In epidemiology, in the year 2030 estimated prevalence of diabetes mellitus (DM) in Indonesia reached 21.3 million people (Diabetes Care, 2004). Based on the results of the Basic Health Research (Riskesdas) in 2007, found that the proportion of causes of death due to DM in the age group 45-54 years in urban areas ranked 2nd of 14.7%. DM ranked the 6th leading cause of death 5.8% in rural areas.

The problems that arise in the treatment of diabetes in Indonesia are:
1. Lack of early diagnosis adekuatnya
2. Limited access to comprehensive treatment
3. Kurangya recognition and early treatment of complications.
4. Inadequate education of society at large. This is contributing to high death and disability due to diabetes.

Diabetes associated with an increased risk of heart disease and blood vessels (stroke), chronic kidney disease, leg amputations, and blindness. Financing and the impact of DM complications is very high. This thinking underlies the importance of early detection and adequate intervention.

Diabetes and its impact

DM diagnosis established by laboratory tests of fasting blood sugar and blood sugar tests after eating (glucose load). Patients were asked fast 8-10 hours before the examination of blood sugar. Someone stated levels of DM when fasting blood sugar> 126 mg% and blood sugar levels 2 hours after glucose load more than 200 mg%. In general, patients were also asked to collect urine samples.

This is intended to detect glucose in urine. In normal circumstances there is no glucose in urine. If levels in the blood sugar is high, some glucose will be excreted through urine. Disorders of glucose tolerance should be alerted as early symptoms of DM. Lifestyle changes and regular laboratory tests are recommended.

In general known type 2 diabetes, namely type 1 diabetes (insulin dependent), and diabetes type 2 (non-insulin dependent). There is also a diabetes in pregnancy, and diabetes due to malnutrition. Type 2 diabetes usually begins in middle adulthood (40-50 years). The case of type 2 diabetes mellitus reported to continue to increase in many developing countries (including Indonesia). This may be caused by a number of cases of obesity (overweight) and lack of physical activity in children.

Mortality and morbidity in diabetes is more determined by the appearance of complications. Complications of diabetes are as follows: blood sugar level is very low (hypoglycemia) blood sugar levels are very high (hyperglycemia), increased risk of infection, complications of small blood vessels (microvascular), neurological disorders, and complications of large blood vessels (makrovaskuler). Diabetes mellitus is one cause of blindness in the adult group, the main cause of non-traumatic amputations, and the main cause of kidney failure.

DM issues in Indonesia

Indonesia is one country with the highest absolute DM patients in the world. Increased prevalence of DM in Indonesia has consistently appeared from time to time. Increased prevalence of DM can not be separated from food consumption patterns and lifestyles.

Various epidemiological studies consistently show that the increased prevalence of DM associated with obesity, lack of physical activity, and emotional stress. A situation which is identical to the pattern of urban life (urbanization) and the pattern of life kebaratan (westernization).

Urbanization and westernization was quite prominent in the various regions in Indonesia. Economic progress of the growing impact fast-food outlets, lack of exercise opportunities, and high emotional stress.

Another problem in the handling of DM in Indonesia is the lack of awareness and early detection. Diabetes mellitus complications will provide over time. This is what underlies the need for early detection and effective interventions as early as possible. The public is more familiar triad P (Polyuria / lots of urine, Polidipsi / lots of drinking, and Polifagi / lots of eating) as the classic symptoms of DM.

The problems that arise are a symptom triad P is not very typical for DM, and many DM patients who showed no symptoms. In many cases, the DM often with inadequate control. Fear of taking medicine regularly and failure in life style changes are often observed in many cases.

Educate the public about the dangers of DM complications is needed. In many cases, people with DM was treated when complications occur has been so bad. This will provide the burden of pain and disability are greater for people with DM and their families. DM complications handling costs will be much higher than the recognition and prevention efforts are effective DM.

Discover and control

In accordance with the theme of World Diabetes Day in 2009, ‘Understand Diabetes and Control’, then diabetes should be understood as a whole, both risk factors, diagnosis and complications.

