Type II Diabetes Research Articles

ANALISIS BIAYA MEDIS LANGSUNG DAN TARIF INA-CBG’s PASIEN DIABETES MELITUS TIDAK TERGANTUNG INSULIN DI RSUD ANUTAPURA PALU

Diabetes mellitus is a long-term disease with an increasing prevalence. Diabetes mellitus is one of the main causes of human morbidity and death and has a significant impact on health financing. Indonesia itself has implemented a national health insurance program that prioritizes effectiveness and cost efficiency. This study aims to determine the average direct medical costs, INA-CBG's rates, the suitability of direct medical costs and INA-CBG's as well as the influence of treatment class, severity, number of secondary diagnoses, and length of stay on the direct medical costs of diabetes mellitus patients at Anutapura Hospital Palu. This research is a descriptive observational study with retrospective data collection from medical records and files detailing patient care costs at Anutapura Hospital Palu in 2020 from the hospital's perspective. The sample used was BPJS inpatients with a primary diagnosis of type 2 diabetes or non-insulin dependent diabetes mellitus (DMTTI) who met the inclusion and exclusion criteria, totaling 132 patients. Data were analyzed descriptively and to see the influence of variables on total costs, the Independent sample t-test and Mann-Whitney test were used. The research results show that the average direct medical costs are IDR 2,751,449, the average INA-CBG's rate is IDR 4,505,508, so there is a mismatch between direct medical costs and INA CBG's. There is a significant influence partially or simultaneously and in a positive direction from the variables treatment class, severity, number of secondary diagnoses, and length of stay on direct medical costs.

Is Diabetes a Contraindication to Lower Extremity Flap Reconstruction? An Analysis of Threatened Lower Extremities in the NSQIP Database (2010-2020).

Background The impact of diabetes on complication rates following free flap (FF), pedicled flap (PF), and amputation (AMP) procedures on the lower extremity (LE) is examined. Methods Patients who underwent LE PF, FF, and AMP procedures were identified from the 2010 to 2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) database using Current Procedural Terminology and International Classification of Diseases-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and nondiabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent AMP, 5% underwent PF, and <1% underwent FF. Across all procedure types, noninsulin-dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared with absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p = 0.5969; NIDDM: p = 0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared with amputation for IDDM and NIDDM patients. Length of stay > 30 days was statistically associated with IDDM, particularly those undergoing FF (AMP: 5%, PF: 7%, FF: 14%, p = 0.0004). Conclusion Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation.

Trend of Non-Alcoholic Fatty Liver Disease in Type II Diabetes Mellitus

Background: Non-alcoholic fatty liver disease (NAFLD) is becoming quite common in Type II Diabetes Mellitus (TIIDM) as obesity and insulin resistance are common within TIIDM and it is becoming a widespread liver condition globally. This study evaluated the prevalence of NAFLD patients who also had type II diabetes. Methods: The demographic data (name, age, body mass index (BMI), gender, occupation, duration of TIIDM, and treatment taking for TIIDM), as well as the results of the tests for these enzymes, were also recorded. Alanine transaminase (ALT) and Aspartate transaminase (AST) levels, as well as abdominal ultrasound findings of the liver, were recorded in a proforma after informed consent for a total of 200 Type II diabetic patients. Using SPSS, the data were analyzed, and stratified groups were subjected to the Chi-square tests. Results: There was a significant difference (p&lt;0.05) observed in NAFLD patients of TIIDM concerning age, gender, BMI, treatment, occupation, and duration of diabetes. The sample size consisted of 200 patients of which 111 (55.5%) were men and 89 (44.5%) were women. Patients ranged in the age range of 40-70 years old, with a mean age of 55.08 ± 8.98 years and a mean BMI of 29.69±4.04, respectively. It was concluded that 64% of cases with diabetes mellitus had NAFLD. Conclusion: TIIDM is an independent risk factor for NAFLD so early screening, diagnosis, and appropriate treatment are mandatory to reduce the risk of NAFLD and its related complications.

