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Penyakit diabetes melitus tipe 2 (DM tipe 2) merupakan penyakit metabolik kronik yang betkaitan gaya hidup, penyakit ini semakin meningkat jumlahnya dan saat ini penyakit diabetes melitus sudah merupakan salah satu ancaman utama kesehatan umat manusia jumlah penderita penyakit DM tipe 2 di negara maju maupun negara berkembang terus meningkat setiap tahun. Indonesia menempati urutan ke 4 jumlah penderita DM di dunia setelah India, Cina, Amerika Serikat Penyakit ini tidak bisa ditumbuhkan dan dampak yaug ditimbulkan dari penyakit ini melipuli beberapa aspek antara lain aspek personal sosial dan ekonomi Upaya pencegahan yang paling baik agar insiden DM tipe 2 tidak meningkat adalah dengan mengendalikan faktor risikonya. Salah satu Faktor risiko yang dapat diubah yang ada pada seseorang adalah meningkatkan aktifitus fisik. Penelitian ini adalah penelitian yang melihat aktifitas fisik dengan risiko kejadian DM tipe 2 di lima wilayah DKI Jakarta, subyek yang terlihat dalam penelitian ini adalah DKI Jakarta yang berusia 25 s/d 64 talum. Penelitian ini dilakukan karena adanya kecenderungan peningkatan prevelen DM lipe 2 di masyarakat dan terjadinya perubahan gaya hidup dimasyarakat yang lebib banyak menyukai gaya hidup inaktif. Penelilian ini menggunakan pendekalan kuantitalif dengan disain penelitian kasus kontrol menggunakan data sekunder dari data survei Faktor Risiko penyakit tidak menular di lima wilayah DKI Jakarta tahun 2006. Yang menjadi kasus pada penelitian ini adatah subyek dengan hasil pemeriksaan laboratorium glukosa darah dinyatakan DM oleh dokter, sedangkan kontrol adalah subyek dengan hasil pemeriksaan laboratorium glukosa darah dinyatakaa tidak DM oleh dokter Jumlah sampel dalam penelilian ini adatah 575 subyek. Analisa data dilkukan dengan uji chi square dan analisis multivariat logistic regrusion. Dari hasil penelitian temyata tidak seluruh variabel independ yang diteliti masuk dalam ltandidat model don banya t..-dapat6 wriabel yang bisa masuk dslam kand.idat model ynitu umur,IMT,Riwaynt hipertenskadm: WL, kadm: trigliserida don diet semi, don terdapal 2 variabel yang m..-upeka confounder ynitu wriobel umur don kadm: trigliserida. Pada basil ekhir pencfilian ini didapalltan niJai p value sebesar 0,306 nilai OR scbesar 0,782 (95% CI: 0,488-1,253) nilai tersebut setelah dikontrol dengan variabel umur, don kadm: trigliserida Artinya adanyalmbungan tersebut bel:sifat protektif tapi hubuogan lmebut tidek bemJakna, seltingga penelililm. ini belum bisa membuktikon bahwa ada lmbungan aktifitas fisik dengan kejadian DM tipe2. Kelermban poda penelitian ini - lain, time -adak dapat dilihat dengan jelas, masih terdapat bias dan masih dipengarubi adanya confounding_ !'ada penelitian dimasa mendatmlg perlu mempertimbangkan disoin yang lebih tepat dengan knalitas data yang lebih baik.
