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"[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.]"

"ABSTRAKLatar belakang: Vitamin D dianggap berperan dalam patogenesis diabetes melitus tipe 1 (DMT1), memperbaiki kontrol metabolik dan menurunkan risiko terjadinya komplikasi mikrovaskuler.Tujuan: Mengetahui profil kadar vitamin D remaja DMT1 dan hubungan kadar vitamin D dengan retinopati dan nefropati diabetik.Metode: Penelitian potong lintang pada remaja DMT1 usia 11-21 tahun dengan lama sakit minimal satu tahun. Semua subjek dilakukan wawancara menggunakan kuesioner, pemeriksaan fisis lengkap, kadar 25(OH)D, HbA1c, rasio albumin/kreatinin urin, dan fotografi fundus.Hasil: Terdapat 49 subjek, 34 (69,4%) perempuan dan 15 (30,6%) lelaki dengan median lama sakit lima tahun (1-16 tahun). Sebanyak 96% subjek menggunakan insulin basal bolus. Median HbA1c adalah 9,5% (6,3% - 18%). Tidak ada subjek dengan kadar 25(OH)D ≥ 30 ng/mL, 6 subjek (12,2%) dengan kadar 25(OH)D 21-19 ng/mL dan 87,8% memiliki kadar 25(OH)D ≤ 20 ng/mL. Rerata kadar 25(OH)D adalah 12,6 ng/mL (SD ±5,4 ng/mL). Faktor yang berhubungan dengan kadar vitamin D adalah lama pajanan matahari (RP 13,3; 95%IK = 1,8-96, p= 0,019). Jenis pakaian, penggunaan sunblock, IMT, lama sakit, konsumsi susu tidak berhubungan dengan kadar vitamin D. Prevalens retinopati pada penelitian ini adalah 8,2%, mikroalbuminuria 28,5%, dan nefropati 16,3%. Tidak terdapat hubungan bermakna antara kadar vitamin D dengan retinopati, mikroalbuminuria, dan nefropati diabetik.Kesimpulan: Tidak ada remaja DMT1 dengan kadar vitamin D yang cukup dan tidak ada hubungan antara kadar vitamin D dengan retinopati, mikroalbuminuria, dan nefropati diabetik.;Background: Many studies showed that vitamin D involved in the pathogenesis of type 1 diabetes mellitus (T1DM), metabolic control and decreased the risk of microvascular complication.

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ABSTRACT

Objective: To find out the vitamin D profile in adolescence with T1DM and its association with retinopathy and nephropathy diabetic.

Methods: This was a cross sectional study performed during April to May 2015 involving T1DM adolescence aged 11-21 years old with duration of illness ≥ 1 year. We used questionnaire to know factors associated with vitamin D level. We performed physical examinations, tests for level of 25(OH)D serum, HbA1c, urine albumin/creatinine ratio and fundal photographic.

Results: There were 49 subjects, 34 female (69.4%) and 15 male (30.6%) with median duration of illness was five years (1-16 years). Most of the subjects (96%) were on basal bolus regimen. Median of HbA1c level was 9.5% (range 6.3%-18%). None of the subject had 25(OH)D level ≥ 30 ng/mL, 12.2% with 25(OH)D level of 21-19 ng/mL and 87,8% was ≤ 20 ng/mL. Mean of 25(OH)D level was 12.6 ng/mL (SD ±5.4 ng/mL). Duration of sun exposure was associated with 25(OH)D level (prevalent ratio of 13.3; 95%CI = 1.8-96, p= 0.019); While type of clothing, sunblock, body mass index, milk and juice intake were not associated with 25(OH)D level. Diabetic retinopathy was found in 4 subjects (8.2%), microalbuminuria in 14 subjects (28.5%), and nephropathy in 8 subjects (16.3%). All the subjects who suffered from microvascular complication had 25(OH)D level ≤ 20 ng/mL. None of the subjects with 25 (OH)D > 20 ng/mL suffered had microvascular complication. There was no significant association between vitamin D level with diabetic retinopathy, microalbuminuria, or diabetic nephropathy.

Conclusion: None of the adolescent with type 1 DM had sufficient vitamin D level, and 87.8% had vitamin D deficiency. There was no association between vitamin D level with diabetic retinopathy, microalbuminuria, or diabetic nephropathy."

