JURNAL KEDOKTERAN DIPONEGORO
(DIPONEGORO MEDICAL JOURNAL)
Online http://ejournal3.undip.ac.id/index.php/medico
E-ISSN : 2540-8844
DOI: 10.14710/dmj.v12i3.37822
JKD (DMJ), Volume 12, Number 3, May 2023 : 119-123
Erika Martining Wardani, Riezky Faisal Nugroho
THE CORRELATION LIFESTYLE WITH THE INCIDENCE OF
DIABETES MELLITUS TYPE 2
Erika Martining Wardani1*, Riezky Faisal Nugroho2
1Departement of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia
2Departement of Nutrition, Politeknik Kesehatan Kemenkes Surabaya, Indonesia
ABSTRACT
Background: The change in social structure from agricultural to industrial societies has contributed significantly to
lifestyle changes that have led to an increase in non-communicable diseases, including diabetes (DM). Lifestyle changes
are diet and exercise. Unhealthy diet and lack of exercise are among the triggers for the development of DM type
2. Objective: To analyze the correlation between lifestyle (diet and physical activity) and the incidence of DM type 2.
Methods: The design of this study is analytical observational with a retrospective study. The population of this study was
all patients sufferers diagnosed with diabetes mellitus type 2 at the Waru Sidoarjo Health Center. Sampling was carried
out by purposive sampling, 60 samples in this study, research instruments using questionnaire sheets and glucometer. The
statistical test in this research is Chi-Square. Results: Based on research that has been carried out, it was found that there
was a relationship between diet (p=0.000 < α=0.05) and physical activity (p=0.001 < α=0.05) and the incidence of DM
type 2. Conclusion: lifestyle relationship with the incidence of DM type 2. Nurses and nutritionists to pay more attention
to diet and conduct diabetic gymnastics. For DM people to control their diet and physical activity regularly.
Keywords : life style, diet, physical activity, DM Type 2
INTRODUCTION According to the report on the results of Riskesdas
Changes in social structure from agricultural (2018), the Ministry of Health of the Republic of
patterns to industrial societies have contributed Indonesia in 2018, the prevalence of people with
significantly to lifestyle changes and may lead to an Diabetes Mellitus in Indonesia increased from 1.5%
increase in non-communicable diseases, one of which in 2013 to 2.0% in 2018 while the prevalence in East
is diabetes mellitus.1,2 Some of those lifestyles are Java was 2.6%.9 The Sidoarjo 2.5% of people with
diet and physical activity. Lifestyle is known to have diabetes mellitus.10
a significant influence on the occurrence of type 2 People are now very busy with work behind the
diabetes mellitus by reducing the incidence of desk which causes no opportunity for recreation or
diabetes through good dietary habits and physical exercises. The number of transportation facilities such
activity.3 A healthy diet lies in planning 3J (number, as motorbikes makes not a few people reluctant to
type and schedule of meals).4 People's diet today has walk to cover a distance of only about 100 m. This
shifted to a modern diet that tends to be allows a person to suffer from non-communicable
instantaneous. Many experts cite this as a triggering diseases, one of which is diabetes mellitus. 11
factor and are associated with the onset of various
diseases. One of the diseases in question is diabetes METHODS
mellitus.5 This study is an analytical observational study,
On the other hands the industrial revolution which is a retrospective study. This study was
changed the type and amount of work of a person. conducted in January-March 2021. The population in
Before the industrial revolution, most of the people this study was all patients diagnosed with type 2
did heavy physical work. Gradually the machine diabetes mellitus who visited the Waru Sidoarjo
reduces the physical work that must be done. So health center with a total of 60 respondents taken by
fewer and fewer people do physical work and more purposive sampling.
and more work behind a desk.6,7 The independent variable is the lifestyle
According to the International Diabetes consisting of diet and physical activity, while the
Federation (IDF), in 2021, 537 million adults (ages dependent variable is the incidence of type 2 diabetes
20-79) worldwide, or 1 in 10, had diabetes.8 Indonesia mellitus.
ranks second highest in the Southeast Asia region.
