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ABSTRAK Latar belakang: Tujuan penelitian ini adalah untuk mengetahui pengaruh minyak zaitun dan minyak bekatul terhadap kontrol glikemik dan profil lipid pada pasien dengan diabetes mellitus tipe 2. Metode: 10 subjek menerima 15 ml / hari minyak zaitun dan minyak bekatul. Kadar glukosa darah puasa, glukosa postprandial, kolesterol total, low-density lipoprotein (LDL), high-density lipoprotein (HDL), dan trigliserida (TG) diukur. Subjek dicross over setelah periode wash out. Data dianalisis menggunakan uji-t berpasangan atau uji Wilcoxon yang sesuai dalam kelompok minyak bekatul dan minyak zaitun. Hasil: perubahan glukosa darah puasa, glukosa postprandial, kolesterol total, LDL, dan TG tidak berbeda secara signifikan pada kedua kelompok. Namun, secara signifikan menurunkan kadar HDL diamati pada dua kelompok. Kesimpulan: Minyak bekatul dan minyak zaitun tidak berpengaruh signifikan terhadap kadar glukosa darah puasa dan glukosa postprandial.

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ABSTRACT Background: The aim of this study was to determine the effect of extra virgin olive oil (EVOO) and rice bran oil (RBO) on glycemic control and lipid profile in patients with type 2 diabetes mellitus (DM). Methods: 10 subjects received 15 ml/day of EVOO and RBO. Fasting blood glucose, postprandial glucose, total serum cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) were measured. Subjects were cross-covered after wash out. Data were analyzed using paired t-test or Wilcoxon test as appropriate in the group RBO and EVOO. Results: the changes of fasting blood glucose, postprandial glucose, total cholesterol, LDL, and TG were not significantly different in the two groups. However, significantly decreased the levels of HDL were observed in two groups. Conclusion: RBO and EVOO no significant influence on the levels of fasting blood glucose and postprandial glucose.

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Hipoglikemia bisa terjadi selama pasien dirawat di rumah sakit yang disebabkan oleh iatrogenic. Tujuan penelitian ini untuk mengeksplor pengalaman perawat dalam pemantauan, penanganan dan penggunaan protokol hipoglikemia di rumah sakit. Penelitian ini dilakukan dengan wawancara mendalam pada 10 perawat tentang pengalaman mereka dalam pemantauan, penanganan, dan penggunaan protokol hipoglikemi, sehingga memperoleh enam tema yakni: perawat memahami hipoglikemia berdasarkan gejala fisik dan nilai gula darah; kecemasan perawat menghadapi hipoglikemi; ketidakberadaan dokter dan hambatan komunikasi dalam penanganan hipoglikemi; perawat melakukan pemeriksaan gula darah dan keluhan pasien untuk mengkaji hipoglikemia; memutuskan untuk melakukan tindakan medis secara mandiri sesuai kebiasaan; dan merasa tidak familiar dengan keberadaan protocol hipoglikemia. Kesimpulan dari penelitian menunjukkan bahwa dalam penanganan hipoglikemia perawat masih mengalami kecemasan dan cenderung memberikan intervensi sesuai dengan kebiasaan.

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ABSTRACT
Patients may experience hypoglycemia during hospitalization which is caused by Iatrogenic. This study aimed to describe experience of nurses in monitoring, treating and using guideline of Hypoglycemia in patients with diabetes mellitus. An indepth interview was conducted that involved 10 nurses. There were six themes identified through this method, they were nurses anxiety facing hypoglycemia the absence of physician and communication barriers in the treatment of hypoglycemia nurses undertaking blood glucose check and complains of patients in monitoring hypoglycemia deciding to follow medical treatment independently based on routine and found unfamiliar with the existence of protocol. The conclusion indicates that nurses are still struggling with anxiety and tend to apply their routine in dealing with hypoglycemia.

