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"Swedish massage merupakan teknik masase berfokus pada relaksasi dan meningkatkan sirkulasi darah dengan melibatkan otot. Tujuan penelitian untuk mengetahui pengaruh Swedish massage terhadap nilai ankle brakial index pada pasien diabetes tipe 2. Penelitian ini merupakan penelitian quasi eksperiment dengan kelompok kontrol, pemilihan sampel secara purposive sampling. Hasil penelitian menunjukkan ada perbedaan signifikan sebelum dan sesudah diberikan masase selama 3 minggu pada nilai ABI kanan (p = 0.015) dan ABI kiri (p = 0.045) antara kelompok kontrol dengan intervensi. Penelitian ini menyarankan perawat melakukan masase di layanan klinik untuk meningkatkan nilai ABI pada pasien diabetes melitus tipe 2.

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Swedish massage is a massage technique involving the muscles which focuses on promoting relaxation and blood circulation. This research aimed to investigate the effects of Swedish massage on Ankle Brachial Index (ABI) in type 2 diabetes mellitus patients. This study was quasi experimental with a control group and employed purposive sampling. There was a significant difference of intervention group and control on the right side of ABI (p = 0.015) and on the left side of ABI (p = 0.045) in three weeks of massage. This study suggests that nurse should perform massage in clinical practice to increase the ABI score for type 2 diabetes mellitus patients."

"ABSTRAKNeuropati sensori dan perubahan perfusi perifer merupakan jenis komplikasi jangkapanjang pasien DM tipe 2. Kedua masalah ini menyebabkan pasien berisikomengalami trauma pada kaki. Gejala neuropati dapat berupa perubahan sensasiproteksi dan nyeri sedangkan perfusi perifer berupa perubahan akle brachial index(ABI). Berbagai upaya dilakukan untuk mengurangi gejala neuropati sensori danperubahan perfusi perifer, salah satu diantaranya adalah masase kaki secara manualyang sampai saat ini belum ditemukan penelitian terkait. Penelitian ini bertujuanuntuk mengidentifikasi pengaruh masase kaki secara manual terhadap sensasiproteksi, nyeri dan ABI pada pasien DM tipe 2. Penelitian ini merupakan penelitianquasi eksperimen dengan kelompok kontrol dan pengambilan sampelnya dengancara consecutive sampling. Hipotesis yang dibuktikan dalam penelitian ini adalahada perbedaan sensasi proteksi, nyeri dan ABI setelah dilakukan masase kaki secaramanual. Sampel penelitian terdiri dari 30 responden kelompok intervensi dan 30responden kelompok kontrol. Hasil uji independent t test menunjukan adaperbedaan yang bermakna pada sensasi proteksi dan nyeri setelah dilakukan masasekaki secara manual (p= 0.000), tetapi tidak ada perbedaan yang bermakna padaABI setelah dilakukan masase kaki secara manual (p= 0.440). Kesimpulan yangdidapat adalah masase kaki secara manual berpengaruh terhadap peningkatansensasi proteksi dan penurunan nyeri pasien DM tipe 2. Rekomendasi untukperawat spesialis adalah perlunya menerapkan dan mengembangkan masase kakisebagai suatu intervensi mandiri perawat khususnya dalam memberikan asuhankeperawatan pada pasien DM tipe 2.

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ABSTRACTNeuropathy sensory and impaired peripheral perfusion are the long complication on type 2 DM patient. Both problems placed the patient at risk for foot injury. Neuropathy symptoms included loss of protection sensation and pain otherwise peripheral perfusion is change of ankle brachial index (ABI). There are modalities to reduce neuropathy sensory symptoms and impaired peripheral perfusion, one of them is manually foot massage that until this time was not yet being researched. This research aimed to identify influence of manually foot massage on protection sensation, pain and ankle brachial index. The design of this research was a quasi experimental research with control group and the sample was recruited by consecutive sampling. This research try to identify differences between protection sensation, pain and ABI of type 2 diabetes mellitus patient after manual foot massage intervention. That consisted of 30 sample for each group (intervention and control group) in this research. Independent t test indicated that there were significant differences between protection sensation and pain after performing manually foot massage (p= 0.000), however there were no significant differences of ABI after manually foot massage intervention (p= 0,440). The conclusion of this research is manually foot massage had effect on increasing protection sensation and reducing pain level on type 2 DM patient. The recommendation of this study is the importance of implementation and development manually foot massage as an independent nursing intervention for taking care of type 2 DM patient."

