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"Latar belakang Diabetes Mellitus (DM) merupakan salah satu masalah kesehatan utama di negara berkembang maupun negara maju.1 Pada tahun 2007, sekitar 23,6 juta orang Amerika menderita DM, dimana sebagian besar adalah pekerja.2 Penelitian oleh Poulsen (2014) menemukan bahwa 3,5% petugas kesehatan menderita DM selama periode pengamatan 7 tahun.3 Informasi mengenai dampak kerja shift terhadap kontrol glikemik pada pada pekerja yang memiliki DM tipe 2 masih belum banyak diketahui. Metode Kasus wanita berusia 52 tahun bekerja sebagai perawat di rumah sakit, mengikuti jadwal shift malam dan telah didiagnosis DM tipe 2 sejak 7 tahun lalu. Pencarian literatur dilakukan melalui pencarian elektronik (PubMed dan ProQuest) serta hand searching dengan kata kunci “kontrol glukosa darah”, “diabetes mellitus tipe 2”, “kerja shift” dan “kerja shift malam” yang memenuhi kriteria inklusi dan eksklusi. Hasil Hasil pencarian didapatkan 92 studi dan 3 studi yang relevan ditemukan dengan desain potong lintang. Studi oleh Manodpitipong (2017) menunjukkan bahwa kerja shift malam dikaitkan dengan HbA1c yang lebih tinggi (p = 0,044) dibandingkan dengan kerja siang hari. Studi oleh Chalernvanichakorn (2008) memberikan hasil kontrol glikemik yang baik secara signifikan lebih tinggi pada pekerja harian dibandingkan pekerja shift (28,3% vs 15,8%) dengan p = 0,02. Studi oleh Ghazawy (2013) menunjukkan bahwa HbA1c lebih tinggi di antara pekerja dengan diabetes yang melakukan kerja shift dibandingkan dengan pekerja yang hanya bekerja siang hari (p = 0,01). Kerja shift sendiri berpengaruh signifikan terhadap pengendalian diabetes (p = 0,04), dengan OR = 3,83 (1,02 – 14,34). Kesimpulan Bukti penelitian menunjukkan adanya hubungan antara kerja shift malam dengan kontrol glikemik yang buruk pada pekerja dengan DM tipe 2. Pekerja shift malam berisiko 2-3 kali memiliki kontrol glikemik yang buruk daripada pekerja non-shift. Bukti yang ditemukan dalam studi Manodpitipong dan Chalernvanichakorn dapat diterapkan pada pasien ini karena karakteristik subjek penelitian yang sama.