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Nama : Utami RachmawatiProgram Studi : Magister Ilmu KeperawatanJudul Riset : Hubungan Karakteristik, Melek DM, dan Kesadaran Diri dengan Manajemen Diri Lansia dengan DM di Kota Depok Melek DM dan kesadaran diri merupakan aspek internal yang perlu dimiliki lansia dengan DM selama menjalani manajemen diri DM. Penelitian ini bertujuan untuk mengetahui hubungan karakteristik, melek DM, dan kesadaran diri dengan manajemen diri lansia dengan DM. Desain penelitian ini adalah deskriptif korelasi dengan pendekatan cross-sectional menggunakan sampel lansia dengan DM di wilayah Depok sebesar 106 responden yang dipilih dengan teknik cluster sampling. Analisis menggunakan uji t independen pada variabel jenis kelamin, suku, pendidikan terakhir, riwayat DM keluarga dan Pearson product moment pada variabel usia, penghasilan, melek DM dan kesadaran diri. Analisis multivariat menggunakan regresi logistik. Karakterisik responden memiliki median usia 64 tahun, mayoritas bersuku Jawa, memiliki proporsi pendidikan rendah dan menengah yang sama, median penghasilan 2 juta, serta sebagian besar memiliki riwayat DM keluarga. Hasil penelitian menunjukkan bahwa terdapat hubungan yang signifikan antara usia, jenis kelamin, penghasilan, melek DM, dan kesadaran diri dengan manajemen diri DM. Hasil analisis multivariat menununjukkan bahwa usia merupakan variabel paling dominan dalam mempengaruhi manajemen diri DM lansia. Peningkatan intervensi berbasis lansia diharapkan menjadi salah satu alternatif penanggulangan DM lansia dengan memperhatikan karakteristik usia, penghasilan, dan melek DM. Pendekatan yang bisa dilakukan yakni dengan menerapkan intervensi edukasi kesehatan perorangan dengan media audiovisual.

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Name Utami RachmawatiStudy Program Master of NursingTitle Associations between Characteristics, Diabetes Literacy, and Self Awareness with Diabetes Self Management of Community Dwelling Elderly in Depok Diabetes literacy and self awareness becomes the internal factors elderly should have to manage their diabetes routines. This research was aimed to indicate associations between characteristics, diabetes literacy and self awareness to diabetes self management of elderly with diabetes. This research used cross sectional correlation method and used 106 sampel of elderly with diabetes chosen by cluster sampling. This research took place in Depok. The datas were analyzed using bivariate with t independent test for sex, ethnicity, education, and family history also Pearson product moment for age, income, diabetes literacy, and self awareness. Logistic regression was used for multivariate analysis. Respondent median age was 64 years, mostly from Java, had an equal proportion of basic and middle range education. Median of income was 2 million and mostly had diabetes positive family history. This research showed a significant correlation between age, sex, income, diabetes literacy, and self awareness with diabetes self management. Multivariate analysis showed that age was the dominan factor affecting diabetes self management in elderly. Elderly based intervention should consider age, income, and diabetes literacy as an alternative to compete against diabetes. Individual health education using audiovisual media could be one of the way to achieve them.

