Management of a Patient with Type 2 Diabetes Mellitus and Uncontrolled Hypertensive Urgency Using a Family Doctor Approach in a First-Level Health Facility in Indonesia: A Case Report

Abstract : Noncommunicable diseases (NCDs) result from genetic, environmental, and behavioral factors. These diseases include cardiovascular conditions and diabetes. According to the Lampung Provincial Health Office in 2021, the prevalence of type 2 diabetes mellitus increased from 1.37% to 3.76% (equivalent to 88,518 cases), and the prevalence of hypertension rose from 15.10% to 17.35%. NCDs are chronic and affect quality of life and productivity, necessitating comprehensive management. The goal of a family medicine approach in treating patients with type 2 diabetes mellitus and hypertension is to identify clinical, psychological, and psychosocial factors. Primary data is collected through anamnesis, physical examination, and home visits to evaluate the physical environment. Patient Mrs. A, a 55-year-old farmer, reported complaints of headaches and frequent nighttime urination. She has a history of hypertension since 2022 and type 2 diabetes mellitus since 2023. Management was carried out holistically using a patient-centered, family-oriented, and community-based approach grounded in Evidence-Based Medicine. Interventions included both pharmacological and non-pharmacological via family conferences. Evaluation of the interventions showed improved knowledge among the patient and her family, a reduction in the patient’s blood pressure and blood glucose levels, and behavioral changes in the patient to consume meals aligned with recommended dietary allowances.