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"Hipoglikemia adalah komplikasi akut diabetes melitus yang seringkali terjadi secara berulang yang ditandai dengan gula darah kurang dari 70 mg/dl. Kondisi tersebut akan berdampak secara psikologis yaitu ketakutan akan serangan ulang yang menciptakan perasaan traumatis pada penyandang diabetes melitus. Penelitian ini bertujuan untuk memperoleh pemahaman yang mendalam tentang pengalaman penyandang diabetes melitus yang pernah mengalami episode hipoglikemi di Persadia Kota Depok. Penelitian ini merupakan penelitian kualitatif deskriptif dengan pendekatan fenomenologi terhadap enam partisipan. Hasil penelitian didapatkan enam tema utama yaitu penurunan fungsi fisik sementara sebagai respon hipoglikemia, perasaan traumatis ketika mengalami hipoglikemia, pemahaman partisipan terhadap penyebab hipoglikemia, kesadaran untuk pencegahan hipoglikemia, keyakinan internal menjadi sumber koping utama dalam menghadapi hipoglikemia, kebutuhan pelayanan keperawatan. Hasil penelitian ini diharapkan dapat menjadi masukan dalam meningkatkan edukasi pada pasien yang mengalami hipoglikemia.

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Hypoglycemia is an acute complication of diabetes mellitus which frequently occur repeatedly marked by blood glucose less than 70 mg/dl. The condition will affect the psychological fear of repeated attacks that create a traumatic feelings in people with diabetes mellitus. This study aims is to gain an in depth understanding of experiences of persons with diabetes mellitus who had experienced of hypoglycemia episodes in Persadia Depok. Qualitative descriptive phenomenology approach was applied to 6 participants. The findings revealed 6 themes: decline in physical function while in response to hypoglycemia, traumatic feelings when experiencing hypoglycemia, participants understanding that caused of hypoglycemia, awareness of hypoglycemia prevention, internal beliefs became the main source of coping to faced of hypoglycemia and nursing care needs. The results of this study suggest a need of improvement in nursing education for patients with hypoglycemia."

"Hipoglikemia merupakan salah satu komplikasi diabetes melitus tipe 2. Anggota keluarga biasanya menjadi orang pertama yang mengetahui kejadian hipoglikemia pada klien. Penelitian ini bertujuan untuk mengetahui pengalaman keluarga klien diabetes melitus tipe 2 menghadapi hipoglikemia. Penelitian ini adalah penelitian kualitatif dengan desain fenomenologi deskriptif. Wawancara mendalam terhadap 11 partisipan mengidentifikasi empat tema yaitu: keluarga mempersepsikan hipoglikemia adalah sesuatu yang biasa, keluarga mampu mengenali gejala awal hipoglikemia, keluarga memberikan dukungan positif bagi klien dalam menghadapi hipoglikemia, dan hipoglikemia memiliki dampak negatif bagi keluarga. Hasil penelitian menunjukkan peran penting perawat untuk memberikan edukasi yang komprehensif mengenai hipoglikemia terhadap keluarga klien diabetes melitus tipe 2.

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Hypoglycemia is one of diabetes complications. Hypoglycemia can increase risk of cardiovascular diseases or even lead to death. Family members are usually the first people to recognize hypoglycemia. Hypoglycemia is an unpredictable condition which make they should aware with it. A qualitative study using a phenomenological description design was utilized. In depth interviews were conducted with 11 family members of the person with type 2 diabetes. Family rsquo s experiences dealing with hypoglycemia were described into four main themes family perceive hypoglycemia is a common thing, family is capable in recognizing early symptoms of hypoglycemia, family provide positive support to person dealing with hypoglycemia, and hypoglycemia affects the family negatively. This study denotes a major role of nurse to provide a comprehensive education about hypoglycemia to the family of the person type 2 diabetes."

