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CHAPTER I
PRELIMINARY
1.1 Background
Diabetes Mellitus (DM) or abbreviated diabetes is a health disorder in the
form of a collection of symptoms caused by increased blood glucose levels due to
deficiency or insulin resistance. This disease has long been known, especially
among families, especially large-bodied families (overweight) along with the
"high lifestyle". The reality is then, DM becomes a disease of the general public, a
burden of public health, expanding and bringing many deaths.
In the prevalence of the world population with DM in the calculation reached
125 million per year with DM, with predictions doubled to 250 million within the
next 10 years (in 2010). Increased prevalence will be more prominent in
developing countries compared to developed countries. The prevalence of DM in
Indonesia is 1.2% - 2.3% of the population aged over 15 years.
The increasing trend of prevalence will make the change in the position of
DM increasingly rampant, which is marked by changes or increase in rank among
the top 10 diseases (leading desiases). In addition, DM also contributes to death.

1.2 Formulation of the problem

1.2.1 How is the history of Diabetes Mellitus discovery?
1.2.2 What is the understanding and classification of Diabetes Mellitus?
1.2.3 What are the symptoms of Diabetes Mellitus?
1.2.4 How to prevent Diabetes Mellitus?
1.2.5 How to treat the disease Diabetes Mellitus?
1.2.6 How to treat herbal Diabetes Mellitus?

1.3 The purpose of writing

1.3.1 Students can know the history of Diabetes disease discovery.
1.3.2 Students can know classification of Diabetes Mellitus.
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1.3.3 Students can know symptoms of Diabetes Mellitus

1.3.4 Students can know prevent Diabetes Mellitus
1.3.5 Students can know to treat the disease Diabetes Mellitus
1.3.6 Students can know to treat herbal Diabetes Mellitus
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CHAPTER II
DISCUSSION

2.1 History of Diabetes Disease

The history of diabetes has actually been documented for thousands of years.
From the first found to date, many breakthroughs have been made regarding this
disease.
The first mention of diabetes occurred in 1552 BC, when Hesy-Ra, an
Egyptian doctor, documented frequent urination as a symptom of a mysterious
illness that also caused the sufferer to become emaciated. The ancient healer also
noted that ants seem to be interested in the urine of people who have this disease.
In 150 AD, Arateus, the Greek physician described what we now call diabetes as
"melting flesh of body and limbs into the urine." Since then, doctors have begun
to gain a better understanding of diabetes. Centuries later, to diagnose diabetes,
one must immediately taste the urine.
In the 1800s scientists successfully developed a chemical test to detect the
presence of sugar in the urine. The longer the doctor gets to know about diabetes.
In the past, diabetes treatments include frequent suggestions of horseback riding
that are considered capable of reducing excessive urination.
In the 1700s and 1800s, doctors began to realize that dietary changes can help
the management of diabetes. They advise patients to do things like eat fat and
animal flesh or eat sugar. During the French-Prussian War of the 1870s, French
physician Apollinaire Bouchardat noted that the condition of diabetic patients
improved after being given an army ration.
In 1916, Boston scientist Elliott Joslin published a book entitled Diabetes
Mellitus Care which outlines that a fasting diet combined with regular exercise
can significantly reduce the risk of death in diabetic patients. Currently, doctors
still use the principles found Joslin to treat diabetes patients.
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2.2 Definition and classification of diabetes mellitus

