Pola makan dan obesitas sebagai faktor resiko diabetes mellitus tipe-2 di Rumah Sakit Sanglah Denpasar

WIARDANI, Ni Komang, Prof.dr. Hamam Hadi, MS.,ScD

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Gizi dan Kesehatan)

Latar Belakang: Diabetes Mellitus (DM) merupakan penyakit kronik yang prevalensinya terus meningkat di seluruh dunia, termasuk di Indonesia dan khususnya di Propinsi Bali terutama pada kelompok usia dewasa. Peningkatan prevalensi DM bersamaan dengan peningkatan prevalensi obesitas akibat perubahan gaya hidup dan pola makan yang kurang sehat. Ledakan jumlah penderita DM di seluruh dunia menimbulkan persoalan yang sukar diatasi yaitu biaya perawatan yang mahal jika penyakit DM sudah disertai dengan berbagai komplikasi penyakit lain. Tujuan Penelitian: secara umum penelitian bertujuan untuk mengetahui hubungan antara pola makan dan obesitas dengan penyakit DM tipe 2 di Rumah Sakit Sanglah Denpasar. Metode Penelitian: Penelitian merupakan penelitian analitik observasional menggunakan rancangan Matched Case Control Study. Subyek terdiri dari kasus dan kontrol dengan perbandingan 1:2 yang di matched umur dan jenis kelamin. Kasus adalah penderita DM tipe 2 yang baru terdiagnosis pada kunjungan pertama di RS Sanglah Denpasar. Kontrol terdiri 2 kelompok yaitu kontrol 1 adalah penderita rawat jalan selain DM di RS Sanglah dan kontrol 2 adalah individu sehat tetangga kasus. Lokasi penelitian di RS Sanglah Denpasar. Jumlah subyek 147 orang yang ditentukan dengan metode konsekutif. Data yang dikumpulkan yaitu identitas sampel, berat badan, tinggi badan, lingkar pinggang, pola makan, aktivitas fisik dan kadar gula darah. Pola makan dikumpulkan dengan Food Frequency Questionnaire (FFQ), aktivitas fisik dengan International Physical Activity Questionnaire (IPAQ) yang dimodifikasi, kadar gula darah dengan biosensor glukosa. Model regresi logistik berganda digunakan untuk mengetahui berbagai faktor risiko yang berhubungan dengan DM tipe 2. Hasil: Hasil penelitian menunjukkan terdapat 5 variabel yang berhubungan signifikan dengan kejadian DM tipe 2 yaitu interaksi obesitas overall dengan konsumsi serat (OR:10.7, CI 95%: 3.5-33.7), riwayat keluarga (OR:5.5, CI 95%: 2.2-13.3), sumber protein hewani tinggi lemak (OR: 4.9, CI 95%: 1.5-16.1), sumber protein hewani rendah lemak (OR: 0.1, CI 95%: 0-0.5) dan hipertensi (OR:3.7, CI 95%:1.4-9.9) Kesimpulan: Interaksi antara obesitas overall dengan pola konsumsi serat, riwayat keluarga, sumber protein hewani tinggi lemak, sumber protein hewani rendah lemak dan hipertensi merupakan faktor risiko DM tipe 2 di RS Sanglah Denpasar.

Background: Diabetes Mellitus (DM) is a chronic disease with its prevalence increasing in the worldwide, including in Indonesia and in Bali province especially among adult group. The increasing prevalence of DM that is followed by the increasing prevalence of obesity is affected by changes in lifestyle and unhealthy dietary patterns. Explosion of the DM patients quantity in the worldwide causes unsolved problems such as high cost of care if DM disease have been accompanied by various other complication diseases. Objective: The study conducted to know relations between dietary patterns and obesity with the type 2 DM in Sanglah Hospital, Denpasar. Methods: The study was observational analytic with matched case control study. Subject of the study was divided into two group, i.e. case and control with comparison case and control 1:2 which matched to age and sex. The cases were type 2 DM patients who had recently diagnosed on first visited in Sanglah Hospital. Control 1 were outpatients of non-type 2 DM in Sanglah Hospital and control 2 were taken from the caseneighboring household. Total subject were 147, taken by consecutive method. Collected data were subject identity, dietary patterns, physical activity, weight, height, waist circumference and fasting blood sugar. Dietary patterns were collected using Food Frequency Questionnaire (FFQ), physical activity were colleted using International Physical Activity Questionnaire (IPAQ) modified, and fasting blood sugar were using biosensor of glucose. Multiple logistic regression models were used to indentify risk factors associated with type 2 DM. Result: This study showed that there were 5 variables significantly related with type 2 DM, i.e. interaction of overall obesity with the dietary fiber intake (OR:10.7;CI 95%: 3.5-33.7), family history (OR:5.5, CI 95%: 2.2- 13.3), source of high fat animal protein (OR:4.9, CI 95%:1.5-16.1), source of low fat animal protein (OR:0.1, CI 95%: 0-0.5), hypertension (OR:3.7, CI 95%: 1.4-9.9) Conclusion: the interaction between overall obesity with dietary fiber intake, family history, source of high fat animal protein, source of low fat animal protein and hypertension were the risk factors of type 2 DM occurrence in Sanglah Hospital, Denpasar.

Kata Kunci : Obesitas dan Pola Makan,DM Tipe 2