presus ikk pipit

7/23/2019 Presus Ikk Pipit

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PRESENTASI KASUS

DIABETES MELLITUS DISERTAI ATHRALGIA DAN CEPHALGIA PADA WANITA

PARUH BAYA DENGAN KEKHAWATIRAN TERHADAP PEKERJAAN DAN

PENYAKITNYA

Diajukan Untuk Memenuhi Sebagian Syarat

Mengikuti Ujian Kepaniteraan Klinik Bagian Ilmu Kedokteran Keluarga

di PUSKESMAS NGAMPIAN !"G!AKA#$A

Disusun oleh:

PIPIT PUSPITA DEWI

2!"!#$

Di%&u'%n 'e(%)%:

)*+ Ti,ie' Hi)%-%,i. M+Kes

B%/i%n Il0u Ke)o',e*%n Kelu%*/%

1%'ul,%s Ke)o',e*%n )%n Il0u Keseh%,%n

Unie*si,%s Muh%00%)i-%h Yo/-%'%*,%

2!3


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HALAMAN PENGESAHAN

P*esen,%si K%sus

DIABETES MELLITUS DISERTAI ATHRALGIA DAN CEPHALGIA PADA

WANITA PARUH BAYA DENGAN KEKHAWATIRAN TERHADAP PEKERJAAN

DAN PENYAKITNYA

Diajukan Untuk Memenuhi Sebagian Syarat

Mengikuti Ujian Kepaniteraan Klinik Bagian Ilmu Kedokteran Keluarga

di Pu%ke%ma% Ngampilan !ogyakarta

Disusun oleh:

PIPIT PUSPITA DEWI

2!"!#$

Di(*esen,%si'%n (%)% :

H%*i. T%n//%l : R%4u. 2 Dese04e* 2!3

Te0(%, : Pus'es0%s N/%0(il%n Yo/-%'%*,%

Men-e,u&ui.

Dosen Pe04i04in/ Unie*si,%s Do',e* Pe04i04in/ Pus'es0%s

)*+ Ti,ie' Hi)%-%,i. M+Kes )*+ Kh%i*%ni 1i,*i

Men/e,%hui.

Ke(%l% Pus'es0%s N/%0(il%n

)*+ Din% K%*,i'% S%*i


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KATA PENGANTAR

Pu&i s-u'u* '%0i (%n&%,'%n 'e(%)% All%h SWT -%n/ ,el%h 0eli0(%h'%n

'%*uni% )%n *%h0%,5N-% sehin//% (enulis )%(%, 0en-eles%i'%n (*esen,%si '%sus

4%/i%n Il0u Ke)o',e*%n Kelu%*/% -%n/ 4e*&u)ul DIABETES MELLITUS DISERTAI

ATHRALGIA DAN CEPHALGIA PADA WANITA PARUH BAYA DENGAN

KEKHAWATIRAN TERHADAP PEKERJAAN DAN PENYAKITNYA+ Penulis

0en-%)%*i seles%in-% (en-usun%n l%(o*%n ini ,i)%' le(%s )%*i 4%n,u%n 4e*4%/%i (ih%'.

un,u' i,u (enulis 0en-%0(%i'%n u6%(%n ,e*i0% '%sih 'e(%)% :

!+ )*+ Din% K%*,i'%. sel%'u Ke(%l% Pus'es0%s N/%0(il%n2+ )*+ Kh%i*%ni 1i,*i. sel%'u )o',e* (e04i04in/ (us'es0%s"+ )*+ Ti,ie' Hi)%-%,i. M+Kes. sel%'u )osen (e04i04in/ unie*si,%s$+ )*+ Nu*. )*+ Ani,% se*,% selu*uh s,%7 )%n '%*-%8%n Pus'es0%s N/%0(il%n3+ Re'%n5*e'%n Co5Assis,ensi )%n selu*uh (ih%' ,e*'%i, %,%s 4%n,u%n )%n

'e*&%s%0%n-%

9+ Se0u% (ih%' -%n/ ,el%h 0en)u'un/ (enulis%n l%(o*%n ini

D%l%0 (enulis%n l%(o*%n ini (enulis 0%sih 0e0ili'i 4%n-%' 'e'u*%n/%n+

K*i,i' )%n s%*%n s%n/%, )ih%*%('%n un,u' 0en-e0(u*n%'%n l%(o*%n ini+

Yo/-%'%*,%. Noe04e* 2!3

Pen-usun.

Pi(i, Pus(i,% De8i. S+Ke)

DAFTAR ISI


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KATA PENGANTAR++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

BAB I PENDAHULUAN++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ +++++++++++

A+ LATAR BELAKANG++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

B+ RUMUSAN MASALAH++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

C+ TUJUAN PENULISAN+++++++++++++++++++++++++++++++++++++++++++++++++Error! Bookmark not defined.

D+ MAN1AAT PENULISAN+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

BAB II TINJAUAN PUSTAKA+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

A+ DIABETES MELITUS++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

!+ De7inisi+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

2+ E(i)e0iolo/i++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

"+ 1%',o* *esi'o+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

$+ 'l%si7i'%si+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

3+ P%,o7isiolo/i+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

9+ Di%/nosis++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

+ Pen%,%l%'s%n%%n+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

#+ Ko0(li'%si+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

B+ ATRHALGIA+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

C+ CEPHALGIA+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

BAB III PRESENTASI KASUS+++++++++++++++++++++++++++++++++++++++++++Error! Bookmark not defined.

A+ IDENTITAS PASIEN+++++++++++++++++++++++++++++++++++++++++++++++++Error! Bookmark not defined.

B+ ANAMNESIS+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++Error! Bookmark not defined.

C+ PEMERIKSAAN 1ISIK++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

D+ PEMERIKSAAN PENUNJANG+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

E+ H;ME


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9+ Geno/*%0+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

+ 1%0il- M%(++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

#+ Ben,u' Kelu%*/%+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

=+ 1%0il- Li7e 6-6le+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

!+ 1%0il- APGAR++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

!!+ 1%0il- SCREEM++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

!2+ 1%0il- li7e Line++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

!"+ Pe*il%'u Hi)u( Be*sih )%n Seh%,++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

1+ DIAGN;SIS KERJA+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

G+ PENATALAKSANAAN++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

BAB I


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Di%4e,es Meli,us >DM? 0e*u(%'%n su%,u 'elo0(o' (en-%'i,

0e,%4oli6 )en/%n '%*%',e*is,i' hi(e*/li'e0i% -%n/ ,e*&%)i '%*en% 'el%in%n

se'*esi insulin. 'e*&% insulin %,%u 'e)u%5)u%n-% >A0e*i6%n Di%4e,es

Asso6i%,ion. 2!?

Ju0l%h (en)u)u' )uni% -%n/ s%'i, )i%4e,es 0elli,us 6en)e*un/

0enin/'%, )%*i ,%hun 'e ,%hun+ H%l ini 4e*'%i,%n )en/%n &u0l%h (o(ul%si

0enin/'%,. (ol% hi)u(. (*e%lensi o4esi,%s 0enin/'%, )%n 'e/i%,%n 7isi'

'u*%n/ >S0el,@e* B%*e. 22?+ L%(o*%n )%*i WH; 0en/en%i s,u)i (o(ul%si

DM )i 4e*4%/%i Ne/%*%. &u0l%h (en)e*i,% )i%4e,es 0elli,us (%)% ,%hun 2

)i In)onesi% 0ene0(%,i u*u,%n 'e5$ ,e*4es%* )%l%0 &u0l%h (en)e*i,% )i%4e,es

0elli,us )en/%n (*e%lensi #.$ &u,% &i8%

S%%, ini. 4%n-%' o*%n/ 0%sih 0en%n//%( (en-%'i, Di%4e,es Melli,us

0e*u(%'%n (en-%'i, o*%n/ ,u% %,%u (en-%'i, -%n/ h%n-% ,i04ul '%*en% 7%',o*

'e,u*un%n+ N%0un. se,i%( o*%n/ )%(%, 0en/i)%( Di%4e,es Melli,us 4%i' ,u%

0%u(un 0u)%+ Tin//in-% '%)%* /lu'os% )%*%h se6%*% ,e*us 0ene*us %,%u

4e*'e(%n&%n/%n )%(%, 0en-e4%4'%n 'o0(li'%si )i%4e,es+ Be*)%s%*'%n

(eneli,i%n Mu**%- >2? ,i%( != 0eni, %)% s%,u o*%n/ )i )uni% -%n/ ,e*'en%

s,*o'e. %)% s%,u o*%n/ -%n/ 4u,% )%n %)% s%,u o*%n/ )i )uni% )i%0(u,%si %'i4%,

'o0(li'%si Di%4e,es Melli,us >M%ul%n%. 2=?+ Be*4%/%i 'o0(li'%si )%(%,

,e*&%)i &i'% (en%,%l%'s%n%%n Di%4e,es Melli,us ,i)%' o(,i0%l

Menu*u, )%,% Rise, Keseh%,%n D%s%* >RIKESDAS. 2? (*e%lensi

)i%4e,es 0eli,us )i P*o(insi D%e*%h Is,i0e8% Yo/-%'%*,% >DIY? 0en6%(%i !.!

