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Sugar levels that accumulate in the blood due to not being absorbed well by body cells can cause various organ disorders. If not controlled properly, it can lead to various complications that can be life-threatening. Risk factors that can affect blood sugar levels are food, activity, and weight gain. Therefore, one way to keep blood sugar levels under control is by doing walking therapy activities. The purpose of this study was to determine the effect of walking on the fasting blood sugar levels when in patients with type 2 diabetes mellitus in Tuminting Village, Manado City. This research is a quantitative research with a method used pre-experimental method using a with a pre-test-post test one group design approach. The sample was taken based on the number of respondents obtained as many as 19 people using Purposive sampling. Data collection was done by using blood glucose test tools and observation sheets. The results of data analysis using the Paired sample t-test showed P value of 0.001 or smaller than ≤0.05 which means that the alternative hypothesis Ha is accepted or through walking activities can reduce the fasting blood sugar levels when in patients with type 2 diabetes mellitus.

Diabetes is a non-communicable disease. Diabetes is one of the most common chronic diseases in the world and is characterized by increased levels of glucose in the body. This metabolic disease occurs as a result of insufficient insulin secretion. Considering that every person has the right to have, to live a healthy, sustainable and prosperous life. The main target of this activity is the Lateri Village community. Socialization activities are carried out using 1 method, which is power point presentation of material. The specific objectives of implementing socialization to prevent diabetes with Tropicana Slim include increasing awareness of safe, healthy and sustainable living, as well as bringing positive changes in sustainable lifestyle behavior patterns by consuming Tropicana Slim products to stabilize sugar levels in the body.

The patient came with complaints that the body often felt weak even though the patient did not do strenuous activities. This complaint has worsened in the last 1 week, causing the patient to be discouraged from doing activities and disrupting his daily activities Patient also complained that his weight was decreasing. Another complaint that was felt was that the hands often felt numb. History of diabetes mellitus in the last 10 years, but the patient admitted that he did not routinely take medicine to control his blood sugar. The KGDS examination obtained in the patient was 324 mg/dl. The patient's BMI was 18.2 kg/m2 and classified as underweight. Primary data was obtained through autoanamnesa and physical examination by conducting home visits, filling out family folders, and filling out patient files. Assessment was carried out based on holistic diagnosis at the beginning, process, and end of the visit quantitatively and qualitatively. Interventions include education about the causes of diabetes mellitus, education about lifestyle modification and the importance of taking medication regularly to control blood sugar levels and explaining complications that may arise from the patient's disease so that patients make preventive efforts.  

Blood sugar levels, or blood glucose levels, are crucial for overall health and are regulated by the pancreas through insulin. Normal blood sugar levels range between 70-99 mg/dL when fasting and up to 140 mg/dL two hours after eating. Abnormal blood sugar levels can suggest a variety of health issues, including hypoglycemia (low blood sugar levels caused by excess insulin, certain drugs, or illnesses such as diabetes) and hyperglycemia (high blood sugar levels associated with diabetes). Regular blood sugar monitoring is necessary, especially for diabetics. Guava, a tropical fruit, includes a variety of phytochemicals that have been linked to pharmacological benefits such as antibacterial capabilities. This research uses an extraction process involving solid-liquid extraction or maceration, with methanol being the optimal solvent. The extract yields 9.51%. Wistar rats are used to investigate its antidiabetic efficacy. The rats are divided into three groups: positive control, negative control, and extract treatment. Diabetes is induced by subcutaneous injection of Alloxan, followed by oral administration of the methanol extract. Blood glucose levels are assessed after fasting for 6-8 hours. The extract from dried Guava leaf powder yields a concentrated extract with a 9.51% yield. In vivo assessments showed a significant reduction in blood glucose levels in rats treated with guava leaf extract, suggesting potential anti-hyperglycemic effects. The phenolic compounds in guava leaves contribute to antioxidant and anti-hyperglycemic effects. The study highlights the potential therapeutic effects of guava mint leaves and their extract components for diabetes management and antioxidant health benefits.

