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"In this book, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chronic kidney disease and minority patients. In addition, evolving concepts and new developments in the field are presented in other chapters, such as prevention of type 2 diabetes and the epidemic of sleep apnea and its implication for diabetes and hypertension evaluation and management. An important title covering two of the most troubling disorders of our time, Diabetes and hypertension : evaluation and management will provide the busy practitioner with cutting edge knowledge in the field as well as practical information that can translate into better care provided to the high-risk population of diabetics and hypertensive patients."

"This book outlines best practice and scientific progress in the management of people with type I diabetes who undertake a sport at any level. The book explores endocrine response to exercise, hypoglycemia and dietetics in the diabetic patient, and provides real-life examples of type I diabetes management at the professional athlete level. It is the first source of reference for specialists in diabetes when seeking advice on how to manage their patient and provides practical advice for equipping the type I diabetes patient with the ability to fulfill their sporting potential."

"In Diabetes and peripheral vascular disease, a panel of distinguished leaders in the field of medicine, podiatry, and vascular and endovascular therapy assimilate the latest literature on these issues and others for an in-depth review of the management of peripheral vascular disease. Providing an overview of the management of diabetes and diabetic foot changes as well as providing a view of cutting-edge and emerging topics in optimization of arterial status, this important title addresses pathophysiology, anatomy, diagnosis and management of diabetic peripheral vascular disease, emphasizing a multi-disciplinary approach. The first chapter of the book provides an overview of this complex disease process and discusses the teamwork required for optimal management. The chapters continue with the basic pathophysiology of diabetic atherosclerosis and a contemporary review of the management of diabetes. The genesis of diabetic foot ulceration and prevention and management strategies is covered, as is the effects of neuropathy and microvascular changes in the diabetic foot. In addition, Diabetes and Peripheral Vascular Disease covers the microbiology of diabetic foot infections, the role of endovascular interventions and vascular surgery as well as the management of the complications of these procedures, the process of amputation for those patients who have progressed beyond a limb salvage situation, and the effects of diabetes on the cerebrovascular system as well as its implications in patients with aortoiliac disease."

"ABSTRAKKontrol glukosa darah dapat dipertahankan melalui perawatan mandiri. Motivasi melakukan self monitoring blood glucose (SMBG) yang baik dapat meningkatkan diabetes self management pada pasien diabetes melitus tipe 2.Tujuan penelitian ini adalah untuk mengetahui hubungan motivasi melakukan SMBG dengan diabetes self management pada pasien diabetes melitus tipe 2.Penelitian ini menggunakan metode kuantitatif observasional analitik dengan pendekatan crossectional, melibatkan 96 pasien. Alat ukur yang digunakan berupa kuesioner karakteristik responden, Treatment Self Regulation Questionare, Diabetes Self Management Questionare, Diabetes Knowledge Scale.Hasil penelitian menunjukkan terdapat hubungan yang bermakna antara motivasi melakukan SMBG dengan diabetes self management (p = 0,001). Hasil analisis regresi logistik menunjukkan motivasi melakukan SMBG berhubungan dengan didabetes self management setelah dikontrol variabel pengetahuan.Kesimpulan diperlukan perhatian khusus dari perawat untuk meningkatkan motivasi melakukan SMBG pada pasien diabetes melitus tipe 2 dalam self care management.

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ABSTRACT

Glycemic control could be maintained through diabetes self-management. Motivation to perform self-monitoring blood glucose (SMBG) could improve diabetes self-management in type 2 diabetes mellitus patients.

The purpose of this study was to explore the relationship between motivation to perform SMBG and diabetes self-management in patients with type 2 diabetes mellitus.

This study applied quantitative method with a cross sectional approach, involving 96 patients. The Instruments used were questionnaires for respondent characteristics, Treatment Self-Regulation Questionnaires, Diabetes Self Management Questionnaire and Diabetes Knowledge Scale.

The results show that there was a significant relationship between motivation to perform SMBG and diabetes selfmanagement (p = 0,001). Results of logistic regression analysis showes that motivation to perform SMBG is associated with diabetes self-management after controlled by knowledge variable.

In conclusion it is a necessarily for nurses to provide attention to increase motivation to perform SMBG in patients with type 2 diabetes mellitus as part of self care management."

