Changes in Behavioral Risk Factors for Diabetes in Indonesia: Evidence from National Surveys Before and After The COVID-19 (2018 And 2023)

Edy Sud; Wahiduddin; Noor N Nur; Hasnawati Amqam; Suriah

doi:10.55489/njcm.170120266131

Authors

Edy Sud Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia https://orcid.org/0009-0006-7083-6008
Wahiduddin Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-5741-2693
Noor N Nur Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia https://orcid.org/0009-0009-7430-6946
Hasnawati Amqam Department of Environmental Health, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0003-4961-8517
Suriah Department of Health Promotion and Behavioral Sciences, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-2239-0017

DOI:

https://doi.org/10.55489/njcm.170120266131

Keywords:

Behavior, COVID-19, Diabetes Mellitus, Indonesia, National Survey, Risk Factors

Abstract

Background: This study assessed whether associations between key behavioral risk factors and diabetes mellitus (DM) changed between 2018 and 2023.

Methodology: A repeated cross-sectional analysis was conducted using pooled data from Riskesdas 2018 and SKI 2023, including 54,299 adults aged ≥15 years. DM was defined using fasting or 2‑hour postprandial glucose. Poisson regression with robust variance estimated adjusted prevalence ratios (PRs), including interaction terms for survey year.

Results: Low physical activity remained associated with higher DM prevalence (PR = 1.11; 95% CI: 1.03-1.20), with no significant change over time. Dietary risk showed an inverse association with DM (PR = 0.79; 95% CI: 0.71-0.88), which was significantly attenuated over time (PR interaction = 1.27; 95% CI: 1.09-1.48). A similar pattern was observed for smoking (PR = 0.75; interaction PR = 1.18). Alcohol consumption became inversely associated with DM in 2023 (interaction PR = 0.55; 95% CI: 0.31-0.96), although no significant association was observed overall.

Conclusions: Low physical activity remained a consistent risk factor for diabetes in Indonesia, while other behavioral associations varied between 2018 and 2023, underscoring the need for continuous surveillance and behavior-based interventions.

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