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"Komplikasi kronis pada diabetes melitus berupa ulkus kaki diabetik dapat dicegah dengan melakukan perawatan kaki mandiri. Salah satu faktor yang berperan dalam perilaku perawatan kaki adalah efikasi diri.Tujuan penelitian ini adalah untuk mengetahui hubungan efikasi diri dengan perilaku perawatan kaki pada individu dengan diabetes melitus tipe 2 (DMT2).Penelitian ini menggunakan metode kuantitatif observasional analitik dengan pendekatan crossectional, melibatkan 74 individu dengan DMT2. Alat ukur yang digunakan berupa kuesioner karakteristik demografi, Foot Care Confidence Scale, Nottingham Assessment of Functional Footcare, dan pengetahuan perawatan kaki.Hasil penelitian menunjukkan terdapat hubungan positif yang bermakna antara efikasi diri dengan perilaku perawatan kaki (r = 0.303; p = 0.009). Hasil analisis multivariat didapatkan efikasi diri menjadi prediktor terhadap perilaku perawatan kaki setelah dikontrol oleh pengetahuan dan tingkat pendidikan.Kesimpulan dari penelitian ini adalah perlunya upaya untuk memperbaiki perilaku perawatan kaki pada individu dengan DMT2 dengan meningkatkan efikasi diri menggunakan sumber-sumber efikasi diri yang ada.

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Chronic complications of type 2 diabetes mellitus such as diabetes foot ulcer could be prevented by performing foot self care. Self efficacy is the most important role in foot care.

This study aims to investigate the relationship between self efficacy and foot care behavior.

This study was observational analytic with cross-sectional approach, recruited 74 people with type 2 diabetes mellitus using consecutive sampling method. Data collection was done using demographic questionnaire, Foot Care Confidence Scale, Nottingham Assessment of Functional Foot-care and diabetic foot self care knowledge.

The result showed that there was a positive relationship between self efficacy and foot care behavior (r = 0.303; p = 0.009). Multivariate analysis showed that self efficacy became a strong predictor of foot self care behavior along with knowledge and educational level.

In conclusion, it is needed to improve foot self care in people with type 2 diabetes mellitus through increasing self efficacy."

"Efikasi diri dan kepatuhan merupakan faktor yang penting dalam meningkatkan kualitas hidup pasien DM tipe 2. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat efikasi diri dan kepatuhan dengan kualitas hidup pasien DM tipe 2 yang menjalani rawat jalan di Rumah Sakit di Jakarta.Desain dalam penelitian ini adalah cross sectional, dengan jumlah sampel 125 pasien DM tipe 2. Alat ukur yang digunakan adalah Diabetes Management Self-Efficacy (DMSES), the Diabetes Activities Questionare (TDAQ), dan Diabetes Quality Of Life (DQOL).Hasil penelitian menunjukkan bahwa efikasi diri (0,0005), dan kepatuhan (0,0005) berhubungan secara signifikan dengan kualitas hidup dengan variabel yang paling dominan adalah kepatuhan.Hasil uji multivariat menunjukkan bahwa variabel efikasi diri, kepatuhan, tingkat pendidikan, dan depresi menentukan kualitas hidup pasien DM. Perlunya dikembangkan pengkajian dan intervensi keperawatan yang berfokus pada efikasi diri dan kepatuhan pasien DM tipe 2.

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Self-efficacy and adherence are important factor in improving the quality of life of patients with type 2 diabetes. This study aimed to determine the relationship between self-efficacy and adherence to the quality of life of patients with type 2 diabetes mellitus in an outpatient unit of a Hospital in Jakarta.

This study was a cross-sectional, with sample of 125 patients with type 2 diabetes mellitus. The Diabetes Management Self- Efficacy (DMSES), the Diabetes Activities Questionare (TDAQ), and the Diabetes Quality of Life (DQOL) were employed as instruments.

The results showed that selfefficacy (0.0005), and adherence (0.0005) were significantly associated with quality of life and the most dominant variable is adherence.

Multivariate test results indicate that the variable self-efficacy, adherence, education level, and depression determines quality of life of diabetic patients. This study suggestsis the need fornursing assessment and interventions that focus on the self-efficacy and adherence diabetes mellitus patient."

