• Titiek Hidayati Department of Community and Family Medicine, Medical and Health Science Faculty, Universitas Muhammadiyah Yogyakarta, Indonesia
  • Siti Nur Fatimah Department of , Medical Faculty, Padjadjaran University, Indonesia.
  • Shelly Iskandar Department of , Medical Faculty, Padjadjaran University, Indonesia.


Objective: The aim of the overall study was to determine the quality of life (QOL) and the factors that influence it in patients with diabetes mellitus (DM) in primary health care (PHC) Jetis 1, Bantul.

Methods: This cross-sectional study was conducted on 153 DM patients in PHC Jetis I, Bantul. Respondents were recruited by inclusion and exclusion criteria. Primary data on exposure to cigarette smoke, adherence with physical activity, perception of disease, and QOL are collected through interviews. Data were analyzed by a mean test for ratio scale data and Chi-square test.

Results: The results showed that the QOL and the level of adherence of DM patients in Puskesmas Jetis I were classified as very good. Male patients, elementary school graduates, normal body mass index (BMI), normal fasting blood sugar levels, adherent DM medication, and positive disease perception have a greater chance of having a better QOL. The mean of the random blood sugar and the fasting blood sugar levels exceeded the normal values, with 261.70 ± 121.15 mg/dl and 167.43 ± 10.23, respectively.

Conclusion: The QOL of DM patients in I Jetis PHC is very good. Men, normal BMI, adherent with medication therapy, and normal fasting sugar levels are associated with an increase in QOL.

Keywords: Quality of life, Diabetes mellitus, Adherence, Normal fasting blood sugar.

Author Biography

Titiek Hidayati, Department of Community and Family Medicine, Medical and Health Science Faculty, Universitas Muhammadiyah Yogyakarta, Indonesia

public health dan Family  Medicine departement, Universitas Muhammadiyah Yogyakarta


