Hasil Pencarian  ::  Simpan CSV :: Kembali

"Tujuan: Mengumpulkan informasi mengenai penanganan dan komplikasi diabetes, serta kesadaran pengendaliandiri sendiri penderita diabetes di Indonesia. Studi ini juga mengevaluasi perspektif dokter, aspek psikologis, dankualitas hidup pasien.Metode: Studi non-intervensi, potong lintang, merekrut 1832 pasien dari pusat kesehatan sekunder dan tersierdi Indonesia. Data mengenai demografi , riwayat medis, faktor resiko, dan laporan pemeriksaan klinis termasuklaboratorium dikumpulkan dari rekam medis pasien. Sampel darah dikumpulkan untuk pengukuran HbA1c yangtersentralisasi.Hasil: Di antara 1832 pasien, 1785 individu memenuhi syarat untuk dianalisis. Rata-rata usia adalah 58,9+9,6tahun. Lamanya menderita diabetes 8,5+7,0 tahun. Mayoritas pasien (97,5%) menderita diabetes tipe 2.67,9% pasienmemiliki kontrol diabetes yang buruk (A1c: 8,1 ± 2,0%). 47,2% pasien memiliki kadar Glukosa Plasma Puasa >130mg/dL (161,6±14,6 mg/dL). Dislipidemia dilaporkan pada 60% pasien (834/1390) dan 74% (617/834) di antaranyamendapatkan obat hipolipidemik. Neuropati merupakan komplikasi paling umum (67.2%); komplikasi diabeteslainnya antara lain: katarak: 14.5% Retinopati diabetik non-proliferatif: 8.3%, kreatinin serum>2 mg/dl: 3.6%,ulkus yang sudah sembuh: 3.8%, angina pectoris 9.9% dan stroke 5.6%. Sekitar 81.3% pasien menerima terapi obathipoglikemik oral (OHO) (± insulin), 37,7% pasien menerima terapi insulin (±OHO). Penggunaan biguanide diikutioleh sulfonylurea. Mayoritas pasien menggunakan insulin manusia 73,2%, regimen premiks 58,5%, insulin analog24,9%. Mayoritas respon indeks kesehatan WHO-5 jatuh dalam teritori positif.Kesimpulan: Kontrol glikemik yang buruk pada mayoritas pasien diabetes perlu diperhatikan. Terdapat kebutuhan untukpenyesuaian terapi dari sebagian besar pasien menuju terapi farmakologis yang lebih intensif dan pendekatan multidisiplinerharus digunakan. Temuan studi ini perlu dikomunikasikan kepada pembuat kebijakan dan dokter untuk membantumereka memberikan perawatan kesehatan dan fasilitas yang baik.

---

AbstractAim: To collect information on diabetes management, diabetes complications, and awareness of self-control indiabetic population of the country. This study also evaluated the physician perspectives, psychological aspects, andquality of life of diabetic patients.Methods: This was a non-interventional, cross-sectional study, which recruited 1832 patients from secondary andtertiary medical centers across Indonesia. Data on demography, medical history, risk factors and clinical examinationreports including laboratory assessments were collected from medical records of patients. Blood samples of all patientswere collected for centralized HbA1c measurements.Results: Among 1832 patients, 1785 individuals were eligible for analysis. The mean age of the patients was 58.9+9.6years. The mean duration of diabetes was 8.5+7.0 years. Majority (97.5%) of the patients had type 2 diabetes. 67.9%had poor control of diabetes (A1c:8.1 ± 2.0%). 47.2% had FPG>130 mg/dL (161.6±14.6 mg/dL). Dyslipidemia wasreported in 60% (834/1390) and 74% (617/834) of those received lipid lowering treatment. Neuropathy was most commoncomplication (63.5%); other complications were: Diabetic retinopathy 42%, nephropathy 7.3%, severe late complications16.9%, macrovascular complications 16%, microvascular complications 27.6%. About 81.3% of patients were on OADs(± insulin), 37.7% were on insulin (±OADs). Majority used biguanides followed by sulfonylureas. Human insulin was usedby 73.2%, premix regimen 58.5%, analogues usage was 24.9%. Majority of the WHO-5 well being index responses fell inpositive territory.Conclusion: Poor glycaemic control in majority of patients is a concern. There is a need for a large proportion ofpatients to be adjusted to more intensive pharmacotherapy and a multi-disciplinary approach for management shouldbe adopted. The study fi ndings should be communicated to policymakers and physicians to help them provide properhealthcare and its facilities in Indonesia."

