142
Jurnal Ners dan Kebidanan.
Volume 6.
Nomor 2.
Agustus 2019, hlm.
142Ae147
JNK
JURNAL NERS DAN KEBIDANAN
(JOURNAL OF NERS AND MIDWIFERY)
https://ojs.
id/index.
php/jnk Description of Stress Level of Diabetes Mellitus Patients with Hyperglycemia Yeyen.
CADewi Rachmawati .
Tri Cahyo Sepdianto Poltekkes Kemenkes Malang.
Indonesia Corresponding Author dewi_rachmawati@poltekkes-malang.
Article Information Abstract History Article:
Received, 08/08/2024 Accepted, 20/04/2026 Published, 28/04/2026 Uncontrolled diabetes mellitus will cause short-term and long-term This study aimed to describe the stress levels in diabetes mellitus patients experiencing hyperglycemia.
A quantitative descriptive study design was used with a purposive sampling technique with inclusion criteria of blood glucose levels Ou250 mg/dL accompanied by comorbid diseases such as stroke, chronic kidney disease (CKD), or acute coronary syndrome with a sample size of 39.
The instrument used the Depression Anxiety Stress Scale (DASS-.
The results showed that 48.
72% of respondents experienced moderate stress, 33.
33% mild stress, 12.
excessive stress, and 5.
13% normal stress.
These findings indicate that moderate stress is the dominant stress level among patients with This condition may be due to the long duration of diabetes experienced by most patients, which increases their awareness of potential complications and leads to regular involvement in treatment to prevent disease progression.
Therefore, it is hoped that diabetes patients can independently monitor blood glucose levels to prevent complications, which ultimately can reduce stress and anxiety.
mkasih mas Keyword:
DASS-42.
Diabetes Mellitus.
Hyperglycemia.
Stress A2026 Journal of Ners and Midwifery Correspondence Address:
Poltekkes Kemenkes Malang Ae East Java.
Indonesia
P-ISSN : 2355-052X
Email: direktorat@poltekkes-malang.
E-ISSN : 2548-3811
DOI: https://doi.
org/10.
26699/jnk.
ART.
This is an Open Access article under the CC BY-SA license .
ttps://creativecommons.
org/licenses/by-sa/4.
Yeyen, et.
Description of Stress Level of Diabetes Mellitus Patients A 29
INTRODUCTION
Non-communicable diseases are a major problem that determines the health status of a region (Shahid et al.
, 2.
Non-communicable diseases such as diabetes mellitus and cardiovascular disease are increasing every year (Huang et al.
, 2025.
Shahid et al.
, 2.
Indonesia ranks 4th largest in the number of people with diabetes in the world after India.
China, and the United States (Wahidin et al.
, 2024.
Soeatmadji et al.
, 2.
Prevalence is 6% of the total population, estimated in 1995 there 5 million people and about 12.
4 million people in 2025 (Chen et al.
, 2025.
Shahid et al.
The estimated number of people with diabetes mellitus in East Java is 2.
6% of the population aged 15 years and above.
The highest number of cases of diabetes mellitus is in Mojokerto City with 6,258 people .
7%) (Dinas Kesehatan Provinsi Jawa Timur, 2022 .
Trisnadewi et al.
Oktora & Butar, 2.
Diabetes mellitus is a long-term disease characterized by high blood sugar levels.
Common symptoms include polyuria, polyphagia, and polydipsia (Banday et al.
, 2.
Complications of hyperglycemia include short-term and long-term Short-term complications include ketoacidosis and long-term complications include a double risk of cardiovascular disease and kidney failure (Mezil & Abed, 2021.
Rehman & Akash.
The main causes of hyperglycemia are stress, medication, and food intake.
Stress and diabetes mellitus are closely related (Alfianto et al.
, 2021.
Andoko et al.
, 2021.
Vedantam et al.
, 2.
Lack of stress control and high levels of stress make it difficult to control blood sugar levels (Hidayat et al.
