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"ABSTRAK Latar belakang : Prevalens diabetes melitus (DM) terus meningkat di negaraberkembang yang merupakan negara endemis tuberkulosis (TB). Diabetes melitusmeningkatkan risiko infeksi, hambatan konversi sputum dan kegagalanpengobatan TB. Penelitian ini bertujuan menganalisis faktor-faktor yangmempengaruhi konversi sputum Basil Tahan Asam (BTA) mikroskopik padaakhir bulan kedua pengobatan TB pada pasien TB paru kasus baru dengan DM.Metode : Penelitian kohort retrospektif ini dilaksanakan di RSUP Perahabatanterhadap pasien-pasien TB paru BTA positif kasus baru dengan DM yang berobatpada periode Juli 2012 sampai Juni 2015. Hubungan faktor risiko dengan konversisputum BTA mikroskopik dianalisis dengan analisis bivariat dan multivariat.Hasil penelitian: Proporsi kegagalan konversi sputum BTA mikroskopik padapasien TB paru kasus baru dengan DM adalah 43,04%, sedangkan pada pasientanpa DM 22,75% (p<0,001, KI95% 0,11-0,30) dan risiko relatif (RR) kegagalankonversi 1,89 kali lebih tinggi pada kelompok DM. Faktor risiko yang meningkatbermakna pada pasien gagal konversi adalah kadar kepositifan sputum BTAsebelum terapi (p=0,021), HbA1c (p=0,014), GDP (p=0,047), GD 2jam PP(p=0,030) dan kavitas pada foto toraks (p=0,033) sedangkan albumin serum lebihrendah bermakna (p=0,013). Analisis multivariat mendapatkan faktor risikoterkuat untuk kegagalan konversi sputum adalah kadar albumin serum yangrendah (p=0,046, aOR 0,464, KI95% 0,218-0,986), tingkat kepositifan sputumBTA mikroskopik sebelum terapi yang tinggi (p=0,009, aOR 2,313, KI95%1,230-4,349) dan kadar HbA1c yang tinggi (p=0,018, aOR 1,298, KI 95% 1,047-1,610).Kesimpulan: Tingkat kepositifan sputum BTA sebelum terapi yang tinggi, statuskontrol DM yang tidak baik, kavitas pada foto toraks dan kadar albumin serumyang rendah meningkatkan risiko kegagalan konversi sputum BTA pada pasienTB dengan DM.ABSTRACT Background: The link of DM and TB is more prominent in developing countrieswhere TB is endemic and the burden of DM is increasing. Diabetes mellitusincreases the risk of TB infection, delayed sputum smear conversion and TBtreatment failure. This study would like to evaluate factors associated withdelayed sputum smear conversion in the end of two months of TB treatment innew cases TB with DM patients in Persahabatan Hospital.Methods: This retrospective cohort study was conducted in PersahabatanHospital, included all new cases TB with DM patients in the period from July2012 - June 2015. All the risk factors performed bivariate and multivariateanalysis in association with sputum smear conversion in the end of two months ofTB treatment.Results: The proportion of sputum smear conversion failure is higher in TB-DMthan non-DM patients (43,04 vs 22,75%) (p<0,001, CI95% 0,11-0,30) with therelative risk (RR) for sputum conversion failure 1,89 higher in TB-DM patients.Bivariate analysis resulted in significant higher of initial sputum smear level(p=0,021), HbA1c (p=0,014), FBG (p=0,047), post prandial Blood Glucose(p=0,030) and cavity at chest x-ray (p=0,033) and significant lower of serumalbumin (p=0,013) in non-conversion patients. Multivariate analysis resulted inrisk factors strongly associated with sputum conversion failure are low albuminlevel (p=0,046, CI95% 0,218-0,986), high initial sputum smear level (p=0,009,CI95% 1,230-4,349) and high HbA1c level (p=0,018, CI 95% 1,047-1,610).Conclusions: Higher initial sputum smear level, uncontrolled diabetic status,cavity at chest x-ray and lower albumin level associated with sputum smearconversion failure in TB-DM patients.;Background: The link of DM and TB is more prominent in developing countrieswhere TB is endemic and the burden of DM is increasing. Diabetes mellitusincreases the risk of TB infection, delayed sputum smear conversion and TBtreatment failure. This study would like to evaluate factors associated withdelayed sputum smear conversion in the end of two months of TB treatment innew cases TB with DM patients in Persahabatan Hospital.Methods: This retrospective cohort study was conducted in PersahabatanHospital, included all new cases TB with DM patients in the period from July2012 - June 2015. All the risk factors performed bivariate and multivariateanalysis in association with sputum smear conversion in the end of two months