The aim of education and screening for type 2 diabetes mellitus in the elderly group is to provide early detection of type 2 diabetes mellitus and increase knowledge of type 2 diabetes mellitus using seminars, workshops, counseling, and leaflet media. This activity involves checking blood sugar levels as a screening for type 2 diabetes mellitus and providing education regarding signs and symptoms, risk factors, treatment, and complications that occur in type 2 diabetes mellitus. This activity is important to increase insight and create behavior that is willing to carry out self-care so that complications of type 2 diabetes mellitus can be avoided.

One of the patient safety indicators related to medical treatment of surgical wound infection is the main complication experienced by hospitalized patients, the determinants of the cause of surgical wound infection (ilo) post sectio caesaria are DM sufferers, wound care and HB levels Objective: determine hb levels, wound care and DM related to the incidence of surgical wound infection in post sc patients at H. Badaruddin Kasim Tanjung Hospital. The quantitative research method with the research design design carried out is a retrospective, retrospective observational study. The total population of 40 post-SC mothers in 2022 in September - December, total sampling technique. The data was analyzed using the Chi Square test. The results of the study found that there was a relationship between hb levels and ILO incidence in post sc patient respondents, p values = 0.001 and ? = 0.05, p < ?, there was a relationship between wound care and ILO events in post sc patient respondents, p values = 0.000 and ? = 0.05, p < ? and there was a relationship between dm and ILO events, p values = 0.000 and ? = 0.05, p < ?.

Diabetes Mellitus (DM) is the most common non-communicable disease (NCD) in the world. This disease is a heterogeneous disease, characterized by high glucose levels. DM is the 4th cause of death in most developing countries. One of the complications of DM is neuropathy, which is reduced sensation in the feet and is often associated with ulcers on the feet. The aim of this community service is to provide information and knowledge about promotive and preventive efforts in dealing with DM. This outreach method is pre-test, education and post-test which is carried out using leaflets and questionnaires containing questions to measure the level of community knowledge. From this counseling, results were obtained through comparison charts between the pre-test and post-test, namely that there was an increase in knowledge from before the education was carried out and after the education about diabetes mellitus and treating foot ulcers using foot exercises. It is hoped that this counseling will continue to have a good impact on participants and can change healthy living behavior for the better.

Hyperlipidemia is a metabolic disorder that indicates an increase in lipid levels in the body. Obesity, particularly central obesity, is correlated with hyperlipidemia and metabolic syndrome. Complications of hyperlipidemia such as coronary artery disease, type 2 diabetes, and high blood pressure can be fatal if left untreated. Education and early detection of hyperlipidemia are crucial to prevent serious complications and maintain good health. This community service involved 50 elderly at Santa Anna Elderly Care Facility. All respondents participated in a series of activities, including education through posters, physical examinations, and diagnostic tests. Results of the diagnostic tests indicated 2 respondents had LDL levels ? 135 mg/dL, 6 respondents had HDL levels < 40 mg/dL, and 12 respondents had total cholesterol levels ? 200 mg/dL. The results of the education activities are expected to increase public awareness, all of which can reduce the overall healthcare burden when applied correctly and properly.

Periodontal disease is a complication that often occurs in diabetes mellitus (DM) patients. This disease can worsen the patient's general health condition. This community service aims to increase awareness and knowledge about periodontal disease in DM patients at the Bara-Barayya Health Center. The methods used include counseling, dental and oral health checks, and distribution of educational leaflets. The results of the activity showed a significant increase in the knowledge and awareness of DM patients regarding the importance of maintaining oral health. It is hoped that this will help in the prevention and management of periodontal disease in DM patients.

Diabetes Mellitus (DM) is a metabolic disorder characterized by increased blood sugar levels due to insufficient insulin function. Patients with diabetes mellitus often experience other health problems such as obesity, heart disease and kidney disease which further exacerbate their health problems, especially if they are exposed to Covid 19 which can eventually lead to death. The need for information that strengthens and refreshes the knowledge possessed is urgently needed so that while living life during this pandemic, you can stay healthy. The method used in community service activities is carried out by counseling and discussion methods. This activity was carried out face-to-face, the total number of activity participants was 45 people, although initially it was targeted to be 100 people. The results of this activity, the people of Taeno Hamlet said that 80% felt very satisfied and 20% were satisfied with this counseling activity. These results were obtained through a questionnaire after this activity took place. This can be seen by the enthusiasm of the participants to ask about a healthy lifestyle. Patients with diabetes mellitus must have a healthy behavior and exercise diligently in order to maintain body stamina and follow the treatment that has been carried out so far. Counseling activities for patients with co-morbidities not only diabetes mellitus are urgently needed to provide information, strengthen understanding and provide updated information regarding how Covid 19 can affect patients, especially those with comorbidities.

