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"The purpose of this study was to provide a reference of chronic diabetes complications by investigating the prolonged hyperglycemia effects on hematological, biochemical and histopathological changes (liver, kidney, spleen, cardiac muscle, adrenal gland, and endocrine pancreas) in diabetic rats induced by streptozotocin.

Methods: Ten adult female Sprague-Dawley of uniform age were divided into two Groups. Group 1 was made diabetic by single intraperitoneal injection of streptozotocin (60 mg/kg/bw) whereas Group 2 served as control. After six months, the rats were anesthetized using pentobarbital. Cardiac puncture was performed to get 3 ml of the blood sample; following 12 hours of an overnight fast. Serum chemistry test and complete blood analysis for lipid profile and blood glucose test; liver and renal functions were performed. Tissue specimens of liver, kidney, spleen, cardiac muscle, adrenal gland, and endocrine pancreas were fixed in 10% formal saline and processed for histological study.

Results: There were severe histopathological changes in the affected organs; and the presence of a significant abnormality of lipid profile, liver, and renal functions.

Conclusions: The presence of histopathological changes with abnormal biochemical changes is related to the chronic absence of insulin production in the destroyed β ?cells which reflect the diabetic complications in a human being."

"Background: The purpose of this study was to provide a reference of chronic diabetes complications by investigatingthe prolonged hyperglycemia effects on hematological, biochemical and histopathological changes (liver, kidney,spleen, cardiac muscle, adrenal gland, and endocrine pancreas) in diabetic rats induced by streptozotocin. Methods:Ten adult female Sprague-Dawley of uniform age were divided into two Groups. Group 1 was made diabetic by singleintraperitoneal injection of streptozotocin (60 mg/kg/bw) whereas Group 2 served as control. After six months, the ratswere anesthetized using pentobarbital. Cardiac puncture was performed to get 3 ml of the blood sample; following 12hours of an overnight fast. Serum chemistry test and complete blood analysis for lipid profile and blood glucose test;liver and renal functions were performed. Tissue specimens of liver, kidney, spleen, cardiac muscle, adrenal gland, andendocrine pancreas were fixed in 10% formal saline and processed for histological study. Results: There were severehistopathological changes in the affected organs; and the presence of a significant abnormality of lipid profile, liver, andrenal functions. Conclusions: The presence of histopathological changes with abnormal biochemical changes is relatedto the chronic absence of insulin production in the destroyed β –cells which reflect the diabetic complications in ahuman being."

"Diabetes Mellitus is a chronic disease characterised by elevated levels of blood glucose known as hyperglycaemia. Diabetes is due to impaired insulin action in the metabolism of glucose and can result in impaired wound healing. Excessive production of pro-inflammatory cytokines, an increased number of macrophages and neutrophils, and decreased levels of transforming growth factor ? beta 1 (TGF-β1) serum can be characteristic of impaired wound healing. This study aims to determine the effects of squid extract on certain wound parameters such as levels of tumour necrosis factor ? alpha (TNF-α), and TGF-β1 serum and the number of macrophages and neutrophils.Methods: This was a post-test only, randomized controlled group study that was conducted on male Wistar rats. Experimental animals were divided into 6 groups; (1) normal wound with standard diet, (2) diabetic wound with standard diet, (3) diabetic wound with chitosan supplement, (4) diabetic wound given squid extract orally once a day, (5) diabetic wound given squid extract orally twice a day, and (6) diabetic wound given squid extract orally once every two days. Levels of TNF-α and TGF-β1 serum were observed using Enzyme-Linked Immunosorbent Assay. Haematocylin and eosin staining was used to observed macrophage and neutrophil counts. All data was analysedstatistically by one-way analysis of variance.Results: TNF-α serum levels showed a significant decrease (p < 0.05) in subjects that received squid extract orally once every two days. The mean levels of TGF-β1 showed no significant differences. The mean number of macrophage cells showed a significant decrease (p < 0.05) in all treatment groups. The mean number of neutrophil cells also showed significant decrease (p < 0.05) in all treatment groups.Conclusions: Squid extract is effective in lowering the TNF-α serum levels and the number of macrophages and neutrophils cells in Wistar rats. However, there were insignificant findings on increasing levels of TGF-β1 serum. This data suggests that squid extract is most effective during the inflammatory phase of wound healing which takes places about 2-4 days after wound creation.Keywords: diabetic wound, squid, TNF"

