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"Latar Belakang. Jumlah penyandang diabetes melitus terus meningkat sementara kendali glikemik masih sulit tercapai. Edukasi perlu berkelanjutan untuk mencapai kendali glikemik yang baik, sayangnya terdapat kendala waktu yang terbatas. Aplikasi telepon seluler merupakan sarana pemberian edukasi berkelanjutan dan berperan pada kendali glikemik tetapi manfaatnya di Indonesia belum diketahui. Tujuan. Mengetahui manfaat edukasi berbasis aplikasi telepon seluler dalam pengendalian glikemik penyandang DM tipe 2 dengan terapi insulin dosis multipel harian. Metode. Desain uji acak tersamar. Total 29 subjek pada kelompok intervensi (aplikasi DM educorner + edukasi standar) dan 31 subjek pada kelompok edukasi standar yang memenuhi kriteria inklusi yaitu DM tipe 2 berusia 30-60 tahun dengan insulin dosis multipel harian, memiliki A1C ≥ 7%, dan dapat menggunakan telepon pintar. Dilakukan pemeriksaan A1C saat awal dan setelah intervensi 3 bulan. Uji Wilcoxon digunakan untuk menganalisis perbedaan perubahan A1C setelah intervensi di kelompok edukasi dan aplikasi. Perbedaan perubahan A1C antar kelompok dianalisis dengan uji Mann Whitney. Perbedaan proporsi penurunan A1C ≥ 1% menggunakan uji kai kuadrat. Hasil. Perubahan A1C signifikan pada kelompok intervensi (edukasi + aplikasi) pasca 3 bulan evaluasi yaitu dari 9,5 (7,8-13)% menjadi 8,3 (5,8-10,5)%, p < 0,001. Tidak terdapat perbedaan perubahan signifikan A1C antara kelompok intervensi dengan kelompok kontrol, p = 0,103. Proporsi penurunan A1C ≥ 1% tidak berbeda bermakna antar kelompok, p = 0,427. Kesimpulan. Terdapat perbedaan nilai A1C penyandang DM tipe 2 dengan terapi insulin dosis multipel harian sebelum dan setelah pemberian edukasi dan aplikasi. Tidak terdapat perbedaan penurunan A1C maupun proporsi penurunan A1C ≥ 1% penyandang DM tipe 2 dengan terapi insulin dosis multipel harian antara kelompok yang mendapatkan edukasi secara tatap muka dan aplikasi dengan kelompok yang hanya mendapatkan edukasi secara tatap muka.

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Background. The number of people with diabetes mellitus increases while glycemic control is still difficult to achieve. Education needs to be given continuously to achieve good glycemic control, unfortunately there are time limited. The mobile phone application provides continuous education and plays a role in glycemic control but its benefits in Indonesia are still unknown. Objective. To know the benefit of mobile phone application-based education on glycemic control for people with type 2 diabetes on multiple daily dose insulin Methods. Randomized controlled trial. 29 subjects on the intervention group (education + smartphone application) and 31 subjects on the control group (education) who fulfill the inclusion criterias: type 2 diabetes, age 30-60 years old, using multiple daily dose insulin, A1C ≥ 7%, and operating smartphone. A1C was measured at the beginning and 3 months after intervention. Wilcoxon test was performed to analyze the difference of A1C before and after 3 months after intervention. Mann Whitney test was performed to analyze the difference change of A1C between groups. Chi square was performed to analyze the difference of proportion A1C ≥ 1% decrease between groups. Results. A1C change significantly in the intervention group after 3 months evaluation from 9,5 (7,8-13)% to 8,3 (5,8-10,5)%, p < 0,001. A1C change between groups is no difference, p = 0,103. There is no differemce of proportion A1C ≥ 1% decrease between groups, p = 0,427. Conclusion. There was a difference in A1C value of people with type 2 diabetes with multiple daily dose insulin therapy before and after the provision of education and application. There is no difference in A1C reduction and the proportion of A1C reduction ≥ 1% of people with type 2 diabetes mellitus with multiple daily dose insulin therapy between intervention (education + application) group and control (education only) group."

