Part 1 - Curriculum Vitae

St.
Paul University Philippines

Tuguegarao City, Cagayan 3500 1
PART 1 INTRODUCTION
The latest global estimates from the International
Diabetes Federation forecast that by 2040, 642 million
people will be living with diabetes (The Lancet, 2017).
World Health Organization (2017) stated that the
number of people with diabetes has risen from 108 million
in 1980 to 422 million in 2014. The global prevalence of
diabetes among adults over 18 years of age has risen from
4.7% in 1980 to 8.5% in 2014.
In addition, the patients who have diabetes then,
patient can confirm that there is a problem with blood
sugar levels who are experiencing hyperglycemia. Therefore,
patients should be able to control blood sugar in order not
to increase or experience hyperglycemia. One way to be able
to control blood sugar in patients with diabetes is
counseling.
This is due to the fact that the patient needs the
delivery in controlling patient’s own blood sugar.
According to the American Counseling Association,
counseling is defined as, a professional relationship that
empowers diverse individuals, families, and groups to
accomplish mental health, wellness, education, and career
goals (Austin, 2017).
SPUP Graduate School

St. Paul University Philippines
Based on data from the Indonesian Central Bureau of
Statistics in 2003, it is estimated that Indonesians aged
over 20 years are 133 million. With a DM prevalence of
14.7% in urban areas and 7.2%, in rural areas, it is
estimated that in 2003 there were 8.2 million people with
diabetes in urban areas and 5.5 million in rural areas
(Mayasari et al., 2014).
South Sulawesi provincial health data showed that
patients with diabetes mellitus treated at community health
clinic in 2010 were 9.61%, 2011 was 9.32%, increased in
2012 by 12.6%. The data of Makassar City health office
revelas that the diabetes mellitus patients in 2012 as many
as 14,067 cases, increased by 14,604 cases in 2013, and in
2014 increased by 21,452 cases (Syatriani, 2017).
The hospital medical records in Labuang Baji Hospital
and Pelamonia Hospital Makassar, shows that the data on the
number of people with diabetes mellitus is still very much
happening. In Labuang Baji Hospital Makassar in 2010 the
number of diabetes mellitus cases was as many as 476 cases,
in 2011 was as many as 672 cases, and in 2012 was as many
as 682 cases (Mayasari et al., 2014).
In addition, data of diabetes mellitus in Pelamonia
Hospital Makassar were increasing from about 1,375 people

in 2012, about 1,568 people in 2013, and about 1,792 people
year 2014 (Usman, 2017).
According to Schmitt et al. (2013), patients with good
glycaemic control reported significantly more glucose
management, dietary control, physical activity, and health-
care use than those with poor control.
The World Health Organization projects that diabetes
will be the seventh leading cause of death in 2030.
Nevertheless, healthy diet, regular physical activity,
maintaining a normal body weight and avoiding tobacco use
are ways to prevent or delay the onset of type 2 diabetes
(WHO, 2017).
A retrospective cohort study conducted by Franklin
(2012) claimed that regularly scheduled lifestyle
counseling in real-world settings motivates patients with
diabetes to achieve targeted average blood glucose more
quickly than scenarios in which patients receive physician
advice less frequently. However, one of the factors of a
treatment failure is non-adherence to planned therapy, one
of the most important attempts to improve patient adherence
to therapy is by providing comprehensive, accurate, and
structured counseling about the therapy. The existence of
this counseling is very important because diabetes is a

disease associated with patient lifestyle. Therefore, the
purpose of this study was the assessment of the self care
behaviors of patients with diabetes mellitus to develop a
proposed counseling program.
STATEMENT OF THE PROBLEM
This study aimed at the assessment of the self-care
behaviors of patients with diabetes mellitus to come up
with a proposed counseling program. This study specifically
answers the following problems:
1. What is the profile of the participants in terms of:
1.1. age;
1.2. gender;
1.3. blood sugar levels;
1.4. body mass index (BMI); and
1.5. history of smoking?
2. What is the degree of manifestation of the self-care
behaviors of the participants in general and in terms
of:
2.1. glucose management;
2.2. dietary control;
2.3. physical activity; and
2.4. health-care use?

3. Is there a significant difference in the self-care
behaviors of the participants when grouped according to
profile variables?
4. What counseling program can be proposed to enhance self-
care behaviors?
HYPOTHESIS
Likewise, the following hypotheses were tested in the
study at 𝛼 = 0.05.
1. There is no significant difference in the self-care
age.
gender.
blood sugar levels.
body mass index.
history of smoking.