"Hubungan antara Merokok sebagai Faktor Risiko yang dapat Dimodifikasi dari berbagai Komplikasi Kronis pada Lansia dengan Diabetes Mellitus Tipe 2. Merokok dikenal sebagai variabel yang dapat diubah melalui aktifitas intervensi yang spesifik. Saat ini di Indonesia belum terdapat penelitian mengenai komplikasi kronis di antara para lansia penderita Diabetes Mellitus (DM) tipe 2. Penelitian ini bertujuan untuk mempelajari risiko dari aktifitas merokok terhadap komplikasi kronis di antara para lansia penderita DM tipe 2. Penelitian ini menggunakan Riset Kesehatan Dasar (Riskedas) 2007. Sebanyak 1.565 lansia (usia 60++ tahun) penderita DM tipe 2 dipilih secara acak. Sebanyak 70-80% dari para lansia tersebut memiliki komplikasi kronis, dan 32,11% sampel penelitian adalah perokok. Para lansia yang merokok lebih dari 24 batang per hari memiliki risiko 2,5 (95% CI, 1,54-3,97), sementara itu lansia yang merokok 1-12 batang per hari, dan yang merokok 13-24 batang per hari memiliki risiko masing-masing setinggi 1,3 dan 1,6 untuk terserang komplikasi kronis dibandingkan mereka tidak merokok, terkontrol secara usia, tingkat obesitas, dan aktifitas fisik. Persentase perokok di antara para lansia penderita DM tipe 2 cukup tinggi. Sebagian besar dari mereka memiliki tingkat pendidikan, tingkat status sosioekonomi, aktifitas fisik, serta tingkat konsumsi buah dan sayur yang rendah. Mereka pun kurang memiliki akses terhadap layanan kesehatan. Merokok meningkatkan risiko komplikasi kronis DM tipe 2.

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Smoking is known as a variable that can be changed through a specific intervention activity. Recently in Indonesia, research related to chronic complication among elderly with type 2 Diabetes Mellitus (DM) was not available. This research has objective in exploring the risk of smoking towards chronic complication among elderly with type 2 DM. This research was using Riset Kesehatan Dasar (Riskesdas) in 2007. Riskesdas is a representative Indonesia Health Survey. 1,565 elderly (aged 60++ years) with type 2 DM have selected by random. 70-80% of the elderly have Chronic Complications and 32.11% of the sample is smokers. The elderly who smoke more than 24 cigarettes per day have risk 2.5 (95% CI, 1.54-3.97), smoker 1-12 cigarettes per day, and smoker 13-24 cigarettes per day have risk 1.3 and 1.6 respectively to get chronic complication compared with those who do not smoke, controlled by age, obesity, and physical activity. The proportion of smokers among elderly with type 2 DM is high, most of them are low education, low socioeconomic status, lack of access to the health services, low of physical activity, and low consume vegetables and fruit. Smoking increases the risk of chronic complication of type 2 DM."