"Komplikasi ulkus diabetikum pedis (UDP) terjadi pada 15% pasien DM tipe 2. Seluruh kasus UDP dalam serial kasus ini diawali oleh trauma pedis sehingga menyebabkan luka yang tidak menyembuh disertai demam, kelemahan tubuh, mual, anoreksia, dengan atau tanpa disertai gejala klasik DM. Suatu uji klnis mendapatkan sebanyak 69% penderita DM dengan komplikasi UDP menderita malnutrisi. Tata laksana nutrisi pada serial kasus ini adalah pemberian nutrisi optimal, meliputi makronutrien, mikronutrien, dan nutrien spesifik sesuai kebutuhan untuk memperbaiki dan mencegah malnutrisi, komplikasi lainnya, dan kekambuhan serta mendukung penyembuhan ulkus.Rentang usia pasien pada serial kasus ini adalah 52–70 tahun. Kebutuhan energi basal dihitung dengan persamaan Harris-Benedict. Kebutuhan energi total didapat dari perkalian kebutuhan energi basal dengan faktor stres. Pemberian nutrisi dilakukan bertahap sesuai toleransi sampai mencapai kebutuhan total.Makronutrien diberikan dengan komposisi sesuai dengan keadaan pasien.Pemberian protein sesuai dengan fungsi ginjal, pembatasan asam lemak jenuh dan kolesterol, karbohidrat terutama jenis kompleks, dan cukup serat.Garam diberikan sesuai tekanan darah.Diusulkan pemberian mikronutrien berupa vitamin dan mineral sesuai Angka Kecukupan Gizi (AKG) serta nutrien spesifik asam lemak omega-3.Pemantauan dilakukan terhadap perkembangan klinis, toleransi asupan makanan, kapasitas fungsional, status ulkus, laboratorium, dan antropometri.Seluruh pasien membutuhkan insulin dengan dosis yang terus meningkat untuk menjaga kadar glukosa darah dan mengalami penurunan berat badan, namun kebutuhan energi total dapat tercapai, luka membaik dan kapasitas fungsional meningkat. Tata laksana nutrisi yang diberikan harus bersifat individual disesuaikan dengan keadaan umum dan klinis pasien.Edukasi nutrisi selama dan pasca rawat penting diberikan dalam meningkatkan motivasi pasien menjalankan diet yang benar untuk menjaga status gizi. Status gizi dan kontrol glikemik yang baik penting dalam penyembuhan luka, mencegah kekambuhan dan timbulnya komplikasi diabetes melitus yang lain.

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Diabetic foot ulcers are common and estimated to affect 15% of all diabetic individuals. All patients had pedal trauma as an initiation of their non-healing wounds which were then developed to form ulcers. The ulcers presented with febrile, lethargy, nausea, anorexia, with or without diabetes mellitus classical symptoms. A clinical trial found 69% patients of this disease were malnourished. The goal of medical nutrition therapy on type 2 diabetes mellitus with diabetic foot ulcer is to provide the patients with appropriate nutrition containing macronutrient, micronutrient, and specific nutrient according to the requirement, to reverese and prevent malnutrition, other complications and recurrence, and support the wound healing.

Patient’s age range in this case series was 52–70 years old. Basal energy requirements calculated using Harris-Benedict equation and multiplyit by stress factor for the total energy requirements. Diets were gradually given according patient’s tolerance until total energy requirements were achieved.Macronutrients composition were given according to patient’s condition, with protein adjusted to renal function, limiting saturated fat and cholesterol, complex carbohydrate, sufficient fiber and sodium given according to blood pressure. Micronutrient recommendation was vitamin and mineral sejumlah as much as Recommended Dietary Allowance (RDA) and omega-3 fatty acid. Monitoring was done at clinical status, nutrition intake and tolerance, functional capacity, wound/ulcer status, laboratory and anthropometric assessment.

All patients needed increasing dose of insulin in maintainingglucose control and experienced mild weight loss, total energy requirements were achieved by all patients. Patient’s functional capacities were increased, and had improvement wound status. Nutrition therapy for patients should be given individuallyaccording to general and clinical condition. Nutrition education and motivation during and after hospitalization are important part of this disease’s management to keep the patient’s compliance on nutrition intake as recommended to maintain good nutritional status and glycemic control, prevent other complications and re-ulceration."