Farmaki et al.
, 2021.
Tomic et al.
, 2.
According to research conducted by Lusiana & Mansyur .
at the West City Health Center in Gorontalo City to 52 people, 38 respondents .
1%) experienced moderate stress and as many as 32 respondents .
5%) experienced an increase in blood sugar levels with a bad category.
This is supported by Susanti & Bistara, 2022 which stated that there is a relationship between stress levels and blood glucose levels, indicating that the higher the blood glucose level, the higher the patientAos stress The presence of stress triggers the release of catecholamines and glucocorticoids.
Over a prolonged period, these hormones influence gluconeogenesis and lipolysis, which ultimately lead to hyperglycemia (Arunima, 2019.
Ingrosso et , 2023.
Nurhidayati et al.
, 2.
Additionally, glucocorticoids interfere with glucose uptake into the cells, causing glucose to remain in the bloodstream and resulting in hyperglycemia.
These hormones also affect pancreatic beta cells in insulin secretion and contribute to increased insulin resistance (Sharma et al.
, 2022.
Vedantam et al.
The latest data from the website of RSUD dr.
Soedono Madiun from January to March 2023 patients with diabetes mellitus who were in the inpatient room were 56 cases, worth .
%) or 14 cases who experienced diabetes mellitus with Based on the description above, researchers are interested in conducting research on the description of stress levels in patients with diabetes mellitus with hyperglycemia at RSUD dr.
Soedono Madiun to identify the level of stress experienced by patients with diabetes mellitus with hyperglycemia conditions that can be lifethreatening.
METHODS
The research design was descriptive The population of this study consisted of all hospitalized patients with diabetes mellitus and hyperglycemia, totaling 56 patients.
The sample size was determined using the Taro Yamane and Slovin formulas with a 10% significance level, resulting in a minimum sample of 39 respondents.
Samples were selected using purposive sampling.
In the implementation phase, a screening process was conducted based on the inclusion criteria, namely patients diagnosed with diabetes mellitus with hyperglycemia with blood glucose levels Ou250 mg/dL and having comorbidities such as stroke, hypertension, chronic kidney disease (CKD), and heart disease .
cute coronary syndrome/ACS).
Based on this screening, 39 respondents met the inclusion criteria, while 17 patients did not meet the inclusion criteria and were Jurnal Ners dan Kebidanan.
Volume 13.
Issue 1.
April 2026, page.
therefore excluded from the study.
Thus, the final number of respondents included in the analysis was 39 patients.
The study was conducted in Wijayakusuma C.
D, and E wards of RSUD Dr.
Soedono Madiun from February 1 to March 10, 2024, and had obtained ethical clearance with the approval 4/4128/102.
9/2024.
The research variable was the stress level of patients with diabetes mellitus and hyperglycemia, which was measured using the DASS-42 (Depression Anxiety Stress Scal.
questionnaire, adapted from the study by Kusumadewi et al.
, .
From the total 42 items, 14 stress-related questions were selected, namely items 1, 6, 8, 11, 12, 14, 18, 22, 27, 29, 32, 33, 35, and 39.
Scoring was conducted as follows: a score of 0 for Aunever,Ay 1 for Ausometimes,Ay and 3 for Aualways.
Ay The total score was calculated and categorized into five levels of stress: normal stress .
Ae.
, mild stress .
Ae.
, moderate stress .
Ae .
, overload .
Ae.
, and burnout (>.
RESULTS
Table 1.
General Data of respondents in the study of stress level of diabetes mellitus patients with hyperglycemia at IRNA Wijayakusuma C.
D, and E RSUD dr.
Soedono in Madiun on 01 February Ae 10 March 2024.
Variable Frequency Percent (%) Age 50Oe54 years 55iA59 years 60iA64 years 65iA69 years 70iA74 years 75iA79 years Gender Male Female Education Primary School Junior High School Senior High School University Employment Housewife Farmer Merchant Teacher Self-employed Retired History of diabetes 0Oe1 years 1iA5 years 6iA10 years History of treatment Regular Irregular Therapy NR (NovoRapi.
