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"Sebagian besar pasien Diabetes Melitus mengalami komplikasi kronik, dan yangpaling sering adalah kaki diabetik yang disebabkan karena penurunan sirkulasi.Tujuan penelitian ini adalah untuk mengetahui pengaruh masase dan rendam kakiterhadap peningkatan sirkulasi kaki. Rancangan penelitian ini adalah quasieksperimen menggunakan pendekatan desain nonequivalent control group denganpretest-posttest. Pemilihan sampel dengan purposive sampling sebanyak 62responden. Uji statistik dengan menggunakan uji General Linier Model. Hasilpenelitian menunjukan terdapat perbedaan yang signifikan selisih nilai ABIpretest-postest antara kelompok intervensi dan kelompok kontrol (p-value 0.001).Rekomendasi dari penelitian ini adalah masase dan rendam kaki dapat digunakanuntuk meningkatkan sirkulasi kaki pada pasien Diabetes melitus.

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Most of the Diabete Mellitus patients experienced chronic complications , and the

most frequent was due to diabetic foot circulation decrease in. The purpose of this

study was to determine the effect of massage and foot soak to increase leg

circulation. This study design was quasi-experimental approach with

nonequivalent control group pretest-posttest. The sample was selected using

purposive sampling involved 62 respondents. Statistical test was using the

General Linear Model test. The results showed a significant ABI difference in

pretestposttest values between the intervention group and the control group

(pvalue 0.001). Recommendations from this research are massage and"

"Diabetes merupakan salah satu penyakit kronis yang bisa menyebabkan banyak komplikasi pada penderitanya sehingga menurunkan kulitas hidup bahkan kematian. Salah satu komplikasi paling sering yang terjadi adalah masalah pada kaki seperti kehilangan sensori, ulkus kaki diabetik, hingga amputasi. Pencegahan komplikasi masalah kaki ini harus aktif dilakukan sebagai bentuk preventif dan promotif di masyarakat. Tujuan dari penulisan karya ilimiah ini adalah memberikan gambaran asuhan keperawatan pada kelurga dengan masalah ketidafektifan manajemen kesehatan. Metode yang digunakan adalah laporan asuhan keperawatan keluarga dari tahap pengkajian hingga evaluasi. Intervensi keperawatan dilakukan selama tiga minggu dengan intervensi unggulan yang dilakukan adalah perawatan kaki diabetes. Hasil evaluasi menunjukan bahwa intervensi yang dilakukan efektif untuk mencegah masalah kaki diabetes dan meningkatkan kesadaran keluarga atas pentingnya perawatan kaki secara rutin. Intervensi perawatan rutin disarankan digunakan oleh perawat dalam memberikan tindakan preventif dan promotif pada penderita diabetes mellitus untuk mencegah terjadinya komplikasi lebih lanjut.

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Diabetes is a chronic condition that can lead to several complications in patients, lowering quality of life and even causing death. Foot issues including sensory loss, diabetic foot ulceration, and even amputation are among the most frequent consequences that can arise. As a form of prevention and social promotion, it is imperative to aggressively pursue the prevention of foot problem complications. This scholarly paper aims to give a general overview of nursing care for families who have issues with inefficient health management. A report on family nursing care from the assessment to evaluation stages is the technique adopted. The nursing intervention was carried out for three weeks with the leading intervention carried out being examination and treatment of diabetic feet. According to the evaluation's findings, the intervention is successful in preventing diabetic foot issues and raising family awareness of the value of regular foot examinations and maintenance. It is advised that nurses provide preventative and promotive measures to diabetes mellitus patients as part of routine assessment and care interventions in order to stop further complications."