"Penderita DM (diabetesi) tidak hanya kalangan lansia tetapi juga sudah banyak diderita oleh kalangan pada usia produktif. Permasalahan terkait dengan perawatan diri sering ditemukan pada diabetesi yang baru saja didiagnosa atau sudah lama didiagnosa DM. Beberapa hambatan yang terjadi pada diabetesi dalam melaksanakan perilaku peraatan diri yaitu keterbatasan dalam pengetahuan dan keterampilan dalam penyusunan menu, kekurangan informasi kurangnya aktivitas fisik, kepatuhan terhadap pengobatan yang rendan dan juga dukungan dari keluarga dan lingkungan sekitar yang minim.Pengendalian DM pada diabetesi sangata diperlukan untuk mengurangi komplikasi DM. Berdasarkan kondisi tersebut dikembangkan program GEPARI. Tujuan dari program ini adalah meningkatkan perilaku perawatan diri para diabetesi. Metode yang digunakan yaitu studi kasus keluarga dan aggregate dewasa DM menggunakan pendekatan proses keluarga dan komunitas yang melibatkan 10 keluarga dan 34 diabetesi dewasa. Program ini didasarkan pada lima pilar pengendalian DM yaitu edukasi, manajemen nutrisi, aktivitas fisik, pengobatan dan juga pemeriksaan gula darah yang dilaksanakan selama 12 sesi. Evaluasi terhadap pengetahuan, sikap dan keterampilan dan tingkat kemandirian keluarga menggunakan kuesioner sedangkan gula darah sewaktu diukur menggunakan glucometer yang dilaksanakan sebelum dan sesudah pelaksanaan program GEPARI. Hasil implementasi didapatkan hasil bahwa terjadi peningkatan pengetahuan, sikap dan keterampilan (p>0,05), penurunan glukosa darah sewaktu dan peningkatan kemandirian keluarga. Program GEPARI disarankan dapat dilaksanakan dalam pelayanan kesehatan komunitas. 

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People with DM (diabetes) are not only among the elderly but also have suffered by many people of productive age. Problems related to self-care are often found in people with diabetes who have just been diagnosed or have been diagnosed with diabetes for a long time. Some of the obstacles that occur in diabetes in carrying out self-care behavior are limitations in knowledge and skills in preparing menus, lack of information, lack of physical activity, low adherence to medication and also minimal support from family and the surrounding environment. reduce DM complications. Based on these conditions, the GEPARI program was developed. The aim of this program is to improve self-care behavior of diabetics. The method used is a family case study and aggregated adult DM using a family and community process approach involving 10 families and 34 adult diabetes. This program is based on the five pillars of DM control, namely education, nutrition management, physical activity, medication and also blood sugar checks which were carried out for 12 sessions. Evaluation of knowledge, attitudes and skills and level of family independence using a questionnaire, while blood sugar is measured using a glucometer which is carried out before and after the implementation of the GEPARI program. The results of the implementation showed that there was an increase in knowledge, attitudes and skills (p>0.05), a decrease in blood glucose and an increase in family independence. The GEPARI program is recommended to be implemented in community health services."

"Masyarakat perkotaan memiliki pola hidup yang mengutamakan kemudahan dalam banyak kegiatan. Pola hidup yang mencerminkan hal tersebut seperti dalam pengkonsumsian makanan atau minuman cepat saji dan aktifitas fisik yang rendah. Pola hidup seperti yang telah dijelaskan dapat memicu terjadinya peningkatan faktor risiko penyebab diabetes mellitus tipe 2. Lamanya proses perawatan pada klien yang telah mengalami komplikasi, dapat memicu terjadinya masalah psikososial seperti ketidakberdayaan. Ketidakberdayaan merupakan persepsi seseorang tentang kegiatannya atau tindakan yang dilakukan tidak akan mempengaruhi apapun. Intervensi yang dapat dilakukan pada klien dengan ketidakberdayaan seperti menanamkan pikiran positif, dan melatih afirmasi positif. Intervensi yang dilakukan pada klien dapat mengontrol ketidakberdayaan yang dialami.