"ABSTRAKBy 2015, 68% of deaths in Indonesia are due to non-communicable diseases (NCD) and are forecast to increase to 74% by 2030. Riskesdas data of 2013 show that 69.6% of cases of diabetes mellitus and 63.2% of cases of hypertension have not been diagnosed. The government has been trying to proactively make efforts to prevent NCD through the implementation of Posbindu (Integrated Health Post) NCD, but visit Posbindu NCD in the work area of Pasir Mulya Puskesmas, Bogor City is very diverse. The purpose of this study is to analyze the factors of management, communication, partnership, and innovation in the implementation of Posbindu NCD and determinants of the implementation of Posbindu NCD. We conducted in-depth interviews, focus group discussions, document review and observation at two Posbindu NCD with the highest number of visits and the lowest in Gunung Batu Village, Bogor City in 2017. We interviewed 15 informants, consisting of cadres, in charge of NCD Puskesmas, in charge of Puskesmas Pembantu and supervisor of Posbindu NCD. This research found 4 factors, namely management (human resources, fund, and facilities), innovation, communication and partnership that influence the result of Posbindu implementation. Therefore, to run effectively the Posbindu NCD program, then 4 of those factors need to be optimized.ABSTRAKPada tahun 2015 sebanyak 68% kematian di Indonesia disebabkan penyakit tidak menular (PTM) dan diproyeksi meningkat menjadi 74% tahun 2030. Data Riskesdas tahun 2013 menunjukkan bahwa 69,6% kasus diabetes melitus dan 63,2% kasus hipertensi belum terdiagnosis. Pemerintah proaktif melakukan upaya pencegahan PTM melaluipelaksanaan Posbindu PTM. Data kunjungan Posbindu PTM di wilayah kerja Puskesmas Pasir Mulya, Kota Bogor menunjukkan jumlah yang sangat beragam. Tujuan penelitian adalah menganalisis faktor manajemen, komunikasi, kemitraan, dan inovasi dalam pelaksanaan Posbindu PTM dan faktor penentu pelaksanaan Posbindu PTM. Disainpenelitian adalah studi kualitatif dengan metode wawancara mendalam, focus group discussion (FGD), telaah dokumen, dan observasi di dua Posbindu PTM dengan jumlah kunjungan tertinggi dan terendah di Kelurahan Gunung Batu, Kota Bogor tahun 2017. Informan penelitian sebanyak 15 orang yang terdiri dari kader, penanggung jawab program PTM Puskesmas, penanggung jawab Puskesmas Pembantu dan pembina Posbindu PTM. Penelitian menemukan terdapat perbedaan manajemen (SDM, dana, dan sarana), inovasi, komunikasi dan kemitraan antara Posbindu RW 1 dan RW 7 yang memengaruhi hasil pelaksanaan Posbindu PTM. Keempat faktor tersebut pada Posbindu dengan kunjungan terbanyak berjalan lebih optimal dibandingkan dengan Posbindu dengan kunjungan terendah. Agar program PosbinduPTM dapat berjalan efektif maka perlu optimalisasi faktor manajemen, inovasi, komunikasi dan kemitraan."

"Penyandang DMT2 memiliki beban fisik dan psikologis pada status kesehatannya setelah menyandang DMT2, yang dapat mempengaruhi pencapaian HbA1c < 7% masih belum optimal. Oleh sebab itu, salah satu keberhasilan dalam mencegah komplikasi kronik adalah pengukuran kesadaran diri status kesehatan penyandang DMT2 yang berlangsung selama seumur hidup. Status kesehatan merupakan kondisi yang menggambarkan kesehatan baik secara fisik dan mental. Sayangnya, penyandang DMT2 belum dapat menilai dirinya sendiri dan memantau status kesehatan karena belum ada instrumen yang mudah dipakai dan digunakan sebagai alat evaluasi. Instrumen tersebut diperlukan untuk mengukur status kesehatan diri agar penyandang DMT2 dapat memperluas kesadaran dirinya sehingga akan terlibat aktif dalam perawatan kesehatan. Penelitian ini bertujuan mengembangkan instrument kesadaran diri status kesehatan. Penelitian dibagi menjadi tiga tahap, yaitu tahap pertama adalah pengembangan instrument; tahap kedua adalah uji validitas secara empirik; dan tahap ketiga adalah penormaan dan interpretasi instrumen. Tahap pengembangan instrumen terdiri dari validasi konstruk oleh 3 pakar, merancang instrumen, dan uji validitas isi rancangan instrumen oleh 6 pakar. Pada tahap uji validitas secara empirik, uji validitas konstruk melibatkan 602 penyandang DMT2 dengan komplikasi kronik. Hasil penelitian tahap 1 mendapatkan 100 butir pernyataan (CVI 1) mencakup 4 dimensi, yaitu kemitraan perawat, dialog, pola kesadaran diri, dan status kesehatan. Uji Confirmatory Factor Analysis (CFA) pada tahap dua menghasilkan 77 butir pernyataan yang fit unidimensional mengukur kesadaran diri status kesehatan. Tahapan ketiga menghasilkan skala dan skor kesadaran diri yang mudah dijumlahkan oleh penyandang DMT2 dengan terdiri dari kesadaran diri rendah (0-23), kesadaran diri sedang (31-57) dan kesadaran diri tinggi (58-77).

