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"Diabetes melitus merupakan sekelompok gangguan metabolisme tubuh, ditandai dengan hiperglikemik kronis yang dapat mengakibatkan komplikasi akut dan kronis. Prevalensi penyakit DM meningkat pada agregat dewasa sebagai kelompok rentan. Karya Ilmiah akhir Spesialis ini menggunakan integrasi teori manajemen, community as partner, family centre nursing, dan health promotion model. Pelaksanaan intervensi dengan pendekatan asuhan keperawatan keluarga pada 10 keluarga binaan dan asuhan keperawatan komunitas pada 65 diabetesi dewasa dengan purposive sampling. Terjadi peningkatan tingkat kemandirian keluarga dalam merawat agregat dewasa dengan DM. 90% kemandirian keluarga setelah intervensi adalah Tingkat kemandirian III dan 10% Tingkat Kemandirian IV. Terjadi peningkatan pengetahuan sebanyak 18,3%, sikap sebesar 22% dan perilaku sebesar 56% pada agregat dewasa dengan DM. Intervensi Dialatama merupakan suatu bentuk intervensi latihan yang efektif untuk mengatasi masalah gaya hidup kurang gerak, dan diagnosis keperawatan seperti ketidakefektifan pemeliharaan Kesehatan, perilaku Kesehatan cenderung berisiko, risiko ketidakstabilan gula darah, risiko disfungsi neurovaskuler perifer dan beberapa diagnosis lainnya. Intervensi Dialatama ini dapat diberikan kepada individu, kelompok maupun komunitas. Intervensi bisa dilakukan oleh masyarakat secara umum, baik yang memiliki masalah aktual maupun yang berisiko. Diharapkan Program Dialatama dapat terus dijalankan oleh diabetes secara aktif dan mandiri.

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Diabetes Mellitus is metabolic disease because alter secretion, act of insulin or both, showed by hyperglycemia. The prevalence of DM increased in the aggregate of adults as a susceptible group. This specialist's final scientific work uses the integration of management theory, community as partner, family center nursing, and health promotion model. Implementation of the intervention with the approach of family nursing care in 10 assisted families and community nursing care for 65 adult diabetics with purposive sampling. There was an increase in the level of family independence in caring for the aggregate of adults with DM. 90% of family independence after the intervention is Level III independence and 10% Independence Level IV. There was an increase in knowledge as much as 18.3%, attitudes by 22% and behavior by 56% in the aggregate of adults with DM. Dialatama intervention is an effective form of exercise intervention to overcome sedentary lifestyle problems, and nursing diagnoses such as ineffective health maintenance, health behaviors that tend to be at risk, risk of blood sugar instability, risk of peripheral neurovascular dysfunction and several other diagnoses. This Dialatama intervention can be given to individuals, groups or communities. Interventions can be carried out by the general public, both those who have actual problems and those who are at risk. It is hoped that the Dialatama Program can continue to be run by diabetics actively and independently"

"Diabetes melitus merupakan penyakit metabolik dengan karakteristik peningkatan kadar gula darah (hiperglikemi) akibat terganggunya fungsi produksi dan kerja insulin pada pangkreas. Dampak hiperglikemi yang tidak teratasi akan menyebabkan komplikasi/keparahan pada penderita diabetes. Inovasi MARI THERAPI merupakan intervensi keperawatan berupa manajemen diri diabetes yang terdiri dari edukasi, manajemen nutrisi, latihan fisik, perawatan kaki, minum obat, pemeriksaan kadar glukosa darah dan relaksasi hipnosis lima jari dengan therapi musik, yang diberikan pada dewasa dengan diabetes melitus pada keluarga maupun di komunitas. Intervensi ini diimplementasikan kepada dewasa diabetes sebanyak 31 orang selama 55-60 menit setiap sesi sebanyak 13 minggu (6 tahap=13 sesi pertemuan). Hasil implementasi di keluarga didapatkan bahwa rerata skor kepatuhan hidup sehat meningkat 29,8, dan rerata skor hiperglikemi menurun 203gr/dl setelah diberikan asuhan keperawatan keluarga. Hasil implementasi di komunitas didapatkan rerata skor kepatuhan hidup sehat 15,26 dan rerata skor hiperglikemi menurun 127,74 gr/dl setelah diberikan asuhan keperawatan komunitas intervensi MARI THERAPI. Hasil dependent t tes didapatkan bahwa intervensi MARI THERAPI berpengaruh untuk meningkatkan kepatuhan hidup sehat dan menurunkan hiperglikemi dewasa dengan diabetes (p<0,05). Intervensi MARI THERAPI dapat digunakan sebagai pilihan intervensi keperawatan dan direkomendasikan pada individu, keluarga, kelompok maupun masyarakat pada dewasa dengan diabetes melitus.