-%n/ ,e*)i%/nos% oleh ,en%/% 'eseh%,%n )%n !.9 ,e*)i%/nos% )en/%n

/e&%l% %s0% )%n &%n,un/ %,%u DM )i,e,%('%n (e*n%h )i)i%/nosis 0en)e*i,%

(en-%'i,+ Di%/nosis DM )i,e,%('%n &i'% 0en)e*i,% %,%u 0en/%l%0i /el%&%

)i%4e,es+ P%sien DM )en/%n *%8%, &%l%n )i *u0%h s%'i, sel%0% ,%hun 2

se4es%* ! 9=3 > ="? 0enu*u, l%(o*%n Din%s Keseh%,%n P*o(insi DIY


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Be*)%s%*'%n l%,%* 4el%'%n/ -%n/ )i,e0u'%n )i%,%s. 0%'% 0%s%l%h -%n/ )%(%,

)i*u0us'%n %)%l%h:!+ B%/%i0%n% (ene/%'%n )i%/nosis se*,% (en%,%l%'s%n%%n (en-%'i, Di%4e,es

Meli,us ,i(e II 2+ B%/%i0%n% (*insi(5(*insi( (el%-%n%n 'e)o',e*%n 'elu%*/% )%l%0

(en%n/%n%n 0%s%l%h iniC. TUJUAN PENULISAN

!+ Tu&u%n u0u0L%(o*%n ini )isusun un,u' 0e0enuhi se4%/i%n s-%*%, u&i%n Ke(%ni,e*%%n

Klini' Il0u Ke)o',e*%n Kelu%*/% Unie*si,%s Muh%00%)i-%h

Yo/-%'%*,%+2+ Tu&u%n 'husus

Un,u' 0en/e,%hui )%n 0e0%h%0i ,en,%n/ (en-%'i, Di%4e,es Meli,us se*,%

0ene*%('%n (*insi(5(*insi( (el%-%n%n 'e)o',e*%n 'elu%*/% )%l%0

0en/%,%si 0%s%l%h (en-%'i, )%l%0 'elu%*/%+D. MANFAAT PENULISAN

!+ M%n7%%, 4%/i Pus'es0%s

Se4%/%i s%*%n% 4%/i (e*en6%n%%n (enin/'%,%n (el%-%n%n 'eseh%,%n

'e(%)% 0%s-%*%'%, )%n 0en/o(,i0%l'%n (e*%n%n Pus'es0%s

Dih%*%('%n '%*-% ,ulis ini )%(%, 0e04e*i'%n su04%n/%n

(e0i'i*%n se4%/%i u(%-% un,u' 0en/u*%n/i %n/'% 0o*4i)i,%s )%n

'o0(li'%si %'i4%, )i%4e,es 0eli,us2+ M%n7%%, 4%/i Penulis

Se4%/%i s%*%n% (e04el%&%*%n )%n (en/%l%0%n )%l%0 u(%-%

(enin/'%,%n (el%-%n%n 'eseh%,%n )en/%n 0ene*%('%n il0u5il0u

'e)o',e*%n 'elu%*/%


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BAB II

TINJAUAN PUSTAA

A. DIABETES MELLITUS

" Pen#ertian

Di%4e,es Melli,us >DM? 0e*u(%'%n s%l%h s%,u 'elo0(o' (en-%'i,

0e,%4oli6 -%n/ )i,%n)%i oleh hi(e*/li'e0i% '%*en% /%n//u%n se'*esi

insulin. 'e*&% insulin. %,%u 'e)u%n-%+ Ke%)%%n hi(e*/li'e0i% '*onis )%*i

)i%4e,es 4e*hu4un/%n )en/%n 'e*us%'%n &%n/'% (%n&%n/. /%n//u%n 7un/si.

)%n 'e/%/%l%n 4e*4%/%i o*/%n. ,e*u,%0% 0%,%. /in&%l. s%*%7. &%n,un/. )%n

(e04uluh )%*%h >ADA. 2!2?+ WH; 0e*u0us'%n 4%h8% DM 0e*u(%'%n

su%,u 'u0(ul%n (*o4le0% %n%,o0i' )%n 'i0i%8i %'i4%, )%*i se&u0l%h

7 , )i )i) , & l h ) 7i i i i li 4 l , , l ,i


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P%)% '%sus )i%4e,es 0elli,us. =5=3 %)%l%h '%sus DM ,i(e II

>ADA.2!2?+ DM ,i(e II &u/% se*in/ )ise4u, se4%/%i Non In)e(en)en,

insulin Di%4e,es Melli,us >NIDDM?. '%*en% (en)e*i,% DM ,i(* II ,i)%'

4e*/%n,un/ insulin un,u' )%(%, 4e*,%h%n hi)u(+ Di%4e,es ini 0eli(u,i

in)ii)u -%n/ 0e0ili'i *esis,ensi insulin )%n 4i%s%n-% 0en/%l%0i

)e7isiensi insulin *el%,ie %,%u 'e'u*%n/%n insulin (%)% %8%ln-% )%n

se(%n&%n/ 0%s% hi)u(n-% sehin//% in)ii)u ini ,i)%' 0e04u,uh'%n

(en/o4%,%n insulin un,u' 4e*,%h%n hi)u(+ A)% 4%n-%' 'e0un/'in%n -%n/

0en&%)i (en-e4%4 ,i04uln-% )i%4e,es ini+ W%l%u(un e,iolo/in-%

s(esi7i'n-% ,i)%' )i'e,%hui. ,e,%(i (%)% )i%4e,es ,i(e ini ,i)%' ,e*&%)i

)es,*u'si sel 4e,%+ Ke4%n-%'%n (%sien -%n/ 0en)e*i,% DM ,i(e ini

0en/%l%0i o4esi,%s. )%n o4esi,%s )%(%, 0en-e4%4'%n 4e4e*%(% *esis,ensi

insulin >ADA.2$?

$" E%idemio&o#i

Di%4e,es 0elli,us ,el%h )i'%,e/o*i'%n se4%/%i (en-%'i, /lo4%l oleh

;*/%nis%si Keseh%,%n Duni% %,%u Wo*l) He%l,h ;*/%ni@%,ion >WH;?+

Ju0l%h (en)e*i,% DM ini 0enin/'%, )i se,i%( Ne/%*%+ Be*)%s%*'%n )%,%

)%*i WH; >29?. )i(e*'i*%'%n ,e*)%(%, !! &u,% o*%n/ )i )uni% 0en)e*i,%

)i%4e,es (%)% ,%hun 2 )%n )i(*e)i'si %'%n 0enin/'%, 0en&%)i "99 &u,%

(en)e*i,% (%)% ,%hun 2"+ Se'i,%* $.# &u,% o*%n/ )i )uni% ,el%h 0enin//%l

%'i4%, DM+ se,en/%h )%*i (en)e*i,% DM ini ,i)%' ,e*)i%/nosis

>Pu*n%0%s%*i.2=?Menu*u, l%(o*%n WH;. In)onesi% 0ene0(%,i u*u,%n 'e e0(%,

,e*4es%* )%*i &u0l%h (en)e*i,% )i%4e,es 0eli,us )en/%n (*e%lensi #.9

)%*i ,o,%l (en)u)u' se)%n/'%n (osisi u*u,%n )i%,%sn-% -%i,u In)i%. Chin%

)%n A0e*i'% Se*i'%, )%n WH; 0e0(*e)i'si 'en%i'%n &u0l%h

(en-%n)%n/ DM )i In)onesi% )%*i #.$ &u,% (%)% ,%hun 2 0en&%)i

se'i,%* 2! " &u,% (%)% ,%hun 2" Sen%)% )en/%n WH; In,e*n%,ion%l


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&u0l%h (en-%n)%n/ DM )%*i &u,% (%)% ,%hun 2= 0en&%)i !2 &u,% (%)%

,%hun 2"+ D%*i l%(o*%n ,e*se4u, 0enun&u''%n (enin/'%,%n &u0l%h

(en-%n)%n/ DM se4%n-%' 25" '%li li(%, (%)% ,%hun 2"

>Pu*n%0%s%*i.2=?

'" Faktor Re(iko Dia)ete( Me&&it*(

1%',o* *isi'o DM Ti(e II %n,%*% l%in : *i8%-%, 'elu%*/% 0en)e*i,%

)i%4e,es >o*%n/ ,u% %,%u s%u)%*% 0en)e*i,% DM ,i(e II?. o4esi,%s >BMI

23 '/02?. 'u*%n/ 'e4i%s%%n %',ii,%s 7isi'. *%se,ni' >A7*i'%5%0e*i6%.

A0e*i'% His(%ni'. A0e*i'% %sli. Asi%5A0e*i'%?. se4elu0n-%

)ii)en,i7i'%si'%n '%)%* /lu'os% )%*%h (u%s% ,e*/%n//u %,%u ,ole*%nsi

/lu'os% ,e*/%n//u >TGT?. *i8%-%, )i%4e,es 0elli,us /es,%sion%l >DMG?

%,%u 4%-i l%hi* $ '/. hi(e*,ensi >,e'%n%n )%*%h !$=00H/. HDL F

"3 0/)l )%n ,*i/lise*i)% 23 0/)l. sin)*o0 o%*iu0 (oli'is,i' %,%u

%'%n,osis ni/*%6%ns )%n *i8%-%, (en-%'i* %s6ul%* >Po8e*s.23?

+" &a(ifika(i etio&o#i dia)ete( me&&it*(

!+ Di%4e,es ,i(e ! >)es,*u'si sel 4e,%. 4i%s%n-% 0en-e4%4%'%n )e7isiensi

insulin %4solu,?:

5 )i(e*%n,%*%i oleh sis,e0 i0un.

5 i)io(%,i'

2+ Di%4e,es ,i(e 2 >4e*%*i%si 0ul%i -%n/ ,e*u,%0% )o0in%n *esis,ensi

insulin )ise*,%i )e7isiensi insulin *el%,i7 s%0(%i -%n/ ,e*u,%0% )e7e'

se'*esi insulin )ise*,%i *esis,ensi insulin?

"+ Di%4e,es ,i(e l%in


11/45

o De7e' /ene,i' 'e*&% insulin

M%,u*i,- ;nse, Di%4e,es o7 ,he Youn/ >M;DY?