SCOPE AND LIMITATION
The study was conducted for the assessment of the
self-care behaviors of patients with diabetes mellitus to
come up with a proposed counseling program. Self-care
behaviors included glucose management, dietary control,
physical activity, and health care use.
In addition, the data was collected from diabetic
patients of Labuang Baji and Pelamonia General Hospital
Makassar, South Sulawesi, Indonesia. Furthermore, this
study covered the total population of diabetic patients who
were hospitalized in these 2 hospitals and who were aged 18
- 60 years old. Moreover, the period for gathering the data
for this study was for two months duration from February 12
- April 12, 2018. And then, participants who were diagnosed
type 1 or type 2 diabetes mellitus were included in this
study.
Although this research was carefully prepared, the
researcher is still aware of its limitations and
shortcomings. First of all, the research was conducted in 2
hospitals which have many cases of diabetes mellitus during
hospitalization. Another limitation is that the researcher
assessed the self-care behaviors participants for two
months only. Third, the population of the research

conducted to diabetes mellitus patients who were
hospitalized only and with the exclusion of out-patients on
the two hospitals. Third, since the diabetes self-
management questionnaire (DSMQ) is designed to measure the
diabetes patients’ self-care behaviors which may give
useful information.
SIGNIFICANCE OF THE STUDY
Department of Health. The results of this study is
expected to be an input for the preparation of health
development policies and programs. In addition, the results
of this study also shall be used as input for the
development of science.
Diabetic Nurse Educator. The diabetic nurse educators
would be the one which give counseling to the diabetic
patients directly, they would be benefited with additional
information on how counseling could help these types of
patients.
Hospital. The hospital can employ the training of the
health care provider on DM by Association of Diabetes
Indonesia or Persatuan Diabetes Indonesia.
Health Workers. The health worker would be more aware
toward counseling approach for diabetes mellitus patients.

Nursing Education Institution. Science schools that
apply the recommended approach derived from the results of
this study would be able to train the students better than
before which concerns counseling especially about diabetes
mellitus patients.
Diabetic Patients. The contribution of this study
would be beneficial for people with diabetes who need
counseling to control blood sugar in diabetes mellitus
patients. In other words, the findings of this study would
redound to the benefit of patients considering that ability
to control blood sugar for diabetes mellitus patients is an
important role in having a healthy lifestyle. The greater
demand for diabetes mellitus patients with diabetes
mellitus theory background justifies the need for more
effective and life-changing approaches.
Researcher. The result of this study would more
valuable to ascertain and improve cognition to the
researcher concerning counseling of diabetes mellitus
patients.
Future Researchers. In addition, the study also would
help future researchers discover critical areas in the
educational diabetes counseling process in which

researchers were not able to explore yet in general
hospitals.
PART II METHODOLOGY
RESEARCH DESIGN
In this paper, the researcher used descriptive survey
study which described the self-care behavior of patients
diagnosed with diabetes mellitus as a basis for the purpose
of counseling program.
PARTICIPANTS OF THE STUDY
The participants of the study are those included in
the criteria inclusion in which there was 72 participants.
The inclusion criteria as following:
1. Hospitalized in Labuang Baji Hospital and Pelamonia
Hospital Makassar.
2. Participants aged above 18 years old.
3. Participants are willing to participate in the study.
4. Participants are diagnosed type 1 or type 2 diabetes
mellitus.
5. Participants have limited information about control of
blood sugar.
6. Participants disposed to cooperate and willing to fill
the instrument which the researcher provided.

Participants who are reluctant to participate in the study
are excluded as participants.
INSTRUMENTATION
The primary data in this study was the profile of the
participants in terms of age, gender, blood sugar levels,
body mass index, and history of smoking. In addition, the
questions for diabetes mellitus patients used Diabetes
Self-Management Questionnaire (DSMQ) by Schmitt, et al.
(2013) to assess the self-care behaviors of the
participants.
Furthermore, the primary data of blood sugar levels
was from using blood glucose meter ACCU Check. The
researcher was using random plasma glucose test which means
that if participants who had 200 mg/dl are considered to
have high blood sugar levels.
Moreover, for the primary data of body mass index the
platform scale in the hospital was used to know the
participants’ weight and height. After that, the researcher
grouped the body mass index under four categories:
underweight, normal weight, overweight, and obese which
according by American Cancer Society (2016).
In addition, the researcher used the Self-Management
Questionnaire (DSMQ) by Schmitt, et al. (2013) to asses the