ofTB treatment.Results: The proportion of sputum smear conversion failure is higher in TB-DMthan non-DM patients (43,04 vs 22,75%) (p<0,001, CI95% 0,11-0,30) with therelative risk (RR) for sputum conversion failure 1,89 higher in TB-DM patients.Bivariate analysis resulted in significant higher of initial sputum smear level(p=0,021), HbA1c (p=0,014), FBG (p=0,047), post prandial Blood Glucose(p=0,030) and cavity at chest x-ray (p=0,033) and significant lower of serumalbumin (p=0,013) in non-conversion patients. Multivariate analysis resulted inrisk factors strongly associated with sputum conversion failure are low albuminlevel (p=0,046, CI95% 0,218-0,986), high initial sputum smear level (p=0,009,CI95% 1,230-4,349) and high HbA1c level (p=0,018, CI 95% 1,047-1,610).Conclusions: Higher initial sputum smear level, uncontrolled diabetic status,cavity at chest x-ray and lower albumin level associated with sputum smearconversion failure in TB-DM patients.;Background: The link of DM and TB is more prominent in developing countrieswhere TB is endemic and the burden of DM is increasing. Diabetes mellitusincreases the risk of TB infection, delayed sputum smear conversion and TBtreatment failure. This study would like to evaluate factors associated withdelayed sputum smear conversion in the end of two months of TB treatment innew cases TB with DM patients in Persahabatan Hospital.Methods: This retrospective cohort study was conducted in PersahabatanHospital, included all new cases TB with DM patients in the period from July2012 - June 2015. All the risk factors performed bivariate and multivariateanalysis in association with sputum smear conversion in the end of two months ofTB treatment.Results: The proportion of sputum smear conversion failure is higher in TB-DMthan non-DM patients (43,04 vs 22,75%) (p<0,001, CI95% 0,11-0,30) with therelative risk (RR) for sputum conversion failure 1,89 higher in TB-DM patients.Bivariate analysis resulted in significant higher of initial sputum smear level(p=0,021), HbA1c (p=0,014), FBG (p=0,047), post prandial Blood Glucose(p=0,030) and cavity at chest x-ray (p=0,033) and significant lower of serumalbumin (p=0,013) in non-conversion patients. Multivariate analysis resulted inrisk factors strongly associated with sputum conversion failure are low albuminlevel (p=0,046, CI95% 0,218-0,986), high initial sputum smear level (p=0,009,CI95% 1,230-4,349) and high HbA1c level (p=0,018, CI 95% 1,047-1,610).Conclusions: Higher initial sputum smear level, uncontrolled diabetic status,cavity at chest x-ray and lower albumin level associated with sputum smearconversion failure in TB-DM patients.;Background: The link of DM and TB is more prominent in developing countrieswhere TB is endemic and the burden of DM is increasing. Diabetes mellitusincreases the risk of TB infection, delayed sputum smear conversion and TBtreatment failure. This study would like to evaluate factors associated withdelayed sputum smear conversion in the end of two months of TB treatment innew cases TB with DM patients in Persahabatan Hospital.Methods: This retrospective cohort study was conducted in PersahabatanHospital, included all new cases TB with DM patients in the period from July2012 - June 2015. All the risk factors performed bivariate and multivariateanalysis in association with sputum smear conversion in the end of two months ofTB treatment.Results: The proportion of sputum smear conversion failure is higher in TB-DMthan non-DM patients (43,04 vs 22,75%) (p<0,001, CI95% 0,11-0,30) with therelative risk (RR) for sputum conversion failure 1,89 higher in TB-DM patients.Bivariate analysis resulted in significant higher of initial sputum smear level(p=0,021), HbA1c (p=0,014), FBG (p=0,047), post prandial Blood Glucose(p=0,030) and cavity at chest x-ray (p=0,033) and significant lower of serumalbumin (p=0,013) in non-conversion patients. Multivariate analysis resulted inrisk factors strongly associated with sputum conversion failure are low albuminlevel (p=0,046, CI95% 0,218-0,986), high initial sputum smear level (p=0,009,CI95% 1,230-4,349) and high HbA1c level (p=0,018, CI 95% 1,047-1,610).Conclusions: Higher initial sputum smear level, uncontrolled diabetic status,cavity at chest x-ray and lower albumin level associated with sputum smearconversion failure in TB-DM patients."

