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Abstrak: Insulin resistance (IR) and pancreatic β-cell dysfunction lead to type 2 diabetes mellitus (DM). We tested whether risk factors would differ for DM that was preceded predominantly by IR, β-cell dysfunction, or both among 4,384 older adults (mean age, 72.7 (standard deviation, 5.6) years) in the Cardiovascular Health Study, which was conducted in North Carolina, California, Maryland, and Pennsylvania (1989-2007). When evaluating established risk factors, we found older age, greater adiposity, higher systolic blood pressure, a lower high-density lipoprotein cholesterol level, a higher triglyceride level, and a lower alcohol intake to be independently associated with greater IR but, conversely, with better β-cell function (P < 0.001). The prospective associations between some risk factors and incident DM varied significantly depending on whether DM was preceded predominantly by IR, β-cell dysfunction, or both. For example, obesity and lower high-density lipoprotein cholesterol levels were positively associated with DM preceded predominantly by IR (hazard ratio (HR) = 5.02, 95% confidence interval (CI): 2.81, 9.00; and HR = 1.97, 95% CI: 1.32, 2.93, respectively), with a significant association with and an insignificant trend toward a lower risk of DM preceded predominantly by β-cell dysfunction (HR = 0.33, 95% CI: 0.14, 0.80; and HR = 0.78, 95% CI: 0.43, 1.39, respectively). In conclusion, among older adults, DM risk factors were differentially associated with DM preceded predominantly by IR or β-cell dysfunction. Biologic and clinical implications of putative subtypes of DM require further investigation.

Abstrak: Faktor yang berhubungan dengan pasien berkontribusi terhadap meningkatnya prevalensi resistensi antibiotik. Hal tersebut menuntut dilakukan suatu upaya peringatan akan bahaya resistensi antibiotik. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berpengaruh terhadap respon penerimaan pesan gambar peringatan bahaya resistensi antibiotik yang dikembangkan dari Extended Parallel Process Model (EPPM). 3 buah gambar peringatan yang berisi tentang resistensi antibiotik dapat menyebabkan kematian, makin lamanya penyembuhan luka operasi, dan hari perawatan di rumah sakit yang bertambah lama dipilih untuk diteliti, dan dengan desain potong lintang yang digunakan untuk melihat pengaruh faktor usia, jenis kelamin, pendidikan dan pekerjaan terhadap respon penerimaan pesan dari ketiga gambar tersebut pada 402 orang responden. Hasil yang diperoleh adalah ketiga gambar tersebut menghasilkan komponen ancaman yang tinggi dan komponen efikasi yang tinggi pula. Respon penerimaan pesan yang dihasilkan adalah baik, sehingga dianggap efektif menyampaikan informasi mengenai bahaya resistensi antibiotik kepada masyarakat. Gambar peringatan mengenai bahaya resistensi antibiotik dapat mengakibatkan makin lamanya penyembuhan luka operasi menjadi gambar yang paling efektif dibanding gambar peringatan lainnya. Faktor yang meningkatkan respon penerimaan pesan yang baik mengenai bahaya resistensi antibiotik adalah kelompok usia dewasa awal, jenis kelamin perempuan, pendidikan tinggi dan yang tidak bekerja. Kata Kunci: gambar peringatan, resistensi antibiotik, EPPM, ancaman, efikasi. Patient-related factors contribute to the increased prevalence of antibiotic resistance. It requires an attempt to warn of the dangers of antibiotic resistance. This study aims to analyze the factors that influence the response of receiving the antibiotic resistance warning picture message developed from the Extended Parallel Process Model (EPPM). 3 warning images containing antibiotic resistance can cause death, increasing length of wound healing, and lengthy hospitalization days selected for study, and with cross-sectional design used to examine the effect of age, sex, education and work on the response of receiving messages from these three images on 402 respondents. The results obtained are the three images produce high threat components and high efficacy components as well. The response of received messages generated is good, so it is considered effective to convey information about the danger of antibiotic resistance to the community. A warning picture of the dangers of antibiotic resistance may result in the longer duration of surgical wound healing being the most effective image than any other warning image. Factors that improve the response of good messages about the dangers of antibiotic resistance are the early adult age group, female gender, college education and non-working. Keywords: pictorial warning, antibiotic resistance, EPPM, threat, efficacy