1. Esser A, Gube M, Schettgen T, Kraus T, Lang J. QALY as evaluation tool in a health surveillance program. Int J Hyg Environ Health 2014;217:399-404.
2. Akrom SG, Darmawan E. Improving Outpatient’s Quality of Life via Patient Adherence of Antihypertensive Therapy Using Mobile Phone (SMS) and Brief Counseling5A” in Polyclinic of Internal Medicine at PKU Muhammadiyah Bantul Hospital. Yogyakarta: Jurnal Farmasi Klinik Indonesia.
3. Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2 diabetes and quality of life. World J Diabetes 2017;8:120-9.
4. Grandy S, Chapman RH, Fox KM, SHIELD Study Group. Quality of life and depression of people living with Type 2 diabetes mellitus and those at low and high risk for Type 2 diabetes: Findings from the study to help improve early evaluation and management of risk factors leading to diabetes (SHIELD). Int J Clin Pract 2008;62:562-8.
5. Jiao F, Wong CKH, Gangwani R, Tan KCB, Tang SCW, Lam CLK, et al. Health-related quality of life and health preference of chinese patients with diabetes mellitus managed in primary care and secondary care setting: Decrements associated with individual complication and number of complications. Health Qual Life Outcomes 2017;15:125.
6. Chew BH, Mohd-Sidik S, Shariff-Ghazali S. Negative effects of diabetes-related distress on health-related quality of life: An evaluation among the adult patients with Type 2 diabetes mellitus in three primary healthcare clinics in Malaysia. Health Qual Life Outcomes 2015;13:187.
7. Laxy M, Hunger M, Thorand B, Meisinger C, Kirchberger I, Holle R, et al. The intermediate burden of diabetes mellitus in patients with cardiovascular disease (Cvd): A Quality adjusted life year (Qaly) - Analysis based on primary longitudinal data. Value Health 2014;17:A494.
8. Schwappach DL. Resource allocation, social values and the QALY: A review of the debate and empirical evidence. Health Expect 2002;5:210-22.
9. International Diabetes Federation. Diabetes Atlas. 6th ed. Belize: NAC, Bruss Belg International Diabetes; 2015.
10. World Health Organization. Global Health Risks-Mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization; 2017.
11. American Diabetes Association. (2) classification and diagnosis of diabetes. Diabetes Care 2015;38 Suppl: S8-16.
12. Clark M. Adherence to treatment in patients with Type 2 diabetes. J Diabetes Nurs 2004;8;386-91.
13. Rahman MS, Akter S, Abe SK, Islam MR, Mondal MN, Rahman JA, et al. Awareness, treatment, and control of diabetes in Bangladesh: A nationwide population-based study. PLoS One 2015;10:e0118365.
14. Amelia R, Lelo A, Lindarto D, Mutiara E. Quality of Life and Glycemic Profile of Type 2 Diabetes Mellitus Patients of Indonesian: A Descriptive Study. In: IOP Conference Series: Earth and Environmental Science. IOP Publishing; 2018. p. 12171.
15. Kesehatan DR. Riset Kesehatan Dasar. Jakarta: Badan Penelit Dan Pengemb Kesehat Dep Kesehat Repub Indones; 2013.
16. IDF. The Metabolic Syndrome. Int Diabetes Fed.
17. Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world – a growing challenge. N Engl J Med 2007;356:213-5.
18. Yogyakarta PK. Profil Kesehatan Tahun 2015 Kota Yogyakarta. Yogyakarta: Yogyak Dinas Kesehatan Kota; 2015. p. 15.
19. Bantul DK. Profil Kesehatan Kabupaten Bantul. Yogyakarta: Yogyak Dir Jenderal Pelayanan Med; 2010.
20. Akrom A. Factors Relate to the Hypercreatininemia Event of Patients at the Risk of Metabolic Syndrome in Jetis I Public Health Center. Pharmaciana.
21. Jellinger PS. Metabolic consequences of hyperglycemia and insulin resistance. Clin Cornerstone 2007;8 Suppl 7:S30-42.
22. Grandy S, Fox KM. EQ-5D visual analog scale and utility index values in individuals with diabetes and at risk for diabetes: Findings from the study to help improve early evaluation and management of risk factors leading to diabetes (SHIELD). Health Qual Life Outcomes 2008;6:18.
23. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2•7 million participants. Lancet 2011;378:31-40.
24. Kesehatan RI. Waspada Diabetes; Eat well, Life well. Jkt Kementrian Kesehat RI; 2014.
25. Peña-Longobardo LM, Rodríguez-Sánchez B, Mata-Cases M, Rodríguez-Mañas L, Capel M, Oliva-Moreno J, et al. Is quality of life different between diabetic and non-diabetic people? The importance of cardiovascular risks. PLoS One 2017;12:e0189505.
26. Hemmingsen B, Gimenez-Perez G, Mauricio D, Roqué I Figuls M, Metzendorf MI, Richter B, et al. Diet, physical activity or both for prevention or delay of Type 2 diabetes mellitus and its associated complications in people at increased risk of developing Type 2 diabetes mellitus. Cochrane Database Syst Rev 2017;12:CD003054.
27. Wahyuningrum R, Wahyono J, Mustofa M, Prabandari YS, A qualitative study discovering the common medication-therapy problems in patients with Type 2 diabetes mellitus (t2dm) in Indonesia. Asian J Pharm Clin Res 2017;10:246-50.
28. Siddiqui AN, Khayyam KU, Siddiqui N, Sarin R, Sharma M. Diabetes prevalence and its impact on health-related quality of life in tuberculosis patients. Trop Med Int Health 2017;22:1394-404.
29. Nuworza K. Illness Perception, Religiosity and Mental Health of Diabetic Patients in Ghana [PhD Thesis]. University of Ghana; 2013.
30. Indrayana S, Guo SE, Lin CL, Fang SY. Illness perception as a predictor of foot care behavior among people with Type 2 diabetes mellitus in Indonesia. J Transcult Nurs 2018;1:1043659618772347.
