Penurunan Kadar Glukosa Darah pada Pasien Diabetes Melitus Tipe 2 dengan Penerapan Latihan Berjalan Kaki

Roni Sianturi(1*), Akhmad Mustofa(2), Chanif Chanif(3), Khoiriyah Khoiriyah(4)


(1) Program Studi Pendidikan Profesi Ners, Fakultas Ilmu Keperawatan dan Kesehatan, Universitas Muhammadiyah Semarang
(2) Universitas Muhammadiyah Semarang
(3) Universitas Muhammadiyah Semarang
(4) Universitas Muhammadiyah Semarang
(*) Corresponding Author

Abstract


Kondisi hiperglikemi dalam jangka panjang pada diabetes melitus tipe 2 (DMT2) akan menyebabkan terjadinya komplikasi baik mikrovaskular maupun makrovaskolar, untuk mencegah terjadinya berbagai komplikasi DMT2 diperlukan pendekatan salah satunya dengan penerapan latihan berjalan kaki. Tujuan dari studi ini adalah menerapkan latihan berjalan kaki untuk menurunkan kadar glukosa darah sewaktu (GDS) pada pasien diabetes melitus tipe 2 (DMT2). Studi kasus deskriptif dengan pendekatan asuhan keperawatan melibatkan dua pasien DMT2 yang dipilih secara acak dengan kriteria inklusi penderita DMT2, usia 20-60 tahun, tidak sedang menjalani terapi insulin, tidak mengalami komplikasi diabetes seperti retinopati, nepropati, kaki diabetik dan penyakit kardiovaskular, tidak ada masalah sendi dan keseimbangan. Pasien diinstruksikan melakukan latihan berjalan 30 menit/hari selama lima hari dan dilakukan pemeriksaan tekanan darah dan GDS 15 menit sebelum dan sesudah latihan (Pre dan Post). Hasil studi menunjukkan penurunan kadar GDS pada pasien 1 rata-rata sebesar 15,2 mg/dL (282,8 mg/dL - 267,6 mg/dL),  dan pasien 2 sebesar 10,2 mg/dL (127 mg/dL - 116,8 mg/dL). Latihan berjalan kaki 30 menit/hari selama lima hari dengan intensitas sedang mampu menurunkan kadar GDS pada pasien DMT2. Latihan ini perlu dilakukan secara rutin untuk mendapatkan hasil yang maksimal.

Keywords


Diabetes Melitus; Latihan Berjalan; Latihan Aerobik

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References


Alaidarous, T. A., Alkahtani, N. M., Aljuraiban, G. S., & Abulmeaty, M. M. A. (2020). Impact of the Glycemic Control and Duration of Type 2 Diabetes on Vitamin D Level and Cardiovascular Disease Risk. Journal of Diabetes Research, 2020(Cvd). https://doi.org/10.1155/2020/8431976

American Diabetes Association. (2015). Factors Affecting Blood Glucose. Diabetes Care, 16, 2383.

American Diabetes Association. (2022a). Standards of medical care in diabetes-2022. The Journal of Clinical and Applied Research and Education Diabetes Care, 45(1), 1–270. https://doi.org/10.2337/diacare.29.02.06.dc05-1989

American Diabetes Association. (2022b). Why Does Exercise Sometimes Raise Blood Glucose (Blood Sugar)? Retrieved February 8, 2022, from https://www.diabetes.org/healthy-living/fitness/why-does-exercise-sometimes-raise-blood-sugar

Balitbang Kemenkes RI. (2013). Riset Kesehatan Dasar; Riskesdas 2013. Jakarta.

Behroozian, A., & Beckman, J. A. (2020). Microvascular Disease Increases Amputation in Patients With Peripheral Artery Disease. Arteriosclerosis, Thrombosis, and Vascular Biology, 40(3), 534–540. https://doi.org/10.1161/ATVBAHA.119.312859

Cheng, L. J., Wang, W., Lim, S. T., & Wu, V. X. (2019). Factors associated with glycaemic control in patients with diabetes mellitus: A systematic literature review. Journal of Clinical Nursing, 28(9–10), 1433–1450. https://doi.org/10.1111/jocn.14795

Chiang, S. L., Heitkemper, M. M. L., Hung, Y. J., Tzeng, W. C., Lee, M. S., & Lin, C. H. (2019). Effects of a 12-week moderate-intensity exercise training on blood glucose response in patients with type 2 diabetes: A prospective longitudinal study. Medicine (United States), 98(36). https://doi.org/10.1097/MD.0000000000016860