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Background Diabetes Mellitus (DM) is considered to be one of a major problem in both developing and industrialized countries.1 As of 2007, approximately 23.6 million Americans have diabetes, most of whom are or wish to be participating members of the workforce.2 Research by Poulsen et al., (2014) found that 3.5% of health workers had diabetes during the 7-year observation period.3 A person with diabetes should be individually assessed to determine whether or not that person can safely and effectively perform the particular duties of the job in question.2 Shift work is considered to be disruptive to normal diurnal biological rhythms and has been associated with many health problems.4 Observational studies revealed that night-shift work is associated with increased risk of prevalent diabetes and incident diabetes.7 Information regarding the impact of shift work on blood glucose control or glycemic state in workers who have a history of type 2 diabetes is still not widely known. Method The case is about a 52-year-old female who worked as a nurse in non-intensive ward of government hospital and performed night shift work. She has been diagnosed with type 2 Diabetes Mellitus for seven years . A literature search was conducted through PubMed and ProQuest and also performed with the hand searching method. The inclusion criteria of this search strategy were systematic review, cohort study, worker with type 2 DM, shift work, blood glucose control and glycemic control. The exclussion criteria were articles not in english and inaccessible full text article. Then, they were critically appraised based on Center of Evidence- Based Medicine, Oxford University, Critical Appraisal for Etiology. Result Three relevant studies were found through literature searching and all of those studies were cross sectional design. The first study by Manodpitipong, et al.(2017) showed that night shift work was associated with significantly higher haemoglobin A1c (p = 0.044) compared with day work. While there were no differences between unemployed participants and day workers (p = 0.572). The second study conducted by Chalernvanichakorn, et al.(2008) give result that good glycemic control was significantly higher in day workers versus shift workers (28.3% vs 15.8%) with p = 0.02. A higher proportion of shift workers had hypoglycemic symptoms compared to day workers (42.5% vs. 26.7%). The third study by Ghazawy, et al.(2013) showed that HbA1c was significant higher levels among diabetic shift workers compared to diabetic day-time workers (p=0.01), where mean of current shift workers and former shift workers were 7.8±1.9 and 8.4±2.6, compared to 6.3±1.1. Shift work itself has a significant effect on control of diabetes (p = 0.04), with an OR = 3.83 (1.02 – 14.34), whereas age, duration of diabetes, BMI and waist circumference had no significant effect. Conclusion The research evidence found from the three studies above shows that there is association between night shift work and poor glycemic control in workers with type 2 DM. But the causation effect between the two variables cannot be determined yet, because there are many confounding factors that influence it. Night shift workers are two to three times more likely to have poor glycemic control than non-shift workers. The evidence found in the two study (Manodpitipong and Chalernvanichakorn) can be applied to our patient because of the same characteristic: female, diabetic worker, involved in night shift work. For future studies, cohort research should be conducted to find causality between shift work and glycemic control. Recommendation to our patient is to pay more attention to diet and adhere to treatment. It is necessary to inform the doctor that she is involved in shift work so that the doctor will provide a suitable regimen and diet for the patient."

"Diabetes melitus tipe 2 merupakan masalah kesehatan yang masih dihadapi di Indonesia. Hiperglikemia menyebabkan risiko komorbiditas meningkat salah satunya tuberkulosis paru. Pasien DM dengan TB paru meningkatkan morbiditas dan mortalitas. Dukungan nutrisi dilakukan untuk membantu memperbaiki kadar glukosa darah. Energi yang mencukupi dan pemberian serat merupakan tatalaksana gizi yang dapat membantu memperbaiki kadar glukosa darah. Serial kasus ini melaporkan empat pasien diabetes melitus tipe 2 dengan tuberkulosis paru yang memiliki rentang usia 49-57 tahun dan status gizi yang bervariasi. Terapi medik gizi diberikan sesuai dengan rekomendasi nutrisi untuk pasien diabetes melitus. Pemenuhan kebutuhan mikronutrien diberikan dengan suplementasi. Hasilnya yaitu kadar glukosa darah dua orang pasien dalam rentang normal 140-180 mg/dl, dengan asupan sesuai target kebutuhan dan komposisi protein 16-20%, lemak 20-18%, karbohidrat 52-64% dan serat 10-20 g/hari. Namun dua pasien dengan status gizi obes kadar glukosa darah masih belum terkontrol dan asupan energi belum mencapai target kebutuhan karena anoreksia dan infeksi yang belum teratasi. Kesimpulannya dukungan nutrisi dengan energi dan serat sesuai rekomendasi dapat membantu memperbaiki kadar glukosa darah.

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Type 2 diabetes still a major health problem in Indonesia. Hyperglycemia increase the risk of comorbidity include lung tuberculosis. Since morbidity and mortality of patients with type 2 diabetes and lung tuberculosis increase, nutrition therapy may improve blood glucose level. Provide adequate energy and fiber as a part of medical nutrition therapy for maintain the blood glucose level. This is a case series of four patients with type 2 diabetes and lung tuberculosis, age 49-57 years old, having various nutritional status. The medical nutritional therapy was given to patients according to the diabetes mellitus guidelines. Supplementation were administered to fulfill their requirement. Result: the blood glucose level of two patients within normal range 140-180 mg/dl, with adequate energy intake, protein 16-20%, fat 20-28%, and carbohydrate 52-64% and fiber 10-20 g/day. However the others with obesity remains uncontrolled glucose level, despite of their low intake of energy. It occured due to anorexia and untreated infection. Conclusion: Medical nutritional therapy with adequate energy and fiber may improve the blood glucose level."

