A Quasi-Experimental Study on Lifestyle Education and Peripheral Circulation in Type 2 Diabetes Patients
DOI:
https://doi.org/10.33755/jkk.v11i3.903Keywords:
Ankle Brachial Index (ABI), Dietary Compliance, Peripheral Arterial Disease, Physical Activity, Type 2 Diabetes MellitusAbstract
Background: Type 2 diabetes mellitus (DM) poses a high risk for macrovascular complications such as Peripheral Arterial Disease (PAD). The Ankle Brachial Index (ABI) is a non-invasive, reliable screening tool for early detection of PAD. Lifestyle factors, particularly physical activity and dietary adherence, play a crucial role in maintaining vascular health. However, structured educational interventions integrating these aspects with ABI assessment remain limited.
Objective: This study aimed to determine the effect of physical activity education and dietary compliance on ABI values in patients with type 2 diabetes mellitus.
Methods: A quasi-experimental one-group pretest-posttest design was employed. Thirty type 2 DM patients from Riung Bandung Community Health Center and Bandung City Hospital participated in a 7-day structured educational intervention focusing on physical activity and diet. Data collection included a modified version of the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire and ABI measurements. Statistical analyses used Wilcoxon signed-rank test and Spearman correlation.
Results: Post-intervention, participants showed improved dietary adherence (fruit/vegetable consumption increased from 3.2 to 4.9 days/week) and physical activity (specific exercise increased from 3.1 to 4.7 days/week). The mean ABI value increased from 0.94 to 1.02, with 80% of participants experiencing ABI improvement. There was a significant positive correlation between improved physical activity and dietary adherence with increased ABI values (p < 0.05).
Conclusion: A 7-day structured educational intervention effectively improved physical activity and dietary compliance, leading to better vascular function as indicated by ABI improvement. This approach is promising for community-based prevention of vascular complications in type 2 DM patients
References
1. Dwi E, Sari L, Silvitasari I. PENGARUH SENAM KAKI TERHADAP ANKLE BRACHIAL INDEX PADA PASIEN DM T2 DI PUSKESMAS BANYUANYAR. Jurnal Imliah Ilmu Kesehatan. 2023;1(4).
2. Yurlina F, Yunie Atrie U, Julia H. Pengaruh Pendidikan Kesehatan terhadap Kepatuhan Diet pada Pasien Diabetes Mellitus Tipe 2 di Rawat Jalan RSUD Palmatak. Jurnal Keperawatan. 2023 Jul 27;13(2):49–58.
3. Kaka AS, Landsteiner A, Ensrud KE, Logan B, Sowerby C, Ullman K, et al. Risk prediction models for diabetic foot ulcer development or amputation: a review of reviews. J Foot Ankle Res. 2023 Dec 1;16(1).
4. Guo P, Tu Y, Liu R, Gao Z, Du M, Fu Y, et al. Performance of risk prediction models for diabetic foot ulcer: a meta-analysis. PeerJ. 2024;12(7).
5. Nur C, Tahir M. Efektifitas Senam Terhadap Sensitivitas Kaki Pada Pasien Diabetes Mellitus Tipe 2 Wilayah Kerja Puskesmas Pangkajene Kabupaten Sidenreng Rappang [Internet]. Vol. 01, Jurnal Inonasi Pengabdian Masyarakat. 2021. Available from: https://stikesmu-sidrap.e-journal.id/JIPengMas
6. Jumari J, Luawo HP, Ratnawati R, Pratama EF. PENINGKATAN NILAI ANKLE BRACHIAL INDEX (ABI) DENGAN INTERVENSI AKUPRESUR DAN SENAM KAKI PADA PASIEN DIABETES MELITUS TIPE 2. Klabat Journal of Nursing [Internet]. 2024;6(2):2685–7154. Available from: http://ejournal. unklab.ac.id/index.php/kjn
7. Nihullohti Astam, Aminah S. The Relationship Between Physical Activity and Diet Compliance with Blood Glucose Levels in Type 2 Diabetes Mellitus Patients at Mary Cileungsi Green Hospital in November 2022. Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing). 2023;3(9).
8. Fatimah OM, Purwanti OS. THE RELATIONSHIP BETWEEN DIABETES SELF MANAGEMENT AND ANKLE BRACHIAL INDEX VALUE IN PATIENTS WITH DIABETES MELLITUS. Indonesian Journal of Global Health Research [Internet]. 2024; Available from: https: //doi.org/10.37287/ijghr.v6i3.3103.
9. Setyorini A, Asty Sasbilla A, Studi Keperawatan P, Tinggi Ilmu Kesehatan Surya Global S. SENAM KAKI DIABETIK BERPENGARUH TERHADAP PENINGKATAN ANKLE BRACHIAL INDEX (ABI) PADA PENDERITA DIABETES MELITUS TIPE II. Nursing Science Journal (NSJ). 2023;4(1):2722–4988.
10. Said A, Mikawati M, Rahmadania W, Mudatsir A. Diabetes Distress: Assessment And Screening Of Stress Levels Among People With Diabetes Mellitus. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal). 2022;8(2).
