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"Latar Belakang : Pasien Non-Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR) dengan neuropati kornea akan mengalami terganggunya stabilitas air mata. Penurunan sekresi dan konsituen air mata akan menyebabkan gangguan berupa mata kering. Pada pasien Diabetes dengan retinopati diabetik, gangguan kornea ini berpotensi lebih memperburuk gangguan penglihatan yang terjadi. Tujuan : Menilai stabilitas air mata pada pasien NPDR, PDR dengan neuropati kornea sebelum, sesudah diberikan tetes mata Sodium hyaluronat+Vitamin A,E (HA+Vit A,E) atau Sodium Hyaluronat saja (HA). Metodologi : Penelitian ini merupakan uji eksperimental randomisasi acak terkontrol, dengan dua kelompok utama (NPDR, PDR), kedua kelompok mendapatkan tetes mata HA+Vit A,E atau HA selama 28 hari. Sensitivitas kornea, Skoring Ocular Surface Disease Index (OSDI), Non-Invasive Break Up Time (NIBUT), Schirmer I, jumlah sel goblet konjungtiva dinilai pada 0, 2, 4 minggu. Hasil : 96 subyek berpartisipasi, 65.6% wanita, 34.4% laki-laki (rerata usia 54.4 tahun). Skor OSDI memperlihatkan perbaikan signifikan, nilai terbesar pada kelompok PDR HA+Vit A,E dengan -4.86±5.76 (P= 0.000), NIBUT memperlihatkan perbaikan signifikan, nilai terbesar pada kelompok NPDR HA dengan 4.79±2.63 (P= 0.000), Schirmer I memperlihatkan perbaikan signifikan, hasil terbesar pada kelompok NPDR HA dengan 2.41±2.35 (P= 0.000). Sitologi impressi konjungtiva memperlihatkan perbaikan signifikan, terutama pada kelompok NPDR HA+Vit A,E (66% perbaikan). Seluruh kelompok memperlihatkan perbaikan signifikan, tetapi perbaikan antar kelompok tidak bermakna. Kesimpulan : Parameter seluruh kelompok memperlihatkan perbaikan yang signifikan setelah diberikan tetes mata HA+Vit A,E maupun HA saja, Tetapi jika dibandingkan antar kelompok, tidak terdapat perbedaan perbaikan yang signifikan.

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Background : Patient with Non-Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR) with corneal neuropathy will experiencing disruption in tear film stability. Decrease in tear film secretion and constituent will cause dry eyes. In Diabetic patients with diabetic retinopathy, this corneal disorder has the potential to further worsen visual impairment.

Purpose : To Assess tear film stability in NPDR, PDR patients with corneal neuropathy before, after treatment with topical Sodium hyaluronat+Vitamin A,E (HA+Vit A,E) or Sodium Hyaluronat only (HA).

Method : This study was a double blind experimental randomized control trial with two parallel groups (NPDR, PDR), both group receives HA+Vit A,E or HA for 28 days. Corneal sensitivity, Ocular Surface Disease Index (OSDI), Non-Invasive Break Up Time (NIBUT), Schirmer I, conjungtival goblet cells will be assessed on 0, 2, 4 weeks.

Result : 96 subjects participated, 65.6% female, 34.4% male, mean age 54.4 years old. OSDI score shows significant improvement, highest improvement seen on PDR HA+Vit A,E with -4.86±5.76 (P= 0.000), NIBUT hows significant improvement, highest improvement seen on NPDR HA with 4.79±2.63 (P= 0.000), Schirmer I shows significant improvement, highest improvement seen on NPDR HA with 2.41±2.35 (P= 0.000). Conjungtival goblet cells shows significant improvement, highest improvement seen on NPDR HA+Vit A,E (66% improved). All groups shows shows significant improvement, but between groups the improvement was not statistically significant.

Conclusion : Parameters on all groups shows statistically significant improvement after topical HA+Vit A,E or HA. But, if compared between groups, the improvement was not significantly differed."

