Abstract

Diabetes melitus adalah penyakit yang menyebabkan morbiditas dan mortalitas di dunia. Hubungan antara diabetes melitus dengan obesitas telah diketahui, tetapi peran distribusi pada daerah abdominal belum sepenuhnya dijelaskan. Tujuan penelitian ini untuk mengetahui pengaruh pemberian edukasi kesehatan terhadap perubahan lingkar pinggang pada pasien diabetes melitus tipe 2. Penelitian ini merupakan studi eksperimental dengan satu kelompok desain pretest-posttest di Surabaya pada bulan Juni - Juli 2013, dan melibatkan 31 subjek yang diberi program edukasi kesehatan selama 1 bulan yang dibagi dalam 4 pertemuan. Data dari pretest dan posttest dikumpulkan dan dianalisis dengan metode wilcoxon signed rank test pada data yang tidak normal (p > 0,05). Hasil penelitian menunjukkan peningkatan pengetahuan dan perilaku pasien serta mengurangi besar lingkar pinggang pasien secara signifikan (p < 0,05). Lingkar pinggang mulai menunjukan perbedaan signifikan pada minggu ketiga edukasi (Z = 12,93; P = 0,003) dibandingkan pretest. Penurunan lingkar pinggang antara posttest dan pretest sebesar 0,94 cm (minggu ke-4) dan 1,68 (4 bulan kemudian). Oleh karena itu, edukasi kesehatan memiliki manfaat dalam meningkatkan self-monitoring diabetes melitus yang dapat mengurangi lingkar pinggang yang berguna untuk mengurangi risiko komplikasi. Diabetes mellitus is a disease that causes morbidity and mortality in the world. Association of diabetes mellitus with obesity are well known, but the role of distribution in the abdominal area has not been fully elucidated. The aim of this study was to determine the relationship of giving education to change waist circumference in type 2 diabetes mellitus. This study is an experimental with one group pretest-posttest design in Surabaya, from June July 2013, and involving 31 subjects whom were given health education program for 1 month which are divided in 4 meetings in Surabaya University. Data from the pretest and posttest were collected and analyzed with the Wilcoxon signed rank test method on the data that isn’t normal (p > 0.05). The results showed an increase in knowledge and behavior of patients and reduced significantly the size of the waist circumference (p <0.05). Waist circumference began to show a significant difference in the third week of education (Z = 12.93, P = 0.003) compared to the pretest. The decrease in waist circumferences between the pretest and posttest were 0.94 cm (week 4) and 1.68 (4 months later). Therefore, health education has benefits in increasing self-monitoring of diabetes mellitus that can reduce waist circumference are useful for reducing the risk of complications.

References

1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for 2000 and projections for 2030. Diabetes Care. 2004; 27(5): 1047-53. 2. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2011; 34(1): S11-61. 3. Trbovic MS, Strajtenberger T, Sekerija M. Standardized educational program in persons, with type 2 diabetes on oral hypoglycemic therapy: effects on glycemic control and body mass index. Diabetologia Croatica. 2011; 40(2): 35-40. 4. Klein SM, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, et al. Waist circumference and cardiometabolic risk: a consensus statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association. American Journal of Clinical Nutrition. 2007; 85(5): 1197-202. 5. Huang LH, Liao YL, Hsu CH. Waist circumference is a better predictor than body mass index of insulin resistance in type 2 diabetes. Obesity Research and Clinical Practice. 2012; 6(4): e314-e320. 6. Janiszewski PM, Janssen I, Ross R. Does waist circumference predict diabetes and cardiovascular disease beyond commonly evaluated cardiometabolic risk factors? Diabetes Care. 2007; 30(12): 3105-9. 7. Lam KT, Carpentier A, Lewis GF, van de Werve G, Fantus IG, Giacca A. Mechanisms of the free fatty acid-induced increase in hepatic glucose production. American Journal of Physiology Endocrinology and Metabolism. 2003; 284(5): E863-73. 8. National Heart Lung and Blood Institute. Assessing your weight and health risk: waist circumference. 2011 [cited 2012 Jan 1]. Available from: http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/-risk.htm. 9. Maljani A. Waist circumference, body mass index, hip circumference and waist-to-hip ratio in type 2 diabetes patients in Gorgan, Iran. Journal of Clinical and Diagnostic Research. 2011; 5(2): 201-5. 10. Kasiulevicius V, Sapoka V, Filipaviciute R. Sample size calculation in epidemiological studies. Gerontologija. 2006; 7(4): 225–31. 11. Abdo NM, Mohamed ME. Effectiveness of health education program for type 2 diabetes mellitus patients attending Zagazig University Diabetes Clinic, Egypt. Journal of Egypt Public Health Association. 2010; 85(3-4): 113-30. 12. World Health Organization. Waist circumference and waist–hip ratio: report of a WHO expert consultation [manuscript in internet]. Geneva, Switzerland. 2008 [cited 2012 Jan 1]. Available from: http://whqlibdoc. who.int/publications/2011/9789241501491_eng.pdf. 13. Balkau B, Deanfield JE, Haffner SM. International day for the evaluation of abdominal obesity (IDEA): a study of waist circumference, cardiovascular disease and diabetes in 168,000 primary care patients in 63 countries. Circulation. 2007; 116(17): 1942-51. 14. Warren TY, Wilcox S, Dowda M, Baruth M. Independent association of waist circumference with hypertension and diabetes in African American Women, South Carolina, 2007–2009. CDC, Preventing Chronic Disease. 2012; 9: E105. 15. Hajer GR, Van Haeften TW, Visseren FL. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. European Heart Journal. 2008; 29(24): 2959–71. 16. Coker RH, Williams RH, Evans WJ. Influence of exercise intensity on abdominal, metabolic syndrome and related disorders. Metabolic Syndrome and Related Disorder. 2009; 7(4): 363-68. 17. Church TS, Martin CK, Thomson AM, Earnest CP, Mikus CR, Blair SN. Changes in weight, waist circumference andcompensatory responses with different doses of exercise among sedentary, overweight postmenopausal women. Plos One. 2009; 4(2): e4515.

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