"Latar Belakang. Hipoglikemia berat di pasien diabetes melitus tipe 2 (DMT2) saat ini sering dihubungkan dengan peningkatan mortalitas, kejadian kardiovaskular, dan penurunan fungsi kognitif.Tujuan. Tujuan penelitian ini adalah untuk membuat model prediksi untuk hipoglikemia berat pada pasien DMT2 rawat jalan di pusat kesehatan nasional tersier.Metode. Penelitian ini merupakan penelitian kohort retrospektif yang dilaksanakan di Poliklinik Metabolik-Endokrin Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo. Semua pasien DMT2 dewasa (berusia ≥18 tahun) yang sudah mejalani kontrol selama setidaknya 1 tahun diikutsertakan sebagai subjek penelitian. Data mengenai kejadian hipoglikemia berat dalam 1 tahun terakhir dikumpulkan dari anamnesis dengan subjek penelitian, sedangkan variabel bebas (meliputi usia, tingkat pendidikan, pemahaman mengenai gejala hipoglikemia, HbA1C, lama DMT2, penyakit ginjal kronik, penyakit hati kronik, riwayat hipoglikemia, penerapan pemantauan gula darah mandiri, penggunaan sulfonilurea, dan penggunaan insulin) diambil dari data rekam medis pasien 1 tahun sebelum pengumpulan data.Hasil. Penelitian ini berhasil mengumpulkan 291 subjek, dengan insidensi kejadian hipoglikemia berat 25,4%. PGK std. V (adjusted-OR 9,84 [IK95% 1,68-57,62]; p=0,011); riwayat hipoglikemia berat (adjusted-OR 5,60 [IK95% 2,94-10,69]; p<0,001); dan penggunaan insulin (adjusted-OR OR 2,60 [IK95% 1,31-5,15]; p=0,006) memiliki asosiasi yang bermakna secara statistik terhadap peningkatan risiko hipoglikemia berat. Model prediksi yang dibuat berdasar variabel tersebut mampu menunjukkan validasi yang baik dengan AUROC sebesar 0,742 (IK95% 0,67-0,81); p<0,001.Kesimpulan. Sebagian besar subjek DMT2 mengalami setidaknya 1 episode hipoglikemia berat. Riwayat hipoglikemia berat, penggunaan insulin, dan PGK std. V memiliki asosiasi yang bermakna terhadap risiko hipoglikemia berat.

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Background. Severe hypoglycemia in type 2 diabetes mellitus (T2DM) patients is often associated with inreased mortality and cardiovascular events, as well as decreased cognitive function.

Aim. The objective of this study is to develop a prediction model for severe hypoglycemia in T2DM patients in a tertiary care hospital in Indonesia.

Method. This study is a retrospective cohort study in endocrinology out-patient clinic in Dr. Cipto Mangunkusumo National General Hospital. All subjects ≥18 years of age who had been visiting the clinic for at least a year were included. Subjects were interviewed whether they had any events of severe hypoglycemia within the last 1 year; while independent variables (including age, education level, patients’ understanding of hypoglycemia symptoms, HbA1C level, duration of T2DM, chronic kidney disease, chronic liver disease, history of severe hypoglycemia, self-monitoring blood glucose application, sulfonylurea use, and insulin use) were taken from medical records 1 year prior from data collection.

Result. We collected 291 subjects, among whom incidence of severe hypoglycemia was 25.4%. Stg. V CKD (adjusted-OR 9.84 [95%CI 1.68 to 57.62]; p=0.011); history of severe hypoglycemia (adjusted-OR 5.60 [95%CI 2.94 to 10.69]; p<0.001); and insulin use (adjusted-OR 2.60 [95%CI 1.31 to 5.15]; p=0.006) were associated with increased risk of severe hypoglycemia. Using those variables, our model yielded an AUROC of 0.742 (95%CI 0.67 to 0.81); p<0.001.

Conclusion. High proportion of T2DM subjects suffered at least one episode of severe hypoglycemia. History of severe hypoglycemia, insulin use, and stg. V CKD were associated with the risk of severe hypoglycemia. "

"Salah satu kelompok penyakit metabolik yang terjadi karena kelainan sekresi insulin, kerja insulin atau keduanya adalah Diabetes Melitus (DM) yang ditandai dengan hiperglikemia. Kondisi hiperglikemia yang berkepanjangan menyebabkan DM menjadi salah satu masalah kesehatan yang besar di seluruh dunia karena komplikasinya dapat muncul secara akut maupun kronik. Perawat berperan penting dalam menurunkan angka morbiditas dan mortalitas melalui Diabetes Self- Management Education (DSME) dan Diabetes Self-Management Support (DSMS) untuk mencegah komplikasi dan membantu meningkatkan perubahan gaya hidup yang penting bagi individu. Penerapan DSME dan DSMS dapat dilakukan perawat dengan mengaplikasikan teori Self Care Dorothea Orem pada proses keperawatan. Penerapan teori ini berfokus pada kemampuan individu dalam melakukan tindakan keperawatan mandiri, mengenali dan mengatur kebutuhan perawatannya. Penerapan evidence based practice sesuai program DSME dan DSMS dalam upaya meningkatkan self care pasien DM adalah melalui penggunaan buku harian Pemantauan Gula Darah Mandiri (PGDM). Proyek inovasi latihan kekuatan otot dan keseimbangan dilakukan pada pasien DM lansia untuk mencegah jatuh, meningkatkan kekuatan otot dan keseimbangan berjalan.