"ABSTRAKIndonesia merupakan negara dengan beban ganda pada penyakit menular dan tidak menular. Tuberkulosis merupakan salah satu penyakit infeksi yang memiliki prevalensi cukup tinggi dengan Indonesia berperingkat dua dari seluruh negara dalam hal jumlah pasien tuberculosis, diabetes mellitus merupakan salah satu penyakit tidak menular yang memiliki prevalensi cukup tinggi juga. Konvergensi keduanya menimbulkan implikasi serius terhadap morbiditas dan mortalitas dari masing-masing penyakit tersebut, pada tuberkulosis dengan adanya komorbiditas ini meningkatkan resiko munculnya kavitas; kavitas inilah yang memiliki implikasi untuk memperlambat konversi. Dengan menggunakan metode cross-sectional serta analisisi chi-square pada pasien tuberkulosis dengan komorbiditas diabetes mellitus diteliti. Hasilnya tidak ditemukan adanya hubungan yang jelas pada subjek yang memiliki lesi kavitas dan tidak terutama pada konversi pasca 2 bulan pengobatan. Sehingga terdapat perbedaan antara pasien dengan komorbid diabetes mellitus dan tuberkulosis pada umumnya. Perlu dilakukan studi lebih lanjut dengan desain kohort prospektif dengan menghitung kontrol gula darah pada diabetesnya