"ABSTRAKPengetahuan sangat penting dalam mengembangkan diabetes self-management untuk mencegah resiko komplikasi jangka panjang dengan diet yang ketat. Tujuan penelitian ini untuk mengetahui hubungan antara pengetahuan dan diabetes self-management dengan tingkat stress pasien diabetes melitus yang menjalani diet. Penelitian ini menggunakan desain cross-sectional. Jumlah total sampel didapatkan sebesar 106 responden dengan multistage sampling, Kriteria inklusi meliputi pasien DM <5 tahun dengan rentang usia 35-55 tahun, tidak menggunakan insulin injeksi, Pasien DM masih berkeluarga dan tinggal dengan keluarganya. Data didapatkan dengan kuesioner Knowledge of Diabetic Diet Questionnaire, Self-Management Dietary Behaviors Questionnaire, dan tingkat stress menjalani diet. Kemudian dianalisis dengan uji Spearman test. Hasil penelitian menunjukkan bahwa tingkat pengetahuan (p=0,049; r=-0,192) dan diabetes self-management (p=0,000; r=-0,341) memiliki hubungan terhadap tingkat stress saat menjalani diet. Diabetes self-management memiliki hubungan yang sangat kuat dari pada tingkat pengetahuan terhadap tingkat stress pasien diabetes yang menjalani diet. Penelitian selanjutnya diharapkan bisa menggunakan responden dengan wilayah yang lebih luas dan serta mengembangkan intervensi yang lebih baik untuk meningkatkan pengetahuan tentang diet pada pasien diabetes melitus.ABSTRACTThe correlation between knowledge level and diabetes self-management towards stress level of patients DM with diet. Knowledge is very important in developing diabetes self-management to prevent the risk of long-term complications with a strict diet. The purpose of this study was to determine the relationship between knowledge and diabetes self-management with stress levels of people with diabetes mellitus who went on a diet. This study uses a cross-sectional design. The total samples obtained were 106 respondents with multistage sampling, inclusion criteria included patients with DM <5 years with a range of ages 35-55 years, did not use insulin injection, DM patients were still married and lived with their families. Data are obtained with questionnaire of Knowledge of Diabetic Diet Questionnaire (KDDQ), a Self-Management Dietary Behaviors Questionnaire (SMDBQ), and a stress level on a diet. Data analyzed by the Spearman Rho. The results showed that the level of knowledge (p=0.049; r=-0.192) and diabetes self-management (p=0,000; r=-0,341) had a relationship to stress levels while on a diet. Diabetes self-management has a very strong relationship to the level of knowledge of the stress level of diabetics with diet. Future studies are expected to be able to use respondents with a wider area and develop better interventions to increase knowledge about diets in people with diabetes mellitus."

"Gangguan pada fungsi insulin membuat pasien diabetes mellitus tipe 2 mengalami kondisi hiperglikemia. Kondisi tersebut membuat pasien diabetes mudah terbangun di malam hari karena nokturia dan mempunyai durasi tidur yang pendek. Penurunan kualitas tidur pada pasien diabetes mellitus tipe 2 dapat mengganggu aktivitas sehari-hari, perubahan emosional dan dapat menurunkan kualitas hidup pasien. Tujuan dari penelitian ini adalah untuk melihat hubungan antara kualitas tidur dengan manajemen perawatan diri. Penelitian ini juga meneliti variabel yang dapat mempengaruhi manajemen perawatan diri seperti usia, jenis kelamin, tingkat pendidikan, lama penyakit diabetes, tingkat stress, dukungan keluarga dan ulkus diabetikum. Metode penelitian yang digunakan dalam penelitian ini adalah cross-sectional dengan menggunakan kuesioner karakteristik responden, pittsburgh sleep quality index, perceived stress scale, diabetes self-management questionnaire dan dukungan keluarga. Penelitian ini dilakukan pada 152 pasien diabetes mellitus tipe 2 yang terbagi menjadi 79 responden tanpa ulkus diabetikum dan 73 responden dengan ulkus diabetikum. Hasil penelitian ini menunjukkan bahwa sebanyak 63.2 responden memiliki kualitas tidur yang buruk, 59.2 responden memiliki stress ringan, 57.2 responden memiliki dukungan keluarga buruk dan 56.6 memiliki perilaku manajemen perawatan diri diabetes baik. Penelitian ini juga menemukan bahwa terdapat hubungan yang bermakna antara kualitas tidur dengan manajemen perawatan diri diabetes p < 0.05. Hubungan yang bermakna juga ditemukan pada variabel lama penyakit DM dan tingkat stress p < 0.05. Tidak ada hubungan yang bermakna antara usia, jenis kelamin, tingkat pendidikan, dukungan keluarga dan ulkus diabetikum dengan manajemen perawatan diri diabetes. Kesimpulan yang diambil dari penelitian ini adalah terdapat hubungan yang bermakna antara kualitas tidur dengan manajemen perawatan diri diabetes pada pasien diabetes mellitus tipe 2.