"Ulkus diabetikum merupakan kerusakan integritas kulit dengan erosi jaringan subkutan di bawahnya. Ulkus terjadi akibat adanya gangguan mikrovaskular dari saraf pada penderita diabetes melitus. Ulkus yang tidak kunjung sembuh dipengaruhi karena vaskularisasi yang buruk. Salah satunya dikarenakan penyakit arteri perifer seperti aortoiliac disease. Asuhan keperawatan perioperatif yang diberikan pada pasien aortoiliac disease bertujuan untuk mempertahankan perfusi jaringan perifer atau kecukupan aliran darah melalui pembuluh kecil di ujung kaki dan tangan untuk mempertahankan fungsi jaringan. Melalui tindakan latihan kaki diabetes pada pasien pre maupun post thromboendarterectomy artery dapat meningkatkan sirkulasi sehingga perbaikan luka menjadi lebih baik.

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Diabetic ulcers are damage to the integrity of the skin with erosion of the underlying subcutaneous tissue. Ulcers occur due to microvascular disorders of the nerves in people with diabetes mellitus. Ulcers that do not heal are affected due to poor vascularization. One of them is due to peripheral artery disease such as aortoiliac disease. Perioperative nursing care given to patients with aortoiliac disease aims to maintain peripheral tissue perfusion or adequate blood flow through the small vessels at the ends of the feet and hands to maintain tissue function. Through the action of diabetic foot exercises in patients pre and post thromboendarterectomy arteries can increase circulation so that wound repair becomes better."

"This book, a distinguished panel of clinicians provides a thorough update of the significant improvements in knowledge surrounding the pathogenesis of diabetic foot problems, as well as the optimal healthcare treatment for this debilitating condition. The authors, many practicing at the famous Joslin-Beth Israel Deaconess Foot Center, again illuminate the successful new multidisciplinary approach now clearly required for the successful treatment of diabetic foot. Drawing on the experiences of diabetologists, podiatrists, vascular surgeons, infectious disease specialists, orthotists, plastic and orthopedic surgeons, this invaluable third edition, so timely given the continued rise of diabetes and its complications, clearly describes established techniques known to be effective. This updated edition blends new knowledge with the time-tested principles of diabetic foot management and will be of significant value to all physicians and researchers with an interest in a state-of-the-art understanding of diabetic foot."

"[ABSTRAKPenderita neuropati perifer diabetik yang mengalami penurunan sensasi kaki dapatberakibat terjadinya luka diabetik. Penelitian ini bertujuan mengetahui efektivitaskombinasi senam kaki diabetik dan terapi SPA terhadap peningkatan sensasi kakipada pasien dengan neuropati perifer diabetik. Penelitian ini menggunakan kuasiexperimental pretest-posttest design with control group dengan jumlah sample 35orang yang didapat dengan tehnik purposive sampling. Pengukuran sensasi kakidilakukan pada hari pertama minggu ke-1 dan hari terakhir minggu ke-4 perlakuan.Sampel penelitian yaitu pasien neuropati perifer diabetik dengan skor sensasi kakimaksimal 8. Hasil uji mann whitney menunjukkan ada perbedaan reratapeningkatan sensasi kaki yang diberikan kombinasi senam kaki diabetik dan terapiSPA dibandingkan hanya diberikan tindakan senam kaki diabetik (p value < 0.05).Tindakan kombinasi senam kaki diabetik dan terapi SPA lebih efektif dalammeningkatkan sensasi kaki yang akan berpengaruh terhadap menurunnya resikoluka pada pasien DM.

