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library.uns.ac.id digilib.uns.ac.id
HUBUNGAN HbA1C (GLYCATED HEMOGLOBIN), GULA DARAH PUASA
DAN GULA DARAH 2 JAM POST PRANDIAL DENGAN PROFIL KAKI
PASIEN DIABETES MELITUS TIPE 2 DI RSUD DR MOEWARDI
SKRIPSI
Untuk Memenuhi Persyaratan
Memperoleh Gelar Sarjana Kedokteran
ERLYN MERIKA
G0015068
FAKULTAS KEDOKTERAN
UNIVERSITAS SEBELAS MARET
SURAKARTA
2018
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PERNYATAAN
Dengan ini menyatakan bahwa dalam skripsi ini tidak terdapat karya yang pernah
diajukan untuk memperoleh gelar kesarjanaan di suatu perguruan tinggi dan
sepanjang pengetahuan penulis juga tidak terdapat karya atau pendapat yang
pernah ditulis atau diterbitkan oleh orang lain, kecuali yang secara tertulis diacu
dalam naskah dan disebutkan dalam daftar pustaka.
Surakarta, 8 Oktober 2018
Erlyn Merika Kusuma Putri
NIM. G0015068
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ABSTRAK
Erlyn Merika, G0015068, 2018. Hubungan Hba1c(Glycated Hemoglobin), Gula
Darah Puasa Dan Gula Darah 2 Jam Post Prandial Dengan Profil Kaki Pasien
Diabetes Melitus Tipe 2 Di RSUD Dr Moewardi
Latar Belakang: Kaki Diabetik merupakan salah satu komplikasi pada DM tipe 2
yang sudah menjadi masalah yang rumit dan tidak terkelola di seluruh dunia
terutama Indonesia. Hal ini disebakan karena sedikitnya tenaga kesehatan,
kurangnya pengetahuan masyarakat, dan biaya pengelolaan yang besar membuat
masalah kaki diabetik belum tertangani dengan baik. HbA1c merupakan kadar
gula darah rata-rata dalam jangka waktu 2-3 bulan. Kadar HbA1c 7% akan
mempunyai risiko lebih tinggi terkena kaki diabetik dibandingkan dengan
penderita Diabetes Melitus tipe 2 dengan kadar HbA1c <7%. Selain itu kadar
GDP dan G2PP ikut berperan dalam risiko terjadinya kaki diabetik. Penelitian ini
bertujuan untuk mengetahui hubungan antara HbA1c, GDP dan G2PP terhadap
profil kaki pasien DM tipe 2 di RSUD Dr.Moewardi.
Metode: Penelitian ini bersifat observasional analitik dengan pendekatan cross
sectional. Subyek penelitian adalah pasien DM tipe 2 di Poliklinik Penyakit
Dalam Sub Endokrinologi RSUD Dr Moewardi. Subyek penelitian dipilih dengan
menggunakan metode simple random sampling pada bulan Agustus 2018 -
September 2018. Data penelitian didapatkan melalui pemeriksaan laboratorium
gula darah, pemeriksaan monofilamen dan ABI sesuai Foot Diabetics Assesment
berdasarkan NICE Guideline. Data kemudian dianalisis menggunakan uji regresi
logistik ganda.
Hasil: Terdapat korelasi yang positif antara HbA1c, GDP dan G2PP terhadap
profil kaki pasien DM tipe 2, dimana masing-masing parameter dapat
meningkatkan risiko terjadinya kaki diabetik(OddsRatioHbA1C=3,677179;
OddsRatioGDP=1.04; OddsRatioG2PP=1.01)
Simpulan: Terdapat hubungan antara HbA1c, GDP dan G2PP terhadap profil
kaki pasien DM tipe 2 di RSUD Dr.Moewardi Surakarta.
Kata kunci: HbA1c,GDP,G2PP, Profil Kaki
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ABSTRACT
Erlyn Merika, G0015068, 2018. The Relation of A1C, Fasting Plasma Glucose,
2 Hour-Plasma Glucose with the profile of Foot in Patient Type 2 Diabetes
Mellitus in RSUD Dr. Moewardi
Background: Diabetic foot is one of the complications in type 2 diabetes mellitus
which is a complicated global problem and poorly managed problem due to the
lack of health workers, lack of community knowledge, and large management
costs make diabetic foot problems not handled properly. HbA1c is the average of
glucose level for 2-3 months.HbA1c levels ≥ 7% will have a higher risk of diabetic
foot compared with type 2 diabetes mellitus patients with HbA1c levels <7%.