"Latar belakang: Diabetes melitus tipe 2 (DMT2) disandang oleh 10,7 juta orang di Indonesia dan menjadi tiga besar penyakit tidak menular penyebab kematian. Sebagian besar kematian terjadi akibat komplikasi yang diawali oleh kontrol glikemik kadar HbA1c yang tidak adekuat, dan diasosiasikan dengan aspek multifaktorial seperti karakteristik sosiodemografi maupun perilaku individu dalam merawat diri—Self-Care Behaviour. Penelitian ini bertujuan mengetahui hubungan antara tingkat kontrol glikemik pada penyandang DMT2 dengan karakteristik sosiodemografi dan perilaku self-care yang dimiliki. Metode: Studi ini menggunakan desain potong-lintang terhadap data sekunder yang dikumpulkan sebelumnya pada Kohor Penyakit Tidak Menular Bogor 2021. Data dikumpulkan menggunakan kuesioner Self-Care Behaviour yang divalidasi dalam bahasa Indonesia, pengukuran kadar HbA1c serta karakteristik penyandang. Populasi studi adalah penyandang DMT2 di lima fasilitas kesehatan primer di Kota Bogor. Sampel dianalisis menggunakan uji Chi-Square dan perhitungan odds ratio. Hasil: Analisis dilakukan pada 237 responden, terdiri atas 90 responden kelompok usia lansia (38%) dan 147 dewasa (62%). Jenis kelamin responden didominasi perempuan sebanyak 171 responden (72,2%) dan 66 responden laki-laki (27,8%). Sebanyak 149 responden (62,9%) memiliki skor Self-Care Behaviour yang baik. Sejumlah 134 responden (56,6%) memiliki kadar HbA1c yang terkontrol. Empat dari tujuh komponen Self-Care Behaviour—pengetahuan, motivasi, dukungan, dan efikasi—berhubungan dengan kontrol glikemik (p<0,001). Efikasi menjadi prediktor kadar HbA1c terkontrol paling kuat (Odds ratio [OR]: 9,7; 95% Confidence Interval [CI] 5,27–17,67). Skor keseluruhan Self-Care Behaviour yang baik meningkatkan probabilitas kadar HbA1c terkontrol 9,1 kali (95% CI 4,94–16,7) dibanding skor kurang baik. Komponen komunikasi, sikap, dan pembiayaan tidak memiliki hubungan signifikan. Tingkat pendidikan dan riwayat DMT2 di keluarga berhubungan dengan tingkat keseluruhan Self-Care Behaviour dan dengan kontrol kadar HbA1c. Kesimpulan: Aspek perilaku self-care pada penyandang DMT2 mempunyai dampak substansial dan signifikan terhadap kontrol glikemik yang dimiliki penyandang.

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Introduction: Type 2 diabetes mellitus (T2DM) affects 10.7 million individuals in Indonesia and ranks among the top three non-communicable diseases leading to death. Most of mortality result from complications initiated by inadequate glycemic control, associated with multifactorial aspects such as sociodemographic characteristics and individual self-care behaviour. This study aims to explore the relationship between glycemic control levels in individuals with T2DM and their sociodemographic characteristics and self-care behavior. Method: This study is a cross-sectional study utilizing previously collected secondary data from the Non-Communicable Disease Cohort in Bogor 2021 Data were collected using a validated Self-Care Behaviour questionnaire in Bahasa Indonesia, along with primary data of HbA1c levels and respondent socio-characteristics. The study population consisted of individuals with T2DM from five primary healthcare facilities in Bogor city. The samples were analyzed using Chi-Square test and risk calculation. Result: The research analysis included 237 respondents, consisting of 90 elderly (38%) and 147 adults respondents (62%). The respondents were predominantly female, with 171 respondents (72.2%) compared to 66 male respondants (27.8%). A total of 149 respondents (62.9%) exhibited good Self-Care Behaviour scores. Approximately 134 respondents (56.6%) maintained controlled HbA1c levels. Four out of seven Self-Care Behaviour components—knowledge, motivation, support, and efficacy—were associated with glycemic control (p<0.001). Efficacy identified as the most influential predictor for controlled HbA1c levels (odds ratio [OR]: 9.7, 95% Confidence Interval [CI] 5.27–17.67). An overall good Self-Care Behaviour score is associated with a 9.1-fold increased probability of achieving controlled HbA1c levels (95% CI 4.94–16.7) compared to group with poor score. Self-Care Behaviour components of communication, attitude, and financing were not signicifantly associated. Education level and a family history of T2DM were associated with overall Self-Care Behaviour and with HbA1c control."