DNA 0i,o'on)*i%

o Pen-%'i, e'so'*in (%n'*e%s

(%n'*e%,i,is

,u0o* atau(%n'*e%,e',o0i

(%n'*e%,o(%,i 7i4*o'%l'ulus

o En)o'*ino(%,i

%'*o0e/%li

sin)*o0% Cushin/

7eo'h*o0osi,o0%

hi(e*,i*oi)is0e

o K%*en% o4%, %,%u @%, 'i0i%

%6o*. (en,%0i)in. %s%0 ni'o,in%,

/lu'o'o*,i'oi). ho*0on ,i*oi)

,i%@i). )il%n,in. in,e*7e*on5%l7%. )ll

o In7e'si

*u4el% 'on/eni,%l i*us si,o0e/%lo >CM


12/45

%n,i4o)i %n,i insulin

o Sin)*o0 /ene,i' l%in -%n/ 4e*'%i,%n )en/%n DM

sin)*o0 Do8n. Sin)*o0 Kleine7el,e*. sin)*o0 Tu*ne*.

)ll

$+ Di%4e,es 0elli,us /es,%sion%l >DMG? >ADA. !==?

," Patofi(io&o#i

Insulin )ih%sil'%n oleh (%n'*e%s )%n )i )%l%*nn-% ,e*)%(%,

'u0(ul%n sel -%n/ 4e*4en,u' se(e*,i (ul%u (%)% (e,%. '%*en% i,u

)ise4u, (ul%u5(ul%u L%n/e*h%ns -%n/ 4e*isi sel 4e,%

-%n/0en/elu%*'%n ho*0on insulin -%n/ s%n/%, 4e*(e*%n )%l%0

0en/%,u* '%)%* /lu'os% )%*%h+ Insulin -%n/ )i'elu%*'%n oleh sel 4e,%

,%)i )%(%, )ii4%*%,'%n se4%/%i %n%' 'un6i -%n/ )%(%, 0e04u'% (in,u

0%su'n-% /lu'os% 'e )%l%0 sel. un,u' 'e0u)i%n )i )%l%0 sel

/lu'os%,e*se4u, )i0e,%4olis%si'%n 0en&%)i ,en%/%+ Bil% insulin ,i)%'

%)%. 0%'% /lu'os% )%l%0 )%*%h ,i)%' )%(%, 0%su' 'e )%l%0 sel

)en/%n %'i4%, '%)%* /lu'os% )%l%0 )%*%h 0enin/'%,+ Ke%)%%n inil%h

-%n/ ,e*&%)i (%)% )i%4e,es 0eli,us ,i(e ! >Su-ono.23?+P%)% )i%4e,es 0eli,us ,i(e 2 &u0l%h insulin no*0%l. 0%l%h

0un/'in le4ih 4%n-%' ,e,%(i &u0l%h *ese(,o* insulin -%n/ ,e*)%(%,

(%)% (e*0u'%%n sel -%n/ 'u*%n/+ Rese(,o* insulin ini )%(%,

)ii4%*%,'%n se4%/%i lu4%n/ 'un6i (in,u 0%su' 'e )%l%0 sel+ P%)%

'e%)%%n ,%)i &u0l%h lu4%n/ 'un6in-% -%n/ 'u*%n/. hin//% 0es'i(un

%n%' 'un6in-% >insulin? 4%n-%'. ,e,%(i '%*en% lu4%n/ 'un6in-%

>*ese(,o*? 'u*%n/. 0%'% /lu'os% -%n/ 0%su' sel %'%n se)i'i,. sehin//%

sel %'%n 'e'u*%n/%n 4%h%n 4%'%* >/lu'os%? )%n /lu'os% )i )%l%0

(e04uluh )%*%h 0enin/'%,+ Den/%n )e0i'i%n 'e%)%%n ini s%0%


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,in//i %,%u no*0%l+ P%)% )i%4e,es 0eli,us ,i(e 2 &u/% 4is% )i,e0u'%n

&u0l%h insulin 6u'u( %,%u le4ih ,e,%(i 'u%li,%sn-%'u*%n/ 4%i'.

sehin//% /%/%l 0e04%8% /lu'os% 0%su' 'e )%l%0 sel+ Di s%0(in/

(en-e4%4 )i%,%s. )i%4e,es 0eli,us &u/% 4is% ,e*&%)i %'i4%, /%n//u%n

,*%ns(o*, /lu'os% )i )%l%0 sel sehin//%/%/%l )i/un%'%n se4%/%i 4%h%n

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*ese(,o* insulin %,%u )i s%l%h s%,u &%lu* sin-%l (%s6%*ese(,o*+ P%)% DM

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14/45

0ole'ul (os,*e6e(,o* )%(%, 0en-e4%4'%n *esis,ensi insulin+

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As%0 le0%' 4e4%s &u/% 0e04e*i'%n 'on,*i4usi (%)%

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0e04e*i'%n 'on,*i4usi (%)% (%,o/enesis DM ,i(e II+ P%)% DM ,i(e II.

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)%n *esis,ensi insulin (%)% o,o, *%n/'%+ Se4%/%i %'i4%, )%*i *esis,ensi

insulin (%)% &%*in/%n le0%'. %s%0 le0%' 4e4%s )i'elu%*'%n )%*i

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2+ G%n//u%n Se'*esi Insulin

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P%)% %8%l (e*&%l%n%n (en-%'i, DM ,i(e II. se'*esi insulin ,%0(%'n-%

no*0%l )%n '%)%* insulin )%l%0 (l%s0% ,i)%' 4e*'u*%n/+ N%0un (ol%

se'*esi insulin -%n/ 4e*)en-u, )%n osil%,i7 len-%(. )%n 7%se (e*,%0%

se'*esi insulin >-%n/ 6e(%,? -%n/ )i(i6u oleh /lu'os% 0enu*un+

Se6%*% 'ole',i7 h%l ini )%n (en/%0%,%n l%in 0en/is-%*%,'%n


15/45

sin,es% insulin+ N%0un (%)% (e*&%l%n%n (en-%'i, 4e*i'u,n-%. ,e*&%)i

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(e*6o4%%n )en/%n DM ,i(e II. )i(e*'i*%'%n 0ul%50ul% *esis,ensi

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16/45

isle,+ A0iloi) -%n/ 0en/elilin/i sel 4e,% 0un/'in 0en-e4%4'%n sel

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17/45

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0/)L


18/45

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19/45

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20/45

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se'*esi 4%s%l )%n se'*esi (*%n)i%l+ Te*%(i insulin )iu(%-%'%n 0%0(u

0eni*u (ol% se'*esi insulin -%n/ 7isiolo/is+ De7isiensi insulin 0un/'in

4e*u(% )e7isiensi insulin 4%s%l. insulin (*%n)i%l %,%u 'e)u%n-%+

De7isiensi insulin 4%s%l 0en-e4%4'%n ,i04uln-% hi(e*/li'e0i% (%)%

'e%)%%n (u%s%. se)%n/'%n )e7isiensi insulin (*%n)i%l %'%n

0eni04ul'%n hi(e*/li'e0i% se,el%h 0%'%n+ Te*%(i insulin un,u'

su4s,i,usi )i,u&u'%n un,u' 0el%'u'%n 'o*e'si ,e*h%)%( )e7isiensi -%n/

,e*&%)i+

Jenis )%n l%0% 'e*&% insulin insulin 'e*&% 6e(%, >rapid in%ulin?

'e*&% (en)e' >%hort a&ting?

'e*&% 0enen/%h >intermediate a&ting?

'e*&% (%n&%n/ >long a&ting?

insulin 6%0(u*%n ,e,%( >premi)ed in%ulin?

Pe04e*i%n )%(%, (ul% se6%*% 'o04in%si %n,%*% &enis insulin 'e*&%

6e(%, %,%u insulin 'e*&% (en)e' un,u' 'o*e'si )e7isiensi insulin

(*%n)i%l. )en/%n 'e*&% 0enen/%h %,%u 'e*&% (%n&%n/ un,u' 'o*e'si

)e7isiensi insulin 4%s%l+ Ju/%)%(%, )il%'u'%n 'o04in%si )en/%n ;H;+

Te*%(i insulin ,un//%l %,%u 'o04in%si )isesu%i'%n )en/%n 'e4u,uh%n

(%sien )%n *es(ons in)ii)u ,e*h%)%( insulin. -%n/ )inil%i )%*i h%sil

(e0e*i's%%n '%)%* /lu'os% )%*%h h%*i%n+ Pen-esu%i%n )osis insulin

)%(%, )il%'u'%n )en/%n 0en%04%h 25$ uni, se,i%( "5$ h%*i 4il% s%s%*%n


23/45

Insulin )i(e*lu'%n (%)% 'e%)%%n!+ Penu*un%n 4e*%, 4%)%n -%n/ 6e(%,

2+ Hi(e*/li'e0i% 4e*%, -%n/ )ise*,%i 'e,osis"+ Ke,o%si)osis )i%4e,i6$+ Hi(e*/li'e0i% hi(e*os0ol%* non 'e,o,i'3+ Hi(e*/li'e0i% )en/%n %si)osis l%',%,9+ G%/%l )en/%n 'o04in%si ;H; )osis h%0(i* 0%'si0%l+ S,*es 4e*%, >in7e'si sis,e0i'. o(e*%si 4es%*. IMA. s,*o'e?#+ Keh%0il%n )en/%n DM)i%4e,es 0eli,us /es,%sion%l -%n/ ,i)%'

,e*'en)%li )en/%n (e*en6%n%%n 0%'%n=+ G%n//u%n 7un/si /in&%l %,%u h%,i -%n/ 4e*%,!+ Kon,*%in)i'%si )%n %,%u %le*/i ,e*h%)%( ;H;

