Analisis Perbedaan Kadar HbA1C Berdasarkan Konsumsi Karbohidrat, Indeks Glikemik, Beban Glikemik, dan Aktivitas Fisik pada Pasien Diabetes Melitus Tipe 2

Minanton Minanton, Nuridha Fauziyah

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ABSTRACT

 

Glycemic control is a key indicator of successful diabetes mellitus type 2 management. Both the quality and quantity of carbohydrate intake—reflected by the Glycemic Index (GI) and Glycemic Load (GL)—play a major role in regulating blood glucose levels. However, many patients still have limited understanding of how GI, GL, and physical activity affect their HbA1c levels. This study aimed to analyze the relationship between carbohydrate intake, glycemic index, glycemic load, and physical activity with glycemic control (HbA1c) among patients with type 2 diabetes mellitus at Hamori Hospital, Subang. This research employed a comparative study with a cross-sectional approach. A total of 66 patients with type 2 diabetes were recruited using consecutive sampling. Carbohydrate intake was assessed using a modified semi-quantitative Food Frequency Questionnaire (FFQ), which demonstrated good validity (r = 0.84) and reliability (α = 0.91). GI and GL values were calculated based on food composition data, while physical activity was measured using the International Physical Activity Questionnaire (IPAQ) with reliability α = 0.88. HbA1c values were obtained from recent laboratory examinations. Data were analyzed using One Way ANOVA with SPSS version 23. The mean carbohydrate intake was 276.5 ± 51.7 g/day, mainly derived from white rice (62.1%). The mean GI was 66.2 ± 9.5, GL 185 ± 32.4, physical activity 1,695 ± 583 MET-min/week, and HbA1c 7.8 ± 1.0%. ANOVA results showed significant differences in HbA1c levels across categories of carbohydrate intake (F = 7.92; p = 0.001), GI (F = 9.13; p < 0.001), GL (F = 10.02; p < 0.001), and physical activity (F = 6.89; p = 0.002). Glycemic load exhibited the strongest influence on HbA1c variation among groups. Significant differences in HbA1c were observed based on carbohydrate intake, glycemic index, glycemic load, and physical activity. Glycemic load was identified as the most dominant factor influencing glycemic control. These findings emphasize the importance of dietary regulation based on GI and GL, along with increasing physical activity, as key strategies for diabetes management and as the foundation for developing a culturally tailored digital diabetes management application in Indonesia.

 

Keywords: Type 2 Diabetes Mellitus, Glycemic Index, Glycemic Load, Carbohydrate Intake, Physical Activity, Hba1c. 

 

ABSTRAK

 

Kontrol glikemik merupakan indikator utama keberhasilan penatalaksanaan diabetes melitus tipe 2. Kualitas dan jumlah karbohidrat yang dikonsumsi, yang tercermin dalam nilai Indeks Glikemik (IG) dan Beban Glikemik (BG), berperan besar dalam menentukan kadar glukosa darah pasien. Namun, masih banyak pasien yang belum memahami pengaruh IG, BG, dan aktivitas fisik terhadap kadar HbA1c mereka. Penelitian ini bertujuan untuk menganalisis hubungan konsumsi karbohidrat, indeks glikemik, beban glikemik, dan aktivitas fisik dengan kontrol glikemik (HbA1c) pada pasien diabetes melitus tipe 2 di RS Hamori Subang. Penelitian ini menggunakan desain komparatif dengan pendekatan cross-sectional. Sebanyak 66 pasien diabetes melitus tipe 2 dipilih dengan teknik consecutive sampling. Data konsumsi karbohidrat dikumpulkan menggunakan Food Frequency Questionnaire (FFQ) semi-kuantitatif yang telah dimodifikasi dan teruji validitas (r = 0,84) serta reliabilitasnya (α = 0,91). Nilai IG dan BG dihitung berdasarkan komposisi makanan yang dikonsumsi, sedangkan aktivitas fisik diukur dengan International Physical Activity Questionnaire (IPAQ) yang memiliki reliabilitas α = 0,88. Nilai HbA1c diperoleh dari hasil pemeriksaan laboratorium terkini. Analisis data dilakukan dengan uji One Way ANOVA menggunakan perangkat lunak SPSS versi 23. Rata-rata konsumsi karbohidrat responden adalah 276,5 ± 51,7 g/hari, dengan sumber utama berasal dari nasi putih (62,1%). Rata-rata nilai IG adalah 66,2 ± 9,5, BG 185 ± 32,4, aktivitas fisik 1.695 ± 583 MET-min/minggu, dan HbA1c 7,8 ± 1,0%. Uji ANOVA menunjukkan perbedaan signifikan kadar HbA1c antar kategori konsumsi karbohidrat (F = 7,92; p = 0,001), IG (F = 9,13; p < 0,001), BG (F = 10,02; p < 0,001), dan aktivitas fisik (F = 6,89; p = 0,002). Variabel beban glikemik memberikan pengaruh paling besar terhadap variasi HbA1c antar kelompok. Terdapat perbedaan signifikan kadar HbA1c berdasarkan tingkat konsumsi karbohidrat, indeks glikemik, beban glikemik, dan aktivitas fisik. Beban glikemik merupakan faktor yang paling dominan dalam memengaruhi kontrol glikemik. Temuan ini menegaskan pentingnya pengaturan diet berbasis IG dan BG serta peningkatan aktivitas fisik dalam pengelolaan diabetes, dan dapat menjadi dasar pengembangan aplikasi manajemen diabetes berbasis digital yang sesuai dengan pola makan masyarakat Indonesia.

 

Kata Kunci: Diabetes Melitus Tipe 2, Indeks Glikemik, Beban Glikemik, Konsumsi Karbohidrat, Aktivitas Fisik, Hba1c.


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DOI: https://doi.org/10.33024/mahesa.v6i6.23268

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