Prevalensi Diabetes Melitus (DM) Tipe 2 yang terus meningkat menjadikannya sebagai salah satu tantangan utama kesehatan masyarakat di Indonesia. Keragaman kondisi sosial, ekonomi, dan kesehatan antar wilayah berpotensi menimbulkan variasi kejadian DM Tipe 2 yang dipengaruhi oleh determinan individu maupun kontekstual. Penelitian ini bertujuan menganalisis hubungan determinan individu dan kontekstual terhadap kejadian DM Tipe 2 di Indonesia menggunakan pendekatan multilevel. Penelitian menggunakan desain cross-sectional dengan data Survei Kesehatan Indonesia dan Badan Pusat Statistik tahun 2023. Sampel penelitian terdiri dari 15.303 responden dari 249 kabupaten/kota. Analisis dilakukan menggunakan regresi logistik multilevel dengan kabupaten/kota sebagai level kontekstual. Hasil penelitian menunjukkan proporsi DM Tipe 2 sebesar 15,05% serta adanya variasi geografis antar kabupaten/kota, dengan wilayah risiko tinggi lebih banyak ditemukan di Indonesia bagian barat dan tengah. Determinan individu yang berhubungan dengan peningkatan odds kejadian DM Tipe 2 meliputi pertambahan usia (OR=1,01;95%CI:1,01–1,02), aktivitas fisik rendah (OR=1,34;95%CI:1,11–1,65), obesitas sentral (OR=1,17;95%CI:1,01–1,36), dan riwayat hipertensi (OR=1,28;95%CI:1,11–1,48). Sementara itu, determinan kontekstual tidak menunjukkan hubungan yang bermakna secara statistik setelah mengontrol determinan individu. Penelitian ini menyimpulkan bahwa varaisi kejadian DM Tipe 2 dalam populasi penelitian lebih banyak dijelaskan oleh determinan individu dibandingkan determinan kontekstual. Oleh karena itu, penguatan deteksi dini dan pengendalian faktor risiko metabolik melalui skrining obesitas sentral, hipertensi, dan gangguan glukosa darah perlu dioptimalkan untuk menurunkan beban DM Tipe 2 di Indonesia.

The increasing prevalence of Type 2 Diabetes Mellitus (T2DM) continues to rise and has  become a major public health challenge in Indonesia. Variations in social, economic, and health conditions across regions may contribute to geographic disparities in T2DM occurrence through both individual- and contextual-level determinant. This study aimed to examine the association between individual and contextual determinants of T2DM in Indonesia using a multilevel approach. A cross-sectional study was conducted using data from the 2023 Indonesia Health Survey and Statistics Indonesia. The study included 15,303 respondents from 249 districts. Data were analyzed using multilevel logistic regression with districts as the contextual level. The findings showed that the proportion of T2DM was 15.05%, with geographic variation observed across districts. Areas with a higher risk of T2DM were predominantly located in western and central Indonesia. Individual determinants associated with higher odds of T2DM included increasing age (OR=1.01;95%CI:1.01–1.02), low physical activity (OR=1.34;95%CI:1.11–1.65), central obesity (OR=1.17;95%CI:1.01–1.36), and a history of hypertension (OR=1.28;95%CI:1.11–1.48). In contrast, contextual determinants were not significantly associated with T2DM after adjustment for individual determinants. This study concludes that variation in T2DM occurrence was explained more by individual determinants than by the contextual determinants examined. Therefore, strengthening early detection and control of metabolic risk factors through screening for central obesity, hypertension, and abnormal blood glucose levels should be prioritized to reduce the burden of T2DM in Indonesia.