6+ Tera%i kom)ina(i 1PERENI2$3?Pe04e*i%n ;H; 0%u(un insulin sel%lu )i0ul%i )en/%n )osis

*en)%h. un,u' 'e0u)i%n )in%i''%n se6%*% 4e*,%h%( sesu%i )en/%n

*es(ons '%)%* /lu'os% )%*%h+ Be*s%0%%n )en/%n (en/%,u*%n )ie, )%n

'e/i%,%n &%s0%ni. 4il% )i(e*lu'%n )%(%, )il%'u'%n (e04e*i%n ;H;

,un//%l %,%u 'o04in%si ;H; se&%' )ini+ Te*%(i )en/%n ;H;

'o04in%si. h%*us )i(ilih )u% 0%6%0 o4%, )%*i 'elo0(o' -%n/

0e0(un-%i 0e'%nis0e 'e*&% 4e*4e)%+ Bil% s%s%*%n '%)%* /lu'os%

)%*%h 4elu0 ,e*6%(%i. )%(%, (ul% )i4e*i'%n 'o04in%si ,i/% ;H; )%*i

'elo0(o' -%n/ 4e*4e)% %,%u 'o04in%si ;H; )en/%n insulin+P%)% (%sien -%n/ )ise*,%i )en/%n %l%s%n 'lini' )i 0%n% insulin

,i)%' 0e0un/'in'%n un,u' )i(%'%i )i(ilih ,e*%(i )en/%n 'o04in%si

,i/% ;H;+ Un,u' 'o04in%si ;H; )%n insulin. -%n/ 4%n-%'

)i(e*/un%'%n %)%l%h 'o04in%si ;H; )%n insulin 4%s%l >insulin 'e*&%

0enen/%h %,%u insulin 'e*&% (%n&%n/? -%n/ )i4e*i'%n (%)% 0%l%0 h%*i

0en&el%n/ ,i)u*+ Den/%n (en)e'%,%n ,e*%(i ,e*se4u, (%)% u0u0n-%

)%(%, )i(e*oleh 'en)%li /lu'os% )%*%h -%n/ 4%i' )en/%n )osis insulin

-%n/ 6u'u( 'e6il+ Dosis %8%l insulin 'e*&% 0enen/%h %)%l%h 95! uni,

-%n/ )i4e*i'%n se'i,%* &%0 22+. 'e0u)i%n )il%'u'%n e%lu%si )osis

,e*se4u, )en/%n 0enil%i '%)%* /lu'os% )%*%h (u%s% 'eeso'%n h%*in-%+

Bil% )en/%n 6%*% se(e*,i )i %,%s '%)%* /lu'os% )%*%h se(%n&%n/ h%*i


24/45

0%sih ,i)%' ,e*'en)%li. 0%'% o4%, hi(o/li'e0i' o*%l )ihen,i'%n )%n

)i4e*i'%n insulin s%&%+

om%&ika(i

Ko0(li'%si )i%4e,es -%n/ )%(%, ,e*&%)i )i4e)%'%n 0en&%)i )u% -%i,u

'o0(li'%si %'u, )%n 'o0(li'%si '*oni'+ Ko0(li'%si %'u, 4e*u(% 'o0%

hi(o/li'e0i. 'e,o%si)osis )i%4e,i'. 'o0% hi(e*os0ol%* non'e,o,i'+

Ko0(li'%si '*oni' )%(%, 4e*u(% 0%'*o%n/io(%,i. 0i'*o%n/io(%,i. neu*o(%,i

)i%4e,i'. in7e'si. '%'i )i%4e,i'. )%n )is7un/si e*e'si+

B. ATRHAL4IA

%? Pen#ertianA*,h*%l/i% 4e*%s%l )%*i 4%h%s% Yun%ni. %*h,*o -%n/ %*,in-% sen)i

)%n %l/os %*,in-% n-e*i+ J%)i %*,h*%l/i% %)%l%h n-e*i sen)i. 4%i' s%,u

0%u(un 4e4e*%(% sen)i+ Is,il%h %*,h*%l/i% e*%, '%i,%nn-% )en/%n %*,h*i,is

%,%u (e*%)%n/%n sen)i+ A*,h*%l/i% 0e*u(%'%n s%l%h s%,u /e&%l% ,e*se*in/

)%*i %*,h*i,is+

)" Etio&o#i

Pen-e4%4 u0u0 %*,h*%l/i% %)%l%h:

! Pe*/e*%'%n -%n/ ,i)%' 4i%s% %,%u 'es%l%h%n 4e/e*%'. se(e*,i 'eseleo

)%n s,*%in2 Te*'%)%n/ 6e)e*%. ,e*0%su' (%,%h ,ul%n/" Gou, >'hususn-% &e0(ol '%'i?$ ;s,eo%*,*i,is. (en-%'i, sen)i )e/ene*%,ie3 Se(,i6 %*,h*i,is

9 Ten)ini,is Bu*si,is# In7e'si (en-%'i, se(e*,i in7luen@%. 6%0(%'. )e0%0 *e0%,i'. he(%,i,is.

/on)o'. *u4ell% %,%u 6%6%* %i*+= ;s,eo0ieli,iss+! %u,oi0un (en-%'i, se(e*,i *heu0%,oi) %*,h*i,is )%n lu(us


25/45

S%n/%, 0u)%h un,u' 0e0%h%0i *%s% s%'i, ini &i'% An)%

0en/%n//%( 4%h8% %(% -%n/ ,e*&%)i %)%l%h 4%h8% %)% se)i'i, (elu0%s

4e*s%0% 4%n,%l%n )en/%n 'e*us%'%n ,ul%n/ *%8%n 'onse'uen+ Sinoiu0

)%n 4%n,%l ,ul%n/ *%8%n (elin)un/ 0e04u%, 'ehil%n/%n e7e',ii,%s

0e*e'% -%n/ 0en-e4%4'%n ,ul%n/ 4e*%)% )%l%0 'on,%' s%,u s%0% l%in.

0en-e4%4'%n /ese'%n -%n/ se*in/ 4%h'%n ,ul%n/ 4e*)e*i' ,e*)en/%* un,u'

0e04u%, /e*%'%n ,e*,en,u. )%n 0en/h%sil'%n e*osi )%n (en%04%h%n5

(en%04%h%n+

d" Faktor Re(iko

A)% 4e4e*%(% (en-%'i, -%n/ )%(%, 0en-e4%4'%n n-e*i )i sen)i.

se(e*,i *heu0%,oi) %*,h*i,is. /%n//u%n %u,oi0un -%n/ 0en-e4%4'%n

'e'%'u%n )%n n-e*i )i )%l%0n-%+ ;s,eo%*,h*i,is %)%l%h )e/ene*%si ,ul%n/

*%8%n sen)i )%n (e,u04uh%n ,ul%n/ ,%&i. -%n/ s%n/%, se*in/ ,e*&%)i (%)%

o*%n/ )e8%s% )en/%n usi% le4ih )%*i $3 ,%hun )%n 4is% 0en-e4%4'%n n-e*i

sen)i+

N-e*i ini &u/% 4is% )ise4%4'%n oleh 4u*si,is %,%u (e*%)%n/%n (%)%

4u*s%. -%n/ ,e*)i*i )%*i '%n,un/ 4e*isi 6%i*%n (%)% ,ul%n/ (*o0inen6es.

0e0un/'in'%n /e*%'%n 4e4%s )%*i o,o, )%n ,en)on (%)% ,ul%n/+

C. CEPHAL4IA

a" Pen#ertian

N-e*i 'e(%l% %,%u 6e(h%l/i% %)%l%h n-e*i %,%u *%s% ,i)%' en%' )i 'e(%l%.

