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February 6, 2026Tropical Medicine & International Health0 citationsOpen Access

Where Are the Gaps in Diabetes Care? An Evidence Gap Mapping of the Diabetes Patient Journey in Indonesia

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RHRachmadianti Sukma HanifaUniversity Medical Center GroningenSKSudewi Mukaromah KhoirunnisaUniversity Medical Center GroningenRMRizka MaulidaUniversity of Indonesia

Key Points

  • This study aims to understand the diabetes patient journey in Indonesia and identify gaps in diabetes care.
  • Utilized evidence gap mapping to assess literature from January 2014 to March 2025.
  • Conducted systematic searches in PubMed, Web of Science, Scopus, and Embase.
  • Used random-effects meta-analyses to calculate pooled prevalence of diabetes touchpoints.
  • Visualized evidence through chord diagrams, bar charts, and heatmaps.
  • True diabetes prevalence was 13%, with awareness at 71%, screening at 19%, diagnosis at 15%, treatment at 89%, adherence at 59%, and control at 31%.
  • Most studies lacked application of established diabetes patient journey frameworks.
  • Low-quality studies primarily affected prevalence estimates, especially in nationally representative samples.
  • High heterogeneity was observed within subgroups across touchpoints.

Abstract

ABSTRACT Objective Understanding the diabetes patient journey, from awareness, screening, diagnosis, treatment, adherence and control, is crucial for improving outcomes. However, in many low‐ and middle‐income countries, including Indonesia, data across this continuum of care remain limited due to limited health information exchange capacity. This study aimed to map and estimate the prevalence of true diabetes and key touchpoints along the patient journey to identify gaps in diabetes management in Indonesia. Methods We applied an evidence gap mapping approach by systematically searching relevant literature published between 1 January 2014, and 27 March 2025, in PubMed, Web of Science, Scopus and Embase, complemented by unstructured searches of government websites. Evidence was visualised using a chord diagram, bar chart and heatmaps. Random‐effects meta‐analyses were used to estimate pooled prevalence, stratified by study setting and sample representativeness relative to the national population. Results Among 94 records, none fully applied diabetes patient journey frameworks and most of the evidence was assessed as low quality. Screening was the least studied touchpoint and awareness missed nationally representative data. Pooled prevalence estimates were: true diabetes 13% (95% confidence interval (CI): 9%–17%), awareness 71% (95% CI: 54%–85%), screening 19% (95% CI: 0%–55%), diagnosis 15% (95% CI: 6%–27%), treatment 89% (95% CI: 80%–95%), adherence 59% (95% CI: 49%–69%) and control 31% (95% CI: 25%–36%). Prevalence rates were generally lower in studies conducted in the general population using nationally representative samples. Pooled prevalence across touchpoints and subgroups decreased after excluding low‐quality studies, although heterogeneity within subgroups remained high. Conclusion Evidence gap mapping offers a practical approach to generating local patient journey data in countries with limited health information exchange capacity. Specifically for Indonesia, a comprehensive consideration of the diabetes patient journey is lacking. Barriers exist across all touchpoints, particularly in the general population.

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Cite This Study

Hanifa et al. (2026) studied this question.

synapsesocial.com/papers/698586118f7c464f23009f5ehttps://doi.org/10.1111/tmi.70100
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