REVIEW OF POTENTIAL PLANTS IN INDONESIA AS AN ANTIDIABETIC WITH HYPOGLYCEMIC ACTIVITIES

Background: Diabetes mellitus which is characterized by hyperglycemia is a metabolic disease due to insulin action, defects in insulin secretion, or both. Various studies have shown that herbs that have a hypoglycemic effect can be used in the treatment of diabetes mellitus. Generally, herbs can slow down the complications of diabetes mellitus and improve metabolism. The ability of plants to restore the function of pancreatic tissue to increase insulin production or make it easier for insulin to process glucose is related to the effects of hypoglycemia. Objective: Comparing plants that have a hypoglycemic activity that can be used in the treatment of diabetes mellitus in Indonesia. Methods: studying literature from various databases, websites, national journals, and relevant international journals to identify plants that have hypoglycemic activity. Results: The mechanism A. sativum as a hypoglycemic involves different fiber viscosities; A. vera involved as a hypoglycemic by protecting pancreatic? cells; Asiatic acid in C. asiatica increasing glycolysis by restoring the activity of key enzymes; G. max inhibiting ?-amylase and the stigmasterol increasing the absorption of blood glucose and reducing insulin resistance; P. macrocarpa exert their antidiabetic action via ?-glucosidase modulation, an extra distinctive pancreatic mechanism; S. arvensis has the potential to inhibit ?-amylase enzymes. Conclusions: This review article has presented 6 detailed comparisons of plants that have a hypoglycemic activity that can be used in the treatment of diabetes mellitus in Indonesia and we believe can be useful for students, researchers, or practitioners. Keywords: Diabetes mellitus, hypoglycemia, Indonesian plants

Effectiveness of Valsartan in Obese Versus Non-Obese Type 2 Diabetic patients presented with microalbuminuria

Aim: To ascertain efficacy of Valsartan, an angiotensin receptor blocker (ARB) in reducing microalbuminuria in obese verses non obese patients. Methods: This comparative study was done in Department of Nephrology Pakistan Institute of Medical Sciences Islamabad from July 1, 2018 to December 31, 1018. Patients fulfilling selection criteria were enrolled and categorized as two groups obese & non-obese; both groups were given valsartan. Urine ACR and serum creatinine was followed every month for 6 months. Results: Average age of all cases as 52.06 ± 4.11 years while the mean age in obese and non-obese cases was 52.48 ± 4.25 years and 51.63 ± 3.95 years, respectively. The mean change in Urine ACR (from baseline to 6th months) in obese cases was 41.76 ± 25.81 and non-obese cases was 76.05 ± 7.63, p-value <0.001. In obese cases mean urine ACR at 1st and 2nd month was same from baseline, p-value > 0.05 while at 3rd, 4th month was statistically lower as compare to baseline urine ACR, p-value < 0.05. Moreover, in non-obese cases the mean urine ACR was statistically decreased at 1st, 2nd, 3rd, 4th, 5th and 6th month when compared with baseline, p-value < 0.001. At 4th month in obese cases none of the cases achieved ACR < 30 while in non-obese cases 4(7.4%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.05. At 4th month in obese cases 12(22.2%) cases achieved ACR < 30 while in non-obese cases 31(57.4%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.001. At 6th month in obese cases 20(37%) cases achieved ACR < 30 while in non-obese cases 41(75.9%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.001. Conclusion: Valsartan is more effective in reducing microalbuminuria in non-obese patients as compared to obese patients. Keywords: Diabetes mellitus, obesity, microalbuminuria, Valsartan

Mechanisms of Action of Flavonoids in the Management of Diabetes mellitus

Management of diabetes mellitus is a challenge for clinicians. Uncontrolled hyperglycemia increases the risk of microvascular and macrovascular complications, damaging the body systems. Although a number of antidiabetic drugs are available for therapeutic intervention, toxicity, loss of efficacy in chronic use and high cost of treatment have necessitated the search for new molecules to manage diabetes. Safety and cost are the main prerequisite for the new antidiabetic molecules. Medicinal plants and their purified phytochemicals have shown promising antidiabetic potential in the past few years. The flavonoids can be widely classified into different categories like anthocyanins, catechins, flavanols, flavones, flavanones etc. Some flavonoids have hypoglycemic properties. They may improve al-tered glucose and oxidative metabolisms of diabetic states. The hypoglycemic effect of some herbal extracts has been confirmed in human and animal models of type 2 diabetes mellitus (T2DM). Some of the important phytoconstituents from the classes of flavonoid have been discussed here. The current review summarizes the antidiabetic activity of flavonoids, the mechanism-based action of flavonoids that target the various metabolic pathways in humans. Keywords: Diabetes mellitus, Flavonoids, Medicinal plants, mechanisms of action, T2DM

Is lack of patient knowledge a cause of poorly controlled diabetes mellitus?

