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Kata kunci: Diabetes melitus tipe 2, prediabetes, stres, dewasa
Prediabetes is a golden period in delaying the occurrence of type 2 diabetes mellitus because in this period the course of the disease can still be stopped. The study aim was to knowing the impact of stress on the conversion of prediabetes to type 2 diabetes mellitus in adults. This study used retrospective cohort design. The data used are secondary data from the Cohort Study of Risk Factors for Non-Communicable Diseases in Bogor, Indonesia. Data collection in this study was carried out since 2011 until 2015 with a total population of 5890. Based on the exclusion and inclusion criteria, the total of study participants were 1059. During 5 years of follow-up, among prediabetic adults there were 169 subjects categorized as T2DM and 219 subjects categorized as stressed. Bivariate analysis shows that stress and age at baseline is a risk factor on the conversion of prediabetes to T2DM (p < 0,05). Final model on multivariate analysis, shows the hazard ratio of stress was 1.815 (95% CI: 1.307 - 2.520) with p < 0.05. This findings, expected to be used as information and motivation in an effort to make prevention and control of T2DM. Especially in individuals with prediabetes who suffer from stress because it has an impact with conversion of prediabetes to T2DM.
Key words: Type 2 diabetes mellitus, prediabetes, stress, adults
Penyakit kusta merupakan penyakit menular yang masih banyak menimbulkan masalah kompleks. Masalah tersebut bukan hanya dari segi medis tetapi meluas sampai ke masalah sosial, ekonomi dan budaya (W1-L0,2000). Kabupaten Jeneponto merupakan salah satu kabupaten endemis kusta di provinsi Sulawesi Selatan yang memiliki Case Detection Rate tertinggi ( 50,9/100.000) di tahun 2006 dan prevalensi rate 4/10.000. Jumlah kasus baru yang ditemukan di tahun 2006 sebesar/69 kasus. Sebagian besar kecamatan yang ada di wilayah kabupaten Jeneponto dinyatakan endemis dan derajat endemisitasnya, cukup tinggi sehingga risiko tertularnya penduduk menjadi sangat besar. Masih tingginya case detection rate di kabupaten Jeneponto disertai kepadatan hunian yang cukup tinggi memungkinkan penularan kusta melaitri droplet maupun sentuhan langsung. Untuk itu perlu di ketahui hubungan kepadatan human terhadap risiko kejadian kusta. Tujuan penelitian ini tuttuk rnengetahui hubungan faktor hunian dengan kejadian kusta di Ka.bupaten Jeneponto setelah dikontrol oleh faktor konfounding yaitu umur, jenis kelamin, vaksinasi BCG, pengeluaran, riwayat kontak serurnah, pendidikan dart pekerjaan. Penelitian ini menggunakan disain study kasus kontrol yang dipadankan( pair wise matching). Sampel penelitian adalah seluruh penderita kusta baru yang ditemukan periode Juli 2006 sampai September 2007. Jumlah kasus sebanyak 115 orang dan jumlah kontrol sebanyak 115 orang. Analisis data diIakukan meialui tiga tahapan, yaitu Univariat (distribusi frekuensi), Bivariat (uji McNemar) dan rnultivariat (Conditional Multiple Logistic Regression). Hasil penelitian menunjukan bahwa kepadatan hunian berhubungan dengan kejadian kusta dengan nilai OR 10,65 (95% Cl: 4,11— 27,62) dart nilai p 0,000 setelah dikontrol variabel pengeluaran, pekerjaan dan riwayat kontak serurnah. Dari hasil penelitian ini disarankan perlu dilaksanakan pemeriksaan kontak serumah yang lebih intensif pada wilayah puskesmas yang tingkat kepadatan hunian tinggi, screening terhadap rumah yang ada penderita kusta terutarna pada rumah-rumah dengan tingkat kepadatan hunian tinggi.
Disease of Leprosy represent contagion which still many generating the problem of complex. The problem not merely from medical facet but extending to problem of social, cultural and economic ( WHO,2000). Sub-Province of Jeneponto represent one of the sub--province of endemic of leprosy in Province of South Sulawesi owning highest Case Detection Rate ( 50,9/100.000) in year 2006 and prevalence rate 4,1/10.000. Amount of new case found in year 2006 amount 169 cases. Mostly district of exist in region of sub-province of Jeneponto expressed by endemic and degree of high endemic enough so that its contagious risk resident become very big. Still height of case detection rate in sub-province of Jeneponto accompanied by density of dwelling which high to enough enable infection of leprosy through droplet and also direct touch. For that need in knowing relationship of density of dwelling to risk of leprosy occurrence. Target of this research to know relation of factor of dwelling with occurrence of leprosy in Sub-Province of Ieneponto after controlled by confounder that is age, gender, vaccination BCG, expenditure, history contact house, education and work. This research use to design case control study (pair wise matching). Sample of Research is all new leper was found by period of July 2006 until September 2007. Amount of case of counted 115 people and amount of control of counted 115 people. Data analyzing conducted to through three steps, that is Univariate ( frequency distribution), Bivariate (McNemar test) and multivariate (Conditional Multiple Logistic Regression). Result of research of show that density of dwelling relate to occurrence of leprosy with Odd Ratio 10,65 ( 95% CI: 4,11 - 27,62) and p value 0,000 after controlled by variable of expenditure, job and history contact house. From result of this research is suggested require to be executed by a inspection contact more intensive house at region of puskesmas (public health center) which mount density of high dwelling and screening to existing house of leper especially at house with level density of high dwelling.