"Penyakit ginjal kronik (PGK) merupakan salah satu komplikasi serius yang sering terjadi pada pasien diabetes melitus tipe 2. Dibutuhkan sebuah penanda yang dapat mendeteksi PGK sejak awal untuk mencegah progresifitasnya. Penelitian ini bertujuan untuk menganalisis hubungan antara kadar malondialdehida (MDA) serum dengan estimasi laju filtrasi glomerulus (eLFG). MDA merupakan penanda stres oksidatif yang diprediksi berperan dalam tahap awal kerusakan ginjal. Desain penelitian ini adalah potong lintang. Populasi yang digunakan adalah pasien DM tipe 2 rawat jalan di Puskesmas Pasar Minggu. Sampel yang dianalisis sejumlah 50 orang (14 laki-laki, dan 36 perempuan, rentang usia 39-74 tahun), diambil dengan tenik total sampling. Kadar MDA diukur secara spektrofotometri berdasarkan reaksi antara MDA dengan asam tiobarbiturat, dengan nilai koefisien korelasi (r) dari metode tersebut 0,9996 dan koefisien variasi (%KV) intra dan antar pengukuran berkisar 2,75-13,33%. Nilai eLFG diukur berdasarkan metode kinetik Jaffe, dengan koefisien korelasi (r) 0,9994 dan %KV intra dan antar pengukuran berkisar 2,91 – 9,52%. Kadar MDA pasien DM tipe 2 diperoleh 0,82 ± 0,26 nmol/ml, dan nilai eLFG diperoleh 78,30 ± 26,77 (Cockroft-Gault); 76,08 ± 24,17 (MDRD study); dan 79,25 ± 21,04 (CKD-EPI). Terdapat hubungan yang bermakna antara kadar MDA dengan nilai eLFG berdasarkan persamaan Cockroft-Gault (p =0,039, r = -0,293), tetapi tidak terlihat hubungan yang bermakna dengan nilai eLFG berdasarkan persamaan MDRD study dan CKD-EPI (p = 0,051 dan p = 0,053; r = -0,277 dan r = -0,275).

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Chronic kidney disease (CKD) is one of serious complication that most common in type 2 diabetes mellitus patients. It is important to find a marker that can detect it earlier to prevent its progression. The aim of this study was to analyze the correlation between malondialdehyde (MDA) concentration and estimated glomerular filtration rate (eGFR). MDA is an oxidative stress marker which was predicted allies in early stage of kidney damage.

The design of this study is cross sectional. The population was type 2 DM outpatients at Pasar Minggu Local Government Clinic. Total sampling method was used in sample selection. Samples being analyzed were as much as 50 patients (14 males, 36 females, age ranges : 39-74 years). MDA was measured by spectrophotometric based on its reaction with thiobarbituric acid. The coefficient correlation (r) of this method was 0.9996 and the coefficient of variation (%CV) within and between run were 2.75 - 13.33%.

eGFR was measured based on kinetic Jaffe method. Its coefficient correlation (r) was 0.9994 and %CV within and between run were 2.91-9.52%. MDA concentration in type 2 DM patients in this research was 0.82 ± 0.26 nmol/mL and the eGFR values were 78.30 ± 26.77 (Cockroft-Gault); 76.08 ± 24.17 (MDRD study); and 79.25 ± 21.04 (CKD-EPI). There was a significant correlation between MDA concentration and eGFR based on Cockroft-Gault formula (p =0.039, r = -0.293), but there were no significant correlation between MDA concentration and eGFR based on MDRD study and CKD-EPI (p = 0.051 and p = 0.053; r = -0.277 and r = -0.275)."

"Hingga saat ini, penanda biologis yang menggambarkan gangguan fungsi ginjal akibat diabetes melitus (DM) belum dapat mendeteksi adanya kerusakan sejak dini. Studi ini bertujuan untuk mengetahui hubungan antara 8-iso-Prostaglandin F2α dengan laju filtrasi glomerulus yang diestimasi (eLFG) sebagai penanda gangguan fungsi ginjal yang terjadi pada pasien DM tipe 2. Sebagai salah satu senyawa penanda terjadinya stres oksidatif, 8-iso-Prostaglandin F2α diduga berkaitan dengan gangguan fungsi ginjal sebagai salah satu komplikasi diabetes. Kadar 8-iso-Prostaglandin F2α diukur dari urin dan nilai eLFG dihitung dari kreatinin serum. Sampel urin dan serum diambil dari 36 pasien DM tipe 2 dengan teknik total sampling. Metode spektrofotometri digunakan untuk mengukur kadar kreatinin serum, sedangkan untuk pengukuran kadar 8-iso-Prostaglandin F2α digunakan metode enzyme immunoassay. Data lain yang diperlukan diperoleh melalui kuesioner. Hasil yang diperoleh menunjukkan bahwa peningkatan kadar 8-iso-ProstaglandinF2α berbanding terbalik dengan penurunan nilai eLFG pasien DM tipe 2. Namun, hubungan tersebut tidak bermakna secara statistik. Faktor usia dan kadar glukosa darah merupakan faktor yang paling mempengaruhi nilai eLFG pada pasien DM tipe 2.