"ABSTRAKLatar belakang: Thalassemia merupakan suatu penyakit gen tunggal yang disebabkan oleh kerusakan pada gen dalam mengontrol produksi protein sehingga sel darah merah akan mudah pecah dan pengikatan oksigen terganggu. Hal ini akan memicu terjadinya anemia dan membutuhkan transfusi darah secara rutin dan seumur hidup. Transfusi darah rutin menyebabkan terjadinya akumulasi besi yang memicu beberapa komplikasi, salah satunya adalah gangguan pada fungsi pankreas. Tujuan: Untuk mengetahui hubungan antara profil besi dengan gangguan fungsi pankreas berupa diabetes mellitus dan gangguan toleransi glukosa pada subjek thalassemia mayor. Metode: Desain potong-lintang pada 79 subjek thalassemia mayor di Pusat Thalassemia RS Cipto Mangunkusumo Jakarta. Hasil: Dua 2,53 subjek mengalami gangguan toleransi glukosa dan 77 97,47 subjek dengan nilai toleransi glukosa normal. Nilai median feritin serum pada kelompok gangguan toleransi glukosa yakni 5595,5 2062,0-9199,0 ng/mL sedangkan yang tidak mengalami gangguan toleransi glukosa yakni 3309,0 487,0-11247,0 ng/mL p= 0,574 . Nilai median saturasi transferin pada subjek gangguan toleransi glukosa yakni 76 52-100 sedangkan yang tidak mengalami gangguan toleransi glukosa yakni 89 11-100 p= 0,827 . Kesimpulan: Tidak didapatkan adanya hubungan yang signifikan antara kadar feritin serum dan saturasi transferin terhadap gangguan fungsi pankreas.

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ABSTRACTBackground Thalassemia is a single gene disease that is caused by defect on gene which controls the protein production that eventually leads to red blood cell lysis and defect on oxygen binding capacity. Therefore, the patient needs regular blood transfusion during his lifetime. Regular blood transfusion causes iron accumulation that leads to complications such as defect on pancreas function. Aim To know the association between iron profile and defect on pancreas function such as diabetes mellitus and glucose intolerance in major thallassemia subjects. Methods Cross sectional design on 79 major thalassemia subjects in Thalassemia Center of RS Cipto Mangunkusumo, Jakarta. Results Two 2.53 subjects were glucose intolerant and 77 97,47 subject has a normal blood glucose. Median value of serum ferritin level in glucose intolerant subjects was 5595.5 2062,0 9199,0 ng mL meanwhile the median value of serum ferritin level in normal glucose level subjects was 3309.0 487,0 11247,0 ng mL p 0.574 . The median value of transferrin saturation in glucose intolerant patients is 76 52 100 meanwhile the median value of tranferrin saturation level in normal glucose level subjects is 89 11 100 p 0,827 . Conclusion There is no significant association between serum ferritin level and transferrin saturation and defect of pancreas function."

"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."

"Prevalensi kejadian diabetes melitus tipe 2 di Indonesia, terutama pada kelompok PNS/TNI/POLRI/BUMN semakin meningkat. Penelitian ini bertujuan untuk mengetahui gambaran dan hubungan faktor risiko penyakit diabetes melitus tipe 2 pada peserta Posbindu PTM Kementerian Kesehatan RI pada tahun 2017 - 2018. Data yang digunakan adalah data sekunder surveilans Posbindu PTM, jumlah sampel sebanyak 222. Desain penelitian yang digunakan adalah studi cross-sectional. Analisis pada data dilakukan hingga tingkat multivariat regresi logistik ganda dengan model prediksi. Hasil yang didapatkan yakni model akhir yang berhubungan signifikan terhadap kejadian diabetes melitus tipe 2 yaitu usia (p = 0,031; POR= 6,31; 95% CI 1,18 - 33,68) dan riwayat DM keluarga (p = 0,003; POR = 25,6; 95% CI 3,02 - 217, 82). Ditemukan variabel kurang konsumsi sayur dan buah termasuk variabel confounding (p= 0,179; POR = 0249; 95% CI = 1,89). Faktor dominan yang didapatkan yakni riwayat diabetes melitus pada keluarga. Sehingga diharapkan penelitian ini dapat menjadi dasar untuk penguatan program Posbindu PTM dalam mengendalikan dan mencegah risiko diabetes melitus tipe 2 pada pegawai Kementerian Kesehatan RI.