Besides that, the levels of GDP and G2PP play a role in the risk of diabetic foot.
This study aims to determine the relationship between HbA1c, GDP and G2PP on
the profile of foot in type 2 DM patients in Dr.Moewardi Hospital.
Methods: This study was an observational analytic study with cross-sectional
approach. The subjects are patient with type 2 Diabetes in in Dr. Moewardi
Hospital. The subjects were chosen with simple random sampling in August 2018-
September 2018 . The result is analyzed using Multiple Logistic Regression to
perform the significance and the contribution of independent variables.
Results: There is a positive correlation between the A1C, Fasting Plasma
Glucose, 2 Hour-Plasma Glucose with the profile of Foot in Patient Type 2
Diabetes Melitus, and each parameters increased the risk of foot
diabetics(OddsRatioHbA1c=3,677179;OddsRatioGDP=1.04;OddsRatioG2PP=1.
01)
Conclusions: There is a relation between the between the A1C, Fasting Plasma
Glucose, 2 Hour-Plasma Glucose with the profile of Foot in Patient Type 2
Diabetes Melitus
Keywords: A1C, Fasting Plasma Glucose, 2 Hour-Plasma Glucose, Foot Profile
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PRAKATA
Puji syukur kepada Tuhan Yang Maha Esa, penulis dapat menyelesaikan
skripsi dengan judul “Hubungan HbA1c, GDP, G2PP Terhadap Profil Kaki
Diabetik Pasien Diabetes Melitus Tipe 2 di RSUD Dr. Moewardi Surakarta.”
Skripsi ini disusun sebagai salah satu syarat kelulusan tingkat sarjana di
Fakultas Kedokteran Universitas Sebelas Maret Surakarta. Penulis menyadari
bahwa skripsi ini tidak lepas dari kerjasama dan bantuan dari berbagai pihak.
Untuk itu, penulis menghaturkan terima kasih yang sebesar-besarnya kepada:
1. Eva Niamuzisilawati, dr., Sp.PD,M.Kes,FINASIM dan R.P Andri Putranto,
dr., M.Kes, selaku pembimbing yang telah berkenan membagikan waktu dan
ilmunya untuk membimbing saya dengan sabar, baik, dan penuh motivasi
sehingga skripsi saya dapat berjalan dengan lancar.
2. Dr. Supriyanto Kartodarsono, dr., Sp.PD,KEMD, FINASIM selaku penguji
yang telah berkenan menguji dan mendampingi saya serta memberikan ide,
saran, dan nasehat yang sangat berguna bagi saya.
3. Bagian SMF Interna dan Poliklinik Interna Sub Endokrin RSUD Dr
Moewardi, dr.Wisnu, dr. Erry, dr. Dayat, Ibu Sulis, Pak Ari dan semua yang
telah membantu saya dengan sabar.
4. Staf Bagian Skripsi FK UNS Bapak Nardi dan Ibu Nita yang telah
memberikan arahan dalam penyusunan skripsi ini.
5. Untuk keluarga saya, ayah, ibu, kedua adik saya yang senantiasa mendukung
dan mendoakan saya.
6. Teman-teman PSFK UNS, KMK FK UNS, kelompok B6, Kak Dimas, Nadia,
sahabat saya Ervina, Tita, Hellen, Cindy, dan semua teman yang tidak bisa
saya sebutkan satu persatu.
7. Friska Erika, Nabila Boediono, Margaretha Hildaria sebagai rekan skripsi
yang selalu membuat saya termotivasi.
8. Pihak-pihak yang berperan dalam penulisan skripsi ini, yang tidak bisa saya
sebutkan satu persatu.
