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"ABSTRACTPhysical activity programs offered in Indonesian hospitals are often inadequate to help type 2 diabetes (T2D) patients meet international physical activity recommendations. This study aimed to identify T2D patients' physical activity enablers and barriers, their preferences for, and experiences with, physical activity programming, with a view to developing future programs that are suited to these patients' needs and preferences. Four focus groups were conducted with 28 patients (50% female) of the T2D clinic at the Local General Hospital of Yogyakarta. Discussions were thematically analysed in NVivo 10. The most reported types of physical activity were walking and participation in the hospital-based exercise program. Participants were motivated to be physically active for the health benefits and for social interactions. The main barriers to physical activity were a lack of enjoyment, the absence of knowledge about appropriate activities for T2D patients, and a shortage of time due to social and family obligations. Based on study participants' preferences, future physical activity programs need to include educational components, regular clinical evaluations, consultations with health educators, and efforts to increase the reach of the programs. This study provides practical suggestions for physical activity programming that meet the needs of T2D patients in Indonesia."

"Aktivitas fisik sebagai salah satu pilar penatalaksanaan Diabetes Mellitus dan pemeriksaan HbAlc sebagai evaluasi kendali gula darah jangka panjang seringkali tidak digunakan. Penelitian ini bertujuan untuk menilai fisibilitas dan efektivitas aktivitas fisik dan kendali gula darah pada penyandang DM tipe 2 di masyarakat pada umumnya. Studi menggunakan desain kohort prospektif dengan 5 bulan masa pengamatan (12 November 2007 - 9 April 2008) dan 2 lokasi pengambilan sampel: di kelompok senam DM (persadia) dan di poliklinik DM RS Husada, Jakarta. Pengambilan sampel dilakukan dengan metode non-random sampling secara consecutive selama 2 bulan masa enrollment. Sampel adalah 95 orang penyandang DM tipe 2 yang telah menandatangani formulir informed consent. Variabel independen utama adalah aktivitas fisik yang dinilai baik dari segi frekuensi, durasi, intensitas maupun kompositnya, menggunakan kuesioner yang telah divalidasi. Sedangkan variabel dependen-nya adalah kendali gula darah yang dinilai dari kadar HbAlc plasma vena darah dalam persen. Data dikumpulkan dan diukur dua kali: pada awal dan akhir penelitian (minimal 12 minggu setelah data pertama diambil). Analisis multivariat dilakukan dengan Regresi Cox Proportional Hazard menggunakan perangkat STATA versi 9.2. Hasil penelitian ini menemukan adanya hubungan antara aktivitas fisik dan kendali gula darah pada 95 orang penyandang DM tipe 2 di RS Husada Jakarta (HRadjusted = 0,54; 95%CI 0,27-1,11) selelah dikQntrol terhadap variabel pengobatan dan pola konsumsi serat. Dengan demikian, tenaga kesehatan tidak perlu lagi ragu-ragu untuk menganjurkan para penyandang DM tipe 2 untuk mengintegrasikan aktivitas fisik ke dalam kehidupan mereka sehari-hari guna memperbaiki kendali gula darahnya.

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Physical acitivity is often underutilized as one of the cornerstones of diabetes management and so is the use of HbAlc in long-term glycemic control. The purpose of this study is to assess the feasibility and effectiveness of physical activity and blood glucose control among diabetes type 2 patients in general population.

A prospective cohort study design was used to conduct the study for a period of 5 months (l2th November 2007 - 9th April 2008) using 2 catchment areas: diabetes exercise club (persadia) and diabetes policlinic Husada Hospital, Jakarta. A non-random (consecutive) sampling technique during a 2-month enrollment period yielded a participation of 95 type 2 diabetes patients as study subjects, all of whom have signed informed consents.

The main independent variable assessed was physical activity in the forms of frequency, duration, intensity and composite using validated questionnaires whilst the outcome of blood glucose control expressed as percentage of plama venous HbAlc. Data were collected twice: at baseline and at least 12 weeks after. Multivariate analysis was conducted using Cox Proportional Hazard Regression and the software STATA 9.2 version.

Results from the study found an association between physical activity and blood glucose control among 95 diabetes type 2 patients in Husada Hospital Jakarta (HRadjusted = 0,54; 95%CI 0,27-1,11) after adjusting for drug therapy and dietary pattern consumption of fibre. ThUs. health care providers should not be hesitant to advice diabetics patients to integrate physical activity into their daily lives in order to improve their glycemic control."

