Tugas : Bahasa Inggris

Dosen : Amriati Mutmainna, S.Kep.Ns.,MSN

NURSING CARE

DIABETES MELLITUS

OLEH :
Kelompok 1
A2 2018

1. Muhammad Iqbaalul Rasyid (NH0118049)

2. Mutmainna (NH0118051)
3. Selvia Watafuhan (NH0118077)
4. Susanti Marilalan (NH0118085)
5. Tasya Putri Tamara Makmur (NH0118088)
6. Wirda (NH0118092)
7. Yohanis Agustinus Mapada (NH0118095)
8. Yuni Saraila (NH0118096)

PROGRAM STUDI S1 ILMU KEPERAWATAN

SEKOLAH TINGGI ILMU KESEHATAN
NANI HASANUDDIN
MAKASSAR
2021
 PREFACE

First of all, thanks to Allah SWT because of the help of Allah, writer finished writing
the paper entitled "nursing care Diabetes mellitus" right in the calculated time.

The purpose in writing this paper is to fulfill the assignment that given by Amriati
Mutmainna, S.Kep.Ns.,MSN as lecturer in department English.

In arranging this paper, the writer trully get lots challenges and obstructions but with
help of many indiviuals, those obstructions could passed. writer also realized there are still
many mistakes in process of writing this paper.

Because of that, the writer says thank you to all individuals who helps in the process
of writing this paper. hopefully allah replies all helps and bless you all.the writer realized tha
this paper still imperfect in arrangment and the content. then the writer hope the criticism
from the readers can help the writer in perfecting the next paper.last but not the least
Hopefully, this paper can helps the readers to gain more knowledge about nursing care
Diabetes mellitus.

Makassar, September 29st, 2021

The Writer
 TABLE LIST OF CONTENT

PREFACE.........................................................................................................................
TABLE LIST OF CONTENT...........................................................................................
CHAPTER I (INDTRODUCTION)
A. Background...........................................................................................................
B. Formulate of the problem......................................................................................
CHAPTER II (RELATED LITERATURES)
A. Definition...............................................................................................................
B. Risk Factors...........................................................................................................
C. Signs and Symptoms.............................................................................................
D. Diagnosis...............................................................................................................
E. Treatment Option..................................................................................................
CHAPTER III (CASE STUDY)
A. Patient’s profile.....................................................................................................
B. History of past and present illness of the patient...................................................
C. 11 gordon’s functional pattern..............................................................................
D. Physical examination.............................................................................................
E. Diagnostic examination.........................................................................................
F. Pathophysiology....................................................................................................
G. Nursing care..........................................................................................................
H. Drug study.............................................................................................................
CHAPTER IV (CONCLUSION)
A. Conclusion.............................................................................................................
B. Suggestion............................................................................................................
BIBLIOGRAPHY
 CHAPTER I

INDTRODUCTION

A. Background
Diabetes mellitus is a general term for heterogeneous disturbances of
metabolism for which the main finding is chronic hyperglycaemia. Given that
diabetes mellitus is a lifelong disease, monitoring and monitoring in the management
of diabetes mellitus at any time is important. In this case, the role of people with
diabetes mellitus and their families is very necessary, especially in controlling blood
sugar levels and monitoring activities in people with diabetes mellitus into a healthy
situation or at least close to normal.(Ong et al., 2017)
Diabetes mellitus is prevalent worldwide and has been on the rise in
Singapore, with the Asian population becoming both more affluent and obese over the
last 25 years . A report by the International Diabetes Federation, released in 2015,
revealed that Singapore has the second-highest proportion of people with diabetes
among developed nations, however, the degree of disease heterogeneity in Asian
people with adult-onset diabetes is not clear, particularly with regard to the presence
of islet-cell autoimmunity.(Ong et al., 2017)
Mechanisms underlying diabetes and falls risk are not well elucidated. People
with diabetes developed peripheral neuropathy and retinopathy, vestibular
dysfunction, cogni-tive impairment, musculoskeletal/neuromuscular lesion of the
lower limbs or dizziness and hypoglycaemia events with insulin use. Insulin treatment
was associated with excessive risk of falls, possibly owing to more severe disease
and/or hypoglycaemia episodes.(Yang et al., 2016)
According to the International Diabetes Federation “diabetes is one of the
largest global health emergencies of the 21st century”. In 2015, the prevalence of
diabetes worldwide was of one in 11 adults and the estimated prevalence of the
impaired glucose toleration was of one in 15 adults. These numbers are expected to
further increase, especially in the urban population, leading to more medical and
economic challenges, added on top of the 12% global health expenditure currently
spent on diabetes. A recent study conducted in the Romanian population showed that
diabetes is one of the major health care problems for our medical system, as its
prevalence is of 11.6% and the prediabete’s one is of 16.5%.(Bădescu et al., 2016)
B. Formulate of the problem
1. What is the definition of Diabetes Mellitus ?
2. What are the risk factors for Diabetes Mellitus ?
3. What are the signs and symptoms of Diabetes Mellitus ?
4. What are the diagnoses of Diabetes Mellitus ?
5. How to choose Diabetes Mellitus treatment ?
6. How is nursing care in patients with Diabetes Mellitus ?
 CHAPTER II