Hypertension is a measurement of systolic blood pressure of more than 140 mmHg or diastolic blood pressure of 90 mmHg and the measurement is more than 2 times. The purpose of this literature review is to determine the relationship between elderly sleep quality and high blood pressure in hypertensive patients based on the literature review. Writing this journal uses a literature study approach from several search databases from pubmed and proquest with the last 5 years of publication (2017-2022). Keywords used are sleep quality, elderly, and hypertension. The literature study showed that from 10 journals studied, there was a relationship between sleep quality and hypertension from several factors, including sleep duration <6 hours, frequent awakenings at night, illnesses suffered and the elderly experienced nocturia. Where nocturia is someone who often urinates excessively at night. In conclusion, from 10 articles that show a significant relationship, it has been analyzed that sleep quality is related to hypertension, but poor sleep quality can be caused by several triggering factors including sleep duration > 6 hours, illnesses such as diabetes mellitus, and hyperlipidemia, and sleep quality. in women aged > 60 years and over more often experience nocturia so that the quality of sleep decreases.

Geriatrics is a branch of gerontology that studies the level of health in the elderly from various aspects, including: promotive, preventive, curative and rehabilitative which includes physical, mental and social health. In principle, geriatrics strives for a happy and useful old age. Throughout the world today, the number of elderly people is estimated to be more than 629 million people, and in 2025 it is projected that the number of elderly people will reach 1.2 billion. Indonesia is a country that has a fairly high number of elderly people. In 2010 the number of elderly aged 65 years and over was 11 million, and it is projected that in 2020 the number of elderly will increase by 7.2%. Even the United States Census Bureau estimates that Indonesia will experience the largest increase in elderly citizens in the world in 2025, namely 414%. The increasing number of elderly will affect the welfare of the elderly (Ministry of Welfare of the Republic of Indonesia. 2012). The increase in the elderly population is of course accompanied by the risk of various degenerative diseases such as diabetes mellitus, coronary heart disease, osteoarthritis, neuromuscular disease and lung disease. Around 50-80% of elderly people aged more than 65 years will experience more than one chronic disease. This is related to the fact that the older you get, the more health problems you experience. One way to improve the quality of life for the elderly is to do physical exercise. Physical exercise can maintain or improve flexibility, cardiopulmonary endurance, agility, strength and balance. Several studies show that physical exercise has a consistent effect in reducing the risk of falls in healthy older adults. Kuptniratsaikul's research in 2009-2010 showed that simple balance exercises carried out by elderly people with a history of falls could reduce the incidence of falls in the elderly and significantly improve body balance. A 2017 Cuevas meta-analysis study showed that balance training programs showed the greatest effect in reducing the risk of falls in the elderly. For elderly people who are not yet able to do balance exercises independently, they need professional assistance.

According to The International Association for the Study of Pain, pain is an unpleasant sensory and emotional experience accompanied by potential and actual tissue damage. Pain is a condition that is more than just a single sensation caused by certain stimuli, including post-operative pain. One way to reduce post-operative pain in patients with diabetes mellitus (DM) gangrene is the music distraction technique which can produce endorphins to reduce pain. The aim of this research is to determine the effect of applying musical distraction techniques on post-op patients with diabetes mellitus (DM) gangrene during wound care at the Tanjungpinang City Regional Hospital. This research design is a pre-experimental design. The sample for this study was 30 respondents and analyzed using the Wilcoxon range test. The results show that there is a significant difference in influence between the pre-test and post-test after being given the musical distraction technique, so it can be concluded that there is an influence of applying the musical distraction technique on post-op gangrene diabetes mellitus (DM) patients during wound care at the Tanjungpinang City Hospital. Suggestions This research is one of the non-pharmacological therapy options for pain management. So it can be applied to post-op patients with diabetes mellitus (DM) gangrene during wound care.