se,e0(%, %,%u 0en-elu*uh )%n )%(%, 0en&%l%* 'e 8%&%h. 0%,%. /i/i. *%h%n/

4%8%h )%n lehe*+)" &a(ifika(i

N-e*i 'e(%l% )i'l%si7i'%si'%n 0en&%)i )u% -%i,u n-e*i 'e(%l% (*i0e* )%n

n-e*i 'e(%l% se'un)e*+ N-e*i 'e(%l% (*i0e* 'e0u)i%n )i4%/i 0en&%)i

e0(%, '%,e/o*i -%i,u 0i/*%ine. n-e*i 'e(%l% ,i(e ,e/%n/. n-e*i 'e(%l%


26/45

!+ Mi#raine

Is,il%h 0i/*%ine 4e*%s%l )%*i '%,% Yun%ni -%n/ 4e*%*,i s%'i, 'e(%l% sesisi+

Te*)%(%, )u% s-n)*o0e 'linis 0i/*%ine. -%i,u 0i/*%ine )en/%n %u*% )%n

0i/*%ine ,%n(% %u*%+ Sel%0% 4e4e*%(% ,%hun. 0i/*%ine )en/%n %u*%

)i'%,%'%n se4%/%i 0i/*%ine 'l%si' )%n sin)*o0 -%n/ 'e)u% )i'%,%'%n

se4%/%i 0i/*%ine u0u0+ Mi/*%in )ise*,%i %u*% )i%8%li )en/%n %)%n-%

/%n//u%n (%)% 7un/si s%*%7. ,e*u,%0% isu%l. )ii'u,i oleh n-e*i 'e(%l%

he0i'*%ni%l >unil%,e*%l?. 0u%l. )%n '%)%n/ 0un,%h. 'e&%)i%n ini ,e*&%)i

4e*u*u,%n sel%0% 4e4e*%(% &%0 '%)%n/(ul% ,e*&%)i )%l%0 seh%*i (enuh

4%h'%n le4ih+ Mi/*%in ,%n(% %u*% 0e*u(%'%n n-e*i 'e(%l% he0i'*%ni%l

)ise*,%i %,%u ,%n(% 0u%l 0un,%h -%n/ ,e*&%)i se6%*% ,i4%5,i4% ,%n(%

/%n//u%n 7un/si s%*%7 se4%/%i (e*,%n)% )%n /e&%l% ini ,e*&%)i )%l%0

4e4e*%(% 0eni, %,%u &%0+ As(e' he0i'*%ni%l )%n sens%si 4e*)en-u,

0e*u(%'%n '%*%',e*is,i' (%lin/ 'h%s -%n/ 0e04e)%'%n 0i/*%ine )en/%n

&enis n-e*i 'e(%l% l%inn-%2+ N7eri e%a&a C&*(ter

N-e*i 'e(%l% 6lus,e* 0e*u(%'%n sin)*o0% n-e*i 'e(%l% -%n/ le4ih se*in/

,e*&%)i (%)% (*i% )i4%n)in/ 8%ni,%+ N-e*i 'e(%l% 6lus,e* ini (%)% u0u0n-%

,e*&%)i (%)% usi% -%n/ le4ih ,u% )i4%n)in/ )en/%n 0i/*%ine+ N-e*i (%)%

sin)*o0 ini ,e*&%)i he0i'*%ni%l (%)% )%e*%h -%n/ le4ih 'e6il )i4%n)in/

0i/*%ine. se*in/ '%li (%)% )%e*%h o*4i,%l. sehin//% )i'%,%'%n se4%/%i

'l%s,e*+ Ji'% se*%n/%n ,e*&%)i. n-e*i ini )i*%s%'%n s%n/%, 4e*%,. n-e*i ,i)%'

4e*)en-u, 'ons,%n sel%0% 4e4e*%(% 0eni, hin//% 2 &%0+Ti)%' se(e*,i 0i/*%ine. n-e*i 'e(%l% 6lus,e* sel%lu unil%,e*%l )%n 4i%s%n-%

,e*&%)i (%)% *e/ion -%n/ s%0% se6%*% 4e*ul%n/5ul%n/+ N-e*i 'e(%l% ini

u0u0n-% ,e*&%)i (%)% 0%l%0 h%*i. 0e04%n/un'%n (%sien )%*i ,i)u*.

,e*&%)i ,i%( h%*i. se*in/'%li ,e*&%)i le4ih )%*i se'%li )%l%0 s%,u h%*i+ N-e*i

'e(%l% ini 4e*0ul%i se4%/%i sens%si ,e*4%'%* >4u*nin/ sens%s,ion? (%)%

%s(e' l%,e*%l )%*i hi)un/ %,%u se4%/%i sens%si ,e'%n%n (%)% 0%,% In&e'si


27/45

sin)*o0 Ho*ne*. 4%h'%n )i,e0u'%n (ul% (%sien )en/%n /e&%l%

/%s,*oin,es,in%l"+ N-e*i 'e(%l% ,i(e ,e/%n/ >NKTT? 0e*u(%'%n is,il%h -%n/ )i/un%'%n un,u'

0en)es'*i(si'%n n-e*i 'e(%l% ,%n(% se4%4 -%n/ &el%s )%n 'u*%n/ 0e0ili'i

/%04%*%n 'h%s )i4%n)in/ 0i/*%ine )%n n-e*i 'e(%l% 6lus,e*+ P%)%

u0u0n-%. NKTT 0e*u(%'%n /%n//u%n '*oni' -%n/ 4e*0ul%i se,el%h

u0u* 2 ,%hun+ G%n//u%n ini )i,%n)%i )en/%n se*%n/%n n-e*i 'e(%l%

4il%,e*%l (%)% 4%/i%n o66i(i,%l ,%n(% sens%si )en-u,%n )%n ,i)%' )ise*,%i

*%s% 0u%l. 0un,%h. %,%u /%n//u%n (en/lih%,%n+ N-e*i 4i%s% )i)es'*i(si'%n

se(e*,i %)% (i,% -%n/ 0en/i'%, 'e(%l% )en/%n 'e,%,+ W%ni,% le4ih se*in/

,e*'en% )i4%n)in/ (*i%+

Ta)e& '.. Jeni(86eni( N7eri e%a&a

N7eri

e%a&a

Sifat

N7eri

Loka(i Lama

N7eri

Frek*en(i 4e6a&a

Ik*tan

Mi/*en

u0u0

Be*)en-u, Unil%,e*%l %,%u

Bil%,e*%l

95$# &%0 S(o*%)i'

Be4e*%(% '%li

se4ul%n

Mu%l.

0un,%h.

0%l%ise.

7o,o4i%

Mi/*en

'l%si'

Be*)en-u, Unil%,e*%l "5!2 &%0 S(o*%)i'

Be4e*%(% '%li

se4ul%n

P*o)*o0%

isu%l. 0u%l.

0un,%h.

0%l%ise.

7o,o4i%

Kl%s,e* Men&e0u5

'%n. ,%&%0

Unil%,e*%l.

o*4i,%

!352

0eni,

Se*%n/%n

4e*'elo0(o'

)en/%n

*e0isi l%0%

L%'*i0%si

i(sil%,e*%l.

8%&%h

0e*%h.

hi)un/

,e*su04%,.


28/45

,e/%n/ )i,e'%n 0ene*us %nsie,%s

Neu*%l/i%

,*i/e0inus

Di,usu'5

,usu'

De*0%,on s%*%7

%8%l?. Bil%,e*%l

>l%n&u,?

Be*%*i%si.

(*o/*esi7

Be*%*i%si.

se0%'in

se*in/

P%(ile)e0%.

)e7isi,

neu*olo/i'

7o'%l.

/%n//u%n

0en,%l %,%u

(e*il%'u.

'e&%n/. )ll

6? Manife(ta(i &ini(

Menu*u, A*i7 M%ns&oe*. )'' >2? 0%ni7es,%si 'linis %)%n-% n-e*i 'e(%l%

%,%u 6e(h%l/i% 0e0e*lu'%n %n%0nesis 'husus -%i,u:

!+ A8i,%n )%n l%0% se*%n/%n

2+ Ben,u' se*%n/%n (%*o'sis0%l (e*io)i' %,%u ,e*us 0ene*us

"+ Lo'%lis%si n-e*i

$+ Si7%, n-e*i 4e*)en-u,5)en-u,. *%s% 4e*%,. 0enusu'5nusu'. )ll

3+ P*o)*o0%l

9+ Ge&%l% (en-e*,%

+ 1%',o* (*esi(i,%si

#+ 1%',o* -%n/ 0en/u*%n/i %,%u 0e04e*%,'%n n-e*i 'e(%l%


29/45

!!+ Ri8%-%, 'elu%*/%

!2+ Ri8%-%, ,*%u0% 'e(%l%

!"+Ri8%-%, (en-%'i, 0e)i' (e*%)%n/%n sel%(u, o,%'. hi(e*,ensi. )e0%0

,i7oi). sinusi,is. /l%u'o0%. )s4+

!$+ Ri8%-%, o(e*%si

!3+ Ri8%-%, %le*/i

!9+ Pol% h%i) 4%/i 8%ni,%

!+ Ri8%-%, (e0%'%i%n o4%, %n%l/e,i'. n%*'o,i'. (enen%n/. %so)il%,o*

BAB III

PRESENTASI KASUS

A. IDENTITAS PASIEN

N%0% : N-+SJenis 'el%0in : Pe*e0(u%n


30/45

Al%0%, : Gen)in/%n RT != RW "No+ RM : 22 $9 !

T%n//%l (e0e*i's%%n : 2$ noe04e* 2!3Kun&un/%n Ru0%h : 23 noe04e* 2!3

B. ANAMNESIS

. e&*0an Utama

Kon,*ol *u,in Di%4e,es Melli,us$. Ri9a7at Pen7akit Sekaran#

Seo*%n/ (%sien 8%ni,% )%,%n/ 'e Pus'es0%s N/%0(il%n un,u'

'on,*ol *u,in Di%4e,es Melli,us+ P%sien 0en/%'u ,e*'en% (en-%'i,

Di%4e,es Melli,us su)%h se&%' ! ,%hun -%n/ l%lu >23?+ ;s 0en/e,%hui

&enis o4%, DM -%n/ )i 0inu0. os 0inu0 o4%, DM ,e*se4u, *u,in

0es'i(un os 0en/e,%hui )%n 0e0i'i*'%n 4%h8% /in&%ln-% %'%n *us%'

'%*en% 0inu0 o4%, ,e*us50ene*us+ ;s ,i)%' 0e*%s% 'ese0u,%n (%)% 'e)u%

u&un/5u&un/ &%*i ,%n/%n )%n '%'i se*,% os &u/% ,i)%' 0e*%s%'%n (%n)%n/%n

0%,%n-% '%4u*+ ;s 0en/%,%'%n 4%h8% '%)%* /ul%n-% n%i' ,u*un+Sel%in i,u os &u/% 0e*%s%'%n (e/%l5(e/%l (%)% 4%)%n )%n linu5linu

(%)% selu*uh (e*sen)i%n Q ! 4ul%n ini+ Keluh%n )i*%s%'%n 0e04e*%, 'e,i'%

os 4e*%',ii,%s )%n 4e*'u*%n/ 'e,i'% 0inu0 o4%,+ ;s &u/% 0e*%s%'%n n-e*i

'e(%l% -%n/ )i*%s%'%n )i 4%/i%n )e(%n+ N-e*i 'e(%l% 0e04e*%, &i'%

0e0i'i*'%n sesu%,u )%n 4e*'u*%n/ 'e,i'% 4e*is,i*%h%,+'. Ri9a7at Pen7akit Da0*&*

Ri8%-%, 'eluh%n -%n/ s%0% >?Ri8%-%, (en-%'i, /in&%l. %s0%. hi(e*,ensi. %le*/i lie*. s,*o'e. )%n &%n,un/

