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"Diabetes melitus (DM) merupakan penyakit kronik yang memiliki pengaruh tidak hanya pada fisik tetapi juga pada psikososial. Klien DM yang mengalami sakit yang lama cenderung merasa cemas terhadap penyakit yang kemudian dapat menjadi tidakberdayaan dan keputusasaan yang dapat menyebabkan depresi. Oleh karena penting untuk melakukan asuhan keperawatan tidak hanya fisik tetapi juga untuk psikososial. Tujuan dari karya ilmiah akhir ini adalah untuk menggambarkan terapi keperawatan generalis, Thought Stopping, Proggressive Muscular Relaxtion dan Acceptance Commitment Therapy dalam menurunkan kecemasan dan meningkatkan manajemen diri pada klien DM secara tatap muka dan Daring ,elalui pendekatan teori Orem. 5 orang klien DM diberikan terapi secara tatap muka dan 5 orang klien diberikan terapi secara daring. Hasil menunjukkan terapat penurunan kecemasan dan peningkatan manajemen diri baik pada klien yang diberikan terapi tatap muka maupun yang diberikan terapi daring. Klien yang mendapatkan terapi melalui tatap muka memiliki terapat penurunan kecemasan dan peningkatan manajemen diri lebih besar daripada klien yang dilakukan secara daring. Diperlukan penelitian lebih lanjut terkait penerapan terapi keperawatan ners dan ners spesialis untuk menurunkan kecemasan dan manajemen diri klien DM terutama dengan metode daring.

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Diabetes mellitus (DM) is a chronic disease that has an effect not only on the physical but also on the psychosocial. People with Chronic DM tend to feel anxious about their diseases and worry about the complication. This worriness can lead to feelling helpless and hopeless which can cause depression. The worryness also make them ig ore to do self management which caused greater risk of diabetic complication. So that it is important for nurse to not not only on give physically intervation but also for pschylogy aspect The aim of this paper is to describe generalist nursing therapy, Thought Stopping, Progressive Muscular Relaxtion and Acceptance Commitment Therapy in reducing anxiety and improving self-management of DM clients face-to-face and by online, using the Orem theory approach. Five people with DM were given face-to-face therapy and 5 clients were given online therapy. The results showed that there was a decrease in anxiety and improved self-management both in clients who were given face-to-face therapy and those who were given online therapy. Clients who get face-to-face therapy have a bigger anxiety reduction and increased self-management than client who been given online therapy. Further research is needed related to the application of mental health nursing therapies to reduce anxiety and self-management of DM clients, especially with online methods."

"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."

"Daun Moringa oleifera Lam. memiliki berbagai manfaat dan efek terapeutik seperti anti-inflamasi, antikanker, antitumor, antimikroba, antioksidan dan antidiabetes. Manajemen Diabetes Mellitus (DM) sangat penting untuk mencegah terjadinya komplikasi. Terapi antidiabetes oral sering menimbulkan efek samping yang cukup serius. Pemberian daun kelor pada hewan menunjukkan efek antidiabetes yang kuat, tetapi efektivitas konsumsi sediaan daun kelor pada manusia menunjukan hasil yang berbeda-beda. Review ini bertujuan untuk meninjau efek konsumsi berbagai bentuk sediaan daun kelor terhadap kadar glukosa darah pada pasien DM dan kemungkinan pengembangan formulasi bentuk sediaan sebagai antidiabetes. Pencarian literatur dilakukan terkait topik selama 10 tahun terakhir, dan beberapa artikel lebih dari 10 tahun yang dapat mendukung teorinya. Hasil review menunjukkan bahwa senyawa bioaktif metabolit sekunder (kuersetin, terpenoid, dan asam klorogenat) dalam daun kelor yang berperan sebagai antidiabetes, perubahan signifikansi pada kadar glukosa darah dari intervensi daun kelor yang paling baik sebesar 28,6% dengan dosis 2 tablet per hari, dan strategi pengembangan formulasi yaitu sediaan kapsul dari ekstrak etanol daun kelor yang dapat meningkatkan efektivitas aktivitas oral antidiabetes.

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Moringa oleifera Lam. leaves has various benefits and therapeutic effects such as anti-inflammatory, anticancer, antitumor, antimicrobial, antioxidants and antidiabetic agents. Diabetes Mellitus (DM) management is very important to prevent complications. Oral antidiabetic therapy often causes quite serious side effects. Giving Moringa leaf to experimental animals showed a strong antidiabetic effect, but effectiveness of consuming Moringa leaf preparations in humans showeds different results. This review aims to review the effects of consuming various Moringa leaf dosage forms on blood glucose levels in humans and the possibility of developing an antidiabetic dosage form. A literature search was carried out related to research on the effectiveness of consumption of various dosage forms of Moringa leaves in DM patients during the last ten years, and several articles over ten years that can support the theory. The result of the review showed that the secondary metabolites (quercetin, terpenoids, and chlorogenic acid) in Moringa leaves that act as antidiabetic, indicate a significant change in blood glucose levels and the best Moringa leaf intervention was 28.6% at a dose of 30 tablets every 15 days for 90 days. Formulation development strategy was capsuled preparation of ethanol extract of Moringa leaves that was increasing the effectiveness of the oral antidiabetic activity."

