Author Guidelines – Nutrix Journal 1

THE RELATIONSHIP OF DIABETES MELLITUS DIET KNOWLEDGE

WITH BLOOD GLUCOSE LEVELS IN PATIENTS DIABETES
MELLITUS TYPE II IN HERMANA HOSPITAL
LEMBEAN

Jessica Katuuk1 Priscillia Saluy2

1. Student, Faculty of Nursing, Klabat University, Jl. Arnold Mononutu, Minahasa Utara, 95371, Indonesia
2. Lecturer, Faculty of Nursing, Klabat University, Jl. Arnold Mononutu, Minahasa Utara, 95371, Indonesia

E-mail: ¹ s21410306@student.unklab.ac.id ²psaluy@yahoo.com

Abstract

Knowledge is information obtained from other people. Knowledge about the diabetes mellitus (DM) diet is very
important for people with DM because it is one of the factors for reducing glucose levels in the blood. Blood glucose
level is the amount of sugar produced by food in the bloodstream. Diets that are recommended for diabetics are fruits,
vegetables, eating the right portions, and foods to avoid, such as chocolate, sweet tea, and sweet bread. The purpose of
this study is to find out if there is a significant relationship between knowledge about type 2 DM diets and blood
glucose levels in type 2 DM patients at Hermana Hospital Lembean. The design used by researchers in this research is
descriptive correlative. Researchers gave questionnaires to respondents in the hospital and also taking fasting blood
glucose levels in patients with type 2 diabetes mellitus and only one time taking. The sampling technique uses
purposive sampling method, with a sample of 40 respondents. The results of the analysis using the Spearman 's rho
statistical test showed a p value of 0.300 <0.005 which means there was no significant relationship between knowledge
about the diabetic diet with blood glucose levels in type 2 diabetes patients and the correlation coefficient of 0.171
means that it was very weak. For further researchers to be able to add a lot of samples and also take more complete data
such as diet adherence, medication adherence and also glucose levels (Hba1C) which are measured completely.
Keywords: Blood sugar levels, Knowledge of DM diet, Type 2 diabetes.

Abstrak

Pengetahuan merupakan suatu informasi yang di diperoleh dari orang lain. Pengetahuan tentang diet diabetes melitus
(DM) sangat penting bagi penderita DM karena merupakan salah satu faktor untuk menurunkan kadar glukosa di dalam
darah. Kadar glukosa darah adalah jumlah gula yang dihasilkan makanan yang ada di dalam aliran darah. Diet yang
dianjurkan bagi penderita diabetes yaitu buah-buahan, sayuran, makan dengan porsi yang sesuai, dan makanan yang
harus dihindari yaitu makanan seperti cokelat, teh manis, dan roti manis. Tujuan dari penelitian ini yaitu untuk
mengetahui apakah ada hubungan yang signifikan antara pengetahuan tentang diet DM tipe 2 dengan kadar glukosa
darah pada pasien DM tipe 2 di RS Hermana Lembean. Desain yang digunakan peneliti dalam penelitian yaitu
descriptive korelatif. Peneliti memberikan kuesioner kepada responden yang ada dirumah sakit dan juga pengambilan
kadar glukosa darah puasa pada pasien diabetes melitus tipe 2 dan hanya satu kali pengambilan. Teknik pengambilan
sampel menggunakan metode purposive sampling, dengan sampel berjumlah 40 responden. Hasil analisis menggunakan
uji statistik spearman’s rho menunjukan nilai p value 0,300<0,005 yang artinya tidak ada hubungan yang signifikan
antara pengetahuan tentang diet diabetes dengan kadar glukosa darah pada pasien diabetes tipe 2 dan koefisien korelasi
0,171 artinya sangat lemah. Bagi peneliti selanjutnya agar dapat menambah sampel yang banyak dan juga mengambil
data yang lebih lengkap seperti kepatuhan diet, kepatuhan minum obat dan juga kadar glukosa (Hba1C) yang diukur
dengan lengkap.

Keywords: Diet DM, DM tipe 2, Kadar glukosa darah, Pengetahuan.