self-care behaviors of the participants. The rating scale
was designed as a four-point Likert scale with the response
options “applies to me very much’ (three points), ‘applies
to me to a considerable degree’ (two points), ‘applies to
me to some degree’ (one point), and ‘does not apply to me’
(zero points). The responses were converted such that
higher scores are indicative of more effective self-care.
To enable individual adjustment in items which assess
aspects of self-monitoring of blood sugar (SMBG) or medical
treatment, boxes offering to tick ‘is not required as a
part of my treatment’ were added (Schmitt et al, 2013).
Analysis of responses as part of study 1 led to the
identification of 16 items which formed the final scale for
full psychometric assessment. Seven of these items are
formulated positively and nine inversely with regard to
what is considered effective self-care. The questionnaire
allows the summation to a ‘Sum Scale’ score as well as
estimation of four subscales scores. In view of their
contents, the subscales were labeled ‘Glucose Management’
(items 1, 4, 6, 10, 12), ‘Dietary Control’ (items 2, 5, 9,
13), ‘Physical Activity’ (items 8, 11, 15), and “Health-
Care Use’ (items 3, 7, 14). One item (16) requests an
overall rating of self-care and is to be included in the

‘Sum Scale’ only. Scoring of the questionnaire involved
reversing negatively worded items such that higher values
are indicative of more effective self-care (Schmitt et al,
2013).
Scale scores were calculated as sums of item scores
and then transformed to a scale ranging from 0 to 10 (raw
score/theoretical maximum score * 10; for example, for the
subscale “Glucose Management’ a raw score of 12 leads to a
transformed score of 12 / 15 * 10 = 8). A transformed score
of then thus represented the highest self-rating of the
assessed behavior. Scale score of Diabetes Self-Management
Questionnaire (DSMQ) will calculate (Schmitt et al, 2013):
Glucose management = (raw score/theoretical maximum*10)
= (raw score/15*10)
Dietary control = (raw score/theoretical maximum*10)
= (raw score/12*10)
Physical activity = (raw score/theoretical maximum*10)
= (raw score/9*10)
Health care use = (raw score/theoretical maximum*10)
= (raw score/9*10)
If ‘not required as a part of my treatment’ had been
marked in an item, it was not used, and the scale score
computation was adapted accordingly (by reducing the

theoretical maximum score by three points). However, in
case of more than half of the items of a scale missing, a
scale score should not be computed. Patients with HbA1c
values up to 7.5% were classified as ‘good glycaemic
control’, patients with values between 7.6 and 8.9% were
classified as ‘medium glycaemic control’, and patients with
values from 9.0% as ‘poor glycaemic control’(Schmitt et al,
2013).
This 16-item questionnaire to assess self-care
activities associated with glycaemic control was developed,
based on theoretical considerations and a process of
empirical improvements (Schmitt et al, 2013).
Four subscales, glucose management, dietary control,
physical activity, and health-care use, as well as a ‘Sum
Scale’ (SS) as a global measure of self-care were derived.
To evaluate its psychometric quality, 261 patients with
type 1 or 2 diabetes were assessed with the DSMQ and an
established analogous scale, the Summary of Diabetes Self-
Care Activities Measure (SDSCA). The DSMQ’s item and scale
characteristics as well as factorial and convergent
validity were analyzed, and its convergence with HbA1c was
compared to the SDSCA. So that, the conclusion provided
preliminary evidence that the DSMQ is a reliable and valid

instrument and enables an efficient assessment of self-care
behaviors associated with glycaemic control. The
questionnaire should be valuable for scientific analyses as
well as clinical use in both type 1 and type 2 diabetes
patients (Schmitt et al, 2013).
Fatimah (2016) asserted that the diabetes self-
management questionnaire (DSMQ) in Indonesian language
which valid and reliable already. The validity and
reliability test conducted data retrieval from 30
participants who are people with diabetes mellitus in
Posbindu Working Area Puskesmas Pisangan. The validity test
results of the DSMQ questionnaire or self-management
questionnaire are as follows: test results validity and
reliability with degree of freedom 30-2 = 28 (r table
0,312), in self-management questionnaire there are 7 item
of invalid statement that is 3, 4, 5, 8, 9, 13, and 14, but
statement at Invalid numbers are important in diabetes
self-management, then those statements are discarded but
the structure of the word is fixed. While the results of
reliability test questionnaire is alpha cronbach's r 0.635
so that the questionnaire is declared reliable.
Furthermore, self-management instruments that have been