Abstrak Indonesia is the sixth country with the highest number of Diabetes Mellitus sufferers in the world. One way to control blood sugar levels is to regulate a DM diet by consuming foods high in fiber and antioxidants. Snack bars are very suitable as a snack for DM sufferers. This research aims to obtain a formulation and determine the effect of adding corn flour on the antioxidant activity and dietary fiber of snack bars with the best substitutes for corn flour and spirulina flour. Research Method: This research is an experimental type of research using a completely randomized design (CRD) with independent variables in the form of a comparison of the composition of corn flour, namely F1 = corn flour 33.3% and spirulina flour 8.3%; F2= 50% corn flour and 8.3% spirulina flour and 8.3% spirulina flour; F3= 66.67% corn flour and 8.3% spirulina flour. The snack bar formulation uses wheat flour, corn flour, spirulina flour, eggs, margarine, Diabetasol powdered milk and Tropicana sugar. The steps in the procedure for making a snack bar are the preparation process, mixing process, forming or molding process, oven process, then letting it sit and serving. The analyzes used are organoleptic, antioxidant analysis, dietary fiber analysis, proximate analysis. The formulation that was acceptable to the panelists was the F3 formulation with the addition of 66.67% corn flour and 8.3% spirulina flour. The use of corn flour and the addition of spirulina flour in snack bars can increase the content of dietary fiber (9%) and antioxidants (36.16%). Comparison with the standard quality of snack bars for diets, F3 snack bars contain protein (7.89%), carbohydrates (50.38%), ash (1.2%), fat (15.20%), and energy (365 .35). The fat, carbohydrate, dietary fiber and mineral content meets the SNI 014216-1996 and USDA 5048 quality standards, while the protein content is still lacking.

The elderly are an age group that is prone to falls. The purpose of this service is to detect the risk of falls in the elderly and provide assistance in balance training as an effort to prevent the risk of falls in the elderly. Falls occur due to unintentional loss of balance resulting in failure of postural stability, or unexpected and sudden changes resulting in a position landing on the floor. Associated risk factors include current health status (living in the community, nursing home, hospital, frail or active state), diseases suffered (diabetes, hip fracture, stroke) and general changes related to aging (decreased balance, coordination, muscle strength, visual impairment, etc.). The output targets to be achieved are in the form of publications in accredited national journals and copyright for videos of community service activities. The method used is a fall risk detection examination using the Time Up and Go Test and continued with the provision of balance training, so that the elderly who have a risk of falling can be recognized as early as possible so that the provision of balance training can maintain and improve the balance of the elderly body.

Background: Knowledge about wound care in families and patients with diabetes mellitus foot wounds needs to be increased so that families can assist in the optimal wound healing process and patients can understand more about wound care. The need for education with booklets and audiovisual media for families of diabetes mellitus patients is to increase the effectiveness of family understanding in detecting signs of diabetes mellitus foot problems and appropriate treatment. The purpose of the case study is to illustrate the application of education using booklets and audiovisual media to increase family knowledge about the treatment of diabetic foot wounds in the Sekaran Health Center target area. This research method uses a case study with a descriptive approach. The results of the study regarding family knowledge about the treatment of diabetes mellitus foot wounds were obtained in subject I before receiving education a good level of knowledge with a score of 24, after receiving education a good level of knowledge with a score of 28, subject II before receiving education a moderate level of knowledge with a score of 19, after receiving education level of knowledge is good with a score of 26. Conclusion: health education is very important to increase family knowledge about the treatment of foot wounds with diabetes mellitus, carried out at the Sekaran Health Center.

