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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.]"

"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."

"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."

"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."

"Latar Belakang: Kaki diabetik dapat sembuh tanpa komplikasi tetapi ada juga yang menjalani amputasi karena luka yang progresif. Luka kaki diabetik yang menjalani debridemen dapat sembuh lebih cepat. Kadar Procalsitonin (PCT), Leukosit, dan protein C-reaktif (CRP) pra dan pasca debridemen diduga bisa menjadi indikator yang baik untuk mengetahui luaran klinis pada pasien dengan kaki diabetik.Tujuan: Untuk mengetahui hubungan kadar PCT, Leukosit dan CRP pra dan pasca debridemen dengan luaran klinis pada pasien luka kaki diabetikMetode: Sebanyak 36 pasien yang mengunjungi institusi RSCM dari bulan September hingga bulan November 2020 dilibatkan dalam penelitian ini. Pasien dengan PAD berat, gangguan imunitas dan sepsis berat, dikeluarkan dari kelompok penelitian, dan keadaan luka diseragamkan dengan kriteria PEDIS III. Pasien dibagi ke dalam kelompok luaran baik (n=24) dan kelompok luaran buruk (n=12). Hubungan antara kadar PCT, CRP, dan jumlah Leukosit serum dengan luaran klinis dianalisis. Untuk mengontrol variabel perancu dilakukan analisis multivariat dengan uji regresi logistik.Hasil: Secara statistik dijumpai adanya perbedaan yang bermakna pada PCT pra dan pasca debridemen serta Leukosit pasca debridemen antara pasien luka kaki diabetik luaran klinis baik dengan luaran klinis buruk (p=0,05). Luas area di bawah kurva ROC PCT pra debridemen adalah 0,842 dengan sensitivitas 75% dan spesifisitas 87.5%. Leukosit pasca debridemen menunjukkan nilai prediksi yang baik untuk luaran buruk dengan sensitivitas 41.7% dan spesifisitas 91.7%. Hasil dari analisis multivariat menggunakan analisis regresi logistik menunjukkan tidak terdapat pengaruh yang signifikan dari Leukosit pasca debridemen terhadap luaran klinis setelah mempertimbangkan anemia sebagai variabel perancu dengan nilai signifikan p adalah 0,077.Kesimpulan: PCT pra dan pasca debridemen memiliki hubungan yang signifikan secara statistik dengan luaran klinis dan dapat digunakan sebagai prediktor luaran klinis pasien luka kaki diabetik.

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Background: Diabetic foot can heal without complications, but others undergo amputation due to progressive wounds. Diabetic foot wounds that undergo debridement can heal faster. Pre and post debridement levels of procalcitonin (PCT), leukocytes, and C-reactive protein (CRP) are thought to be good indicators to determine clinical outcomes in patients with diabetic foot.

Objective: To determine the relationship between pre and post debridement PCT, leukocyte and CRP levels with clinical outcomes in diabetic foot wound patients.

Methods: A total of 36 patients who visited RSCM from September to November 2020 were included in this study. Patients with severe PAD, immunocompromise and severe sepsis, were excluded from the study group, and the wound condition was uniform with PEDIS III criteria. Patients were divided into a good outcome group (n=24) and a bad outcome group (n=12). The relationship between level of PCT, CRP, and serum leukocyte counts and clinical outcome was analyzed. To control confounding variables, multivariate analysis was performed using logistic regression test.

Results: There were significant differences in pre debridement PCT, post debridement PCT and post debridement leukocytes between diabetic foot wound patients with good clinical outcome and poor clinical outcome (p = 0.05). The area under the curve for pre debridement PCT ROC was 0.842 with 75% sensitivity and 87.5% specificity. Post debridement PCT give prediction value for bad clinical outcome with 41.7% sensitivity and 91.7% specificity. The results of multivariate analysis using logistic regression analysis showed that there was no significant effect of post debridement leukocytes on clinical outcome in diabetic foot wound patients after considering anemia as a confounding variable with a significant p-value of 0,077.