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ABSTRACT

Indonesia is a country with a double burden of both transmissible and intransmissible disease. Tuberculosis is one of the transmissible disease that is quite prevalent in Indonesia and currently Indonesia is second in number of tuberculosis patient, meanwhile one of the leading chronic disease in number in Indonesia is diabetes Mellitus. The convergence of both disease could lead to serious implication in both the morbidity and mortality of each, from tuberculosis standpoint it could lead to delays in elongated duration in treatment; also cavitary lesion is shown to be more common in diabetes mellitus patient, and in general tuberculosis patient it can result in delay of conversion. So, using chi-square analysis the relationship between cavitary lesion and conversion in patient with tuberculosis comorbidity diabetes mellitus is studied. The result is inconclusive (p=0.906) with the realiton between cavitary lesion and conversion in tuberculosis patient with diabetes mellitus after 2 month intensive treatment. Thus this study should be reassessed by using prospective study design and with the control of glucose level to be respected"

"ABSTRAKLatar belakang : Jumlah pasien diabetes melitus (DM) di dunia diperkirakan meningkat menjadi 366 juta pada tahun 2030 dengan peningkatan tercepat pada negara berpendapatan rendah dan menengah. Orang dengan TB laten memiliki kemungkinan jangka panjang menjadi TB aktif. Hubungan antara TB dan DM sudah lama diketahui. Orang dengan DM memiliki risiko lebih tinggi berkembangnya TB laten menjadi TB aktif. Tujuan: mengetahui prevalens TB paru dan faktor yang mempengaruhi munculnya TB paru pada pasien DM tipe 2 di RSUP Persahabatan. Metode : Penelitian ini merupakan penelitian potong lintang di Poli Endokrin RSUP Persahabatan. Subjek penelitian yaitu pasien DM tipe 2 yang berobat di Poli Endokrin RSUP Persahabatan. Data yang diperoleh dilakukan analisis bivariat dan multivariat antara variabel bebas dan terikat Hasil: Jumlah subjek penelitian yaitu 174 subjek yang terdiri dari jenis kelamin laki-laki sebanyak 71(40,8%) dan perempuan 103(59,2%). Prevalens TB paru pada pasien DM tipe 2 yaitu 49 orang (28,2%) yang terdiri dari TB paru BTA (+) yaitu 37 subjek (21,3%) dan TB paru BTA (-) sebanyak 12 subjek (6,9%). Faktor yang memiliki hubungan dengan terjadinya TB paru pada pasien DM yaitu riwayat kontak erat dengan penderita TB (aOR 3,2; [95% IK 0,538-3,164 ]), IMT rendah (aOR 15,92 [95% IK 4,760-56,160), lama DM kurang dari 1 tahun (aOR 23,136 [95% IK 4,654-11]) dan kadar HbA1C >8 (aOR 17,475 [95% IK 3,428-89,094]). Kesimpulan: Prevalens TB paru pada pasien DM tipe 2 pada di RSUP Persahabatan adalah 28,2%. Terdapat hubungan bermakna secara statistik antara kontak dengan penderita TB, lama menderita DM dan kadar HbA1c dengan terjadinya TB paru pada pasien DM tipe 2.

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ABSTRACTBackground : Diabetes mellitus (DM) patients in the world is estimated rise to 366 million by 2030, with the fastest increase in low and middle income countries. Approximately one-third of the world population is estimated suffer from latent tuberculosis (TB). People with latent TB have a long -term possibility of becoming active TB. The relationship between TB and diabetes has been known. People with DM have a higher risk of developing latent TB into active TB . Objective : To determine the prevalence of TB and the factors that affect the develping TB in patients with DM at Persahabatan Hospital Methods: This study was a cross sectional study. Subject was 174 patients with DM type 2 taken by consecutive sampling. Datas were performed bivariate and multivariate analyzes between independent and dependent variables Results : 174 subjects consisted of male 40.8 % and women 59.2 %. Prevalence of pulmonary TB in patients with type 2 DM are 49 people ( 28.2 % ). Factors that correlation with the development of pulmonary TB in DM patients were patients with a history of close contact with TB patients (aOR 3,2; [95% CI 0,538-3,164 ]), underweight BMI (aOR 15,92 [95% CI 4,760-56,160), duration of diabetes of less than 1 year (aOR 23,136 [95% CI 4,654-11]) and HbA1c levels > 8 (aOR 17,475 [95% CI 3,428-89,094]). Conclusion : Prevalence TB in patients with type 2 DM at Persahabatan Hospital was 28.2 %. There were correlation between contact with TB patient, duration suffering from DM and HbA1c levels with development of pulmonary TB in patients with type 2 DM."

