Analysis of the Appropriateness of Standard Lunch Portion for Diabetes Mellitus Patients in Class 3 Wards at Ulin Regional General Hospital, Banjarmasin

Abstract

Diabetes Mellitus (DM) is a chronic disease with a high prevalence in Indonesia, including South Kalimantan, and its management relies heavily on proper dietary regulation, particularly the accuracy of carbohydrate portions such as rice. Ulin Regional General Hospital (RSUD Ulin) Banjarmasin, as a referral hospital, treats a large number of DM patients in Class 3 wards, where socioeconomic and educational factors often affect health conditions and access to optimal care. Inaccuracy in food portions within hospital food service can have a direct impact on patients’ blood sugar control. Previous studies have shown discrepancies in the portions of staple foods served. This study aims to determine the standard portion of regular rice, analyze the accuracy of regular rice portions in lunch menus, and identify factors influencing it for Diabetes Mellitus patients in Class 3 wards at RSUD Ulin Banjarmasin in 2025. The research used a qualitative approach with a descriptive case study method. Data collection was carried out through direct weighing of the rice portions served, observation of the portioning process, and in-depth interviews with key informants (ward nutritionists, administrative staff, and food handlers). The results showed that the standard portions for regular rice in the DM diet for lunch are: 1300 kcal (100 g), 1500 kcal (150 g), 1700 kcal (200 g), 1900 kcal (200 g), 2100 kcal (250 g), and 2300 kcal (300 g). There was a high level of portion inaccuracy (72.4%). Analysis using the System Management Theory framework indicated that this inaccuracy is a systemic problem stemming from dysfunction and lack of synergy among subsystems in food service management. Factors influencing portion accuracy include incomplete dietary order information from nutritionists, administrative delays in producing labels due to insufficiently detailed input, reliance on non-standard portioning tools and limited measuring equipment (scales), and lack of specific training on DM diets and the importance of portion accuracy for food handlers. Feedback mechanisms and monitoring of portion accuracy were also found to be ineffective.