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"Type 2 diabetes mellitus (T2DM) is strongly associated with lower performance on multiple domains of cognitive function and with structural abnormalities of the brain. With the growing epidemic of diabetes and aging population, neural complications of diabetes are expected to rise and becoming a challenge for future health implications. Understanding pathophysiology, factors associated with this complication, manifestation of cognitive impairment and various metabolic and neuroradiologic markers suggestive of this pathologic condition is crucial for proper management of this potentially debilitating complication of T2DM. This review will discuss briefly important aspects of cognitive impairment in T2DM."

"BACKGROUND: type 2 diabetes mellitus (T2DM) and gastroesophageal reflux disease (GERD) are commonly seen in the geriatric population. This study aimed to investigate the prevalence, risk factors, and alarm-symptoms incidence of GERD among elderly patients with T2DM in a rural area of Central Sulawesi. METHODS: this cross-sectional study was conducted from July-September 2019 in Public Health Center of Beteleme, Central Sulawesi. Patients aged ≥60 years old, newly or previously diagnosed with T2DM according to the 2019 American Diabetes Association (ADA) criteria or to the 2015 Indonesian Society of Endocrinology (PERKENI) criteria, were consecutively recruited. We excluded patients being on proton-pump inhibitor or H2-receptor antagonist therapy or having a history of gastric or esophageal surgery. GERD was diagnosed in patients with the score of ≥8 based on the Indonesian version of GERD questionnaire (GERD-Q). RESULTS: among 60 elders with T2DM, 28.3% (95% confidence interval [CI], 16.9-39.7) had GERD. Statistical analysis showed that GERD was significantly associated with consumption frequency of tea (p=0.019) and coffee (p=0.015). No significant relationship was found between gender (p=0.562), obesity (p=0.803), achievement of blood glucose-level control (p=0.478), duration of T2DM (p=0.304), and type of antihyperglycemic drugs (p=0.202) with GERD. Unintentional weight loss was the leading alarm symptom (47.1%; 95%CI, 23.4%-70.8%) found across the GERD group. CONCLUSION: GERD was prevalent among elderly patients with diabetes. Frequent consumption of either tea or coffee was associated with GERD. Alarm symptoms need further evaluation to screen for complications."

"ABSTRAKNama : Naila KarimaProgram Studi : Magister Epidemiologi Komunitas Judul : Hubungan Diabetes Mellitus dengan Kejadian Gangguan FungsiKognitif Ringan pada Lansia Puskesmas Kecamatan Cipayung Kota Depok Tahun 2017Pembimbing : Dr.dr.Helda, MKesDiabetes mellitus merupakan salah satu faktor risiko terjadinya Mild Cognitive Impairment MCI . MCI adalah gangguan fungsi kognitif ringan yang mengacu pada keadaan transisipenuaan normal dan demensia dan tidak mengganggu aktivitas harian. Tujuan penelitian iniadalah untuk mengetahui hubungan diabetes mellitus dengan kejadian gangguan kognitif ringanpada lansia di wilayah kerja puskesmas kecamatan Cipayung kota Depok. desain studi yangdigunakan adalah cross sectional menggunakan data primer dengan instrument MoCa-Inatervalidasi. Sampel berjumlah 272 pasien lanjut usia. Analisis data dilakukan menggunakan coxregression. Hasil analisis data diperoleh prevalensi MCI sebesar 47,1 dan lansia dengan DMsebesar 17,3 . Pada analisis multivariat didapatkan MCI berisiko 2,4 kali lebih besar pada lansiayang memiliki DM dibandingkan dengan lansia yang tidak memiliki DM setelah dikontrolvariabel hipertensi dan variabel interaksi DM dengan hipertensi PR=2,436 95 CI: 1,191-4,983 .Skrining deteksi dini MCI pada lansia dengan DM merupakan intervensi awal untukmencegah terjadinya demensia.Kata kunci:Diabetes mellitus DM , Mild Cognitive Impairment MCI , Lansia