)i s%n/'%l+. Ri9a7at Pen7akit e&*ar#a

%+ Ri8%-%, hi(e*,ensi >? i4u4+ Ri8%-%, Pen-%'i, &%n,un/ >? i4u6+ Ri8%-%, DM >? %-%h)+ Ri8%-%, %s0%. %le*/i. s,*o'e. )%n /in&%l )is%n/'%l

,. Ri9a7at Per(ona& So(ia& Ekonomi

Pen)i)i'%n

P%sien 0e*u(%'%n ,%0%,%n SMP+ Ti)%' 0el%n&u,'%n 'e &en&%nh

4e*i'u,n-% '%*en% 'e,e*4%,%s%n 4i%-%+ Pe'e*&%%n

P%sien 0en/%,%'%n 4%h8% (%sien 0e0(un-%i us%h% '%n,in -%n/

su)%h )i&%l%ni Q !3 ,%hun+ P%sien 0e*u(%'%n (en6%*i n%7'%h u,%0%

)%l%0 'elu%*/% se,el%h su%0in-% (ensiun+ P ' i


31/45

Lin/'un/%n

S%%, ini (%sien ,in//%l 4e*s%0% su%0i )%n %n%' 'eli0% (%sien -%n/

4elu0 0eni'%h+ Me*e'% ,in//%l )i (in//i* &%l%n *%-% -%n/ ,i)%'

,e*l%lu le4%*+ Lin/'un/%n ,e0(%, ,in//%l (%sien ,e*0%su'

lin/'un/%n -%n/ ,i)%' ,e*l%lu (%)%, (en)u)u'. &%*%' %n,%* *u0%h

,i)%' s%lin/ 4e*)e'%,%n+ Lin/'un/%n se'i,%* *u0%h (%sien 6u'u(

4e*sih )%n 0en)%(%, sin%* 0%,%h%*i -%n/ 6u'u(+ G%-% hi)u(

P%sien 0en-u'%i )%n se*in/ 0en/'onsu0si /o*en/%n se*,%

s%-u*%n+ P%sien ,i)%' (e*n%h 4e*ol%h*%/% se*,% &i'% %)% 0%s%l%h

sel%lu 0e0i'i*'%n 0%s%l%h ,e*se4u,+ S%%, ini (%sien ,e*l%lu

0e0i'i*'%n ,en,%n/ us%h% '%n,in -%n/ )i0ili'in-% %'%n )i/usu*+-. Re:ie9 S7(tem

Sis,e0 Neu*olo/is : n-e*i 'e(%l% >?

Sis,e0 Res(i*%si : ,i)%' %)% 'eluh%n+

Sis,e0 '%*)io%s'ule* : ,i)%' %)% 'eluh%n+

Sis,e0 /%s,*oin,es,in%l : ,i)%' %)% 'eluh%n+ Sis,e0 u*olo/is : ,i)%' %)% 'eluh%n+

Sis,e0 0us'ulos'ele,%l : (e/%l5(e/%l )%n n-e*i sen)i

. Anamne(i( I&&ne(

Pe*%s%%n

P%)% s%%, )i)i%/nosis 0en/%l%0i DM ,%hun 23. (%sien 0en/%'u

4i%s% s%&%+ S%%, ini (%sien 0en/'h%8%,i*'%n ,en,%n/ %'i4%, &i'%

se*in/ 0inu0 o4%, ,e*h%)%( /in&%ln-% se*,% (%sien s%%, ini se)%n/

,e*4e4%ni 0e0i'i*'%n 0%s%l%h '%n,inn-% -%n/ %'%n )i/usu* I)e

Menu*u, (%sien. )i*in-% 0en/%l%0i DM '%*en% )ulu se*in/ 0%'%n

-%n/ ,i)%' ,e*'on,*ol+ Sel%in i,u (%sien &u/% 0en/%'u ,i)%' (en%h

4e*ol%h*%/%+ H%*%(%n

P%sien 4e*h%*%( %/%* 4is% se04uh ,o,%l. %'%n ,e,%(i (%sien s%)%*

4il% s%'i,n-% ,i)%' 4is% )ise04uh'%n n%0un h%n-% )%(%,

)i'en)%li'%n+ E7e' ,e*h%)%( 7un/si

P%sien 0ene*i0% 'on)isin-% )%n ,e,%( 4e*se0%n/%, se*,% (%s*%h

,e*h%)%( (en-%'i,n-%+ A'%n ,e,%(i. (%sien 0en/%'u 'eluh%nn-%

%'hi* %'hi* ini se)i'i, 0en//%n//u )%l%0 4e*%',ii,%s ,e,%(i h%l


32/45

!+ Ke%)%%n u0u0 : B%i'2+ Kes%)%*%n : Co0(os Men,is

"+ T%n)% 55?. 6on&un/,i% %ne0is >55?.

s'le*% i',e*i' >55? Hi)un/ : se'*e, >55?. e(is,%'sis >55?

Telin/% : n-e*i ,e'%n >55?. se*u0en >55?

4? Pe0e*i's%%n lehe*Li07ono)i ,i)%' ,e*%4%. J

5?. 'e,in//%l%n /e*%' >5?5 (%l(%si : o6%l 7*e0i,us '%n%n'i*i5 (e*'usi : sono* >?5 %us'ul,%si : su%*% )%s%* esi'ule* >?.

*on6hi >5?. 8he@in/ >5?

5 ins(e'si : )in)in/ )%)% si0e,*is. *e,*%'s

in,e*'os,%l >5?. 'e,in//%l%n /e*%' >5?5 (%l(%si : o6%l 7*e0i,us '%n%n'i*i5 (e*'usi : sono* >?5 %us'ul,%si : su%*% )%s%* esi'ule* >?.

*on6hi >5?. 8he@in/ >5?

Co*

Ins(e'si : i6,us 6o*)is ,%' ,%0(%'P%l(%si : i6,us 6o*)is ,e*%4% )i SIC < line% 0i) 6l%i6ul%

sinis,*%Pe*'usi : 4%,%s &%n,un/

K%n%n %,%s : SIC II (%*%s,e*n%l )e,*%

K%n%n 4%8%h : SIC I< (%*%s,e*n%l )e,*%

Ki*i %,%s : SIC II (%*%s,e*n%l sinis,*%

Ki*i 4%8%h : SIC < line 0i)6l%i6ul% sinis,*%

Aus'ul,%si : 4un/i &%n,un/ S! )%n S2 *e/ule*. 4isin/ >5?.

/%llo( >5?

)? Pe0e*i's%%n %4)o0enIns(e'si : &e&%s >5?. s(i)e*ne*i >5?. %si,es >5?Aus'ul,%si : (e*is,%l,i' >? no*0%lP l i l >? i , ' > ? h ) li ,i) ' , 4


33/45

D. PEMERISAAN PENUNJAN4

T%n//%l Gul% )%*%h

!!2!3 GDS "!GDP !#3.9

!=#2!3 GDS 2"3

!3!2!3 GDP 2=$2JPP 29#

2$!!2!3 GDP 2292JPP 22"

E+ H;ME


34/45

D%,% 7oo) *e6%ll (%)% ,%n//%l 2$ noe04e* 2!3

W%',u Jenis

0%'%n%n

U'u*%n K%lo*i

URT Be*%, >/*?

P%/i Ai* (u,ihN%siTe0(eB%-%0Min-%'Gul%

2 /el%s!!2/el%s! (,/

2 s),2 s)0

523!!2

5"333233

Si%n/ Ai* (u,ihN%siTe0(eS%-u* so(Min-%'Pis%n/

2 /el%s!!2/el%s! (,/! 6en,on/2 s),! 4u%h

5232=!!3

5"333233

M%l%0 Ai* (u,ihN%siT%huTu0is 4un6isMin-%'

2 /el%s!!2/el%s! (,/

2 s),

5223!!

5"333223

To,%l !3

Kl%si7i'%si s,%,us /i@i 4e*)%s%*'%n IMT 0enu*u, N.BI "be%ity

Edu&ation Initiati+eun,u' o*%n/ in)onesi%. (%sien 0e0ili'i BMI 22.93

No*0%lD%l%0 (*%',e'. (e)o0%n &u0l%h '%lo*i -%n/ )i(e*lu'%n un,u' )i%4e,esi

-%n/ 4e'e*&% 4i%s% 0enu*u, PERKENI %)%l%h :Norma& ; BB < '3 a&ori Se0ari

,= < '3 a&ori (e0ari > +3 ka&ori (e0ari

9+ Geno/*%0/eno/*%0 Kelu%*/% N-+ S )i4u%, ,%n//%l 23 noe04e* 2!3

N-+S 9 ,hDMB

Ke,e*%n/%n : L%'i5l%'i (e*e0(u%n

L%'i5l%'i 0enin//%l (e*e0(u%n 0enin//%l P%sienHThi(e*,ensiDM)i%4e,es Melli,usB B*e%)8inne* >(en6%*i n%7'%h?DDe6ision 0%'e* >(e04u%, 'e(u,us%n?


