hypertension in Patients

Age 60 - 69 Years at the Working Area of Puskesmas

Kecamatan Taman Sari in 2019.

No. Analysis Type

Number

(n)

Percentage

(%)

Event DM Type 2

97 100,0

Patients with type 2 DM

60 61,9

ot a patient Type 2 DM

37 38,1

Family history with DM

97 100,0

Yes

69 71,1

28 28,9

Smoking

97 100,0

Heavy Smoker

15 15,5

Light Smokers – Moderate

23 23,7

o Smoking

59 60,8

History of Hypertension

97 100,0

Yes 60 61,9

o 37 38,1

Description of Family History in Patients Aged 60-

69 Years at the Working Area of Puskesmas

Kecamatan Taman Sari in 2019.

The distribution results show that the analysis results

for family history variables with DM where the

proportion is divided into 2 categories namely having

a family history with DM and not having a history

with DM. obtained different results, namely the

highest proportion of respondents who have a family

history with DM as many as 69 respondents (71.1%),

while the lowest proportion is respondents who do not

have a family history with DM as many as 28

respondents (28.9%).

Description of Smoking in Patients Aged 60-69

Years at The Working Area of Puskesmas

Kecamatan Taman Sari in 2019.

The distribution results show that the analysis results

for smoking variables where the proportion is divided

into 3 categories, namely heavy smokers, light

smokers - moderate and not smoking. different results

obtained, namely the highest proportion of

respondents who did not smoke as many as 59

respondents (60.8%), the proportion of mild smokers

- moderate as many as 23 respondents (23.7%), while

the lowest proportion were respondents with heavy

smokers as many as 15 respondents (15, 5%).

Description of Hypertension History in Patients

Aged 60-69 Years at the Working Area of

Puskesmas Kecamatan Taman Sari in 2019.

The distribution results show that the analysis results

for hypertension history variables where the

Factors that Related to Type 2 Diabetes Mellitus in Patients Aged 60-69 Years at the Working Area of Puskesmas Kecamatan Taman Sari

Jakarta Barat 2019

241

proportion is divided into 2 categories, namely having

a history of hypertension and not having a history of

hypertension. obtained different results namely the

highest proportion were respondents who had a

history of hypertension as many as 60 respondents

(61.9%), while the lowest proportion was respondents

who did not have a family history with DM as many

as 37 respondents (38.1%).

3.1.2 Bivariate Analysis

The Relationship Between Family History with the

Occurrence of Type 2 Diabetes Mellitus in Patients

Age 60 - 69 Years at The Working Area of Taman

Sari in 2019.

Based on the results of the cross-tabulation shows that

the highest proportion of patients who have a family

history of DM in patients with Type 2 DM are 51

respondents (73.9%). Similarly, the highest

proportion of respondents who do not have a family

history of DM in patients who are not sufferers of

Type 2 diabetes are 19 respondents (67.9%).

Based on the Chi-Square statistical test, the p-

value was 0,000 (p <0.05), so it can be concluded that

there is a relationship between family history and DM

with DM Type 2. Based on these results the

Prevalence Ratio (PR) value in this analysis is 2,300

with 95% CI: 1,139 - 4,010, meaning that respondents

who have a family history of DM have 2,300 times

the risk of developing type 2 diabetes compared with

respondents who do not have a family history of DM.

The Relationship Between Smoking and the

Incidence of Type 2 Diabetes Mellitus in Patients

Aged 60-69 Years at the Working Area of

Puskesmas Kecamatan Taman Sari in 2019.

Based on the results of the cross-tabulation shows that

the highest proportion of respondents with heavy

smokers who are not sufferers of Type 2 DM as many

as 8 people (46.7%), while the highest proportion of

respondents smokers mild-moderate with sufferers of

Type 2 DM as many as 12 people (52.2 %) and the

highest proportion of respondents who did not smoke

were 41 people (69.5).

Bivariate analysis statistical test results by making

dummy variables obtained the value of P-Value =

0.177 states that there is no significant relationship

between smoking and the incidence of Type 2

diabetes in patients aged 60-69 years in the working

area of Taman Sari District Health Center in 2019.