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People with T2DM have a physical and psychological burden on their health status after having T2DM, which can affect the achievement of HbA1c < 7% is still not optimal. Therefore, one of the successes in preventing chronic complications is the measurement of self-consciousness of the health status of people with T2DM that lasts for a lifetime. Health status is a condition that describes health both physically and mentally. Unfortunately, people with T2DM have not been able to assess themselves and monitor their health status because there is no instrument that is easy to use and use as an evaluation tool. Instruments are needed to measure health status so that people with T2DM can expand their self-consciousness so that they will be actively involved in health care. This study aims to develop a self-consciousness of health status instrument. The research is divided into three stages, namely the first stage is instrument development; the second stage is empirical validity testing; and the third stage is instrument normalization and interpretation. The instrument development stage consists of construct validation by 3 experts, designing the instrument, and testing the content validity of the instrument design by 6 experts. In the empirical validity stage, the construct validity test involved 602 people with T2DM with chronic complications. The results of phase 1 research obtained 100 statement items (CVI 1) covering 4 dimensions, namely nurse partnership, dialogue, self-awareness patterns, and health status. Confirmatory Factor Analysis (CFA) test in stage two resulted in 77 unidimensional fit statement items measuring health status self-awareness. The third stage resulted in a self-awareness scale and score that is easily summarized by people with T2DM and consists of low self-awareness (0-23), moderate self-awareness (31-57), and high self-awareness (58-77)."

"Background: the familial nature of type 2 diabetes is manifested by the presence of insulin resistance in non-diabetic first degree relatives. Most of these studies have been performed in middle-aged and there is only few published studies in young age individuals and adolescents. This study aimed to determine the relationship between parents history of type-2 diabetes with metabolic syndrome component and insulin resistance in adolescent non-diabetic subjects. Methods: this was a cross sectional study comparing the metabolic profile, risk of metabolic syndrome and insulin resistance in non-diabetic male adolescents (17-24 years old) whose one or both parents were with type-2 diabetes. We performed anamnesis, physical examination, fasting plasma glucose, lipid profile, fasting insulin level and insulin resistance based on HOMA-IR. Results: metabolic abnormalities were more prevalent in subjects whose parents were with history of type-2 diabetes, especially their waist circumference, fasting plasma glucose, triglyceride, fasting insulin and HOMA-IR (p=0.000). There was increased risk of developing central obesity in adolescents with parental history of 19.3 fold (95%CI 2.46-151.07) and insulin resistance of 10.3 fold (95%CI 3.89-27.23). Parental history of type-2 diabetes together with metabolic syndrome component ie. waist circumference >90 cm and triglyceride ≥150 mg/dl were strong determinat factors for insulin resistance (R2=50.7%). Conclusion: the early multiple metabolic defect can be detected in non-diabetes adolescents with parental history of type-2 diabetes. Cluster of metabolic syndrome component in these subject become a powerful determinat factor for insulin resistance.