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Until now, biological marker that describes renal dysfunction due to diabetes mellitus (DM) have not been able to detect any damage early. This study aimed to determine the relationship between 8-iso-Prostaglandin F2α with estimated Glomerular Filtration Rate (eGFR) as a marker of renal dysfunction at type 2 diabetes mellitus. As one of the markers of oxidative stress, 8-iso-ProstaglandinF2α assumed to be associated with renal dysfunction as a complication of diabetes mellitus. The levels of 8-iso-Prostaglandin F2α measured from urine, and eGFR calculated from serum creatinine. Urine and serum samples taken from 36 type 2 DM patients, using total sampling method.

Spectrophotometric used to measure levels of serum creatinine and the levels of 8-iso-Prostaglandin F2α was measured by enzyme immunoassay. Other necessary data obtained through questionnaires. The results showed that increasing level of 8-iso-ProstaglandinF2α was inversely proportional to the decline in eGFR of type 2 DM patients. However, these correlation was not significant statistically. Age and blood glucose were the factors that could effect the value of eGFR in type 2 DM patients."

"[Penyakit ginjal kronik (PGK) adalah salah satu komplikasi yang biasanya terjadi pada pasien diabetes melitus tipe 2. Pendeteksian PGK dilakukan dengan menghitung nilai estimasi laju filtrasi glomerulus (eLFG) maupun urine albumin creatinine ratio (UACR). Salah satu biomarker yang sedang diteliti adalah senyawa 8-iso-Prostaglandin F2α. Tujuan dari penelitian ini adalah menganalisis kadar 8-iso-Prostaglandin F2α dan hubungannya dengan eLFG. Sampel yang dianalisis adalah pasien diabetes melitus tipe 2 wanita di Puskesmas Pasar Minggu yang dikumpulkan oleh peneliti sebelumnya tahum lalu secara total sampling. Nilai eLFG diperoleh berdasarkan nilai kreatinin serum yang dihitung dengan rumus Cockroft-Gault, MDRD study, serta CKD-EPI, sedangkan kadar 8-iso-Prostaglandin F2α diukur dengan menggunakan metode ELISA (Enzyme Linked Immunosorbent Assay). Kadar 8-iso-Prostaglandin F2α diperoleh 7069,38 ± 7611,13 pg/mg kreatinin dan nilai eLFG diperoleh 93,15 ± 37,65 (Cockroft-Gault); 89,47 ± 34,30 (MDRD study); dan 87,05 ± 24,69 (CKD-EPI). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG (92 pasien) berdasarkan persamaan Cockroft-Gault (r = 0,396; p = < 0,001), MDRD (r = 0,375; p = < 0,001) dan CKD-EPI (r = 0,342; p = 0,001). Sehingga diketahui terdapat hubungan yang bermakna antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG dengan α = 0,05.;Chronic Kidney Desease (CKD) is one of complication that most common in type 2 diabetes mellitus patients. The detection of CKD is be done by calculating estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). One of the biomarkes being studied is 8-iso-Prostaglandin F2α. The aim of this study was to analyze concentration of 8-iso-Prostaglandin F2α and its correlation with estimated glomerular filtration rate (eGFR). Samples analyzed were type 2 diabetes mellitus woman patients at Pasar Minggu Local Government Clinic that collected by previous researcher last year in total sampling . eGFR was obtained based on the measurement of serum creatinine, 8-iso-Prostaglandin F2α was measured by ELISA (Enzyme Linked Immunosorbent Assay) method. Concentration of 8-iso-Prostaglandin F2α was 7069,38 ± 7611,13 pg/mg creatinine and the eGFR values 93,15 ± 37,65 (Cockroft-Gault); 89,47 ± 34,30 (MDRD study); and 87,05 ± 24,69 (CKD-EPI). The correlation between 8-iso-Prostaglandin F2α concentration and eGFR (92 samples) is based on Cockroft-Gault (r = 0,396; p = < 0,001), MDRD (r = 0,375; p = < 0,001) and CKD-EPI (r = 0,342; p = 0,001). So there was a significant correlation between 8-iso-Prostaglandin F2α concentration and eGFR., Chronic Kidney Desease (CKD) is one of complication that most common in type 2 diabetes mellitus patients. The detection of CKD is be done by calculating estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). One of the biomarkes being studied is 8-iso-Prostaglandin F2α. The aim of this study was to analyze concentration of 8-iso-Prostaglandin F2α and its correlation with estimated glomerular filtration rate (eGFR). Samples analyzed were type 2 diabetes mellitus woman patients at Pasar Minggu Local Government Clinic that collected by previous researcher last year in total sampling . eGFR was obtained based on the measurement of serum creatinine, 8-iso-Prostaglandin F2α was measured by ELISA (Enzyme Linked Immunosorbent Assay) method. Concentration of 8-iso-Prostaglandin F2α was 7069,38 ± 7611,13 pg/mg creatinine and the eGFR values 93,15 ± 37,65 (Cockroft-Gault); 89,47 ± 34,30 (MDRD study); and 87,05 ± 24,69 (CKD-EPI). The correlation between 8-iso-Prostaglandin F2α concentration and eGFR (92 samples) is based on Cockroft-Gault (r = 0,396; p = < 0,001), MDRD (r = 0,375; p = < 0,001) and CKD-EPI (r = 0,342; p = 0,001). So there was a significant correlation between 8-iso-Prostaglandin F2α concentration and eGFR.]"