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Urban people have a lifestyle that focuses on ease, such as the consumption of fast food or drinks high carbohydrate and low physical activity. This life style can lead to an increase in risk factors associated with type 2 diabetes mellitus. The length of the treatment process in clients with complications can lead to psychosocial problems such as powerlessness. Powerlessness is one's perception of its activities or actions do not affect anything. Interventions that can be performed on the client with the powerlessness such as practice of positive thinking and positive affirmations. Interventions were performed on the client can control the powerlessness experienced."

"Latar Belakang: Insidensi dan prevalensi diabetes melitus tipe 2 (DMT2) terus meningkat. Penurunan imunitas yang terjadi pada DMT2 dapat meningkatkan risiko infeksi. Kontrol gula darah yang baik bermanfaat dalam pengendalian infeksi dan pencegahan komplikasi makro dan mikrovaskuler tetapi penelitian yang melibatkan pasien DMT2 usia lanjut masih belum konklusif. Serial kasus ini dilakukan untuk melihat efektivitas kontrol gula darah terhadap kesintasan pasien DMT2 yang dirawat di rumah sakit, dan untuk implementasi tatalaksana nutrisi sesuai kebutuhan dan kondisi klinis pasien. Metode: Pasien pada serial kasus ini berusia antara 47 ? 65 tahun. Penyulit infeksi pada keempat pasien ini yaitu gangren diabetikum, selulitis, dan sepsis dengan infeksi paru dan infeksi saluran kemih. Tatalaksana nutrisi pasien dilakukan sesuai dengan rekomendasi American Diabetes Association dan Therapeutic Lifestyle Changes disesuaikan dengan kondisi klinis dan toleransi pasien. Perhitungan kebutuhan nutrisi menggunakan rekomendasi untuk perawatan pasien sakit kritis bagi pasien yang dirawat di intensive care unit (ICU), dan menggunakan perhitungan dengan formula Harris-Benedict bagi yang dirawat di ruangan dengan faktor stres sesuai derajat hipermetabolisme pasien. Pasien dipantau selama 7 ? 11 hari. Edukasi diberikan kepada pasien dan keluarga selama perawatan dan saat akan pulang. Hasil: Dalam pemantauan, tiga pasien menunjukkan perbaikan klinis, toleransi asupan, dan laboratorium, dan dapat dipulangkan, sedangkan satu pasien meninggal dunia. Kesimpulan: Kontrol gula darah, asupan nutrisi yang adekuat, dan edukasi yang sesuai, dapat meningkatkan kesintasan pasien DMT2 dengan penyulit infeksi yang dirawat di rumah sakit.

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Background: The incidence and prevalence of type 2 diabetes mellitus (T2DM) is increasing. Immune disfunction in T2DM patient may increase the risk of infection. The appropriate blood glucose control has a benefit in infection control and macro and microvascular complication prevention. The Studies of glycaemic control included older patients did not find convincing evidence. The aim of this case series is to assess the association between glycaemic control and clinical outcome of hospitalized T2DM patient with comorbid infection, and to provide appropriate nutrition therapy based on individual nutrition needs.

Method: Patients in this case series were between 47 - 65 years old. There of those patients were diagnosed T2DM with comorbid gangrenous diabeticum, cellulitis, and sepsis with lung infection and urinary tract infection. Two patients need intensive care in ICU, and another patients in the ward. Two patients received nutrition therapy as critically ill condition, and the rest as American Diabetic Association recommendation, with basal calorie requirement were calculated using Harris-Benedict formula and stress factor suitable for metabolic changes. Monitoring was done for 7 - 11 days. Education was done for the patient and family during hospitalization and discharge planning.

Results: Three patients showed the improvement of clinical conditions, intake tolerance, and laboratory results, whatever one patient was pass away.

Conclusion: Glycaemic control, adequate nutrition intake, and intensive education, may improve survival rate in hospitalized T2DM patient with infection as comorbid."