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Insulin disturbance on diabetes mellitus patients has lead them to have hyperglycemia. This condition makes diabetics had to wake up at night due to nocturia and they also had a short duration of sleep. Decreased sleep quality in patients with type 2 diabetes can interfere their daytime functions, alterations in emotions and decrease their quality of life. Purpose of this study was to examine relationship between sleep quality and self care management among diabetes type 2 patients. This study also added some variables that may affect management of self care such as age, gender, education level, duration of diabetes, stress levels, family support and diabetic foot ulcers. This research using cross sectional methods with questionnaire consist of patient characteristic, Pittsburgh sleep quality index, perceived stress scale, diabetes self management questionnaire and family support. This research has been conducted in 152 diabetes type 2 patients who were divided into 79 respondents without diabetic foot ulcers and 73 respondents with diabetic foot ulcers. Result of this study showed that 63.2 of respondents have poor sleep quality, 59.2 of respondents have mild stress, 57.2 of respondents have poor family support and 56.6 have good diabetes self management behavior. This study also found that there is a significant relationship between sleep quality with diabetes self care management p 0.05. This study also found that there is significant relationship between duration of diabetes and stress level p 0.05. There is no significant relationship between age, sex, education level, family support and diabetic ulcers with diabetes self management care. Conclusion of this study is significant relationship between sleep quality and diabetes self care management on diabetes type 2 patients."

"Self management diabetes berdampak positif terhadap peningkatan outcome klinis. Observasi pada fasilitas pelayanan kesehatan menunjukkan pelaksanaan edukasi kurang efektif. Inovasi teknologi dapat menjadi alternatif solusi dalam mengatasi masalah ini. Penelitian bertujuan mengetahui pengaruh aplikasi self management berbasis android terhadap tingkat pengetahuan dan perilaku self management pada pasien diabetes melitus tipe 2. Penelitian ini berdesain quasi eksperimental pre-posttest dengan kelompok kontrol. Partisipan direkrut di poli rawat jalan dan rawat inap sejak Juni-Agustus 2020. Analisis data menggunakan SPSS versi 25 pada 66 responden. Pada analisis bivariat, terdapat peningkatan pengetahuan pada kelompok intervensi di akhir penelitian (p=0,07). Tidak ada pengaruh aplikasi terhadap perilaku self management diabetes (p=0,940). Pada analisis multivariat, didapatkan hubungan yang signifikan antara penggunaan aplikasi (p=0,045) dan tingkat pengetahuan sebelumnya (p=0,0001) terhadap tingkat pengetahuan posttest. Aplikasi D-SyIs berpotensi meningkatkan pengetahuan diabetes. Perbaikan desain aplikasi diharapkan dapat meningkatkan efektivitas penggunaan aplikasi.

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Self management diabetes has positive impact on increasing clinical outcome. Field observation in healthcare setting showed an ineffective implementation of health education. Technology innovation could be an alternative solution to solve this problem. This research was to examine the effect of android based self management apps towards diabetes self management behavior and diabetes knowledge among type 2 diabetes mellitus patients. A pre-posttest quasy experimental design with control group is used. Participants were recruited from outpatient and inpatient from June to July 2020. SPSS version 25 was used to analyse 66 participants. In bivariat analysis, there was enhancement of diabetes knowledge in intervention group (p=0,07) at the end of research. There was no significant different in self management (p=0,908). In multivariate analysis, there were significant effect of D-SyIs apps (p=0,045) and previous diabetes knowledge (p=0,0001) towards diabetes knowledge. This apps has potential effects to increase diabetes knowledge. Upgrading the app design is needed to increase the apps effectiveness."

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ABSTRAK

Manajemen perawatan diri merupakan komponen penting dalam penatalaksanaan Diabetes Mellitus Tipe 2 (DMT2). Pengetahuan, kesadaran diri dan kepatuhan diabetesi menentukan keberhasilan dalam peningkatan kualitas hidup dan pecegahan komplikasi. Intervensi keperawatan komunitas melalui pendidikan kesehatan dengan Diabetes Self-management Education (DSME), pemanfaatan aplikasi DIMAS serta kelompok swabantu diharapkan dapat meningkatkan manajemen perawatan diri. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran implementasi program DIMAS (Diabetes Management Support) sebagai inovasi dalam asuhan keperawatan komunitas untuk meningkatkan perilaku perawatan diri kelompok diabetesi. Pelaksanaan intervensi DIMAS dilakukan pada keluarga dan komunitas di kelurahan Sukmajaya Kota Depok selama 8 bulan. Hasil evaluasi menunjukkan terjadi peningkatan perawatan diri dan penurunan gula darah sewaktu (GDS) pada diabetesi. Terdapat perubahan yang signifikan pada kelompok diabetesi (n=48) sebelum dan sesudah intervensi pada perawatan diri dan GDS (p=0,000 dan p=0,011). Program DIMAS diharapkan dapat diterapkan perawat sebagai salah satu strategi pelaksanaan program perawatan kesehatan masyarakat (PERKESMAS) di lingkup pelayanan kesehatan primer.