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ABSTRACTName Naila KarimaStudy Program Magister of EpidemiologyTitle Association Between Diabetes Mellitus in Elderly with IncidentMild Cognitive Impairment in Cipayung Health, Center Depok City, 2017Counsellor Dr.dr.Helda,MKesDiabetes mellitus is a risk factors of Mild Cognitive Impairment MCI . MCI is a transition phasebetween healthy cognitive aging and dementia. The purpose of this study is to determaine theassociation between diabetes mellitus in elderly with the incidence of MCI in Cipayung HealthCenter, Depok city. Study design was cross sectional using primary data with validated Montrealcognitive test for Indonesia MoCa Ina . Total sample of 272 elderly people age more than 60years old. cox regression analysis were applied in the research. The result of study showed theprevalence of MCI is 47,1 and elderly with DM is 17,3 . The result of multivariate analysisshowed the elderly people with diabetes mellitus probably had 2,4 risk to get MCI PR 2,43695 CI 1,191 4,983 than elderly with no diabetes after adjusted with hypertention andinteraction diabetes with hypertention variable. Screaning early detection of MCI in elderlywith diabetes mellitus is early intervention to prevent to dementia.Key words Diabetes mellitus DM , Mild Cognitive Impairment MCI , Elderly"

"International Diabetes Federation IDF pada tahun 2014 menyatakan penyandang DM yang berusia 20 -79 tahun sejumlah 8 dari seluruh penduduk Indonesia. Jali merupakan tumbuhan serealia yang mengandung 24,9 gram fruktooligosakarida dari setiap 100 gram bijinya. Perpaduan satu porsi yogurt jali yang terdiri dari 100 ml yogurt, mengandung probiotik Lactobacillus acidophilus dan Bifidobacterium masing masing sebesar 109cfu/mL, dicampur dengan 25 g jali rebus dapat menurunkan inflamasi epitel usus yang ditandai dengan penurunan kadar Calprotectine CP feses, meningkatkan kadar Glucagon Like Peptide-1 GLP-1 dan menurunkan resistensi insulin yang berperan dalam mengontrol kadar glukosa darah.Penelitian ini menggunakan randomized controlled trial parallel group study, untuk menilai pengaruh pemberian yogurt dan yogurt jali selama 12 minggu pada 60 subjek penyandang DM tipe2 masing-masing sebanyak 30 subjek pada kelompok yogurt dan yogurt jali.Didapatkan penurunan rerata BB p.

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Background: International Diabetes Federation IDF in 2014 reported that diabetes mellitus prevalence in Indonesia were 8. Job`s tears is a cereal containing 24.9 grams of fructooligosaccharide per 100 grams of dry seed. The combination of one serving of yogurt with Job`s tears composed from 100 ml yogurt, containing Lactobacillus acidophilus and Bifidobacterium probiotics of 109cfu / mL each, mixed with 25 g of boiled Job`s tears could decrease the inflammation of the intestinal epithelium, decrease the oxidative stress and insulin resistance that will play a role in controlling blood glucose.Method: This study used randomized controlled trial parallel group study to evaluate the effect of yogurt and yogurt with Job`s tears on FBG, GLP-1, CP and body weight in type 2 diabetes mellitus. The subjects in this study were 60 employees of Atma Jaya Jakarta with randomization block, each of 30 subjects in intervention yogurt with Job`s tears and control yogurt only groups.Result: A reduced body weight p."

"Diabetes melitus adalah penyakit metabolisme yang merupakan suatu kumpulan gejala yang timbul pada seseorang karena adanya peningkatan kadar glukosa darah di atas nilai normal. Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan kejadian Diabetes Melitus Tipe 2 pada wanita dewasa di daerah perkotaan di Indonesia tahun 2013. Penelitian ini menggunakan data sekunder Riskesdas 2013 dengan desain studi cross sectional. Sampel adalah wanita dewasa di daerah perkotaan yang tidak hamil dan memiliki kelengkapan data sebanyak 122.880 responden.Hasil penelitian menunjukkan prevalensi DM berdasarkan diagnosis dan gejala sebesar 2.2 % dan menemukan bahwa prevalensi DM tertinggi berada pada faktor risiko, seperti umur ≥ 45 tahun (5.2%), pendidikan rendah (3.1%), tidak bekerja (2.3%), status cerai (3.6%), aktfitas cukup (2.2%), mantan perokok (4%), jarang makan manis (3.8%) dan berlemak (2.3%), obesitas (2.9%), obesitas sentral (2.9%), dan hipertensi (7.6%). Faktor risiko DM yang memiliki hubungan paling dominan adalah umur ≥ 45 tahun (POR : 9.24; 95 % CI 7.69-11.1), status cerai (POR : 5.95; 95 % CI 4.85-7.30), dan hipertensi (POR : 5.10; 95 % CI 4.70-5.54). Untuk itu, perlu diadakan sosialisasi untuk program deteksi dini faktor risiko DM, serta perlunya kesadaran diri untuk cek gula darah secara teratur untuk wanita dewasa di daerah perkotaan.

