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"ABSTRAKDiabetes merupakan penyakit progresif yang tidak hanya membutuhkan perawatan kuratif dan rehabilitatif tetapi juga perawatan paliatif.. Kepuasaan merupakan salah satu indikator penting tercapainya perawatan paliatif yang efektif sehingga pengukuran kepuasan pasien terhadap perawatan menjadi hal yang penting dilakukan. Penelitian ini dilakukan untuk mengetahui gambaran tingkat kepuasan pasien diabetes yang mendapatkan perawatan paliatif. Desain yang digunakan dalam penelitian ini adalah desain penelitian cross sectional menggunakan sampel pasien diabetes di balai asuhan keperawatan Jabodetabek sebanyak 43 responden yang dipilih dengan teknik purposive sampling. Instrumen yang digunakan adalah Home Care Client Satisfaction Instrument-Revised (HCCSI-R), Clien Satisfaction Inventory (CSI), dan Long-form Patient Satisfaction Questionnaire (PSQ-III). Hasil penelitian ini menunjukkan sebanyak 14% responden merasa cukup puas, 60,5% merasa puas, dan 25,6% merasa sangat puas. Pada penelitian ini juga ditemukan tidak ada perbedaan yang bermakna antara karateristik responden dengan tingkat kepuasan (p>0,05). Penelitian ini merekomendasikan kepada praktisi kesehatan untuk memperdalam pengetahuan mengenai perawatan paliatif dan mengaplikasikannya pada pelayanan kesehatan.

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ABSTRACTDiabetes is a progressive disease that needs palliative care aside from curative and rehabilitative. Satisfaction play as one of the most important indicator to get effective achievement of palliative care, so the measurement of patient satisfaction with treatment is necessary. This study was conducted to describe the level of satisfaction of diabetes patients who receive palliative care. This study used cross sectional approach with 43 respondents of diabetic patients accommodate under nursing care centers in Jabodetabek selected with purposive sampling technique. This study used Home Care Client Satisfaction Instrument-Revised (HCCSI-R), Clien Satisfaction Inventory (CSI), and the Long-Form Patient Satisfaction Questionnaire (PSQ-III) to measure satisfaction level. The results showed that 14% of respondents felt quite satisfied, 60.5% were satisfied, and 25.6% felt very satisfied. This research also found that there is no significant differences between the characteristics of the respondents with the level of satisfaction (p> 0.05). The study recommend healthcare practitioners to deepen their knowledge about palliative care and apply it to health services."

"ABSTRAKDiabetes melitus merupakan sekelompok gangguan metabolisme tubuh, ditandai dengan hiperglikemik kronis yang dapat mengakibatkan komplikasi akut dan kronis. Salah satu peran perawat sebagai pemberi asuhan adalah memberikan asuhan keperawatan yang berkualitas melalui pendekatan Teori Self Care Orem. Penggunaan pendekatan teori ini diharapkan dapat membantu perawat dalam menanggulangi keterbatasan yang dimiliki pasien dan melibatkan pasien secara aktif dalam proses perawatannya melalui peilaku perawatan mandiri. Tujuan penulisan karya ilmiah akhir ini adalah menganalisis hasil proses belajar residensi keperawatan medikal bedah melalui penerapan asuhan keperawatan, penerapan evidence based nursing practice, dan inovasi keperawatan. Data yang diperoleh selama praktik klinik menunjukkan sebagian besar pasien diabetes melitus mengalami komplikasi ulkus kaki diabetik yang disebabkan oleh perilaku perawatan kaki mandiri belum optimal. Hasil penerapan evidence based nursing practice berupa kegiatan edukasi perawatan kaki mandiri dapat meningkatkan pengetahuan dan membentuk perilaku perawatan kaki sebagai tindakan pencegahan dini. Hasil kegiatan inovasi keperawatan melalui pengkajian kesehatan mandiri adalah pasien dapat melakukan pengkajian mandiri terhadap kebutuhan edukasi dan mendapatkan edukasi sesuai kebutuhan mereka. Kesimpulan dari karya ilmiah akhir ini adalah perlunya peningkatan kualitas asuhan keperawatan pada pasien diabetes melitus melalui pendekatan teori keperawatan untuk meningkatkan kemandirian pasien dalam pengelolaan penyakitnya.