"Peningkatan kasus diabetes melitus tipe 2 (DMT2) dengan berbagai komplikasinya memberikan dampak gangguan fungsional seseorang dalam bentuk gangguan kognitif dan kapasitas fisik. Keduanya masih reversibel dan baru diketahui berhubungan sehingga disebut sebagai PhysioCognitive Decline Syndrome (PCDS). Kondisi PCDS baru dipelajari pada lansia dan belum spesifik pada penyandang DMT2.TujuanMengetahui korelasi antara kendali glikemik dengan komponen physiocognitive decline syndrome pada penyandang DMT2 dewasa usia pertengahan.Metode Studi potong lintang menggunakan consecutive sampling dari pasien di poliklinik metabolik endokrin dan poli jantung terpadu sejak Januari 2021 – November 2022. Subjek DMT2 berusia 40 – 59 tahun diinklusi. Pemeriksaan kekuatan genggam tangan, dan kecepatan berjalan 6-meter diperiksakan di ruangan standar. MoCA-Ina dilakukan oleh dokter yang telah dilatih. Data HbA1c subjek yang diperiksa adalah HbA1c 3 bulan terakhir. Analisis korelasi Pearson’s atau Spearman’s pada SPSS 20.0 dilakukan sesuai sebaran data.Hasil Sebanyak 133 subjek telah dianalisis. Usia median mencapai 53 tahun dengan proporsi laki-laki dan perempuan serta komplikasi pada masing-masing kateori kendali glikemik (batas HbA1c 7,0%) serupa. Subjek didominasi dengan pendidikan SMA dan Sarjana/Diploma. Median durasi terdiagnosisnya diabetes melitus mencapai 7 tahun dengan HbA1c median 7.6%. Nilai MoCA-Ina pada subjek mencapai nilai median 24 dengan kecepatan berjalan rerata 1.02 + 0.23 m/detik dan median kekuatan genggam tangan 24 kg. Terdapat korelasi bermakna hanya pada HbA1c dengan kekutan genggam tangan (r = -0.24, R2 = 0.06, p value <0.01), terutama pada perempuanKesimpulanTerdapat korelasi bermakna antara kendali glikemik dan kekuatan genggam tangan.

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Increasing cases of type 2 diabetes melitus (T2DM) including its complication have caused functional dysfunction consisted of cognitive decline and physical incapacity. Both cognitive decline and physical incapacity had been just known to be reversible and related to each other, so it is termed as PhysioCognitive Decline Syndrome (PCDS). However, it had been just evaluated in geriatric and not specific to T2DM patient.

To investigate the correlation between glycaemic correlation and component of physiocognitive decline syndrome in middle-aged adult with T2DM.

A cross sectional study with consecutive sampling in our metabolic and endocrine clinic and integrated heart centre in January 2021 – November 2022 had been conducted. Inclusion criteria was 40 – 59 years old subjects with T2DM. Measurement of HbA1c in the last 3 month were analysed, while hand grip strength and gait speed were done in standard room. MoCA-Ina had been conducted by trained doctor. Correlation analysis using Pearson’s or Spearman’s in SPSS 20.0 was done according to data distribution.

133 subjects were analysed. Median age was 53 years old with both sex and complication within each glycaemic control category (HbA1c 7,0% cut off) were similar. Subjects were dominated by high school and undergraduate/diploma education level. Most subjects were diagnosed in up to 7 years of T2DM. Median of HbA1c levels in our study was 7.6%. MoCA-Ina score was 24 in median with mean of gait speed was 1.02 + 0.23 m/s. Our median for hand grip was 24 kg. Significant correlation was only found in relationship of HbA1c and hand grip strength (r = -0.24, R2 = 0.06, p value <0.01).

There was significant correlation between glycaemic control and hand grip strength.

