The Potential of Strawberry, Rome Beauty Apple, and New Combination on Fasting Blood as Supporting Diet Therapy in Patients with Type II Diabetes Mellitus

Niken Yuliwati, Riezky Faisal Nugroho

Abstract


Strawberries (Fragaria x ananassa) and Rome beauty apples (Malus sylvestris) contain high antioxidants to reduce oxidative stress and improve the glycemic response with diabetes mellitus (DM) type II. This study aimed to analyze the effect of strawberries, Rome beauty apples, and their combination to decrease fasting blood glucose levels of type II DM patients. This experimental research used a randomized pre-post-test with a control group design. Subjects were 44 patients divided into four groups: K (control, not given the fruit), P1 (strawberries 200 g/day), P2 (apples 300 g/day), and P3 (the combination strawberries 100 g/day, apples 150 g/day) for 14 days in February–March 2019 in Surakarta. The inclusion criteria were DM patients aged 40–55 years who received oral antidiabetic drug therapy. Exclusion criteria were type II DM patients who, based on the doctor's diagnosis, had complications such as gastritis, hypertension, chronic renal failure, heart disease, liver disease, stroke, cancer, patients with consumption of antioxidant supplements. Mean of blood glucose level on K (149.82±39.125), P1 (141.00±38.079), P2 (128.73±31.841), and P3 (177.73±50.176). Analysis paired t test results showed a significant difference between before and after treatment (p=0.045). To find out which group was the most meaningful, the Bonferroni post hoc test. Decrease of fasting blood glucose levels with group K (−10.55, p>0.05), P1 (−30.18, p<0.05), P2 (40.27, p<0.05), and P3 (−32.91, p<0.05). ANOVA test was used to analyze, and the post hoc Bonferroni test with a control comparison was performed, resulting in p=0.028, in P2 and p>0.05 in P1 and P3. In conclusion, strawberries, Rome beauty apples, and their combination significantly decreased fasting blood glucose levels of type II DM patients, with the highest and most significant decrease in Rome beauty apples.

 

POTENSI STROBERI, APEL ROME BEAUTY, DAN KOMBINASI BARU TERHADAP GULA DARAH PUASA SEBAGAI PENUNJANG TERAPI DIET PADA PASIEN DIABETES MELITUS TIPE II

Stroberi (Fragaria x ananassa) dan apel Rome beauty (Malus sylvestris) mengandung antioksidan tinggi untuk mengurangi stres oksidatif dan memperbaiki respons glikemik pada diabetes melitus (DM) tipe II. Tujuan penelitian adalah menganalisis pengaruh buah stroberi, apel Rome beauty, dan kombinasinya terhadap penurunan kadar glukosa darah puasa pasien DM tipe II. Jenis penelitian eksperimen dengan rancangan randomized pre-post-test dengan control group design. Subjek penelitian 44 pasien yang dibagi empat kelompok, yaitu K (kontrol tidak diberi buah), P1 (stroberi 200 g/hari), P2 (apel Rome beauty 300 g/hari) dan P3 (kombinasi stroberi 100 g/hari dan apel 150 g/hari) selama 14 hari pada bulan Februari–Maret 2020 di Surakarta. Kriteria inklusi adalah pasien DM usia 40–55 tahun yang mendapat terapi obat antidiabetik oral. Kriteria eksklusi adalah pasien DM tipe II yang berdasar atas diagnosis dokter mengalami komplikasi seperti mag, hipertensi, gagal ginjal kronik, penyakit jantung, penyakit hati, strok, kanker, dan pasien dengan konsumsi suplemen antioksidan. Kadar glukosa darah rerata pada K (149,82±39,125), P1 (141,00±38,079), P2 (128,73±31,841), dan P3 (177,73±50,176). Hasil analisis paired t test menunjukkan terdapat perbedaan yang signifikan antara sebelum dan sesudah perlakuan (p=0,045). Untuk mengetahui kelompok mana yang paling bermakna, dilakukan Uji Post Hoc Bonferroni. Penurunan kadar glukosa darah puasa pada K (−10,55; p>0,05), P1 (−30,18; p<0,05), P2 (−40,27; p<0,05), dan P3 (−32,91; p<0,05). Analisis dilakukan dengan uji ANOVA dan Uji Post Hoc Bonferroni dengan perbandingan kontrol menghasilkan p=0,028 pada P2 serta p>0,05 pada P1 dan P3. Simpulan, pemberian stroberi, apel Rome beauty, dan kombinasinya signifikan menurunkan kadar glukosa darah puasa pasien DM tipe II dengan penurunan tertinggi dan bermakna pada apel Rome beauty.


Keywords


Apel; Apple; diabetes melitus; diabetes mellitus; diet therapy; strawberry; stroberi; terapi diet

Full Text:

PDF

References


Fathonah R, Indriyanti A, Kharisma Y. Labu kuning (Cucurbita moschata Durch.) untuk penurunan kadar glukosa darah puasa pada tikus model diabetik. GMHC. 2014;2(21):27–33.

Poznyak A, Grechko AV, Poggio P, Myasoedova VA, Alfieri V, Orekhov AN. The diabetes mellitus atherosclerosis connection: the role of lipid and glucose metabolism and chronic inflammation. Int J Mol Sci. 2020;21(5):1835.