"Latar belakang: Hubungan antara TB dan DM sudah lama diketahui. Sistem imun rendah pada DM sehingga risiko berkembangnya TB laten menjadi TB aktif lebih tinggi. Penderita DM memiliki 2-3 kali risiko untuk menderita TB dibanding tanpa DM. Sekitar 10% kasus TB secara global berhubungan dengan DM. Prevalensi TB DM berdasarkan penelitian potong lintang oleh Wijayanto di Poli Endokrin RSUP Persahabatan pada pasien DM tipe 2 dari Oktober sampai Nopember 2013 adalah 28,2%. Pablos-Mendez dkk. menemukan bahwa hanya DM yang kurang terkontrol atau tidak terkontrol dikaitkan dengan peningkatan risiko TB. Tujuan: Tujuan utama dari penelitian ini adalah untuk menentukan sensitivitas dan spesifisitas mikroskop sputum BTA dan Xpert MTB / RIF untuk diagnosis TB pada pasien dengan DM. Metode: Penelitian ini adalah studi analitik deskriptif potong lintang pada pasien kelompok DM yang masih menjalani pengobatan di RS Persahabatan dari bulan Mei 2014 sampai jumlah sampel tercapai. Penelitian akan dilakukan di poli Paru dan Penyakit Dalam divisi Endokrin dan Metabolik RS Persahabatan. Pasien dengan keluhan tuberklosis baik yang belum pernah minum OAT atau dengan riwayat pengobatan sbelumnya dan didukung dari foto toraks yang menunjukan gambaran kecurigaan TB akan dilakukan pemeriksaan diagnostik mikrobiologis sputum BTA dan Xpert MTB/RIF. Hasil: Tujuh puluh subjek diskrining dan hanya 55 subjek memenuhi kriteria inklusi. Terdapat 32 laki-laki (58,2%) dan 23 perempuan (41,8%). Umur antara 25-72 tahun. Indeks massa tubuh kurang 11 (20%), normal 31(56,4%) dan lebih 13(23,6%). Gula darah antara 110-481 mg/dl. Lama menderita DM <5 tahun adalah 40 (72,7%), 5-10 tahun adalah 7(12,7 %), 10-15 tahun adalah 6(10,9%) dan >15 tahun adalah 2(3,6%). HbA1c terkontrol 11(20%) dan tidak terkontrol 44(80 %). Riwayat tidak pernah TB 41 (74,5%), TB sembuh 9(16,4%) dan gagal atau putus obat 5 (9,1%). Sputum BTA(+) 29 (52,7%) dan Xpert MTB/RIF(+) 36(65,5%). Tingkat HbA1c tidak terkontrol BTA(+)/Xpert MTB/RIF(+) 30 (54,5%). Uji diagnostik kedua alat memiliki sensitivitas 77,8 % dan spesifisitas 94,7%. Kesimpulan: Xpert MTB/RIF memiliki nilai kepositifan yang lebih tinggi daripada sputum BTA dalam mendeteksi M.Tb. Tidak ada perbedaan sensitivitas dan spesifisitas pemeriksaan mikroskopik sputum BTA dan Xpert MTB/RIF dalam upaya penegakan diagnosis TB pada pasien DM.

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Background: The relationship between Tuberculosis (TB) and Diabetes Mellitus (DM) has long been known. People with DM have 2-3 times the risk of developing TB. The prevalence of TB-DM based on cross sectional study by Wijayanto in Endocrine clinic at Persahabatan Hospital in DM type 2 patients in 2013 was 28.2%. Pablos-Mendez et al. found that only DM poorly controlled or uncontrolled associated with the increased risk of TB.

Purpose: The main purpose of this study is to determine the sensitivity and specificity of Acid Fast Bacilli (AFB) smear and Xpert MTB/RIF for diagnosis of TB in DM.

Methods: This study is a cross-sectional descriptive analytic study in patients with DM group who are still undergoing treatment at Persahabatan Hospital from May 2014. The study is conducted in Pulmonary clinic and Internal Medicine clinic. Patients with DM who have TB complaints that have not been taken either TB drug or with a history of treatment and supported from chest X-ray shows the suspicion of TB will require the microbiological diagnosis of AFB smear and Xpert MTB/RIF.

Result: Seventy subjects are screening and only 55 subjects meet the inclusion criteria. There are 32 males (58.2%) and 23 females (41.8%). There are ages between 25-72 years old. Their body mass index are less than 11(20%), normal 31(56.4%) and over 13(23.6%). The blood sugar is between 110-481 g/dl. The length of suffer DM <5 years are 40(72.7%), 5-10 years were 7(12.7%), 10-15 years were 6(10.9%) and >15 years are 2(3.6%). The controlled HbA1c is 11(20%) and uncontrolled is 44(80%). By history of TB which has never been suffered are 41(74.5%), treatment cured are 9(16.4%) and failure or withdrawal are 5(9.1%). Smear of AFB(+)ve are 29(52,7%) and Xpert MTB/RIF(+) are 36(65,5%). Uncontrolled HbA1c levels pulmonary TB with AFB smear/Xpert (+)ve are 30(54.5%). Sensitivity and specificity by using both are 77.8% and 94.7%.

Conclusion: The Xpert MTB/RIF has a higher value of positivity that detect M.Tb than AFB smear.There is no difference in the sensitivity and specificity of AFB smear and Xpert MTB/RIF for TB diagnosis in patients with DM."