Introduction The prevalence of people with DM in Indonesia has

increased from before which was 5.7% (2007) to 6.9%
Author Guidelines – Nutrix Journal
(2013) (IDF) Atlas, 2015). The results of the 2013 Basic
Health Research (Riskesdas) showed that the DM
population had increased from 1.1% (2007) to 2.1%
(2013). Research from Munawar (2011) found that
adherence to the diets of diabetics in Indonesian patients
is currently lacking, even though dietary regulation in
diabetic patients is very important to prevent an increase
in blood glucose levels and reduce the incidence of
diabetic complications.
Diabetes mellitus (DM) is a non-communicable disease
but requires serious treatment because it has caused 4
million people to die each year. At present DM disease
has become a serious threat to health in the world. As
stated by WHO (2016), there are 70% of deaths in the
world caused by DM, and there are 90-95% of people
suffering from type 2 diabetes. Patients with type 2
diabetes mellitus who die before the age of 70
experience a large increase in low-income countries
compared to low-income countries (WHO Global
Report, 2016). In 2015, as stated by IDF (International
Diabetes Federation) (2015) Indonesia ranked 7th in the
world with the prevalence of people suffering from DM
among other countries such as China, India, America,
Brazil, Russia, Mexico, and the last is Indonesia, with
an estimated 10 million people with diabetes.
Adherence in the diabetic diet is one of the factors for
controlling blood sugar in order to remain normal and
prevent complications. Research from the Diabetes
Control and Complication Trial (DCTT) conducted in
the United States shows that if normal blood glucose is
protected from serious illnesses such as cerebrovascular
disease, coronary heart disease, eye damage, kidney
failure, and nerve disease. The effect of lack of dietary
knowledge on diabetes can be prevented by regulating
healthy eating patterns and in accordance with the
body's needs in order to avoid the risk of disease and
diabetes complications (Chatterjee, Davies & Heller,
2018).
An unhealthy lifestyle is one of the factors causing type
2 diabetes, especially unhealthy eating patterns.
Research from Rahmawati (2011) found that as many as
82.1% of diabetics with poor dietary habits or eating
habits had uncontrolled blood glucose values, while
39.6% of diabetics who had regular diets had lower
blood glucose values. Controlled Diabetes mellitus
patients who are not properly considered can increase
the risk of complications, because diabetes mellitus
patients are susceptible to complications caused by
insulin deficiency or inadequate insulin action (Smeltzer
et al, 2012). Similarly, Sutrisno (2012) says that food
intake that is not properly controlled and excessive can
be at risk of an increase in insulin in the body. Diet is a
therapy that is very influential in patients with type 2
diabetes mellitus, and can facilitate the work of drugs
used by patients with type 2 DM such as hypoglycemic
tablets, anti-aggression and antibiotics given to patients
2
with diabetes mellitus. Food management often causes
dietary changes including the amount of food consumed
for diabetics mellitus, which creates a dilemma in the
implementation of diabetes mellitus diet compliance.
According to Rahmawati Research (2015) about the
picture of control and blood sugar levels in patients with
diabetes mellitus recommends nurses provide
education / education for DM patients. Results of
fasting blood glucose levels in patients who have been
diagnosed with type 2 diabetes mellitus> 126 mg / dl.
Food diets should be recommended for people with type
2 diabetes, which is paying attention to the food
consumed, such as the type of food, the amount eaten,
and the schedule for eating. The type of food, the
amount and also the schedule is very important to be
considered by diabetics so that the calories in the body
are balanced. The principle of the DM diet that must be
considered is the number of calories given must be
exhausted, do not be reduced or added according to
needs, the diet schedule must be in accordance with the
interval, which is divided into 6 meal times, namely 3
times the main meal and 3 times a snack
(Tjokroprawiro, 2012).
Then the results of previous studies according to Phitri
and Widyaningsih (2013) and Husnah (2016), most
diabetics are not compliant with the diet program. The
results of Cholifah's study (2015) showed that there was
a relationship between diet and GDS levels in type II
DM patients. Phitri and Widyaningsih (2013) research
found that most diabetics did not adhere to the diet
program as many as 31 respondents (57.4%), while the
results of Husnah's research (2016) showed that many
DM patients were still not suitable (42.4%) and the role
of officers for education is still low, (87%) DM patients
have not received education about diet from officers.
The nursing theory used by researchers is a theory taken
from Dorothea Orem which talks about self care. Where
this theory explains that if someone has a strong and
healthy immune system then they can be able to care for
themselves. Meanwhile, if their immune system
declines, it is easy to contract the disease and it will be
difficult to care for themselves. In this case, patients
who are able to do self care in this case knowing and
complying with diet DM are expected to be able to
control blood sugar levels.
Based on preliminary studies conducted by researchers
in January 2020 at Hermana Hospital Lembean the
number of inpatients was found to be type 2 diabetes
mellitus patients. And according to observations made
on patients and also information obtained from the head
of nursing at Lembean Hospital they said that dietary
knowledge from existing patients was still lacking.
Therefore, based on the previous background, the
researcher is interested to raise the case with the title
Author Guidelines – Nutrix Journal 3

