Cegah Amputasi Gangrene Penderita Diabetes Mellitus Tipe 2 Melalui Pemanfaatan Media Video Senam Kaki

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ABSTRAK

Diabetes mellitus (DM) menjadi masalah kesehatan di seluruh dunia, diperkirakan 462 juta orang (6,28% populasi dunia) terkena DMT2. Hiperglikemia kronik menyebabkan disfungsi endotel seperti kalsifikasi medial arteri yang menyebabkan gangguan sirkulasi dan syaraf di kaki. Ulkus DM yang terinfeksi menyebabkan gangrene sehingga berisiko amputasi apabila tidak ditangani. Ankle Brachial Index (ABI) untuk screening gangguan sirkulasi kaki. Strategi pencegahan mengurangi risiko ulkus, gangrene dan amputasi dapat menggunakan pendidikan kesehatan pada pasien terkait gaya hidup dan olah raga/senam. Angka kejadian DM tertinggi di Desa Karanggedang dibandingkan 10 desa lainnya di Kecamatan Sidareja. Sejumlah 61 orang DMT2 memiliki GDS > 200 mg/dl. Tujuan PKM ini yaitu meningkatkan kesadaran penderita DMT2 tentang gaya hidup yang baik, serta perbaikan sirkulasi perifer dengan perbaikan nilai ABI pada 2 kali pengkuran. Metode PKM ini menggunakan ceramah, diskusi, tanya jawab, wawancara, demonstrasi, redemonstrasi, dan menonton video senam kaki diabetes meliputi tahap persiapan hingga evaluasi sebanyak 14 kali pertemuan. Didapatkan hasil rata-rata peserta berumur 55,27 tahun, mayoritas memiliki hipertensi 9 (60%) orang, lama menderita DM 1-6 tahun, skala nyeri pre 5 (sedang) yang menurun 2 poin menjadi 3 (ringan), mengeluh baal pre 12 (80%) dan membaik menjadi 5 (33,5%) orang, kadar GDS pre 216,07 mg/dl menurun menjadi 185 mmg/dl, nilai ABI pre seluruh peserta 0,81 (abnormal) dan membaik seluruhnya saat post 1,12 (normal) yang signifikan secara statistik. Saran bagi penderita DMT2 di Desa Karanggedang agar tetap rutin melakukan senam kaki diabetes secara mandiri, dan bagi kader kesehatan aktif mengingatkan dan memotivasi penderita untuk melakukan senam kaki diabetes secara rutin.

Kata kunci: senam kaki diabetes, ABI, gangren, amputasi.

ABSTRACT

Diabetes mellitus (DM) is a health problem worldwide, it is estimated that 462 million people (6.28% of the world's population) are affected by T2DM. Chronic hyperglycemia causes endothelial dysfunction such as calcification of the medial artery which causes circulatory and nerve disorders in the legs. Infected DM ulcers cause gangrene so there is a risk of amputation if untreated. Ankle Brachial Index (ABI) is used to screen for circulatory disorders in the legs. Prevention strategies to reduce the risk of ulcers, gangrene, and amputation can use health education in patients related to lifestyle and exercise/sports. The highest DM incidence was found in Karanggedang Village compared to 10 other villages in Sidareja District. A total of 61 DMT2 patients had GDS > 200 mg/dl. The purpose of this community service is to increase awareness of DMT2 sufferers about a good lifestyle, as well as to improve peripheral circulation by increasing the ABI value in 2 measurements. This community service method uses lectures, discussions, questions and answers, interviews, demonstrations, re-demonstrations, and watching videos of diabetic foot exercises starting from the preparation stage to evaluation for 14 meetings. The results showed that the average age of participants was 55.27 years, have hypertension 9 (60%) people, have suffered for 1-6 years, pre pain scale 5 (moderate) decreased by 2 points at the post becomes 3 (mild), pre numbness complaints 12 (80%) and improved to 5 (33.5%) people, pre levels blood glucose 216.07 mg/dl which decreased post levels blood glucose becomes 185 mg/dl, the pre-ABI of all participants was 0.81 (abnormal) and a statistically significant increase at all at post 1.12 (normal). Suggestions for DMT2 sufferers in Karanggedang Village to continue to regularly do diabetes foot exercises independently, and for care providers to always actively remind and motivate the sufferers to routinely do diabetic foot exercises.

Keywords: diabetic foot exercise, ABI, gangrene, amputation.