CHAPTER I

PRELIMINARY

1.1 Background Issues

Diabetes Mellitus (DM) is one of the health problems that affect productivity and can
decrease Human Resources.
This disease not only affects individuals, but the health system of a country. Although
there has not been a national survey, in line with changes in lifestyle including the Indonesian
diet is estimated by the sufferer.
DM is increasing, especially in the adult age group above all socioeconomic status.
Currently DM DM efforts have not occupied the main priority scale in health services,
although it is known that the negative impact caused by chronic complications in chronic
heart disease, hypertension, brain, nervous system, liver, eyes and kidneys.
DM or diabetes is a disease caused by increased blood sugar levels (hyperglycemia)
due to lack of absolute or relative insulin hormone. Absolute means no insulin at all while
relatively means the amount is quite / indeed slightly high or less work power. Hormone
Insulin is made in the pancreas. There are 2 kinds of DM type:
DM type I. or so-called DM that depends on insulin. DM is caused due to lack of
insulin in the blood that occurs due damage from pancreatic beta cells. Prominent symptoms
are the occurrence of frequent urination (especially night), often hungry and often thirsty,
most people with DM type is normal weight or lean. It usually occurs at a young age and
requires lifelong insulin.
DM type II or called DM that is not dependent on insulin. DM is due to the existing
insulin can not work properly, levels insulin can be normal, low or even even increased but
insulin function for glucose metabolism is absent / less. As a result glucose in the blood
remains high resulting in hyperglycemia, 75% of patients with type II DM with obesity or
there is very overweight and usually known to DM after the age of 30 years.
Type 3 diabetes or Gestational Diabetes mellitus (English: gestational diabetes, insulin-
resistant type 1 diabetes, double diabetes, type 2 diabetes which has progressed to require
injected insulin, latent autoimmune diabetes of adults, type 1.5 "diabetes, type 3 diabetes ,
LADA) or diabetes mellitus that occurs only during pregnancy and recovers after delivery,
with the involvement of interleukin-6 and C-reactive protein on pathogenesis paths.GDM
may be harmful to fetal or maternal health, and about 20-50% of women with GDM survive.

1.2 Formulation of the problem

Based on the above background can be formulated the following issues.
1.2.4 What is the meaning of Diabetes Militus (DM)?
1.2.2 What are the types of Diabetes Militus?
1.2.3 What are the signs and symptoms of Diabetes Militus?
1.2.4 What are the factors that cause Diabetes Militus?
1.2.5 How is the treatment and handling of Diabetes Militus?
1.2.6 How does Diabetes Militus relate to the limbs?

2.4 Objectives
Based on the formulation of the above problems, the goals achieved from this research are:
To know the understanding of Diabetes Militus
1.3.1 To know what type of Diabetes Militus
1.3.2 To know what are the signs and symptoms of Diabetes Militus
1.3.3 To know what are the factors causing Diabetes Militus?
1.3.4 To know how to treat and handle Diabetes Militus
1.3.5 To know the relationship of Diabetes Militus with limbs
 CHAPTER II
DISCUSSION

2.1 Understanding Diabetes Mellitus

Diabetes Mellitus is a metabolic disease that is a collection of symptoms that arise in a

person because of an increase in blood glucose levels above normal values. This disease is
caused by impaired glucose metabolism due to insulin deficiency either in absolute or
relative. (Ministry of Health, 2013).
The World Health Organization (WHO) data have recorded Indonesia with a population
of 230 million people, occupying the fourth position in the world in terms of the largest
number of diabetics after China, India and the United States. Even the Ministry of Health said
the prevalence of diabetes reached 14.7 percent in urban areas and 7.2 percent in rural areas.
Assuming the population aged over 20 years in 2010 reached 148 million people, it is
estimated there are 21.8 million citizens of the city and 10.7 million villagers suffering from
diabetes (http://health.liputan6.com accessed April 25, 2015).
Based on the data of Basic Health Research (RISKESDAS) in 2013, the prevalence of
diabetes and hyperthyroidism in Indonesia based on doctor diagnosed interviews of 1.5
percent and 0.4 percent. DM diagnosed with a doctor or symptoms by 2.1 percent. The
highest prevalence of diabetes diagnosed by doctors is in DI Yogyakarta (2.6%), DKI Jakarta
(2.5%), North Sulawesi (2.4%) and East Kalimantan (2.3%). The prevalence of diabetes
diagnosed by doctors or symptoms is highest in Central Sulawesi (3.7%), North Sulawesi
(3.6%) and Nusa Tenggara Timur 3.3%. (Ministry of Health, 2013).
 Based on Survailans data Non-communicable Diseases P2PL Field Health Office South
Sulawesi Province in 2014 there Diabetes Mellitus 27,470 new cases, 66,780 old cases with
747 deaths. (Dinkes Sulsel, 2015).
Looking at the above background, the authors are interested in preparing a paper
entitled Diabetes Mellitus.