"Hingga saat ini, belum ada penanda biologis yang menggambarkan kondisi penyakit ginjal kronik (PGK) akibat diabetes melitus (DM) sejak dini. Studi ini bertujuan untuk mengetahui hubungan antara rasio albumin kreatinin urin (Urine Albumin Creatinine Ratio, UACR) dengan laju filtrasi glomerulus yang diestimasi (estimated Glomerular Filtration Rate, eGFR) sebagai penanda gangguan fungsi ginjal pada pasien DM tipe 2 RSUPN Dr. Cipto Mangunkusumo. Sampel urin dan serum diambil dari 18 subjek sehat dan 10 pasien DM tipe 2. Metode spektrofotometri digunakan untuk mengukur kadar albumin urin, kreatinin urin dan kreatinin serum. Data lain diperoleh dari kuesioner. Hasilnya, nilai eGFR pasien DM (68,85 ± 15,36 (Cockroft); 73,94 ± 16,30 (CKD-EPI)) lebih rendah dibandingkan dengan subjek sehat (90,51 ± 15,69, p < 0,01 (Cockcroft); 91,13 ± 21,21, p < 0,05 (CKD-EPI)), sedangkan nilai UACR pasien DM (314,99 ± 494,92) lebih tinggi dibandingkan dengan subjek sehat (0,48 ± 0,75, p < 0,01). Namun, tidak ditemukan hubungan yang bermakna antara UACR dengan eGFR pasien DM.

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Until now, no biological marker that describes the condition of chronic kidney disease (CKD) due to diabetes mellitus (DM) from the outset. This study aimed to determine the relationship between urine albumin creatinine ratio (UACR) with estimated Glomerular Filtration Rate (eGFR) as a marker of renal dysfunction at type 2 diabetes mellitus patients at RSUPN Dr. Cipto Mangunkusumo. Urine and serum samples taken from 18 healthy subjects and 10 type 2 diabetic patients. Spectrophotometric methods used to measure levels of urinary albumin, urinary creatinine and serum creatinine. Other data obtained from questionnaires.

Results, eGFR values were lower in DM patients (68.85 ± 15.36 (Cockroft); 73.94 ± 16.30 (CKD-EPI)) compared with healthy subjects (90.51 ± 15.69, p < 0.01 (Cockcroft); 91,13 ± 21,21, p < 0,05 (CKD-EPI)), while the value of UACR in DM patients (314.99 ± 494.92) was higher than healthy subjects (0.48 ± 0.75, p < 0.01). However, there was no significant correlation between UACR with eGFR of DM patients."

"Latar Belakang: Prevalensi Diabetes Melitus (DM) tipe 2 cenderung meningkat di seluruh dunia dan keteraturan pengobatan masih menjadi masalah hingga saat ini. Penelitian terdahulu menemukan bahwa terdapat hubungan antara temperamen dengan kontrol glukosa namun belum banyak penelitian yang membahas hal ini. Penelitian ini bertujuan mengetahui hubungan antara temperamen dengan terkontrol atau tidak terkontrolnya DM tipe 2.Metode: Penelitian ini adalah penelitian analitik potong lintang. Pengambilan sampel dilakukan dengan consecutive sampling pada 110 penyandang DM tipe 2 di Poliklinik Metabolik Endokrin RSCM selama bulan Agustus-Desember 2015. Responden dikelompokkan menjadi penyandang DM terkontrol atau DM tidak terkontrol berdasarkan hasil laboratorium HbA1c terakhir. Responden mengisi kuesioner Modified-Temperament and Character Inventory versi bahasa Indonesia.Hasil: Hasil penelitian ini menunjukkan bahwa skor temperamen harm avoidance, novelty seeking, dan reward dependence tidak berhubungan bermakna dengan terkontrol atau tidak terkontrolnya DM tipe 2.Simpulan: Tidak ada hubungan bermakna antara temperamen dengan pengendalian kadar HbA1c pada penyandang DM tipe 2.

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Background: Prevalence on type 2 Diabetes Mellitus (DM) tend to increase across the world and regulating treatment still being one of the matters to be discussed until recently. Previous research had found that there are correlations between temperament with glucose control but with limited study on that area. This research aim to qualify the relationship between temperament to controllable or uncontrollable type 2 DM.

Method: This research is a cross sectional sampling method. Sampling conducted with consecutive sampling on 110 respondents with type 2 DM in RSCM Metabolism Endocrine Polyclinic, sampling was done between August to December 2015. Respondents are grouped to two different groups which is controllable DM and uncontrollable DM based on last HbA1c laboratory results. Respondents were requested to fill up Modified-Temperament and Character Inventory questionnaire in Bahasa Indonesia.