"The relationship of knowledge about the diet of DM
with blood glucose levels in type 2 DM patients at
Hermana Hospital Lembean."
Methods
After everything is finished the researcher thanks the
Head of Nursing of Lembean Hospital who has been
willing to take the time and place of conducting the
research, as well as nurses who assist researchers in
conducting research.

Researchers used descriptive correlative research Results

designs. According to Sudjana, Nana and Ibraham,
(2007), this design explains the study of correlation is This section discusses the analysis of data that has been
an object that studies the relationship between two or processed using the SPSS application to provide
more variables, namely the extent of the relationship of information from the results of research that has been
the dependent variable with the independent variable. conducted on type 2 DM patients at Lembean Hospital,
This research was carried out in an institutional hospital Kauditan.
in type 2 diabetes patients.
Table 1. Results of knowledge of Diabetes Mellitus
Population taken by researchers there were 40 patients
treated with diagnoses of type 2 DM. The sampling
technique in this study used purposive sampling. Frequency Percent
Purposive sampling according to Notoatmodjo (2010) (F) (%)
the meaning is: sampling based on a certain Less 5 12.5
consideration such as population characteristics or Moderate 16 40.0
characteristics that have been known previously. Good 19 47.5
Total 40 100
This research method uses descriptive correlative in
which there are 62 inpatients in Lembean Hospital with Based on the table above the results of diabetes mellitus
DM diagnoses. The sampling technique used was dietary knowledge from 40 respondents there are 19
purposive sampling method to be used as respondents in respondents (47.5%) good knowledge, 16 respondents
accordance with the limitations of the study. Collected (40.0) sufficient knowledge, and 5 respondents (12.5%)
using a questionnaire that was distributed to lack of knowledge.
respondents. The population taken was all inpatients
Table 2. GDP
with a diagnosis of type 2 diabetes mellitus and only 40
people were respondents because of the limitations of Frequency Percent
patients who were in the hospital at the time of the (f) (%)
Covid-19 pandemic. Diabetes 40 100