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The prevalence of type 2 diabetes mellitus in Indonesia, especially in the PNS / TNI / POLRI / BUMN groups is increasing. This study aims to determine the description and relationship of risk factors for type 2 diabetes mellitus in Posbindu PTM participants of the Ministry of Health of Indoneesia in 2017 - 2018. The data used is secondary surveillance data of Posbindu PTM, the number of samples are 222. The design study is cross-sectional study. Data was analyzing by multivariate multiple logistic regression with prediction models. Variables that was significantly associated with the incidence of type 2 diabetes mellitus, there age (p = 0.031; POR = 6.31; 95% CI 1.18 - 33.68) and diabetes family history (p = 0.003; POR = 25.6; 95% CI 3.02 - 217, 82). Variables in vegetable and fruit less consumption is confounding variable (p = 0.179; POR = 0249; 95% CI = 1.89). The dominant factor is diabetes family history. This study is expected to be the basis for strengthening the Posbindu PTM program in controlling and preventing the risk of type 2 diabetes mellitus in employees of the Ministry of Health Republic of Indonesia."

"ABSTRAKDiabetes Melitus (DM) merupakan suatu penyakit menahun yang merupakan problem kesehatan masyarakat di Indonesia, terutama di kota-kota besar, yang meningkat menyertai adanya perubahan pola hidup masyarakat. Di Jakarta, penelitian epidemiologis pada penduduk yang dilakukan pada tahun 1982 mendapatkan prevalensi DM penduduk usia > 15 tahun sebesar 1,7 %, dan pada penelitian tahun 1993 meningkat menjadi 5,7 %. Jika tidak dikelola dengan baik, DM dapat mengakibatkan komplikasi kronik, baik komplikasi mikrovaskular yang dapat mengenai mata dan ginjal, maupun komplikasi makrovaskular yang terutama mengenai pembuluh darah jantung, otak, dan pembuluh darah tungkai bawah. Keadaan hiperglikemia kronik disangka merupakan dasar terjadinya komplikasi kronik, antara lain melalui proses glikasi berbagai macam protein. Terbentuknya produk akhir glikosilasi lanjut (advanced glycation end product) yang ireversibel akan berpengaruh terhadap fungsi protein terkait.Komplikasi kronik DM terjadi balk pada pasien DM yang tidak tergantung insulin (DMTTI non insulin dependent DM = NIDDM = DM tipe 2) maupun DM yang tergantung insulin (DMTI = insulin dependent DM = IDDM = DM tipe 1), walaupun ada perbedaan dalam kekerapan jenis komplikasi yang terjadi. Komplikasi makrovaskular lebih sering ditemukan pada DM tipe 2, sebaliknya pada DM tipe 1, komplikasi mikrovaskular yang terjadi pada ginjal dan mata tampak lebih menonjol.Di antara komplikasi menahun makrovaskular DM, "kaki diabetes" merupakan komplikasi yang paling mengesalkan, baik bagi pasien maupun bagi dokter yang mengelolanya. Kasus ulkus/gangren diabetes merupakan kasus DM yang terbanyak dirawat. Diperkirakan sebanyak sepertiga dari seluruh pasien DM akan mengalami masalah pada kakinya. Hari perawatan yang lama dan biaya pengobatan yang mahal merupakan salah satu persoalan yang harus mendapat perhatian sebaik-baiknya. Belum lagi dihitung tenaga yang hilang akibat kecacatan, dan ketidakhadiran di tempat kerja, serta biaya yang diperlukan untuk pengelolaan kecacatan tersebut. Apalagi kalau dilihat nasib pasien pasca amputasi, 30 - 50 % pasien yang telah diamputasi akan memerlukan tindakan amputasi untuk kaki sisi lainnya dalam kurun waktu 1 - 3 tahun setelah amputasi. Suatu nasib yang sungguh sangat suram."

"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."

