Journal of Community Engagement in Health https://jceh.
ISSN: 2620-3758 .
2620-3766 .
https://doi.
org/10.
30994/jceh.
Vol.
9 No.
1 March.
Page 53-61 The Role of STDE Training in Improving Coastal Community Preparedness for Diabetes Emergencies Merina Widyastuti *.
Dwi Priyantini .
Ninik Ambar Sari3.
Kukuh Widodo Emergency Nursing Dept.
Hang Tuah College of Health Sciences Surabaya.
Indonesia Emergency Nursing Dept.
Rumkital Dr.
Ramelan Surabaya .
Indonesia *Corresponding author: merinawidyastuti@stikeshangtuah-sby.
ABSTRACT
Diabetes mellitus is one of the chronic diseases with an increasing prevalence in Indonesia, including in coastal areas.
Emergencies due to complications of diabetes, such as hypoglycaemia or hyperglycaemia, are often not handled quickly due to limited public Therefore, real efforts are needed to equip the community with basic skills in managing diabetes emergencies.
Simple Treatment for Diabetic Emergency (STDE) is one of the educational methods developed by the STIKES Hang Tuah emergency department team to increase knowledge and skills in recognizing the signs and symptoms of hypoglycaemia or hyperglycaemia in patients with diabetes mellitus.
This program aims to equip the community with basic skills in handling diabetes mellitus emergencies, including hypoglycaemia and hyperglycaemia conditions.
The target of this STDE program is the community of Gisik Gebang Hamlet.
Gisik Cemandi.
Sedati Sidoarjo as many as 39 people.
This activity was carried out for 1 week, which was divided into 3 sessions, namely initial assessment and pretest, training with simulation, and post-test.
The results showed that the average pre-test attitude and knowledge score was 69.
18, the average post-test score was 87.
3, and with the Wilcoxon statistical test, p < 0.
001, there was a difference in attitude and knowledge of the participants before and after STDE training, with an increase of 27.
This program is an innovation that coastal communities hope will be able to recognize the early signs of a diabetes emergency and take simple actions that can save lives before advanced medical help is available.
Keywords : Diabetic Emergency.
Coastal Communities.
Hypoglycemia.
Hiperglycemia Simple Treatment Received Revised Accepted : February 19, 2026 : February 23, 2026 : March 31, 2026 This is an open-access article distributed under the terms of the Creative Commons AttributionShareAlike 4.
0 International License INTRODUCTION Diabetes mellitus is a chronic disease with a high incidence rate, both in Indonesia and In addition to causing long-term complications, this condition can also trigger a potentially life-threatening emergency.
Emergency situations occur when blood sugar levels Journal of Community Engagement in Health https://jceh.
ISSN: 2620-3758 .
2620-3766 .
https://doi.
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Vol.
9 No.
1 March.
Page 53-61 drop drastically .
or rise very high .
yperglycemic crisi.
, so that the body loses the ability to maintain normal function.
Both of these conditions can lead to decreased consciousness, seizures, coma, and even death if not treated immediately.
The signs and symptoms of both conditions are often not recognized by coastal communities.
This can be caused by lack of exposure to information about danger signs, local culture and customs where coastal communities prefer traditional medicine.
Both of these conditions require quick and appropriate treatment in emergency facilities.
Early diagnosis in the emergency department and evidence-based treatment can prevent amputation, related disability, and death (Frazee, 2.
In coastal areas and communities with limited access to health services, public knowledge of the signs of diabetes emergencies is still low.
This increases the risk of delayed treatment and worsens morbidity and mortality.
Of the 171 cases of diabetic distress, 55 were HHS diagnoses, 47 were DKA, and 49 were combined DKA and HHS.
This review shows the prevalence of diabetes emergencies.
episodes of DKA range from .
8%-73.
4%).
HHS .
9%-58%), and severe hypoglycemia .
3%-64.
7%) per year in developing countries.
Infections, the onset of new diabetes, and nonadherence to medication and diet are reported as the most common risk factors of this diabetes emergency (Haile & Fenta, 2.
The prevalence of HHS is more common in older people with type 2 diabetes, the course of the disease is slower, they tend to be severely dehydrated, and the risk of death is higher (Patel, 2.
This figure shows that cases of hyperglycemia are more common than hypoglycemia.
