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"ABSTRAKBackground: diabetic nephropathy (DN) is the leading cause of blood dialysis worldwide and a major etiology of End-Stage Renal Disease cases in Indonesia. Previous studies showed a relevant link between A1166C polymorphism of Angiotensin II Type-1 Receptor (AT1R) gene and glomerular hyper-filtration as a part of pathogenesis of DN. The aim of this study was to elaborate the association between A1166C AT1R polymorphism and susceptibility of individual with type-2 diabetes to DN in Malay Indonesian population. Methods: a case-control study of 120 consecutive patients with type-2 diabetes mellitus (40 patients in each groups for macro-albuminuria, micro-albuminuria, and normo-albuminuria) was conducted for A1166C AT1R gene polymorphism. The A1166C polymorphism of the AT1R gene was determined based on PCR/RFLP. Results: the mutant C allele was found in 5%, 13.75%, and 12.5% in normo-, micro-, and macro-albuminuria patients respectively. The heterozygote AC genotype was found significantly higher in micro-albuminuria, compared to normo-albuminuria group. Heterozygote AC genotype (OR 3.2 [1.01-10.08], p=0.03) and C allele (OR 2.8[0.95-8.67], p=0.038) were significantly higher in DN, indicating A1166C AT1R gene polymorphism as a risk factor for DN in Malay Indonesian population with type-2 diabetes. Conclusion: there was positive association between A1166C AT1R polymorphism and susceptibility of type-2 diabetics to DN in Malay Indonesian Population. It also indicated that the A1166C AT1R polymorphism could play a role in early pathogenesis of DN."

"ABSTRAKBackground: periodontitis is a major cause of chronic infection in diabetic patients. Diabetic patients have four-fold risk of having cardiovascular disease. Chronic inflammation caused by periodontitis, a non-traditional cardiovascular risk factor is widely known to play a major role in atherogenesis. Among non-diabetics, an association has been found between periodontitis and arterial stiffness, but in diabetic patients the result is inconsistent. No study has investigated either the proportion of periodontitis or its correlation with arterial stiffness in type 2 diabetes population in Indonesia. Methods: this study was a cross-sectional study involving 97 patients with type 2 diabetics, who were recruited on Endocrinology Clinic from April to August 2017. Periodontitis was measured for pocket depth, clinical attachment loss and bleeding on probing by a periodontist. Carotid-femoral PWV (Pulse Wave Velocity) was measured using SphygmoCor Xcel with cuff-based tonometry technique. Results: periodontitis was found in 99% type 2 diabetic subjects and 78% of them had severe periodontitis. There was no significant correlation found between pocket depth, clinical attachment loss and cfPWV (r=0.024, p=0.407 and r=0.011, p=0.456); whereas there was a weak positive correlation between pocket depth and PWV (r=0.294, p=0.041) in well-controlled type 2 diabetics. Conclusion: most of type-2 diabetics had severe periodontitis; however, the correlation between periodontitis and arterial stiffness could not be concluded in this study."

"Diabetes mellitus (DM) is a complex and chronic metabolic disorder leading to many complications. One of the most common complications of DM is diabetic neuropathy. There are many studies exploring corneal sensitivity as a potential marker of diabetic neuropathy. This review aims to explore association between corneal sensitivity and diabetic neuropathy. In diabetic neuropathy, corneal sensitivity is impaired due to low level of corneal nerve trophic factors, impaired sensory nerve fibers, and lost communication of dendtritic cell. In diabetic patients, this condition can be assessed by several techniques, such as Cochet Bonnet aesthesiometry, non-contact corneal aesthesiometry, and confocal microscopy. Few promising therapeutic targets for impaired corneal sensitivity include stem cell and growth factor therapy that can be used to prevent complication in patient with diabetic neurotrophic keratopathy. Impaired corneal sensitivity serve as a potential marker of diabetic neuropathy. Doctors, opthalmologists and internists, should anticipate the possibility of observing the following changes in diabetic patients with neuropathy by using corneal sensitivity assessment test."

