Description of Diabetes Mellitus Patients' Knowledge About Hypoglycemia and Initial Treatment of Hypoglycemia

Acute complications of Diabetes Mellitus such as hypoglycemia are emergencies that can occur in the course of Diabetes Mellitus. Hypoglycemia is a result of low blood sugar levels below normal. This study aimed to determine the knowledge of Diabetes Mellitus patients about Hypoglycemia and the initial treatment of Hypoglycemia. The research design uses a descriptive research design and purposive sampling technique with a sample size of 30 people. Data collection uses a questionnaire sheet. The results of the study showed that 46.7% of Diabetes Mellitus patients in the initial treatment of Hypoglycemia were in the sufficient knowledge category and 16.7% were lacking, which means that patient knowledge in terms of handling hypoglycemia still needs to be improved to maximize the patient's ability to prevent acute complications of Diabetes Mellitus, namely Hypoglycemia. Counseling by Polyclinic staff for Diabetes Mellitus patients regarding the early treatment of Hypoglycemia needs to be done to overcome Hypoglycemia.


INTRODUCTION
Hypoglycemia is one of the acute complications experienced by diabetes mellitus sufferers (1).
Hypoglycemia is also known as a decrease in blood sugar levels, which is a condition where blood sugar levels are below normal, which can occur due to an imbalance between the food eaten, physical activity, and the drugs used.Hypoglycemia syndrome is characterized by clinical symptoms including the patient feeling dizzy, weak, shaking, vision becoming blurry and dark, cold sweats, increased heart rate, and sometimes loss of consciousness (hypoglycemia shock) (2).
Based on the results of the researcher's preliminary study on January 30, 2018, the medical The results of researchers' interviews with 10 DM patients who visited the Internal Medicine Polyclinic at Mardi Waluyo Regional Hospital, Blitar City, showed that patient data showed that 7 out of 10 patients had experienced hypoglycemia, 1 out of 10 patients did not know the meaning of hypoglycemia and how to treat it.The most common causes of hypoglycemia include patients forgetting to eat, eating too little, excessive insulin doses, and fatigue.
Based on the case notes above, researchers found the problem that the management of diabetes mellitus as a trigger for complications such as hypoglycemia in the community is still lacking and requires further prevention and treatment to reduce the number of hypoglycemia incidents.
From the descriptions above, researchers are interested in researching "Illustration of Knowledge of Diabetes Mellitus Patients About Hypoglycemia and Initial Treatment of Hypoglycemia in the Internal Medicine Polyclinic at Mardi Waluyo Regional Hospital, Blitar City".

METHODS
This research uses a descriptive method.The research sample was diabetes mellitus patients who came to the Internal Medicine Polyclinic at Mardi Waluyo Regional Hospital, Blitar City with a total of 30 respondents.The sampling technique is purposive sampling technique (3).The data collection tool is a questionnaire consisting of questions describing diabetes mellitus patients' knowledge about hypoglycemia and the initial treatment of hypoglycemia which contains statements that have been tested based on aspects of validity and reliability.
Before collecting data, the researcher asked for a research permit from the Head of the Regional Unity, Politics and Disaster Management Agency of Blitar City after receiving a letter of recommendation, then asked for a copy of the letter at Mardi Waluyo Regional Hospital, Blitar City.
After collecting the data, the data is coded, then scored, then the data is tabulated and analyzed.Data processing is carried out by giving a score where each correct answer is given a score of 1 and an incorrect answer is given a score of 0 for each sub-variable which is calculated using the following formula: The data that has been obtained is analyzed descriptively and narrated according to the frequency distribution table.Data collection was carried out by paying attention to several research ethical principles including informed consent, anonymity, and confidentiality.

RESULT
Characteristic respondent The majority of Diabetes Mellitus patients' knowledge about initial management of hypoglycemia, namely 46.7% (14 patients) was sufficient, and 16.7% (5 patients) was insufficient.

DISCUSSION
1. Knowledge of Diabetes Mellitus Patients about the concept of Hypoglycemia.
Based on the results of research using a questionnaire, it was found that the knowledge of Diabetes Mellitus patients at the Internal Medicine Polyclinic at Mardi Waluyo Hospital, Blitar City regarding the concept of Hypoglycemia was mostly in the good category, namely 86.7% (26 patients), sufficient knowledge was 10% (3 patients ), and lack of knowledge was only 3.3% (1 patient).
According to researchers, these results prove that the level of knowledge of Diabetes Mellitus patients about Hypoglycemia is mostly good.This can be caused by several factors, where according to (4) factors that influence the level of knowledge include age, education, employment, socio-economics, information, and experience.
Based on the percentage of questionnaire answers to statements about the concept of Hypoglycemia, some did not meet the good category standards.As in the results of the answers to statement number 1 "Normal blood sugar levels are 70-110 mg/dl", 67% (20 patients) answered correctly, while the remaining 33% (10 patients) still answered incorrectly.This shows that patients do not fully understand what normal blood sugar levels are, this also influences the patient's understanding of the concept of hypoglycemia.And for statement number 6 "Excessive activity and exercise does not affect blood sugar reduction", 63% (19 patients) answered correctly, while the remaining 37% (11 patients) still answered incorrectly.This shows that the patient's understanding of preventing hypoglycemia is still in the sufficient category.Exercise or other vigorous activity has a similar effect to insulin (5).When you exercise, you will use a lot of blood glucose so that blood glucose levels will decrease (2).Exercise is indeed needed to control blood sugar, but this is done as long as it is not excessive.And try to check your blood sugar before and after exercise (6).