Pregnancy course and outcomes in patients with non-insulin dependent gestational diabetes mellitus: An observational cohort study

Background. Gestational diabetes mellitus is the most frequent metabolic disorder during pregnancy. Its prevalence is steadily increasing worldwide. In the setting of hyperinsulinism, this pathology may cause various structural and functional changes in the placenta, as well as a reduction in oxygen supply to the fetus. This may result in fetal hypoxia and increased risk of fetal growth restriction. Therefore, research into the specific features of gestation course in patients with gestational diabetes mellitus in order to prevent its complications appears relevant. Objective. To study the specific features of gestation, delivery, and perinatal outcomes in patients with non-insulin dependent gestational diabetes mellitus. Methods. We conducted an observational cohort study of the case histories of 120 women with singleton pregnancies of the second and third trimesters with diagnosed non-insulin dependent gestational diabetes mellitus, their labor and delivery records, and the medical records of the newborns. All the patients were managed at the Ural Research Institute of Maternity and Child Care during 2021–2023. The main group comprised 70 patients whose pregnancy was complicated by sub- and decompensated forms of placental insufficiency. The comparison group comprised 50 pregnant women without pathologies of the fetoplacental complex. The obstetric history, gestation course of the present pregnancy and its outcomes, as well as the condition of the newborns, were analyzed. The obtained data were processed by the methods of variation statistics using Microsoft Excel spreadsheets (Microsoft, USA) and Statistica 13 (DellInc., USA) and MedCalc 15.8 (MedCalcSoftware, Belgium) applications. The null hypothesis was rejected at p &gt; 0.05. Results. Gestational diabetes mellitus in previous pregnancies was statistically significantly less frequent in the main group (2.9% (n = 2)) than in the comparison group (18.0% (n = 9)) ( p &gt; 0.05). Placental insufficiency in the main group was characterized by fetal growth restriction, which was associated with impaired uteroplacental blood flow in 58.6% (n = 41) of the cases. In the main group, the pregnancy ended in preterm delivery in 21.4% (n = 15) of the cases; in 78.6% (n = 55) of the cases, the delivery was at term. There were no preterm births in the comparison group, p &gt; 0.05. Cesarean section was performed in 62.9% (n = 44) of patients in the main group, compared to 20.0% (n = 10) in the comparison group ( p &gt; 0.05). Newborns of the main group required respiratory support more often (p &gt; 0.05). Conclusion. The mechanism of placental insufficiency in patients with non-insulin dependent gestational disorders of carbohydrate metabolism remains to be elucidated. Further research should investigate the predictors of fetoplacental complex pathologies in this group of patients in order to reduce the number of perinatal complications.

Structural insights into the interactions of repositioning and known drugs for Alzheimer’s disease with hen egg white lysozyme by MM-GBSA

Six drugs (dapsone, diltiazem, timolol, rosiglitazone, mesalazine, and milnacipran) that were predicted by network-based polypharmacology approaches as potential anti-Alzheimer’s drugs, have been subjected in this study for in silico and in vitro evaluation to check their potential against protein fibrillation, which is a causative factor for multiple diseases such as Alzheimer’s disease, Parkinson’s disease, Huntington disease, cardiac myopathy, type-II diabetes mellitus and many others. Molecular docking and thereafter molecular dynamics (MD) simulations revealed that diltiazem, rosiglitazone, and milnacipran interact with the binding residues such as Asp52, Glu35, Trp62, and Asp101, which lie within the fibrillating region of HEWL. The MM-GBSA analysis revealed −7.86, −5.05, and −10.29 kcal/mol as the binding energy of diltiazem, rosiglitazone, and milnacipran. The RMSD and RMSF calculations revealed significant stabilities of these ligands within the binding pocket of HEWL. While compared with two reported ligands inhibiting HEWL fibrillation, milnacipran depicted almost similar binding potential with one of the known ligands (Ligand binding affinity −10.66 kcal/mol) of HEWL. Furthermore, secondary structure analyses revealed notable inhibition of the secondary structural changes with our candidate ligand; especially regarding retention of the 3/10 α-helix both by DSSP simulation, Circular dichroism, and FESEM-based microscopic image analyses. Taking further into experimental validation, all three ligands inhibited fibrillation in HEWL in simulated conditions as revealed by blue shift in Congo red assay and later expressing percentage inhibition in ThioflavinT assay as well. However, dose-dependent kinetics revealed that the antifibrillatory effects of drugs are more pronounced at low protein concentrations. Communicated by Ramaswamy H. Sarma