RELATED LITERATURES

A. Definition
Diabetes is a serious chronic disease that occurs when the pancreas does not
produce enough insulin (a hormone that regulates blood sugar or glucose), or when
the body cannot effectively use the insulin it produces. This decrease in hormone
results in all sugar (glucose) consumed by the body cannot be processed perfectly, so
that glucose levels in the body will increase.(Hidayat, 2021)
B. Risk factors
DM risk factors are divided into risk factors but can be changed by humans, in
this case it can be in the form of eating patterns, patterns of daily habits such as
eating, resting patterns, activity patterns and stress management. The second factor is
a risk factor but cannot be changed such as age, gender and the patient's factor with a
family background with diabetes.
Age factors affect the decline in all body systems, including the endocrine
system. Increasing age causes insulin resistance conditions which result in unstable
blood sugar levels so that the number of DM occurrences is one of them due to the
aging factor which degeneratively causes a decrease in body function.
Risk factors for the incidence of type two diabetes mellitus include age,
physical activity, exposure to smoke, body mass index (BMI), blood pressure, stress,
lifestyle, family history, HDL cholesterol, triglycerides, gestational diabetes, history
of glucose abnormalities and abnormalities. Research conducted.states that family
history, physical activity, age, stress, blood pressure and cholesterol values are
associated with the occurrence of type 2 diabetes, and people who have body weight
with obesity have a 7.14 times risk of developing type 2 diabetes. two when compared
with people who are at ideal or normal weight.(Isnaini, 2018)
C. Signs and symptoms
Signs and symptoms that are often encountered in DM patients are polyuria,
polydipsia, polyphagia and weight loss that cannot be explained. In addition to other
symptoms that can be found are weakness, tingling, itching, eye fog, erectile
dysfunction in men and pruritusvulva in women.(Maya Annisa Lubis, 2018)
 Symptoms that should prompt consideration of diabetes include polyuria,
polydipsia, fatigue, blurry vision, weight loss, poor wound healing, numbness, and
tingling.(Khoshbaten et al., 2011)
All symptoms that were not completely self- explanatory were
accompanied by a standard description, consistent with the Rome II criteria : early
satiety (feeling full soon after starting to eat, rendering the per- son unable to finish a
normal meal); postprandial fullness (an unpleasant feeling of food staying in the
stomach after a normal meal); bloating (a feeling as if the stomach or abdomen were
swollen); heartburn (a burning pain or discomfort behind the breastbone rising up
toward the throat); dysphagia (difficulty in swallowing, in which solid food or liquids
stick on the way down); anal block- age (a feeling of blockage in the anus or back
passage that made it difficult to pass bowel movements); and urgency (a need to have
a bowel movement that made the person rush to the toilet).(Bytzer et al., 2001)
D. Diagnosis
1. Classic symptoms of DM (polyuria, polydipsia, or weight loss + GDS
concentration of 211.1 mmol/L (200 mg/dL).
2. Fasting blood glucose level 27.0 mmol/L (2126mg/dL). Fasting is no calorie
intake for at least 8 hours.
3. GD 2 hours after eating 211.1 mmol/L (≥200mg/dL) at OGTT. Test according to
WHO with 75g of anhydrous glucose dissolved in water or 1.75g/kgBW,
maximum 75g.
4. In asymptomatic patients, it is found that the blood glucose level is > 200 mg/dL
(11.1 mmol/L) or the fasting glucose level is 2126 mg/dL and the glucose
tolerance test (TTG) is disturbed on more than 1 examination.
5. HbAlc 26.5.(Wahyuni, 2020)
E. Treatment option
Treatment of Type II Diabetes Mellitus Oral hypoglycemic drugs
Sulfonylureas: Sulfonylureas include tolbutamide, glibenclamide, chlorpropamide,
glipizide, acetohexamide, gliclazide and tolazamide.(Akram, 2021)
These include insulin sensitizers, drugs which reduce insulin resistance by
interaction with the PPAR- (peroxisome proliferators- activated receptor-) a nuclear
receptor which regulates genes involved in lipid metabolism. The effect on insulin
