SEVERE DIABETIC NEUROPATHY RESULTS IN POOR SLEEP QUALITY IN TYPE-2 DIABETES MELLITUS PATIENTS
DOI:
https://doi.org/10.34011/jmp2k.v35i3.3102Keywords:
diabetes melitus, kualitas tidur, neuropati diabetik, neuropathy symptom score, total neuropathy scoreAbstract
Diabetes mellitus merupakan kelainan metabolisme kronis yang dapat menyebabkan komplikasi seperti neuropati diabetik. Neuropati diabetik dapat berimbas pada penurunan kualitas hidup secara substansial akibat gangguan tidur yang disebabkannya. Penelitian dilakukan untuk mengetahui hubungan keparahan neuropati diabetik dengan kualitas tidur pasien diabetes mellitus tipe 2. Penelitian analitik obervasional dengan desain cross-sectional. Subjek penelitian diambil berdasarkan teknik consecutive sampling pada pasien neuropati diabetik yang dirawat jalan di RSUD dr. Zainoel Abidin Banda Aceh pada September–November 2024. 69 responden terpilih sebagai sampel penelitian. Penilaian derajat keparahan neuropati diabetik dilakukan menggunakan Total Neuropathy Score (TNS) dan Neuropathy Symptom Score (NSS). Kualitas tidur dinilai menggunakan Pittsburgh Sleep Quality Index (PSQI). Hasil menunjukkan adanya korelasi antara keparahan neuropati diabetik berdasarkan TNS (r=0,492; p-value=0,000) dan NSS (r=0,721; p-value=0,000) dengan kualitas tidur pasien. Skor TNS menunjukkan hubungan yang kuat, dan skor NSS menunjukkan hubungan yang sangat kuat, dengan arah positif terhadap kualitas tidur pasien dengan neuropati diabetik. Hal ini menunjukkan bahwa peningkatan keparahan neuropati menyebabkan peningkatan skor kualitas tidur, yang bermakna sebagai penurunan kualitas tidur pasien dengan neuropati diabetik.
References
U. Galicia-Garcia et al., “Pathophysiology of Type 2 Diabetes Mellitus.,” Int. J. Mol. Sci., vol. 21, no. 17, Aug. 2020, doi: 10.3390/ijms21176275.
A. Azriful, Y. Adnan, E. Bujawati, S. Alam, and N. Nildawati, “Mengungkap Fakta Faktor Risiko Diabetes Melitus Di Indonesia,” Media Penelit. dan Pengemb. Kesehat., vol. 34, no. 4, pp. 814–823, 2024, doi: 10.34011/jmp2k.v34i4.1988.
International Diabetes Federation, “IDF Diabetes Atlas,” Brussels, 2025.
D. W. Soeatmadji, R. Rosandi, M. R. Saraswati, R. P. Sibarani, and W. O. Tarigan, “Clinicodemographic Profile and Outcomes of Type 2 Diabetes Mellitus in the Indonesian Cohort of DISCOVER: A 3-Year Prospective Cohort Study,” J. ASEAN Fed. Endocr. Soc., vol. 38, no. 1, pp. 68–74, May 2023, doi: 10.15605/jafes.038.01.10.
Kementerian Kesehatan Republik Indonesia, “Penyakit Tidak Menular,” in Survei Kesehatan Indonesia (SKI), Jakarta: Kementerian Kesehatan Republik Indonesia, 2023, pp. 223–279.
F. Nasution, A. Andilala, and A. A. Siregar, “Faktor Risiko Kejadian Diabetes Mellitus,” J. Ilmu Kesehat., vol. 9, no. 2, pp. 94–102, 2021, doi: 10.32831/jik.v9i2.304.
R. Galiero et al., “Peripheral Neuropathy in Diabetes Mellitus: Pathogenetic Mechanisms and Diagnostic Options,” Int. J. Mol. Sci., vol. 24, no. 4, p. 3554, Feb. 2023, doi: 10.3390/ijms24043554.