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"Latar BelakangPeningkatan kasus diabetes melitus tipe 2 (DMT2) dengan berbagai komplikasinya memberikan dampak gangguan fungsional seseorang dalam bentuk gangguan kognitif dan kapasitas fisik. Keduanya masih reversibel dan baru diketahui berhubungan sehingga disebut sebagai PhysioCognitive Decline Syndrome (PCDS). Kondisi PCDS baru dipelajari pada lansia dan belum spesifik pada penyandang DMT2.TujuanMengetahui korelasi antara kendali glikemik dengan komponen physiocognitive decline syndrome pada penyandang DMT2 dewasa usia pertengahan.MetodeStudi potong lintang menggunakan consecutive sampling dari pasien di poliklinik metabolik endokrin dan poli jantung terpadu sejak Januari 202-November 2022. Subjek DMT2 berusia 40-59 tahun diinklusi. Pemeriksaan kekuatan genggam tangan, dan kecepatan berjalan 6-meter diperiksakan di ruangan standar. MoCA-Ina dilakukan oleh dokter yang telah dilatih. Data HbA1c subjek yang diperiksa adalah HbA1c 3 bulan terakhir. Analisis korelasi Pearson’s atau Spearman’s pada SPSS 20.0 dilakukan sesuai sebaran data.HasilSebanyak 133 subjek telah dianalisis. Usia median mencapai 53 tahun dengan proporsi laki-laki dan perempuan serta komplikasi pada masing-masing kateori kendali glikemik (batas HbA1c 7,0%) serupa. Subjek didominasi dengan pendidikan SMA dan Sarjana/Diploma. Median durasi terdiagnosisnya diabetes melitus mencapai 7 tahun dengan HbA1c median 7.6%. Nilai MoCA-Ina pada subjek mencapai nilai median 24 dengan kecepatan berjalan rerata 1.02 + 0.23 m/detik dan median kekuatan genggam tangan 24 kg. Terdapat korelasi bermakna hanya pada HbA1c dengan kekutan genggam tangan (r = -0.24, R2 = 0.06, p value <0.01), terutama pada perempuanKesimpulanTerdapat korelasi bermakna antara kendali glikemik dan kekuatan genggam tangan.

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Background

Increasing cases of type 2 diabetes melitus (T2DM) including its complication have caused functional dysfunction consisted of cognitive decline and physical incapacity. Both cognitive decline and physical incapacity had been just known to be reversible and related to each other, so it is termed as PhysioCognitive Decline Syndrome (PCDS). However, it had been just evaluated in geriatric and not specific to T2DM patient.

Aim

To investigate the correlation between glycaemic correlation and component of physiocognitive decline syndrome in middle-aged adult with T2DM.

Methods

A cross sectional study with consecutive sampling in our metabolic and endocrine clinic and integrated heart centre in January 2021-November 2022 had been conducted. Inclusion criteria was 40-59 years old subjects with T2DM. Measurement of HbA1c in the last 3 month were analysed, while hand grip strength and gait speed were done in standard room. MoCA-Ina had been conducted by trained doctor. Correlation analysis using Pearson’s or Spearman’s in SPSS 20.0 was done according to data distribution.

Result

133 subjects were analysed. Median age was 53 years old with both sex and complication within each glycaemic control category (HbA1c 7,0% cut off) were similar. Subjects were dominated by high school and undergraduate/diploma education level. Most subjects were diagnosed in up to 7 years of T2DM. Median of HbA1c levels in our study was 7.6%. MoCA-Ina score was 24 in median with mean of gait speed was 1.02 + 0.23 m/s. Our median for hand grip was 24 kg. Significant correlation was only found in relationship of HbA1c and hand grip strength (r = -0.24, R2 = 0.06, p value <0.01).

Conclusion

There was significant correlation between glycaemic control and hand grip strength."

