Escalating Trends of Type 2 Diabetes in Indonesian Youth: A Public Health Perspective on Obesity and Lifestyle
DOI:
https://doi.org/10.61978/medicor.v3i2.752Keywords:
Type 2 Diabetes, Adolescents, Indonesia, Obesity, Physical Activity, Nutrition Policy, Youth HealthAbstract
Introduction & Objective : This study analyzes the alarming rise in youth-onset type 2 diabetes mellitus (T2DM) in Indonesia, focusing on lifestyle factors such as obesity, dietary habits, and physical inactivity, while assessing systemic gaps and policy responses to inform targeted intervention strategies. Methodology Summary : A descriptive epidemiological approach was employed, analyzing national health survey data, registry records, and relevant literature from 2010–2024. Key variables included prevalence rates, age specific incidence, dietary habits, physical activity, and obesity trends. The study also reviewed health system capacity and public policy frameworks. Key Results and Discussion : Results indicate that youth T2DM prevalence has reached 2.3% nationally, with adolescents aged 10–19, especially females, showing the highest increase. Primary contributors include obesity (urban youth obesity at 24%), poor nutrition, and reduced physical activity. Urban children were found to be significantly more affected than rural counterparts. Diagnostic infrastructure and pediatric diabetes care remain limited. Influences such as food advertising and weak regulatory frameworks further exacerbate the problem. International models demonstrate that integrated school, community, and healthcare strategies can mitigate risks. Digital tools and regulatory reforms are underutilized in Indonesia but present opportunities for scalable impact. Conclusion and Implications : To mitigate the projected surge in youth onset T2DM, Indonesia must urgently implement school-based screening, regulate unhealthy food advertising to minors, and improve pediatric diabetes care access particularly in underserved regions.
References
Abarca-Gómez, L., Abdeen, Z., Hamid, Z. A., Abu-Rmeileh, N., Acosta-Cázares, B., Acuin, C. C. S., Adams, R. J., Aekplakorn, W., Afsana, K., Aguilar-Salinas, C. A., Agyemang, C., Ahmadvand, A., Ahrens, W., Ajlouni, K., Akhtaeva, N. S., Al-Hazzaa, H. M., Al‐Othman, A., Al‐Raddadi, R., Buhairan, F. A., … Ezzati, M. (2017). Worldwide Trends in Body-Mass Index, Underweight, Overweight, and Obesity From 1975 to 2016: A Pooled Analysis of 2416 Population-Based Measurement Studies in 128·9 Million Children, Adolescents, and Adults. The Lancet, 390(10113), 2627–2642. https://doi.org/10.1016/s0140-6736(17)32129-3 DOI: https://doi.org/10.1016/S0140-6736(17)32129-3
Ağırbaşlı, M., Tanrikulu, A. M., & Berenson, G. S. (2016). Metabolic Syndrome: Bridging the Gap From Childhood to Adulthood. Cardiovascular Therapeutics, 34(1), 30–36. https://doi.org/10.1111/1755-5922.12165 DOI: https://doi.org/10.1111/1755-5922.12165
Alkandari, H., Al‐Abdulrazzaq, D., Davidsson, L., Sharma, P. N., Al-Tararwa, A., Mandani, F., Al-Shawaf, F., Al-Hussaini, F., Qabazard, M., Haddad, D., Al-Mahdi, M., Al-Jasser, F., Alanezi, A., Al-Sanea, H., Al-Basari, I., Al-Adsani, A., Shaltout, A., & AbdulRasoul, M. (2019). Incidence of Type 2 Diabetes in Kuwaiti Children and Adolescents: Results From the Childhood-Onset Diabetes Electronic Registry (CODeR). Frontiers in Endocrinology, 10. https://doi.org/10.3389/fendo.2019.00836 DOI: https://doi.org/10.3389/fendo.2019.00836