"[ABSTRAKDiabetes melitus (DM) yang telah diderita selama bertahun-tahun dapat mengarahke berbagai komplikasi, diantaranya yaitu terjadinya peripheral arterial disease(PAD). Salah satu indikator terjadinya PAD pada pasien DM tipe 2 yaitu adanyapenurunan nilai ankle brachial index (ABI) pada ekstremitas bawah pasien. Jika halini terus dibiarkan, maka bisa terjadi neuropati yang dapat memicu munculnyaulkus kaki diabetik. Intervensi yang dapat diberikan untuk meningkatkan nilai ABIyaitu dengan melakukan foot massage atau latihan ROM ankle dorsofleksi. Tujuanpenelitian ini adalah untuk mengetahui efektivitas pemberian kombinasi footmassage dan latihan ROM ankle dorsofleksi terhadap nilai ABI pada pasien DMtipe 2. Penelitian ini merupakan penelitian quasi experiment dengan metode pre andpost test without control yang terdiri dari 2 kelompok intervensi dengan besarsampel 20 responden. Hasil penelitian ini menunjukkan bahwa terdapat hubunganyang signifikan antara pemberian kombinasi latihan ROM ankle dorsofleksi danfoot massage terhadap peningkatan nilai ABI (p value = 0,033 untuk ekstremitaskanan dan p value = 0,001 untuk ekstremitas kiri). Rekomendasi penelitian ini yaituagar para perawat dapat memberikan intervensi kombinasi latihan ROM ankledorsofleksi dan foot massage dalam rangka mencegah terjadinya PAD pada pasienDM tipe 2.

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ABSTRACTThe chronic diabetes mellitus has the potential to cause several complicationsincluding peripheral arterial disease (PAD). A parameter indicating PAD amongstType 2 diabetes mellitus patients is the decline in the ankle brachial index (ABI) ontheir lower extremity. Once this condition persists, it can cause neuropathy leadingto the occurrence of leg diabetic ulcer. An intervention believed to overcome thisproblem is conducting foot massage or ankle dorsiflexion range of motion (ROM)exercises. This research aimed at investigating the effectiveness of exercisecombination of foot massage and ankle dorsiflexion ROM on ABI scores amongtype 2 diabetes mellitus patients. This study used quasi-experiment method with preand post-test without control design, and consisted two intervention groupsinvolving 20 participants. The study revealed that there was distinctive correlationbetween the exercise combination of foot massage and ankle dorsiflexion ROM andthe increase of ABI scores of the patients (p value = 0.033 for the right extremitiesand p value = 0.001 for the left extremities).The findings suggest that suchintervention can be considered or even be provided by nurses taking care of type 2diabetes mellitus patients to prevent them from the possible deterioratingcomplication, the peripheral artery disease.;The chronic diabetes mellitus has the potential to cause several complicationsincluding peripheral arterial disease (PAD). A parameter indicating PAD amongstType 2 diabetes mellitus patients is the decline in the ankle brachial index (ABI) ontheir lower extremity. Once this condition persists, it can cause neuropathy leadingto the occurrence of leg diabetic ulcer. An intervention believed to overcome thisproblem is conducting foot massage or ankle dorsiflexion range of motion (ROM)exercises. This research aimed at investigating the effectiveness of exercisecombination of foot massage and ankle dorsiflexion ROM on ABI scores amongtype 2 diabetes mellitus patients. This study used quasi-experiment method with preand post-test without control design, and consisted two intervention groupsinvolving 20 participants. The study revealed that there was distinctive correlationbetween the exercise combination of foot massage and ankle dorsiflexion ROM andthe increase of ABI scores of the patients (p value = 0.033 for the right extremitiesand p value = 0.001 for the left extremities).The findings suggest that suchintervention can be considered or even be provided by nurses taking care of type 2diabetes mellitus patients to prevent them from the possible deterioratingcomplication, the peripheral artery disease., The chronic diabetes mellitus has the potential to cause several complicationsincluding peripheral arterial disease (PAD). A parameter indicating PAD amongstType 2 diabetes mellitus patients is the decline in the ankle brachial index (ABI) ontheir lower extremity. Once this condition persists, it can cause neuropathy leadingto the occurrence of leg diabetic ulcer. An intervention believed to overcome thisproblem is conducting foot massage or ankle dorsiflexion range of motion (ROM)exercises. This research aimed at investigating the effectiveness of exercisecombination of foot massage and ankle dorsiflexion ROM on ABI scores amongtype 2 diabetes mellitus patients. This study used quasi-experiment method with preand post-test without control design, and consisted two intervention groupsinvolving 20 participants. The study revealed that there was distinctive correlationbetween the exercise combination of foot massage and ankle dorsiflexion ROM andthe increase of ABI scores of the patients (p value = 0.033 for the right extremitiesand p value = 0.001 for the left extremities).The findings suggest that suchintervention can be considered or even be provided by nurses taking care of type 2diabetes mellitus patients to prevent them from the possible deterioratingcomplication, the peripheral artery disease.]"

