Management of Diabetes Mellitus

and Hypertension for Primary Care

Provider

Satriyo Dwi Suryantoro

Mentoring Spesialis dan Pelayanan PRB

12 Juni 2023
Definitions and Epidemiology
Diabetes Mellitus

Diabetes Mellitus is a serious, chronic condition in which raised levels of blood

glucose occurs because body cannot produce any or enough of the hormone insulin
or cannot effectively use the insulin it produces

Insulin is an essential hormone produced in the pancreas. It allows glucose from the
bloodstream to enter body’s cells then it will be converted into energy or to be
stored.

An insuiin deficit, if left unchecked over long term, will cause damage to many of the
body’s organs, leading to disabling and life-threatening health complications such as
cardiovascular disease (CVD), kidney damage (nephropathy), nerve damage
(neuropathy) etc
EPIDEMIOLOGY
Number of people with DM (20 – 79 yrs old)

415 millions 463 millions

worldwide worldwide ???

2015 2017 2019 2021 2023

425 millions 537 millions

worldwide worldwide
Diagnosis of type 2 DM
What is the role of Primary
Health Care Provider ???
Recommendations
SCREENING
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 Other Recommendations

For high risk individuals Encourage for routine

(obesity, high FPG, A1C > 6,0, A1C target < 7,0 physical activities, consult
history of Gestational DM) without with expert if necessary
hypoglycemia is
Metformin use Smoking and
appropriate
as prevention tobacco use
for DM is cessation is
recommended recommended

Evaluate since initial visit Comprehensive On treatment Personalized treatment

and develop personalized Medical target or BP in target for BP in
continuous plan Evaluation is DM patients ≤ patients with DM
required 130/80 mmHg
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Thank you
Managing Hypertension
In Primary Health Care
Definition and Epidemiology

Hypertension

✓ Defined if there is an increase in a person’s Systolic Blood Pressure (SBP) in

the office/clinic ≥ 140 mmHg and/or an increase in a person’s Diastolic Blood
Pressure (DBP) in the office/clinic ≥ 90 mmHg following repeated
examination
✓ These definitions apply to all adults ( > 18 years old)
✓ Hypertension, along with pre-hypertension and other hazardous high blood
pressure,is responsible for 8,5 million deaths from stroke (CVA), ischaemic
heart disease, and renal disease worldwide
Prevalence 2019 (women)
Prevalence 2019 (men)
Another problem
Classification

Based on Office/Clinic Blood Pressure Measurement

Classification (Cont’d)
Based on Office, Ambulatory (ABPM), and Home Blood Pressure (HBPM)
Measurement
Office Blood Pressure Measurement
Home Blood Pressure Measurement
What next ???
THANK YOU