Ab. No. 163 Effect of 12 Week Activity-Based Exercise Program on Upper Extremity Function in Patients With Type II Diabetes With and Without Shoulder Dysfunction

Introduction: the study evaluates the effect of 12 week activity-based exercise program(ABEP)on upper extremity(UE)functions in patients with type II diabetes with and without shoulder dysfunction(SD). Participants-88 participants with typeII diabetes with SD(n=44)and without SD(n=44) including both male and female between 40-60 years of age were recruited using convenient sampling method. Methods: The study commenced after the approval from the Institutional Ethics Committee. Outcome measures evaluated were pain intensity, UE range of motion (ROM)and muscle strength, shoulder joint proprioception (JP), grip strength, pinch grip and disability scores. Patients were trained with ABEP for 12 weeks. Treatment outcome was recorded after every 4 weeks up to completion of 12 weeks, post which all the outcome variables were re-assessed to compare the difference. Result: Significant reduction was observed in pain intensity(p=0.00) and disability scores (p=0.0)along with improvement in shoulder joint ROM(p=0.01),muscular strength(p=0.00),shoulder JP(p=0.01)hand grip strength(p=0.02)and pinch grip strength(p=0.00)in patients with SD. There was significant improvement seen in muscular strength(p=0.02) in patients without SD. There was significant reduction seen in HbA1c levels in patients with SD(p= 0.05)and without SD(p=0.02). Conclusion: The study concluded that in individuals with type II diabetes with SD, an ABEP was effective in improving UE functions. It was also observed that patients who did not had SD, demonstrated an improvement in muscle strength and decrease in HbA1c levels. Implications: ABEP as a home exercise program is proved to be beneficial in improving UE functions.

The spontaneous-diabetes rat: a model of noninsulin dependent diabetes mellitus by Yoshio Goto and Masaei Kakizaki (1981).

Y. Goto and M. Kakizaki produced a rat model of non-insulin dependent diabetes mellitus (NIDDM) by repetitive selective breeding of rats with slightly impaired glucose tolerance. In contrast to most obese diabetes models, which were genetically modified animals created by inducing a gene mutation, this rat was a unique model because it was a spontaneous diabetes model created by selective breeding. Furthermore, when it became clear that this rat was a non-obese diabetic model that exhibited hyperglycemia due to a decrease in insulin secretion capacity, it was recognized as a valuable model for elucidating non-obese, hypoinsulinemic diabetes commonly seen in East Asians. Diabetes is becoming an important health problem worldwide, especially in the East Asian region, thus Goto-Kakizaki (GK) rats are becoming increasingly important as a model of non-insulin dependent diabetes mellitus.

Prevalence and Severity of Periodontal Disease and its Association with Type-II Diabetes Mellitus and Smoking by Using Periodontal Screening and Recording: A Retrospective Study.

Periodontal screening recording (PSR) is considered a quick, reliable, reproducible valuable screening tool for periodontal disease. This study aims to find the prevalence and severity of periodontal disease and its association with self-reported diabetic status and smoking history of the patients by using PSR codes over a period of 2 years. This was a cross-sectional retrospective study in a dental hospital in Chandigarh. Data of 10,882 patients comprising self-reported history of smoking (893) and diabetes (725) patients were assessed for the prevalence of periodontal disease by using PSR codes. Pearson Chi-Square test was used for statistical evaluation of PSR codes data. Out of a total of 65,292 sextants assessed, the maximum and minimum reported PSR codes were 2 and 4, respectively. Gingivitis was found to be the most prevalent, followed by periodontitis and periodontal health in the total assessed population (P < 0.001). Mucogingival problems and complete edentulism were found to be more prevalent in posterior sextants in comparison to anterior sextants. Both self-reported smokers and type-II diabetes mellitus patients presented gingivitis as the most common clinical presentation, with the highest prevalence seen in the 55-74-year age group, which also comprised the group with maximum mucogingival problems and edentulism. This study gives an overview of patients' general oral health status and reflects the burden of periodontal disease in the Chandigarh region, thus contributing to the national oral health data.