Surakarta, 27 November 2018
Erlyn Merika
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DAFTAR ISI
PRAKATA ...................................................................................................... v
DAFTAR ISI .................................................................................................... vi
DAFTAR TABEL ............................................................................................ viii
DAFTAR GAMBAR ....................................................................................... ix
DAFTAR LAMPIRAN .................................................................................... x
BAB I ............................................................................................................... 1
A. Latar Belakang ..................................................................................... 1
B. Rumusan Masalah ................................................................................ 4
C. Tujuan Penelitian ................................................................................. 4
D. Manfaat Penelitian ............................................................................... 5
BAB II .............................................................................................................. 6
A. DIABETES MELITUS TIPE 2
1. Definisi ........................................................................................... 6
2. Epidemiologi .................................................................................. 6
3. Faktor Risiko .................................................................................. 7
4. Patofisiologi ................................................................................... 7
5. Kriteria ........................................................................................... 9
6. Komplikasi ..................................................................................... 11
B. KAKI DIABETIK
1. Definisi ........................................................................................... 12
2. Epidemiologi .................................................................................. 12
3. Faktor Risiko .................................................................................. 13
4. Patofisiologi ................................................................................... 13
5. Hubungan HbA1c,GDP, G2PP terhadap profil kaki diabetik ........ 14
6. Diagnosis ........................................................................................ 15
7. Interpretasi...................................................................................... 16
8. Algoritme ....................................................................................... 17
9. Tatalaksana ..................................................................................... 19
C. Kerangka Pemikiran ............................................................................. 21
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D. Hipotesis ............................................................................................... 22
BAB III ............................................................................................................ 23
A. Jenis penelitian ..................................................................................... 23
B. Lokasi penelitian .................................................................................. 23
C. Waktu penelitian .................................................................................. 23
D. Subyek penelitian ................................................................................. 23
E. Teknik sampling ................................................................................... 24
F. Besar sampel ....................................................................................... 24
G. Rancangan penelitian .......................................................................... 26
H. Variabel penelitian .............................................................................. 26
I. Definisi operasional penelitian ............................................................. 26
J. Instrumen penelitian ............................................................................. 29
K. Cara kerja penelitian ............................................................................ 30
L. Teknik analisis data .............................................................................. 34
M. Jadwal Penelitian .................................................................................. 36
BAB IV ............................................................................................................ 37
A. Deskripsi Sampel ................................................................................. 37
B. Karakteristik Sampel Penelitian ........................................................... 38
C. Analisis Data ........................................................................................ 40
BAB V .............................................................................................................. 45
A. Pembahasan .......................................................................................... 45
B. Hubungan HbA1c,GDP,G2PP terhadap profil kaki diabetik ............... 49
C. Keterbatasan Penelitian ........................................................................ 54
BAB VI ............................................................................................................ 55
A. Simpulan .............................................................................................. 55
B. Saran ..................................................................................................... 55
DAFTAR PUSTAKA ...................................................................................... 58
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DAFTAR TABEL
Tabel 2.1 Kriteria DM tipe 2 ....................................................................... 9
Tabel 2.2 Kategori DM tipe 2 terkontrol baik dan terkontrol buruk .......... 10
Tabel 3.1 Tabel Tingkat Hubungan Antar Variabel ................................... 35
Tabel 4.1 Karakteristik Demografi Sampel Penelitian ............................... 39
Tabel 4.2 Uji Kolmogorov-Smirnov Profil Kaki Diabetik ......................... 40
Tabel 4.3 Uji Regresi Logistik Ganda ........................................................ 41
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DAFTAR GAMBAR
Gambar 2.1Kerangka Pemikiran .................................................................... 21
Gambar 3.1Cara Penggunaan Monofilamen .................................................. 31
Gambar 3.210 Titik Lokasi Pemeriksaan Monofilamen ................................ 31
Gambar 4.3.1Persamaan Regresi Logistik Ganda untuk HbA1c ................... 42
Gambar 4.3.2Persamaan Regresi Logistik Ganda untuk GDP ....................... 43
Gambar 4.3.3Persamaan Regresi Logistik Ganda untuk G2PP...................... 44
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DAFTAR LAMPIRAN
Lampiran 1. Surat Kelayakan Etik (Ethical Clearance)
Lampiran 2. Informed Consent
Lampiran 3. Foot Diabetic Screening and Assesment
Lampiran 4. Diabetes Foot Ulcer Assesment
Lampiran 5. Distribusi Sampel Penelitian
Lampiran 6. Hasil analisis statistik dengan SPSS (Uji Normalitas)
Lampiran 7. Hasil analisis statistik dengan SPSS (Regresi Logistik Ganda)
Lampiran 8. Data Responden
Lampiran 9. Surat Pengantar Penelitian di RSDM
Lampiran 10. Daftar Singkatan
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LAMPIRAN
Lampiran 1. Surat Kelayakan Etik (Ethical Clearance)
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Lampiran 5. Distribusi Sampel Penelitian
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Lampiran 6
Hasil Uji Normalitas Data
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Lampiran 7
Hasil Uji Regresi Logistik
Notes
Output Created 14-DEC-2018 09:20:13
Comments
Input Data /Users/macbookpro/Documents/data akhir.sav
Active Dataset DataSet2
Filter <none>
Weight <none>
Split File <none>
N of Rows in
Working Data File 73
Missing Value
Handling
Definition of Missing User-defined missing values are treated as
missing
Syntax LOGISTIC REGRESSION VARIABLES
Hasil
/SELECT=g2pp1 LT 180
/METHOD=ENTER G2PP
/SAVE=PRED
/CLASSPLOT
/PRINT=CORR CI(95)
/CRITERIA=PIN(0.05) POUT(0.10)
ITERATE(20) CUT(0.5).