"Latar Belakang. Hanya sepertiga pasien DM tipe 2 yang mencapai target HbA1c yang diharapkan. Beberapa studi menunjukkan bahwa health coaching terbukti mampu menurunkan kadar HbA1c secara bermakna, namun belum banyak diketahui pengaruh health coaching dalam jangka panjang setelah coaching dihentikan.Tujuan. Tujuan penelitian ini adalah untuk mengetahui pengaruh edukasi dan health coaching dalam perbaikan kendali glikemik jangka panjang pada pasien DM tipe 2 rawat jalan di pusat kesehatan nasional tersier.Metode. Penelitian ini merupakan penelitian observasional lanjutan dari 6 bulan RCT yang dilaksanakan di dua pusat kesehatan nasional tersier untuk membandingkan kombinasi edukasi dan health coaching dengan edukasi sajapada pasien DM tipe 2 dengan diabetes yang tidak terkontrol. Subjek penelitian diikuti pada bulan ke-6 dan ke-18 dari RCT awal. Keluaran primer adalah beda rerata HbA1c antar kedua kelompok, dan keluaran sekunder adalah beda proporsi subjek yang mengalami penurunan HbA1c ≥1% dari baseline dan beda proporsi subjek yang mencapai target HbA1c <7%. Analisis data menggunakan uji-T independen dan uji Chi-square.Hasil. Penelitian ini berhasil mengumpulkan 42 dari 60 subjek (70%) yang mengikuti penelitian hingga bulan ke-18. Tidak ada perbedaan yang bermakna rerata HbA1c antara kelompok intervensi dibandingkan kelompok kontrol (8,70[±2,00] vs 9,02 [±1,71], p=0,334); dengan rerata HbA1c yang meningkat secara bermakna jika dibandingkan dengan rerata HbA1c bulan ke-6 (8,70 [±2,00] vs 7,83 [±1,80], p=0,016). Keluaran sekunder didapatkan perbedaan yang bermaknaproporsi subjek yang mengalami penurunan kadar HbA1c ≥1% antara kelompok intervensi dibandingkan kelompok kontrol (41,4% [n=12] vs 10,3% [n=3], p=0,015); serta tidak ada perbedaan yang bermakna proporsi subjek yang mencapai target HbA1c <7% (13,8% [n=4] vs 6,9% [n=2], p=0,670).Kesimpulan. Health coaching tidak mampu mempertahankan perbaikan kendali glikemik pada pasien DM tipe 2 untuk jangka panjang jika coaching dihentikan, diperlukan pemberian coaching ulang agar perbaikan kendali glikemik dapat menetap.

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Background. Only one-third of type 2 DM patients achieved the expected HbA1c

target. Several studies have shown that health coaching has been shown to be able

to significantly reduce HbA1c levels, but it is not widely known the effects of

long-term health coaching after coaching is stopped.

Aim. This study was to determine the effect of education and health coaching in

improving long-term glycemic control in outpatients with type 2 diabetes at a

tertiary national health center.

Method. This study is a follow-up observational study of 6 months RCT

conducted in two tertiary national health centers to compare the combination of

education and health coaching with education alone in type 2 diabetes mellitus

patients with uncontrolled diabetes. Study subjects were followed at 6 and 18

months of baseline RCT. The primary outcome was the difference in the mean

HbA1c between the two groups, and the secondary outcome was the difference in

the proportion of subjects who experienced a decrease in HbA1c ≥1% from

baseline and the difference in the proportion of subjects who achieved the HbA1c

target <7%. Data analysis used independent T-test and Chi-square test.

Result. This study managed to collect 42 out of 60 subjects (70%) who attended

the study until the 18th month. There was no significant difference in the mean

HbA1c between the intervention group and the control group (8.70 [± 2.00] vs

9.02 [± 1.71], p = 0.334); with the mean HbA1c which increased significantly

when compared with the mean HbA1c at 6 months (8.70 [± 2.00] vs 7.83 [± 1.80],

p = 0.016). Secondary outcomes showed a significant difference in the proportion

of subjects who experienced a decrease in HbA1c levels ≥1% between the

intervention group and the control group (41.4% [n = 12] vs 10.3% [n = 3], p =

0.015); and there was no significant difference in the proportion of subjects who achieved the HbA1c target <7% (13.8% [n = 4] vs 6.9% [n = 2], p = 0.670).

Conclusion. Health coaching is unable to maintain improved glycemic control in type 2 DM patients for the long term when coaching is stopped, re-coaching is needed so that improved glycemic control can persist."