Amed, S., Islam, N., Sutherland, J., & Reimer, K. (2017). Incidence and Prevalence Trends of Youth-Onset Type 2 Diabetes in a Cohort of Canadian Youth: 2002-2013. Pediatric Diabetes, 19(4), 630–636. https://doi.org/10.1111/pedi.12631 DOI: https://doi.org/10.1111/pedi.12631
Anders, S., & Schroeter, C. (2015). Diabetes, Diet-Health Behavior, and Obesity. Frontiers in Endocrinology, 6. https://doi.org/10.3389/fendo.2015.00033 DOI: https://doi.org/10.3389/fendo.2015.00033
Arsyad, D. S., Westerink, J., Cramer, M. J., Ansar, J., WAHIDUDDIN, W., Visseren, F. L., Doevendans, P. A., & Ansariadi, A. (2022). Modifiable Risk Factors in Adults With and Without Prior Cardiovascular Disease: Findings From the Indonesian National Basic Health Research. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-13104-0 DOI: https://doi.org/10.1186/s12889-022-13104-0
Awan, M. U. M., Shahid, R., Khan, N., Yousaf, Z., Asif, V., Munir, M., Mahnoor, Javaid, S., & Shabbir, Z. (2024). Prevalence of Diabetes Mellitus in People Aged 40 Years and Above. JHRR, 4(2), 1530–1534. https://doi.org/10.61919/jhrr.v4i2.1166 DOI: https://doi.org/10.61919/jhrr.v4i2.1166
Bendor, C. D., Bardugo, A., Pinhas‐Hamiel, O., Afek, A., & Twig, G. (2020). Cardiovascular Morbidity, Diabetes and Cancer Risk Among Children and Adolescents With Severe Obesity. Cardiovascular Diabetology, 19(1). https://doi.org/10.1186/s12933-020-01052-1 DOI: https://doi.org/10.1186/s12933-020-01052-1
Burton, J. J., & Alonso, L. (2024). Overnutrition in the Early Postnatal Period Influences Lifetime Metabolic Risk: Evidence for Impact on Pancreatic Β‐cell Mass and Function. Journal of Diabetes Investigation, 15(3), 263–274. https://doi.org/10.1111/jdi.14136 DOI: https://doi.org/10.1111/jdi.14136
Cho, M. J., Kim, M. S., Kim, C. J., Kim, J. D., Kim, E. Y., & Lee, D. (2014). Fasting Serum C-Peptide Is Useful for Initial Classification of Diabetes Mellitus in Children and Adolescents. Annals of Pediatric Endocrinology & Metabolism, 19(2), 80. https://doi.org/10.6065/apem.2014.19.2.80 DOI: https://doi.org/10.6065/apem.2014.19.2.80
Dabelea, D., Mayer‐Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., Bell, R. A., Badaru, A., Talton, J. W., Crume, T., Liese, A. D., Merchant, A. T., Lawrence, J. M., Reynolds, K., Dolan, L. M., Liu, L. L., & Hamman, R. F. (2014). Prevalence of Type 1 and Type 2 Diabetes Among Children and Adolescents From 2001 to 2009. Jama, 311(17), 1778. https://doi.org/10.1001/jama.2014.3201 DOI: https://doi.org/10.1001/jama.2014.3201
Gunawan, T. D., & Sekartini, R. (2024). Physical Activity Levels and Sleep Disturbances in Indonesian Primary School Students During the COVID-19 Pandemic. Paediatrica Indonesiana, 64(2), 106–112. https://doi.org/10.14238/pi64.2.2024.106-12 DOI: https://doi.org/10.14238/pi64.2.2024.106-12
Jeong, H. S., & Hong, S. K. (2018). Claim for Recovery of Inheritance by Residents of South ＆ North Korea and Exclusion Period. Law Research Institute Chungbuk National University, 29(1), 271–301. https://doi.org/10.34267/cblj.2018.29.1.271 DOI: https://doi.org/10.34267/cblj.2018.29.1.271
Kappes, C., Stein, R., Körner, A., Merkenschlager, A., & Kieß, W. (2021). Stress, Stress Reduction and Obesity in Childhood and Adolescence. Hormone Research in Paediatrics, 96(1), 88–96. https://doi.org/10.1159/000519284 DOI: https://doi.org/10.1159/000519284
Khan, S., Zaheer, S., & Safdar, N. F. (2019). Determinants of Stunting, Underweight and Wasting Among Children ≪ 5 years of Age: Evidence From 2012-2013 Pakistan Demographic and Health Survey. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-6688-2 DOI: https://doi.org/10.1186/s12889-019-6688-2