"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."

"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 (DM) meningkatkan risiko terkena TB paru, terutama pada kelompok berisiko tinggi. Meskipun penemuan kasus secara aktif dan peningkatan pelaporan di fasilitas kesehatan sangat penting, namun keterlibatan sektor swasta dalam pengendalian TB masih rendah karena adanya fragmentasi dan dana yang tidak memadai. Sistem Informasi Tuberkulosis (SITB) adalah perangkat lunak utama untuk mencatat dan melaporkan kasus TB, namun aksesnya terbatas dan sistemnya tidak terintegrasi dengan baik. Untuk mengatasi tantangan ini, diperlukan e-screening tool untuk mengintegrasikan skrining TB ke dalam skrining diabetes yang ada saat ini secara efisien sehingga notifikasi TB di FKTP swasta dapat meningkat. Penelitian ini menggunakan pendekatan mixed exploratory sequential, yang menggabungkan metode kuantitatif dan kualitatif secara bertahap. Penelitian ini terdiri dari 4 tahap.Di tahap pertama, dilakukan analisis faktor determinan TB pada pasien DM menggunakan data Riskesdas 2013 dan 2018. Lalu tahap 2 dilakukan analisis/evaluasi mengenai implementasi proses notifikasi TB pada FKTP swasta dan pada tahap 3, rancangan prototype e-screening tool. Pada tahap 4, uji coba protoype dilakukan di 2 di klinik di Jakarta Timur dan Jakarta Barat.Hasil penelitian di tahap 1 menunjukkan bahwa variabel diagnosa penyakit kanker, riwayat merokok, ketersediaan rumah sakit swasta dan ketersediaan praktik dokter/klinik secara statistik memiliki hubungan yang signifikan terhadap kejadian TB pada pasien DM. lalu dari hasil uji multivariat diperoleh hasil bahwa kanker merupakan faktor prediktif pada kejadian penyakit TB paru pada penderita DM. hasil penelitian tahap 2 menunjukkan bahwa belum semua FKTP swasta memiliki SITB mandiri yang menyebabkan pencatatan dan pelaporan kasus TB menjadi temuan milik puskesmas dimana hal ini berdampak pada rendahnya notifikasi TB di FKTP swasta. Hasil penelitian tahap 3 dan 4 menunjukkan bahwa untuk meningkatkan notifikasi TB di FKTP swasta dapat dilakukan dengan merancang e-screening tool TB dengan pendekatan kaskade TB 6T. Dengan mengintegrasikan JKN Mobile, E-RM, P-Care dan SITB dalam bentuk partner satu sehat, serta didukung dengan SDM, sarana prasarana dan pembiayaan yang cukup diharapkan dapat meningkatkan notifikasi TB di FKTP swasta sehingga dapat menurunkan angka kematian atau angka kesakitan akibat TB pada pasien DM.

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Diabetes mellitus (DM) increases the risk of developing pulmonary TB, especially in high-risk groups. While active case finding and improved reporting at health facilities are critical, private sector involvement in TB control remains low due to fragmentation and inadequate funding. The Tuberculosis Information System (TBIS) is the primary software for recording and reporting TB cases, but access is limited and the system is not well integrated. To overcome these challenges, an e-screening tool is necessary to efficiently integrate TB screening into existing diabetes screening so that TB notifications at private primary care facilities can increase.

This study used a mixed exploratory sequential approach, which combines quantitative and qualitative methods in 4 stages. In the first stage, the determinants of TB in patients with DM were analyzed using 2013 and 2018 Riskesdas data. Then in stage 2, an analysis/evaluation of the implementation of the TB notification process at private primary care facilities was carried out and in stage 3, an e-screening tool prototype was designed. Stage 4 is the pilot study of protype being carried out in 2 private clinics, at East and West Jakarta.

The results of stage 1 of the study showed that the variables of cancer diagnosis, smoking history, availability of private hospitals and availability of TB screening in DM patients were significantly associated with TB screening in DM patients. The results of the multivariate test showed that cancer was a predictive factor in the incidence of pulmonary TB disease in patients with DM. The results of phase 2 of the study showed that not all private primary health care facilities have independent SITB, which causes the recording and reporting of TB cases to be the findings of the puskesmas, thus has an impact on the low notification of TB in private primary health care facilities. The results of phase 3 and 4, showed that improving TB notification at private primary care facilities can be done by designing a TB e-screening tool with a 6T TB cascade approach.

By integrating JKN Mobile, E-RM, P-care and SITB in the form of the intergrated system of Satu Sehat, and supported by sufficient human resources, infrastructure and financing, these allow room for a better national TB control management. In this light, TB notification rate has a good potential for improvements at private primary care facilities, and thus eventually contributing to a reduction of mortality or morbidity due to TB in DM patients."

"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."