"Obat antidiabetes yang paling banyak diresepkan di Puskesmas Indonesia adalah metformin atau kombinasi metformin dan sulfonilurea. Studi tentang metformin telah menunjukkan berbagai dampak penurunan kognitif pada pasien dengan diabetes mellitus tipe 2, sedangkan sulfonilurea telah terbukti mengurangi dampak ini. Penelitian ini bertujuan untuk membandingkan dampak metformin dan metformin-sulfonilurea pada fungsi kognitif dan menentukan faktor apa yang mempengaruhinya. Studi potong lintang ini dilakukan di Puskesmas Pasar Minggu dengan melibatkan 142 pasien diabetes melitus tipe 2 yang mengonsumsi metformin atau metformin-sulfonilurea selama >6 bulan dan usia >36 tahun. Fungsi kognitif dinilai menggunakan kuesioner Montreal Cognitive Assessment versi bahasa Indonesia. Efek dari metformin dan metformin-sulfonylurea pada penurunan kognitif tidak menunjukkan perbedaan yang signifikan, bahkan setelah mengontrol kovariat (aOR = 1,096; 95% CI =  13.008px;">0,523–2,297; nilai-p = 0,808). Analisis multivariat menunjukkan usia (OR = 4,131; 95% CI = 1,271–13,428; nilai-p = 0,018) dan pendidikan (OR = 2,746; 95% CI = 1.196–6.305; nilai-p = 0,017) mempengaruhi fungsi kognitif. Pendidikan yang lebih rendah dan usia yang lebih tua cenderung menyebabkan penurunan kognitif, tenaga kesehatan didorong untuk bekerja sama dengan ahli kesehatan masyarakat untuk mengatasi faktor risiko fungsi kognitif ini.

