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"Penelitian ini bertujuan untuk mengetahui hubungan antara profil lipid darah dengan derajat retinopati diabetik penderita DM tipe-2. Penelitian potong-lintang pada 52 pasien retinopati diabetika dilaksanakan di Poliklinik Mata, Rumah Sakit Cipto Mangunkusumo, Jakarta. Data yang dikumpulkan meliputi data demografi, gaya hidup, lama menderita DM, pemeriksaan fisik dan antropometrik, asupan lemak, asam lemak dan kolesterol data kadar gula darah puasa, A1C, kolesterol total, kolesterol-LDL, kolesterol-HDL and trigliserida, dan pemeriksaan fundus. Analisis statistik yang digunakan adalah uji chi-square untuk mengetahui hubungan antara profil lipid darah dengan derajat retinopati diabetik. Subyek terdiri dari 20 orang laki-laki dan 32 orang perempuan dengan rerata usia 53,8 ± 5,2 tahun. Sebanyak 53,8% telah didiagnosis DM selama >10 tahun, dengan rerata IMT adalah 24,1 ± 3,3 kg/m2 dan 38,5% diklasifikasikan sebagai obes I dan II. Rerata kadar gula darah puasa 157,5 ± 71,8 mg/dL, dan A1C 9,1 ± 2,4 %. Sebanyak 40,4% subyek mempunyai kadar kolesterol total darah tinggi, 34,6% kadar kolesterol-LDL darah sangat tinggi, dan 65,4% dengan kolesterol-HDL dan trigliserida darah normal. Derajat keparahan retinopati diabetika ditunjukkan dengan adanya 61,6% subyek dengan retinopati diabetika non-proliferasi berat (NPDR) and retinopati diabetika proliferasi (PDR). Kesimpulannya, belum dapat dibuktikan adanya hubungan yang bermakna antara profil lipid dengan derajat retinopati diabetika.

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This study aimed to determine the relationship between plasma lipid profile and the severity of diabetic retinopathy in type 2 diabetes patients. A cross sectional study was done in Ophthalmologic Clinic, Cipto Mangunkusumo General Hospital, Jakarta for 52 diabetic retinopathy (DR) patients. Data collected were demographic, life style, duration of diabetes, physical and antropometric examinations, fat, fatty acid and cholesterol intake, fasting plasma glucose, A1C, total-, LDL-, HDL-cholesterol and triglyceride level, and fundus examination.

Statistical analysis was done using chi-square test to see the associations between plasma lipid profile and DR in type 2 diabetes patients. Subjects comprised of 20 males and 32 females diabetes patients with mean age of 53.8 ± 5.2 years. As much as 53.8% had been diagnosed as DM for >10 years. The mean value of BMI was 24.1 ± 3.3 kg/m2 and 38.5% were classified as obese I and II. The mean value of fasting plasma glucose was 157.5 ± 71.8 mg/dL, and A1C was 9.1 ± 2.4 %.

For lipid profile, 40.4% had high total cholesterol level (>240 mg/dL), 34.6% had high and very high LDL-cholesterol level (≥160 mg/dL), and 65.4% had normal HDL-cholesterol (40-60 mg/dL) and triglyceride level (<150 mg/dL). For the severity of retinopathy, 61.6% had severe non-proliferative diabetic retinopahy (NPDR) and proliferative diabetic retinopahy (PDR). In conclusion, there were no significant associations between plasma lipid profile and the severity of diabetic retinopathy."

"Ulkus diabetik merupakan komplikasi dari diabetes melitus, lama sembuh dan terjadi berulang sehingga mempengaruhi kualitas hidup penderita. Penelitian ini bertujuan mengidentifikasi hubungan antara tingkat depresi dengan kualitas hidup pasien ulkus diabetes. Desain penelitian ini adalah deskriptif korelasi dengan pendekatan cross-sectional. Pemilihan sampel dengan cara purposive sampling yang melibatkan 30 responden. Hasilnya menunjukkan adanya hubungan yang signifikan antara nilai depresi dengan kualitas hidup dengan p-value 0,000. Hasil penelitian ini diharapkan merekomendasikan program pencegahan dan penanganan depresi pada pasien dengan ulkus diabetik.

