{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:10:21Z","timestamp":1772169021425,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.75763.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000}},{"DOI":"10.12688\/f1000research.75763.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000}},{"DOI":"10.12688\/f1000research.75763.3","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000}}],"reference-count":18,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002161","name":"Ministry of Science and Higher Education","doi-asserted-by":"publisher","award":["066\/UN5.2.3.1\/PPM\/KP-DRPM\/2021"],"award-info":[{"award-number":["066\/UN5.2.3.1\/PPM\/KP-DRPM\/2021"]}],"id":[{"id":"10.13039\/501100002161","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    Background The chewing Betel habit is a hereditary tradition from the ancestors of the\n                    <ns3:italic>Batak-Karo<\/ns3:italic>\n                    tribe, Indonesia.\n                    <ns3:italic>Karo<\/ns3:italic>\n                    people believe that chewing betel habit is their unifier. The chewing-betel habit process begins with concocting a mixture of ingredients such as betel leaf, lime, gambier, areca nut, and with or without tobacco addition, then chewed slowly. This study aimed to analyze whether the habit of chewing betel can affect BGL in the\n                    <ns3:italic>Karo<\/ns3:italic>\n                    ethnic community in the\n                    <ns3:italic>Karo<\/ns3:italic>\n                    district. Methods In total, 48 participants from the\n                    <ns3:italic>Karo<\/ns3:italic>\n                    community were divided into 4 groups (n=12 per group), namely: I. non-T2DM participants without chewing betel habits; II. non-T2DM participants with chewing-betel habit; III. T2DM participants without chewing-betel habit and IV. T2DM participants with chewing-betel habit. The sampling technique was consecutive sampling. The data were collected by interviews and blood sampling (fasting and 2 hours postprandial (2hPP)). The collected data were analyzed by paired t-test, Independent sample t-test, Wilcoxon, and Mann-Whitney with a significance level of p-value &lt;0.05. Results This study showed that fasting BGL condition in group-I compared to group II (84.33\u00b112.32 vs 81.00\u00b14.84) mg\/dl and group-III compared to group-IV (196.25\u00b1104.81 vs 150.00\u00b142.45) mg\/dl had no significant difference. Also, the BGL of 2hPP condition in group-I compared to group-II (111.25 \u00b122.62 vs 108.33\u00b118.99) mg\/dl, and group-III compared to group-IV (314.92\u00b1128.97 vs 229.25\u00b158.26) mg\/dl, in statistically there was no difference (p&gt;0.05). Although the data showed that group-III was higher than group-IV. Conclusion This study concludes that with or without chewing-betel habits affect blood sugar levels in type 2 diabetes subjects (Groups III and IV).\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.75763.4","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T12:45:27Z","timestamp":1701866727000},"page":"100","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of chewing-betel habits on blood glucose levels in the Karo ethnic community, Karo district"],"prefix":"10.12688","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5638-4734","authenticated-orcid":false,"given":"Yunita 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yang dirasakan wanita karo di Desa Sempajaya Kecamatan Berastagi Kabupaten Karo.","author":"L Sinuhaji","year":"2010"},{"key":"ref-14","first-page":"29-33","article-title":"[Pharmacological action of gambir].","volume":"40","author":"S Sugiyama","year":"2005","journal-title":"Yakushigaku Zasshi."},{"key":"ref-15","doi-asserted-by":"publisher","DOI":"10.3390\/molecules21060708","article-title":"Antioxidative and antidiabetic effects of natural polyphenols and isoflavones.","volume":"21","author":"A Umeno","year":"2016","journal-title":"Molecules."},{"key":"ref-16","article-title":"Body mass index (BMI)","year":"2021"}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/11-100\/v4\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-100\/v4\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-100\/v4\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T11:45:07Z","timestamp":1763379907000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/11-100\/v4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,6]]},"references-count":18,"URL":"https:\/\/doi.org\/10.12688\/f1000research.75763.4","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.75763.3","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.75763.2","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.75763.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.158368.r423855","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.158368.r433581","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.158368.r423855","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,6]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/11-100\/v4#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.139203.r153576, Mustofa Mustofa, Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing (FK-KMK), Universitas Gadjah Mada, Yogyakarta, 26 Oct 2022, version 3, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/11-100\/v3#referee-response-153576","order":0,"name":"referee-response-153576","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.139203.r208629, Hadeer Akram Abdulrazzaq Al-Ani, Department of Public Health, School of Medicine, University of California Davis, Davis, CA, 19 Oct 2023, version 3, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/11-100\/v3#referee-response-208629","order":1,"name":"referee-response-208629","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Yunita Sari Pane<\/b>; \n<i>Posted: 31 Oct 2023<\/i>; Dear Reviewer, Kindly check on the progress on latest revision from the 2nd reviewer for the further process.  Thank You.  