Diabetes is very important Pengandalian implemented as early as possible, to avoid the cost of very expensive treatment. Even since the children and adolescents, healthy lifestyle by eating lots of vegetables and fruit, get exercise and not smoking is a good habit in the prevention of diabetes mellitus.

Therefore, the role of educators both formal and informal, DM educators and health cadres (doctors, paramedics, and trained community anggoat) very important role to reduce morbidity DM.
Development of partnerships with various elements in society and across sectors associated with DM in each region is an important activity carried out.

Understanding the risk factors of DM is very important to know, understand and can be controlled by the community, educators, educators and health workers in the surrounding community.

The purpose of DM control program in Indonesia is the implementation of controls to reduce risk factors for morbidity, disability and death caused by DM. DM control take priority on early prevention through risk factor prevention of DM is promotive and preventive efforts by not ignoring the curative and rehabilitative efforts are adequate.

Heart

The heart is a muscle that pumps blood around the body. In a heart attack (myocardial infarction), part of the heart muscle to die while not getting blood. To stay healthy, the heart requires oxygen and nutrients carried by the other’s blood. This is obtained through the arteria (blood vessel) coronary, which wrap the outside of the heart.

Heart Disease

Heart attack

These diseases can affect any part of the heart. However, the most common disease is a chronic disease in the coronary arteria called atherosclerosis. Therefore, heart disease commonly known and most common is coronary heart disease or coronary arteria disease. The disease is most often causes a heart attack in someone who can cause death. The reason is the narrowing of the coronary arteries, where the vessel serves to provide blood to the heart muscle. Constriction caused by a pile of cholesterol or other proteins derived from food intake in the body. This buildup causes the coronary blood vessels become stiff. Rigidity is called atherosclerosis.

Atherosclerosis occurs if there is accumulation of plaque, or fatty deposits in artery walls. After a time, plaque can accumulate, harden and narrow arteries, and inhibits blood flow to the heart. Coronary arteria disease or coronary artery disease (CAD) is that basically leads to most heart attacks.

Blockage in one or more coronary arteries can cause a heart attack suddenly. The reason for asking the heart exceeds the available oxygen so that trigger heart attacks. Why? If the heart muscle does not receive oxygen for a long time, the surrounding tissue may be damaged. Unlike other networks, did not have the heart muscle regeneration. The longer the attack, the more damage to the heart and the more likely it died.

Even in an artery that is not too narrow because timbungan plaque and fat deposits of plaque can rupture and form a crust of blood or thrombus. In addition, the diseased arteries also tend to experience sudden muscle contractions. Thus, a piece of crust of blood can form a contraction, releasing chemicals which then result in narrowing the artery wall, triggering a heart attack.

If the work system of the heart is damaged, the normal rhythm of the heart can become chaotic and the heart began to tremble with uncertainty or experiencing fibrillation. This abnormal rhythm known as arrhythmia is a deviation from normal heart rhythm. This will cause the heart to lose its ability to effectively pump blood to the brain. Within ten minutes, brain death and the patient was beyond help.

In addition to coronary heart disease due to fat deposition in the arterial wall, there are also other heart diseases caused birth defects. For example imperfect heart, heart valve disorders, weakened heart muscle. Another cause is the bacteria that cause infections of the heart.

Heart Illness Symptoms
If the symptoms of heart attacks happen to you:

Recognize any of these symptoms occur whether chest pain, shortness of breath, or heart palpitations.

Immediately stop all work no matter what you are doing and sit or lie down while you breathe deeply.

If you are alone while the symptoms lasted more than a few minutes immediately contact the local emergency phone number and say you have a heart attack. Or contact the people around you to give the same information.

If anyone can take you to the hospital faster than the arrival of paramedics, immediately asked for assistance to go take you to the emergency room at the hospital. Faster would be better handled.

But if you wait for paramedics to come, so while waiting, you can loosen tight clothing, including belts or ties. Create yourself in a position that feels comfortable.

Remain calm, no matter you are the victim or benefactor. Panic can increase the likelihood of arrhythmia or heart rhythm irregularities that threaten life.