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ABSTRACTDiabetic peripheral neuropathy patients with decreasing in foot sensation willimpact on diabetic ulcers. This study aims to explore the effect of combinationbetween diabetic legs exercise and SPA therapy on foot sensitivity escalationamong patients with diabetic peripheral neuropathy. This study used quasiexperimentalpretest-posttest design with control group with 35 respondents andrecruited by purposive sampling methode. Data were collected from patients withperipheral diabetic neuropathy and had 8 maximum score of foot sensitivity.. Footsensitivity was measured on the 1st day of intervention and end day of intervention.Mann whitney test analysis showed significant differences on foot sensitivity withcombination of diabetic legs exercise and SPA therapy compare to diabetic legsexercise only (p value < 0.05). It can be inferred that combination of diabetic legsexercise and SPA therapy are more effective to increase legs sensitivity. Therefore,combined effect of those therapies may eventually decrease diabetic ulcers risk., Diabetic peripheral neuropathy patients with decreasing in foot sensation willimpact on diabetic ulcers. This study aims to explore the effect of combinationbetween diabetic legs exercise and SPA therapy on foot sensitivity escalationamong patients with diabetic peripheral neuropathy. This study used quasiexperimentalpretest-posttest design with control group with 35 respondents andrecruited by purposive sampling methode. Data were collected from patients withperipheral diabetic neuropathy and had 8 maximum score of foot sensitivity.. Footsensitivity was measured on the 1st day of intervention and end day of intervention.Mann whitney test analysis showed significant differences on foot sensitivity withcombination of diabetic legs exercise and SPA therapy compare to diabetic legsexercise only (p value < 0.05). It can be inferred that combination of diabetic legsexercise and SPA therapy are more effective to increase legs sensitivity. Therefore,combined effect of those therapies may eventually decrease diabetic ulcers risk.]"

"Upaya pencegahan primer pada pengelolaan kaki diabetik bertujuan untuk mencegah luka kaki secara dini. Penelitian ini bertujuan untuk mengetahui hubungan pengetahuan dan praktik perawatan kaki pada klien diabetes melitus tipe 2 di Kalimantan Selatan. Penelitian ini merupakan penelitan descriptive correlational dengan desain cross sectional dan jumlah sampel sebanyak 106 orang. Hasil analisis Chi Square menunjukan adanya hubungan yang bermakna antara pengetahuan dengan praktik perawatan kaki pada klien diabetes melitus tipe 2 (p=0,040). Faktor pengetahuan memiliki peluang 2,38 kali untuk melakukan praktik perawatan kaki. Direkomendasikan untuk perlunya dikembangkan pendidikan kesehatan tentang perawatan kaki dan pemeriksaan kaki.

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Primary prevention in management of diabetic foot is to prevent foot injuries. This study aimed to determine the correlation between knowledge and practice of foot care in the type 2 diabetic patients in South Kalimantan. This study was a descriptive correlational research with cross sectional design and recruited 106 samples. Chi Square analysis results showed a significant correlation between knowledge and practice of foot care in the type 2 diabetic patients (p = 0.04). Factor of knowledge had chance 2,38 times on performing practice of foot care. This study recommended the important of development of health education about foot care and foot examination."

"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."

"Penyakit DM tipe 2 menyerang usia dewasa diatas 40 tahun dengan komplikasi yang serius. Tujuan penelitian ini adalah meneliti apakah konsumsi kopi dapat menurunkan resiko kejadian diabetes tipe 2. Desain penelitian menggunakan studi kasus kontrol dengan DM tipe 2 sebagai kelompok kasus dan kontrol non DM tipe 2 dengan sampel sebanyak 482 tiap kelompok.Hasil penelitian kelompok non diabetes tipe 2 lebih banyak minum kopi murni dengan odd ratio = 0.75 dapat disimpulkan kopi murni merupakan faktor proteksi diabetes tipe 2 dan bermakna 􀁣2=4.61, p=0.036, Takaran 1-3 sendok makan dibandingkan dengan kelompok yang tidak minum kopi didapatkan odd ratio=0.65, p=0.001036.Secara keseluruhan lamanya minum kopi didapatkan odd ratio rerata = 0.863 dan spearman korelasi bermakna pada p < 0.01.Secara keseluruhan didapatkan odd ratio = 0.758 antara jumlah kopi yang diminum perhari dengan kejadian diabetes tipe 2, disimpulkan jumlah kopi yang diminum berperan menurunkan angka kejadian diabetes tipe 2. dengan korelasi spearman =- 0.121. Dari hasil analisa logistik regresi didapatkan seluruh kekentalan campuran kopi merupakan faktor protektif dari kejadian diabetes tipe 2. dan takaran 3 sendok tanpa gula mempunyai faktor protektif yang sangat tinggi.