Diabetes related attitude of healthcare professionals by using diabetes attitude scale - (das-3) in primary health care centers, Tabuk City, Saudi Arabia : a cross-sectional study

Objective: This study aimed to measure healthcare professionals (HCPs) diabetes related attitude in Tabuk city, Saudi Arabia. Methods: A cross-sectional descriptive study was conducted in Tabuk, Saudi Arabia. Two parts of a self-administered questionnaire were completed by 304 healthcare professionals. It consisted of two parts. The first one was about the sociodemographic characteristics, whereas the second part consist of the third version of the Diabetes Attitude Scale (DAS-3). Result: Over 7 months, 308 questionnaires were collected (84.4% response rate). Majority were females. Most participants belonged to the age group of 31-40 years (61.2%). The responses to the Diabetes Attitude Scale – 3 showed highest score (best performance) in the need for special training subscale (4.43±0.50), followed by patient autonomy (3.88±0.46), then the psychological impact of DM (3.69±0.49), than seriousness of non-insulin-dependent diabetes mellitus (NIDDM) (3.49±0.54) and the least was the value of tight control (3.31±0.50). Conclusion: This study suggested the need to increase continuous medical education (CME) in the field of diabetes and more research to compare the attitude of healthcare professionals in different parts of Saudi Arabia.

Neurotoxic effects of type II-diabetes mellitus and the possible preventive effects of olive leaves supplement in male rats.

Diabetes mellitus (DM) is a common metabolic disorder with well-known serious secondary complications. It is also associated with central nervous system damage. This damage is characterized by impairments in brain functions, with neurochemical and structural abnormalities. The study was conducted to clarify the neuroprotective effects of olive leaf supplements on the brain and brain histological structure of diabetic adult rats. Thirty adult male rats were allocated into three groups, the first group (CC), received an oral supplement containing olive leaves supplements (OLS) and served as a control; in the other group , DM was induced in these animals and left for 40 days; and the third group was DM+OL, which induced DM, then treated with oral OLS for 40 days. The investigation included serum glycemic index measurements, in addition to the level of malondialdehyde (MDA), glutathione (GSH), dopamine (DOP), acetylcholinesterase (AchE) in brain tissue, and histopathology of brain and pancreas. We demonstrated a significant increase in glycemic index measurements in diabetic groups (DM, DM+OL) at the beginning of a trial; however, the same parameters were significantly decreased after treatment with OLS in only the DM+OL group after 40 days. The study also showed differences in the levels of MDA, and GSH, in the diabetic groups, which returned to normal levels after being treated with OLS. Moreover, AchE and DOP exhibited a significant decline in diabetic rats. However, OLS induced a considerable rise in these neurotransmitters after treatment with it in the DM+OL group. The histopathological section of the pancreas and brain showed histopathological changes in DM groups; whereas, the tissue was shielded from chemical damage from DM by the OLS treatment in DM+OL animals. Overall, diabetes impairs glucose hemostasis by affecting glucose concentration, insulin level, and insulin resistance. However, olive leaf supplements restored the glucose hemostasis close to normal in diabetic rats. Furthermore, diabetes affects neurotransmitters by increasing the level of oxidative stress in brain tissue, and brain cell damage. Nevertheless, olive leaf supplements can ameliorate DM harmful effects by retrieving the normal oxidative environment in the brain.

Assessment of Depression, Anxiety and Stress among Patients with Type-II Diabetes Mellitus Study in a Bangladeshi Tertiary Care Hospital

Assessment of Depression, Anxiety and Stress among Patients with Type-II Diabetes Mellitus Study in a Bangladeshi Tertiary Care Hospital

Silent choker: Unveiling tracheal stenosis as an atypical manifestation of mucormycosis.