"Exercise pada pasien DM selama ini hanya difokuskan pada latihan daerah ankle saja, namun belum ada latihan fisik yang berfokus melatih seluruh otot kaki. Home‑Based Foot–Ankle Exercise (HBFAE) melatih seluruh otot kaki yang menggabungkan empat jenis exercise yang direkomendasikan American Diabetes Association yaitu stretching, strengthening, resistance dan balance exercises. Tujuan dari penelitian ini mengidentifikasi efektivitas HBFAE terhadap ABI pada pasien DM Tipe 2. Metode penelitian ini adalah Randomized Controlled Trial (RCT) double blind sampel 40 responden (20 intervensi dan 20 kontrol). Kelompok intervensi diberikan perlakuan HBFAE, kelompok kontrol diberikan perlakuan senam kaki diabetes. Perlakuan pada kedua kelompok diberikan sebanyak 24 kali (1 kali/hari, 5 kali dalam seminggu). Hasil penelitian menunjukan HBFAE (p value 0,001) dan senam kaki diabetes (p value 0,003) mampu meningkatkan ABI. Uji efektifitas menunjukan HBFAE efektif dalam meningkatkan nilai ABI dengan skor efektivitas 0,72 (72%), dibandingkan senam kaki diabetes hanya 0,14 (14%). Variabel confounding gula darah, lama DM, riwayat merokok, dan riwayat ulkus kaki pada penelitian ini tidak berhubungan dengan perubahan skor ABI (p value > 0,05). HBFAE dapat menjadi standar terapi exercise di rumah (komunitas) maupun di instalasi pelayanan kesehatan untuk mencegah komplikasi vaskularisasi kaki pada pasien DM karena mudah dan mampu dilakukan secara mandiri.

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Exercise in DM patients so far only focused in the ankle area and there is no exercise that focuses on training all leg muscles. Home-Based Foot-Ankle Exercise (HBFAE) trains all leg muscles by combining the four types of exercise recommended by the American Diabetes Association, namely stretching exercises, strengthening exercises, resistance exercises, and balance exercises. The purpose of this study was to identify the effectiveness of HBFAE on the Ankle Brachial Index (ABI) in Type 2 DM patients. The research method was a Randomized Controlled Trial (RCT) with a sample of 40 respondents (20 intervention and 20 control). Respondents in the intervention group were given HBFAE treatment, while the control group was given Diabetic Foot Exercise (standard treatment). The treatment in both groups was given 24 times (1 time/day, 5 times a week). The results showed that HBFAE (p-value 0,001) and diabetic foot exercise (p-value 0,003) were able to increase ABI. The results of the effectiveness test showed that HBFAE was effective in increasing the ABI value an effectiveness score of 0,72 (72%) compared to diabetic foot exercise was only 0,14 (14%). The results analysis of the confounding variables showed blood sugar levels, duration of DM, smoking and foot ulcers history in this study were not associated with changes in ABI (p-value > 0,05). HBFAE can be a standard exercise therapy both at home (community) and health care to prevent foot vascular complications because it’s implementation is easy and can be done independently.