31. Perwitasari DA, Santosa SB, Faridah IN, Kaptein AA. Illness perceptions and quality of life in patients with diabetes mellitus Type 2. Indones J Clin Pharm 2017;6:190-9.
32. Sheu WH, Ji LN, Nitiyanant W, Baik SH, Yin D, Mavros P, et al. Hypoglycemia is associated with increased worry and lower quality of life among patients with Type 2 diabetes treated with oral antihyperglycemic agents in the Asia-Pacific region. Diabetes Res Clin Pract 2012;96:141-8.
33. Nasution A, Simbolon RC, Tanjung HR. Characteristics, antihyperglycemics utilization, and quality of life in patients with Type 2 diabetes mellitus admitted to a primary health center. Indones J Pharm Clin Res 2018;1:1-10.
34. Suppapitiporn S, Chindavijak B, Onsanit S. Effect of diabetes drug counseling by pharmacist, diabetic disease booklet and special medication containers on glycemic control of Type 2 diabetes mellitus: a randomized controlled trial. J Med Assoc Thai 2005;88:S134-41.
35. Mogensen CE, Neldam S, Tikkanen I, Oren S, Viskoper R, Watts RW, et al. Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: The candesartan and lisinopril microalbuminuria (CALM) study. BMJ 2000;321:1440-4.
36. Franciosi M, Lucisano G, Pellegrini F, Cantarello A, Consoli A, Cucco L, et al. ROSES: Role of self-monitoring of blood glucose and intensive education in patients with Type 2 diabetes not receiving insulin. A pilot randomized clinical trial. Diabet Med 2011;28:789-96.
37. Indonesia PE. Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. Dalam Konsensus; 2011.
38. Borgsteede SD, Westerman MJ, Kok IL, Meeuse JC, de Vries TP, Hugtenburg JG, et al. Factors related to high and low levels of drug adherence according to patients with Type 2 diabetes. Int J Clin Pharm 2011;33:779-87.
39. Al-Qasem A, Smith F, Clifford S. Adherence to medication among chronic patients in Middle Eastern countries: Review of studies. East Mediterr Health J 2011;17:356-63.
40. Sabaté E. Adherence to Long-Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization; 2003.
41. Wabe NT, Angamo MT, Hussein S. Medication adherence in diabetes mellitus and self management practices among Type-2 diabetics in Ethiopia. N Am J Med Sci 2011;3:418-23.
42. KemenKes RI. Riset Kesehatan Dasar (Riskesdas). Jkt Badan Litbangkes DepKes RI Tersedia. Available from: https://wwwK4health OrgsitesdefaultfileslaporanNasional20Riskesdas2007.
43. Spasić A, Radovanović RV, Djordjević AC, Stefanović N, Cvetković T. Quality of life in Type 2 diabetic patients. Acta Fac Med Naissensis 2014;31:193-200.
44. Younis BB, Arshad R, Yousuf H, Salman F, Masood J, Khurshid S, et al. Impact of Type 2 diabetes mellitus on quality of life in people with diabetespresenting to a specialist diabetes clinic. Turk J Med Sci 2017;47:123-6.
45. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008;10:348-54.
46. Sakthong P, Chabunthom R, Charoenvisuthiwongs R. Psychometric properties of the Thai version of the 8-item morisky medication adherence scale in patients with Type 2 diabetes. Ann Pharmacother 2009;43:950-7.
47. Saputri GZ, Akrom A, Darmawan E. Improving outpatient’s quality of life through patient adherence of antihypertensive therapy using mobile phone (SMS) and brief counseling-5A in polyclinic of internal medicine at pku muhammadiyah bantul hospital, Yogyakarta. Indones J Clin Pharm 2017;6:67-77.
48. Corea G. Need for Change: Towards the New International Economic Order. Korea: Elsevier; 2014.
49. Wen CP, Wai JP, Tsai MK, Yang YC, Cheng TY, Lee MC, et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: A prospective cohort study. Lancet 2011;378:1244-53.
50. Dede ND, Ipekci S, Kebapcilar L, Arslan M, Kurban S, Yildiz M, et al. Effect of Aerobic Exercise Training on Serum Malondialdehyde Level and Quality of Life in Type 2 Diabetes. In: 20th European Congress of Endocrinology. BioScientifica; 2018.
51. Ware JE Jr. SF-36 health survey update. Spine (Phila Pa 1976) 2000;25:3130-9.
52. van Dulmen S, Sluijs E, van Dijk L, de Ridder D, Heerdink R, Bensing J, et al. Patient adherence to medical treatment: A review of reviews. BMC Health Serv Res 2007;7:55.
53. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005;353:487-97.
54. Zyoud SH, Al-Jabi SW, Sweileh WM, Morisky DE. Relationship of treatment satisfaction to medication adherence: Findings from a cross-sectional survey among hypertensive patients in Palestine. Health Qual Life Outcomes 2013;11:191.
55. Butt M, Ali AM, Bakry MM, Health-related quality of life in poorly controlled Type 2 diabetes patients-association of patients’ characteristic with EQ-5D domain, mean EQ-5D scores, and visual analog scale score. Asian J Pharm Clin Res 2018;11:93-8
56. Bernard HR. Research Methods in Anthropology: Qualitative and Quantitative Approaches. Lantham, MD: Rowman and Littlefield; 2017.
57. Saputri GZ, Dini AS. Validation of behaviour measurement instrument of patients with diabetes mellitus and hypertension. Mater Sci Eng 2017;259:12014.
273 Views | 135 Downloads
How to Cite
Hidayati, T., S. N. Fatimah, and S. Iskandar. “NORMAL FASTING BLOOD SUGAR LEVELS AND MEDICATION ADHERENCE IMPROVE THE QUALITY OF LIFE OF TYPE 2 DIABETES MELLITUS PATIENTS IN PRIMARY HEALTH FACILITIES”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 11, no. 11, Nov. 2018, pp. 472-7, doi:10.22159/ajpcr.2018.v11i11.29006.
Original Article(s)