improved are used for data retrieval. Total score of the
lowest respondent is 0 and the highest is 48.
Ultimately, based on validity and reliability tests
conducted abroad by Schmitt et al. (2013) and in Indonesia
by Fatimah (2016) is already declared valid and reliable to
be utilized in this study.
DATA GATHERING PROCEDURE
The first step was the submission of the study
proposal to Ethics Reviews Committee (ERC). The ERC
reviewed and approved with minor modification as submitted
under Expedited Review. After that, the researcher
integrated the recommendations, submitted a revised copy of
the proposal and attached compliance form to ERC for
compliance checking.
Furthermore, the next step in this study was conducted
by seeking permission through formal letter from St. Paul
University Philippines to Governor South Sulawesi Province
thru head of UPT P2T, BKPMD South Sulawesi Province,
Indonesia. The Governor South Sulawesi Province thru head
of UPT P2T, BKPMD South Sulawesi Province, Indonesia gave
the researcher a research permit to be given to the
hospital administrators in Labuang Baji and Pelamonia
Hospital.

And then, the hospital administrator in Labuang Baji
and Pelamonia Hospital gave a letter to bring it for the
head of the medical ward. The content of the letter was a
recommendation to conduct research in the medical ward
Labuang Baji and Pelamonia Hospital. The head of medical
ward allowed the researcher to obtain medical records and
went to the diabetes mellitus patients directly.
After that, the researcher sought informed consent
from participants. To serve as baseline data, the
researcher administered age and gender of participants from
nurses or from medical records. And then, the researcher
went to the participants directly for their history of
smoking which included how many years they had smoked
already and how many sticks per day did they consume.
In addition, participants’ blood sugar levels were
seen by using a blood glucose meter ACCU Check.
Furthermore, the participants’ body mass index was seen by
using a platform scale in the hospital to know the
participants’ weights and heights. After that, the
researcher grouped the body mass index into four
categories: underweight, normal weight, overweight, and
obese which according by American Cancer Society (2016).

The researcher used the Diabetes Self-Management
Questionnaire (DSMQ) Indonesian version by Fatimah (2016)
for the assessment of the participants’ self-care
behaviors. The assessment was done for two months in
Labuang Baji Hospital and Pelamonia Hospital Makassar,
South Sulawesi, Indonesia. Thereafter, the researcher
analyzed the Diabetes Self-Management Questionnaire (DSMQ)
by using the Statistical Package for the Social Sciences
(SPSS 21.0). Lastly, the study conducted served as basis
for determined participants self-care behaviors and
proposed counseling program.
DATA ANALYSIS
The data was analyzed by using the Statistical Package
for the Social Sciences (SPSS 21.0). The following
statistical tools and measurements were used to analyze and
interpret the data gathered as follows:
1. Frequency and percentage distribution (%) were used to
present the age, gender, and history of smoking.
2. Weighted mean (M) were used to describe the blood sugar
level, body mass index and self-care degree. To
interpret the means, given scale of interpretation will
be used:

Table 1. Interpretation of Blood Sugar Levels
Blood Sugar Level Interpretation

200 mg/dl or more Diabetes
Below 200 mg/dl Normal
Table 2. Interpretation of Body Mass Index
BMI Interpretation
Less than 18.5 Underweight
18.5 to 24.9 Normal weight
25 to 29.9 Overweight
30 or more Obese
Table 3. Interpretation of Self-Care Behaviors Scores
Self-Care Behaviors Scores Interpretation

9.00 – 10.00 Very high degree
7.00 – 8.99 High degree
5.00 – 6.99 Moderate degree
0.00 – 4.99 Low degree
3. Chi-Square Test was used to determine the significant
difference on self-care behaviors of the participants
when grouped according to profile variables in general
and in terms of glucose management, dietary control, and
health-care use.
PART III RESULTS
RESULTS
The summary of finding on this study detailed in the
below as following:
1. The profile of the participants
1.1. Majority of the participants are above 45 years
old.