E. Gómez-Pimienta et al., “Decreased Quality of Life in Individuals with Type 2 Diabetes Mellitus Is Associated with Emotional Distress,” Int. J. Environ. Res. Public Health, vol. 16, no. 15, p. 2652, Jul. 2019, doi: 10.3390/ijerph16152652.
H. Degu, A. Wondimagegnehu, Y. M. Yifru, and A. Belachew, “Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?,” PLoS One, vol. 14, no. 2, p. e0211449, Feb. 2019, doi: 10.1371/journal.pone.0211449.
K. C. Chang, Y. W. Pai, C. H. Lin, I. Te Lee, and M. H. Chang, “Glycemic variability’s impact on painful diabetic peripheral neuropathy in type 2 diabetes patients,” Sci. Rep., vol. 14, no. 1, p. 22276, 2024, doi: 10.1038/s41598-024-73472-y.
C. Naranjo, M. Dueñas, C. Barrera, G. Moratalla, and I. Failde, “Sleep Characteristics in Diabetic Patients Depending on the Occurrence of Neuropathic Pain and Related Factors,” Int. J. Environ. Res. Public Health, vol. 17, no. 21, p. 8125, Nov. 2020, doi: 10.3390/ijerph17218125.
G. Casadei, M. Filippini, and L. Brognara, “Glycated Hemoglobin (HbA1c) as a Biomarker for Diabetic Foot Peripheral Neuropathy,” Diseases, vol. 9, no. 1, 2021, doi: 10.3390/diseases9010016.
D. Choi, B.-Y. Kim, C.-H. Jung, C.-H. Kim, and J.-O. Mok, “Association between Sleep Quality and Painless Diabetic Peripheral Neuropathy Assessed by Current Perception Threshold in Type 2 Diabetes Mellitus,” Diabetes Metab. J., vol. 45, no. 3, pp. 358–367, May 2021, doi: 10.4093/dmj.2019.0219.
T. Issar et al., “The utility of the Total Neuropathy Score as an instrument to assess neuropathy severity in chronic kidney disease: A validation study,” Clin. Neurophysiol., vol. 129, no. 5, pp. 889–894, 2018, doi: 10.1016/j.clinph.2018.02.120.
A. Abulhaija, “The Relationship Between Total Neuropathy Score-reduced, Neuropathy Symptoms and Function,” University of South Florida, 2017.
Zamroni, A. Asmedi, and D. Nuradyo, “Neuropathy Symptom Score dan Neuropathy Deficit Score sebagai Skor Diagnostik Neuropati Diabetik,” Berk. Neurosains, vol. 15, no. 1, pp. 46–53, 2016, doi: 10.22146/bns.v15i1.55726.
A. Almalki et al., “Sleep Quality Among a Sample of Medical Students and the Association with Academic Performance: An Updated Data,” J. Epidemiol. Glob. Health, vol. 15, no. 8, 2025, doi: 10.1007/s44197-025-00345-6.
A. Shahid, K. Wilkinson, S. Marcu, and C. M. Saphiro, “Pittsburgh Sleep Quality Index (PSQI),” in STOP, THAT and One Hundred Other Sleep Scales, New York: Springer US, 2011, pp. 279–283.
J. Elliot et al., “Female sex is a risk factor for painful diabetic peripheral neuropathy: the EURODIAB prospective diabetes complications study,” Diabetologia, vol. 67, no. 1, pp. 190–198, 2024, doi: 10.1007/s00125-023-06025.
M. E. Lenert, A. Avona, K. M. Garner, L. R. Barron, and M. D. Burton, “Sensory Neurons, Neuroimmunity, and Pain Modulation by Sex Hormones,” Endocrinology, vol. 162, no. 8, Aug. 2021, doi: 10.1210/endocr/bqab109.
A. Azmiardi, D. Tamtomo, and B. Murti, “Factors Associated with Diabetic Peripheral Neuropathy among Patients with Type 2 Diabetes Mellitus in Surakarta, Central Java,” Indones. J. Med., vol. 4, no. 4, pp. 300–312, 2019, doi: 10.26911/theijmed.2019.04.04.02.