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"Latar Belakang. Prevalensi penyakit arteri perifer (PAP) pada pasien diabetes melitus lebih tinggi dibandingkan populasi umum. Penyakit arteri perifer dapat meningkatkan mortalitas dan morbiditas terutama akibat penyakit kardiovaskular pada pasien diabetes melitus tipe 2 (DM tipe 2). Tidak semua pasien dengan PAP dapat terdeteksi dengan pengukuran ankle brachial index (ABI) istirahat, sehingga diperlukan pemeriksaan ABI treadmill. Pemeriksaan ABI treadmill dapat mendeteksi PAP pada fase awal, sehingga profil pasien pada kelompok ini berbeda dengan klompok PAP yang dideteksi dengan ABI istirahat. Diketahuinya profil pasien PAP ini penting untuk membantu meningkatkan kewaspadaan pasien, khususnya pasien DM tipe 2. Tujuan. Mengetahui profil pasien DM tipe 2 dengan PAP yang dideteksi dengan ABI treadmill. Metode. Penelitian dengan desain potong lintang dilakukan di Poliklinik Metabolik Endokrin dan Kardiologi, Departemen Ilmu Penyakit Dalam, Rumah Sakit Cipto Mangunkusumo pada Februari sampai April 2016 dengan metode sampling konsekutif. Subjek dengan nilai ABI istirahat normal/ perbatasan menjalani treadmill dengan protokol Bruce yang digunakan juga sebagai protokol uji latih jantung treadmill. Diagnosis PAP ditegakkan bila terdapat penurunan nilai ABI lebih dari 20% dibandingkan ABI istirahat. Hasil. Sebanyak 92 subjek dianalisis untuk mengetahui profil pasien DM tipe 2 dengan PAP yang dideteksi dengan ABI treadmill. Lima belas subjek (16,3%) didiagnosis PAP. Kelompok PAP memiliki persentase subjek dengan durasi diabetes ≥ 10 tahun sebanyak 53,3%; dislipidemia sebanyak 73,3%; penyakit ginjal kronik (PGK) sebanyak 33,3%; perokok sebanyak 40%; komplikasi neuropati sebanyak 53,3%; albuminuri sebanyak 53,3%; retinopati sebanyak 40%; dan respons iskemia jantung positif/sugestif positif sebanyak 40% subjek. Sedangkan kelompok tanpa PAP memiliki subjek dengan durasi diabetes ≥ 10 tahun sebanyak 33,8%; dislipidemia sebanyak 57,1%; PGK sebanyak 19,5%; perokok sebanyak 32,5%; komplikasi neuropati sebanyak 37,7%; albuminuri sebanyak 26,4%; retinopati sebanyak 28,6%; respons iskemia jantung positif/sugestif positif sebanyak 28,5% subjek. Kesimpulan. Prevalensi PAP yang dideteksi dengan ABI treadmill pada pasien DM tipe 2 adalah 16,3% (IK 95%: 8-23%). Kelompok PAP yang dideteksi dengan ABI treadmill memiliki subjek dengan durasi DM ≥ 10 tahun, dislipidemia, perokok, PGK, neuropati, albuminuria, retinopati dan respons iskemia jantung positif/sugestif positif lebih banyak daripada subjek tanpa PAP.

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Background. The prevalence of peripheral arterial disease (PAD) among diabetes patients was higher compared to general population. PAD increases morbidity and mortality, especially due to cardiovascular disease, in type 2 diabetes mellitus patients (T2DM). Not all patients having PAD could not be detected by resting ankle brachial index (ABI) measurement, hence it is required treadmill ABI examination. The examination enable to detect PAD in the earlier phase, therefore patients profile would different with PAD patient detected from resting ABI examination. The profiles are important to raise the awareness of T2DM patients.