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Diabetes mellitus is a metabolic disease which is a collection of symptoms that occur due to an increase in blood sugar levels above normal. This study aims to determine the risk factors assosiated with type 2 diabetes mellitus in adult women in urban areas. This study used a data from Riskesdas 2013 and using cross sectional as design study. Samples were adult women above 18 living in urban areas who are nor pregnant and has complete data.Result shows the prevalence of DM that based on diagnosis and symptoms is 2.2 % and the risk factors with highest prevalence of diabetes are age ≥ 45 (5.2%), low educated (3.1%), umemployed (2.3%), divorced (3.6%), enough activity (2.2%), former smokers (4%), rarely eat sweets (3.8%) and fatty foods (2.3%), obese (2.9%), central obese (2.9%), and hypertension (7.6%). The risk factors that highly associated are age ≥ 45 (POR : 9.24; 95 % CI 7.69-11.1), divorce (POR : 5.95; 95 % CI 4.85-7.30), and hypertension (POR : 5.10; 95 % CI 4.70-5.54). Therefor, screening for DM and self-awareness to check the blood sugar level are s strongly recommended among adult women in urban areas."

"Diabetes Melitus Tipe 2 DMT2 disebabkan oleh gaya hidup tidak sehat. Karyawan PT.X menderita DMT2 dengan prevalensi 6;5 . Tujuan penelitian ini menganalisis polamakan dan aktivitas fisik penderita DMT 2; dengan metode penelitian kualitatif analisisdeskriptif pada 12 responden. Pola makan diukur menggunakan kuesioner FoodFrequency Quesionnair FFQ dan aktivitas fisik dengan International Physical ActivityQuesionnair IPAQ ; serta dilakukan observasi dan wawancara mendalam. Hasilpenelitian menunujukkan bahwa; karakteristik dari 12 orang responden berumur ge; 40tahun 75 ; laki-laki 91;7 ; dan responden yang memiliki riwayat keluarga DM 58;3 . Pola makan respnden tidak teratur; konsumsi karbohidrat berlebih atau tinggiIndeks Glikemiknya IG ; aktivitas responden kategori ringan dan jarang berolahraga.Rata-rata Metabolic Equivalent MET responden secara total dari aktivitas kerja;aktivitas transportasi; kegiatan di rumah dan berkebun; olahraga yaitu di bawah 600MET-menit/minggu; responden beralasan tidak ada waktu dan malas berolahraga.Disarankan program promosi kesehatan tentang makanan sehat atau rendah IG untukkaryawan dan istrinya; bila memungkinan perusahaan menyediakan makanan sehat bagikaryawan; promosi pentingnya olahraga dan membuat program olahraga untukmengimbangi aktivitas kerja yang ringan.

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Diabetes is a non-infectious disease to 4 causes of death in Indonesia; prevalence of 6.9%; occurs at ≥ 15 years old (Kemenkes; 2014); Nearly 90% are Type 2 Diabetes Mellitus (T2DM) caused by unhealthy lifestyles. PT.X employees suffer from T2DM with a prevalence of 6.5%. The purpose of this study to analyze patterns of eating and physical activity of the patient DMT 2; with qualitative research methods of descriptive analysis on 12 respondents. The diet was measured by Food Frequency Quesionnair questionnaire and physical activity with International Physical Activity Quesionnair; and observation and in-depth interviews were conducted. The results showed that the characteristics of 12 respondents were ≥ 40 years old (75%); male (91.7%); and respondents who had a family history of DM (58.3%). Irregular eating patterns; excessive carbohydrate consumption or high Glycemic Index (GI). The activity of respondents in the category of mild and rarely exercise. Mean Total Metabolic Equivalent (MET) respondents from total work activities; transportation; domestic; exercise is below 600 MET-minutes/week; Respondents reasoned no time and lazy to exercise. Suggested health promotion programs on healthy or low GI foods for employees and their wives; if possible company provides healthy foods and create sports programs. "