Diabetes mellitus disease Type 2 is a metabolic chronicle disease which directly with people life style, this disease progressively increase by bets and at this present time diabetes mellitus disease is one of main threat of health of the mankind. Amount of Diabetes mellitus disease Type 2 patients increase both in developing countries and well developed countries every single year. Indonesia is in 41h place on the amount of Diabetes mellitus patients in worlds after India. Cbina, United States (Depkes,2005). This disease cannot be healed or effect which generaled from this disease cover some aspects such as personnel, social and economic aspects. The most important prevention effort so that Diabetes mellitus disease Type 2 do not increase is by controlling the risk factor. One of Risk factor available for alknd on the someone is increasing the physical activity. This r=h is a research focus in physical activity and the occurrence of Diabetes mellitus disease Type 2 in live region in DKI subjects in this research are people with age of25 to 64 year. Main reason of this research caused hy tendency of the increasing prevalcal of Diabetes mellilns disease Type 2 in oommunity and the change of people life style where tbcy preferred to choose inactive life style. This =h apply quantitative approach by case-control design research using secondmydata from Risk Factor Non Contagious Disease data SUIVcy in five region of DKI Jalou:la 2006. Wliat beooming case at this research is subject with .result inspection of Blood glucose laboratory witb Diabeles mellitus disease Type 2, while control variable is sullject with result inspeclioo of blood glucose and no Diabetes mellitus disease Type 2 detected Amount of samples in Ibis research are 575 subjects Data analysis acoomplished with chi-square test and logistic regression multivariate analysis. From research result simply not all independent variable which checked by is admission in modeling candidate and only 6 variable which can enter in model candidate that is age, JMT, hypertension history, rate IDL, triglyceride rate and fiber diet, and !here are 2 variable which is confounder variable that is triglyceride rate and age. On the final result of this research we got value equal to 0,306, OR value equal to o,m ( 95 % Cl : 0,48&-1.253) assess after controlled with age variable, and triglyceride rate_ Which mean that there is relation, and protective bet the relation is not significant, so !bat this research not yet prove that there is relation between physical activity with the occurrence of Diabetes mellitus disease Type 2. Weakness of this research for example time sequent have no seen clearly, still there are diffraction and still influenced by the existence of connfounding.
Prevalence diabetes is increasing rapidly especially in low and middle- income countries, one of which is Indonesia. Based on Riskesdas in 2018, the prevalence of diabetes mellitus based on the diagnosis of doctors in the population of all ages by province reaches 1,5%. The incidence rate of kidney disease in the diabetic population does not decrease. Some large cross-sectional studies in the world reveal that the prevalence of chronic kidney disease in people with type 2 diabetes even reaches 50%. Duration suffering diabetes is a risk factor for chronic kidney disease that needs to be considered. This study aims to determine the relationship duration suffering from diabetes with chronic kidney disease in patients with type 2 diabetes mellitus in Indonesia. This type of research is quantitative, with cross-sectional study design. This study uses secondary data from the 2018 Riskesdas survey. The number of samples was 639 people, who met the inclusion and exclusion criteria in this study. The analysis used cox regression The prevalence of chronic kidney disease in patients with type 2 diabetes mellitus in Indonesia is 17.68%. There was a relationship duration suffering diabetes with chronic kidney disease in patient type 2 diabetes mellitus in Indonesia which is statistically significant with p = 0.0000. So, important to screening mass type 2 diabetes mellitus as early as possible and routine screening kidney function since type 2 diabetes mellitus diagnose by a doctor.
Bankground: Cardiovascular disease, including stroke, is a major health problem in the world. Every year, there are more than 13.7 million new cases and 5.5 million deaths from stroke that occur globally. Based on Riskesdas data in 2018, the prevalence of stroke in Indonesia reached 10.9 per mile. In DKI Jakarta Province, the prevalence of stroke based on doctor's diagnosis increased from 9.7 per mile (2013) to 12.2 per mile (2018). Based on IDF data in 2019, the prevalence of diabetes in Indonesia reached 10.7 million cases and made Indonesia the country with the seventh most cases globally. In addition, according to the Health Social Security Administration (BPJS), the funds used for stroke services continued to increase, namely 1.43 trillion (2016), 2.18 trillion (2017) and 2.56 trillion (2018) and decreased to 2. 1 Trillion (2020). Although there is a decline in 2020, stroke is still ranked third as a provider of BPJS social security funds. Diabetes mellitus which is a risk factor for stroke has increased prevalence in DKI Jakarta Province from 2.5% (2013) to 3.4% (2018). Objective: To determine the relationship between type 2 diabetes mellitus and the incidence of stroke in the population aged 18 years. In DKI Jakarta Province in 2018. Methods: The study was conducted with quantitative methods and used an analytical cross-sectional study. The data source used in this study is secondary data from Riskesdas 2018. There are 1,537 samples analyzed according to the inclusion and exclusion criteria. Results: Based on the results of the analysis, the prevalence of stroke was 1.6% and type 2 diabetes mellitus was 7.7%. There is a significant relationship between the variables of type 2 diabetes mellitus and the incidence of stroke. In addition, covariate variables such as age (POR=5.26; 95%CI: 2.28-12.12), occupation (POR=2.63; 95%CI: 1.12-6.19), hypertension ( POR=9.52; 95%CI: 2.83-32.06), and heart disease (POR=5.30; 95%CI: 1.75-16.04) were also significantly associated with the incidence of stroke. Based on the stratification analysis, it was found that the variables that became the interaction effect (modification) were education, hypertension, and heart disease. Meanwhile, the confounding variables were age, education, hypertension, and heart disease. Conclusion: Type 2 diabetes mellitus is an important risk factor to consider in the prevention and control of stroke in Indonesia.