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Diabetes mellitus (DM) is one of the public health problems worldwide, including in Indonesia. Cardiovascular disease was the main cause of death (75-80%) in DM, three-fourths of this death was caused by coronary heart disease (CHD). Approximately 34.2% of patients with acute coronary syndrome (ACS) receiving care at ICCU of Dr. Cipto Mangunkusumo General Hospital (RSCM) suffered from DM. Mortality rates of ACS in DM patients were still high and ACS prognosis in DM patients were still unfavorable. There are many factors playing a part in atherosclerosis and ACS incidence in DM patients, such as metabolic disorders due to hyperglycemia and the fomration of advanced glycation end product (AGE), oxidative stress, atherogenic dyslipidemia in DM in the form of high triglyceride level and low HDL cholesterol as well as an increase in small dense LDL, and insulin resistance. In addition, other risk factors of CHD frequently encountered with DM were hypertension, obesity, thrombocytc hyperaggregation and hypercoagulation. The management ofthis disease which was based on the control of risk factors was not yet satisfactory. Inflammatory response played an important role in pathogenesis of atherosclerosis, beginning with early lesion up to acute coronary syndrome. Increase in inflammatory responses (hsCRP) could predict cardiovascular event and predict post-ACS prognosis. Studies in DM population showed an increase in inflammation. ln-depth studies on inflammatory responses in ACS DM patients have not yet been reported. In normal condition, there was a balance of proinflammatory and antiinflammatory cytokines. The ratio of proinflammatory and antiinflammatory cytokines in ACS, particularly DM patients has not been studied. The relationship between metabolic factor (blood glucose, glyco Hb and lipid) and inflammatory response in ACS DM patients has not yet also been studied. Currently, the effort to decrease inflammatory response is made, among others, by aspirin, statin hypolipidemic medication and insulin sensitizer. Although aspirin and statin were used routinely in ACS patients and have proved to reduce inflammation, morbidity and mortality rates of ACS patients were still high. Thus, we would like to observe whether an addition of other medications in standard therapy could reduce inflammation better. Curcumin in experimental animals-and humans) showed -hypolipidemic effect (decrease 'in absorption and increase in catabolism) and hypoglycemia (effect on PPAR-7). Curcumin also demonstrated antiinflammatory effect. In this study we would like to observe the effects of curcumin on both metabolic factors and inflammatory responses in ACS patients. PROBLEM IDENTIFICATION The above elaboration showed a discrepancy associated with inflammatory response in DM ACS patients. Up to now, the relationship of metabolic factor and inflammatory response in DM ACS has not been clear yet. Likewise, the effects of curcumin on metabolic factor and inflammatory response in ACS have not yet been identified. OBJECTIVES To evaluate inflammatory responses in DM ACS and its relationship with metabolic factors (glucose, blood; glyco Hb, total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride); to evaluate the ratio of proinflammatory and antiinflammatory cytokines (IL-6/IL-10) in ACS DM patients, and to identify the effects of curcumin on metabolic factors and inflammatory responses in ACS patients. SETTING The study was conducted at ICCU of RSCM, ICCU of Persahabatan, ICCU of RS MMC and ICCU of Medistra Hospital, Cardiology Polyclinic, Department of Internal Medicine, Faculty of Medicine University of Indonesia! RSCM and Integrated Cardiac Service Poiyclinic of RSCM. STUDY SUBJECTS ACS patients (DM and non-DM) and CHD (DM and non-DM). DESIGN There were two studies: l. Observational design to observe inflammatory responses (hscRP, IL-6, IL-IO, VCAM and ICAM) in DM ACS, non-DM ACS, DM CI-ID, and non-DM CHD; to evaluate the relationship between metabolic factors (fasting blood glucose, blood glucose 2 hours PP, glyco Hb, total cholesterol, LDL cholesterol, HDI.. cholesterol and triglyceride) and inflammatory responses (hsCRP, IL-6, IL-10, VCAM and ICAM) in ACS DM. 2. Interventional study which was a double-blind randomized trial to evaluate the effects of curcumin at escalating doses (low dose 3:-:IS mglday, moderate dose 3x30 mg/day and high dose 3x60 mg/day on metabolic factors (fasting blood glucose. blood glucose 2 hours PP and glyco Hb) and the effects of curcumin at escalating doses on inflammatory responses (hsCRP, ll.-6, VCAM and ICAM) in ACS patients. RESULTS In observational study, |46 subjects were analyzed, consisting of 84 ACS patients, (30 DM ACS patients and 54 non-DM ACS), and 62 CHD (25 DM CHD patients and 37 non-DM CHD patients). The results of the study in the four groups of patients showed: 1. Inflammatory response in DM ACS was higher than in DM CHD (hsCRP, p=0.00; II..-6, p=0.00; IL-10, p=0.00) and non-DM ACS (ICAM, P=0.03). 2. The ratio of proinflammatory and antiinflammatory cytokines (IL-6/II..-10) in DM ACS did not differ from that of DM CHD (p=0.2l) and non-DM ACS (p=0.5 l). 3. There was a relationship between metabolic factors and inflammatory responses in DM ACS: triglyceride and ll.-6 (r=O.39, p=0.03) and II..-I0 (r=0.37, p=o.o4). In interventional study we performed randomization in 75 ACS patients divided into four groups, consisting of low-dose curcumin group of 15 patients, moderate-dose curcumin group of 15 patients, high-dose curcumin group of IS patients, and placebo group of 30 patients. The results of the study in these four groups showed: l. Low-dose curcumin showed a decrease in hsCRP in one week ofthe first month after intervention, there was a significant difference liom that of placebo (p=0.04). Low-dose, moderate-dose, high-dose curcumin groups showed a decrease in IL-6, but was not significantly different from placebo. Low-dose, moderate-dose, high-dose curcumin did not show a decrease in VCAM and ICAM after intervention of 2 months. 2. Low-dose curcumin group tended to experience a decrease in glyco Hb level after intervention of 2 months (p=0.06); however, it was not significantly different from that of placebo. 3. There was a tendency that low-dose curcumin reduced total cholesterol and LDI. cholesterol; however, it was not significantly different from that of placebo. There was a tendency that low-dose curcumin increased HDL cholesterol; however, it was not significantly different from that of placebo. 4. There was a tendency that the pattern of escalating doses had some effects in inflammatory responses and metabolic factors, in which low-dose curcumin showed the best effects, followed by moderate-dose and finally high- dose curcumin. CONCLUSIONS In this study, inflammatory responses in DM ACS patients were higher than those in DM CHD and non-DM ACS patients. There was no difference in the ratio of proinflammatory and antiinflammatory cytokines (IL-6fIL-IO) in DM ACS compared with DM CHD and non-DM ACS. ln addition, the present study identified some of the relationships between metabolic factors and inflammatory responses. Low-dose curcumin reduced hsCRP in one week of the first month after the intervention in ACS patients. There was a tendency that low-dose curcumin reduced glyco Hb level in ACS.