From, Yunita Sari Pane","URL":"https:\/\/f1000research.com\/articles\/11-100\/v4#referee-comment-10488","order":2,"name":"referee-comment-10488","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Yunita Sari Pane<\/b>; \n<i>Posted: 10 Dec 2023<\/i>; Dear&nbsp; Hadeer Akram Abdulrazzaq Al-Ani&nbsp; (the second reviewer) Thank you for your comment on improving our article. Here I respond to your comment and question.  Suggestion No. 1: Abstract: Please delete and rephrase the sentences \u201cOur previous study showed that\u201d Replied No. 1: Delete  \n<b>Question No. 2:<\/b> Methodology: The sample size - Please justify why you selected this formula. Why did you select the numbers for each parameter (for example, you chose 88 for n1 and the same for others)? Justify and support with references. \n<b>Answer No.2:<\/b> Based on Kawamori et al., 2014 (page76 Table 2 Changes in glycemic control) \n<b>BGL Fasting:<\/b> n1=92(baseline intervention group) n2=36(baseline placebo group) S1=25.8(Standard deviation of BGL fasting changes from baseline intervention group) S2=15.1(Standard deviation of BGL fasting changes from the baseline placebo group) m1=-29.2 m2=-3.4 Z\u03b1=1.64 Z\u03b2=0.842 \u03c3 2 == (n1- 1) S12 + (n2 - 1) S 22 (n1 + n2 - 2) Thus, \u03c3 for BGL fasting is 20.43 Thus, n for BGL fasting is 7.7\u22488 subject. \n<b>BGL 2hour PP:<\/b> n1=88(baseline intervention group) n2=33(baseline placebo group) S1=43.6(Standard deviation of BGL fasting changes from baseline intervention group) S2=39.8(Standard deviation of BGL fasting changes from the baseline placebo group) m1=-50,2 m2=-4,2 Z\u03b1= 1.64 Z\u03b2= 0.842 \u03c3 2 == (n1 - 1) S12 + (n2 - 1)S22 (n1 + n2 - 2) Thus, \u03c3 for BGL 2hour PP is 42.77 Thus, n for BGL 2hour PP is 10.57\u2248 11 subject. From the results of the sample size formula calculation above, the sample size (n) for BGL fasting is a minimum of 8 subjects, while n for BGL2hour PP is a minimum of 11 subjects. Considering the possibility of sample dropout increasing by 10% from the n obtained, it was decided to take the largest sample (11 subjects), so that the number of n used in this study for each group was 12 subjects.   \n<b>Suggestion No.3:<\/b> Limitations: Please add to the limitations the accuracy of using the Family Dr&reg; Blood Glucose Monitoring System, AGM-5135, All Medicus Co., Ltd. \n<b>Replied No. 3:<\/b> Thirdly, limitations for accuracy of using the Family Dr&reg; Blood Glucose Monitoring System, AGM-5135, All Medicus Co., Ltd is due to the peripheral blood(end of the extremities) is used in the study where the reading might slightly be different compared to the blood taken from a vein. Unfortunately, the study was held during the pandemic thus the situation was not favorable and caused us to carry out a simple method in the study.   \n<b>Question No. 4:<\/b> 1. Statistical analysis: There is a significant limitation of using independent t-tests, etc., because these tests are biased, especially when measuring the overall effects of the groups. This is very clear in the statistical analysis and interpretations obtained in this study, where there was no significance in some results while significant in others. The best statistical test should be used regardless of the sample size, and normality, and others should be repeatedly measured with ANOVA and posthoc because the effect size will be clearer to the readers and give the final decision on whether chewing Betel has a significant effect. Therefore, I recommend re-analyzing the statistical tests and reformatting and re-editing the manuscript. The main reason I request this is that there is no point in your study in this figure; the readers now see that chewing Betel is significant and not significant, which one should be recommended? \n<b>Answer No. 4:<\/b> Our reason for using paired t-test, Independent sample t-test, Wilcoxon, and Mann-Whitney, is because: 1. The sample size is too small in this study and the standard deviation (SD) is too wide, especially in groups III and IV. Normally, in this case, it is a parametric statistic but the data is not homogenous, so it is not recommended to use the ANOVA test although the data in the study is parametric. We would like to analyze the data before and after the study is conducted, as we want to observe the difference in the BGL in each group and compare it among the groups themselves.   \n<b>Suggestion No. 5:<\/b> Please update your references with ones from the last five years. \n<b>Replied No. 5:<\/b> Great apologies, as we can\u2019t change the references as those have been fundamental for my study, however I consider your suggestion by providing some latest references which are realatable to my study. Daryanti F, Jazuli M, Florentinus TS, Hartono. Values of Character Education in the Sirih Pinang Symbol: A Cultural Value of Coastal Society. Jurnal Pendidikan Progresif. 2020; 10(2): 292-29 Musdja. Antioxidant Activity of Cathecins Isolate of Uncaria Gambier ROXB in Male Rats. LIFE: International Journal of Health and Life-Sciences. 2018; 4(2): 34-46.   \n<b>Question No. 6:<\/b> In the discussion, please do not discuss confounding factors like duration of use because there are no findings in your statistical outputs about it. \n<b>&nbsp;Answer No. 6:<\/b> We include duration in our study because we consider it as baseline data in our study, thus it is important to be measured, but not required to be included in the statistic analysis. &nbsp;","URL":"https:\/\/f1000research.com\/articles\/11-100\/v4#referee-comment-10742","order":3,"name":"referee-comment-10742","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.158368.r423855, Biswajit Patra, Fakir Mohan University, Balasore, Odisha, 17 Nov 2025, version 4, indexed","URL":"https:\/\/f1000research.com\/articles\/11-100\/v4#referee-response-423855","order":4,"name":"referee-response-423855","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Indonesian Ministry of Science and Higher Education, number: 12\/E1\/KP.PTNBH\/2021. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}