"ABSTRAK Latar Belakang : Pasien diabetes melitus tipe 2 dengan penyakit arteri perifer (terutama critical limb ischemia) memiliki tingkat amputasi yang masih tinggi. Perkembangan teknik endovaskular memungkinkan tindakan revaskularisasi dengan tingkat keberhasilan yang tinggi dan komplikasi yang rendah dibandingkan operasi bypass.Tujuan : Penelitian ini bertujuan mengetahui tingkat keberhasilan klinis 1 tahun setelah tindakan Percutaneus Transluminal Angioplasty dan distribusi faktor-faktor yang mempengaruhi keberhasilan klinis.Metode : Penelitian ini merupakan studi kohort retrospektif pada pasien diabetes melitus tipe 2 dengan penyakit arteri perifer yang menjalani tindakan PTA pada tahun 2008-2012 di Pelayanan Jantung Terpadu Rumah Sakit Cipto Mangunkusumo Jakarta. Pasien diikuti selama 1 tahun setelah tindakan PTA. Luaran yang dinilai pada penelitian ini adalah keberhasilan klinis dan limb salvage. Definisi keberhasilan klinis adalah tidak mengalami amputasi mayor, tidak terjadi restenosis, dan tidak mengalami nyeri berulang. Sedangkan tingkat limb salvage adalah proporsi pasien dengan plantar stand yang utuh setelah tindakan PTA.Hasil : Tindakan PTA dilakukan pada 43 pasien dengan diabetes tipe 2. Manifestasi paling sering adalah gangren (30.2%) dan luka iskemik (30.2%). Sedangkan 8(18.2%) pasien datang dengan nyeri pada istirahat dan 9(20.2%) pasien datang dengan klaudikasio. Selama 1 tahun, 3 pasien mengalami amputasi mayor, 3 pasien mengalami restenosis, dan 4 pasien mengalami nyeri berulang. Keberhasilan klinis untuk 1 tahun adalah 75% dan tingkat limb salvage selama 1 tahun adalah 90%. Pasien dengan diabetes terkendali dan CTO memiliki proporsi keberhasilan klinis yang lebih tinggi.Simpulan : Tindakan PTA pada pasien diabetes melitus tipe 2 dengan PAD memiliki keberhasilan klinis dan tingkat limb salvage yang cukup baik.Kata Kunci : Angioplasti; diabetes; critical limb ischemia; penyakit arteri perifer; PTA; limb Salvage

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ABSTRACT Background : Diabetic patient with PAD (especially critical limb ischemia) still have a high rate of limb amputation. The development in endovascular technique allows revascularization with high level of success and low complication compare to surgical (bypass).Objectives :The aim of this study is to evaluate the clinical outcome 1 year after PTA in type 2 diabetic patient with PAD.Methods : This was a retrospective cohort study, with 1 year follow up, to evaluate the clinical outcome of diabetic patients with PAD that has undergone PTA procedure in 2008-2012 in Cipto Mangunkusumo Hospital. The main outcome measured were clinical success and limb salvage rate. Clinical success defined as no major amputation, no restenosis, and no reccurence pain after PTA. Limb salvage rate defined as proportion of patient with intact plantar stand after PTA.Results : PTA was performed in 43 patient with diabetes. In this study most frequent manifestation were gangren (30.2%) and ischemic wounds (30.2%), while 8 patients (18.2%) came with resting pain, and 9 patients (20.2%) have claudication. During one year follow up 3 patients (6.9%) had major amputation, 3 patients (6.9%) had restenosis, and 4 patients had resting pain reccurence. The clinical succes rate for one year is 75%, with limb salvage rate for 1 year is 90%. Patients with controlled diabetes and chronic total occlusion had a higher proportion of clinical success.Conclusion : PTA procedure for diabetic patient with PAD has good clinical outcome with high level of limb salvage rate.Keyword : Angioplasty; critical limb ischemia; diabetes; peripheral arterial disease; PTA; limb salvage"

"ABSTRAKFaktor-Faktor Yang Berhubungan dengan Penerapan GayaHidup Sehat Diabetes Pada Penderita DM tipe 2 di KotaPematangsiantar Tahun 2017Penyakit Diabetes Mellitus DM menjadi salah satu masalah kesehatan yangbesar di dunia, termasuk di Indonesia. Prevalensi DM tipe 2 mengalamipeningkatan di Kota Pematangsiantar akibat dari perubahan gaya hidup. Tujuanpenelitian ini untuk menganalisis faktor-faktor yang berhubungan denganpenerapan gaya hidup sehat penderita DM tipe 2. Desain penelitian yangdigunakan adalah Cross Sectional, jumlah sampel 124 responden diambil denganmenggunakan Cluster Sampling. Analisis data menggunakan Uji Chi Square danregresi logistik ganda. Hasil penelitian menunjukkan ada hubungan antarapersepsi hambatan, efikasi diri, pengetahuan, dukungan keluarga, dan jeniskelamin dengan penerapan gaya hidup sehat DM Faktor-faktor yang palingdominan berhubungan dengan penerapan gaya hidup sehat adalah efikasi diri OR=8,378 dan dukungan keluarga OR=2,626 . Responden yang memilikiefikasi diri yang tinggi akan berpeluang 8 kali lebih besar melakukan penerapangaya hidup sehat, dan responden yang mendapat dukungan keluarga yang tinggiberpeluang 3 kali lebih besar melakukan penerapan gaya hidup sehat.Rekomendasi dari penelitian ini agar dilakukan upaya peningkatan efikasi diridengan pemberian edukasi pada penderita DM dengan melibatkan peran sertakeluarga penderita.Kata kunci : Diabetes melitus, Penerapan gaya hidup sehat, Persepsi Individu,Efikasi Diri, Pengetahuan, Dukungan Keluarga.

