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Latar belakang: Diabetes melitus merupakan penyakit tidak menular yang menjadi prioritas global, penyebab utama kematian dan kecacatan. Indonesia menempati peringkat ketiga di dunia dengan 73,7% kasus DM yang tidak terdiagnosis. Prevalensi DM di Indonesia terus mengalami peningkatan setiap tahunnya. Obesitas sentral dikaitkan dengan peningkatan risiko diabetes melitus. Beberapa penelitian telah menunjukkan adanya hubungan antara obesitas sentral dengan kejadian diabetes melitus. Namun, penentuan diagnosis DM hanya didasarkan pada pemeriksaan glukosa darah sewaktu, tanpa disertai informasi mengenai gejala dan Riwayat DM sebelumnya. Penelitian ini bertujuan untuk mengetahui hubungan obesitas sentral dengan diabetes melitus yang baru didiagnosis berdasarkan pemeriksaan kadar glukosa darah atau HbA1c pada penduduk usia ≥15 tahun di Indonesia.
Metode: Penelitian ini menggunakan data sekunder Survei Kesehatan Indonesia (SKI) tahun 2023. Jumlah sampel yang dianalisis sebanyak 25.494. Analisis multivariat menggunakan cox regression untuk mengetahui hubungan antara obesitas sentral dengan kejadian diabetes melitus yang baru didiagnosis berdasarkan pemeriksaan kadar glukosa darah atau HbA1c pada penduduk usia ≥15 tahun di Indonesia setelah dikontrol oleh variabel kovariat.
Hasil: Prevalensi diabetes melitus yang baru didiagnosis sebesar 16,0%. Obesitas sentral meningkatkan risiko diabetes melitus sebesar 1,6 kali (PR: 1,6; 95% CI: 1,53–1,76) setelah dikontrol usia, jenis kelamin, aktivitas fisik, hipertensi, dan dislipidemia.
Kesimpulan: Penduduk usia ≥15 tahun di Indonesia dengan obesitas sentral memiliki risiko 1,6 kali lebih besar untuk menderita diabetes melitus dibandingkan penduduk usia ≥15 tahun tanpa obesitas sentral setelah dikontrol oleh usia, jenis kelamin, aktivitas fisik, hipertensi dan dislipidemia. Temuan ini menekankan pentingnya modifikasi gaya hidup melalui pola makan sehat, aktivitas fisik rutin, serta deteksi dini sebagai upaya pencegahan dan pengendalian DM.
Masalah stunting pada anak masih menjadi tantangan serius di Indonesia, termasuk di Kabupaten Pohuwato, Gorontalo. Penelitian ini bertujuan untuk menganalisis pengaruh edukasi Panduan Gizi Seimbang Berbasis Pangan Lokal terhadap perubahan praktik pemberian makan, asupan gizi, status besi, dan status gizi anak baduta. Desain penelitian yang digunakan adalah mixed methods exploratory sequential design, diawali dengan riset formatif kualitatif untuk pengembangan media edukasi, kemudian dilanjutkan dengan kuasi eksperimen dengan pendekatan non-randomized pretest-posttest control group design. Intervensi edukasi dilakukan selama 12 bulan dengan pendekatan komunikasi perubahan perilaku sosial (SBCC) menggunakan modul PGS-PL yang disesuaikan dengan kondisi lokal melalui edukasi intensif, peer educator dan juga demo masak.
Hasil penelitian menunjukkan bahwa edukasi PGS-PL berpengaruh signifikan terhadap peningkatan skor keragaman makanan (DDS) (OR = 1,89; p = 0,048) dan Konsumsi sumber pangan hewani (OR=1,55, p = 0,037), serta peningkatan asupan energi, protein, karbohidrat, lemak, vitamin A, asam folat, zat besi, dan seng (p < 0,05). Namun, tidak ditemukan pengaruh signifikan terhadap kadar serum ferritin dan serum transferrin receptor. Status gizi anak mengalami peningkatan signifikan pada indeks tinggi badan menurut umur (TB/U) sebesar 0,60 z-score (p = 0,007), tetapi tidak signifikan pada indeks berat badan menurut umur (BB/U), dan terdapat penurunan signifikan pada indeks berat badan menurut tinggi badan (BB/TB) (p = 0,034).