sensitivity may result from decreased production of nonesterified fatty acids. They
have the capacity to potentiate the effect of endogenous insulin. One of these,
troglitazone, which belongs to the thiazolidinedione group, is used in Type II diabetes
mellitus. Repaglinide, a benzoic acid derivation which stimulates insulin production at
meal times has been used in type II diabetes mellitus patients.
1. DPP-4 inhibitors: Drugs targeting the incretin pathway are the latest addition to
the available antidiabetic agents. Incretin-based therapy is either delivered orally
(dipeptidyl peptidase-4 [DPP- 4]) inhibitors or injected subcutaneously (glucagon-
like peptide-1 [GLP-1] mimetics and analogues). Dipeptidyl peptidase-4 inhibitors
are effective either as a single or combination therapy in lowering glycated
hemoglobin, fasting and postprandial glucose levels, with a low incidence of
hypoglycemia and no weight gain. There are 3 DPP-4 inhibitors currently
available (sitagliptin, saxagliptin, and vildagliptin), with more expected to be
available in the future. DPP-4 inhibitors are effective in the treatment of patients
with type 2 diabetes.
2. Incretin mimetics: Incretin-related therapies offer great potential for the treatment
of people with type II diabetes mellitus. Major incretins that affect glucose
metabolism are GLP-1: glucagon-like peptide-1 and GIP: glucose-dependent
insulinotropic polypeptide. These therapies have a unique mechanism of action
that addresses glucose appearance as well as glucose disappearance.
3. Thiazolidinediones: The thiazolidinediones also known as glitazones, are a class
of medications that are used in the treatment of diabetes mellitus type 2. They
were introduced in the late 1990s.
4. Αlpha glucosidase inhibitors: One alternative approach o the treatment of
overweight patients with NIDDM is to use drugs which inhibit the enzymes
involved in the breakdown of carbohydrates in the intestine. Acarbose is a sham
sugar that competitively inhibits α-glucosidase enzymes situated on the brush
border of the intestine. As a result, dietary carbohydrates are poorly absorbed, and
the postprandial rise in blood glucose is reduced. Undigested starch enters the
large intestine where it is broken down by fermentation. Abdominal discomfort,
flatulence and diarrhea can result, and dosage needs careful adjustment to avoid
these side effects. Very little acarbose enters the circulation, since it is mainly
inactivated in the gut, but liver dysfunction may rarely occur with high doses.
Treatment to prevent or delay progression to T2DM Patients who are
identified with prediabetes should be referred for education and life-style
interventions to a qualified health professional (which may include clinician,
 dietitian, nursing staff and pharmacist). Intensive lifestyle change or programs
have been proven effective in delaying or preventing the onset of diabetes by
about 50-58%. Effective lifestyle changes include setting achievable goals,
obtaining weight loss when needed (between 5-10% of total body weight is
recommended), and increasing physical activity to a minimum of 150 minutes per
week.(Redmon et al., 2016)
1. Patients with IGT, IFG or an A1c should be referred to an effective ongoing
support program targeting weight loss of 7% of body weight and increasing
physical activity to at least 150 minutes per week of moderate activity such as
walking.
2. Metformin therapy for prevention of T2DM may be considered in those patients
meeting criteria for prediabetes.
3. At least annual monitoring for the development of diabetes in those with
prediabetes may be utilized. • Screening for and treatment of modifiable risk
factors for CVD are suggested.

Patients who respond to lifestyle interventions : Annual follow-up and

reassessment of risks for developing diabetes (American Diabetes Associa- tion,
2014; Chiasson, 2002; Heart Outcomes Prevention Evaluation Study Investigators,
The, 2002; Kelley, 2002; Eriksson, 1999)

Patients who are high risk and not responding to lifestyle interventions: Intensify
education and counseling on lifestyle interventions. Lifestyle change remains the
preferred method to prevent diabetes.
 CHAPTER III