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The most prescribed antidiabetic drugs in Indonesian primary health care are metformin or a combination of metformin and sulfonylurea. Studies on metformin have shown various impacts on cognitive decline in patients with type 2 diabetes mellitus, whereas sulfonylurea has been shown to reduce this impact. This study aimed to compare the impacts of metformin and metformin-sulfonylurea on cognitive function and determine what factors affected it. This crosssectional study was conducted at Pasar Minggu Primary Health Care involving 142 type 2 diabetes mellitus patients taking metformin or metformin-sulfonylurea for >6 months and aged >36 years. Cognitive function was assessed using the validated Montreal Cognitive Assessment Indonesian version. The effects of metformin and metformin-sulfonylurea on cognitive decline showed no significant difference, even after controlling for covariates (aOR = 1.096; 95% CI = 0.523–2.297; p-value = 0.808). Multivariate analysis showed age (OR = 4.131; 95% CI = 1.271–13.428; p-value = 0.018) and education (OR = 2.746; 95% CI = 1.196–6.305; p-value = 0.017) affected cognitive function. Since a lower education and older age are likely to cause cognitive decline, health professionals are encouraged to work with public health experts to address these risk factors for cognitive function."

"Penelitian ini bertujuan mengetahui efek hiperglikemia postprandial terhadap kemampuan memori jangka pendek pada pasien DM tipe 2. Penelitian ini adalah penelitian kuantitatif dengan desain quasy experiment post test group.Jumlah sampel sebanyak 35 responden. Hasil penelitian ini menyatakan ada perbedaan kadar gula darah dan kemampuan memori jangka pendek antara satu jam dan dua jam setelah makan. Saran penelitian ini adalah perlu dilakukan skrining kognitif sejak dini kepada pasien DM, edukasi pasien DM diberikan dua jam setelah makan dan perlu ada penelitian lanjutan yang melibatkan jumlah sampel yang besar dan faktor-faktor yang berkontribusi terhadap penurunan kognitif pasien DM.

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This study aims to determine the effects of postprandial hyperglycemia on the ability of short-term memory in patients with type 2 diabetes. This research is a quantitative research with quasy experiment posttest design. Number of respondents were 35 people. The results there are differences in blood sugar level and short term memory ability one hour and two hour after meal.

Suggestion study was conducted in early cognitive screening for diabetic patients, education were given two hours after a meal and there needs to be further research involving a large number of samples and the factors that contribute to cognitive decline."

"[Saat ini belum ada penanda biologis yang dapat digunakan untuk mendeteksi PGK sejak dini. Rasio albumin terhadap kreatinin urin (UACR) dan estimasi laju filtrasi ginjal (eLFG) digunakan sebagai penanda gangguan fungsi ginjal. Penelitian ini bertujuan untuk mengetahui hubungan antara UACR dengan eLFG pada pasien DM tipe 2 dengan normoalbuminuria dan mikroalbuminuria. Sampel yang dianalisis adalah urin dan serum 90 orang pasien DM tipe 2 di Puskesmas Pasar Minggu yang dikumpulkan tahun lalu, dengan teknik total sampling. Kreatinin urin diukur dengan metode kinetic jaffe. Albumin urin diukur dengan metode bromkresol hijau. eLFG diperoleh dari nilai kreatinin serum. Hasil rerata UACR yang didapatkan (15,60±1,93). Hasil rerata eLFG Cockroft Gault (95,65±4,17), MDRD (89,71±3,65) dan CKD-EPI (87,00±2,62). Hasil hubungan antara UACR dengan eLFG rendah MDRD (p= 0,004,r= -0,422); Cockroft (p= 0,083,r= -0,261); CKD-EPI (p= 0,006,r= -0,404), sedangkan dengan LFG tinggi MDRD (p= 0,020, r= 0,346); Cockroft (p= <0,0-01, r= 0,540); CKD (p= 0,002, r= 0,449). Kesimpulan yang didapatkan yaitu hubungan bermakna antara UACR dengan eLFG rendah dan tinggi. Tidak ditemukan hubungan yang bermakna antara UACR normoalbuminuria dan mikroalbumnuria dengan eLFG. ;Diabetes mellitus type 2 is one of the causes complication of chronic kidney disease (CKD). Currently there are no biological markers that can be used to detect CKD early. Urinary albumin to creatinine ratio (UACR) and estimated kidney filtration rate (eLFG) is used as a marker of impaired kidney function. This study aimed to determine the relationship between UACR with eLFG in patient type 2 diabetes mellitus with normoalbuminuria and microalbuminuria. Samples were urine and serum of 90 patients with type 2 diabetes mellitus in Puskesmas Pasar Minggu which were collected last year, with total sampling technique. Urinary creatinine was measured by Jaffe kinetic method. Urine albumin was measured by the method bromkresol green. eLFG obtained from serum creatinine values. UACR results obtained (15.60 ± 1.93). Results eLFG Cockroft Gault (95.65 ± 4.17), MDRD (89.71 ± 3.65) and CKD-EPI (87.00 ± 2.62). Results relationship between UACR with low eLFG MDRD (p = 0.004, r = -0.422); Cockroft (p = 0.083, r = -0.261); CKD (p = 0.006, r = -0.404), while the high eLFG MDRD (p = 0.020, r = 0.346); Cockroft (p = <0.001, r = 0.540); CKD (p = 0.002, r = 0.449) so there is a significant relationship between UACR with low and high eLFG. There is no significant relationship between UACR normoalbuminuria and microalbuminuria with eLFG., Diabetes mellitus type 2 is one of the causes complication of chronic kidney disease (CKD). Currently there are no biological markers that can be used to detect CKD early. Urinary albumin to creatinine ratio (UACR) and estimated kidney filtration rate (eLFG) is used as a marker of impaired kidney function. This study aimed to determine the relationship between UACR with eLFG in patient type 2 diabetes mellitus with normoalbuminuria and microalbuminuria. Samples were urine and serum of 90 patients with type 2 diabetes mellitus in Puskesmas Pasar Minggu which were collected last year, with total sampling technique. Urinary creatinine was measured by Jaffe kinetic method. Urine albumin was measured by the method bromkresol green. eLFG obtained from serum creatinine values. UACR results obtained (15.60 ± 1.93). Results eLFG Cockroft Gault (95.65 ± 4.17), MDRD (89.71 ± 3.65) and CKD-EPI (87.00 ± 2.62). Results relationship between UACR with low eLFG MDRD (p = 0.004, r = -0.422); Cockroft (p = 0.083, r = -0.261); CKD (p = 0.006, r = -0.404), while the high eLFG MDRD (p = 0.020, r = 0.346); Cockroft (p = <0.001, r = 0.540); CKD (p = 0.002, r = 0.449) so there is a significant relationship between UACR with low and high eLFG. There is no significant relationship between UACR normoalbuminuria and microalbuminuria with eLFG.]"