"Latar belakang: Diabetes melitus tipe 2 (DMT2) disandang oleh 10,7 juta orang di Indonesia dan menjadi tiga besar penyakit tidak menular penyebab kematian. Sebagian besar kematian terjadi akibat komplikasi yang diawali oleh kontrol glikemik kadar HbA1c yang tidak adekuat, dan diasosiasikan dengan aspek multifaktorial seperti karakteristik sosiodemografi maupun perilaku individu dalam merawat diri—Self-Care Behaviour. Penelitian ini bertujuan mengetahui hubungan antara tingkat kontrol glikemik pada penyandang DMT2 dengan karakteristik sosiodemografi dan perilaku self-care yang dimiliki. Metode: Studi ini menggunakan desain potong-lintang terhadap data sekunder yang dikumpulkan sebelumnya pada Kohor Penyakit Tidak Menular Bogor 2021. Data dikumpulkan menggunakan kuesioner Self-Care Behaviour yang divalidasi dalam bahasa Indonesia, pengukuran kadar HbA1c serta karakteristik penyandang. Populasi studi adalah penyandang DMT2 di lima fasilitas kesehatan primer di Kota Bogor. Sampel dianalisis menggunakan uji Chi-Square dan perhitungan odds ratio. Hasil: Analisis dilakukan pada 237 responden, terdiri atas 90 responden kelompok usia lansia (38%) dan 147 dewasa (62%). Jenis kelamin responden didominasi perempuan sebanyak 171 responden (72,2%) dan 66 responden laki-laki (27,8%). Sebanyak 149 responden (62,9%) memiliki skor Self-Care Behaviour yang baik. Sejumlah 134 responden (56,6%) memiliki kadar HbA1c yang terkontrol. Empat dari tujuh komponen Self-Care Behaviour—pengetahuan, motivasi, dukungan, dan efikasi—berhubungan dengan kontrol glikemik (p<0,001). Efikasi menjadi prediktor kadar HbA1c terkontrol paling kuat (Odds ratio [OR]: 9,7; 95% Confidence Interval [CI] 5,27–17,67). Skor keseluruhan Self-Care Behaviour yang baik meningkatkan probabilitas kadar HbA1c terkontrol 9,1 kali (95% CI 4,94–16,7) dibanding skor kurang baik. Komponen komunikasi, sikap, dan pembiayaan tidak memiliki hubungan signifikan. Tingkat pendidikan dan riwayat DMT2 di keluarga berhubungan dengan tingkat keseluruhan Self-Care Behaviour dan dengan kontrol kadar HbA1c. Kesimpulan: Aspek perilaku self-care pada penyandang DMT2 mempunyai dampak substansial dan signifikan terhadap kontrol glikemik yang dimiliki penyandang.

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Introduction: Type 2 diabetes mellitus (T2DM) affects 10.7 million individuals in Indonesia and ranks among the top three non-communicable diseases leading to death. Most of mortality result from complications initiated by inadequate glycemic control, associated with multifactorial aspects such as sociodemographic characteristics and individual self-care behaviour. This study aims to explore the relationship between glycemic control levels in individuals with T2DM and their sociodemographic characteristics and self-care behavior. Method: This study is a cross-sectional study utilizing previously collected secondary data from the Non-Communicable Disease Cohort in Bogor 2021 Data were collected using a validated Self-Care Behaviour questionnaire in Bahasa Indonesia, along with primary data of HbA1c levels and respondent socio-characteristics. The study population consisted of individuals with T2DM from five primary healthcare facilities in Bogor city. The samples were analyzed using Chi-Square test and risk calculation. Result: The research analysis included 237 respondents, consisting of 90 elderly (38%) and 147 adults respondents (62%). The respondents were predominantly female, with 171 respondents (72.2%) compared to 66 male respondants (27.8%). A total of 149 respondents (62.9%) exhibited good Self-Care Behaviour scores. Approximately 134 respondents (56.6%) maintained controlled HbA1c levels. Four out of seven Self-Care Behaviour components—knowledge, motivation, support, and efficacy—were associated with glycemic control (p<0.001). Efficacy identified as the most influential predictor for controlled HbA1c levels (odds ratio [OR]: 9.7, 95% Confidence Interval [CI] 5.27–17.67). An overall good Self-Care Behaviour score is associated with a 9.1-fold increased probability of achieving controlled HbA1c levels (95% CI 4.94–16.7) compared to group with poor score. Self-Care Behaviour components of communication, attitude, and financing were not signicifantly associated. Education level and a family history of T2DM were associated with overall Self-Care Behaviour and with HbA1c control."