"ABSTRACTMultidiscipline care is defined as a care consisting of at least a physician, a nurse, and other healthcare worker (eg. dietician). Multidiscipline care has generated benefits, both in medical aspects (eg. increasing patients compliance) and nonmedical aspects (eg. more cost-effective than conventional treatment). There are several models of multidiscpline care; however, which model is more suitable for type 2 diabetes care is not clear yet. In this review, we aimed to identify and compare multidiscipline care method for reducing glycated hemoglobin ( HbA1C) levels in type 2 diabetes patients, particularly Asian patients because they have greater tendency to develop type 2 diabetes at lower degrees of obesity and at younger ages than Caucasian ethnic group. There were limited number of studies examining multidiscipline care for type 2 diabetes patients, moreover for Asian patients. They showed mixed results on the efficacy of multidiscipline care in achieving HbA1C target. Healthcare personnel visit, either personal or group session, appeared effective both for general and Asian T2DM patients. It needs further studies to clarify which models are most effective for practices of varying cultures, socio-economic condition, and healthcare settings."

"Latar Belakang: Beberapa penelitian terakhir menunjukkan adanya hubungan antara diabetes melitus tipe 2 (DMT2) dengan kejadian hipotiroid subklinis (HSK). Penelitian lain menunjukkan bahwa pada DMT2 yang disertai HSK, angka kejadian retinopati ternyata lebih tinggi dibanding pada DMT2 yang tanpa disertai HSK. Pasien HSK sendiri diketahui mempunyai risiko tinggi terhadap kejadian dislipidemia. Bagaimana hubungan antara dislipidemia dengan retinopati pada pasien DMT2 dengan HSK, sampai saat ini masih belum diketahui. Tujuan: Mengetahui proporsi HSK pada pasien DMT2, hubungan antara HSK dengan kontrol glukosa darah, HSK dengan dislipidemia, serta hubungan antara dislipidemia dengan kejadian retinopati pada pasien DMT2 dengan HSK. Metode: Desain penelitian yang digunakan adalah potong lintang. Sampel adalah pasien dewasa yang sudah didiagnosis DMT2 minimal 1 tahun, yang berobat ke poliklinik rawat jalan Divisi Metabolik Endokrin RSCM yang memenuhi kriteria inklusi. Data-data yang dikumpulkan adalah kontrol glukosa (HbA1c), profil lipid (kolesterol total, LDL, HDL, trigliserida), TSHs, fT4 dan data retinopati. Data diambil dari rekam medis maupun pemeriksaan laboratorium. Hasil: Proporsi penyakit HSK pada pasien DMT2 sebesar 7.2 % dan sebagian besar berusia di atas 60 tahun. Tidak didapatkan perbedaan proporsi antara lakilaki dan perempuan. Dari analisis didapatkan pasien DMT2 dengan kontrol gula darah yang buruk (HbA1c >7) memiliki risiko 3,664 kali lebih besar mengalami HSK dibanding dengan pasien DMT2 yang gula darahnya terkontrol baik (p:0,010). Pada pasien DMT2 dengan HSK yang disertai dislipidemia, risiko terkena retinopati 2,76 kali lebih besar dibanding pasien tanpa dislipidemia (p:0,014). Simpulan: Terdapat hubungan bermakna antara HSK dengan kontrol gula darah (HbA1c) pada pasien DMT2. Terdapat hubungan antara HSK dan dislipidemia pada pasien DMT2. Terdapat hubungan antara dislipidemia dengan kejadian retinopati pada pasien DMT2 dengan HSK.

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Background: Some recent studies suggest that there is a link between type 2 diabetes mellitus (T2DM) and the incidence of subclinical hypothyroid (SCH). Other studies have shown that if a T2DM is accompanied SCH, the incidence of retinopathy was higher than in the T2DM without SCH. SCH patients themselves are known to have a high risk of occurrence of dyslipidemia. The the relationship between the incidence of dyslipidemia and retinopathy in patients with T2DM with SCH, is still unknown.