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Diabetic ulcers is complications of diabetes mellitus, delayed healing and repeated that affect the quality of life patients. The purpose of this study was to identify the relationship between depression and quality of life patients with diabetic ulcer. The design of this study is a descriptive correlation cross-sectional approach. The selection of samples were done in purposive sampling method and involved 30 respondents. The result are a significant correlation value depression with quality of life with p-value 0,000. The results of this study are expected to recommendation a program of prevention and treatment of depression patients with diabetic ulcers."

"Latar Belakang Diabetes melitus dapat menyebabkan gangguan sistem saraf otonom (SSO) yang disebut sebagai neuropati otonom diabetik. SSO mengendalikan banyak sistem organ dan salah satu gangguannya dapat bermanifestasi sebagai disfungsi ereksi (DE). Prevalensi DE dan neuropati otonom diabetik di dunia masih beragam dan hubungan keduanya masih memiliki hasil yang bervariasi. Dengan deteksi dini neuropati otonom diabetik diharapakan dapat turut mendeteksi DE dan mencegah progresifitas DE menjadi lebih berat. Terdapat pilihan skrining untuk mendeteksi neuropati otonom salah satunya dengan Survey of Autonomic Symptom (SAS) dan pemeriksaan variabilitas detak jantung (HRV)Tujuan Mengetahui proporsi dan hubungan antara neuropati otonom dengan disfungsi ereksi pada DMT2 yang dinilai dengan kuesioner SAS dan pemeriksaan HRVMetode Penelitian ini menggunakan studi potong lintang dari 86 pasien DMT2 di Poliklinik Metabolik Endokrin RSUPN dr. Cipto Mangunkusumo sejak Agustus 2021 hingga November 2021. Pasien dilakukan wawancara dengan kuesioner SAS, IIEF-5, dan Pemeriksaan HRV. Dilakukan analisis multivariat untuk menilai hubungan variabel bebas dan terikat setelah dikontrol dengan variabel-variabel perancu yang berhubungan.Hasil Pada penelitian ini didapatkan proporsi pasien DE pada DMT2 sebanyak 59,3%. Proporsi pasien neuropati otonom yang dinilai dengan HRV sebanyak 94,3% dan neuropati otonom yang dinilai dengan kuesioner SAS sebanyak 41,9%. Terdapat hubungan secara statistik bermakna setelah dilakukan analisis multivariat antara neuropati otonom diabetik yang dinilai dengan kuesioner SAS dengan DE (adjusted OR 18,1 [IK95% 3,90-84.33]). Pemeriksaan HRV dalam penelitian ini tidak menunjukan hubungan yang signifikan secara statistik dengan DE.Kesimpulan Proporsi pasien dengan neuropati otonom diabetik yang dinilai dengan kuesioner SAS didapatkan sebesar lebih dari 40% dan yang dinilai dengan HRV lebih dari 90%. Terdapat hubungan yang secara statistik bermakna antara neuropati otonom diabetik yang dinilai dengan kuesioner SAS dengan DE.

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Background Diabetes mellitus (DM) affecting the autonomic nervous system known as diabetic autonomic neuropathy (DAN), which controls many organ systems and can manifest as erectile dysfunction (ED). The range of ED and DAN prevalence has been found to vary widely depending on the baseline comorbidities in the population of the subject studied. Autonomic neuropathy is still rarely studied and its relationship with erectile dysfunction needs to be explored whether the two variables are related. By early detection of autonomic neuropathy, it is hoped that can help detect ED and prevent the progression more severe. There are screening options to see autonomic neuropathy: survey of Autonomic Symptoms (SAS) questionnaire and Heart rate variability (HRV) test.

Objective To determine the proportion and relationship between diabetic autonomic neuropathy and erectile dysfunction in Type 2 DM using SAS questionnaire and HRV examination

Methods Cross-sectional study of 86 type 2 DM patients at the Metabolic Endocrine Polyclinic, dr. Cipto Mangunkusumo from August 2021 to November 2021. Patients were interviewed with the IIEF-5 questionnaire, SAS and HRV examination. Multivariate analysis with logistic regression analysis was performed to assess the relationship between diabetic autonomic neuropathy with ED in the type 2 DM population.

Results In this study, the proportion diabetic autonomic neuropathy in Type 2 DM was 41.9% with SAS questionnaire and 94,3% with HRV, and Proportion of ED was 59.3%. The proportion of autonomic neuropathy who had ED was 91.7% with SAS and 69,7% with HRV. There was a statistically significant relationship between diabetic autonomic neuropathy use SAS and ED (adjusted OR 18.1 [95% CI 3.90-84.33]). HRV examination did not show an association with ED in this study.