 

Kata kunci :

DSME, aplikasi smart-phone, kelompok swabantu, perawatan diri

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ABSTRACT

Self-care management is an important component in the management of Diabetes Mellitus Type 2 (DMT2). Knowledge, self-efficacy and compliance in self-care are the main factor to improving quality of life and preventing complications. Community nursing interventions through health education with Diabetes Self-management Education (DSME), DIMAS applications and self-help groups are expected to improve diabetes self-care management. This paper aims is to provide an overview of the implementation of the DIMAS (Diabetes Management Support) as an innovation to improve the self-care management. The implementation was carried out on families and communities in Sukmajaya Depok City for 8 months. The results show an increase in self-care and a decrease in blood sugar (GDS). There were significant changes in the intervenstion group (n = 48) before and after the intervention in self-care and GDS (p = 0,000 and p = 0.011). The DIMAS program is expected to be implemented as a public health care strategy (PERKESMAS) in primary health services.

 

Key words:

DSME, smart-phone application, self-help groups, self-care

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"Penerapan pedoman gizi kedalam menu sehari-hari merupakan tantangan bagi mayoritas pasien diabetes karena memerlukan penyesuaian dan kesukarelaan dari pasien untuk mengubah pola makan yang sudah lama terbentuk dan sering menimbulkan kejenuhan dan stress disebabkan pasien diabetes harus mengikuti program diet seumur hidupnya. Aktivitas self management serta respon psikologis memiliki pengaruh yang besar pada pasien diabetes melitus dalam melakukan usaha pengontrolan diet. Penelitian ini menggunakan desain cross sectional yang dilakukan di RSPAD Gatot Soebroto, RS Fatmawati dan RSUPN Dr. Cipto Mangunkusomo Jakarta dengan jumlah responden 260 orang pasien diabetes melitus tipe 2. Pengukuran respon psikologis menggunakan Problem Areas In Diabetes PAID, aktivitas self management diukur menggunakan Diabetes Self Management Questionare DMSQ yang telah dilakukan uji validitas dan reliabilitas serta pengukuran asupan makanan melalui kuesioner food recall 1x24 jam dan status nutrisi dinilai dengan indeks massa tubuh IMT. Hasil analisis menunjukkan terdapat hubungan bermakna antara respon psikologis dan status nutrisi p = 0,000, OR =4,944 , terdapat hubungan bermakna antara diabetes self management dengan status nutrisi p = 0,002, OR = 2,217 yang tidak dipengaruhi variabel perancu jenis OAD, asupan makanan, dan usia. Diperlukan penambahan materi konseling untuk memenuhi kebutuhan psikologis terkait diabetes serta penguatan edukasi secara berulang-ulang kepada pasien.

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The application of nutritional guidelines into the daily menu is a challenge for the majority of diabetic patients because it requires adjustment and volunteering of patients to change the long established diet and often leads to saturation and stress because diabetic patients should follow a diet plan for the rest of their lives. Self management activities as well as psychological responses have a great influence on diabetes mellitus patients in doing diet control efforts. This research use cross sectional design which done in Gatot Soebroto army hospital, Fatmawati Hospital and Dr. Cipto Mangunkusomo hospital Jakarta with the number of respondents 260 people with type 2 diabetes mellitus. Measurement of psychological response using Problem Areas In Diabetes PAID, self management activity is measured using Diabetes Self Management Questionare DMSQ which has tested the validity and reliability and measurement of food intake through food recall questionnaire 1x24 hours and nutritional status assessed with body mass index BMI. The result showed that there was a significant correlation between psychological response and nutritional status p 0,000, OR 4,944 , there was a significant correlation between diabetes self management with nutritional status p 0,002, OR 2,217 unaffected by confounder type OAD, intake food, and age. Required addition of counseling material to meet the psychological needs related to diabetes as well as the strengthening of education repeatedly to the patient."