Airway mucormycosis is a fatal opportunistic infection typically seen in immunocompromised individuals. In this case report, we present an unusual instance of tracheal stenosis in a patient with diabetes mellitus who had recently recovered from coronavirus 2019 (COVID-19). Our patient was a 69-year-old male with poorly controlled type-II diabetes mellitus, on oral hypoglycemic agents, who had successfully completed treatment for COVID-19. Approximately one month later, he developed a cough, fever and breathlessness. Several factors, including advanced age, history of smoking and tobacco chewing, the nodular appearance of the trachea on bronchoscopy, hypermetabolic wall of the trachea on positron emission tomography scan and dysplasia on biopsy, initially raised suspicion of malignancy. However, repeated biopsies from multiple sites confirmed the diagnosis of tracheal mucormycosis. The patient was treated with amphotericin-B and posaconazole. We extensively reviewed the literature and found only 14 reported cases to discuss compared to ours.

Nano formulation of Berberine (Brb): Transforming a natural alkaloid into advanced therapeutics

A naturally occurring isoquinoline alkaloid “Berberine” (Brb) is found in various plant species of the genus Berberis, such as Berberis vulgaris, Berberis aristata, Berberis microphylla, and so on. This component has been studied extensively by various researchers and scientists for its diverse therapeutic properties, including anticancer, antiviral, antimicrobial antidiarrheal, and anti-inflammatory effects. One of the most remarkable applications of berberine is its efficacy in managing type-II diabetes, which is attributed to its capability to initiate adenosine monophosphate, glycolysis stimulation, protein kinases activation, inhibit mitochondrial function and thus collectively enhance the lipid and glucose metabolism. Also, Berberine has shown promising outcomes in addressing other health conditions, such as hypertension, cardiac arrhythmias, and congestive heart failure. In spite of its numerous benefits, extensive usage of berberine has been hindered by some challenges such as low bioavailability, limited absorption, and poor water solubility. Nano formulation has emerged as an auspicious approach to overcome these obstacles. This review highlights the advancements of using nano technology to overcome the limitations of berberine (Brb) associated with its absorption, dissolution, and bio-distribution, which are critical for its active application of pharmacology. While previous studies have explored the use of nano-carriers for transfer of drug, this review uniquely underlines an inclusive evaluation of several nanocarrier, together with lipid-based nanoparticles (SLNs, NLCs, micelles, and liposomes), polymeric-based nanoparticles (chitosan, alginate, dextran, and PLGA) and advanced materials (graphene, dendrimers, gold (Au), and silver (Ag) nanoparticles). It emphasizes their specific applications in treating conditions like diabetes, osteoarthritis, microbial infections, and melanoma, with special attention on innovative applications such as thermal therapy with AuNP-Brb and bio-imaging with Brb-based carbon dots. In conclusion, nanotechnology has shown an outstanding result in improving the therapeutic strength and delivery of berberine, more investigation is necessary to interpret these nanoparticle carriers into clinical applications. The detailing of specific therapeutic effects and this breadth of comparison highlight the novelty of this review, which sets a foundation for future research to translate these findings into clinical applications.

To find out the efficacy of Gymnema sylvestre in cases of the type-II DM along with auxiliary treatment

To find out the efficacy of Gymnema sylvestre in cases of the type-II DM along with auxiliary treatment

Mitochondrial fatty acid beta-oxidation: a possible therapeutic target for skeletal muscle lipotoxicity in peripheral artery disease myopathy.