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ABSTRACTDiabetes mellitus is a metabolic disorder that characterized by chronic hyperglycemia which could lead to acute and chronic complications. One of nurse roles in managing diabetes mellitus is deliver nursing care using Orem's Theory of Self Care as guide of nursing practice. With this theoretical approach, nursing is expected to be able to overcome the limitations and inability of the patients and actively involve patients in the treatment process through self-care behaviors. The aims of this paper is to analyze the implementation of nursing care, application of evidence based nursing practice, and innovation program which integrated to clinical practice. Based on patient collective data, that was found that the majority of diabetes mellitus patients had been hospitalized with diabetic foot ulcers complications that caused by non-optimal foot self-care behavior. The results of evidence based nursing practice showed that the diabetic foot care education program can improve the knowledge and build the foot self-care behavior as early prevention action. The results of innovation program through self-health assessment program are patients could assess their needs of educations and get health education according to assessment results. In conclusion, it's needed to improve the quality in caring for diabetes mellitus patients through application of nursing theory to increase the self-care behaviors in management of disease."

"Diabetes melitus merupakan masalah kesehatan yang serius dan menurut survei PAPDI (1993) menempati urutan nomor lima sebagai penyebab ra\'vat inap1. Berdasarkan surYei epidemiologis, kekerapan diabetes melitus di Indonesia berkisar 1,4%-2,3% 2. Sejak ditemukannya insulin oleh Banting dan Best pada tahun 1921, komplikasi diabetes melitus berangsur-angsur bergeser ke komplikasi menahun. lmpotensi merupak.an salah sa tu komplikasi menahun diabetes melitus. lmpotensi adalah suatu keadaan ketidakmampuan penis untuk ereksi baik parsial maupun menyeluruh dan atau mem.pertahankannya agar dapat penetrasi ke dalam vagina 3. Penelitian yang dilal.-ukan The h1assachussets h1ale Aging Study (MMAS) pada tahun 1987-1989 yang melibatkan 1290 orang, mendapatkan angka kejadian impotensi 5% - 15% pada pria sehat usia 40 - 70 tahun. Angka ini menjadi 3 kali lipat apabila menderita diabetes melitus4. Penelitian di Indonesia yang melibatkan subyek dalam jumlah besar belum ada. Ian Effendi dkk5, mendapatkan angka kejadia11 impotensi pada pasien diabetes melitus sebesar 43% sedangkan Nasution AW dkk6, mendapatkan angka sebesar 46%. Angka yang tepat sukar ditentukan karena kelainan ini, apabila ti.dak ditanyakan, tidak selalu dikemukak.an pasien karena malu. Meskipun demikian, tidak jarang bahwa in1potensi merupakan keluhan utama yang membawa pasien maupun istrinya mengunjungi dokter.

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Diabetes mellitus is a serious health problem and according to the PAPDI survey (1993) ranks number five as a cause of hospitalization1. Based on epidemiological surveys, the frequency of diabetes mellitus in Indonesia is around 1.4% -2.3% 2. Since the discovery of insulin by Banting and Best in 1921, diabetes mellitus complications have gradually shifted to chronic complications. Impotence is one of the chronic complications of diabetes mellitus. Impotence is a condition of the inability of the penis to erect either partially or completely and/or maintain it so that it can penetrate into the vagina. 3. Research carried out by The Massachusetts Age Aging Study (MMAS) in 1987-1989 involving 1290 people, found an incidence of impotence of 5% - 15% in healthy men aged 40 - 70 years. This figure triples if you suffer from diabetes mellitus4. There is no research in Indonesia involving large numbers of subjects. Ian Effendi et al5, found that the incidence rate of impotence in diabetes mellitus patients was 43%, while Nasution AW et al6, obtained a figure of 46%. The exact figure is difficult to determine because this disorder, if not asked, is not always brought up by the patient because of embarrassment. However, it is not uncommon for in1potency to be the main complaint that brings the patient and his wife to visit the doctor."