"Diabetes self care DSC merupakan bagian dari pengelolaan diabetes. Tujuan penelitian ini adalah menganalisa hubungan DSC dengan score PEDIS dan kontrol glikemik pasien DM. Penelitian ini merupakan cross sectional studi yang melibatkan 106 pasien. Statistik menunjukkan ada hubungan bermakna antara DSC dengan score PEDIS p 0,0005 dengan korelasi kuat r -0,74 dan kontrol glikemik p 0,0005 dengan korelasi sedang 0,45 . Hasil Regresi menunjukkan DSC berhubungan dengan score PEDIS setelah dikontrol variabel jenis pekerjaan dan lama terdiagnosis DM. DSC berhubungan dengan kontrol glikemik setelah dikontrol jenis pekerjaan dan jenis OAD. Perawat dapat menggunakan DSC sebagai indikator score PEDIS dan kontrol glikemik pasien.

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Diabetes self care DSC is an integrated part in diabetes management. The aim of this study was to analyze the correlation between DSC with PEDIS score and glycemic control in diabetes patients. This study applied a cross sectional design, involving 106 patients. Statistics showed a significant association between DSC and PEDIS score p 0.0005 with a strong correlation r 0.74 and glycemic control p 0.0005 with a moderate correlation 0.451 . The regression test showed that the DSC was associated with the PEDIS score after controlled with the variable of occupations and duration of having diabetes. DSC associated with the glycemic control after controlled with occupation and type of anti diabetics agent. Nurses may consider patient rsquo s diabetes self care score as an indicator of the PEDIS score and the glycemic control. "