"Perawatan dengan injeksi insulin secara kontinu setiap harinya diperlukan bagi penderita Diabetes Mellitus tipe I yang telah kronis, di mana pankreas sama sekali tidak menghasilkan insulin, untuk mengontrol kadar gula darahnya. Model minimal Bergman terdiri dari tiga persamaan diferensial yang memodelkan dengan cukup akurat penderita DM tipe I sesederhana mungkin.Simulai model ini dilakukan dengan memberikan sinyal masukan laju insulin dengan batasan antara 0 sampai 100 mU/min dan gangguan glukosa makanan dimodelkan sebagai fungsi eksponensial 1,157 exp(-0,05.t) mmol/L.min yang dimulai pada menit ke-100, dengan batasan perubahan laju insulin eksternal yang merupakan sinyal kendali sistem sebesar ± 16,667 mU/min. Sinyal masukan insulin diberikan untuk mengurangi kadar gula darah, tetapi tetap menjaga agar tidak terjadi hypoglycemia (< 3,33 mmol/L).Perancangan pengendali MPC (Model Predictive Control) dengan constraints yang berbasiskan metode aktif set menggunakan persamaan ruang keadaan linier, dan analisa simulasi dilakukan dengan mengubah parameter-parameter pengendali berupa control horizon, prediction horizon, batas maksimal dan batas minimal sinyal kendali serta matriks bobot R dan Q.

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Diabetes Mellitus refers to condition in which the pancreas produces no effective insulin. Treatment consist of daily injection or continuous infusions of insulin to maintain blood glucose levels between critical values (3,33 ? 6,67 mmol/L). The Bergman minimal model consist of three differential equations as powerful modeling to describe the dynamics of type 1 diabetic system as simply as possible.This simulation model is done by giving inputs are the manipulated insulin infusion rate with range between 0 and 100 mU/min, and the meal glucose disturbance described as exponential function (1,157 exp(-0,05.t) mmol/L.min) and simulated at minute 100. The manipulated insulin infusion rate is given for prevention of long-term complications due to hyperglycemia and hypoglycemia (<3,33 mmol/L).MPC (Model Predictive Control) with constraints is designed based on active set method using linier state space equation and analyze the simulation by altering controller parameters are control horizon (Hu), prediction horizon (Hp), maximum and minimum of control signal (Umaks and Umin), and also weight matrix of R and Q."

"Disfungsi otonom kardiovaskular (DOK) merupakan komplikasi diabetes melitus tipe 1 (DMT1) yang menjadi penyebab kematian tersering pada dewasa. Gejala subklinis dapat berawal sejak remaja tetapi deteksi dini melalui pemeriksaan fungsi otonom kardiovaskular belum rutin dilakukan. Studi terdahulu menunjukkan bahwa kontrol glikemik dan lama sakit berpengaruh terhadap progresivitas DOK. Data di Indonesia mengenai masalah ini belum ada. Penelitian ini bertujuan untuk mengetahui prevalens DOK pada pasien DMT1 anak dan menilai hubungan DOK dengan rerata lama sakit dan kadar HbA1C. Tiga puluh delapan anak berusia 10-18 tahun dengan DMT1 yang terdiagnosis lebih dari 5 tahun menjalani 3 pemeriksaan uji refleks kardiovaskular (URK) di Poliklinik Endokrinologi Anak RSCM Kiara. Disfungsi otonom kardiovaskular dengan 1 nilai abnormal URK ditemukan pada 36,8% anak. Tidak ditemukan korelasi bermakna antara DOK dengan rerata lama sakit dan kadar HbA1C. Berdasarkan penelitian ini, prevalens DOK pada remaja cukup tinggi sehingga deteksi dini sebaiknya dilakukan secara rutin. Penelitian lanjutan dengan rentang sakit yang lebih panjang dan data HbA1C serial perlu dilakukan untuk mengevaluasi peran kontrol glikemik dan lama sakit terhadap kejadian DOK.

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Cardiovascular autonomic dysfunction (CAD) is a type 1 diabetes mellitus (T1DM) complication which becomes the most common cause of death in adults. Subclinical symptoms may have occurred since adolescence, yet early detection using cardiovascular autonomic function examination has not been performed routinely. Previous studies showed that glycemic control and duration of illness affected CAD progressivity. However, there is still no data regarding this issue in Indonesia. This study aimed to determine the prevalence of CAD in pediatric T1DM patients and the correlation between CAD and average length of illness, as well as HbA1C levels. Thirty-eight children aged 10-18 years who had been diagnosed with T1DM for more than 5 years underwent a series of three cardiovascular reflex test (CRT) at the Pediatric Endocrinology Polyclinic RSCM Kiara. Cardiovascular autonomic dysfunction which was defined by one abnormal CRT value was found in 36.8% children. No significant correlation was found between CAD and the average length of illness and HbA1C levels. Based on the study, CAD prevalence in adolescents is substantially high, which emphasize the need of routine early detection. Further research with a longer duration of illness and serial HbA1C data need to be carried out to evaluate the role of glycemic control and illness duration in CAD occurrence."