Diabetes mellitus, a DM also known in Indonesia as diabetes is a metabolic
disorder caused by many factors, with a symptom of chronic hyperglycemia and
carbohydrate metabolism, fat and protein disorders, as a result of: deficiency of
insulin hormone secretion, insulin activity and deficiency glucose transporter.
The incidence of DM begins with insulin deficiency as the main cause. On the
other hand the onset of DM may begin with a relative insulin deficiency caused
by insulin resistance. This condition is characterized by the insolubility of organs
using insulin, so that insulin can not function optimally in regulating glucose
metabolism. As a result blood glucose levels increase. Diabetes Mellitus
Classification:
2.2.1 Diabetes Mellitus Type 1
Diabetes mellitus type 1, diabetes of children (English: childhood-
onset diabetes, juvenile diabetes, insulin-dependent diabetes mellitus,
IDDM) is diabetes that occurs due to reduced ratio of insulin in the blood
circulation due to the loss of insulin-producing beta cells on the islands
Langerhans pancreas. IDDM can be suffered by children as well as adults.
Until now IDDM can not be prevented and can not be cured, even with
diet and exercise. Most people with type 1 diabetes have good health and
weight when the disease begins to suffer. In addition, the sensitivity and
response of the body to insulin is generally normal in people with this type
of diabetes, especially in the early stages. The most common cause of beta
cell loss in type 1 diabetes is an autoimmune reaction that destroys the
pancreatic beta cells. Such autoimmunity reactions can be triggered by the
presence of infection in the body.
Currently, type 1 diabetes can only be treated by using insulin, with
careful monitoring of blood glucose levels through blood testing monitors.
The basic treatment of type 1 diabetes, even for the earliest stages, is the
replacement of insulin. Without insulin, ketosis and diabetic ketoacidosis
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can lead to coma can even lead to death. Emphasis is also placed on
lifestyle adjustments (diet and exercise). Regardless of the usual injection,
it is also possible to administer insulin through the pump, allowing for 24
hours insulin feeding at predetermined dosage levels, as well as allowing
the dose (a bolus) of insulin required at mealtimes. And it is also possible
to provide insulin input through "inhaled powder".
Treatment of type 1 diabetes should continue. Treatment will not
affect normal activities if sufficient awareness, appropriate care, and
discipline in the examination and treatment are carried out. Glucose levels
are average for type 2 diabetes patients.
Should be as close as possible to normal numbers (80-120 mg / dl, 4-6
mmol / l). Some doctors recommend up to 140-150 mg / dl (7-7.5 mmol / l)
for those with problems. lower numbers, such as "frequent hypoglycemic
events". Figures above 200 mg / dl (10 mmol / l) are often followed by
discomfort and frequent urination resulting in dehydration. Figures above
300 mg / dl (15 mmol / l) usually require prompt treatment and may lead to
ketoacidosis. Low blood glucose levels, called hypoglycemia, can cause
loss of consciousness.
2.2.2 Diabetes Mellitus Type 2
Diabetes mellitus type 2 (non-insulin-dependent diabetes mellitus,
NIDDM) is a type of diabetes mellitus that occurs not caused by the ratio
of insulin in the blood circulation; it is a metabolic disorder caused by
mutations in many genes, including those expressing β cell dysfunction,
disturbance of insulin hormone secretion, cell resistance to insulinyang
caused by GLUT10 dysfunction with resistin hormone cofactors causing
tissue cells, especially in the liver to be less sensitive to insulinserta RBP4
which suppresses glucose absorption by striated muscle but increases blood
sugar secretion by the liver. Gene mutation often occurs on chromosomes
which are the most densely populated chromosomes found in humans.
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In NIDDM found high SGLT1 expression, high RBP4 ratio and

hormone resistin, increased rate of glycogenolytic metabolism and
gluconeogenesis in the liver, decreased rate of oxidation reaction and
increased rate of esterification reaction in liver. NIDDM can also be caused
by dyslipidemia, lipodystrophy, and insulin resistance syndrome.
In the early stages of the abnormality that arises is reduced sensitivity
to insulin, which is characterized by increased levels of insulin in the
blood. Hyperglycemia can be treated with anti-diabetic drugs that can
increase insulin sensitivity or reduce glucose production from the liver, but
the more severe the disease, insulin secretion is reduced, and insulin
therapy is sometimes needed. There are several theories that mention the
exact cause and mechanism of the occurrence of this resistance , but central
obesity is known to be a predisposing factor for the occurrence of insulin
resistance, in terms of the expulsion of adipokines (its a group of
hormones) it impairs glucose tolerance. Orbitality is found in
approximately 90% of the world's patients developed a diagnosis of type 2
diabetes. others include incubation and family history, although in the last
decade has continued to increase starting to affect teenagers and children.