2.2 Types of Diabetes Mellitus

The World Health Organization (WHO) classifies forms of diabetes mellitus based on
treatment and symptom:
2.2.1 Type 1 diabetes, which includes the ketoacidosis symptoma to the destruction of beta
cells in the pancreas caused or caused autoimmunity, and is idiopathic. Diabetes
mellitus with obvious pathogenesis, such as cystic fibrosis or mitochondrial deficiency,
is not included in this classification.
2.2.2 Type 2 diabetes, caused by deficiency of insulin secretion, is often accompanied by
insulin resistance syndrome
2.2.3 Gestational diabetes, which includes gestational impaired glucose tolerance, and,
according to a clinical stage without consideration of pathogenesis, is made into:

3.4 Signs and symptoms of Diabetes Mellitus

Early signs can be seen that a person suffering from DM or diabetes is seen directly
from the effect of elevated blood sugar levels, where the increase in blood sugar levels reach
160 - 180 mg / dL and urine (urine) diabetics containing sugar (glucose ), so urine is often
dilebung or dikerubuti ants.
Patients with diabetes generally show signs and symptoms below although not all
experienced by patients:
1. Number of urine released more (Polyuria)
2. Often or quickly feel thirsty / thirsty (Polydipsia)
3. Excessive hunger or eating a lot (Polyphagia)
4. Urine frequency increases / keep urinating (Glycosuria)
5. Losing weight is not clear why
6. Tingling / numbness on the nerve ends ditelapak hands & feet
7. Get tired and weak all the time
8. Experiencing myopic vision abruptly
9. If the wound / scratched (korengan) slow healing
10. Easily infected especially on the skin

2.4 Factors causing Diabetes Mellitus

Diabetes can be caused by several trigger factors, including :
2.4.1 Dietary habit
Eating excessively and exceeding the amount of calories needed by the body can spur the
onset of diabetes mellitus. excessive consumption of food and not balanced with adequate
amounts of insulin secretion can cause blood sugar levels to increase and will certainly cause
diabetes mellitus.
2.4.2 Obesity (overweight)
Overweight people over 90 kg tend to have a greater chance of developing diabetes
mellitus. Nine out of ten obese people have the potential to develop diabetes mellitus.
2.4.3 Genetic factors
Diabetes mellitus can be inherited from parent to child. Genes that cause diabetes
mellitus will be brought by the child if his parents suffer from diabetes mellitus. Inheritance
of this gene can be up to his grandchild even squeaky although the risk is very small.

2.4.4 Chemicals and medicines

Chemicals can irritate the pancreas that causes inflammation of the pancreas,
inflammation of the pancreas will result in decreased pancreatic function so there is no
secretion of hormones for the body's metabolic processes including insulin. Any type of drug
residue that accumulates in a long time can irritate the pancreas.
2.4.5 Diseases and infections of the pancreas
o Infection of microorganisms and viruses in the pancreas can also cause
inflammation of the pancreas which will automatically cause the function of the pancreas
down so there is no secretion of hormones for the body's metabolic processes including
insulin. Diseases such as high cholesterol and dyslipidemia can increase the risk of diabetes
mellitus
2.4.6 Lifestyle
2.4.7 cigarette question

2.5 Complications
Long-term complications include cardiovascular disease (double risk), chronic renal
failure (the main cause of dialysis), retinal damage that can lead to blindness, as well as nerve
damage that can lead to impotence and gangrene with the risk of amputation. More serious
complications are more common when control of blood sugar levels is poor.

2.6 Methods of treatment and treatment of Diabetes Militus

Patients with type 1 diabetes generally undergo insulin therapi therapy (Lantus /
Levemir, Humalog, Novolog or Apidra), besides that is by exercising sufficiently as well as
controlling the diet (diet).
In people with type 2 diabetes mellitus, treatment and treatment management focused
on lifestyle and physical activity. Controlling the value of blood sugar levels is the key to the
treatment program, which is by reducing weight, diet, and exercise. If this does not achieve
the expected results, then tablet drug administration will be required. Even the administration
of insulin injections is also needed when the tablet does not overcome the control of blood
sugar levels.
 CHAPTER III
COVER

3.1 Conclusions
From the paper I created, it can be concluded that the disease of Diabetes Militus
(DM) is very dangerous and frightening. Lots of factors that cause a person suffering from
Diabetes Militus. Like conohnya, Obesity (excess weight), genetic factors, unhealthy
lifestyles (rarely exercise), lack of sleep, and many others.

3.2 Suggestions
The suggestions for readers of this paper are as follows.
1. Always be careful in maintaining the pattern of life. Often exercise and adequate rest
2. Keep your diet. Do not consume too much food or drinks that are too sweet. Because it
can cause sugar levels jumped high.