119
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(DIPONEGORO MEDICAL JOURNAL)
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E-ISSN : 2540-8844
DOI: 10.14710/dmj.v12i3.37822
JKD (DMJ), Volume 12, Number 3, May 2023 : 119-123
Erika Martining Wardani, Riezky Faisal Nugroho
The instrument used is a questionnaire sheet, for Table 2. The correlation lifestyle with the incidence of
diet variables are instruments compiled by the DM type 2
researchers themselves, while physical activity Incidence of DM P value
variables use the GPAQ (Global Physical Activity Variable type 2
Questionnaire) questionnaire. Blood sugar levels are n %
Dietary habit Healthy 21 35 0.000
checked using a glucometer.
No healthy 39 65
Then test the data using the chi-square test and
perform statistical tests using the SPSS version 23.0 Physical High 26 43.3 0.001
activity Low 34 56.7
program for Windows at significance level = 0.05. If
the statistical test results in p 0.05 indicating a
relationship between the independent and dependent Table 2 shows that most respondents were found
variables, the hypothesis is rejected. to have an unhealthy diet with 39 respondents. Most
respondents also had low physical activity with 34
RESULTS respondents. The results of the chi square test
Demographic data respondent obtained a p value of 0.000 (p <0.05), so it can be
Table 1. Demographic data respondents with DM type 2 concluded that Ha is accepted, meaning that there is a
(n=60)
relationship between dietary habit and the incidence
Demographic data n %
of DM type 2.
Gender
The results of the chi square test obtained a p
Man 29 48.3 value of 0.001 (p <0.05), so it can be concluded that
Woman 31 51.7 Ha is accepted, meaning that there is a relationship
Ages (Years) between physical activity and the incidence of DM
< 45 6 10 type 2.
45-60 40 66,7
> 60 14 23,3 DISCUSSION
Level of education Diabetes is more prevalent at the age of over 40
Not educated 12 20 years, because the ability of the pancreas to produce
Elementary 12 20 insulin will decrease at an increasingly high age.
Middle 22 36.7 Diabetes mellitus is more likely to occur in women,
Academy 14 23.7 because metabolism in women is slower than in men,
Employee so women have a greater chance of developing
Employee 44 73.3 diabetes. However, other studies state differently that
Unemployee 16 26.7 the incidence of diabetes mellitus increases every year
Smoking habit with a higher increase in men than women.12
Yes 31 51.7 The level of education does not directly affect
No 29 48.3 the onset of diabetes mellitus. However, it is
Time ilness (years) suspected to affect the diet through the selection of the
<5 16 26.7 type of food consumed daily. The level of education
>5 24 73.3 will affect a person's level of food consumption in
choosing foodstuffs to meet their needs.13,14 that the
relationship between work and the incidence of
Table. 1 shows that most of the respondents
diabetes that the absence of work makes the body less
man gender (51,7%), aged 45-60 were 42 people
mobile and can be a trigger for obesity. This will lead
(66.7%). Majority of education levels, up to 22
to the occurrence of insulin resistance.
respondents in middle school (36.7%) and employe
This situation makes body tissues less sensitive
status 44 people (73.3%). Respondent with smoking
to insulin. Therefore, sugar in the blood has difficulty
habit 31 people (51.7%) and with time illness more
leaving the blood and entering cells.15
than 5 years is 24 people (73.3%).
A healthy diet is defined as eating according to
the 3J plan of number, variety and regularity of meals.