"Aktivitas fisik dapat mengurangi risiko terjadinya dan mortalitas akibat Diabetes Mellitus DM tipe 2. Namun, hasil yang didapatkan dari aktivitas fisik oleh pasien DM tipe 2 berbeda-beda. Selain aktivitas fisik terdapat juga beberapa faktor lain yang memiliki hubungan signifikan terhadap faktor prognostik pasien DM tipe 2. Penelitian ini dilakukan untuk mencari tahu hubungan antara aktivitas fisik dan faktor-faktor lain pada pasien DM tipe 2. Penelitian ini menggunakan desain studi cross-sectional pada 57 subjek pasien di Rumah Sakit Husada Jakarta yang dianalisis menggunakan uji chi-square. Hasil menunjukkan bahwa tidak ada hubungan yang signifikan secara statistik p > 0,05 antara aktivitas fisik terhadap faktor-faktor seperti jenis kelamin, usia, status gizi, asupan energi, asupan karbohidrat, asupan lemak, asupan protein dan pemberian tata laksana pada pasien DM tipe 2. Hal ini menunjukkan bahwa aktivitas fisik dapat dilakukan pada pasien DM tipe 2 tanpa harus memperhatikan faktor-faktor tersebut.

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The effect of physical activity is known to be useful in Type 2 Diabetes Mellitus T2DM . However, the outcome of physical activity in T2DM patient is varied. Physical activity is not the only factor for the outcome for T2DM. This study objectives is to find the relation between those factors to physical activity in T2DM patient. A cross sectional study was designed in this study and 57 subject in Husada Hospital Jakarta is analyzed by using chi square analysis.

The result of this study shows that there are no significant relation p 0.05 between physical activity and related factors such as gender, age, nutritional status, energy intake, protein intake, carhbohydrate intake, fat intake and pharmacology therapy in T2DM patients. This result means that physical activity could be done in T2DM patients with or without the other related factors. "

"Diabetes mellitus tipe 2 adalah penyakit yang menyebabkan morbiditas tinggi, mortalitas, komplikasi penyakit, dan peningkatan biaya kesehatan. Prolanis bertindak sebagai perawatan kesehatan upaya penderita penyakit kronis untuk mencapai kualitas hidup yang optimal dengan efektif dan biaya pelayanan kesehatan yang efisien. Namun, kepatuhan pasien DM tipe 2 yang rendah adalah a faktor yang membuat program Prolanis kurang optimal. Tujuan dari penelitian ini adalah untuk menentukan deskripsi kepatuhan prolanis pada pasien DM tipe 2 di Bojonggede Perawatan Kesehatan Utama. Ini adalah penelitian kualitatif dengan desain studi kasus. Data Teknik pengumpulan adalah wawancara mendalam, observasi, dan tinjauan dokumen. Itu hasil 7 pasien dengan DM tipe 2 menunjukkan bahwa faktor predisposisi untuk kepatuhan adalah kurangnya pengetahuan tentang DM tipe 2 masih pada tingkat terendah tahu. Bala bantuan Faktor tersebut dari tenaga kesehatan, seperti kegiatan kunjungan rumah masih belum optimal. Sementaradukungan keluarga telah diberikan, tetapi sebagian kecil dari penderita DM tipe 2 masih kurang dukungan keluarga. Faktor yang memungkinkan kepatuhan prolanis untuk aksesibilitas telah terjangkau, namun fasilitas untuk senam, pendidikan, buku pemantauan kesehatan, dan masih kurang. Faktor persepsi kepatuhan adalah kecemasan tentang DM tipe 2, takut konsekuensi yang akan terjadi, dan adanya manfaat berpartisipasi dalam program prolanis, dan juga hambatan kepatuhan seperti hujan, waktu program implementasi, aktivitas kerja, fasilitas dan infrastruktur.