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The Risk of Type 2 Diabetic among Coffee Drinker in Palembang Municipality Year of 2006-2007. Prevalence of Type 2 Diabetic approximately 4.7%, and expose people age of 40 year above with serious complications. The objectived of the research was to find out the association between cofee consumption dan the risk of type 2 diabetic.

Method : The design of the research was case control study with type 2 diabetic as cases group and non diabetic type 2 as control group with matching of the aged group with sample size 482 for each group.

Result: Pure coffee consumption of 1- 3 tea spoon the odd ratio was 0.65. and for group less than 1 year the odd ratio =0.49, 1-2 years the odd ratio = 0.55, 3-5 years the odd ratio = 0.13, 6-10 years odd ratio=0.42, 11- 20 the odd ratio =0.60 and more than 20 years the odd ratio=0.29 and it could concluded the risk of type 2 diabtetic inversely associated with duration of coffee consumption. The overall odd ratio of coffee consumption frequencies was 0.758 with spearman correlation = -0.121,or more frequently coffe consumsption the lowest risk of type 2 diabetic. By regresion analysis it was found out the overall coffee viscosities was protected factors for the risk of type 2 diabtetic especially mixed 3 spoon coffee with out sugar had high protected index."

"Diabetes melitus merupakan penyakit kronis yang dapat mengurangi harapan hidup. Lansia tentunya mengalami proses penuaan sehingga lebih mudah terkena penyakit diabetes. Kurangnya pencegahan faktor risiko diabetes menyebabkan keparahan dan durasi hiperglikemia yang lama, berisiko terjadi komplikasi kronis seperti neuropati diabetik. Latihan senam tangan dan kaki merupakan tindakan keperawatan berbasis bukti yang dapat mengurangi gejala neuropati, serta meningkatkan sensasi dan kemampuan ADL. Penulisan ini bertujuan untuk menjabarkan asuhan keperawatan pada lansia dengan diabetes tipe 2 dengan gejala neuropati melalui latihan senam tangan dan kaki untuk mengurangi keluhan nyeri kronis dan menurunkan risiko kerusakan integritas jaringan pada Nenek L di PSTW Budi Mulia 4 Ciracas. Nenek L berusia 64 tahun mengalami diabetes tipe 2 dengan kadar GDS saat ini 335 mg/dL. Gejala yang dirasakan berupa kesemutan, nyeri (seperti tertusuk), terasa tebal saat berjalan dan beristirahat, serta penurunan sensasi pada tangan dan kaki. Setelah dilakukan intervensi sebanyak 24 kali selama 8 hari, terjadi peningkatan sensasi pada kaki dan tangan, serta penurunan gejala neuropati. Latihan senam tangan dan kaki diharapkan dapat menjadi program harian yang dilaksanakan di PSTW Budi Mulia 4 Ciracas pada lansia dengan diabetes tipe 2 dengan gejala neuropati untuk mengurangi keluhan nyeri kronis dan mencegah risiko kerusakan integritas jaringan.

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Diabetes mellitus is a chronic disease that can reduce life expectancy. The elderly experience an aging process, are susceptible to diabetic. The lack of prevention of diabetic risk factors causes the severity and long duration of hyperglycemia, the risk of chronic complications such as diabetic neuropathy. Hand and foot exercises are evidence-based nursing actions that can reduce neuropathy symptoms and improve ADL sensation and ability. This paper aims to describe nursing care for the elderly with type 2 diabetic with symptoms of neuropathy through exercise of the hands and feet to reduce complaints of chronic pain and reduce the risk of damage to tissue integrity in Nenek L at PSTW Budi Mulia 4 Ciracas. Nenek L, 64 years old, has type 2 diabetes with current GDS level of 335 mg/dL. Symptoms are tingling, pain (like being stabbed), feeling thick when walking and resting, and decreased sensation in the hands and feet. After 24 interventions for 8 days, can increase in sensation in the feet and hands, and reduce in neuropathy symptoms. Hand and foot exercises expected to become a daily program carried out at PSTW Budi Mulia 4 Ciracas in elderly with type 2 diabetes with neuropathy symptoms to reduce chronic pain complaints and prevent the risk of damage to tissue integrity."