11. Sofianingrum A, Jati SP, Martini M. Challenges on Standardized Diabetes Mellitus Care Implementation in the Primary Health Care in Indonesia: A Narrative Review. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal). 2023;9(2).
12. Yurlina F, Yunie Atrie U, Julia H. Pengaruh Pendidikan Kesehatan terhadap Kepatuhan Diet pada Pasien Diabetes Mellitus Tipe 2 di Rawat Jalan RSUD Palmatak. Jurnal Keperawatan. 2023 Jul 27;13(2):49–58.
13. Gardner AW, Montgomery PS, Wang M, Shen B, Casanegra AI, Silva-Palacios F, et al. Diet is associated with ankle-brachial index, inflammation, and ambulation in patients with intermittent claudication. J Vasc Surg. 2020 Oct 1;72(4):1375–84.
14. Syihabuddin M, Sri Wahyunigsih I. Hubungan Antara Aktifitas Fisik, Nilai Ankle Brachial Index Dan Pola Makan Dengan Kejadian Neuropati Diabetik Pada Pasien Dm. Jurnal Riset Kesehatan Modern [Internet]. 2025;7(2). Available from: https://journalpedia.com/1/index.php/jrkm
15. Muslim B, Sulastri D, Yuliana D. Hubungan Peran Edukasi Kesehatan Dalam Meningkatkan Kepatuhan Pengobatan dan Olah Raga pada Pasien Diabetes Mellitus di Wilayah Kerja Puskesmas Putih Doh Kecamatan Cukuh Balak Kabupaten Tanggamus Tahun 2024. Journal of Citizen Research and Development. 2025;
16. McDermott MM, Dayanidhi S, Kosmac K, Saini S, Slysz J, Leeuwenburgh C, et al. Walking Exercise Therapy Effects on Lower Extremity Skeletal Muscle in Peripheral Artery Disease. Circ Res. 2021 Jun 11;128(12):1851–67.
17. Suza DE, Hijriana I, Ariani Y, Hariati H. Effects of lower extremity exercises on ankle-brachial index values among type 2 diabetes mellitus patients. Open Access Maced J Med Sci. 2020 Jan 2;8(E):1–6.
18. Alisa F, Andika M, Refti Y, Allam A, Nursuari H, Valentina P, et al. Pengaruh Active Lower Range of Motion Terhadap Nilai Ankle Branchial Index (ABI) PadaPasien Diabetes Mellitus Tipe II. Jurnal Keperawatan Muhammadiyah. 2022;7(2).
19. Aditiya Nurul Hamdi M, Sasmito Adi G. HUBUNGAN AKTIVITAS FISIK DENGAN KEJADIAN NEUROPATI PERIFER DIABETIKUM PADA PENDERITA DM TIPE II DI PUSKESMAS MAESAN. Vol. 8, Jurnal Kajian Ilmiah Interdisiplinier. 2024.
20. Lariwu CK, David BY, Gunung S, Tomohon M, Korespondensi A, Florence J, et al. PENGARUH SENAM KAKI TERHADAP NILAI ABI PADA PASIEN DMT2. Vol. 1, Journal | Watson Journal of Nursing. 2022.
21. Geby Arditha S, Hasanah U, Keperawatan Dharma Wacana A. IMPLEMENTASI SENAM KAKI TERHADAP NILAI ANKLE BRACHIAL INDEX DAN NILAI IPSWICH TOUCH TEST IMPLEMENTATION OF FOOT EXERCISES ON ANKLE BRACHIAL INDEX VALUES AND IPSWICH TOUCH TEST VALUES. Jurnal Cendikia Muda. 2025;5(4).
22. Ziady HH, El-Zeiny NAE monem, Fetohy EM, Hewi SAH, Hagras EMA. Assessment of diabetes health literacy and its predictors among diabetic older adults attending geriatric clubs, 2024. Alexandria Journal of Medicine [Internet]. 2025 Dec 31;61(1):1–10. Available from: https://www.tandfonline.com/doi/full/10.1080/20905068.2025.2464362
23. Feldman H, ElSayed NA, McCoy RG, Moverley J, Oser SM, Segal AR, et al. Standards of Care in Diabetes—2023 Abridged for Primary Care Providers. Clinical Diabetes. 2023;41(1):4–31.
24. Nuryani N, Usman WI, Maesarah M. Nutrition Education, Physical Activity and Dietary Habits in Diabetes Mellitus Patients. Media Gizi Indonesia. 2023 Oct 23;18(2SP):8–12.
25. Saripah I. Edukasi Perilaku ABC (Antecedents, Behaviour, Consequences) Efektif Dalam Meningkatkan Kepatuhan Diet Pasien Diabetes Mellitus ABC Behavioral Education (Antecedents, Behavior, Consequences) is Effective in Increasing Diet Compliance Diabetes Mellitus Patients. JACOM: Journal of Community Empowerment. 2024;2(1):33–42.
26. Powers MA, Bardsley JK, Cypress M, Funnell MM, Harms D, Hess-Fischl A, et al. Diabetes Self-management Education and Support in Adults with Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care. 2020 Jul 1;43(7):1636–49.