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Type 2 diabetes mellitus is a disease that causes high morbidity, mortality, disease complications, and increased health costs. Prolanis acts as a health care effort for sufferers of chronic diseases to achieve optimal quality of life in an effective and cost efficient health service. However, low compliance with type 2 DM patients is a factor that makes the Prolanis program less than optimal. The purpose of this study is to determine the description of prolanal adherence in type 2 DM patients in Bojonggede Primary Health Care. This is a qualitative research with a case study design. Data collection techniques are in-depth interviews, observations, and document reviews. The results of 7 patients with type 2 DM showed that the predisposing factor for adherence was the lack of knowledge about type 2 DM still at the lowest know level. Reinforcements These factors from health workers, such as home visits are still not optimal. While family support has been provided, but a small proportion of sufferers of type 2 diabetes still lack family support. Factors that allow prolanis compliance for accessibility have been reached, but facilities for gymnastics, education, health monitoring books, and still lacking. Perceived factors of compliance are anxiety about type 2 diabetes, fear of the consequences that will occur, and the benefits of participating in prolanis programs, and also obstacles to compliance such as rain, program implementation time, work activities, facilities and infrastructure."

"Obesity is a common comorbidity of type-2 diabetes and one of the most modifiable risk factors for preventing other comorbid conditions, such as diabeticnephropathy and cardiovascular disease. Using a cross-sectional design, this study aimed to determine eating behavior, factors related with obesity and thedominant factor of obesity in patients with type-2 diabetes. Data were collected from 133 members of the Chronic Disease Countermeasure Program inJatinegara Primary Health Care, East Jakarta, that were selected using purposive sampling. Food intake was assessed by 1 × 24-hour food recall and theFood Frequency Questionnaire, Physical activity was assessed by the Global Physical Activity Questionnaire. Results showed that 63.9% of the surveyedtype-2 diabetics were obese (body mass index ≥ 25 kg/m2) and that the respondents consumed more fat than the recommended value (30.77% ± 9.06%)but less energy than the required value (62.06% ± 23.67%). The prevalence of obesity among adults with type-2 diabetes could be associated with nutritional knowledge, education level, and the length of suffering from the disease. Nutritional knowledge was found to be a dominant factor associated with obesity."

"Background: thyroid dysfunction is more likely to occur in diabetes mellitus patients than general population. Until now, no study has been done to find prevalence of hypothyroidism and hyperthyroidism in Indonesian diabetics. This study aimed to find the proportion and characteristics of thyroid dysfunction in Indonesian type 2 diabetes mellitus patients. Methods: a cross-sectional study was conducted in Endocrine and Diabetes Polyclinic, Department of Internal Medicine, Cipto Mangunkusumo Hospital from July to September 2015. This study include type 2 diabetes mellitus patients, age ≥ 18 year-old, willing to undergo thyroid laboratory testing. In this study, hypothyroidism defined as TSH more than 4.0 mIU/L, while hyperthyroidism is defined as TSH less than 0.4 mIU/L with eCLIA. Results: from 364 subjects who were recruited from Endocrine and Diabetes Polyclinic, Cipto Mangunkusumo Hospital, 303 subjects underwent this study until analysis. Two hundred and three (273) subjects (90.1%) were euthyroid, 7 subjects (2.31%) were hyperthyroid, and 23 subjects (7.59%) were hypothyroid. Majority of the patients had subclinical hypothyroidism (56.5% based on Zulewski and Billewicz Score and 65.2% based on fT4 laboratory result), while 42.9% and 71.4% subjects had clinical hyperthyroidism based on clinical appearance and fT4 laboratory result respectively. Conclusion: proportion of hypothyroidism was 7.59% and hyperthyroidism was 2.31%, while the proportion of total thyroid dysfunction was 9.9% among diabetics. It is suggested that screening for thyroid dyscfunction can be done in high risk condition as a part of comprehensive management in type 2 diabetes mellitus patients."