"Indonesia merupakan negara berkembang dengan risiko DM dan tuberkulosis yang tinggi. Penelitian cross sectional ini bertujuan untuk mengetahui hubungan perilaku pengendalian DM dengan tuberkulosis. Pengambilan data dilakukan pada 291 pasien DM melalui kuesioner, pemeriksaan sputum BTA dan pemeriksaan radiologi didapatkan sebesar 35,7% pasien DM dengan tuberkulosis. Pada penelitian ini didapatkan bahwa proporsi TB positif pada pasien DM yang telah didiagnosis DM <2 tahun, tidak memiliki riwayat hipertensi, mengalami gejala DM mudah lapar, berat badan turun dan lemah badan, tidak menerima edukasi dan tidak menggunakan obat antidiabetes berhubungan dengan kejadian tuberkulosis.

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Indonesia is a development country with high risk of DM and tuberculosis. This research has design of cross sectional study to know association between behavior control of DM with prevalence of tuberculosis. It was applied to 291 patients with DM by using questionnaire instrument, BTA sputum, and radiology examination. 35.7% patients were diagnosed as TB. In this research, it can be concluded that proportion of positive TB in patients with DM who was diagnosed as DM <2 years, had no hypertension, had symptoms of DM (feeling very hungry, weight loss, fatigue), not accepted education and did not use oral antidiabetic have association with prevalence of tuberculosis in patients with DM."

"Diabetes melitus dan gizi kurang secara terpisah dikatakan dapat meningkatkan kejadian tuberkulosis. Studi potong lintang analitik ini bertujuan untuk mengetahui adanya hubungan antara gizi kurang dengan prevalensi tuberkulosis paru (TBP) pada pasien diabetes melitus tipe 2 (DMT2). Dari keseluruhan 462 pasien DMT2, 125 pasien (27.1%) di antaranya menderita TBP. Total pasien DMT2 yang menderita gizi kurang sebesar 125 pasien (27.1%). Sementara itu, dari keseluruhan pasien DMT2 yang menderita TBP, 78 pasien (62.4%) juga menderita gizi kurang. Hasil uji chi-square menunjukkan adanya hubungan antara gizi kurang dengan prevalensi TBP yang bermakna secara statistik (p <0.000).

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Diabetes mellitus and undernutrition separately were proved as risk factors of tuberculosis incidence. This analytical cross sectional study aimed to measure the prevalence of lung tuberculosis (TBP) among type 2 diabetes mellitus (DMT2) patients and its association with undernutrition. A total of 462 DMT2 patients were analyzed and the results showed that 125 patients (27.1%) had TBP and 125 patients (27.1%) were undernourished. Within DMT2 patients who had TBP, there were 78 undernourished patients (62.4%). We concluded there is a highly significant statistical association between undernutrition and prevalence of TBP among DMT2 patients (p <0.000)."

"Prevalensi terjadinya Tuberkulosis (TB) paru meningkat seiring dengan peningkatan prevalensi pasien (Diabetes Melitus) DM. TB dapat menyebabkan intolerasi glukosa dan memperburuk kontrol glikemik pada penderita DM. Tujuan penelitian ini adalah menganalisa dan melakukan evaluasi terhadap masalah terkait obat serta memberikan reomendasi penyelesaian masalah untuk meningkatkan kualitas hidup pasien dengan DM, TB, dan dispepsia. Pemantauan Terapi Obat (PTO) dilakukan dengan mengumpulkan data pasien dari rekam medis kemudian menganalisis berdasarkan metode Hepler and Strand serta merekomendasikan penyelesaian masalah yang ditemukan. Berdasarkan hasil analisis, ditemukan bahwa terdapat indikasi yang tidak diterapi yaitu DM dan anemia mikrositik tanpa terapi pengobatan farmakologi. Berdasarkan hasil analisis pemantauan terapi obat pada pasien, dapat disimpulkan bahwa pengobatan yang diterima hampir seluruhnya tepat indikasi. Selain itu, tidak terdapat interaksi obat dari obat-obat yang diresepkan. Namun, ditemukan indikasi yang tidak diterapi yaitu mual serta diabetes yang hanya diberikan terapi non farmakologi dengan diet, akan tetapi gula darah pasien sudah terkontrol, serta indikasi anemia mikrositik tanpa terapi.

