Development of a New Smartphone Application to Increase Dietary Compliance in Patients with Chronic Kidney Disease

Aim: Nutritional therapy in chronic kidney disease (CKD) requires certain regulations in the diet of the patients. Patients’ self-management becomes possible with the development of mobile phones and their software. In the current study, a smartphone application that could be used to increase dietary compliance of CKD stage 4-5 and hemodialysis patients was developed. It is aimed that patients can control the dietary intake of energy, protein, sodium, potassium, phosphorus, and fluid by using the developed mobile application. Subjects and Method: The mobile application has been developed by the researchers until the final control and test phase. Later, the final control and test phase of the developed application were carried out by 5 expert dietitians, 5 specialist doctors, and 5 hemodialysis patients. Results: The majority of the participants stated that the application was easy to use, interesting, visually well designed, contains sufficient reliable information, and that they can recommend it to other patients. Participants who examined the application also offered suggestions about the application. Conclusion: The application was updated according to the evaluations and suggestions of the participants. The final application was formed to be ready for the use of the patients.

Correlation between Noncompliance Behavior and Biochemical Parameters of Chronic Kidney Disease Patients Undergoing Hemodialysis

Background and Objectives Compliance with dietary, fluid, and medication instructions is a critically significant factor for the health and well-being of patients undergoing hemodialysis for an extended period. The current study assessed the correlation between noncompliance behavior and biochemical parameters of chronic kidney disease (CKD) patients undergoing hemodialysis. The study's objectives were 1) to assess patients' noncompliance behavior using a questionnaire, 2) to determine the biochemical parameters of CKD patients having noncompliance behavior, and 3) to find the correlation between biological parameters and noncompliance behavior. Methods A cross-sectional study was conducted from July 12, 2018, to February 10, 2019. A purposive sampling technique was used to recruit the participants, and 100 participants were included in the study. The End-Stage Renal Disease–Adherence Questionnaire was used to assess the non-compliance behavior. Results Most dialysis patients (70%) were compliant with the therapeutic regime, while 30% failed to comply. The study revealed a significant positive correlation between noncompliance behavior and biochemical parameters of CKD patients undergoing hemodialysis (r = 0.578, p < 0.05). Conclusion Noncompliance behavior is significantly correlated with the biochemical parameters among patients with CKD on dialysis. Optimal health is possible through fluid and dietary compliance in these patients. Hence, adherence behavior plays a significant role in the health and recovery of dialysis patients with CKD.

Dietary Compliance and Quality of Life in Celiac Disease: A Long-Term Follow-Up of Primary School Screening-Detected Patients

Background: Whether the diagnostic approach for celiac disease (CD) can really affect quality of life (QoL) and dietary compliance remains controversial.Aims: This study aimed to evaluate QoL and compliance to gluten-free diet (GFD) in adolescents/young adults diagnosed with CD through a screening strategy during childhood compared to age-matched CD patients diagnosed by case-finding and to assess whether follow-up at a referral center for CD influences compliance and QoL.Materials and Methods: Thirty-seven CD patients who were diagnosed by screening programs (SC-group) and 38 age-matched CD patients diagnosed due to symptoms (CF-group) were enrolled. Patients were asked to answer a questionnaire on QoL, dietary compliance, and follow-up care for CD.Results: Twenty-nine patients of the SC-group (median age 18.0 years, interquartile range [IQR] 16.0–19.0) and 31 patients of the CF-group (median age 17.0 years, IQR 15.5–18.0) completed the questionnaire. No significant difference relating adherence to the GFD and QoL was shown between the two groups. The majority (93.5%) of CF-group regularly had annual follow-up at a referral center compared to 37.9% of the SC-group (p &lt; 0.001).Conclusion: The diagnostic strategy does not seem to impact QoL and dietary compliance. However, implementation of follow-up might still be necessary for patients identified through screening.