"Nefropati diabetik telah diketahui merupakan salah satu penyulit jangka panjang diabetes melitus (DM) yang berbahaya, yang dapat menyebabkan kegagalan ginjal tahap akhir. Namun, data adanya nefropati diabetik di antara pasien diabetes tipe 2 yang menjalani rawat jalan saat ini belum ada. Penelitian cross-sectional ini ditujukan untuk mengetahui prevalensi nefropati diabetik di antara penderita diabetes tipe 2 rawat jalan yang datang untuk pertama kalinya ke Klinik Metabolik dan Endokrinologi, RSUPN Dr. Cipto Mangunkusumo, Jakarta. Dari Desember 2001 sampai Juni 2002, 100 pasien baru diabetes tipe 2 diikutsertakan dalam studi. Empat puluh dua di antaranya adalah laki-laki dengan usia rata-rata 54 + 9,6 tahun. Overt nephropathy (makroalbuminuria) ditemukan pada 11% pasien, incipient nephropathy (mikroalbuminuria) terdapat pada 26% penderita, sedangkan sisanya normal (normoalbuminuria). Hasil penelitian menunjukkan bahwa lama sakit yang lebih dari 5 tahun menunjukkan korelasi bermakna dengan derajat albuminuria. Namun, tidak ada hubungan bermakna antara derajat albuminuria dengan faktor-faktor risiko lain, yaitu usia, dislipidemia, hipertensi, obesitas, dan kadar HbA1c. Semua pasien dengan overt nephropathy menunjukkan tes klirens kreatinin di bawah 75 ml/ menit (rerata 45,3 mL/menit), secara bermakna lebih rendah dari pasien dengan mikro- atau normoalbuminuria (p=0,01). Retinopati ditemukan pada 10 dari 11 (90%) pasien dengan overt nephropathy. Analisis multivariat memperlihatkan bahwa lama sakit dan retinopati secara bermakna berkorelasi dengan terjadinya nefropati diabetik (p < 0,05). Sebagai kesimpulan dapat dikatakan bahwa prevalensi nefropati diabetik (yaitu overt nephropathy dengan retinopati) di antara pasien diabetes tipe 2 rawat jalan adalah 10%. Lama sakit merupakan faktor risiko penting bagi timbulnya penyulit ini. (Med J Indones 2004; 13: 161-5)

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Diabetic nephropathy has been known as one of the most serious long-term complications of diabetes mellitus (DM), which could lead to end-stage kidney failure. However, data showing the presence of diabetic nephropathy among ambulatory type 2 diabetic patients is currently not available. This cross-sectional study was conducted to find the prevalence of diabetic nephropathy among non-hospitalized type 2 diabetic patients, who came for the first time to the Metabolic and Endocrinology Clinic, Dr. Cipto Mangunkusumo Hospital, Jakarta. From December 2001 to June 2002, 100 new type 2 diabetic patients were included in the study. Forty-two of them were men and the mean age was 54 + 9.6 years. Overt nephropathy (macroalbuminuria) was found in 11% of patients, while incipient nephropathy (microalbuminuria) was 26%, and the rest were normal (normoalbuminuria). Duration of illness of more than 5 years was significantly correlated with the degree of albuminuria. However, there is no significant correlation between the degree of albuminuria and other risk factors, i.e. patient’s age, dyslipidemia, hypertension, obesity, HbA1c level. All patients with overt nephropathy had creatinine clearance test below 75 ml/ min. (mean 45.3 mL/min), significantly lower than patients with micro- or normoalbuminuria (p=0.01). Retinopathy was found in 10 out of 11 (90%) patients with overt nephropathy. Multivariate analysis showed that the duration of illness and retinopathy was significantly correlated with the presence of diabetic nephropathy (p< 0.05). We concluded that the prevalence of diabetic nephropathy (i.e. overt nephropathy with retinopathy) among non-hospitalized type 2 diabetic patients was 10%. The duration of illness was an important risk factor for the development of this complication. (Med J Indones 2004; 13: 161-5)"

"Diabetes Melitus Tipe 2 DMT2 disebabkan oleh gaya hidup tidak sehat. Karyawan PT.X menderita DMT2 dengan prevalensi 6;5 . Tujuan penelitian ini menganalisis polamakan dan aktivitas fisik penderita DMT 2; dengan metode penelitian kualitatif analisisdeskriptif pada 12 responden. Pola makan diukur menggunakan kuesioner FoodFrequency Quesionnair FFQ dan aktivitas fisik dengan International Physical ActivityQuesionnair IPAQ ; serta dilakukan observasi dan wawancara mendalam. Hasilpenelitian menunujukkan bahwa; karakteristik dari 12 orang responden berumur ge; 40tahun 75 ; laki-laki 91;7 ; dan responden yang memiliki riwayat keluarga DM 58;3 . Pola makan respnden tidak teratur; konsumsi karbohidrat berlebih atau tinggiIndeks Glikemiknya IG ; aktivitas responden kategori ringan dan jarang berolahraga.Rata-rata Metabolic Equivalent MET responden secara total dari aktivitas kerja;aktivitas transportasi; kegiatan di rumah dan berkebun; olahraga yaitu di bawah 600MET-menit/minggu; responden beralasan tidak ada waktu dan malas berolahraga.Disarankan program promosi kesehatan tentang makanan sehat atau rendah IG untukkaryawan dan istrinya; bila memungkinan perusahaan menyediakan makanan sehat bagikaryawan; promosi pentingnya olahraga dan membuat program olahraga untukmengimbangi aktivitas kerja yang ringan.