Kim, O. Y., Kim, E. M., & Chung, S. (2020). Impacts of Dietary Macronutrient Pattern on Adolescent Body Composition and Metabolic Risk: Current and Future Health Status—A Narrative Review. Nutrients, 12(12), 3722. https://doi.org/10.3390/nu12123722 DOI: https://doi.org/10.3390/nu12123722
Kostopoulou, E., Skiadopoulos, S., Partsalaki, I., Gil, A. P. R., & Spiliotis, B. E. (2021). Repetitiveness of the Oral Glucose Tolerance Test in Children and Adolescents. World Journal of Clinical Pediatrics, 10(3), 29–39. https://doi.org/10.5409/wjcp.v10.i3.29 DOI: https://doi.org/10.5409/wjcp.v10.i3.29
Lee, H. S. (2021). Diagnosis and Treatment of Pediatric Type 2 Diabetes Mellitus. Journal of Korean Medical Association, 64(6), 432–437. https://doi.org/10.5124/jkma.2021.64.6.432 DOI: https://doi.org/10.5124/jkma.2021.64.6.432
Lee, S. H., Cho, M. H., Kim, Y. H., & Chung, S. (2017). Two Cases of Successful Type 2 Diabetes Control With Lifestyle Modification in Children and Adolescents. Journal of Obesity & Metabolic Syndrome, 26(1), 71–75. https://doi.org/10.7570/jomes.2017.26.1.71 DOI: https://doi.org/10.7570/jomes.2017.26.1.71
Lin, X., Xu, Y., Pan, X., Xu, J., Ding, Y., Sun, X., Song, X., Ren, Y., & Shan, P.-F. (2020). Global, Regional, and National Burden and Trend of Diabetes in 195 Countries and Territories: An Analysis From 1990 to 2025. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-71908-9 DOI: https://doi.org/10.1038/s41598-020-71908-9
Long, D., Wang, C., Huang, Y., Mao, C., Xu, Y., & Zhu, Y. (2024). Changing Epidemiology of Inflammatory Bowel Disease in Children and Adolescents. International Journal of Colorectal Disease, 39(1). https://doi.org/10.1007/s00384-024-04640-9 DOI: https://doi.org/10.1007/s00384-024-04640-9
Marks, R. (2015). Childhood Obesity and Parental Health Literacy. Advances in Obesity Weight Management & Control, 3(3). https://doi.org/10.15406/aowmc.2015.03.00055 DOI: https://doi.org/10.15406/aowmc.2015.03.00055
Mohan, V., Ranjani, H., Pradeepa, R., Mehreen, T., Anjana, R., Krishnan, A., & Garg, R. (2014). Determinants, Consequences and Prevention of Childhood Overweight and Obesity: An Indian Context. Indian Journal of Endocrinology and Metabolism, 18(7), 17. https://doi.org/10.4103/2230-8210.145049 DOI: https://doi.org/10.4103/2230-8210.145049
Nadeau, K. J., Anderson, B. J., Berg, E. G., Chiang, J. L., Chou, H. S., Copeland, K. C., Hannon, T. S., Huang, T. T., Lynch, J., Powell, J., Sellers, E., Tamborlane, W. V., & Zeitler, P. (2016). Youth-Onset Type 2 Diabetes Consensus Report: Current Status, Challenges, and Priorities. Diabetes Care, 39(9), 1635–1642. https://doi.org/10.2337/dc16-1066 DOI: https://doi.org/10.2337/dc16-1066
Niu, Z., Zhou, Q., Hu, P., & Wang, T. (2021). Health Beliefs, Trust in Media Sources, Health Literacy, and Preventive Behaviors Among High-Risk Chinese for COVID-19. Health Communication, 37(8), 1004–1012. https://doi.org/10.1080/10410236.2021.1880684 DOI: https://doi.org/10.1080/10410236.2021.1880684
Oseni, T. I. A., Ahmed, S. D., Eromon, P. E., Fuh, N. F., & Azeke, O. D. (2023). Association Between Obesity and Lifestyle Practices Among Adults in a Rural Community in Edo State Nigeria. Open Journal of Medical Research (Issn 2734-2093), 4(1), 13–23. https://doi.org/10.52417/ojmr.v4i1.439 DOI: https://doi.org/10.52417/ojmr.v4i1.653
Perng, W., Oken, E., & Dabelea, D. (2019). Developmental Overnutrition and Obesity and Type 2 Diabetes in Offspring. Diabetologia, 62(10), 1779–1788. https://doi.org/10.1007/s00125-019-4914-1 DOI: https://doi.org/10.1007/s00125-019-4914-1