"Diabetes mellitus (DM) adalah suatu keadaan dimana ditemukan peninggian kadar gula darah kronik yang dapat menimbulkan komplikasi akut dan kronik. Perawatan DM harus meliputi aspek emosional, sosial, perilaku, spiritual dan psikologis serta perubahan fisik dengan menerapkan lima pilar manajemen DM yakni kontrol gula darah, diit, latihan, pengobatan, dan pendidikan kesehatan yang dapat membantu meningkatkan kemampuan pasien dalam perawatan diri dan mencegah komplikasi.Penelitian ini bertujuan untuk menganalisis hubungan kesadaran diri pasien dengan kejadian komplikasi DM di RSUD dr. Adnan W.D Payakumbuh Sumbar. Penelitian ini menggunakan desain Cross Sectional Study. Jumlah sampel pada penelitian ini adalah 69 responden yang terdiri dari pasien rawat inap dan pasien rawat jalan bagian penyakit dalam di RSUD dr. Adnan W.D Payakumbuh. Tehnik pengambilan sampel yang digunakan adalah consecutive sampling.Hasil penelitian menunjukkan kesadaran diri berhubungan dengan kejadian komplikasi DM (p=0,000). Pasien dengan kesadaran diri kurang berisiko 20 kali untuk terjadi komplikasi dibanding pasien dengan kesadaran diri baik setelah dikontrol variabel usia, jenis kelamin, tipe DM, pendidikan, pekerjaan, dan penyuluhan. Diperoleh juga ada hubungan antara penyuluhan dengan kejadian komplikasi DM (p=0,027). Pasien yang tidak mendapatkan penyuluhan berisiko 9 kali untuk terjadi komplikasi dibanding dengan pasien yang pernah mendapat penyuluhan. Faktor konfonding hubungan kesadaran diri dengan kejadian komplikasi DM pada penelitian ini adalah usia, jenis kelamin, tipe DM, tingkat pendidikan, pekerjaan dan penyuluhan. Penelitian ini merekomendasikan perlunya meningkatkan kesadaran diri pasien sebagai salah satu intervensi mandiri perawat dalam mencegah komplikasi DM dan perlu penelitian lebih lanjut terkait strategi yang efektif dalam meningkatkan kesadaran diri pasien DM dengan komplikasi.

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Diabetes mellitus (DM) is a condition manifested by chronic high level of blood sugar that resulting in acute and chronic complications. Nursing care of DM must be concern to emotional, social, behavior, spiritual, psychological, and physical problem by applying five keys of DM management which consists of blood sugar control, diet, exercises, insulin treatment, and health education. These can help to increase patient?s self care and prevent from complications.The purpose of this study was to analyse the relation between self awareness and DM complications at Adnan Hospital Payakumbuh West Sumatera. A design cross sectional study was used in this research. The total samples were 69 DM patients who selected from outpatient and inpatient of Medical Unit Adnan Hospital. The sample was selected by a consecutive sampling method.The result showed that self awareness was correlated to DM complications (p=0,000). The patients which low self awareness have risk 20 times to complications after controlled by age, gender, DM type, level of education, occupation, and health education. Health education was correlated to DM complications too (p=0,027). The patients who never got health education have risk 9 times to complications after controlled by other variables. Confounding factors of correlated self awareness to DM complications in this study were age, gender, type of DM, level of patient education, occupation, and health education. This study recommended on the needs to improve patient self awareness as one of the independent nursing interventions and need future research about the effective strategy to increase patient self awareness with diabetes complications."