Objective: To determine the proportion of SCH in patients with T2DM, the relationship between SCH and glycemic control (HbA1c), SCH with dyslipidemia, and dyslipidemia with the incidence of retinopathy in T2DM patients with SCH.

Methods: The study design used is cross sectional. Sample were adult patients who have been diagnosed with T2DM at least 1 year, who went to the outpatient ward of Metabolic Endocrine Division, Cipto Mangunkusumo Hospital. Collected data include glycemic control (HbA1c), lipid profile (total cholesterol, LDL, HDL, triglycerides), TSHs, FT4 and retinopathy data. Data were retrieved from medical records and laboratory tests.

Results: The proportion of SCH in patients with T2DM 7.2%, and mostly aged over 60 years. There were no differences in the proportion between men and women. From the analysis reveals the T2DM patients with poor blood sugar control (HbA1c >7) had 3.664 times greater risk of developing SCH compared with T2DM patients with well-controlled blood sugar (p:0.010). In patients with T2DM with SCH accompanied dyslipidemia, retinopathy risk 2.76 times greater than patients without dyslipidemia (p:0.014).

Conclusion: There is a significant relationship between the SCH and glycemic control in patients with T2DM, SCH and dyslipidemia and also between dyslipidemia and retinopathy in T2DM patients with HSK."

"Prevalensi Diabetes melitus meningkat pesat dalam satu decade terakhir, pekerja kebersihan menjadi salah satu agregat yang berisiko diabetes melitus karena kondisi pekerjaan, kehidupan, sosial ekonomi, dan gaya hidup. penelitian ini bertujuan mengetahui hubungan faktor determinan kesehatan pekerja kebersihan dengan risiko diabetes melitus. Penelitian ini merupakan penelitian kuantitatif non eksperimental cross sectional melalui pendekatan deskriptif korelatif dengan sampel sebanyak 291 orang. Hasil penelitian menunjukan responden Rata-rata berusia 33 tahun (95% CI), laki-laki (76.6%), suku Betawi (49.5%), menikah (72.5%), lulus SMA ( 95%), ≥UMR (100%), memiliki rumah sendiri ( 50.9 %) dan tidak memiliki pekerjaan sampingan (94%), memiliki kebiasaan merokok ( 55%), dan tidak mengonsumsi alkohol ( 98.3 %). lama kerja 7 tahun (95% CI) , waktu jam kerja 11 jam (95% Cl), tingkat stres sedang, dan dukungan sosial baik. Rata-rata aktivitas fisik 3840 METs/minggu (95%CI), pola diet baik, lama waktu tidur 7 jam (95%CI), risiko diabetes melitus sangat rendah (3) (95% CI). Terdapat hubungan usia (p=0.003), jenis kelamin (p=0.000), dan kebiasaan merokok (p=0.000) dengan risiko diabetes melitus pada pekerja kebersihan. Pekerja kebersihan hendaknya mempertahankan dan meningkatkan pola hidup sehat untuk mencegah risiko diabetes melitus.

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The prevalence of diabetes mellitus has increased rapidly in the past decade. Sanitation workers are considered a high-risk group for diabetes mellitus due to their occupational conditions, lifestyle, socioeconomic factors, and living conditions. This study aims to investigate the relationship between determinants of health among sanitation workers and the risk of diabetes mellitus. A cross-sectional method was employed, with a sample size of 291 individuals. The research findings indicate that the average age of respondents was 33 years (95% CI), predominantly male (76.6%), of Betawi ethnicity (49.5%), married (72.5%), high school graduates (95%), earning at least the minimum wage (100%), owning their own homes (50.9%), having no secondary jobs (94%), being smokers (55%), and abstaining from alcohol consumption (98.3%). The average duration of work was 7 years (95% CI), with an average working time of 11 hours (95% CI). Moderate levels of stress and good social support were reported. The average physical activity level was 3840 METs/week (95% CI), with a healthy dietary pattern and 7 hours of sleep per night (95% CI). The risk of diabetes mellitus was found to be very low (3) (95% CI). There was a significant association between age (p=0.003), gender (p=0.000), smoking habits (p=0.000), and the risk of diabetes mellitus among sanitation workers. It is recommended that sanitation workers maintain and improve their healthy lifestyle practices to prevent the risk of diabetes mellitus."