Aim. To identify profile T2DM patients with PAD detected by treadmill ABI.

Methods. A cross-sectional study was carried out in Metabolic Endocrine and Cardiology Outpatient Clinic, Internal Medicine Department, Cipto Mangunkusumo Hospital during February-April 2016. The study used consecutive sampling method. Subject having normal or borderline resting ABI value is examine using Bruce protocol treadmill. The protocol is also used as a cardiac treadmill exercise test protocol. The patients diagnose as PAD if there is a reducing ABI value more than 20% compared to resting ABI.

Result. The profile of PAD patients detected by treadmill ABI were obtain from 92 subjects. Fifteen subjects (16,3%) were diagnosed having PAD. In the group with PAD, the percentage of subject with diabetes duration ≥ 10 years was 53,3%; dyslipidemia was 73.3%; chronic kidney disease (CKD) was 33.3%; smokers was 40%; complications of neuropathy was 53.3%; albuminuri was 53.3%; retinopathy was 40%; positive / positive suggestive cardiac ischemia response was 40% . Meanwhile the group without PAD, the percentage of subjects with diabetes duration ≥ 10 years was 33.8%; dyslipidemia was 57.1%; CKD was 19.5%; smokers was 32.5%; complications of neuropathy was 37.7%; albuminuri was 26.4%; retinopathy was 28.6%; positive / positive suggestive cardiac ischemia response was 28.5%.

Conclusion. The prevalence of PAD that detected by treadmilll ABI in T2DM patients is 16,3% (95% CI: 8-23%). The Group with PAD detected by ABI treadmill which have duration of diabetes ≥ 10 years, dyslipidemia, smokers, CKD, neuropathy, albuminuria, retinopathy, and the positive result on treadmill exercise test have more subjects than group without PAD."

"Diabetes melitus merupakan salah satu dari penyakit kronis penyebab kematian tertinggi di dunia. Kondisi hiperglikemia akan menyebabkan berbagai komplikasi baik akut maupun kronis mencakup komplikasi mikrovaskuler dan makrovaskuler. Salah satu diantaranya yang paling berbahaya yaitu munculnya peripheral arterial  disease (PAD) yang menyebabkan terjadinya foot ulcers. Penulisan karya tulis ilmiah ini bertujuan untuk menganalisis asuhan keperawatan pada pasien diabetes melitus serta efektivitas pemeriksaan ankle brachial index (ABI) dan senam kaki diabetes untuk mengatasi ketidakefektifan perfusi jaringan perifer. Pemeriksaan ABI dan senam kaki diabetes merupakan intervensi yang dapat digunakan untuk meningkatkan sirkulasi perifer dengan mengidentifikasi terjadinya gangguan pada sirkulasi perifer,  meningkatkan aliran kolateralisasi darah pada kaki dan meningkatkan fungsi insulin. Intervensi pemeriksaan ABI dan senam kaki diabetes dilakukan pada pasien diabetes melitus selama 7 hari perawatan. Hasilnya menunjukkan bahwa penerapan pemeriksaan ABI dan senam kaki diabetes dapat meningkatkan sirkulasi perifer dan mencegah timbulnya luka kaki. Melihat keefektifan pemeriksaan ABI dan senam kaki diabetes untuk meningkatkan sirkulasi perifer maka diharapkan intervensi ini dapat digunakan sebagai perawatan rutin pada pasien diabetes melitus.

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Diabetes mellitus is one of the highest chronic disease causes of death in the world. The condition of hyperglycemia will cause various complications either acute and chronic including microvascular and macrovascular complications. One of the most dangerous is the emergence of peripheral arterial disease (PAD) which causes foot ulcer. The scientific paper aims to analyze nursing care in patient with diabetes mellitus and the effectiveness of measuring the ankle brachial index (ABI) and diabetic foot exercises to overcome the ineffectiveness of peripheral tissue perfusion. The examination of ABI and diabetic foot exercises are interventions that can be used to improve peripheral circulation by identifying disturbances in peripheral circulation, increasing the flow of blood collateralisation in the foot and improving insulin function. Intervention of ABI examination and diabetic foot exercises were carried out in patient with diabetes mellitus for 7 days treatment. The results show that the application of ABI examination and diabetic foot exercises can improve peripheral circulation and prevent foot injuries. Reviewing the effectiveness of ABI examination and diabetic foot exercises to improve peripheral circulation, then it is hoped that this interventions can be used as a routine treatment in patients with diabetes mellitus."