"[ABSTRAKLatar belakang : Hiperglikemia kronik pada pasien Diabetes melitus tipe 1 (DMT1) dihubungkan dengan kerusakan jangka panjang, gangguan fungsi dan kerusakan berbagai organ tubuh lain seperti mata, ginjal, saraf, jantung dan pembuluh kapiler. Salah satu gangguan fungsi organ yang sering diabaikan sebagai akibat hiperglikemia adalah faal paru. Uji fungsi paru dapat membedakan kelainan paru obstruktif, restriktif atau campuran antara obstruktif dn restriktif. Uji fungsi paru dengan spirometri tidak dapat dilakukan dengan baik pada anak dibawah usia 7 atau 8 tahun karena memerlukan koordinasi yang cukup sulit. Penelitian tentang dampak DMT1 terhadap paru di Indonesia belum ada sampai saat ini.Tujuan : Mengetahui gambaran uji fungsi paru pada pasien DMT1 usia 8-18 tahun.Metode : Penelitian potong lintang dilakukan di Poliklinik Endokrinologi dan Respirologi Rumah Sakit Cipto Mangunkusumo (RSCM), serta Laboratorium Prodia Salemba pada bulan Januari 2015. Wawancara orangtua dilakukan dan data kadar HbA1c dalam rentang satu tahun terakhir diambil dari rekam medis subjek atau berdasarkan hasil pemeriksaan sebelumnya. Uji fungsi paru dilakukan sebanyak tiga kali dan diambil salah satu hasil yang terbaik. Kemudian subjek menjalani pengambilan darah untuk pemeriksaan kadar HbA1c dengan metode cation-exchange high pressure liquod chromatography (HPLC) di Laboratorium Prodia.Hasil : Tiga puluh lima subjek berpartisipasi dalam penelitian, terdiri dari 68,6% perempuan. Rerata usia 14 ± 2,7 tahun dan median durasi DM adalah 4 tahun (1,3-10,2 tahun). Rerata parameter FEV1 adalah 86,8 ± 14%, FVC 82,7 ± 12% dan V25 83,1 ± 26,2%. Median FEV1/FVC adalah 92,4 % (77,6-100) dan V50 91,5 % (41,1-204). Fungsi paru normal didapatkan pada 19 subjek (54,3%) dan fungsi paru terganggu sebanyak 16 subjek (45,7%), terdiri dari 10 subjek (28,6%) gangguan restriktif, 2 subjek (5,7%) gangguan obstruktif dan 4 subjek (11,4%) gangguan campuran. Rerata HbA1c dalam 1 tahun terakhir pada subjek dengan gangguan restriktif adalah 10,3%. Simpulan : Nilai parameter uji fungsi paru pasien DMT1 usia 8-18 tahun masih dalam batas normal. Gangguan fungsi paru didapatkan pada 16 subjek (45,7%) dengan gangguan restriksi terbanyak yaitu 10 subjek (28,6%).

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ABSTRACTBackground: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia.Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old.Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory.Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%.Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.;Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder., Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.]"

"Thalassemia b mayor adalah penyakit yang disebabkan oleh kelainan sintesis rantai polipeptida b yang diturunkan secara otosom resesif. Penanganan kasus dengan thalassemia b mayor berupa pemberian transfusi berulang yang akan mengakibatkan hemokromatosis. Hemokromatosis dapat terjadi pada beberapa organ tubuh termasuk pankreas. Tujuan penelitian ini untuk mendapatkan kadar gula darah dan angka kejadian hemokromatosis pada penderita thalassemia b mayor. Telah diperiksa kadar gula darah puasa dan kadar ferritin serum pada 115 penderita thalassemia b mayor yang berumur 10-23 tahun dari Pusat Thalassemia Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia-Rumah Sakit Cipto Mangunkusumo Jakarta. Kadar gula darah diperiksa dengan metode enzimatik sesuai dengan kriteria American Diabetes Association (ADA), kadar ferritin serum diperiksa dengan metode microparticle enzyme immuno assay (MEIA). Pada penelitian didapatkan semua kasus yang diperiksa menunjukkan hemokromatosis, 14,8% dari pada kasus disertai dengan kadar gula darah puasa terganggu dan 2,6% menujukkan adanya diabetes melitus. Penderita thalassemia b mayor yang mendapat transfusi berulang menyebabkan terjadinya hemokromatosis yang dapat mengganggu fungsi pankreas. (Med J Indones 2003; 12: 87-93)