"Diabetes melitus tipe 2 merupakan masalah kesehatan yang masih dihadapi di Indonesia. Hiperglikemia menyebabkan risiko komorbiditas meningkat salah satunya tuberkulosis paru. Pasien DM dengan TB paru meningkatkan morbiditas dan mortalitas. Dukungan nutrisi dilakukan untuk membantu memperbaiki kadar glukosa darah. Energi yang mencukupi dan pemberian serat merupakan tatalaksana gizi yang dapat membantu memperbaiki kadar glukosa darah. Serial kasus ini melaporkan empat pasien diabetes melitus tipe 2 dengan tuberkulosis paru yang memiliki rentang usia 49-57 tahun dan status gizi yang bervariasi. Terapi medik gizi diberikan sesuai dengan rekomendasi nutrisi untuk pasien diabetes melitus. Pemenuhan kebutuhan mikronutrien diberikan dengan suplementasi. Hasilnya yaitu kadar glukosa darah dua orang pasien dalam rentang normal 140-180 mg/dl, dengan asupan sesuai target kebutuhan dan komposisi protein 16-20%, lemak 20-18%, karbohidrat 52-64% dan serat 10-20 g/hari. Namun dua pasien dengan status gizi obes kadar glukosa darah masih belum terkontrol dan asupan energi belum mencapai target kebutuhan karena anoreksia dan infeksi yang belum teratasi. Kesimpulannya dukungan nutrisi dengan energi dan serat sesuai rekomendasi dapat membantu memperbaiki kadar glukosa darah.

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Type 2 diabetes still a major health problem in Indonesia. Hyperglycemia increase the risk of comorbidity include lung tuberculosis. Since morbidity and mortality of patients with type 2 diabetes and lung tuberculosis increase, nutrition therapy may improve blood glucose level. Provide adequate energy and fiber as a part of medical nutrition therapy for maintain the blood glucose level. This is a case series of four patients with type 2 diabetes and lung tuberculosis, age 49-57 years old, having various nutritional status. The medical nutritional therapy was given to patients according to the diabetes mellitus guidelines. Supplementation were administered to fulfill their requirement. Result: the blood glucose level of two patients within normal range 140-180 mg/dl, with adequate energy intake, protein 16-20%, fat 20-28%, and carbohydrate 52-64% and fiber 10-20 g/day. However the others with obesity remains uncontrolled glucose level, despite of their low intake of energy. It occured due to anorexia and untreated infection. Conclusion: Medical nutritional therapy with adequate energy and fiber may improve the blood glucose level."

"Latar Belakang. Terdapat dua hipotesis mengenai terjadinya diabetes melitus tipe 2 yaitu kegagalan sel beta pankreas dan resistensi insulin. Mengingat pengaruh faktor genetik pada kejadian DM tipe 2 maka diperkirakan resistensi insulin juga dipengaruhi faktor genetik. Sejauh ini data prevalensi resistensi insulin dan gambaran metabolik pads saudara kandung subyek DM tipe 2 di Indonesia belum ada.Tujuan. Mendapatkan angka prevalensi resistensi insulin pada saudara kandung subyek dengan DM tipe 2 dan mendapatkan data profil metabolik (profil lipid, IMT, lingkar perut, konsentrasi asam urat darah), tekanan darah dan distribusinya pads seluruh saudara kandung subyek dengan DM tipe 2Metodologi. Studi pendahuluan dan potong lintang dilakukan pada 30 saudara kandung subyek DM tipe 2 yang datang berobat di Poliklinik Metabolik dan Endokrinologi RSUPN Dr Cipto Mangunkusumo, untuk dilakukan wawancara, pemeriksaan fisik, konsentrasi insulin darah puasa, glukosa puasa, trigliserida, kolesterol HDL dan asam urat. Resistensi insulin ditentukan dari persentil 75 dari HOMA-IR.Hasil. Nilai cut-off HOMA-IR pada penelitian ini sebesar 2,04. Frekuensi resistensi insulin pads saudara kandung subyek DM sebesar 26,67% dengan proporsi di tiap keluarga bervariasi dari 0-75%. Semua subyek dengan resistensi insulin memiliki obesitas sentral dan sebanyak 75% memiliki IMT > 25. Komponen metabolik yang paling banyak ditemukan adalah obesitas sentral (56,7%), menyusul hipertensi (46,7%), hipokolesterol HDL dan hipertrigliseridemia masing-masing 26,6%, dan hiperglikemia (20%).Simpulan. Frekuensi resistensi insulin pada saudara kandung subyek DM tipe 2 sebesar 26,67% dengan proporsi yang bervariasi di setiap keluarga antara 0-75%. Komponen metabolik paling banyak ditemukan adalah obesitas sentral.