From this statistical test also known that the value of

Prevalence Ratio (PR) = 0.672 (1 / 0.381 = 2.624)

with 95% CI = 0.381 - 1.184, this shows that patients

who do not smoke 2.624 times more at risk of

developing Type 2 diabetes compared with heavy

smokers. And also obtained P-Value = 0.224 states

that there is no significant relationship between

smoking with the incidence of Type 2 DM in patients

aged 60-69 years in the Taman Sari District Health

Center Work Area in 2019. From this statistical test

also known the value of Prevalence Ratio (PR) =

0.751 (1 / 0.751 = 1.331) with 95% CI = 0.490 -

1,150, this shows that patients who do not smoke are

1,331 times more at risk of developing Type 2

diabetes compared with heavy smokers.

The Relationship Between Hypertension History

and the Incidence of Type 2 Diabetes Mellitus in

Patients Aged 60-69 Years at the Working Area of

Puskesmas Kecamatan Taman Sari in 2019.

Based on the results of the cross-tabulation shows that

the highest proportion of patients who have a history

of hypertension in patients with Type 2 diabetes are

48 respondents (80.0%). Similarly, the highest

proportion of respondents who did not have a history

of hypertension in patients who were not sufferers of

Type 2 diabetes were 25 respondents (67.6%).

Based on the Chi-Square statistical test, the p-

value was 0,000 (p <0.05), so it can be concluded that

there is a relationship between family history and DM

with DM Type 2. Based on these results the

Prevalence Ratio (PR) value in this analysis was

2,467 with 95% CI: 1,523 - 3,994, meaning that

respondents who had a history of hypertension had a

risk of 2,467 times developing type 2 diabetes

mellitus compared to respondents who had no history

of hypertension.

3.2 Discussion

3.2.1 Univariate Analysis

Description of the Incidence of Type 2 Diabetes

Mellitus in Patients Aged 60-69 Years at the

Working Area of Puskesmas Kecamatan Taman

Sari in 2019.

Based on the results of the study the highest

proportion of people with type 2 diabetes mellitus

were 60 (61.9%) respondents. In this study, the

proportion of people with type 2 diabetes mellitus

dominates more than the proportion who are not

patients with type 2 diabetes mellitus. The results of

this study are in line with research conducted by

Kistianita et al. (2017) at Kendalkerap Health Center

in Malang City, from 88 respondents it was obtained

the proportion the highest is in people with type 2

diabetes Mellitus as many as 64 (72.7%).

ICOH 2019 - 1st International Conference on Health

242

Table 2: Relationship of Family History with DM, Smoking, and History of Hypertension with the Occurrence of Type 2 DM

in Patients Age 60 - 69 Years in the Work Area of Taman Sari District Health Center in 2019.

No.

Variable

Category

Kejadian DM Ty

e 2

P-value

PR (95% CI)

Penderita DM

e 2

Bukan Penderita

DM Ti

e 2

Riwayat

Keluarga

dengan DM

Ya Memiliki Riwayat

Keluarga Dengan DM

(73,9%)

(26,1%)

0,000

2,300

(1,319-4,010)

Tidak Memiliki Riwayat

Keluarga Dengan DM

(32,1%)

(67,9%)

Merokok

Perokok Berat 7

(46,7%)

(53,3%)

0,177

0,672

(0,381

–

1,184)

Perokok Ringan -

Sedang

(52,2%)

(47,8%)

0,224

0,751

(0,490

–

1,150)

Tidak Merokok 41

(

69,5%

)

(

30,5%

)

Riwayat

Hipertensi

Ya Memiliki Riwayat

ertensi

(

80,0%

)

(

20,0%

)

0,000

2,467

(1,523 – 3,994)

Tidak Memiliki Riwayat

Hipertensi

(32,4%)

(67,6%)

Based on the results of research conducted at the

Taman Sari District Health Center, most of the

patients who visited PTM & Elderly Poly were

sufferers of type 2 diabetes mellitus and the incidence

of type 2 diabetes mellitus was quite high, this was

caused by factors that triggered the high incidence of

type 2 diabetes mellitus in the working area of the

Taman Sari sub-district health center is caused by

consuming too many snacks at the wrong time, rarely

doing physical activities after eating. Based on the

interview results other than these two factors, there

are other factors that trigger respondents to contract

Type 2 diabetes, which is a factor passed down from

parents.

Puskesmas Taman Sari sub-district has conducted

an integrated post-training program (Posbindu).

Efforts made with the Posbindu program are

monitoring and detection, early, Posbindu activities

are routine monitoring of DM risk factors, counseling

about DM risk factors such as smoking, stress,

physical activities, etc. counseling the community to

know and understand the risk factors that can cause

diabetes mellitus and carry out joint physical

activities such as sports. However, people with type 2

diabetes mellitus are still very high in Puskesmas

Taman Sari Subdistrict, because according to the

results of interviews with Puskesmas staff there is no

effort to provide health education related to good

eating patterns and regular lifestyles in patients with

Type 2 DM patients, therefore researchers

recommend that the health center conduct health

education about the importance of lifestyle and

maintain eating habits of people with Type 2 Diabetes

Mellitus.