The age prevalence in patients with diabetes mellitus was in the range of 44 Ae 69 years, with a mortality rate of 4.
8% (MacIsaac et al.
, 2.
The prevalence of diabetes continues to increase across all age groups, mainly triggered by high cases of overweight and obesity, unhealthy diets, and lack of physical activity (Azbeg et al.
In addition, diabetes mellitus is often found along with other diseases such as hypertension, chronic kidney failure, and stroke.
Findings from previous community service activities found that about 70% of people who came to the initial screening had been diagnosed with hypertension, and 73% had been diagnosed with diabetes mellitus (Rahman, 2.
Diabetic distress, especially hyperglycemia, is statistically caused due to infections .
Ae40%), especially pneumonia and urinary tract infections, and non-adherence to medication .
Ae50%).
Another very important factor is inadequate insulin (Castell Saun et al.
, 2.
Findings from previous service activities to coastal communities in Kendari, the results of random screening were obtained from 46 respondents, there were 15% indicated to have blood sugar levels above This shows that coastal communities' awareness of the importance of early detection of their health is still not optimal(I Putu Sudayasa et al.
, 2.
Treatment of diabetes mellitus in hyperglycemia requires hospitalization for aggressive intravenous fluid administration, insulin therapy, electrolyte replacement, and identification and treatment of the underlying cause, along with periodic monitoring of the patient's clinical and laboratory conditions (Eledrisi & Elzouki, 2.
The initial assessment in Gisik Cemandi hamlet was obtained by many participants who rarely checked themselves to the medical In line with previous findings, the awareness of people with diabetes mellitus to continue to check blood sugar levels, take medication, regulate diet, and exercise is still a challenge in the management of diabetes mellitus (Simanjuntak et al.
, 2.
Early detection and treatment of this disease is essential to help people with diabetes mellitus lead a healthy life, as it helps prevent serious complications (Azbeg et al.
, 2.
The prevention and treatment of diabetes mellitus cannot run alone, but there must be good cooperation between patients, family members, and health services, especially in elderly patients (Susilawati et al.
So this requires the right instruments and methods so that early identification can be carried out.
Simple Treatment for Diabetic Emergency (STDE) is a form of intervention that Journal of Community Engagement in Health https://jceh.
ISSN: 2620-3758 .
2620-3766 .
https://doi.
org/10.
30994/jceh.
Vol.
9 No.
1 March.
Page 53-61 answers the urgency of efforts to improve the ability to recognize diabetes mellitus emergencies and is innovative where educational methods are made as simple and community-based as possible so that they can be widely applied with various backgrounds of community service Health awareness is not only a matter of knowledge, but also a change in attitudes and behaviors.
With the use of STDE, it is hoped that coastal communities will gain a better understanding of the recognition of disease danger signs faster, take advantage of available health services and reduce the risk of complications and deaths due to chronic diseases.
Through additional simulations as part of educational interventions, simple training with Simple Treatment for Diabetic Emergency (STDE) is expected to be a real step to increase community preparedness in dealing with diabetes emergencies.
METHOD
This community service activity will be carried out in Sekardadu Hamlet.
Gisik Gebang.
Gisik Cemandi.
Sedati.
Sidoarjo.
East Java in October 2025.
The main target of this activity is coastal community groups.
The main purpose of this service activity is to increase the knowledge and attitude of the community in recognizing the early signs of diabetes crisis.
The measurement of the attitude and knowledge score of participants was carried out before being given STDE training, and then attitude and knowledge score measurements were carried out afterwards.
The facilitators of this STDE program include 3 lecturers, 2 education staff, supported by 12 nursing professional students who are in the community practice stage, and collaborate with 3 people from the health team from the Sedati Health Center and 4 cadres.
This activity is divided into 3 stages.
The first stage includes blood sugar screening, blood pressure, and a pre-test.
In this first stage, an initial assessment was carried out in the form of periodic blood sugar checks, blood pressure checks, and focus group discussions about participants' knowledge about diabetes mellitus and its emergency in the form of discussions and questionnaires.
this stage, demographic data on age, gender, and diseases experienced in recent years are obtained.
the next stage, education on diabetes mellitus emergencies .
ypoglycemia and hyperglycemi.
was provided by providing STDE materials in the form of take-home booklets and explanatory banners.
this stage, cadres play a fairly important role where cadres monitor the understanding of the participants regarding the knowledge information in the STDE booklet that has been distributed.