"Diabetes melitus merupakan penyakit yang menjadi perhatian seluruh dunia karena mengalami peningkatan angka penderitanya yang drastis secara global. Di Indonesia, diabetes melitus menjadi penyebab kematian terbesar ketiga. Untuk mengurangi angka mortalitas dan morbiditas akibat komplikasi diabetes melitus, perlu dilakukan upaya manajemen diri. Salah satu faktor yang dapat berpengaruh terhadap manajemen diri adalah literasi kesehatan. Tujuan penelitian ini untuk mengetahui hubungan antara literasi kesehatan dengan manajemen diri penderita diabetes melitus tipe 2 di Kota Depok. Penelitian ini menggunakan metode kuantitatif observasional analitik dengan pendekatan cross-sectional pada 62 orang yang dipilih melalui purposive sampling. Hasil analisis melalui uji fisher’s exact menunjukkan tidak terdapat hubungan yang signifikan antara literasi kesehatan dan manajemen diri pada penderita diabetes melitus tipe 2 di Kota Depok (p-value = 0,510, p > α). Penelitian ini dapat dijadikan dasar untuk membuat program kesehatan yang meningkatkan literasi kesehatan dan manajemen diri.

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Diabetes mellitus is a disease that has become a worldwide concern due to the drastic increase in the number of sufferers. In Indonesia, diabetes mellitus is the third leading cause of death. To reduce mortality and morbidity due to complications of diabetes mellitus, self-management efforts need to be made. One factor that can influence self-management is health literacy. The purpose of this study was to determine the relationship between health literacy and self-management of patients with type 2 diabetes mellitus in Depok City. This study used a quantitative observational analytic method with a cross-sectional approach on 62 people selected through purposive sampling. The results of the analysis through fisher's exact test showed no significant relationship between health literacy and self-management in patients with type 2 diabetes mellitus in Depok City (p-value = 0.510, p> α). This study can be used as a basis for creating health programs that improve health literacy and self-management."

"Dukungan keluarga dan motivasi dalam perawatan diabetes dapat meningkatkan pemanfaatan pelayanan kesehatan bagi diabetisi tipe 2 dalam upaya mencegah komplikasi diabetes dan meningkatkan kualitas hidup diabetisi. Penelitian ini betujuan untuk mengetahui hubungan karakteristik, dukungan keluarga, dan motivasi diabetisi tipe 2 dengan pemanfaatan pelayanan kesehatan. Penelitian ini menggunakan deskriptif analitik dengan pendekatan Cross-Sectional. Sampel penelitian berjumlah 110 responden yang diambil secara proporsional random sampling. Analisa data dilakukan dengan menggunakan Chi-Square dan regresi logistik berganda. Hasil penelitian menunjukkan ada hubungan dukungan penghargaan keluarga dan motivasi intrinsik dengan pemanfaatan pelayanan kesehatan p value.

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Family Support and motivation treatment in diabetes patients will improve health services utilization. It aims to prevent diabetes complications and improve the diabetes patients quality of life. This study aimed to investigate the Relationship between patients characteristics, family support and motivation in patients with diabetes type 2 with health services utilization. This study used cross sectional with descriptive analytical approach with 110 respondents Which choosen by proportional random sampling. Analysis result using chi square and multiple logistic regression showed relationship between family reinforcement support and Intrinsic motivation with health services utilization p value."