CASE STUDY

A. Patient’s Profile
Name : Mrs. J
Age : 54 years
Gender : Female
Marital Status : Married
Religion : Islam
Ethnic group : Bugis
Education : Middle school
Occupation : Entrepreneur
Address : Pangkep Regency
Medical Diagnosis : Diabetes Mellitus Type 2
B. History of Past and Present Illness of the Patient
1. Past Illness History
Diseases that have been experienced : Diabetes (approximately 4 years) and
hypertension (approximately 9 years)
Allergy history : none
Habits : SPH, drinking coffee, no alcohol
Drugs : The client has taken oral hypoglycaemic medication (Glibenclamide) from
the Puskesmas for about 1 year
2. Present illness of the patient
Main complaint : Diabetic ulcer on the right foot.
History of chief complaint :
The client said that the wound on the sole of the right foot since 2 months ago
due to being pierced by a fish thorn initially wound like a boil and then broke and
oozed pus and blood. Previously, the client went to the Puskesmas but did not
recover and then was treated and treated at Dr Wahidin Sudirohusodo Hospital.
Aggravating factors :
The client suffers from Type 2 DM, GDS since admission 327 mg%.
C. 11 Gordon’s Functional Pattern
1. Perception Patterns and Health Management
 Prior to illness, the client said that he could not maintain his diet and often drank
excessively sweet drinks. The client does not know about diabetes mellitus. If the
client is sick, always check his health to the nearest hospital or clinic. During
illness, the client said he was worried about his illness, the client said he wanted to
go home quickly and gather with his family as usual, the client followed the diet
or diet given at the hospital.
2. Pattern of fulfillment of nutrition and metabolism
The client said that before the client was sick, he used to eat 3 times a day with a
menu of rice, side dishes, vegetables and fruits, the client likes all kinds of food,
the client does not have allergies to certain foods. Clients drink 8-9 glasses per
day with various drinks such as water, sweet tea and milk and most like sweet
drinks, weight 54 kg. The client said that during his illness the client ate 3 times a
day from the hospital with Type II Diabetes Diet food and did not eat portion.
Drink 11-12 glasses/day with drinks provided by the family and the hospital with
fresh tea and water, body weight 51 kg.
3. Elimination Pattern
The client said that before being admitted to the hospital, the client used to
defecate 1 time per day every morning with the characteristics of soft stool in the
form, yellow color, distinctive odor, the client used to urinate 6-7 times / day with
the characteristics of clear slightly yellowish urine, the amount of 1100 cc. The
client said that while being treated at the client's hospital, he defecated 1 time per
day with the characteristics of soft, shaped stools, typical odor of BAK 8-9 times
per day with the characteristics of clear yellow urine, distinctive odor, the amount
of 1400cc.
4. Activity Pattern
The client said that before the illness the client was active independently and not
assisted by others, and during the illness the client said he felt tired after doing
activities and carrying out activities assisted by his family and nurses such as
eating, drinking, going to the bathroom and doing activities in bed.
5. Sleep and Rest Pattern
The client said that before being admitted to the hospital the client used to sleep
approximately 8 hours / day, the client did not have a bedtime habit, the client
never took sedative drugs (sleeping pills). The client said that while being treated
at the hospital the client slept approximately 4-5 hours or more / day because the
 client was anxious about his current condition and felt aches in the thigh and hip
area. Clients can still sleep because they spend more time day and night in bed.
6. Perceptual and Cognitive Patterns
The client's vision is not functioning properly because it is impaired. Hearing,
taste and smell, the client is functioning well. Sensory, the client is still able to
distinguish sharp and dull sensory even if it has to be with strong pressure.
7. Perception Patterns and Self-Concept
a. self-image
The client said the client could accept the current physical state of his body.
b. Pride
The client said that her self-esteem has increased because her family supports
her in her current pregnancy.
c. Role
The client says her current role is as a mother and a wife.
d. Ideal Self
The client said he wanted to hurry home and gather with his family.
e. Identity
The client said she was aware of her identity as a mother and a wife to her
husband.
8. Patterns of Roles and Relationships
The client said her current role was that of a mother and wife of her husband. The
client's relationship with the closest person does not experience problems. After
being treated at the hospital the client will maintain his current condition and will
always check with the doctor. While at the hospital the client also interacts well
with other patients' families, nurses and other medical personnel.
9. Patterns of reproduction and sexuality
The client has been married once, has 2 children. The client said he never had a
history of reproductive disorders.
10. Coping and stress patterns
The client says if there is a problem, it must be discussed with his family and his
closest relatives. The client resolves the problem by deliberation. The client looks
anxious and stressed about his illness.
11. Patterns of Values and Beliefs
 The client said the client was Muslim and always obeyed in carrying out his
prayer obligations even in bed.
D. Physical Examination
From the physical examination, the data obtained are:
1. General condition composmentis
2. Vital signs BP : 130/90 mmHg, R : 20 x/min S : 36C, N : 80x/minute
3. Body weight before illness: 54 kg, Body weight during hospital: 51 kg.
4. Heat toe check :
Head : Mesocephalic shape
Hair : black, clean, moist
Scalp : clean, no dandruff, no lesions
Eyes : wearing glasses, poor vision, not anemic conjunctiva, sclera not
ikterik.
Nose : clean, no secretions, no enlarged polyps, normal olfactory function
Mouth : clean tongue, moist mucosa, no tartar, good gums, no bleeding
Ears : clean, symmetrical, no hearing loss
Skin : Light yellow skin color, good skin turgor.
Thorax : I : Symmetrical, Right - left chest development is the same
P : Vocal Fremitus right and left are the same
P : Sonor's voice
A: Vesicular sound is not blocked
Heart : I : Ictus kordis Visible
P : Ictus cordis palpable
P : Dim sound
A : Regular S1 and S2 heart sounds
Abdomen : I: symmetrical shape, no ascites
A : Intestinal Peristalsis 10 x / min
P : Tympani quadrant 1,2,3,4
P : There is no tenderness,
Extremities : Upper : left hand infusion RL 20 tpm, no edema
Bottom : no edema, often tingling in the soles of the feet
Genetalia : no abnormalities, no DC installed wound.
Anus : no irritation around the anus.
Endocrine : no enlargement of the thyroid gland, thirst and hunger
 excessive, excessive sweating.
Psychiatry : poor eye contact, restless, anxious about his condition.
E. Diagnostic Examination
1. Blood sugar :
Fasting Blood Sugar : 174 mg/dl (110 mg/dl).
Blood Sugar 2 Hours Post Prandial (GD2JPP) : 133 mg/dl (200 mg/dl).
2. Blood electrolytes :
Urea : 35.4 mg/dl (10-50 mg/dl).
Uric acid : 6.1 (Lk: 3.4-7.0 Pr 2.4-5.7).
Creatinine : 1.04 (Lk : <3.8 Pr <1.1.
HB : 9.9 gr/dl.
Erythrocytes : 3.71 (4.00/6.00).
Lymphocytes : 21.8 (20,0/40,0).
Total cholesterol : 168 (200 U/i).
HDL Cholesterol : 38 (Lk > 55 Pr > 65).
LDL cholesterol : 138 (< 130).
 F. Pathophysiology Insulin Secretion 
Genetic Factors Medical Intoxication Stress Alcoholism