"Ulkus diabetik merupakan salah satu kondisi pada pasien Diabetes Mellitus (DM) akibat adanya komplikasi angiopati dan neuropati. Keadaaan ini dapat memberi dampak yang luas baik dari segi psikologis maupun sosial. Penelitian kualitatif dengan pendekatan fenomenologi deskriptif ini dilakukan untuk mengeksplorasi pengalaman psikologis dan dukungan sosial pada pasien DM tipe 2 dengan ulkus diabetik. Enam orang partisipan yang sedang mengalami ulkus terlibat dalam penelitian ini.Hasil penelitian mengidentifikasi 5 tema yaitu pengalaman pertama terjadinya ulkus, pengalaman psikologis dan dukungan sosial, pengalaman nyeri ulkus, pengalaman spiritual yang berhubungan dengan ritual keagamaan, persepsi dan harapan terhadap pelayanan keperawatan Salah satu tema baru yang dihasilkan dalam penelitian ini adalah pengalaman spiritual yang berhubungan dengan ritual keagamaan. Penelitian selanjutnya menggunakan metode kuantitatif dapat dilakukan berbasis pada hasil penelitian ini.

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Diabetic ulcer is one of conditions for Diabetes Mellitus patient caused by angiopathy and neuropathy. Diabetic ulcer can have tremendous impact on patient psychologically and socially. Qualitative research method with phenomenological approach used in this research is to explore the lived psychological experiences and social support of diabetic foot ulcer of patient with diabetes mellitus type 2. This research involved six participants with diabetic ulcer.This research discovered five themes: first ulcer experience, psychologic and social support experience, pain experience, spiritual experience related to religious ritual, and perception and hope towards nursing practice The new theme found is spiritual experience related to religious ritual. Further research could be done by utilize the quantitative research method based on these result."

"ABSTRAKPenelitian ini bertujuan melihat pengaruh Olah Sehat Lafidzi 21 terhadap kadargula darah penderita diabetes melitus (DM) tipe 2 di Klub Diabetes RS. IslamJakarta Cempaka Putih. Penelitian ini merupakan penelitian kuantitatif dengandesain kuasi eksperimen dengan kelompok kontrol. Hasil penelitian menunjukkanpenurunan kadar gula darah puasa yang signifikan pada kelompok intervensisetelah melakukan Olah Sehat Lafidzi 21 (p=0.00) namun dibandingkan dengankelompok kontrol tidak menunjukkan perbedaan yang signifikan (p=0.29).Kesimpulan penelitian ini adalah Olah Sehat Lafidzi 21 tidak dapat menurunkankadar gula darah secara signifikan pada penderita DM tipe 2 di Klub Diabetes RS.Islam Jakarta Cempaka Putih.

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ABSTRACTThis study aimed to determine the effect of Olah Sehat Lafidzi 21 on bloodglucose level of type 2 diabetic patients in Diabetes Club Jakarta Islamic HospitalCempaka Putih. This research was a quantitative study with quasi-experimentaldesign with a control group. The results showed a significant decrease in fastingblood glucose level in the intervention group after performing Olah Sehat Lafidzi21 (p=0.00) but there was no significant difference compared with the controlgroup who did DM gymnastics once a week (p=0.29). The conclusion was OlahSehat Lafidzi 21 could not lower the blood glucose level significantly in type 2diabetic patients in Diabetes Club Jakarta Islamic Hospital Cempaka Putih."