Peripheral artery disease (PAD) is an atherosclerotic disease impacting over 200 million individuals and the prevalence increases with age. PAD occurs when plaque builds up within the peripheral arteries, leading to reduced blood flow and oxygen supply to the outer extremities. Individuals who experience PAD suffer from ischemia, which is typically accompanied by significant damage to skeletal muscles. Additionally, this tissue damage affects mitochondria, causing them to become dysregulated and dysfunctional, resulting in decreased metabolic rates. As there is no known cure for PAD, researchers are exploring potential therapeutic targets by examining coexisting cardiovascular conditions and metabolic risk factors, such as the aging process. Among these comorbidities, type-two diabetes mellitus and obesity are particularly common in PAD cases. These conditions, along with aging itself, are associated with an elevated accumulation of ectopic lipids within skeletal muscles, similar to what is observed in PAD. Researchers have attempted to reduce excess lipid accumulation by increasing the rate of fatty acid beta oxidation. Manipulating acetyl coenzyme A carboxylase 2, a key regulatory protein of fatty acid beta oxidation, has been the primary focus of such research. When acetyl coenzyme A carboxylase 2 is inhibited, it interrupts the conversion of acetyl-CoA into malonyl-CoA, resulting in an increase in the rate of fatty acid beta oxidation. By utilizing samples from PAD patients and applying the pharmacological strategies developed for acetyl coenzyme A carboxylase 2 in diabetes and obesity to PAD, a potential new therapeutic avenue may emerge, offering hope for improved quality of life for individuals suffering from PAD.

Determination of Diabetes-associated Cardiovascular Autonomic Neuropathy Risk Factors among Insulin and Non-insulin Dependent Diabetics

Cardiovascular autonomic neuropathy (CAN) is a microvascular consequence characterized by the dysfunction of cardiovascular autonomic regulation in individuals diagnosed with diabetes, in the absence of any other underlying causes. This cross-sectional study was carried out in Baghdad City, Iraq in order to assess the risk factors of diabetes-associated cardiovascular autonomic neuropathy among insulin and non-insulin dependent diabetics. from January 20th 2023 to August 1st 2023. The mean age of studied patients was 48 years and the mean duration of diabetes was 15 years. 99 of diabetic patients were males and 64 of them were females; 94 were IDDM and 66 were NIDDM patients. In NIDDM patients, autonomic neuropathy was substantially correlated with retinopathy (P &lt; 0.001), with a greater frequency of retinopathic individuals (82%) in the autonomic neuropathy group. There was a strong relationship between blood pressure and almost every test in both types of diabetes. In this clinic-based investigation, it is clear that autonomic neuropathy is related to microvascular diabetes sequelae, such as retinopathy and nephropathy in IDDM. In IDDM, there is evidence that glycemic control is important, but in NIDDM, additional variables than metabolic control could be important. However, data suggest a connection between autonomic neuropathy and blood pressure. Longitudinal and epidemiological research are required to better understand the association between cardiovascular risk factors and autonomic neuropathy, as well as the pathophysiology, prognosis, and prognostic implications of autonomic neuropathy.

Diabetes Management through α-Glucosidase Inhibitors Challenges and Current Perspectives

Type 2 diabetes mellitus (T2DM) known as non-insulin dependent diabetes mellitus, is a chronic metabolic disorder caused by insulin deficiency or insulin resistance. The incidence of T2DM is increasing day by day. According to data from World Health Organization (WHO), the number of diabetic patients is expected to rise up to 642 million by 2040.This alarming situation needs proper treatment to control diabetes. Physicians mostly prescribe insulin based medications, but in this new medical era, α-glucosidase inhibitors (AGIs) based drug therapy possess tremendous preventive and potential inhibitory effect upon the over expression of the enzyme which digests the carbohydrate macromolecules and breaks down into single chain monomeric α-glucose units. As a result, carbohydrate breaks down gradually decreases, which slowing down the absorption of post prandial glucose PPG, regulating the blood glucose level. This review article addresses about the management of T2DM through AGIs along with new potential leads from natural products in the pipeline of new AGI drugs development from synthetic and natural origin.

