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"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."

"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."

"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."

"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."

"Jumlah kejadian diabetes melitus semakin meningkat setiap tahunnya. Pasien diabetes melitus perlu mendapatkan informasi tentang diabetes melitus minimal setelah ditegakan diagnosa. Perawat sebagai edukator bisa memberikan edukasi terhadap pasien diabetes melitus agar terjadinya peningkatan pengetahuan dan merubah sikap pasien diabetes. Penyampaian edukasi melalui lisan perlu ditambahkan dengan modul, agar pasien dapat meninjau kembali materi yang telah diterima. Penelitian ini bertujuan untuk menguji pengaruh edukasi dengan menggunakan self instructional module terhadap tingkat pengetahuan dan sikap tentang diabetes melitus pada pasien diabetes melitus tipe 2. Penelitian ini menggunakan desain quasi experimental dengan one group pretest postest dengan jumlah sampel 29 orang dengan diagnosa diabetes melitus tipe 2, pengumpulan data menggunakan kuesioner. Analisis statistik menggunakan wilcoxon test. Terdapat pengaruh edukasi kesehatan self instructional module terhadap pengetahuan dan sikap pasien diabetes melitus p

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The number of diabetes mellitus cases have been increasing every year. Diabetes mellitus DM patient needs to get informed about their DM lately after the patient had been diagnosed. Nurse should give the education to enhance patient knowledge and improve their attitude. Health education using modified module has benefit to support the patient in perfoming self learning. This study aimed to test the impact of education using the self instructional module to a level of knowledge and attitude about diabetes mellitus to diabetes mellitus patient type 2. This research used quasi experimental with one group pretest postest design with 29 person samples identified with diabetes mellitus type 2 diagnosis. Data were collected using questionaires. Statistic analysis was done by using wilcoxon test. The research result showed that there were differences of knowledge before and after education by self instructional module p 0,001 "

"Diabetes Mellitus (DM ) merupakan salah satu masalah kesehatan yang terjadi pada masyarakat perkotaan akibat gaya hidup dan stressor. Berbagai komplikasi dapat muncul apabila kadar glukosa tidak dikontrol dengan baik akibat resistensi insulin. Komplikasi yang muncul, perubahan gaya hidup, dan terapi yang harus dijalani sepanjang hidup mengakibatkan terjadinya masalah psikososial keputusasaan. Tujuan penulisan ini adalah untuk melakukan analisis mengenai asuhan keperawatan psikososial keputusasaan pada kilen dengan DM tipe 2. Hasil menunjukkan bahwa kondisi psikososial keputusasaan mungkin menyebabkan ketidakstabilan glukosa darah dan masalah fisik akibat komplikasi DM tipe 2 juga mempengaruhi keadaan psikososial keputusasaan.

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Diabetes mellitus (DM) is the one of health problems in urban communities because their lifestyles and stressors. Various complications develop when glucose levels can not be controlled properly due to insulin resistance. Complications, lifestyle changes, and treatment can stimulate psychosocial problems including hopelessness. The purpose of this paper is to analyze the psychosocial nursing care about clients with hopelessness associated with DM type 2. The results show that hopelessness may induce unstable blood glucose level and physical problems as a result of complications of DM type 2."

"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."

"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."

"DM tipe 2 memiliki pengaruh cukup besar terhadap seluruh aspek kehidupan klien serta memiliki risiko terjadinya berbagai komplikasi yang dapat mengancam jiwa. Self-care diyakini mampu mempertahankan dan meningkatkan status kesehatan klien DM serta mencegah terjadinya komplikasi. Selain perhatian dan kasih sayang klien DM juga membutuhkan informasi terkait penyakit DM dari lingkungan sekitarnya termasuk keluarga. Penelitian ini bertujuan untuk mengetahui hubungan dukungan informasi keluarga dengan self-care klien DM tipe 2 di Kelurahan Ambarketawang Yogyakarta. Desain penelitian menggunakan analitic correlation dengan pendekatan cross sectional. Pengumpulan data dilakukan dengan menggunakan kuesioner dukungan informasi keluarga dan self-care kepada 119 responden. Hasil menunjukkan bahwa dukungan informasi keluarga memiliki hubungan kuat dan positif dengan self-care klien DM tipe 2 p value: 0,000 . Peningkatan dukungan informasi keluarga dianjurkan guna meningkatkan status kesehatan klien DM.

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DM type 2 has a considerable influence on all aspects of a client 39 s life as well as having the risk of complications that can be life threatening. Self care is believed to be able to maintain and improve the health status of the DM client and prevent complications. DM client also requires information related to DM disease of the surrounding environment, including the family. This study aims to determine the relationship of the family with information support self care clients type 2 diabetes in Ambarketawang Yogyakarta. The study design using analytic correlation with cross sectional approach. The data collection was conducted using questionnaires family support and self care to 120 respondents. The results show that the support of family information has a strong and positive relationship with self care clients with type 2 diabetes p Value 0,000 . Improved the support of family information is recommended in order to improve the health status of the DM client."

"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."