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Diabetes mellitus is a metabolic disease characterized by increased blood sugar levels (hyperglycemia) due to disruption of insulin production and action in the pancreas. The impact of unresolved hyperglycemia will cause complications/severity in diabetics. MARI THERAPY innovation is a nursing intervention in the form of diabetes self-management which consists of education, nutrition management, physical exercise, foot care, taking medication, checking blood glucose levels and relaxing five-finger hypnosis with music therapy, which is given to adults with diabetes mellitus in their families and families. in the community. This intervention was implemented to 31 diabetic adults for 55-60 minutes each session for 13 weeks (6 stages = 13 sessions). The results of the implementation in the family showed that the average score for healthy living increased by 29.8, and the average score for hyperglycemia decreased by 203gr/dl after being given family nursing care. The results of the implementation in the community showed that the average score for healthy living was 15.26 and the average hyperglycemia score decreased by 127.74 g/dl after being given community nursing care with the MARI THERAPY intervention. The results of the dependent t test showed that the MARI THERAPY intervention had an effect on increasing adherence to healthy living and reducing hyperglycemia in adults with diabetes (p<0.05). The MARI THERAPY intervention can be used as a nursing intervention option and is recommended for individuals, families, groups and communities in adults with diabetes mellitus."

"ABSTRACTGambier (Uncaria gambier) is known to have antioxidant properties, and some studies have attributed it to the presenceof polyphenols such as catechin. The objective of this study is to investigate the potential of various gambiers availablein Indonesian market as a scavenger of reactive freeradicals and evaluate its anti-hyperglycemic activity as α-glucosidase inhibitor. Isolation of catechin was done by extraction method with technical grade of ethyl acetate as solvent. Analysis of catechin in the dried gambier extract was carried out with TLC method. The molecular weight and content of catechin of dried gambier extract was determined by analyzing its mass spectra and spectrophotometer,respectively. The free radical scavenging activity of catechin of the resultant extracts was measured by using 1,1-diphenyl-2-picrylhydrazyl (DPPH) as stable free radical compound. The anti-hyperglycemic activity of catechin of ethyl acetate extracts was analyzed as α-glucosidase inhibitor. The result showed that various gambiers available in themarket are very active as antioxidant, indicated by IC50of catechin of ethyl acetate extracts which were 4.6 to 18.2μg/mL for DPPH inhibition. The IC50 for α-glucosidase inhibition is ranged from 40.45 to 52.43μ g/mL, so they can be classified as anti-diabetic."

"ABSTRAK Hiperglikemia adalah efek samping yang umum kombinasi steroid dan L-asparaginase, terjadi paling sering selama kemoterapi fase induksi LLA. Sampai saat ini di Indonesia, belum didapatkan data mengenai kejadian hiperglikemia pada pasien anak dengan LLA pada fase induksi dan bagaimana peranan perbedaan kombinasi L-asparaginase dan jenis steroid yang digunakan.Tujuan penelitian ini adalah untuk mengetahui angka kejadian hiperglikemia pada anak LLA fase induksi, perbedaan prednison dan deksametason dalam kombinasinya dengan L-asparaginase dalam menyebabkan hiperglikemia pada anak dengan LLA dan hubungan faktor-faktor lain dengan kejadian hiperglikemia pada fase induksi LLA.Penelitian ini merupakan studi prospektif analitik dengan desain pre-post test, dilakukan di RSCM, RS Kanker ldquo;Dharmais rdquo; dan RSPAD Gatot Soebroto. Pasien yang akan menjalani kemoterapi fase induksi LLA diperiksa kadar gula darah sewaktu pada minggu ke-3 pretest , minggu ke-4, minggu ke-5 dan minggu ke-6 protokol post test .Dari 57 pasien yang berasal dari 3 Rumah Sakit yang berbeda berhasil dikumpulkan, terbanyak berasal dari RSCM 57,9 disusul RS Kanker ldquo;Dharmais rdquo; 24,6 dan RSPAD Gatot Soebroto 17,5 . Rentang umur pasien berkisar antara 1,4 tahun sampai 15,8 tahun dengan rerata 6,7 tahun. Tidak terdapat perbedaan rerata kadar gula darah sewaktu sebelum dan sesudah kombinasi steroid dan L-asparaginase. Tidak didapatkan hubungan antara umur, infiltrasi SSP, leukositosis, sindrom Down, status gizi, riwayat DM pada keluarga, infeksi dan stratifikasi LLA dengan kejadian hiperglikemia. Pemberian deksametason memiliki peluang 10,68 x didapatnya angka di atas rerata perubahan kadar gula darah sewaktu dibandingkan pemberian prednison.Kesimpulan: kejadian hiperglikemia pada penelitian ini adalah 5,2 . Walaupun tidak terdapat perbedaan antara prednison dan deksametason dalam kombinasinya dengan L-asparaginase dalam menyebabkan hiperglikemia, namun deksametason memiliki risiko angka di atas rerata perubahan kadar gula darah sewaktu dibandingkan prednison.

