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"Latar belakang: Diabetes mellitus adalah penyakit tidak menular yang termasuk dalam kategori penyakit kronis dan diperkirakan akan mengalami peningkatan, sehingga diperlukan cara pengendalian oleh Kementerian Kesehatan dalam bentuk pengelolaan diabetes mellitus yang pintar. Penelitian ini bertujuan untuk menganalisis pengaruh EMAS (pendidikan, manajemen nutrisi, aktivitas fisik, manajemen stres) terhadap perubahan perilaku dan kontrol gula darah orang dewasa dengan diabetes mellitus tipe 2. Metode: lakukan intervensi selama 6 bulan, Oktober 2018 hingga Maret 2019. Sampel diambil dengan teknik purposive sampling, yaitu orang dewasa dengan diabetes mellitus tipe 2 di Kecamatan Cisalak Pasar, Kabupaten Ciamnggis, Kota Depok sebanyak 86 orang. Hasil: Perubahan perilaku dan kontrol gula darah orang dewasa dengan diabetes mellitus tipe 2 melalui intervensi EMAS (nilai p 0,001 <0,05). Kesimpulan: Perubahan perilaku orang dewasa dengan diabetes mellitus tipe 2 diperlukan untuk menstabilkan gula darah pasien. Oleh karena itu, dibutuhkan peran komunitas spesialis perawat untuk memberikan intervensi sesuai dengan kebutuhan penderita diabetes mellitus untuk mengelola penyakit.......Background: Diabetes mellitus is a non-communicable disease that is included in the category of chronic diseases and expected to experience an increase, so that a way to control is needed by the Ministry of Health in the form of clever management of diabetes mellitus. This study aimed to analyze the effect of EMAS (education, nutrition management, physical activity, stress management) on behavior change and adult blood sugar control with diabetes mellitus type 2. Methods: do intervention for 6 months, October 2018 to March 2019. Samples were taken by purposive sampling technique, namely adults with type 2 diabetes mellitus in Cisalak Pasar Sub-District Ciamnggis District, Depok City as many as 86 people. Results: Changes in behavior and control of adult blood sugar with type 2 diabetes mellitus through EMAS intervention (p value 0.001 <0.05). Conclusion: Changes in adult behavior with type 2 diabetes mellitus are needed to stabilize the patient s blood sugar. Therefore, it takes the role of the nurse specialist community to provide interventions according to the needs of people with diabetes mellitus to manage the disease."

"Prevalensi DM di Kota Bogor yakni sebesar 2,1% hal ini masih lebih tinggi dibandingkan dengan prevalensi DM di Indonesia menurut data Riskesdas 2013 yakni sebesar 2,0%. Tujuan penelitian ini adalah untuk mengetahui pengaruh aktivitas fisik terhadap kontrol kadar Glukosa darah penderita diabetes mellitus tipe 2 pada studi kohort PTM di Kota Bogor tahun 2011-2016. Menurut uji Log-rank survival berdasarkan aktivitas fisik tidak berbeda bermakna dengan nilai signifikansi 0,941. Bahwa survival antara kelompok aktivitas fisik cukup dan kurang tidak berbeda survival-nya terhadap event kontrol glukosa darah buruk. Penderita DM tipe 2 yang cukup beraktivitas fisik memiliki HR sebesar 0,788 kali (95%CI: 0,456-1,360) dengan p value 0,392. Artinya, penderita DM tipe 2 yang cukup beraktifitas fisik maupun yang kurang tidak menunjukkan perbedaan yang bermakna terhadap kontrol glukosa darah. Tidak ditemukan pengaruh aktivitas fisik terhadap kontrol Glukosa darah penderita diabetes mellitus tipe 2 pada studi kohort PTM di Kota Bogor tahun 2011-2016. Hal ini dikarenakan banyak terjadi sensor dan lost to follow up juga titik pengamatan yang cukup jauh rentangnya yakni 2 tahun. Diperlukan upaya promosi kesehatan yang berkelanjutan dan bagi peneliti lain dapat melakukan studi dengan titik pengamatan dengan rentang waktu yang lebih singkat agar efek dari aktivitas fisik terhadap kontrol glukosa darah penderita DM tipe 2 dapat diukur lebih tepat. ......The prevalence of DM in Bogor City which is equal to 2.1%, this is still higher than the prevalence of DM in Indonesia according to Riskesdas 2013 data which is equal to 2.0%. The purpose of this study was to determine the effect of physical activity on blood glucose level control in patients with type 2 diabetes mellitus in the PTM cohort study in Bogor City in 2011-2016. According to the Log-rank survival test based on physical activity there was no significant difference with a significance value of 0.941. That survival between groups of physical activity is sufficient and the survival of the blood glucose control event is not different. Patients with type 2 DM who have enough physical activity have HR of 0.788 times (95% CI: 0.456-1.360) with p value 0.392. That is, patients with type 2 diabetes who have sufficient physical activity or those who do not show significant differences in blood glucose control. There was no effect of physical activity on blood glucose control in patients with type 2 diabetes mellitus in the PTM cohort study in Bogor City in 2011-2016. This is because there are a lot of sensors and lost to follow-up as well as a far enough observation point, which is 2 years. Continuous health promotion efforts are needed and other researchers can conduct studies with observation points with a shorter time span so that the effects of physical activity on blood glucose control in patients with type 2 diabetes can be measured more precisely."