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ABSTRACTFactors Related to Application of Healthy Lifestyle of Type 2Diabetes Mellitus in Pematangsiantar 2017Diabetes Mellitus DM has become one of the major health problems inIndonesia as well as in many other countries. The prevalence of Type 2 DiabetesMellitus T2DM has increased in Pematangsiantar as result of lyfestyle change.This research aimed to analyze the factors related to application of healthylyfestyle of T2DM patient. This research rsquo s design used was Cross Sectional, thesample of 124 respondents was taken by Cluster Sampling. Data analysis usingChi Square Test and multiple logistic regression. The results show there is arelationship between perception of barriers, self efficacy, knowledge, familysupport, and gender with the application of healthy lifestyle. The most dominantfactors related to the application of healthy lifestyle are self efficacy OR 8,378 and family support OR 2,626 . Respondents who have high self efficacywill have 8 times greater chance of implementing a healthy lifestyle, andrespondents who have high family support have 3 times greater chance ofimplementing a healthy lifestyle. The recommendation of this research is to makeefforts to increase self efficacy by giving education to T2DM patient by involvingpatient 39 s family participation.Key Word T2DM application of healthy lifestyle Individual perceptions knowledge cues to action"

"ABSTRAKPrevalensi Diabetes Mellitus di Provinsi DKI Jakarta mengalami peningkatan danKepulauan Seribu menempati peringkat ke 3 tertinggi setelah Jakarta Selatan danJakarta Timur dengan proporsi 2,7% dengan jumlah kasus yang meningkat daritahun 2012 - 2015 di Kecamatan Kepulauan Seribu Utara. Penelitian ini bertujuanuntuk mengetahui hubungan antara faktor pengetahuan, riwayat diabetes mellituskeluarga, pola kebiasaan makan, aktivitas fisik dan perilaku merokok dengankejadian diabetes mellitus tipe 2 dan faktor mana yang paling dominan yangberhubungan dengan kejadian diabetes mellitus tipe 2. Penelitian dilaksanakan padabulan Februari 2016. Desain penelitian menggunakan case control dengan jumlahsampel penelitian sebanyak 80 kasus dan 80 kontrol. Hasil penelitian menunjukkanbahwa riwayat diabetes mellitus keluarga, faktor pengetahuan tentang diabetesmellitus, pola kebiasaan makan berisiko dan pola kebiasaan makan seratberhubungan signifikan dengan kejadian diabetes mellitus tipe 2. Hasil multivariatmenunjukkan bahwa penduduk dengan riwayat diabetes keluarga berisiko 6,2 kalilebih besar menderita diabetes mellitus dibandingkan dengan penduduk yang tidakmemiliki riwayat diabetes mellitus keluarga setelah dikontrol variabel pengetahuan,pola kebiasaan makan berisiko dan pola kebiasaan makan serat, aktifitas fisik, danperilaku merokok (95% CI: 2,810 ? 13,553). Dari penelitian ini disarankan untukmelakukan upaya preventif dan promotif yaitu dengan upaya perubahan perilakuuntuk menjadi lebih sehat dengan meningkatkan asupan serat, mengurangikebiasaan makan berisiko, dan meningkatkan pengetahuan tentang DM.

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ABSTRACTPrevalence of Diabetes Mellitus in Jakarta increased and prevalence in ThousandIslands District Administration was ranked the third highest after South Jakarta andEast Jakarta with a proportion of 2.7%. The number of cases increased from year2012 to 2015 in the SubDistrict of Kepulauan Seribu Utara. This study aims todetermine the relationship between knowledge, family history of diabetes mellitus,the pattern of eating habits, physical activity and smoking behavior with diabetesmellitus type 2 and the most dominant factors that associated with the occurrenceof diabetes mellitus type 2. The research was conducted in February 2016. Thestudy design using the case control study with a sample size of 80 cases and 80controls. Results showed that a family history of diabetes mellitus, diabetes mellitusknowledge, the pattern of risky eating habits and patterns of fiber eating habitssignificantly associated with diabetes mellitus type 2. Multivariate results showedthat the population with a family history of diabetes 6.2 times greater risk ofsuffering from diabetes mellitus compared with people who do not have a familyhistory of diabetes mellitus after controlled variable of knowledge, the pattern ofrisky eating habits and patterns of fiber eating habits (95% CI: 2.810 ? 13.553).From this research, it is advisable to carry out preventive and promotive efforts toattempt behavioral changes become healthier by increasing fiber intake, reducingthe risk of eating habits, and increase knowledge about diabetes."