1

Sami, W; Ansari, T; Butt, N.S; Hamid, M.R. 2017. Effect of

diet on type 2 diabetes mellitus: A review. International Journal of Health
Sciences (Online) 11 (2):65-71 diakses tanggal 31 Januari 2019

Interventional studies showed that high carbohydrate and high monounsaturated fat diets improve insulin
sensitivity, whereas glucose disposal dietary measures comprise the first line intervention for control of
dyslipidemia in diabetic patients. Several dietary interventional studies recommended nutrition therapy and
lifestyle changes as the initial treatment for dyslipidemia.Metabolic control can be considered as the cornerstone
in diabetes management and its complications. Acquiring HbA1c target minimizes the risk for developing
microvascular complications and may also protect CVD, particularly in newly diagnosed patients. Carbohydrate
intake has a direct effect on postprandial glucose levels in people with diabetes and is the principal
macronutrient of worry in glycemic management. In addition, an individual’s food choices and
energy balance have an effect on body weight, blood pressure, and lipid levels directly. Through the mutual
efforts, healthcare professionals can help their patients in achieving health goals by individualizing their
nutrition interventions and continuing the support for changes. T2DM retinopathy.
86
Dietary habits are essential elements
of individual cardiovascular and metabolic risk.
87
Numerous health benefits have been observed to the Mediterranean diet
over the last decades, which contains abundant intake of fruit
and vegetables. The beneficial effects of using fish and olive
oil have been reported to be associated with improved glucose
metabolism and decreased risk of T2DM, obesity and CVD.
88

Kayar et al.2017.Relationship between the poor glycemic control and risk factors, life
style and complications. Biomedical Research (Onlline) 28 (4): 1581-1586 diakses tanggal
31 Januari 2019

Studi Kayar et al (2017) menyatakan bahwa kontrol glukosa darah tetap menjadi fokus utama
dalam pengelolaan pasien dengan diabetes tipe 2. Namun, dalam hal program pencegahan
komplikasi khususnya risiko kardiovaskular maka penanganan harus dilakukan secara komperensif
salah satunya memperhatikan kontrol tekanan darah. Keseimbangan antara perubahan gaya hidup,
diet, olahraga dan perawatan medis merupakan cara untuk mengurangi risiko kardiovaskular
sehingga menjaga tekanan darah dalam batas normal.

Systolic and diastolic blood pressures were measured using an automatic sphygmomanometer
with an appropriate cuff size on the right arm after a resting period of 10 min. Patients were
diagnosed as DM according to the criteria of American Diabetes Association (ADA).
Duration of the illness and DM disease onset age were documented. Patients whose systolic/
diastolic blood pressure is = 140/90 mmHg or who is on an antihypertensive treatment were
accepted as hypertensive patients [7]. Patients whose BMI is <25 kg/m
were considered

Type 2 diabetes, a chronic degenerative disease of epidemic proportions, is one of the major
challenges to public health in the world. Although effective interventions to reduce the
longterm complications are available, the complex interventions required and the size of the
diabetic population have made the application of such therapies problematic [20]. For this
reasons early and aggressive treatment modalities are recommended.
Glucose control remains a major focus in the management of patients with type 2
diabetes. However, this should always be
in the context of a comprehensive cardiovascular risk factor
reduction program which include smoking cessation and
adoption of healthy lifestyle habits, blood pressure control,
lipid management and, in some circumstances, antiplatelet
therapy [21]. Diet and exercise in the treatment of all stages
should be in the forefront. Ideal and personalized medical
therapy [21]. Diet and exercise in the treatment of all stages
should be in the forefront. Ideal and personalized medical
nutrition therapy applicable though out the life should be
planned. While in the recent past only lifestyle changes was the
cornerstone treatment of type-2 DM, nowadays the medical
treatment is recommended because of insufficiences of nonmedical

approaches. In addition to lifestyle changes, current

treatment for type-2 DM includes oral antidiabetic agents,
insulin or any combination of the above. For the success of
stepwise treatment of type-2 DM, drug choices should be based
on the different pathophysiological processes. In summary, the
effective treatment for type-2 DM depends on the balance
between lifestyle changes, diet, exercise and personalized
medical treatment. A healthy communication between the
patient and health team is of great importance.

Effectiveness of Lifestyle Modification Counseling on

Kumari et al.2018.
Glycemic Control in Type 2 Diabetes Mellitus Patients. Current
research in nutrition and Food Science (Online) 6 (1) 2018: 70-82
(http://www.foodandnutritionjournal.org/)