The instrument used in the study used writing whereas in table 2 fasting blood glucose levels were
instruments (pens / pencils), observation sheets and measured in order to find out whether they were
informed consent (sheets to be signed by respondents), diagnosed with type 2 diabetes and the results showed
and researchers also used a tool that was used later that as many as 40 respondents were diagnosed with
when taking blood glucose, namely Gluco Dr. type 2 diabetes mellitus.
Research flow from the researcher is to make a research Table 3. Spearman's rho analysis of knowledge and GDP
permit application letter from the Nursing Faculty of
Klabat University. After the proposal has been approved GDP
by the supervisor and the researcher has completed the Spearman's rho 0.168
research letter in Lembean Hospital to the hospital P Value 0.300
director to conduct research, then the researcher checks
based on the results from table 2 which states all
the number of respondents and found only 40
respondents have type 2 DM then the results from table
respondents, then the researchers asked for help from
3 show that the results obtained are p value 0.300
the head of nursing at Hermana Hospital Lembean to
<0.005. which shows that Ha was rejected and Ho was
prepare 1 nurse who later will assist researchers in
accepted. which showed no significant relationship
distributing questionnaires and measuring fasting blood
between the relationship of knowledge about the
glucose levels, the next day researchers received]-
diabetic diet with blood glucose levels in type 2 DM
information that the questionnaire had been run and the
patients at Lembean Hospital.
researcher went take the questionnaire sheet using
gloves and only document (photo) the questionnaire
Discussion.
sheet according to the requirements with the head of the
hospital to minimize the spread of covid-19.
The analysis results in table 1 the relationship between
Author Guidelines – Nutrix Journal
knowledge about diet diabetes in patients with type
diabetes mellitus 2 using the Chi Square test shows the
p value of 0.300 where p value <α (0.05). In table 1 the
results of the study showed that there were 19
respondents (47.5%) had good knowledge and there
were 5 respondents (12.5%) had less knowledge.
This research is inversely proportional to the results
Nakamireto research (2016) concerning the relationship
of diabetes diet knowledge mellitus with dietary
compliance in patients type 2 diabetes mellitus in the
work area Puskesmas Gamping II, which states that
there is a significant relationship between knowledge
and diet compliance with a value of p value 0,000 (p
value < 0.005). The results of this study are in
accordance with the theory stated by Kozier et al (2010)
that one factor is affect compliance is knowledge.
Obedience can be defined as the level of behavior
individuals (eg taking medicine, obeying diet, or make a
style change life) as prescribed by health therapy. The
level of compliance can start from not heed every aspect
of the suggestion up to adhere to all therapeutic plans.
Based on table 2 shows that there are 40 respondents all
of whom have type 2 diabetes mellitus which on
average results from their fasting glucose levels> 126
mg / dl.
This result is not the same as the results of the research
performed by Febriana (2014) which states there is a
relationship between diet compliance with levels blood
glucose in Diabetes patients Mellitus Type 2 in Inpatient
Dukoharjo Hospital with a p value of 0.015. and also the
results of research conducted by Ayu, Priyanto &
Wakhid (2016) who also states that there is relationship
between diet compliance with the patient's blood
glucose level type 2 diabetes mellitus at the Clinic
Pratama Gracia Ungaran Semarang with a p value of
0,000.
Based on table 3 shows that of the 40 respondents
showing the results of the analysis using the Spearman
's rho statistical test showed a p value of 0.300 <0.005
which means there was no significant relationship
between knowledge about the diabetic diet with blood
glucose levels in type 2 diabetes patients and the
correlation coefficient of 0.171 means that it was very
weak and insignificant which states that Ha is rejected
and Ho is accepted, which means there is no significant
relationship between relationships knowledge of DM
diets with blood glucose levels in type 2 DM patients at
Lembean Hospital.
The results of this study are inversely proportional to
the research conducted by Rahayu (2013) which states
there is a relationship between knowledge levels about
diets with compliance behaviors taking diets on mellitus
diabetes patients at the Dharma Husada Kediri Nursing
Academy.
4
Conclusion.
This study shows that there is no significant relationship
between the relationship of knowledge about the
diabetic diet with blood glucose levels in patients with
type 2 diabetes mellitus at Lembean Hospital At the
Hermana Hospital Lembean , Kauditan, and
measurements of fasting blood glucose levels were
carried out in patients with type 2 diabetes.
Recommended for patients who have been diagnosed
with type 2 diabetes mellitus in order to increase their
knowledge of the diabetic diet with blood glucose
levels. For further researchers to be able to add a lot of
samples and also take more complete data. For the
people, they should increase their knowledge about
diabetes mellitus diet knowledge, starting from the type
of food, the right food schedule and the amount of food
that is consumed so that it is not excessive. And for
nurses in Lembean Hospital to be able to further
enhance their brand knowledge by giving direction or
for people with diabetes mellitus so that they can
maintain their diets well.
Acknowledgements
Researchers thanked the director of the Hermana
Hospital Lembean Dr. Bobby Parengkuan, to Nurse
Denny Pontororing and to one of the nurses at the
Hermana Hospital Lembean, Kauditan and also to
diabetes patients who were respondents at the time of
the study. Researchers will say special thanks to Mrs.
Priscillia Saluy, BSN., MSN., Mr. Reagen Mandias,
S.Kep., NS., Mrs. Grace Kaparang S.Kep., Ns.
Researcher's family and friends for advice, guidance,
support, and patience during this research project.
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