Resources Processor Time 00:00:00.03
Elapsed Time 00:00:00.00
Variables Created or
Modified
PRE_7
Predicted probability
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Case Processing Summary
Unweighted Casesa N Percent
Selected Cases
Included in Analysis 72 98.6
Missing Cases 0 .0
Total 72 98.6
Unselected Cases 1 1.4
Total 73 100.0
a. If weight is in effect, see classification table for the total number of cases.
Dependent Variable Encoding
Original Value Internal Value
risiko rendah 0
risiko tinggi 1
Block 0: Beginning Block
Classification Tablea,b
Observed
Predictedd
Selected Casesc Unselected Cases
e,f
Hasil Percentage
Correct
Hasil Percentage
Correct risiko
rendah
risiko
tinggi
risiko
rendah
risiko
tinggi
Step
0
Hasil
risiko
rendah 38 0 100.0 0 0 .
risiko
tinggi 34 0 .0 0 0 .
Overall
Percentage 52.8
a. Constant is included in the model.
b. The cut value is .500
c. Selected cases g2pp1 LT 180
d. There are no unselected cases. Therefore, no unselected cases are classified.
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e. Unselected cases g2pp1 GE 180
f. Some of the unselected cases are not classified due to either missing values in the
independent variables or categorical variables with values out of the range of the selected
cases.
Variables in the Equation
B S.E. Wald df Sig. Exp(B)
Step 0 Constant -.111 .236 .222 1 .638 .895
Variables not in the Equation
Score df Sig.
Step 0 Variables G2PP 8.059 1 .005
Overall Statistics 8.059 1 .005
Block 1: Method = Enter
Omnibus Tests of Model Coefficients
Chi-square df Sig.
Step 1 Step 10.493 1 .001
Block 10.493 1 .001
Model 10.493 1 .001
Model Summary
Step
-2 Log
likelihood
Cox & Snell R
Square
Nagelkerke R
Square
1 89.098a .136 .181
a. Estimation terminated at iteration number 5 because
parameter estimates changed by less than .001.
Classification Tablea
Observed
Predictedc
Selected Casesb Unselected Cases
d,e
Hasil Percentage Hasil Percentage
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risiko
rendah
risiko
tinggi
Correct risiko
rendah
risiko
tinggi
Correct
Step
1
Hasil risiko
rendah 29 9 76.3 0 0 .
risiko
tinggi 18 16 47.1 0 0 .
Overall
Percentage 62.5 .
a. The cut value is .500
b. Selected cases g2pp1 LT 180
c. There are no unselected cases. Therefore, no unselected cases are classified.
d. Unselected cases g2pp1 GE 180
e. Some of the unselected cases are not classified due to either missing values in the
independent variables or categorical variables with values out of the range of the selected
cases.
Variables in the Equation
B S.E. Wald df Sig. Exp(B)
95% C.I.for EXP(B)
Lower Upper
Step 1a G2PP .013 .005 7.720 1 .005 1.013 1.004 1.022
Constant -2.688 .947 8.050 1 .005 .068
a. Variable(s) entered on step 1: G2PP.
Correlation Matrix
Constant G2PP
Step 1 Constant 1.000 -.963
G2PP -.963 1.000
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Logistic Regression
Notes
Output Created 14-DEC-2018 09:36:56
Comments
Input Data /Users/macbookpro/Documents/data akhir.sav
Active Dataset DataSet2
Filter <none>
Weight <none>
Split File <none>
N of Rows in
Working Data File 73
Missing Value
Handling
Definition of Missing User-defined missing values are treated as missing
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Syntax LOGISTIC REGRESSION VARIABLES Hasil
/SELECT=gdp1 LT 130
/METHOD=ENTER GDP
/SAVE=PRED
/CLASSPLOT
/PRINT=CORR CI(95)
/CRITERIA=PIN(0.05) POUT(0.10)
ITERATE(20) CUT(0.5).