Penelitian ini menegaskan bahwa edukasi gizi berbasis pgs-pl dengan pendekatan kombinasi edukasi intensif, peer educator dan demo masak dapat menjadi strategi efektif dalam meningkatkan praktik pemberian makan dan status gizi anak balita di wilayah dengan potensi pangan lokal.
Stunting in children remains a serious public health challenge in Indonesia, including in Pohuwato District, Gorontalo. This study aimed to analyze the effect of nutrition education based on the Local Food-Based Balanced Nutrition Guidelines (PGS-PL) on changes in feeding practices, nutrient intake, besi status, and nutritional status of children aged 6–14 months. The research employed a mixed methods exploratory sequential design, starting with formative qualitative research for the development of educational media, followed by a quasi-experimental study using a non-randomized pretest-posttest control group design. The education intervention was conducted over 12 months using a social and behavior change communication (SBCC) approach, incorporating the PGS-PL module adapted to local conditions through intensive education, peer educators, and cooking demonstrations.
The results showed that PGS-PL education had a significant effect on increasing Dietary Diversity Scores (DDS) (OR = 1.89; p = 0.048) and Egg and/or flesh food (EFF) (OR=1,55, p=0,037), as well as improving the intake of energy, protein, carbohydrates, fat, vitamin A, folic acid, besi, and seng (p < 0.05). However, no significant effect was found on serum ferritin and serum transferrin receptor levels. Children's nutritional status showed a significant improvement in the height-for-age index (HAZ) by 0.60 z-score (p = 0.007), but no significant change was observed in the weight-for-age index (WAZ), and there was a significant decrease in the weight-for-height index (WHZ) (p = 0.034).
This study confirms that nutrition education based on PGS-PL using a combination of intensive education, peer educators, and cooking demonstrations can be an effective strategy for improving feeding practices and the nutritional status of toddlers in areas with local food potential.
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
500 mg with Vitamin E 200 mg to Decrease Oxidative Stress and Increase Antioxidant on Technician Crew Military Aircraft. Oxidative stress is pathological condition body that is caused by imbalance between oxidants with antioxidants body, which produces free radicals that can lead cell damage early. Free radical will bind building blocks cell covering of fat, protein and DNA will result damage cell, so cell can not regenerate that affect onset of degenerative diseases. Technicians crew military aircraft as specialized personnel with activity job direct contact with material oxidant, thus high risk of oxidative stress. Vitamin C and vitamin E are antioxidant enzyme exogen outside body which has role inhibiting oxidative stress, so oxidative stress does not occur. The design study experimental studies with intervention randomized double blind controled trial. Sample size 206 people divided into two groups are intervention group with sample size 103 people are given supplements combination vitamin C 500 mg with vitamin E 200 mg and control group with sample size 103 people are given placebo for 40 days without break. Data collected include are characteristics of respondent, pattern and amount of consumption of vitamin C, vitamin E and nutrient food, derived from food frequecy questionnaire (FFQ) and 24-hour recall, examination of oxidative stress by checking levels malondialdehyde (MDA) and examination of antioxidant by checking levels glutathione (GSH) in blood serum in pre and post intervention. The results showed decrease oxidative stress in group intervention who are received suplement combination vitamin C 500 mg with vitamin E 200 mg compared with control group who are received placebo, are significant with p value 0.04 with effects size -0.089 nmol/mL, confidence interval 95 % (-0.17875 - 0.00095). No increase antioxidants in group intervention who are received supplement combination vitamin C 500 mg with vitamin E 200 mg compared with control group who are received placebo, are not significant with p value 0.81 with effects size -0.019 ug/mL, 95% confidence interval ( -0.140 - 0.180).