Penerapan Pendidikan Kesehatan Diet Dengan Kepatuhan Pasien Diabetes Milletus Dilihat Dari 3 J

Diabetes mellitus control can be in the form of insulin injection, diet, exercise, and medication. Health education can also be provide to improve the knowledge and skills of people with diabetes in controlling their blood sugar. This study aims to find out how the level of knowledge and level of adherence to the diet carried out by DM sufferers is seen from the 3J (schedule, amount, and type of food). The design used in this study was a case study on 2 patients with type 2 diabetes mellitus. The instrument of this research was a questionnaire on the level of adherence to the 3J diet, a questionnaire on the level of adherence. The patient’s knowledge before and after the intervention were compared. Their dietary adherence after the intervention were also observed. The results obtained before the intervention the knowledge value of the two respondents were 60 and 53. After the intervention, the knowledge level of the two respondents became 80 and the average results of the adherence level observation of the two respondents were 86 and 84. Based on the observation data, the result of the level of dietary compliance in both clients considered complaint with the diet program. It can be concluded that health education about the 3J diet can increase the level of knowledge and dietary compliance in people with diabetes mellitus. This result can be used as a consideration for the health workers to recommend and educate DM patiens and their families to carry out implement an agreed diet program such as the 3J diet program.Keywords: Diabetes melltus, Diet, Compliance, Health education AbstrakPengendalian diabetes mellitus dapat berupa injeksi insulin, pengaturan diet, olahraga dan obat-obatan. Untuk meningkatkan pengetahuan dan keterampilan diabetisi dalam pengendalian gula darah dapat dilakukan pemberian pendidikan kesehatan. Penelitian ini bertujuan untuk mengetahui bagaimana tingkat pengetahuan dan tingkat kepatuhan akan diet yang dijalankan oleh penderita DM dilihat dari 3 J (jadwal, jumlah dan jenis makanan). Desain karya tulis ilmiah ini berupa studi kasus pada 2 penderita diabetes mellitus tipe 2. Instrument penelitian ini berupa kuesioner tingkat kepatuhan diet 3J, kuesioner tingkat pengetahuan tentang diet diabetes mellitus dan lembar observasi tingkat kepatuhan. Cara mengevaluasi dengan membandingkan nilai pengetahuan sebelum dan sesudah intervensi dan observasi nilai kepatuhan diet sesudah intervensi. Hasil yang didapat sebelum dilakukan intervensi nilai pengetahuan kedua responden adalah 60 dan 53. Setelah dilakukan intervensi nilai tingkat pengetahuan kedua responden menjadi 80 dan hasil observasi tingkat kepatuhan kedua responden rata-rata 86 dan 84. Berdasarkan data observasi didapatkan hasil tingkat kepatuhan diet pada kedua klien dianggap patuh terhadap program diet yang dilakukan. Kesimpulannya adalah pendidikan kesehatan tentang diet 3J dapat meningkatkan tingkat pengetahuan dan kepatuhan diet pada penderita diabetes mellitus. Saran bagi tenaga kesehatan hendaknya menganjurkan dan mengedukasi penderita DM dan keluarganya untuk melakukan dan melaksanakan program diet yang sudah disepakati seperti program diet 3J.Kata kunci: diabetes mellitus, diet, kepatuhan, pendidikan kesehatan

Gambaran Dukungan Keluarga Dan Kepatuhan Diet Pada Pasien Diabetes Mellitus Tipe 2: Literature Review