"Latar belakang: Prevalensi komplikasi DM semakin meningkat termasuk di Indonesia. Untuk mencegah komplikasi DM diperlukan perubahan perilaku. Setiap pasien DM memiliki kebutuhan dan tujuan kesehatan yang bervariasi, maka person-centered approach perlu diberikan sebagai strategi yang menjanjikan untuk mengubah perilaku dalam mencegah komplikasi DM. Salah satu strateginya adalah dengan coaching. Melalui coaching, diharapkan dapat meningkatkan efikasi diri dan penerimaan diri sebagai mediator dalam mengubah perilaku dalam mencegah komplikasi DM. Tujuan: dikembangkannya model coaching keperawatan berdasarkan analisis eksploratori tentang pengalaman perilaku pencegahan komplikasi dan efektivitasnya terhadap efikasi diri, penerimaan diri, perilaku pencegahan komplikasi dan metabolik markers pada pasien DM tipe 2. Metodologi: Penelitian ini menggunakan mixed-method dengan desain eksploratori sekuensial melalui tiga tahap. Purposive sampling digunakan untuk pengambilan sampel. Tahap pertama melibatkan lima belas pasien DM tipe 2 sebagai partisipan, tahap kedua melibatkan tiga orang sebagai pakar, dan tahap ketiga melibatkan 70 pasien DM tipe 2 sebagai responden. Hasil: Teridentifikasi empat tema yang menjadi dasar pengembangan model. Tersusun empat modul sebagai penjelasan model dan pedoman implementasi model coaching keperawatan. Hasil menunjukkan adanya efektivitas intervensi model coaching keperawatan terhadap efikasi diri, penerimaan diri, perilaku pencegahan komplikasi DM, dan tekanan darah sistol (p < 0,001), serta GDP (p = 0,014), namun tidak efektif terhadap HbA1c, kolesterol total, dan tekanan darah diastol (p > 0,05). Analisis lebih lanjut menunjukkan bahwa tidak ada efek variabel perancu terhadap efikasi diri, penerimaan diri, perilaku pencegahan komplikasi DM, GDP dan tekanan darah sistol (p > 0,05), namun ada efek usia terhadap perilaku pencegahan komplikasi DM (p = 0,011), dan ada efek jenis kelamin terhadap tekanan darah sistol (p = 0,018). Simpulan: Setelah mengontrol variabel perancu, intervensi model coaching keperawatan mampu meningkatkan skor rerata efikasi diri, memperbaiki penerimaan diri, meningkatkan perilaku pencegahan komplikasi DM, menurunkan skor rerata GDP, dan tekanan darah sistol. Saran: Intervensi model coaching keperawatan dapat diadopsi sebagai salah satu intervensi keperawatan dalam mencegah komplikasi DM tipe 2.

---

Background: The prevalence of DM complications is increasing, including in Indonesia. To prevent DM complications, behavior change is needed. Each DM patient has varied health needs and goals, so a person-centered approach needs to be provided as a promising strategy to change behavior in preventing DM complications. One of the strategies is coaching. By implementing coaching, it is expected to increase self-efficacy and self-acceptance as mediators in changing behavior in preventing DM complications. Aim: to identify the effectiveness of nursing coaching model intervention on self-efficacy, self-acceptance, prevention DM complications behaviors and the impact on metabolic markers in patients with type 2 DM. Methods: A mixed-method approach with exploratory sequential steps was conducted. Purposive sampling was used to approach the participants. The first step involved fifeteen participants with type 2 DM; the second step involved three experts, and the third step involved 70 participants with type 2 DM. Results: The results showed there were four themes as a basis for developing a model. There were four modules as part of the nurse coaching model. There was an effect of nursing coaching model intervention on self-efficacy, self-acceptance, prevention DM complications behaviors, and systolic blood pressure (p < 0,001), as well as fasting blood glucose (p = 0,014); however, there was no effect of nursing coaching model intervention on HbA1c, total cholesterol, and diastolic blood pressure (p > 0,05). Furthermore, there was no effect of confounding variables on self-efficacy, self-acceptance, prevention DM complications behaviors, fasting blood glucose, and systolic blood pressure (p > 0,05). Conclusion: After controlling confounding variables, a nursing coaching model intervention improves the mean score of self-efficacy self-acceptance, prevention DM complications behaviors, and decreasing the mean score of FBG and systolic. Suggestion: A nursing coaching model intervention can be adopted as one of the nursing interventions to prevent DM complications, especially at the Public Health Center."

"This book, a renowned group of leading researchers and physicians offers a comprehensive overview of the role of C-Peptide in type 1 diabetes. The book is organized in five sections. An Introductory section provides the background and key features of C-peptide?s physiological function and how its deficiency contributes to complications. The second section describes up-to-date information on the biochemical and molecular actions of C-peptide, including membrane binding, interactions with insulin as well as the interaction between C-peptide and zinc and effects on microvascular vasoreactivity. The third section summarizes in vivo animal studies of the type 1 diabetic complications. The fourth section reviews the clinical efforts of C-peptide on inflammation, cardiovascular complication, neuropathy and nephropathy. Finally, in the Conclusions section, a summary of the present state of C-peptide, outstanding questions, and the likely direction of the field are offered. "

"Prevention of type 2 diabetes can be achieved properly by simultaneous prevention of obesity. Prediabetes, or metabolic syndrome, is the period between simple obesity and diabetes, and this critical period needs to be identified in a more consistent and systematic manner by clinicians worldwide. Clinical trials have indicated that diabetes prevention can be achieved by lifestyle changes and also by certain medications, though none are yet approved for use in prevention. On the other hand, there are funding agencies such as the NIH, CDC, and state institutions that are interested in studying the prevention paradigms in different communities and ethnic minorities who are most prone to this epidemic. For these reasons, this title by renowned physician-scientist Derek LeRoith is both timely and vitally important for academic physicians, practitioners, allied health care providers, analysts, community activists, and all others interested in this increasing epidemic. This book provides a unique and comprehensive synthesis of the prevention and early diagnosis of Type 2 Diabetes, focusing on identifying risk factors and then moving into topics that address how to prevent their progression to full-blown diabetes. The difficult task of changing patients’ behavior is given special emphasis. The chapters in this practical volume are written by a wide range of international experts, reflecting the editor’s distinguished, internationally renowned career. The volume is organized in eight sections: an introduction to the overall issue of prevention, definitions of values based on ADA guidelines, pathophysiology, discussion of a range of interventional trials regarding prevention, and an overview of state-of-the-art clinical management approaches. "