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b-thalassemia major is a disease caused by b polypeptide chain synthesis disorder which is inherited as an autosomal recessive from both parents which is marked by little or no b globin chain synthesis. Medication for b thalassemia major patients is by repeated blood transfusions, which causes hemochromatosis. Hemochromatosis can occur in various organs including the pancreas. The aim of the study was to assess the alteration of plasma glucose concentration and the hemochromatosis prevalence. Fasting plasma glucose concentration and serum ferritin examination were measured in 115 b thalassemia major patients with ages between 10-23 years who were out-patients in the Thalassemia Centre, Department of Child Health, Medical School, University of Indonesia / Dr. Cipto Mangunkusumo General Hospital, Jakarta. The plasma glucose concentration examination was conducted by the GDH enzymatic method, with American Diabetes Association (ADA) criteria in the evaluation, while the serum ferritin examination was conducted with the microparticle enzyme immuno assay (MEIA) method. All patients had hemochromatosis, 14.8% of the patients had impaired fasting glucose level and 2.6% of the patients showed indications of diabetes mellitus. b thalassemia major patients who receive frequent transfusions will develop hemochromatosis that will in turn impair the pancreatic function. (Med J Indones 2003; 12: 87-93)"

"Latar Belakang. Terdapat dua hipotesis mengenai terjadinya diabetes melitus tipe 2 yaitu kegagalan sel beta pankreas dan resistensi insulin. Mengingat pengaruh faktor genetik pada kejadian DM tipe 2 maka diperkirakan resistensi insulin juga dipengaruhi faktor genetik. Sejauh ini data prevalensi resistensi insulin dan gambaran metabolik pads saudara kandung subyek DM tipe 2 di Indonesia belum ada.Tujuan. Mendapatkan angka prevalensi resistensi insulin pada saudara kandung subyek dengan DM tipe 2 dan mendapatkan data profil metabolik (profil lipid, IMT, lingkar perut, konsentrasi asam urat darah), tekanan darah dan distribusinya pads seluruh saudara kandung subyek dengan DM tipe 2Metodologi. Studi pendahuluan dan potong lintang dilakukan pada 30 saudara kandung subyek DM tipe 2 yang datang berobat di Poliklinik Metabolik dan Endokrinologi RSUPN Dr Cipto Mangunkusumo, untuk dilakukan wawancara, pemeriksaan fisik, konsentrasi insulin darah puasa, glukosa puasa, trigliserida, kolesterol HDL dan asam urat. Resistensi insulin ditentukan dari persentil 75 dari HOMA-IR.Hasil. Nilai cut-off HOMA-IR pada penelitian ini sebesar 2,04. Frekuensi resistensi insulin pads saudara kandung subyek DM sebesar 26,67% dengan proporsi di tiap keluarga bervariasi dari 0-75%. Semua subyek dengan resistensi insulin memiliki obesitas sentral dan sebanyak 75% memiliki IMT > 25. Komponen metabolik yang paling banyak ditemukan adalah obesitas sentral (56,7%), menyusul hipertensi (46,7%), hipokolesterol HDL dan hipertrigliseridemia masing-masing 26,6%, dan hiperglikemia (20%).Simpulan. Frekuensi resistensi insulin pada saudara kandung subyek DM tipe 2 sebesar 26,67% dengan proporsi yang bervariasi di setiap keluarga antara 0-75%. Komponen metabolik paling banyak ditemukan adalah obesitas sentral.

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Backgrounds. There are two hypothesis in the pathogenesis of type 2 DM, beta cell failure and insulin resistance. As genetic background has significant role in type 2 DM cases, insulin resistance is also suspected to be influenced by genetic factor. Thus far, there are no insulin resistance prevalence data and metabolic abnormalities among siblings of subjects with type 2 DM available in Indonesia.Objectives. To obtain prevalence figure of insulin resistance among siblings of subjects with type 2 DM and to obtain their metabolic abnormality profiles as measured by their BMI, waist circumference (WC), blood pressure, glucose intolerance, concentration of triglyceride, HDL cholesterol and uric acid.Methods. Cross-sectional study is conducted to 30 siblings of subjects with type 2 DM who are still alive and agree to participate in this study. The subjects are interviewed, physically examined and go through laboratory examination (fasting plasma insulin, plasma glucose, serum triglyceride, HDL cholesterol and uric acid concentration). Insulin resistance is derived from 75 percentile of HOMA-IR.Results. The HOMA-IR cut-off value found in this study is 2,04. The frequency of insulin resistance is 26,67% among siblings of subjects with type 2 DM within variation range of 0-75%. All of subjects with insulin resistance have central obesity. About 75% subjects with insulin resistance have BMI ? 25. The metabolic components which are frequently found in this study can be ranked as follows; central obesity (56,7%), hypertension (46,7%), hypocholesterol HDL (26,6%), hypertriglyceridemia (26,6%) and hyperglycemia (20%).Conclusion. The frequency of insulin resistance is 26,67% among siblings of subjects with type 2 DM within variation range of 0-75%. Among the metabolic components found in this study, central obesity is the most frequent."

