Unhealthy Lifestyle and Limited Health Monitoring as Key Risk Factors for Diabetes Mellitus: Evidence From the 2023 Indonesian Health Survey

Abstract

Background: Diabetes Mellitus (DM) is a growing public health concern with significant social and economic impact. The 2023 Indonesian Health Survey (SKI) reported an increase in DM prevalence among individuals aged ≥15 years, rising from 2.0% in 2018 to 2.2% in 2023, potentially influenced by post-pandemic lifestyle changes.

Methods: This cross-sectional study used aggregate data from the 2023 SKI, conducted between March and May 2025. In total, 34,500 census blocks were selected using proportional stratified sampling. Data were collected through interviews and physical examinations. Spearman’s correlation and linear regression analyses were used to identify the risk factors associated with DM.

Result: Significant positive correlations with DM were observed for daily smoking (r=0.337, p=0.039), former smoking (r=0.664, p=0.000), high-fat food consumption (r=0.416, p=0.009), body weight monitoring (r=0.498, p=0.001), telemedicine use (r=0.738, p=0.000), and obesity (r=0.524, p=0.001). Negative correlations were found for occasional smoking exposure (r=-0.417; p=0.009), tobacco use (r≈-0.6), sweet food consumption (r=-0.421; p=0.009), and normal nutritional status (r=-0.592; p=0.000). No significant association was found with physical activity. Multivariate analysis showed that individuals with blood pressure less than once a year had an 8.63-fold higher risk of DM. Telemedicine use, low-frequency starchy tuber intake, and BPJS PBI membership were also associated with increased risk, whereas nut consumption (1–6 times/week) reduced risk by 26%.

Conclusion : Behavioral and healthcare access factors were also significantly associated with DM. Smoking, poor diet, and limited health monitoring increased this risk. Further studies using individual-level data are needed.