"Latar belakang : Hasil pemeriksaan kesehatan terhadap 544 karyawan PT. X yang dilaksanakan pada tahun 2007 menemukan 18 kasus DM (5,66%). Pada PT. X diketabui pula diterapkan pola shift. Beberapa literatur menyebutkan babwa terdapat hubungan antara faktor shift dengan risiko DM. Permasalahannya apakah tingginya prevalensi DM di PT. X berhubungan dengan shift yang diterapkan pada PT. X ?. Dilakukannya penelilian ini adalah untuk mengetahui pengaruh shift terhadap risiko Diabetes Melitus Tipe 2 pada Pekerja Pabrik Baterai PT. X. Metode penelitian : Desain penelilian yang digunakan adahah studi potong lintang. Jumlah sampel yang diambil adalah total sampel berjumlah 544 orang. Pengumpulan data dilakukan dengan kuesioner, wawancara, pemeriksaan kadar glukosa darah TTGO dan pemeriksaan fisik, yang meliputi pengukuran tekanan darah, berat badan, dan tinggi badan. Penilaian kadar glukosa darah TTGO dilakukan sesuai prosedur pemeriksaan. Analisis bivariat dilakukan untuk melihat hubungan antara faktor-faktor penyebab diabetes, seperti usia, jenis kelamin, masa kerja, shift, gizi, latihan jasmani, riwayat DM dalam keluarga, hipertensi, dan merokok terbadap risiko Diabetes Metitus Tipe 2. Analisis regresi logistik digunakan untuk melihat secara simultan faktor-faktor risiko dan perancu terhadap risiko DM tipe 2. Hasil penelilian : Didapatkan responden sebanyak 366 pekerja dari total populasi 544 pekerja. Responden yang menderita DM ditemukan sebanyak 81 orang, dengan komposisi terbanyak berusia > 45 (50,6%), dengan nilai P=0,707 dan OR=1,171; lakilaki (97,5%), dengan nilai P=0,511 dan OR=0,566; masa kerja > 20 tabun (70,4%), dengan nitai P=0,694 dan OR=1,114; 72 respenden bekerja dengan shift (88,9%). dengan nilai P=0,012 dan OR = 2,704; 55 responden menderita obesitas (67,9%), dengan nilai P=0,001 dan OR = 2,384; 47 responden memiliki riwayat DM dalam keluarga (62,7%) dengan nilai P=0,000 dan OR=14,299; 40 respponden tidak melakukan latihan jasmani setidaknya l (satu) kali dalam 1 (sata) minggu (49,4%) dangan nilai P = 0,020 dan OR = 0,673; 13 responden menderita hipertensi (16,0%) dengan nilai P=0,648 dan OR=0,857; serta 28 responden perokok (34,6%) dengan nilai P=0,381 dan OR=1,264. Kesimpulan : Prevalensi Diabetes Melitus responden pabrik baterai PT. X, Jakarta sebesar 22,1%. Prevalensi Diabetes Melitus pada responden dengan shift (8&,9%) lebih tinggi dibandingkan dengan responden tanpa shift (11,1%) serla berbeda secara bermakna. Pekerja dengan shift mempunyai fisiko menderita Diabetes Melitus Tipe 2 sebesar 2,704 kali dibandingkan dengan pekerja tanpa shift. Faktor riwayat DM dalam keluarga, shift, dan gizi berhubungan bermakna terhadap risiko Diabetes Melitus Tipe 2. Sedangkan faktor-faktor lainnya seperti USIa, jenis keiamin, masa kerja dengan shift, latihan jasmani, hipertensi, dan merokok tidak mempunyai hubungan yang bermakna dengan kejadian Diabetes Melitus Tipe 2.

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Background : Result of medical examination of 544 employees from Battery Company "X" in 2007 found that 18 cases suffer from type 2 DM (5,66%). Company "X" applied shift work system. Many literature mentioned the correlation between shift work with the risk of type 2 DM. The question is highly prevalence of type 2 DM in company "X" related with the shift work applied? This study aims to find correlation between shift and other causative factors with the risk of Type 2 Diabetes Mellitus.

Methods : The design of study used was cross sectional study. The number of sampled was involved 544 people. The data were collected by questionnaire, interview, examination of TTGO blond glucose, and physical examination, included measuring blood pressure, body weight and height. Standard procedure of TTGO blood glucose was used. Bivariate analysis was applied to look at the causative factors such as age, sex, work with shift year, shift work, exercise, nutrition status, history of DM in family, hypertension, and smoking with the risk of type 2 DM. In line with the analysis, the regression logistic analysis was used to look out risk factors and confounding factors simultaneously with risk of type 2 DM.

Result: The number of sample involved was 366 employees. It was found that 81 people suffer from type 2 DM, with majority of respondents belonged to the age over 45 years (50.6%;P =0.707 and OR= 1.171); male respondent (97.5%;P=0.511 and OR= 0.566); work with shift over 20 years (70.4%;P= 0.694 and OR=1.114); 72 respondents work with shift (88.9%;P= 0.012 and OR=2.704); 55 respondents with obesity (67.9%;P=0.001 and OR=2.384); 47 respondents with history of DM in family (62.7%;P=0.000 and OR=14.299); 40 respondents never had exercise in a week (49.4%;P=0.020 and OR=0.673); 13 people with hypertension (16.0%;P=0.648 and OR=0.857); 28 people were smoker (34.6%; P=0.381 and OR=1.264).