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Diabetes is a non-infectious disease to 4 causes of death in Indonesia; prevalence of 6.9%; occurs at ≥ 15 years old (Kemenkes; 2014); Nearly 90% are Type 2 Diabetes Mellitus (T2DM) caused by unhealthy lifestyles. PT.X employees suffer from T2DM with a prevalence of 6.5%. The purpose of this study to analyze patterns of eating and physical activity of the patient DMT 2; with qualitative research methods of descriptive analysis on 12 respondents. The diet was measured by Food Frequency Quesionnair questionnaire and physical activity with International Physical Activity Quesionnair; and observation and in-depth interviews were conducted. The results showed that the characteristics of 12 respondents were ≥ 40 years old (75%); male (91.7%); and respondents who had a family history of DM (58.3%). Irregular eating patterns; excessive carbohydrate consumption or high Glycemic Index (GI). The activity of respondents in the category of mild and rarely exercise. Mean Total Metabolic Equivalent (MET) respondents from total work activities; transportation; domestic; exercise is below 600 MET-minutes/week; Respondents reasoned no time and lazy to exercise. Suggested health promotion programs on healthy or low GI foods for employees and their wives; if possible company provides healthy foods and create sports programs. "

"Diabetes melitus merupakan penyakit gangguan metabolik yang ditandai dengan tingginya kadar glukosa darah akibat kelainan pada sekresi insulin, aksi insulin, atau keduanya. Tingginya kadar glukosa darah pada penderita diabetes berhubungan dengan kerusakan jangka panjang, disfungsi, dan kegagalan pada beberapa organ tubuh terutama mata, ginjal, jantung, saraf, dan pembuluh darah. Kadar glukosa darah pada penderita diabetes dapat dipengaruhi oleh berbagai faktor seperti asupan, aktivitas fisik, dan lainlain. Skripsi ini bertujuan untuk melihat perbedaan proporsi kadar glukosa darah pada penderita diabetes berdasarkan aktivitas fisik dan faktor lainnya. Penelitian ini dilakukan pada penderita diabetes di Puskesmas Kecamatan Pasar Minggu pada bulan April 2018. Desain penelitian ini menggunakan desain cross-sectional dengan jumlah sampel 110 orang. Kadar glukosa darah diketahui melalui catatan medik responden, aktivitas fisik dan asupan diketahui melalui kuesioner aktivitas fisik GPAQ dan Semi-quantitative Food Frequency Questionnaire SFFQ. Hasil penelitian menunjukkan bahwa 57,3 penderita diabetes memiliki kadar glukosa darah terkontrol. Uji chi-square menyatakan bahwa variabel aktivitas fisik, kepatuhan minum obat, asupan serat, durasi penyakit, dan stres memiliki perbedaan bermakna dengan kadar glukosa darah. Untuk meningkatkan angka kadar glukosa darah terkontrol pada penderita diabetes, disarankan untuk diberikan edukasi mengenai aktivitas fisik, kepatuhan minum obat, asupan serat, dan manajemen terhadap stres apabila diperlukan kepada penderita diabetes.

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Diabetes mellitus is a metabolic disorder characterized by high blood glucose levels due to abnormalities in insulin secretion, insulin action, or both. High blood levels in diabetics are associated with long term damage, dysfunction, and failure of some organs, especially the eyes, kidneys, heart, nerves, and blood vessels. Blood glucose levels of diabetics can be influenced by various factors such as intake, physical activity, and others.

This study aims to see the differences proportion of blood glucose levels in diabetics based on physical activity and other factors. The study was conducted on diabetics at Puskesmas Kecamatan Pasar Minggu on April 2018. The design of this study is cross sectional with a total sample of 110 people. Blood glucose levels are known through the medical records of respondents, physical activity and intake are known through physical activity questionnaires GPAQ and Semi quantitative Food Frequency Questionnaire SFFQ.

The results showed that 57.3 of diabetics had controlled blood glucose levels. Chisquare test showed that physical activity, medication adherence, fiber intake, duration of disease, and stress have significant differences with blood glucose levels. To increase the rate of controlled blood glucose in diabetics, it is recommended to be educated about physical activity, fiber intake, and management of stress if necessary in diabetics."