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Latar belakang: Diabetes melitus DM tipe 2 merupakan masalah kesehatan dunia. Gangguan DM tipe 2 ditandai dengan peningkatan kadar gula darah secara kronik dan dapat menimbulkan komplikasi baik makro maupun mikrovaskuler. Paru sebagai salah satu organ yang memiliki komponen mikrovaskuler dapat terdampak komplikasi mikrovaskuler DM tipe 2 berupa gangguan kapasitas difusi.Metode: Penelitian studi potong lintang pada subjek DM tipe 2, dewasa, rawat jalan, tanpa kelainan paru berat, gagal ginjal terminal, ataupun gagal jantung kronik yang didapat secara konsekutif dan menjalani proses wawancara, pemeriksaan fisis, laboratorium, spirometri dan uji DLCO.Hasil: Didapatkan total subjek sebanyak 35 orang. Karakteristik subjek DM tipe 2 yang ditemukan adalah rerata usia 57,88 tahun, usia >40 tahun 88,6 , perempuan 54,3 , IMT kategori overweight-obesitas 85,7 , lama menderita DM tipe 2 6,5 memiliki risiko penurunan nilai DLCO sebesar 21 kali daripada nilai HbA1c ABSTRACT Background Type 2 DM has become worldwide health problem. It is characterized with chronic hyperglycemia and causing both macro and microvascular complication. Lung as a microvascular contained organ may be affected by type 2 DM microvascular complication in result lung capacity disorder.Method Cross sectional study in type 2 DM, adult, outpatient basis, without overt lung disorder, terminal kidney failure nor cardiovascular disorder. Subject undergone consecutive sampling, interview session, physical examination, laboratory test, spirometry and DLCO test.Result There were 35 subject in total with characteristic mean age 57.88 y.o, age 40 y.o 88.6 , female 54.3 , BMI overweight obesity 85.7 , duration of type 2 DM 6,5 has 21 time risk to have decreasing DLCO value compare to subject with HbA1c