Conclusion More than half of the subjects had erectile dysfunction and almost all of the patients with diabetic autonomic neuropathy had erectile dysfunction. There is a statistically significant relationship between diabetic autonomic neuropathy using SAS questionnaire and ED."

"Atas rekomendasi dokter spesialis pelayanan Rujuk Balik ke puskesmas dianjurkan bagi pasien di RS yang menderita penyakit kronis termasuk diabetes melitius. Penelitian ini bertujuan untuk melihat faktor-faktor yang berhubungan dengan kesediaan pasien diabetes mellitus tipe 2 peserta JKN di RSU Jagakarsa untuk dirujuk balik ke FKTP.Desain potong lintang dan pendekatan kualitatif melalui wawancara mendalam digunakan dalam studi ini. Hasil penelitian menunjukkan bahwa kepercayaan pasien terhadap dokter layanan primer, persepsi pasien mengenai ketersediaan obat di fasilitas kesehatan primer, jarak tempuh terhadap fasilitas kesehatan primer dan dukungan keluarga dan teman berhubungan dengan kesediaan pasien untuk dirujuk balik. Disarankan untuk mengembangkan SOP rujuk balik di RS dan mengembangkan pojokrujuk balik.

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Back referral service to primary care is provided for JKN patients including diabetes mellitus type 2 patients as recommended by the internal medicine specialist. This studyaim is to analyse the factors that related to willingness of the patients to be referred to primary care after receiving care at the hospital in Jagakarsa Hospital. This study is using quantitative method with cross sectional design, followed by qualitative method with in depth interview.

The study revealed that trust to the primary health care physician, perception on medicine availability in primary health care facility, accessiibility and support from family and friend affect patient willingness to agree with back referral service. The study suggested to develop standard procedure for back referral and initiate back referral corner in hospital."

"Peningkatan Prevalensi Penderita Diabetes Mellitus di era JaminanKesehatan Nasional, akan meningkatkan beban pembiayaan kesehatan.Implementasi Program Rujuk Balik yang melibatkan banyak instansi menjadisangat penting dalam memberikan efisiensi bagi pembiayaan maupun pasien.Penelitian ini untuk mengetahui faktor-faktor yang mempengaruhi implementasikebijakan program rujuk balik pasien diabetes mellitus stabil di Rumah SakitUmum Daerah Johar Baru Tahun 2017 melalui teori Van Meter dan Van Horn. Penelitian ini menggunakan pendekatan kualitatif dengan disain studimelalui content analisis dan metode triangulasi dan pendekatan kuantitatif dengandisain studi kasus. Data primer didapat melalui wawancara mendalam, kuesioner,observasi, dan telaah dokumen. Untuk data sekunder dari dokumen dan literatur. Dari hasil penelitian menunjukan bahwa implementasi Program RujukBalik di Rumah Sakit Umum Daerah Johar Baru belum berjalan efektif. Peranankolaborasi antara pembuat dengan pelaksana kebijakan harus semakin baiksehingga implementasi Program Rujuk Balik akan berjalan dengan optimal.

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The effect of increasing prevalence of Diabetes Mellitus in UniversalHealth Coverage era will increase the cost of finance. Implementation of RereferenceProgram involve many institution that make important for giving financeand patient rsquo s service more efficient. Objective of this reseach is to find theeffectiveness of Re reference policy of Stabil Diabetes Mellitus at Johar BaruHospital in 2017 according to Van Meter and Van Horn theory.

This reseach is using quantitative and qualitative approach with studydesign by analysis content and triangulation method. Primary data is procured fromdeepening inteview, quesioner, observation and documents. Secondary dataprocured from documents and literatures.

From result of this reseach showed that Re reference Program is lessoptimum at Johar Baru Hospital. Collaboration between the policy maker and theimplemeters of Re reference Program need to be better, so there implementation ofRe reference Program will be optimum."

"Introduction: Diabetes mellitus can cause various complications, including diabetic foot ulcers (DFU). Vitamin D levels are known to be correlated with wound healing and insulin resistance. Method: This cross-sectional study aimed to determine the correlation between the serum level of vitamin D and the severity degree of DFU. Thirty DFU patients with normal ankle- brachial index, grouped into degrees according to the Wagner classification, were included in this study. Their serum level of vitamin D was examined using the chemiluminescent immunoassay method. The correlation between these two variables was analyzed. Results: Patients were 18 males (60%) and 12 females (40%) with an average age of 57 years. The average serum level of vitamin D was 10.58 ng/mL. A significant correlation was found between the serum level of vitamin D and the severity of DFU (r= -0.901, p <0.001)."