Pisa, P. T., Pisa, N., Chikandiwa, P., & Chikandiwa, A. (2021). Economic Growth as an Underlying Probable Systemic Driver for Childhood Obesity in South Africa: A Joinpoint Regression and Ecological Analysis Over 10 Years. South African Medical Journal, 111(3), 220. https://doi.org/10.7196/samj.2021.v111i3.14669 DOI: https://doi.org/10.7196/SAMJ.2021.v111i3.14669
Pulungan, A. B., Afifa, I. T., & Annisa, D. (2018). Type 2 Diabetes Mellitus in Children and Adolescent: An Indonesian Perspective. Annals of Pediatric Endocrinology & Metabolism, 23(3), 119–125. https://doi.org/10.6065/apem.2018.23.3.119 DOI: https://doi.org/10.6065/apem.2018.23.3.119
Rajput, R., Jha, S. K., Panda, J. K., Subrahmanyam, A., & Das, S. (2021). An Expert Opinion on the Management of Type 2 Diabetes Mellitus in Children and Adolescents. Journal of Diabetology, 12(4), 424–433. https://doi.org/10.4103/jod.jod_71_21 DOI: https://doi.org/10.4103/jod.jod_71_21
Reilly, J. J., Aubert, S., Brazo‐Sayavera, J., Liu, Y., Cagas, J. Y., & Tremblay, M. S. (2022). Surveillance to Improve Physical Activity of Children and Adolescents. Bulletin of the World Health Organization, 100(12), 815–824. https://doi.org/10.2471/blt.22.288569 DOI: https://doi.org/10.2471/BLT.22.288569
Rokhman, M. R., Arifin, B., Zulkarnain, Z., Satibi, S., Perwitasari, D. A., Boersma, C., Postma, M. J., & Schans, J. v. d. (2022). Translation and Performance of the Finnish Diabetes Risk Score for Detecting Undiagnosed Diabetes and Dysglycaemia in the Indonesian Population. Plos One, 17(7), e0269853. https://doi.org/10.1371/journal.pone.0269853 DOI: https://doi.org/10.1371/journal.pone.0269853
Rosenbauer, J., Neu, A., Rothe, U., Seufert, J., & Holl, R. W. (2019). Types of Diabetes Are Not Limited to Age Groups: Type 1 Diabetes in Adults and Type 2 Diabetes in Children and Adolescents. https://doi.org/10.25646/5987
Trepatchayakorn, S., Supornsilchai, V., Wacharasindhu, S., Aroonparkmongkol, S., & Sahakitrungruang, T. (2014). Original Article. Trends and Characteristics of Childhood Diabetes in a Tertiary Care Center in Thailand. Asian Biomedicine, 8(6), 707–715. https://doi.org/10.5372/1905-7415.0806.348 DOI: https://doi.org/10.5372/1905-7415.0806.348
Yazel-Smith, L., Mikati, H. K. E., Adjei, M., Haberlin-Pittz, K. M., Agnew, M., & Hannon, T. S. (2020). Integrating Diabetes Prevention Education Among Teenagers Involved in Summer Employment: Encouraging Environments for Health in Adolescence (ENHANCE). Journal of Community Health, 45(4), 856–861. https://doi.org/10.1007/s10900-020-00802-2 DOI: https://doi.org/10.1007/s10900-020-00802-2
Ye, Q., & Fu, J. (2017). Paediatric Type 2 Diabetes in China-Pandemic, Progression, and Potential Solutions. Pediatric Diabetes, 19(1), 27–35. https://doi.org/10.1111/pedi.12517 DOI: https://doi.org/10.1111/pedi.12517
Yerramalla, M. S., Fayossé, A., Dugravot, A., Tabák, Á. G., Kivimäki, M., Singh‐Manoux, A., & Sabia, S. (2019). Association of Moderate and Vigorous Physical Activity With Incidence of Type 2 Diabetes and Subsequent Mortality: 27 year Follow-Up of the Whitehall II Study. Diabetologia, 63(3), 537–548. https://doi.org/10.1007/s00125-019-05050-1 DOI: https://doi.org/10.1007/s00125-019-05050-1
Zeitler, P., Arslanian, S., Fu, J., Pinhas‐Hamiel, O., Reinehr, T., Tandon, N., Urakami, T., Wong, J., & Maahs, D. M. (2018). ISPAD Clinical Practice Consensus Guidelines 2018: Type 2 Diabetes Mellitus in Youth. Pediatric Diabetes, 19, 28–46. https://doi.org/10.1111/pedi.12719 DOI: https://doi.org/10.1111/pedi.12719