Resources Processor Time 00:00:00.04
Elapsed Time 00:00:00.00
Variables Created or
Modified
PRE_8 Predicted probability
Case Processing Summary
Unweighted Casesa N Percent
Selected Cases Included in Analysis 72 98.6
Missing Cases 0 .0
Total 72 98.6
Unselected Cases 1 1.4
Total 73 100.0
a. If weight is in effect, see classification table for the total
number of cases.
Dependent Variable Encoding
Original Value Internal Value
risiko rendah 0
risiko tinggi 1
Block 0: Beginning Block
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Classification Tablea,b
Observed
Predictedd
Selected Casesc Unselected Cases
e,f
Hasil
Percentage
Correct
Hasil
Percentage Correct
risiko
rendah
risiko
tinggi
risiko
rendah
risiko
tinggi
Step 0 Hasil
risiko rendah 38 0 100.0 0 0 .
risiko tinggi 34 0 .0 0 0 .
Overall Percentage 52.8 .
a. Constant is included in the model.
b. The cut value is .500
c. Selected cases gdp1 LT 130
d. There are no unselected cases. Therefore, no unselected cases are classified.
e. Unselected cases gdp1 GE 130
f. Some of the unselected cases are not classified due to either missing values in the independent
variables or categorical variables with values out of the range of the selected cases.
Variables in the Equation
B S.E. Wald df Sig. Exp(B)
Step 0 Constant -.111 .236 .222 1 .638 .895
Variables not in the Equation
Score df Sig.
Step 0 Variables GDP 22.336 1 .000
Overall Statistics 22.336 1 .000
Block 1: Method = Enter
Omnibus Tests of Model Coefficients
Chi-square df Sig.
Step 1 Step 26.427 1 .000
Block 26.427 1 .000
Model 26.427 1 .000
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Model Summary
Step
-2 Log
likelihood
Cox & Snell R
Square
Nagelkerke R
Square
1 73.163a .307 .410
a. Estimation terminated at iteration number 5 because
parameter estimates changed by less than .001.
Classification Tablea
Observed Predictedc
Selected Casesb Unselected Cases
d,e
Hasil
Percentage
Correct
Hasil
Percentage
Correct
risiko
rendah
risiko
tinggi
risiko
rendah
risiko
tinggi
Step 1 Hasil risiko
rendah 32 6 84.2 0 0 .
risiko
tinggi 10 24 70.6 0 0 .
Overall
Percentage 77.8 .
a. The cut value is .500
b. Selected cases gdp1 LT 130
c. There are no unselected cases. Therefore, no unselected cases are classified.
d. Unselected cases gdp1 GE 130
e. Some of the unselected cases are not classified due to either missing values in the
independent variables or categorical variables with values out of the range of the selected
cases.
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Variables in the Equation
B S.E. Wald df Sig. Exp(B)
95% C.I.for EXP(B)
Lower Upper
Step 1a GDP .040 .010 16.507 1 .000 1.041 1.021 1.061
Constant -5.717 1.378 17.226 1 .000 .003
a. Variable(s) entered on step 1: GDP.
Correlation Matrix
Constant GDP
Step 1 Constant 1.000 -.978
GDP -.978 1.000
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Logistic Regression
Notes
Output Created 14-DEC-2018 09:40:24
Comments
Input
Data /Users/macbookpro/Documents/data akhir.sav
Active Dataset DataSet2
Filter <none>
Weight <none>
Split File <none>
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N of Rows in
Working Data File 73
Missing Value
Handling
Definition of Missing User-defined missing values are treated as missing
Syntax LOGISTIC REGRESSION VARIABLES Hasil
/SELECT=HBA1C1 LT 7
/METHOD=ENTER HbA1c
/SAVE=PRED
/CLASSPLOT
/PRINT=CORR CI(95)
/CRITERIA=PIN(0.05) POUT(0.10) ITERATE(20)
CUT(0.5).
Resources Processor Time 00:00:00.03
Elapsed Time 00:00:00.00
Variables Created or
Modified
PRE_9 Predicted probability
Case Processing Summary
Unweighted Casesa N Percent
Selected Cases
Included in
Analysis 72 98.6
Missing Cases 0 .0
Total 72 98.6
Unselected Cases 1 1.4
Total 73 100.0
a. If weight is in effect, see classification table for the total number of cases.