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The prevalence of pulmonary tuberculosis (TB) increases along with the increasing prevalence of DM (Diabetes Mellitus) patients. TB can cause glucose intolerance and worsen glycemic control in DM patients. The purpose of this study was to analyse and evaluate drug-related problems and provide recommendations for problem solving to improve the patients quality of life with DM, TB, and dyspepsia. Drug Therapy Monitoring (PTO) is carried out by collecting patient data from medical records, analysing it based on the Hepler and Strand methods, and recommending solutions to the problems found. Based on the results of the analysis, it was found that there were indications without therapy DM and microcytic anaemia without pharmacological treatment. Based on the results of the monitoring analysis of drug therapy in patients, it can be concluded that the treatment received was almost entirely indicated. In addition, there were no drug interactions with the prescribed drugs. However, indications were found that were not treated, namely nausea and diabetes, which were only given non-pharmacological therapy with diet, but the patient's blood sugar was controlled, as well as indications of microcytic anaemia without therapy"

"Diabetes mellitus merupakan penyakit degeneratif dengan gejala hiperglikemia kronis akibat defisiensi maupun resistensi insulin. Kejadiannya terus meningkat terutama di perkotaan akibat perubahan gaya hidup seperti pola makan tinggi kalori rendah serat, aktivitas kurang, obesitas, merokok, konsumsi alkohol dan stress. Penulisan ini bertujuan untuk menganalisis asuhan keperawatan yang diberikan pada Tn.S (59th) dengan diabetes, khususnya perawatan kaki untuk mencegah ulkus kaki. Intervensi perawatan kaki yang dilakukan kepada Tn.S selama tujuh hari menunjukkan bahwa kaki bersih, lembab, tidak ada luka, terasa lebih nyaman dan kesemutan sudah berkurang. Dengan demikian, perawatan kaki perlu dilakukan pada pasien diabetes baik saat di rumah sakit maupun di rumah.

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Diabetes Mellitus is a degenerative disease whose symptom chronic hyperglycemia because of deficiency or insulin resistance. The incidence of diabetes rapidly increasing trough years, especially in urban areas due to changes in lifestyle like a high calorie low fiber in diet, less activity, obesity, smoking, alcohol consumption and stress. This paper was made to analyze nursing care that was given to Mr.S (59 yo) with diabetes, especially footcare to prevent foot ulcer. Footcare which given to Mr.S for seven days indicated that the feet clean, moist, no injuries, feels more comfortable and nomb has decreased. Thus, footcare must be done by diabetic patients both in the hospital or at home."

"Diabetes melitus (DM) dan tuberkulosis (TB) merupakan double burden disease yang prevalensinya cukup tinggi di Indonesia. Tingginya prevalensi TB dan DM tidak lepas dari peran tenaga kesehatan dalam mendiagnosis dan mendokumentasikan pasien yang berobat ke fasilitas pelayanan kesehatan. Penelitian berdesain cross-sectional ini melihat perbedaan persentase penemuan kasus DM pada pasien TB yang berobat ke dokter dan tenaga kesehatan nondokter. Dengan metode consecutive sampling, didapatkan 242 pasien TB yang terdaftar di 12 Puskesmas dan 2 klinik di Jakarta yang diminta kesediaannya melakukan pengisian kuesioner dan pemeriksaan GDP/TTGO.Hasil penelitian menunjukkan kejadian DM lebih tinggi pada pasien TB dibandingkan dengan populasi umum (27,5%, n=236). Persentase penemuan kasus DM pada pasien TB yang berobat ke dokter lebih tinggi dibandingkan yang berobat ke tenaga kesehatan nondokter namun tidak berbeda bermakna (28% vs 19%, p=0,361). Pembandingan persentase penemuan kasus juga dilakukan menurut gejala DM: polifagi, polidipsi, poliuri, berat badan turun, lemah badan, kesemutan, dan penglihatan memburam. Dari seluruh gejala, persentase penemuan kasus DM pasien yang berobat ke dokter masih lebih tinggi dibandingkan yang berobat ke tenaga kesehatan nondokter. Berdasarkan hasil penelitian, diharapkan tenaga kesehatan meningkatkan kewaspadaan mengenai gejala DM yang mungkin ada pada pasien TB sebagai bentuk deteksi dini guna mengantisipasi akibat yang tidak diinginkan.