Background: Diabetes is a chronic debilitating disease. A large percentage of Pakistani population suffers from this disease and its consequences. Awareness regarding the disease and its management is poor. Aim: To evaluate the awareness of diabetic patients presenting at Services Hospital regarding diabetes. Study design: Observational cross-sectional case-series study. Settings & duration: Department of medicine Services hospital, Lahore, from 01-07-2020 to 31-12- 2020. Methodology: We interviewed 100 diabetic patients who presented to the OPD/ER of the hospital. All the participants were selected randomly. A simple questionnaire was used to record the demographic details of the patients as well as their response to a series of 13 questions. The knowledge of the participants was taken to be good if they were able to answer at least 8 or more of the questions correctly. Results: Overall, a total of 100 adults were interviewed. The median age of the study population was 52.06 years with standard deviation of 13.49 years. There were 46 females and 54 males. Only 30% of the patients had sufficient knowledge regarding the disease and its complications. When stratification was done there was no significant association with any variable. Conclusion: There is a lack of knowledge among the diabetes regarding their disease. Even education from doctors is not helpful in this regard. Once patients are aware of the disease and its complications the glycemic control improves markedly. Keywords: Diabetes Mellitus, Poor Control, Patient Knowledge

To Determine the Frequency of Congenital Heart Disease in Infants of Diabetic Mothers

Aim: To determine the frequency of Congenital Heart Disease in infants of diabetic mother. Methodology: Cross sectional (Descriptive) study conducted in the Department of Pediatrics Special Care Baby Unit (SCBU) Khyber Teaching Hospital Peshawar from 15-04-2015 to 15-10-2015. The sample size was150 patients, using 52.5% incidence of CHD in IDM and 95% confidence interval with 8% margin of error under WHO software Results: This study was carried out on 150 patients at the Department of Pediatrics, Khyber Teaching Hospital Peshawar. CHD was detected in 79 (52.7%) patients while in 71 (47.33%) patients, CHD was not detected. Conclusion: Our study concluded moderate prevalence of Congenital Heart Disease in infants born to diabetic mothers. Keywords: Diabetes mellitus, Pregnancy, Newborn, Heart defects

EDUKASI PENGATURAN DIET DIABETES MELLITUS (DM) PADA PENYANDANG DM SELAMA MENJALANI PUASA RAMADHAN

ABSTRAKPengaturan diet DM sebagai salah satu pilar penatalaksanaan DM masih menjadi masalah sehingga memerlukan edukasi lebih lanjut bagi para penyandang DM di wilayah kerja puskesmas Tanjung Karang Kota Mataram terutama di bulan puasa. Pengaturan diet sangatlah penting sehingga glukosa darah penyandang DM tetap terkontrol pada batas normal. Tujuan kegiatan pengabdian ini adalah untuk meningkatkan pemahaman penyandang DM dalam mengatur diet dibulan puasa sehingga meminimalisir timbulnya berbagai komplikasi akibat ketidakstabilan glukosa darah, meningkatkan kualitas hidup dan dapat menjalankan puasa dengan lancar. Pengabdian kepada masyarakat ini dilakukan dengan metode ceramah dan diskusi. Kegiatan yang dilakukan berupa pre-test, pemberian edukasi serta post-test pengetahuan tentang diet saat menjalankan puasa pada penyandang DM. Dari 30 orang penyandang DM yang mengikuti kegiatan ini didapatkan pengetahuan sebelum diberikan edukasi dengan kategori baik 10%, cukup sebanyak 40% dan kurang sebanyak 50% dan setelah diberikan edukasi terjadi peningkatan pengetahuan dengan kategori baik sebanyak 67% dan cukup 33%. Dengan demikian dapat disimpulkan terjadi peningkatan pengetahuan terkait pengaturan diet pada penyandang DM melalui edukasi yang baik sehingga bisa diterapkan dalam kehidupan sehari-hari. Kata kunci: diabetes mellitus; diet; puasa; edukasi. ABSTRACTThe regulation of the DM’ diet as one of the pillars of DM management is still a problem so it requires further education for people with DM in the working area of the Tanjung Karang Public Health Center, Mataram City, especially during the fasting month. Dietary regulation is very important so that the blood glucose of people with diabetes remains controlled at normal limits. The purpose of this service activity is to increase the understanding of people with diabetes in regulating diet in the month of fasting so as to minimize the emergence of various complications due to blood glucose instability, improve quality of life and be able to carry out fasting smoothly. This community service is carried out using lecture and discussion methods. Activities carried out in the form of pre-test, providing education and post-test knowledge about diet when fasting for people with DM. Of the 30 people with DM who took part in this activity, knowledge was obtained before being given education in the good category of 10%, sufficient as much as 40% and less as much as 50% and after being given education there was an increase in knowledge in the good category as much as 67% and enough 33%. Thus, it can be concluded that there is an increase in knowledge related to diet management in people with DM through good education so that it can be applied in everyday life. Keywords: diabetes mellitus; diet; fasting; education.