Insulin Retention

Cell damage  Focus on cell   Cortisol secretion  Cell Damage 

Langerhans Langerhans Insulin

Insulin Hormone Deficiency

Symptoms of DM
Prolonged
(polyphagia, polyuria and
 synthesis of triglycerides  glucose levels in the accumulation of
polydipsia) Use of stored nutrients
from glycerol blood (hyperglycemia)  amino acid synthesis glucose in the blood
(glycogen) in the liver and
muscles (glycogenolysis)
Changes in the client's Atherosclerosis
health status The use of the body's
Final Metabolism Ketone protein reserves increases
body fat Glucose level exceeds renal
Glycogen reserves
threshold > 180 mg
decreased/depleted Elasticity of blood
 formation of
vessels  (rigid)
Less information lymphocytes and
Uncontrolled antibodies
ketogenesis
Reserve usage
Kidneys are unable to
decreased/depleted
Ignorance absorb
Decreased response and Transport nutrients
resistance to infection to cells/tissues
Ketoacidosis use of cad. Nutrients in
Lack of knowledge The Adipose tissue and skeletal
Polyuria and glucosuria
need to learn about the muscle (gluconeogenesis)
disease and its prognosis Metabolic acidosis Entry of infectious agents
Cell and tissue
Compensation damage
Water and electrolytes come Infection
mechanism out with urine Energy/nutrient reserves 
pe  metabolic energy
Intake less products

Osmotic diuresis
Hyperventilation fatigue Retinal blood Kidney cells/blood
Changes in nutrition less vessels/cells vessels
than required
Nutrient supply to
Lack of fluid
Kussmaul Breathing tissues  Nephropathy
volume
Misperception Retinopathy