"Ulkus diabetik merupakan salah satu komplikasi kronis diabetes melitus (DM). Terjadinya ulkus diabetik diawali dengan adanya neuropati dan penyakit vaskular perifer sebagai dampak hiperglikemia serta adanya trauma akibat kurangnya pasien melakukan perawatan kaki. Tujuan penelitian ini untuk mengetahui hubungan antara kepatuhan pasien dengan kejadian ulkus diabetik dalam konteks asuhan keperawatan pada pasien DM di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini menggunakan rancangan crossectional study. Jumlah sampel penelitian 88 responden terdiri dari 44 orang pasien DM dengan ulkus dan 44 orang pasien DM tanpa ulkus. Teknik pengambilan sampel yaitu consecutive sampling dan acak sederhana. Analisis statistik yang digunakan yaitu uji Chi Square dan regresi logistik ganda. Hasil penelitian menunjukan adanya hubungan yang bermakna antara kepatuhan pasien DM (p=0,000), kepatuhan memonitor glukosa darah (p=0,000), diet (p=0,000), aktivitas (p=0,023), perawatan kaki (p=0,000), kunjungan berobat (p=0,000) dengan kejadian ulkus diabetik. Kepatuhan kunjungan berobat merupakan faktor paling dominan berhubungan dengan kejadian ulkus diabetik (OR=8,95). Karakteristik demografi jenis kelamin merupakan faktor pengganggu. Sedangkan umur, tingkat pendidikan dan status ekonomi bukan faktor pengganggu. Kesimpulan penelitian ini adalah terdapat hubungan antara ketidakpatuhan pasien DM dengan kejadian ulkus diabetik. Saran peneliti yaitu pasien perlu mendapat pendidikan kesehatan, pemeriksaan kaki secara teratur, pasien harus mematuhi terhadap saran petugas kesehatan. Perlu dilakukan penelitian mengenai faktor-faktor yang berhubungan dengan ketidakpatuhan pasien DM.

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Diabetic ulcer is one of chronic complications of Diabetes Mellitus. Neuropathy and peripheral vascular disease are the beginning of ulcer, as the result of hyperglycemia condition, and a trauma caused by lack of foot care. The aim of this study is to identify the relation of patient adherence with diabetic ulcer occurance in the context of nursing care of patient with diabetes mellitus at Dr. Hasan Sadikin Hospital, Bandung. Crossectional study design was used in this study. The samples size were 88 patients with diabetes mellitus, consisted of 44 patients with diabetic ulcer and 44 patients without diabetic ulcer. Samples were selected by simple random and consecutive sampling technique. Chi Square and a multiple logistic regression were used to examine the relation of patient adherence with occurrence diabetic ulcers.

The result showed that there was a significant corelation of diabetes mellitus patient adherence (p=0,000), adherence of monitoring blood glucose level (p=0,000), diet (p=0,000), activities (p=0,023), foot care (p=0,000), and visiting health care provider (p=0,000) with diabetic ulcer occurence. Adherence of visiting health care provider was the most dominant factor related to diabetic ulcer occurence (OR=8,95). Sex was confounding factor. Whereas age, education and economic level were not confounding factors. It is concluded that there was a relationship between patient adherence and the occurance of diabetic ulcer. Recommendations of this research were patient need to get health education, regular foot examination, patient adherence to recommendations health care provider. Further research about factors related to nonadherence in diabetes mellitus patients need to be done."