"ABSTRAKPasien diabetes cenderung mengalami masalah psikologis seperti kecemasan yang dapat menyebabkan rendahnya kontrol glikemik, kurangnya perawatan diri, serta menurunnya kualitas hidup. Apabila kecemasan tidak tertangani dengan baik akan menyulitkan pengelolaan diabetes. Penelitian ini bertujuan mengetahui faktor dominan yang memengaruhi tingkat kecemasan diabetisi tipe 2. Desain penelitian adalah analitik cross sectional dengan jumlah sampel 110 diabetisi tipe 2. Analisis data menggunakan pooled T-test, chi-square, dan regresi logistik. Hasil penelitian menunjukkan bahwa faktor yang memengaruhi tingkat kecemasan diabetisi tipe 2 adalah usia, status pekerjaan, lama menderita DM, kontrol gula darah dan aktivitas fisik. Kontrol gula darah merupakan faktor yang paling berpengaruh terhadap tingkat kecemasan diabetisi tipe 2, dimana responden dengan gula darah tidak terkontrol berisiko 7,356 kali untuk mengalami cemas tingkat sedang-berat dibandingkan responden dengan gula darah terkontrol CI 95 OR= 1,564-34,6 . Penelitian ini dapat meningkatkan kewaspadaan diri perawat dalam mengkaji aspek psikologis diabetisi dengan mengetahui faktor-faktor yang berpengaruh terhadap kecemasan.

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ABSTRACTPatients with diabetes tend to experience psychological problems such as anxiety that leads to a lower glycemic control, low self care, and decreased quality of life. Thus, it needs to be handled properly to prevent more complicated diabetes management. This study aimed to determine the dominant factor affecting the level of anxiety in patient with type 2 diabetes. An analitic cross sectional study was conducted that included 110 patients with type 2 diabetes. Statistical analysis used pooled T test, chi square and logistic regression. The results showed that the factors affecting the level of anxiety in patient with type 2 diabetes were age, employment status, duration of diabetes, blood glucose control and physical activity. Blood glucose control was the most dominant factor in the level of anxiety of patient with type 2 diabetes. This found is based on data that patients with uncontrolled blood glucose were 7.356 times more likely to have a medium high level of anxiety as compared to those with controlled blood glucose 95 CI OR 1.564 to 34, 6 . This study results can lead nurses to improve their self awareness in assessing psychological aspects by recognising factors affecting anxiety."

"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.......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."

"Latar Belakang. Hiperglikemia sering terjadi pada pasien pascabedah pintas arteri koroner (BPAK). Kondisi ini mempengaruhi prognosis pada pasien, sehingga dibutuhkan protokol insulin intensif yang efektif dan aman digunakan. Di Indonesia belum ada protokol standar yang terbukti efektif dan aman pada pasien pascabedah pintas arteri koroner (BPAK). Tujuan. Mengetahui persentase pasien pascabedah pintas arteri koroner (BPAK) jantung yang mencapai target glukosa darah dalam 6 jam dan insiden kejadian hipoglikemia dengan menggunakan protokol insulin PERKENI 2011.Metode. Penelitian ini menggunakan desain retrospektif dari rekam medis pasien dewasa 318 tahun yang mengalami hiperglikemia (>200 mg/dL) pascabedah pintas arteri koroner (BPAK). Parameter yang dilihat karakteristik dari subjek, proporsi glukosa darah terkendali (150-200 mg/dL) dalam enam jam dan proporsi hipoglikemia. Proporsi pencapaian glukosa darah ditargetkan >50% dan kejadian hipoglikemia <12%.Hasil. Penelitian ini dilakukan di Pelayanan Jantung Terpadu RSUPN Dr. Cipto Mangunkusumo periode Januari 2018 sampai September 2023. Sebanyak 98 subjek diikutsertakan dan didapatkan persentase pasien yang mencapai target glukosa darah dalam 6 jam sebesar 54,1% dan proporsi hipoglikemia sebesar 5,1%.Kesimpulan. Berdasarkan penelitian ini persentase pasien yang mencapai target glukosa darah dalam 6 jam sebesar 54,1% dan proporsi hipoglikemia sebesar 5,1% dengan menggunakan protokol insulin PERKENI 2011.......Background. Hyperglycemia often occurs in patients after coronary bypass surgery. This condition affects the patient’s prognosis, so an intensive insulin protocol is needed that is effective and safe to use. In Indonesia, there is no standard protocol that has been proven to be effective and safe in patients after coronary bypass surgery.Aim. To determine the percentage of post-coronary artery bypass surgery (CABG) patients who achieve blood glucose targets within 6 hours and the incidence of hypoglycemia using the PERKENI 2011 insulin protocol.Methods. This study used a retrospective design from medical records of adult patients (318 years old) who experienced hyperglycemia (>200 mg/dL) after coronary bypass surgery. The parameters seen were the characteristics of the subjects, proportion of controlled blood glucose (150-200 mg/dL) within six hours and proportion of hypoglycemia. The proportion of blood glucose achieved is targeted at >50% dan the incidence of hypoglycemia <12%.Results. This research was conducted at the Integrated Heart Service of RSUPN Dr. Cipto Mangunkusumo for the period January 2018 to September 2023. A total of 98 subjects were included and it was found that the percentage of patients who reach the blood glucose target within 6 hours was 54.1% and the proportion of hypoglycemia was 5.1%.Conclusion. Based on this study, the percentage of patients who achieved the blood glucose target within 6 hours was 54.1% and the proportion of hypoglycemia was 5.1% using the PERKENI 2011 insulin protocol."