Lantus Oral Lantus & NR Microangiopathy Yes Yeyen, et.
Description of Stress Level of Diabetes Mellitus Patients A 31
Diabetes Symptoms Blood Pressure HbA1c
Blood Sugar
Disease Comorbidities Duration Disease History Polydipsia
Polyphagia
Polyuria
Easily tired <120, <80 120iA139, 80iA89
140iA159, 90iA99
>160, >100
0Oe6,5% >6,5% 250-300 mg/dl 301-350 mg/dl 351-400 mg/dl CKD
ACS
Hypertension 0-1 years 1-5 years 6-10 years Source: Primary Data .
, n=39 Based on Table 1 above, 30.
8% of the patients were aged between 50 and 58 years, and 69.
2% were Regarding educational background, 35.
had completed primary school.
In terms of occupation, 38.
5% were housewives.
A majority of 3% had a history of diabetes for 1 to 5 years, and 4% reported irregular treatment adherence.
NovoRapid therapy was administered to 53.
8% of the patients.
Additionally, 17.
9% experienced microangiopathy, while 46.
2% exhibited classic diabetic symptoms such as polyphagia.
Blood pressure readings exceeding 160/>100 mmHg were observed in 35.
9% of patients.
Furthermore, 64.
had HbA1c levels greater than 6.
Comorbid conditions were noted, with 41% of patients diagnosed with chronic kidney disease (CKD) and another 41% with hypertension.
Overall, 61.
5% of patients had been living with diabetes for a duration of 1 to 5 years.
Table 2.
Stress levels of diabetes mellitus patients with hyperglycemia at IRNA Wijayakusuma C.
D, and E RSUD dr.
Soedono in Madiun.
Stress Levels Frequency Percent (%) Moderate 48,72 Mild
33,33
Excessive 12,82 Normal
5,13
Source: Primary Data .
, n=39 Based on Table 2, it was found that less than half of patients with diabetes mellitus and had moderate .
72%), while 33.
33% experienced mild stress, 1 82% were categorized as having severe stress, and 13% were in the normal category.
Jurnal Ners dan Kebidanan.
Volume 13.
Issue 1.
April 2026, page.
Table 3.
Stress levels of diabetes mellitus patients with hyperglycemia by age, gender, presence of microangiopathy, comorbidities and duration disease history.
Stress Levels Characteristics Normal
Mild
Moderate Excessive Age
50Oe54
10,25
15,38
55iA59
17,94
60iA64
65iA69
70iA74
75iA79
Gender
Male
17,94
12,82
Female 35,89 12,82 Microangiopathy Yes
41,03
Disease Comorbidities CKD
ACS
Hypertension Duration disease 0-1 years 1-5 years 6-10 years Source: Primary Data .
, n=39 Based on Table 3, the age group analysis showed that 15.
38% of respondents aged 50Ae54 years were categorized as having moderate stress, 25% had mild stress, and 2.
5% each were classified as experiencing excessive stress and no stress .
Among respondents aged 55Ae59 years, 17.
94% experienced moderate stress, while 5% were categorized as having excessive stress.
terms of gender, female respondents demonstrated higher stress levels, with 35.
89% classified as having moderate stress, 15% with mild stress, and 82% experiencing stress.
Regarding the microangiopathy group, the findings indicated that 03% of patients without microangiopathy experienced moderate stress, while among those with microangiopathy, 7.
5% each were found to experience moderate stress and mild stress.
Based on patientsAo comorbid conditions, 22.
5% of patients with hypertension experienced moderate stress, 5% had mild stress, and 2.
5% each experienced excessive stress and were categorized as normal.
Meanwhile, among patients with a history of CKD, 5% experienced moderate stress, and 7.
experienced excessive stress.
DISCUSSION