The symptoms are perceived if you have coronary heart disease include pain or pain in the chest where most people thought it was just as indigestion. Then the other symptoms of feeling depressed in the middle of the chest for 30 seconds to 5 minutes. Another thing is the cold sweat, palpitations, dizziness, and felt like fainting. These symptoms are not always perceived the sufferer. Other warning signs are gasping for breath during exercise.

For several months before a heart attack heart disease usually often feel very tired. Do not assume these symptoms are caused by lack of sleep and stress of the job.

Pain or feeling pressured in the chest, called angina, gave warning to half of those who suffer a heart attack. Some people experience breathless or exhausted and feeling weak as the symptoms, indicating that the heart is not getting enough oxygen because of coronary blockage.

Usually a few days before having a massive heart attack, a person will experience muscle contractions suddenly in the chest which is a small attack or a mild heart attack. Generally mild heart attack occurred before the major attack a few days later.

Tips Preventing Heart Disease

To be protected from coronary heart disease, you can do the following things:

*Healthy eating
Avoid foods that contain lots of fat or high cholesterol. Seafood has a high cholesterol content which may harm the heart. Reduce eating fried foods that contain lots of fat, otherwise the food can be processed in a way boiled, steamed or baked.

Wherever possible, the food products we eat low-fat or no fat. Choose milk, cheese, butter or other foods low in fat. Fry using olive oil has a little fat so that it can be the choice when to process food by frying.

Besides avoiding fatty foods, avoid foods with too high sugar content like soft drinks. Do not consume tertalu many karbohirat, because in the body, carbohydrates are broken down into fat. In contrast, consumption of oats or wheat that can help keep the heart healthy.

Keep your diet is not excessive to avoid obesity, because someone who has a waist circumference of more than 80 cm, greater risk of this disease.

*Stop smoking
Cigarette smoking is not good for heart health, then immediately stop this practice in order to stay healthy heart.

*Avoid Stress
Stress is very difficult to avoid when living in big cities like Jakarta is known for its traffic jams and preoccupations. When a person experiences stress, the body will release the hormone cortisol which causes the blood vessels become stiff. Hormone norepinephrine to produce the body when suffering from stress, which will result in increasing blood pressure. So, very good if you avoid the stress both in the office or at home.

*Hypertension
Problem of hypertension or high blood pressure can also cause heart disease. Hypertension can injure the arterial wall and allows the channel to enter LDL cholesterol and increase the accumulation of arterial plaque.

*Obesity
Overweight or obese increases the high blood pressure and abnormal fat. Avoiding or treating obesity or obesity is the main way to avoid diabetes. Accelerate diabetes and coronary heart disease increases the risk of heart attack.

*Exercising regularly
You can do sports activities such as walking, brisk walking, or jogging. Non-sport activities are competitive and not too much work to strengthen the heart and blood circulation throughout the body.

*Consumption of antioxidants
Air pollution, motor vehicle fumes or smoke created the emergence of free radicals in the body. Free radicals can cause ulcers or deposits in blood vessels that can cause blockage. To remove the content of free radicals in the body, there is need for antioxidants that will catch and throw. Antioxidants can be obtained from a variety of fruits and vegetables.

*Heredity
One of the parents or siblings had suffered a heart attack before age 60 have a greater risk of suffering from this disease. Therefore, if you have relatives who have experienced a heart attack, you should be more careful in keeping your diet and your lifestyle can support a healthy heart.

Overcoming Heart Disease

If you feel the early symptoms of heart disease or had suffered a mild heart attack, do not ignore it. You really need early treatment by trained medical personnel. This can save the heart from further damage and can even prevent more fatal consequences such as death.

But if heart attack symptoms begin to occur, it is important to seek immediate medical assistance. Greatest risk of death from heart attack is within one hour after a heart attack. Treatment quickly and accurately from the medical team could save the heart muscle from damage that can not be repaired. The more heart muscle is saved, the more effective heart pumping will return after the attack. Do not put off getting medical help because of fear is considered absurd.

If the blockage has occurred, the medical action is generally taken with the installation of catheterization and the ring that prevents coronary arteries are not clogged. However, there may be some blockage in other arteries.

Love your heart

Seeing the value of heart this organ for survival, then immediately improve your lifestyle to stay healthy. Begin to enjoy healthy food, nutritious and low in cholesterol. Avoid smoking and stress. And exercise regularly. Start with a healthy lifestyle from this day to love your heart.

