ArticleBMJ open2025
Trends of diabetes and pre-diabetes in Indonesia 2013-2023: a serial analysis of national health surveys.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo examine trends in the prevalence of diabetes and pre-diabetes in Indonesia from 2013 to 2023 and to explore demographic and socioeconomic factors associated with these changes.
designSecondary data analysis on multiseries cross-sectional study.
settingThree waves of the Indonesian National Health Survey (2013, 2018 and 2023), each employing nationally representative, stratified multistage sampling.
participantsNationally representative respondents aged 15 years and older who completed fasting plasma glucose (FPG) and oral glucose tolerance tests (OGTT). PRIMARY AND SECONDARY OUTCOME MEASURES: Diabetes and pre-diabetes were defined based on FPG and OGTT tests and self-reported diagnosis. Multivariable and ordinal logistic regression models assessed associations between glycaemic status and demographic, socioeconomic and health-related factors.
resultsFrom 2013 to 2023, the prevalence of diabetes rose from 10.7% (95% CI: 10.2% to 11.2%) in 2013 to 11.8% (11.3% to 12.3%) in 2018, before declining to 11.3% (10.7% to 11.9%) in 2023. Meanwhile, pre-diabetes prevalence decreased from 44.5% (43.6% to 45.3%) in 2013 to 39.2% (38.0% to 40.3%) in 2023. Age-standardised and synthetic cohort analysis revealed that younger birth cohorts had lower diabetes prevalence at the same age compared with older generations. In contrast, diabetes prevalence remained high and stable among older adults, suggesting that an increase in diabetes prevalence was due to the increase in older population size rather than increased risk. Multivariable regression confirms that higher age and BMI were strong predictors for diabetes, pre-diabetes and abnormal glycaemic states. Wealth quintiles showed different associations: higher wealth was linked to lower pre-diabetes odds, but not consistently to diabetes.
conclusionsThe ageing population drives the rise of diabetes prevalence in Indonesia. Generational improvements were shown among younger adults, while persistent high diabetes prevalence in older adults underscores ongoing challenges. These findings highlight the importance of age-targeted and cohort-targeted screening and prevention strategies.
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