Cigarroa, I., Espinoza-Sanhueza, M. J., Lasserre-Laso, N., Diaz-Martinez, X., Garrido-Mendez, A., Matus-Castillo, C., … Celis-Morales, C. (2020). Association between walking pace and diabetes: Findings from the chilean national health survey 2016–2017. International Journal of Environmental Research and Public Health, 17(15), 1–10. https://doi.org/10.3390/ijerph17155341

Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., … Tate, D. F. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065–2079. https://doi.org/10.2337/dc16-1728

Critchley, J. A., Carey, I. M., Harris, T., DeWilde, S., Hosking, F. J., & Cook, D. G. (2018). Glycemic control and risk of infections among people with type 1 or type 2 diabetes in a large primary care cohort study. Diabetes Care, 41(10), 2127–2135. https://doi.org/10.2337/dc18-0287

Demoz, G. T., Gebremariam, A., Yifter, H., Alebachew, M., Niriayo, Y. L., Gebreslassie, G., … Shibeshi, W. (2019). Predictors of poor glycemic control among patients with type 2 diabetes on follow-up care at a tertiary healthcare setting in Ethiopia. BMC Research Notes, 12(1), 1–8. https://doi.org/10.1186/s13104-019-4248-6

Fayehun, A. F., Olowookere, O. O., Ogunbode, A. M., Adetunji, A. A., & Esan, A. (2018). Walking prescription of 10 000 steps per day in patients with type 2 diabetes mellitus: A randomised trial in Nigerian general practice. British Journal of General Practice, 68(667), e139–e145. https://doi.org/10.3399/bjgp18X694613

Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing (14th ed.). Philadelphia: Wolters Kluwer.

International Diabetic Federation. (2019). IDF Diabetes atlas 9th edition (9th ed.). Belgium: International Diabetes Federation.

International Diabetic Federation. (2021). IDF Diabetes Atlas (10th ed.). Belgium: International Diabetes Federation. Retrieved from www.diabetesatlas.org

Iqbal, Z., Azmi, S., Yadav, R., Ferdousi, M., Kumar, M., Cuthbertson, D. J., … Alam, U. (2018). Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and Pharmacotherapy. Clinical Therapeutics, 40(6), 828–849. https://doi.org/10.1016/j.clinthera.2018.04.001

Kementerian Kesehatan Republik Indonesia. (2018). Laporan Nasional Riset Kesehatan Dasar. Kementrian Kesehatan RI, 1–582. Retrieved from https://dinkes.kalbarprov.go.id/wp-content/uploads/2019/03/Laporan-Riskesdas-2018-Nasional.pdf

Kirwan, J. P., Sacks, J., & Nieuwoudt, S. (2017). The essential role of exercise in the management of type 2 diabetes. Cleveland Clinic Journal of Medicine, 84(7), S15–S21. https://doi.org/10.3949/ccjm.84.s1.03

Lee, S. F., Pei, D., Chi, M. J., & Jeng, C. (2015). An investigation and comparison of the effectiveness of different exercise programmes in improving glucose metabolism and pancreatic β cell function of type 2 diabetes patients. International Journal of Clinical Practice, 69(10), 1159–1170. https://doi.org/10.1111/ijcp.12679

Lee, S. K., Shin, D. H., Kim, Y. H., & Lee, K. S. (2019). Effect of diabetes education through pattern management on self-care and self-efficacy in patients with type 2 diabetes. International Journal of Environmental Research and Public Health, 16(18). https://doi.org/10.3390/ijerph16183323

Mendes, R., Sousa, N., Themudo-Barata, J. L., & Reis, V. M. (2019). High-intensity interval training versus moderate-intensity continuous training in middle-aged and older patients with type 2 diabetes: A randomized controlled crossover trial of the acute effects of treadmill walking on glycemic control. International Journal of Environmental Research and Public Health, 16(21), 1–14. https://doi.org/10.3390/ijerph16214163

Olson, R. D., Piercy, K. L., Troiano, R. P., Ballard, R. M., Fulton, J. E., Galuska, D. A., … Olscamp, K. (2018). Physical activity guidelines for Americans. The Oklahoma nurse (2nd ed.). U.S. Department of Health and Human Services. https://doi.org/10.1249/fit.0000000000000472

Pahra, D., Sharma, N., Ghai, S., Hajela, A., Bhansali, S., & Bhansali, A. (2017). Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: A randomized crossover study. Diabetology and Metabolic Syndrome, 9(1), 5–11. https://doi.org/10.1186/s13098-017-0263-8

Perkeni. (2021). Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2021. Perkumpulan Endokrinologi Indonesia2. Jakarta: PB Perkeni. Retrieved from www.ginasthma.org.