Lack of understanding Acetone smelling breath Ischemic Peripheral cells/tissues

Damage to skin
Worried Anorexia Necrotic integrity Neuropathy
G. Nursing care

No. Nursing Diagnosis Goal Of Care Intervention Rationale

1 Damage to skin integrity related to increased The client will show signs 1. Assess the wound 1. Provides information
blood glucose levels, characterized by: of wound healing, with area every time you about the
Subjective : the following criteria : change the dressing. effectiveness of
‒ The client said the wound on the leg had not ‒ Clean wound edges 2. Perform wound care therapy and identifies
healed. ‒ New network growth with aseptic and anti- the need for additional
Objective : ‒ No signs of infection septic techniques appropriate
‒ Looks like a wound on the right leg 3. Observe for signs of interventions
‒ The size of the wound is 2-3 cm infection 2. High glucose levels in

‒ Vital signs 4. Collaboration in the the blood will be a

BP: 130/90 mmHg administration of growth medium for

N : 88 x/minute antibiotics microorganisms

R : 20x/minute 3. The client may enter

S : 36, C with an infection that

usually has
precipitated a state of
ketoacidosis or may
develop a nosocomial
infection
4. Early treatment can
 prevent sepsis
2 Resti expansion of infection related to There is no expansion of 1. Assess the wound 1. Provides information
increased blood glucose levels. infection, with criteria area every time you about the
‒ Clean wound edges change the dressing. effectiveness of
‒ There is growth new 2. Perform wound care therapy and identifies
network. with aseptic and anti- the need for additional
‒ No signs of infection septic techniques appropriate
3. Observe for signs of interventions
infection 2. High glucose levels in
4. Collaboration in the blood will be a
administering growth medium for
antibiotics microorganisms
3. The client may enter
with an infection that
usually has
precipitated a state of
ketoacidosis or may
develop a nosocomial
infection
4. Early treatment can
prevent sepsis
3 Lack of knowledge related to lack of The client states 1. Build a trusting 1. Attention needs to be
information about the disease is characterized understanding of the relationship by created before the
by: condition, prognosis and listening attentively, patient is willing to
Subjective : treatment, with the and always being take part in the
‒ The client asks about his illness following criteri : there for the patient. learning process
‒ Clients always ask about the program the ‒ The client understands 2. Discuss major topics 2. Awareness of what is
disease about the disease such as Complications happening helps
‒ Clients understand of acute and chronic patients to be more
about DM treatment disease including consistent with their
‒ Clients can carry out a visual disturbances treatment and
healthy lifestyle and (retinopathy), changes prevent/reduce the
participate in in neurosensory and onset of these
treatment programs cardiovascular, and complications.
changes in kidney 3. Awareness of the
function/hypertension importance of diet
3. Discuss diet plans, control will help
consumption of high- patients in planning
fiber foods and ways meals/adhering to the
to eat out. program. Fiber can
4. Demonstrate stress slow down the
management absorption of glucose
techniques, such as which will reduce
deep breathing, or fluctuations in blood
distraction. sugar levels but can
cause discomfort in
the gastrointestinal
tract. Flatus increases
and affects the
absorption of vitamins
and minerals.
4. Promotes relaxation
and control of the
stress response which
can help to limit the
occurrence of
glucose/insulin
imbalances.
H. Drug Study
1. Infusion of NaCl : Martos 10% (1 : 1).
2. Actrapids 8-8-6.
3. Ceftriaxone 1gr/12 hours.
4. Ciproploxaxine 2 x 500 mg.
5. Captopril 2 x 25 mg.
6. Kalmico 500 mg 2x1.
7. Diet DM 1700 cal, low salt.
 CHAPTER IV

CONCLUSION

A. Conclusion
Diabetes is a serious chronic disease that occurs when the pancreas does not produce
enough insulin (a hormone that regulates blood sugar or glucose), or when the body
cannot effectively use the insulin it produces. DM risk factors are divided into risk
factors but can be changed by humans, in this case it can be in the form of eating
patterns, patterns of daily habits such as eating, resting patterns, activity patterns and
stress management. Treatment of Type II Diabetes Mellitus Oral hypoglycemic drugs
Sulfonylureas: Sulfonylureas include tolbutamide, glibenclamide, chlorpropamide,
glipizide, acetohexamide, gliclazide and tolazamide.
B. Suggestion
In making this paper, the authors realize there are still shortcomings and errors caused
by the limited knowledge that the author has. therefore, the author asks for criticism
and advice from the readers.
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