"[ABSTRAKLatar belakang: mengetahui hubungan antara asupan makronutrien dan gayahidup terhadap status HbA1c penyandang diabetes melitus (DM) tipe 2. Metode:penyandang DM tipe 2 dikategorikan ke dalam 2 kelompok, yaitu kontrolglikemik (KG) baik (HbA1c < 7,0) dan KG buruk (HbA1c > 7,0). Datakarakteristik dasar seperti usia, jenis kelamin, status gizi, durasi menderita DM,jenis dan jumlah obat DM yang digunakan, serta ada/ tidaknya komplikasi DMyang diderita. Asupan makronutrien terdiri dari asupan energi total harian, asupankarbohidrat, protein, lemak dan serat. Faktor gaya hidup meliputi ketaatanmengikuti diet sesuai yang direkomendasikan, aktivitas fisik, ketaatan konsumsiobat, merokok dan minum alkohol. Data-data dari kedua kelompok kemudiandihubungkan dengan status HbA1c dengan uji Chi square. Hasil penelitian: usiapenyandang DM yang lebih muda (< 55 tahun), asupan karbohidrat dan ketaatanmengikuti diet berhubungan bermakna secara statistik dengan status HbA1c (P <0,05). Rasio asupan makronutrien (karbohidrat, protein, lemak) pada kelompokKG baik adalah 47: 18: 35 dan KG buruk 51: 16: 33. Kesimpulan : Hasilpenelitian ini menunjukkan bahwa status HbA1c berhubungan bermakna denganfaktor usia, asupan karbohidrat, dan ketaatan mengikuti diet. Edukasi sebaiknyadiberikan kepada penyandang DM tipe 2 dengan KG buruk, terutama yang berusia< 55 tahun agar mengatur pola makannya sesuai dengan yang direkomendasikandengan memperhatikan jenis, jumlah, dan jadwal.

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ABSTRACTBackground: Determining the relationship between macronutrients intake and lifestylefactors and HbA1c status of diabetic type 2 patient in improving the effectiveness ofpatient?s nutrition therapy and preventing diabetes complications. Methods: Diabetictype 2 patients were categorized into 2 groups; patients with good glycemic control (GC)or HbA1c < 7.0 and patients with poor glycemic control (PC) or HbA1c > 7.0. Clinicalcharacteristics were differentiated by age, gender, body mass index (BMI), duration ofillness, type and amount of diabetic medication, and other diabetic complication.Macronutrient intake consisted of total daily calories and carbohydrate, protein, fat andfiber intakes. Lifestyle factors consisted of the adherence to dietary advice andmedication, physical activities, smoking habit, and alcohol intake. The data were be usedto determine their relationship with HbA1c status using Chi Square test. Results:Younger diabetic type 2 patients (< 55 years old), carbohydrate intake, and adherence todietary advice were identified as statistically significant variables related to HbA1c status(P <0.05). Macronutrient intake ratio (carbohydrate : protein : fat) for GC was 47 : 18 : 35and PC was 51 : 16 : 33. Conclusions: The results demonstrate that HbA1c status indiabetic type 2 patient are related to age, carbohydrate intake and adherence to dietaryadvice. Education to be provided to younger diabetic type 2 patients (<55 years old) tomaintain good dietary pattern according to medical nutrition therapy, Background: Determining the relationship between macronutrients intake and lifestylefactors and HbA1c status of diabetic type 2 patient in improving the effectiveness ofpatient’s nutrition therapy and preventing diabetes complications. Methods: Diabetictype 2 patients were categorized into 2 groups; patients with good glycemic control (GC)or HbA1c < 7.0 and patients with poor glycemic control (PC) or HbA1c > 7.0. Clinicalcharacteristics were differentiated by age, gender, body mass index (BMI), duration ofillness, type and amount of diabetic medication, and other diabetic complication.Macronutrient intake consisted of total daily calories and carbohydrate, protein, fat andfiber intakes. Lifestyle factors consisted of the adherence to dietary advice andmedication, physical activities, smoking habit, and alcohol intake. The data were be usedto determine their relationship with HbA1c status using Chi Square test. Results:Younger diabetic type 2 patients (< 55 years old), carbohydrate intake, and adherence todietary advice were identified as statistically significant variables related to HbA1c status(P <0.05). Macronutrient intake ratio (carbohydrate : protein : fat) for GC was 47 : 18 : 35and PC was 51 : 16 : 33. Conclusions: The results demonstrate that HbA1c status indiabetic type 2 patient are related to age, carbohydrate intake and adherence to dietaryadvice. Education to be provided to younger diabetic type 2 patients (<55 years old) tomaintain good dietary pattern according to medical nutrition therapy]"