1.2. Majority of the participants are female.
1.3. Majority of the participants have high blood sugar
levels.
1.4. The most of the participants have normal weight.
1.5. Majority of the participants are non-smokers.
2. The degree of manifestation of the self-care behaviors
of the participants in general and in terms of glucose
management, dietary control, physical activity, and
health care use
2.1. In general terms
2.1.1. Majority of the participants are diabetes
mellitus patients have low degree of self-
care behaviors.
mellitus patients have low degree of glucose
management.
mellitus patients have low degree of dietary
control.
mellitus patients have low degree of
physical activity

mellitus patients have moderate degree of
health-care use.
2.2. In specific terms
2.2.1. Glucose management
2.2.1.1. There is no significant difference on the
participant’s glucose management and their
age, gender, body mass index, and history of
smoking.
2.2.1.2. There is a significant difference on the
participant’s glucose management and their
blood sugar levels.
2.2.2. Dietary control
participant’s dietary control and their age,
gender, body mass index, and history of
smoking.
participant’s dietary control and their
blood sugar levels.
2.2.3. Physical activity
participant’s physical activity and their

age, body mass index, and history of
smoking.
participant’s physical activity and their
gender, blood sugar levels.
2.2.4. Health-Care Use
participant’s health-care use and their age,
gender, body mass index, and history of
smoking.
participant’s health-care use and their
blood sugar levels.
3. Significant difference in the self-care behaviors of the
participants when grouped according to profile variables
3.1. There is no significant difference on the
participant’s self-care behaviors and their age,
gender, and history of smoking.
3.2. There is a significant difference on the
participant’s self-care behaviors and their body
mass index, blood sugar levels.
4. Counseling program can be purposed to enhance self-care
behaviors

4.1. The hospital supports counseling program through
build counselors PEDI (Perhimpunan Edukator
Diabetes Indonesia/Educator Diabetes Association of
Indonesia) from health workers.
4.2. The hospital concerns to having the counselors who
are registered counselors which must have licensed
from PEDI.
4.3. PEDI counselors show increases the knowledge
diabetes mellitus patients through counseling
especially about self-care behaviors, such as
glucose management, dietary control, physical
activity, and health-care use.
CONCLUSION
This study concluded that generally there is poor
self-care behaviors of the participants particularly in low
glucose management, dietary control, and physical activity.
In addition, poor self-care behaviors of the participants
also are particularly in moderate health-care use.
Furthermore, diabetes mellitus patients experienced the
highest number of cases occurred in this study was above 45
years old, female participants, high blood sugar levels,
normal weight, and had not history of smoking.

The self-care behaviors of the participants in this
study described about glucose management, dietary control,
physical activity and health-care use which had affect from
blood sugar levels. On the contrary with age, gender, and
history of smoking which had not affect for glucose
management, dietary control, physical activity and health-
care use. In addition, for body mass index and blood sugar
levels depend on self-care behaviors; conversely, for age,
gender, and history of smoking are not depend on affected
from self-care behaviors.
The counselors should notice those entire important
subjects to ensure counseling appositely. Self-care
behaviors were important things to do for diabetes mellitus
patients because it can help patients to control blood
sugar within normal range.
RECOMMENDATION
1. Department of Health. The researcher recommended
department of health to come up with counseling program
and have a new roles of Puskesmas or Hospitals.
2. Hospital. The researcher suggested the hospitals to
adhere to the training of the health worker providers on
DM facilitated by Association of Diabetes Indonesia or
Persatuan Diabetes Indonesia.

3. Health Workers. Health workers must be more aware toward
counseling approach for diabetes mellitus patients. In
addition, the researcher recommended hospital to
increase health service both diabetic treatment and
counseling program so the diabetes mellitus patients
bring something from hospital to home for increase well-
being degree.
4. Nursing Education Institution. The researcher suggests
that health science schools to include curriculum
subjects for students on how to strengthen patients
through counseling.
5. Diabetic Patients. The researcher also recommended for
people with diabetes who need counseling to control
blood sugar in diabetes mellitus patients especially for
older people, females, blood sugar levels above 200
mg/dl, have not history of smoking, and self-care
behaviors low degree. In other words, the researcher
redound to the benefit of diabetes mellitus patients
considering that ability to control blood sugar for
diabetes mellitus patients is an important role in
having a healthy lifestyle. The greater demand for
diabetes mellitus patients with diabetes mellitus theory

background justifies the need for more effective and
life-changing approaches.
6. Family Patients. The researcher suggested to family
members of diabetes mellitus patients to applicant
maximize the application of self-care behaviors.
7. Future Researchers. Future researchers could improve and
ascertain cognition concerning counseling of diabetes
mellitus patients. In addition, future researchers could
discover and explore critical areas in the educational
diabetes counseling process which were not explored yet
in general hospitals and utilize another research
designs.