International Diabetes Federation. IDF diabetes atlas. 8th Edition. Brussel: International Diabetes Federation; 2017.

Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia. Hasil utama Riskesdas 2018 [Internet]. Jakarta; Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia; 2019 [cited 2020 January 15]. Available from: https://www.litbang.kemkes.go.id/hasil-utama-riskesdas-2018.

Jasaputra DK, Rahardja F, Christian E. Efek jus gel lidah buaya (Aloe vera L.) dalam menghambat penyerapan glukosa di saluran cerna pada manusia. GMHC. 2014;2(1):1–5.

American Diabetes Association. 7. Diabetes technology: standards of medical care in diabetes—2020. Diabetes Care. 2020;43(Suppl 1):S77–88.

Yaribeygi H, Sathyapalan T, Atkin SL, Sahebkar A. Molecular mechanisms linking oxidative stress and diabetes mellitus. Oxid Med Cell Longev. 2020;2020:8609213.

Burgos-Morón E, Abad-Jiménez Z, de Marañón AM, Iannantuoni F, Escribano-López I, López-Domènech S, et al. Relationship between oxidative stress, ER stress, and inflammation in type 2 diabetes: the battle continues. J Clin Med. 2019;8(9):1385.

Mihaylova D, Popova A, Alexieva I, Krastanov A, Lante A. Polyphenols as suitable control for obesity and diabetes. Open Biotechnol J. 2018;12:219–28.

Alkhatib A, Tsang C, Tiss A, Bahorun T, Arefanian H, Barake R, et al. Functional foods and lifestyle approaches for diabetes prevention and management. Nutrients. 2017;9(12):1310.

Sarkar D, Ankolekar C, Shetty K. Beneficial lactic acid bacteria (LAB)-based biotransformation of plant and dairy substrates to enhance type 2 diabetes-relevant health benefits. In: Shetty K, Sarkar D, editors. Functional foods and biotechnology: biotransformation and analysis of functional foods and ingredients. Boca Roton: CRC Press; 2020. p. 345–60.

Putri MD, Wiboworini B, Dirgahayu P. The effect of strawberry on type 2 diabetes mellitus: a review. Int J Nutr Sci. 2020;5(1):1–6.

Shi GJ, Li Y, Cao QH, Wu HX, Tang XY, Gao XH, et al. In vitro and in vivo evidence that quercetin protects against diabetes and its complications: a systematic review of the literature. Biomed Pharmacother. 2019;109:1085–99.

Yuliwati N. Laporan hasil analisis buah apel dan stroberi. Surakarta: Laboratorium Pangan dan Gizi, Jurusan Teknologi Pertanian, Fakultas Pertanian, Universitas Sebelas Maret; 2020 [unpublished].

Różańska D, Regulska-Ilow B. The significance of anthocyanins in the prevention and treatment of type 2 diabetes. Adv Clin Exp Med. 2018;27(1):135–42.

Park E, Edirisinghe I, Wei H, Vijayakumar LP, Banaszewski K, Cappozzo JC, et al. A dose-response evaluation of freeze-dried strawberries independent of fiber content on metabolic indices in abdominally obese individuals with insulin resistance in a randomized, single-blinded, diet-controlled crossover trial. Mol Nutr Food Res. 2016;60(5):1099–109.

Yuliwati N. Laporan hasil uji buah apel, stroberi dan kombinasi. Yogyakarta: Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada; 2020 [unpublised].

Bule M, Abdurahman A, Nikfar S, Abdollahi M, Amini M. Antidiabetic effect of quercetin: a systematic review and meta-analysis of animal studies. Food Chem Toxicol. 2019;125:494–502.

Al-Ishaq RK, Abotaleb M, Kubatka P, Kajo K, Büsselberg D. Flavonoids and their anti-diabetic effects: cellular mechanisms and effects to improve blood sugar levels. Biomolecules. 2019;9(9):430.

de Oliveira Raphaelli C, dos Santos Pereira E, Camargo TM, Vinholes J, Rombaldi CV, Vizzotto M, et al. Apple phenolic extracts strongly inhibit α-glucosidase activity. Plant Foods Hum Nutr. 209;74(3):430–35.

Ying L, Chaudhry MT, Xiao F, Mao Y, Wang M, Wang B, et al. The effects and mechanism of quercetin dietary supplementation in streptozotocin-induced hyperglycemic arbor acre broilers. Oxid Med Cell Longev. 2020;2020: 9585047.

Ayuhapsari N, Wijaningsih W, Jaelani M. Efektifitas pemberian buah apel manalagi dengan dosis bervariasi terhadap penurunan kadar glukosa darah pada penderita diabetes mellitus tipe ii di kelompok prolanis Puskesmas Genuk Kota Semarang. J Ris Gizi. 2018;6(2):13–8.

Yuliwar R. Jus apel manalagi dan kadar glukosa darah tikus putih yang mengalami hiperglikemia. JIKI. 2017;3(2):145–57.

Agustinah W, Sarkar D, Woods F, Shetty K. Apple and blueberry synergies for designing bioactive ingredients for the management of early stages of type 2 diabetes. J Food Qual. 2016;39(4):370–82.




DOI: https://doi.org/10.29313/gmhc.v9i1.6409

pISSN 2301-9123 | eISSN 2460-5441


Visitor since 19 October 2016: 


Free counters!


Global Medical and Health Communication is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.