D. Abdissa et al., “Prevalence and Determinants of Peripheral Neuropathy among Type 2 Adult Diabetes Patients Attending Jimma University Medical Center, Southwest Ethiopia, 2019, an Institutional-Based Cross-Sectional Study,” J. Diabetes Res., vol. 2020, 2020, doi: 10.1155/2020/9562920.
R. L. Wu, N. Chen, Y. Chen, X. Wu, C. Y. Ko, and X. Y. Chen, “Visceral Adiposity as an Independent Risk Factor for Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus: A Retrospective Study,” J. Diabetes Res., vol. 2024, p. 9912907, 2024, doi: 10.1155/2024/9912907.
A. P. Picon, N. R. S. Ortega, R. Watari, C. Sartor, and I. C. N. Sacco, “Classification of the severity of diabetic neuropathy: a new approach taking uncertainties into account using fuzzy logic,” Clinics, vol. 67, no. 2, pp. 151–156, Feb. 2012, doi: 10.6061/clinics/2012(02)10.
W. Wang et al., “Prevalence and risk factors of diabetic peripheral neuropathy: A population-based cross-sectional study in China,” Diabetes Metab. Res. Rev., vol. 39, no. 8, 2023, doi: 10.1002/dmrr.3702.
Karmilayanti, Y. Goysal, M. I. Basri, S. Aulina, and A. K. Bintang, “The relationship between the severity of peripheral diabetic neuropathy and sleep quality in type 2 diabetic mellitus patients,” Med. Clínica Práctica, vol. 4, p. 100210, Apr. 2021, doi: 10.1016/j.mcpsp.2021.100210.
L. Ferini-Strambi, “Neuropathic Pain and Sleep: A Review,” Pain Ther., vol. 6, no. S1, pp. 19–23, Dec. 2017, doi: 10.1007/s40122-017-0089-y.
L. Fu et al., “Deteriorated sleep quality and associate factors in patients with type 2 diabetes mellitus complicated with diabetic peripheral neuropathy,” PeerJ, vol. 12, p. e16789, Jan. 2024, doi: 10.7717/peerj.16789.
Y. R. Lai et al., “HbA1c Variability is Strongly Associated with the Severity of Peripheral Neuropathy in Patients with Type 2 Diabetes,” Front. Neurosci., vol. 13, no. FEB, pp. 1–9, 2019, doi: 10.3389/fnins.2019.00090.
J. A. Abu-Shennar, I. Alenezi, N. Bayraktar, H. Bebis, H. Şahin, and Q. R. S. Qassar, “The Prevalence and Risk Factors of Diabetic Peripheral Neuropathy and its Impact on Sleep Quality Among Adult Patients with Type 2 Diabetes Mellitus,” Stechnolock Brain Neurol. Disord., vol. 1, no. 1, pp. 1–12, 2024.
Y. T. A. Prahardini, S. Sasmiyanto, and S. A. Ginanjar, “Hubungan Neuropati Diabetikum dengan Kualitas Tidur Pada Pengidap DM Tipe 2 di Rumah Sakit Baladhika Husada Jember,” Protein J. Ilmu Keperawatan dan Kebidanan., vol. 2, no. 3, pp. 150–158, 2024, doi: 10.61132/protein.v2i3.579.
M. Alshehri, “The Relationship Between Pain, Daily Function, and Sleep Quality in Diabetic Neuropathy,” Majmaah J. Heal. Sci., vol. 12, no. 1, p. 78, 2024, doi: 10.5455/mjhs.2024.01.008.
R. Pop-Busui et al., “Diabetic Neuropathy: A Position Statement by the American Diabetes Association,” Diabetes Care, vol. 40, no. 1, pp. 136–154, Jan. 2017, doi: 10.2337/dc16-2042.
M. Badri, M. Alkhaili, H. Aldhaheri, G. Yang, M. Albahar, and A. Alrashdi, “From good sleep to health and to quality of life – a path analysis of determinants of sleep quality of working adults in Abu Dhabi,” Sleep Sci. Pract., vol. 7, no. 1, p. 1, Feb. 2023, doi: 10.1186/s41606-023-00083-3.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Siti Atika, Endang Mutiawati, Farida Farida, Rachmad Suhanda
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