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Backgrounds. There are two hypothesis in the pathogenesis of type 2 DM, beta cell failure and insulin resistance. As genetic background has significant role in type 2 DM cases, insulin resistance is also suspected to be influenced by genetic factor. Thus far, there are no insulin resistance prevalence data and metabolic abnormalities among siblings of subjects with type 2 DM available in Indonesia.Objectives. To obtain prevalence figure of insulin resistance among siblings of subjects with type 2 DM and to obtain their metabolic abnormality profiles as measured by their BMI, waist circumference (WC), blood pressure, glucose intolerance, concentration of triglyceride, HDL cholesterol and uric acid.Methods. Cross-sectional study is conducted to 30 siblings of subjects with type 2 DM who are still alive and agree to participate in this study. The subjects are interviewed, physically examined and go through laboratory examination (fasting plasma insulin, plasma glucose, serum triglyceride, HDL cholesterol and uric acid concentration). Insulin resistance is derived from 75 percentile of HOMA-IR.Results. The HOMA-IR cut-off value found in this study is 2,04. The frequency of insulin resistance is 26,67% among siblings of subjects with type 2 DM within variation range of 0-75%. All of subjects with insulin resistance have central obesity. About 75% subjects with insulin resistance have BMI ? 25. The metabolic components which are frequently found in this study can be ranked as follows; central obesity (56,7%), hypertension (46,7%), hypocholesterol HDL (26,6%), hypertriglyceridemia (26,6%) and hyperglycemia (20%).Conclusion. The frequency of insulin resistance is 26,67% among siblings of subjects with type 2 DM within variation range of 0-75%. Among the metabolic components found in this study, central obesity is the most frequent."

"Beberapa studi epidemiologi maupun studi metaanalisis menunjukkan beberapa faktor pada DM tipe 2 memiliki hubungan dengan risiko terjadinya kanker. Mutan p53 yang terbukti berkontribusi terhadap perkembangan tumor sementara insulin yang diketahui berperan dalam mengendalikan kadar gula tubuh, dipilih menjadi biomarker yang akan diteliti pada penelitian ini. Penelitian ini bertujuan untuk mempelajari hubungan kadar mutan p53 dan insulin pada kelompok pasien DM tipe 2 + kanker (n=51) dan pasien DM tipe 2 (n=51). Penelitian ini merupakan penelitian cross-sectional dengan teknik pengambilan sampel consecutive sampling. Pada penelitian, diketahui tidak terdapat perbedaan yang bermakna (p=0,774) pada nilai mutan p53 antara kelompok pasien DM tipe 2 + kanker (1,65±0,10 ng/mL) dan kelompok pasien DM tipe 2 (1,62±0,09 ng/mL). Terdapat perbedaan bermakna (p<0,001) pada kadar insulin antara kelompok pasien DM tipe 2 + kanker (19,33±2,68 µIU/mL) dan kelompok pasien DM tipe 2 (37,31±2,68 µIU/mL). Tidak terdapat korelasi bermakna antara kadar mutan p53 dengan kadar insulin pada kelompok pasien DM tipe 2 + kanker (r=0,191; p= 0,179) dan pada kelompok pasien DM tipe 2 (r=-0,081; p= 0,574). Berdasarkan hasil penelitian, dapat disimpulkan bahwa tidak ada perbedaan bermakna pada kadar mutan p53 antara kelompok pasien DM tipe 2 + kanker dan kelompok pasien DM tipe 2, namun terdapat perbedaan pada kadar insulin pada kedua kelompok. Selain itu, tidak ada korelasi bermakna antara kadar mutan p53 dan insulin pada kedua kelompok.

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Epidemiological studies and meta-analysis have shown that several factors in type 2 DM are related to cancer incidents. Mutant p53 is scientifically proven to contribute in tumor development while insulin that known well to play an important role in controlling body glucose levels, therefore those two biomarkers were chosen to be investigated in this study. This research aimed to study the correlation of mutant p53 and insulin in type 2 DM + cancer (n=51) and type 2 DM patients (n=51). This research was a cross-sectional study with consecutive technique sampling. This study showed that there was no significant difference (p=0.774) of mutant p53 value between type 2 DM + cancer patients group (1.65±0.10 ng/mL) and type 2 DM patients group (1.62±0.09 ng/mL). However, it was significant difference (p<0.001) of insulin value in type 2 DM + cancer patients group (19.33±2.68 µIU/mL) and type 2 DM patients group (37.31±2.68 µIU/mL). There was also no significant correlation between mutan p53 and insulin value in type 2 DM + cancer patients group (r=0.191; p=0.179) and type 2 DM patients group (r=-0.081; p=0.574). Based on the results, we concluded that there was no significant difference of mutant p53 value in type 2 DM + cancer patients group and in type 2 DM patients group but there was significant difference of insulin value in both groups. There was also no significant correlation between mutan p53 and insulin value in both groups."