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Latar belakang: sifat kekeluargaan diabetes tipe 2 dimanifestasi oleh adanya resistensi insulin pada keturunan pertama keluarga non-diabetes. Sebagian besar penelitian ini telah dilakukan pada usia menengah dan hanya beberapa penelitian yang dilakukan pada usia muda dan remaja. Penelitian ini bertujuan untuk menganalis hubungan antara riwayat orang tua yang memiliki diabetes melitus (DM) tipe 2 dengan komponen sindroma metabolik dan kejadian resistensi insulin pada subyek dewasa muda non-diabetes.

Metode: studi ini merupakan penelitian potong lintang pada pria dewasa muda non-diabetes (usia 16-24 tahun) dengan riwayat satu atau kedua orang tua DM tipe 2. Sebagai pembanding adalah subyek yang tidak mempunyai riwayat orang tua DM tipe 2. Dilakukan pemeriksaan anamnesis, pemeriksaan fisis, dan pemeriksaan laboratorium glukosa darah puasa, profil lipid, insulin puasa dan resistensi insulin dengan menggunakan rumus HOMA-IR.

Hasil: profil metabolik yang abnormal lebih banyak ditemukan pada subyek dengan riwayat orang tua menderita DM tipe 2, khususnya dalam hal lingkar pinggang, glukosa darah puasa, trigliserida, insulin puasa dan HOMA-IR (p=0.000). Subyek dewasa muda non-diabetes dengan riwayat orang tua DM tipe 2 beresiko untuk menglami obesitas sentral sebesar 19.3 kali (95%CI 2.46-151.07) dan juga beresiko terhadap terjadinya resistensi insulin sebesar 10.3 kali (95%CI 3.89-27.23). Hasil uji regresi logistik menunjukkan bahwa faktor orang tua menderita DM tipe 2 bersama–sama dengan komponen sindroma metabolik yaitu lingkar pinggang >90 cm dan kadar trigliserida ≥150 mg/dl merupakan faktor determinan kuat untuk terjadinya resistensi insulin (R2=50.7%).

Kesimpulan: pada Subyek dewasa muda non-diabetes dengan riwayat orang tua menderita DM tipe 2 sudah dapat ditemukan abnormalitas metabolik yang multipel. Kluster dari komponen sindoma metabolik pada populasi tersebut merupakan faktor determinan kuat untuk terjadinya resistensi insulin."

"Diabetes mellitus merupakan penyakit kronis metabolis yang ditandai dengan kondisi hiperglikemia dan dapat berkomplikasi ke berbagai organ seperti hepatopati. Pengobatan diabetes mellitus memerlukan biaya yang tinggi dan masih memiliki berbagai efek samping yang tidak diinginkan. Oleh karena itu, diperlukan adanya pengobatan alternatif dari bahan-bahan herbal yang dapat memberikan efek antihiperglikemik dan efek protektif pada hepar dengan salah satu yang berpotensi adalah daun jati (Tectona grandis). Penelitian ini diawali dengan 30 tikus Wistar yang dibagi menjadi 6 kelompok, yaitu kelompok normal, kelompok kontrol positif yang diberikan metformin, kelompok kontrol negatif, dan tiga kelompok perlakuan lain yang diberikan ekstrak etanol daun jati. Induksi diabetes mellitus dilakukan dengan injeksi streptozotosin (STZ) dosis 40 mg/kgBB secara intraperitoneal. Setelah 3 hari induksi, diberikan perlakuan sesuai kelompok masing-masing selama 40 hari dan GDP akan diukur secara berkala. Pada hari terakhir, dilakukan terminasi dan pengambilan organ hepar untuk pemeriksaan histopatologi preparat hepar. Pemeriksaan dilakukan dengan mencari adanya perubahan histopatologi hepar pada hepatosit berupa makrovesikular steatosis, mikrovesikular steatosis, perubahan hidrofik, degenerasi ballooning, dan nekrosis. Data GDP akan dianalisis menggunakan uji One-Way ANOVA. Penelitian ini menunjukkan bahwa ekstrak etanol daun jati dengan dosis 200 mg/dL, 400 mg/dL, dan 800 mg/dL dapat menurunkan GDP tikus diabetes yang diinduksi STZ. Akan tetapi, ekstrak etanol daun jati tidak memiliki pengaruh terhadap perubahan gambaran histopatologi hepar pada tikus diabetes yang diinduksi STZ. Ekstrak etanol daun jati dapat menurunkan kadar GDP tikus yang diinduksi STZ tetapi tidak memiliki pengaruh terhadap perubahan gambaran histopatologi hepar dati tikus tersebut.

