BACKGROUND Studies on precision health care for older adults with diabetes in Indonesia are still limited. This study was aimed to reach the experts consensus on the suitable precision health care strategies for older adults with diabetes. METHODS A total of 10 experts (4 physicians, 4 nurses, and 2 dietitians) agreed to participate in the 3-round interview using Delphi technique. The experts should have at least 5 years of experience in teaching or working as health professionals in a hospital. RESULTS Consensus was reached that precision health care consisted of eight elements: self-management, interdisciplinary collaborative practice, personalized genetic or lifestyle factors, glycemic target, patient preferences, glycemic control, patient priority-directed care, and biodata- or evidence-based practice. The strategies of precision health care for diabetes were divided into seven steps: conducting brief deducting teaching; assessing self-management level and risk of cardiovascular disease; organizing a brainstorming session among patients to exchange experiences on glycemic target and specific target behavior; making a list of patients’ needs and ranking the priorities; setting a goal and writing action; doing follow-up; and reporting the goal attempts. CONCLUSIONS The eight elements of precision health care provided the basis of precision health care strategies for diabetic older adults, which are the real and measurable strategies for precision health care implementation in clinical settings.

Study Objective: Pain is a sensory and emotional experience shown by the patient as a response to the damage of the skin tissue or muscle. In fact, it is usually found that diabetic patients who experience pain during wound care treatment can not be handled properly. The purpose of this study is to find out the effect of TENS intervention towards the level of pain in DM patients with peripheral neuropathy in diabetic foot ulcer treatment. Design: Random control trial (RCT) Method and Measurements: 28 respondents which were divided into 14 interventions and 14 control groups. Respondents' pain was assessed before and after the intervention of TENS for 15 minutes with the electrical frequency of 100 Hz using Numeric Rating Scale tools. Statistic test: statistical test was conducted using independent T test and Paired T test. Results: There is a difference in the level of pain in the intervention group and control groups with P = 0.000. Intervention of TENS for 15 minutes with a frequency of 100 Hz effectively reduces the pain level of the patients with diabetes mellitus with with peripheral neuropathy in diabetic foot ulcer treatment is done with a P value of <0.05. Conclusions: TENS effectively reduces pain in diabetic patients with peripheral neuropathy in diabetic foot ulcer treatment.

Indonesia contributes to 45% of TB cases in the world. Currently, Diabetes mellitus (DM) case is increasing. DM may worsen TB. The risk of developing latent into active TB increases with the presence of DM. Treatment failure in TB patients with DM is more frequent than non-DM. The aim of this study was to analyze of TB DM collaboration program at the one hospital in Semarang City. This was a qualitative study with content analysis. Informants consisted of internists, nurses, patients. This study showed there was a gap between technical guidance from minister of health and implementation of DM screening from TB patient. Besides, human resources factors also contribute to that gap.

Background. It has been shown that dietary patterns are associated with glucose control. However, the association between the types of food consumed and blood glucose in overweight or obese individuals is still unclear. The present study aimed to determine the association between unhealthy food consumption and impaired glucose metabolism in adults with overweight or obesity. Methods. The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2018/RISKESDAS 2018). The body mass index (BMI) was calculated as weight (kg)/height squared (m2) and was determined based on the World Health Organization (WHO) criteria for the Asian population. A validated questionnaire and food card were used to assess the diet. Fasting plasma glucose and 2-hpost-prandial glucose were employed to determine blood glucose markers. Results. In total, 8752 adults with overweight or obesity were included in this analysis. We found that consumption of sweet, grilled, and processed foods was associated with impaired fasting plasma glucose (IFG) before and after adjustment ( p < 0.05 ). Consumption of high-fat foods was also associated with impaired glucose tolerance (IGT) for all models tested ( p < 0.05 ). Furthermore, all models showed a link between processed food consumption and combined glucose intolerance (CGI) ( p ≤ 0.001 ). Conclusions. Differential food group consumption was associated with IFG, IGT, and CGI in Indonesian adults who were overweight or obese.