This is not only aimed at participants but also families.
This was followed by a third stage, a simulation of hypoglycemia and hyperglycemia events, which concluded with a post-test.
In the implementation of the simulation of hypoglycemia and hyperglycemia, the role of cadres is to accompany the participants and help provide an understanding of the emergency situation that occurs and the actions that should be taken by the participants.
The post-test was conducted by measuring knowledge and observing actions conveyed verbally during the simulation.
This activity was attended by cadres and the elderly community, totaling 41 people.
The selection of participants was carried out by total sampling according to inclusion criteria, including participants with a residential address in Gebang village who were willing to participate in the STDE program until it was completed.
Participants who are unable to participate in the program until the end are excluded from the criteria.
At the beginning of the program, 41 participants were Over time, there were 2 participants who dropped out and did not continue, so the pre and post-measurements were followed by 39 participants.
Data collection was carried out by interviews and The instrument for educational guidance is provided in the form of an STDE booklet that contains guidelines explaining hypoglycemia and hyperglycemia, each of which includes a definition, causes, signs and symptoms, pre-hospital management, and complications.
For the attitude and knowledge instrument in the form of a questionnaire of 20 questions.
Gutman questions with a ratio scale and tested using the Wilcoxon test .
< 0.
Journal of Community Engagement in Health https://jceh.
ISSN: 2620-3758 .
2620-3766 .
https://doi.
org/10.
30994/jceh.
Vol.
9 No.
1 March.
Page 53-61
RESULTS
Characteristics Gender
Male
Women
Age
18 Ae 59 Years old
60 Ae 69 Years old
70 Ae 79 Years Old
Comorbid
Diabetes Mellitus
DM HT
Etc Table.
1 Demographic Data Characteristics STDE .
The results of the STDE program show that the community is very enthusiastic about recognizing the types and signs of symptoms in diabetes mellitus disorder.
This is illustrated by the 3 stages of the activity.
there were only 2 participants who dropped out due to illness.
The distribution of STDE program participants is in the age range of 43 - 79 years, with an average age of 60 years.
Most of the program participants are women .
4%).
At the blood sugar level check, the average participant was in the range of 105 Ae 240 mg/dl with an average of 166 mg/dl.
Related to comorbid disease, 15.
4% of participants were people with diabetes mellitus, 46.
2% people with hypertension, 28.
2% with diabetes mellitus and hypertension, and a small number of others, namely 10.
3% suffering from cataracts, hepatitis, and pulmonary TB Table 2.
Knowledge and Attitude Scores Before and After the STDE 2025 Training Program .
Median (Min Ae Ma.
Rerata A s.
Pre-Test Ae .
69,18 A 5,160 < 0,001 Post-Test - .
87,33 A 8,628
The results of the pre-test were obtained with an average attitude and knowledge score of 69.
and the post-test obtained an average of 87.
Thus, there was an increase in knowledge and attitudes by 27%.
The changes that seemed significant were in the participants' knowledge of the recognition of hypoglycemia and hyperglycemia, as well as the difference in signs in the two conditions.
At the beginning of the screening in stage 1, most of the program participants were able to correctly mention the definition of diabetes mellitus, normal sugar levels, what are the causes of diabetes mellitus, and the signs and symptoms of diabetes mellitus, but for the difference in signs and symptoms in hypoglycemia and hyperglycemia, almost half could not mention them correctly.
In addition, related to awareness to take medication is quite good, but most of the participants showed a lack of awareness of routine checkups.
Figure 1.
The atmosphere of checking blood sugar and blood pressure of community service participants Figure 2 Implementation of phase 1, initial assessment and pre test Journal of Community Engagement in Health https://jceh.
ISSN: 2620-3758 .
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Figure 3.
Community Service Team from STIKES Hang Tuah Surabaya Figure 5.
Implementation of stage 2 diabetic emergency education and simulation https://doi.
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Vol.
9 No.
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Page 53-61 Figure 4.
Community Service Team from STIKES Hang Tuah Surabaya Figure 6.
Implementation of phase 3 and post test
DISCUSSION