Spanish flu (1918-1919)

This flu virus strains are named
H1N1 virus. It is estimated that the virus strain transmitted from human to human
This is a mutation of the H1N1 bird flu virus or who have antigenic
drift to become a highly pathogenic strain to humans. Killing
more than 40-100 million more people
of the victims of World War I that almost ended at the time
it .. Victims in
Indonesia due to the flu that time nearly one million.

Asian flu (1957)

Asian flu comes from northern China and is caused by the H2N2 virus strain, which again
believed to develop from the bird flu virus crosses and human viruses
already exists. Victims as much as it generated no Spanish flu because of the
progress in making the vaccine. This flu killed nearly one million people.

Hong Kong flu (1960)

Hong Kong flu caused by strains
H3N2 virus was fierce as the virus strain in the two previous pandemics. Epidemics
spread in Hong Kong, India, Northern Australia, Europe, California, Africa, and
South America.

Special Note for Swine
Flu:

·
Dr. Richard Shope of the U.S. is the one who first proposed the term swine flu. In 1932, he ran
snot the pigs on the farm and managed to pass it on to fellow pigs.

·
Shope prove that the people who survived for pandemic flu
Spanish 1918-1919 (after World War I) had antibodies to the “virus
pigs “it, but children born after 1920 do not have the antibodies.
He then concludes that flu pandemic like the Spanish flu was caused by
by viruses with the type of “pig”.

·
According to Laurie Garrett, some experts predict flu virus’ flu
pigs “will appear with each cycle of 90-100 years. Means, pandemic flu
1918-1919 predicted would happen in the year 2009-2019.

Why Must Wash Hands?

Someone suffering flu nose shut with her hand as sneezing, then memagang handle on the bus, when you hold the handle, the flu bacteria may soon moved into your hands and if you hold your nose or mouth, germs can enter our bodies. That picture of how easily germs move from one person to another. Diseases such as diarrhea, intestinal worms, Acute Respiratory Infections (ARI), tuberculosis and even deadly diseases such as SARS, avian influenza (H5N1) and swine flu (H1N1) can be prevented by washing hands properly. Unfortunately, many people who crumble these healthy habits and mengganggapnya not important. And the habit to wash hands properly, you and your family life can be more healthy.

The way the Right Hand Washing

Proper hand washing should use soap and under running water. While the technique measures the correct hand washing is as follows.

* Wet hands with water under a faucet or water flow.
* Take enough liquid soap to the hands. It would be better if the soap contains antiseptic.
* Rub your palms together.
* Run up to the fingertips.
* Rubbing his palms back left hand (or vice versa) with a radius of each lock (alternating) between the right and left hand. Rub between the fingers. Do otherwise.
* Put back the fingers one by the other finger back and locked to each other.
* Apply the right thumb with left palm in a circular motion. Do the same with the left thumb.
* Rub your palms with the other fingers back with forward movement, backward and turning. Do otherwise.
* Hold your right wrist with his left hand and do the twist. Do well for the left hand.
* Clean the soap from his hands under running water.
* Dry your hands using a tissue and when using the faucet, close the faucet with a tissue.

Dried with a tissue better than dry hands using a hand dryer in the mall common. Because the hand dryer in a similar manner to accommodate a lot of bacteria that can spread to others.

When are you currently Washing Hands?

Proper hand washing is generally done just before eating, before preparing food, after handling raw meat, before and after touching a sick person, after using the bathroom, after coughing or sneezing or blowing your nose, after changing diapers or pads, before and after treating wounds, after cleaning or taking out the trash, after touching animals or animal waste.

You also should teach good hand washing habits to your child is still small. A delighted child learn and touch things without knowing whether the object is dirty or not. Then put his hand into the mouth or eating without washing hands. As a result the child may be suffering from the disease. According to research, child killer disease number 1 in Indonesia is because of diarrhea, but this can be prevented by teaching children to wash their hands.

Given the importance of washing hands, every step proclaimed October 15 as World Hand Washing Day. Familiarize yourself and your family to wash their hands right now.