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Medical Faculty and Health Science

Muhammadiyah University of Yogyakarta

2011

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Diabetic Mellitus tipe 2 is a common endocrine disease

The prevalency of diabetic mellitus tipe 2 in the world andindonesia

The relationship between diabetic mellitus type 2 anddepression

What are the factors that contributed to depression outcomeand make depression better post SHG therapy of diabeticmellitus type 2 in community health center?

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Can self help group therapy which given patients of diabeticmellitus type 2 by comorbid depression:

improved the quality of life

controled blood glucose level controled total cholesterol level

than diabetic mellitus type 2 patient by comorbid depressionwho is not given SHG therapy?

1. General researchTo know and analyze the influence of SHG to quality of life,blood glucose level, total cholesterol level, risk factors andprognose factors on patient by diabetic mellitus type 2 incomorbid depression

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2. Spesific research

To know the factor which relate with quality of life andrisk and prognose factors

To know the influence of total cholesterol and bloodglucose level

To know the percentage of depression

1. Clinic : to give reference to take decision in management.

2. Community : to give information about the function of selfhelp group as alternative therapy.

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The research about result of self help group therapy ondiabetic mellitus type 2 by comorbid depression to qualityof life, control blood glucose level, total cholesterol level,

risk factors and prognose factors never practiced inIndonesia.

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Classification of diabetic mellitus based on ADA, 2010.

1. DM type 1

Diabetic Mellitus is a metabolic disease group byhyperglicemic signs because it has less of of secretioninsulin, insulin action, or both of them (ADA, 2010).

2. DM type 2

3. DM other type (genetic defect of beta cell function,genetic defect of insulin function, ecsocrin pancreasdisease, chemical medicine and imunology).

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The risk factors of depression by Maslim, 2002:Female gender, education level, married statue, income

level, age, smooking, and complication.

1. General signsLost of willingness and funLess of energy, fatigue, and less of activity

2. Extra signs

Less of concentration and attentionThink of bad future

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1. Low depression

2. Middle depression3. High depression without psychotic signs

4. High depression with psychotic signs

Diabetic increase risk depression because of fairly and loss

feeling and it is needed to change life quality to ignore thecomplication (Mezuk, 2008).

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It is group therapy in some situtations and conditions,

concious of two or more than two persons who have thesame problem and share it to better.

1. Share feeling and experiance among group3. To increase the knowlage, to change, the attitude and toincrease quality of life

A. Introduction

B. Problem solving

C. Closing

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DIABETES

MELLITUS

GLUCOSE LEVEL CONTROL :

COMPLIANCE TO TREATMENT

LAZY TO CHECKING BLOOD

EATING / DRINKING EXCESSIVE

MAINTENANCE COSTS

DEPRESSION

GLUCOSE

LEVEL

UNCONTROLED

GLUCOSE

LEVELCONTROLED

SHG

Insulin levels in the blood too low and glucagon levels toohigh.

Inhibited glycolysis and stimulated gluconeogenesis.

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REPAIR

NO

IMPROVEMENT

DIABETES

MELLITUSDEPRESSION

RISK FACTORS:

a. YOUNG AGEb. WOMEN'S GENDER

c. EDUCATION LEVEL

d. INGKAT REVENUE

e. SMOKING

f. SOCIAL STATUS

g. STATUS OF ETHNIC MINORITIES

h. COMPLICATIONSi. COMORBID

SHG

PROGNOSTIC

FACTOR

A. Biologycal Factor

B. Genetic factorsC. Psychosocial Factors

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Cholesterol level controled :

Treatment regulery

Blood ecamination lazynes

Over consumtion of food and drink

Care payment

Diabetic

mellitusDepression SHG

Cholesterol level

controlled

Cholesterol leveluncontrolled

The function of lipid based on (mayes etall, 2003)

1. Arange the cell membranestracture

2. Substancy of energy3. As hormone and vitamine

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Diabetic

MellitusDepression

Quality of life:Physical

Psychological

Social Relation

Family Intimace

Friendship

Financial

Self help

group

Improved of

Life Quality

The definition of life quality based on Dorland, 2003.it is described to measure the emotional, social, and physic

condition of someone and the capibility to do task and it isfunction in daily life.

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Therapy SHG (Self Help Group) capable to controlblood glucose, cholesterol total, have recovery ofbetter depression score, have recovery of better lifequality levels in type 2 diabetic group with comorbid

depression when compared with the control group.

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Quasi-experimental study

PROBE (Prospective, randomized, open, end-Blinded

Evaluation) test design

Target Population : female patients with type 2

diabetesAffordable Population : female patients with type 2diabetes based on Perkeni 2006 criteria which controlat clinic in the district of Bantul, Yogyakarta

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2;)] 22212

22

2ss

n+=-

+= sms b

Sample : 50 people, Each group consisted of 25 people. Toestimate the number of cases dropped out samples of each groupup to 28 people.

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Inclusion Criteria:

(1) Woman with Perkeni 2006 criteria; (2) >20 years old, (3)BDI score over 10; ( 4) self-help therapy group meeting atleast 3 times, (5) not receiving treatment for psychiatricdisorders, (6) signing an informed consent; (7) not active

smokers and alcoholics; (8) can reading. 2. Exclusion Criteria:

(1) Patients in a state of pregnancy, (2) patients using insulintreatment, (3) patients experienced major complications

associated with diabetes.

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Independent Variable (Free): Self help group

Dependent Variable (Depends): Risk and prognose factor

Blood glucose levels Cholesterol levels

Quality of life

Self Help Group (SHG)Type 2 DiabetesDepressionCommunity health centerDrop out

Risk Factor

Prognose Factor

Fasting Blood Glucose

Total Cholesterol

Quality of Life

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Paired Sample T-Test for normally distributed data

Wilcoxon Signed Rank Test when data not normallydistributed

Differences considered significant if p

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Presentase Depresi di Puskesmas Sedayu

Depresi : 36 orang Non Depresi : 16 orang

Persentase depresi : 69,23%

Kasihan IIDepresi : 28 0rang

Non Depresi : 13 orang

Persentase depresi: 68,29%

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NORMALITY TEST

RISK FACTORS-BDI SCORE

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