Background: Obesity can trigger inflammation or inflammatory disease, which is one of the main features of adipose tissue dysfunction. Adipose secretes several different peptides called adipocytokines, which can induce several pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1. Omentoplasty pancreas dan sleeve gastrectomy is a surgical technique that can treat overweight and metabolic syndrome in obesity and type II DM. This study aims to determine the effect of pancreatic omentoplasty on weight loss and improvement of triglyceride and interleukin-1 levels in rats obesity with type II diabetes mellitus performed sleeve gastrectomy. Methods: This study is an experimental study in vivo. Eighteen rats participated in this study and were grouped into the control group (KI) and the KII and KIII treatment groups. Triglyceride levels were assessed using the spectrophotometric method, and IL-1 levels were assessed using the ELISA method. Data analysis was carried out using SPSS univariate and bivariate. Results: The KII and KIII treatment groups experienced a decrease in body weight, triglyceride levels, and Interleukin-1 levels of rats after the treatment intervention, p<0.05. The KIII treatment group showed the most significant reduction in body weight, triglyceride levels, and Interleukin-1 levels compared to the KII treatment. Conclusion: Pancreatic omentoplasty is effective in reducing body weight, reducing triglyceride levels, and reducing IL-1 levels in obese rats with type II diabetes mellitus undergoing sleeve gastrectomy surgery.

BACKGROUND: Obesity is a risk factor happening liver fibrosis because it makes presence of oxidative stress and inflammation that has role on pathogenesis and hepatic fibrosis progression. Until this moment, liver disease management still focused for treat disease primary, the most rational management of liver fibrosis is liver transplant, however number success transplant liver lower from on transplant kidneys, only 70-80% of recipients survived for at least 1 year, so that sleeve gastrectomy and liver omentoplasty procedure could become a choice for treating liver fibrosis on obese patients. AIM: This study aims to investigate correlation between sleeve gastrectomy and omentoplasty on TGF-β and IL-10 in obese rats with liver fibrosis METHOD: This study used a true experiment in-vivo design on male Wistar rat (Spargue Dawley) 4-6 weeks of age. Samples were divided into groups that includes normal control group, positive control group, group with sleeve gastrectomy, and group with both liver liver omentoplasty and sleeve gastrectomy. The level of TGF-β and IL-10 will be measured for descriptive and hypothesis analysis. RESULT: There is an increased level of IL-10 and TGF-β. Statistical analysis result shows a significant increase of IL-10 and TGF-β expression between normal group and control group with group given treatment sleeve gastrectomy and liver liver omentoplasty (p<0.05). CONCLUSION: liver Liver omentoplasty and sleeve gastrectomy procedure on obese mice with liver fibrosis could increases IL-10 expression but could not reduce (TGF-β expression).

Background: DM, especially type 2 diabetes mellitus (DMT2), is closely related to obesity. Insulin resistance and inflammation that occur in obese patients can be treated with SG procedures. Post-SG weight loss can reduce the lipo apoptotic process and can improve the function of pancreas β cells. The omentum is rich in potential mesenchymal stem cells and is rich in anti-inflammatory cytokines, and various growth factors, so the omentoplasty procedure is believed to be able to provide a regenerating effect on the pancreatic tissue so that the performance of the pancreas can be optimal. Methods: An experimental study with 18 rats which were divided into control and treatment groups. The treatments were sleeve gastrectomy and pancreatic omentoplasty. Furthermore, analysis of body weight and levels of IL-10 and HOMA IR was carried out with the help of SPSS software version 25 univariate and bivariate. Results: There was a difference in mean body weight, levels of IL-10, and HOMA IR before and after treatment, p<0.001. Conclusion: Omentoplasty is effective in improving the condition of diabetes mellitus with obesity after sleeve gastrectomy surgery in vivo.

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