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One of metabolic diseases that occurs due to abnormalities in insulin secretion, insulin action or both is diabetes mellitus (DM). It is characterized by hyperglycemia. Prolonged of hyperglycemia causes various complication become major health problem worldwide. Nurses play an important role in reducing morbidity and mortality through the Diabetes Self-Management Education (DSME) and Diabetes Self-Management Support (DSMS) to prevent the complications and improve lifestyle changes. Framework of DSME and DSMS were applied using Dorothea Orem's Self Care. The application of this theory focuses on the individual's ability to independently perform nursing actions, identify and manage the treatment needs. Evidence-based practice related to DSME and DSMS programs by using Self Monitoring Blood Glucose Diary (SMBG). The inovation project was muscle strengths and balances exercises in elderly diabetic patients with neuropathy, in other to prevent falls and improve the muscle strengths and balances."

"Hipoglikemia merupakan kondisi saat kadar glukosa darah di bawah batas normal. Salah satu penyebab umum hipoglikemia adalah penggunaan obat-obat tertentu. Hipoglikemia akibat dari konsumsi obat dalam dosis lazim disebut sebagai Reaksi Obat yang Tidak Dikehendaki (ROTD). Studi cross-sectional ini bertujuan untuk mengetahui prevalensi dan menganalisis obat-obat yang berpotensi menyebabkan ROTD berupa hipoglikemia di RSUD Pasar Minggu periode Agustus 2019 hingga April 2020. ROTD hipoglikemia dideteksi dengan metode trigger tools yakni penggunaan dekstrosa 40%. Analisis kausalitas ROTD dan obat terkait dilakukan menggunakan algoritma Naranjo. Penelitian ini menemukan 180 (0,06%) dari 291.584 pasien mengalami hipoglikemia. Namun, hanya 102 pasien yang memiliki riwayat pengobatan diikutsertakan dalam penelitian. Total kasus hipoglikemia berjumlah 113 dengan prevalensi hipoglikemia akibat dari ROTD mencapai 78,8% (89 kasus). Kejadian ini umum dialami pasien diabetes melitus tipe 2 (97,8%) dan pasien yang mengalami kekurangan asupan makan (89,7%). Sebanyak 57 (50,4%) kasus hipoglikemia termasuk kejadian mungkin ROTD (probable) dan 32 (28,3%) kasus merupakan kejadian cukup mungkin ROTD (possible). Obat yang berpotensi menyebabkan ROTD hipoglikemia adalah glimepirid (34,8%), glikuidon (23,9%), insulin (15,2%), glibenklamid (9,8%), metformin (9,8%), gliklazid (1,1%), gabapentin (1,1%), siprofloksasin (1,1%), propranolol (1,1%), klopidogrel (1,1%), dan nifedipin (1,1%). Penelitian ini menyimpulkan bahwa ROTD merupakan penyebab utama dari kasus hipoglikemia di RSUD Pasar Minggu dengan faktor risiko utama yaitu riwayat penyakit diabetes dan asupan makan yang kurang.

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Hypoglycemia is a condition when blood glucose levels are below normal. One of the common causes of hypoglycemia is the use of certain drugs. Hypoglycemia that results from drug consumption in normal doses is known as Adverse Drug Reaction (ADR). The purpose of this cross-sectional study was to determine the prevalence and analyze potential drugs that might cause hypoglycemia due to ADR at Pasar Minggu District Hospital from August 2019 until April 2020. Hypoglycemia was detected using a trigger tools method that is dextrose 40% prescription. The causality assessment was carried out using Naranjo algorithm. Based on this research, hypoglycemia was found in 180 (0.06%) out of 291,584 patients. However, there were only 102 patients eligible for this study with 113 total cases of hypoglycemia. The prevalence of hypoglycemia due to ADR was found to be 78.8% (89 cases). These events mostly happened in patients with type 2 diabetes mellitus (97.8%) and low food intake (89.7%). The Naranjo algorithm showed 57 (50.4%) cases are probable and 32 (28.3%) cases are possible. The potential drugs cause hypoglycemia due to ADR were glimepiride (34.8%), gliquidone (23.9%), insulin (15.2%), glibenclamide (9.8%), metformin (9.8%), gliclazide (1.1%), gabapentin (1.1%), ciprofloxacin (1.1%), propranolol (1.1%), clopidogrel (1.1%), and nifedipine (1.1%). Based on this study, it can be concluded that ADR is the main cause of hypoglycemia cases in Pasar Minggu District Hospital and the main risk factors are history of diabetes and low food intake."