Description of Family History with DM in Patients

Aged 60-69 Years at the Working Area of

Puskesmas Kecamatan Taman Sari in 2019.

Based on the results of the study the highest

proportion of respondents who have a family history

with DM as many as 69 (71.1%) respondents in this

study the proportion of family history with DM is

more dominant when compared to the proportion who

do not have a family history of DM. The results of

this study are in line with research conducted by

Trisnawati & Setyorogo (2012) at the Cengkareng

District Health Center in West Jakarta, from the 50

respondents the highest proportion was obtained

among respondents who had a family history of DM

with 22 (75.9%).

Based on the results of research conducted at the

Taman Sari District Health Center, most respondents

have a family history of DM. The number of

respondents who have a family history of DM one of

them due to lack of parental knowledge so it is not

informative enough to inform their offspring and

unhealthy eating patterns such as consuming junk

food, fast food, it is necessary to have self-awareness

to prevent increased risk factors by regulating

patterns eating, physical activity and diligently

checking blood sugar once a month. We recommend

that people who have a family history of DM should

be more careful in maintaining the lifestyle and

always controlling blood sugar levels.

Description of Smoking in Patients Aged 60-69

Years at the Working Area of Puskesmas

Kecamatan Taman Sari in 2019.

Factors that Related to Type 2 Diabetes Mellitus in Patients Aged 60-69 Years at the Working Area of Puskesmas Kecamatan Taman Sari

Jakarta Barat 2019

243

Based on the results of the study the highest

proportion of smoking variables found in respondents

who did not smoke as many as 59 (60.8%). The

results of this study are in line with research

conducted by Sutriana (2018) of employees at PT

Pins Indonesia, of the 112 respondents obtained the

highest proportion of respondents who did not smoke

as many as 89 (79.5%).

Cigarettes can cause thickening and hardening

resulting in narrowing of the arteries. Smokers are

those who smoke every day for a minimum period of

6 months during their lifetime still smoking when the

survey was conducted (MOH, 2004). Based on the

results of interviews with respondents, it is known

that the high proportion of respondents who do not

smoke is caused by some respondents who have not

been diagnosed with Type 2 diabetes or who have

stopped smoking after being diagnosed with Type 2

diabetes. In addition, the history of hypertension that

some respondents have is one of the factors causing

the respondent do not smoke.

Description of Hypertension History in Patients

Age 60 - 69 Years at the Working Area of

Puskesmas Kecamatan Taman Sari in 2019.

Based on the results of the study the highest

proportion of respondents who had a history of

hypertension were 60 (61.9%) respondents. In this

study, the proportion of respondents who had a

history of hypertension was more dominant compared

to the proportion who did not have a history of

hypertension. The results of this study are in line with

research conducted by Kistianita et al., (2017) at the

Kendalkerap Health Center in Malang City, from 88

respondents the highest proportion was obtained by

respondents who had a history of hypertension of 45

(51.1%).

Based on the results of research conducted at the

Taman Sari District Health Center, most respondents

have a history of hypertension, some respondents still

consume salt for their food needs in large quantities,

in addition to consuming salt that does not match the

amount of some respondents also experience stress

due to economic problems. Efforts to reduce

hypertension by reducing salt consumption, taking

the medication regularly and managing stress.

The program that has been carried out by the

Taman Sari sub-district health center staff is an

integrated post-training program (Posbindu), an effort

undertaken with the posbindu program that is

monitoring and early detection of hypertension,

counseling, and providing counseling to the public to

know and understand the risk factors can cause

hypertension.

3.2.2 Bivariate Analysis

The Relationship Between Family History with

DM with the Occurrence of Type 2 Diabetes

Mellitus in Patients Age 60 - 69 Years at the

Working Area of Puskesmas Kecamatan Taman

Sari in 2019.

Statistical test results state that there is a significant

relationship between patients who have a family

history of DM with the incidence of type 2 diabetes

mellitus (p-value = 0,000). Based on research

conducted at the Taman Sari District Health Center,

most respondents have a family history of DM, many

respondents have a family history of DM one of

which is due to lack of parental knowledge so it is not

informative enough to inform their offspring, who are

at risk of having a family history of DM. therefore the

researchers suggest respondents do a screening of

sugar levels, regulate diet 3 times a day and multiply

eating fruits and vegetables, not smoking and

routinely doing physical activities doing sports.

