Pengendalian status gizi kadar glukosa darah dan tekanan darah melalui terapi gizi medis pada pasien DM Tipe 2 rawat jalan di RSU Mataram NTB

SUHAEMA, Prof. dr. H.A.H. Asdie, SpPD-KEMD

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Prevalensi diabetes melitus (DM) terus meningkat secara global, termasuk di Indonesia. Sekitar 90-95% kasus DM adalah DM tipe 2. Penelitian Diabetes Control and Complication Trial (DCCT) dan U.K. Prospective Diabetes Study Group (UKPDS) membuktikan manfaat terapi gizi medis (TGM) dalam pengendalian glikemik. Di Indonesia penelitian dimaksud belum banyak dilakukan. Tujuan Penelitian: untuk mengetahui pengaruh TGM terhadap asupan zat gizi, pengendalian status gizi, kadar glukosa darah dan tekanan darah pasien DM tipe 2 rawat jalan. Metode: Jenis penelitian adalah eksperimental acak terkendali (Randomized Controlled Trial [RCT]). Subyek penelitian berjumlah 60 orang (perlakuan dan kontrol). Kelompok perlakuan mendapat TGM 3 kali selama 3 bulan sedangkan kontrol mendapat konseling gizi konvensional. Pengolahan data dengan komputer, analisis zat gizi menggunakan program nutrisurvey. Untuk mengetahui pengaruh intervensi dilakukan uji statistik ttest. Hasil: Asupan energi, lemak dan karbohidrat kelompok perlakuan menurun secara berurutan sebesar -14,05% (p=0,009), -35,64% (p=0,019) dan - 19,14% (p=0,035). Penurunan IMT dan LP kelompok perlakuan sebesar - 0,41 kg/m² dan -0,24 cm dan kontrol -0,23 kg/m² dan -0,14 cm, (p>0,05). Kadar glukosa darah puasa perlakuan menurun -23,6 mg/dL dan kontrol - 14,03 mg/dL, (p=0,036). Tekanan darah sistolik dan diastolik perlakuan secara berurutan menurun -3,33 mmHg (p=0,035) dan -1,67 mmHg (p=0,895), sedangkan kontrol +0,5 mmHg dan -1,33 mmHg, (p>0,05). Kesimpulan: Asupan zat gizi, status gizi, kadar glukosa darah dan tekanan darah penyandang DM tipe 2 yang mendapat TGM cenderung lebih terkendali dibandingkan dengan yang mendapat konseling gizi konvensional.

Background: The prevalence of diabetes mellitus (DM) is increasing globally, including in Indonesia. Studies by Diabetes Control and Complication Trial (DCCT) and U.K. Prospective Diabetes Study Group (UKPDS) prove the benefit of medical nutrition therapy (MNT) to glycemic control. Similar studies have not been done much in Indonesia. Objective: To identify the effects of MNT to nutrient intake, control of nutrition status, blood glucose and blood pressure of type 2 DM outpatients. Method: This was a randomized controlled trial. Subject of the study consisted of 60 people. The experiment group got MNT; whereas the control group got conventional nutrition counseling. Data were processed using computer, nutrients were analyzed using nutri survey. Statistical t-test was done to identify the effect of intervention. Result: Intake of energy, fat and carbohydrate of the experiment group decreased significantly close to the necessity at subsequent decrease as much as -14.05 (p= 0. 009), -35.64 (p=0.019) and -19.14 (p=0.035). Body mass index In the experiment group decreased -0.41kg/m2 and waist circumference -0.24cm, where as the control group -0.23 kg/m2 and -014cm. Blood glucose level during fasting decreased -23.6 mg/dl in the experiment group and -14.03 mg/dl in the control group (p=0.036). Systolic and dyastolic blood pressure of the experiment group decreased -3.33 mmHg (p=0.035) and -1.67 mmgHg (p=0.895), whereas the control group + 0.5 mmHg and -1.33 mmHg; the change was insignificant. Conclusion: Intake of nutrient, nutrition status, blood glucose level and blood pressure of type 2 DM patients that got MNT was more controllable than of those that got conventional nutrition counseling.

Kata Kunci : TGM,Konseling gizi konvensional,DM tipe 2,Asupan zat gizi,Status gizi,Kadar glukosa darah,Tekanan darah, MNT, conventional nutrition counseling, type 2 DM, nutrient intake, nutrition status, blood glucose, blood pressure