Diabetes mellitus is a chronic disease that is closely related to lifestyle. This disease is exprienced by many people in the world. The family has to provide support that can have a positive impact on dietary complience. It can be in the form of being able to control what can be consumed according to the recommendations of health workers during the diet, reminding each other, and providing support to family members who are on a diabetes mellitus diet. To determine the description of family support and dietary complience in patients with type 2 diabetes mellitus. The research method used in this study was a literature review by conducting an online searh from the Medline database source and the Garuda portal. There were 5 articles found that matched the inclusion and exclusion criteria. The results showed that 361 respondents (52,7%) had good family support and 432 respondents (63%) had non-adherent dietary compliance levels. Good family support can prevent complications and help treatment so that patients are more enthusiastic and can carry out activites as usual. Dietary non-compliance can delay the patient’s recovery. Familly support, although it is good, does not guarantee that dietary complience will also be good. Other factors can affect dietary complience, such as age, education, and occupation.Keywords: Type 2 diabetes mellitus; family suppor; dietary complience AbstrakDiabetes mellitus merupakan penyakit kronis yang berhubungan erat dengan pola hidup, penyakit ini banyak dialami oleh penduduk di dunia. Keterlibatan keluarga merupakan langkah yang harus ditempuh untuk memberikan dukungan yang dapat berdampak positif terhadap kepatuhan diet. Dampak positif dukungan keluarga terhadap kepatuhan diet adalah dapat mengontrol apa saja yang dapat dikonsumsi sesuai anjuran tenaga kesehatan selama diet, saling mengingatkan, serta memberikan support kepada anggota keluarga yang sedang menjalankan diet diabetes mellitus. Untuk mengetahui gambaran dukungan keluarga dan kepatuhan diet pada pasien diabetes mellitus tipe 2. Metode penelitian yang digunakan dalam penelitian ini yaitu literature review dengan melakukan penelusuran online dari sumber database medline dan portal garuda didapatkan 5 artikel yang sesuai kriteria inklusi dan ekslusi. Hasil penelitian menunjukkan sebanyak 361 responden (52,7%) memiliki dukungan keluarga baik dan 432 responden (63%) memiliki tingkat kepatuhan diet tidak patuh. Dukungan keluarga baik dapat mencegah terjadinya komplikasi serta membantu pengobatan sehingga pasien lebih semangat dan dapat melakukan aktivitas seperti biasa. Ketidakpatuhan diet dapat memperlampat penyembuhan pasien. Walaupun dukungan keluarga baik, tidak menjamin kepatuhan diet akan baik, karena terdapat faktor lain yang mempengaruhi kepatuhan diet yaitu seperti usia, pendidikan, dan pekerjaan.Kata Kunci: Diabetes mellitus tipe 2; dukungan keluarga; kepatuhan diet

Analysis of Family Duty with Diet Compliance in Mellitus Diabetes Patients in the Working Area of Dinas Kesehatan, Jayawijaya District

Non-Communicable Diseases (PTM) has become a serious health problem in the community. One PTM that has received a lot of attention is Diabetes Mellitus (DM) which occurs when the body cannot produce enough of the hormone insulin or cannot use insulin effectively. The aim of this study was to analyze the relationship between family support tasks and dietary adherence in Diabetes Mellitus patients in Jayawijaya District Health Office. The type of research used is survey research with explanatory research methods. The population in this study were 145 diabetes mellitus patients treated at the Jayawijaya District Health Office. The sample of this study were patients with militus diabetes who underwent treatment at the Jayawijaya District Health Office who met the sample criteria of 58 people. The sampling technique used in this research is purposive sampling technique. Based on the results of the study there is a relationship between family duties and dietary compliance in diabetus mellitus patients using spearman correlation calculations of 0.000 < 0.05 in addition to data obtained as many as 38 (65.5% ) respondents from 43 respondents of family duties are good and obedient to the diet diabetus mellitus, while from 13 respondents with family duties are quite obtained data as many as 7 respondents (12.1%) disobedient. And from 2 respondents with family duties, less data was obtained by 2 respondents (3.4%) disobedient. Based on the results of the research, it is hoped that further communication, information, and education (IEC) will improve regarding the dietary needs of diabetes mellitus.