"Latar Belakang: Insidensi dan prevalensi diabetes melitus tipe 2 (DMT2) terus meningkat. Penurunan imunitas yang terjadi pada DMT2 dapat meningkatkan risiko infeksi. Kontrol gula darah yang baik bermanfaat dalam pengendalian infeksi dan pencegahan komplikasi makro dan mikrovaskuler tetapi penelitian yang melibatkan pasien DMT2 usia lanjut masih belum konklusif. Serial kasus ini dilakukan untuk melihat efektivitas kontrol gula darah terhadap kesintasan pasien DMT2 yang dirawat di rumah sakit, dan untuk implementasi tatalaksana nutrisi sesuai kebutuhan dan kondisi klinis pasien. Metode: Pasien pada serial kasus ini berusia antara 47 ? 65 tahun. Penyulit infeksi pada keempat pasien ini yaitu gangren diabetikum, selulitis, dan sepsis dengan infeksi paru dan infeksi saluran kemih. Tatalaksana nutrisi pasien dilakukan sesuai dengan rekomendasi American Diabetes Association dan Therapeutic Lifestyle Changes disesuaikan dengan kondisi klinis dan toleransi pasien. Perhitungan kebutuhan nutrisi menggunakan rekomendasi untuk perawatan pasien sakit kritis bagi pasien yang dirawat di intensive care unit (ICU), dan menggunakan perhitungan dengan formula Harris-Benedict bagi yang dirawat di ruangan dengan faktor stres sesuai derajat hipermetabolisme pasien. Pasien dipantau selama 7 ? 11 hari. Edukasi diberikan kepada pasien dan keluarga selama perawatan dan saat akan pulang. Hasil: Dalam pemantauan, tiga pasien menunjukkan perbaikan klinis, toleransi asupan, dan laboratorium, dan dapat dipulangkan, sedangkan satu pasien meninggal dunia. Kesimpulan: Kontrol gula darah, asupan nutrisi yang adekuat, dan edukasi yang sesuai, dapat meningkatkan kesintasan pasien DMT2 dengan penyulit infeksi yang dirawat di rumah sakit.