Genetic counseling program for patient with hyperglycemic syndrome

Diabetes melitus merupakan sekelompok kelainan heterogen yang ditandai dengan hiperglikemia. Bahkan, diabetes termasuk penyakit yang dapat terjadi karena faktor genetik. Semakin lama menderita diabetes, maka akan memperburuk kualitas hidupnya. Intervensi yang dapat digunakan untuk meningkatkan kualitas hidup penderita dengan melakukan genetic counseling, Hanya saja, intervensi ini masih jarang diimplementasikan. Oleh karena itu, penelitian ini bertujuan untuk menilai pengaruh genetic counseling terhadap kualitas hidup pada penderita Diabetes Melitus. Penelitian ini mengguanakan desain Quasi-Experimental Without Control Group dengan desain pretest and posttest. Sampel yang digunakan sejumlah sebanyak 38 orang, pengumpulan data dilakukan dengan pengisian kuesioner kualitas hidup (SF-36). Uji Paired-Sample T Test digunakan untuk uji hipotesis. Genetic counseling memiliki pengaruh terhadap kualitas hidup partisipan (p < 0.05). Treatment ini perlu dilakukan dalam praktek keperawatan sehari-hari karena terdapat benefits ke kualitas hidup pasien diabetes. Keywords: diabetes; genetic counseling; intervensi keperawatan; kualitas hidup

ROLE OF VIRECHANA IN THE EFFECTIVE MANAGEMENT OF DIABETES MELLITUS W.S.R. TO PRAMEHA - A CASE STUDY

Diabetes Mellitus refers to a group of common metabolic disorders that share the phenotype of hyperglycemias. Depending upon factors contributing to hyperglycemia include reduced insulin secretion, glucose utilization and increased glucose production. Diabetes mellitus is now become most common among all diseases in the present era. In India, this is increasing rapidly and seems that India is going to be capital of Diabetes Mellitus in next coming years. According to Ayurvedic texts, Acharya Charaka has explained about Prameha which can be com- pared with Diabetes Mellitus. The main symptom of Prameha is ‘Prabhuta Aavila Mutrata. Tridosha dushti in Prameha progressively leads to affect Rasa, Meda, Shukra, Ambu, Lasika, Majja and Oja. All these affected Dosha and Dushya influence Basti and manifest the symptom like ‘Prabhuta Avila Mutrata’. Virechana was giv- en in this case because Acharya Charak has mentioned dushti of Kapha, Pitta and Vata is present in Prameha. Phalashruti of Virechana says that there is elimination of Dosha in the sequence of Vit (mala), Pitta, Kapha, Anil. Hence role of Virechana is important in the Chikitsa of Prameha. Keywords: Diabetes Mellitus, Prameha, Samshodhan, Virechan.

Deteksi Dini Faktor Resiko Diabetes Melitus Di Dusun Kalangan Kecamatan Sawangan Kabupaten Magelang

One of the subdistricts in Magelang regency which has a problem with the Diabetes Mellitus Disease in the Sawangan District, especially in the area of Sawangan Public Health Center, namely Kalangan, Gondowangi Village. So as the resolve this problem must be done various efforts of early detection in solve the problem of Diabetes Mellitus. One of the solutions to solve this problem is the dissemination as early detection and utilization of Diabetes Mellitus herbal plants. With the socialization and utilization of herbal medicinal plants on Diabetes Mellitus, it is expected that the community can pay attention to healthy lifestyles in the future, reduce the incidence of Diabetes Mellitus in the community and can take advantage of herbal treatments around the house so that people are not dependent on chemical or synthetic treatments that have side effects in the body. Keywords: diabetes mellitus; early detection; herbal medicinal plants Abstrak: Salah satu Kecamatan yang ada di Kabupaten Magelang yang terdapat masalah Diabetes Mellitus yaitu Kecamatan Sawangan khususnya di wilayah kerja Puskemas Sawangan II yaitu Dusun Kalangan desa Gondowangi. Sehingga untuk mengatasi hal tersebut harus di lakukan berbagai upaya Deteksi Dini dalam mengatasi masalah Diabetes Mellitus. Salah satu dalam mengatasi masalah tersebut di lakukan sosialisasi sebagai bagian deteksi dini Diabetes Mellitus dan pemanfaatan tanaman herbal Diabetes Melitus. Dengan di adakannya sosialisasi dan pemanfaatan tanaman obat keluarga (TOGA) tentang Diabetes Melitus di harapkan mayarakat kedepannya dapat memperhatikan pola hidup sehat, mengurangi kejadian penyakit Diabetes Melitus di masyarakat dan dapat memanfaatkan pengobatan herbal di sekitar rumah agar masyarakat tidak ketergantungan dengan pengobatan kimia atau sintetik yang mempunyai efek samping dalam tubuh. Kata kunci: deteksi dini; diabetes mellitus; tanaman obat keluarga

Perubahan Kualitas Tidur Ibu Hamil Trimester III Melalui Pregnancy Massage

This study aims to determine the factors that affect dietary compliance in patients with type II diabetes mellitus, including family support, knowledge, income, and nutritional counseling. The research method used in this study is cross-sectional. This study indicates a relationship between family support, understanding, revenue, and nutritional counseling on dietary compliance in older people with type II diabetes Mellitus in 2019 in a district in Jambi. In conclusion, there is a relationship between family support, knowledge, income, and nutritional counseling on dietary compliance in older people with type II diabetes Mellitus. Keywords: Diabetes Mellitus, Family Support, Knowledge, Nutrition Counseling