"Diabetes melitus tipe 2 merupakan penyakit metabolik kronik dengan komplikasi yang dapat menyebabkan disabilitas hingga kematian. Upaya pencegahan komplikasi diabetes yaitu menerapkan perilaku self-management. Penelitian ini bertujuan untuk mengidentifikasi korelasi antara kualitas edukasi yang dilakukan perawat terhadap perilaku self-management pasien diabetes melitus tipe 2. Data diperoleh dari 126 responden di Puskesmas Cimanggis, Tapos, Sukmajaya, dan Persadia Cabang Kota Depok dengan teknik purposive sampling. Instrumen penelitian yang digunakan telah diuji untuk mengukur Kualitas Edukasi yang Dilakukan Perawat dan self-management diabetes (SDSCA). Hasil analisis korelasi Pearson menunjukkan terdapat hubungan positif yang bermakna antara kualitas edukasi yang dilakukan perawat terhadap perilaku self-management pasien diabetes melitus tipe 2 (p=0,000). Hasil penelitian ini dapat dijadikan evaluasi bagi pelayanan keperawatan untuk meningkatkan kualitas edukasi dengan harapan meningkatkan self-management pasien diabetes melitus tipe 2.

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Type 2 diabetes mellitus is a long-life chronic metabolic disease with  accompanying complications that could lead to disability or death. Diabetes self-management has been considered as an effort to reduce the complications. This study aimed to identify the correlation between the quality of nurse-led education with type 2 diabetes self-management behavior. A total  of 126 subjects with T2DM were recruited from Puskesmas Cimanggis, Tapos, Sukmajaya, and Persadia Cabang Kota Depok with purposive sampling. Previously validated scales were used to measure the quality of nurse-led education and diabetes self-management (SDSCA). The result of Pearson Correlation analysis showed that there is significantly-positive correlation between nurse-led education with self-management of type 2 diabetes mellitus patients (p=0,000; r=0,436). The result of this research could be a suggestion for further nursing care to educate diabetician to improve their self-management."

"Studi ini melaporkan terkait gambaran pelaksanaan kombinasi intervensi ankle pumping dan breathing exercise yang dilakukan pada lansia dengan COVID-19 komorbid diabetes mellitus tipe 2, serta diagnosis keperawatan ketidakstabilan kadar glukosa darah. Metode yang digunakan dalam studi adalah case report untuk mengevaluasi kondisi hiperglikemia dan hiperkoagulasi, sekaligus mencegah kerentanan desaturasi oksigen akibat terlalu banyak aktivitas. Kriteria inklusi pada penelitian ini merupakan pasien lansia COVID-19 dengan komorbid hiperglikemia dan hiperkoagulasi, yang dalam hal ini terdapat pasien Tn. J berusia 66 tahun, dirawat di Ruang Rawat Inap COVID-19. Hasil laboratorium terkait hemostasis darah pasien menunjukkan kadar d-dimer yang tinggi, yaitu 886.47 ng/ml, namun nilai PT/APTT (Prothrombin Time/Activated Partial Thromboplastin Time) masih dalam batas normal. Selain itu, GDS (Gula Darah Sewaktu) pasien saat diperiksa menunjukkan hasil 191 mg/dl dengan interpretasi tinggi. Kombinasi intervensi dilakukan sebagai bentuk analisa efektivitas yang nantinya diharapkan dapat dilakukan sehari-hari. Evaluasi juga dilakukan dengan menggunakan tiga komponen, yaitu KGDH (Kurva Gula Darah Harian), kadar d-dimer, dan saturasi oksigen. Hasil yang dipaparkan menunjukkan bahwa kombinasi intervensi tersebut dapat direkomendasikan sebagai upaya atau metode profilaksis terhadap lansia penyintas COVID-19 dengan komorbid hiperglikemia dan hiperkoagulasi.