"Rekomendasi pemberian cairan karbohidrat sebelum operasi pada populasi diabetes melitus tipe 2 (DMT2) masih lemah. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian CHO terhadap profil gula darah perioperatif dan resistensi insulin pada populasi DMT2. Penelitian ini merupakan uji klinis acak tersamar ganda yang melibatkan 44 pasien dewasa dengan DMT2 yang menjalani operasi elektif kategori minor. Subjek dibagi menjadi kelompok kontrol dan kelompok CHO. Pencatatan terhadap kadar gula darah (GD) pada empat titik waktu pengukuran, yaitu prabedah, intrabedah, pascabedah, dan 1 hari pascabedah, serta kadar insulin sebelum dan sesudah operasi. Komplikasi yang direkam meliputi kejadian mual, muntah, aspirasi, infeksi, serta pemajangan lama rawat. Kelompok CHO memiliki profil gula darah yang lebih stabil dibandingkan kelompok kontrol (p=0,003) terutama 1 hari pascabedah dengan median lebih rendah (137,5 (79–248) vs. 147,0 (88­–228)). Kelompok kontrol memiliki fluktuasi gula darah signifikan. Resistensi insulin kelompok CHO menurun signifikan dari nilai prabedah (p=0,01). Insiden hiperglikemi sebesar 65% pada kelompok CHO dibanding 45% pada kontrol dengan insiden hipoglikemia 10% pada kelompok kontrol. Tidak ada komplikasi dalam penelitian ini. Pasien DMT2 yang mendapat CHO memiliki profil GD lebih stabil dan penurunan resistensi insulin pascabedah.

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Preoperative carbohydrate loading (CHO) recommendations in type 2 diabetes (T2DM) patients are still controversial. This study aimed to evaluate the effects of CHO towards perioperative blood glucose (BG) and insulin resistance in T2DM underwent elective surgery. Forty-four patients were allocated randomly to control group and CHO group. Blood glucose was examined at four time points: preloading, intraoperative, end of surgery and 1-day post-surgery. Insulin was examined at preloading and end of surgery. Complications recorded including nausea, vomiting, aspiration, infection and prolong hospital stay. The CHO group had a more stable BG compared to control (p=0,003) notably at 1-day post-surgery with lower BG median in CHO (137,5 (79–248) vs. 147,0 (88­–228) while control group had significant BG fluctuation. Insulin resistance trend between group were not statistically significant (p=0,34), however insulin resistance in CHO group was significantly lower compared to preloading (p=0,01). About 65% subjects in CHO group had hyperglycemia compared to 45% in control group. There were 10% subjects with hypoglycemia in control group. There were no complications observed during this study. T2DM patients receiving CHO had more stable perioperative BG profile and could lower insulin resistance due to surgery."

"Kesibukan dan aktivitas masyarakat yang bekerja di daerah perkotaan akan menuntut perubahan gaya hidup seperti pola makan dan aktivitas yang kurang baik. Hal ini dapat menyebabkan penyakit diabetes melitus. Salah satu masalah psikososial yang dapat muncul pada klien dengan diabetes melitus adalah ketidakberdayaan, yaitu persepsi bahwa tindakan atau perilaku yang telah dilakukannya tidak memberikan hasil signifikan atau tidak akan memengaruhi hasil yang diharapkan dan menyebabkan klien sulit mengendalikan situasi yang terjadi dan akan terjadi. Ketidakberdayaan yang tidak teratasi dapat menimbulkan depresi yang dapat memperburuk keadaan klien dengan diabetes melitus. Karya Ilmiah ini merupakan gambaran dan analisis penerapan asuhan keperawatan ketidakberdayaan yang mengalami diabetes melitus tipe 2.

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The bustle and activity of urban communities demand lifestyle changes, including the eating habits and lack of physical activities. These changes may lead to diabetes mellitus. The impact of diabetes mellitus can cause physical and psychosocial problems. The psychosocial problem that may arise is powerlessness. Powerlessness means lack of control over a situation. A person who is powerless will have a perception that it is better to do nothing because whatever they do there will be no significant affect and outcome to their wellbeing. Powerlessness that is not resolved can lead to depression which then may worsen the client with diabetes mellitus. This paper describes the nursing care given to a client with diabetes mellitus and powerlessness. This scientific work indicates the importance of nursing care for powerlessness to support client’s recovery."