"Diabetes melitus adalah suatu kumpulan gejala yang timbul pada seseorang yang disebabkan oleh karena adanya peningkatan kadar gula (glukosa) darah akibat kekurangan insulin baik absolut maupun relative. Laporan akhir studi kasus ini bertujuan memberikan gambaran asuhan keperawatan pada pasien DM dengan gejala xerosis yang menerapkan perawatan kulit pemberianminyak zaitun selama 5 hari, dengan frekuensi 2x setiap harinya. Pasien mengeluh gatal, kulit terasa sangat keringdan bersisik pada kulit, hal tersebut dikarenakan adanya neuropati perifer yang menyebabkan terjadinya penurunan kelenjar keringat dalam tubuh sehingga menyebabkan kulit menjadi kering. Penggunaan minyak zaitun merupakan salah satu penatalaksanaan yang dapat digunakan untuk perawatan kulit diabetes pada pasien yang mengeluhkan pruritus, xerosis dan bersisik. Disarankan kepada perawat agar memberikan edukasi pada klien serta libatkan keluarga klien dalam menjaga kelembaban kulityang bertujuan untuk mengurangi pruritus dan xerosis. Hasil evaluasi didapatkan adanya peningkatan kelembapan pada kulit pasien dan struktur kulit yang semula tampak mengeras dan menghitam menjadi lembut.

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Diabetes mellitus is a collection of symptoms that arise in a person caused by an increase in blood sugar (glucose) levels due to lack of insulin both absolute and relative. The final report of the case study aims to provide an overview of nursing care for DM patients with symptoms of xerosis who apply olive oil skin care for 5 days, with a frequency of 2x per day. The patient complains of itching, the skin feels very dry and scaly on the skin, this is due to the presence of peripheral neuropathy which causes a decrease in sweat glands in the body causing dryness of the skin. The use of olive oil is one of the treatments that can be used for diabetes skin care in patients who complain of pruritus, xerosis and scaly. It is recommended to nurses to provide education to clients and involve the client's family in maintaining skin moisture which aims to reduce pruritus and xerosis. The evaluation results found an increase in moisture on the patient's skin and the structure of the skin that originally seemed hardened and blackened to soft."

"Penderita penyakit diabetes mellitus (DM) terus meningkat dari tahun ke tahun. Pada tahun 2001 secara nasional jumlah penderta DM mencapai 2,5 %. Diperlukan peran pelayanan laboratorium klinik yang handal, agar dapat melakukan pemeriksaan dan pemantauan dari penyakit DM. Beberapa parameter penunjang diagnosis DM yang biasa digunakan adalah kadar glukosa darah dan trigliserida.Dalam memberikan pelayanan kesehatan, laboratorium wajib menjaga mutu dari hasil pemeriksaan yang dikeluarkannya. Salah satu upaya dalam menjaga mutu adalah dengan menggunakan bahan kontrol sebagai pembanding hasil pemeriksaan. Penggunaan bahan kontrol komersial relatif mahal untuk digunakan secara rutin. Perlu diupayakan penggunaan bahan kontrol alternatif. Bahan alternatif yang dapat digunakan adalah bahan kontrol dari spesimen pasien dan bahan kontrol rata-rata harian pasien. Pada penelitian ini dibandingkan sisi akurasi (validitas, reliabilitas, presisi) dan biaya yang digunakan dari bahan kontrol alternatif dengan bahan kontrol komersial. Penelitian dilakukan dengan studi potong lintang di Laboratorium Kesehatan Banda Aceh selama bulan Oktober 2002.Untuk kedua parameter (glukosa dan trigliserida darah) bahan kontrol spesimen pasien mempunyai validitas baik (nilai koefisien korelasi 0,5), reliabilitas baik (koefisien Kappa > 0,5), presisi cukup baik (selang kepercayaan 95 % yang sempit). Sedangkan untuk bahan kontrol rata-rata harian validitas kurang baik (nilai koefisien korelasi < 0,5), reliabilitas kurang baik (koefisien Kappa < 0,5), presisi kurang baik (selang kepercayaan 95 % yang lebar) dibandingkan dengan bahan kontrol komersial.Hasil penelitian menunjukan bahwa bahan kontrol spesimen pasien cukup baik digunakan sebagai bahan kontrol alternatif. Berdasarkan hasil analisis biaya diketahui bahwa penggunaan bahan kontrol alternatif tersebut lebih efisien. Kepada praktisi laboratorium disarankan untuk menggunakan bahan kontrol spesimen pasien sebagai bahan kontrol alternatif komersial.Daftar Pustaka 38 (1976 - 2002)