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ABSTRACTHyperglycaemia is a common side effect of steroid and L asparaginase combinations, occurring most often during LLA induction phase. To date in Indonesia, it has not been obtained data on the incidence of hyperglycemia in children with LLA in the induction phase and how the role of combinations of L asparaginase and different type of steroid used.The purpose of this study is to determine the incidence of hyperglycemia in children LLA induction phase, knowing the difference between prednisone and dexamethasone in combination with L asparaginase in causing hyperglycemia in children with LLA and determine the relationship of other factors related to hyperglycaemia.This study is a prospective analytic study with pre post test design, conducted in RSCM, National Cancer Hospital Dharmais and RSPAD Gatot Soebroto. When undergoing chemotherapy induction phase LLA, blood sugar levels were checked at the 3rd pretest , 4th, 5th and 6th week of protocol post test .Of the 57 patients from three different hospitals that had been gathered, mostly came from RSCM 57.9 followed by the Cancer Hospital Dharmais 24.6 and RSPAD 17.5 . The patient age ranged from 1.4 years to 15.8 years with a mean of 6.7 years. There was no difference in mean blood sugar levels before and after combination of steroids and L asparaginase. There were no relationship between age, CNS infiltration, leukocytosis, Down syndrome, nutritional status, family history of diabetes, infections and LLA stratification with the incidence of hyperglycemia. Dexamethasone has a 10.68 x chance of obtaining a rate above the mean change in blood sugar levels compared to prednisone.Conclusion The incidence of hyperglycemia in this study is 5.26 . Despite no difference between prednisone and dexamethasone in combination with L asparaginase in causing hiperglycaemia, but dexamethasone has a risk to have value above the mean change in blood sugar levels when compared to prednisone."

"Pendahuluan: Hiperglikemia yang memicu peningkatan stress oksidatif dapat menyebabkan inflamasi pada jaringan hepar. Penelitian ini bertujuan untuk melihat pengaruh ekstrak etanol daun Annona muricata yang memiliki fungsi hepato-protektif terhadap perubahan histopatologi hepar mencit yang mengalami diabetes mellitus. Metode: Penelitian ini menggunakan 25 ekor mencit Swiss Webster yang akan dibagi secara acak ke dalam 5 kelompok: kelompok Kontrol Negatif (KN), Kontrol Positif (KP), Dosis Rendah (DR), Dosis Sedang (DS), dan Dosis Tinggi (DT). Gambaran histopatologi akan dinilai menggunakan skor NASH CRN yang kemudian akan diolah menggunakan SPSS versi 24 dengan menggunakan uji Chi-Square. Sementara kadar glukosa darah akan diuji menggunakan uji Kruskal-Wallis dengan post hoc Mann Whitney U Test. Hasil: Hasil uji ekstrak etanol daun Annona murica menunjukkan perbedaan secara signifikan pada perubahan pengaruh inflamasi lobular (p=0,000) dan steatosis (p=0,001). Data kadar glukosa darah yang didapatkan pada pre-test (H0) dibandingkan dengan post-test (H14) tidak memiliki perbedaan yang bermakna(p=0,542). Di antara masing-masing data dari 5 kelompok pada hari ke-14 setelah perlakuan (H14) tidak memiliki perbedaan yang bermakna (p=0,553). Pada penelitian ini juga ditemukan adanya hubungan yang signifikan antara variabel steatosis dengan inflamasi lobular (p=0,535). Kesimpulan: Tidak terdapat hubungan yang signifikan antara pemberian ekstrak etanol daun Annona muricata terhadap penurunan kadar glukosa darah mencit. Terdapat hubungan yang signifikan terhadap pemberian ekstrak etanol daun Annona muricata terhadap perubahan steatosis dan inflamasi lobular hepar mencit.Introduction: Hyperglycemia which triggers an increase in oxidative stress can cause inflammation of the liver tissue. This study aims to look at the effect of the ethanol extract of Annona muricata leaves which has a hepato-protective function on liver histopathological changes in mice that have diabetes mellitus. Method: This study used 25 Swiss Webster mice which were randomly divided into 5 groups: the Negative Control (KN), Positive Control (KP) group, the treatment group dose 150 mg, 300 mg, 600 mg. Histopathological features will be assessed using the NASH CRN score which will then be processed using SPSS version 24 using the Chi-Square test. While blood glucose levels will be tested using the Kruskal-Wallis test with the post hoc Mann Whitney U Test. Results: The results of the ethanol extract of Annona murica leaves in the 5 dose groups showed significant differences in lobular inflammation (p = 0,000) and steatosis (p = 0.001). While blood glucose levels obtained at the pre-test (H0) compared with the post- test (H14) did not have a significant difference (p = 0.542). The 14th day of the test (H14) between the 5 dose groups did not have a significant difference (p = 0.553). In this study also found a significant relationship between steatosis variables with lobular inflammation (p = 0.535). Conclusion: There is a significant relationship to the ethanol extract of Annona muricata leaves on changes in steatosis and lobular liver inflammation in mice. There was no significant relationship in ethanol extract of Annona muricata leaves administration on mice blood glucose level."