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Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia and can cause many organ complication including hepatopathy. Treatment of diabetes mellitus requires high costs and still has unwanted side effects. Therefore, it is necessary to have an alternative treatment from herbal ingredients that have antihyperglicemic and hepatoprotective effect, one of which has the potential to be teak (Tectona grandis) leaves. This study began with 30 Wistar rats which were divided into 6 groups, namely normal group, positive control group was treated with metformin, negative control group, and three other treatment groups were treated with teak leaf ethanol extract. Diabetes mellitus induction was carried out using intraperitoneal injection of streptozotocin (STZ) 40 mg/kg. After the induction, treatments for each group is given for 40 days and FBG will be measured periodically. Then, the rat was terminated and the liver was harvested for histopathological examination to look for liver histopathological change on hepatocytes the form of macrovesicular steatosis, microvesicular steatosis, hydrophic changes, ballooning degeneration, and necrosis. The FBG data will be analyzed using One-Way ANOVA test. This study showed that teak leaf ethanol extract with doses of 200 mg/dL, 400 mg/dL, and 800 mg/dL could reduce the FBG of STZ-induced diabetic rats. However, the extract has not been shown to improve histopathological changes in the rat’s liver. Teak leaf ethanol extract can reduce the FBG levels of STZ-induced rats but did not have an effect on changes in the histopathological appearance of the rat’s liver."

"[ABSTRAK Diabetes melitus merupakan sekelompok gangguan metabolisme tubuh, ditandaidengan hiperglikemik kronis yang dapat mengakibatkan komplikasi akut dankronis. Salah satu peran perawat sebagai pemberi asuhan adalah memberikanasuhan keperawatan yang berkualitas melalui pendekatan Teori Self Care Orem.Penggunaan pendekatan teori ini diharapkan dapat membantu perawat dalammenanggulangi keterbatasan yang dimiliki pasien dan melibatkan pasien secaraaktif dalam proses perawatannya melalui peilaku perawatan mandiri. Tujuanpenulisan karya ilmiah akhir ini adalah menganalisis hasil proses belajar residensikeperawatan medikal bedah melalui penerapan asuhan keperawatan, penerapanevidence based nursing practice, dan inovasi keperawatan. Data yang diperolehselama praktik klinik menunjukkan sebagian besar pasien diabetes melitusmengalami komplikasi ulkus kaki diabetik yang disebabkan oleh perilakuperawatan kaki mandiri belum optimal. Hasil penerapan evidence based nursingpractice berupa kegiatan edukasi perawatan kaki mandiri dapat meningkatkanpengetahuan dan membentuk perilaku perawatan kaki sebagai tindakanpencegahan dini. Hasil kegiatan inovasi keperawatan melalui pengkajiankesehatan mandiri adalah pasien dapat melakukan pengkajian mandiri terhadapkebutuhan edukasi dan mendapatkan edukasi sesuai kebutuhan mereka.Kesimpulan dari karya ilmiah akhir ini adalah perlunya peningkatan kualitasasuhan keperawatan pada pasien diabetes melitus melalui pendekatan teori keperawatan untuk meningkatkan kemandirian pasien dalam pengelolaan penyakitnya.ABSTRACT Diabetes 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 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 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 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. ]"