2.2.3 Diabetes Mellitus Type 3

Gestational diabetes mellitus or diabetes mellitus that occurs only
during pregnancy and recovers after delivery, with involvement of
interleukin-6 and reactive protein C on pathogenesis paths.GDM may be
harmful to fetal or maternal health, and about 20-50% of women with
GDM survive.
Diabetes mellitus in pregnancy occurs in about 2-5% of all
pregnancies. GDM is temporary and can increase or disappear after
childbirth. GDM is curable, but requires careful medical supervision during
pregnancy.
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Although GDM is temporary, if it is not handled properly it can harm

the health of the fetus and the mother. Risks that can be experienced by
infants include macrosomia (high infant weight / above normal), congenital
heart disease and central nervous system disorders, and skeletal muscle
defects. Increased fetal insulin hormone can inhibit the production of fetal
surfactants and lead to respiratory distress syndrome. Hyperbilirubinemia
may result from damage to red blood cells. In severe cases, prenatal death
can occur, most commonly as a result of poor placental perfusion due to
vascular damage. Induction of pregnancy may be indicated by decreased
placental function. Cesarean section may be performed if there is a sign
that the fetus is in danger or an increased risk of injury associated with
macrosomia, such as shoulder dystocia.

2.3 Symptoms and Complication of Diabetes Mellitus

2.3.1 Symptoms
Three classic symptoms experienced by diabetics. That is:
1. Lots of drinking
2. Lots of urine
3. Weight loss.
In the early stages of symptoms are generally mild so not perceived,
only known after the existence of laboratory tests. In the advanced stages
of symptoms that appear include:
1. Thirst
2. Lots of urine
3. Weight loss
4. Hunger
5. The body is weak
6. Itching
7. Tingling
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8. Eyes blur
9. Dry skin and poor sex drive

2.3.2 Complications
1. Blurred vision
2. Heart disease
3. Kidney illness
4. Skin and nerve disorders
5. Decay
6. Sex desire decreases
If not properly addressed, in the long term diabetes can cause various
complications. So for people with diabetes do not be careless to always
measure blood sugar levels, either to the laboratory or use their own tools.
If not alert then it can result in disorders of blood vessels, among others:
1. Brain blood vessel disorders (stroke),
2. Eye blood vessels (visual disturbances),
3. Heart blood vessels (coronary heart disease),
4. Renal blood vessels (kidney failure), as well as
5. Leg veins (hard wounds heal / gangrene).

2.4 Prevention of Diabetes Mellitus

DM prevention efforts on actually consists of three parts, namely:

2.4.1 Primary Prevention

Actions taken on primary prevention to avoid DM include:
1. Maintain a healthy and balanced daily diet.
2. Perform adequate physical activity according to age and ability.
3. Avoiding drugs that can trigger the occurrence of diabetes.
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2.4.2 Secondary Prevention

When there is a DM, then that should be done is the treatment of diabetes
in order not to arise complications, with various attempts made for the
purpose of:
1. Short-term: Eliminate complaints / symptoms and maintain a sense of
comfort and health.
2. Long-term: Prevent arising and continuing complications
(complications) with the ultimate goal of
reducing morbidity and mortality due to diabetes.
People with diabetes can exercise, eat and drink like everyone else
without diabetes with little regulation.High blood sugar levels in a long
time, is the beginning of the course of the occurrence of complications, in
addition to causing disruptive complaints such as frequent urination,
thirst, hunger and weight loss. Therefore, the first action that should
always be pursued is to lower blood sugar levels.
In general, efforts to lower blood sugar in secondary prevention include:
1. Planning a good and balanced meal to get the ideal weight according
to age and gender
2. Physical activity is sufficient to the age and ability of the patient
3. When the eating arrangements and physical activity has not managed
to control sugar his blood, then needed drugs, either drunk or insulin
injections
4. Need to counsel patient about various things related to diabetes and
its complication

2.5 How To Treat Diabetes Mellitus

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).
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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.