Kata kunci: Aktivitas fisik, kontrol glukosa darah, diabetes mellitus
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.
Key words: physical activity, diabetes mellitus, blood glucose control
Aktivitas fisik sebagai salah satu pilar penatalaksanaan Diabetes Mellitus dan pemeriksaan HbAlc sebagai evaluasi kendali gula darah jangka panjang seringkali tidak digunakan. Penelitian ini bertujuan untuk menilai fisibilitas dan efektivitas aktivitas fisik dan kendali gula darah pada penyandang DM tipe 2 di masyarakat pada umumnya. Studi menggunakan desain kohort prospektif dengan 5 bulan masa pengamatan (12 November 2007 - 9 April 2008) dan 2 lokasi pengambilan sampel: di kelompok senam DM (persadia) dan di poliklinik DM RS Husada, Jakarta. Pengambilan sampel dilakukan dengan metode non-random sampling secara consecutive selama 2 bulan masa enrollment. Sampel adalah 95 orang penyandang DM tipe 2 yang telah menandatangani formulir informed consent. Variabel independen utama adalah aktivitas fisik yang dinilai baik dari segi frekuensi, durasi, intensitas maupun kompositnya, menggunakan kuesioner yang telah divalidasi. Sedangkan variabel dependen-nya adalah kendali gula darah yang dinilai dari kadar HbAlc plasma vena darah dalam persen. Data dikumpulkan dan diukur dua kali: pada awal dan akhir penelitian (minimal 12 minggu setelah data pertama diambil). Analisis multivariat dilakukan dengan Regresi Cox Proportional Hazard menggunakan perangkat STATA versi 9.2. Hasil penelitian ini menemukan adanya hubungan antara aktivitas fisik dan kendali gula darah pada 95 orang penyandang DM tipe 2 di RS Husada Jakarta (HRadjusted = 0,54; 95%CI 0,27-1,11) selelah dikQntrol terhadap variabel pengobatan dan pola konsumsi serat. Dengan demikian, tenaga kesehatan tidak perlu lagi ragu-ragu untuk menganjurkan para penyandang DM tipe 2 untuk mengintegrasikan aktivitas fisik ke dalam kehidupan mereka sehari-hari guna memperbaiki kendali gula darahnya.
Physical acitivity is often underutilized as one of the cornerstones of diabetes management and so is the use of HbAlc in long-term glycemic control. The purpose of this study is to assess the feasibility and effectiveness of physical activity and blood glucose control among diabetes type 2 patients in general population. A prospective cohort study design was used to conduct the study for a period of 5 months (l2th November 2007 - 9th April 2008) using 2 catchment areas: diabetes exercise club (persadia) and diabetes policlinic Husada Hospital, Jakarta. A non-random (consecutive) sampling technique during a 2-month enrollment period yielded a participation of 95 type 2 diabetes patients as study subjects, all of whom have signed informed consents. The main independent variable assessed was physical activity in the forms of frequency, duration, intensity and composite using validated questionnaires whilst the outcome of blood glucose control expressed as percentage of plama venous HbAlc. Data were collected twice: at baseline and at least 12 weeks after. Multivariate analysis was conducted using Cox Proportional Hazard Regression and the software STATA 9.2 version. Results from the study found an association between physical activity and blood glucose control among 95 diabetes type 2 patients in Husada Hospital Jakarta (HRadjusted = 0,54; 95%CI 0,27-1,11) after adjusting for drug therapy and dietary pattern consumption of fibre. ThUs. health care providers should not be hesitant to advice diabetics patients to integrate physical activity into their daily lives in order to improve their glycemic control.