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Quality Test of Control Material as Supporting Examination of Diabetes Mellitus in Provincial Health Laboratory of Nanggroe Aceh Darussalam in 2002Data show that diabetes mellitus (DM) patients are mounting year by year, In 2001, the number of DM patients reached the level of 2.5% nationally. Therefore, it is necessary to have a reliable clinical laboratory service in examining and monitoring DM. Several supporting parameters that can be used for DM diagnosis are blood glucose and blood triglicerides.

In providing health service, health laboratory has to control the quality of issued result. One of the efforts to keep the quality is to use material control as a comparison of result examination. The use of commercial control material is relatively expensive for routine purpose. Therefore, it is necessary to strive for alternative control material. In this case, the alternative control materials that can be used are from patient's specimen and the average of daily patients material control. In this research, accuracy, which consists of validity, reliability and precision, and cost, are used in comparison with commercial control material. The research was conducted by using cross sectional design in Health Laboratory of Banda Aceh in October 2002.

The result of the study shows that the validity of patients specimen material control is good with correlation coeffecient value is 0.5, however the average of daily patients material control are worse compared to that of commercial material control. This is shown by correlation coefficient value which is smaller than 0.5. Reliability of material control specimen and the average material control are good. This is shown by Kappa coefficient value, which are more than 0.5 for glucose and trigliserida parameters and Cochran test, which is smaller than 0.05 for each. Precision of patient's specimen material is very good, shown by narrower 95% confidence interval, while the average of daily material control is worse, shown by wider 95% confidence interval than that of commercial control material.

The above results show that patient's specimen control material and the average of daily material can be used as control materials, with condition of the availability of actual value determination. Besides, in terms of cost analysis, it is known that the use of both alternative control materials are more efficient in cost, which is lower than the use of commercial control material. From the result of this research, it is suggested to laboratory practitioners to use patients control material as an alterative of commercial material control.

References 38 (1976 - 2002)"

"Tesis ini membahas bagaimana klien Diabetes Melitus memberikan makna kehidupan dalam kondisi sakitnya. Tujuan dalam penelitian ini menguraikan persepsi, respon psikososial, kebutuhan penatalaksanaan, harapan dan makna kehidupan klien. Penelitian ini adalah penelitian kualitatif dengan desain deskriptif. Hasil penelitian menemukan tujuh tema besar yang sesuai dengan tujuan penelitian dan satu tema tambahan yaitu beban yang dihadapi klien. Kesimpulannya makna kehidupan klien didapatkan dalam kondisi penderitaan dan pendalaman nilai spiritual. Penelitian ini menyarankan penggunaan model Adaptasi Roy dalam pengembangan teori keperawatan khususnya masalah psikososial; tersusunnya format pengkajian psikososial sebagai panduan mengidentifikasi masalah psikososial di keluarga, rumah sakit maupun masyarakat.

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This thesis discussed how the client Diabetes Mellitus give life meaning in the pain condition. The purpose of this study described the perceptions, psychosocial responses, needs management, client expectations and the meaning of life. This study is a descriptive qualitative research design. The study found seven broad themes consistent with the purpose of research and one additional theme is the burden faced by the client.

In conclusion the meaning of the life of the client obtained under conditions of suffering and deepening of spiritual values. This study suggests the use of Roy's adaptation model in nursing theory development in particular psychosocial problems; compilation format psychosocial assessment as a guide to identify psychosocial problems in families, hospitals and the community."