Conclusion: Type 2 DM prevalence among workers of battery company "X", Jakarta was 22,1%. Prevalence of type 2 DM among shift workers (88.9%) were higher than workers without shift (11,1%). Shift workers were much more susceptible to type 2 DM than workers without shift. History of DM in family, shift work, and nutrition status had significant correlation with the risk of type 2 OM. Age, sex, work with shift, weekly exercize, hypertension, and smoking did not have significant correlation with the risk of typa 2 DM."

"Diabetes melitus tipe 2 merupakan penyakit metabolik kronik dengan risiko komplikasi yang cukup tinggi. Upaya pencegahan terjadinya komplikasi diabetes dapat dilakukan dengan melakukan manajemen diri diabetes. Tujuan penelitian ini adalah untuk mengidentifikasi tingkat pengetahuan dan kemampuan manajemen diri diabetes pada kelompok pekerja buruh yang menjalani shift malam. Data diperoleh dari 106 responden di Kota Bekasi dengan menggunakan teknik snowball sampling. Instrument penelitian yang digunakan yaitu instrument tingkat pengetahuan dan instrument manajemen diri diabetes yang dikembangkan dan mengacu pada DSMQ. Hasil penelitian menunjukkan bahwa tingkat pengetahuan terhadap penyakit dan manajemen diri pada pekerja buruh yang menjalani shift malam masuk kedalam kategori cukup baik dengan jumlah 67 responden dan kemampuan manajemen diri diabetes pada kelompok pekerja buruh yang menjalani shift malam dalam kategori baik dengan jumlah 54 responden. Penelitian ini merekomendasikan pemberian edukasi kesehatan terkait manajemen diri diabetes pada penyandang diabetes melitus tipe 2 yang menjalani shift malam seperti edukasi mengenai mengatur waktu makan dan minum obat, waktu berolahraga, dan waktu yang tepat untuk mengecek kadar gula darah pada pekerja shift malam agar pekerja shift malam dapat selalu terpantau dan tidak mengalami hipoglikemia ataupun komplikasi lainnya.

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Type 2 diabetes mellitus is a chronic metabolic disease with a high risk of complications. Diabetes self-management has been considered as an effort to reduce complications. This study aimed to identify knowledge level of diabetes and diabetes self-management skills in a group of laborers with type 2 diabetes mellitus who worked night shifts. A total of 106 subjects were recruited from Bekasi City with snowball sampling. The research instrument used is a knowledge level instrument and diabetes self-management that refers to DSMQ. The result showed that the level of knowledge of diabetes melitus and self-management was in the fairly good category with a total of 67 respondents and diabetes self-management in the group of workers who underwent night shift were in the good category with a total of 54 respondents. This study provides education related to diabetes management in people with type 2 diabetes who undergo night shift such as education about managing the time to eat and take medication, when to exercise, and the right time to check sugar levels in night shift workers so that night shift workers can always be monitored and there was no hypoglycemia or other complications."

"[ABSTRAKDiabetic Kidney Disease DKD pada Diabetes Melitus Tipe 2 DMT2 merupakan komplikasi kronik yang dapat dicegah dan ditunda progresifitasnya dengan pengontrolan glikemik yang baik dan penatalaksanaan yang tepat dari komorbid lainnya Pengontrolan glikemik menjadi tanggung jawab bersama antara multidisiplin profesi kesehatan di ruang rawat dokter perawat dietisien farmasis dengan pasien serta keluarga Model Self care Orem sangat sesuai untuk diaplikasikan dan dikembangkan di ruangan pada asuhan keperawatan pasien dengan penyakit kronik Pasien dapat bersinergi secara aktif sesuai kemampuannya dalam mencapai tujuan dari setiap intervensi keperawatan Disamping itu pendekatan model self care Orem sesuai untuk mempersiapkan pasien dalam meningkatkan kemampuan self care untuk pasca rawat Pelaksanaan praktek berbasis pembuktian pengukuran suhu kaki dengan termometer infrared dapat menjadi perangkat tambahan untuk menilai adanya gejala inflamasi lokal sehingga upaya deteksi dini menjadi lebih komprehensif Pelaksanaan kegiatan inovasi pemantauan dan pemeriksaan kesehatan mandiri pada pasien DM dapat meningkatkan upaya promosi kesehatan pada pasien DM