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Dependent Variable Encoding
Original Value Internal Value
risiko rendah 0
risiko tinggi 1
Block 0: Beginning Block
Classification Tablea,b
Observed
Predictedd
Selected Casesc Unselected Cases
e,f
Hasil
Percentage
Correct
Hasil
Percentage
Correct
risiko
rendah
risiko
tinggi
risiko
rendah
risiko
tinggi
Step
0
Hasil risiko
rendah 38 0 100.0 0 0 .
risiko
tinggi 34 0 .0 0 0 .
Overall
Percentage 52.8 .
a. Constant is included in the model.
b. The cut value is .500
c. Selected cases HBA1C1 LT 7
d. There are no unselected cases. Therefore, no unselected cases are classified.
e. Unselected cases HBA1C1 GE 7
f. Some of the unselected cases are not classified due to either missing values in the
independent variables or categorical variables with values out of the range of the selected
cases.
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Variables in the Equation
B S.E. Wald df Sig. Exp(B)
Step 0 Constant -.111 .236 .222 1 .638 .895
Variables not in the Equation
Score df Sig.
Step 0 Variables HbA1c 32.503 1 .000
Overall Statistics 32.503 1 .000
Block 1: Method = Enter
Omnibus Tests of Model Coefficients
Chi-square df Sig.
Step 1 Step 89.346 1 .000
Block 89.346 1 .000
Model 89.346 1 .000
Model Summary
Step
-2 Log
likelihood
Cox & Snell R
Square
Nagelkerke R
Square
1 10.244a .711 .949
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a. Estimation terminated at iteration number 11 because
parameter estimates changed by less than .001.
Classification Tablea
Observed
Predictedc
Selected Casesb Unselected Cases
d,e
Hasil
Percentage
Correct
Hasil
Percentage
Correct
risiko
rendah
risiko
tinggi
risiko
rendah
risiko
tinggi
Step
1
Hasil risiko
rendah 37 1 97.4 0 0 .
risiko
tinggi 1 33 97.1 0 0 .
Overall
Percentage 97.2 .
a. The cut value is .500
b. Selected cases HBA1C1 LT 7
c. There are no unselected cases. Therefore, no unselected cases are classified.
d. Unselected cases HBA1C1 GE 7
e. Some of the unselected cases are not classified due to either missing values in the
independent variables or categorical variables with values out of the range of the selected
cases.
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Variables in the Equation
B S.E. Wald df Sig. Exp(B)
95% C.I.for EXP(B)
Lower Upper
Step 1a HbA1c 15.118 6.190 5.965 1 .015 3677179.703 19.793 683136373606.913
Constant -108.650 44.181 6.048 1 .014 .000
a. Variable(s) entered on step 1: HbA1c.
Correlation Matrix
Constant HbA1c
Step 1 Constant 1.000 -1.000
HbA1c -1.000 1.000
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Lampiran 8. Dokumentasi Penelitian
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Skripsi dengan judul: Hubungan HbA1c, GDP, G2PP Terhadap Profil Kaki
Diabetik Pasien Diabetes Melitus Tipe 2 di RSUD Dr. Moewardi Surakarta
Erlyn Merika, NIM: G0015068, Tahun: 2018
Telah diuji dan sudah disahkan di hadapan Dewan Penguji Skripsi
Fakultas Kedokteran Universitas Sebelas Maret
Pada Hari Selasa, Tanggal 27 November 2018
Pembimbing Utama
Nama : Eva Niamuzisilawati, dr., Sp.PD,M.Kes
NIP : 197907112014122001 (…………………………..)
Pembimbing Pendamping
Nama : R.P Andri Putranto, dr.,M.Si
NIP : 196305251996031001 (…………………………..)
Penguji
Nama : Supriyanto Kartodarsono, dr., Sp.PD(K)EMD
NIP : 195501281981011002 (…………………………..)
Surakarta, 2018
Ketua Tim Skripsi Kepala Program Studi
Kusmadewi Eka Damayanti, dr., M.Gizi Sinu Andhi Jusup, dr., M.Kes.
NIP 19830509 200801 2 005 NIP 19700607 200112 1 002
library.uns.ac.id digilib.uns.ac.id
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