Patient Knowledge About Initial Treatment of Hypoglycemia
For the results of research on the knowledge of Diabetes Mellitus patients at the Internal Medicine Polyclinic, Mardi Waluyo Hospital, Blitar City regarding Initial Treatment of Hypoglycemia, most of them were in the sufficient category, 46.7% (14 patients), in the good category, 36.7% (11 patients), and in the poor category, 16. .7%(5 patients).According to (7) health information or education can increase knowledge.Meanwhile, increasing knowledge will influence behavior.According to researchers, this is related to DM patients who have experienced hypoglycemia, namely 73.3% (22 patients) with a total experience percentage of 46.7% (14 patients) experiencing episodes of hypoglycemia more than 3 times during their illness, indicating that the patient's knowledge needs to be Description of Diabetes Mellitus Patients' Knowledge About Hypoglycemia and Initial Treatment of Hypoglycemia Dewi 13 improved in terms of management or handling of hypoglycemia as an effort to prevent repeated occurrences of hypoglycemia.
Based on the results of a cross-tabulation between whether or not they had ever received information about hypoglycemia and knowledge about the initial management of hypoglycemia, as many as 30% (9 patients) who had received information about hypoglycemia were in the sufficient category.According to researchers, this is due to a lack of application of the knowledge they have gained through their illness experience.For example, in the concept of treating hypoglycemia, giving glucose needs to be done to raise blood glucose so that it returns to normal, but in reality, it is stated that giving candy or drinking sugar solution can overcome the symptoms of decreasing blood sugar levels.It was found that 20% (6 patients) still answered that this statement was wrong.

CONCLUSION
Based on the research results, it was found that the knowledge of Diabetes Mellitus patients at the Meanwhile, the research results of patient knowledge regarding the initial treatment of hypoglycemia were mostly in the sufficient category, namely 46.7% (14 patients), 36.7% (11 patients) in the good category, and 16.7% (5 patients) in the poor category.The results obtained indicate that patient knowledge regarding the management of hypoglycemia still needs to be improved to maximize the patient's ability to prevent acute complications of Diabetes Mellitus, namely Hypoglycemia.Mardi Waluyo Regional Hospital health workers can provide counseling regarding the initial treatment of hypoglycemia.Counseling is carried out in the inpatient room in the patient's discharge plan because it is impossible to hold counseling in the Polyclinic due to the limited number of patients visiting and the number of polyclinic staff.This is done to maximize the patient's ability to prevent acute complications in Diabetes Mellitus patients.
records of the Internal Medicine Polyclinic of Mardi Waluyo Hospital Blitar, in 2017 recorded 2741 Description of Diabetes Mellitus Patients' Knowledge About Hypoglycemia and Initial Treatment of Hypoglycemia Dewi 9 visits from Diabetes Mellitus patients, in 2018 there were 1281 patients during January, and 411 patients experienced hypoglycemia.during 2017.
by using the formula, namely P = f/n x 100% Determining the level of knowledge of DM patients about hypoglycemia and initial treatment of hypoglycemia by converting it into the following categories: 76 -100% = Good knowledge 75 -56% = Sufficient knowledge ≤ 55% = insufficient knowledge Description of Diabetes Mellitus Patients' Knowledge About Hypoglycemia and Initial Treatment of Hypoglycemia Dewi 10

Table 1
Most of the Diabetes Mellitus patients in the Internal Medicine Polyclinic, namely 60%, are over 60 years old.Most of the Diabetes Mellitus patients in the Internal Medicine Polyclinic, namely 73%, are female.Most of the Diabetes Mellitus patients in the Internal Medicine Polyclinic, namely 40%, have a high school education.Most of the Diabetes Mellitus patients in the Internal Medicine Polyclinic, namely 47%, work as housewives

Table 2 .
Long Suffering from Diabetes Mellitus

Table 4 .
Ever received information about hypoglycemia

Table 6 .
Have experienced symptoms of hypoglycemia

Table 7 .
The number of hypoglycemia episodes experienced.

Table 8 .
Diabetes Mellitus Patients' Knowledge about the concept of Hypoglycemia.

Table 9 .
Knowledge of Diabetes Mellitus Patients regarding Initial Treatment of Hypoglycemia.
Internal Medicine Clinic of Mardi Waluyo Hospital, Blitar City regarding the concept of Hypoglycemia was mostly in the good category, namely 86.7% (26 patients), for sufficient knowledge 10% (3 patients), and knowledge less only 3.3% (1 patient).Most of the results of knowledge about the concept of Hypoglycemia which are included in the good category are certainly influenced by factors that influence knowledge such as age, education, information, and the experience that most of the respondents have is good.