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of emptying of the stomach without any organic
obstruction either in the stomach or small intestine
proximal part (Camiller et al., 2013). Light activity
such as walking casually half an hour after eating
will help empty the food in the stomach because the
food is quickly digested (Hasler, 2011).
Treatment group and control group participants
used gastrointestinal drugs. Symptoms associated
with gastroparesis in DM patients can be treated
using prokinetic drugs such as: metoclopramide,
cisapride and domperidone. These drugs can
penetrate the blood brain barrier causing side effects
drowsiness, anxiety, anxiety and fatigue. There is an
effect of gastrointestinal drug use on the decrease in
clinical sign of gastroparesis in DM patients. The
use of prokinetic drugs is not recommended in the
long term because it will lead to Parkinson's
syndrome and can occur seizures (Camilleri,
Bharucha and Farrugia, 2011). Between treatment
and control group also used same medication for
hipoglikemik and gastrointestinal drug, however
intervention group have more decrease in clinical
sign of gastroparesis than control group.
Most of the participants in the treatment group
showed an abnormal 2 hour blood glucose level that
is ≥200 mg/ dL. Adaptive behavior of individuals
and families, can not change the condition of
recombinant organ or cell DM patients that have
been damaged. This is in accordance with previous
research which states that the effects of gastroparesis
can damage the absorption of drugs so that blood
glucose levels become difficult to control (Oh and
Pasricha, 2013).
This study used diabetic gastroparesis patients
with the use of DM drugs and varying doses; oral,
insulin or a combination of oral-insulin. Incoming
foods will be absorbed in the small intestine that
activates insulin and glucagon. Insulin will cause
increased glycogenesis and inhibit glycogenolysis
(Guyton and Hall, 2014). Glucagon increases
glycogenesis by activating adenyl cyclase and
increasing intracellular cyclic adenosine
monophosphate (cAMP) in the liver. This will
activate phosphorylase through protein kinase
resulting in the breakdown of glycogen. With
glucagon then gluconeogenesis will also increase so
that the patient's blood glucose level is controlled
(Guyton and Hall, 2014).
The study participants who showed normal blood
glucose levels were some of the treatment group
participants and the control group who used
combination therapy of oral hypoglycemic drugs and
insulin. But the control group, although most use
oral hypoglycemic drugs can normalize blood
glucose levels. This is because most of the control
group participants with less duration of DM sickness
than the treatment group. Long suffer of DM
demonstrates the longer duration of DM disease that
is felt, the patient will feel bored and bored to
control the disease and obey the rules of the existing
diet. In addition to long-term DM pain associated
with damage to organs that produce insulin or cell
receptors (Camiller et al., 2013).
5 CONCLUSIONS
Supportive-educative nutrition can improve
understanding and acceptance of the family about
the patient's condition, related to increase family
support for the patient and changes in adaptive
nutritional intake behavior and decreased clinical
picture of gastroparesis. However, there was no
effect of supportive-educative nutrition on blood
glucose levels of 2 hp pp series of DM patients with
gastroparesis. The patient's blood glucose levels still
show abnormal blood glucose levels. Subsequent
studies may use gastric or endoscopic scintigraphic
diagnostic tests to confirm diabetic gastroparesis.
ACKNOWLEDGEMENT
We would like to acknowledge all of the
participants, nurse, and other hospital staff who
cooperated in the present study.
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