Efficacy of Phenylalanine- and Tyrosine-Restricted Diet in Alkaptonuria Patients on Nitisinone Treatment: Case Series and Review of Literature

<b><i>Introduction:</i></b> Nitisinone used in alkaptonuria (AKU) can result in keratopathy due to strongly increased tyrosine levels. <b><i>Methods:</i></b> This study aimed to investigate nutritional status and changes in plasma tyrosine and phenylalanine and urinary homogentisic acid (u-HGA) levels in 8 adult AKU patients (mean age, 56.3 ± 4.7 years) who were on tyrosine/phenylalanine-restricted diet together with 2 mg/day nitisinone. <b><i>Results:</i></b> The treatment period was 23.4 ± 6.9 months. Daily dietary protein intake was restricted to 0.8–1.0 g/kg/day. Daily tyrosine intake was restricted to 260–450 mg/day for females and 330–550 mg/day for males. Tyrosine/phenylalanine-free amino acid supplements accounted for an average of 56.1% of daily protein intake. The following assessments were performed: anthropometric and plasma tyrosine level measurements every 2 months; ophthalmological examination every 6 months, and nutritional laboratory analyses and measurements of plasma amino acids and u-HGA once in a year. It was targeted to keep the plasma tyrosine level &#x3c;500 μmol/L. The plasma tyrosine level was &#x3c;100 μmol/L before the treatment in all patients and around a mean of 582.5 ± 194.8 μmol/L during the treatment. The diet was rearranged if a plasma tyrosine level of &#x3e;700 μmol/L was detected. The u-HGA level before and after the 1st year of treatment was 1,429.3 ± 1,073.4 mmol/mol creatinine and 33.6 ± 9.5 mmol/mol creatinine, respectively. None of the patients developed keratopathy or experienced weight loss and protein or micronutrient deficiency. <b><i>Conclusion:</i></b> AKU patients should receive tyrosine/phenylalanine-restricted diet for reducing plasma tyrosine level to the safe range. Tyrosine/phenylalanine-free amino acid supplements can be safely used to enhance dietary compliance. Keratopathy and nutrient deficiency should be frequently monitored.

Diet Compliance, Blood Glucose Levels, and Hospitalization Duration of Type II Diabetes Mellitus Patients with Hypertension Complications in the Pancaran Kasih General Hospital, Manado

BACKGROUD: Diabetes mellitus is an assembly of symptoms that arise in a person caused by increased blood sugar levels due to insulin deficiency, both absolute and relative. The highest prevalence in North Sulawesi is in Tomohon City (4.8%) then Manado City (3.2%). AIM: This study aimed to determine the correlation between dietary compliance with blood glucose levels and duration of hospitalization of type 2 diabetes mellitus (T2DM) patients with hypertension complications in the Pancaran Kasih General Hospital, Manado. METHOD: This research was observational with a cross-sectional design. The population in this study were all patients with type 2 diabetes who were hospitalized and 34 people involved as a sample through purposive sampling technique. RESULTS: The results showed that 88.2% of respondents with not normal blood glucose did not adhere to the diet. Fisher’s test obtained p = 0.011 (p < 0.05), indicated a significant correlation between dietary compliance with blood glucose levels. About 82.4% of patients did not adhere to the diet with a long day of hospitalization and p = 0.027 (p < 0.05). It indicated a significant correlation between dietary compliance and length of stay. CONCLUSION: This study concluded a correlation between dietary compliance with blood glucose levels and dietary compliance and length of stay for T2DM patients with hypertension complications.

The Relationship between Patient Motivations with Dietary Compliance in Patients Diabetes Mellitus at Haruai Health Center

One of the risk factors that affect the increase in blood sugar levels in diabetes mellitus is an irregular diet. To prevent this, it is necessary to comply with the diet. In order for patients to comply with diet therapy, self-motivation and external motivation are needed. To determine patient motivation, level of dietary compliance and the correlation between patient motivation and dietary compliance in diabetes mellitus patients at community Haruai.This study used a cross sectional approach. The sample technique was taken 25% of the total population by purposive sampling method, the sample size was 43. The results of this study indicated based on Sperman Rank (Rho) analysis there was a correlation between patient motivation and dietary compliance in diabetes mellitus patients at community Health Center Haruai with a p value of 0,000. There is a positive correlation between motivation and dietary compliance in diabetes mellitus patients, which means that the better the motivation of the patient, the better the dietary compliance is in the diabetes mellitus patient and both have a strong correlation.