Abstract :
Diabetic ulcers are the most common complication of uncontrolled Diabetes Mellitus (DM), characterized by high blood glucose levels that lead to complications such as neuropathy (motor, sensory, autonomic) and vascular abnormalities, making infections more likely. According to research in Indonesia, the incidence of diabetic ulcers ranges from 15-25% of the total number of diabetes mellitus patients, with an annual prevalence of 2% to 5-7.5% in patients with neuropathy. Application of evidence-based medicine-based family doctor services to patients by identifying risk factors, clinical problems, and patient management based on a patient-centered and family problem-solving framework. This case report taken by primary data through auto-anamnesis, physical examination and home visits. Secondary data was obtained from the patient’s medical record. The assessment is based on a holistic diagnosis from entire of the study qualitatively and quantitatively. Patient Mr. E, 61 years old has internal factor risks such as elderly age, curative treatment patterns, inappropriate eating habits, lack of knowledge about the disease which, and external risk factors in the form of curative family treatment patterns and lack of family support related to patient’s disease. Patient’s management is holistic and comprehensive, patient-centered, family approach, and community-based in the literature based on EBM. Patient was intervened with media posters about DM, diet, proper diabetic ulcer care and educating families to support patients. Results of the intervention evaluation are increase in patient and family’s knowledge, controlled blood sugar, and eating behavior according to Adequacy of Nutrition Level.
Keywords :
Family Medicine Services, Holistic Management, Type 2 Diabetes Melitus.References :
- Oliver TI, Mutluoglu M. Diabetic Foot Ulcer. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK37328/
- Kementrian Kesehatan Republik Indonesia. 2022. Infodatin Lansia 2022. Jakarta: Pusat Data dan Infromasi Kementerian Kesehatan RI.
- Perkumpulan Endokrinologi Indonesia. 2021. Pedoman pengelolaan dan pencegahan diabetes Melitus tipe 2 di Indonesia 2021. Jakarta: PB PERKENI.
- Suyono, S. Pengaturan makanan dan pengendalian glukosa darah. Dalam: Waspadji S, Sukardji K, Octariana M, editor. Pedomam diet diabetes Melitus. Jakarta: Balai Penerbit Fakultas Kedokteran
- Ganesan VS, Balaji V, Seshaiah V. 1994. Diabetes in the elderly. Int J Diab Dev Countries. Vol. 14:119-23.
- Annis AM, Caulder MS, Cook ML, Duquette D. Family history, diabetes, and other demographic and risk factors among participants of the National Health and Nutrition Examination Survey 1999-2002. Prev Chronic Dis. 2005 Apr;2(2):A19
- Hosseini, F., Jayedi, A., Khan, T.A. et al. Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose–response meta-analysis of prospective cohort studies. Sci Rep. 2022; 12, 2491.
- 2022. Ageing and Health. World Health Oranization. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health/
- Meneilly GS, Tessier D. 2001. Diabetes in elderly adults. J Gerontol. 56A(1):M5-11
- Tumiwa, F., Yuanita, A. 2010. Terapi Gizi Medis Pada Diabetes Melitus. Jurnal Biomedik. Vol. 2(2):78-87
- Sari, N., Nawangsari, H., Yosdimyati, L. 2019. Pengaruh senam kaki terhadap neuropati perifer pada 16 penderita dm tipe 2 di desa kaliwungu kecamatan jombang kabupaten jombang.
- Hannyta Ratna Bravo. 2020. Pentingnya Senam Kaki Diabetes Bagi Penderita DM. https://kakidiabetindonesia.com/mai n/news/detail/47/pentingnya-senamkaki-diabetet-bagi-penderita-diabete s-Melitus. Accessed March 30, 2024
- Graciella V, Prabawati D. 2020. The effectiveness of diabetic foot exercise to peripheral neuropathy symptoms and fasting blood glucose in type 2 diabetes patients. ICHD. Vol. 30:45-9.
- National Center for Biotechnology Information. PubChem Compound Summary for CID 3488, Glyburide. https://pubchem.ncbi.nlm.nih.gov/compound/Glyburide. Accessed Oct. 13, 2022
- Tseng TS, Lin WT, Gonzalez GV, Kao YH, Chen LS, Lin HY. Sugar intake from sweetened beverages and diabetes: A narrative review. World J Diabetes. 2021 Sep 15;12(9):1530-1538. doi: 10.4239/wjd.v12.i9.1530. PMID: 34630905; PMCID: PMC8472506.