Perawatan Diabetes: Trend,

Issue, legal etik, dan

evidence based nursing

Ns. Harmilah. S.Pd, S.Kep, M.Kep, Sp.MB

Poltekkes Kemenkes Yogyakarta

Pokok Bahasan
• Perspektif perawatan
diabetes
• Legal etik perawatan
diabetes
• Trend dan issue
perawatan diabetes
* Long-term condi<on when the
body can’t produce insulin OR
can’t effec<vely use insulin
• Type 1 diabetes: mostly in
childhood ~ Insulin dependent
• Type 2 diabetes: contribute to
around 90% of total diabetes but
preventable and manageable
• Pre-diabetes: impaired glucose
tolerance/fas<ng BG
• Gesta<onal diabetes: diabetes at
pregnancy
Diabetes Facts
• An estimated 463 million adult aged 20-79 years (9.3% of world’s
population) are currently living with diabetes
• The estimated number of IGT is 374 million (7.5% of world’s
population)
• An estimated 1.1 million children and adolescents (<20 year) have T1D
• The number of death resulting from diabetes and its complication in
2019 is estimated to be 4.2 million
• An estimated 15.8% of life birth are affected by hyperglycemia in
pregnancy
• Annual global expenditure on diabetes is estimated to be USD 760 million
Global picture of diabetes
Diabetes facts
Legal Etik Perawatan Diabetes
• Indonesia Law: UU no 38 Tahun
• 2014 tentang Keperawatan
• Nurse ROLEs:
• Diabetes Nurse Specialists
• Certified Diabetes Educators
• Nurse podiatrist
• Wound care practioners
• Case managers (community)
Diabetes Partnerships
• Indonesia International
Trend dan Issue (1)
Screening for diabetes (T1D, T2D, pre-diabetes)
• Prevention of T2D
• Self management, self care, self care behavior
• Life style modification
- Diabetes education (health literacy, coaching)
- Dietary intake (adherence, type, calorie, obesity,
bariatric)
- Physical activity (adherence, type, dance)
- Medication (adherence, insulin, oral anti diabetic)
• Self monitoring, continuous glucose monitoring
• Complementary alternative therapy (herbs, TCM)
Trend dan Issue (2)
1. Diabetes complicatons
• Foot care: behavior, identificaton, neuropathy
• Cardiovascular complicatons
• Diabetes and eyes health (retinopathy)
• Diabetes and kidney problems (nephropathy)
• Hypoglycemia or hyperglycemia (DKA, HHS, LA)
• Men's health (impotency, sexual related problems)
2. Praccal diabetes during Ramadan
3. Gene<c diabetes (counseling)
4. Psychosocial aspect on diabetes (distress,
depression)
Diabetes dan COVID-19
• Secara global, diabetes menjadi komorbid terbanyak kedua
• setelah penyakit kardiovaskuler (Hussain et al, 2020; Roncon et al, 2020; Hill et
al,2020; Yang et al, 2020; Wicaksana et al, 2020).
• Penyandang diabetes berisiko tinggi terinfeksi COVID-19 (Hill etal, 2020;
Puig-Domingo et al, 2020).
• Pasien COVID-19 dengan diabetes memiliki risiko masuk ICU
(OR = 2,79 95%CI 1.85-4.22), mortality rate (OR = 3,21 95%CI
1.82-5.64) (Roncon et al, 2020; Banerjee et al, 2020; Wicaksana et al, 2020).
• Hiperglikemia berkaitan dengan perburukan outcome
perawatan pasien COVID-19 (Huang et al, 2020; Pal & Bhansali, 2020)
WASSALAMU ALAIKUM WR