"[ABSTRAKDiabetic Kidney Disease DKD pada Diabetes Melitus Tipe 2 DMT2 merupakan komplikasi kronik yang dapat dicegah dan ditunda progresifitasnya dengan pengontrolan glikemik yang baik dan penatalaksanaan yang tepat dari komorbid lainnya Pengontrolan glikemik menjadi tanggung jawab bersama antara multidisiplin profesi kesehatan di ruang rawat dokter perawat dietisien farmasis dengan pasien serta keluarga Model Self care Orem sangat sesuai untuk diaplikasikan dan dikembangkan di ruangan pada asuhan keperawatan pasien dengan penyakit kronik Pasien dapat bersinergi secara aktif sesuai kemampuannya dalam mencapai tujuan dari setiap intervensi keperawatan Disamping itu pendekatan model self care Orem sesuai untuk mempersiapkan pasien dalam meningkatkan kemampuan self care untuk pasca rawat Pelaksanaan praktek berbasis pembuktian pengukuran suhu kaki dengan termometer infrared dapat menjadi perangkat tambahan untuk menilai adanya gejala inflamasi lokal sehingga upaya deteksi dini menjadi lebih komprehensif Pelaksanaan kegiatan inovasi pemantauan dan pemeriksaan kesehatan mandiri pada pasien DM dapat meningkatkan upaya promosi kesehatan pada pasien DM

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ABSTRACTDiabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients , Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ]"

"[ABSTRAK Diabetic Kidney Disease (DKD) pada Diabetes Melitus Tipe 2 (DMT2) merupakan komplikasi kronik yang dapat dicegah dan ditunda progresifitasnya dengan pengontrolan glikemik yang baik dan penatalaksanaan yang tepat dari komorbid lainnya. Pengontrolan glikemik menjadi tanggung jawab bersama antara multidisiplin profesi kesehatan di ruang rawat (dokter, perawat, dietisien, farmasis) dengan pasien (serta keluarga). Model Self care Orem sangat sesuai untuk diaplikasikan dan dikembangkan di ruangan pada asuhan keperawatan pasien dengan penyakit kronik. Pasien dapat bersinergi secara aktif sesuai kemampuannya dalam mencapai tujuan dari setiap intervensi keperawatan. Disamping itu pendekatan model self care Orem sesuai untuk mempersiapkan pasien dalam meningkatkan kemampuan self care untuk pasca rawat. Pelaksanaan praktek berbasis pembuktian, pengukuran suhu kaki dengan termometer infrared dapat menjadi perangkat tambahan untuk menilai adanya gejala inflamasi lokal sehingga upaya deteksi dini menjadi lebih komprehensif. Pelaksanaan kegiatan inovasi pemantauan dan pemeriksaan kesehatan mandiri pada pasien DM dapat meningkatkan upaya promosi kesehatan pada pasien DM.ABSTRACT Diabetic Kidney Disease (DKD) in Type 2 Diabetes Mellitus (T2DM) is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments. Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward (doctors, nurses, dietisien, pharmacists) and patients (and families). Orem?s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases. Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention. Besides, Orem?s self care model approach appropriate to prepare the patient to improve the ability of self care for post-hospitalization. Implementation of evidence-based practice, the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive. Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients. ;Diabetic Kidney Disease (DKD) in Type 2 Diabetes Mellitus (T2DM) is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments. Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward (doctors, nurses, dietisien, pharmacists) and patients (and families). Orem?s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases. Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention. Besides, Orem?s self care model approach appropriate to prepare the patient to improve the ability of self care for post-hospitalization. Implementation of evidence-based practice, the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive. Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients. , Diabetic Kidney Disease (DKD) in Type 2 Diabetes Mellitus (T2DM) is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments. Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward (doctors, nurses, dietisien, pharmacists) and patients (and families). Orem’s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases. Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention. Besides, Orem’s self care model approach appropriate to prepare the patient to improve the ability of self care for post-hospitalization. Implementation of evidence-based practice, the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive. Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients. ]"