"Hiperglikemia kronis yang jika tidak terkontrol dapat merusak pembuluh darah yang merupakan salah satu penyebab utama kematian terkait diabetes yang disebabkan oleh stroke. Penelitian ini bertujuan untuk mengetahui gambaran kesadaran diri penyandang diabetes mellitus terhadap risiko komplikasi stroke di kota depok. Penelitian deskriptif yang melibatkan 100 responden penyandang diabetes melitus tipe 2 di Kota Depok. Pengambilan data secara offline pada 3 puskesmas di Kota Depok menggunakan kuesioner kesadaran diri penyandang diabetes melitus tipe 2 terhadap risiko komplikasi stroke yang dikembangkan sendiri dengan nilai alpha cronbach 0,826. Hasil penelitian ini menunjukkan mayoritas responden (55%) berusia 61 – 80 tahun, 61% berjenis kelamin perempuan dan 89% responden beragama Islam. Tingkat pendidikan terakhir yang dapat ditempuh responden paling banyak yaitu di tingkat SMA (34%). Sebagian besar (64%) responden tidak pernah mengikuti penyuluhan/ edukasi diabetes melitus dan sebanyak 62% responden telah menyandang diabetes melitus selama <5 tahun. mayoritas responden (61%) memiliki tingkat kesadaran diri terhadap risiko komplikasi stroke yang sedang, 20% responden memiliki tingkat kesadaran diri rendah, dan 19% responden yang telah memiliki kesadaran diri tinggi terhadap risiko komplikasi stroke. Penelitian ini merekomendasikan pemberian edukasi kesehatan terkait risiko komplikasi stroke pada penyandang diabetes melitus tipe 2 agar dapat meningkatkan kesadaran diri penyandang diabetes melitus tipe 2 terhadap risiko komplikasi stroke.

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Chronic hyperglycemia which if not controlled can damage blood vessels which is one of the leading causes of diabetes-related deaths caused by stroke. This study aims to describe the self-awareness of people with diabetes mellitus on the risk of stroke complications in the city of Depok. Descriptive research involving 100 respondents people with type 2 Diabetic in the city of Depok. Offline data retrieval at 3 puskesmas in Depok City using a self-awareness questionnaire for people with type 2 diabetes on the risk of stroke complications developed by the researcher with a Cronbach alpha value is 0.826. The results of this study indicate that, the majority of respondents (55%) are aged 61 – 80 years old, 61% are female and 89% of respondents are muslim. The most level of education that respondents can take is high school (34%). Most of respondent (64%) had never attended to diebetes melitus counseling/education and 62% respondents had type2 diabetes mellitus for <5 years. The majority of respondents (61%) have a moderate level of self-awareness of the risk of stroke complications, 20% of respondents have a low level of self-awareness, higher than 19% of respondents who have high self-awareness. This study recommends providing health education related to the risk of stroke complications in people with type 2 diabetes, especially in the dimension of the question with the majority of people's perceptions being inaccurate so that it can increase increasing self-awareness of people with type 2 diabetes about the risk of stroke complications"