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1719

CURRICULUM VITAE
Name : Amriati Mutmainna

Date of birth : June 29, 1991
Place of birth : Ujung Pandang
Religion : Islam
Civil status : Married
Age : 25 years old
Address : BTN Tamarunang Indah 1 Blok G4/21 Gowa
Nationality : Indonesia
Profession : Assistant Lecturer
Specification : Clinical Instructor and Event Organizer
Seminar
Contact Number : 0921 450 0707
Email : amriatimutmainna29@gmail.com
Facebook : Amriati Mutmainna
Educational
Year Educational
2003 Sekolah Dasar Negeri Toddopuli Makassar,
South Sulawesi, Indonesia
2006 Sekolah Menengah Pertama Negeri 33 Makassar,
2009 Sekolah Menengah Atas Negeri 5 Makassar,
2013 Program Studi S1 Keperawatan Stikes Mega
Rezky Makassar, South Sulawesi, Indonesia
2015 Program Profesi Ners Stikes Mega Rezky
Makassar, South Sulawesi, Indonesia

Work Experiences
Year Work Experiences

2015 Stikes Mega Rezky Makassar, South Sulawesi,
Indonesia
2016 Educare Institute Makassar, South Sulawesi,
Indonesia
Publication Research
Year Title Research

2013 Analysis Risk Factors of Stroke Disease for
Patients in the Internal Treatment Room,
Labuang Baji Hospital, Makassar, South
Sulawesi
Seminar and Workshop
Year Title/Theme
2016 Gerontology Professionals Nursing Care are
Encouraging Positive Aging
2016 The improvement of Antenatal Care (ANC)
Services in Order to Reduce Maternal and
Infant Mortality Rate in ASEAN

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St.

Paul University Philippines

The latest global estimates from the International

Diabetes Federation forecast that by 2040, 642 million

people will be living with diabetes (The Lancet, 2017).

World Health Organization (2017) stated that the

number of people with diabetes has risen from 108 million

in 1980 to 422 million in 2014. The global prevalence of

diabetes among adults over 18 years of age has risen from

4.7% in 1980 to 8.5% in 2014.

In addition, the patients who have diabetes then,

patient can confirm that there is a problem with blood

sugar levels who are experiencing hyperglycemia. Therefore,

patients should be able to control blood sugar in order not

to increase or experience hyperglycemia. One way to be able

to control blood sugar in patients with diabetes is

This is due to the fact that the patient needs the

delivery in controlling patient’s own blood sugar.

According to the American Counseling Association,

counseling is defined as, a professional relationship that

empowers diverse individuals, families, and groups to

accomplish mental health, wellness, education, and career

goals (Austin, 2017).

SPUP Graduate School

Based on data from the Indonesian Central Bureau of

Statistics in 2003, it is estimated that Indonesians aged

over 20 years are 133 million. With a DM prevalence of

14.7% in urban areas and 7.2%, in rural areas, it is

estimated that in 2003 there were 8.2 million people with

diabetes in urban areas and 5.5 million in rural areas

(Mayasari et al., 2014).

South Sulawesi provincial health data showed that

patients with diabetes mellitus treated at community health

clinic in 2010 were 9.61%, 2011 was 9.32%, increased in

2012 by 12.6%. The data of Makassar City health office

revelas that the diabetes mellitus patients in 2012 as many

as 14,067 cases, increased by 14,604 cases in 2013, and in

2014 increased by 21,452 cases (Syatriani, 2017).

The hospital medical records in Labuang Baji Hospital

and Pelamonia Hospital Makassar, shows that the data on the

number of people with diabetes mellitus is still very much

happening. In Labuang Baji Hospital Makassar in 2010 the

number of diabetes mellitus cases was as many as 476 cases,

in 2011 was as many as 672 cases, and in 2012 was as many

as 682 cases (Mayasari et al., 2014).

In addition, data of diabetes mellitus in Pelamonia

Hospital Makassar were increasing from about 1,375 people

SPUP Graduate School

in 2012, about 1,568 people in 2013, and about 1,792 people

year 2014 (Usman, 2017).

According to Schmitt et al. (2013), patients with good

glycaemic control reported significantly more glucose

management, dietary control, physical activity, and health-

care use than those with poor control.

The World Health Organization projects that diabetes

will be the seventh leading cause of death in 2030.

Nevertheless, healthy diet, regular physical activity,

maintaining a normal body weight and avoiding tobacco use

are ways to prevent or delay the onset of type 2 diabetes

A retrospective cohort study conducted by Franklin

(2012) claimed that regularly scheduled lifestyle

counseling in real-world settings motivates patients with

diabetes to achieve targeted average blood glucose more