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Background: The incidence and prevalence of type 2 diabetes mellitus (T2DM) is increasing. Immune disfunction in T2DM patient may increase the risk of infection. The appropriate blood glucose control has a benefit in infection control and macro and microvascular complication prevention. The Studies of glycaemic control included older patients did not find convincing evidence. The aim of this case series is to assess the association between glycaemic control and clinical outcome of hospitalized T2DM patient with comorbid infection, and to provide appropriate nutrition therapy based on individual nutrition needs.

Method: Patients in this case series were between 47 - 65 years old. There of those patients were diagnosed T2DM with comorbid gangrenous diabeticum, cellulitis, and sepsis with lung infection and urinary tract infection. Two patients need intensive care in ICU, and another patients in the ward. Two patients received nutrition therapy as critically ill condition, and the rest as American Diabetic Association recommendation, with basal calorie requirement were calculated using Harris-Benedict formula and stress factor suitable for metabolic changes. Monitoring was done for 7 - 11 days. Education was done for the patient and family during hospitalization and discharge planning.

Results: Three patients showed the improvement of clinical conditions, intake tolerance, and laboratory results, whatever one patient was pass away.

Conclusion: Glycaemic control, adequate nutrition intake, and intensive education, may improve survival rate in hospitalized T2DM patient with infection as comorbid."

"Efikasi diri dan kepatuhan merupakan faktor yang penting dalam meningkatkan kualitas hidup pasien DM tipe 2. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat efikasi diri dan kepatuhan dengan kualitas hidup pasien DM tipe 2 yang menjalani rawat jalan di Rumah Sakit di Jakarta.Desain dalam penelitian ini adalah cross sectional, dengan jumlah sampel 125 pasien DM tipe 2. Alat ukur yang digunakan adalah Diabetes Management Self-Efficacy (DMSES), the Diabetes Activities Questionare (TDAQ), dan Diabetes Quality Of Life (DQOL).Hasil penelitian menunjukkan bahwa efikasi diri (0,0005), dan kepatuhan (0,0005) berhubungan secara signifikan dengan kualitas hidup dengan variabel yang paling dominan adalah kepatuhan.Hasil uji multivariat menunjukkan bahwa variabel efikasi diri, kepatuhan, tingkat pendidikan, dan depresi menentukan kualitas hidup pasien DM. Perlunya dikembangkan pengkajian dan intervensi keperawatan yang berfokus pada efikasi diri dan kepatuhan pasien DM tipe 2.

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Self-efficacy and adherence are important factor in improving the quality of life of patients with type 2 diabetes. This study aimed to determine the relationship between self-efficacy and adherence to the quality of life of patients with type 2 diabetes mellitus in an outpatient unit of a Hospital in Jakarta.

This study was a cross-sectional, with sample of 125 patients with type 2 diabetes mellitus. The Diabetes Management Self- Efficacy (DMSES), the Diabetes Activities Questionare (TDAQ), and the Diabetes Quality of Life (DQOL) were employed as instruments.

The results showed that selfefficacy (0.0005), and adherence (0.0005) were significantly associated with quality of life and the most dominant variable is adherence.

Multivariate test results indicate that the variable self-efficacy, adherence, education level, and depression determines quality of life of diabetic patients. This study suggestsis the need fornursing assessment and interventions that focus on the self-efficacy and adherence diabetes mellitus patient."

"Introduction: Diabetes mellitus can cause various complications, including diabetic foot ulcers (DFU). Vitamin D levels are known to be correlated with wound healing and insulin resistance. Method: This cross-sectional study aimed to determine the correlation between the serum level of vitamin D and the severity degree of DFU. Thirty DFU patients with normal ankle- brachial index, grouped into degrees according to the Wagner classification, were included in this study. Their serum level of vitamin D was examined using the chemiluminescent immunoassay method. The correlation between these two variables was analyzed. Results: Patients were 18 males (60%) and 12 females (40%) with an average age of 57 years. The average serum level of vitamin D was 10.58 ng/mL. A significant correlation was found between the serum level of vitamin D and the severity of DFU (r= -0.901, p <0.001)."