Potensi Sinar Matahari Pagi Untuk Menurunkan Kadar Gula Darah Penderita Diabetes
Abstrak
Background: Sunlight contains ultraviolet A (UV A) and ultraviolet B (UV B). UV B is able to produce vitamin D. Vitamin D is believed to increase insulin sensitivity and secretion. Therefore the purpose of this study is to discover the efficacy of morning sunlight on the blood sugar of diabetic patients.
Method: This study is a quasi-experiment with control group design, which was conducted in the working area of North Purwokerto Puskesmas I and II. A total of 40 respondents were divided into 2 groups, each group of 20 respondents were involved in this study, using consecutive sampling technique. The inclusion criteria in this study are (1) diabetics patients using oral hypoglycemic drugs, (2) have fasting blood glucose level ? 126 mg/dL, (3) aged ? 40 years, (4) have no chronic complication of diabetes (kidney disease, retinopathy, nephropathy, and neuropathy), (5) willing to be a respondent, (6) had not eaten for at least 8 hours when the study was conducted, (7) participated in all sessions of the research; while the exclusion criteria: (1) have an obesity BMI, (2) under a severe stress. Procedure: The intervention group was asked to sunbathe in the morning sunlight for 20 minutes, between 06:00-09.00. During this sunbathing session respondents sat and wore one layer of clothing (without wearing a jacket) and with materials that easily absorb sweat. This activity was carried out 5 times in a row. On the fifth day, respondents measured their fasting blood glucose level again. The statistical analysis used was the Wilcoxon and Mann-Whitney Test.
Result: The result showed that there were significant differences in the mean fasting blood glucose level before and after treatment in the intervention group (p = 0.000), but no differences were found in the control group (p = 0.881). Furthermore, using the Mann Whitney test, there were significant differences in fasting blood glucose after the treatment between the two groups (p=0,000)
Conclusion: Morning sunlight has the potential to reduce fasting glucose level in diabetic patients. Further research is needed on morning sunlight for diabetics by considering several confounding variables.
Referensi
Alvarez, J. A. dan Ashraf, A. 2010. Role of Vitamins D in Insulin Secretion and Insulin Sensitivity for Glucose Homeostatic. International Jurnal of Endocrine 22(8)
American Diabetes Association. 2004. Diagnosis and classification of diabetes mellitus. Diabetes Care. 27 (1), S5-S10. http://www.care.diabetesjournal
Bell, D.S., & Ala, B. 2002. Chronic complications of diabetes. Southern Medical Journal, 95 (1), 30-34.
Borissova, A.M., Tankova, T., Kirilov, G., Dakovska, L., Kovacheva, R. 2003. The effect of vitamin D3 on insulin secretion and perpheral insulin sensitivity in type 2 diabetic patients. International Journal of Clinical Practice 57:258-261
Chawla, A., Chala, R., & Jaggi, S. 2016. Microvascular and macrovascular complications in diabetes mellitus: distinct or continuum? Indian Journal Endocrinology and Metabolism; 20(4): 546-551. Doi: 10.4103/2230-8210.183480
Dunning, T. Care of People with diabetes: A manual of nursing practice. 2013. Blackwell Publishing Ltd. DOI: 10.1002/9780470774649
Feldman, A.L., Long, G.H., Johansson, I., Weinehall, L., Fharm, E., Wenberg, P.,............Rolandsson, O. 2017. Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up. International Journal of behavioral nutrition and physical activity. 14:39
Ganz, M.L., Wintfeld, N., Li, Q, Alas, V., Langer, J., Hammer, M. 2014. The association of body mass index with the risk of type 2 diabetes: a case-control study nested ini an electronic health records system in the United States. Diabetology & Metabolic Syndrome: 50
Holick MF. 2004. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. American Journal of Clinical Nutrition.79:362–71
Homenta, H. 2012. Diabetes Meliitus Tipe 1. Rewiew, Universitas Brawijaya.
IDF,2017, IDF Diabetes Atlas eight edition 2017, International Diabetes Federation, www.diabetesatlas.org.
Kim, C., Kong, S., Laughlin, G.A., Golden, S.H., Mather, K.J., Nan, B.,.................Barret-Connor, E. 2013. Reductions in glucose among postmenopausal women who use and do not use estrogen therapy. Menopause. 20 (4):393–400pmid:23168523
Louet, J.F., LeMay, C., Mauvais-Jarvis, F. 2004. Antidiabetic actions of estrogen: insight from human and genetic mouse models. Current atheresclerosis report. 6:180-185
Manson, J.E., Chlebowski, R.T., Stefanick, M.L., Aragaki, A.K., Rossouw, J.E., Prentice, R.L., ...................Wallace, R.B. 2013. The women’s health initiative hormone therapy trials: update and overview of health outcomes during the intervention and post-stopping phases. JAMA. 310 (13):1353–1368pmid:24084921
Penckofer, S., Kouba J., Wallis, D. E., & Emanuele, M. A. 2008. Vitamin D and Diabetes Let the Sunshine In. Diabetes Education. 34(6): 939–passim. doi:10.1177/0145721708326764
Pittas, A.G, Lau, J., Hu, F.B., Dawson-Hughes, B. 2007. Review: the role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. Journal of Clinical Endocrinology Metabolic 92: 2017-2029
Price, S.A. dan Lorraine, M.W. (2005). Patofisiologi : Konsep Klinis Proses-proses Penyakit (edisi 6 vol.2). Jakarta: EGC.
Scott, RA., Langenberg, C., Sharp, SJ., Franks, PW., Rolandsson, O., Drogan, D.................. Warehman, NJ. 2013. The link between family history and risk of type 2 diabetes is not explained by athropometric, lifestyle or genetic risk factors: the EPIC-InterAct Study. Diabetologia; 56 (1): 60-69
Setiati S. Vitamin D status among Indonesian elderly women living in institutionalized care units. 2008. Acta Medica Indonesia. 40:78–83
Webb AR, Engelsen O. Calculated ultraviolet exposure levels for a healthy vitamin D status. 2006. Photochem Photobiol. 82:1697–703