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This study reports related to description of the implementation of ankle pumping and breathing exercise interventions combination carried out in the elderly with COVID-19 comorbid diabetes mellitus type 2, as well as nursing diagnoses of instability in blood glucose levels. The method used in this study is a case report to evaluate the conditions of hyperglycemia and hypercoagulation, as well as to prevent susceptibility to oxygen desaturation due to too much activity. The case report starts from the results of assessment, nursing diagnosis, outcome criteria, and intervention results. The inclusion criteria in this study were elderly COVID-19 patients with comorbid hyperglycemia and hypercoagulation, in this case there was a patient Mr. J is 66 years old, being treated at the COVID-19 Inpatient Room. Laboratory results related to the patient's blood hemostasis showed a high level of d-dimer, namely 886.47 ng/ml, but the PT/APTT (Prothrombin Time/Activated Partial Thromboplastin Time) value was still within normal limits. In addition, the patient's GDS (blood sugar at the time) when examined showed a result of 191 mg/dl with a high interpretation. The combination is carried out as a form of effectiveness analysis that is expected to be carried out on a daily basis. Evaluation was also carried out using three components, namely KGDH (Daily Blood Sugar Curve), d-dimer levels, and oxygen saturation. The results shown indicate that the combination of these interventions may be recommended as an effort or method of prophylaxis for elderly COVID-19 survivors with hyperglycemia and comorbid hypercoagulation."

"Diabetes Melitus DM penyakit kronis yang membutuhkan terapi jangka panjang dan intervensi untuk adaptasi perubahan gaya hidup dan pengobatan untuk meningkatkan target terapi. Penelitian bertujuan mengetahui pengaruh konseling oleh apoteker pada perbaikan kepatuhan, kadar HbA1c dan kualitas hidup pasien DM tipe 2 di RSUD Kota Depok. Penelitian dilakukan dengan desain pretest-posttest control group design pada 81 responden dengan alat ukur pill count untuk kepatuhan, pemeriksaan darah untuk kadar HbA1c dan kuesioner EQ-5D-5L untuk kualitas hidup. Karakteristik sosiodemografi dan klinis responden DM tipe 2 di RSUD Kota Depok antara kelompok uji dan kontrol tidak terdapat perbedaan yang signifikan p>0,05 . Pasien kelompok uji menunjukkan peningkatan kepatuhan terapi, penurunan kadar HbA1c dan peningkatan kualitas hidup secara signifikan, sementara pada kelompok kontrol hanya kadar HbA1c peningkatan yang signifikan sementara kepatuhan dan kualitas hidup tidak menunjukkan perubahan yang signifikan. Kepatuhan terapi responden dipengaruhi oleh konseling apoteker secara signifikan. Kadar HbA1c responden dipengaruhi oleh kepatuhan terapi dan pola makan secara signifikan. Kualitas hidup responden berdasarkan nilai deskriptif dan nilai VAS dipengaruhi oleh kadar HbA1c secara signifikan. Hasil penelitian ini dapat disimpulkan konseling oleh apoteker menyebabkan perbaikan pada kepatuhan, kadar HbA1c dan kualitas hidup responden pasien DM tipe 2 di RSUD Kota Depok.

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Diabetes Mellitus DM a chronic disease requiring long term therapy and interventions for the adaptation of lifestyle changes and medications to improve therapeutic targets. The aim of this research is to know the influence of counseling by pharmacist on improvement of adherence, HbA1c level and quality of life of DM type 2 patient in RSUD Kota Depok. The research was done by pretest posttest control group design design on 81 respondents with pill count methods for adherence, blood tests for HbA1c levels and EQ 5D 5L questionnaires for quality of life. Sociodemographic and clinical characteristics of DM type 2 respondents in RSUD Kota Depok between test and control group were not significantly different p 0,05 . Patients in the test group showed improved adherence to therapy, decreased HbA1c levels and improved quality of life significantly, while in the control group only HbA1c levels were a significant increase while adherence and quality of life did not show significant change. Adherence of respondents influenced by pharmacist counseling significantly. HbA1c levels of respondents is influenced by adherence of therapy and diet significantly. The quality of life of respondents based on descriptive value and VAS value influenced by HbA1c level significantly. The results of this study can be concluded by the pharmacist counseling led to improvements in adherence, HbA1c levels and quality of life of DM type 2 patients in Depok City Hospital. "

"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)."