PPNI. (2017). Standar Diagnosis Keperawatan Indonesia Definisi dan Indikator Diagnostik (I). Jakarta: Dewan Pengurus Pusat Persatuan Perawat Nasional Indonesia.

PPNI. (2018). Standar Intervensi Keperawatan Indonesia Definisi dan Tindakan Keperawatan (I). Jakarta: Dewan Pengurus Pusat Persatuan Perawat Nasional Indonesia.

PPNI. (2019). Standar Luaran Keperawatan Indonesia Definisi dan Kriteria Hasil Keperawatan (I). Jakarta: Dewan Pengurus Pusat Persatuan Perawat Nasional Indonesia.

Rehmaitamalem, & Rahmisyah. (2021). Pengaruh jalan kaki terhadap penurunan kadar gula darah pada pasien diabetes mellitus. Jurnal Keperawatan Sriwi, 8(1), 11–14.

Riebe, D., Ehrman, J. K., Ligouri, G., & Magal, M. (2018). ACSM’s guidline for exercise testing and prescription. American College of Sport Medicine2 (10th ed.). Philadelphia: Wolters Kluwer. https://doi.org/10.5860/choice.35-6295

Sabania, B. F., Murti, B., & Hanim, D. (2016). Association between Hormonal Contraception and Blood Glucose Level Among Women of Childbearing Age in Sangkrah Community Health Center, Surakarta. Indonesian Journal of Medicine, 01(01), 1–11. https://doi.org/10.26911/theijmed.2016.01.01.01

Shakil-ur-Rehman, S., Karimi, H., Gillani, S. A., Amjad, I., Ahmad, S., & Yaseen, A. (2018). Response to a Supervised Structured Aerobic Exercise Training Program in Patients with Type 2 Diabetes Mellitus – Does Gender Make a Difference? A Randomized Controlled Clinical Trial. Journal of the National Medical Association, 110(5), 431–439. https://doi.org/10.1016/j.jnma.2017.10.003

Singh, R., Pattisapu, A., & Emery, M. S. (2020). US Physical Activity Guidelines: Current state, impact and future directions. Trends in Cardiovascular Medicine, 30(7), 407–412. https://doi.org/10.1016/j.tcm.2019.10.002

Solomon, T. P. J., Tarry, E., Hudson, C. O., Fitt, A. I., & Laye, M. J. (2020). Immediate post-breakfast physical activity improves interstitial postprandial glycemia: a comparison of different activity-meal timings. Pflugers Archiv European Journal of Physiology, 472(2), 271–280. https://doi.org/10.1007/s00424-019-02300-4

Sylow, L., Kleinert, M., Richter, E. A., & Jensen, T. E. (2017). Exercise-stimulated glucose uptake-regulation and implications for glycaemic control. Nature Reviews Endocrinology, 13(3), 133–148. https://doi.org/10.1038/nrendo.2016.162

Teich, T., Zaharieva, D. P., & Riddell, M. C. (2019). Advances in Exercise, Physical Activity, and Diabetes Mellitus. Diabetes Technology and Therapeutics, 21(S1), S112–S122. https://doi.org/10.1089/dia.2019.2509

Tharek, Z., Ramli, A. S., Whitford, D. L., Ismail, Z., Mohd Zulkifli, M., Ahmad Sharoni, S. K., … Jayaraman, T. (2018). Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC Family Practice, 19(1), 1–10. https://doi.org/10.1186/s12875-018-0725-6

van Dam, R. M. (2020). A global perspective on white rice consumption and risk of type 2 diabetes. Diabetes Care, 43(11), 2625–2627. https://doi.org/10.2337/dci20-0042

Verberne, A. J. M., Korim, W. S., Sabetghadam, A., & Llewellyn-Smith, I. J. (2016). Adrenaline: Insights into its metabolic roles in hypoglycaemia and diabetes. British Journal of Pharmacology, 173(9), 1425–1437. https://doi.org/10.1111/bph.13458

Wu, H., & Ballantyne, C. M. (2020). Metabolic Inflammation and Insulin Resistance in Obesity. Circulation Research, 1549–1564. https://doi.org/10.1161/CIRCRESAHA.119.315896

Zheng, X., Qi, Y., Bi, L., Shi, W., Zhang, Y., Zhao, D., … Li, Q. (2020). Effects of Exercise on Blood Glucose and Glycemic Variability in Type 2 Diabetic Patients with Dawn Phenomenon. BioMed Research International, 2020, 1–6. https://doi.org/10.1155/2020/6408724


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DOI: https://doi.org/10.26714/nm.v6i3.9186

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