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ABSTRACTDiabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ;Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients , Diabetic Kidney Disease DKD in Type 2 Diabetes Mellitus T2DM is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward doctors nurses dietisien pharmacists and patients and families Orem rsquo s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention Besides Orem rsquo s self care model approach appropriate to prepare the patient to improve the ability of self care for post hospitalization Implementation of evidence based practice the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients ]"

"[ABSTRAK Diabetic Kidney Disease (DKD) pada Diabetes Melitus Tipe 2 (DMT2) merupakan komplikasi kronik yang dapat dicegah dan ditunda progresifitasnya dengan pengontrolan glikemik yang baik dan penatalaksanaan yang tepat dari komorbid lainnya. Pengontrolan glikemik menjadi tanggung jawab bersama antara multidisiplin profesi kesehatan di ruang rawat (dokter, perawat, dietisien, farmasis) dengan pasien (serta keluarga). Model Self care Orem sangat sesuai untuk diaplikasikan dan dikembangkan di ruangan pada asuhan keperawatan pasien dengan penyakit kronik. Pasien dapat bersinergi secara aktif sesuai kemampuannya dalam mencapai tujuan dari setiap intervensi keperawatan. Disamping itu pendekatan model self care Orem sesuai untuk mempersiapkan pasien dalam meningkatkan kemampuan self care untuk pasca rawat. Pelaksanaan praktek berbasis pembuktian, pengukuran suhu kaki dengan termometer infrared dapat menjadi perangkat tambahan untuk menilai adanya gejala inflamasi lokal sehingga upaya deteksi dini menjadi lebih komprehensif. Pelaksanaan kegiatan inovasi pemantauan dan pemeriksaan kesehatan mandiri pada pasien DM dapat meningkatkan upaya promosi kesehatan pada pasien DM.ABSTRACT Diabetic Kidney Disease (DKD) in Type 2 Diabetes Mellitus (T2DM) is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments. Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward (doctors, nurses, dietisien, pharmacists) and patients (and families). Orem?s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases. Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention. Besides, Orem?s self care model approach appropriate to prepare the patient to improve the ability of self care for post-hospitalization. Implementation of evidence-based practice, the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive. Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients. ;Diabetic Kidney Disease (DKD) in Type 2 Diabetes Mellitus (T2DM) is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments. Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward (doctors, nurses, dietisien, pharmacists) and patients (and families). Orem?s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases. Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention. Besides, Orem?s self care model approach appropriate to prepare the patient to improve the ability of self care for post-hospitalization. Implementation of evidence-based practice, the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive. Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients. , Diabetic Kidney Disease (DKD) in Type 2 Diabetes Mellitus (T2DM) is a chronic complication that can be prevented and delayed its progresivity with a good glycemic control and appropriate treatments. Glycemic control is a shared responsibility between the multidisciplinary health professions in the ward (doctors, nurses, dietisien, pharmacists) and patients (and families). Orem’s Self care model is appropriate to be applied and developed in the acute care of patients with chronic diseases. Patients can actively work together within its capabilities in achieving the objectives of each nursing intervention. Besides, Orem’s self care model approach appropriate to prepare the patient to improve the ability of self care for post-hospitalization. Implementation of evidence-based practice, the measurement of foot temperature with an infrared thermometer may be enhancements to assess the presence of local inflammatory symptoms so that early detection efforts become more comprehensive. Implementation of innovation activity monitoring and self health assesment can improve health promotion efforts in diabetic patients. ]"