"Depresi menjadi penyebab utama disabilitas di seluruh dunia dan berkontribusi pada beban penyakit global. Dampak depresi yang tidak tertangani adalah bunuh diri dimana hal ini akan meningkatkan angka mortalitas nasional. Prevalensi depresi di Indonesia meningkat dari 3,7% menjadi 6,1% di tahun 2015 ke tahun 2018. Diabetes melitus yang merupakan faktor risiko depresi juga mengalami peningkatan prevalensi pada periode tahun yang sama. Penelitian ini bertujuan untuk mengetahui keterkaitan diabetes melitus dengan kejadian depresi di Indonesia. Penelitian ini menggunakan desain studi potong lintang. Sumber data yang digunakan yaitu data sekunder Riskesdas 2018. Responden penelitian adalah penduduk di Indonesia yang berusia ≥ 18 tahun. Terdapat 646.000 responden yang memenuhi kriteria inklusi dan eksklusi. Berdasarkan hasil analisis didapatkan prevalensi depresi sebesar 6% dan prevalensi diabetes melitus sebesar 2,2%. Terdapat hubungan yang signifikan antara diabetes melitus dengan depresi. Responden yang memiliki diabetes melitus 1,8 kali (POR=1,827; 95%CI=1,732—1,927) lebih mungkin untuk mengalami depresi dibanding dengan seseorang yang tidak memiliki diabetes melitus setelah dikontrol oleh variabel penyakit kronis lain.

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Depression is becoming the leading cause of disability worldwide and contributing to the global burden of disease. The impact of untreated depression is suicide, which raises the national mortality rate.  The prevalence of depression in Indonesia increased from 6% to 6.1% in 2015 to 2018. Diabetes mellitus as a risk factor for depression also has prevalence which keep increasing in 2015 to 2018. This study aims to determine the relationship between diabetes mellitus and depression in Indonesia. This study used a cross-sectional study design. The data source used was secondary data obtained from Riskesdas 2018. The respondents of the study were all population in Indonesia aged ≥ 18 years. There were 646000 respondents that matched the inclusion and exclusion criteria. The results of the study found that the prevalence of depression was 6% and the prevalence of diabetes mellitus was 2.2%. There is a significant association between diabetes mellitus and depression. Respondents who had diabetes mellitus 1.8 (POR=1.827; 95%CI=1.732—1.927) more likely to become depressed than those who did not have diabetes mellitus after being controlled by other chronic disease variable."

"Diabetes melitus merupakan penyakit kronis yang prevalensinya terus meningkat secara global. Salah satu komplikasi serius dari diabetes adalah luka kaki diabetik, yang dapat menyebabkan amputasi jika tidak ditangani dengan baik. Tujuan penelitian ini adalah untuk menganalisis faktor yang berhubungan dengan penggunaan complementary alternative medicine (CAM) pada perawatan luka kaki diabetik. Penelitian ini menggunakan metode kuantitatif dengan pendekatan cross sectional melibatkan sampel sebanyak 154 pasien diabetes melitus tipe 2 dengan luka kaki diabetik. Data dikumpulkan melalui kuesioner dan pemeriksaan klinis, kemudian dianalisis menggunakan uji regresi logistik. Hasil penelitian menunjukan ada hubungan antara tingkat pendidikan, penghasilan, status luka, suku dan literasi kesehatan dengan penggunaan CAM. Hasil analisis regresi logistik menunjukkan status luka berhubungan dengan penggunaan CAM setelah dikontrol variabel pendidikan dan penghasilan. Kesimpulan perlunya adanya program edukasi tentang jenis, manfaat, risiko penggunaan CAM yang aman dan efektif dalam perawatan luka kaki diabetik.

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Diabetes mellitus is a chronic disease with a globally increasing prevalence. One of the serious complications of diabetes is diabetic foot ulcers, which can lead to amputation if not properly managed. This study aims to analyze the factors associated with the use of complementary and alternative medicine (CAM) in the treatment of diabetic foot ulcers. A quantitative cross-sectional method was employed, involving a sample of 154 type 2 diabetis patients with foot ulcers. Data were collected through interviews, clinical examinations, and questionnaires, and analyzed using logistic regression tests. The results showed a significant relationship between educational level, income, ethnicity, and health literacy with the use of CAM. Logistic regression analysis indicated that age was related to CAM use after controlling for education and income variables. The study concludes that there is a need for educational programmes on the types, benefits and risks of safe and effective use of CAM in the management of diabetic foot ulcers."