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Diabetes mellitus (DM) and tuberculosis (TB) are double burden diseases whose prevalence is still high in Indonesia. The high prevalence of both diseases cannot be separated from the role of health professionals in recording the diagnosis of TB patient who went to health care facilities. This cross-sectional study is conducted to see the difference between casefinding of DM among TB patients who went to doctors and other health professionals. Using consecutive-sampling-method, obtained 242 TB patients who were registered in twelve PHCs and two clinics in Jakarta. Data were collected by filling the questionnaire and FBG/OGT test.The result showed that the percentage of DM is higher in TB patients compared with the general population (27,5%, n=236). The percentage of DM case-finding in TB patient who went to the doctor was higher than those who went to other health professionals (28% vs 19%, p=0,361). Benchmarking percentage of case-finding was also done by comparing through DM manifestations include: poliphagia, polydipsia, polyuria, weight loss, weakness, numbness, and blurred vision. From all of the manifestations, the percentage of case-finding was higher in patients who went to the doctor, but it?s not statistically significant. According to the result, health professionals are expected to increase awareness about DM manifestations that may be presented in TB patients in order to detect cases earlier and anticipate the unwanted impacts."

"Kasus Tuberkulosis di Indonesia masih tinggi dan menduduki peringkat kedua dunia. Di sisi lain, kasus DM yang dapat meningkatkan risiko TB semakin banyak. Pada DM terjadi penurunan dan abnormalitas sistem imun yang dapat memperparah infeksi TB. Penelitian ini bertujuan untuk mengetahui hubungan DM dengan kesembuhan pengobatan TB. Desain penelitian ini adalah cross-sectional dengan total sampel enam puluh data rekam medis pasien TB dan TB-DM yang memenuhi kriteria inklusi dan eksklusi di RSCM tahun 2014. Hasil menunjukkan terdapat pasien TB-DM sebesar 48.3 . Pasien TB-DM yang sembuh dalam enam bulan sebesar 27.6 dan tidak sembuh dalam enam bulan sebesar 72.4 . Analisis bivariat menunjukkan tidak terdapat hubungan bermakna antara DM dengan kesembuhan pengobatan TB OR 2.46; 95 CI 0.838-7.223. Selain itu, didapatkan pasien TB-DM dengan gula darah tidak terkontrol sebanyak 55.2. Pasien TB-DM terkontrol yang tidak sembuh dalam dua belas bulan sebesar 7.7, sedangkan pasien TB-DM tidak terkontrol yang tidak sembuh dalam dua belas bulan sebesar 68.8. Analisis bivariat menunjukkan terdapat hubungan bermakna antara kontrol gula darah pada pasien TB-DM dengan kesembuhan pengobatan TB OR 26.4; 95 CI 2.653-262.695.

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Indonesia still has high Tuberculosis cases and Indonesia placed second in the world in this matter. On the other hand, Diabetes Mellitus cases, that can increase Tuberculosis risk, is increasing. In DM, the immune system is reduced and became abnormal so it can make Tuberculosis infection worse. This study evaluate the relation between DM and Recovery of Adult Pulmonary Tuberculosis. This research is cross sectional, with total sample sixty medical record of TB and TB DM cases that fullfilled the inclusion and exclusion criterias in RSCM 2014.

In this research, there are 48.3 of TB DM cases in sixty TB cases in RSCM. TB DM patient that are cured in six months is 27.6 and TB DM patient that are not cured in six months is 72.4. Bivariate analysis showed that there is no significant correlation between DM and the recovery of Tuberculosis OR 2.461 95 CI 0.838 7.223. From glucose control perspective, the percentage of uncontrolled TB DM patient is 55.2. Controlled TB DM patient that are not cured in 12 months is 7.7 meanwhile uncontrolled TB DM patient that are not cured in 12 months is 68.8 . Bivariate analysis showed that there is a significant correlation between blood glucose control in TB DM patient and the recovery of Tuberculosis OR 26.4 95 CI 2.653 262.695."