"ABSTRAKHipoglikemia bisa terjadi selama pasien dirawat di rumah sakit yang disebabkan oleh iatrogenic. Tujuan penelitian ini untuk mengeksplor pengalaman perawat dalam pemantauan, penanganan dan penggunaan protokol hipoglikemia di rumah sakit. Penelitian ini dilakukan dengan wawancara mendalam pada 10 perawat tentang pengalaman mereka dalam pemantauan, penanganan, dan penggunaan protokol hipoglikemi, sehingga memperoleh enam tema yakni: perawat memahami hipoglikemia berdasarkan gejala fisik dan nilai gula darah; kecemasan perawat menghadapi hipoglikemi; ketidakberadaan dokter dan hambatan komunikasi dalam penanganan hipoglikemi; perawat melakukan pemeriksaan gula darah dan keluhan pasien untuk mengkaji hipoglikemia; memutuskan untuk melakukan tindakan medis secara mandiri sesuai kebiasaan; dan merasa tidak familiar dengan keberadaan protocol hipoglikemia. Kesimpulan dari penelitian menunjukkan bahwa dalam penanganan hipoglikemia perawat masih mengalami kecemasan dan cenderung memberikan intervensi sesuai dengan kebiasaan.

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ABSTRACTPatients may experience hypoglycemia during hospitalization which is caused by Iatrogenic. This study aimed to describe experience of nurses in monitoring, treating and using guideline of Hypoglycemia in patients with diabetes mellitus. An indepth interview was conducted that involved 10 nurses. There were six themes identified through this method, they were nurses anxiety facing hypoglycemia the absence of physician and communication barriers in the treatment of hypoglycemia nurses undertaking blood glucose check and complains of patients in monitoring hypoglycemia deciding to follow medical treatment independently based on routine and found unfamiliar with the existence of protocol. The conclusion indicates that nurses are still struggling with anxiety and tend to apply their routine in dealing with hypoglycemia. "

"Tesis ini membahas bagaimana klien Diabetes Melitus memberikan makna kehidupan dalam kondisi sakitnya. Tujuan dalam penelitian ini menguraikan persepsi, respon psikososial, kebutuhan penatalaksanaan, harapan dan makna kehidupan klien. Penelitian ini adalah penelitian kualitatif dengan desain deskriptif. Hasil penelitian menemukan tujuh tema besar yang sesuai dengan tujuan penelitian dan satu tema tambahan yaitu beban yang dihadapi klien. Kesimpulannya makna kehidupan klien didapatkan dalam kondisi penderitaan dan pendalaman nilai spiritual. Penelitian ini menyarankan penggunaan model Adaptasi Roy dalam pengembangan teori keperawatan khususnya masalah psikososial; tersusunnya format pengkajian psikososial sebagai panduan mengidentifikasi masalah psikososial di keluarga, rumah sakit maupun masyarakat.

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This thesis discussed how the client Diabetes Mellitus give life meaning in the pain condition. The purpose of this study described the perceptions, psychosocial responses, needs management, client expectations and the meaning of life. This study is a descriptive qualitative research design. The study found seven broad themes consistent with the purpose of research and one additional theme is the burden faced by the client.

In conclusion the meaning of the life of the client obtained under conditions of suffering and deepening of spiritual values. This study suggests the use of Roy's adaptation model in nursing theory development in particular psychosocial problems; compilation format psychosocial assessment as a guide to identify psychosocial problems in families, hospitals and the community."

"[Peningkatan jumlah lansia berkontribusi pada peningkatan penyakit degeneratifkronis seperti diabetes melitus yang memerlukan penatalaksanaan manajemendiri. Penelitian bertujuan untuk mengetahui arti dan makna pengalamanmanajemen diri lansia dengan diabetes melitus di Kota Depok. Penelitianmenggunakan metode kualitatif fenomenologi deskriptif dengan wawancaramendalam pada sembilan partisipan, Hasil wawancara dianalisis menggunakanmetode Colaizzi. Penelitian mengidentifikasi 11 tema yaitu mengenali gejalaawal, pengetahuan tentang diabetes melitus, upaya terhadap respon padaperubahan kadar gula darah, perawatan diri, faktor pendukung perawatan diri,faktor penghambat perawatan diri, dampak diabetes melitus, upaya mengeloladampak diabetes melitus, perubahan aktivitas, dukungan keluarga yang dirasakan,dan kualitas hidup lebih baik.

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ABSTRACTIncreasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.;Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.;Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.;Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.;Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life., Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi’s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.]"