2.6 How to treat herbal Diabetes Mellitus

Diabetes Mellitus can be treated by way of herbs using several types of plants,
among others:
1 Turmeric
Turmeric contains curcumin which is an orange dye in turmeric able to
overcome various problems in blood.Curcumin is also able to suppress
blood sugar levels. so using turmeric as a cure for diabetes is very
appropriate.
Turmeric has been believed to always overcome diabetes. It is justified
until now and justified by medical research on good content to overcome
the problems contained in your blood like diabetes. How to make diabetes
medicine from turmeric:
1. Prepare 100 grams of turmeric that has a dark orange color or often
called turmeric masters
2. Peel and then wash
3. After that poached turmeric and add a little salt
4. After the medication boils lift and chill the herb
5. Strain the turmeric water and drink 1 glass each morning and
afternoon until your blood sugar is normal
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2 Mengkudu
Mengkudu can be a powerful diabetes drug to lower blood sugar levels
because the fruit mengkudu contain proxeroni.The content can help open
the pores of the cells, so the body will easily absorb the nutrients.
How to make diabetes medicine from mengkudu:
1. Blend 2 mengkudu using blender and given a little water to facilitate
the process of smoothing
2. After smooth, squeeze the mengkudu juice
3. Drink 1 cup of water mengkudu plus 3 tablespoons of honey
4. We recommend this diabetes drug taken 2 days

3 Bean vegetables
Bean vegetables can accelerate the production of insulin that can reduce
blood sugar levels because beans contain B-sitosterol that is able to
overcome the problem. How to make diabetes medicine from bean
vegetable:
1. Boil ½ kg of green beans and add 2 glasses of water
2. Boil until boiling to sterilize drugs from germs and bacteria
3. After that lift and let it cool
4. After cold, drink 1 glass in the morning and 1 glass at night do until
your blood sugar is normal

4 Brotowali
Brotowali is very powerful to treat various chronic diseases, one disease
that can be cured with diligent drinking water boiling brotowali is
diabetes. How to make diabetes medicine from brotowali:
1. Prepare some of the following ingredients 20 cm of brotowali rod, 1
handful of papaya root, and 3 bay leaves
2. Wash all three ingredients until clean
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3. Then boil all ingredients using 3 glasses of water

4. Allow to boil and the water shrinks only 1 ½ cups left
5. After that let it cool then drink the water every morning until your
blood sugar is normal

5 Phaleria Macrocarpa
Phaleria macrocarpa is very powerful to treat various chronic diseases,
one disease that can be cured with diligent drinking water boiling phaleria
macrocarpa is diabetes. How to make diabetes medicine from phaleria
macrocarpa:
1. Prepare 3 pieces of the dried phaleria’s macrocarpa
2. Then boiled the phaleria macrocarpa and add 3 bay leaves
3. Use 3 cups water to boil the ingredients
4. Boil until water stays 1 ½ cups
5. After that let until the herb is cold
6. After cold, drink regularly
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CHAPTER III
CLOSING

3.1 Conclusion
As a health disorder, diabetes provides a great burden as a health problem by
seeing that:
1. The symptoms of DM itself quite a lot and heavy, each interruption is quite a
challenge member in overcoming it.Faced with a feeling of hunger only, for
example a form of disturbance that is quite severe faced by every patient,
where the desire to refrain from eating.
2. DM is an easy disease "cooperation" with other diseases. If DM cooperates
among high blood sugar groups then they can form a "triangle king of
disease".
3. If DM enters the stage of complication, complications of DM are entered into
all pathways of the human body system.

In general, DM is a public health burden that is quite heavy considering that:

1. Diabetes can not be cured, can only be controlled or intercepted (slowed). DM
will be a lifelong part of a patient's life.
2. Vulnerable to complications, advanced circumstances. This advanced state
can be because the patient feels painless, thus neglecting treatment and care.
In addition it is certainly late to see a doctor to make a diagnosis and
treatment.
3. Diabetic complications are severe and can lead to death.

3.2 Suggestion
Students should know all matters relating to diabetes mellitus such as the history
of the discovery of this disease, until its development until now. Similarly, the
symptoms, how to prevent and how to treat it, it is important to remember
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considering diabetes is among the top ten diseases that cause death. So that
students are expected to be able to deliver it to the public