"Efikasi diri dan kepatuhan merupakan faktor yang penting dalam meningkatkan kualitas hidup pasien DM tipe 2. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat efikasi diri dan kepatuhan dengan kualitas hidup pasien DM tipe 2 yang menjalani rawat jalan di Rumah Sakit di Jakarta.Desain dalam penelitian ini adalah cross sectional, dengan jumlah sampel 125 pasien DM tipe 2. Alat ukur yang digunakan adalah Diabetes Management Self-Efficacy (DMSES), the Diabetes Activities Questionare (TDAQ), dan Diabetes Quality Of Life (DQOL).Hasil penelitian menunjukkan bahwa efikasi diri (0,0005), dan kepatuhan (0,0005) berhubungan secara signifikan dengan kualitas hidup dengan variabel yang paling dominan adalah kepatuhan.Hasil uji multivariat menunjukkan bahwa variabel efikasi diri, kepatuhan, tingkat pendidikan, dan depresi menentukan kualitas hidup pasien DM. Perlunya dikembangkan pengkajian dan intervensi keperawatan yang berfokus pada efikasi diri dan kepatuhan pasien DM tipe 2.

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Self-efficacy and adherence are important factor in improving the quality of life of patients with type 2 diabetes. This study aimed to determine the relationship between self-efficacy and adherence to the quality of life of patients with type 2 diabetes mellitus in an outpatient unit of a Hospital in Jakarta.

This study was a cross-sectional, with sample of 125 patients with type 2 diabetes mellitus. The Diabetes Management Self- Efficacy (DMSES), the Diabetes Activities Questionare (TDAQ), and the Diabetes Quality of Life (DQOL) were employed as instruments.

The results showed that selfefficacy (0.0005), and adherence (0.0005) were significantly associated with quality of life and the most dominant variable is adherence.

Multivariate test results indicate that the variable self-efficacy, adherence, education level, and depression determines quality of life of diabetic patients. This study suggestsis the need fornursing assessment and interventions that focus on the self-efficacy and adherence diabetes mellitus patient."

"ABSTRAKDukungan keluarga sangat berperan penting dalam pengelolaan diri pasiendiabetes melitus. Penelitian ini bertujuan mengeksplorasi sistem dukungankeluarga masyarakat Cirebon dalam perubahan gaya hidup pasien diabetesmelitus. Penelitian ini adalah penelitian kualitatif dengan metode fenomenologi.Partisipan dalam penelitian ini berjumlah 8 partisipan pasien dan 8 partisipananggota keluarga. Hasil analisa data pada pasien dan keluarga teridentifikasidelapan tema, yaitu: respon psikologis terhadap penyakit, perubahan gaya hidup,dukungan informasional, dukungan emosional, dukungan instrumental, reaksiemosi positif, harapan untuk kesehatan dan kendala dalam dukungan. Tema yangberkaitan dengan dukungan penghargaan tidak secara spesifik ditemukan dalampenelitian ini. Hasil penelitian diharapkan dapat menjadi masukan dalammeningkatkan kualitas asuhan keperawatan dalam membantu klien merubah gayahidupnya.

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ABSTRACTFamily support is very important in the self-management of diabetes mellituspatients. This study aims to explore the family support system in cireboncommunity lifestyle change of diabetic patients. This research employs qualitativemethodology, with phenomenology approach. Participants in this study were 8patients and 8 caregiver. The data analysis revealed eight themes emerged frompatient and caregivers were psychological response to the disease, lifestylechanges, informational support, emotional support, instrumental support, appraisalsupport, positive emotional reactions, expectations and constraints for health insupport. Themes related to the appraisal support is not specifically identified inthis study. The results of this research are expected to contribute positively inimproving nursing care quality to helping clients change their lifestyle."