This quasi-experimental prospective study was conducted among 224 chi-squared, t-test and Wilcoxon test. In
this study, the lifestyle modification counseling proved to be effective and showed significant improvement
in fasting blood sugar (175.5±32.3 to 144.7±17.6),postprandial blood sugar (275.5±61.3 to199.0±48.3),
hemoglobin A1c by 9.3±1.5 to 8.4±1.3. Significant improvement was observed in diastolic blood pressure
(82.6±7.0 to 79.4±6.1) and high-density lipoproteins cholesterol (47.3±10.5 to 58.8±5.6) from 3 to12 months
follow up with significant p value <0.001 in the intervention group. The study showed good adherence to
balanced diet, physical activity, and tobacco and alcohol cessation but less adherence was observed towards
meditation for stress management, regular checkups, and medicine adherence. Lifestyle modification counseling
is an effective, noninvasive approach towards glycemic control in type 2 diabetes mellitus patients. Lifestyle
intervention holistic model used in this counseling may be helpful for type 2 diabetes mellitus patients to improve
adherence and self-care behavior towards the management of their diabetes. Lifestyle intervention is an
effective, non- invasive way to manage weight, glycemic control, blood pressure and to reduce the risk of fatal
complications in T2DM patients 6 and 12 month follow-ups. The results of our study indicate significant
reductions in body fat, systolic and diastolic blood pressure, pulse rate, blood sugar F and PP, HbA1C, and an
increase in HDL-cholesterol was achieved during follow-ups as compared to the usual care group. Additionally,
the adherence of intervention holistic model was increased. This study alsoshows significant improvement in
adherence towards diet chart, fibrous diet, reduce intake of sugar rich products,
junk foods, physical activity, stress management, checking glucose level and daily monitoringof feet for
diabetes complications and it was enhanced from 3 month to 6 month of follow-up but not sustained till 12
months. The study results conclude that life style modification counseling and its adherence can give
significant and beneficial impact on diabetes control and management.

Kumari et al (2018) melakukan sebuah penelitian dengan metode yang menunjukkan bahwa kelompok
penyandang diabetes yang dilakukan intervensi modifikasi gaya hidup menunjukkan peningkatan signifikan
terhadap tekanan darah diastolik. Studi ini menunjukkan modifikasi terhadap diet yang seimbang,
aktivitas fisik, berhenti merokok dan minum alkohol dapat membantu penyandang diabetes
meningkatkan status kesehatannya.

komplikasi. Bukti lain menunjukkan bahwa kepatuhan

Novita menyatakan bahwa terapi nutrisi dan
terhadap pengobatan dapat
meningkatkan profil metabolik (gula darah dan kolesterol), dan tekanan darah di
mana prevalensi hiperkolesterolemia dan hipertensi pasien diabetes lebih tinggi
dibanding dengan orang tanpa diabetes, serta memiliki resiko yang lebih tinggi
untuk terkena penyakit kardiovaskular. Ketidakpatuhan pasien diabetes terhadap

Novita.2013.Profil Penerapan Self-Care dan Status Depresi Pasien Diabetes Mellitus Tipe 2
di Puskesmas Kalirungkut Surabaya. (Online) Jurnal Ilmiah Mahasiswa Universitas Surabaya 2 (2)

*
ADDRESSING HYPERTENSION IN THE PATIENT WITH
Ali A. Rizvi.2017.
TYPE 2DIABETES MELLITUS: PATHOGENESIS, GOALS, AND
THERAPEUTIC APPROACH. Eur Med J Diabetes (Online) 5(1): 84–92.
Rizvi (2017) menyatakan bahwa intervensi berbasis gaya hidup sebagai pilar pengobatan dini, serta
berkelanjutan dalam mengontrol tekanan darah pada pasien dengan diabetes, baik untuk mencegah
penyakit kardiovaskular dan meminimalkan perkembangan nefropati dan retinopati.Metode non-
farmakologis termasuk penurunan berat badan; modifikasi diet yang meningkatkan konsumsi buah
segar,sayuran, dan produk susu rendah lemak; aktivitas fisik; menghindari makanan olahan yang
mengandung tinggi natrium; dan menghindari tembakau dan konsumsi alkohol berlebih

Lifestyle-based interventions as the pillar of early, as well as ongoing, treatment of

hypertension is particularly important in patients with DM, both to prevent CV disease and
to minimise progression of nephropathy and retinopathy.
Non-pharmacologic methods
include weight reduction; dietary modifications that increase consumption of fresh fruits,
vegetables, and low-fat dairy products; physical activity; avoidance of processed foods that
are high in sodium content; and avoidance of tobacco and excess alcohol intake. The ADA
guidelines advise that among patients with a systolic BP of 120–139 mmHg, or a diastolic
pressure of 80–89 mmHg, lifestyle changes and primarily non-drug modalities should be
introduced to reduce BP (Table 2). Lifestyle modifications to reduce weight, improve diet, restrict salt
intake, and
incorporate physical activity have beneficial actions not only on BP, but also on glycaemic
control, lipid profile, and overall CV risk. Efforts are needed to translate the knowledge
already gained into population-based implementation while conducting further research into
understanding pathogenetic mechanisms and expanding the therapeutic armamentarium.
27,28
1

Junianty, Silvia (2012) dalam penelitian berjudul

Berbanding terbalik dengan
HUBUNGAN TINGKAT SELF CARE DENGAN KEJADIAN
KOMPLIKASI PADA PASIEN DM TIPE 2 DI RUANG RAWAT INAP
RSUD mengatakan bahwa menunjukkan bahwa pasien tingkat self care tinggi
atau rendah dapat menyebabkan kejadian komplikasi yang ditunjukkan
melalui hubungan yang rendah dan pasti.

Junianty, silvia.2012. Hubungan Tingkat Self Care dengan Kejadia

Komplikasi pada Pasien DM Tipe 2 di ruangan rawat inap RSUD. 1(1)

Treatment
https://www.hindawi.com Journal of Diabetes Research
Adherence and Its Associated Factors in Patients
with
Type 2 Diabetes: Results from the Rio de Janeiro
Type 2 Diabetes
Cohort Study

Adherence of Type-2 Diabetic Patients to Treatment