Results: Result on this research indicates that temperament score in harm avoidance, novelty seeking, and reward dependence are unrelated with whether Type 2 DM being controllable or uncontrollable.

Conclusion: Absent of significant relation between temperament and HbA1c level control in type 2 DM patients."

"Latar Belakang.Pengetahuan dan perilaku perawatan kaki secara mandiri merupakan dasar yang harus dimiliki oleh pasien diabetes melitus. Tujuan penelitian ini bertujuan untuk mengetahui efektivitas pemberian edukasi perawatan kaki melalui aplikasi diary monitoring terhadap pengetahuan dan perilaku perawatan kaki pada pasien diabetes melitus tipe 2. Metode penelitian menggunakan kuasi eksperimen dengan pendekatan pre-post test dengan kelompok kontrol. Sampel dalam penelitian ini berjumlah 72 responden yang dibagi menjadi 36 respoden kelompok intervensi dan 36 responden kelompok kontrol. Kelompok intervensi diberikan perlakuan edukasi standar RS dan pemberian aplikasi diary monitoring perawatan kaki (penginstalan, penjelasan penggunaan), sedangkan kelompok kontrol hanya diberikan edukasi standar RS (leaflet). Hasil penelitian ini menunjukkan bahwa ada perbedaan yang signifikan rerata selisih skor tingkat pengetahuan perawatan kaki antara kelompok intervensi dan kelompok kontrol p value 0,003 (<0,05), ada perbedaan yang signifikan rerata selisih skor perilaku perawatan kaki antara kelompok intervensi dan kelompok kontrol p value 0,000 (<0,05). Aplikasi diary monitoring diharapkan dapat diterapkan pada pasien secara mandiri dan mudah dilakukan di rumah agar dapat meningkatan pengetahuan dan perilaku perawatan kaki pada pasien DM tipe 2.

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Background.Knowledge and behavior of independent foot care are supposed to be the fundamental owned by diabetes mellitus patients. Objective this study aims to determine the effectiveness of providing foot care education through a diary monitoring application on knowledge and foot care behavior in type 2 diabetes mellitus patients. Methods uses a quasi-experimental approach with a pre-post test approach with a control group. The sample in this study consisted of 72 respondents who were divided into 36 respondents in the intervention group and 36 respondents in the control group. The intervention group was given standard hospital educational treatment and the foot care diary monitoring application (installation, explanation of use), while the control group was only given standard hospital education (leaflets). Results of this study show that there is a significant difference in the mean difference in foot care knowledge level scores between the intervention group and the control group p value 0.003 (<0.05), there is a significant difference in the mean difference in foot care behavior scores between the intervention group and the control group p value 0.000 (<0.05). It is hoped that the diary monitoring application can be applied to patients independently and is easy to do at home in order to increase knowledge and foot care behavior in type 2 DM patients."

"[ABSTRAKDiabetic Kidney Disease DKD pada Diabetes Melitus Tipe 2 DMT2 merupakan komplikasi kronik yang dapat dicegah dan ditunda progresifitasnya dengan pengontrolan glikemik yang baik dan penatalaksanaan yang tepat dari komorbid lainnya Pengontrolan glikemik menjadi tanggung jawab bersama antara multidisiplin profesi kesehatan di ruang rawat dokter perawat dietisien farmasis dengan pasien serta keluarga Model Self care Orem sangat sesuai untuk diaplikasikan dan dikembangkan di ruangan pada asuhan keperawatan pasien dengan penyakit kronik Pasien dapat bersinergi secara aktif sesuai kemampuannya dalam mencapai tujuan dari setiap intervensi keperawatan Disamping itu pendekatan model self care Orem sesuai untuk mempersiapkan pasien dalam meningkatkan kemampuan self care untuk pasca rawat Pelaksanaan praktek berbasis pembuktian pengukuran suhu kaki dengan termometer infrared dapat menjadi perangkat tambahan untuk menilai adanya gejala inflamasi lokal sehingga upaya deteksi dini menjadi lebih komprehensif Pelaksanaan kegiatan inovasi pemantauan dan pemeriksaan kesehatan mandiri pada pasien DM dapat meningkatkan upaya promosi kesehatan pada pasien DM

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ABSTRACTDiabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients , Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ]"