Association between Body Mass Index and Glycemic Status (Fasting and Postprandial) among Prolanis Participants in Primary Health Care Center
Abstract
Obesity and abnormal body mass index (BMI) are established risk factors for type 2 diabetes mellitus. However, the association between BMI and glycemic status may vary across clinical populations, particularly among individuals enrolled in chronic disease management programs. This study aimed to assess the association between BMI category and glycemic status, measured by fasting plasma glucose (FPG) and 2-hour postprandial plasma glucose (2-h PPG), among Prolanis participants at Pasar Rebo Primary Health Center. An analytical cross-sectional study was conducted using secondary medical record data from a single predefined assessment month. Participants with complete records of sex, body weight, height, FPG, and 2-h PPG were included. BMI was classified according to the WHO Asia-Pacific criteria for descriptive analysis and collapsed into underweight, normoweight, and overweight–obese groups for inferential analysis. Glycemic status was classified into normal, prediabetic range, and diabetic range categories. The association between BMI category and glycemic status was analyzed using cross-tabulation and the Fisher–Freeman–Halton exact test. A total of 454 participants were included in the final analysis. Most participants were female (68.9%) and were classified as overweight or obese (68.5%). This study’s results show that the BMI category was not significantly associated with FPG status (p = 0.888). Diabetic-range FPG was observed in 83.2% of the underweight–normoweight group and 83.3% of the overweight–obese group. Similarly, BMI category was not significantly associated with 2-h PPG status (p = 0.159). Diabetic-range 2-h PPG was found in 46.2% of the underweight–normoweight group and 55.6% of the overweight–obese group. These findings suggest that BMI category alone may have limited ability to discriminate fasting or postprandial glycemic status among Prolanis participants. Direct glycemic monitoring remains important across BMI categories in this high-risk primary care population.
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References
Ahmed, B., Sultana, R., & Greene, M. W. (2021). Adipose tissue and insulin resistance in obese. Biomedicine & Pharmacotherapy, 137, 111315. https://doi.org/10.1016/j.biopha.2021.111315
Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., … ElSayed, N. A. (2026). Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026. Diabetes Care, 49(Supplement_1), S27–S49. https://doi.org/10.2337/dc26-S002
Chait, A., & den Hartigh, L. J. (2020). Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease. Frontiers in Cardiovascular Medicine, 7. https://doi.org/10.3389/fcvm.2020.00022
Dimitriadis, G. D., Maratou, E., Kountouri, A., Board, M., & Lambadiari, V. (2021). Regulation of Postabsorptive and Postprandial Glucose Metabolism by Insulin-Dependent and Insulin-Independent Mechanisms: An Integrative Approach. Nutrients, 13(1), 159. https://doi.org/10.3390/nu13010159
Fadlilah, S., Nugroho, A., & Bistara, D. N. (2024). The Role of The Chronic Disease Management Program in Indonesia (PROLANIS) As A Diabetes Mellitus Management Strategy: A Scoping Review. Public Health of Indonesia, 10(2), 247–261. https://doi.org/10.36685/phi.v10i2.753
Gifari, N., Nuzrina, R., Kuswari, M., & Sitoayu, L. (2025). Association between body composition and fasting blood glucose in patients with type 2 diabetes. AcTion: Aceh Nutrition Journal, 10(2), 485. https://doi.org/10.30867/action.v10i2.2555
Hossain, S., Chowdhury, A. I., Sarwer, Md. N., Akter, F., & Mukta, N. A. (2025). Association Between Blood Glucose and Body Mass Index With Dietary Diversity and Physical Activity: A Cross‐Sectional Study on Marma Tribes of Bandarban in Bangladesh. Health Science Reports, 8(7). https://doi.org/10.1002/hsr2.71113
Joshi, S., Kesavadev, J., K M, P. K., Saboo, B., Mehta, A., Bhattacharyya, A., … Samajdar, S. S. (2025). Postprandial Glucose: A Variable in Continuum. Clinical Medicine Insights: Endocrinology and Diabetes, 18. https://doi.org/10.1177/11795514251370507
Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of Type 2 Diabetes – Global Burden of Disease and Forecasted Trends. Journal of Epidemiology and Global Health, 10(1), 107. https://doi.org/10.2991/jegh.k.191028.001
Khuon, D., Rupasinghe, D., Saphonn, V., Kwong, T., Widhani, A., Chaiwarith, R., … Jiamsakul, A. (2024). BMI as a predictor of high fasting blood glucose among people living with HIV in the Asia-Pacific region. HIV Medicine, 24(2), 139–152. https://doi.org/10.1111/hiv.13351
Klein, S., Gastaldelli, A., Yki-Järvinen, H., & Scherer, P. E. (2022). Why does obesity cause diabetes? Cell Metabolism, 34(1), 11–20. https://doi.org/10.1016/j.cmet.2021.12.012
Młynarska, E., Bojdo, K., Bulicz, A., Frankenstein, H., Gąsior, M., Kustosik, N., … Franczyk, B. (2025). Obesity as a Multifactorial Chronic Disease: Molecular Mechanisms, Systemic Impact, and Emerging Digital Interventions. Current Issues in Molecular Biology, 47(10), 787. https://doi.org/10.3390/cimb47100787
Mohamed-Mohamed, H., Pardo-Moreno, T., Jimenez-Palomares, M., Perez-Ardanaz, B., Sánchez-Lara, E. M., Vazquez-Lara, M. D., … Ramos-Rodríguez, J. J. (2025). Impaired Glucose Tolerance and Altered Body Composition in Obese Young Adults: A Case–Control Study. Biomedicines, 13(7), 1569. https://doi.org/10.3390/biomedicines13071569
Muharram, F. R., Tjandra, S., Madani, N. J., Rokx, C., & Abdullah, A. (2025). Trends in the double burden of malnutrition among Indonesian adults, 2007 to 2023. Scientific Reports, 15(1), 34883. https://doi.org/10.1038/s41598-025-17348-9
Pan, X., Wang, L., & Pan, A. (2020). Epidemiology and determinants of obesity in China. The Lancet Diabetes & Endocrinology, 8(7), 616–627.
Par, F., Sarvi, F., Khodadost, M., Pezeshki, B., Doosti, H., & Tabrizi, R. (2025). A Nonlinear Association of Body Mass Index and Fasting Blood Glucose: A Dose‐Response Analysis From Fasa Adults Cohort Study (FACS). Health Science Reports, 8(3). https://doi.org/10.1002/hsr2.70560
Reik, A., Schauberger, G., Wiechert, M., Hauner, H., & Holzapfel, C. (2024). Association Between the Postprandial Response to an Oral Glucose Tolerance Test and Anthropometric Changes After an 8‐Week Low‐Calorie Formula Diet – Results From the Lifestyle Intervention (LION) Study. Molecular Nutrition & Food Research, 68(12). https://doi.org/10.1002/mnfr.202400106
Shibib, L., Al-Qaisi, M., Guess, N., Miras, A., Greenwald, S., Pelling, M., & Ahmed, A. (2024). Manipulation of Post-Prandial Hyperglycaemia in Type 2 Diabetes: An Update for Practitioners. Diabetes, Metabolic Syndrome and Obesity, Volume 17, 3111–3130. https://doi.org/10.2147/DMSO.S458894
Stefan, N. (2020). Causes, consequences, and treatment of metabolically unhealthy fat distribution. The Lancet Diabetes & Endocrinology, 8(7), 616–627. https://doi.org/10.1016/S2213-8587(20)30110-8
Wang, Y., Zhang, X., Li, Y., Gui, J., Mei, Y., Yang, X., … Zhang, L. (2024). Obesity- and lipid-related indices as a predictor of type 2 diabetes in a national cohort study. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1331739
Zhang, X., Yue, Y., Liu, S., Cong, X., Wang, W., & Li, J. (2023). Relationship between BMI and risk of impaired glucose tolerance and impaired fasting glucose in Chinese adults: a prospective study. BMC Public Health, 23(1), 14. https://doi.org/10.1186/s12889-022-14912-0
Zhao, X., Yao, T., Song, B., Fan, H., Liu, T., Gao, G., … Liu, C. (2024). The combination of body mass index and fasting plasma glucose is associated with type 2 diabetes mellitus in Japan: a secondary retrospective analysis. Frontiers in Endocrinology, 15. https://doi.org/10.3389/fendo.2024.1355180
Authors
Copyright (c) 2026 Valiant Zahirul Azmi, Dinnisa Haura Zhafira Hidayat, Adnan Ahmad, Citra Ayu Maharani Permatasuri, Lyriestrata Anisa, Alya Zahra Sonia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Qanun Medika by FK UM Surabaya is liscence under Lisensi Creative Commons Atribusi 4.0 Internasional.