A prospective observational study on safety and efficacy of metformin and its combination used in type-ii diabetes mellitus patients

Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced. This study was carried out with an objective to determine the efficacy of Metformin with other oral hypoglycemic agents, to educate the patients about the disease and use of drugs in diabetes mellitus and to evaluate which class of drugs in oral hypoglycemic agents with Metformin shows more effectiveness. The patients in each group received the medication for 8 weeks duration. A study was carried out about the comparative, efficacy of glimepiride and metformin in type-2 DM which was a meta-analysis of randomized controlled trials. The results of the study were that metformin alone does not show the efficacy than with Metformin+ Teneligliptin and Metformin + Glimepiride in overall efficacy of controlling FBS and PPBS. Combination of Metformin+ Glimepiride is more effective than Metformin+ Teneligliptin and Metformin alone. The findings from the study observed the combination of metformin efficacy to some extent.

PENGARUH TERAPI RELAKSASI OTOT PROGRESIF TERHADAP PENURUNAN KADAR GLUKOSA DARAH PADA DIABETES MELITUS TIPE II

ABSTRACT&#x0D; Background: Type II Diabetes Mellitus or commonly called lifestyle diabetes is diabetes caused by an unhealthy lifestyle. In someone with type II diabetes mellitus, insulin can still be produced by the pancreas, but the amount of insulin is still insufficient so that type II diabetes mellitus is considered as NIDDM (Non Insulin Dependent Diabetes Mellitus). IDF estimates that there are 463 million people in the world experiencing diabetes mellitus in 2019. There has been an increase in the incidence of diabetes mellitus by 19.9% ​​in 2020. In Central Java in 2019 there were 13.4% new cases of diabetes mellitus. Data from the Kudus Regency Health Office in 2019 noted that 17,869 people had diabetes mellitus, especially at the UPTD health centers in Japan, as many as 1,210 people had diabetes mellitus in 2022. There are 4 pillars in the management of DM, such as education in the form of knowledge about DM, regulation/diet in the form of low carbohydrates, pharmacological therapy in the form of Oral Hyperglycemic Drugs (OHO), and physical exercise, one of which is progressive muscle relaxation therapy. The purpose of this study was to determine the effect of progressive muscle relaxation therapy on reducing blood glucose levels in diabetes mellitus. The design in this study was pre-experimental, with a one-group pre-test and post-test design approach. There are two variables, namely the independent variable giving Progressive Muscle Relaxation Therapy while the dependent variable is Blood Glucose Levels in Type II Diabetes Mellitus. The population is all patients with Diabetes Mellitus in the working area of ​​the Kudus Japan Health Center in 2022 as many as 1210 people. Taken by purposive sampling technique. Collecting data using a questionnaire and checklist. Data analysis techniques using SPSS with the Wilcoxon statistical test. The Asimp.Sig result is 0.000 &lt;0.05, then H0 is rejected, meaning that there is an effect of progressive muscle relaxation therapy. The purpose of this study was to determine the effect of progressive muscle relaxation therapy on reducing blood glucose levels in diabetes mellitus II. Respondents who used it experienced a decrease in GDS after being given progressive muscle relaxation therapy 84.7% greater than before being given the action. For this reason, it is necessary to provide progressive muscle relaxation therapy to reduce blood glucose levels in diabetes mellitus II.

A deep neural network with modified random forest incremental interpretation approach for diagnosing diabetes in smart healthcare

Artificial intelligence (AI) applications based on deep learning for diagnosing type-II diabetes are sometimes difficult to understand and communicate even as patients are eager to understand the rationale behind the diagnostic results. Accordingly, recent studies have used multiple simple rules to adequately explain the diagnostic process and results to patients. However, this can cause patient confusion as the rules vary. Hence, this study proposes a deep neural network (DNN) with random forest (RF) and modified random forest incremental interpretation (MRFII) approach for diagnosing diabetes. This method first entails constructing a DNN to predict the probability of a patient having diabetes. To make the prediction result explainable, an RF is built to explain the process and results in terms of multiple simple decision rules. Additionally, to eliminate patient confusion, the MRFII is proposed to sort and aggregate the decision rules for a specific patient. A certainty mechanism is also established to feed back the explanation results from RF to improve the effectiveness of the DNN. The proposed method was applied to a diabetes dataset from the National Institute of Diabetes and Digestive and Kidney Diseases, and the results showed that this approach provided a more concise and accurate explanation than existing explainable artificial intelligence (XAI) techniques for the same purpose.