35/45

Ke,e*%n/%n : 7un/sion%l

)is7un/sion%l

#+ Ben,u' 'elu%*/%Ben,u' 'elu%*/% nu6le%* 7%0il- >'elu%*/% in,i? -%n/ ,e*)i*i )%*i su%0i. is,*i

)%n %n%' '%n)un/+

=+ 1%0il- li7e 6-6leT%h%( 3 l%un6hin/ 6hil)*en %n) 0oin/ on

!+ 1%0il- APGAR

KRITERIA PERTANYAAN AMPIR

!E"A"# %2&

KA'AN()

KA'AN( %1&

TI'AK A'A

%0&

A'APTA!I *+agaimana angg,ta -./uarga sa/ing

m.mantu satu sama /ain disaat

m.mutu-an s.suatuApa-a pasi.n

puas d.ngan -./uarga -ar.na masing)

masing angg,ta -./uarga suda

m.na/an-an -.aian s.suai d.ngan

s.arusna

PARTNER!IP *+agaimana angg,ta -./uarga

.r-,muni-asi satu sama /ain t.ntang

masa/a)masa/a t.rt.ntu s.p.rti

/iuran nansia/ p.ng./uaran ang

.sar dan masa/a priadi Apa-a

pasi.n puas d.ngan -./uarga -ar.na

dapat m.mantu m.m.ri-an s,/usi

t.radap p.rmasa/aan ang diadapi

PERT#M+#AN *+agaimana p.ruaan angg,ta

-./uarga s./ama taun)taun t.ra-ir

apa-a pasi.n di.ri -..asan untu-

m.ng.mang-an diri *Apa-a pasi.n puas d.ngan -..asan

ang di.ri-an -./uarga untu-

Ka-a- pasi.n

Ana- pasi.n

ana- pasi.n


36/45

KA!I !AYAN( Apa-a i-a pasi.n sa-it -./uargana

m.m.ri p.ratian p.rdu/i dan

m.nunu--an -asi saangna d.ngan

m.raatApa-a pasi.n puas d.ngan

-.angatan ang di.ri-an -./uarga

KE+ER!AMAAN *+agaimana angg,ta K./uarga anda

.ragi a-tu ruang dan uangApa-a pasi.n puas d.ngan a-tu ang

dis.dia-an -./uarga untu- m.na/in

-..rsamaan

T:TA" 9

!-,r -/asi-asi AP(AR ;8)10


37/45

!2+ 1%0il- Li7e Line

T%4el 1%0il- Li7e Line

Ye%* Li7e een, See*i,- o7 illnes

!=$ Meni'%h 5

!==3 Me04u'% us%h% '%n,in 5

2 I4u (%sien 0enin//%l S,*esso* (si'olo/is

23 Te*)i%/nosis DM S,*esso* (si'olo/is

!"+ Pe*il%'u Hi)u( Be*sih )%n Seh%,T%4el PHBS

no K*i,e*i% -%n/ )inil%i &%8%4%n S'o*

! Pe*s%lin%n )i,olon/ ,en%/%

'eseh%,%n

Y% !

2 Me04e*i ASI e's'lusi7 Y% !

" Meni04%n/ 4%li,% se,i%(

4ul%n

Ti)%'

$ Men//un%'%n %i* 4e*sih Y% !

3 Men6u6i ,%n/%n )en/%n %i*

4e*sih )%n s%4un

Y% !

9 Men//un%'%n &%04%n seh%, Y% !

Me04e*%n,%s &en,i' n-%0u'

)i *u0%h se'%li se0n//u

Ti)%'

# M%'%n 4u%h )%n s%-u* se,i%(

h%*i

Y% !

= Mel%'u'%n %',ii,%s 7isi'

se,i%( h%*i

Ti)%'

! Ti)%' 0e*o'o' )i )%l%0

*u0%h

Y% !

To,%l &%8%4%n -%

Kesi0(ul%n : PHBS ,e*(enuhi %(%4il% selu*uh in)i'%,o* ,e*(enuhi+ P%sien

0e0enuhi '*i,e*i% )%*i ! '*i,e*i%. 0%'% (%sien 4e*5PHBS+

1+ DIAGN;SIS KERJADi%4e,es Melli,usA,h*%l/i%Ce(h%l/i%

G+ PENATALAKSANAAN!+ Non 1%*0%'olo/i

E)u'%si 'e(%)% (%sien )%n 'elu%*/% ,en,%n/ (en-%'i, DM

>) 7i i i 7 ', i' ' li' i? , ' i ' ,'


38/45

K%lo*i -%n/ )i'onsu0si (%sien (%)% 7oo) *e6%ll 2$ &%0

su)%h 4%i'. 0%'% (%s%ien h%*us 0e0(e*,%h%n'%n (ol%

0%'%n Be*ol%h*%/% 0ini0%l " se0in//u se'%li sel%0% " 0eni,

Mel%'u'%n sen%0 '%'i DM un,u' 0en6e/%h 'o0(li'%si

Me04e*i'%n e)u'%si 'e(%)% 'elu%*/% (%sien %/%* ,e,%(

0e04e*i'%n su((o*, 'e(%)% (%sien )%l%0 *%n/'% 'on,*ol

)%n 0inu0 o4%, *u,in2+ 1%*0%'olo/i

R Gli4en6l%0i) 3 0/ No+ S !55R Me,7o*0in 3 0/ No+ S !55!R K+ Di6lo7en%6 23 0/ No


39/45

'e(%l% -%n/ )i*%s%'%n )i 4%/i%n )e(%n+ N-e*i 'e(%l% 0e04e*%, &i'%

0e0i'i*'%n sesu%,u )%n 4e*'u*%n/ 'e,i'% 4e*is,i*%h%,+Be*)%s%*'%n %n%0nesis )%n (e0e*i's%%n 7isi'. (%sien )i)i%/nosis

)en/%n Di%4e,es Melli,us ,i(e II+ Belu0 ,e*)%(%, 'o0(li'%si ,e*h%)%(

(en-%'i, (%sien sesu%i )en/%n 'eluh%n (%sien -%i,u *i8%-%, (%n)%n/%n

0%,% '%4u* )is%n/'%l. '%'u5'%'u %,%u 'ese0u,%n (%)% u&un/ &%*i5&%*i

,%n/%n )%n '%'i &u/% )is%n/'%l+D%*i (e0e*i's%%n %n,*o(o0e,*i )en/%n h%sil 4e*%, 4%)%n 3# '/

)%n ,in//i 4%)%n !9 60+ H%sil (e*hi,un/%n In)e's M%s% Tu4uh >IMT?

%)%l%h 22.93+ In,*e(e,%si )%*i IMT menurut N.BI "be%ity Edu&ation

Initiati+e%)%l%h no*0%l+D%l%0 (*%',e'. (e)o0%n &u0l%h '%lo*i -%n/ )i(e*lu'%n un,u' )i%4e,esi

-%n/ 4e'e*&% 4i%s% 0enu*u, PERKENI %)%l%h :Norma& ; BB < '3 a&ori Se0ari

,= < '3 a&ori (e0ari > +3 ka&ori (e0ari

K%lo*i -%n/ )i'onsu0si (%sien (%)% 7oo) *e6%ll 2$ &%0 su)%h 4%i'.

0%'% (%sien h%*us 0e0(e*,%h%n'%n (ol% 0%'%nn-%+P%sien ,in//%l 4e*s%0% su%0i )%n %n%' 'eli0%n-% -%n/ 4elu0

0eni'%h+ Lin/'un/%n se'i,%* *u0%h (%sien 6u'u( 4e*sih )%n *u0%h

(%sien 0en)%(%,'%n sin%* 0%,%h%*i -%n/ 6u'u(+ P%sien )il%'u'%n

(enil%i%n 7un/si 'elu%*/% 0e,o)e APGAR )i)%(%,'%n 7un/si 'elu%*/%

4%i'+

R%s% 'h%8%,i*. /elis%h. ,%'u,. 8%s8%s. (%ni' )%n se4%/%in-%

0e*u(%'%n /e&%l% u0u0 %'i4%, 6e0%s+ N%0un s%0(%i se4%,%s 0%n%

si,u%si &i8% 4e*u(% 6e0%s i,u )%(%, )i,ole*%nsi oleh seo*%n/ in)ii)u

se4%/%i 'es%,u%n u,uh+ K%*en% se*in/'%li 6e0%s 0eni04ul'%n 'eluh%n

7isi' 4e*u(% 4e*)e4%*5)e4%*. 4e*'e*in/%,. s%'i, 'e(%l%. 4%h'%n /%n//u%n

7un/si se'su%l )%n 4e*%/%0 l%inn-%+ Ke%)%%n 6e0%s -%n/ 8%&%*

0e*u(%'%n *es(ons ,e*h%)%( %)%n-% %n6%0%n %,%u 4%h%-% lu%* -%n/ n-%,%

&el%s )%n ,i)%' 4e*su04e* (%)% %)%n-% 'on7li'+ Se)%n/'%n 6e0%s -%n/

s%'i, >%nie,%s? 0e*u(%'%n *es(ons ,e*h%)%( %)%n-% 4%h%-% -%n/ le4ih


40/45

'o0(le's. ,i)%' &el%s su04e* (en-e4%4n-%. )%n le4ih 4%n-%' 0eli4%,'%n

'on7li' &i8% -%n/ %)% )%l%0 )i*i sen)i*i+

Ce0%s %,%u 'e'h%8%,i*%n i,u ,i04ul %'i4%, %)%n-% *es(ons

,e*h%)%( 'on)isi s,*es %,%u 'on7li'+ R%n/s%n/%n 4e*u(% 'on7li'. 4%i' -%n/

)%,%n/ )%*i lu%* 0%u(un )%l%0 )i*i sen)i*i. i,u %'%n 0eni04ul'%n *es(ons

)%*i sis,e0 s%*%7 -%n/ 0en/%,u* (ele(%s%n ho*0on ,e*,en,u+ A'i4%,

(ele(%s%n ho*0on ,e*se4u,. 0%'% 0un6ul (e*%n/s%n/%n (%)% o*/%n5o*/%n

se(e*,i l%04un/. &%n,un/. (e04uluh )%e*%h 0%u(un %l%,5%l%, /e*%'+

K%*en% 4en,u' *es(ons -%n/ )e0i'i%n. (en)e*i,% 4i%s%n-% ,i)%'

0en-%)%*i h%l i,u se4%/%i hu4un/%n se4%4 %'i4%,+

P%)% s%%, ,e*&%)i s,*ess (si'ososi%l %,%u e0osion%l. %'%n ,e*&%)i

(e*u4%h%n 'esei04%n/%n @%, 'i0i% %',i7 (%)% o,%' 0%nusi%+ P%)% s%%,

s,*ess 0enin/'%,. ,u4uh %'%n 0en/elu%*'%n %)*en%lin )%n 'o*,isol + Ji'%

s,*es ,e*&%)i 4e*'e(%n&%n/%n. 0%'% %'%n 0enu*un'%n sis,e0 i0un ,u4uh.