Diabetes Mellitus is a chronic metabolic disorder with multiple etiologies characterized by high sugar levels. Patients with chronic illnesses are very susceptible to depression. This can be overcome if the respondent has good enough resilience and self-efficacy so that he can manage self-care and regulate glycemic levels and strive for better health. The aim of the research is to determine the relationship between resilience, self-efficacy and depression with self-care management in patients with diabetes mellitus in the Besuki Community Health Center working area. This research design is cross sectional/analytic correlation. The study population included 38 Diabetes Mellitus patients with Gangrene. The sampling technique uses probability sampling, total sampling. The sampling used was 38 people. The instrument uses a questionnaire sheet. And multiple linear regression statistical tests. The research results showed that the average resilience was 70.02, self-efficacy was 71, mild depression was 17 respondents and the average self-care management score was 72. Resilience increased self-care management with a p value of 0.000 ≤ α 0.005. Self-efficacy increases self-care management with a p value of 0.000 ≤ α 0.005 with an average coefficient of . the results of multiple linear regression obtained a p value of 0.000 ≤ α 0.005. There is a relationship between self-efficacy, resilience and depression with self-care management in patients with diabetes mellitus in the Besuki Community Health Center working area with a p value of 0.000 ≤ α 0.005 with a coefficient value of 0.608 so, Self-efficacy influences self-care 6 times more than other variables. Self-efficacy, good resilience can reduce depression in chronic patients such as gangrene so that patients have adequate self-care management.

Diabetes Mellitus is a metabolic disorder that occurs chronically or chronically because the body does not have enough insulin hormone due to interference with insulin secretion, the insulin hormone does not work as it should or both (Hendry et al., 2023). The International Diabetes Mellitus Federation (IDF) organization estimates that at least 463 million people aged 20-79 years in the world suffered from diabetes mellitus in 2019 or equivalent to a prevalence rate of 9.3% of the total population of the same age. Based on gender, IDF estimates that the prevalence of diabetes in 2019 is 9% in women and 9.65% in men. (Indonesian Ministry of Health, 2020). Prevalence data from the Indonesian Ministry of Health in 2013-2018, there are 4 provinces with the highest prevalence, namely DKI Jakarta 3.4% East Kalimantan 3.1% In Yogyakarta 3.1%, North Sulawesi 3% and Central Java 2.1% ( Research and Development Agency, Republic of Indonesia Ministry of Health, 2019).

Hypertension is one of the most common cardiovascular diseases and is most common in society. Hypertension is now a major problem for all of us, not only in Indonesia but in the world, because hypertension is a risk factor for heart disease, kidney failure, diabetes and stroke (Indonesian Ministry of Health, 2019). Data from the World Health Organization (WHO) in 2018 shows that around 1.13 billion people in the world have hypertension, meaning that 1 in 3 people in the world are diagnosed with hypertension. The number of people with hypertension continues to increase every year, it is estimated that by 2025 there will be 1.5 billion people affected by hypertension and it is estimated that every year 10.44 million people die due to hypertension and its complications (Ministry of Health, 2019). Based on Riskesdas 2018, the prevalence of hypertension based on measurement results in the population aged 18 years was 34.1%, the highest in South Kalimantan (44.1%), while the lowest was in Papua (22.2%). Hypertension occurred in the age group 31-44 years (31.6%), age 45-54 years (45.3%), age 55-64 years (55.2%). From the prevalence of hypertension of 34.1%, it is known that 8.8% were diagnosed with hypertension and 13.3% of people diagnosed with hypertension did not take medication and 32.3% did not regularly take medication. This shows that the majority of hypertension sufferers do not know that they have hypertension and therefore do not receive treatment (Ministry of Health, 2019).

Diabetes mellitus is a serious problem in public health and one of the four priority non-communicable diseases that are of global concern (Dewi, 2022). The etiology of type 2 diabetes mellitus is insulin resistance, with higher than normal insulin concentrations required to maintain normoglycemia. When insulin production by pancreatic beta cells is inadequate to compensate for increased insulin resistance, blood glucose levels will increase. Secondly, pancreatic beta cell dysfunction occurs as a result of a combination of genetic and environmental factors. Lastly, environmental factors which also play an important role in the occurrence of DM are obesity, eating too much and lack of physical activity (Dewi, 2022). Diabetes mellitus was the direct cause of death for 1.6 million people in 2016. The latest data released by the International Diabetes Federation (FDA) shows that around 415 million people aged 20-79 years worldwide experienced diabetes mellitus in 2015. This figure is predicted will increase to 642 million people in 2040 with prevalence increasing from 8.8% to 10.4%. China, India and the United States are the three countries with the highest number of diabetes mellitus sufferers. According to the World Diabetes Foundation, from 2014 until now 382 million people in Indonesia suffer from diabetes mellitus. This number is predicted to increase to 592 million people in 2035 (Maria, 2021).