Peningkatan Vaskularisasi Perifer dan Pengontrolan Glukosa Klien Diabetes Mellitus Melalui Senam Kaki

Abstract

Pendahuluan: Diabetes Mellitus merupakan penyakit metabolik kronis. Diabetic foot ulcers merupakan komplikasi yang sering terjadi akibat kadar glukosa yang tidak terkontrol.  Tujuan penelitian menjelaskan pengaruh senam kaki terhadap status vaskularisasi perifer dan glukosa darah. Metode: Penelitian menggunakan quasy experimental pre-post test control group design. Populasi berjumlah 30 responden yang terbagi dalam kelompok perlakuan dan kontrol. Teknik sampling menggunakan purposive sampling. Kriteria inklusi meliputi klien DM berusia >45 tahun, DM tipe II, dan glukosa darah acak < 300 mg/dl. Kriteria eksklusi meliputi klien ulkus diabetikum, GDA >300 mg/dl, gout artritis. Intervensi senam kaki diberikan 3 kali seminggu selama 4 minggu. Pengukuran variabel capilarry refill time menggunakan observasi penekanan ujung jari. Pengukuran variabel glukosa menggunakan glukosa stick-test. Analisis data menggunakan Wilcoxon & mann whitney test digunakan mengukur variabel capillary refill time. Independent & paired t-test digunakan mengukur variabel glukosa. Hasil: Uji variabel CRT menggunakan Mann-Whitney test menunjukkan nilai p = 0.022 yang berarti ada pengaruh senan kaki tehadap capillary refill time. Hasil uji variabel Glukosa darah menggunakan paired t test menunjukkan p=0.004, dan independent t test menunjukkan p=0.012 yang berarti ada pengaruh senam kaki terhadap kadar glukosa darah. Diskusi: Senam kaki terbukti meningkatkan Nitric Oxode Syntesis, vasodilatasi arteri, terjadi pembakaran gula darah yang mengakibatkan turunnya gula darah, afinitas oksigen hemoglobin, dan viskositas darah. Sebaliknya, terjadi peningkatan sirkulasi darah, saturasi oksigen, perfusi jaringan, dan sistem imunitas sehingga dapat mencegah ulkus kaki diabetik. Dalam upaya preventif, sebaiknya dinas kesehatan khususnya puskesmas untuk menyediakan media promosi kesehatan melalui penyediakan booklet senam kaki kaki.

 

Introduce: Diabetes Mellitus was a chronic metabolic disease. Diabetic foot ulcers were a complication that often results from uncontrolled glucose levels. This study was to explain the effect of foot exercises on the status of peripheral vascularization and blood glucose. Methods: The study was quasy experimental design. The population were 30 respondents divided into treatment and control group. The sampling technique uses purposive sampling. Inclusion criteria included client DM aged >45 years, DM type II, and random blood glucose <300 mg/dl. Exclusion criteria included respondents who had complications of diabetic foot ulcer, random blood glucose > 300 mg / dl, gout arthritis. Measurement of capillary refill time variables using fingertip emphasis observation. Measurement of random blood glucose variables using a glucose stick test.Data analysis using wilcoxon & mann whitney test was used to measure the capillary refill time variable. Independent & paired t-test was used to measure glucose variables. Interventions were given 3 times a week for 4 weeks. Result: In the CRT variable using the Mann-Whitney test showed a p value = 0.022 which means that there was an effect of foot exercises on the status of peripheral vascularization. On the blood glucose variable using paired t test showed p = 0.004, and independent t test showed p = 0.012 which means there is an influence of foot exercises on blood glucose levels. Discuss: Foot have been shown to increase Nitric Oxode Syntesis, arterial vasodilation, blood sugar burning which results in a decrease in blood sugar, oxygen affinity of hemoglobin, and blood viscosity. Conversely an increase in blood circulation, oxygen saturation, tissue perfusion, and immune system can prevent diabetic foot ulcers. In a preventive effort the health department, especially the puskesmas, should provide health promotion media through the provision of foot exercise exercises.