The Relationship Between Smoking and The

Incidence of Type 2 Diabetes Mellitus in Patients

Aged 60-69 Years at the Working Area of

Puskesmas Kecamatan Taman Sari in 2019.

Statistical test results state that there is no significant

relationship between smoking and the incidence of

type 2 diabetes mellitus (p-value = 0.177 & 0.224).

According to Action on Smoking and Health (2015),

a lot of evidence shows that smoking is a risk factor

for type 2 diabetes mellitus. Smoking has been

identified as a possible risk factor for insulin

resistance. Smoking has also been shown to reduce

glucose metabolism which can cause type 2 diabetes

mellitus and smoking has also been linked to the risk

of chronic pancreatic and pancreatic cancer,

indicating that cigarette smoke can be toxic to the

pancreas. People who smoke about 20 cigarettes per

day have a higher risk of developing diabetes mellitus

than nonsmokers.

Based on research conducted at the Taman Sari

District Health Center, most respondents do not

smoke. This is one of them because some respondents

did not smoke from before being diagnosed with

Type 2 DM, besides that some respondents had a

history of hypertension and stopped smoking after

being diagnosed with DM Type 2.

The Relationship Between Hypertension History

and the Incidence of Type 2 Diabetes Mellitus in

Patients Aged 60-69 Years at the Working Area of

Puskesmas Kecamatan Taman Sari in 2019.

ICOH 2019 - 1st International Conference on Health

244

Statistical test results state that there is a significant

relationship between patients who have a history of

hypertension and the incidence of type 2 diabetes

mellitus (p-value = 0,000). Based on observations

made at the Taman Sari District Health Center, most

respondents had a history of hypertension. This may

be caused by age at risk, wrong diet, stress or low

physical activity so it is expected to maintain a diet

by reducing salt consumption, actively moving like

sports, managing stress by listening to music and

stopping smoking and drinking alcohol, taking drugs

hypertension according to doctor's prescription and

routinely check blood pressure and pulse.

Taman Sari sub-district health center has an

integrated post-training program or POSBINDU

where the program is to monitor and detect

hypertension early on, counseling, and provide

counseling to the public about risk factors that can

cause hypertension. Based on the results of the study,

researchers advised health workers to do more

counseling to the public about risk factors that can

cause hypertension.

4 CONCLUSIONS

From the results of data processing research that has

been done, it can be concluded that:

1. The description of the incidence of type 2 diabetes

mellitus in patients aged 60-69 years in the

working area of the Taman Sari subdistrict health

center in 2019 is that people with type 2 diabetes

mellitus as much as 61.9% while those who are

not sufferers of type 2 diabetes mellitus as much

as 38.1%.

2. Description of family history with DM in patients

aged 60-69 years in the working area of Taman

Sari sub-district health center in 2019 with the

highest proportion of 71.1% with respondents

who have a family history of DM.

3. Description of smoking in patients aged 60- 69

years in the working area of Taman Sari sub-

district health center in 2019 with the highest

proportion of 60.8% of respondents who do not

smoke.

4. The description of the history of hypertension in

patients aged 60-69 years in the working area of

Taman Sari sub-district health center in 2019 with

the highest proportion of 61.9% of respondents

who have a history of hypertension.

5. There is a relationship between family history

with DM with the incidence of type 2 diabetes

mellitus hypertension in patients aged 60-69 years

in the working area of Taman Sari sub-district

health center in 2019 that is obtained a P-Value =

0,000.

6. There is no relationship between smoking and the

incidence of hypertension type 2 diabetes mellitus

in patients aged 60 - 69 years in the working area

of Taman Sari sub-district health center in 2019

with P values = 0.177 and 0.224.

7. There is a relationship between the history of

hypertension and the incidence of hypertension

type 2 diabetes mellitus in patients aged 60-69

years in the working area of Taman Sari sub-

district health center in 2019 that is obtained the

value of P-Value = 0,000.

5 SUGGESTION

Based on the results of research conducted can be

given several suggestions, namely:

1. For the puskesmas organizing health education

about the importance of lifestyle and maintaining

a diet for people with Type 2 diabetes.

2. The family should do a screening of sugar levels,

adjust the diet 3 times a day and multiply eating

fruits and vegetables, not smoking and regular

physical activity to do sports.

3. For puskesmas (health workers) to educate the

public more about risk factors that can cause

hypertension.

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