%04%n/ n-e*i )%n ,ole*%nsi ,e*h%)%( n-e*i le4ih &%uh l%/i. sehin//% *%s%

n-e*i 'e(%l% %'%n le4ih se*in/ ,e*&%)i )en/%n in,ensi,%s -%n/ le4ih s%'i,+

B. PENERAPAN PRINSIP ED/TERAN ELUAR4A!+ P*i0%*- C%*e :

P*insi( ini su)%h )i,e*%('%n (%)% (%sien ini. )i0%n% (%sien )%,%n/

(e*i's% 'e (el%-%n%n (*i0e* ,e*le4ih )hulu. -%i,u (us'es0%s+2+ Pe*son%l 6%*e :

Pel%-%n%n -%n/ )i4e*i'%n 0e04e*i'%n 'en-%0%n%n 'e(%)% (%sien"+ Holis,i' 6%*e :

S%%, 0ene/%''%n )i%/nosis (%sien (%)% '%sus )ilih%, ,i)%' h%n-% )%*

se/i 'linisn-% s%&% ,e,%(i &u/% 0en%n-%'%n )%*i se/i (si'is. %)%'%h

0%s%l%h %,%u 4e4%n (i'i*%n -%n/ 0e0(en/%*uhi (e*&%l%n%n (en-%'i,

(%sien+$+ Co0(*ehensie 6%*e :

D%l%0 0en%n/%ni '%sus (%)% (%sien ini. )il%'u'%n (en%,%l%'s%n%%n

se6%*% 0en-elu*uh 0ul%i )%*i (*o0o,i7. (*een,i7. 'u*%,i7 0%u(un


41/45

Dil%'u'%n ho0eisi, (%)% ,%n//%l 23 noe04e* 2!3 )%n 29

noe04e* 2!3 un,u' 0e0oni,o* 'e%)%%n (%sien )i lin/'un/%n *u0%h9+ E0(h%sis on P*een,ie Me)i6ine :Pene'%n%n (%)% us%h% (en6e/%h%n (en-%'i, 4e*'e04%n/ 0en&%)i

le4ih 4%i' )en/%n e)u'%si (e0%h%0%n (en-%'i, )%n 0o)i7i'%si /%-%

hi)u( (%)% (%sien++ P%,ien,56en,e*e) C%*e. 1%0il- 1o6use) Co00uni,-5o*ien,e) C%*e :

P%)% '%sus ini ,el%h )il%'u'%n e's(lo*%si 0en/en%i %s(e' )ise%se )%n

illnes )%*i (%sien ini. -%i,u DIABETES MELLITUS DISERTAI

ATHRALGIA DAN CEPHALGIA PADA WANITA PARUH BAYA

DENGAN KEKHAWATIRAN TERHADAP PEKERJAAN DAN

PENYAKITNYA+#+ Coll%4o*%,ie C%*e :

P%)% (%sien ini )%(%, )il%'u'%n 'ol%4o*%si )en/%n 4i)%n/ l%in se(e*,i

%hli /i@i un,u' 0e04%n,u 0e0(e*,%h%n'%n (ol% 0%'%n+

C. DIA4N/SIS H/LISTI

DIABETES MELLITUS DISERTAI ATHRALGIA DAN CEPHALGIA

PADA WANITA PARUH BAYA DENGAN KEKHAWATIRAN

TERHADAP PEKERJAAN DAN PENYAKITNYA

D. USULAN PEMERISAAN PENUNJAN4

%+ U*in len/'%(4+ Pe0e*i's%%n (*o7il li(i) len/'%( >'oles,*ol ,o,%l. HDL. LDL?6+ Pe0e*i's%%n 7un/si /in&%l >u*eu0. 6*e%,inin?

E. PENATALASANAAN /MPREHENSIF

!+ P*o0o,i7 E)u'%si 'e(%)% (%sien )%n 'elu%*/% ,en,%n/ (en-%'i, DM

>)e7inisi. 7%',o* *esi'o. 'o0(li'%si? un,u' 0enin/'%,'%n

(e0%h%0%n (%sien )%n 'elu%*/% ,en,%n/ (en-%'i, (%sien+ K%lo*i -%n/ )i'onsu0si (%sien (%)% 7oo) *e6%ll 2$ &%0 su)%h

4%i'. 0%'% (%s%ien h%*us 0e0(e*,%h%n'%n (ol% 0%'%n Be*ol%h*%/% 0ini0%l " se0in//u se'%li sel%0% " 0eni,

Mel%'u'%n sen%0 '%'i DM un,u' 0en6e/%h 'o0(li'%si

Me04e*i'%n e)u'%si 'e(%)% 'elu%*/% (%sien %/%* ,e,%(

0e04e*i'%n su((o*, 'e(%)% (%sien )%l%0 *%n/'% 'on,*ol )%n

0inu0 o4%, *u,in

2+ P*een,i7


42/45

Men/'onsu0si 4u%h54u%h%n. s%-u*5s%-u*%n )%n %i* (u,ih

"+ Ku*%,i7Be*)%s%*'%n PERKENI 2!!. (en/en)%li%n '%)%* /lu'os% )%*%h )%(%,

0e0%'%i 'o04in%si 2 o4%, %n,i hi(e*/li'e0i o*%l )i0ul%i )%*i )osis

*en)%h -%i,u Me,7o*0in 3 0/ (e* !2 &%0 s%%, 0%'%n )%n

Gli0e(i*i)e ! 0/ (e* 2$ &%0 se4elu0 0%'%n+

BAB ?

ESIMPULAN DAN SARAN

A. ESIMPULAN

D%*i h%sil %n%0nesis )%n (e0e*i's%%n 7isi' se*,% 'un&un/%n 'e *u0%h

(%sien (en)e*i,% Di%4e,es Melli,us. )%(%, )i%04il 'esi0(ul%n se4%/%i

4e*i'u,:P%sien 8%ni,% 9 ,%hun )en/%n *i8%-%, Di%4e,es Melli,us -%n/

)ise4%4'%n oleh 7%',o* /ene,i' '%*en% %-%h (%sien 0en)e*i,% h%l -%n/

s%0% )en/%n (%sien+ Se,el%h ,e*)i%/nosis (en-%'i, DM (%sien *u,in

'on,*ol se,i%( se(uluh h%*i se'%li )%n *%&in 0inu0 o4%, se,i%( h%*in-%.

(%sien (%,uh 0en&%l%ni h%l ,e*se4u, 0es'i(un (%sien 'h%8%,i* &i'% 0inu0

o4%, ,e*us 0ene*us %'%n 0e04u%, /in&%ln-% *us%'+ D%*i h%sil 7oo) *e6%ll

2$ &%0. (%sien 0e0ili'i (ol% 0%'%n -%n/ 4%i'+D%*i %n%lisis /eno/*%0. (%sien %)%l%h %n%' 'e e0(%, )%*i e0(%,

4e*s%u)%*%+ A-%h (%sien 0e0ili'i (en-%'i, se*u(% )en/%n (%sien %'%n

,e,%(i %-%h (%sien su)%h 0enin//%l+ D%*i (enil%i%n 0e,o)e APGAR


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B. SARAN

!+ Me04e*i'%n le%7le, 'e(%)% se,i%( (%sien 0en/en%i (en-%'i, DM.

)%7,%* 0enu sesu%i )en/%n 'e4u,uh%n '%lo*i un,u' 0e0(e*,%h%n'%n

(ol% 0%'%n (%sien2+ Men-%*%n'%n sen%0 '%'i )i%4e,es un,u' 0enu*un'%n 'o0(li'%si

0i'*o%s'ule* DM"+ Mel%'u'%n (e0e*i's%%n (enun&%n/ )%l%0 *%n/'% u(%-% )e,e'si )ini

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,e*%(i su((o*, 'e(%)% (%sien )%l%0 *%n/'% 'on,*ol )%n 0inu0 o4%,

*u,in+


44/45

LAMPIRAN

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45/45

PERKENI+Pengelolaan dan Pen&egahan Diabete% Melitu% $ipe ( di Indone%ia+

Pe*'u0(ul%n En)o'*inolo/i In)onesi% 2!!+

PERKENI+Kon%en%u% Pengelolaan Di%lipidemia di Indone%ia/ J%'%*,%: Pus%, Pene*4i,%n

Il0u Pen-%'i, D%l%0 1%'ul,%s Ke)o',e*%n UI 2!2+

9+

Perkumpulan Endokrinologi Indonesia *PERKENI. Konsensus Pengendalian

dan Pen4egahanDiabetes Melitus tipe 2 di Indonesia

M6(hee/%non/+ 2!2+ P%,o7isiolo/i (en-%'i, (en/%n,%*0enu&u 'e)o',e*%n 'linis e)isi 3+

J%'%*,% : EGC

h,,(s:888+s6*i4)+6o0)o6!$#=$""=2A*,h*%l/i%5)o6

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