Conclusion: Pre and post debridement PCT in statistic have significant correlation for clinical outcome and can be used as a predictor of clinical outcome in diabetic foot ulcer"

"Latar Belakang: Peningkatan jumlah penderita ulkus kaki diabetes berdasarkan data epidemiologi saat ini ternyata setiap tahunnya terus meningkat. Faktor genetik berperan dalam proses penyembuhan luka ulkus kaki diabetes dan peranan faktor genetik terhadap penyembuhan luka penderita ulkus kaki diabetes belum banyak diteliti terutama di Indonesia. Matrix Metalloproteinases MMPs merupakan proteolitik enzim yang memegang peranan pada proses remodeling connective tissue dan degradasi extracellular matrix. Polimorfisme pada gen MMP-9 diduga kuat mempengaruhi proses terjadinya ulkus dan proses penyembuhan luka pada penderita ulkus kaki diabetes. Metode Penelitian: Tujuan penelitian ini adalah menganalisis hubungan polimorfisme gen Matrix metalloprotein- 9 -1562 C>T dan 836 A>G dengan perkembangan penyembuhan luka ulkus kaki penderita diabetes mellitus tipe 2. Rancangan penelitian adalah sebuah penelitian prospektif potong lintang. Penelitian ini dilakukan di Divisi Bedah Vaskular dan Endovaskular FKUI/RSCM Jakarta bekerjasama dengan Laboratorium Biologi Biomolekuler FKUI/RSCM Jakarta selama periode September 2016 - Desember 2016. Populasi target adalah penduduk Jakarta, populasi terjangkau adalah pasien Ulkus Diabetik yang berobat di divisi bedah vascular dan endovascular FKUI/RSCM Jakarta. Besar sampel ditentukan berdasarkan formula uji hipotesis dua proporsi. Dilakukan analisis DNA dan polimorfisme gen MMP-9. Dilakukan dokumentasi foto klinis luka ulkus kaki diabetes pada saat luka sebelum debrideman dan di hari ke 21, kemudian diukur luas luka dan jaringan granulasi dengan menggunakan program ImageJ. Hasil: Perkembangan penyembuhan luka terdapat pada Polimorfisme gen Matrix Metalloprotein-1562C>T CC yaitu sebanyak 17 dari 32 orang 31,48 , CT yaitu sebanyak 9 dari 21 orang 16,67, hasil uji statistik dengan nilai p=0,477. Polimorfisme gen Matrix Metalloprotein 836A>G AA yaitu sebanyak 10 dari 14 orang 18,52, AG yaitu sebanyak 9 dari 19 orang 16,67, GG yaitu 7 dari 21 orang 12,96, Hasil uji statistik p = 0,087. Kesimpulan: Kedua polimorfisme gen MMP-9 tersebut tidak terdapat hubungan bermakna.

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Background: According to epidemiology data, amount of diabetic ulcer patients is continue to increase. Genetic factor has a role in diabetic foot ulcer healing and the role of genetic it self in managing the ulcer only has a few study or publication conducted in Indonesia. Matrix Metalloproteinase MMPs is the proteolytic enzyme which has role in connective tissue remodeling process and extracellular matrix degradation. MMP 9 genes polymorphism is strongly predicted influencing ulcer formation process and ulcer healing process in diabetic foot ulcer patients.

Methods: The goal of this study is to analyze the relation between MMP 9 genes polymorphism with the progress of ulcer healing di diabetic foot ulcer patient. This is a cross sectional prospective study design at Vascular surgery and Endovascular division, surgery department FKUI RSCM Jakarta cooperated with Biology Biomolecular laboratory at FKUI RSCM during September december 2016. Target population are all Jakarta citizens, and accessible population are all diabetic foot ulcer patients in Vascular surgery and Endovascular division FKUI RSCM, Jakarta. Sample size is determined based on dual proportion hypothesis test formula. Blood sample are taken and sent to biology medic laboratory to perform DNA and MMP 9 gene polymorphism analysis. The characteristic of ulcer is documented before and on day 21, then the ulcer size and granulation tissue are measured using ImageJ program.

Results: Improvement of healing ulcer in gene polymorphism of matrix metalloproteinase 1562C T CC is about 17 from 32 patients 31,48, CT is about 9 from 21 patients 16,67, statistic testing with p value 0,477. Gene polymorphism metalloproteinase 836A G AA is 10 from 14 patienrs 18,52, AG is 9 from 19 patients 16,67 , GG is 7 from 21 patients 12,96, statistic testing with p value 0,087.

Conclusions: There are not significant relationship in both of MMP 9 gene polymorfsm with diabetic foot ulcer healing progress"