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DOI: 10.14710/dmj.v12i3.37822
JKD (DMJ), Volume 12, Number 3, May 2023 : 119-123
Erika Martining Wardani, Riezky Faisal Nugroho
An unhealthy diet leads to an imbalance between help diabetics reduce their consumption of insulin and
carbohydrates and other requirements of the body.As non-insulin treatments.17,18
a result, sugar levels in the body increase beyond the In addition, the lack of physical activity makes
ability of the pancreas to work, leading to diabetes the secretory system of the body run slowly. As a
mellitus.16 result, there is a buildup of fat in the body which
Diabetics have two major insulin-related gradually becomes excess weight and leads to the
problems: insulin resistance and impaired insulin onset of diabetes mellitus.25 Low physical activity has
secretion. Insulin normally binds to special receptors a three times greater risk of diabetes compared to high
on the cell surface. Binding of insulin to such physical activity. Other studies state that people who
receptors leads to a series of reactions in glucose have heavy daily physical activity have a lower risk
metabolism within the cell. The response of insulin of suffering from diabetes mellitus compared to
secretion to an increase in blood glucose people whose daily physical activity is low. 26
concentration provides a feedback mechanism that is A person with a hereditary history of diabetes
essential for the regulation of blood glucose and running Life's simple 7 has a low risk of
concentration. That is, the increase in blood glucose developing diabetes. Life's simple 7 is an AHA
increases insulin secretion, and insulin further causes (American Heart Association) program to reduce the
the transfer of glucose into the cells, since it reduces risk of cardiovascular disease. One can at least
the blood glucose concentration back to normal running two of the seven Life's simple 7 programs to
values. 17,18,19 be at low risk of developing diabetes, and two of them
In addition to an unhealthy diet, insufficient are healthy diets and high physical activity.27 Similar
physical activity is also a predisposing factor to the studies also explain that low physical activity and
occurrence of diabetes mellitus. Normal muscles that eating instant food as a form of unhealthy diet are risk
are in a state of rest that can result from a lack of factors for someone with a family history of diabetes.
physical activity are hardly permeable to glucose One of the low physical activities that increases the
except when muscle fibers are stimulated by insulin. risk of diabetes is associated with the number of hours
The increased risk of diabetes mellitus in low spent watching TV during the week.28,29
physical activity occurs due to a decrease in muscle
contractions leading to reduced permeability of cell CONCLUSION
membranes to glucose. As a result, there is a Most respondents with type 2 diabetes mellitus
disruption of glucose transfer into cells and a reduced have a history of unhealthy diet and light physical
response to insulin which leads to a resistant state and activity. These two things are part of the risk factors
can give rise to diabetes mellitus.20,21 for diabetes, especially in respondents with a family
Physical activity is defined as a daily activity history of diabetes. Nurses and nutritionists to pay
divided into 3 parts. The first part, that is, work- more attention to diet and conduct diabetic
related physical activity; inquire about physical gymnastics and for people with DM to control their
activity on working days (strenuous activity). The diet and physical activity regularly.
second part, which is physical activity outside of
work (moderate activity). The third part, which is ETHICAL APPROVAL
physical activity related to travel; ask about the type This research has passed the ethical clearence at
of transportation used to get to and from work, Universitas Nahdlatul Ulama Surabaya with no
markets, mosques/churches, and others.22,23 Such 0281/EC/KEPK/UNUSA/2020.
physical activity can be measured using the GPAQ
(Global Physical Activity Questionnaire) CONFLICTS OF INTEREST
questionnaire.24 There are no conflicts of interest. This article has
Physical activity can reduce the risk of diabetes not yet been published.
through the effects of weight loss and insulin
sensitivity. A person with low levels of body fat has FUNDING
a low risk of developing diabetes as well. The authors are responsible for all research
Additionally, physical activity has been shown to funding without grants or external funding sources.
121
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E-ISSN : 2540-8844
DOI: 10.14710/dmj.v12i3.37822
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Erika Martining Wardani, Riezky Faisal Nugroho
AUTHOR CONTRIBUTIONS 10. Dinas Kesehatan. Hasil Utama Riset Kesehatan
EMW were responsible for the completeness and Dasar Jawa Timur 2018. Jakarta: Badan
accuracy of the manuscript data and drafts, and also Penelitian dan Pengembangan Kesehatan,
wrote the main draft of the screenplay. RFN were Kementrian Kesehatan Republik Indonesia.
responsible for study design and contributed to data 2018; 1–82
analysis and interpretation. 11. Mmiyauchi M, Toyoda M, Kaneyema N,
Miyatake H, Tanaka E, Kimura M, Umezono
ACKNOWLEDGMENTS T, et al. Exercise therapy for the management
We would like to thank the LPPM Universitas of type 2 diabetes mellitus: superior efficacy of
Nahdlatul Ulama Surabaya dan Politeknik Kesehatan activity monitors over pedometers. Journal of
Kemenkes Surabaya for their motivated, and Diabetes Research. 2016. http://dx.doi-
supported. org/10.1155/2016/5043964
12. Wardani, E. M., Wijayanti, L. & Ainiyah, N.
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